IVF #4


Those of you who deal with pregnancy announcements regularly have my respect and my sympathy.  I don’t get them very often, probably because I don’t work a regular job in a regular workspace, and since I run away from anyone who seems fertile. 

Or, I should.

It’s been building up for a while.   I’m confronted by more and more pregnancies on my blogroll, particularly among DE friends in the computer.  It seems like everyone is getting their DE pregnancy on the first try.  I have given myself the same pep talk over and over again, even as I itched to write something snarky to infertiles whose conversation is now all-pregnant, all the time. 

Part of the pep talk is how grossly unfair that would be; several of the blogs I mention above are consumed with pregnancy guilt and they are all about gratitude, and don’t deserve snark of any kind.  Hence the self-control and pep talks.

The problem with this pregnancy announcement pain is that it doesn’t make sense.  Someone else didn’t take my pregnancy.  They’re not stacked up on a shelf (that I can’t reach) somewhere.  It doesn’t affect me or my chances.  I’m also on the brink of what we all think is my last (set of) cycle(s), and there don’t seem to be any looming reasons why one of them won’t work soon.  I’m even covered by insurance for these FETs.  So you’d think a pregnancy announcement would be doable, and I think I thought so too.   I try so hard to not Go There because I know it makes me look jealous and self-absorbed and selfish.  In my heart of hearts I know I am, can be, these things; but being known for them is something else.  Something that I want to avoid.

But then there’s the Lupron, and it’s Christmas, and my loss is still pretty recent, and oh! you pregnant bloggers are killing me. 

So the pregnancy announcement came, during a cozy women’s group meeting with no where to run to.  The kicker is, I had a feeling it was coming.  Take a woman under 25 with not-very-reliable birth control, add a few weeks of casual references to having some kind of bug and not feeling well, and throw in the crucial catalyst: this would be a really, really bad time for me to hear this news, and I knew it.  I stood in my kitchen and wondered who I could call who might know ahead of time, and just ask.  So I could stay home and miss it.

I didn’t; I went.  One of the women did know ahead of time, and didn’t think to give me any warning.  She wouldn’t know how much I needed that.  She might know now.

Because it all came out, and I was surprised.  I tried to look blank for a while but then the tears started to flow. I just tried not to sob.  It’s funny that this, my loss of control at someone else’s joyful news, might make me look petty or jealous.  Because this yawning, roaring pit of grief was so much bigger than I expected, so much more raw and monstrous than jealousy or spite. 

For me it’s the abyss of God’s face, turned away.  When regular people get pregnant and I see how it happens in an instant and is unstoppable, I realize how different I am.  It’s so comforting to be surrounded by others for whom it’s difficult too; we can overcome this difficulty.  But to be confronted by people who get pregnant in the literal blink of an eye without thought or effort is to be confronted by the loss of a part of my humanity.  That God would turn his face away, for this long, is so terrifying and baffling that I can’t put words to the pain of it.

Having to keep it together and not draw focus during someone else’s happy time made it many times worse.  Particularly since I suck at that.  My friends knew I was suffering but what can you do?  It didn’t help that our friend is due on the very day I would have been, and what are the chances of that?

I tried to not look sad and I know that didn’t work.  I tried not to cry, and that didn’t work.  I told myself I just shouldn’t sob audibly.  I breathed and told myself "this is not about me" over and over and over again.  I didn’t scream til I got to the car.  My friends were lovely, wonderful, and it could have been a lot worse. 

I feel bad for my pregnant friend.  I’m sure the celebration was muted because of me, and I should have had the opportunity to skip it.  For her, as well as for me.  I hated myself for draining joy out of the night and I would have done anything to change that.

So it all came out, and still is.  It wasn’t an easy night and today might not be a great day but I’ll have to let it run its course.

I have a perspective on this that I wrote about several months ago, when a 43-year old who is a close friend got pregnant.  That pregnancy announcement was a lulu and it so drove me to the brink that I ended up writing this about it.  I’m linking it separately because it’s long, and it mentions the Bible a lot, and if some of you don’t feel like Going There, you don’t have to.  For some reason I never had the nerve to publish it and I hardly have the nerve now.

But it might be what gets me through today. 

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At yesterday’s scan, they saw the gestational sac clearly in my tube.  I don’t remember which tube.  I have had only the very occasional twinge on either side, no pain, no spotting or anything.

