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.

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The First Ultrasound – Recap

I almost had a heart attack at our first ultrasound with the twins (how crazy to even get to type “twins”…!!!).

We got to town extra early, so we were at the doctor’s office about 30 minutes before the appointment time.  When I stepped into the office, my first impression was, Wow, this place is very nice.  The OB practice looks nicer than many practices that I’ve been to in the Bay Area.  The receptionist greeted us and gave Annie an iPad to sign in.  We don’t even use iPads here at any of the OB offices or IVF clinics that I’ve been to here.  That was a surprise.

I asked Annie if she felt nervous.  She was actually not nervous at all.  She was feeling excited and just wanted to get the scan done soon to see what we had inside.  But I was nervous.  I’d say 90% of me believed that we would be able to see a heartbeat, but there was 10% of me that was anxious and thought the worst.  You know how that goes.

We were there with Annie, Kenneth, and their two younger kids.  I sat way far from everybody.  Somehow I felt that I needed some space from everyone so I could stay calm.

When the nurse came out to get us, we all stood up.  That apparently threw her off as she didn’t know who all these people were.  She guaranteed that everybody would be able to go in for the scan, but for the first part of the appointment she only had two seats for our group.  Annie indicated that she wanted me to be with her.

We were led to a tiny area with two chairs.  The nurse was training someone else.  We sat down while she typed in her laptop with the information that we told her.  I don’t think she knew who I was.  Annie just answered whatever questions the nurse had for her.  Then the nurse said at one point to Annie, Your husband had a vasectomy….? alluding to the fact that it didn’t quite make sense for Annie to be currently pregnant while her husband’s sper.m supply had been cut off.  At that point, I knew that she was very confused about the situation.  We had to quickly clarify the situation, that Annie was my gestational carrier and I was the mother.  So once that was explained, we went on to deal with last menstrual period.  The nurse asked when it was.  Annie was like… Uh 6 months ago?  I don’t think the nurse knew much about IVF.  She said she had never had a patient who came in who did IVF, so there was no button on her screen to put in a date for a day 5 or day 3 transfer that would calculate the due date.  She didn’t know how to calculate the due date based on the day of transfer.  So she put in the transfer date of January 9, which gave the due date of October 6th.  She knew that it wasn’t right, but there was no way to change that.  She guaranteed me that the nurse practitioner would change it to the most appropriate date.  I told her the due date and she believed that it was right, but we still needed to wait until later for it to be changed.

Here comes the heart attack part.  I said to the nurse that if there was a heartbeat we should be able to see it today, right?  She said, oh not necessarily.  She said that you guys are so early (6 weeks 5 days) that the heartbeat doesn’t always show.  I was like, No no, my doctor back in California said that we should be able to see a heartbeat by 6 weeks 2 days.  She said that Oh not on the bedside ultrasound that we use.

I was panicking.  Uh no… we are NOT only just going to use a bedside ultrasound.  When we booked the appointment, Annie specifically asked for a vaginal ultrasound, and she confirmed it two times with the office about that.  The nice nurse got a little combative and said, Uh no that’s not what we usually do at the first ultrasound.  And I was like… but we confirmed that it WAS going to be a vaginal ultrasound.  She said that this is not your fault but someone at the office is going to hear about it because they shouldn’t have confirmed with you that it was going to be the more detailed ultrasound.  I wanted to cry.  I said, Don’t tell me that I took a day off with my husband and flew all the way over here from California for you to tell me that I will not be able to get a vaginal ultrasound to get a definitive answer on the heartbeat.  I waited for five whole years for this moment.  At that point, the nurse realized how serious the situation was.  She said that they were very flexible and she was going to make sure that we would get to see a heartbeat today before we left.  So basically, whoever made the appointment for Annie did not notify the nurse that this was an IVF case where a vaginal ultrasound was needed.  One wasn’t scheduled.  And in order to get one done, we’d have to be squeezed in between the ultrasound technician’s appointments.  The nurse smiled and told me not to worry.  She’d make sure that we got all the things that we needed done.

Phew.  For a moment, I thought that we would have to go home empty-ended without a definitive answer.  That would have been so devastating for me.

That whole process took a total of 20, 25 minutes.  Next we were taken into an exam room to see the nurse practitioner.  This practice is very interesting.  You don’t see the OB at the first visit.  The expectant mom always sees the NP first.  The NP was super nice.  She reassured me that we would go next door once the ultrasound room was freed up.  In the mean time, she asked me about the transfer and the pregnancy.  The great thing about her was that she addressed me 100% of the time because I was the mom.  She talked to me about the care and she asked me questions.  She was respectful and showed the understanding that this is my pregnancy and not Annie’s.  Truthfully, I didn’t know too many questions to ask.  I know a lot about infertility but I know nothing about pregnancy.  So we discussed a bit about the care.  The NP suggested checking the uterus with the bedside ultrasound before we headed for the vaginal one later.

At that moment I was nervous.  I just didn’t know if we’d see something.  The NP left the room and pulled in a machine.  Annie lay down and the probe was put on her tummy.  Instantly we could see two dark circles.   The probe picked up the flickering movement of one of the circles right away.  It was the most amazing thing to see.  When I saw it, I couldn’t stop my tears from coming.  I was overwhelmed with joy that the heartbeat was so easy to find.  Annie grabbed my hand and kept saying, You are a mommy.  The NP tried to look at the other dark circle closely.  We could see something, but couldn’t quite see the flickering heart like the first one.  It was a relief to see one heartbeat but I was also very eager for the other one to have a heartbeat too.  I stopped crying and asked if I could bring Bob back.

