Today, we had a follow-up sonogram after a few scary, sketchy days. We were warned at the last two sonograms to anticipate fluctuating hormone levels as Baby B began to deteriorate, but when we watched my progesterone level drop from 35 to 20, we were really concerned. Particularly, when the drop came with several days of intermittent spotting.
Over the last three blood draws, the climb in my HCg level slowed remarkably going from 25,009 to 30,055 to 37,969. Again, such a change was predicted -- even a drop was mentioned -- but to watch what should be a predictor of health slug by was worrisome. The doctor, though, is wholly unconcerned. In fact, at my exam he was nearly celebratory, even pumping his fists in the air, saying "Yay!"
As a precaution with regards to the declining progesterone level, and maybe to shut me up, Dr. K (my OB/GYN) doubled the supplement I'm taking. Really, I'm not sure that he anticipated a 15 unit drop in four days, and since I'm at the stage where historically my levels bottom out and cause a miscarriage, I think he's either unwilling to take a chance, or more willing to appease me. Regardless of his motive, I'm grateful that he's so conservative and not willing to take one change lightly. In two weeks, the placenta should be fully functional and I'll begin weaning off the supplements completely, moving back down to one per day, then one every other day, and so on. Two weeks more seems like a lifetime.
At today's scan, we were all able to see that Baby B's gestational sac is making clear progress in deterioration. Dr. K recalled the last results on his computer and reviewed Dr. T's images, and was confident that our worries have decreased. He had a difficult time getting clear measurements because the edges of the gestational sac show signs of bleeding (which is likely related to my increased spotting) and are hazy with debris as it collapses in on itself. He said there is still a chance of ovarian rupture until the gestational sac is completely gone, and advised me to take pain on the left side or increased bleeding seriously. Dr. T (my MFM/Perinatologist) will follow up in a week, but based on the rate of deterioration since Wednesday, Dr. K wondered if he would see anything at all. We'll know for sure in six days.
Seeing how the sac had deteriorated was rather bittersweet. We're so pleased I don't have to have surgery at this stage and risk the life of Baby A, but at the same time, watching something so lovely disappear is disheartening -- especially when Dr. K was able to identify the location where the fetal pole (heartbeat) likely began and ended.
To clarify, though, we are not ungrateful. It is such a relief to be at this stage growing a baby that is safely implanted high above my cervix -- a baby who has a strong and healthy heartbeat and who is now measuring three days ahead of schedule. It is such a relief to not be forced into deciding to kill one baby to hopefully save another, while really risking both. It's a relief now to imagine that my pregnancy could become very much like a normal pregnancy, and that there could be days ahead absent of questions and concerns. Based on the fact that we've seen a healthy heartbeat and accurate growth now four times, there's a very good chance the day will come that we'll bring home another baby.
Our Heavenly Father has been far more gracious to us than we could have every hoped He would be. We are awed by His mercy, and we are humbled by His love for us. Saying "Thank You" for all this is just not enough...
Tuesday, December 30, 2008
Saturday, December 27, 2008
On Indiscretion and Disappointment
Despite our news on Christmas Eve, we had a lovely, low-key holiday. It's still nice to have this sweet secret, though I'm quite sure it's not much of a secret anymore. At James' urging, I mentioned this pregnancy to a handful of people, who have shared our news with another handful of people, and now, following a few unexpected conversations and e-mails, I'm not sure we have news left to share. I'm beginning to wish I would have held firm to my original plan of not telling a soul until I was scheduled to give birth.
My complaint is not necessarily about the fact that people know of our pregnancy. It's more about the fact that we weren't given the chance to make the announcement we wanted to make when we reached a point where we felt safe and comfortable discussing our progress. I'm hurt that people I love and trust could disregard me so completely, just for a juicy bit of gossip. I'm frustrated that I now have to deal with people who have no idea what they're talking about sharing their unwelcome opinions. I'm sad that I have to deal with others so scornful I can nearly feel their negative energy burning through my chest. Knowing that others I wouldn't normally welcome near a more vulnerable me share in my news adds a burden I absolutely didn't want or expect to deal with.
I don't feel ecstatic about this pregnancy, but rather reservedly hopeful at best.
I'm a long way from being "safe," and I'm afraid of this 7-9 week range.
If I lose this pregnancy now, exactly what I hoped to avoid by keeping things a secret is guaranteed to crash down on me.
That disappoints me deeply.
My complaint is not necessarily about the fact that people know of our pregnancy. It's more about the fact that we weren't given the chance to make the announcement we wanted to make when we reached a point where we felt safe and comfortable discussing our progress. I'm hurt that people I love and trust could disregard me so completely, just for a juicy bit of gossip. I'm frustrated that I now have to deal with people who have no idea what they're talking about sharing their unwelcome opinions. I'm sad that I have to deal with others so scornful I can nearly feel their negative energy burning through my chest. Knowing that others I wouldn't normally welcome near a more vulnerable me share in my news adds a burden I absolutely didn't want or expect to deal with.
I don't feel ecstatic about this pregnancy, but rather reservedly hopeful at best.
I'm a long way from being "safe," and I'm afraid of this 7-9 week range.
If I lose this pregnancy now, exactly what I hoped to avoid by keeping things a secret is guaranteed to crash down on me.
That disappoints me deeply.
Wednesday, December 24, 2008
Gone for Good
The sonogram today confirmed Baby B is gone for good. While there was no notable deterioration in the gestational sac at this point, there was no growth to speak of and still no heartbeat. Based on blood levels and scan results, it's probable that the baby died sometime between Thursday and Monday.
My perinatologist brought two colleagues into the room during today's scan, and their consensus was not to recommend surgery at this point, but rather to continue the watchful wait. There is still a risk of ovarian rupture, but the growth level of the gestational sac between Monday and today was minimal. As a result, a rupture is not necessarily anticipated.
Despite having another baby we won't meet until Heaven, we're so grateful for today's news. If a heartbeat would have been present in Baby B today, my OB would have pushed for surgery to remove the ectopic pregnancy, and general anesthesia in the first trimester could be damaging -- even fatal -- to Baby A in my uterus. Also, by waiting and allowing the baby to be slowly reabsorbed, its corpus luteum will continue benefit the overall pregnancy. The doctors plan to rotate weekly scans until Baby B is completely gone.
