Jelly Beans and Other Mundane Things...

I have a hard time believing that I'm seven months pregnant. This pregnancy is really speeding by. Before I know it, it will be March and I'll be juggling being a mother of two. 

28 weeks pregnant and growing by the day (wider than "out" because baby is sideways)

In the past few weeks, Smudge has really started to act like she's paying attention when we talk about what's happening. She now knows there's a baby in mommy's belly. Not that I think she has any concept of what that actually means, but it's cute to talk to her about it. She pulls up my shirt and gives "huggies" and "kisses". A few weeks ago, she read a book to my belly and today she tried to feed the baby a tomato through my belly. But I think some of my favorite times are when we're getting her ready for bed and she wants to lotion my belly, because she saw me doing it once. 

"Lotion Mommy Belly"

Of course, then she also pulled up Daddy's shirt yesterday and said, "Huggies Daddy baby", so maybe she doesn't quite get it after all. Or maybe Daddy has just gone a bit far on the sympathy weight. (Joke, honey.)

I know I've mentioned the love that I have for my new OB practice. ESPECIALLY when it came to the 1hr diabetes test 2 weeks ago. Nothing better than getting to eat a bunch of jelly beans rather than that disgusting syrupy drink. Even better was finding out 3 days later that I passed. So much pressure off. Take that, AMA. 

Of course, that doesn't mean I've stopped gaining weight. This pregnancy is SO different than it was with Smudge. I was able to curtail my gain with her and craved really nothing but protein and a carb here and there. This kid has me eating chocolate and cupcakes and seriously, enough already. I just can't stop eating. I keep saying it's so incredibly different that this is either a boy or a girl who will NOT be 5 1/2 pounds like big sister was. And sure enough, I had a growth scan yesterday. Baby is only measuring 1 day ahead, but is at least 10% larger than Smudge was at this point and already is estimated at 2lbs 10oz. This kid is going to be HUGE. And no complaints from me - VBAC and all. Unfortunately, in addition to being huge, the Squish is also transverse, snuggling against my uterus like a body pillow staring up at my diaphragm. I'll definitely be asking Dr. B about this on Monday. I need to know when I should start inversions or chiropractic. I don't want to be late 3rd trimester worrying about needing a c/s because my kid is too comfortable. It's bad enough I'm worrying about it now. At least s/he's not jackknifed like Smudge was. Then I'd be worried about hips too (or at least more than I already am). 

Not that the past few weeks have been completely without torture. What kind of fun would that be? Last week I found myself spending the afternoon in Labor and Delivery. I wasn't thrilled with my first experience at Jersey Shore. I had to wait almost 20 minutes before anyone even acknowledged that I was standing there. And it's not that people were busy. There were no less than 2 doctors and 3 nurses at the nursing station at any one time. They were just waiting to let the secretary do her job, and she made no bones about the fact that her job would be done in her time. Me standing there in excruciating pain, be damned. They made me fill out paperwork without even asking me if I was okay. All i could think was they better be damned lucky if I weren't in labor... because it I was getting ready to birth a 27 weeker, and they were making me fill out PAPERWORK first, there was going to be hell to pay. The triage nurse was just about as nice, but a couple of the other nurses I met were very kind. I think i just had the crappy luck to be in an empty triage the day a bitch was assigned there and didn't want to be bothered. 

At least, when push came to shove, I wasn't in labor. Just had a nasty bladder infection that was causing a lot of referred belly pain thanks to an inflamed bladder. There, aren't you glad you know that now? A week of antibiotics and all is right with the world. I have my follow up with my new OB (we can just call him Dr. B) on Monday, so I'm sure they'll re-dip my urine then to make sure it's gone. Although based on how I feel, it is. 

And just for funsies... Smudge decided to start getting ready for baby too and had some naked baby wearing time the other night. Even she knows how beneficial skin-to-skin is!

Until next time.....

A Breath of Fresh Air

I don't think until the last  four weeks, I have ever had a time during pregnancy where I was completely comfortable with my choice of providers. During my pregnancy with Smudge, I quashed those feelings, completely ignoring my gut, and stayed with my provider. Well, we all know how that ended. I didn't intend to do that twice. 
Four weeks ago, I was awaiting a consultation with a new obstetrical provider. Well, that consultation couldn't have gone better. When I walked in with two full pages of questions, I was sure he would hate me. Instead, it was as if someone had given him my questions ahead of time. He had ALL of the right answers. There wasn't one thing I had any concern about. So, rather than take my consult with him and discuss my concerns with the midwives the following week, I switched to his practice officially that afternoon. 

