Tuesday, November 30, 2010

9w4d Ultrasound

So, after getting increasingly petrified about this ultrasound over the past few days, I finally went in today to find out that everything... was fine. The baby measured right on target at 9w4d, with a heartbeat of 171bpm. While I was convinced last week that I had lost the baby, over the past few days I definitely hung onto that fear, but then also had this underlying feeling that everything was ok. I just didn't know which was the true gut feeling that I should actually listen to.... glad it was the good one. The other baby has nearly been absorbed already, which was sad but interesting too, to see nature just taking care of things. There was still a second gestational sac, but the ultrasound was only picking up a tiny dot of something within the sac, so it will probably be nearly absorbed by time I go in for my appointment next week with the high-risk doctor. And while I'm not even sure why I would still need to go to the high-risk doctor, I figure I might as well, 1) because my RE wanted me to, and 2) because that will let me have another ultrasound. If it weren't for that appointment, I likely wouldn't be having another ultrasound until my next appointment with my OB on 12/28. I don't understand how "normal" people can handle going so long between ultrasounds. It's still going to drive me crazy to have to go two weeks between the high-risk and next OB appointment, although part of that is because 13 weeks/Christmas is in the middle of that time, and it would make me feel better to have one last confirmation that everything is ok before we start telling everyone. While I'm not out of the woods yet with the risk of miscarriage, I just keep thinking that every day we make it lowers the risk just a little bit until I can get to the magical 13 week mark when the risk is around 2%. I know miscarriage still happens too often after that point, but since the odds aren't going to get any better than that, that's at least what the goal is to get to at this point.

I believe this is referred to as the "gummy bear" stage... for good reason, I think. The baby is upside down, with a little arm bud sticking out on the middle left.

The baby is still upside down, but this is straight-on, with the arm and leg buds showing up as the bright spots at the top and middle.

Sunday, November 28, 2010

9 weeks

This week has been a bit of a mess inside my head. I thought my symptoms were lessening during the week, so I am now convinced that the remaining baby passed about mid-week. I realize symptoms can come and go, and some people don't even get any symptoms until weeks after this point, if at all, but these 1.5 week gaps between ultrasounds leave me enough time to imagine the worst.... despite any evidence to the contrary. I was trying to explain to Ryan that I thought I had lost the baby since all of my symptoms had disappeared, although I had to pause while telling him this to try to get my nausea under control. :-\ If I do decide to acknowledge my symptoms, then I can also convince myself that they're all just a side-effect of the progesterone and estrogen meds I'm still taking - which is entirely possible, but hopefully at least some of this is still being caused by a growing baby. I thought the bloating had gone down some mid-week, although I realized that that was probably just because I was wearing some work pants that are a bit looser around the waist, because when I tried to put on my non-loose jeans the next day, I was right back to being uncomfortable and constricted. I also realize that bloating usually goes down a bit before the real baby belly starts, but I've just been clinging to my symptoms as a security blanket so much that I don't want any of them to go. In fact, although the low-level nausea was back most of the day yesterday, today is the first day in weeks that I haven't put on my Sea-bands because I *want* to feel the nausea. A bit twisted, perhaps, but it's not bad and it provides me with some comfort. And if I go in for my next ultrasound on Tuesday to find out that I lost the second baby too, at least then I have a few more feelings and memories to hold onto for what it felt like to be pregnant again.

I've also still been dealing with a stuffy nose (one of the first symptoms I had, starting the day I got my first positive HPT at 3w3d!), which has been fine, except now it feels like it's starting to develop into a cold. Sleep has also been a struggle for me the last few weeks. I'm not sure how much of that I can blame on the time change three weeks ago or the pregnancy, but I've been waking up about every half hour from 6:30 on... extremely frustrating, especially this week since I had a couple days off work so I was hoping to catch up on some sleep, and instead I was up by 9:30 every day except Friday, when I managed to power through a few hours of crappy sleep and actually got a few more solid hours of sleep in, waking up after noon for the first time in ages. The craving of the week continues to be hamburgers, although that's starting to taper off now after 3 hamburgers in a week. I also ate mac n' cheese yesterday, and the cheese actually tasted sort of... good. I'm confused by that, given my long-standing dislike of cheese.

