One in a Million

Goodbye, Sweetest Heart

The bad news has begun. Baby B has died.

I have felt all along that Baby B was a girl, so I will take the liberty of using "she"--it seems wrong to say "it," as if her time was so brief and so insignificant that she was just an inanimate object. She was real, and she lived the most that she could, and she was precious to my husband and me.

She let go of life very recently, within the last few days. I still *feel* her with me. I still feel her spirit and though I know it can't last, I cherish her presence.  I know that she would have lived if she could have. Her little heart fought to beat, and she tried to catch up in growth. It is my own fault, for giving her worthless genes that could never sustain the life she deserved to have.

The other one, who I think is a boy, appears strong and healthy. I would show you his picture, but it also contains the image of dead Baby B, so it feels right to keep it private. And it pains me to look at it. Baby A continues to grow, and his heartbeat is strong--156 bpm. We even got to hear his heartbeat yesterday, a first for my husband and me. D keeps marveling at that, but I think that if we lose this little one, too, the memory of hearing that whoosh-whoosh-whoosh will only make the loss harder to bear. I have decided to delay my next ultrasound until right before we leave for the CVS. Ultrasounds are nothing for me but embryo death-watch, and the lead up to them is stressful and upsetting even when they turn out well. Of course, we don't want to travel all the way for the CVS if our remaining little one has left us, so we'll do a quick heartbeat check before we go.

Nearly everyone wants me to focus on Baby A, but I can't. Why does the drama of death outweigh the miracle of life? I don't know, but I loved Baby B, and in my irrational heart I want the doctor to be wrong, wrong, wrong. I want this to be a terrible mistake and I want to undo time and I want to make it right.

While I slept yesterday afternoon, in an attempt to delay the inevitable grief, my husband investigated local prenatal massage, and when I awoke he made me a mint Oreo milkshake. I couldn't bear to let him see how much his kindness made me cry. Later, my mother knew all the right things to say while I wept on the phone. We have a complicated relationship, as mothers and daughters often do, yet in the darkest times she is always just right. I told her that I couldn't do this anymore, couldn't lose my babies one after another, couldn't bear to claw my way out of the misery of miscarriage one more time. And she said: You can. You can. You are the strongest woman I know, and you can survive this, and whatever happens next.

So now I am moving, slow and coma-like, through the next two weeks. Ten days to ultrasound, 13 days to CVS, 14 days to results. At the end, the waiting and wondering will be over. We will either rejoice, or begin the long, slow process of loss and of grief. Whatever lies in store, I will be grateful that the limbo is over.

March: Not for the Faint of Heart

March is here! March. February slipped away as the exhaustion and nausea of the first tri dominated my days and nights. But now it's March, the month when I will either miscarry, or be More Pregnant Than Ever Before. It's the month when I will undergo CVS, a test I wouldn't have dreamed of having before I learned of the high risk of fatal genetic disorders for my offspring. It's the month when I will find out if the twins are healthy. It's the month when I may have to face some of my greatest fears, and make decisions that will lie heavy on my heart for the rest of my life.

At my 7w3d ultrasound on Monday, we had a bit of a scare. Baby A was measuring wonderfully, with a good heartbeat. Baby B was small--by 4 days--and had no perceptible heartbeat. The mood from the RE and the NP was not optimistic, but they told us to come back in a few days for a re-check. I could barely absorb the good news about Baby A; the fiercest mama instincts awoke in me. I tried to brace myself for any outcome, but I refused to give up on Baby B.

I didn't want to have the ultrasound two days later; I thought it was a bit of a waste since it could easily be inconclusive. But I diligently went back, and to our delight Baby B had grown two days' worth, and there was the faintest flicker of a heartbeat on the screen! It was weak and slow and hard to see, but I figured we could cut that little heart some slack. After all, it had just started beating. And there was Baby A, who had also grown, whose heart was beating more brightly than before. It was a good, good ultrasound--though I know we're not out of the woods; not by a long shot. Other women can cling to that oft-quoted statistic of miscarriage risk dropping to 5% after seeing the heartbeat. But not me. I've had good ultrasounds before, only to face miscarriage weeks later.

So we take tentative, quiet doses of joy and hope these days, in between the worry and the fear and the relentless maladies of a twin pregnancy. The time is coming when the biggest questions will be answered; the secrets that lie within my babies' chromosomes will be revealed; the fate of this pregnancy will become known. Until then, we hope for the best, knowing too well that we may face the worst.

Jinx!

It took three days and the encouragement of some very good friends for me to screw up the courage to schedule my CVS appointment. It just seemed so presumptuous of me to assume I would be pregnant at ten weeks! But the doctor I want to perform the procedure is one of the best and most experienced in NYC, and I know she books up fast. So I gritted my teeth at a mere five weeks, three days and scheduled the appointment. Even though we hadn't officially seen a sac yet. And on some strange burst of intuition, I had them schedule a twin CVS which takes more time than a singleton CVS.

