Taking a break

I will be back soon! I'm slammed at work and in my 2nd job as a photographer and need to catch the heck up! I'm also in a pretty good place mentally. I have one friend who had her baby a couple months ago and one preparing to deliver, and while I'm obviously insanely jealous, I'm also happy for them. I miss Caleb and think about where I should be at in my life every day, but...it's not as soul-sucking as it was. I just don't have a lot to post about right now.  That might change tomorrow and I need an outlet again, but for today: nothing.

So for anyone who is just starting this journey: it does get easier. It won't go away - I can't imagine it ever will, but it does get easier.

Please

Sometimes I am overwhelmed with fear that this will happen again.  I think anyone who has suffered miscarriage or pregnancy loss or infant loss goes through the same emotions. It's occasionally enough to make me not want to try again. To just give up.  But what if? What if it doesn't happen again? And what if I missed out on beautiful, wonderful children because I was scared?

But.

But what if it does? Would I be okay? Would Chris be okay? What would we do? My heart shattered on April 12 and it doesn't quite fit back together the way it did before. If it broke into a million pieces again, would I be able to put the shards back together this time?

Does that thought ever go away? I hate that I can't take comfort in the things most women do.  I just want to be naive again. I heard the heartbeat. I made it into the second trimester. I was days away from being halfway through the pregnancy. If I get pregnant again, will there come a day when I'm able to relax and consider the possibility of bringing an actual baby home with me, and not just a box of memories?  At this point I can't imagine it.

I think someone's trying to tell me something...

After I posted that I wasn't sure what to make of the ladybugs, I came inside to find the front door screen crawling with them - on the inside! No idea how they got there. There were probably close to a dozen. I shooed them off. The next time I came to the door, they were all back. And every time I chase them off (so they don't die trapped between the doors!) they come back.

It's like someone is trying to make sure I get the message.

Signs

Ok, I'm SO not the kind of person that looks for signs everywhere, but....

...every single walk I've taken since we got home, I've come back inside the house only to find a ladybug on me.  Every. Single. One. Today I specifically looked outside because I thought they must just be swarming all over the place, but I only saw one other one out there. 

Weird, no??

Superhero: The TAC Details

I now have a bionic cervix. Does that make me a superhero? A super woman who is now able to carry a child to term! Oh, wait. That's most women.

Prior to heading out to Chicago, I'd read other stories of the surgery - particularly Trisha's and Jaded's - and had very specific ideas about what to expect. None of them truly prepared me for the excruciating pain. I don't think that it's possible to really wrap your head around it unless you're actually experiencing it. I was also expecting a ton of waiting and it to be loud and busy and crazy, but since I was the first surgery of the day, it was the opposite. Yes, we had to check in at 6am, which meant waking up at 5am, but it was well worth it. We didn't have to really wait at all, and everything proceeded on time. Highly recommended to get that slot if you can swing it.

We left Omaha Wednesday afternoon to drive out to Chicago, which took about an hour and a half longer due to tons of construction. On the way there, I got a call from the hospital asking if I'd consent to having my surgery photographed for some magazine. Of course I said yes - I'm all for educating anyone I can about the TAC. I told Trisha about it and she joked that my cervix would now be bionic AND famous. Autographs, anyone?

Once we arrived in Chicago, we got some deep dish pizza (can you go to Chicago without doing that?), checked into the hotel, and grabbed a few hours of sleep. I wasn't nervous at all, surprisingly. The next morning we woke up early, around 5:30, and headed to the hospital. We found the parking garage right away, and note: you do have to pay to park. Which...am I just small town spoiled? Paying to park at a hospital? Valet is actually cheaper, so I recommend that, and obviously that has the advantage of delivering you right to the door.

Once we checked in, Chris was given some paperwork to read over and a code that he could use to check my progress on a monitor. I was called to pre-op almost immediately with three other patients who were also having various surgeries. They set me up in a little curtained-off area with a recliner where I changed into the hospital gown, was given an IV, took a pregnancy test (which I knew would be negative, sob) and answered a bunch of questions about my medical history. When she was putting in the IV, she couldn't do it in the back of my hand like she prefers, because I have "tiny" veins. She has to do it in the crook of my elbow, which meant I had to keep my arm straight...a problem since they put it in my left arm and I'm left handed. So ouch. After about 45 minutes, they brought Chris back to wait with me. Dr. Haney, a few of his staff, the anesthesiologist, and a few residents talked to us, answering any questions we had and giving the details of how the next two days would progress. I was under the impression that I'd be given the choice between general anesthesia and a spinal, but I don't remember them actually asking. I told them about my bad epidural experience, so maybe they made the choice for me based on that. The nurse then walked me back to the OR room, and Chris went back to the waiting room.

The OR room was just like in the movies - bright white, big lights, bed in the middle of the room. It was a little surreal. They strapped me onto the bed with my arms out, crucifix style...and that's the last thing I remember.

The surgery took about two hours - longer than average thanks to my severely retroverted uterus. After it was over and I was in recovery, Dr. Haney talked to Chris for about 20 minutes and let him know that the surgery went well, and they talked about the loss that we experienced. Dr. Haney told Chris that while I was going under I was chanting to the staff, "Let's do this! Yeah! Bionic Cervix! Whoo!" and got them all excited. Don't ever give me drugs. When I woke up, I was in a recovery room and Chris was next to me. I remember very little about the next few hours. I felt really shitty. My stomach didn't hurt - but my head was groggy and I felt dizzy and nauseated, like a really bad hangover. I was in recovery for about three hours, and drifted in and out of consciousness for most of it. I vaguely remember Chris taking this picture of me and asking if I looked cute. Obviously the answer is a resounding NO, but he said yes like a good husband. That black cord I'm clutching for dear life is the pain pump. I could press a button every eight minutes to dispense pain meds.

After I was deemed sufficiently awake, the transporter (sadly, not Jason Statham) wheeled us across the hospital complex to my recovery room in maternity. It shows how far I've come in my grief that it only momentarily bothered me. The last time I was in a maternity room was after delivering Caleb.