Poor guy.  He had been sitting outside for over 45 minutes having not a clue about what was going on inside.  A nurse went to get him. When he showed up, the look on his face was so worried that I felt sorry to have kept him waiting for so long.  And poor him.  He couldn’t gauge from my facial expression if it was good news or bad news because I just finished crying.  When we showed him the first heartbeat, he was naturally concerned about the other one.

We were then told that the ultrasound room freed up and we were able to get the vaginal one done.  Annie’s husband and kids came in.  We could instantly see the two round circles again.  The tech typed in Baby A and Baby B.  It was just so surreal to see those words typed on the screen.  The tech measured Baby A first.  Like I said, it was 6 weeks 5 days with a heart rate of 128.  The true relief came when she zoomed into Baby B and measured its size and its heart rate.  7 weeks 1 day with a heart rate of 125.  When I saw that, I cried again.  I just couldn’t hold my tears (nor did I want to).  It was one of the most amazing 5 minutes in my life to see the lives that are now living inside Annie.

When we returned to the other room to see the NP, Annie, Bob and I had a group hug with the babies too.  Annie kept saying, You are going to be mommy and daddy!  The NP came in again to congratulate us.  We discussed the next appointment.  We’ll have another scan done at 8 weeks 5 days.  Dr. E basically wants a scan every 2 weeks to make sure that the cervix is long and closed.  The NP also mentioned that they’d still want to see if they could wait til 39 weeks for delivery even when it’s twins and it’s supposed to be a scheduled C-section (due to Annie’s hernia problems).  So as of now, I don’t have the definite due date.  But she said that we don’t need the NT part of the scan at 13 weeks because we did PGS testing.  I plan on attending the ultrasound appointment again at around 12 weeks 5 days or 12 weeks 6 days.

So this is it.  Despite the drama at the appointment, we are so relieved and happy with the outcome.  I know it’s still early, but we feel tremendously blessed to have a chance to have two babies at the same time.  It is still so surreal and hard to wrap my mind around it.  Praise God for the lives that He has been sustaining for us inside Annie.  Now we need the babies to stay put until we see them face-to-face in September.

MicroblogMondays: Approaching Our First Ultrasound

Microblog_Mondays

We are currently in Annie’s town waiting for our first prenatal ultrasound.  As you know, we opted out of doing a third beta.  Waiting for another beta was simply something that I didn’t want to do.  So we took a leap of faith, purchased plane tickets, and hope to be able to see some flickering heartbeats on the screen for the first time.

How have I been feeling?  I feel hopeful that we will finally see a heartbeat (or two heartbeats) for the first time in our journey to make a baby.  Annie has been feeling mostly okay. She hasn’t felt nauseated but was feeling yucky last week.  She said that food didn’t sound good at all, and she could not cook raw meat.  Having food aversion is similar with her last two pregnancies.  The difference is that her symptoms only lasted a few days the last pregnancy but it has been persistent during this pregnancy.  Although I felt sorry for her feeling yucky, I was happy that she was feeling pregnancy symptoms.  It is reassuring to know that maybe things are on track and her body has been changing rapidly.  She continues to feel very tired, which is also a good symptom to have.

Despite having a lot of hope, sometimes I still feel anxious as I have the fear that we might not see anything on the ultrasound.  My daily prayer is for Annie’s health and safety, the baby/babies’ healthy growth, safety and protection for Annie’s family, and also for Bob’s and my complete trust in the Lord for what He has planned for us.  I believe that God has been protecting me from having negative thoughts.  Although I still at times have this fear and image in my head of not seeing a heartbeat, I more often have joy in my heart that we may well be on our way to becoming parents.  Not being the one carrying my own baby/babies only occupies a fraction of my mind.  The rest of my mind is very much appreciative of Annie’s selfless choice of helping us build our family.

I am letting myself to have a little more faith that the pregnancy is progressing as it should be.  These are the things I’ve done:

  • lying in bed discussing baby names with Bob at bed time
  • searching online, reading, and watching videos about pregnancy at 6 weeks and beyond
  • telling my dad about the good news
  • upping my 401K contribution per paycheck so it will reach the annual limit by end of July in preparation of maternity leave sometime in August or September
  • sharing our news with my HR person at work so that I could get educated on maternity leave by our HR person
  • marking on my work calendar 12 weeks and 20 weeks so I know when we may have to fly out
  • finding myself thinking about the second bedroom in the house, how we will move the bookcases out of the room, and finally doing window treatment in the whole house after our remodel four years ago
  • thinking about the possibility of doing a maternity photo shoot with Annie and how to go about doing one
  • thinking about the need to purchase a new car to go pick up the baby/babies later this year
  • thinking about the reality of actually having a baby shower

As you can see, I’m making progress in believing that this may well be happening.

Our trip to Annie’s town was as smooth as one could hope. The flight departed on time and arrived early. The whole place was covered in snow.


But it wasn’t that cold. Kenneth came to pick us up as Annie wasn’t feeling too well. It was so wonderful seeing them again. And it is so amazing that we are staying with Annie and her husband so we could save on hotel. Annie’s two younger kids were waiting out front for us in the snow. We went to pick up eggs from the chicken coop in their backyard.

Annie and Kenneth are truly lovely people.  They made Bob a turkey/Thanksgiving dinner because Bob usually gets a prime rib Thanksgiving meal with my family and would miss having turkey. Annie couldn’t contain her excitement last week when she said she had a surprise for us. Bob was so touched and had a wonderful time having his turkey dinner for the first time  in the past year.

The highlight of the night was the homemade piñata that Annie made for us. After the boys busted it open in the garage, we found what Annie had hid inside. She knit two pairs of booties and a headband for our babies. 


We have the most thoughtful gestational carrier. I feel so blessed. 

So friends, this is it. We will find out the state of our pregnancy later this afternoon. I hope to have good news to share.