I felt a lot of relief after I booked the appointment. I mean, it's not like I ordered nursery furniture or anything. It's a vital prenatal test for me to have and it has to be scheduled during a small window of time. Booking the appointment was absolutely the right, smart thing to do.

But sometimes I think that I've jinxed myself by booking the test, and by a hundred other tiny moments that should be mine by rights, but have been marred by all my miscarriages. I know how tenuous these early days weeks are (can I say that now? Weeks? I think I can!). A friend with fertility problems once described it as "the tricky first tri," and that phrase is never far from my mind. I'm very ill this time around, and I even worry that experiencing the pregnancy on such a deep physical level will jinx me. Shouldn't I not think about it? Dream about it? Won't it only become real by pretending it doesn't exist?

But then I think: no. After all, Tinkerbell was saved by the applause of children who believed. And the Velveteen Rabbit became real because he was so very loved. Fervent belief and bottomless love are not in short supply around here.

So I continue to embrace my pregnancy and all the potential that each bright day holds. Sometimes there is fear; there is worry; there is the icy edge of anticipated grief gnawing at my heart. But there are also baby names that randomly drift through my mind. There is the package of three new maternity t-shirts that I bought (on clearance), since my usual shirts already fail to cover my belly. There is the peek into the room meant to be the nursery, which was bitterly dubbed the Empty Room for months, and a vision of two cribs! I was bold enough to imagine two cribs!

That's an awful lot of potentially jinxing behavior. Well, at least if things go wrong, I can spread the blame around.

Snippets

• I am six weeks, four days pregnant. Every day feels like a small and special victory. It's hard to believe that my CVS will be in less than a month.
• I have daily bloody noses, but no spotting or bleeding, which is delightful.
• My father now calls me 2-3 times a week, instead of 2-3 times a month. Last night he said, "So you feel nauseous a few times a week?" Ah ha ha ha ha ha! No, Dad, every blessed moment of every blessed day.
• My mother saw a pretty appalling picture of me that was taken recently and told me that I'd never looked more beautiful.
• I always wanted to be so healthy about what I put in my body during pregnancy. Ah ha ha ha ha ha! Cherry Coke is one of the few reliable products that settles my stomach. Other surprising favorite foods: sorbet, grapefruit juice, scrambled eggs, chips and salsa, and sweet potatoes.
• The local market has been out of sourdough bread the last two times D has shopped there. I need my sourdough bread, dammit! I want buttered toast more than anything.
• Constant, non-stop illness has made me more bitchy and needy than I've ever been before. I'm not proud of this, and D has the patience of a saint. I haven't found a way to really explain to him what it's like to need to eat X food IMMEDIATELY, and that anything that interferes will prompt tears or a tantrum. It may be one of those things men just can't understand, and who can blame them? I don't know if I would have been able to understand before.
• My current odds: 25% chance both babies will be healthy; 50% chance that one will be healthy; 25% chance that neither will be healthy. I think it's entirely possible to fall in the first category, and that is what I'm hoping and praying for.
• Each day I wonder, "Is it today? Will their hearts start beating today?"
• Each day I remind myself that this miracle is not so great the higher power can't handle it.

Who Deserves A Baby?

Last night I dreamed that I was on a reality show called Who Deserves A Baby? Undoubtedly this dream was spurred on by the Starbucks "The Way I See It #208" Cup, which reads:

I wish couples who desperately take every means to conceive a child would realize that adoption is a wonderful alternative. A child who becomes your child through adoption completes a family. Just as when you commit to your spouse or partner there are no biological ties, yet a family was formed. This child enters a family the same way! It is not blood and flesh that form a family, but the heart.

I can't agree more with the majority of that quote. It's the first sentence, so dripping with judgment, that really bakes my potato (as my folksy Southern husband would say). There are many excellent critiques of this cup all over the blogosphere, so all I'll add is, Screw You, Starbucks.

Anyway, I heard about #208 yesterday and it made me pretty sad, as one of those selfish and desperate infertile women who selfishly and desperately pursued assisted reproductive technology instead of skipping down the golden path to adoption, which is paved with marshmallows, by the way. I know it's hard to believe, but for us ART was significantly cheaper and less involved than pursuing adoption right now. Not that I'm defensive. Not that I need to explain myself to strangers on the Internets or coffee-cup pundits.

But! Back to my dream! So there was this brand-new reality show called Who Deserves A Baby? and I was one of several sad, driven women who were forced to compete to prove their maternal worthiness. This was a very complicated dream. For example, in one task I had to remodel and manage a store that sold maternity clothing, and I had the brilliant idea of putting toilets in the dressing room--probably because these days, I spend more time in the bathroom than out of it. Now that I am awake, I'm rather grossed out by toilet/dressing rooms--but again, I digress.

