Friendships and Betas

Monday was really hard for me. I am in the early stages of trying to rebuild a friendship that got caught in the awkward emotion-filled mess of: They got pregnant, we lost a baby; they had a baby, we lost another baby. Neither of us was able to be there for the other during some of the biggest moments of our lives. How do you repair that? Their baby is their life; they are now a unit. I totally get it. At the same time, their baby (like all babies) is a reminder of our pain and our losses.

On Monday morning I also got a call from my RE. My Luteal HCG progesterone blood results were back. And they were good. Really good. Scary good. I could hear it in the nurse practitioner’s voice. With numbers that good, she was pretty sure that not only was the Luteal HCG working, but that I am likely pregnant. I hung up the phone and sobbed in terror. Then I told myself it still might not be true.

Those of you who haven’t experienced recurrent losses, or my dear friends who have tirelessly been striving to get pregnant without avail, are probably thinking: What the hell? What is wrong with you? Can’t you even get excited at the possibility of that desired outcome?  The thing is it’s terrifying. Just because I might be pregnant again, does not mean I will have a baby. Based on our previous experiences, for us, pregnancy = joy, excitement, mindfucking fear, loss, heartache, and pain.

I had been instructed to wait until Wednesday to test, since the HCG from the injections would still be lingering in my system and could cause a false positive. I didn’t even know if I was pregnant, and yet I was already willing myself not to get attached, and preparing to say goodbye.  I was praying that I would miscarry early.

When Monday evening came, I had discovered our final set of friends had announced their pregnancy. That’s it. There aren’t anymore. We have watched pretty much every single set of friends get pregnant and go on to have healthy babies in the time we’ve been trying. We are now alone on the island. I wasn’t surprised. I had prepared myself in anticipation of this day. Of course we are happy for them. They are an amazing couple and I had been praying they’d conceive easily. I can genuinely say I do not want to see other couples suffer in the ways we have. I want my friends to have seamless conceptions and naively blissful pregnancies. But since we are human, we are also jealous of the fact they all get to have what we don’t.

As I stared at their Facebook announcement, for a split second I let a tiny thought escape my mind. Maybe this possible pregnancy of ours will happen, maybe we will have kids together. I abruptly popped that little thought bubble. No! It doesn’t work that way for us. We don’t get to have kids at the same time as our friends. I know better, it never works out that way. And then another thought occurred, a terrifying thought: What will come of this friendship? Are we going to lose yet another friendship because they will be pregnant and have a baby during a time when we could possibly be struggling to cope with continual miscarriages?

I couldn’t help but cry in fear of not only losing this potential pregnancy, but what would come of this friendship? They currently live out of state, but they will be moving back to our state this fall. We have been looking forward to having them closer.  On Monday night I lay awake in concern. Would this friendship be like so many and wither under the strain of our losses and their gain? Would I feel the need to avoid them because of the pain it causes me to see others so easily achieve what we can’t? Will we drift apart, because they will get to move on with life and be parents, while we might be caught in the webs of still trying to conceive? I don’t know.

I had already been struggling with: How do we rebuild a friendship after it has been torn down by the hardships between fertile friends vs. infertile friends? How one prevents this breakdown from occurring at all, is beyond me.

The lapse in time that occurred between Monday and Wednesday morning was gradual. I felt I was moving in slow motion. My husband was on a work trip in Chicago, and while he called to see if I needed consoling once our friends had broke their news, he didn’t ask about my progesterone blood results. And I couldn’t bring myself to divulge. (Honestly, the fact he didn’t ask was fine. Blood tests are so frequent in this journey. And I could tell he was tired and had a lot of work to do.)

On Tuesday night I set out my home pregnancy test (hpt) in preparation for Wednesday morning. If the test was positive I would need to go in straight away to see my RE.  I tossed and turned much of the night. When my alarm went off I headed to the bathroom. The test was positive. I am pregnant for the 3^rd time. I immediately let my husband know via text, because honestly you don’t make a big deal of it when the previous two failed.  He was of course surprised considering we weren’t confident in this cycle, due to the whole IUI timing fiasco.