This morning I had my next appointment with my new OB practice. I met Dr B's partner, Dr R. She was like a breath of fresh air. Completely relatable, young and an osteopath - so right on track with my natural tendencies. I was concerned that perhaps she didn't share all of Dr B's beliefs in terms of VBAC and natural Cesarean, but she quickly laid those fears to rest. She said Dr B trained her as a resident, so she essentially practices EXACTLY as he does, as do their other partners. She said any member of the practice would support my birth wishes. 

And I think the best part of my visit today was when she told me that I'm measuring perfectly for 25 weeks, my belly looks great and she thinks I'm right on track for my weight gain. I expressed my concerns about how quickly I was gaining and what the midwives said about it. Dr R said she had no concerns about my gain, I'm right on track and if she had any worries she would tell me. 

The good news is my gain is slowing. I'm attributing it to stress. I'm no longer stressed about my provider and I'm now gaining less than 1lb a week. I know that still sounds like a lot, but considering how I was gaining earlier, it's really good. I'm now up 20lbs in 25w. That's horrifying to me, considering I only gained 20lbs all together with Anna. But my diet is different now, my activity level is different now and it's an entirely different pregnancy. This baby will NOT let me stop eating. I'm trying really hard to make the right dietary choices, especially since I'm CONSTANTLY hungry. Smudge didn't do this to me. So, as Dr R said today, either this is a boy or I'm just growing a girl who will weigh more than 5 1/2 lbs. And we're totally okay with that. 

My new goal is 35lbs. I do not want to gain 40lbs. But hopefully I can keep it just under that. 

In other news, I scheduled my glucose tolerance test. Guess who gets to eat jelly beans instead of that awful disgusting drink? THIS GIRL. I'm waiting to clarify how many I have to eat, but I'm psyched. Not only about that - but that they draw all blood work in their office, so I don't even have to go sit at lab corp. 

Other good news from this week, the hospital where I'm going to deliver the Squish is now certified "baby-friendly" which means I'm going to have the BEST lactation support possible. And as if that weren't good enough, now the labor and delivery unit has telemetry monitoring, which means I won't have to be tied to a bed AT ALL while I'm in labor. I may even be able to get into the tub. That would be awesome.

GTT in 2 weeks. Until then.... 

19w6d: An Anatomy Scan in Pictures

Meet Squishy!

Just lounging. Hard to tell in the picture, but in this shot baby's right arm is hanging down by my cervix, knocking on the exit.

We have the same shot with Smudge, with the exasperated hand on the forehead, saying,"Really, mom? Are we done yet?"

We got shots of Smudge's hands. Seems only poetic that this time we got feet.

Hand on the forehead

Hi Squishy

Profile

We saw baby yawn and then shove fingers into his or her mouth.
S/he looks just like Smudge. 

Everything looks perfect with Squishy. The perinatologist once again said he doesn't understand why I needed the c/s with Smudge and that he thinks I have a reasonable chance at a VBAC. Baby measures perfect - exactly 19w6d - and in the 40-50% for weight and length. 

I've also met a handful of people who have used the doctor that I have a consult with next week, and say he's fabulous. My midwife appointment is the following week. By the end of the month, I will know who my provider will be. 

Meanwhile, Squishy is bouncing around like a wild person and we're still firmly on Team Green.

I'm a Bad Blogger. 18w Update

Stephen King always talks about his "faithful readers". Well, if I have any, i owe them an apology. I've been very lax at blog upkeep. It's been over a month, but it's been a VERY sleepless month, in my defense. Do you want to know the main difference between being pregnant with #1 and #2?

The toddler.

And I love that toddler more than I ever knew possible. But man, if having one doesn't make being pregnant a LOT more difficult. Gone are the days where when I was tired, I could just put up my feet and try to rest. Enter The Toddler. She needs attention and mommy time and honestly, who could blame her? She's going to have to share me pretty soon, and although I'm so happy to be giving her a sibling, I know it's going to be an adjustment for all of us. But man, am I tired. I'll be really happy when this latest round of teeth are in.

But here we are at 18w. And just because nothing can be easy, i spent this morning at the perinatologist. Over the weekend I had a lot of intense cramping and a little bit of spotting. Finally monday morning, I called the midwives just to get their opinion. Fast forward to today.

A picture of an 18w Squishy picture

Baby looks great. So, no worries there, and I'm perfectly happy with no documentable reason for what I experienced. It's certainly better than some of the alternatives, like pre-term labor, placenta previa, etc. But when the perinatologist du jour came in to check on me, he saw that I was worried and told me we could chat in his office before i left.

We reviewed my c/s (again) and Smudge's birth history, which led to a shocking statement from him that still has me reeling.

He doesn't think I had a complete abruption. 

