MicroblogMondays: Ups and Downs of an Early Pregnancy

Remember my friend of whom I was jealous because she got pregnant with her own eggs?  Well, she has been going on an emotional roller coaster ride.

Her second beta doubled nicely.  Her 5-week ultrasound showed a beautiful early pregnancy in her uterus with a gestational sac and a yolk sac.  So this is the kicker.  A famous doctor who treats her autoimmune issues ordered beta for her every other day until the heartbeat ultrasound.  Any normal people would just wait for the 6-week ultrasound after the two early doubling beta and the great 5-week ultrasound.  (And most times they just go straight to the 6-week one and skip the 5-week one.)  But no.  My friend’s autoimmune doctor wanted one every other day.  The beta on the day of her 5-week ultrasound (on a Friday) was around 4200.  Beta three days later (on a Monday) was only around 5000.  The doubling time was 300 hours.  It should be 72 to 96 hours at that level.  My friend panicked.  I mean, I would too.  But did it really mean anything at that point?  Her doctor ordered another beta the next day which turned out to be around 5800.  Doctor was happy with the results but my friend was still panicking.  Her doctor told her to repeat her beta again the next day, two days before the 6 week 2 day ultrasound.  I was adamantly against it.  What is the point of going again and again?  At this point, the best indicator would have been the scan, and not some elusive beta level that doesn’t tell you much.  Why go to the lab and spend 30 to 45 minutes and then torture herself waiting for the results?  It just didn’t make sense to me.

My friend absolutely drove me nuts though.  She and her partner decided together that the beta on Wednesday would not help her situation.  But that whole day she messaged me and wondered if she should have gotten the beta done.  She went back and forth with her decision, regretting not going one minute, and then agreeing that it was wise to wait for the scan.  Her thought was, if it was going to be bad news, she’d want to know.  And if it was good news, then she could feel better going to the scan.  But what if the news was inconclusive?  Where would that leave her?  But I know that she needed the support, so I reassured her repeatedly that it was the right decision for her not to do the beta.  But I have been so mad at her autoimmune doctor.  Does she even care about her patients’ emotional well being?  Does it really help to know the beta level so frequently after confirming an in utero pregnancy?  Because there is really nothing one could do but to wait.

My poor friend was at her scan with her partner last Friday.  She was so nervous that she was crying lying on the table while waiting for the nurse practitioner (who was the one who did all of my scans at my former clinic).  Her heightened nervousness even prevented her from seeing the heartbeat on the ultrasound.  At 6 weeks 2 days, she was measuring 5 weeks 5 days with a heartbeat of 81.  The nurse practitioner wasn’t concerned about it at all and said that at this early point a few days of lag should be okay.  And since she was measuring at 5 weeks 5 days, the heart might have just started beating.  When my friend sent me a text, she didn’t sound very optimistic about it.  And when I saw the heart rate, I didn’t feel very optimistic for her.  But who are we to say that this is not going to turn out to be fine?

That was Friday morning.  We happened to have a citywide power outage in our area that morning.  I was allowed to go home early and have a long weekend by 11:15am.  So instead of going home, I decided to join my friend who was sitting at the clinic waiting room to wait for her work phone call after noon because she had no power at home.  I thought that I could join her for lunch afterwards and she could use some support.

My friend’s emotions were all over the place.  She of course did some google search and it was not looking good.  She consulted with an RE who has supported her in the past couple of years who said that the three-day lag of the pregnancy plus the low heart rate made him a little bit concerned.  Her clinic didn’t say much and just told her to get another ultrasound in a week, and her autoimmune doctor was happy with the results.  But my poor friend was a mess.

(Side note: I visited with my former nurse while I was at my former clinic. It was a bit emotional for me to go back there while expecting twins via surrogacy.  It was so sweet to see my nurse being so happy for us.  I didn’t try to visit with Dr. No Nonsense, my former RE, because he did after all abandon me about a year ago after promising to call me to discuss the next steps but never did.  My nurse admired all the photos I showed her and was just so thrilled.)

