25 months later.....

It's been 25 months since my last post on this blog. A lot has happened since then.

Since then, I gave birth to the most amazing little man, who will turn 2yo one month from today. Man, how did that happen already? Quick birth story: I went into labor on my due date, mild contractions every 10-15 minutes during the day, then my water broke. I labored at home another couple hours, then headed to the hospital and got my epidural about 2 hours later....and was only 2cm. Started on Pitocin, the little one didn't tolerate high doses of it, and 12 hours later I was only 4cm. Ended up with a c-section for failure to progress, he was sunny side-up, never dropped into my pelvis, and was bigger than expected for my small frame (8lbs 5oz).

We left NYC when the little guy was 2 months old. We spent 2 months living with my Mom, then moved into an apartment in Atlanta. I went back to work when he was 6.5 months old, at a terrible job with a horrible boss, and left there after 5 months (long story for another post). A month later, I started at a great job -- I work three days/week, office hours only (no hospital rounds), and it's straight salary so no pressure to see more patients or bill for extra things.

Curly is absolutely a dream. He is happy nearly all the time -- unless he's hungry or tired, like most toddlers. His language development is incredible -- this morning, for instance, he pointed out the tree/animals on his wall over his crib and informed me that "Mommy put on owl stickers on wall." He also asked that "Mommy put on monkey t-shirt on C." He understands absolutely everything, and cracks us up daily -- often intentionally. He's a great sleeper, and happily plays in his crib after he wakes up in the mornings. He's typically a great eater, some days better than others though. (He never took to purees so got table food very early, and eats what we eat. I refuse to make special meals for him.) He loves school, loves to read, loves music and going to music class, and can entertain himself with his toys. He's had a few colds here and there, but has never been truly sick and his worst injury has been a tooth getting slightly pushed back from a fall. He has an amazing memory -- last week he reminded me that "black goat jumped, scared C at zoo," something that happened on January 1st. He gives the best hugs and happily cuddles with me at bedtime.

Figuring we'd hit the jackpot with #1, we decided to start trying for #2 last summer. I waited until after we had moved from an apartment into our rental home to stop the mini-pill; I've known so many people to get pregnant the first month with #2 that I wanted to be fully prepared if that happened. I didn't get PPAF even at that point, and C was still nursing 3-4x/day, so I started the process of weaning him (while taking HPT's weekly just in case and using my CBFM as per directions I found for preventing with BFing -- clearly my body was trying, as I'd have weeks of EWCM at a time, but nothing was happening). First I weaned him down to twice a day, only at waking & bedtime. Still nothing. So finally in November, I weaned him to bedtime only. Two weeks later, on Thanksgiving Day, AF finally arrived. I continued using the CBFM and never got a "peak," but had clear fertile signs around CD18-23, and we happened to be on vacation.

A week after we got back from vacation, I was complaining to DH that I felt nauseous. He said "probably because you are pregnant," but I brushed him off. The next day, though, I felt the same way so POAS and at 10dpo in the evening, got a faint positive! Holy cow, I was shocked!! Of course I kept POAS every other day, making sure the lines got darker. They did. I called the midwife practice where I had an appointment a few weeks later to discuss fertility issues (having turned 35yo and officially TTC for 6 months), and switched the appointment to a dating scan at what I figured was 7 weeks.

We went for that scan. Waiting about 3 hours b/c the technician was running seriously late (thank goodness for a playroom in the waiting room). They found a gestational sac that measured accurately, 6w5d, but no fetal pole. Had labs sent and was prepared for the worst. Beta was high (around 18K), progesterone around 15, but when I finally spoke to the OB a few days later she recommended against supplementing since studies indicate that low progesterone is the result of a non-viable pregnancy, not the cause. Went in a week later for repeat scan, and there was the heartbeat! Measuring a couple days behind at 7w2d. Had a 3rd scan with my "new OB" appointment two weeks later, and measured 9w5d, right on track. Heard the heartbeat regularly at home by that point.

