A Milestone of Our Own...

Twenty-three weeks and five days! We definitely have a lot to be thankful for this Thanksgiving. Everything has been going well. Doctor's appointments and ultrasounds have all been good, including an extra visit we had a couple weeks ago. After a particularly active weekend for baby, he was quieter Tuesday, Wednesday, and Thursday morning. I was still feeling him move around, but not as frequently, and Dr W keeps saying to call if anything seems different at all, so I called to check. I thought the nurse would just say that as along as I was feeling him not to worry, but Dr W wanted me to come in just to check that everything was going ok. The NP did a quick ultrasound and said everything was fine. And since then he's been a busy boy. I think he was just tired from his busy weekend!
The milestone of 22/23 weeks has been a... weird one. Most people wouldn't consider it a milestone at all, and wouldn't even know why it might be one. But most preemie mamas probably do. Twenty-two weeks is the earliest that a baby can possibly survive outside the womb. Not all hospitals or doctors will give them a chance that early, but some will, if the baby shows the will. I don't want to be a part of the population that considers this a milestone. I tried not to think about it, and I knew my husband wouldn't want to hear about it, but here we are. This is our life, and knowing our baby is potentially "viable" outside the womb is some weird, small comfort, even if we don't want to acknowledge it.  Of course we're praying every day that this pregnancy will be a full-term, healthy pregnancy, but the reality is that, from here on out, our baby boy's chances get better with every passing day.
Other than that, we're just riding along, counting the weeks. My blood pressure has been nice and low, and my belly has been growing. My worries, for the most part, have been pretty calm, and some of them even normal for a typical pregnancy! For example, what to do with M when baby makes his debut. Of course, all my worrying now doesn't matter, because I still don't know whether I'll need a scheduled c-section (I'm not sure whether the type of c-section I had last time will allow for a VBAC), if I'll go into labor on my own, or whether I'll have to have a c-section because I don't go into labor on my own. My doctor won't induce labor with a VBAC, so if it doesn't happen on it's own, it will result in a c-section. And that's all assuming we make it to term! So I'm trying to put off worrying, and just know that we have plenty of people who love M and are capable of taking care of her. At least that's something any second time mom might be worrying about! The other challenge has been, since 20 weeks, Dr W wants me to "take it easy" when I get home from work. I'm supposed to have time every day when I sit with my feet up and said that I should maybe be  starting to feel a little frustrated at how much I'm on the couch, so as a family we're working on finding that balance. It's definitely a challenge, with a two-year old and a full time job, but we're working it out!  So we continue with prayers and positive thoughts, and hope for the best!

It's a....

Sorry if there is anyone out there waiting in suspense for the results of our ultrasound! Fortunately, I'm pretty sure there isn't. :) But, either way, we're having a boy! I have been saying all along that I was sure this baby would be a boy. I'm not sure if it was a gut feeling, or just the fact that this pregnancy has been so different, but really, from them moment I had a positive pregnancy test, I had a boy in mind. So when the tech asked if we wanted to know the gender and whether we had any guesses, I immediately said boy, and she just said, "Well, I have to agree with you!" So there you have it. I can honestly say I would have been happy either way, but now that we know for sure, I really am excited for a boy! I keep picturing a little toddler with a mop of curly blonde hair like M's.
In other news, both M and the hubby have been able to feel baby move. I was at 17 wks, 6 days when M felt him, and 18 wks, 3 days when the hubby felt him. It seems really early, but he is one feisty guy! I feel him frequently throughout the day, enough so that the other night, when I woke up in the middle of the night and realized I really hadn't felt him since that afternoon, I had started to worry, and had to distract myself for a good hour until he started moving again and I was able to calm down and go back to sleep. I'm pretty sure I never felt M so much that I felt the need to worry about her after just one evening!
I am really showing now at almost 19 wks (tomorrow). Although M was born at 28 wks, multiple people have said that I'm showing now more than I ever showed when I was pregnant with her. It's probably true though. I started out 20 lbs heavier, and was doing abs pilates a few times a week, so I had abs of steel! And that is definitely not the case since... hah... Because I never got big with her, I've been wondering whether I would grow more quickly this time around, as most women do with their second pregnancy. Since I didn't ever stretch all that much, I wasn't sure. But here's a picture of me earlier in the week, right around 18 weeks. We're getting there!

Deep Breath

Well, good things are happening. :) It's been a week or two, but we got the results of our DNA test back, and they were negative for Down's syndrome and the other things it tested for. I got the call while at work, and it was kind of funny how anti-climatic it seemed after all the decision-making that went into it. I called the hubs and let him know, and that was the end of it. But having one less thing to worry about is definitely a plus.
Also good: I've been checking my blood pressure every day and it has yet to be high at all, much less as high as it was in the doctor's office at my last visit. That is really comforting. There have been a couple times when I've been a little short of breath and been overly aware of my heart beat, but I asked Dr W about that at the last appointment and he confirmed that it's totally normal for pregnancy. I've been feeling really pretty good. I've had some heartburn, and my hips are already getting achy from sleeping on my sides, but all in all, I'd say things are pretty good.
This Tuesday we have our 16 week ultrasound and doctor appointment, and are expecting to find out the gender! I find it hard to believe that they'll already be able to tell at 16 weeks, but two friends I have who have seen specialists both said they were actually pretty sure they were having boys at 12 weeks!! Crazy! I'm still convinced this baby is a boy, so I guess it should be easy to tell, right!
As always, I'm nervous for our upcoming appointment. I know going in that my blood pressure will most likely be high when the nurse takes it. It helps to know that I'll have a whole long list of lower blood pressures to show the dr, but at the same time there is a part of me that doesn't trust my cuff. I use an automatic wrist cuff and I know that it's not flawless. I've checked it against a real one about 4 times, and it's been either a little low or right on every time, so I should be confident in it, but when I go to the doctor's office and get readings that are SO much higher, it's hard to feel confident that it could really be so much lower at home! But obviously, you can see the anxiety my appointments cause so I guess it makes sense!
Really, I get nervous about the whole appointment in general. I don't know why, except maybe that I'm just worried about anything that could have changed in the last month. But I'm nervous for our ultrasound too. I'm really excited to see our baby! But I'm kind of nervous to find out the gender! I'll be happy once we know. I just get nervous about big news like that! Kind of like I'm always happy to have people know I'm pregnant, but I really don't like telling them. Weird huh?
For now, we're trying to decide how we're going to find out the gender and tell our families. M can't come to this ultrasound because the doctor's appointment is afterward and it's going to be a looong afternoon if Dr W is as far behind as usual, and it all starts in the middle of nap time. The hubs wants to find out as a family, and suggested that we have the ultrasound tech put it in an envelope for us to open with her when we get home. I'm not really sure M will understand enough to be excited about it. I kind of like that idea, but I also kind of want to find out right away. So that's still up for discussion.  Afterwards, when we get back into town, we'll either tell M then or find out together as a family, then we're going to get together with our parents and my sisters and brother-in-law to tell them the news over dessert. My parents are chomping at the bit to know. There are no boys in our family, so we're all curious to see if this one really is!
Other exciting news: I am DEFINITELY feeling baby movement! I've been pretty sure I've been feeling it faintly actually since maybe 13 weeks, definitely 14 weeks, but this week (15 weeks) I'm really sure, and I can actually say I've been feeling this baby daily already! Which seems odd, because I don't think I ever got to that point with M. The day she was born, the nurse at the doctor's office asked if I'd felt her move at all that day, and I told her no, but I remember that that really didn't surprise me because I was still having days here and there when I wouldn't. In retrospect, I realize that that's probably not normal, but at the time I didn't think much of it. I think a big part of it was that she was so much smaller than they thought she should be at that point in the pregnancy. The hubs said the reason I'm already feeling this one so much is because it's going to be 10 lbs! And I tell him to stop talking because I would like this one to be able to make it out. :P All I know is I can't wait until M can feel the baby moving. It's going to be so much fun! Hopefully it doesn't freak her out... Haha... It's hard to guess what she's going to be scared of these days!
So it's another week of taking it one step at a time, and taking a deep breath and reminding myself to trust God. I've had just an underlying sense of anxiety the past couple of days, and I'm sure that it's because I just need to spend a little time talking to God and focusing on my trust in him. I still believe that this pregnancy is in His hands and that it will go well, but as it becomes more real, with my growing belly and upcoming gender reveal, the anxiety over the possibilities become more real as well. I need to start my "God jar" so that I can write down each anxiety as it comes and put it in God's jar as a physical way of handing it over to Him every day. I know that I may have to put it back on more than one occasion, but I think that phyiscal exercise would really be a good one for me right now. Actually, I'm going to do that now.
As always, prayers are appreciated for a healthy baby and for my body to do it's job!