I'm sure you can see where this is going. In one of the rounds, the women were judged in a mocking, scathing way. I lost points for wearing the same outfit three times in one week (true) and for failing to style my hair (also true). I also lost points for being overemotional and gaining weight (again, true and true). The whole element of judgment reduced me to a whimpering puddle of tears. I was so upset I even called a meeting with Amanda Peet, who (in my dream) reprised her role as Jordan from the abominable Studio 60. Even though I tried, tried with all my heart, I couldn't make anyone understand how painful infertility is--and my best efforts were mocked in the final cut of the show.

So where does this leave me? Well, I'm laughing at my crazy dream, and dreading the day that a variation on this "show" becomes an actual part of network programming. But more than that, I'm feeling vulnerable and defensive, and realizing just how deeply infertility has marked my soul. The desire for a child is such a primal one; how can we ever discount its power?

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Well, enough of my dreamscapes. I am six weeks and one day pregnant. With twins! Here they are:

I know it's not much to see yet--but the sacs are the perfect size, and look just right. We're hoping for a heartbeat TWO heartbeats (!) at my next prenatal visit in 9 days. D and I are so excited, even though it's a long, long road ahead of us. But I'll post more about that later.

Took a belly picture yesterday, since I'm feeling all puffed out. No doubt my giant, cyst-studded ovaries are helping with the bulk. Unfortunately I had to crop out my head because I look like death warmed over, what with the dark circles under my eyes and utter exhaustion seeping from every pore. Also I was having a bad hair day. And, oh yeah, Internet privacy and all. But here I am!

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I will try to be better about posting. I've been thinking a lot about where to go with this blog. When I started it, I never dreamed I'd get pregnant so quickly, and most of the time I'm so nervous and exhausted and exhilarated and nauseous that the posts I'd write would bore you to tears. And I'm just feeling so earnest these days. There's not much funny about earnest, you know? I mean, the other thing I could post about is what I eat every day, which is of vast interest to me but probably not the rest of the world. So please bear with me while I figure this out. Mwa!

Hope and Love

Wow, I feel like it's been such a long time since I blogged. I think I started, then abandoned, at least a half-dozen posts in the last week. Fear is so effective at paralyzing my tongue. I wanted, more than anything, to give voice to all the worries plaguing my mind. But to even think them--let alone write them down and commit them to record--would surely open the door for my fears to be realized. At least, that was another fear added to the already-long list.

Now, today, I am less afraid. I think in large part the fear stemmed from the innate knowledge that one, or more, of the embryos was failing last week. I have no solid proof of this, just intuition--the same intuition that has always guided me through the last hours of a chemical pregnancy. The initially high betas and their very slow doubling are the most compelling evidence I have, but even without that, I would trust my inner sense. I have learned at least that much through my infertility and miscarriage travails. This, perversely, makes me proud--but what a shame that it should take such an ordeal to teach me to tap into my deeper wisdom. Better late than never, I guess.

In good news, my betas finally started doubling, and are now doubling beautifully. We had a five-week ultrasound yesterday and *maybe* saw a sac, but nothing definitive. Next Friday, at the six-week ultrasound, we should know more. For now, I feel confident and happy. I feel pregnant! And I love being pregnant. I don't even mind the exhaustion or the incredibly sore breasts or the daily vomiting (sometimes twice or thrice daily, ugh). I have longed for this. Since my 12-week miscarriage I have desperately missed the wondrous feeling of growing new life within me. I missed it so dearly that it became as much a constant and essential part of me as the beating of my heart. It is the greatest gift, the highest privilege, that I could ever desire, and I will never, ever take it for granted.

I love that little life. I love that bond that we have already formed, that bright spark connecting mother and child. I know that s/he will grow and thrive within me for as long as possible, hopefully for a good nine months. But if something should go wrong, this time right now will be the only chance I had at mothering him or her in this realm. I am trying my best not to waste a moment of this time on fear or doubt. Whatever the future may hold, right now, I am pregnant. Right now, our child grows within me. And I love him or her with all my heart and soul.

Retiring the Red Panties

So when you take Prometrium? And you have icky discharge all day long? And you have a history of miscarriage? And you make the mistake of wearing red underpants one day?

Yeah. There's nothing quite like that momentary freak-out, thinking that you're staring at panties soaked with blood. So the red underwear are going away for the duration of this pregnancy.

Tomorrow is my third beta. D asked me what a good number would be (something to hope for?), and I honestly have no idea. I guess above 500. Ahhh, it's all such a crapshoot--especially at this early stage.

