I am in pain.

I don't really know what else to say. I don't know if it's depression or if it's normal grief. But I am hurting a lot. Nobody understands. Friends are either about to have babies or announcing they are pregnant. And I just hurt. There are some days when I feel like there is a light at the end of this tunnel, and then there are days like today when I am convinced that I will hurt forever. Forever.

14 Vials

14 vials of blood later, my RPL panel has been drawn. Not without incident. The lab receptionist had trouble reading the doctor's ordered tests and entered my name incorrectly into the system. I'll be amazed if all the right tests were done and they all make it to my doctor.

Oh, and I had to give a credit card to cover whatever isn't covered by insurance...Nothing like $6,200 in blood work to enhance the holiday season!

About the Duggars (Briefly)

This isn't a blog where I ever talk about other people and their fertility decisions. I do not agree with a lot of what I know about the Duggars, and they likely wouldn't agree with a lot of things about my life either. But I do want to talk briefly about her most recent pregnancy.

The EXACT day Michelle Duggar publicly announced she was pregnant with their 20th child, was the EXACT day that my husband and I found out we had lost our 5th pregnancy. It was a raw day for me and I was very angry at some of the rhetoric used in her pregnancy announcement. The implication being that God was giving them babies, and they would take as many as God would give them. Of course, in my fragile emotional state, I wanted to throat punch her through the television. The arrogance. The entitlement. That somehow God had chosen her to be special. God chooses her to have 20 babies, and chooses me to grieve the loss of 4 of mine.

But in our own grief and suffering, the Duggars and their life went back to being the least of my worries or concerns. Until a month later, when the world learned she had miscarried. And in the weeks that have passed since then, I am shocked and appalled at the disgusting things that have been said about her.

NO ONE deserves to lose a baby. NO ONE deserves the grief, suffering, and heartache that comes with the loss of a pregnancy. NO ONE should ever be judged for how they handle their grief after such a loss. People may not agree with the lifestyle the Duggars live, but for crying out loud - let her grieve in peace. Every woman deserves at least that much in a time like this.

CD1

It's been over 3 months since I've had to deal with a period. And today she returns. After a 34 day cycle with a textbook 14 day LP, she's here. If my first cycle post m/c is anything like my first cycle after last summer's m/c, I'm in for a long miserable week.

I don't exactly know how to feel about this. Glad it's over. Sad it's over. I mean, it's been over for a while. But now it's really really over. I still have to call my doctors and tell them my period is back. I'm dreading doing that. I don't know why - I don't even like having to talk to them any more.

Sigh.

This does mean that I'll get to have my blood panel done before we leave town for the holidays so maybe, just maybe, the results will be ready shortly after we get back into town.

I've been doing a ridiculous amount of thinking lately. About whether or not I want to try again. Maybe if the RPL testing gives us some "answers" I'll feel better about it. But this last loss has been really rough on me. Much rougher than I ever imagined it could be. And I don't know how I would handle another loss. I don't know if it's fair to put my family through that. My perfect blessing of a son deserves so much more than a mom who is emotionally wrecked. And even if the next one isn't a loss, I will be a nervous wreck for the entire pregnancy. I get a lump in my throat just thinking about whether or not I would even be able to enjoy another pregnancy.

One step at a time. One slow step at a time. RPL testing, get this miserable period over with. And then enjoy Christmas with my family. My sweet, wonderful, beautiful little boy deserves that - and a whole lot more.

Ovulation and BFN. Time to move on.

Well, I ovulated. Almost on fucking schedule. How is that even possible? I was 10 weeks pregnant and I ovulated 17 days after I passed the embryo (20 days from when the heavy bleeding started). Normal ovulation for me is 14-16 days into my cycle. Un-freaking-real. The day I ovulated I took a pregnancy test and there was still the faintest shadow of line there. Today it is gone. That is what the online pregnancy community refers to as a BFN (big fat negative).

So there is nothing at all physically left of this pregnancy now. Other than the pictures from our ultrasound the day we saw the heartbeat. I don't think I'll keep those forever, but right now I can't bring myself to throw them away.

If only my mind would heal as quickly as my body. :(

Dark days

Ah yes I knew these days were coming. The days where I still ache to the point that I can't see straight through my tears. The days where I feel so lonely and isolated that I can't breath. The days where my exhaustion, depression, and frustration manifest themselves in my anger at the world.

Ah yes. As if losing my pregnancies wasn't impossible enough, I now worry about my relationships that are suffering.

My son. My perfect beautiful miracle. How does one remain a good mother through suffering like this? I have been a horrible mother lately. Getting through, but only going through the motions. And getting beyond frustrated with tantrums and whining and other completely normal 2 year old behavior. It's not fair to him, and I hate it.

And my marriage. It's rough. My husband lost his father this year. I've lost 3 babies in 6 months. We are each trying to grieve and should be supporting each other. And we are struggling with that significantly.

I am so ready to curl up in a ball and give up. How much more can I possibly fucking take?

