I apologize in advance if this is TMI…

I do apologize in advance if this is TMI but I promised I would be more open sharing about the difficulties of fertility issues and our pregnancy loss, and coming up: Trying to Conceive again. This week I got my period back. Aside from being physically brutal, the first period after a pregnancy loss is also emotionally bittersweet: it’s sad because it means my body has completely put the pregnancy behind it.  My body has totally moved on and is ready to try again.  My ovaries have figured out that they need to ovulate again and my uterus has shed its lining and is ready to get pregnant again. But it’s also nice to know that things are moving along as they’re supposed to and returning to normal. It’s nice to know that my body no longer has pregnancy hormones, and that I’m physically back to baseline.

We’ve talked about the fact that we still really want to have another baby but that if we were to experience a third pregnancy loss we would probably be emotionally destroyed so we are probably going to give it one more shot and then if it doesn’t work we will consider not trying again.  I’m not ready to jump right back into taking my temperature and charting my ovulation, so for now we will take the “don’t try, don’t prevent” approach and let nature take its course.  If, in a few months from now I’m still not pregnant then we’ll probably do the whole temping and charting thing, but for now I feel like it’s okay to give my body a bit of a break.

We also need to focus on settling into the community here a bit more and finding more fun things to do.  The first few months we were here, we were so distracted by everything… Ken’s new job, my long commute, Julia’s new school, our new house, etc. that we didn’t really have time to build a community for ourselves but now that we have been here a while and Ken is settled into his practice, we have started making friends, getting involved, getting Julia into activities and it’s really starting to feel like home.  Over the weekend I took Julia to SkyZone (a trampoline place that she absolutely loves) and we went out to discover a new (to us) playground which was really awesome and which she loved!

We joined the JCC and I took Julia to a PJ Library event there a couple weeks ago.  We also started doing swimming lessons there a while ago and Julia will be heading there for their summer camp this summer!

Over the weekend Ken took Julia to the JCC for their Daddy-Daughter Date Night!  She had been excited about it for weeks.  Pretty much as soon as she heard that she could go to a dance with her Daddy, she was so excited about it.  She picked out the dress she wanted to wear and I took her to get her nails done the day of the dance.  They looked so adorable!

At the dance, they had a DJ, a photo booth, and the dinner they served was pizza and tater tots, with ice cream for dessert.  It’s a little girls’ dream come true!

After they got home, I asked Julia which was her favorite song she danced to, and she said “the slow one!”  She kept raving about how she “Danced the night away!”  It was pretty adorable, if you ask me!

In addition to finding activities to get involved with, we’ve been spending some nice time at home recently because Ken has been busy studying, so Julia and I have had a few lazy days at home, watching movies, playing with her toys here, etc.

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After all the activity that I like to plan it’s nice to have a few lazy days here and there!  We do of course have a lot of exciting things coming up which will distract us from the sadness we’ve had over the last few weeks, and will hopefully keep our minds off of “trying again”.  Ken’s parents are coming in town this weekend to celebrate his birthday, Ken is heading to Philadelphia next weekend for a board review course, Julia and I are going up to Connecticut the following weekend for Adam & Jenn’s engagement party, and two weeks after that I’m heading to Arizona for my friend Blair’s wedding!  Blair was a bridesmaid in my wedding and I have known her now for 13 years (!) so I am so excited to celebrate her marriage and see her on her wedding day! It will also be nice to get away by myself for a few days.  My parents are meeting me in Arizona and we’ll be doing a few activities together before the wedding.  It will be nice to have some time with them without Ken or Julia around (I love you both but it’ll be nice to have my parents all to myself for a few days!)

Now that this pregnancy loss is fully behind us physically, I suppose my blogging will turn back to regular every day life… and eventually, if I feel comfortable sharing, “trying to conceive.” So for now, over and out.

Today I did a thing…

Today I did a thing I had been dreading doing for a little while.  I threw away the Pregnancy Journal that I had bought, intending to keep track of the milestones in this most recently lost pregnancy.  I waited to buy it until after my 6-week appointment, when I was told that everything looked great.  There was a beautiful embryo, a lovely little heartbeat, and the Doctor told me he didn’t need to see me again for 4 weeks.  Encouraged by that news, I went out and bought a Pregnancy Journal to keep.  I loved keeping a pregnancy journal when I was pregnant with Julia and I wanted to give this pregnancy the same attention to detail and the same love that I gave Julia because I know that Julia loves to ask questions about when she was in my belly, and some day it will be so nice to share my journal with her.

As I threw away the pregnancy journal (which is now sitting in our trashcan with wilted flowers, some scrambled eggs that Julia didn’t eat this morning, and the peel of a clementine), I thought about how I might do things differently if and when I get pregnant again, and how I might think differently.