August 29, 2012

So things have felt a little crazy lately. There's so much going on this week! Mostly good, just crazy. We heard back from Dr W last Monday, and he said he wanted me to talk to a genetic counselor about what our testing options are, so we had that appointment on Friday. Basically, it took an hour of talking, giving her a basic family history (and by basic, I mean she mapped out a family tree with details of the health to the extent of grandparents and first cousins), then discussed all of the things she saw that could warrant testing for other things if we would be interested (always something extra to worry about), and then finally got around to the topic of Down syndrome testing, which was why we were there. She basically came to the point herself, without our asking, that while the NT scan as a screen is still considered standard because the DNA test (that I previously referred to as MaterniT21) is so new, it is 99+% accurate and therefore the NT scan really isn't necessary, unless people want it. There are some other minor things that may be picked up in the scan, but those things are typically picked up later in pregnancy as well. So, fortunately, she said without being asked that if we would prefer to have just that test done, without any of the pretesting, that would be fine. And with the lab we're using, which is the only one our hospital uses that does allow the test to be done without pretesting, it's called Harmony. I don't know how naming through different labs works, but whatever. And here's the part that makes me a total nerd, but as a health professional, I think this is just so freaking awesome! She explained to me how they actually complete the test, and it made me wish I could watch them do it so I could see how it's done. She explained that they have known for decades that there are bits of the baby's DNA in the mother's blood, but it has been broken down into pieces, smaller even than whole chromosomes, and until recently they weren't able to isolate those tiny little pieces or do anything with them. Now, they are able to isolate those pieces and actually see if there are more pieces of a particular chromosome (for DS, chromosome 21) and if there are, they know that there are more of that chromosome in the baby's DNA, and therefore a trisomy of that chromosome. Seriously, how cool is that?!? Ok, maybe not to everyone, but I was amazed. Plus, the test is less than a year old. I'm not gonna lie, I'm kind of excited for my blood to be a part of that...
We actually had that meeting at our local hospital via video chat, and our hospital didn't have the right tubes to draw my blood that day, so I had it drawn at the hospital were my dr is (about 1.25 hrs away) when I saw him Tuesday. Now we wait for 2-2.5 weeks for results.
At that dr appointment, we had our daughter along because the plan was to visit my grandma afterward, who lives near by, and tell her about the baby. We were able to hear the baby's heartbeat (or "heartbeef", according to M) for the first time, and M loved that. We've seen it on 3 ultrasounds now, but there's just something about that sound. It was particularly reassuring at about 158, because that was just after the nurse took my blood pressure and it read 138/98. SERIOUSLY??? That top number is high by not outrageous, but 98?!? That makes me a nervous wreck. Granted, it's always high when I'm in a doctor's office, especially now with being pregnant, because that's what went so wrong during my first pregnancy, but it hasn't been that high since shortly after M was born. So that stressed me out. But when Dr W came in, he didn't seem overly concerned. I told him that when I'd checked my BP at home, it was around 112/70 and he just asked me to check it twice a day and keep a log. If it is consistently over 160/100 then I should call, but if that happens just once here or there it's ok. I have been taking it today and the highest it's been is 118/75. I had a paramedic friend double check my electronic cuff because I think it sometimes reads low, but that was accurate. So that's reassuring to me. It just makes me wonder, is my blood pressure really that reactive to my emotions/environment? Is it more so than the average person? I think it may be.
The other thing Dr W said is that high blood pressure this early in a pregnancy is really not likely to be indicative of pre-e. More likely, it's an indication of an underlying blood pressure problem. Dr P said the same thing with M when my BP originally started going up, because I didn't have other signs of pre-e at that point, but it went back down after she was born. So I don't know. But either way, Dr W didn't seem immediately concerned, and he told us before I even got pregnant that he would put me on bedrest immediately at the slightest indication of possible pre-e, so I trust his judgement and and just going to roll with it. I'm surprisingly not too anxious about it. I was at first, but that afternoon I had a long drive for work, and I spent some time praying and thinking, and just found peace in knowing that God is good and I trust Him exclusively. Granted, at this point, I feel like trusting him means I want to trust Him to bring this pregnancy to term, but I know that no matter what happens, it is for good, and He's got it all planned out. Right now, I have peace in that. Tomorrow, I may need reminding.
In other news, we also received an offer on our house, which has been on the market for a little over a year, on Tuesday. It was a little lower than we are hoping for and we are now in negotiations, but that has been one more stressor. I'm optimistic that we'll be able to find a happy medium and it will turn out well, but the process of trying to make quick decisions and crunch numbers and decide what our lowest acceptable number would really be, not to mention with a two year-old who thinks that NOW is a good time for Mom and Dad to pay attention to her, can be overwhelming. Hopefully though, it will be a good thing. It sure would be nice to have a place to set up baby's room before it gets here!
With all of these things going on (oh, and at work, it's the end of the month so there's lots of paperwork due AND we're moving our office TOMORROW, just in case I needed something else to focus on) things have been a little extra tense with the hubs. It's really hard to go through this pregnancy together, wanting so badly to just be happy and excited, but so afraid that everything could change at the drop of a hat. And it's hard knowing that we basically have no ability to plan for when we'll need to pack up and move out or where exactly we'll be going (most likely to the in-laws' once they head to FL for the winter while we find a house of our own). We stayed up late a night or two ago, and just spent some time talking. We talked about what each of us needs right now, and ways the other can support those needs. I know he feels overwhelmed with work and taking on so much more of the house work, and I feel rotten "taking it easy" after work while he does so much, not to mention having so little energy for M. But my energy is improving, and while I still have to listen to my body and take it easy, I think we may be entering the happy window of the second trimester where I'll be feeling better. Hooray! Anyway, after we talked, things have been better, and both of us are trying to express appreciation for the each other and the ways that the other is affected by everything going on. Hopefully we can maintain that equilibrium and make time to enjoy being a family, as well as a couple. It's a lot to balance, but both of us want more for our marriage than the frustration that comes with stress, and we are working to find productive ways to make our marriage better.
Before I finish, I have to say that while I have been sitting here typing, I swear I just felt the baby move twice. And I'm not talking like a little uncertain flutter. I've been trying to convince myself all week that I've just been feeling gas moving with the little flutters I've felt, because I'm only 12 weeks! But I seriously think what I just felt could have been felt from the outside. No lie. It could still be just gas, but it sure felt like a baby. I just can't believe that I would feel that much at 12 weeks! This baby might be a giant...