No, that's not what he said. He said I DIDN'T have a complete abruption. And what he says makes sense, because he just highlighted every doubt I've had over the last 22 months. A complete abruption would be the equivalent of severing the adults aorta. Completely cutting off blood supply and oxygen to the baby. Babies who have complete abruptions die and those that don't, have resuscitations. They don't have 1 minute apgars of 9.  Maybe they don't have normal placental pathology either (my placenta was completely normal - i saw the report).

My OB lied about so many things. For example: when I had my 35 week scan, and Smudge weighed in at 5-12,  we laughed about it, because I had "requested" a 6 1/2 pound baby. Then when she was born, my OB said, "well, we always knew she was going to be small". You f-ing liar, do you not think I remembered that 35 week conversation? You may have dozens of patients. I only have 1 OB. I know what we talked about. Truth is, you missed an IUGR situation, and you just didn't want to get called on it.

My doula told me months after Smudge was born that my OB had been pushing for a c/s for hours. Did i just become an inconvenience who was taking up a hospital bed for 2 shifts? Did she just pull out the ONE reason she knew I wouldn't refuse?

Did I really have a c/s that I didn't need?

I'm so upset. I'm heartbroken and hurt and all of these adjectives I can't even name. And I'll never know the truth. My chart is a mess. It's handwritten, not even computerized and my doctor can write whatever she wants. No one has to corroborate anything. 

My c/s was a huge step in my feeling like a complete failure. 1st having to do IVF, then the c/s and then not being able to breastfeed. I feel like my body has completely failed me. And I know that the c/s is partly responsible for the breastfeeding issues, because the IV fluid lead to increased swelling that my 5lb baby couldn't maneuver around and the IV narcotics I was forced to have (i refused them, and the anesthesiologist gave them anyway. He said I "had" to have them, but he would give me a smaller dose) then impacted my ability to breastfeed in recovery. 

I'm still dealing with the emotional impact of all of it. I really hate my body, I feel like I can't do anything right. 

And this may have not been my fault. This could be just a freaking OB on her own schedule who didn't want to just let me take more time when my contractions spaced. So convenient that my contractions spaced and then I had the decel that sent me to the OR. 

I'll never know.

18w midwife appointment tomorrow. Smudge's appointment at CHOP is Monday. Anatomy scan the following week and Fetal Echo with Smudge's cardiologist the week after. 

October is going to be busy. So much to think about right now. Really didn't want to add to the pile. 

Please send hugs and vegan cupcakes. 

NT Scan and Perinatologist Update

I swear that was the longest appointment ever.  It was good news. Squishy looks great. But because of some of the issues with my last pregnancy and with Smudge, there was a lot to talk about .

First, the NT Scan. It looked great. Squishy is CRAZY active. More than Smudge ever was. Just as stubborn too. Goodie. But the NT measurement looked awesome. 1.4mm. The perinatologist said that's a great measurement at any point in the pregnancy. They also saw the nasal bone, which is good news. There were no other soft markers present that would indicate a chromosomal abnormality. They saw all of the major organs they were looking for, 2 arms and 2 legs. The umbilical cord has 3 vessels and Squishy is measuring a couple of days ahead, at 12w2d. 

See... Squishy.

It's a picture of a monitor, so please forgive the quality.
Our actual pictures won't be scanned until tomorrow.

We talked a lot about my Smudge pregnancy. He's concerned that I won't be able to VBAC, but that's not his expertise, so I'm not really considering his opinion. If Dr Z and the midwives think I can do it, that's all that matters. Dr C (from the perinatology institute) can make sure Squishy grows and thrives while s/he's inside, my midwives will take care of things from there. He had some concerns about placenta placement, but it's nice and posterior for now, so there are no concerns with my incision. Two fibroids have made an appearance (background: I had three at the beginning of my Smudge IVF cycle and at my c-section they found nine. At the beginning of my Squishy cycle there were none, so we fully expected them to make an appearance at some point, since they're likely hormonally driven) but they're on the exterior of my uterus, like the other ones were, so not concerned about them at this point. Also, the cyst that was on my right ovary (and at one point the size of my head) has completely resolved. So yay that. 

I brought up my concerns about Smudge not having grown in my last month of the pregnancy. (At 35 weeks, she was measuring approximately 5lbs 12oz, and then was born 5 weeks later at 5lbs 8oz - just this side of low weight for gestational age.) He reviewed all of my records from my pregnancy, and said that at every scan I had, she was measuring 40-50%.  He agreed that it was concerning that it appears she didn't gain any weight from 35-40 weeks. He plans on monitoring me a little bit closer at the end of this pregnancy. I'm okay with that. A few extra ultrasounds aren't going to hurt - but it they indicate that the baby is in trouble, then we will be able to do something about it. We were fortunate that Smudge was healthy, despite her lack of growth. It might not be the same next time. 

