14 Weeks… Welcome to the 2nd Trimester!

  I am so grateful to have made it to this milestone. After our 3 first trimester losses in the past year (2 DW’s, 1 mine), the second trimester seemed like a pipe dream. I am not sure if it’s the intralipids, prednisone, or fragmin, but I’m glad that I strong-armed our RE into implementing a more aggressive protocol after my NK cytokine findings in October.

Pregnancy has been nice lately. I’m still a bit pukey at certain times in the morning, usually when I have been slow to get food into my belly, or when I’m brushing my teeth. I’m still on the 4 Diclectin daily, as it’s allowing me less food aversions, so I’m eating healthier. I’m up about 12lbs from pre-pregnancy, and up 17lbs from pre-IVF. I’m starting to not care so much about the weight gain, as my bump begins to show more. 

Sleep has been terrible, as my anxiety has been high from this elevated NT crap. I’m a little less obsessed with it now that the NIPT has been sent off, and there’s just waiting to do now. It’s out of my hands. Work has also been stressing me out, as we are 99.99% going on strike, and that means “bye bye salary!”. As a two-teacher household, we are hit even harder. We have money saved (that was supposed to go towards a minivan), and there is a strike fund that we’ve been paying into for years and years which will start to pay us back and definitely soften the blow. It’s all just crazy town over here though. DW’s is leading her school in this strike, and has been stressed out worse than I’ve ever seen her be. 

I started weaning down from my 10mg of Prednisone last week. Last week I went down to 7.5mg daily, and today I go down to 5mg daily. Next week I will be down to 2.5mg daily, and then off of it completely. During December’s failed FET, they didn’t give me proper weaning/tapering instructions and told me to go off cold turkey. My body didn’t respond well, as I had full-body aches, was exhausted to the point of bed-ridden, and I was super hypotensive (my normal BP is around 100/70, and it went down to 90/70). I’m hoping to avoid all of that this time. I have developed a wider “moon face”, and have probably gained more weight than I would’ve without the prednisone, so I’m looking forward to going off of it soon. I’m still on the Fragmin though, and will probably ask to stay on blood thinners until 6 weeks postpartum because while I don’t have a thrombophilia, my sister had a DVT and my grandpa died of a pulmonary embolism. I’m supposed to stay on the aspirin until the end as well.

My hair remains a mess. The front half has been combed out, but the back is still in dreads. DW likes to say that I’m “all business in the front and party in the back”, which makes me laugh my ass off. A couple of days ago, I had a meltdown because I regretted taking out those hard-earned mature dreads. I hate my hair not in dreads. It’s this super fine, wavy sometimes curly always frizzy mess. I have to put way more work into my “normal hair” than I do with my dreads. DW came home to me bawling my eyes out over this one day, and agrees that I should just redread what I took out. I always wanted my dreads a bit thinner, so I might take this as an opportunity to get what I want. It’ll take a while, but I’m glad I didn’t continue to take more out.

I’m definitely showing now, and DW has been coming home and greeting both me and my bump. My belly kinda asserts itself in our hugs now too, which is kinda fun, thinking that Dumplin’ is part of our hug. Clementine has been guarding my belly more closely now, insisting on lying such that her front legs rest on my belly, in Sphinx pose.

  
I’m getting more and more excited about Dumplin’, and have been itching to pull out the boxes of baby clothes that were handed down from my BIL and SIL almost five years ago. We’ve got lots of shuffling to do of stuff in different rooms. We’re moving the entertainment stuff from the rec room to the living room, the office stuff into the rec room, and turning the office into Dumplin’s room. We chose to keep the spare room as the guest bedroom, because all of our family is from out of town and do often stay over. 

I’ve been visualizing good things for us, partly because it helps me get through this tough time, but also because I’m trying to believe in the law of attraction. In my mind, Dumplin’ is perfect. Early next week, the NIPT results will show no/low risk for all trisomies, and we can breathe a sigh of relief. We start moving furniture in preparation for Dumplin’s room, making space for him/her in our home. The next week, at our early anatomy ultrasound, Dumplin’ measures normal on everything, especially his/her heart. We start setting up Dumplin’s room. Two weeks after that, he/she measures normal for everything at the anatomy ultrasound and fetal echocardiogram. We celebrate by washing, sorting, and putting away the baby clothes we’ve been waiting so long to finally be able to use. The rest of the pregnancy is full of happiness, laughter, and love shared between myself, DW, Dumplin’, and those we care about. We have a wonderful summer spent at the cottage or travelling. We celebrate our fifth wedding anniversary with a baby moon. I return to work in September and love being back at my old school. I am able to work until close to Dumplin’s due date. Dumplin’ is welcomed into the world through a meaningful, intense, birth without fear. He/she continues to be wonderful. These are my hopes and prayers. 