Once at the RE, they drew my blood and promised to call in the late afternoon with the results. We would be looking at two things. One: betas. The beta is a sequence of two blood draws measuring HCG, which should roughly double over a two day period in early pregnancy. I will say my beta with our last loss doubled just fine. So, it isn’t necessarily an indicator of a successful pregnancy, but it can reveal a failing pregnancy early on. Two: my pesky nemesis, progesterone.

The nurse practitioner called around 4:30 p.m. She said, “Yep, you are pregnant.” Really? They always say that. Yes, I know, I had a positive hpt. Still, I guess it feels good to hear those words. My progesterone had already dropped significantly, so I would need to begin progesterone injections again. My first beta came back at 2,358. With my previous pregnancy the first beta was 174. Like I said, the number itself doesn’t mean a whole lot and there is a wide range of what is considered ‘good’, but knowing this number was higher, somehow made me feel a little better.

After I heard that first beta I started to relax and ordered myself to stop thinking about miscarriage (easier said than done).  The number was good. Today I am pregnant. All I can do is take it one day at a time.  I keep telling myself: even if #3 ends in loss, we will still, somehow, be yet another step closer to that someday end goal.

On Friday I went in for my second beta. The nurse practitioner took way too long to call me with the results that evening. By 6 p.m. I still hadn’t received a call. I was concerned it was a bad sign, and I was also worried I would have to go the entire weekend without knowing. She finally called and apologized for the delay. Beta #2: 5,349. Awesome. I couldn’t help but allow a small flutter of excitement to escape. With my previous pregnancy my second beta was 517 (with a three day gap between, rather than two days). My progesterone had dropped a little more, but I had already had my first injection, and it was still within range.

There are a handful of reasons miscarriages occur. Sometimes, like with my first loss, we don’t know why.  Here are the major causes:

1. chromosomal (our second loss, and not preventable)
2. anatomy (the structure of the uterus, I should be OK there)
3. infection (I will be on an antibiotic for 8-10 weeks as a preventable measure)
4. blood/clotting issue (I am on baby aspirin as a preventable measure)
5.  hormonal (I am on twice weekly progesterone injections)
6.  immune issues (it’s a complicated cause, we aren’t concerned with that at this time)

My RE has me on a combination of pills and injections in an effort to prevent what we can. I have particularly struggled with being put on Erythromycin (the antibiotic). I understand my doctor feels the benefit outweighs any possible risk. However, I detest the idea of being on any medication, and especially while pregnant. After much stewing and debating with the nurse practitioner and RE, I gave in. I told myself I have to trust my RE 100%. The goal is to keep this pregnancy, and we are going to do everything we can to bring home a healthy baby.

The Stay Pregnant Protocol (SPP)

I would like to thank each one of you for your support, thoughts, and prayers. Knowing we have so many incredible wishes and prayers spinning around in the universe is the best reassurance we can get at this point! Once again, our journey dangles somewhere between the sweetest thing and potential loss. This is nowhere near over. We ask that each of you continue to send out those happy thoughts and prayers!

Dark Chocolate Fixes Everything

I am a stress eater. Despite my usual over-the-top healthy eating habits, when I get stressed or upset I consume expensive dark chocolate – lots of it. After my second miscarriage I lived on fancy dark chocolate bars and crackers for a week.

When my husband comes into the kitchen to discover me shoveling every household sweet into my mouth, he typically says, “Ooh no… what are we stressed about now?”

It began yesterday. We were out of my sinful dark chocolate. So I ruthlessly dug into the chocolate-chip paleo cookies I had stashed in the freezer. I ate the remaining three in one sitting.

Here’s what brought all of this binge eating about: As I entered the dreaded two-week-wait, I was still feeling great; I was in a positive mood, with zero Clomid side effects to bring me down. About a week after ovulation I went in for my post-ovulation Progesterone blood tests. My Progesterone level on Monday gave an outstanding showing – a stellar seventeen – an impressive number for me. However, by Thursday it had dropped to an underwhelming, pregnancy-inhibiting two. A level that low at 10 or 11 days past ovulation (dpo) does not allow for pregnancy.  Along with boosting my egg quality, we had also hoped the Clomid would help to boost my Progesterone during the Luteal phase of my cycle. Unfortunately, I didn’t even make it the full two weeks; by 11 or 12 dpo my body was done. (For those who don’t know, the Luteal phase or that two-weeks after ovulation should last at least 14 days.) My first Clomid cycle failed; time to move on.

