Saturday, October 29, 2011

Three years of wedded bliss

This post reminds me that I started this blog more than a year ago. Last year I was forcing myself to remember that trying to have a baby wasn't all that has happened in two years. This year, despite everything that happened in the past 12 months celebrating our 3rd wedding anniversary has been a very happy event.

In the office this week one of the younger blokes (29 years old - really not that young I guess) asked me and another married colleague what was good about being married. Put on the spot I don't think we did our best to sell the institute of marriage. With a little more time to think about it, here's what I've come up with.

My 10 favourite things about being married:
1. Even the small things are more enjoyable with company, a cup of coffee, meals, reading the newspaper.

2. I'm always thinking about something and it is great to have someone to bounce ideas off. Of course, this isn't one of Matt's favourite things about marriage. We call it talking in draft. Matt sometimes wants to know what's draft and what's final.

3. Planning together. It is really nice to work toward common goals and achieve them. Things that make our lives better together.

4. Creating shared rituals. Matt and I have discovered our own perfect holiday location. We've been there three years in a row, and I look forward to when we will be able to say we've holidaying there for 20 years.

5. Emotional support and back up. I remember when I broke up with a very serious ex-boyfriend I was devastated. I was so bad I was unable to eat (for me, that is bad), I couldn't laugh or have fun, I was relentlessly sad. I remember my uncle saying to me at the time, "this is not the worst thing that you are going to have happen in your life, you will get over this". I've thought about this statement a lot this year when I've had much worse things happen in my life and thought, my uncle was so right. The funny thing is, it hasn't seemed as bad, with Matt to help and support me. You can deal with so much more when you have the right people in your life.

6. Financial flexibility. We don't argue about money in our household, which is great. We've both had opportunities to improve ourselves individually with the financial support of the other. Matt's had a year off to study and quickly secured a better job and now I have the opportunity to work part-time. I guess this is a little like achieving our common goals - we decide what's best for us and do what we must to make it work. Even it that means cooking a million different varieties of dinners with mince meat  :)

7. Affection. My young work colleague thought one of the perks of being single was surprise kisses on the dance floor, which I guess would fall under the same heading. Wedded affection may not always be spontaneous, but you can pretty much be sure, you'll get the hug when you need it most and a snuggle on a cold night.

8. Having a fall guy. Sometimes you just don't want to go to the work christmas drinks or other such events. Now if I want to weasel out of something I get to blame the husband for pre-booking us to some other social occasion without first consulting the calendar.

9. Sharing the chores around. I think I am a good wife but I'm undeniably a very bad housewife. Now some of my least favourite chores Matt doesn't mind doing (eg the laundry) and some of Matt's least favourite chores I don't mind doing (eg the grocery shopping and cooking). Then there are the rest of the chores we both hate doing, but with the hour of power system, we both hook in together for 1 hour each week (or so....) and just get it done. What ever doesn't get done in the hour, we have agreed to live with.

10. Even more family. I've always been close with my own family, but we are pretty small. With Matt I got a much bigger family. I have newphews, so I still have the joy (and occasional trials!) of having children around me without yet having my own. Family can be trying sometimes, but I like the way you can bounce back and all is forgiven. I love having a bigger family with a whole new range of characters.

I've really enjoyed writing this post.  :)

Saturday, October 22, 2011

Taking a step back

Most people who know me, know I work pretty hard. I am reliable. If I have a job to do, it gets done. I take my work very seriously and while I love to have fun at work it would never be at the expense of actually performing my role to the highest standard.

This year I've had two unexpected lengthy drop outs of the office for ectopic pregnancy surgery and recovery and one shorter planned drop out for my gallbladder surgery. I am grateful that because I have been a hard worker with the one employer for a long time I have a large sick leave balance, that even now (after 50 sick days since February) has a few weeks left in it. So I'm not on sick leave stressing about getting back to work for the money, I'm stressing about letting people down and not getting to complete things for which I was responsible.

With the curette confirmed I decide to meet with work and ask if I could return to work part-time. I feel so distressed about the idea of returning full-time to the same role. I just don't have the same stamina to manage the pressure of the day-to-day work load. I'm so lucky because I know just in my asking that my workplace will do practically anything to help me out. The Acting CEO is more than happy to arrange a 3-day week for me and to have me oversee a few smaller, special projects instead of the state-wide role I'd been performing.

Phew. It is a massive release to know for at least 3-months I will return to work only 3-days a week. More days off than in the office. Excellent.

The next day is curette day. It is uneventful, fast and painless when compared to every other surgery I've had in 2011. It is also sad. I remember my first one of these procedures I had back in 2009 when we lost our first pregnancy and I know I'm nowhere near as sad and that I'm emotionally dealing with this better. I guess so much has happened since then.