My perinatologist brought two colleagues into the room during today's scan, and their consensus was not to recommend surgery at this point, but rather to continue the watchful wait. There is still a risk of ovarian rupture, but the growth level of the gestational sac between Monday and today was minimal. As a result, a rupture is not necessarily anticipated.
Despite having another baby we won't meet until Heaven, we're so grateful for today's news. If a heartbeat would have been present in Baby B today, my OB would have pushed for surgery to remove the ectopic pregnancy, and general anesthesia in the first trimester could be damaging -- even fatal -- to Baby A in my uterus. Also, by waiting and allowing the baby to be slowly reabsorbed, its corpus luteum will continue benefit the overall pregnancy. The doctors plan to rotate weekly scans until Baby B is completely gone.
Tuesday, December 23, 2008
Monday's Numbers
After Monday's exam, my biweekly blood draw was done at the office. My HCg levels were 25,009. Progesterone was at 35.4. To me, those HCg levels indicate that the twin has indeed died, though the upcoming scan will be necessary to verify. The progesterone level is unbelievable. I've never, ever had such high or healthy levels.
Though I'm disappointed to have lost another baby (and a twin, particularly), its presence in my body has very probably helped its sibling survive. By having ovulated twice, and by having two corpora lutea, the progesterone level I've achieved very probably will push me into the second trimester. For that, I'm extraordinarily grateful.
Though I'm disappointed to have lost another baby (and a twin, particularly), its presence in my body has very probably helped its sibling survive. By having ovulated twice, and by having two corpora lutea, the progesterone level I've achieved very probably will push me into the second trimester. For that, I'm extraordinarily grateful.
Collecting My Thoughts
I've had the information about the condition of our pregnancy for about 24 hours now, and I think it would be a good time to collect some of my thoughts. I still feel stunned and disappointed by the news. I was hopeful yesterday's scan would bring clarity -- one or two, healthy or not. Instead, I have more questions than ever. I'm frustrated at the timing of the news here at Christmastime. Where I felt excited and happy, I now feel concerned and distracted. I'm also no longer allowed to leave town, so the plans to see my family have been completely cancelled.
But all of those are small things compared to my health and the health of this pregnancy and these babies.
First to explain, a heterotopic pregnancy is not a vanishing twin pregnancy. A heterotopic pregnancy is a combination intrauterine and ectopic pregnancy. Heterotopic pregnancies are somewhat common in women who have IVF, but spontaneous heterotopic pregnancies are more rare. A heterotopic pregnancy most commonly includes an ectoptic pregnancy in the fallopian tube. A pregnancy anywhere else -- the cervix, the ovary, or the abdominal cavity -- is less common.
It's true that the twin in my ovary could deteriorate if it has indeed died, but there's a chance that it might live. If the baby lives, the pregnancy could become quite dangerous, potentially killing the baby growing in my uterus, ending my chance at further reproduction, even leaving my life at risk. If the baby dies, well, that's another baby gone.
God is a God of miracles, but in this situation, it's hard to know how to pray.
But all of those are small things compared to my health and the health of this pregnancy and these babies.
First to explain, a heterotopic pregnancy is not a vanishing twin pregnancy. A heterotopic pregnancy is a combination intrauterine and ectopic pregnancy. Heterotopic pregnancies are somewhat common in women who have IVF, but spontaneous heterotopic pregnancies are more rare. A heterotopic pregnancy most commonly includes an ectoptic pregnancy in the fallopian tube. A pregnancy anywhere else -- the cervix, the ovary, or the abdominal cavity -- is less common.
It's true that the twin in my ovary could deteriorate if it has indeed died, but there's a chance that it might live. If the baby lives, the pregnancy could become quite dangerous, potentially killing the baby growing in my uterus, ending my chance at further reproduction, even leaving my life at risk. If the baby dies, well, that's another baby gone.
God is a God of miracles, but in this situation, it's hard to know how to pray.
That Which I Don't Understand (by James)
I am sitting in dark, cold hotel room in Grand Rapids. Michigan, trying to make sense of the recent developments of the pregnancy. I'm confused. I'm not sure what to pray for or even how to pray. It all seems surreal. The odds of a heterotopic pregnancy with one of the twins in the ovary is so rare. Yet, this is where we find ourselves.
I'm ready to get back home and be with Amanda and just hold her and love her and tell her how proud I am of her for being strong and fully relying on God. The same God who has brought us out of tough situations before will do the same again. No matter what the situation or outcome, I cannot deny he is working in our lives.
7 weeks today. For that, I am grateful. A strong heartbeat. A good position in the uterus. I pray for your continued growth Baby A.
For you Baby B, I'm overwhelmed by your presence. I can't understand many things. What I do know is that even if you have passed on, you are still a creation of God that has been given to us.
Tomorrow is a big day and will be more telling of things to come. Please pray for wisdom from the MFM and clarity for us.
God is good all the time and all the time God is good.
I'm ready to get back home and be with Amanda and just hold her and love her and tell her how proud I am of her for being strong and fully relying on God. The same God who has brought us out of tough situations before will do the same again. No matter what the situation or outcome, I cannot deny he is working in our lives.
7 weeks today. For that, I am grateful. A strong heartbeat. A good position in the uterus. I pray for your continued growth Baby A.
For you Baby B, I'm overwhelmed by your presence. I can't understand many things. What I do know is that even if you have passed on, you are still a creation of God that has been given to us.
Tomorrow is a big day and will be more telling of things to come. Please pray for wisdom from the MFM and clarity for us.
God is good all the time and all the time God is good.
Monday, December 22, 2008
The Good News and The Bad News
We had our follow-up sonogram today, and the doctor came in joking about how many babies we were going to have. We reminded him that we were there to indeed check for multiples, and his joking tone became excited as he remembered my blood results and the report from the perinatologist the week prior.
When the sono began, the doctor had no problem spotting the beautiful baby growing in my uterus. "Just one," he said. I felt a little disappointed, having been so sure that the numbers and my symptoms could not be wrong. "Are you sure?" I asked. "The perinatologist mentioned the other thing was a little high up in the uterus." Just one, he clarified again.