Advertisements

Some Random Tidbits

Well I’m 7w6d (based on LMP), or 7w2d (based on my last ultrasound), and I’ve got a couple of things to update you on. I’m considering doing those weekly Bumpdate posts, but I’m kind of nervous, and am not sure which dating to use at this point. Suggestions?

Midwife Appointment:

I was so happy that DW was able to meet the midwife with me. As I mentioned in my previous post, I had applied to 6 midwifery clinics in my region, and all were either full or wouldn’t accept me because I’m out of their catchment area. I was really bummed about this, but then, I received a call from the midwifery clinic that is the furthest away from me, offering me a spot. They were going out on a limb accepting me because I don’t live near their catchment area at all (compared to 3 other clinics where I’m on the border). Something feels serendipitous about this, and I feel like I will have a really good experience with them. 

Things that I wasn’t thrilled with:

– all of the pregnant women in their waiting room looked grumpy and unfriendly. Not a single one smiled the entire 20 minutes we sat waiting to be seen.

– my midwife was 20 minutes late for our appointment. Granted, she was with another patient, but my family doctor and endocrinologist are ON TIME or have a maximum wait of 10 minutes. I timed this because most appointments will be during the work day, and if I have to drive across 3 cities to get there, I need to factor in how this will work with work. 

Things that I really like so far:

– our midwife used to be an OB-GYN in India. She practiced for 20 years before moving to Canada and trained to be a midwife. She has been a midwife for 10 years. This means she has a lot is experience, even beyond the scope of midwifery care. 

– our midwife is a good listener. I felt comfortable interrupting her to ask questions. She paused many times to offer me opportunities to digest information and to ask more questions. She explained things well, using a slow but comfortable pace. 

– Our midwife was very clear about informed choice, and that her job is to lay all of the options out on the table, but that the choice is ours. There would be no bullying me into choosing one way over another. With both DW and I being highly intelligent, with backgrounds in science and medicine, this appealed to us. I’m also incredibly picky, and am a stick in the mud when I don’t get my way.

– I have two midwives: at any given time, there is always one that is on call, and the other is in the office available for appointments. I will meet the other one next week. 

– at our birth, the midwife from my pairing that is on call, plus another midwife from another pairing will be attending. There will always be TWO midwives present: one for me, and one to take care of Dumplin’ (I LOVE THIS). 

– despite being outside of their catchment area, both of my midwives in my pairing live close to us, and are willing to still do home visits after Dumplin’ is born.

Last Intralipids:

Well I had my last intralipid infusion today. Being all paranoid that this infusion wouldn’t have enough lasting power to get me into the “safe zone”, I asked one of the nurses if she could ask the head nurse if they’d let me do one more infusion in a couple of weeks. The nurse said that once the placenta is established (8-12 weeks), I shouldn’t need it anymore, but everything I’ve read about NK cells is that they are active (ie. A threat) until 16 weeks. We’ll see what they say. Those of you who have been pregnant on intralipids- at how many weeks did they do your last infusion?

Diclectin:

Diclectin successfully turned me into a bed-ridden zombie with a hangover. The drowsiness was so bad, that I dialled back my dose from 2 at night + 2 during the day, to just 1 + 1. It’s still managing to prevent me from puking, but I feel less like a waste of space, and can actually interact with my wife.

Pregnancy Acne:

I have honestly maybe had 1 pimple in 12 months. But this past week, 6 nasty pimples erupted on my face. They are the small red ones with deep white pus coming to the surface. I am gross and have been expressing them, but the pockets are so deep that a few have gotten worse or won’t drain completely. My face is an absolute mess, and I am embarrassed to go out in public. I’ve been dabbing them with tea tree oil, hoping that they will just go away. You know that alleged “pregnancy glow”? Well apparently my version is just extra oily pizza face. Ladies- those of you who experienced this, does it go away? Or do I need to go into hiding like a celebrity who’s recovering from several major plastic surgery jobs?