The following week I finally get to have a follow up appointment with my fertility specialist. It feels like months since I've seen him, but it only a few weeks. When he sees me waiting in his rooms he looks sheepish and says "I don't think I want to see you." I tell him too bad, that I have a massive list of questions so he is just going to have to suck it up. As we walk down the corridor he puts his arm around my shoulders and says "I'm so sorry".

I wasn't joking about my list - I had written one as I was worried when I got in there I would forget everything. The first thing he answers is the result of the curette. They test the products of conception to find out if there is a reason the baby miscarried. Like our first miscarriage there was a chromosomal problem, the fetus had two extra chromosomes. So it wasn't the drugs, or the surgeries, or the infections that caused the miscarriage, it was nature.

The rest of the list is pretty straight forward, except for my belly button wound - which is STILL OOZING! Not as badly as the initial infection, but just not healed. My specialist takes another swab and armed with the results of my blood cultures from when I was in hospital he send it off to be tested. He gives me a new antibiotics prescription that I am only to fill if he rings me with the result of the swab.
It turned out I was still infected, so I needed to go back on the antibiotics.

Now it is a waiting game where only my emotional health will determine when we get back in the IVF saddle. Thankfully there are eight little frozen embryos ready and waiting to be transferred, when I think I'm ready for another go. Initially I was thinking 3 months off, but we'll see...  with no chance of natural conception, I think I will find myself wanting to get back into it sooner, especially while I'm able to take a step back at work and focus on myself for a while.

Monday, October 17, 2011

More ultrasounds more tears

My first impression of the alternative specialist I am booked into is good. He is really understanding of everything that has been going on and helps me feel at ease.

He goes through everything that has been chased down by his receptionist and my fertility specialist's office, tracking back through all the medical incidents of the past few weeks. Dates, dates, dates. We agree the baby should be bigger than the 6 weeks it measured at the ultrasound. He then adds, the heartbeat is a little slower than he would liked. He asks if he can do an in room scan.

I'm across the hall in a foreign ultrasound room. It is fancy! There is a big TV high on the wall, so it is easy to see the screen when reclined in the bed. Matt is with me, standing next to the bed. I'm looking at the TV and even though the doctor isn't even scanning I'm looking at the big screen thinking I'm going to be looking at the baby up there and it might be dead. Oh crap, this is going to be hard. I'm already getting choked up.

I am just holding it together when the doctor comes in. He is quickly getting on with the scan, another internal scan. He is poking around I can't see anything of note on the screen, then the doctor starts talking me through it. There is the gestation sack, there is the baby, there is no apparent heart beat. The baby measures 6 weeks. He says he is sorry, but there doesn't appear to be a heart beat. He leaves me to get dressed and come back across the hallway to the other office. I am crying as I get redressed. Matt is angry. He says he is just sick of it.

The specialist explains that the in-room scan is not as good as the diagnostic ulstrasound, and although it doesn't look good, he would hate to recommend a curette (to clean out the uterus) without getting a diagnostic scan done. He refers me to have another scan done. I feel it is all over, but I'm hanging onto the little bit of hope, perhaps the diagnostic scan will miraculously see an 8 week old fetus with a strong, fast heart beat.

The next day Matt and I again roll into an x-ray centre. In the diagnostic ultrasound the sonographer says the baby is still the same size as our earlier scan (which was nearly a week ago) and there is no longer a heartbeat. Even when you are expecting it, it is horrible. I am weeping on the bed. I want to have a private and dignified grief, but here I am stuck with a stranger in a clinical little room and I can't contain my sadness. And I know I have to pull it together enough to get up and go out and pay (I had asked if I could pay before I went in, given the expected result, but apparently this is not possible). We ditched waiting for the scan films - all those baby ultrasounds of babies just look freaky to me these days, let alone knowing it is your dead baby.

As this was the mostly expected outcome, the alternative fertility specialist had tentatively booked me in for a curette on Friday. A curette to remove the products of conception (this is now the medical term for what was only days ago called the baby). In just a couple of phone calls the procedure is confirmed.

I don't understand my own thinking through all of this. In part I'm relieved it is almost all over. This has been such an incredibly traumatic experience and if the pregnancy did continue, I don't know when, if ever, I would have stopped worrying about the damage all the drugs I had to take early on might have caused. In part, the much larger part, I'm devastated. Why has it been so hard? Why have we had so many pregnancies, but no babies? Why all the loss?

For certain, the whole of me is worn thin. I can't fathom going back to work as it has been for the past few years.

Something's got to give.