Chris brought up a body pillow, another pillow, and a blanket that we'd brought from home. Best idea EVER. I would not have been even the slightest bit comfortable without those things. We spent the day watching TV, movies, and I slept on and off. Chris played Civilization 5, and I think he was glad to have an excuse to be off work and play a computer game all day. ;) In terms of pain, there was actually very little from the incision. However, I was extremely dizzy and felt sick whenever I moved my head. I attempted to have some water and a bit of a smoothie, and immediately threw it up. Hours later I tried to eat dinner, and threw that up too. The puking is what caused my incision to hurt - without that, I would have still been fine, pain-wise. Of course, that also could have been thanks to the pain pump. Since after dinner I was still feeling dizzy and nauseous, the anesthesia resident came to check on me. I had to get my blood pressure taken laying down, sitting up, and standing. Standing, it was 90/60, which I thought was low, but apparently it was okay. The resident said I was just taking a long time to recover from the anesthesia - that is, after grilling me to make sure I wasn't suffering from drug withdrawls. "Could you be suffering from withdrawl from anything? Do you take any illegal drugs? Be honest." Yes, ma'am. The lack of heroin at the hospital is positively disgraceful! Ok, I shouldn't laugh. I know people lie about drug use all the time at hospitals. But I'm me, and I'm so not a drug user...I don't even drink caffeine. (Not because I'm some crazy health nut, but because it upsets my stomach, so you can go back to not being impressed.) That was the first time I'd sat up or stood and it hurt like a mother effer.

Shortly thereafter, around 10:30, Chris headed over to the hotel to sleep for the night. I fell asleep right after he left, but woke up off and on until about 3am, when I woke up for good. I passed the time reading and watching TV, which was difficult since I had the IV in my left arm and had to keep it straight. Every time I bent it, an alarm would go off and I had to call the nurse to turn it off. A catheter had been placed during the surgery (while I was out of it), and I hadn't even realized it until a few hours into the day. At one point I felt like I had to pee really badly, which I knew wasn't right because of the catheter (which, by the way, I couldn't feel at all and didn't hurt a bit). I had to call the nurse yet again - I think I was a "problem" patient - and it turned out the tubing had gotten tangled so it wasn't draining correctly. The relief I felt after she untangled it was amazing. I wouldn't mind having one of those all the time, you know, minus the whole having to carry around a pee bag thing.

At 4am - almost a full day after the surgery and a little over twelve hours since I'd been in recovery - the nurse came to remove the IV and catheter. Neither hurt, but since I was still feeling dizzy from the drugs, the nurse decided to keep the IV cap in just in case I couldn't keep down the pain pills and they needed to do intravenous drugs again. Luckily, I was able to keep down two Percocet. Just after that, I had to get up to pee, which was again excruciating. It was actually kind of funny (the situation, not the pain), because I couldn't go. I could feel it right there, but nothing was happening...so the nurse ran some water and put my hand in warm water. Is that funny just to me? That nurses use frat party tricks to make you pee? Okay then.

After that she had me sit in the chair for a few hours. Apparently I was supposed to have done that the day before, but due to the dizzy spells didn't want to risk it. Around seven I got back in bed and tried to get some more sleep. Dr. Haney came and talked to me for almost an hour around 8am to make sure I didn't have any more questions. We talked a bit about the sad state of treatment for second trimester losses. Chris made it back to the hospital around 9:30 (after leaving an hour earlier... Chicago traffic!), just in time to miss both Dr. Haney and a crying jag, after I'd asked twice for more pain pills and over an hour later they still hadn't arrived. That was the only real failing of the hospital, and the nurse apologized profusely when she finally showed up. I had some breakfast - about one bite of sausage and one bite of French toast - I just wasn't hungry at all. I was able to keep that down, so they decided I was okay to be discharged. They removed the IV cap, I changed into my street clothes, got one last dose of Percocet, and waited for the transporter to arrive to wheel us out to the car. I was still feeling the incision from puking, and was still dizzy and feeling slightly nauseous. However, as you can tell from the picture, I felt a lot better.

The ride to the hotel sucked for obvious reasons, as did the walk from the parking garage to the hotel room. I'm sure I looked like total hell and like someone fresh of a bender or something. Chris made me get up and walk around the room every hour or so, and oh my god. I don't know exactly what caused it, but Trish said she had it too, so it must be normal, but there was this burning sensation that was beyond excruciating. It wasn't at the site of the incision, but off to the side. I have no idea what it was, but I still feel it occasionally, and it's the most painful part. I kept taking two Percocet every few hours until I passed out for the night. [Edit: I not know that it's the nerves regenerating! So it's a good pain. Super incredibly painful and shitty, but it means everything is healing!]

The next morning (this morning) I woke up and could tell it felt a ton better already. I still have slight dizziness occasionally and the incision is still painful, but the terrible burning sensation is mostly gone. Don't get me wrong - walking around still sucks. And my back is killing me from walking around stooped over. But compared to yesterday I already feel better. I haven't had any discharge or bleeding, which I know some women experience. I bought an abdominal binder that is specifically for use after C-sections and abdominal surgery, which has helped quite a bit by supporting it and offering constant pressure. I also take a travel pillow with me to press against it when I am standing up or coughing or whatever. Each time I walk it's really painful for the first few steps, then gets progressively better. Right now, it's a toss up between what hurts worst - my back or my incision. I'm down to one Percocet every three hours. The bottle actually says one pill every four to six hours, but the hospital said one to two every three or four hours, and I called my best pharmacist friend and he told me that what the hospital said is fine, especially for just a few days. They gave me 50 pills, which means I'll have plenty left over to sell on the black market. Takers?

I keep half joking to Chris that I'd better get fucking pregnant now that I've gone through this. And I will say that I'm now scared of the C-sections that I'll be having in the future...this is painful shit! And to do this on top of having a newborn? Yikes. I don't know how people do it. Maybe the newborn cuteness acts as a numbing agent or something.

So now I just wait. Wait to feel back to normal, wait to get knocked up, wait to put this damn thing to use. Oh, and wait to shower. I am grosssssss right now.