We were ecstatic. Started telling some family members, but no one beyond that. At 13w5d, had the NT scan and everything looked perfect, measuring a few days ahead, and I got Materniti21 results the following day -- all normal. We started telling our friends, cousins, and co-workers. Baby #2 would be here in September! Despite the slow start, everything looked good and we were thrilled.

I had been wanting to post on this blog for some time. Mainly to record my symptoms, so I would have a frame of reference for next time. Unlike my pregnancy with Curly, this time during the first trimester I felt nausea AFTER I ate. So I'd eat a small breakfast, something light for lunch, and then basically nothing else the rest of the day. I ended up losing 10lbs during the first trimester, which was fine since I had never fully lost the baby weight from C. I was still considered "obese" and had to do an early 1hour GTT b/c of it; the midwife was actually happy with the weight loss. I was of course tired, and between the fatigue and the nausea I was often in bed right after C went to sleep. I also had crazy diarrhea, often rushing to the bathroom in the afternoons between patients. It was February, the height of Norovirus season, and C finally succumbed to the bug that was hitting his school (and my office). At that point I was around 11-12 weeks. I was fine the first time he threw up, but the next day he did again and the smell set me off....I vomited several times that week, and had the worst diarrhea ever. But we both recovered. (And for the record, I also had pinkeye at around 5 weeks, a yeast infection after the 2nd ultrasound at 8 weeks, and developed a rash on my hand that I think is probably Molluscum. My immune system was totally shot.) He had basically stopped nursing even at bedtime when I was around 8-9 weeks pregnant, then he asked a couple times that week after being sick, but has not nursed again since. After that week, I felt much better. The nausea went away and I could finally eat again! And sweets, oh how I wanted anything sweet. I was still tired after work -- it would hit right around 4:30/5pm, just in time for my PM commute -- but I was otherwise doing well. Feeling happy and excited and enjoying my growing belly and finally getting into my maternity clothes.

DISCLAIMER: The rest of this post discusses 2nd trimester loss.

I had another OB appointment at 14w5d. She found the heartbeat right away, despite my anterior placenta diagnosed the week prior. Everything else was normal. Later that week, I couldn't find the heartbeat at home with my Doppler. I attributed it to the anterior placenta/baby's position. I was certain that I was started to feel the same "flutters" I had felt around 14-15 weeks with Curly, and that reassured me. It felt like being tickled from the inside, and I only felt it on the sides of my belly, which made sense b/c of the placenta positioning. I even felt "tapping" a couple times when I was leaning forward or laying on my belly. But over the next couple weeks, I tried several times with the Doppler and was not successful. I posted on the FF boards and got dozens of stories of other women with anterior placentas and difficulty with the Doppler, even from their OB, and felt better about it.

We left to go out of town for Passover -- to my mom's vacation house in Destin, Florida. My sister came in town as well, and my stepbrother + 4 kids live there. I left the Doppler at home. We had a fun Seder, and C was really having a good time away. At 17w4d, I started having some very dark brown spotting just on the toilet paper when I wiped. I stayed on the couch, super hydrated, and it went away. Then that night I had one drop of bright red blood on the toilet paper. Because of my blood type (I'm A- and DH is O+), I called the OB and she sent me to the ED to get Rhogam.

In the ED, they did an exam and my cervix was closed. The tech came in for a scan and said my bladder wasn't full enough (they had just asked me to pee in a cup!), so I got an IV hooked up. The screen had been turned away from me, but DH said he "saw the baby" and he figured it was fine. She came back half an hour later, and again kept the screen turned away from me. She asked if I'd had a dating scan already, and I said yes -- several scans. I could see a reflection in her glasses, and couldn't make out movement. Before she left, I asked if she'd seen the heartbeat, and she just said "I cannot confirm or deny anything, the doctor will be back in soon." I think I knew then that it was bad news.