Sunday, October 16, 2011

Antibiotics, ultrasounds and patience

IV anitbiotics are the business! After a full night in the women's ward I am only oozing a bit and the smell of the ooze has disappeared. My temperature is also under control. By this time I've had IV antibiotics for more than 24 hours. Of course I am stoked when the consulting specialist says he is happy with how the infection has responded and I can be discharged. Again, given that my specialist has already referred me for the ultrasound, which is now only two days away, the consulting specialist says just to go in for it as planned.

Matt was coming in to visit in the morning and as it turned out he was able to take me back to the beach house. I'm given a prescription for a some serious oral antibiotics that I need to take for the next week.

Back at the beach house Matt and I settle in for a quiet week.

I try not to think about the upcoming scan too much, knowing there is absolutely nothing I can gain from worrying about it.

On Thursday morning we drive to Byron Bay for the scan. Again, only the gestation sack can be seen through the abdomen, so we need to do the internal scan to see how the baby is going. To my great surprise the sonographer starts saying here is the baby and this little flicker you can see here is the heartbeat. It is beating at 91 beats per minute, which is normal for a baby measuring six weeks old, which is the size your baby is measuring at. The baby is 4.3 millimetres long from crown to rump.

I'm stunned. Matt seems pleased.

We ring all our family who we know are waiting. I'm cautious to tell everyone that while the heartbeat is good news, that the baby should be about eight weeks old by now, so I'm concerned it is developing too slowly. We discuss whether this could just be because of all the other things that have been happening and hope it will simply catch up in the weeks to come.

I wait until Friday to ring my fertility specialist's office - they still hadn't received my scan results. I hope even though my specialist is on leave (still!) that they have someone lined up who can give me a clinical opinion on the scan. I have to explain to the receptionist why I'm concerned about the scan result. I'm also concerned about my expected return to work. I'm supposed to be going back Monday week, however I can't help but think, if the baby isn't developing as it should, then next week I'm going to need more tests and at the worst I'll physically miscarry, or need to go in for a curette. All of these things will mean I will need more time off work recovering. I just don't want to go back to work and then again be off on more sick leave. The receptionist tells me she will chase up the scan results and contact some of the specialists from the group to see if she can have someone see me, or look at my scan.

I'm lucky another doctor from the group can fit me in on Tuesday but I start to cry on the phone. I was hoping to get an opinion on the scan today.

That afternoon I'm crying. Matt says "I don't understand why you are upset". I know he doesn't. I know I should be happy, but I'm not. I wanted the scan to give me certainty. Certainty the baby was kicking arse and well or certainty the baby was not viable.

I tell Matt that I've spent the whole day trying to get an opinion on the scan and arranging appointments with other specialists. I was hoping that the scan would put an end to it. I secretly hoped there would be no heartbeat and I would know it was over. This result of a heartbeat, but a small baby just seemed so uncertain. The baby just seemed too small. Now we had to wait until next Tuesday to know for sure.

Monday, October 10, 2011

Sand, sunburn, infection

On the drive down to the coast I tell Matt that I'm feeling pretty tired and that perhaps I've over done it in getting packed up to head to the beach house. Don't get me wrong - I haven't done much. Matt has done all the heavy lifting and I have just packed a few grocery items and my own clothes, Matt has then transferred everything to the car. Just quietly - I wish it was like this all the time. My lazy side loves it! Matt and I agree I should take it really easy on the weekend just resting inside. I'll get to the beach during the week.

Matt's sister and her family are already at the beach house when we arrive. They help Matt unload the car and have got things set up for us, so all I need to do when I get there is heat up the pre-made dinners we bought in advance (knowing that I wouldn't be my usual self in the kitchen this holiday) and settle into the couch.

The following day is a Saturday. The weather is AMAZING! But I stick to the plan. Matt and everyone else head off to the beach and I settle in at the house. My belly button wound is annoying me because it is still oozing. After my other surgeries I didn't have any ooze. This one was oozing while I was at the hospital and hasn't stopped. My sister in law and I decide it would be a good idea to get some sun on it to try and dry it out a bit. So I sit on the deck with my belly slightly exposed to try to get some sun on the belly button.

I'm not here long before Matt comes back to the house and says he thinks I would like it the beach. He will carry a camp chair down for me and walk slowly with me (the full 100 metres) to the beach. I think this sounds completely manageable and quickly apply some sunscreen to all my exposed limbs and face.

The beach is beautiful. It is a really warm day for spring. My nephews are having a great time in the surf, digging in the sand and playing beach soccer. Our dog, Rocky, loves the beach. He is greeting all the other dogs on the beach and then running back to sit under my camp chair in the shade. I'm still trying to get some sun on my belly button and other wounds to try and dry them out a bit.

After an hour we head home and I head to bed. I need about two hours rest before I'm up again. That afternoon Matt's Dad and his partner arrive too. I'm grateful everyone else is taking care of meals. I'm able to take it very easy.