When I first got pregnant with Julia, I was all smiles.  I was excited, hopeful, optimistic and overjoyed to be pregnant, and after only one month of trying!  Sure, there was a part of me that worried about what could happen since we knew about my unicornuate uterus and the risks that brought to a pregnancy, but because it was my first time getting pregnant, I was mostly just excited to know that everything seemed to be in working order.  I immediately went out and bought a pregnancy journal… we told all our closest family and friends right away, and luckily everything went well.  We never had to un-tell anyone, we didn’t have any complications and at the end of 37 weeks and 6 days, a beautiful and healthy baby girl was born.

The second time I got pregnant, I had that same joy and excitement.  We were in Las Vegas when we found out, and we told the friends we were with.  We also called our parents to let them know the exciting news.  I didn’t buy a pregnancy journal until we got home to Baltimore, but then just a few weeks later we were given the awful news that we had just an empty gestational sac and that it was a partial molar pregnancy.  We had to un-tell our friends and family, we had to throw away the journal, and we had to sit with the disappointment and heartbreak for months as I went in week after week for blood tests and 2 D&Cs.

After one loss, getting pregnant again this most recent time we were both hesitant to get too excited.  We told fewer people this time than we had last time (though I am still of the opinion that I would rather people know so we can be surrounded by love if anything goes wrong than keep it to ourselves and have to suffer in silence).  Ken was better at keeping his excitement in check… he said that he was “cautiously optimistic” and “nervously excited,” but I immediately started making plans in my head… I’d be almost 20 weeks at Blair’s wedding and I’d be showing by then and would need a maternity dress.  I’d be over 30 weeks at Adam and Jenn’s wedding and would surely need a fancy maternity dress for that occasion.  I’d be due in the middle of the summer, but luckily Julia would be in summer camp then, and she’d have a 1-month old baby sibling by the time  school would be starting.  We all know what happened this time…

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So there sits my pregnancy journal in the trash can.

Next time, how will we feel?  How will we act?  Will we do anything differently?  Will we tell fewer people?  Will we be less excited?  Less hopeful?  When will we feel ready to tell people, ready to buy a journal?  Ready to post about it on Facebook?  Will I feel comfortable telling people I’m pregnant before it’s been confirmed on ultrasound?  Before we get past the first trimester?  Before I’m showing?  Who knows… it’s hard to say.  But I do know that having 2 pregnancy losses definitely will affect our feelings the next time.  I don’t know how, and I’m not prepared to make any grand plans about how we’ll do things differently because I know myself, and I know that I like to share exciting news, I like to be surrounded by supportive friends through happy and sad events.  But I don’t think I’ll be overjoyed like I was the first two times I got pregnant.  I don’t think I’ll count weeks on the calendar to figure out how far along I’ll be for various upcoming events.  I think when I see “pregnant” pop up next time, I’ll feel scared, terrified, nervous, and a little bit hopeful.  Will I feel comfortable telling my parents again, and risking breaking their hearts?  Will we want to tell Ken’s brothers and risk having to get those well-meaning but terrible to hear phone calls from family telling us how sorry they are to hear our bad news?  I don’t know.  Only time will tell.

Why we Marched

Dear Julia,

On January 21, 2017, the day after Donald Trump was inaugurated as President of the United States, we woke up at 7 in the morning and drove two hours down to Washington, D.C. to go to the Women’s March on Washington.  Getting to the march was an adventure in and of itself–we parked a mile from the Metro Station, walked in the cold to the Metro with you on my back in the Toddler Tula and all our snacks in a plastic bag on your stroller, we waited in a line that wrapped around the parking lot just to get in the metro, then we got on a train which took over an hour to get us to our stop.  You complained the whole way there that you didn’t want to be in your stroller, but there were no seats for us.  The metro was crowded, hot and stuffy, and you ate about half our snacks on the metro.  Once we got there, it took at least 15 minutes just to get out of the metro station because it was packed full of people.  And then when we got outside, despite my best attempts to meet up with friends of ours who were also in DC for the march, it was impossible to get where you wanted to go because it was so crowded and it was difficult to get in touch with anyone because the cell service was awful.  But once we got there, the experience was incredible: thousands and thousands of people, many with pink pussy hats on, many with poignantly written signs, many chanting various chants about democracy, our rights as women, and our dislike of Donald Trump.  You are 4, so you asked a lot of questions.  The whole way there you asked, “When are we going to be there? How many more minutes?” and I tried to explain to you that we were going to a march with a lot of other women.  I wore my “Nasty Woman” shirt and you picked out a rainbow shirt which was perfect for the occasion.

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The whole day I tried to answer your questions as best I could, but because you’re 4, you didn’t ask all of the questions, and I certainly couldn’t really explain to you fully why we marched so here is my attempt at explaining to you why we marched together as mother and daughter on January 21st.