At lunch my friend cried twice.  She wanted this so much and just wanted to have good news all around.  But when do we ever get to have a smooth-sailing journey?  From Friday to today, my job has been to remind her NOT to goo.gle because it does her no good.  While there are going to be success stories online, there is bound to be stories that ended sadly.  Their stories are not her story.  Why scare herself?  So every few hours, I write her and make sure that she does not google.  She was feeling angry and asked me why she had to suffer.  These are questions that nobody can answer.  So I told her that it could turn around.  She declared to me, “I think it will go badly” referring to the next scan.  But I told her not to play God and not to give a verdict even before anything happens because it may not happen.  I told her what I read in a book, that we try to make ourselves feel better by declaring things that are negative, that are not true.  But in reality, we don’t know what tomorrow will hold and how things will turn out.  But we jump to conclusion because we want to prepare ourselves for the bad things that may happen.  The truth is, there is no preparing.  If her pregnancy ends in a loss, it would still hurt like hell.  But by declaring the untruth, she is denying herself in that moment the joy of being pregnant.  She is pregnant at this point.  And this is the fact.  The fact is no one knows what will happen but God. So we should not play God and should hold onto the facts.  It is okay to cry.  It is okay to feel sad.  But putting herself in the situation of researching online and declaring that things will end badly is not going to help her a bit.

I did ask Dr. E, my own RE, about my friend’s results.  This is what Dr. E said, “The hCG level stops doubling so you are totally right on monitoring especially when you see a pregnancy in the uterus.  It doesn’t provide any guidance.  I’m glad she had a heartbeat.  I’ve seen patients without heartbeat at that age and then the next day it’s there.  The heartbeat doesn’t help guide me because I like that it is present.  The one thing that bothers me is the CRL (note: crown to rump length).  With IVF you know exactly how far along a patient is…..the three day discrepancy is the only thing that has me worried.  But there is still a chance.”  Of course I am not sharing with my friend what Dr. E says.  It is not helpful to tell her any of this.  And no doctors can predict the outcome, so why share with my friend, right?  But I really hope and pray that my friend’s baby holds on tight so we will see a great scan next week.  But I think my friend will be nervous at every single scan for quite some time.  It is just the trauma that comes with trying for a long time and wanting something so badly.  Our innocence is lost forever.

MicroblogMondays: 16 Weeks Ultrasound and Headaches

Just a warning that this is definitely NOT a micro post (and it’s actually super long)…

Annie does not experience any pregnancy symptoms except for these headaches.  They started about a month ago and sometimes get really bad.  Tylenol does not work for her so once she was in the 2nd trimester, our OB allowed her to use Ibu.profen when the headaches get bad.  Annie doesn’t want to take that all the time so she just endures the headaches.  She looked into the side effects of Love.nox and Syn.throid.  Both of them said headaches.  She was scheduled to stop Love.nox by 14 weeks anyways but I told her to continue until the meds runs out.  Once I learned about the headaches and the side effects, I told her to stop the injections.  But since Syn.throid is helpful with controlling the thyroid thus preventing preterm labor, she would need to be on.  Her dosage is so small that our OB doubts that the headaches have anything to do with that.  Annie did not have headaches during her first three pregnancies, but she does get headaches during her monthly cycle.  So I would imagine the increased blood flow during the second trimester in her body and the pregnancy hormones carrying twins both trigger these headaches.  She said they are constantly on the background and a few times they got really bad.  She uses essential oils.  Last week she had a massage and a chiropractic adjustment of her neck two times.  She does feel better after the adjustments.  This week she’ll have more adjustments and an acupuncture session.  Many asked if she is hydrated and she guarantees me that she is.

Here comes the part that scared me.  Because she was originally prescribed Syn.throid by Dr. E, my reproductive endocrinologist, we kept Dr. E in the loop regarding the headaches to see if Annie could stop the thyroid meds.  Dr. E is an alarmist by nature.  After learning that Annie has had these headaches for a long time, she really wanted Annie to be seen by a neurologist because to her, untreated headaches could be dangerous and headaches could be due to other neurological conditions and not just pregnancy hormones.  Annie wasn’t worried and still isn’t worried about these headaches being neurological based.  But Dr. E wrote me and asked me to convince Annie to go see a neurologist.  That was two days before we flew in for the scan.  I was sitting there at work with  my mind going really far away, having irrational fears about pre-term labor, Annie’s life being in danger, and the babies’ health on the line.  Simply because my doctor was suggesting my gestational carrier to see a neurologist.  Annie did try to call the neurologist office in town and was told that she would never be seen for just headaches unless she gets a referral.