We also discussed the two congenital issues that Smudge had. Her severe hip dysplasia and her cardiac defect. The latter automatically got me signed up for a fetal echo. I'm okay with that. Dr C said I could go back to Smudge's cardiologist for the echo, which is great. I just love her (another Dr C). Her hip dysplasia was another story. As of right now, Smudge's orthopedic surgeon at Children's Hospital of Philadelphia (CHOP) is calling it Developmental Dysplasia of the Hips. If Squishy is born with hip dysplasia as well, both babies will be given the diagnosis of Congenital Dysplasia of the Hips. Unfortunately, this is something they can't look for in utero. Dr S (the ortho) has already agreed to see us soon after birth for an ultrasound, rather than waiting the standard 4 weeks. I just can't wait that long. Smudge was in treatment at 6 days old. I'd feel negligent if Squishy needed something that we weren't providing in that time. 

I know this has already been so long - but wait - there's more. 

My MTHFR comes back into play, as being homozygous for the mutation makes me a higher risk for having a child with a spinal/neural tube defect (which we were initially concerned about with Smudge). However, since my homocysteine level has been normal, he's less concerned. Even though, he's recommending that combined with my age, I have the 2nd trimester AFP blood test done. He said at their clinic, they're 95% accurate with picking up spinal defects via ultrasound, but it's better to be safe than sorry. 

After all of that, I had my blood drawn for my 1st trimester risk of chromosomal abnormalities. 

He also told us that the clinic has been involved in some groundbreaking research, and that they're now offering a blood test (not covered by insurance now, but hopefully one day will be) which can indicate the trisomies and certain other genetic disorders like Turners Syndrome with 99% accuracy. That's just amazing. Hopefully we won't have to be concerned about the risk enough to pay for this test, but it's nice to know there's a more accurate blood test available prior to having to submit to an amniocentesis, should it come to that. 

That's enough, right?

It was a lot of information in one day. I practically fell asleep on my way home and I'm still really dragging. Smudge's Dad is working hard on trying to get her to bed, because I'm pretty sure if I were doing it, I'd be asleep before she would. 

Now we wait for the results. But based on the ultrasound, we hopefully have little (other than my age and egg quality) to worry about. 

Stay tuned....

Honestly - How Many Pregnant Chicks Check the Paper EVERY Time They Wipe?

I can't be the only one.  Not by a long shot. 

Today is 11w6d, which is an interesting anniversary of sorts. With Smudge, at 11w6d, I started bleeding. I'll never forget shaking like a leaf, calling Smudge's Dad and then my nurse. Then my emergency u/s where I could breathe when I still saw her heart beating. 

Sub-chorionic hematoma AKA the scariest day of my life. The day I thought I was losing her, just like I lost her twin. 

And today, in the face of my newly surfaced pregnancy nightmares, I'll spend the day waiting for the other shoe to drop. 

Tomorrow is my NT scan. Between my age, my egg quality, my nightmares, my teething toddler and my lack of sleep, I just need it to get here already. 

I'm not feeling clever today... but I AM still pregnant!

I'm too tired to be clever today (or at least to pretend i'm clever), but I still wanted to update on my first appointment with my midwives. It went really well. I'm 10w2d today and I was nervous. I know way too many girls who have had late 1st tri losses lately and I was sure something would have happened between my 8w at Dr Z and today. But my midwife (today I saw Louise) didn't make me wait at all. I didn't get a picture, but i can't believe how big Squishy has gotten in the last 2+ weeks and I saw the heartbeat immediately. So, that's the baby update and it's a good one. 

Then we talked a lot about my labor with Smudge. She said there were positive indications for a VBAC. 1) I was full term and I went into labor sort of spontaneously (I told her about the acu-induction and everything else I did) and 2) I did get to 10cm and pushed for a long time. She said those are both very good signs that I should be able to have a good trial of labor. That made me feel a lot better, because one of the other midwives wasn't as positive at my annual, when we talked about my contractions spacing apart. But that didn't even phase Louise when I told her. I also had a VERY uncomfortable pelvic exam, where she was feeling out the shape of my pelvis.  She said that the top of my pelvis is more pointed than rounded (which would be normal), but there's plenty of posterior room and there's no physical reason she could see for why Smudge couldn't descend other than her posterior position. So, that's another check in the right column. 

She talked about nutrition, and like so many ladies have told me, told me really not to sweat the numbers right now; to try to increase my protein to stay fuller longer. She has the same goals I do: to keep my gain under 25lbs total. So, hopefully we can stay under that number. 
We also talked about the possibility of having to have another c/s, which I definitely would like to avoid. But in the case we feel like that is where I'm headed, or even if we don't think that, but I decide to for my own comfort, I can make a prenatal appointment with their cooperating doctor (Dr M) so I can meet him and discuss some of my concerns about my last c/s. Louise also told me that it's policy at my new hospital that when the baby and mother are stable, the baby is admitted in the OR and stays with mom in recovery. Since one of my biggest issues is that Smudge was kept from me for HOURS after my last c/s, that really reassured me. 