Obviously, this week was Thanksgiving, which was a point of concern for us, since we're not planning on telling everyone until Christmas, when I'll hopefully be 13 weeks. To throw everyone off the trail, I actually drank some beer at Thanksgiving... or at least, I drank out of a beer bottle ;) We had replaced some Yuengling with near-beer, which wasn't my favorite, but at least crappy pilsners just taste like glorified water anyway. It sometimes seems a little strange that we're going to such lengths to avoid telling people early - especially our families - but we're doing this for a couple different reasons, with the main one being I don't want everyone to get too excited this early, since we've had such a rough time getting and staying pregnant. Especially with some younger kids involved, I would just rather wait until second trimester to tell everyone to hopefully avoid the awkwardness and sadness of having to untell everyone.

8-9 week comparison

Saturday, November 20, 2010

8 weeks

This is a rather bittersweet milestone. I was supposed to be 8w1d during my first pregnancy when I went in for the ultrasound that showed there was no longer a heartbeat and the baby was only measuring 6w3d. And given what happened at my last ultrasound this time around, I'm not feeling as happy to have reached 8 weeks as I thought I would be. So, assuming the remaining baby is still doing ok, this is the most pregnant I've ever been, and I thought I would feel more confident at this point. Instead I just feel more worried than before, now that everything is just pinned on the one remaining. I guess as some small consolation, my nausea was worse yesterday than it had been, since I inexplicably was worried that all of my symptoms were going to stop since we now knew that the one baby had passed. That's why I had been trying to pin down when the heartbeat may have stopped so I could remind myself that I still had some pretty noticeable symptoms even after that point to try to nip that worry in the bud. My internet research (always taken with a grain of salt) also revealed that Vanishing Twin Syndrome is apparently quite common, with up to 1 out of 8 singleton births starting out as twins (and I did not double-check that stat, so I may have just perpetuated false information here). That makes me feel slightly better too, since I'm just so worried that having one pass is just going to lead to the second baby passing too... and although it's entirely possible that the second heartbeat may still stop too, that happening would likely be completely independent of the first baby passing.

On a slightly more upbeat note, I've also had a few more symptoms crop up lately, which are more of the digestive tract variation, so I won't get into the details of that here. But one of the very first symptoms I had (like, within days of transfer) was a sudden inability to form coherent sentences... I normally can get a bit tongue-tied, but this was a whole new animal, since I would just say the complete wrong word (usually at least getting the first couple of letters right before veering off into randomness), forget what I was saying, or just end the sentence at a completely different place than I planned to. It was frustrating but also a bit funny since it was so weird. And then a couple of weeks ago, I was on my way to eat at Chick-Fil-A, which is a straight shot from my house - literally, two turns to get out of my neighborhood, go straight for about 2-3 miles, then turn right into the parking lot. I somehow managed to turn at the light before the parking lot, and I didn't even realize I had switched lanes to get into the turn lane until it was too late. I somehow snapped out of whatever daze I was in to realize what was happening (which went like this - "What am I doing? What?! NOOOoooo..."), but since there was a divider, I couldn't even get back out of the turn lane. So instead I took a nice little detour, probably involving an illegal U-turn, just so I could have my fast food since nothing else seemed appealing. And then yesterday at work, I managed to have the concentration of a gnat, since I kept trying to work on something that I needed to have done the day before, but yet I kept getting distracted. A coworker came by to talk to me about it, I swore I would have comments to him within the next couple of hours... and then I immediately started working on something else. I would suddenly remember again, start working on it again, get distracted by something else and leave off in the middle of my edits. Once I actually left the document on top of my keyboard so I would remember to work on it when I got back from the printer, and yet I still immediately forgot as soon as I removed it from my keyboard so I could unlock my computer. And when I did actually get to it and was taking notes on the hard copy, I managed to leave the last letter off of nearly every word that I wrote. So weird.