The doctor came in a few minutes later, and said the scan revealed no heartbeat or fetal movement, and that the fetus measured a few weeks behind. Diagnosed "missed miscarriage" and "intra-uterine fetal demise." Since my cervix was closed, I could go home and follow-up with my OB the next day. I waited for my Rhogam shot and we went home, utterly devastated and in complete shock. How could that be? How does this happen? Were they sure? Maybe the tech didn't know what she was talking about. How could I be feeling movement if the baby wasn't moving? It didn't make any sense.

Also, what a mind-fuck. To have had a bad first scan, to be told I was going to miscarry and it was likely a blighted ovum and that my progesterone was too low but nothing could be done -- but THEN to see a heartbeat. To see it THREE times on normal scans and hear it at home a dozen times. To have normal testing. To have finally relaxed and started telling people. To have made plans.

I spoke to the midwife's office the next day. Their OB was out of town, so I could come back to Atlanta and see a hospitalist I'd never met before, and "depending on their comfort level," would either be induced to deliver a dead baby or might have surgery. I did not like the sound of that, so I called my previous OB/GYN's office in Birmingham -- she had been my doctor through med school, and was my mom's doctor, and I fully trusted her. I got on her schedule for the next afternoon for a pre-op visit, with surgery likely the day after. We packed up, did some very quick shopping at the outlets (b/c C needed clothes/shoes), and left early the next morning.

We drove straight to the doctor's office (5 hours in the car). They did a repeat ultrasound, and have a high-tech machine and a screen up on the wall so you can see what they are doing. I will never get that image out of my mind. There was clearly a baby there, but just kind of floating -- not moving at all. No heartbeat. Her measurements said 15 weeks. We spoke to the doctor for a while, asked a bunch of questions, most of which she had no answer to. The plan was made for the next day. I had no desire to be induced or to miscarry naturally -- I wanted the whole thing over with fast, and she agreed that would be the best for my emotional health. Because I was further along than she thought by dates, she was going to enlist the help of another doctor too -- part of the reason I like her is because she never hesitates to ask for help. We went home, I arranged a baby-sitter for C, and I did not sleep at all. I think DH was the most in shock, as he had presumed the ED had just made a mistake and all would be well. I was just heartbroken, and if it weren't for a busy toddler who needed my attention, I probably would have been curled up in bed, sobbing.

The next morning was Wednesday. We went early for an 8am appointment with the perinatologist upstairs. He was lovely and also tried to answer questions -- although, again, there really were not any answers. Then he inserted Dilipans -- a cervical ripening agent. It felt like a horrible pap smear, but nothing excruciating. My cervix was still closed but softening slightly -- I was still spotting a tiny amount. Then we went downstairs and I registered for my surgery. A while later they brought me back, started the IV and did bloodwork. I spoke to the anesthesiologist and my doctor again. I asked her why I felt like there was movement when there clearly wasn't -- she said she actually doesn't think anyone feels any fetal movement until 16-18 weeks, sometimes later, and that it was my body interpreting other feelings (gas, an itch, etc) because my brain wanted it to be movement. I was feeling it even that morning. Everyone was very nice and sweet and kept saying they were sorry I had to be there. So was I. They gave me a pre-cocktail of tylenol & celebrex. I asked the anesthesiologist for something to relax me a little and got some Versed as they wheeled me back.

Next thing I knew, I was waking up in the recovery room. I started crying. I wasn't pregnant anymore.

That was a week ago. The physical recovery wasn't terrible. I took 3 days of Methergine to help with uterine contractions/bleeding. I took Aleve every 12 hours for a couple days, and only took the pain killer at bedtime for 2 nights. I requested an Rx for Ambien as well, and I am still taking a half dose at bedtime. I took 7 days of an antibiotic too. The bleeding was much lighter than a regular period and had stopped completely by Sunday night. I had a lot of thigh/back pain for a couple days, then just minor cramping. My back still hurts, but not sure if that's related to this or not.