Dr. E also forwarded a meta-analysis study about the effect of vaginal progesterone suppositories to prevent pre-term labor in women with a history of one.  She felt that it would be beneficial to Annie since she is carrying twins and might have the risk of per-term labor.  I said I would run it by our OB.

I was not super worried per se, but I really didn’t/still don’t like this feeling of doom and gloom.  Annie again is not worried because she has no other symptoms.  Her blood pressure is good.  She does not have any localized weakness or pain on any other part of her body.  She only has these freaking headaches that are super annoying.  I am just so thankful that she is my gestational carrier because her calmness is contagious.  She has learned to give it all up to God and I really have to learn to do that as well.  She is not ignoring these headaches.  She actively tries to find a solution to resolve them.  But she is just not worried that any of this was caused by problems in her brain.  She will go see a neurologist if he/she would see her, but she isn’t stressed about it.  I figured we’d see the OB anyways on Friday, so waiting a day or two to talk to him wasn’t going to make the situation worse.  So I prayed repeatedly for my peace and trust in the Lord and just waited.  But there is always something that can cause worries, isn’t there?

It was such a blessing for Bob and me to attend the ultrasound on Friday with Annie when we reached 16 weeks 2 days.  I was a bit nervous before going in because you just don’t know what you’d see on an ultrasound.  I had confident that both babies were still there but a part of me was anxious.  I didn’t really have much time to think about things because once Annie arrived, the ultrasound technician was ready for us.  It was so wonderful to see Annie and her/our bump in person.  Hugging her felt so interesting because inside her bump was our babies.  Annie hopped on the table and off we went with the abdominal ultrasound.  Annie said that she did feel some movements the other day and was quite sure that it was the babies.  This time I didn’t feel sad but felt that it was such an amazing thing for her to feel the babies.

I reminded the tech that Dr. OB said that he would do all the preliminary anatomy stuff during this scan because Bob was able to be present for this one.  The tech was super friendly and said she’d get whatever she could get.  Immediately we saw Baby A waving his/her arm on the screen.  It was quite exciting to see that he/she was so much bigger at this point.    The tech first measured Annie’s cervix, which she said was adequate.  Baby A was moving around.  The tech changed into different views and measured a bunch of different things.  She looked at the heart, which was beating at 151 beats per minute.  We could see the four chambers, the baby’s kidneys, head, brain, arms, legs, stomach, diaphragm, etc. etc. etc.  Everything seemed to be going well.

When it came time to see the sex of the baby, I only wanted to know if we really had a boy and a girl inside, but I don’t want to find out which baby is which.  Bob really wanted to find out.  So when the tech looked, I hid in the bathroom adjacent to the ultrasound room.  Bob was going to stick himself right in front of the screen and find out.  I was adamant about him not finding out because it would mean one day he’d leak out the information and I wouldn’t have my surprise anymore.  He was really torn because he really wanted to know. Eventually he agreed not to and hid in the bathroom with me.  He was half mad because I was denying him the right to know, but he agreed with me later on that he would not be able to keep a secret from me.

Apparently the tech took a very good look and confirmed to herself what she saw.  Baby A was measuring 16 weeks 6 days and his/her leg was very long, measuring at 17 weeks 3 days.

The tech then switched over to Baby B, who also had a great heart rate of 156.  We could clearly see that he/she had a tall nose.  The profile was just very cute (probably only in my eyes as his/her mother).  This baby was measuring 16 weeks 4 days and the tech also confirmed his/her sex.  So we officially know that we are going to have one boy and one girl.  🙂

Both babies weigh about 6oz each and over 4 inches each.

The tech changed the view to 3D for Baby B.  He/she was holding his/her fists up on the cheeks.   We switched again and saw that the babies’ head were together.  Apparently one baby was head down and the other was breech.  So their heads were together but one was up and one was down.  You can click on the page “Ultrasound Photos” on the left to see the babies, the two heads of the babies looking like an infinity sign, and the 3D image of Baby B.

The technician measured the blood flow of the umbilical cords and the placentas and it seemed to be fine for both babies.

