A Legume

In February of 2016, Kyle and I went to what we hoped would be our last ultrasound at an IVF facility. I was about 8 weeks along with our first pregnancy from an IVF cycle, and we expected to see a bouncy little bean growing healthily and to be dismissed from the IVF facility and picked up by our usual OB/GYN. Sure, some people struggled through years of IVF to get pregnant, but not us. We’d gotten pregnant right away and would have a beautiful baby in October of 2016. October 17 was the due date.

That… didn’t happen.

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(you start to ask yourself this a lot when you’re dealing with infertility)

Instead of an 8-week-old fetus, we saw something measuring about 6 weeks, if that, shaped like a flying saucer and not bouncing at all. We saw a heartbeat, but it was slow and weak, 65 bpm, very appropriate for a healthy adult, not at all for an 8-week-old fetus.

We had the cool ultrasound tech, the one we’ve had for nearly every ultrasound since then that’s brought us either good or bad news. She’s got a great sense of humor and was trying to keep us optimistic. “I’ve seen it go either way!” she said, but the doctor we spoke to afterwards was less than pleased.

“It rarely ends well when this is the case, but we’ll want you back next week to make sure. If the baby grows between now and then, we’ll take it as a good sign and just adjust your due date accordingly. If it doesn’t…”

So one week later, we came back, not expecting anything good, and sure enough, we got nothing good. The gestational sac was still there, but the weird little flying saucer fetus was gone. No heartbeat, no movement, nothing at all. We talked to the doctor again, who offered that I could wait it out, take a medication, or have a D&C. I chose the latter, not wanting to go through the pain of labor just to give birth to essentially nothing, not even remnants of fetal tissue.

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(it sucked)

In February of 2017, our first ultrasound for another pregnancy got bumped up a week because I’d started bleeding. A lot. I sat down on the toilet and it was like a murder scene. A clot the size of a lemon came out of me after I laid down and tried to slow things a little bit. The doctor wanted to see if there was anything left, if the bleeding had been the result of a subchorionic hemorrhage (a condition in which blood gets between the gestational sac and uterine wall and causes Problems).

I wasn’t surprised when nothing showed up on the screen. A clot the size of a lemon isn’t something that usually comes along with a healthy pregnancy.

Understandably, I’m a little nervous about these first ultrasounds. They’ve brought nothing but bad news so far, slow heartbeats, missing fetuses, nothing there. This morning, I’ve been shaky and tense since I woke up. I could barely eat breakfast, and only partly because of morning sickness. I couldn’t pay attention at work, and ended up pausing a lot of my tasks to just sit and breathe and try to calm down.

I got to the ultrasound place pretty early, but Kyle was running pretty late (like 15 minutes or so). Nothing distracted me or helped. None of the magazines in the waiting room held any appeal, Facebook and Tumblr seemed to just make me more tense, and I couldn’t even think of anything but “what if this is another miscarriage or failure? What if something’s wrong?”

Kyle finally arrived and we went back into a small room with dim lights. I changed and lay down on the warmed table, resting a hand behind my head and trying to stop shaking. I counted the tiles on the ceiling. The ultrasound tech–our favorite tech again–squirted warm jelly on the probe and told me, “alright, here we go.”

I saw it immediately, what I thought was a gestational sac. The trouble was, it didn’t have anything in it–no yolk sac, no fetus, nothing. That… wasn’t a good sign. At this point, we should’ve seen at least a yolk sac, maybe something more, but we saw nothing, just a dark circle surrounded by the grey of uterine tissue.

“Well, it’s something,” the tech said. “Let’s keep going.” She moved the probe around a bit, and suddenly, I gasped. There, right there on the screen, was a definite gestational sac with everything in place–the yolk sac, which provides nutrients for the baby until the placenta is fully developed, and the fetal pole, the beginnings of the baby itself. And flickering right there, in the middle of the fetal pole, was a heartbeat. Constant. Steady. And faster than we’d seen since Sam.

“98 beats per minute, which is excellent at this stage!” the tech announced. Faster than it had ever been with our first miscarriage last year. Steady. Strong.

We looked around a little more–I have some free fluid in my lower abdomen, likely thanks to my still-swollen ovaries, which are both still enormous (61 mm and 71 mm, respectively–that’s a peach and a pear in fruit sizes). The “gestational sac” we saw earlier looks like it’s actually a uterine cyst, which isn’t a bad thing but will have to be monitored as this pregnancy progresses. They want me back in a week to measure everything–to make sure the actual baby is growing and to make sure that the cyst is not (if it is, that might indicate that it’s an ectopic pregnancy, which presents its own set of Very Big problems).