I scheduled my NT scan, anatomy scan and fetal echo (which apparently is now standard with our perinatologist, but we have no problem with that since Smudge had a cardiac defect when she was born). 10 days until we get to see Squishy again! <3

I'll leave you with pictures of our newest acquisition: A City Select Stroller with a second seat. OMG. I don't know how I haven't had this stroller the whole time, but we found an amazing deal on craigslist.

Smudge really LOVES it too. We can't get her out of it. She actually climbed into it herself this morning. So, we're going to be using it as a single stroller until Squishy gets here, which is one of the great things about it. 

Hopefully, next time I'll have some pictures for you of Squishy, and not just toys.

Pomp and Circumstance

Last weekend, this was me:

That stomach virus was AWFUL. I haven't been sick like that in a long time. Dr. Z told me just to stay hydrated and the baby would be fine, so I shouldn't worry. Yeah, right. Whatever. But I dug in with my vitamin waters and chicken broth. Stayed hydrated and 72 hours later felt so much better.

TOO much better. 

All of my symptoms were gone. I wasn't bone tired anymore. I ate eggs and CHICKEN. 

Tuesday morning I called my nurse and asked if there was any chance she could get me in earlier for an u/s. So, the next day (because Fran is awesome), I went in for my 8w ultrasound.

And Squishy is still going strong. HB 170, growth right on track at 8w0d. The Visible Embryo says Squishy has a four chambered heart now. Fetal development is chugging right along. Oh - and Squishy is no longer an embryo. S/he's now a fetus. Which means:

I hate leaving Dr Z, especially for unknown waters. I am very glad to have changed providers to the midwives at a great hospital and Dr Z really likes them and their cooperating doctor, which is great news (he didn't love the OB who delivered Smudge). But at Dr. Z's office, I know everyone and they spoil me. I  guess we'll find out soon enough. Our first appointment with the midwives is at 10w2d.

Meanwhile, my dizzy spells are back and I'm a little queasy again. Someone remind me, the next time I start to feel great to just embrace it and not question everything. 

3-4 weeks until I'll be able to hear Squishy's heartbeat for myself on the doppler. Until then, I'm just going to get through this one day at a time. 

Cleared to Call!

Last week, Dr. Z told me not to call my midwife yet. We emailed our doula anyway, and good thing, too, since that same day she got emails from two other former clients saying they were due in March too! She only takes four clients a month and we're #3!

This week, even though I had a moment of panic because I couldn't see the heartbeat, Chris and Dr. Z both assured me they saw it just fine. Fran told me it was averaging 135 but as high as 150. And when the u/s was over, he told me to go ahead and call the midwives.

Squishy is measuring 8.3mm and 6w5d (which incidentally is the same Smudge was measuring one day later, just 7.9mm. Smudge's heartbeat was 158). Everything looks perfect. Dr. Z is not concerned about the gigunda cyst. He says it will resolve. Still no sign of any of the nine fibroids I had at the end of my pregnancy with Smudge.

So, phone call made. 10w2d appointment with the midwives scheduled.

So far this pregnancy, i'm just really hit by a truck exhausted. And chasing after a toddler like this is no easy task. I'm a little queasy and my chicken aversion is back and rearing it's ugly head again. I'm also gaining weight like there's no tomorrow. I'm not eating a whole lot more, so I'm hoping I can blame some of it on the crazy progesterone doses I'm on. I know part of it is also that I'm not eating fat free dairy any longer (like I was with Smudge's pregnancy). Now that I'm dairy free, the alternatives are not fat free, so I probably need to try to make some adjustments there as well. I only gained 20 pounds last time, and I'm practically 1/2 way there already. Disgusting. I'll get this under control. I refuse to add a weight issue to this pregnancy. 

And here is Squishy at 7w:

One, Singular Sensation.....

Crazy doubling betas, insane bleeding for more than a week... it's all been stressing me out more than I care to admit. This pregnancy is already so different from my last. Including the way it's starting. Not with anything bittersweet. No lost twin. No lost anything, despite that horrendous nightmare about losing the baby the other night. 

Just this: I give you...... Squishy.

Hi, Baby: 6w1d. 

Squishy is measuring right on track at 3.7mm and at 6w. We were able to see a heartbeat today at 111bpm, which is exactly where it should be according to the American Pregnancy Association,  and what I think is the best webpage ever explaining early fetal development (and doing it well).