Well hello there OPK

I'm really trying to stay on top of my cycle in this waiting period. And I've been having some signs that ovulation might be about to happen, so this morning I took an OPK. In order to be positive, the test line has to be equally dark or darker than the control line.

Left is test. Right is control.



Darker, no. But as dark? Maybe not quite, but really darn close if you ask me.

Now this doesn't mean I'm going to ovulate tomorrow. I can have positives on these things for over 4 days, but let's recap. I'm only 18 days out from when the heavy bleeding started and only 15 days out from passing the embryo, and here I am (still biochemically pregnant) gearing up to throw out another egg.

My body sure does want to get pregnant. If only it would be happy to stay that way . . .

My arm hurts just looking at this list

Here are all the tests that have been ordered for me:

- Anticardiolipin Ab, IgG, Qn
- Protein S Panel
- Factor V Leiden Mutation
- Protein C Deficiency
- PrtCAg+PrtSAg
- Antitrhombin III, Func/Immunol
- Hemoglobin A1C
- Prolactin
- TSH, 3rd generation
- Free T4
- Lupus anticoagulant
- Beta-2 glycoprotein
- Prothrombin gene mutation
- Karotype

Dr. D Consult

We showed up to our consult with our 30 pages of homework filled out. She was every bit as nice and calming and comforting as I expected based on what I had read about her. She was also very positive - telling us that if all of our tests come back normal that we have a 75% of success with our next pregnancy. I don't know why, that part made me cry. Probably because I don't believe it.

We have lots of tests coming up. Okay, I have lots of tests coming up. My husband only has 1 test. I am not going to have any testing done until my period shows up again. While some tests like the genetics don't require homeostatic hormone levels, others do and I'd rather just go once. So here's what we have coming up:

1) A sonohysterogram. An ultrasound procedure where they will inflate my uterus with saline via a catheter and then do a detailed ultrasound to look for any uterine abnormalities such as a septate (heart shaped) uterus or any fibroids or polyps. The chance that I have a septate uterus that went unnoticed through my entire first pregnancy is slim, but possible. The chance of fibroids or polyps that may have developed since my first pregnancy is greater - given that my periods have changed since I had my son (they are extremely heavy) and that in this most recent pregnancy the baby was situated in a position where the ultrasound tech couldn't get good measurement. Treatment is relatively straightforward, but does require surgery.

2) Hormonal deficiencies / abnormalities. The list here is LONG. My lab work writeup calls for 15 different tests and most of them fall under this category. Everything from thyroid to prolactin to diabetes. We did talk about my thyroid results from July and I'll talk about that a little more below. Treatment with medication is relatively easy for all of these problems.

3) Clotting disorders. There are acquired types of clotting disorders and there are inherited forms. There are two things in my history that point to an unlikelihood that this is our problem - 1) an uncomplicated full term pregnancy with my son and 2) the previous use of hormonal birth control with no complications (birth control pills can cause clotting problems). However, there is 1 very alarming piece of my history - my dad died of a stroke when he was 49 years old and he was adopted, so we have no family history at all. Given such a young age for such a serious stroke she is testing me for all clotting disorders. Treatment with medication is relatively easy for this problem as well.

4) Chromosomal abnormalities. Now we get to the complicated stuff. She said she sees this in about 3-5% of RPL patients. It is possible that my husband or I could have genetic translocation. This is where an individual is completely normal because they have all of their required genetic material, but it can be located in the wrong place. It creates no problems for the person with the translocation, however when trying to create an embryo, the genetic material from the egg and the sperm do not match up. This is the most serious of all the problems we talked about. Depending on what chromosomes could potentially be translocated, the chance of miscarriage could range from 50% to 95%. It is absolutely possible for someone with genetic translocation to create a healthy embryo (like our son), it's just a lot more common for a genetically abnormal embryo to develop. Given our 2 chemical pregnancies (most very early pregnancies that terminate are due to chromosomal abnormalities) I am concerned about this one. Treatment is not easy or cheap - it requires in vitro fertilization with preimplantation genetic diagnosis (IVF w/ PGD).

So that's where we are. We will have all of these tests done and go back for a follow up consultation with her. She did warn us that more than 50% of all RPL patients get through this initial testing with an unexplained diagnosis. But we will cross that bridge later.

I do like her, and she's one of the best in our area - so I'm trying to stay positive. There are however, a couple of things that worry me:

1) No semen analysis. Because we get pregnant so easily she thinks it would be a waste to do a SA. Obviously my husband doesn't have a shortage of swimmers, but I would have been more comfortable if we were at least going to address the quality of his sperm. While we are talking about it, I wouldn't mind knowing about the quality of my eggs.

2) She doesn't have a problem with a TSH of up to 3.5 and she also doesn't treat thyroid antibodies. She is the expert, so I'm not going to get upset about this . . . YET. However, if everything else I listed above comes back normal and my TSH stays at this borderline level, I may be seeking a 2nd opinion.

So that's where we are. Now I just wait for my period to show up so we can start these tests.