August 18, 2012

Well, I've been meaning to get on here and post again for weeks, but every time I think about it, going to bed at 8:30 seems to win out! Phew! Talk about tired! By the time I get home from work, we eat dinner (which the husband usually prepares) and then I hang out on the couch most of the evening until M goes to bed, and then I'm not far behind. So yeah, not lots of blogging getting done. But, I'm 10 weeks, 4 days, and all is well. We have already had 3 ultrasounds- 6wks, 8wks, and 10wks. At the first ultrasound, the heart rate was still a little slower than they wanted to see, although the dr wasn't really concerned, saying that it usually picks up right around 6 weeks, so he just wanted to see it again to double check. They scheduled another ultrasound for 10 weeks, and when we saw the doctor at 8 weeks, they just did a little in-office one to reassure me that there was indeed a strong, fast heart beat. At the most recent one on Tuesday the heart rate was 171. Perfect!
Over the past weeks, I've had a few emotional ups and downs, but, amazingly, mostly ups. Once we saw that little heartbeat again at 8 weeks, I've been able to settle in to this pregnancy and trust that things are going well. I haven't seen a counselor. I did try calling one a few times, but must have had a wrong number because I never got an answer. I've kind of decided to just see how it goes.
As far as giving myself the shots every morning, well, that lasted for 2 weeks. And then suddenly, my hand would no longer move under my command. I literally had to have the hubs push my hand for two days to help me do it until I had another appointment and he could get trained to do it himself. So now every morning he gives me my shot before I leave for work. I hope he doesn't plan on going anywhere for the rest of this pregnancy. :) So grateful for him these days!
The big decision of the past week has been trying to decide whether to have any testing done for Downs syndrome. At my last dr's appointment at 8 weeks we ended up seeing the nurse practitioner because the dr was behind, and she didn't mention it, and I didn't realize how soon the testing would need to be done, so we hadn't talked about it. So when, at the 10 week ultrasound, the other dr asked if we had decided on that testing, we had some talking to do. There was no discussion required as to what a positive test would mean. We both want this baby, and all the genes that come with it. It's just a matter of what we want to know ahead of time. There are a lot of factors that come into play. With MTHFR, there are a couple different types, but one of those types is associated with an increased risk of DS. I'm not sure if it's the one I have or not. I think I have partially decided against looking further into it, at least for the time being. It doesn't really matter, and it's not a huge increase. I have been working with a couple of families of children with DS lately, and with each one, the conversation of whether they knew ahead of time came up either right before or right after I got pregnant. Neither of them knew ahead of time that their baby had DS, and both described the moment they realized something was wrong as really traumatic. Neither baby had any markers show up on an ultrasound, so no testing was done to identify it. One of the moms said she wished she would have known, the other wasn't sure, because she had a friend who did and said that her pregnancy was really difficult. It's hard to know which is the better situation, and I'm sure it's different for everyone.
Both of us really want to be able to enjoy this pregnancy, but, more importantly, we really want to enjoy the birth of this baby as a family. We didn't have that with M, because I was under general anesthesia, and the hubs was in the waiting room. He went to M as soon as he was able, and met her all by himself. I still can hardly think about him standing there all alone with the dr talking about odds of survival, surrounded by nurses, monitors, etc. The first time I saw her was so difficult, and I had seen pictures, heard him talking about her for 2 days, and had him standing behind me. I can't imagine anything more difficult. This time, we want something better for our family. If our baby would have DS, then I think the best time for us to adjust to that idea would be while I'm still pregnant. It would be hard, but it would still be our beautiful baby. So we have decided to go ahead and have the test. The waiting period will probably be tough, but I think it will be worth it. Most likely it will be negative, and if it's not, then we'll have time to prepare to welcome our baby into the world.
Our dr's office offers a nuchal translucency (NT) scan and a blood test, and, if that comes back with an "increased risk", a newer genetic test called MaterniT21. This is a blood test (of my blood) that is about 99% accurate. It's also totally safe for the baby, because there is no need to retrieve any amniotic fluid or anything else inside the amniotic sac, as in the amniocentesis. I wouldn't be comfortable with an amniocentesis because of the risk of miscarriage associated with it, but I can handle one more needle prick for myself. My only concern is that the NT scan and blood test are only about 85% accurate, so there's still a chance that they could miss the need for further testing. After asking some questions of Ashley over at Those Newmans, we decided to ask if my dr would skip the pretesting and just do the MaterniT21 test. He wasn't in on Friday, but his nurse called back and said she thinks it should be ok, but she'll have to check with the dr. So we'll see.
Speaking of Those Newmans, Ashley and her blog have played a pretty big role in the decision to test, as well. I originally found her blog while I was googling MTHFR and fertility, and continued to follow it. Her son, Eli was born with DS and they did find out ahead of time. The way they were able to prepare themselves and become excited all over again for the special journey God had mapped out for them helped me to understand that, if necessary, we can do that for our family as well.
With all of the thought and emotions that have been put into this decision, I have to remind myself that the odds of any genetic abnormality are really low. It's a precaution we have decided to take for our family, but odds are, like everything else, it's going to turn out fine!

