Let's talk about the next 7 days

I sit here this morning completely emotionally exhausted thinking about this upcoming week. While I'm sure many of these topics will get their own post at some point in the next week, thinking about all of them this morning is a little overwhelming.

1). This will be the first week in three weeks that we will not have an ultrasound or any other way to check to see if this peanut is still alive.

2). I will have my first appointment with my midwife who has done all of my miscarriage appointments.

3). We will (hopefully) pass the gestational age that everything went wrong last time. At 7w4d last time there was a gloriously strong heartbeat. At 8w5d it was gone.

4). And finally we will watch June 14th come and go. The EDD for our last pregnancy. And instead of becoming 2nd time parents, we will spend June 14th clinging to whatever hope we can find that we won't have to say goodbye to another pregnancy and spend another due date with such sorrow.

Quick (and boring) afternoon update

The nurse called when I couldn't get to the phone of course.  She left a very nice message confirming everything we discussed this morning with the RE.  She told me that my regular practice could decide when would be a good time to come off my progesterone.  And she did not give me my beta level.  For a split second I thought about calling back to ask what it was, and then the calmer part of my brain intervened.  I don't need the number.  Everything we saw this morning looks good.  Certainly if they were concerned about the blood work they would have mentioned it.  So I'm letting it go.  I can live without it.

A good morning

Well, all things considered, this morning was a resounding success.  Baby is measuring 7w0d (more on that in a second), and the heartbeat was a wonderful 144bpm.  We didn't just see the heartbeat today, but heard it as well, and man is that an experience like no other.  It's the first time I've heard a fetal (embryonic, whatever) heartbeat since I was pregnant with my son.  Hearing the sound of a heart of a new life beating inside you fill a silent room, it's just more incredible than words can describe.

The RE (not my normal RE) said everything looks perfect multiple times and told me that they'd call me later today with blood work results and final instructions (like how long to stay on my progesterone), but that I should go ahead and schedule an appointment with my normal practice (which I did last week based on my normal RE's recommendation).  

About that measurement.  I did have a mild cardiac event when he told me that the baby is measuring 7w0d today.  Because exactly 1 week ago the baby was measuring 6w3d and that is only 4 days of growth in the last 7 days.  I asked if there was concern about that, and his response was very reassuring.  Basically he said we are measuring a moving 3-D object about 1cm in length by zooming into my uterus on a computer screen and trying to nail down a 2-D measurement.  And at this stage every millimeter counts.  If the measurement last week was high by just 1mm and the measurement this week is low by just 1mm, then I've had perfect growth over the last week.  The sac has grown perfectly over the last 2 weeks and the heart rate has accelerated perfectly over the last week.  He said there is absolutely nothing to be concerned about.  (And then I remembered the last pregnancy where the tech couldn't get good measurements and depending on the angle and how the baby was moving she was easily getting a range of 3-4 days with each measurement she took.)  

Phew.  

So for now I wait for blood work, which should still be rising, and wait for my appointment next week with my midwives.  I may beg like a drug addict for an ultrasound between now and the NT scan at 12 weeks.  Or inquire as to whether or not a perinatologist/high-risk OB would be better suited to follow me until the pregnancy is further along.  I absolutely adore my midwife practice, but as I've said before, handling complex situations is not their specialty.  

Yo-yo

In a matter of hours I've gone from feeling okay and eating breakfast, to being the sickest that I have been yet. I am starving hungry, but have not been able to keep anything down. And I still haven't taken my vitamins today either - which should be a treat.

A part of me is very relieved. And a small part of me is reconsidering Zofran.

It's only Wednesday

Shit, it's been a long week.  In 24 hours we'll have a baby update and I'm feeling kinda sick about it.  More nervous about tomorrow than I was last week.

I've decided that the sickness I experienced between 5 1/2 and 6 1/2 weeks is just not coming back.  It's not gone completely, it's just been replaced with a more nagging type of all day manageable nausea.  The type of nausea that actually is lessened by eating smaller meals at closer together intervals and is completely tolerable.  I feel like 7 weeks is WAY too early for my sickness to have improved, but 1) there is obviously nothing I can do about it and 2) I'm trying to find some comfort in the fact that I am still sick.

With the pregnancies that I lost, I specifically said to my husband on more than one occasion - I just don't feel pregnant.  I mean I really and truly felt like my normal regular self without a period.  That is definitely not the case now.  And if I hadn't had the extreme sickness I had last week, I'd honestly be pretty happy with my symptoms right now.

But the minds games are KILLING me.  This is harder than I ever imagined it would be.  Then I remind myself that my regular practice probably won't do another ultrasound until the NT scan and that's still over 4 weeks away . . . and then the anxiety really sets in.  I am going to try to convince them that I might die if I have to wait 4 weeks for another ultrasound.

What we hope to see tomorrow:

1) An embryo that has grown appropriately in the last week.  They are measuring millimeters in my uterus through a transvaginal ultrasound, and each millimeter makes the difference in each gestational day here . . . so if you give a small fudge factor for measuring inconsistencies, the embryo doesn't have to measure EXACTLY 7w3d tomorrow (it measured 6w3d last week), but it should be darn close.

2) A heartbeat with a rate that has accelerated.  The heart technically starts beating sometime early in the 5th week (although much too small to be detected via ultrasound) and starts out beating around 80bpm.  The fetal heart rate should increase by approximately 3bpm per day up until sometime around the 9th week, when it will stabilize and then slow down a bit for the remainder of pregnancy.  These are all approximate guidelines and timeframes, so there is no magical number we are shooting for, but faster than 121bpm is certainly what we are hoping for tomorrow.

