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: I Am Not The Only One

Microblog_Mondays So, my Dear Colleague who knows everything about my fertility treatment is also a source of information for me at work.  She has a way of finding out things about others that I will never be able to find out.   One day she went to a social function and hung out with a bunch of work people including my supervisor.  My Dear Colleague was commenting on my Pregnant Coworker, wondering why she would announce her pregnancy so early at 7 weeks.  Once she said that, people started rolling their eyes and grumbling about how Pregnant Coworker is over the top with her talk about her pregnancy.   They said that she mentions about her pregnancy every time she opens her mouth.  One time a manufacturer representative said that he would bring chocolate to a presentation.  Pregnant Coworker immediately said that she couldn’t eat any chocolate because the caffeine is not good for her pregnancy.  My supervisor said she audibly let out a sound of disgust once she heard that.  My supervisor also said this, “Oh and she has the guts to be talking about her pregnancy right in Isabelle’s face.”  Wow, I didn’t know that Pregnant Coworker has been that obvious and other people have been watching us.  I have never told my supervisor about our fertility journey.  However, about a year ago, she was riding with my Dear Colleague in a car.  She did mention to my Dear Colleague that she didn’t want to pry or ask for details, but she wanted to know if Bob and I were okay.  My Dear Colleague didn’t tell her details but just told her to think very good thoughts for us.  That was around the time we had our chemical pregnancy.  I know that work people have probably been wondering about us because we’ve been married for almost four years but still have no babies.  I kind of feel a bit vindicated that I am not the only person who thought that my Pregnant Coworker is a bit over the top with her pregnancy.  My supervisor apparently is going to start trying after her overseas honeymoon in a month.  I hope that she will be more sensitive and compassionate when/if she needs to announce her pregnancy.  And that she will also be able to enjoy a piece of chocolate, unlike my Pregnant Coworker who worries about the trace amount of caffeine in it.

MicroblogMondays: “Dang it!”

Microblog_Mondays

“Dang it!!!”

Those were the words that came out of my mouth at 5:30 this morning in a dark room in this nice bed and breakfast.

I am on vacation.  Our long-awaited vacation at a coastal town.  A time away that I had been looking forward to, so that we can relax and recharge before we go back to the IVF madness.

Of course I woke up at 5:30am.  Why?  Because that’s the stupid time that I usually wake up to take my temperature.  I was praying that it would keep itself up at least for one more day.  Well… it dropped below cover line.  Today is only 11 days past ovulation.  My period is not supposed to come this early.  I usually have a nice long 14-day luteal phase.  This is a joke.

Dang it!  Why can’t my body cooperate for once?!?  All I want is a nice relaxing vacation without having to worry about stupid AF coming.  Now I am on a toilet paper watch.

A temperature drop doesn’t always mean the immediate arrival of AF.  It may take a day.  It may not.  We have two more days here.  I really hope that AF doesn’t come until tomorrow after 4pm, so that the first day of the cycle will be on Wednesday.  We drive home on Wednesday so if that’s the case, I can go to the clinic on January 1st.

Nevertheless, I am on TP watch.  Do you know how disappointing and depressing it is to have to watch for blood every single time I go to the bathroom while on vacation?

I lay in bed feeling sorry for myself, at 5:30am.  This is crazy.  I feel that I should NOT be affected by this.  But the sense of unfairness kept me from feeling calm about it.  All I could think of was, I can’t even have a relaxing time without thinking or worrying about stupid IVF cycle on my own vacation.

If my period comes today before 4pm, we’ll have to drive back to the city for 2.5 hours tomorrow to do the 5 minute ultrasound.  The thought of that makes it so depressing.

Bob rubbed my back and told me that it was okay.  He said that, maybe we can tell the clinic that we’ll just postpone our cycle until next month.

I shook my head in the dark.  I am not postponing the cycle.  Period.

ARRRGGHHHH.

It doesn’t help that I saw a pregnancy announcement of an acquaintance popping up on my FB screen.  An ultrasound photo indicating that baby’s arrival end of July.  I immediately unfollowed her.  I don’t need this right now.

The sense of unfairness enlarged and engulfed my heart.

I will be okay.  I just need the time to vent.

*****

On a more pleasant note, these pictures also describe how our vacation has been:

  photo 5

photo 4

photo 3

photo 2

 photo 1

Hopefully we can enjoy our time for a couple more days.