A Little Bit of Crazy

I'm so excited! Like, possibly weird excited... I placed an order on Amazon.com for a "Big Sister" shirt for M. We tried to find one locally, then tried making one with an iron-on because we wanted it asap, thinking we would use it to tell my sister and her husband about the baby when they planned to come to our house on the 4th. But the iron-on was a TOTAL failure. As soon as I washed it (per package directions) parts of it peeled off, and when M put it on, the material (of course) stretched and it tore the iron-on to pieces! Boo! So... I just sucked it up and bought one. :) My sister and hubby have already heard the news, but it will be a fun way to share with some other people down the road and a great way for M to get excited about it. She is actually already interested and has been  saying she wants "baby Gwert" to come out and play with her toys. I seriously can't believe she hasn't spilled the beans yet. We saw her godparents yesterday and I thought for sure she was going to say something, but she got distracted. Phew! As far as I know, she hasn't said anything to her sitter yet, but then again, the sitter might just be too nice to ask until we bring it up. Fortunately, she's on vacation for the next two weeks and M will be staying with grandparents during the day, so there's one less place to spill it. :)
M was in the best mood this evening. We had so much fun. It's been a rough couple of weeks. She hasn't been sleeping well, meaning she's been up early and her naps have been short, and she just hasn't seemed to feel well. She would say her belly hurt, or her ear hurt, or her arm hurt, but never anything consistently. She would be fine one minute, then melting down about something that typically wouldn't bother her the next minute. She has also been doing A LOT of whining, and yesterday when I told her she needed to use her big girl voice (for the 100th time) she said, "Don't tell me that Mama!" Oy! We finally decided she was constipated, and, after treating that for a few days, she is back on a better schedule of dirty diapers and today is the first day she has seemed like herself (after a 3.5 hour nap to boot! Awesome!). Let me just say, it is so easy to appreciate what a happy girl she is when we've been missing that for a couple weeks! We played outside for the first time in weeks, since the heat has FINALLY broken! It has been in the upper 90s even up until it gets dark, so we have missed that! It was a great evening.
The hubby made a major grocery shopping trip this afternoon. We have started on a meal plan to make grocery shopping and meal prep easier, so he made a big trip to get us started. (Yes, I am a lucky girl to have a man who willingly does a lot of our grocery shopping!) Why is this relevant you ask? Well, I have an unreasonable fear of going to Walmart. Where we live, that's the best, cheapest place to do a one-stop shopping trip. I don't usually have this fear. It's not my favorite place to be, but typically there is no anxiety involved. But when I was pregnant with M, we did one of our big shopping trips, and spent a big chunk of the afternoon walking around the store, finding everything on our list. I was 26ish weeks pregnant and, by the end of it, was having a fair amount of low back pain. Not a big deal, just uncomfortable. So I went home and took a warm bath. The pain got worse and moved up towards my rib cage, and ended up being pretty intense. Over the next 10 days, that pain would come and go, getting progressively worse, until I was diagnosed with HELLP Syndrome on March 11 and M came unexpectedly into the world at 28 weeks, 1 day. Until very recently, maybe the beginning of this year, every time I entered into Walmart, I  would think of that. I still do pretty often. I associate it with the beginning of the problems that led to M being born so early. That's not really accurate. I had had elevated blood pressure before then and was on blood pressure medication, although I had no other signs of pre-e. But for whatever reason, that is the moment I associate with the beginning of the end of that pregnancy. I know that it had nothing to do with Walmart, and likely even had little to do with being on my feet so long that one day. That may have been the straw that broke the camel's back, but I doubt it. I'm pretty sure it would have happened one way or another. The warm bath could have exacerbated the liver inflammation that was already coming on (in fact, I'm pretty sure it did, because both that time and a later time that I took warm baths I ended up in a lot of pain) but that wasn't the root of the problem. But, even though my logical brain knows these things, I find myself wanting to avoid doing any major shopping at Walmart now that I'm pregnant again. I did offer to go along today. I haven't even mentioned to my husband that I feel this way, mainly because I didn't realize it until he was there today. I'm sure if I tell him he will continue to be amazing and take over all the shopping for the duration. But I'm pretty sure I just need to get over it. I'll tell him about it, and maybe next time we'll go together, and I'll be more aware of how long I'm on my feet. They have benches, after all! Or I won't. It's not the hardest place for me to avoid for the next 9 months. Either way, this baby is going to be safe and healthy, and grow big and strong, all the way to term! And I'm pretty sure Walmart isn't going to be the deal-breaker.

Feelin' Good!

Over the past few days, the idea of having baby #2 on the way has been sinking in. I thought I would be more anxious, given our history, but actually, I'm just really excited! I just feel good about what is to come! I know there are no guarantees, but my goal is to enjoy this pregnancy as much as possible and to give this baby the healthiest start possible, regardless of how long he/she stays inside of me. I know that, on the off chance that baby should decide to come early, the healthier I have been the healthier and stronger he/she will be. But I feel good! :)
That being said, I know myself well enough to know that I won't feel so positive every day. Overall, I am a positive person, but I am also a realist. I imagine that most of the time I will feel happy and optimistic and good, but that, once in a while, the reality of the situation will overwhelm me. The possibilities may loom and I'll want to freak out. And because I want to deal with all of the emotions coming my way in the healthiest way possible, I have decided to work a therapist throughout my pregnancy to achieve that. My goal is to make an appointment to get established with someone in the near future, and then basically have them available so that I can make an appointment if needed. That way, when I do have the urge to freak out, I'll have some one to call and strategies to help me deal with it. I feel good about that decision, so now I just have to take the step of picking someone and making the call.
We have tried to simply explain what's going on to M. She's only two, so what she understands is pretty limited, but oh my gosh, it's so cute! When we told my Dad, we had her tell him, and she said, "Mama's pregnick!" We have been calling the baby Baby Squirt so that she has something to call it, and she pronounces is "Baby Gwert." In the morning and before bed we pray for baby to stay safe and grow big and strong, and the last two nights, when we were finished, she said, "I love Baby Gwert bunches and bunches!" That's a good way to bring tears to a mama's eyes! It just made my heart swell so big! I feel so blessed to be at a place in our lives where we can expand our family to four. I know it will be crazy, but it will also be so good!
On Monday morning, after finding out we were pregnant, I had three doctors to call: Dr P, who put me on the Clomid, Dr S, the RE, and Dr W, my MFM. I spoke with Dr P's nurse, who congratulated me and said she would let Dr P know. Then I called Dr S's office to cancel our infertility appointment. As much as I would have loved to go through with that appointment to get some questions answered, particularly about PCOS, I am so happy not to need it! I also called Dr W's office to set up my first prenatal appointment. For some reason, that had to be complicated. The first person who answered the phone sent me to the voicemail of someone who sets up new patient appointments because that's their policy for a new pregnancy, even though I'm an established patient. That person called back to update my information, but it was already up to date since I was just in there last month. The a third person, a nurse, called later to tell me that it's too early to do anything, but I should wait until I have missed my period be at least a week, which by my calculations is tomorrow, but by hers isn't until next Wednesday, 7/11. At that point, they will order blood work, see where my HCG levels are, and schedule my appoint and first ultrasound accordingly. That's all well and good, and I understand the reasoning behind it, but I sure would like to have an appointment on the books! I think I would just feel better knowing when that it is coming, but also, it would be nice logistically. My husband and I both have jobs that involve a lot of scheduling and, with notice, it's pretty easy to schedule around other things, but it's a lot harder without knowing in advance. Oh well, we'll make it work. :)
I'll leave you with the phrase that I have been repeating to myself and my husband daily. I warned him that he'll probably hear it a lot over the next nine months, but that I have to say it out loud. **This is going to be a long, healthy, perfect pregnancy!!!**