Dr Z couldn't see any explanation for the bleeding I experienced. So, of the options available, he thinks we were dealing with implantation bleeding from my thick lining. All that matters is that he sees no bleeding or interruption around the pregnancy. He also doesn't see any of my fibroids (there were 9 at my c-section for Smudge). So all good news there. 

I do have a cyst on my right ovary the size of my head. We'll hope that resolves sometime soon.

And as a complete aside, on my way out of the office, Dr Z pulled me aside and asked if he could ask me a question. He may be looking for more nurses.... and on the weekend. He wanted to know if he could call me to discuss working for him. That would just be amazing and I continue to be so touched that he thinks enough of me to ask me to work for him. And I wouldn't have to worry about how to tell him I'm pregnant, either! 

Next u/s is scheduled for thursday. Please continue to send us all the positives you can, because we're not out of the woods yet. We're still aiming for that 8w mark, where the chance of m/c drops to less than 5%. Seeing a heartbeat today was great news, but I'll be happy when our risk of losing this baby drops below double digits. Stay tuned.

Blood, Sweat and Tears... a 2ww Update

This morning I am 9dp3dt (9 days post 3 day transfer). That makes me 12dpo (days post ovulation). So what would be a better way to celebrate this milestone, than to go to the bathroom at work yesterday and find light brown (really tan-ish) CM/spotting.

Okay - as if that isn't panic inducing enough.

When I got home from work, that brown CM was bright red blood.

Let's TRY to focus on the positive here for a few minutes. I have NO cramping. A few twinges here and there, which is totally normal for the 2ww. And I have NEVER bled after IVF before coming off of PIO. My first cycle I didn't get my period until 6 days after the PIO stopped (and no spotting prior at all) and my second, I never even so much as spotted before my bleed at 11w6d pregnant.

But I also had bright red bleeding, which I've never had before other than either my period or when i had the sub-chorionic hematoma when I was 12w pregnant with Smudge.  And bright red bleeding right now is NOT what I needed to see. I'm at the point where I just need to know either way. If this didn't work, I need to mourn and move on. Right now, I'm trying to not focus on the implications of what that would mean. If it DID work, and I am pregnant right now - i just want to be pregnant and love my baby and take it one day at a time. 

What is killing me is the not knowing. At 12dpo, I should be able to have an idea of what is going on in there.  Smudge's Aunt rushed home last night with a FRER for me, because honestly I just need to know right now either way. But I'm too chicken to use it. Dr. Z's office doesn't start answering the phone until 8:30am - and that's too long away. I'm going to call the answering service in about 1/2 hour and ask to be patched to the office. They've done it before, and hopefully they'll do it again. I'm going to ask Fran, no, I'm going to beg her for an early beta. This was SO different when it was just me. But I'm completely incapable of being a stable parent right now. Last night, I got out of the shower, started bleeding and walked into Smudge's room to get her ready for bed. I cried the entire time I was rocking Smudge to sleep. I can't parent her this way. I'm prepared for a 12dpo beta to be low - but at least I'll know if it's positive or negative and be ready to move forward. 

The good news this morning is that before I went to sleep, the bleeding was just brown spotting again and that there was no blood overnight. 

Now I just have to get to beta. 

Deja Vu?

If you'll indulge me for a few minutes, I'd like to bring your attention to the anonymous group blog I posted for while we were trying to conceive Smudge. 4dp3dt (4 days post 3 day transfer), I made this post (link in caption):

http://bloominbabies.blogspot.com/2010/03/ivf-2-2-week-wait-update.html

Well, yesterday was 4dp3dt for this IVF cycle. Once again, I went in for a blood draw at the crack of dawn. And once again, I waited all day for the phone to ring. 

I sat with my phone in my hand waiting for it to ring, only to look down and see a voicemail from Fran saying my P4 was greater than 40! Of course I called her right back to find out the exact number. She said their new machine only says >40. So, that blows that I can't see how awesome my number is, but I'm not going to look that gift horse in the mouth, no way. 

And I know, I know, stop comparing cycles... but at this point, really, CAN I?

All I know, is based on past performance, I have the potential to be EXTREMELY disappointed now. 

How the heck am I supposed to make it an ENTIRE week until Beta?

Pregnant Until Proven Otherwise!!

We spent the morning staring at my cell phone waiting for the call that we were being pushed back to monday. We hit the road and still kept staring at my phone. Even when I was drinking my pomegranate spritzer to fill my bladder, I was still waiting. 

Well - we didn't get pushed to a 5dt. 

I had a few moments of worry. What if we only had 1 or 2 left? What if we lost so many?