3) HCG that has increased.  As I mentioned last week, doubling times once betas get this high can really slow down a lot and bloodwork is not the best indicator of pregnancy outcome at this point.  But my HCG should still be increasing and not by an insignificant amount.  Just like the heartbeat, there is no magic number here, but higher is better.

Afternoon Update

I feel like complete and total shit again and I can't think of a better update.  I absolutely hate that this has to be a war between physical and mental well being, but for now the worse I feel physically the better I feel mentally.

Glad I caught up on my work yesterday when I was feeling better . . .

7 weeks

7 weeks pregnant today.  If all is still going well, the baby should be about the size of a blueberry.

Up until yesterday I was fairly optimistic about this pregnancy, but my relatively good day yesterday really played some head games with me.  I wouldn't say that I felt great or normal yesterday, but I tolerated a fair amount of food and didn't even feel the need to keep a plastic bag with me at all times.  Jury is still out on how I feel today.  I've only been awake for about 30 minutes and don't feel great, but that's a pretty typical morning for me, pregnant or not.  (I'm slow and grumpy to wake up.)

Of course, to mess with my head even more, I had my first dream last night about miscarrying this pregnancy.  In between the last miscarriage and this pregnancy, I had miscarriage dreams quite frequently, but somehow my mind had kept them at bay during this pregnancy . . . until now.  I'll save you the gory details, but it was horrifying and upsetting and did nothing to calm my nerves.

Thursday morning feels a million hours a way.  Still 2 full more days to analyze why I'm feeling better and to hope I start feeling worse again really soon. I am so glad my RE is bringing me back for another ultrasound and I am so glad my husband is going to be able to go with me.  I feel like this one may not have the same happy outcome as previous ones.

Life/Pregnancy with RPL

This weekend was a pretty rough one physically for me.  I hugged the toilet multiple times and last night after fixing dinner for my family I went and laid down on our bed and cried my eyes out for about 15 minutes.  Too sick to do anything other than cry.  (My mom was in town, or I wouldn't have even bothered making dinner.)  I finally was able to pull myself together and eat a few bites of the meal.  Evenings are much worse for me than mornings.  Every night I lay in bed and convince myself that if I just mentally suppress the nausea for long enough, I'll be able to finally fall asleep.  This has been taking me over an hour or two at night to get to sleep.

So when the alarm went off this morning, the very first thing I thought was, "Hmmm.  I didn't get up to pee last night."  As I step out of bed to go to the bathroom the second thing I think, "WTF?  My boobs don't feel like they were punched in my sleep."  And as I slowly wake up this morning and try to get into the Monday morning groove, I am obsessed with one nagging and constant thought, "I don't feel sick yet today."

And those three things in combination are making me completely fucking neurotic right now.  I am going to try the absolute best I can to take advantage of feeling good to get some real work done this morning.  I was so sick last week that for hours on end I would just stare at my computer trying to get through the day.  I fell behind on some stuff that is going to bite me in the rear if I don't catch up on it asap.  So wish me luck that after spending a few hours on work that I will be hugging the toilet again.  Because if my sickness doesn't come back really really soon then I'm going to probably lose my mind.

Zofran? No thank you!

My RE told me yesterday I should go ahead and schedule my first appointment with my regular doctors, even though she's going to follow me for one more week.

So I called my practice this morning and as soon as I identified myself and said I was pregnant the receptionist was so excited. "Oh, we are so happy to hear this. We've been pulling for you." Which was very sweet, but also made me feel a little like the office sympathy case. Whatever, it was mostly sweet. She went on to ask me several questions about how I was feeling, if I was feeling different, etc. I told her I was really sick. Not to the point where I am concerned about nutrition or hydration. Just to the point that I carry a plastic bag with me everywhere because the feeling is that it's going to happen any (and every) second. Being the super sweet sympathetic person that she is, she said, "Oh, let me put you through to a nurse. I'm sure we can get a script of Zofran called in for you." And in my head I said, "Are you fucking insane??? I am not doing one thing to take away any of these pregnancy symptoms. They are the only thing keeping me from being committed to a padded room." And somehow between my head and my mouth that turned into, "That's really nice of you to offer, but it's giving me some peace of mind right now, so I'm going to pass."

I'm not going to lie - I had forgotten how miserable the first trimester was with my son. Feeling miserable is never fun . . . But it is damn sure providing me some mental comfort right now. And if I have to choose between physical ailments that are of no true health concern or sanity, I'll gladly carry my plastic bag with me every day for the next 33.5 weeks!

First appointment with my regular doctors is June 13th. It will be emotional - there are quite a few doctors there (5 or 6) and the one I'm seeing is the one who diagnosed and tracked both my previous miscarriages.

Small update (with small freak out)

The nurse called me back with my bloodwork yesterday afternoon.  Beta is up to 36,818.  Cue minor freak out.  Based on facts, that is fine.  FACT:  Once betas are over 6,000 it is completely normal for them to take over 96 hours to double.  FACT:  Once betas are over 6,000 and an embryo is present, transvaginal ultrasound is considered the more appropriate way to track the viability of a pregnancy as there can be WILD variations in beta levels.  FACT: For 6 weeks since LMP, the standard range of normal is anywhere from 1,080 to 56,500, and I'm obviously much closer to the higher end of that spectrum.

In my brain, it's not fine.  My betas went from doubling every 44 hours to doubling every 95 hours and that seems like a MASSIVE slow down.  I'm trying not to let the crazy in me run away with this.  Many doctors even stop drawing betas once they detect an embryo on an ultrasound (some stop even sooner).  Unfortunately my RE practice does not stop.  In fact, when I go back next week for what will hopefully be my last visit, they are going to draw one again.  ARGH.  Why?  Just to give me something else to worry about I suppose.