To be fair, it wasn’t entirely a bust… I did ovulate (even if it was just one follicle). And now that we know the Clomid doesn’t boost my Progesterone enough, I will be put on post-ovulation Luteal HCG injections this next cycle.

The last time I was pregnant I was on ridiculously enormous needled Progesterone injections. My husband administered them in my rump, twice weekly. The nurse assured me these injections are not going to be nearly as painful or intimidating. They will go in my abdomen or thigh… I can even give them to myself. Oh goody! Injections aren’t cheap, so let’s hope they work.

In that same Progesterone phone call I was bluntly informed of the next step our RE has planned for us.  Intrauterine Insemination (IUI). Enough with this natural shit – we are putting our full-on trust in Western medicine. Well… It isn’t IVF (and I know a lot of my IF friends are there). But still… Those of you who remember the stubborn au naturale place we came from will understand that it is, once again, a big step for us. Especially since our first two pregnancies were achieved the old fashion way. But this seems to be the way to go, so, Western medicine – we surrender…

Ha! Now seriously, you didn’t think I’d completely fold and give in to Western medicine that easily, did you? I am also headed back to my acupuncturist this cycle. I still believe in it, and I want to give my body every possible chance. I honestly give acupuncture all of the credit for the two pregnancies I have had after struggling with infertility.  They may not have been successful… But I got pregnant – twice – and that’s pretty darn impressive.

More on the IUI. It is what my husband and I like to refer to as the medical turkey baster. After I nice little bath, or wash as they call it, his swimmers will be placed into a catheter and injected into me – giving them a little boost, or a head-start… Sometimes we all need that in life, right?!  We have several reasons for progressing to IUI at this point. One: time and money. We are sick of wasting both – it is time to get this show on the road! Hum, I feel like I’ve said that before. Two: although some may disagree, the wash the semen will be put through may be somewhat helpful with the morphology issue we have faced.  To an extent the wash should help to eliminate the less healthy swimmers.

So why am I consuming chocolate like it’s going out of style?  After the call about the Progesterone and IUI, my husband and I had both agreed it was the direction we would go. Then yesterday morning rolled around and I was supposed to head out for an ultrasound to make sure I was good to go for this next Clomid cycle. About an hour before leaving the house my husband casually said, “I don’t know. Maybe we should try naturally one more cycle.” We do this. We go back and forth. It is so hard to know when to give in. What direction to go. So then he has me questioning our decision.  In my head I keep tossing around the pluses and minuses of pushing forward with IUI.

Anyhow, I arrive to my ultrasound appointment in time to verify the costs on IUI, the semen wash, etc. Of course insurance covers nothing.  I am ushered back to the ultrasound room. It is a room I have been in many times; the same room we were in when we learned we had lost our baby girl. I have since gotten past the trauma that room used to conjure up each time I’d walk in. As the nurse practitioner is checking out my ovaries we chat about the next step in our journey. She tells me everything looks great. Then as she is heading out the door she casually mentions a cyst on my right ovary. Red flag! She tells me it is where I ovulated from during this past cycle. It could be an issue. She asks me to have my blood drawn to make sure the cyst isn’t putting out hormones. Great.

Setbacks! I am so sick of them! I know other couples struggling with infertility can relate. Some weeks it feels as though you are handed setback after setback – some more difficult than others.  But come on – give us all a break! We’ve all been tested more than we’d like, and we have proven we can and will push on. So for once, please, just stop with all of the pesky roadblocks!

As you can probably imagine, I’ve been worrying and eating all day. I worry about the costs of the upcoming procedures, and I scoop a handful of chocolate chips into my mouth.  I cry about the possible ramifications of my newly discovered cyst, and I down a rice cake (what? oh, I ran out of the unhealthy stuff).

And then I got the call. “Your blood work was fine. The cyst should be gone by your next ultrasound. Go ahead and proceed with the Clomid and everything as planned.” Oh! Really? I feel so much better now. Sure, the expenses are still there, but we will figure it out. I guess I can lay off the chocolate for a bit – at least until we restock!