We finally got to meet Dr. OB.  I had only talked to him on the phone several times so it was nice to finally meet him in person.  He was a middle-aged man who sounded very passionate about his job. He talked a mile a minute and every single time we asked a question, he gave an example of one of his patients and what happened to her.  So this is basically what we discussed:

  • Dr. OB asked if Annie had any localized pains, slurred speech, or other things.  He felt her head, her forehead, and areas around her nose to check for sinus problems.  After that, he said that it is highly unlikely that her headaches are due to a brain tumor or a blood clot.  The neurologist received Dr. E’s referral and said that he’d need Dr. OB’s notes in order to see if a visit with him is warranted.  But Dr. OB said that the headaches are most likely due to the fluctuation in hormones and he has seen it many many times.  He will write the notes and forward to the neurologist clinic and see what the neurologist would say.
  • The babies are doing well.  They are measuring on time and there is nothing to worry about.  Baby B does have a little white dot on his/her heart shown on the scan, which is called “fetal echogenic intracardiac focus”.  The doctor said that it occurs in 5% of pregnancy and by itself it’s not harmful to the baby at all.  But when it happens with a load of other problems such as short femur, high risk for Down syndrome, or other things, then it may raise some concerns.  As for us, Dr. OB said that it will resolve itself and there is nothing to worry about.  I guess it is his job to inform us of this thing.
  • One baby is currently breech (feet down) and the other one head down.  Baby A is in the front of the uterus with an anterior placenta.  Baby B is in the back with a posterior placenta.  The placentas are in the right place and not covering the cervix in any way whatsoever.  This is a relief.
  • We’ll have the 20-week ultrasound and by then we’ll see more anatomical structures that will be bigger then.
  • Annie will be seen every four weeks until 32 weeks.  At 32 weeks, she’ll come in twice a week for monitoring and non-stress test.
  • She will do her blood sugar test for gestational diabetes in the next week or two.  It’s done early because she’s carrying twins.
  • Annie’s urine is good without protein.  Her blood pressure was 110/70 which was excellent.
  • We will aim at delivery at 38 weeks by Ceasarean section.  I forgot to ask when we determine if we would do a C-section early.
  • I asked how we would be able to tell if there’s preeclampsia. Dr. OB said that she’ll be monitored closely after 32 weeks so she’ll be in good hands.
  • Annie only gained three pounds in the last 4 weeks.  I forgot to ask if this is a good gain or if she needs to gain more weight.  I will write the doctor and ask.
  • Dr. OB said that the vaginal progesterone suppositories are not warranted in Annie’s case because studies show that for those who are at risk for preterm labor would still have a higher chance of having pre-term labor even with extra progesterone.  In our case, Annie never had that problem.  It is not warranted at this point.  Plus Annie joked that she pushed for over 50 hours for both of her last two births and her cervix was shut closed.  Dr. OB was joking that in this case since Annie had a steel of a cervix, we most likely won’t have to worry about this problem.
  • Finally, Dr. OB said that he’d order a vaginal ultrasound next time so we can measure the cervix more accurately.

I think that’s about all the issues that we discussed on that day.  I have to tell you that I was tremendously relieved and happy to see the babies alive and well on the screen.  It is not a given that we have a good scan and I don’t take things for granted.  I didn’t know this until that evening but Annie was very nervous going in this scan.  She is usually the calm and confident one, but something shook her a little.  In her surrogacy group there are these two surrogates who got pregnant with twins at around the same time with her.  One discovered that she lost both babies at 16 weeks and the other one lost one of the two babies at 15 weeks.  Because of this, Annie said she only cared about the heartbeats during our ultrasound.  She just wanted to know that they are both still alive.  It is tremendously sad to learn about these other losses.  This knowledge makes me even more grateful for what we have.

The rest of the visit was great.  We attended a Seder Meal with Annie and Kenneth’s friends.  People there knew who we were and came to tell us that they had been praying for us.  We went to the only breakfast place in town the next morning and the server there was Annie’s close friend so she told us that she had been praying for us.  You’ve gotta love small towns.  They are so warm and friendly and they are so happy for us.  We hung out with Annie and her kids for a little before we left.  I passed on many maternity clothes from my friend to her.  I also got to take her bump photo with her (which you could see on the left side here that says “Gestational Carrier’s Bump Photos”).  It was such a precious time to share with her.