The following day, based on the success of the earlier beach trip, Matt convinces me to join the family in a trip to the nature reserve, where everyone can fish, swim and play in the sand (except Rocky - no dogs allowed). It is only 300 - 400 metres into the reserve. I'm slow moving, but get there. In my attempts to dry out my belly button wound I've managed to get a ridiculous sunburn on a portion of my belly - making me even stiffer when getting in and out of chairs. After a couple of hours sitting in my camp chair enjoying the view, I need to get home. I feel so tired. This time, after we are home I sleep for three hours.

That night I say to Matt "I feel like I'm going backwards". I pull out my discharge information forms and look at the things that might happen and require further medical attention. The only thing I have is a sore abdomen - but I can't figure out if it just recovering normal sore, or extra sore.

Overnight, this changes when I wake up and feel wetness around me in the bed. At first I think I'm bleeding, but then the smell hits me. My belly button has started super oozing and it is super disgusting. In what is now a Paterson~Prior family classic I ask Matt to "smell my fingers" that are covered in ooze. He is suitably grossed out.

Offensive ooze from wounds is definitely on the seek medical attention list. During the day I had looked up the hospitals - just in case we needed them. I ring the Byron Bay emergency number and explain my symptoms and my surgery. They tell me I should come in. I then tell them that I'm still pregnant. With this information they recommend I go to the Tweed Hospital instead as they have ultrasound equipment. I then ring the Tweed Hospital emergency to see if they think Byron would be able to handle it, or if I'll need the ultrasound. The triage nurse tells me I should just see a doctor tomorrow. I decide to ring 13 HEALTH. The nurse strongly recommends I get to the Tweed Hospital and says if the pain is too much in a car, we should call an ambulance.

At 2am ish Matt and I head off on a 40 minute drive to Tweed Heads. As I hobble into emergency the triage nurse is up on her feet and asking if I'm okay. As I get closer her I explain the situation and she says "I remember you from the phone". I'm through to her little office, she is taking my temp - it is high. I'm literally oozing. It really is disgusting. Within minutes I'm in an emergency room bed. I can't believe it, only an hour ago this same nurse told me I could just see a doctor the next day.

From this point it is a bit of blur. There is again needles in and blood out. This time they have these two weird glass bottles. I say to the doctor "I've been in hospital a bit lately and had a lot of blood tests, but those bottles are a bit different, what are they for?" The doctor tells me the that the bottles are for blood cultures. They will literally put those bottle in ovens and see what they grow. Gross.

Physical inspection of the infected area, that is my belly button, is a problem. The best indicators of infection (other than ooze) are hot areas and redness. Of course my sunburn has meant neither of these symptoms are detectible as the whole area is red and hot. It is a bit of laughing point for the medical staff. They are all curious as to how I sunburned just that one area.

The emergency room doctor has arranged for some pain relief (more morphine) and is searching for IV antibiotics that are safe to give during early pregnancy. Because I am worried about all the drugs I'm being administered she explains that some drugs that are okay when the baby is developing in early pregnancy are not ideal in late pregnancy - morphine being an example (apparently you can suck that stuff down in early pregnancy, but at the end the baby gets the same effect, so basically comes out asleep - that can be a problem). Matt is convinced to go back to the beach house as I'm going to be in emergency until the gynaecologist can see me. The doctor thinks I'll be in for a couple of days. At one point the doctor tells me I may even need another surgery to wash out my abdomen depending on the extent of the infection.

My belly button is pouring out this stinky fluid and I keep folding up my hospital gown to absorb it. I'm running out of gown. The nurses change over and I ask my new nurse if I can new gown and perhaps a dressing to absorb the ooze. Once this is taken care of I can rest.

I'm eventually wheeled out to ultrasound. I am disappointed that the sonographer only has instructions to look for the infection collection and not to see if the baby is still okay. He finds a collection, deep under the belly button, but it isn't too big. He thinks now that the ooze has found a way out that I should improve.

Back in emergency it is a few more hours before the gynaecologist comes in to see me. He takes a look at my wound and cleans it up again. He asks me all the questions about the other symptoms. Since I woke up with the infection I've started bleeding more heavily again, including some small clots. The gynaecologist  advises he is going to have me admitted to the women's ward so that I can have more IV antibiotics and see a surgeon consultant.

Matt arrives back at the hospital just in time to come with me up to the women's ward. I meet my new nurse and ask her about changing my dressing. I ask her if there is possibly a way we can dress it with something with a little less stickiness. My damn sunburn is killing me every time the dressing needs to be changed! She immediately understands and provides me with my very own supply of not so sticky tape and sterile bandages that are just big enough that the tape doesn't need to touch the sunburn! Brilliant!