Wordless Wednesday

...except it's not Wednesday and I'm not wordless. I feel wordless. I feel like I have nothing to say. The truth is, I'm just kind of frustrated. I'm not pregnant. I didn't REALLY think I'd get pregnant right away, but I'd hoped.

And now in our second month, I haven't ovulated yet. Hello, world of complete and total TMI that comes with the territory of talking about trying for a loin fruit.* But whatever, right? I talked about spewing a tiny person from my vagina, so talking about something so innocent as an egg (or lack thereof) is comparatively tame.

So I both chart and use the Clear Blue Easy Fertility Monitor (CBEFM). That means that I generally know the exact day I ovulated, exactly how long each phase of my cycle is, and just generally am pretty in touch with my body. The CBEFM measures two different hormones in your body, and tells you which days you have high fertility and which days are peak fertility. Generally, you get a few days of high, followed by a couple days of peak, followed by another high day. For instance, last cycle I had high readings on CD 13 and 14, peak readings on CD 15 and 16, and a high reading on CD 17. I ovulated on CD 15. The cycle before that I had a high on CD 16, peak on CD 17 and 18, and high on CD 19, with ovlulation on CD 18. The cycle before that, I didn't have the monitor, but I didn't ovluate until CD 23. Today is cycle day 19 and I haven't even gotten a high reading yet.

My cycles were getting MORE regular and MORE typical, and then this cycle all of the sudden is going back to late ovulation. If I even ovulate at all. Stressing about it probably isn't helping (don't you know that all you need to do to make a baby is relax and have fun? Or, more likely, be 17 and in the back of a Chevy), but dude. You need an EGG if you want a BABY. And my g-d ovaries aren't reasing their little prisoner! Come on, you little bitches. Just one. Give me my egg! It's mine! You can't friggin' keep it from me!

Anyway, so that's frustrating me.

And then I was thinking about getting pregnant at all, and I realized that holy mother of god, I don't want to go through all that again. I want to jump right ahead to 20 weeks. I don't want a freaking poppyseed. I want a cantalope. I worked my way to a cantalope and I want my damn cantalope! You really should be able to just jump ahead to where you were pushed off track. Look, dude, I didn't ASK to leave the baby train. I was forcibly removed! I should get a free pass to get back on at the same stop I got off at. It was a long enough trip there. Do I really have to start all the way at the beginning again??

And on top of that, there's a mother fucking mosquito biting me in my own house! You don't belong in here! Get out!

So yeah. Frustrated would be my word of the day.

On the plus side, I had some really awesome coconut bonbons over the weekend. But now they're gone. So back to frustrated.



*Is loin fruit the best way you've ever heard of to refer to children, or THE BEST WAY you've ever heard of to refer to children??

The Man with the Plan

So, like I said in my previous post, my surgery is scheduled for September 30. I have to report to the hospital at 6am (SIX. A. M. Gahhhhh.) on Thursday the 30th. I'll be there overnight and discharged Friday, then we'll come home Sunday (I mentioned this is all going on six hours away in Chicago, right?). I should be able to resume normal activities about 10 days later.

It will be similar to recovery from a C-section, only without the trauma of just having pulled an 8lb baby out of the incision. On the downside, you also don't have a cute newborn to distract you from the fact that there are staples. Staples in your stomach. Where no staples should ever be. Maybe I'll put a bib on Riley (our 100lb hound dog) and pretend that he's a baby. That's veering off into towel-baby territory, isn't it? I'll just take a step back from that statement now.

Ahem.

After all my worries that Chris wanted to wait an extra month or two before we started to try again, he DID decide that he was on the bandwagon to FWP last month (FWP = my favorite baby-making acronym: 'fucking with purpose.' Be sure not to put a typo there and type 'fucking with porpoise,' which is an entirely different animal. Literally.).

Sadly, the much-despised Aunt Flo is here, so month one of trying to conceive is a bust. That's probably a good thing since Chris spent much of the time in the week before I ovulated drinking with his buddies,* and I'd prefer a non-flipper baby...but now that I say that I'll absolutely take a flipper baby if that's what I get. Hey, he'd be a great swimmer, right?? We're not waiting until after the surgery to keep trying for a baby, however. If I get pregnant between now and then, we'll just push the surgery back until I'm 10 weeks along, which is when they prefer to perform the procedure if you're doing it during pregnancy.

T-minus 36 days. Whooo!



*Chris was actually pretty cute when he realized that we'd been trying that week - he freaked out a little that he'd gone to a bachelor party and told me that next time I needed to let him know beforehand so he can not drink. Which is a pretty generous offer considering his work has beer Fridays. My work doesn't have beer Fridays. I want my work to have beer Fridays, and then I want to NOT be able to participate because I'm knocked up.

I think I'm going to do it!

Where it stands right now is.....

I think I'm going to do it. Almost everyone I've talked to has expressed the same thought I have: "Better safe than sorry." If a (fairly) minor surgery is what it takes, then it's a small price to pay. I keep reading story after story after story about TVC (the vaginal cerclage) failing, especially when it's placed on an emergency basis. Apparently your cervix can tear right through that sucker. Who knew?

I keep thinking: if I don't get it placed and something happens, I'll never forgive myself. I'll blame ME for losing another pregnancy, or if my child has health problems from being a preemie, or anything like that. But. If I got it placed and NOTHING happens, and I have a successful pregnancy, I'll never know whether it's because the first time was a fluke or if it was because the TAC (abdominal cerclage) worked. Obviously, since the TAC was the only thing that would have changed, I'll assume it was that. Therefore, I won't be able to regret having it placed. Does that make sense? And if, God forbid, I had another loss after it was placed, I'll know that I would have done everything I could have done to prevent it. In all those scenarios, the only time I come up with any possible regret is if I DON'T do it. So I have to do it.

Granted, something could go wrong with the surgery itself. I could have a bad reaction to some part of the it, but the risk there is so minimal I can't consider it. I've gone under before, and generally they say if you've done it once without issue you'll be fine in the future. And Dr. Haney is one of the few doctors in the world who is an expert at this, so I feel 100% confident in him doing the surgery.

Dr. Haney has another Omaha patient who was cared for by the team at the other big hospital here, and I called that MFM team today and they are willing to take me on - and support the TAC decision - once I am pregnant.