But so far, it looks like finally, FINALLY, things are starting to go right, and I’ll finally have a baby legume come late April, 2018.

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(the legume in question, measuring exactly six weeks, one day)

Days of the Month

I bought a calendar for my office today. Here it is:

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It’s a necessity, really. Without going into too much detail, my work is deadline-based, and if I’ve got too many deadlines approaching at once, it ends very badly for myself and the people I’m working with. As the saying goes, you can have it good, fast, or cheap–pick two. So I fill out the calendar with due dates for various projects, and I color code them: pink for proposals, green for qualifications, teal for presentations, mauve for meetings, blue for holidays, purple for appointments, and orange for personal things (birthdays, anniversaries, etc.). I really like colors.

As I flipped through the calendar, I started vaguely thinking ahead, first about the immediate future and then about later days (because that’s how we look at time, in order, unless we’re writing science fiction, in which case, everything is made up and the points don’t matter).

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The immediate future is all medication, monitoring, retrievals, and (hopefully) transfers. I started my medications last night, and man, what an adventure. My computer wouldn’t turn on, and the site with injection instructions wouldn’t load on my phone, so I had to sit at Kyle’s computer with a bunch of syringes and needles and vials of medication while he messed around with my computer and made sure that Sam was sleeping comfortably. Last year, I didn’t have this problem, because I did so many IVF cycles in such a short window that I never unlearned the process of mixing medication, drawing it up, injecting it, and disposing of the waste.

This year, though, it’s been almost a year since the last time I did this, so I was sort of all thumbs. I got diluent all over the place by accidentally drawing too much air into a syringe, and then I don’t think I mixed one medication correctly. I dropped stuff all over the place, and by the time it was over, I just wanted a nap. That desire doubled about two hours later when the first hormone headache came on–not quite as bad as a migraine, but unpleasant nonetheless.

I’ve got a least another 10-12 days of this (leaning more towards 12; my doctor really likes to push me as far as she can when it comes to stims), if not another 18 (she talked about “coasting” me for a while to give eggs a better chance to develop without me developing OHSS again). At some point in there, I’ll take a trigger shot to tell my body to mature the eggs for retrieval, and 38 hours later, I’ll take a blissful nap and wake up to hopefully hear that they got a spider’s worth of mature eggs.

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(I refuse to put a picture of a bunch of baby spiders on here. You’re welcome)

Assuming I don’t develop OHSS again, and assuming that those eggs are mature and good, we’ll do a transfer five days later. We’re going to transfer two embryos this time because so far, we could’ve transferred every single embryo we’ve created at once and had exactly zero children. There’s a risk of twins, which I’m not thinking about right now (dear everyone who’s like “aw, I’d love to have twins”: ARE YOU CRAZY? I’d be fine if we had twins, but I’m definitely not actively desiring that), but I don’t think that risk is very big for us. Really, we’re just hedging our bets to try and get one.

So that takes us through the middle of August. In that time, I’ve got things to keep me occupied–date nights, wedding receptions, work meetings, the usual–but it’s not too busy. I don’t feel really stressed right now, which is a big difference between this cycle and the previous several. I hope it helps.

If this cycle works, my due date would be somewhere between April 24 and April 30. I thought about that and realized that if we went as late as we did with Sam, and my due date was April 30, the baby would be born on May 4, which is auspicious.

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(I’m not naming twins born on May 4 Luke and Leia, but I wish I could)

(and anyway, twins are always born early, so that wouldn’t happen)

(but can you imagine? They’d save the entire galaxy. I’d probably name them Mark and Carrie)

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(like as long as I’m not giving birth in an ice cream cone, I think things will go well)

So with that in mind, I kept flipping through the calendar, doing the mom thing of jotting down birthdays, vacations, anniversaries, and appointments. All the while, I was keeping track in my mind of potentially important dates.

Assuming a retrieval date on August 4, I’d have a transfer date of August 9.

They’d do a blood pregnancy test around August 19. I’d know that day if I was pregnant or not. I’ll probably know earlier because I’m impatient and will buy a bunch of pregnancy tests, maybe at the Dollar Store, and watch my HCG levels go down from the trigger and hopefully rebound.

They’d do an ultrasound to confirm the pregnancy, tell us if there’s one or two, somewhere around the first week of September. That will be the worst week, even if the pregnancy test is positive, because that’s when I’ll be afraid that we’ll see a repeat of what happened with Finley–a slow beating heart that eventually stops and disappears into nothing.