I didn't really have very long to worry about it, because before long, Jennifer was calling me in to go back. Penguin socks on, bare butt flapping in the breeze - hospital gowns are such joy. I can say one thing about ultrasound guided transfers... they SUCK. I miss my carefree non-u/s guided transfers where I didn't have to worry about peeing on the doctor  and the speculum putting too much pressure in places. 

But a few minutes later, I was seeing my embryos in a petri dish on the monitor getting sucked into the catheter that would deliver them to my uterus and a few minutes after that I saw them delivered 1 1/2 centimeters below the uterine fundus where hopefully they will eventually find a good spot and snuggle in. 

Folks, I'm PUPO!

And now, the nitty gritty! We had 10 eggs retrieved. 8 of them were mature and subjected to ICSI. Of those 8, 7 fertilized. Guess what? WE STILL HAVE SEVEN EMBRYOS!!!

We transferred three 8-cell embryos, 2 grade 2 and 1 grade 3. By comparison, during my Smudge cycle, we transferred 2 grade 2 and 1 grade 4. Dr. Z was sure to remind us that he never grades anything a 1. And seriously, one of the grade 2's looks pretty darned perfect. 

And the other 4? Well apparently, they're still thriving and we'll know monday if we are able to freeze any of them.

Please keep everything crossed for us. Say a prayer, throw some salt, light a candle, or whatever it is you do. Progesterone check on wednesday, Beta next wednesday (6/27).

Retrieval and Fertilization All-in-One

In January when we started thinking about this cycle, June seemed so FAR away.  But, here I am this morning, so bloated that my clothes don't fit and I'm wearing maternity underwear. My egg retrieval was yesterday. As usual, Dr. Z had to practically climb inside to get to my right ovary. I'll never understand why it likes to hide like it does.  But he did what he had to do, and he got them out. 

He got 10 eggs.

I was initially disappointed. My estrogen was SO high for me and everything has been looking so good. I was really hoping for more than that. But then I snapped out of it and realized that more eggs wouldn't matter. My hope was that the eggs we had would be MUCH better quality than the ones we've had in the past.

And I got my answer.

This morning Fran called. Early, thankfully, and with amazing news.

Of the 10 eggs, 8 were mature and fertilized with ICSI (Intracytoplasmic Sperm Injection). And as of this morning, we have SEVEN embryos growing well.

A 70% fertilization rate. OMG. 

So, what does this mean? Well this morning, we have seven day 1 embryos. We hope by day 3 they are 8 cells with minimal fragmentation and then MAYBE, just MAYBE, if quite a few of them keep on truckin'... we would be pushed to a day 5 transfer to see which ones make it to blast and then transfer two of those. 

You can see the difference between a day 3 and a day 5 embryo.
On day 5 it is called a blastocyst and it's getting ready to hatch.

Fran will call me back tomorrow and let me know what time to be there on saturday for my day 3 transfer. She'll also give me a brief update on how Scott (the awesome embryologist) says our embryos are doing.

Then, on Saturday morning, unless we get a phone call, we'll go in for our 3 day transfer, like both of our cycles before this.

Smudge and her Twin. We think Smudge is the embryo on the left.
In this picture (on day 3), that embryo was ahead in growth and was a compacted Morula,
on it's way to becoming a blastocyst.

stages of embryo growth

However, if on Saturday we get a call in the morning, we will know that we're pushed back for a 5 day transfer and will go in on Monday morning.

OMG. I'm still in shock. Go go gadget ovaries. You did awesome.

Stay tuned.

A Welcome Day Off

Guess who doesn't get ANY needles today? That's right. THIS girl!

So, this is a boring update. No ultrasound this morning. I triggered last night. Smudge has been having some trouble getting down to sleep thanks to some molars, so her Dad was busy. Smudge's Aunt had to do the trigger honors, and despite both of us being terrified she might f it up somehow, she did a great job!

This morning I went to Dr. Z's office. On the way, I noticed the street sign on the highway for the exit I take. I always see it, but I just never paid attention before. Do you know what I mean. Anyway - this is what I saw:

All roads lead to hope.

Anyway, this trip was just for a blood draw. No follicle check this morning. There's no reason to. They triggered me, so 36 hours from trigger, they go in and take all of the eggs out. The follicles should keep growing (and therefore eggs maturing) post trigger, so it's always a little bit of a surprise to find out how many they'll get. 

I can't wait to find out what my E2 was today. They'll tell me tomorrow before retrieval. There's a chart somewhere online (i'll have to google) that gives you an estimate of how much estrogen each follicle puts out and at what stage. It can help you figure out exactly how many good eggs you have going on in there. All I know is my numbers are better than they have ever been. 

Nothing but good things can happen tomorrow.

T-22.5 hours until show time. 