Can’t believe we are almost 17 weeks.  Praise the Lord for the growing and healthy babies.  I pray that Annie’s headaches will go away forever.  Hopefully we will see our babies in 21+ weeks!

MicroblogMondays: What’s In a Name?

I don’t know if people who have been trying for a baby for a long time are all like me.  I have had names for my future babies for quite some time.  I guess when there is plenty of time to wait, there is also a lot of time to consider names.  I have fallen in love with this one particular boy name a couple of years ago.  It’s a name that could be viewed as an English name or a Chinese name, and it also exists in many other languages.  It has a great meaning in my native tongue, which means “to enlighten”.  I just love it so much.   I didn’t have a middle name for the boy for the longest time.  My husband, who is quite a jokester, has not been very helpful in this endeavor.  He kept on coming up with funny sounding Indian names that couldn’t possibly become our boy’s name.  We finally found something that we liked after we got pregnant.  This middle name has a meaning that is symbolic of enlightenment found in difficult situations, which matches our boy first name perfectly.  As for a girl, I have liked this one middle name for a long time.  It is also in my native language that means “easygoing”, but it is not an English name so it doesn’t sound too good as a first name.  Hence it will become our baby girl’s middle name.  With a Chinese middle name, an Indian first name seems fitting for a girl.  I had liked this one Indian girl name for a long time, but it seems like every other Indian girl has that name.  I do not want a super popular name for my child.  So this name has been abandoned.  A couple of years ago I came across this other beautiful name that means “grace”, which is perfect for us.  We haven’t told any of our parents about the names yet, but my mother-in-law recently has declared that we can do all we want to name our babies, but she’ll call our children the names that she will give them.  These names that she will come up with will not be on any formal or government documents but she can use them if she wants to.  I have no qualms about them.  Now since I won’t disclose the babies’ real names on this blog now or ever, I will tell you all their nicknames that derive from these real names.  Like I said, my husband is a jokester.  He jokes around a lot.  Our boy’s first name unfortunately sounds like vegetables in one of Bob’s Indian languages.  I am quite adamant about using that name so even though it means something funny in his language, we are still going to use that name.  Now since the name means vegetables, we have nicknamed our baby boy “Okra”, which is Bob’s favorite vegetable.  Unfortunately, there is not a single emoji made for Okra, so our boy has appeared as an eggplant in Bob’s texts to me.  And then my jokester husband has been making fun of our girl’s first name and been rhyming it with something funny.  I initially was upset that he had been butchering our girl name and had considered not using that name.  But knowing Bob that he likes to joke and he’d butcher whatever name we’d come up with, I decided to just use that name and let that joke become the nickname for our girl.  I won’t explain why but we have nicknamed our girl “Bunny”, which derives from the joke for our girl’s name.  So there you have it.  Okra and Bunny.  Or as presented as an emoji of a Bunny and an emoji of an Eggplant in all of Bob’s texts to me.  I hope that Fac.ebook answers Bob’s inquiry/complaint about the nonexistence of the Okra emoji so we will be able to use one in the future for the boy.  Otherwise he’d have an identity crisis: Am I an Okra or an Eggplant???

Not Happily Ever After

You may wonder how an intended mother may feel once she is expecting via gestational surrogacy.  The answer is, it changes all the time, and you don’t know when and how frequently your feelings may change.

The other night Bob and I were chatting in bed about how we’d turn 15 weeks the next day.  Suddenly, this sadness overcame me.  It just hit me like a ton of bricks without warning.  I lay there and started tearing up.  What went through my mind was how Annie will start feeling the babies’ movements in a few weeks and I will feel nothing inside of me.  That loss on that particular day at that particular moment was so unbearable.  My babies are growing in another person’s body, and I am 100% grateful for that.  However, this same fact also reminded of my missing out on this experience and it was very difficult to bear.  I knew all of this going in, and I knew that these feelings are going to surface once in a while.  I do think that it is important to acknowledge them and cry when I need to cry.