We watched the heartbeat, feeling very excited. After a moment or two, he standardly scanning the rest of my pelvic region. He examined the outside of the uterus, the right ovary, then the left. When he got there, he went round and round, zooming in and out, and I could see what he saw. "There's a gestational sac here," he said, pointing out all the parts. He continued to check and measure and print and document, then agreed with himself that it was indeed a gestational sac, and I had a heterotopic pregnancy.
A heterotopic pregnancy is a pregnancy where there's both a growing intrauterine pregnancy, and a pregnancy outside of the uterus. Most commonly, the baby growing outside of the uterus grows in the fallopian tube. In very rare cases, it grows in the cervix, ovary or abdomen.
Instances of heterotopic pregnancies are on the rise with the increase of frequency of IVF, but spontaneous heterotopic pregnancies are rare. With my baby growing on my left ovary, I find myself in the rarest of rare situations.
During the sonogram, the doctor was unable to find a heartbeat in the heterotopic twin, and the "ring of fire" (bloodflow on the sonogram) was not complete, reaching only the top and bottom of the gestational sac, instead of completely circling it as it should. My doctor is hopeful that the absence of a heartbeat and the incomplete ring of fire means the baby has died, is deteriorating and will eventually be reabsorbed by my body. But, because it's still so early in this pregnancy and not totally unusual to not see a heartbeat at this stage, he's sending me to be scanned again on Wednesday. If there is growth or a heartbeat, he'll want to discuss surgery -- by Friday, if he can make me.
At this point, that's too overwhelming to consider. I've decided unless I'm in actual imminent danger -- like, hemmoraging or something -- I'm delaying surgery for at least a few more days. There are many things to consider, many pros and cons to the various approaches, lots of decisions weighing heavily on our hearts and minds. I'll lay out my thoughts in some posts over the next couple of days. Meanwhile, please keep praying for me and for my babies. (Such a bittersweet thing to say...)
When the sono began, the doctor had no problem spotting the beautiful baby growing in my uterus. "Just one," he said. I felt a little disappointed, having been so sure that the numbers and my symptoms could not be wrong. "Are you sure?" I asked. "The perinatologist mentioned the other thing was a little high up in the uterus." Just one, he clarified again.
We watched the heartbeat, feeling very excited. After a moment or two, he standardly scanning the rest of my pelvic region. He examined the outside of the uterus, the right ovary, then the left. When he got there, he went round and round, zooming in and out, and I could see what he saw. "There's a gestational sac here," he said, pointing out all the parts. He continued to check and measure and print and document, then agreed with himself that it was indeed a gestational sac, and I had a heterotopic pregnancy.
A heterotopic pregnancy is a pregnancy where there's both a growing intrauterine pregnancy, and a pregnancy outside of the uterus. Most commonly, the baby growing outside of the uterus grows in the fallopian tube. In very rare cases, it grows in the cervix, ovary or abdomen.
Instances of heterotopic pregnancies are on the rise with the increase of frequency of IVF, but spontaneous heterotopic pregnancies are rare. With my baby growing on my left ovary, I find myself in the rarest of rare situations.
During the sonogram, the doctor was unable to find a heartbeat in the heterotopic twin, and the "ring of fire" (bloodflow on the sonogram) was not complete, reaching only the top and bottom of the gestational sac, instead of completely circling it as it should. My doctor is hopeful that the absence of a heartbeat and the incomplete ring of fire means the baby has died, is deteriorating and will eventually be reabsorbed by my body. But, because it's still so early in this pregnancy and not totally unusual to not see a heartbeat at this stage, he's sending me to be scanned again on Wednesday. If there is growth or a heartbeat, he'll want to discuss surgery -- by Friday, if he can make me.
At this point, that's too overwhelming to consider. I've decided unless I'm in actual imminent danger -- like, hemmoraging or something -- I'm delaying surgery for at least a few more days. There are many things to consider, many pros and cons to the various approaches, lots of decisions weighing heavily on our hearts and minds. I'll lay out my thoughts in some posts over the next couple of days. Meanwhile, please keep praying for me and for my babies. (Such a bittersweet thing to say...)
The Cooperative Twin --
in the uterus where it belongs.
The Rebel Baby --
laying low in my left ovary.
Sunday, December 21, 2008
I Am Powerless (by James)
This morning we are at 6 weeks, 5 days pregnant and I think Amanda has been pregnant forever. In reality, tomorrow will be 3 weeks since the positive HPT.
I must admit that I thought having the bi-weekly blood draws and the extra eyes of an MFM would make this pregnancy easier mentally. And, for the most part, it is very helpful. I would rather know that the HGC and Progesterone numbers are climbing than being left in the unknown. There is something to be said about ease of mind.
All of that can quickly go away though as I learned on Thursday. When I am in a far off land (Green Bay, Wisconsin), the last thing I wanted to hear from Amanda is that she has some spotting and slight abdominal pain. There was nothing I could do except pray. And I prayed heavily that day. The good news is that what she experienced was common and the blood results since Thursday indicate that "by the numbers" the pregnancy is going great so far.
Lesson learned - I'm powerless. All the doctor visits, blood draws, internet research are great indicators of things to come. However, I have to continue to rely on God during this pregnancy. Otherwise, I am going to find myself a nervous wreck, walking on egg shells for the next 7-8 months. I refuse to live in a spirit of fear.
Amanda is doing great. She continues to be exhausted beyond belief, but is really resting more than she typically would for a woman constantly on the go. The kids do not expect anything. They're quite oblivious to the whole situation. Amanda and I have open conversations about the pregnancy with them in the room and so far neither Bub or Gracie expect anything. I'm hoping that is the case and they are not playing dumb. I can't wait until the day we will feel comfortable to tell them "our secret".
Friends, please continue to pray. The next couple of weeks are crucial based on our history of miscarriages. 6-8.5 weeks range seems to be when our early losses have occurred. I can sense your prayers. They are greatly appreciated.
I'm excited to visit the OB tomorrow morning to see how things have progressed. Hopefully, we will also be able to answer the question of "twins or not".