The emotional recovery has been harder. I am okay when I'm busy with something -- even if it's reading or watching TV. But then it hits me again, that I'm not pregnant, that I'm not having a baby this fall. And I start crying again. I have tried three times now to go into my closet an pack up my maternity clothes, and I just start crying and cannot do it. I was putting away C's clothes last night and saw the t-shirt we had made for him that says "Only Child Club, membership due to expire in September 2015." I nearly lost it completely, except he was running around and being silly.

I do not have any results yet, and I've been told that a "reason" is only found 50-65% of the time. They did sent the placenta for cultures and chromosomes, and I expect to have results next week. The fact that I had three good scans and normal bloodwork suggests either an infection (which is doubtful since I never had a fever), or some problem with the placenta itself, but it could still have been chromosomal. I called yesterday to set up an appointment with a perinatologist here in Atlanta for a "recurrent loss counseling session," did my "intake" and waiting to hear back from the scheduler. I'd like to be tested for MHTFR and anti-phospholipid, but not sure what else to ask for (any suggestions?). The fact that I had one normal pregnancy that went to term makes it slightly less likely to be one of those issues, but I am not convinced.

I took this week off of work. I did not know where I would be physically, and could not imagine the emotional hardship of seeing patients and "un-telling" everyone I was pregnant. The plan is to go back next week (I do not have any paid sick days, although my mom has said she would help if needed). I did request not to have any newborn or prenatal visits for a few weeks.

I still do not think it's fully hit me. That there's no baby in my fat tummy. That I won't have to complain all summer about the heat and being pregnant in HOTlanta in August. That I don't need to buy all new maternity clothes (my previous wardrobe being suited for winter in NYC and not summer in the South). That I won't have a newborn again in September, and be out of work until January. Part of me feels like I just lost six months of my life. That it was a dream, and did not really happen. Maybe I can trick myself into believing that we were waiting to TTC again until C turned 2yo. But then I remember. Or see a pregnant woman or a newborn. Or walk into my closet. And it all hits me again.

I am not sure where to go from here. I desperately want to be pregnant again. But as anxious as I was when I got pregnant with C right after my first loss, how do you get pregnant again after a fetal demise in the second trimester? How do you feel reassured by ANY ultrasound or testing that says "all's good."

DH said the morning after the ED visit that "nothing could be worse than this." I contradicted him. Wouldn't it be worse to carry to term and have a stillbirth or death within the first couple days, like what happened to my friend during residency? Wouldn't it be worse to have a healthy child then get diagnosed with cancer? Wouldn't it be worse for your child to be in a horrible accident? The list goes on and on. Of COURSE there are worse things that could happen. But not to us RIGHT NOW. And he is scared to get pregnant again. He does not want this to happen again. He told my mom that maybe C would just be on only child. My wonderful husband, who's from a family of 6 kids and originally wanted "at least" 4, contemplating not wanting more kids because he cannot handle something like this again. I guess nothing could be worse.

My first miscarriage was mostly a secret. When I got pregnant again, I did tell some people that I had a loss prior, and people would tell me they had been through the same. But at the time, no one knew. With this, everyone knows. And no one knows what to do or say. My grandparents brought over flowers -- thanks, but no thanks. My friends sent a care package designed for someone on bedrest -- a TV tray, pajamas, slippers. Again, thanks but not thanks. I do not want to hear about your first trimester miscarriages, or the fact that you once had a D&C. It is NOT THE SAME THING. This loss is nothing like my first loss. This baby had a heartbeat, was moving. I saw it bouncing around in my belly, kicking at that big cushy anterior placenta! It was alive. And then it wasn't. Only someone who has been through THIS knows what I am going through.

I knew I needed to blog about it. I do not know if people read this -- if they ever did, or if I'm still on anyone's reading list after 2 years away. But I needed to put the story into words. I need to remember the details. I loved this baby. I will always love this baby. I will always miss this baby.