So if a C-Section is what it takes to get our take home baby...well, then my husband can just thank his precious-vajayjay-not-ripped-up-from-vaginal-delivery stars.

Now all I need is to get the surgery scheduled and to get knocked up!

Conflict resolution

Hmmm.

HMMMMM.

That's all I can really say. Once again, I'm super conflicted and left to sort out the pieces on my own. I said it in one of my other posts, but I'll say it again: I hate that the lives of future children depend on me making the right choice in treatment. This is why we GO to doctors! So they can tell us what to do! I want to blindly be pointed in the right direction, please.

I had the Maternal-Fetal Medicine appointment today and it was a mixed bag. On the plus side, he agreed that the loss could very likely be the result of an incompetent cervix.

On the down side, that's about all he agreed with.

He would place me on progesterone shots, though there's no evidence that they are helpful one way or another with 2nd trimester losses like mine - they're proven to help later in pregnancy, but studies haven't shown they are helpful at 20 weeks. But then, they haven't been shown to NOT be helpful either, so there's no reason not to use them.

Where we really derail is regarding the cerclages. He believes that a TAC - or any cerclage, even - is overkill. He wouldn't place a preventative vaginal cerclage at 12 weeks, but would place an emergency one if the bi-weekly* cervical scans showed funneling or shortening of the cervix. He listed the risks of TVCs as the main argument against using one unless absolutely necessary, such as risk of rupture, infection, the cervix rejecting the stitches, etc. When I brought up TACs, he repeated the conventional wisdom: that they are only used when TVCs fail. He also said if a TVC is overkill, a TAC is beyond overkill; that it's riskier to place a TAC; that you always have to deliver via C-Section (all of which I knew).

I asked if there was a chance that your cervix could go from "okay" to "Houston, we have a problem!" in the two weeks between checks, and he said it's possibly but not likely.

Dude, it wasn't likely that my water would break and I'd lose my son. NOT LIKELY means nothing to me at this point. When you're on the losing side of statistics, numbers are never comforting again. (Ahem...a bit of frustration apparently, there.) I asked if doing weekly checks during the timeframe when my water broke would help at all, and he said it wasn't necessary but if it would make me more comfortable, he'd have no problem doing it.

I wasn't processing very well at the time, so I missed questions that I now want to ask. Like: "If you think it's IC, I don't understand the 'wait and see' approach." Like: "I thought that placing emergency cerclages were riskier than placing preventative cerclages. Is that the case?" And: "If so, why wouldn't you just do a preventative one?" And: "Please can you just give me a magic pill to fix everything?"

So now, I have a consensus on the diagnosis but two very different treatment plans.

If it happens again, would I ever be able to forgive myself for not moving forward with a TAC? Really, that's all it boils down to.

But the idea of going "behind" my doctor's back and doing something he specifically said wasn't needed makes my heart race, like I'm cheating on a test and scared of getting caught. Only this time I'd have to tell the teacher I cheated. How do I even do that, anyway? "Hey, I'm pregnant..and I'd like to be seen by your high-risk group...and, um, I had a TAC placed, despite your recommendations." For a majority of doctors out there, having a TAC placed with just one loss is...I don't know, equivalent to having chemo started with one abnormal pap smear. I'm sure they'd think I was crazy...and probably that Dr. Haney is too. I know he's on a mission to eradicate the TVCs because of the risks associated with them - namely, that they fail up to 25% of the time, and in the 75% of cases where they work, you still end up with premature babies up to 40% of the time. And the skipping the TVC to go straight to the TAC - that's an out there proposition that few doctors prescribe to today. But I get it. I'm on board with it.

Don't get me wrong - I really, really like the doctor that I saw today. I have full confidence in him. If I hadn't talked to Dr. Haney, I'd be all over this treatment plan. But he doesn't have the stake in this that I do.

I suppose the next step is a third opinion. Sigh.



*One of those confusing words with multiple meanings. Here we're looking at every two weeks, although I'm not going to lie - I'd love twice weekly. Or even daily. Hourly, perhaps. Maybe I can just permanently hook an ultrasound machine up to me?

Dr. Stitches

I just got off the phone with the Dr. Miracle I talked about in my previous post, or Dr. Stitches, as Courtney calls him. We were on the phone for about an hour and 15 minutes...and holy cow, does that man talk a lot! But in a good, "I'm-really-passionate-about-what-I'm-telling-you" way, not a condescending "I'm-the-doctor-so-you'd-better-listen-to me" way.

We went over my history in more detail and he was more convinced than ever that I have incompetent cervix, and he's certain that when I talk to the doctors they'll agree. We (well, he) also talked about the types of cerclages in details, and why he believes that the only person who should ever have a TVC (transvaginal) is one who refuses to deliver via c-section and who is willing to risk the death or extreme prematurity of another baby. His mission is to replace all TVCs with TACs (transabdominal), as he believes they are safer and more effective by miles. We talked about the risks, the procedure itself, future pregnancies, and what the next steps would be if I decided to pursue this option.

Seriously, we talked for over an hour and it would be impossible to summarize it all here, so if you have any specific questions, leave them in the comments and I'll try to answer.

But I think it's obvious that I'm in love and would drive myself to Chicago tomorrow if I could.

Dr. Miracles?

My mind is just spinning. (This is going to be a long one; I apologize in advance. But when aren't they?? I write like I talk....a LOT.)

I have a friend who lost her twin boys at around the same time I lost Caleb. She had true incompetent cervix; she was 2cm dilated and her bag of waters was bulging out before she went into labor. Recently, she found her "Dr. Miracle" and has been having consults with him. She emailed me and told me that during their consult, he mentioned that he firmly believes nearly every case of mid-trimester loss can be linked back to one cause: incompetent cervix (IC), where your cervix either funnels or opens prematurely. To treat IC, most doctors will do something called a transvagincal cerclage (TVC). This puts a stitch at the bottom of your cervix to keep it closed. The problem with it is that because it's low in your cervix, your cervix can still funnel down to the stitch, creating a V shape that puts all the pressure from the bag of waters on one small point, so the chance for pPROM occurring again is present. To prevent this, a patient with a TVC usually goes on bedrest for the remainder of her pregnancy. It has about a 80% success rate. If all goes well, the stitch is removed once you've reached full term and you can deliver normally. Another way of treating IC is by placing a transabdominal cerclage (TAC). This puts the stitch at the top of your cervix and is 99% effective, and requires no bedrest. However, it's permanent and all future pregnancies must be delivered via C-section. Most doctors and insurance companies won't approve a transabdominal cerclage unless a transvaginal one has already failed.