I must admit that I thought having the bi-weekly blood draws and the extra eyes of an MFM would make this pregnancy easier mentally. And, for the most part, it is very helpful. I would rather know that the HGC and Progesterone numbers are climbing than being left in the unknown. There is something to be said about ease of mind.
All of that can quickly go away though as I learned on Thursday. When I am in a far off land (Green Bay, Wisconsin), the last thing I wanted to hear from Amanda is that she has some spotting and slight abdominal pain. There was nothing I could do except pray. And I prayed heavily that day. The good news is that what she experienced was common and the blood results since Thursday indicate that "by the numbers" the pregnancy is going great so far.
Lesson learned - I'm powerless. All the doctor visits, blood draws, internet research are great indicators of things to come. However, I have to continue to rely on God during this pregnancy. Otherwise, I am going to find myself a nervous wreck, walking on egg shells for the next 7-8 months. I refuse to live in a spirit of fear.
Amanda is doing great. She continues to be exhausted beyond belief, but is really resting more than she typically would for a woman constantly on the go. The kids do not expect anything. They're quite oblivious to the whole situation. Amanda and I have open conversations about the pregnancy with them in the room and so far neither Bub or Gracie expect anything. I'm hoping that is the case and they are not playing dumb. I can't wait until the day we will feel comfortable to tell them "our secret".
Friends, please continue to pray. The next couple of weeks are crucial based on our history of miscarriages. 6-8.5 weeks range seems to be when our early losses have occurred. I can sense your prayers. They are greatly appreciated.
I'm excited to visit the OB tomorrow morning to see how things have progressed. Hopefully, we will also be able to answer the question of "twins or not".
Friday, December 19, 2008
Relief
The spotting from yesterday never changed to the bright red, scary color, and today, it stopped altogether. Also, I just spoke to my nurse about yesterday's blood draw -- my HCg level is at 15,547, and my progesterone level is 22.4. Those values are really good, and I am very grateful. My next scan is on Monday.
Thanks to each of you for your prayers and concern. I'm hoping the next 2-4 weeks pass very quickly so these numbers will no longer matter.
Thanks to each of you for your prayers and concern. I'm hoping the next 2-4 weeks pass very quickly so these numbers will no longer matter.
Thursday, December 18, 2008
Personal Statistics vs. Common Statistics
Late last night, I began spotting lightly. It stopped this morning, but it just began again, slightly heavier this time (though still considerably lighter than what would normally be considered dangerous). I have a slight twinge of continual pain on the left side.
Spotting -- even bleeding -- isn't uncommon in pregnancies. However, in my five previous pregnancies, I've only had spotting in the three that ended in the first trimester. It's hard not to let personal statistics override common ones.
As for the pain, it's not terrible, and it could just be pelvic tendons beginning to stretch. I remember having a similar pain when pregnant with Gracie, and nothing came of it obviously. I imagine the pain of stretching tendons would be more obvious this time since I have a cerclage buried in among them (which could also cause the spotting). Still, the pain coupled with the spotting cause me to feel concern.
I'm off for my biweekly blood work. If the progesterone level has moved further down, that could cause the spotting and it would hopefully be repairable at this point. If I'm miscarrying, my HCg levels should begin to drop. If everything remains stable and/or increases, I'm probably OK. I should know more tomorrow.
Spotting -- even bleeding -- isn't uncommon in pregnancies. However, in my five previous pregnancies, I've only had spotting in the three that ended in the first trimester. It's hard not to let personal statistics override common ones.
As for the pain, it's not terrible, and it could just be pelvic tendons beginning to stretch. I remember having a similar pain when pregnant with Gracie, and nothing came of it obviously. I imagine the pain of stretching tendons would be more obvious this time since I have a cerclage buried in among them (which could also cause the spotting). Still, the pain coupled with the spotting cause me to feel concern.
I'm off for my biweekly blood work. If the progesterone level has moved further down, that could cause the spotting and it would hopefully be repairable at this point. If I'm miscarrying, my HCg levels should begin to drop. If everything remains stable and/or increases, I'm probably OK. I should know more tomorrow.
Wednesday, December 17, 2008
Something New to Worry About
(And I'm totally kidding about this worrying me... sort of.)
Feeling More Optimistic
After a day of research, I feel much more optimistic. James e-mailed me with article after article that stated from about 6 weeks on, HCg levels aren't accurately predictive of pregnancy health. The increase slows down, and numbers won't double more than every 96 hours or so. The ultrasounds become much more important than the HCg levels after 6 weeks, and what we saw Monday was good.
Randi mentioned praying for my mind to be quiet and sound, and I think that's precisely what I need. Moreover, we need wise, conservative doctors who aren't afraid to do what's necessary to protect my pregnancy and my health. We need God's grace to accept the calls they make, even if they don't make sense.
Randi mentioned praying for my mind to be quiet and sound, and I think that's precisely what I need. Moreover, we need wise, conservative doctors who aren't afraid to do what's necessary to protect my pregnancy and my health. We need God's grace to accept the calls they make, even if they don't make sense.
Tuesday, December 16, 2008
The Disadvantage of Knowing Too Much
My results from yesterday have just come in: my HCg level is 8510, and my progesterone level is 22.0.
The progesterone, while it has dropped, is still at the top of a safe range, so I'm not extraordinarily concerned about the level at this point. I do feel concerned that it seems to have a downward trend, instead of having a slight upward climb as it should. I still am on a very low dose of a progesterone supplement, so we have a chance to bring it up if necessary, but I have 2-4 weeks before a placenta would be present and capable of taking over, replacing what I take. Thursday's draw should be telling.
As for the HCg levels, I was concerned about the fact that they took 81 hours to double instead of the 48-72 hours I considered normal, but James found this information on several websites:
Look most closely at progression: during the huge majority of early pregnancies (80-90%), the level will double every couple of days, or 72 hours. As your pregnancy progresses, levels rise and that doubling time increases. The expected doubling time for HCG levels:
• Under 1200 mIU/ml: 48-72 hours.
• Between 1200 to 6000 mIU/ml: 72-96 hours.