When I was little (about your age), my mom took me to two marches… I don’t really remember either of them but I’ve heard the stories. One was about pro-choice issues, and one was a Gay Pride parade. Even though I don’t remember them, I’ve always felt like that was the beginning of my starting to understand why it’s important to stand up for what you believe in and stand up for those you care about. So even if you don’t remember our day, I have pictures to show you and stories to tell you, and even now (almost 2 weeks later), I still love hearing you chant, “Show me what democracy looks like! This is what democracy looks like!”

When my mom (your Gaggee) was younger, she marched on Washington for women’s rights, the right to choose, equal rights for Blacks and Whites, and other vitally important issues of human and civil rights.  We marched on January 21st because it is sickening and disheartening that we are still fighting for these same issues over 40 years later.  My mom marched in the hopes that I wouldn’t have to fight the same battles she fought and now I marched for you in the hopes that you don’t have to fight these same battles.  These issues should have been settled long ago and we should not be fighting again and again for the same things. (Sure, new issues come up all the time as society changes and technology advances, but we should not still be making arguments about why a woman should be the one to decide whether or not she wants to go on birth control, whether or not she wants to have an abortion.  We should not be arguing anymore about the fact that women should be paid just as much as men for doing the same job they do as well as they do it.  We should not be arguing about the fact that inner-city Black kids deserve the same educational opportunities that suburban White kids have.)

We have kept you shielded as much as possible from the ordeal we just went through, but if Donald Trump and his people have their way, the decision we just had to make would be illegal, or at least significantly more difficult than it was.  Cause call it what you will, I just had an abortion.  We terminated an otherwise viable pregnancy.  We saw and heard the heartbeat.  We saw the embryo with its little “crown” and “rump.”  The little thing inside of me could have grown into a baby.  There is a small possibility that I could have carried that pregnancy to term, but making that choice could have put my life in grave danger, and could have left you without a mother and Daddy without a wife.  Given all the information available to us, I decided that taking that risk was not worth it.  Instead, I chose to continue with the other (the “good”) side of my uterus intact in the hopes that some day we can have a healthy pregnancy on that side and carry a little sibling for you to term. Believe me, the decision we made was not an easy one, but it was one we had to make and one we were free to make on our own, as a family, based on our beliefs, our hopes for the future, and with the advice of my doctors, who gave us all of the information they possessed.  Nobody pressured us to make a decision one way or the other and I never felt judged for making the decision we made.  That is how it should be.  NOBODY should ever be allowed to tell another human being (well… with limited exceptions (I’m a lawyer, what can I say?)) what choices they should make for their body.  Pregnancy is not an easy thing and nobody should ever be forced to go through a pregnancy that they do not want.  I don’t care what the reason is that they don’t want it… NOBODY should be forced to go through a pregnancy that they do not want.  It’s your body, it’s your choice.  The choice that we had to make was made ever so slightly easier because, from a Jewish perspective, there was only one choice to make.  In Judaism, life does not begin until birth and in the case of choosing between the life of an unborn baby or the life of a mother, the life of the mother is always considered first.  But even if I just didn’t want to be pregnant, that should still be my choice to make.  Even if the condom breaks, it’s a woman’s choice to decide what should happen to her body.  If a woman is raped, it’s her choice and her choice alone what to do with her body.  And that is why I marched.  Because YOU should always be allowed to make the decisions that you want for your body.

Ever since I can remember, I have wanted to be a mother.  I wanted you so badly and was overjoyed when I found out I was pregnant with you.  I am so happy I got the little girl I always dreamed of having (a boy would have been cool too, but I really really wanted a little girl!) and you are everything to me.  Yeah, I complain sometimes that you’re stubborn like your daddy, and that you’re defiant and too smart for your own good, but you are such a smart, confident, creative, loving and wonderful little girl and I hope you always know how much we wanted you and how much we love you.  I marched on January 21st for you, for your future, and to show you that you can do anything you put your mind to.  These days you tell us you want to be an Obstetrician when you grow up.  If that remains true, I hope you get there some day.  But I want you to know that whatever you want to do, you can do it.  Don’t ever let anyone tell you that you can’t do something because you’re a girl.  I marched on January 21st because I love you more than you can possibly imagine and I want you to know that you have a world of possibilities open to you always.

Love,

Your Mama

 

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Recovering

Well I’m now a little over a week post-op and am starting to feel normal again.  Mostly I’m so happy to have this whole experience behind us and I’m excited that we can start to move on physically from this pregnancy loss.  Emotionally I’m sure there will be little reminders here and there, but physically this loss is completely behind us now.  The next steps are for me to get my period back and then we’ve been recommended to wait 3 cycles before we start “trying” again.  I’ve already resumed taking my pre-natal vitamins and extra folic acid, so I’m ready as soon as we are given the “all-clear.”  And luckily now that my OB practice here has followed me through this whole ordeal, they know about me and are willing to see me right at 6 weeks when I get pregnant next.