But maybe it won’t. They’ll transfer me to Dr. Solano then, and maybe I’ll have another ultrasound, and maybe I’ll see another little chicken hawk or two bouncing around inside of me like I’m the home of Cirque du Soleil now. That’d be the beginning of October, probably. I’d have a nuchal translucency scan around then, too, and I’ll want to do one of those blood tests to make sure everyone’s chromosomally okay. Maybe we’ll find out the gender(s) then. If we have two boys, I will feel a sense of panic because that’s three boys.

(also because we have plenty of girl names in mind but zero boy names)

Late October, when we go on vacation to Texas, I’ll be at the beginning of the second trimester and feeling great. We’ll get back, and I’ll count down until the end of November, when we’ll have the anatomy scan. If we don’t do the chromosome test, that’s when we’ll find out the gender(s). Hopefully, everything will measure alright and we’ll keep trucking along.

In February, I’ll have a maternity photo shoot. February is a good time to do a maternity photo shoot at a science museum, I think. I imagine standing underneath a giant T-Rex and feeling less than planetary compared to such a gargantuan lady.

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(needs more feathers, though)

The last month of pregnancy will be the worst, I’ll bet, because that’s how it was with Sam. I’ll be miserably rolling from place to place, tired and sore and cranky and ready for it to be over. And then it will be, and our family will grow again, and that will be awesome. I’ll be more prepared this time–every baby is different, but certain things are the same: the lack of sleep, the difficulty of the first couple of months, the gradual development of a routine, the way things eventually find an orbit and stay there for a while.

These dates might mean nothing, but they might mean something. We’ll see. In the meantime, it’s 200 units of Gonal F and 75 units of Menopur tonight and every night until my next monitoring on Monday.

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I belong to quite a few miscarriage support groups–groups where people share their experiences, comfort each other, give advice, etc. For the most part, I post there to try and give advice on the medical side of things, as after nearly half a dozen miscarriages under my belt over the course of a year, I feel like I have a bit of experience in that area. I’m no expert, but I feel like sometimes, you don’t an expert so much as you need someone who’s been in your shoes before, like when you want to know how to distinguish contractions from gas or whatever. If you’re afraid of going in for a D&C, it helps to read about someone’s experience rather than just the pamphlet they give you beforehand. It’s all well and good to know that your cervix will be dilated by a series of rods called laminaria and that the remaining fetal tissue will be removed with a curette, along with the uterine lining and remains of the placenta; but it’s even better to hear, “It was like I blinked and it was over. There was far more blood than I expected afterwards, but it stopped by the next day. I didn’t have much cramping, and the cramps I felt were minor. Everyone was really nice and understanding on every level.”

So I like to post about those things. And I occasionally like to post about some emotional stuff, but not a lot, which I’ll get to shortly. Namely, I like trying to help people to understand that in 99% of situations, your miscarriage was not your fault. You’ll have the miscarriages that you know were caused by something external, but they’re comparatively rare. Nearly two-thirds are chromosomal abnormalities, and another sizable chunk are other biological issues–physical issues with the uterus or cervix, immunological issues, myriad other things that can’t be helped.

And the other thing I like to help with is telling people that it’s okay to feel what you feel. That it’s okay to cry, that it’s okay to be furious, that it’s okay to question everything, that it’s okay to grieve.

But that’s the flip side of things for me, because I feel weird on these groups. I feel like there’s something wrong with me.

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Nearly every post about a newly recognized miscarriage talks about devastation, heartbreak, being broken overall, just all this pain that makes it difficult to even get up in the morning, let alone live the day after and the day after that. And I get that. I objectively and intellectually understand this level of pain, because it seems like the correct reaction to a miscarriage, even a really early one. You’ve pinned your hopes on this life growing inside of you, and then it’s not there, and that’s logically devastating, heartbreaking, and painful.

But that’s not what I feel.

I don’t know why I don’t feel that. I don’t know why I never felt that.

My first miscarriage was very early, just a week after I found out I was pregnant. It was a chemical pregnancy, when an egg fertilizes but doesn’t implant for whatever reason. If you test early, you’ll get a positive, but the line will get lighter and lighter and eventually, it will just be gone. In that case, I didn’t feel sad. I just felt embarrassed; after all, we’d told so many people and now had to go and tell them, “just kidding, not pregnant after all!”