For several reasons, I didn't think that IC was the cause for me, but at her urging I looked up his profile and emailed him. My email to him and his reply to me are below:

MY EMAIL

Hi, Dr. Haney!

I was given your name by several different people. I'm not sure if my situation is something that can be treated, or if it was truly a "fluke". My water broke at 18.5 weeks pregnant in April of this year and I went into labor at 19.5 weeks. Obviously the baby did not survive. One of your huge advocates, Txxxxx Mxxxx, said that you mentioned during her phone consult that almost all cases where the woman went into labor mid-trimester are cases of IC. I THINK I'm one of the rare cases where that wasn't the situation, and just wanted to hear your thoughts and be sure that I and my doctors are not missing something.

According to the last ultrasound I had, on 4/9 (my water broke on 4/7), my cervix was high and closed. They didn't do a vaginal ultrasound, though, and I'm not sure how accurate abdominal ultrasounds are for cervical length. When I did go into labor, I was a fingertip dilated and they had to give my Cytotec to allow me to deliver.

I have had a full RPL panel and an HSG and thus far none of the tests have come back abnormal. My doctor suspects placental abruption, but the pathology came back clear without any signs of that. I had spotting during the pregnancy and I know that blood can act as an irritant and therefore cause your water to break.

I'm assuming that because my cervix wasn't dilated when I went into labor and the last ultrasound showed a good cervix length that I didn't have IC, but just wanted to verify and ensure that we're looking at all possible angles.

Thanks!
Lara

HIS RESPONSE EMAIL
Dear Lara,

I am sorry to hear of your loss and am sure this was devastating for you. You history is virtually conclusive of an incompetent cervix. There is virtually no way you could have preterm labor or an abruption at 18.5 weeks. That is why your pathology revealed nothing as the problem is your cervix, not placental abnormalities. If your spotting occurred in the weeks prior to your loss, this likely represented the bleeding associated with cervical changes as is common at term when cervical changes precede labor. I can explain it better over the phone but the funneling of the cervix which is seen in IC is caused by inadequate support at the top of the cervix. As the membranes descend into the top of the cervix they contain the amniotic fluid and the hydrostatic pressure from the fluid pulled by gravity widens the “incompetent” cervix. As the membranes containing amniotic fluid continue downward and shorten the length of the cervical mucus column, vaginal bacteria come into contact with the membranes and the inflammation causes the rupture of your membranes. Since the dilating force is related to the descent of your amniotic fluid-filled membranes, once your membranes rupture and the fluid is lost, your cervix no longer has this hydrostatic wedge and the cervix will temporarily appear normal by ultrasound because of its elasticity. To detect funneling, you would have to have had your ultrasound prior to the rupture of your membranes.

Quite simply, this was no fluke as membranes don’t rupture with a normal cervix. Unfortunately, my experience tells me that you have IC and will undoubtedly repeat this clinical course with subsequent pregnancies. I can appreciate that this may be a bit confusing so I would recommend that we talk on the phone so you can ask all your questions and get a clear understanding and make a decision you are comfortable with.

You can arrange that by contacting my assistant, Ms. Exxx Fxxxxxxx, at 773-xxx-xxxx. I look forward to speaking with you. Good luck.

A.F. Haney

Needless to say, this shocked me. It was absolutely not the answer I expected. My mind went a million places.

This was never even mentioned as a possibility by my OB. Is this a cutting-edge study? Is it something that most doctors have considered and dismissed? Is this one of those beliefs that have doctors split?

Could it be a scam? Honestly, one of the first thoughts I had was, "Yeah, but isn't he going to say that to everyone? Is he preying on bereaved parents who would do anything to have a living baby to get them to do this super expensive procedure?" Would a doctor really be a scam artist? I don't know enough about the medical field to know, but we're conditioned to respect doctors and trust their opinions.

His profile looks respectable, though, and his explanation makes complete logical sense to me. I don't see how it can "just happen" - doesn't there have to be a cause for everything?

I'll take this email and whatever information I get from him during my phone consult (scheduled for Friday) and present it at my MFM appointment and see what they say. If the MFMs don't agree, then do I go against their advice and look into it anyway? Do I get a third...or fourth...or fifth opinion until I find someone else who agrees with Dr. Haney? What if the MFMs are on the fence about it? What if they say it's not the cause at all? How would I even pursue Dr. Haney's ideas without offending my local team of doctors?

And I hate to say it, because I would do absolutely anything for a live baby (see: wearing diapers on my head), but I would be disappointed that I'd lose my chance for a natural, unmediated delivery if I had to have a TAC. Obviously I would come to terms with it, but it'd be yet another thing to mourn the loss of (along with Caleb, my innocence, my naivety, the excitement for another pregnancy, the ability to say "when" instead of "if" when talking about the future...). It's the least of my concerns, but since I'm being so honest here, it was another thought I had. "Oh...there goes my hippie, soothing, moving around, unmedicated, natural birth plan!"

So. many. questions!!

I hate that the world of maternal fetal medicine (and even regular OBs and RE and all that) isn't conclusive and that there are so many differing opinions. It's up to each of us to find the theory/doctor/practice that we believe is most correct, and if we choose wrong....we could end up with another dead baby.

Life, as it happens.

Since having a huge, epic cry over finding out that our "friend" is having a boy, I've been doing pretty good. And I have to give a shout out to Chris (who doesn't read this, but I still feel the need to give props) for dealing with me that night. I know he didn't quite understand where I was coming from, but he just let me cry and held me, which is exactly what I needed. And in the morning, I felt better. I won't say I'm entirely at peace with the fact that they're having a son (and that she's blogging about "folding cute, little clothes for my son...my special little gift to come.") but I got most of the emotions out during TearFest July 2010 and have been feeling pretty great since then.