Big News!

Oh how things have changed since my last post. And so very much for the good! I got my BFP yesterday (Saturday)!! Read: big fat positive pregnancy test! I was totally shocked! Friday morning I peed on my first stick and there was the faintest of faint lines, but I though "Surely that's nothing." Actually, with my first pregnancy, I remember using a cheap-o test and being able to see where the line would be, and I was sure that's all that faint line was. So what did I do? Dunked a second test in water for comparison purposes. ;) When that one didn't show any line at all, I definitely began wondering. My boobs have been feeling fuller since 4 DPO (days post-ovulation), and I started feeling really tired about midweek, but I attributed everything to being on my first round of Clomid and, let's face it, when you're a full-time working mom of a two year-old, it's hard to differentiate tired vs really tired. BUT when I re-tested Saturday morning the line was clearly darker! The hubs had to be convinced that these little Wondfo tests are really sensitive and accurate, and he insisted that I send a picture to my BFF, who I mentioned just got her BFP last week. I did, and when she called I answered the phone to lots of squealing. :) So he took that to be a positive interpretation.

Top: Friday's HPT; Middle and Bottom: Saturday's HPTs

 

My Chart with Climbing Temps!

So wow! We went from thinking our timing was rotten and having scheduled an appointment with an RE to being pregnant! I kept thinking, "Well, if God wants us to be pregnant, our bad timing isn't going to stop Him." So here we are!
Things have absolutely fallen into place. I was frustrated when my original RE appointment was pushed back to Tuesday,  but had it been scheduled for Friday, they probably would have said, "Congrats! You're pregnant! $40 please!" Also, we were supposed to spend Saturday on the river. I was concerned about the 100+ degree heat, but we decided to make it a little shorter day and spend more time in the water, but the friend who was supposed to go along hurt his back, so we canceled the trip. Instead we spent the morning visiting our parents and telling them our exciting news. (Yes, we already told our parents. We're each close to our parents and wanted to share with them asap, although the rest of the general public won't know for a while). I was able to take a nap when M did too. Like I said, I'm already tired.
The third thing that fell right into place was getting my Lovenox shots from the pharmacy. Earlier in the week, I called my insurance to make sure I would be able to get them from Walgreens rather than via mail order, and was informed that they would only pay for 12 shots a month. I also needed a pre-auth, so I called my MFM and left it in their hands. When I called back the next day to check in, I was told that the insurance wouldn't pay for any at all until I was officially pregnant. My MFM insisted that I have the medication on hand so that I could begin taking it immediately upon getting a positive HPT. So I really needed to have it on hand. I took the prescription to Walgreens to at least get the process started, and, lo and behold, they filled the entire 30 day prescription for a $45 copay, which is what they said I would have to pay for just 12 shots! Hooray!!!  So I was able to start my shots immediately yesterday morning. :) I actually had to run back to Walgreens for alcohol swabs, and ended up giving myself the first shot in the car. I had to force myself not to hesitate, but I did it! The bad news is that it hurt way more than the practice shot at the dr's office. Not the shot itself so much, but the medication. But not as bad as having to visit my baby in the NICU every day... Yesterday's shot left an ugly bruise and needle mark, but today's was a little smoother and I held pressure on it a little longer, and the result is much nicer.

First 2 Lovenox Shots

You can see the darker bruise on the bottom of the picture and today's mark a little above and to the left. My belly is going to be beautiful... Looks like I'll be wearing a tank top over my swimsuit!

 Tomorrow I will be calling the RE to cancel my appointment and my MFM to schedule a new one. Hooray! I may also call my regular OB to let him know that the Clomid was a success and that I am preggo!

Remember the friend who just found out she is also preggo? Well, her son is 3 weeks older than M and this time around, we're due 9 days apart! She's due March 3, which, amazingly, is the same day she was due with her son, and I am due March 12. And, because I like to keep it interesting, March 12 is just one day after M's birthday! My birthday is on the 8th and my dad's is on the 16th, so March is already a busy birthday month, and it's only going to get busier. Before getting pregnant with M, I had said that I would really like to have a March baby. Getting pregnant that June wasn't in the cards for us, but I (of course) was happy with our June due date when we did get pregnant. However, apparently the power of my suggestion was strong, because of course, she made her grand entrance in March after all. This time, I have been saying that I want to make it to 39 weeks and 6 days, because my MFM said he wouldn't let me go past 40 weeks and that because of my last c-section, they wouldn't induce labor if I don't start on my own, so if I go past 40 weeks it will for sure be a c-section delivery. But, as it turns out, 39 weeks 6 days is M's birthday! It's going to be interesting to say the least! But I'm excited to make it to March, and if that means that both my babies share a birthday, I am a-okay with it.

Here's to a full-term, healthy, and uneventful pregnancy! I'm talking myself up to it and, when I get nervous, just tell myself that this will be a long, healthy pregnancy with a healthy, chunky baby in our arms at the end. It will happen! All prayers are appreciated as we embark on this journey as a family!