MicroblogMondays: Crying Buckets

Microblog_Mondays

A while ago, I wrote about a good friend of mine who announced that she’d try for a second child.  It was so unexpected to me because all along her husband had been adamant about no more children.  Her potential pregnancy has been in the back of my mind.  I have been thinking about how I’d react to her pregnancy, and I have considered how I wanted her to break the news to me.   I will see her and two other good friends for dinner next Tuesday.  The last thing I want her to do is to tell me in person or to call me on the phone.  I had a feeling that I had to write her an email before the I saw her in person.  This is part of my email to her:

“Last time when we came to visit you at your place, you shared with me that you were trying for number two.  I thank you for sharing that with me.  I have one request.  When you get pregnant, could you please give me a heads up with an email before you announce it in person?  I ask because I would love for you to get pregnant and would love to fully prepare myself to celebrate it with you.  Given our situation, an email will allow me time and space to process the news and get ready to celebrate with you.  I hope that this is not too much to ask.  “

I woke up the next morning at 5:30am to take my basal body temperature.  I checked my email and saw her response.  This is part of what she wrote to me:

“Great to hear from you!  Thanks so much for reaching out about this.  I appreciate very much knowing your preference on these issues and I want you to know that I completely respect your wishes and want to be as sensitive as possible about your situation.

I was planning to give you a call this weekend before the dinner to talk in advance, so I’m glad your email came first.  We are actually expecting now.  I was hoping to share this with you ahead of time – there is absolutely no need to celebrate at dinner or have that be part of our conversation.  I did email Chloe (note: another good friend of ours) just a few days ago to let her know the news and also to ask that we not talk about it at dinner.  While it is mostly good news, we are having some mixed prenatal screening results that mean that the baby potentially isn’t healthy and that I’m at risk for several things down the line in the pregnancy.  So in truth, I’m not celebrating just yet anyway.

How about if you let me know what works for you in terms of future discussions?  I have been thinking about you guys a lot…”

After I saw the email.  I was stunned.  While I expected her not to have any problems conceiving, I didn’t think that she’d conceive pretty much right away at age 38.  I thought that it’d at least take her a bit more than a few months.  The fact that she told me in late September about trying and is already pregnant in December shows how unfair this is.

At 5:30am, I broke into tears.  I lay back in bed and had this heart-wrenching cry that woke Bob up.  My pillow case was all wet from all the tears.  I was just feeling sorry for myself for once again facing a situation with a friend who conceived so easily.  I was also feeling sorry for her for having to worry about herself and her baby.  I just let myself feel and allow my emotions to flow because I don’t know any other way to get over this.  I am not going to stop being friends with her.  But I really needed that time to grieve watching others so easily achieve what we haven’t yet.  I needed time to process the news and be ready to say congratulations.  I didn’t write her back for whole two days.  And this is what I wrote:

“Thanks for being so sensitive about my needs.  It does usually take me a couple of days to process pregnancy news.  So I am so glad that we touched base before we meet up which allowed me time to digest everything.  I am so sorry that there aren’t all good news about this pregnancy.  It must be worrisome to know that the testing results with the baby are mixed, and there might be health complications for you.  I would like to know what is going on with you and the baby health wise.  Would you like to talk on the phone today or tomorrow some time?

Love you girl.  I want nothing but the best for you.  I hope that everything will be fine in the end.”

We haven’t had the time to talk yet so hopefully we can do that soon.  At least before our dinner.  Bob told me not to go to dinner but I refuse.  I don’t like avoidance behavior.  And I truly love her and my other friends.  I have mostly gotten over the news.  I just really needed the time to cry.  I thought that I wouldn’t be reacting so strongly and be so sad, but this is one of my closest friends so the news really hit me hard.  It hurts so much.  I am so glad that I wrote her an email ahead of time.  Imagine her calling me out of the blue sharing her news. It would’ve been hard for me to respond sincerely without crying.  I hope that this pregnancy doesn’t change our friendship, and I truly hope that things will work out in the end for her.  I hope that I’d brave enough to talk with her without shedding any tears.

The Craziest Story

At least it is the craziest in my books.

About five years ago, I became friends with the nanny of one of my therapy kids.  She brought him in for therapy weekly and we became very friendly with each other.  I knew that she was trying to get pregnant but seemed to have had problems.  I remember one time she was about to do a heart surgery but couldn’t because they found out that she was pregnant.  A couple of months later, I asked her how she was doing.  She told me that she went ahead and had the heart surgery because the baby was no more.  When my client graduated from therapy, I stopped seeing the nanny regularly.  She and I are friends on Face.book so I would see her updates once in a while.  I would pay attention to her belly and would see that she wasn’t pregnant.  