I've talked a little bit before about our plans for any future pregnancies and what we've been doing thus far. I would wear a dirty diaper on my head if it meant that I would have a take-home baby in the future. I'd accessorize with air fresheners and glitter, but damn straight I'd rock that diaper 24/7 if it'd help. Hence the supplements I'm taking, the acupuncture I have scheduled for next week (so excited), the tests I've brow beaten my OB into performing, etc. Anything I can do to achieve a healthy pregnancy and healthy baby, I'll be all over.

That being said, I don't really know that my OB is on the same page as I am. I love her - she's very nice, extremely competent, and also very unworried. She's confident that it was just a fluke and that I don't need to make any changes for the next pregnancy, especially after all the tests came back normal. She's probably right. But I can't shake the feeling that I need to be doing SOMETHING proactive next time.

So today I called the Maternal-Fetal Medicine department (MFM) and scheduled a consultation. After my water broke, I saw one of the MFM doctors and he had mentioned that while not necessary, I could be a candidate for MFM care next time. Since I haven't felt 100% comfortable with the lack of action plan for next time (other than a couple extra checkups/ultrasounds), I want to explore my other options for care should I get pregnant again. I am not hoping for miracles; I don't think they'll be able to give me answers as to why this happened; I don't think they have some magic test that hasn't already been performed. I am hoping that they'll be more understanding and offer me weekly or bi-weekly checkups and ultrasounds to keep my mind at ease; that they might be more aggressive with treatments (even if unnecessary...if it can't hurt, I want to do it); that they might be more willing to work with an admittedly bat-shit-crazy-paranoid woman (a title which I loathe, but is well-earned).

I told Chris the other day that I have this sinking feeling that our journey isn't over yet and that this will happen to us again...that there is something wrong with me that the HSG and RPL screen didn't pick up. I'm sure that's coming from a place of pure terror and is normal when when something this devastating occurs for seemingly no reason. But in the back of my head, I can't help but think we have to go through this one more time before we get our take home baby. I hope not. I really, really hope that's not the case. I know people who have gone through this more than once and it's so fucking unfair. But they made it through...and I know that if it does, I can too. That being said, please god no.

Where's that crystal ball when you need it??

Snake oil and quackery

I'm not a crunchy-granola hippie - I haven't checked my shampoo for phthalates; I eat lots of frozen foods chock full of unnatural preservatives; I love coating myself in chemicals to fake a tan; I got the flu shot; I plan to vaccinate my kids. But I was going to a midwife and planning a natural birth and I am open to the idea that modern science might not have all the answers; that you can't necessarily isolate one part of the body and diagnose it without looking at the rest of the body as well.

Today I went in for a consultation at a natural healing center, which was recommended by several people. I figured it couldn't hurt to see what they said about getting my body in balance and the best health it can possibly be in for the next baby.

During the consultation, I told the herbalist/healer/owner guy about my medical history (it's always so comfortable telling guys about your period, amiright? Or is that just me??) and about what I hoped to achieve...namely, a baby. Full-term. Alive.

He checked a pressure point in my ankle, my eyes, the pulse in both wrists, my ear, and my tongue. He said that my pulse is pretty sluggish and that I might be slightly anemic. He also diagnosed a food allergy by looking at my tongue - which one he can only guess at, but that he's confident that I have one. He also mentioned (based on a slightly inflammed pressure point and history) that I might have minor thyroid issues. He advised that I continue to take the supplements I currently am taking (Vitex, Pom juice, fish oil, Green Tea, acidophilus, prenatal) and added a fertility one and a tincture that he explained in detail, but I can't remember the details other than that he was adding something for digestive health and stress. I've had issues with dairy before, so he advised trying to cut that out for a week, then the last day adding it to all three meals to see how I feel. If that doesn't seem to be the allergy issue, I'll add it back in and cut out something else the next week.

In a month or two when we're actively trying to conceive, the supplements will change, and once I get pregnant, they'll change again. He said that he knows of several herbs and supplements that are thought to help strengthen the amniotic sac and can help prevent pPROM.

Whether any of that is backed up by actual medical science, I couldn't tell you. But I'd drink the urine of a unicorn if someone told me it'd help. So I'm giving it a month or so to see what happens - whether my cycles become more regular, if I feel like I have more energy, if I'm sleeping better - and if so, I'll continue it. I'll also likely add in acupuncture at some point. It certainly won't replace modern medicine, but I'm hoping that supplementing it with a more holistic approach will help. And if it doesn't do anything, then no harm done...right? RIGHT?!?

Holiday cheer

I cannot WAIT for the 4th of July! It's my favorite holiday by far. Granted, I will have to deal with seeing the person I was talking about in my previous post (the friend that I've cut out as much as I can), but I'm hopeful that fireworks and s'mores will remedy that. What CAN'T fireworks and s'mores remedy, really? Not much, methinks.

I can't believe how fast this summer is going. It's hard to believe that it's been 10 weeks since I lost Caleb, and that when I was pregnant with him I thought this summer would drag on FOREVER. Not so! His due date is just around the corner...less than two months away. And with it is my birthday. I didn't remember until today how close our birthdays were supposed to be - mine is August 31; his was supposed to be September 3. Damn!! The two will always be associated in my mind.