These complicated feelings made the next day even more difficult.  A close friend of mine who had been banking day 5 and then day 3 embryos for the last two years (because of diminished ovarian reserve) just received her positive beta after failing her first transfer a month ago.  She started banking after she turned 40 and she had been quite adamant about not using donor eggs.  I totally respect what she’s been doing and support her in her endeavor.  It has not been easy for her and I want her to be successful.  At the same time, I didn’t know how I’d feel if/when she eventually gets her BFP.  I found out on Wednesday that her BFP has hit me hard.  I was super jealous of two things: 1) she does not have to consider the need of donor eggs, and 2) she gets to experience a pregnancy.  I know that this jealousy and these thoughts are not rational.  As a close friend, I *should* be very excited for her.  But I was just super super jealous.  There is no rhyme or reason.  Like I said, I would not have known how I’d feel about a particular person’s pregnancy until it happens.  There have been many times I am immediately very happy for someone and do not feel an ounce of jealously.  Unfortunately this time my primary feeling has been jealousy rather than anything else.  I felt a little bad for not being able to fully celebrate with my friend, but I was told by another co-sister on this journey (and she’s a therapist herself) that I don’t have to feel bad.  I am not going to analyze myself too much, but I believe this stems from both my need to use donor eggs and my necessity to use a gestational carrier.  I knew that I was still sorting through my feelings about not being able to carry, but I was surprised by my feelings regarding donor eggs.  I thought I have completely worked through those emotions, but I guess the grief for foregoing my own eggs lingers for longer than I thought.  I knew and still know that I was completely done with my own eggs at the time we moved forward to donor eggs and am very grateful for having the twins using this method, but it’s still tough when someone else achieves what I can’t.

Today was tough for me.  My friend was of course still super excited and sent me two pee stick photos.  It was hard for me to see pee sticks without prior warning.  Pee sticks, bump photos, and ultrasound photos still serve as such a trigger for me.  She also mentioned about other pregnancy related things that were too much for me at this point.   After a few moments, she asked me if it was okay for her to show me these photos.  I was silent for a little while then decided to tell her that I was okay with them because as a good friend, I don’t want to dampen her joy.  However, my friend A. wanted to make sure that I don’t get ambushed by this friend in the future so it might be wise to establish some boundaries.  I decided to be honest with my friend so I made this suggestion: “I support you and love you and am very happy for you for getting to this point.  Just for me, you may need to be a bit less specific about your pregnancy symptoms and things in the future.  I’m not saying that you are overdoing anything right now because you are not, but this is to protect myself because I don’t get to experience what you will experience.  I don’t know how I’d react.”  My friend took it very well and thanked me for being open with her.  I wish I could be there for her 100% but as of now, I am not quite there yet.

So it goes to tell you that even when we are 15 weeks into this pregnancy, we don’t live happily ever after.  We still have all sorts of feelings to process.  And sadness and jealousy hit whenever they want to.  We’ll have to be honest with ourselves and handle these feelings as they come.  Hopefully, like what A. said, that by the time the twins come, I will be so busy mothering that this stuff will have less opportunity to fill the space in my head.

MicroblogMondays: “Freedom”

After eight days of being home, my trip quickly came to an end.  Unexpectedly, my emotions were all over the place the last day I was in my home town.  I woke up thinking that this would be the last time I would roam around my birth place “freely” all by myself.  It would be the last time I could quickly get ready to go out the door, meet up with my dad for breakfast without a lot of effort, ride on public transportation without much thought, and go in and out of stores at a shopping mall independently without a lot of care or consideration.  And that was what happened.  I savored the “freedom” that I had on that particular day because my life is going to change drastically the next time I step foot in my place of origin.  I will no longer be only responsible for myself.  I will have two lives that are dependent on my provision and care.  I have been waiting for a very very long time for this responsibility and it made my last day there with my family different and memorable.  For this reason alone, my trip home was the correct choice for me in terms of my emotional state and timing.  Without my grandmother’s funeral, I would not have had a chance to experience this final “freedom” before I become a mother of live children.  It made me nostalgic of what I have been given so far in my life but at the same time my gratitude for this opportunity to become a mother grows exponentially.  It is hard to explain my feelings on that last day.  It is complicated.  It signified a sort of finale and a beginning.  I am just grateful that I have this day to remember and I am quite sure that when we return to my home town with the twins in the future, I will be even more appreciative of the reality of a new life and this lack of “freedom” that I have been craving for so long.