So imagine how shocked I was when I saw an update on Face.book two days ago at lunch.  I was mindlessly scrolling the screen of my phone up and down and almost exclaimed out loud.  Good thing I didn’t because the lunch room was full of my coworkers who would have no idea why this would be a big deal.  The nanny had posted an ultrasound photo and a photo of her with her expanded belly.  I gasped and checked her page.  I saw a post by her husband a couple of days prior with pictures of them presenting a bun in their oven.  I quickly got back to my desk and wrote the nanny a message.  I expressed how happy I was to see her photos and to find out the news, as I knew how many years and how hard she had tried to get pregnant.  She quickly wrote back and wanted to share her story with me on the phone.  It was inconvenient for me to chat with her at work, so I promised to call her soon.

I finally had a chance to chat with her last night.   This is her story.

She started trying for a baby five years ago.  She had her daughter at 17.  Now her daughter is 22.  So this nanny is 39 years old, my age.  She was a single mom for a long time and finally met a wonderful guy who became her husband.  In the past five years, she got pregnant and miscarried a total of six times.  She lost two natural pregnancies.  She got pregnant three more times through a fresh cycle and three subsequent frozen embryo transfers.  She even did egg donation through a proven donor who helped every single recipient with a live birth.  She did get pregnant but yet, she miscarried.  All of these miscarriages happened between five to eight weeks.  Early miscarriages.  In the beginning she was told that the miscarriages could be due to her poor egg quality.  However, the pregnancy loss from the donor egg cycle could not have been due to her own egg quality issue.  She and her husband felt that they were running out of options here so they were planning on pursuing surrogacy in India.  Then one night in November last year changed their lives.

She and her husband were watching a new program that discussed about the effects of triclosan on fertility.  Triclosan is an antibacterial agent that is found in many household products, including anti-bacterial soap.  It is associated with endocrine disruption.  My friend paid close attention because she had been using anti-bacterial soap in the last twelve years.  She had a yeast infection and her doctor told her to use anti-bacterial soap to wash herself.  Since then she had been using products containing triclosan for her showers.  She said that this chemical goes into your bloodstream the fastest when you use it to wash your behind.  After watching the program, she and her husband threw out all of the household products containing triclosan and switched over to other products.  From December to March this year, she lived a triclosan-free life and estimated that by March her body should be rid of any triclosan.

In March this year, this friend thought that she could try a fresh IVF cycle one more time with her own eggs.  This is the result.  She had 19 high grading blastocysts (19!  And she’s my age…).  Three were transferred.  She got extremely high beta.  At her early ultrasound scans, they could find two embryos and two heartbeats.  So she was beyond thrilled that she was carrying twins.  Then at her 11-week ultrasound, her doctor kept on looking at Baby A saying that something was wrong, as the baby’s head was on one side but the body was on the other side.  She was almost having a heart attack thinking that something was wrong with the baby.  The doctor tried to look around and found that Baby A had split into two!  So instead of having Baby A and Baby B, now they also have baby C, who is the identical twin of Baby A!  Triplets… I can’t imagine…

At 15 weeks, everything is looking good.  The doctor of course discussed with them about selective reduction but the couple has decided that they are going to keep all the babies.  So my friend, at 39 years old, after trying for so long for five years, is finally carrying not one, not two, but three babies inside her.  The only thing that she has changed was getting rid of everything triclosan in her life.  Isn’t that crazy?

So now she has a remainder of 16 embryos frozen, plus the six that remained from the donor egg cycle.  (It seems like she herself yielded more blastocysts to keep than the 22-year-old donor did.)  

I don’t know about you.  I am still in awe of this story… that toxins in one’s body are so powerful to affect a person’s fertility health in such a profound way… and wasted five years of her life and many little lives.  I know Bob is skeptical about it… but I truly believe that this change made a difference in my friend’s body, allowing her system to accept the babies.  I know everyone’s body is different when it comes to the effect of environmental toxins.  So whatever works for her may not work for me.  I can’t help but think about how many women may benefit from this kind of information so they’d be saved from years of heartaches by just changing one thing in their lives.

I am beyond thrilled for her.  And I still think that this is the craziest story I’ve heard.