So here's this week's comparison pic. Although the bloating felt worse this week, it actually looks about the same in the comparison to last week's picture. So really, the only thing notable in this week's pic is the presence of my trusty Sea-Bands :)
7-8 week comparison

Thursday, November 18, 2010

7w6d Ultrasound

I went in for my last ultrasound with my RE this morning before I graduate to my OB, and just as I feared the second I heard one of the babies was measuring 2 days behind at my first ultrasound, we only had one heartbeat today. I'm not sure if it definitely was the one that measured smaller on the first ultrasound, but that seems to make the most sense. So it measured 6w1d last week, which the internet tells me is about 4.5mm, when it should have been about 6.4mm, which is what it was this week (10 days later). My guess is it stopped growing sometime towards the end of last week, based on the time it would likely have taken to grow to 6.4mm and then a little beyond, since my understanding from my first miscarriage is that the baby will usually atrophy and shrink down again once the heart stops beating. I guess the medical term for this situation is Vanishing Twin Syndrome, since the other baby will keep my hormone levels up so everything isn't shed out of me. Instead, we will just wait for it to... vanish. My RE thought it should be reabsorbed back into my body by time I'm out of first trimester, so he also referred me to a high-risk doctor to monitor things to make sure the viable baby isn't threatened while the other one is reabsorbed. I have my first appointment with my new OB on 11/30, and then go to the high-risk doctor on 12/1. At this point, I'm planning to go to the OB until the second baby is reabsorbed, and then I'll transfer back to the midwives I normally see. I got the distinct impression the high-risk doctor will not work with midwives (since they told me that they wouldn't see me until I had an OB selected, since they needed to coordinate with the delivering doctor - which I find odd, since the midwives have hospital privileges to... deliver babies), so although it's going to stress me out to switch practices, I figure it's easier this way so that the high-risk doctor and OB will coordinate with each other until I don't need to be seen by the high-risk doctor.


I'm feeling a strange mix of sadness for the baby we lost, happiness for the baby we still have, and a small amount of relief for the health concerns that I had with carrying and delivering twins. None of these emotions feels especially appropriate on their own, though, and so I landed at just feeling pretty numb today. Since I was kind of expecting this to happen, I didn't even cry when my RE first said there was no heartbeat, which was good, since I wanted to stay present for the rest of the ultrasound rather than just losing it (which I did on the way to work instead). The part that did make me tear up during the ultrasound was actually being able to see the heartbeat of the remaining baby, though. I hadn't been able to make out the heartbeat last week, so it really got to me when my RE went into a closeup and I could actually tell which was the head end of the little lima bean-looking being, and then saw a very noticeable flutter in the middle. All I can hope for is that this one hangs on, and since it measured pretty much right on target at 14.5mm with a strong heartbeat of 164bpm, it looks like we're still in the game. I've been doing my trusty internet research most of the evening, trying to find some reassurance in statistics that just because we lost one of the twins, that we won't lose both. The chances of losing the second one are supposedly quite low - about 5% now (per http://humrep.oxfordjournals.org/content/18/8/1720.full) - and while I know that the statistics won't dictate the outcome of my own situation, I'm trying to keep in mind that the odds are definitely in favor of this one sticking just so I don't get too caught up in thinking about the negatives.

Tuesday, November 16, 2010

Waiting Game

Just waiting until the next ultrasound on Thursday. I still feel fairly positive, although it's also in the back of my mind that one or both of the babies may have stopped growing. My intensified bloating and "morning" sickness is providing me with some comfort (however misplaced) that things are still progressing ok in there, so I'm hopeful that they're both fine. I just keep telling myself that people go on to have successful pregnancies all of the time after infertility/miscarriage, and why shouldn't I be able to too? On a possibly related note, I just downloaded some old Cranberries music, including their album "Everybody Else is Doing It, So Why Can't We?"... I suspect that may have influenced my latest mantra ;) The highlight of my day is probably still when I can go home and put on my purple pants... although this isn't exactly new. I bought these pair of purple lounge pants a while back that are my winter "house pants" that I change into when I get home each day from work, and for some reason the purple pants (and previously, flannel pants) just make me happy. This is especially true now, since my work pants don't exactly fit now, and I hate anything tight around my waist anyway, so usually by the end of the day I'm uncomfortable and irritated. I'm sure in a few months I will look back at this level of discomfort and laugh at myself, but in the meantime, I can still grump about my work pants and look forward to the purple pants waiting for me at home :)