I've spent most of the last 10 weeks thinking about next time. We've had so much advice from so many friends and family, and I seriously appreciate all the different viewpoints (and trust me, this post is directed at no one in particular...we've been hearing all sides for weeks now!!). Because my cycles were so irregular before - like, it's amazing it happened so fast with Caleb - I'd like to get going sooner rather than later [see: turning 30 in August]. The sad fact is that no matter what, if we get pregnant anytime in the next two years, this next baby (pleasepleaseplease let there be a next baby) wouldn't have been here had Caleb lived. However, I hope that our next child never feels like they are just a replacement, because truly they will have to some extent saved me. I did talk to the doctor about whether waiting any additional time could be beneficial; she assured me that it made no difference whether we waited three or four or five months. There have been some studies that have shown better outcomes if you wait a year or two, but, um, no way [see again: turning 30 in August]. This journey has already been long enough without stretching it out even further by waiting that long to even start trying. And it might take that long to just get pregnant, who knows?? I feel so much joy and hope and the prospect of finishing what we started back with our Big Fat Positive and I know that I'm ready when my body is. But I would never ever pressure Chris into trying if he wasn't ready. Ok...that's a lie. I would totally pressure him. But I'd never ever actually try if he wasn't fully into the idea. The sight of a plus sign on a test is going to be emotional enough; I don't need to feel nervous about his reaction on top of that - the same reason I never threw out the birth control pills before he was ready (despite the suggestions of several friends, an aunt, and a fortune teller.) (Ok, the fortune teller may not have said EXACTLY that but I was trying to convince myself that's what she meant so that it would be FATE that got me pregnant and not me cheating on birth control....who can argue with FATE?) (Well, clearly I can since I talked myself out of it.). Hopefully he comes around to three months; if not, then we'll wait four. In the long run, it's just a month and in the long run, September 3 is just an arbitrary goal that I seriously understand may not - probably won't - happen. I mean, it'd have to happen on our first shot, and while I'm sure Chris's boys are good swimmers, I'm not sure they're THAT good. I'm going to be gutted on September 3 no matter what, and if I have a bit of excitement to look forward to that day, then I'll take it. And if it doesn't happen....well, it'd be just a sprinkle of disappointment on the sundae that is life.

Wait, what?

Worst analogy ever.

In sad news, my mom found out that the college she's worked at the last four years is closing suddenly. She just found out yesterday - after a student called to ask her about it, no less - and school was supposed to start in just a few weeks. They're not sure if they'll be able to pay the teachers for July and August (which was in their contracts). She's completely devastated, and I spent today crying with her. I know it doesn't seem like a huge deal, but especially in this economy, especially in the post-secondary teaching world....it's going to be difficult to find a new position. I know that she just feels like the universe is dumping everything on our family and she's just waiting for the next shoe to drop. Hopefully fate is one-legged and there's not another shoe coming.

Good Lord, what is with these terrible analogies today??

In happy news, it's fricking beautiful out. Like the best weather we've had all year. I kind of want to take the next week off and just lay out back reading and sit on our porch and go camping and hiking and possibly float down a river in a barrel and be outside constantly. Mmmm. Just thinking about that makes me feel all warm and fuzzy. Is it wrong strongly resent work for keeping me inside during this weather?

Keep on keepin' on

Nothing really worth blogging about has happened recently. I'm almost mostly good. I am still sad. I still cry sometimes. I am excited to try again. I'm terrified to try again. I have pretty much had to cut one specific person out of my life and avoid her (not you, Rachel! Love you!) because I can't stand hearing about or seeing her pregnant. She's quickly approaching the time when we lost Caleb, and seeing her pass by that date is going to be a stab in the heart. If I'm entirely honest, I'm not excited for her. The jealousy and the feeling of unfairness has completely overshadowed any bit of excitement that should exist. Part of it is just who it is...there are other women who are having babies who I AM excited for. Still jealous of, yes, but there exists at least a modicum of excitement as well. Just not for this one person. It's just too unfair.

Chris and I are having a "debate" about when to start trying again. We were cleared to go after three cycles, but he wants to wait four just to be sure. My number one huge gigantic goal is to be pregnant by Caleb's due date, and if we wait four we won't hit that goal. It's unlikely that we'll get lucky enough to hit it waiting three cycles, and with four cycles it's impossible. He can't understand why it means so much to me to be pregnant again by that specific date, and I can't understand why he thinks waiting another cycle will be any safer. Since I need his cooperation, we'll probably wait four. But I'm continuing to try to convince him otherwise. I need some sort of bribery! Sex won't work (I won't have sex with you unless you have sex with me???). He buys himself all the gadgets and electronics he wants. Maybe clean, folded laundry every day so he doesn't have to root through a laundry basket for a pair of boxers? Putting on the "good wife" apron for a little while might just do it.

I just wish that the world wasn't chock full of reminders about what I lost. Example: Yesterday I went to the Summer Arts Festival - a local street fair - with my family, and not only was it apparently Pregnant Women Day, but the entire festival reminded me that last year when we went, Chris and I had just decided to try for a baby later that year so I went with the mindset of finding things for a nursery and child's room. Seeing those same booths this year - the wooden train here, the rubber ducky painting here - was such a slap in the face. HAHA! fate seemed to say, HAHA! Get excited about having a baby and be confident that you'll have one by this time next year and I'll show you!

Yeah, well, curse words and inappropriate hand gesture to you, fate. You sure showed me!

Planning Ahead

When I was pregnant with Caleb, I was extremely superstitious. I didn't buy anything for him until well into my second trimester. I didn't want to jinx anything. By the time my water broke, I had purchased a few outfits, but everything I had for him fit into one small box that is now packed up at my mom's house waiting for baby number two.*

I've always loved baby things, and started keeping a bookmark folder full of things I loved - toys, nursery decor, clothes, furniture - well before I was pregnant. Like maybe two years before I got pregnant (don't tell my husband!!). I came close to deleting it after Caleb died, but instead just renamed it and moved it so I wouldn't see it every day. After a month or so, I started slowly saving new things to it. Just one here, one there...but it was a start.

Yesterday I got an email that Threadless was having one of their rare $10 sales. Threadless is a community-based t-shirt design company, and on any given day there's a 90% chance that either my brother or my sister is wearing one of their t-shirts and a 60% chance that they both are (sometimes the same design). I don't wear t-shirts, but when I discovered that they sell onsies and kid's tees, I was beyond excited. So cute! When I found out I was pregnant with Caleb, I started stalking the Threadless site, waiting for one of those sales. The sale never happened in the five months that I was pregnant, so Caleb never got his Threadless onsies.

When I got the email, my heart leapt - and then sank. I had no reason to buy them.

But then. Then I had a revelation. Last time I was so cautious. I did everything "right." And a fat lot of good that did me. So screw it. I was going to take advantage of that $10 sale. And I was going to do it now, before the designs I loved so much went out of production.