My mom arrived Sunday before my surgery, and it was so nice that she was able to come help.  Julia and I picked her up from the airport and then the three of us went out for a girls dinner.  Monday was a good day for us to show my mom the routine… how to get to school, etc. and Julia also had her first swim class!

Tuesday, Ken and I had to leave bright and early to drive down to Baltimore.  We checked in and then they started all the pre-op things… a urine test, blood pressure, etc. The nurse was very confused when my urine pregnancy test came back positive.  The thing that was most annoying about this whole ordeal was having to explain what was going on to so many people over and over again. The whole reason I was having this surgery was because I was pregnant and the pregnancy implanted in the wrong place, and yet the nurse was confused about why my pregnancy test came back positive. I kept wanting to put a post-it note on my forehead saying “yes, I know I’m pregnant.”

Once I was all done getting checked in, Ken was able to join me and we sat and waited for a while until they wheeled me back for surgery.  All-told the surgery took about an hour and forty-five minutes.  I was in quite a bit of pain when I first woke up, but they gave me some pain meds that took care of it.  I was admitted for the night onto a VIP floor where they had fancy bottled water, no techs (only nurses), free coffee and tea 24-hours a day, and some other nice amenities.  Apparently it was an accident that I was admitted to that floor, but it was a nice accident to have happen to me! That night I had a couple of visitors stop by after Ken went to Pete & Sarah’s house to sleep.  I took the advice I have always been given about abdominal surgery, which is to get up and walk as quickly and as often as possible and I think that really helped my recovery process.

The next morning I was still in quite a bit of pain, but I definitely felt ready to head home and sleep in my own bed! 2-2-20176

We got discharged a little after lunch and Ken drove us back home, where I proceeded to get back in bed!  My co-worker, Nichole sent me the most fuzzy and cozy bathrobe I have ever seen, and it was so nice to know she had been thinking of me! 2-2-20175

I pretty much spent the next 2 days in bed… getting up just to walk around a little and use the bathroom, but within a couple days the pain started to get much better and I felt well enough to get out a little bit.  At this point, a week and 2 days post-op I am feeling mostly back to normal.  I still have some tenderness in my belly around the incisions and I still find myself getting tired if I over-do it, and in the mid-late afternoon, but I’m sure that will subside over the next couple of days.  We have a busy weekend planned, and then on Monday afternoon I’ll go for my 2-week post-op appointment with the surgeon, at which time she will write me a back-to-work note.  I’ll probably go back to work either Tuesday or Wednesday, but probably with limited driving the first couple weeks back.  Spending long periods of time in the car, sitting in one position, is probably not great for the internal healing that needs to happen since it causes additional pain and tenderness.

Overall I would say the experience I had at Hopkins was amazing.  All the nurses, doctors, techs, residents, everyone… was professional, kind, courteous, explained things well, etc. It’s not somewhere I would want to go for routine care but with something as rare and bizarre as what I had going on, I was so grateful for the care they provided.

And at home, it was nice to know my mom was holding down the fort while I rested and got back to normal.  My mom was originally going to go home on Sunday, but she decided to extend her trip a bit and stay until Tuesday so that she could help out with Julia’s second swim class and so she could visit with Uncle Neil & Aunt Karen and with Rachel (all of whom came to visit over the weekend!)  It was nice to visit with them, and I’m glad I had my mom’s help for the first two days of the week with getting Julia to and from school.

Now that my mom went home, we are trying to get back onto some sort of routine.  I’m glad I still have a couple of days to relax a little before I need to get back to work, and I’m looking forward to the fun things we have planned for this weekend.

I’m still anxiously awaiting the time I can finally write my post about “Poppyseed 2.0 being on his/her way” after a healthy pregnancy has been confirmed, but until that time I’ll keep you posted on our every day life and some of the amazing things our 4-year old is doing these days!  Maybe I’ll even be a little more open this time around about our “Trying to Conceive” experience for those who find that sort of information helpful.

 

Surgery Scheduled!

After being given a bit of a run-around on Monday afternoon, I am so glad to finally have nailed down a surgery date.  My surgery is scheduled for January 24th at 1:45 PM.  On Monday afternoon I was first told that there was a possibility my surgery wouldn’t be until the end of March… so then I put my tears to good use and cried on the phone with several individuals until I was told that the surgical coordinator would work with me to get me scheduled as soon as possible.  Finally Tuesday morning I was given a date and time.  It is such a relief to know that we are getting this taken care of soon and that after that we can move on with our lives and try again.  I guess in this case being a squeaky wheel paid off!