My nausea has continued to get worse over the last few days, although it's still really not that bad. I just have a low level of constant nausea with some waves of stronger nausea throughout the day as I get hungry. I've been able to stay on top of eating as soon as I get hungry, which I think is really helping. I was worried that that was going to make me gain weight too quickly, but I seem to be doing ok in that department too... despite increasing my daily consumption of pretzel rods, bananas, and ice cream. But definitely not all at the same time - just rereading that sentence again made my stomach turn. Ugh. I get to play this fun game now to see what I might be able to stomach - it basically consists of thinking about the food/drink and then waiting to see whether I feel like I'm going to throw up. So far, salads have failed this game fairly consistently, which is pretty bad since that's what I normally eat for lunch at work. Every day. I used to actually look forward to it (almost two years into the daily salad regime), and now it's a struggle. I've tried different dressing (actually switching to Ranch, which makes everything taste better but isn't exactly healthy) and switching lettuce, going from red leaf to iceberg (since I got sick of having to wash each individual leaf of lettuce), and now to the pre-washed containers of organic mixes. I think I may be ok if I can find the right mix - the one I have now is an herb mixture, and there's something in there that is not agreeing with my overly-sensitive sense of smell right now. Part of the reason I like the daily salads so much is because it reduces the stress of figuring out what I'm going to bring to work each day - whatever I can do to minimize time spent preparing meals and cost is the ideal, especially if it also helps me keep my weight fairly stable.

Ryan has now completed hopefully the last injection he'll be giving me. I have one more shot to go tomorrow, but he's out of town again, so he got to celebrate his last delestrogen injection on Sunday. We figured out right from the beginning that the shots hurt less if I'm distracted, and what better distraction is there than Ryan's singing? There have been some notable songs over the last month and a half, although I think my favorites were the one that had no words, just odd, disgruntled noises that had me laughing so hard I was afraid I was going to mess up the shot, and then the last one, which was set to the tune of "La Bamba" and involved the opening line "You got a needle in your back." Classic.

Friday, November 12, 2010

7 weeks

7 weeks today. The most notable development this week was daily nausea, and more of it. I get motion sickness very easily anyway, so this was one symptom I was definitely expecting. Except for Tuesday, though, it hasn't been too bad - just a few waves of nausea throughout the day, which triggers me to a) put on my Seabands, and b) eat some pretzels. I learned pretty quickly not to mess around with my eating schedule, since Tuesday (my late day at work with a standing 5pm meeting) I ended up feeling so wretched it took me over an hour to get through half a baked potato and a can of ginger ale. I thought I had kept up with the snacking, but after getting stuck in some stop-and-go traffic on the way home, I found myself contemplating if it would be messier to throw up in my lunch bag or out the car window. Luckily it didn't come to that, but I was miserable and beginning to regret tempting fate by reveling in any pregnancy symptom I could come up with. The next morning, I was already down by a couple of pounds, which was a bit concerning, but with a better handle on eating as soon as I feel any amount of nausea or light-headedness, I went right back up to my normal weight. I also had more sensitivity to smell this week, which probably didn't help with the nausea issues, and besides a fit of absolute rage last week, I've been pretty steady emotionally. In fact, I'm even starting to feel a bit more comfortable with this pregnancy, which is a little silly since I'm still so early, but really, no matter how much worrying I do it won't change the outcome anyway. So I've decided if I want to believe that this pregnancy is going to last through the end, I'm not going to try to discourage myself from taking comfort in that.

Not too much difference in this week's comparison picture, although it does look like the bloat has gone down a bit.

6-7 week comparison

Monday, November 8, 2010


Today was my early ultrasound at 6w3d, and sure enough, we have twins. Twins! My doctor even had me guess before he started the ultrasound, and although I had strongly suspected it ever since the first HPT, for some reason I was the most confident yet when I told him there were twins in there. Five seconds later he confirmed it, and about five seconds after that, he confirmed that both had heartbeats. He was actually going so quickly that I was having troubles keeping up, which was probably for the best, since I didn't want to start crying or anything and miss everything he was doing. So he measured Baby A first (the smaller of the two), which measured at 6w1d with a heartbeat of 121bpm, which are apparently both perfectly normal measurements (although of course I'm worried that it measured 2 days behind where it should be). He also measured Baby B, which I think he said came in at 6.4mm (but didn't mention the weeks/days measurement), and he didn't do the heartbeat. Everything looked good, although my doctor did point out that although there are two currently, it's not uncommon for one to be absorbed. Which may sound harsh, and I hope it's not because he saw cause for concern due to Baby A's size (although he also said that's normal for there to be a disparity in sizes - even this early - in multiples), but I feel like I'm being fairly pragmatic about this so far and so I appreciated the same from him, as I am not going to be naive enough again to think that just because we saw the heartbeat that everything is guaranteed to turn out fine.