• Over 6000 mIU/ml: more than 96 hours
The progesterone, while it has dropped, is still at the top of a safe range, so I'm not extraordinarily concerned about the level at this point. I do feel concerned that it seems to have a downward trend, instead of having a slight upward climb as it should. I still am on a very low dose of a progesterone supplement, so we have a chance to bring it up if necessary, but I have 2-4 weeks before a placenta would be present and capable of taking over, replacing what I take. Thursday's draw should be telling.
As for the HCg levels, I was concerned about the fact that they took 81 hours to double instead of the 48-72 hours I considered normal, but James found this information on several websites:
Look most closely at progression: during the huge majority of early pregnancies (80-90%), the level will double every couple of days, or 72 hours. As your pregnancy progresses, levels rise and that doubling time increases. The expected doubling time for HCG levels:
• Under 1200 mIU/ml: 48-72 hours.
• Between 1200 to 6000 mIU/ml: 72-96 hours.
• Over 6000 mIU/ml: more than 96 hours
Monday, December 15, 2008
Do You See What I See?
Today's ultrasound went beautifully. I love my perinatologist, and he and his employees seemed genuinely happy to see me today. Happy that I was pregnant again. It's nice to have two sets of eyes watching my every gestational move. Today, the peri decided to run some tests and piggybacked off my regular bi-weekly labwork, so other than having five vials of blood drawn today to appease his curiosity, it was a good day indeed.
As for what we saw, we saw one perfectly visible gestational sac with a yolk sac and a very new fetal pole (heartbeat). There was another something else there, and it's too soon to say precisely what it is.
My doctor, who is very conservative (particularly given my history) put it this way: he was unwilling to call it a twin pregnancy at this point, but he did say he's seen things like what I have later develop and reveal a growing baby. At this stage in a pregnancy, a day or two can make a world of difference.
What I mean by that is a gestational sac is not visible until 5 1/2 weeks, in general. We're estimating that I'm 5w 6d today based on when we assumed I ovulated or generally ovulate. The truth of the matter is that my pregnancy could be a couple of days younger than we think, and this early, that could mean the difference between seeing a gestational sac and not seeing one.
Also, it is not impossible for a woman to ovulate, and ovulate again a few hours or even a couple of days later. I've read forums of women who are pregnant with twins, and one measures twenty weeks, while the other measures twenty weeks and three days. That could just be a difference in size estimation, but it could also mean a discrepancy in ovulation times.
I'm not hanging onto twins, but it's not officially been ruled out yet. In an effort to explain what we saw, the doctor said what's there could just be a pocket of implantation blood revealed on the ultrasound, but (1) it looked nothing like the implatation bleeding I've seen on ultrasound before, and (2) I don't think he'd even suggest the possibility of twins unless he really thought there was some sort of a chance. Time will tell, I guess.
As of today, we're very excited to be pregnant with one baby implanted within the uterus who appears to be very healthy and is maintaining some excellent numbers. We're very curious about what the doctor found, and wonder if it will become something, or if it will merely go away. I have a repeat ultrasound in one week (at 6w6d), and again, two weeks after that (at 8w6d). Things should be clear for us very soon...
As for what we saw, we saw one perfectly visible gestational sac with a yolk sac and a very new fetal pole (heartbeat). There was another something else there, and it's too soon to say precisely what it is.
My doctor, who is very conservative (particularly given my history) put it this way: he was unwilling to call it a twin pregnancy at this point, but he did say he's seen things like what I have later develop and reveal a growing baby. At this stage in a pregnancy, a day or two can make a world of difference.
What I mean by that is a gestational sac is not visible until 5 1/2 weeks, in general. We're estimating that I'm 5w 6d today based on when we assumed I ovulated or generally ovulate. The truth of the matter is that my pregnancy could be a couple of days younger than we think, and this early, that could mean the difference between seeing a gestational sac and not seeing one.
Also, it is not impossible for a woman to ovulate, and ovulate again a few hours or even a couple of days later. I've read forums of women who are pregnant with twins, and one measures twenty weeks, while the other measures twenty weeks and three days. That could just be a difference in size estimation, but it could also mean a discrepancy in ovulation times.
I'm not hanging onto twins, but it's not officially been ruled out yet. In an effort to explain what we saw, the doctor said what's there could just be a pocket of implantation blood revealed on the ultrasound, but (1) it looked nothing like the implatation bleeding I've seen on ultrasound before, and (2) I don't think he'd even suggest the possibility of twins unless he really thought there was some sort of a chance. Time will tell, I guess.
As of today, we're very excited to be pregnant with one baby implanted within the uterus who appears to be very healthy and is maintaining some excellent numbers. We're very curious about what the doctor found, and wonder if it will become something, or if it will merely go away. I have a repeat ultrasound in one week (at 6w6d), and again, two weeks after that (at 8w6d). Things should be clear for us very soon...
A Very Grainy First Photo
On the Big Screen
Friday's Numbers
It just occurred to me that I failed to post Friday's numbers. They've been coming in later in the day when I seem to be the busiest, so time just got away. On Friday, my HCg increased to 3889, and my progesterone went back up to 25.4.
I'm excited about that progesterone level. Ususally, I come in around 12-15, and we fight to get it up to 16-18, the low end of a good range. And when I say fight, I mean it. Usually, I'm taking two supplements orally and one compounded supplement elsewhere, and it's a real nightmare. This time, I'm taking one average dose orally, and I think that's more for my peace of mind than anything. It's that number that makes me feel very hopeful that this baby (or these babies) is (are) meant to be.
When the nurse told me of the HCg level, I was concerned it hadn't risen enough. She said they like to see them double every 48-72 hours, which it did. It doubled within 56 hours, but still, I was worried. Later in the day, when I really thought about it, I remembered that the previous number doubled every 26 hours. Most women wouldn't have their blood analyzed every three to four days, so based on that law of averages, I was still more than ok. On the chart, I still sit above the high line, and when the numbers are run, I still well within the range of twins (meaning if that's what this is, my numbers are still healthy).
This morning, we're on our way to the perinatologist for the initial scan. I'm excited, and very nervous. It's amazing to be here once again.