Now that my HCG levels have dropped significantly, my body seems to be responding to the decrease and has started doing what it’s supposed to do (aka shedding the endometrium on the good side of my uterus, which is rather unpleasant since it’s had 10+ weeks to build up).  My follow-up appointment with the MFMs yesterday showed that the gestational sac in the horn is starting to decrease in size, and is sort of collapsing in on itself since it’s now somewhat irregularly shaped.  But the embryo is still very clearly there, still the size of an 8-week embryo, which was emotionally difficult to see.  The Ultrasound Tech offered to turn off the monitor, but my own morbid curiosity got the better of me and I wanted to see what the doctors were seeing and understand what they were talking about.

I feel so very lucky that my mom is retired and financially well off enough that she is able to come help us out while I have my surgery.  She will arrive next Sunday, the 22nd and will stay with us for a week.  That way she can stay at home with Julia while Ken takes me to Baltimore for the surgery, and then my mom can help get Julia to and from school while I’m home resting and recuperating after my operation, and Ken can still focus on the studying he needs to do for his Boards.  In the evenings while I’m still recovering, one of them can take care of me and one of them can take care of Julia.

Before then though, we still have this weekend to plan… I’ve planned a date night for the two of us for Friday night… we are going to a little Italian restaurant in Harrisburg called Mangia Qui (which I’m excited to try since their menu looks awesome!) and then we are going to go see Hidden Figures.  Saturday Julia has soccer during the day, and I’m hoping we can find a time either Saturday afternoon or Sunday to go back to the Farm Show to check out some of the things we may have missed and maybe to get one more milkshake or possibly some fried mozzarella cubes, or potato donuts!  Monday Julia is off from school for MLK Day so I’ll have to plan something fun for the two of us to do with a day off from school and work.  I’ll see if I can make it a fun adventure-filled day since I won’t be able to have one of those with Julia for a little while after my surgery.

That’s all for now… I’m sure I’ll have another update before my surgery!

Just keeping ourselves busy!

This weekend was a very busy one but was a lot of fun!  We’ve been trying to keep ourselves busy and distracted so we keep our minds off of what is going on.  Friday night we had a family date night in with Shabbat dinner and a movie night (we showed Julia The Princess Bride since she is now willing to sit through non-animated movies)!

Saturday we had Julia’s first indoor Soccer Shots class, which was a lot of fun.  The coach was great–he’s very energetic, keeps the kids engaged, and Julia did pretty well listening and having fun. She’s very competitive (gee, I wonder where she gets that from?) so when the other team scored a goal and her team didn’t, she got very upset, but I tried to remind her that it’s about having fun and doing your best and that’s all that matters.  Hopefully she’ll keep that in mind throughout the season.

After soccer, Julia’s friend Jonah from her old school came over with his Daddy and the four of us went to the Pennsylvania Farm Show!  Luckily the “Farm Show Complex” is only about a 5-minute drive from our house because this event is like the event of the year here in Central Pennsylvania.  The event takes up the entire huge complex, and there are so many neat things to see… on Saturday we only saw about a quarter of what there was to see, so Ken and I went back on Sunday with Julia to see the parts that we missed.  There’s a big food court with unique items such as milkshakes, potato donuts, fried mozzarella cheese cubes, and burgers that are made out of 70% beef and 30% mushrooms.  There’s a big area focused on farming and agriculture, where we got to see some baby pigs, chicks hatching from their eggs, and some 3-month old calves.  There’s also a ton of vendors showing off all kinds of farming equipment and farming techniques.  In a separate area there are arts and crafts demonstrations (Julia got to watch some spinning, weaving, a pottery wheel, etc.), baking and cooking demonstrations, and the traditional county fair-type prizes for best apple pie, best chocolate cake, best quilt, best hand-sewn item, etc.  Overall the farm show was a lot of fun and certainly a uniquely Pennsylvania event, so I’m very glad we went!

Saturday night we also took Julia to a Hershey Bears Hockey game!  She did surprisingly well given that it was a 7 pm game, but when we finally got home she was totally exhausted and a little bit of a mess (she also woke up WAAAAAAAYYY too early Sunday morning, so we ended up needing a 3-hour nap in the morning on Sunday).  We went with another family with their 3 kids (and the friend of one of the kids), so Julia had a lot of fun playing with them while us parents watched the game and chatted.  We had a really nice time and hope to get together with them again soon!