What a Difference a Day Makes

Or, what a difference a doctor makes. Either way, today is a complete reversal of how I felt over the weekend. Today, I actually feel this foreign feeling. It could actually be:

Smudge's Dad says that Dr. O's technique must just be "different". Screw that PC crap. I say she's an idiot. But I feel like I have the right to say that after the IF hell she put me through the last two days.

When I got to Dr. Z's office this morning (first, as usual), my only hope was that Fran was back in the office and I was going to get to see her for monitoring. I got even better. I got Dr. Z. He only had one retrieval this morning, and he made time to see me (I haven't seen him since the middle of last week) before he got that started. The first thing he said was, "Your lining looks great." Great? Yesterday it was 12, which I know isn't anything to sneeze at, but my hallmark is nice thick linings, so 12 didn't make me happy. Today's 16.2mm makes me smile though. 

16mm of beautiful trilaminar lining! MY lining.

He got really quiet then, and was just clicking and measuring. Nothing can make an infertile more nervous that her normally talkative and smiling RE quiet. So, he started talking... mundane stuff. How was your weekend? Telling me about some boring business conference he had to go to. Asking me if I had met Dr O this weekend? That was my in. I mentioned that I had, and that she measures a bit differently that he does. And obviously, that he remains my favorite. 

By then he was done. I sat back and asked him how they looked. He said, "They look great. You're probably going to trigger tonight".

What?!

I told him that yesterday I had only had 2 follicles above 15 and the majority were 12 -13mm. He just shook his head, chuckled and showed me the numbers for myself.

I have 5 that are DEFINITELY mature (above 17mm), 3 that are PROBABLY mature (above 16mm) and 6 that MIGHT mature by retrieval (above 13mm), since they continue to mature after trigger. That might mature category includes one 15.4mm and three 14.5mm or larger. There's no way anyone can convince me that all of these sprung up from 12-13mm follicles overnight. So, thank you Dr. O for needless worry. I'm thrilled I'm not your actual patient, and I'm kind of concerned for the ones who are.

And now that is gone, out of my head, and my focus is on waiting for the phone call with my instructions for tonight and tomorrow.

If I trigger tonight, I'll be on the same timeline as my Smudge cycle, with a wednesday retrieval. Interesting note, my lining was 16mm the night I triggered for her as well.

I feel really positive (and bloated) right now. I know things are working in there. There's no question. I have NEVER felt this bloated or full during an IVF cycle, and that is just a testament to my ovaries in overdrive.

I asked Dr. Z about my estrogen per follicle theory and asked him what he thought. He said that he felt that it showed that the egg quality was going to be superior. I'll take it.

So, for now, I'm sitting here, once again staring at the phone. I'm excited. I'm hopeful. I'm a little uncomfortable.

It looks like tonight is the night. EEEEEEEEEEEK! Here we go again!

I'm Doing it Again

But seriously. Is anyone capable of not comparing cycles? If you are, PLEASE tell me how, because I'm starting to get really upset. I'm hoping part of today's giant let down is Dr O. I DON'T like her. She's completely insincere, and I honestly wonder if she's this way with all of the patients, or just the ones who aren't hers. 

I'm not even going to tell you guys my follicle sizes from today, because they just don't make sense. There are fewer than yesterday on the right, more than yesterday on the left, and one of my 14mms seems to have just up and vanished.


The good news from today is that my E2 is 963 and my lining is up to 12.4mm. (Yeah, whatever. I do not believe it went from 9-12.4 overnight. I think she measured wrong yesterday, because Fran had gotten 10 the day before.)

Anyway - now I'm just worried about too many things. They're increasing my dosage of gonal-f for tonight. And when I say "they", I mean Dr. O, because apparently she's the doctor on this weekend. So, what if she's giving bad advice. She obviously can't measure a follicle... what if she doesn't manage a cycle well either? On my smudge cycle, I triggered monday, with a ton of follicles over 16mm. My failed cycle, I triggered thursday with finally larger follicles, but they all sucked and I obviously didn't get pg. So, what if the longer I stim, the worse the quality will be? Today is stims day 10. And I'm starting to really worry. 

Again, the only good news is that with potentially (depending on her measurements)  8 follicles above 12mm, my estrogen is 963 on stims day 10, whereas with my smudge cycle, on stims day 10, I had 15 follicles over 13 and it was only 1130. So, i'm continuing to have a higher estrogen to follicle ratio. At least I keep telling myself that's good.

So - antagonist experts, talk to me. If I stim for 13-14 days, do you think I still have a chance? Did they start the ganerilix too soon (i started it with a 15 and a 14... btw, the 15 seems to have vanished)? Is Dr O just incapable of accurate measurements? Am I worried about nothing, or do I have a real reason?

I just really need someone to blow some sunshine up my butt, because I'm back on the ledge and it isn't pretty.