I'm excited about that progesterone level. Ususally, I come in around 12-15, and we fight to get it up to 16-18, the low end of a good range. And when I say fight, I mean it. Usually, I'm taking two supplements orally and one compounded supplement elsewhere, and it's a real nightmare. This time, I'm taking one average dose orally, and I think that's more for my peace of mind than anything. It's that number that makes me feel very hopeful that this baby (or these babies) is (are) meant to be.
When the nurse told me of the HCg level, I was concerned it hadn't risen enough. She said they like to see them double every 48-72 hours, which it did. It doubled within 56 hours, but still, I was worried. Later in the day, when I really thought about it, I remembered that the previous number doubled every 26 hours. Most women wouldn't have their blood analyzed every three to four days, so based on that law of averages, I was still more than ok. On the chart, I still sit above the high line, and when the numbers are run, I still well within the range of twins (meaning if that's what this is, my numbers are still healthy).
This morning, we're on our way to the perinatologist for the initial scan. I'm excited, and very nervous. It's amazing to be here once again.
Saturday, December 13, 2008
So Far, So Good (by James)
The nurse called with Amanda's latest blood test results. So far so good! HGC is at 3889 and progesterone climbed to 25.4. Very good numbers. The HGC "doubling time" has decreased a bit t0 57.15. This still puts Amanda in a very good place. (As long as we are doubling HGC every 48-72 hours, we're good.)
I'm anxious for the appointment Monday morning with the MFM, Dr. Trimmer. We should be at a point where we can see gestation sac, fetal pole, heart beat, etc...
I have been tracking Amanda's HGC numbers at www.betabase.info. She is still tracking at the median range for twins and tracking very high for a singleton. We are excited at the possibilities of multiples! We should definitely know on Monday how many we can expect.
Today is the first day since we found out about the pregnancy that time has actually not stood still. We are at 5 weeks 4 days today and now can see 6 weeks at the end of the tunnel.
Amanda has been exhausted. The busy times of the Holiday Season aren't helping things either.
Thank you friends for your continued prayers. They are truly appreciated and felt.
Keep growing baby.
I'm anxious for the appointment Monday morning with the MFM, Dr. Trimmer. We should be at a point where we can see gestation sac, fetal pole, heart beat, etc...
I have been tracking Amanda's HGC numbers at www.betabase.info. She is still tracking at the median range for twins and tracking very high for a singleton. We are excited at the possibilities of multiples! We should definitely know on Monday how many we can expect.
Today is the first day since we found out about the pregnancy that time has actually not stood still. We are at 5 weeks 4 days today and now can see 6 weeks at the end of the tunnel.
Amanda has been exhausted. The busy times of the Holiday Season aren't helping things either.
Thank you friends for your continued prayers. They are truly appreciated and felt.
Keep growing baby.
Wednesday, December 10, 2008
Only 9 days -- Really!? (by James)
Has it really been only 9 days since we found out Amanda was pregnant? I don't think time can move any slower than it has.
I'm so happy we have made it to 5 weeks and 1 day today. There is something to be said about little victories. I know we have lots still ahead and things may change with each blood test results. But as for now I say "THANK YOU GOD!"
Monday we will know more of where this pregnancy is headed. I am excited, yet scared. The problem is I know way too much about early pregnancy than any person not an OB/GYN should know thanks to the internet.
Could it be twins? Maybe. That would be a nice surprise.
Still praying hard for you baby (babies).
I'm so happy we have made it to 5 weeks and 1 day today. There is something to be said about little victories. I know we have lots still ahead and things may change with each blood test results. But as for now I say "THANK YOU GOD!"
Monday we will know more of where this pregnancy is headed. I am excited, yet scared. The problem is I know way too much about early pregnancy than any person not an OB/GYN should know thanks to the internet.
Could it be twins? Maybe. That would be a nice surprise.
Still praying hard for you baby (babies).
Tuesday, December 9, 2008
On a New Week and Higher Numbers
Today, I crossed over into 5 weeks of pregnancy. It's so amazing that really we've only been at this just over a week, and yet, it feels like this process has been going on for ages. It's difficult to realize that many women wouldn't even know they were pregnant at this early stage in the game, whereas I've already been in cahoots with two doctors, several nurses, even more phlebotomists, and perhaps a vampire or two. There's no wonder a loss at eight or nine weeks is so hard for me -- I have more prenatal care in the first weeks of a pregnancy than many women have all along!
Barb, the OB nurse, called today with Monday's blood results: HCg 1569 and progesterone 23.2. My progesterone decreased some, but some fluctuation is normal -- even within the same day -- and my levels are still above the top of a very safe range. If Thursday's test indicates another drop into the teens, my supplementation will likely be increased. At this point, though, there's no change ordered.
As for the HCg level, the little program James runs indicated that it doubled every 26 hours. 26 hours! In a healthy singleton pregnancy, it's not even necessary to double every 48 hours -- a 66% increase is sufficient. Based on the charts he compares, there's a very high probability I'm pregnant with twins. I've been consistently within the upper median range for twins, and the middle median range for triplets. Squeal!
Back to reality, though, HCg levels aren't a precise predictor of numbers of implantations. There are so many contingencies, and because I didn't have a follicle check this month to pinpoint exactly when I ovulated (it was supposed to be a break and all), it could just be that I'm a few days further along than we think. Monday's scan should be telling, both of numbers and of gestational age, and from there, and increasing HCg level will be indicative of pregnancy health. Monday can't get here quick enough!
(Is it just me, or does the babystrology app indicate that I'm pregnant with a seahorse?)
Barb, the OB nurse, called today with Monday's blood results: HCg 1569 and progesterone 23.2. My progesterone decreased some, but some fluctuation is normal -- even within the same day -- and my levels are still above the top of a very safe range. If Thursday's test indicates another drop into the teens, my supplementation will likely be increased. At this point, though, there's no change ordered.
As for the HCg level, the little program James runs indicated that it doubled every 26 hours. 26 hours! In a healthy singleton pregnancy, it's not even necessary to double every 48 hours -- a 66% increase is sufficient. Based on the charts he compares, there's a very high probability I'm pregnant with twins. I've been consistently within the upper median range for twins, and the middle median range for triplets. Squeal!