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This morning I heard back from the doctor about my most recent HCG test result.  Luckily my numbers are dropping very quickly.  Last week it was still up to 119,472 but this week it’s down to just 18,000 which is a nice big drop!  Theoretically as my body starts to see it come down closer and closer to 0, the “good” side of my uterus should catch on and should start cramping and bleeding so my body can start cycling again and going back to normal.  I’m still waiting to hear from the surgeon’s coordinator about scheduling my procedure and I’m hoping it can be soon.  When I spoke with them last week it sounded like it could probably happen toward the end of the month.  This week I go back to Hopkins on Wednesday, where they’ll be checking the size of the gestational sac to make sure it’s continuing to get smaller and to see if my body is starting to reabsorb things.  I was talking to a new friend of mine over the weekend, who had 4 pregnancy losses and she totally understood what I meant when I said that our loss last year was much more shocking and emotionally difficult to process, mostly because it was our first one but that this one was less of a shock because it sort of felt like a continuation of our loss from last year, or like a cruel joke from the universe that since we handled our loss last year so well we could of course deal with another one in such quick succession.  I sort of feel like I’m ready to just put it behind us by having the surgery and moving on with our lives.  I don’t really want to wait to start “trying” since I’ve heard your fertility is greatly increased in the few months immediately following a pregnancy loss so it’s possible that I could get pregnant fairly quickly again this time around.  It’s crazy to think that when I get pregnant again, this will be my 4th pregnancy.  Hopefully this next one will be a bit more successful than the last two!

Wait and see… wait and see…

Yesterday was another difficult day for us for this pregnancy loss… we drove down to Hopkins yesterday afternoon for a follow-up with the doctors who performed the procedure on Friday.  They wanted to check the size of the gestational sac and make sure that things were progressing as they expected them to.  We were also expecting to meet with the Minimally Invasive Gynecologic Surgeon to get some of our questions answered.  Unfortunately her daughter fell on the playground so she had to go pick her up and we weren’t able to meet with her but we are expecting a call from her sometime today to hopefully answer some of our questions.

The good news is that the Doctor saw exactly what she wanted to see: no signs of fetal cardiac activity (that’s never something I imagined I would be happy about, but I suppose in this case that’s a good thing?) and the size of the gestational sac does not appear to have grown.  The bad news is that now we are in a wait and see pattern… we have to wait and see if my HCG level starts to come down in response to the methotrexate and if the size of the gestational sac starts to decrease.  If my HCG levels don’t start to come down, that could be a sign that I need a second dose of methotrexate.  So for now, I have another blood test scheduled for tomorrow and then I’ll need weekly blood tests for the foreseeable future (feels like we’re watching last year on repeat). I have another follow-up scheduled in 2 weeks for a repeat ultrasound to check on the size of the gestational sac.  I think they’re hoping to start seeing the size going down and to start seeing some of the tissue/fluid being reabsorbed by my body.  Until then I just have to deal with still feeling pregnant (sore boobs, 1st trimester exhaustion, hunger every 2 hours, occasional queasiness/dizziness, and occasional cramping) while knowing that I’m not really pregnant anymore.  It’s a weird state to be in.

I’m hopeful that the surgeon can answer some of our questions today and that her answers are what we want to hear… but for now we will just wait and see.  Wait and see.

My Village & A Thank you to the Pumpkin Patch!

Today I was working from home while my Mommy took Julia out to a science museum.  I wasn’t expecting anyone, but the doorbell rang… a flower delivery man was there with a beautiful pink, purple and orange flower arrangement and a little gift bag.  I had no idea who they were from since I hadn’t received a message from anyone that I should expect anything… but when I opened up the card that came with the flowers, it said it was from The Patch!

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A few tears welled up in my eyes.  I am blown away by the generosity of this amazing village of women who rally to support one another through difficult times.  I shared what I went through last week with them and had no idea they were planning on sending me anything, especially since it’s right around the holidays and people are busy visiting family and friends for Christmas and New Years.  It’s a stressful time of year already but it was so amazing that they rallied to support me through this sadness that Ken and I are going through.  In addition to the flowers, they also sent a beautiful figurine of a woman holding a bouquet of flowers.  It’s beautiful and so meaningful to me that they thought to send these to me.  Last but not least, they sent me a gift card to a local day spa so that I can get a little bit of pampering for myself to get myself through this.  I’m thinking I’ll treat myself to a massage and a facial a little closer to the time I’m having my surgery just to make myself feel better about this whole awful situation.

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I feel so lucky to have found myself in such a wonderful group of moms from all over the US (and Canada!) and I cannot begin to thank them enough.  They say it takes a village to raise a child, and I don’t know how I could do it without my virtual village.

Thank you to the Pumpkin Patch!  With love from me, Ken & Julia!

A weird in-between state

In many ways our loss this month is very different than the loss we experienced last year.  First: last year’s loss was the first time we were faced with that kind of sadness and devastation, so in some ways this one seems like less of a shock (it’s as though the world is playing a cruel trick on us).  Second: last year all we had was an empty gestational sac that had to come out one way or another whereas this year we had a healthy little embryo with a healthy little heartbeat.  Third: last year the physical loss was significantly more traumatic than what I’ve gone through so far because I had to have 2 D&Cs with weekly HCG tests for 3 months afterwards, and I had bleeding and cramping for the entire time between the first D&C and the second one.  This time, I had the injection on Friday and since then have had nothing but minor cramping for the first day or two.