The other exciting development from today (besides the confirmation of twins!) is that my daily PIO injections are over! Yay! My back is a mess of bruises and welts right now, so that came not a moment too soon. So now I have to take Endometrin, which has its own set of issues, but at least it doesn't involve sticking a 1.5" needle in my back. I also got the okay to switch from the every-three-days estrogen shot to a twice-a-day pill, which is great except for I don't think I have enough pills left to last me until 12/19, when I'll be done with both the progesterone and estrogen. Since I'm pretty sure we're out of pocket at this point (whenever our insurance finally catches up and lets me know how much we have left for our infertility cap would be awesome - I haven't heard anything from them since our copay bill for the second IUI in July), I'm being a bit more careful about refilling prescriptions if I have other options. At some point this week, I'll count out how many of the estrace pills I have to work backwards to when I can stop with the estrogen injections, and then I'll just have to hack it with those until that point. Which hopefully having a couple days in between injections will give my back a little time to heal.

My doctor also kind of told me I could continue riding - he wasn't too thrilled about it, but he didn't flat out tell me to stop, which is more what I was expecting. He was more worried about the up-down motion (which they apparently usually recommend against using a treadmill, etc., for the same reason), but said that it shouldn't be a problem if I'm careful - although he did want me to hold off on riding until after my spotting stopped. Internet research has pointed to PIO as sometimes being linked to spotting, so I'm really, really hoping that it will go away soon now that I'm off that.

One of my concerns about having twins has already struck though. I'm going back to my doctor in 10 days for another ultrasound, and then if everything looks good, he'll release me to my OB... the only problem is, I normally see a midwife, and it turns out they won't take on "high-risk" pregnancies, which I apparently am with twins. That was a pretty big disappointment, because we really wanted to do things more naturally (yes, despite the fact that we went the high-tech route to get to this point) and I was hoping to have a med-free birth. Although one of my friends was able to do that with twins a couple of years ago, I think that's pretty rare and it stings a bit to have to come to grips with our decision of putting two embryos back has essentially made it much more difficult to do something that was very important to us. I also don't want to endanger the babies in any way, though, so while I have some more research ahead of me to see what kind of options I have, I'm also well aware that two babies + a c-section is still far more preferable than no babies + the idyllic natural birth that may never have been anyway.

So I've been a little subdued today, just thinking about all this stuff (and with some more light-headedness and nausea than normal) and trying to come to terms with the fact that my plans have likely changed, and also acknowledging my role in this decision. That was such a hard part of the IVF process anyway, since it's hard to make decisions that can have lasting, lifetime impacts (ranging from how many embryos we should transfer - since multiples tend to be born prematurely - to whether we should use ICSI to fertilize the embryos - since there are some linkages with ICSI/IVF and increased genetic defects), that will affect both Ryan and me, and any child(ren) we have. But we had weighed the risks at the time, and made what we believed was the best decision based on all of the information we had, so I also have to comfort myself with that rather than focus on the "what ifs".

Saturday, November 6, 2010

6 weeks

I've made it to 6 weeks now. The bloating seems to have lessened a bit, although this week I started having some issues with nausea, smell sensitivity and food aversions. All of which made eating not a very fun experience. I was planning on continuing with my lunches of a salad and fruit to help counteract my full dinners and ice cream/cheesecake desserts, but suddenly the mere thought of a salad is turning my stomach. Normally I fluctuate about 5 lbs each week (starting the week at the heaviest after a weekend of eating out, and then ending at my lightest on Friday), but this week I held pretty steady at my normal Monday weight all week. Not being able to eat salads will not help with this issue.