Baby or Carb Bump:

Is 8 weeks too early to be sporting a mini baby bump with a singleton? Or am I carrying an anterior-facing carb monster from the 8 meals of pancakes with maple syrup that I’ve eaten this week? PS- DW has been bringing me pancakes in bed these days, which has helped tremendously with my morning sickness. She is amazing. So is pancakes for breakfast, lunch, and dinner.

Hmmm… I think that’s all I’ve got for now. 

IVF#2: 10DP5DT: Beta HCG

Just a quickie right now to fill y’all in. We drove to the clinic in a near snowstorm this morning, but we had the awesomeness of each other’s company, and good tunes. I fell asleep in the car on the way home, and have been on the edge of a nap ever since.

Finally, a few minutes ago, we got the call. I know that in this process there are many permutations of “the call”- “the call” to let you know you’ve been cleared to start a cycle, to tell you it’s time to trigger, to tell you when you will be egg collecting or embryo transferring, to tell you how many embryos survived to day ____. But today’s call is the one that has had me glued to my phone. Good thing we don’t live in the 80’s or at a time without call waiting.

So here we are, 10 days post embryo transfer, and my beta HCG level is….

IMG_6377

IMG_6379

Thank you for your continued support, especially those of you who are also waiting for “the call” that brings good news- at whatever stage you are at. I know how hard it can be. These are exciting yet scary times for us, as you can probably imagine. But right now, in this moment, I am PREGNANT.

IVF#2: After 9 Days of Stims

DW and I had a nice date night yesterday. We started off the evening at Whole Foods (always a delight), and then headed to my favourite Thai place. This restaurant is 100% authentic Thai. The women who own it are sisters, and actually purchase most of their spices from Thailand themselves because for some reason, a lot of Thai products aren’t approved for import into Canada. My favourite dishes are their made-from-scratch (and not from a powder) tom yum soup:

IMG_6087

And their tilapia keang som, which is a non-coconut milk based curry. It has a base of tamarind paste:

IMG_6089

DW tried a new dish, called Pad Ped Pla:

IMG_6088

The dishes were served with jasmine rice, and were sooo delicious. We saved some for the next day’s lunch, but by 10pm the same night, we inhaled the leftovers.

After dinner, we hit the movie theatre to watch the new Johnny Depp movie, Mortdecai. We enjoy Depp’s silly humour, and kind of picked this movie without knowing much else about it. However, we were quite pleasantly surprised by how enjoyable it was. Several times I found myself literally laughing out loud. We got home in time for my nighttime Gonal-f injection, and a couple of episodes of the Walking Dead, which we are catching up on on our PVR.

Today, I had monitoring this morning.
Here are today’s stats:

IMG_6113-0

IMG_6108-0

IMG_6112-0

The ultrasound tech was funny today, saying, “uh oh, Dr. ______ isn’t going to like this- so many follicles!”. Ahh such is my life.

She was right. This afternoon one of the nurses called, and I’m supposed to lower my dose of Gonal-f again tonight, down to 200 units.

Monitoring again tomorrow!

IVF#2: After 5 Days of Stims

Just a quickie today, but I wanted to update y’all after today’s monitoring appointment.

Yesterday, I went in for my intralipid infusion, which took about two hours, and involved me being hooked up via IV to a bag of what DW calls the “special mayonnaise”. At $750 a pop, out of pocket, it is also an expensive mayonnaise. I have very few superficial veins, and it took the nurses four tries to tap a live one. They eventually had to go for one in my hand, which hurt a lot, and with the Aspirin that I’m taking, bled a lot afterwards.

IMG_6052

Yesterday, I also noticed globs of egg white cervical mucus, which tells me my estrogen levels are high. Each of the little follicles in my ovaries release estrogen as they mature, contributing to the clusterglobs in my underpants. I anticipate that it is bound to get messier by the day. Lucky for you, I did not take pictures of this, as I might have been tempted to post them.

Today, I ran from appointment to appointment. I had really bad insomnia last night (probably due to high estrogen levels, which messes up my sleep every cycle), and took 50mg of diphenhydramine hydrochloride (Benedryl) at 11pm. Benedryl makes me super groggy and I was laying in bed like a zombie this morning, almost missing my monitoring appointment at the fertility clinic. Over the course of 15 minutes, I managed to shower and dress, set up the crockpot for pulled pork, fry some eggs (sunny side up), butter some gluten-free toast, and make myself a protein shake. I also made it to my appointment only 4 minutes late. Phew!