Right now I feel as though I’m in this very weird in-between stage between being pregnant and not being pregnant.  My body still thinks I’m 2 months pregnant.  The doctors anticipated that between Friday (when we got the methotrexate injection) and today, my HCG levels would rise, which means my body still thinks it’s preparing to house an embryo for the next 7 months. I’m still experiencing some of the physical signs of pregnancy: sore and tender breasts, hunger every 2 hours, occasional light-headedness/queasiness.  But I know that on Friday the doctors injected the sac with methotrexate to terminate the pregnancy and I know that whatever is still inside of me needs to be reabsorbed or come out somehow.  Physically nothing is happening at the moment: I’m not bleeding or cramping, so it feels like once again, my body is failing me and doesn’t know what to do.  My body thinks I’m pregnant but my mind knows I’m not, and that’s a weird place to be.

I’m hoping that on Wednesday we’ll be able to see what size the gestational sac is and we’ll have a better understanding of when we can expect things to happen, when my body will start to expel this pregnancy, when my HCG levels will come down, when we can expect to schedule the surgery to remove the horn, and then when we can try again (if we decide that’s what we want).  We want to have the surgery done as soon as possible, but we also need to make sure we have some additional help at home around the time the surgery is scheduled.  My mom has a trip planned to Harrisburg for mid-February, and Ken’s parents are  planning to come for his birthday weekend.  If we can schedule it around their trips, that would be ideal since they’re already planning to be here and we could have help from my mom and then from Ken’s parents, but if waiting until their trips are scheduled means delaying the whole process more than necessary we might just see if we can get some help from local friends and family (cousins, friends in Baltimore who might be able to help out a bit, etc.)

One of the weirdest parts of this pregnancy loss is that we are in such a small group of people who have experienced this specific type of loss such that there is so little information out there about what we can expect.  I didn’t have a normal ectopic pregnancy so people who had normal ectopics can’t really tell me what to expect.  Last year at least I had a lot of friends who had undergone D&C’s and they could tell me what to expect.  Nobody we know has experienced this so we don’t really know what we’re facing in terms of my numbers dropping or the physical symptoms I am likely to endure in the next few weeks.  So we feel very alone in this experience and unsure of what the future may bring.

Our Yesterday

Yesterday morning Ken and I woke up bright and early (really we couldn’t sleep much after about 3 AM because of nerves and fear) and drove down to the Johns Hopkins Hospital for our 8:15 AM appointment at the Center for Fetal Therapy.  The Ultrasound Tech called us back and did a very comprehensive hour-long ultrasound to see the baby, the heartbeat, where the baby was located and to try to get a sense of my weird and crazy anatomy.  She was amazing–talking to us throughout the whole exam, explaining to us what she was looking for, what she thought she was seeing, what she wasn’t seeing, what her impressions were, etc.  She picked up on our cues… when we were feeling sad, she had the appropriate tone of seriousness and when we were cracking jokes to lighten the mood, she did the same thing with us.  When she was done, the two doctors who started the practice came in to talk to us and do a little bit more imaging.  They were both incredible.  They had the best bedside manner of any doctors I’ve ever had the pleasure of meeting.  They explained things to us the whole time, gave us their thoughts and opinions, fully talked through things with us, and really gave us a complete understanding of what was going on.

Specifically what was going on was somewhat of a mystery to them because even as the world-renowned experts in Maternal and Fetal Medicine at one of the best hospitals in the country (I think it switches places between #1 and #2 along with Brigham & Women’s, the Mayo Clinic and UCSF), they had never seen what I presented to them: pregnancy in the non-communicating rudimentary horn of a unicornuate uterus.  Aside from the location of the pregnancy, everything looked normal: they were seeing a normal and healthy looking embryo right on track for 8 weeks, with a beautiful heartbeat of 160 beats per minute.  This presentation is so rare that in a quick literature review online we were only able to find about 15 cases of this ever happening… only 2 or 3 of them had positive outcomes and the rest had negative outcomes, resulting either in late pregnancy loss or even in maternal death.  So after talking to the doctors for a while, they presented us with our options: continue into essentially uncharted territory with a very high risk pregnancy which could theoretically continue as late as 36 weeks but would also have the potential to rupture anytime after 10-12 weeks and could threaten my life or at least threaten the loss of my entire uterus… or terminate the pregnancy with an injection of methotrexate directly into the gestational sac, followed by a surgical resection of the rudimentary horn, which would leave the other part of my uterus intact in the event that we decide we want to attempt pregnancy again.