I’m supposed to go back on Thursday for another scan.  This is to make sure that the other embryo doesn’t magically show up in my uterus as a second sac.  Since I was 5w2d at this last scan, it’s a long shot but not a total fantasy.  This would be heterotopic pregnancy, supposedly rare but not so rare with IVF.  Chances of a heterotopic: as high as 2%.  Chances of an ectopic in an IVF: 2-4%.

If no second embryo, then I’m going to be encouraged to take methotrexate, an injection, to "resolve" the ectopic and make it stop growing.  If there is a second embryo, then I’ll have no methotrexate – surgery to take out the tube.  I need my tubes like I need an 8-track player, so I’m better off than lots of other women in that respect.

While an ectopic pregnancy can be life-threatening, the doctor thinks we have until the end of the week to decide how to deal with it.  I would be 6 weeks on Saturday but I probably won’t get there.  Since I have no ectopic symptoms, and the sac in the tube is still small, the danger to me is pretty minimal, especially since it’s now diagnosed.

Meanwhile my betas continue to double.  I’m in the 3000’s now (can’t remember the exact number).  With the increasing beta came the longed-for morning sickness.   After a few hours of refusing to throw up last night, I gave in and barfed.  I have always been scared of throwing up, even though when I do, I usually wonder what the big deal was.  I was afraid I’d continue to feel sick but I felt better immediately.

Last night, after a day of crying, the nausea seemed like an unbearable irony.  Today I feel better about it.  I always wondered / worried about how I’d handle that part of a pregnancy, and I did want to get far enough into pregnancy for it to be, well, real. Even though ectopic is an outrageously sucky outcome, at least it’s not the tentative, ephemeral non-result I’ve had before.  So far the nausea starts up in the evening – I woke up with a very empty stomach and feel just fine.  So far.

I’m curious (and would love to hear from anyone with experience) because I have read that after methotrexate, I might have to wait 3 months to try again.  This might be more about conceiving "naturally" or with one’s own eggs, neither of which applies to me.  I have also read that it may take many weeks for the betas to come down, so that I’d have to wait quite a while anyway.  My doctor also tells me that methotrexate doesn’t have a lot of side effects.  Naturally I’m skeptical.

I am wondering if I shouldn’t just ask my doctor to do the surgery anyway, and at least get a look at my endometriosis, and maybe take care of some of it.  I have never had a lap.  I’m secretly hoping I’d be able to try again sooner and that my betas would come back down more quickly if the Wanderer were removed surgically rather than killed slowly with the methotrexate.  Not a good choice either way.

Getting the betas back down was not something I’d thought I’d ever be concerned with.

I have run out of almost all my meds at this, the worst possible time; I will have to get refills and end up with leftovers of everything, which I hate, even though I will certainly need them next time.

What else?  Yesterday was very intense.  Shock and numbness followed by a day of crying which is probably just the beginning.  I didn’t want to hope for the second embryo to show up, but of course I do.  It’s just so strange that in the midst of all this tragedy I am still pregnant, and feeling it more every day.  The perfect timing of this pregnancy is now perfectly awful – I was going to be able to tell my parents at Thanksgiving and the rest of the family at Christmas.  Now I’ll just continue to be Aunt Joy, who seems to wants kids but never has any, is sad a lot, and gets older and fatter every year.

My focus during this time is a kind of submission.  I know it’s okay to be angry at God, but I also think I have to accept that God has allowed this – but God is still good –  if I’m going to recover.  I was thinking about this when I was so worried about the betas and the scan.  Every mother says that the worrying never ends, and I have to figure out how to survive it.  For me that means accepting God in the good and the bad, otherwise I live in fear.  Probably will anyway but I need it to be less.

I also want to be more willing to hope, even for things that are unlikely.  Especially for those things.  I was doing well with hope leading up to yesterday’s scan, and even though I got blindsided again, I think hoping was still worth it.

The comments and emails have been life-giving.  When I’m feeling detached they help me to cry.  The prayers help too.  Thanks so much.

First of all my sleep is crap.  It always is, but lately worse.  I wake up at 3 or 3:30 feeling slightly wired.  I can sort of get back to sleep, but if I don’t have the luxury of sleeping til 8 to make it up, it’s not good.  I’m getting pissed off at the pregnancy websites that say “you need plenty of sleep” or “don’t be surprised if you find yourself sleeping 9 or 10 hours a night.”  And that the progesterone can make you sleepy in the daytime and keep you up at night.  Isn’t that hilarious? 

uh, no.