Matt hangs with me for a few hours and then head back to the beach house. I settle in for the night.

Saturday, October 8, 2011

Truly, irreversibly infertile

Within a couple of hours I am awake in the Mater Mother's ward, Women's Health Unit. They seem to have two floors, one for the mothers with new arrivals, and one for women with all the other gynaecological problems. I'm in a shared room, with another girl who was also admitted to emergency during the night. It seems she also has an ectopic, but is waiting a lot longer for her surgery.

When I wake up I learn I have a catheter - something I haven't had the previous two laparoscopic surgeries. I'm not sure why the doctor's decided I needed one this time. It is a bit weird and I still feel like I need to pee, even with it in. The nurses relocate the bag that my bladder is emptying into and I feel a bit better. It is still weird. The nurses convince me I'm better off keeping it in overnight. I remember how much it hurts to get up and move around after surgery - and that I need to go to the loo every hour because of the drip continually adding fluid to the system - I decide being able to rest would be better.

It is at times like these I appreciate how lucky I am to have such a caring, loving and supportive family. My husband is of course back by my side. My sister comes in to visit soon after. And my aunt and uncle who have lived through the same heart ache visit later in the evening. I'm pretty much exhausted (as is Matt). We have barely slept the night before and I've been pumped full of a range of serious medications. Once Matt knows I'm okay and that I'm basically in need of sleep he decides to head home and get some rest.

Late in the night my room mate is wheeled off to surgery. I have asked the nurses to open the curtains and I snoozily look at the view of the inner city suburb as I drift in and out of sleep.

In the morning the surgical crew is in to visit me. They have images to show me of my insides. It is a little surreal. My urterus looks like a smooth, round, red balloon. My fallopian tube on the other hand looks like an angry black sausage that is about to burst (of course it had burst!). They explain I needed an extra port for the surgery, so instead of three I have four wounds. The extra port was needed to help protect the uterus. I had lost some blood into the abdomen, but not too much. The tube is now gone. My wounds are glued not stitched. I can't really remember much else.

There is no doubt, I am now truly, irreversibly infertile. Still processing that. I'm also still pregnant. Infertile and pregnant. I've been a little paranoid about all the drugs, pain killers and so forth, but what can I do? I ask the ob/gyn that performed the surgery whether it is a problem that the gestation sack is measuring a bit small for my dates. He firmly believes it is too early to tell and that while it is still there, that is a good thing. He agrees that the best thing I can do is wait the additional week and day and get the diagnostic scan my fertility specialist recommended.

I'm discharged late in the day after being checked to see if I have a urinary tract infection (UTI). I'm running a bit of a temperature so that is what made them think it could be a UTI. I'm cleared of the UTI and pleased to be home. My fertility specialist rings me. He is again so sympathetic. He is on his holiday and ringing me to discuss how it all went. He is really sorry he missed the ectopic on the scan in his rooms and he is sorry he wasn't there when I needed surgery. He asks what has happened to the pregnancy that is intrauterine. I tell him it is still there, but that the gestation sack is only measuring 5 weeks and 1 day. He seems so surprised that the fallopian tube ruptured given how small the pregnancy is. He tells me he will look up my file as soon as he gets back from holiday to check on the progress of the remaining pregnancy.

I physically start to recover very quickly. I'm surprised by how well I'm moving and how little pain I have. I was really sore after my first ectopic pregnancy laparoscopic back in February. Only two days after I'm discharged we are leaving for the beach. The holiday has been planned for a while, so even though I'm going to be a bit steady, if you have to rest, where better than by the beach.

Wednesday, October 5, 2011

Baby 1 and Baby 2?

My scan appointment is for late in the day so that Matt can be there too. Waiting, waiting, waiting all day. I've come down with a terrible cold so I've had the day at home resting up and waiting, waiting, waiting.

Early scans like these are all done internally, so when I get into the ultrasound room I've given a few minutes to strip off the lower half and then recline on a funny half bed covered in a sheet. It is a lot more modest than the embryo transfer, so I don't mind too much.

In strides the doctor and he quickly gets to the scan. Within a minute he has ultrasound probe prepared, inserted as required and is showing us a gestation sack that is firmly in the middle of my uterus. Good news! He tells us it is little too early to see anything else. He takes a bit of a look around just to be sure the other embryo that is transfered hasn't taken up residence in my remaining fallopian tube. It looks all pretty good. The specialist leaves me to get dressed and asks me to come across to his consultation room.

Matt and I are really happy - one baby in the right spot. Really it is the best outcome. The safest for the baby and for me. Our best chance for a healthy baby.