Back to reality, though, HCg levels aren't a precise predictor of numbers of implantations. There are so many contingencies, and because I didn't have a follicle check this month to pinpoint exactly when I ovulated (it was supposed to be a break and all), it could just be that I'm a few days further along than we think. Monday's scan should be telling, both of numbers and of gestational age, and from there, and increasing HCg level will be indicative of pregnancy health. Monday can't get here quick enough!
(Is it just me, or does the babystrology app indicate that I'm pregnant with a seahorse?)
Monday, December 8, 2008
On Blood Draws and Twilight
I went to the lab today for my third blood draw. Both HCg and Progesterone levels will be monitored twice weekly until around 10-12 weeks gestation. For today's lab visit, I brought along a well-worn library copy of Twilight. I'm the last of my friends, and maybe the last of all humankind, to read the series.As I signed in, the receptionist phlebotomist literally had to purse her lips to keep from giving away all the good parts of the story. She opened up to say that the series was so good, she was reading the first book again after reading them all and seeing the movie twice. Then she was back to pursing her lips.
When I was called from the waiting room to go back for the draw, the receptionist phlebotomist told the other phlebotomist to look at what I was carrying in my hands. It was just the book, but it may as well have been the holy grail. That phlebotomist, then, wanted to know my every opinion about the book, the series, the characters, the movie, and so on. I told her I was a few pages into chapter one -- I had no opinion. I just hoped it was as good as everyone let on.
I stopped talking to her and looked away from the blood pouring forth from my veins. When I did, I noticed a Twilight poster hanging ominously over a nearby draw station, and I felt just a touch uncomfortable.
Sunday, December 7, 2008
The Christmas Ornament
In the midst of the holiday craziness and at the very beginning stages of this process, I bought the baby its very first Christmas ornament. Last year, after a year of back to back losses, we bought baby ornaments. We bought an individual one for both Ainsley and Zachary, and a combined one for the first and last babies who lived so briefly.James has already been looking at cribs and sleepers and maternity clothes. I chided him for being ahead of the game, but he just said, "I'm going to enjoy this, every minute of it. That's how I want this pregnancy to be." We're doing our best to be naive once again. To be pregnant and excited and expectant. That is why when I saw the little ornament, I knew it was just right.
It's a "Baby's 1st Christmas" ornament (though I removed that part), and it shows Pooh giving Piglet a Christmas package. Around the bottom is this text: "A baby," said Pooh, "is a very nice thing indeed." With that, I concur. We feel extraordinarily blessed to be pregnant once again, and so excited to be pregnant during Christmas. It's wonderful having such a delicious little secret at such a magical time of the year.
Saturday, December 6, 2008
Initial Impressions (by James)
James here. I wanted to share my current emotions and feelings.
First off, I am extremely grateful and feel that God has blessed Amanda with this pregnancy. I will be the first to admit that I don't know what tomorrow holds, but I have made the decision to "live in the moment" and not fear of the unknown.
After months of trying to conceive, I will be honest, I reached the point that I did not think we were going to ever able to conceive again. Amanda and I had recently come to realize that we would be content with this and pursue adoption further. God, thankfully, has other plans!
I have been extremely emotional. In my prayer time, meditation, listening to Christmas music, etc... I get overwhelmed with joy and tears in a matter of seconds. Leading up to this pregnancy, I "just knew" everything would be easy once we conceived. Not so. I realize there is so much that could go wrong at the blink of an eye based on our prior history in pregnancies. Yet, I am grateful!
I want to tell all my friends and the kids today, but know I can't yet. It's hard, especially for the kids. They want a baby brother/sister so bad. Gracie prays for that (literally) every night. I am thankful for those few friends we have told and appreciate their prayers and intercessions. The last 5 days have been joyous, and has made this Christmas season extra special.
Baby, I am praying for you.
First off, I am extremely grateful and feel that God has blessed Amanda with this pregnancy. I will be the first to admit that I don't know what tomorrow holds, but I have made the decision to "live in the moment" and not fear of the unknown.
After months of trying to conceive, I will be honest, I reached the point that I did not think we were going to ever able to conceive again. Amanda and I had recently come to realize that we would be content with this and pursue adoption further. God, thankfully, has other plans!
I have been extremely emotional. In my prayer time, meditation, listening to Christmas music, etc... I get overwhelmed with joy and tears in a matter of seconds. Leading up to this pregnancy, I "just knew" everything would be easy once we conceived. Not so. I realize there is so much that could go wrong at the blink of an eye based on our prior history in pregnancies. Yet, I am grateful!
I want to tell all my friends and the kids today, but know I can't yet. It's hard, especially for the kids. They want a baby brother/sister so bad. Gracie prays for that (literally) every night. I am thankful for those few friends we have told and appreciate their prayers and intercessions. The last 5 days have been joyous, and has made this Christmas season extra special.
Baby, I am praying for you.
Friday, December 5, 2008
35 hours
The results of today's bloodwork were really good. My HCG level was 164 and my progesterone level was 27.4. James ran the number through some system, and it calculates that my HCG level doubles every 35 hours. Provided that it climbs 66% within 48 hours, the pregnancy looks good. This pregnancy (by the numbers) looks great!
The quickness of the climb puts me at a high potential for multiples. My first scan with Dr. Trimmer is at 6 weeks on December 15. We'll see how many there are at that time. Time, please fly!
The quickness of the climb puts me at a high potential for multiples. My first scan with Dr. Trimmer is at 6 weeks on December 15. We'll see how many there are at that time. Time, please fly!
Insomnia
I'm 4w 4d, and I have insomnia. It's 3:08 A.M., and I'm only now beginning to feel like I could lay down to close my eyes. I don't know what the deal is! If there's any advantage, I get things done in the middle of the night. Still, sleep would be so much better.
Still waiting on the lab resuls. Should have them around lunchtime tomorrow.
Still waiting on the lab resuls. Should have them around lunchtime tomorrow.