FritosoriginalObviously I’m a little bit nervous about this pregnancy BUT I’m doing pretty well.  My acupuncturist, Dr. Lee, said on Friday that there was absolutely nothing to worry about and I am muttering that under my breath a lot.   I feel pregnant, I guess; woozy sometimes, sleepy sometimes, wide awake at 3 a.m., and ravenously scarily hungry.  I’m trying to eat fruits and vegetables but people, all I want are Fritos.  I guess I have a salt thing going on.  I’m trying to be conservative and dump soy sauce on my brown rice instead of eating salty fried corn chips all day but it’s taking some will power.

We have the ultrasound Tuesday and at least we’ll all see whatever we see together, and I won’t have to wait 3 hours for a scary phone call.  Did I tell you my clinic coordinator laughed merrily at me on Thursday when I picked up the phone to hear about my second beta?  Apparently my nervous, breathless, stammering “hello” was hilarious. 

But that’s okay.  Maybe I really do have a chance if everyone else is so relaxed and cavalier about it.

I really am doing a pretty good job just keeping the faith that this pregnancy will last.  It’s not comfortable, but it seems like the right way to get through the next few days.

Note to my friends in real life (IRL): Don’t tell anybody that I am pregnant, OK?  Just because I’m spreading my business all over the internet doesn’t mean you get to.  If anyone comes up to me and says “oh my gosh I heard you were pregnant,” I’ll do a highly scientific triangulation of who you know and who they know and Jack Bauer will have Chloe reposition the satellite and then I’ll know it was YOU.  I’m waiting at least until we have a heartbeat to tell.

See?  I almost sound like I believe that will happen.

612.

What a relief.  I was in an absolute tizz about this stupid blood draw.  Didn’t sleep half the night.  Could not shake the idea that my beta levels are like a lead balloon that just won’t rise or act right.  I tried.  I prayed, I knew that we’ll pick ourselves up somehow if this pregnancy tanks, I looked at the very helpful chart at www.babymed.com, that plots my HCG rise confidently above the "average" line.  But what with the hormones and the no sleep I got to my blood draw and collapsed in tears.

What a relief.  I guess I’m really pregnant.  For now, at least.  Please God let me just be pregnant and not get myself into a tizz again too soon. 

My ultrasound appointment is Tuesday at 9 a.m.  We should just see a "sac," I suppose there is still some chance that we’ll see two.  We may see or not see other, bad things at this appointment; I’m going to try really hard to not learn about them in excruciating detail. 

I’m so tired.  But happy.

225.

NOW I’m giddy.

Dscn0513 …and I’m off for my beta blood draw.

…we will find out the number later today.

Thank you for supportive comments.  I am sort of ready for a cliffhanger beta, but feeling a little bit more confident because of the latest:

Dscn0510

While squinting at this one…

THIS ONE…Dscn0506 

came up SO fast I ran away from it with a little scream like it was a snake.

FYI I peed on both at the same time, because I am just that talented.

They are Safeway brand +/- (by Inverness) and EPT Certainty Digital, for any peestick geeks out there.  I have been poring over the peestick literature with Talmudic intensity today.  This is partly because my original two-negatives- followed-by-one-positive stick happened to be a brand that measures the lowest HCg you can get, I think; it’s a First Response Early Result, and according to this incredibly helpful website,  the First Response Early Result can possibly detect as little as 6.3 MlUs of HcG.  Which is why I descended to despair when I got negatives from that one on Friday night and Saturday morning.

Problem is, that stick’s HCG sensitivity could be 6.3, or it could be "15-25."  Apparently, it’s a secret.  All the damn HPTs have possibly lowered their HCG levels (you can tell because they all say "test five days sooner!"), so a positive HPT doesn’t mean I’m going to have a beta over 50. 

But at least these came up fast and positive, from not-very-saved-up early afternoon pee.  So I’m very, very encouraged.  I also learned that the beta HcG shows up in the blood sooner than the urine, so the peestick results are a little bit behind the blood test.  This is why I could have had a positive peestick the day before my very low beta last time – as the beta in the blood fell, the urine still had a higher level.

I know you really, really want me to go and get a life now.  I will try; or at least I will go eat, drink and do something else for a while so I can make MORE PEE.

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