Before we arrived at Hopkins, we didn’t think we would ever have this choice.  We thought it was too risky and they would tell us our only real option was to terminate the pregnancy.  Having the choice made me a little bit hopeful but also made the whole situation a whole lot more difficult emotionally.  They let us stay in the room for over an hour… we called Ken’s dad and called our dear friends Rabbi Uri and Dahlia to seek their spiritual counseling.  Ultimately, the doctors came back in to speak to us and we made the decision that we are not willing to take the risk and the chance of uterine rupture and potentially losing the option to have any future pregnancies.  They took a blood sample and sent us out for lunch.

Our friends Michael (who did his residency at Hopkins and happened to be at the Hospital yesterday) and Pete (who happened to be nearby) came to join us for lunch, which was a nice distraction while we waited for the doctors to call us back. Once they got the medication from the pharmacy, they called us to come back up to the clinic.  Luckily the procedure itself did not take very long and was not particularly painful or uncomfortable for me.  The whole thing took about 20 minutes from start to finish, and they then sent us on our way.  As far as follow-up is concerned, I will have to have a couple of HCG checks similar to last year to make sure my HCG is dropping appropriately.  I will go get blood tests on Tuesday and Friday this week, and then I imagine we will need to make sure it gets all the way down to 0.  On Wednesday we need to be back at Hopkins for a repeat ultrasound to make sure that the size of the gestational sac is getting smaller.  We are also going to meet with a minimally invasive gynecologic surgeon to talk about resection of the rudimentary horn to make sure this never happens again.  The MFMs were not entirely certain about the timing of that surgery but they said that most likely it could happen once the size of the gestational sac has plateaued, which I imagine will take about 6-8 weeks.

So physically, this pregnancy loss is mostly behind us at this point.  There is still some bleeding and cramping in my future while my uterus sheds its lining, but aside from that the physical pain is over with.  The procedure was fairly painless and right now I’m not experiencing much more than minor cramping. But the emotional aspect is still very present.  We both feel very sad about what we just had to endure.  This loss was very different than the one we experienced last year.  Last year all we had was an empty gestational sac with no embryo, no heartbeat.  This time we had a healthy embryo with a beautiful heartbeat.  The only problem this time was the location of implantation.  Last year there wasn’t really a choice to be made: there was unhealthy placental tissue that needed to come out one way or another and my body hadn’t decided to expel it on its own yet but there wasn’t the heartbreak of seeing a healthy little embryo. Last year’s loss was more of a shock in some ways because we had never experienced a loss and had a perfectly healthy and easy pregnancy with Julia so we never expected it to happen.  After the heartbreak of last year this loss seemed less shocking but more heartbreaking and devastating because of the presence of a normal and healthy looking pregnancy in every way except for the location.  This loss also felt more emotionally distressing because of the potential that things could continue normally.  Even though I feel confident that we made the right choice (seeing article after article about ruptured uteruses in cases like this), I will always wonder “what if?”  What if the Doctor was right and this pregnancy could have continued to 36 weeks?  What if we could have had a healthy baby at the end of a difficult pregnancy?  What if my weird horn was the exception and could have stretched to accommodate a baby? Could we be holding a miracle baby in our arms 6 months from now?  We’ll never know now.

So right now the emotional pain is still very palpable.  I keep feeling waves of sadness wash over me as I think about what we just had to do and think about “what if?” and “why us?” It just doesn’t seem fair.

But now we have to keep on keeping on… we have to move on with our lives and put this behind us and try to get past the heartbreak.  We have to get through work and school, we have to get through day by day and eventually we’ll have to get through my surgery in a few weeks.  After that we’ll have to face the difficult decision of whether we want to try again.  I still feel that my desire to have another baby outweighs the fear I have about experiencing another pregnancy loss but I think after one more I might feel differently.  But we will have to see when we have healed emotionally from this loss and when we feel like we’re ready to face the fear and uncertainty again.

For now I feel very grateful that we have our little miracle baby Julia (knowing now how difficult it can be to get and stay pregnant, I feel even more grateful that we had no difficulty getting pregnant with her and that I had an uneventful pregnancy and brought a beautiful and healthy baby girl into this world).  I also feel very thankful for all the love and support we have received from our friends and family all over the country and even the world.  We have received beautiful messages from friends we hadn’t heard from in years sending us their love and thoughts.  I also feel very grateful that my mom was able to come from California to be here with us.  Going through this by ourselves would be very happy.  Her being her gives us the space to be sad together or alone while she can help out with Julia.

And for now I want to wish everyone a Happy Hanukkah, a Merry Christmas and a Happy and Healthy New Year!  2016 was a very difficult year for us in many ways and I hope 2017 brings with it much more joy and happiness.