June 22, 2012

Well, there's good news and there's bad news. I am pretty sure I ovulated on Tuesday (cd16). Hooray! Awesome right? The Clomid seems to have actually worked! The bad news is that I had ZERO signs. My cervix was clamped down tight, I had one tiny patch of very sticky cm, and that's it. For that reason, although the hubs and I have been on an "every other day schedule" when I attempted to woo the hubs Tuesday night and we ended up in an argument, I thought, "Well, it's not like I'm ovulating anyway," and we missed our chance. Seriously?!? When I woke up the next morning at 6 and had that first high temp, we did our business then, hoping for the best, but I know that chances are slim at that point. I would like to think that Sunday may have been recent enough, but with no real fertile cm, I seriously doubt it. Soooo.... I guess there's a chance, and that's nice to know, however small. That's a change from the past four months, since I haven't ovulated since early Feb.
A very good friend found out Tuesday that she is preggo. They have been trying for 10 months now, and I couldn't be happier. Her son is three weeks older than M (although he should have been 3 months older). It's still VERY early, so no one else knows yet, but I feel special and honored that she shared her exciting news with me! I can honestly say that hearing her news makes me purely happy. I would love to share another pregnancy experience with her, but whether or not I end up pregnant this cycle, I have no hesitation in celebrating with her.
There is a very small and silly part of me that feels like if we would be pregnant and due at the same time, I surely would have to go to term or close. Surely God wouldn't give me another preemie and then make me watch my best friend and her baby grow so big. Obviously, I don't presume to know God's plan or purpose. It just seems like that would be an unnecessary pain, so if we were due at the same time it would have to make everything ok. But logic prevails and I know that there are no guarantees, regardless of signs, coincidences, or anything else. Even someone with no history of problems has no guarantees. I just have that fact in my face more than most.
So it would probably be a good thing if I would be a month or even two behind her, just to keep me from comparing and having to watch her finish her pregnancy if I don't make it to term. The logical side of my brain knows that very well.
In other news, I decided to "take the plunge" and call an RE. I talked to a friend who has been dealing with infertility for a long time and asked her for a recommendation. I just don't know where to start looking for that sort of doctor without asking someone who has seen one. She recommended two, both of whom she likes a lot, but one of whom is cheaper, more aggressive, and has appointments in about a week versus a month or two. So that was an easy decision. Although I know now that I am able to ovulate using a low dose of Clomid, I feel like the risk of multiples and the fact that the Clomid resulted in no other fertility signs warrants a visit with a specialist. I am hoping that he will be able to weigh the risks and benefits of Clomid, figure out the reason my cycles are so unpredictable and far between, and figure out the best way to get me ovulating and fertile so that we can make a baby! I just feel like with my medical history of homozygous MTHFR, Factor V Leiden mutation, severe pre-eclampsia and HELLP syndrome on top of whatever is causing me not to ovulate, I need someone who has knowledge in all of these areas and can consider all factors when deciding on the best course of action. So that appointment is next Friday. Just a week away! That will be 10 dpo, so I may start my period that day, which would be unfortunate, but when I called and read his website, I was told that we will start with a consult, then a medical exam and work-up, then a talk with the RE himself to discuss a plan. So I really think that we will leave there with a plan! Hooray! It may just be another round of Clomid while using Pre-Seed, but I'm fine with that if he feels the risks are small enough. Hopefully it will be a worthwhile appointment and we can leave with more knowledge than we have now.
It's going to be a good month!

Frustration!

I had my appointment with Dr W yesterday, but I don't even think he knew why I was there. I saw him last fall for a "pre-conception consult" to basically discuss the game plan for the next time I would be pregnant, and I think he thought that's why I was there yesterday. He started telling me about all the things we're going to do once I'm pregnant to try and prevent or delay severe pre-eclampsia again. But I already know all of that because we've already had that discussion. When I called, I told his nurse all about my concerns with possible PCOS and Clomid vs metformin, and she said "I think that would be a great conversation for you to have with Dr Webb." I asked if I could talk with him on the phone to avoid having to take the afternoon off work and driving an hour each way, but she said he would want to see me in his office. Fair enough. But I really wish she would have talked to him about it first because he basically just told me that he or Dr P aren't qualified to make the decisions and diagnoses based on my situation. He told me that he wouldn't recommend going over 100mg of Clomid because of the risk of multiples. Specifically, twins would double my chances of severe pre-e. He thought I should give it 2-3 cycles with Clomid, and if I'm not pregnant, regardless of whether I have ovulated with it, I should go see a reproductive endocrinologist (RE) who can figure out exactly what's going on and figure out the best way to help me get pregnant with ONE baby. I really feel like they could have told me over the phone that he wouldn't be able to answer my questions, but whatever. They have my $40 copay, so hopefully that makes them happy.
Based on what he said, I really don't think I'm going to wait 2-3 cycles. If I don't ovulate or get pregnant with this round of Clomid I'm just going to see an RE. I was thinking about calling and setting up the appointment and just canceling it if I get pregnant. I imagine they take at least a month to get in anyway. A friend/co-worker who has PCOS and a complicated history as well has a doctor she loves. He's not technically an RE, but worked with one and did a lot of training with him, and basically has a lot of the same knowledge. She loves him and wants me to see him. I haven't decided yet. Part of me likes the idea of seeing some one I have a good referral to, but the other part of me wants to just go straight to the top and skip the possibility of having to involve yet another doctor. The other benefit is that he shouldn't be hard to get into- maybe a couple weeks or so. I am thinking about calling and explaining my situation and seeing if he thinks he could help me or if I should go elsewhere. I've been burned with that before though, when nurses say they want me to come in, and then at the appointment the doctor says they can't really help me or they just don't have any new information from any of the other doctors I've seen. Yesterday wasn't the first time! I guess I'll ponder it this weekend and hope I ovulate and get KU so I don't have to worry about it!
The good thing that came out of my appointment yesterday is that Dr W realized he hadn't taught me how to give myself shots. I will have to give myself daily shots of blood thinner immediately, as soon as I get a positive pregnancy test, so he gave the the prescription to have ready and a nurse showed me how to do it. I was a teensy bit nervous, but it didn't hurt a bit! Hooray! Ok, so it's an almost microscopic needle, and I'm not even afraid of needles, but I wasn't sure I'd be able to stick one into my own belly. But after trying once, it'll be no problem! I'll have to get creative about covering bruises for my maternity pics though!
The less good thing that came from my appointment, besides all the unanswered questions, was a bit of a freakout. When Dr W started talking about the risk that would go along with twins, I started getting really nervous. Are we doing the right thing by trying again? I wouldn't change anything about our little girl, but I hate that she had to go through so much when she was so small. She is an amazing, strong fighter, but no baby should have to be a fighter! I don't want to do that to another baby. We are so blessed that she has done so well. She "caught up" earlier than the doctors expected and has no real lasting issues from her stint in the NICU, but it didn't have to go that way. Things could go worse next time. I know this is what we want, but when I left the doctor's office yesterday, I felt selfish. Is it stupid to want to try this again? I know this risks aren't as high as they could be, but they're not low enough to be comfortable. And I'm scared. What if things go wrong? I don't want to find myself in another fight for my and/or my baby's life.
I know myself well enough to know that there are days I'm going to feel this way. Most of the time I'm excited about the prospect of another baby and optimistic about having a healthy pregnancy, but there are moments when the risks throw themselves in my face. Yesterday was the first time since our daughter was in the hospital where I really questioned whether we should do this again.
We will try, and odds are good that we will have a healthy baby at least fairly close to term. If not, we'll deal with whatever comes our way. God has it under control, but this is definitely one moment where the idea that He won't give us more than we can handle is not a comfort. It's not that I don't think we could handle anything that comes our way, it's just that there are lots of possibilities that I just don't want to! Today I feel much better and much more optimistic, although still recovering a bit from the anxiety of yesterday. But we're off to the river this weekend for some sun and relaxation with the fam for Father's Day!