At the clinic, I had blood work and ultrasound done, which revealed 10 follicles on each side (20 in total!), 4 of which are 10mm or larger. They still have a ways to grow, so I go back in on Friday for my next monitoring.

IMG_6056

I’m happy with this number, and now just want them to grow into big fat juicy follicles. Last IVF, I ended up with 36 follicles, with only 19 being mature. This time, since we are doing a fresh transfer back into me, I hope I am not overstimulated, but still have a good number of mature eggs to make good quality embryos. *Fingers and toes crossed*

After monitoring, I rushed downtown to my acupuncture appointment. I’ve got a whole bunch of herbs that I need to take to increase my kidney yang, as my pulse was a bit slow and weak. I also had an acupuncture treatment, which was nice. My TCM doc is a bit of an odd duck, so it’s always an interesting treatment.

Next update on Friday!

FET#4: Protocol

There are a lot of meds involved in our FET this round, and I thought that I’d like to document it, both for myself, but also to help anyone else who is also going through this. The days refer to cycle day, and non-medical supplementation is in brackets (Chinese Medicine herbs).

Days 3-16: Estrace 6mg daily

Days 3+: ASA 81mg daily

Day 13: Intralipids

Day 17+:
7:30am: Prednisone 10mg, Estrace 2mg, Pink PregVit, 100mg Endometrin, (1000IU Vitamin D, Yuan Support Formula- 4 tablets)
3:30pm: Endometrin 100mg, (Yuan Support Formula)
Dinner time: ASA 81mg, Blue PregVit Folic 5
11:30pm: 5000IU Fragmin, 2mg Estrace, 300mg Prometrium, 100mg Endometrin, levothyroxine 25mcg, (omega 3 fish oils, Yuan Support Formula)

Day 21: Frozen Embryo Transfer

Day 31: HCG beta test

Day 33: Repeat HCG beta test

Sometime after Day 33: Intralipids

Tips:

– Set time alarms on your phone so that you take your meds at the proper times.

– But a pill schedule case like this to organize yourself:

IMG_5547.JPG

– inject the Fragmin super slowly

– protect your underpants from leaky Endometrin using long and wide, but super thin panty liners. Better yet- make your own cloth ones, they are so much more comfortable

– clean your lady parts after Endometrin messes, or else it seems to burn down there

I just started the huge combo of meds today, and let me tell you, the Fragmin burns like a B$&@H! I was perfectly fine with the Lupron, Follistim, and Ovidrel injects during my stimulation phase, but this needle would not break the skin without significant force, and while I plunged very very slowly, the medication itself causes a strong burning sensation. I had DW hold my fat roll for me because I needed two hands to steadily depress the plunger, and it felt like she was pinching me as tightly as she could with fingernails (she wasn’t- that’s just what the Fragmin felt like going in). Anyway, I will find a way to make it work, as it needs to be done daily, but right now it is a not-so-distant unpleasant memory. Some advice: have someone else inject it for you, inject the drug very slowly, stop and catch your breath after the burning feeling, inject some more, and so on.

We also keep a stash of homemade organic tea tree and witch hazel wet naps by the toilet to help me “wipe up” any nasty Endometrin leakage (vaginal suppository). I am back to wearing large Cadillac-sized panty liners again too (so as to not ruin my underwear), so the wipes help to prevent some of the chaffing I experienced last pregnancy.

Happiness Cycle Day 14: Downtown

DW took the day off work today, as we had a day of medical appointments, in town and out of town. She has also been so busy and overworked so far this semester that she really needed a “mental health” day as well.

I must mention that I finally had a good sleep last night, after almost a week of terrible anxiety-induced insomnia.

This morning DW made me a decaf coffee (such a nice treat to be served coffee in the morning), we gave the dogs got some consolation pats on the head, and we were on our way.

Our first stop was the fertility clinic’s satellite clinic, which is in our city. I needed to have my blood work and ultrasound monitoring again. Things are on track, with my uterine lining measuring 9.4 today, up from 8.7 of two days ago. I also got a “present” from one of the receptionists, who wasn’t working today, but had mentioned last time I was in that “she’d give me a troll to put down my pants”. I wasn’t sure what she meant by that, but she meant Treasure Trolls, those dolls from the 80’s, for good luck. We joked about for a bit- especially the part about putting one down my pants. Anyway, today, the phlebotomist nurse gave me this on behalf of the receptionist:

IMG_5513.JPG
So thoughtful and sweet!