We sit down with the specialist and I ask about the bleeding. It has been going on, just very lightly for nearly a week and a half. The specialist tells me (again!) that it is really, really, really common in early pregnancy. He goes on to say that placentas are very complex and that they are continuing to implant and establish for the first 10 or so weeks, so that is the most likely cause. I just have to hang in there.

As my specialist is about to head off on about three weeks leave he gives me a referral to have a diagnostic ultrasound done. He says I should get it done in about a week and a half. By this time we should definitely be able to see a heartbeat and the like if all is progressing well. The diagnostic scan timing falls for when we are on holidays too, but we won't be to far from a major regional centre, so we are confident we will be able to find a radiology clinic to do the scan.

Matt and I are super happy. It is only a few days until our holiday, we have a little baby growing in the right spot. And the bleeding is normal. My new mantra - the bleeding is normal.

That night I drift off to sleep happy and thinking about our one little baby.

At 10.45pm I'm awake and in pain. It is very localised on the right side of my lower abdomen. I wake Matt and tell him I'm in pain. I decide to ring the 13 HEALTH number - a new service introduced in Queensland where you can ring and speak to a nurse about your symptoms. I'm on hold, the pain is not improving, no matter what I do. I hang up and go into the bedroom and say "that's it we are going to emergency."

Matt quickly gets dressed and we are on our way. Really, I was only ringing 13 HEALTH to get permission to go to emergency. Why do I need permission? I'm in pain, I know I'm pregnant, I know I had two embryos implanted and only one is in the uterus, the pain is on the right side (and radiating down my right leg) where an ectopic would most likely be, or it could be a miscarriage. I should be in hospital.

We go straight to the Mater, because we know where that is, and they have a big mother's ward - so I assume obstetrics is in their specialty. I actually rang the Mater Private emergency to ask if I came there if I would be able to see a specialist of my choice, given I have a number of doctors who are involved in this pregnancy and a whole fertility specialist group that my specialist is a part of. They say no, so we figure we may as well go to the public hospital.

At the public hospital emergency I'm admitted to a bed immediately. They are asking what I give my pain out of ten. Now, only two months earlier I had the same question with the gallbladder and it was really high. I think my pain threshold was confused because this was so localised to one spot and I kept saying maybe three or four.

Once again I have the needles in (a cannula to be precise) and blood coming out.

I couldn't sit still. I was rocking on the bed, and then I was crouching on the floor, trying to sit in the seat beside the bed, pacing around. Nothing helped. The nurse kept suggesting I should take some pain relief, but I didn't want to, I was worried about the baby being affected. This went on for the hours. The nurse trying to convince me, me rejecting the offer.

I feel the bleeding is picking up. I panic that it is a miscarriage. I go to the bathroom to change my pad to a hospital issue surf board size pad and have to leave my old pad wrapped up for the nurse (a male nurse) to inspect. Again, modesty is not a helpful trait when needing medical treatments. The nurse assures me that it isn't too much loss, not really all that heavy at all. Really? This is like 100 times what I've been having everyday and has been sending me into a panic and they don't think it is too bad. Crazy. How much blood does there need to be for it to be bad?

A doctor comes in to see me and immediately asks the nurse to bring me some pain relief. She doesn't even ask if I want it, just tells me I need it. I swallow down the pill. We discuss all the things I know about the IVF cycle, the pregnancy, the dates and the pain. I cry because I tell her I think it is miscarriage. She says she will do an examination of cervix to determine if it is a miscarriage once they have my blood test results back.

I'm again rocking and rocking on the bed. The nurse comes over and says to me "you see, you don't look to me like you are not in pain. You look like you have a lot of pain. What do you say to me giving you something that will make it possible for you get comfortable and maybe get some rest." I finally agree. I get a shot of morphine straight into my IV. It hits me instantly and I say "whoa - I need to lie down".

It is a lot better without the pain. Matt is wide eyed beside the bed. I keep telling him how glad I am we came into the hospital.

The doctor comes back and has a tray of instruments to look at my cervix. Basically the duck beak thing they use for pap smears and some long skinny tong/tweezer things and dressings so she clean up the cervix (of the supposedly not too heavy bleeding) and have a good look. She tells me the cervix is still closed. If I was miscarrying this probably wouldn't be the case. In her opinion it is not a miscarriage. She also doesn't think it is an ectopic - just because of my symptoms and my pain. To her the pain I describe and exhibit seems more like stones, kidney stones. She is poking around my sides and back asking if I have any pain.

Once she goes Matt and I are kind of in disbelief - more stones! This is getting ridiculous. How many things can possibly go wrong with me. At least we are a little more at ease that it isn't likely we are miscarrying. Our one little baby is still tucked away in there.