What a Week!

Phew! TGIF! I still have to go to my work picnic this evening and work a game booth, but boy am I glad to have the weekend coming up. This week has been full of... well... just FULL! I had a continuing ed course Wednesday, so I had to get all my home visits scheduled the other 4 days of the week, which meant that I worked at least a little late every night besides Tuesday, which was supposed to be when I went to my dr appointment with my specialist, Dr W. Sunday night we went to a local Blue Grass concert, and M came down with a fever. I brought her to her pediatrician Monday morning, basically just in time for an almost total recovery that made me look like an idiot for bringing her in. Oh well! My mom called it payback... Then, Monday night after work, we went to my in-laws' house for dinner to celebrate M's "Coming Home Day", because two years ago on June 4, she FINALLY came home from the hospital after 12 weeks and 1 day. She was feeling 95% better, so it was a fun day to celebrate. It's amazing to look at her now and see how far she's come. She truly is our miracle girl. She's still a little small for her age, but otherwise you'd never know where she started. She is talking above her age level (things are getting interesting... and hilarious) and recently told me that my hairy legs "are spicy", you know, like salsa... Makes me wonder how salsa makes her mouth feel! She is so much fun right now! We celebrate her birthday in March with my family, but my in-laws are typically still in Florida that time of year, so we celebrate her Coming Home Day with them.  Anyway, Tuesday, Dr W was called in for surgery so my appointment was rescheduled for next Thursday. That was a little frustrating, but I didn't think anything would be happening before then anyway. Wednesday evening we got a call that someone wanted to see our house on Thursday (it's for sale) which was excellent, except that it looked like a toy store threw up and the dishwasher exploded all at the same time. So, after M went to bed, Matt went to mow the grass and I got started cleaning inside. After mowing most of the yard, Matt was backing up with the mower, stepped off the curb, and sprained his ankle. Argh! Basically, that meant that he spent the rest of the evening on the couch with ice while I finished the yard and cleaned house until 1:00am to get it ready for the next day. But, I must have done well, because we heard this morning that the women who looked at it said we're #2 on her list of houses now. Our house has been on the market since last August, so it sure would be nice to get it sold!
On Monday morning, when I was waiting with M to see her doctor, I had some pretty sharp cramping, but had a BM later, so I didn't think much of it. That evening, when checking my cervix, I noticed I was spotting just a little. Not enough that I would have even known if I hadn't been checking. However, that has continued all week, and today is my fifth day of spotting. Because it was so light, I didn't think anything of it until last night, when I realized that it had been 4 days. I REALLY don't think it's a period, but I was afraid that if it was, I would miss this cycle for the Clomid. So, I called Dr P this morning and explained the situation. It's unusual for me to spot in the middle of my cycle, especially consistently for 5 days in a row, and I wanted to just check with him on it. Next Tuesday is day 32, at which point he would have started me on Prometrium to induce a period anyway. He called back about noon today and said that he would go ahead and count this as a period, just to be safe. He said that with women who aren't ovulating, you can sometimes start Clomid at any point in their cycle anyway, so it wouldn't hurt. So, that means I'm starting on Clomid TODAY! Holy moly! Here I thought it would be the end of the month before taking the Clomid and the beginning of July before possibly being fertile, but things just got bumped up! So we shall see. I know I shouldn't get my hopes up that it will work on the first try and lowest dose, but I think just for today I will be happy before trying to temper my excitement. Why not, right? If anyone is reading this, say a prayer for good results! I guess I'll still keep my appointment with Dr W next Thursday, even though I'll be done with the Clomid by then. Maybe he'll have some other input. When I was on the phone with Dr P he told me to start watching for ovulation about 5-9 days after I take my last pill, but I was so excited, I forgot to ask how long I should wait before assuming it's not going to happen. Hopefully it will happen right away and that won't be an issue. But it looks like I'll be checking in with Dr Google in the mean time. Happy ovulating to me!!

Edit: Just after I finished, Matt came down the steps and said the real estate agent called him and said that the lady decided on another house... dang...

Day 18

Well, CD18 has come and is almost gone. I didn't realize how many hopes I had hanging on ovulating by today until last night, when I accepted that it just was not going to happen this way. I really hoped that using progesterone to jump-start my cycle would be enough get me ovulating, but it's just not going to be. I called both my regular OB, Dr P, and my MFM OB, Dr W, who will be following my next pregnancy, to let them know what was going on. They both actually called back at times when I was able to answer my phone during my work day, which was basically a miracle. Dr W's nurse called first, and I updated her on the situation since I hadn't told them anything yet. I also told her that I am concerned about PCOS, but that Dr P wanted to treat with Clomid without looking into whether that is the issue or not. I'm not opposed to Clomid, but there is another medication, Metformin, that may be appropriate for PCOS that would help me cycle without (I think) increasing my chances of having multiples. In my mind, because I'm already considered high risk, I would rather try the medication that doesn't increase my risk of multiples, which is also considered high risk. If Clomid turns out to be the best option, then I'm ok with that, but I need to know that I've covered my options. Dr W's nurse said that "would be a great conversation to have with Dr W." I asked if a phone consult would be possible, since I live an hour away and would have to take off work, but she said he would want to see me in person. That's fine if the appointment is worth my time. Miraculously, she got me in next week Tuesday, so I'm pretty stoked. I really thought I would be waiting another month to get in there. Hooray!!
This afternoon, Dr P called me back himself. Although I felt uncertain about his plan before talking with him today, he answered all of my questions and I feel more confident. I do still want a second opinion from Dr W to address which medication is the best fit, but I feel more confident that Dr P is taking my concerns about PCOS seriously. He basically said that he would like to wait and see if I finish this cycle on my own, and if I don't start my period by day 32, he will do another round of progesterone to get me going again, then prescribe Clomid cycle days 5-9, starting with 50mg, then potentially 100mg, then 150mg in subsequent cycles progressively until I would ovulate. If I still don't ovulate on that highest dosage we would revisit the idea of FSH injections, which he said would "increase monitoring and cost significantly." Let's hope we don't have to go there. I told him of my understanding that Clomid is less likely to work if PCOS is the issue, and he confirmed that. I asked him about Metformin as an alternative, and he explained that typically, Metformin works best for women who are insulin resistant and over weight, neither of which I am (to my knowledge). It's possible that Metformin could still work, and I have a friend who doesn't fit the mold and has had great success (due in July :) ), so I'm not ruling it out yet, but that's good to know. I feel like he is considering that possibility, which I wasn't sure of before. Dr P also explained that research is still inconclusive as to whether or not Metformin produces any better results than Clomid. And later in the afternoon he actually emailed me a research article about a study that found that more live births occurred with the use of Clomid than with Metformin. I haven't made my way through it just yet, but I definitely will. So all in all, I feel much more like he is on my side after our conversation.