After that, we headed downtown, to see my family doctor. I was really nervous and stressed about this appointment, not knowing how to describe and explain the overwhelming emotions and feelings that I have been experiencing since the miscarriage. When we got there, my family doctor was super attentive, gave me room to talk, listened patiently and compassionately, and gave some good advice. I shared with her how depressed and anxious I have been feeling, how it has continued to affect my sleep and made me weary of socializing with friends who aren’t aware of our situation. She had me complete some forms: a depression questionnaire, an anxiety questionnaire, and a survey on the impact of my feelings on my activities of daily living. It was the first time that I had taken inventory of various aspects of my depression and anxiety, and how it has been affecting me beyond just my feelings and sense of hope for the future. This whole time I’ve been so consumed and obsessed with our miscarriage(s) and getting back to making babies that I completely lost sight of how I have been doing as a person. I mean, I knew that I was depressed, and I knew that I had an anxiety problem, but I had always placed them under the context of the miscarriage, and not really that they themselves are focal points that need to be addressed.

I have battled depression before, and had reached a nice homeostasis with Wellbutrin for years. When I first met DW, I had already been on it for many years, but like most people with mental health issues, because I felt better, I thought “why not, let’s try life anti-depressant free!”. That was a couple of years ago, and for the entire time, I have been fine. However, with the fertility challenges and heartbreak of three miscarriages, I think my dear friend depression has snuck back into my life, and has brought his asshole friend anxiety along as back-up.

I have mentioned my emotional struggles on my blog many times, but didn’t realize how bad it has gotten until I answered those questionnaires, and saw and felt the true concern in DW’s and my family doctor’s feedback on how I seem, and have been behaving. I guess this is sort of what an intervention feels like. I’ve been so caught up in my own head, and needed to hear what other people are observing. My depression and anxiety are a big concern right now, and my family doctor is concerned enough about it to suggest that I start some medications right away. She suggested Cipralex, which is an SSRI, and is effective for both depression and anxiety. I would love feedback from anyone who has taken it before. She says that it is safe before, during, and after pregnancy, even though Dr. Google claims otherwise. But I am convinced that you can search anything and find support for it in the form of a online support forum. This I have learned from the all-consuming world of TTC.

She wants me to double check with the RE that he Cipralex won’t interfere/interact with all of the other stuff that I will be on: estrace, prometrium/endometrin, aspirin, fragmin, prednisone, intralipids. I’ve emailed the RE’s nurse, so hopefully I will hear back soon.

I have mixed feelings about taking the Cipralex. On one hand I think that it would be better for me to just tough it out, that it’s normal to have feelings of sadness and despair, or constant worry, given what I’ve been through. On the other hand, it is becoming more and more apparent to me that my depression and anxiety levels are abnormally high, and the culmination of evidence is that that can negatively impact our potential pregnancy even more than the small risk of cardiovascular defects and autism that have been reported but not confirmed. I look at DW, and some of you who seem “recovered” from your miscarriages, and wonder why I’m still stuck in this destructive loop of depression and anxiety. I realize now that it’s because I am struggling with an extra layer of mental illness.

Work has been harassing me again as well. In the past seven days, the person in charge of leaves has called me three times and emailed me once. This is after talking to her already the first time. She didn’t have anything new to discuss the subsequent times, but rather has been very negative and pushy in her tone. DW says that if she calls me again, that we should complain to the union. The last thing you want to do when you have an employee suffering from a mental health challenge is harass them.

Anyway, after my doctor’s appointment we went out for lunch at our favourite Vietnamese place.

IMG_5514.JPG

Then grabbed some baked treats down the street at this great little bakery we found by accident one day the last time we were here. I got a gluten-free chèvre cheesecake, and DW got “the best butter tart ever”, as well as a pear almond tort-like thing that has a fancy French name that I don’t remember.

IMG_5516.JPG

IMG_5515.JPG

We then went shopping at our favourite outdoor store: Mountain Equipment Co-op, where we caught up on some much needed shopping, and bought a couple of early Christmas presents (me mostly).

We also got a call from our primary nurse today. I am supposed to start my long list of meds on Saturday, in preparation for our embryo transfer on Wednesday morning!

I hope that time moves fast, as I’m anxious for our last embryo to come home, but I also feel like I need some time to process everything that has happened today. The good, and the bad new.