I had therapy yesterday and my therapist was so overjoyed for me. She could tell something was different about me right away--told me my hips were wider and that I looked older ("in a good way"). She has proven herself in the past to have powerfully strong intuition, and told me that she thinks there are two healthy babies in there. (Yay for healthy babies!) Boy, I hope that doesn't come back to bite her in the ass. For now, I'll bask in her enthusiasm and optimism.

My latest annoying habit: asking all and sundry "Do you think everything is okay in there? What do you think? What's your opinion?" As if everyone around me had an inside line to my uterus that I somehow missed out on!

Uncertainty

My beta yesterday went up--from 142.5 to 231.

That's good enough that I'm still in the game. I mean, it doubled in a little over 68 hours, and doubling within 72 hours is acceptable. And the rate of doubling is 63%, which is adequate. And did I mention that my levels have always been at the high end of normal for 12DPO and 14DPO? And also that betas are pretty unreliable with IVF for, like, a million-gazillion reasons?

What? Am I trying too hard? You see right through me, don't you?

I know I should know better, but I want the hearty handshake, the flashing lights, the "Congratulations! You're having a baby!" I want the Angel Gabriel to come tell me that everything will be okay. That I will have this baby.

That's asking for a bit much, isn't it?

I fear now that I didn't prepare myself for what it would be like after I finally got pregnant. Just getting this pregnant again was enough of a challenge. I feel like every minute that passes brings me closer to heartbreak. I feel like miscarriage is inevitable for me; has always been inevitable; will always be inevitable. I anticipate grief, and it sits heavy on my shoulders.

As often as I can, I curl up in bed with my hand over my stomach and send my love and light to the embryo(s). I'm so proud of them, with their successful cell division and implantation and fight to live. I know in my heart that if it is at all possible for them to continue to grow and thrive, they will. This may be my only chance to mother them in this realm, and I will give them all the love I've got.

House of Horrors

The vomit, she flows freely in my home.

I've been throwing up daily since Sunday, that oddly-triggered sudden rush to the bathroom that I remember from a previous pregnancy. I think it's way too early for such serious morning sickness, though. I'm not even four weeks pregnant until tomorrow! Undoubtedly the OHSS has contributed to my illness. That said, it's very much reminiscent of the dreaded morning sickness, so I think the pregnancy hormones must have something to do with it.

My husband, on the other hand, has been throwing up since last night. Where I spread my vomiting out over the week, he chose to do it every hour, on the hour. When he surpassed my number of vomiting episodes, I begrudgingly gave him the credit he demanded. This morning, he was such a pathetic puddle splayed on the bed that I called his doctor, only to find out that a virulent stomach "flu" has been ravaging our area since Saturday. The doctor told me to keep him hydrated and to bring him to PromptCare for an IV if he couldn't keep anything down by late afternoon. Fortunately, he's had a few sips of liquid, and hasn't vomited in a few hours. I hope that the worst is over for him.

Here is how much I love my husband:

1. I gave him one of my precious, $50 Zofran Quik-Dissolve Pills, which he promptly vomited within the hour. Fifty dollars down the toilet--literally.

2. I went into the children's aisle of the local pharmacy to buy the Pedialyte Pops the doctor recommended for him. I know. It was not easy to do. (And that's right, Dr. Needs-A-New-Boat! I went SHOPPING! At the pharmacy! Against your orders! Mwahahahahaha!)

And me? I've been nauseous all day, but no vomiting. I hope and pray I don't get this nasty bug. I talked to a plucky nurse at the RE's office, who said, "Oh, don't worry! It won't hurt the baby! But it would be pretty miserable for you with the OHSS." Just as I suspected!

I am also: hugely bloated, with sore, swollen boobs, and totally exhausted. And constipated. I have not been able to do my bed rest thang today because D has needed me. Last night, less than twelve hours after the aspiration, my abdomen was once again hugely distended, so I know it's filling up with fluid again. It's painful today but not as bad as it was, and I'm not having trouble breathing. So far, so good.

But, ugggghhhh.

Just uggghhhh.

The Upside of OHSS, Part 2

Well, yes, it's really cool to watch half a liter of nasty yellow fluid sucked out of your abdomen through a 2-foot needle in your vagina. It's wonderful to have that stuff out of me. I feel like a new woman. I can breathe again. My pants button! It's a miracle!

But it's even cooler to have an early beta, and at 12DPO to have that beta come back at 142.5. Which is a really good, solid number.

Nothing is certain (um, ever, right?)--but definitely not until Friday's repeat beta. Part of me wants to snort and roll my eyes and say in a sarcastic voice, "Yeah, let's see how long THIS lasts." But I can't bear to. I am already that earnest.

Send doubling wishes if you can. Until Friday's results, I will let myself feel a little happy. Because I don't know how long this will last, it makes it all the sweeter.