Thursday, December 4, 2008
Three days later
We've known about this pregnancy only about 72 hours, and yet, it already feels so old. Not old as in we're over it, but old as in it's only been three days?! I think we both forgot just how involved my pregnancies are! Already I've been to the lab twice and to the doctor's office once. I've spoken to the nurse probably six times on the phone and once in person. I still have to connect with Dr. Trimmer, and make my official first OB appointment. So much to do, so little time.
Because it was the end of the year, James was able to modify his benefit elections for 2009. He changed our FSA, so we'll be able to pay for a bit of this pregnancy pre-tax. That's nice. Also, our insurance plan went down about $165/month (for the same coverage), so we won't even notice what's being taken out pre-tax. We're already accustomed to it not being in the paycheck.
As for how I feel, I feel hopeful. I certainly feel pregnant physically. I've been drained and unmotivated, and I have tingly, itchy body parts. No nausea, but that's not a common symptom for me. I'd like to think I've had some food cravings, but it's too early for that. Pseudo-cravings -- that's what I've been having. Now, if only James would get on board and honor the cravings, pseudo or not. He said as long as I crave Sonic, Chicken Express, or Chio's Mexican Food (all the local restaurants -- seriously, all of them), I'm all set.
Because it was the end of the year, James was able to modify his benefit elections for 2009. He changed our FSA, so we'll be able to pay for a bit of this pregnancy pre-tax. That's nice. Also, our insurance plan went down about $165/month (for the same coverage), so we won't even notice what's being taken out pre-tax. We're already accustomed to it not being in the paycheck.
As for how I feel, I feel hopeful. I certainly feel pregnant physically. I've been drained and unmotivated, and I have tingly, itchy body parts. No nausea, but that's not a common symptom for me. I'd like to think I've had some food cravings, but it's too early for that. Pseudo-cravings -- that's what I've been having. Now, if only James would get on board and honor the cravings, pseudo or not. He said as long as I crave Sonic, Chicken Express, or Chio's Mexican Food (all the local restaurants -- seriously, all of them), I'm all set.
Wednesday, December 3, 2008
Initial Lab Results
The lab results came in just now, and it's official -- I'm PREGNANT! My HCg level was at 64, and my progesterone level was at 25.2. I can't recall a time when my progesterone level was so healthy -- especially this early! Remember, it was drawn yesterday, which should have been the first day of my December menstrual cycle. Anything 15 or higher is acceptable. Between 17-20 is good. 25 is WONDERFUL!
I really am so excited about that number because the progesterone issue is always what does me it, whether physically or emotionally. For once, I don't feel worried.
As a precaution, I'll be taking 200mg Prometrium orally only once per day. (I honestly think that's for my peace of mind rather than for any medical reason.) Additionally, I'll have monitoring labs drawn every Monday and Thursday until I reach 10-12 weeks gestation. At that point, the placenta should meet take the place of the corpus luteum and progesterone will be unnecessary.
I tried to call Dr. Trimmer (the perinatologist) to touch base and to see when he wants me in for my first scan. He'll want to make sure the placement is ok with regards to the T.A.C. (transabdominal cerclage). They're out of the office now, so I'll try again another time.
I really am so excited about that number because the progesterone issue is always what does me it, whether physically or emotionally. For once, I don't feel worried.
As a precaution, I'll be taking 200mg Prometrium orally only once per day. (I honestly think that's for my peace of mind rather than for any medical reason.) Additionally, I'll have monitoring labs drawn every Monday and Thursday until I reach 10-12 weeks gestation. At that point, the placenta should meet take the place of the corpus luteum and progesterone will be unnecessary.
I tried to call Dr. Trimmer (the perinatologist) to touch base and to see when he wants me in for my first scan. He'll want to make sure the placement is ok with regards to the T.A.C. (transabdominal cerclage). They're out of the office now, so I'll try again another time.
Tuesday, December 2, 2008
Two more tests can't be wrong...
This morning, I took two more pregnancy tests. Two different brands, even! (Just want to make sure I'm not dealing with a faulty lot.) One test showed two pink lines. The other, a blue plus sign. Three tests later, I'm pretty sure there's no mistake.
I've already called the doctor and will have blood drawn today to confirm the results. They'll also draw for a progesterone baseline. Today would be CD28, so I'm 4w 0d pregnant today.
I've already called the doctor and will have blood drawn today to confirm the results. They'll also draw for a progesterone baseline. Today would be CD28, so I'm 4w 0d pregnant today.
Monday, December 1, 2008
Good News!
We found out today that I'm pregnant! We've been trying to conceive on and off since my most recent loss in August 2007. After being on high doses of Clomid for most of the year, I was beginning to be concerned about broken parts. Honestly, so were the doctors.
After developing an ovarian cyst during my Sept/Oct cycle and having my normally 28-day cycle extend to 52 days, my doctor decided we should take a month-long break. I just saw my OB/GYN two weeks ago for my annual, and he was in agreement for the month only, but then wanted us right back on the conception track. His words, "I don't care who gets you pregnant, as long as we get you there." I'm hoping he meant my doctors by medical procedures -- not some other way! :)
Anyway, this cycle was sort of a wash, what with Thanksgiving and traveling and the adoption seminar. We really had no hope. But, I had a cheap Dollar Tree test in the bathroom, and I took it late at night right before we planned to watch a movie. I took it, left it, and came back to check five minutes later. To my absolute surprise, I saw two lines!
We're very excited, but very apprehensive. Already, we've begun praying. I'll repeat the tests in the morning.
After developing an ovarian cyst during my Sept/Oct cycle and having my normally 28-day cycle extend to 52 days, my doctor decided we should take a month-long break. I just saw my OB/GYN two weeks ago for my annual, and he was in agreement for the month only, but then wanted us right back on the conception track. His words, "I don't care who gets you pregnant, as long as we get you there." I'm hoping he meant my doctors by medical procedures -- not some other way! :)
Anyway, this cycle was sort of a wash, what with Thanksgiving and traveling and the adoption seminar. We really had no hope. But, I had a cheap Dollar Tree test in the bathroom, and I took it late at night right before we planned to watch a movie. I took it, left it, and came back to check five minutes later. To my absolute surprise, I saw two lines!
We're very excited, but very apprehensive. Already, we've begun praying. I'll repeat the tests in the morning.
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