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I chalked the lack of emotion about that one up to it being so early on; I hadn’t been able to let the enormity of pregnancy sink in yet, so of course I wasn’t going to be miserable at the loss. Logical.

I didn’t experience any more losses until last February-Marchish. I was pregnant after my first IVF cycle and only found out that I was losing that baby at the 8 week ultrasound, which showed a tiny disc, like a flying saucer with a slowly flickering heartbeat. When we’d seen Sam at that point, his heartbeat was so fast we could barely see it at all, 179 beats per minute, perfectly perfect for that age. With this one, the heart beat about once per second, which is expected for a six week fetus, and that’s what this fetus looked like–a six week fetus.

The trouble was, of course, that we knew for a fact when we’d conceived. We’d been in that very clinic, me in a gown that didn’t cover my ass and slipper socks and a funny hat. We knew when the baby had been conceived, and it was eight weeks ago, not six.

And another ultrasound showed nothing there whatsoever. Not even a hint of a heartbeat, no more little disc, barely enough tissue left to scrape away and take to the genetics lab for a karyotype analysis. I had my D&C. I found out that the baby was a girl. I called her Finley.

The trouble was that I never felt devastated. Sad, sure. Disappointed, you bet. Angry, absolutely. But I didn’t reach those depths of emotion that people seem to feel over their miscarriages, despite that I probably should have. Finley was the girl we desperately wanted. She was our hope; we were sure that she’d be born. If she had been born, her name wouldn’t have been Finley. It would’ve been something like Evangeline or Arielle or one of my other girl names that I keep stored for such an occasion. There are so many reasons I should’ve been devastated and heartbroken and all those things.

But I wasn’t. I kept waiting for it to come, but it didn’t. I cried when I got home from the D&C, before I fell back asleep. That was it. I felt a little remorse when I found out that she was a girl, but it didn’t send me into any sort of spiral whatsoever; maybe it should have. I don’t know. I felt more like an adult celebrating my first grown-up birthday–no, you’re not really expecting anything, but you’re still a little bummed that nobody bought you a cake or flowers or anything.

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(my birthday is November 5, by the way)

The next miscarriage was an even shorter window. I wasn’t supposed to know that I was pregnant yet by the time I miscarried; I tested on my own, and by the time I went in for the blood test, I’d already started bleeding. That one was a disappointment on a different level–I’d made some good friends in my hopeful birth month birth club on BabyCenter and didn’t want to leave them behind.

(thankfully, I didn’t; we’re still in touch on Facebook and regularly update each other on our lives and ask for advice and are basically awesome with each other ♥)

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(I love you ladies ♥♥♥)

And then the third miscarriage, earlier this year. I didn’t feel really sad over that one, either. I felt fascinated at seeing what was probably the gestational sac come out of me. I felt frustrated that this had happened to my “perfect” blastocyst. I felt even more frustrated that I’d been at the whole IVF thing for more than a year with no results.

But sad? Devastated? Heartbroken? Agonized? No.

Instead, I find myself wondering what’s wrong with me that I don’t feel these things. Am I just so used to disappointment because of infertility that it’s basically the expectation now? Did I lose my ability to feel heartbroken over a miscarriage a long time ago? Am I just a heartless human being?

I get up every morning just fine. The miscarriages aren’t even on my mind. Sometimes, I’ll pass by the baby clothes section in Target and get angry–I should be buying those for one of the miscarried kids right now–but usually, I scoot on past to grab another Target thing.

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(I feel personally attacked by this gif)

I go through my day just fine. Sometimes, I have to explain to Sam that I’m not pregnant (he doesn’t have a very good sense of time; I was pregnant at one point in my entire life, so to him, I’m always pregnant), and that’s annoying, but it’s a dull annoying, more like an unidentified bug buzzing around at the barbecue.

I sleep just fine. Work fills my dreams because it’s stressful. My last thoughts as I drift off to sleep are of stories I’m writing or what the next day will bring, not of what I’ve lost. Day-to-day, I usually forget that I’ve had this many miscarriages. I’m focused on work or on the next steps in the IVF process or in my frustration with those steps or Sam or writing or gaming or any number of things.

I read about people who can’t stop thinking about it, and the promises that the pain will go away or change or something. And I wonder: what does it say about me that I never felt an unbearable pain at these losses? Am I heartless because I felt nothing but a dull ache?

Or am I just so used to loss by this point that I can’t feel it anymore, like a frog boiled alive in a pot of water?

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(anyway, pandas are cute)