My whole meal schedule has also been thrown off the last couple of weeks - normally I eat breakfast around 9:30-10:00, then eat lunch around 1:30-2:00, and then dinner around 6:00-7:00. Now I'm lucky if I make it to 9:30, and then my stomach is growling by 11:30... I can usually fight it off until 12:30, but then I'm starving again by 3:00, so I've had to add a mid-afternoon snack now. So far either a banana or some greek yogurt is sufficing, and I guess that replaces my daily Mountain Dew, from any "extra" calorie standpoint anyway. And who knew finding a tea I could drink would be so hard? I have a stash of about 6-7 kinds of tea at work, and while some of them were automatically excluded because they're caffeinated, I thought the remaining decaf teas (green, apple spice, dandelion, and elderberry/blackberry) would be fine. But then I read to avoid green tea while pregnant (although it wasn't entirely clear if that was under the assumption that it was caffeinated), and then both the apple spice and elderberry/blackberry teas have hibiscus in them, which I'm apparently also supposed to avoid. The dandelion tea literally had just dandelion in it, and that didn't seem to have any dire warnings about it, so at least I could have that.

There are three items that I use on almost a daily basis - a water bottle, a plastic container for salad (although this may no longer be an issue if I can't stomach salad), and styrofoam cups for my oatmeal. The one water bottle is no longer cutting it, so I started looking into getting a bigger one, which then led into researching the dangers of plastic. So now I'm worried about the one I do use (which is metal of some sort for the body but then has a plastic top), since I haven't found a good metal or glass one to replace it yet. It's never been heated though, and although the top is scratched a bit from washing, hopefully it's ok in the interim. The plastic container is supposedly fine (since it's #2), but I'm still worried since it's been used/washed nearly daily for a couple of years and it is pretty scratched up, which apparently helps with leaching. I tried switching to a glass container, but then have the same problem with the cover being plastic (and it didn't have the number listed on it). And now finally - finally! - I'm apparently motivated enough to try to get away from using the styrofoam cups for my oatmeal. The fact that I use and throw away styrofoam every day is something I've felt guilty about for years, but apparently not guilty enough to actually remember to bring a bowl to use. So far I've remembered to bring a glass bowl from home for one day, and hopefully I'll remember to keep doing this next week too.

The first ultrasound is on Monday, and I've moved away from just pure excitement to a mix of excitement and worry now. It turns out Ryan's going to be on an airplane at the time of my appointment, so now I'm disappointed that he's going to miss the big reveal of how many we have in there, and I'm also worried that if I have a blighted ovum (or two), that I'm going to have to deal with that on my own again, since I had gone to the ultrasound on my own during my first pregnancy when we found out the baby had stopped growing. But there's not much we can do about it anyway, and having Ryan there or not won't affect what's going on inside me, so I'll just keep my fingers crossed for good news that I can share with him as soon as he lands.

Below is my first official weekly comparison pic, although there's not much belly-wise to compare, so instead I'm more admiring the fact that there's no clothes on the ground for the 6 week pic and I got one side of my hair relatively tamed at least ;) As I mentioned, the bloat seems to have lessened somewhat, but it looks like it somehow got more concentrated into a narrower ring across my belly. Weird.

5-6 week comparison

Tuesday, November 2, 2010

Beta #3

Third and what should be my final betas were yesterday. Once again, I was too tired to write about it then. The fatigue was even worse yesterday, and basically the entire afternoon at work was spent with my eyes half open just struggling to stay awake. But it wasn't even just feeling tired sleepy - it felt more like a drugged sleepy, like I had taken too many Dramamine. Anyway, so numbers for the third betas were 14,341, which are pretty much right where they should be. We find out how many are in there on Monday, but in the meantime, I've been checking my betas against the single and twin pregnancy numbers on betabase.info, and I have to say, I really have a feeling there are two of them. Although I've heard stories about higher betas before and it turned out to be a singleton, and I also did have my very vivid, potentially prophetic dream the night of the embryo transfer that I was pregnant with one. So we'll see how prophetic that was. Or maybe the second one was just hiding behind the first in my dream, since the baby that showed up on the ultrasound in my dream was already 20 weeks along (the day of transfer! How...ambitious.).