Whenever I see my nurse I ask if my blood tests are back and if he can tell me my HCG number. I want to know it. I manage to snooze a little, but Matt is on guard by the bed.  He gets no sleep at all and is looking weary. I ask my nurse again about the HCG and he looks it up. It is in the mid 7000s. The nurse doesn't know really what it means, just that it is in the normal range for how far along I am. I know it is okay based on my other HCG results I can quickly calculate that number is fine.

The morning shifts are changing over. We are meeting new nurses and doctors and I am advised we are waiting on an ultrasound to have a good look around my pelvis. I decide I'll let my sister know I'm in the hospital. She lives just up the road and will be a good place for Matt to have a rest, once we know what is going on.

Time flies in the hospital. There is so much going on and I'm half out of it on morphine. Around 10am I'm wheeled off to ultrasound. The external scan doesn't show anything, so we need to do an internal again. Pretty quickly the sonographer is onto the issue - there appears to be a second pregnancy and there is bleeding in my abdomen. A ruptured ectopic. The pregnancy that is in the uterus is measuring 5 weeks and 1 day by the gestation sack. This seems a little small to me. By my numbers gestation wise I should be around 6 weeks and 1 day, but this is not the issue right now.

The sonographer leaves to speak with the doctor for radiology. The doctor comes back with her and has a look at the scans. He tells me we have an heterotopic pregnancy and that even though they are more common with assisted fertility, they are still pretty unusual. He says unassisted heterotopic pregnancies occur only 1 in 30,000. With assisted reproduction (like IVF) heterotopic pregnancy occurs in about 1 in 3000 pregnancies, which is still reasonably unusual.

I'm wheeled back to emergency. The emergency doctor tells me the gynaecology registrar will be down to see me and discuss what needs to happen next. Within 15 minutes the gynaecology guy turns up at the end of my bed and tells me again, that I have an ectopic pregnancy. He asks a few questions about why we started doing IVF. I'm surprised by the question and respond "to try to get pregnant".  After a couple more questions it turns out, what he is getting at is that this surgery is likely going to result in my losing my right fallopian tube. I've already lost my left fallopian tube. Losing the right tube means we no longer can conceive naturally at all. He is trying to ascertain how we feel about that and whether we would prefer to try to save the tube.

I'm still coming to terms with what our decision will mean for us. Matt and I quickly discuss it and decide we'd rather not have the chance of having another ectopic pregnancy and as we are firmly down the IVF path we tell the guy to just take the tube. My aunty had three ectopic pregnancies, all at around my age. In her case the tube that they removed the pregnancy from and stitched back up just caused her to have another ectopic and then they took the tube anyway. I don't want that to happen. I really don't want to be back in hospital for this again. See ya later fallopian tube and last chance at natural conception in the future.

Before midday I am being wheeled up to surgery. It really is happening very, very fast. Matt says goodbye just outside theatre. An orderly takes Matt up to the gynaecology ward, so he will know where to find me after the surgery. Thankfully Matt has arranged to go back to my sister's and get some rest while I'm in surgery and recovery.

I'm wheeled into theatre. A whole stack of new faces. The anaesthetist is asking me questions - my asthma is always the issue - I haven't taken my medication. A new ventolin inhaler appears and I'm inhaling puffs, just to be careful. The consulting gynaecologist introduces himself - he is doing the surgery. They will do everything they can to protect the baby that is intrauterine. I'm sliding across onto the table. It is some different bean bag thing, I'm rustling into position. I already have the cannula in my arm so the anaesthetist is injecting me with what ever and I'm out to it.

Monday, October 3, 2011

Now I know is it any easier?

I was pleased when I arrived for my blood test that no other ladies were waiting...speedy processing for me! Just as I jump into the chair the fire alarm starts to go off. Thankfully the nurse is as determined to get me through as I am and she brushes off the nurse that pops her head in the room to tell her to evacuate. In a  jiffy my blood is in a test tube and I'm out the door.

Once again I wait an hour and half and ring my fertility specialist's office. The receptionist has a look for my results - they aren't yet in the system but she goes looking on the fax. She comes back and says she needs to speak to the specialist about the results. I'm on hold for a minute and then she says "Congratulations, you are pregnant."

I'm pleased, but not overjoyed. Let's face it, this is my third congratulations, and still no babies. I ask what my HCG level is. It is 180. I'm happy with that (not that I really know what the number means). I'm instructed to go for another test in two days to check the HCG number is increasing as it should be.

Damn it, Matt is on camp. I try to ring him, but he is out of range. I leave messages hoping he will ring me back. I've got no one to tell. Matt and I have been keeping this cycle on the quiet and I don't really want to tell anyone until I've told Matt.