And I did. I bought my next baby some onesies and some baby tees. I can't worry about what might happen next time. I am going to fully embrace the next pregnancy and the next baby and not be so superstitious. World, you will know when I'm pregnant the second the pee dries on the stick. I'm not wasting a moment before celebrating.

And maybe I'll have another loss. Maybe there won't be a next baby. I hope there will, but maybe there won't. And if that happens...well, I suppose the clothes will go to a niece or nephew. But I can't let that fear control me. I did last time, and I regret it.

So yes. I bought my as-of-yet-nonexistent-2nd-baby some clothes. And it felt great.



*I kind of love the idea that the next baby will have hand-me-downs from his or her older brother - just like in a regular, non-dead-baby family!

It's the final countdown!

When I wrote that title I had this song in my head. I feel like you should, too. So listen, and once it's firmly implanted, come back.

The doctor's visit on Friday was entirely uneventful. They reviewed the HSG results and the CT scan results and, based on the opinion of several different doctors, the test results were normal. It looked like there was a slight dip due to the positioning of the uterus, but after review they determined there was not. My uterus is tilted/retroverted fairly significantly.* That CAN cause problems if it's locked in that position, but during the exam she was able to move it, so that shouldn't have been an issue in my loss. A tilted uterus isn't considered a defect, per se - just a normal variant on the positioning, as something like 30% of females have it. So nothing in the scans came back abnormal, and all of the bloodwork came back negative (with the exception of hetero MTHFR, which again is fairly common - it happens in about 40% of the population - and also shouldn't have been an issue.).

The consensus? A terrible, horrible, no good, very bad, shitty piece of luck. A fluke. My doctor is confident it won't happen again - though, as we learned last week, that isn't a guarantee. All I can do is hope and pray it doesn't.

We're cleared again to start after two more cycles, and right now the plan is to do that. I can only hope that a) we get lucky and get pregnant again right away like we did with Caleb, and b) we get to take the next baby (and all subsequent ones!) home with us.

Fingers crossed!!!

*When this was originally started as a baby blog, I was planning on sharing this with my offspring so they could see how excited I was about meeting them. However, now there is 74% too much uterus talk for that to be feasible.

Don't you hate when you can't think of a title?

I had a minor freak out last night. I've actually been really good for a while*, so I am allowing myself that freak out without getting too mad about it. I went to a movie with a friend, and she took her adorable baby son. She nursed him during the movie and his little kicking legs and those sweet snuffling sounds babies make while nursing just totally got to me. I WANT ONE. I want one SO BAD. I can't even explain it, but you other DBMs or couples suffering from infertility, you know what I mean. The want and desire for a baby took my breath away. Even if we got pregnant right away when we are cleared to start trying again (hopefully in July or August), it would mean I wouldn't have a baby until May...and in May, I should have had an 8 month old. Thoughts like that are so frustrating! I mean, if I hadn't gotten pregnant when I did, we could easily still be trying and it wouldn't be that big of a deal. Right? But I did and I was and but but but. Those "buts" will be the death of me!


*The last time I got upset was over Memorial Day weekend. A couple weeks after we lost Caleb, a mutual friend [we'll call her Jane] let me know that another friend of ours [we'll call her Sally] was pregnant, because Jane didn't want me to be blindsided when Sally made her announcement. Sally decided to spill the beans at a party they were having. I had a feeling they were going to do that, so I skipped the party. Not only for my benefit, but because I didn't want the excitement or joy anyone at the party felt over the news to be tempered by my presence. Soon after I saw that congratulations started to arrive at Sally's Facebook page (dude, Facebook is seriously the devil for a DBM). I was a little irritated that Sally had never taken the time to tell me in person, but assumed Jane had told Sally that I knew [follow that??]. A few days later I saw Jane and asked her if she told Sally about telling me, and she said no, she hadn't. Not only that, but Jane specifically advised Sally that she should make sure to tell me before telling everyone else, and no matter how she did it - whether it was email, phone, taking me out to lunch - it didn't matter as long as she TOLD me. However, Sally didn't. She left me to find out (as far as she knew) on Facebook. And that's just.....that's just cold. I was hurt and offended and a little shocked. Initially I had written it off as Sally just not knowing what to do, but to be told to let me know and still not do it? That's just insensitive. I've refrained from writing Sally a note to tell her how horrible it made me feel, because I'd have to out Jane in the process, but I want to. I've written her notes in my head, though...sent with a flaming bag of dog poop.

**Whoops. My postscript is longer than my actual post. Apparently I had things I needed to get off my chest. Ahem.

Around the corner

It's been a really good week. Being so confident in the upcoming tests has done amazing things for my emotional well-being. There are only two possible outcomes: they find something, or they don't. And I'll be thrilled with either one. If they find something, we can fix it. If they don't find anything, then it really was just a terrible fluke and chances are it won't happen again. At least it shouldn't. I made great strides with karma over the weekend by making a preschooler's LIFE by giving her a pack of glow sticks (which she continually called glue sticks, only adding to the adorableness). It wasn't perfect. I felt a few pangs of loss when playing with her 7-month-old brother, who is doing his part in keeping the cute baby tradition alive in their household with his easy smile and eight-mile-long eyelashes and giant blue eyes. Seeing his dad interact with him took me straight to how Chris would have been with Caleb. Carrying his car seat into the restaurant where I ate with his mom and dad was a physical reminder of what I should have had. Changing his diaper, pinching his toes, tickling his chubby legs...I should have had that. I want that. I hate that I don't have that. But knowing that the testing is being done gives me confidence that I will have that. It just won't be with my first baby boy, Caleb. Which is unfair. So flipping unfair. But I will have it with his little brothers and sisters. (However, despite this leap forward, I haven't made it so far as to unhide all my pregnant and new mom friends from Facebook. One thing at a time!)

But it was a very normal holiday weekend. I hung out with my family, I hung out with friends, I even got to hang out with my husband a bit! There was no crying. There was a lot of laughing. The raw open edges of my heart have worn away to a dull ache...always there, but not always causing pain. Normal. I can haz it.