I secretly tell one person - Matt's cousin. She has experienced similar difficulties conceiving and has been especially supportive of our baby making mission. I also remember the words of a friend when I was stressing out about the last pregnancy. She said well shouldn't you just enjoy knowing you are pregnant now and worry about it if and when you need to.

The next day I'm my tiny bit of pregnancy joy is crushed by the sight of some light bleeding. I can't believe it - one day of enjoying it (kind of) only to start with the bleeding again. I tell myself to wait and see what the numbers say tomorrow when I get the second blood test. I remind myself a high number of pregnancies have bleeding in the early stages and try to calm down about it. Try to enjoy just knowing that I'm pregnant. Try to remember the first time, when I was genuinely excited at this stage and when the doctor told you spotting was normal and you believed them.

Matt rings me on Thursday night and I tell him that I'm pregnant. He is excited. And then I tell him that I'm spotting again. All Matt can say is "you're joking" and not in a ha ha kind of way.

On Friday I go in for my second test. Again when I ring the specialist my result is awesome with my HCG having more than doubled to 440. I speak to the specialist about the bleeding and he again tells me it is common and not to worry about it, unless it is gets heavier or comes with abdominal pain.

Matt gets home from camp and we decide that we will tell our immediate family - explaining that there is still a chance that there could be problems, but that the numbers look good. I can tell even they are getting used to the loss. They want to be happy for us, but we are all tentative.

The best thing for me about this pregnancy being IVF is that unlike my other two pregnancies, where basically there is no monitoring, an IVF pregnancy means I have access to as much monitoring as I can reasonably book. With my concern about the bleeding, my specialist sends me a fist full of blood tests so that I can get tests and check my HCG results as often as I need to keep my mind at ease. Also, it is standard to book an in rooms ultrasound with the fertility specialist for about two weeks after the blood test to make sure the baby is in the right place and hopefully see a heart beat.

Given my specialist has leave booked for when my ultrasound would be due, I'm scheduled to go in a few days earlier than is ideal. While I'm waiting for the ultrasound I get two more blood tests and my HCG numbers are kicking arse.

I'm definitely pregnant, but I don't feel great, and not in a morning sickness kind of way. Just more worry, new worry. I just have to hang in there until I can do the ultrasound and if that is good news, hopefully then I will be able to relax and enjoy it.

Sunday, October 2, 2011

Waiting - the home pregnancy test addiction

Not even 2 weeks, only 12 days to wait for confirmation. If you haven't already figured it out, I'm a home pregnancy test sucker. Despite my good friends warning against it, I just can't help it. I must test.

Having a home pregnancy test addiction is expensive. I used up the last of my bulk online order during my first IVF cycle. In preparation for this cycle I bought a three pack of the cheapest I could find when doing the grocery shopping. I have well and truly given up on the expensive in flow tests, these days the pee in the cup and test do the job just fine, or to date they had.

I started home pregnancy testing 1 week after transfer. 1st test - negative after a few minutes. I immediately discard. I have a tiny bit of home pregnancy test discipline, in that if I do a test that is negative, I am capable of waiting 2 days to the next test.

Two days later, 2nd home pregnancy test - negative after a few minutes. Again I immediately discard.

Matt is going away for the week of the blood test and I was hoping that I would have a positive test that I could tell him about before he leaves. Unfortunately, given my 2 day rule, I'm not due for my next test until Tuesday, a day after he has gone. Matt has told me he'd rather not know and just wait for the blood test - I can't understand that, surely if you can know earlier, you'd want to know.

In a new home pregnancy low, I find myself hours later pulling the test out of the bin. To my surprise I find the test is now indicating positive. This of course does not make me happy. All the rules in testing say do not read a result that appears after 10 minutes (clearly this needs to explicitly be added to the instructions for all the crazy women who dig tests out of the bin). This is well after 10 minutes, but I immediately discarded after about 2 minutes, so did a line appear somewhere between 2 and 10 minutes?

Clearly I now have grounds to retest after just 1 day breaking my only home pregnancy test rule.

The next day I test after a couple of minutes there is still no line. Instead of immediately discarding I wait. I have a shower and start peering past the shower curtain every minute to see if a line is appearing. Eventually the test is in the shower with me, of course carefully held out of the way of the shower. I stare at the test. I think there is a line. It is faint, but faint is sill positive. I think it is positive, but I'm still uncertain.

Stupid three pack of cheap tests. Now I've used them all up and I still don't know if I'm pregnant. I decide not to tell Matt - just in case.

Another day before the blood test and I'm so nervous.

Last cycle I convinced myself I'd prefer to know before I went in for the blood test, or at least have an idea. I've learned this cycle that having the positive home pregnancy test doesn't make you feel better going in to your blood test. All it does it bring you to a new range of worries.