I realized something as I was lying in bed feeling frustrated last night. When M was born so early, I felt so disappointed in my body. I felt as though it had let me down. All my life, I have been able to just about anything I have wanted to do if I worked at it enough. But now, when it comes to the most important thing to me, my body has failed, and there is nothing I can do about it. I had worked through those feelings as much as possible, and since M is doing so well, it hasn't been staring me in the face for a long time. But once I realized that I am still not ovulating with the assistance of progesterone, I began feeling like my body is letting me down yet again. It's not as though this has been a long process thus far. I feel like I am more frustrated than can be accounted for by the last month and a half. But I think that what it comes down to is that the feeling of my body letting me down this time around is stirring feelings that I thought I had worked past. I can't tell you how sickening it is to know that your body has been unable to carry your baby to term, and to see that tiny baby struggling for life, and know that you are completely out of control. The feeling of wanting so desperately to protect her from every bright light, every loud beep, not to mention the invasive medical procedures, and being utterly unable to do so, is beyond words. It's sickening. Only another preemie mama could really know. The night I came home from the hospital, I just laid in bed, hugging my empty belly, and cried and cried. I don't ever want to feel that again. So the feeling of having no control over my body is a difficult one for me. I'm trying to embrace the body that God has given me and trust that he has entrusted me with this struggle for a reason, but I swing between that knowledge and the conclusion that my body is one selfish POS. It has always treated me just fine, but when it comes to growing another human being, it's just doesn't come easily. Hopefully I'll grow to be more graceful and lean more often towards the former. :)

In other news, part of my effort to embrace my body and know that I am fearfully and wonderfully made has been to sign up for my first 5K! I'm in week 2 of training and I'm actually really excited! I decided that it's time for me to force myself into some "me time" so pushing myself to do this is all about me. My mom, sisters, and a couple friends are also signed up, and I think it's going to be a lot of fun! August 18th- let the count down begin!!

May 18, 2012

Wow, it's been a while! So let's see. I started the 10 day round of progesterone (Prometrium), and Dr P told me that I would start on either the last day of the pill or within the following 5 days, if I was to start at all. In fact, I spotted on day 9 and 10, then started my period the following day. It was very light, but I think maybe that makes sense since I never did ovulate?? Either way, I'm just happy to have started my period at all, thank you very much 83 day cycle!!! So now, I'm on CD7 (not counting the first two days of minimal spotting) and have until CD18 to ovulate on my own before Dr P wants to step in and try Clomid. He didn't sound extremely hopeful that I would ovulate on my own, but I hopeful that I will. I feel like my body has responded to the progesterone in a big way (holy exhaustion Batman!) and since I ovulated last time I came off BCP I think it could happen. I sure hope so! I don't know what I'm going to do once I do get pregnant! I feel like last time we got pregnant so quickly once we decided to go for it, and then I was totally naive to anything that could go wrong until it did, and then, surprise, M was here that day! And there was no time to think about anything because we found ourselves smack in the middle of the NICU roller coaster! This time around, I'm so focused on getting pregnant and now needing help to ovulate, but when I think about pregnancy, I just see so many different possibilities outside of a typical, healthy pregnancy. I know I will be giving myself daily blood thinner shots, so normal basically goes out the window right there, but if that's all the "abnormal" I have to deal with, I will be a happy camper. I keep thinking about potential bedrest more than anything. My MTFM, Dr W, made me feel like getting at least close to term is pretty likely with his game plan of blood thinners, and predicted 34-36 weeks, which sound FABULOUS!! He thought that we might be looking at a NICU stay of 2 weeks or less. If someone would have told me that be before M made her grand entrance, I think I would have been devastated, but after 12 weeks in the NICU, 2 weeks sounds very do-able. I want nothing more than to leave the hospital with my baby though. I always think about what that would feel like, and it just seems to amazing to even fathom. On the other hand, Dr W did say that if I show even a hint of pre-e, like high blood pressure, swelling, protein, anything at all, he will put me on bedrest. Soooo... then I signed up for short-term disability for work, so I have 6 months covered there. One less thing to worry about. But there are just so many unknowns (even more than a typical pregnancy) and I basically can't plan anything until I get there. There are only so many back up plans a person can make! So for now I focus my thoughts on getting pregnant (as if that helps) and pregnancy and all the what-ifs that go with it are just a bridge I will have to cross when I get there. And by "bridge", I mean like a thousand bridges to cross before holding that baby in my arms! One way or another, we'll get there!There's an almost superstitious part of me that doesn't want to try to imagine too many possibilities, because I'm afraid that God's is going to try and surprise me, and if I think I have all the possibilities figured out, he'll just have to come up with a really creative way to catch me off guard... I definitely believe God has a sense of humor. :)

May 7, 2012

So I am on day 6 of this progesterone and although I haven't had all of the horrible symptoms I've heard about, I am definitely aware of it in my body. I'm tired, lethargic, and irritable. We have great friends here for an extended weekend, and that's probably a good and a bad thing for them. I'm definitely glad they're here to distract me from my crabbiness and to give the hubby a break, but I'm definitely not at my best. Breaking up fights between two 2 year-olds all morning definitely had me at the end of my rope and naps came just in the nick of time. The dadas are fishing this afternoon, so I laid down and, although I didn't sleep, I did enjoy the time to myself and feel refreshed. My little poppy seed tried to convince me she wasn't going to take a nap, but fortunately I convinced her otherwise and am feeling recharged. I'm trying to squeeze in a post before she gets up.
I've been reading lots of blogs lately. I've never gotten into them until the past few months, and now I have definitely gravitated towards pregnancy/TTC blogs, preemie blogs, as well as blogs by moms of children with special needs. I don't have a child with special needs but I do work with kids under 3 who have all levels of special needs. I love working with them and I especially love working with them as a piece of their family. Missouri's early intervention program, which is where I work, puts a lot of emphasis on working with families as a whole, the idea being that they are the people who spend the most time with their child and, with the right support and education, are the ones who can have the greatest effect on their children. I recently stumbled upon a blog that brings all of these things together, from trying to conceive with MTHFR, to infertility and IVF, to pregnancy, to finding out their little one would be born with Down's Syndrome, to just recently welcoming him into the world. While catching up today, I read about their ultrasounds, both before and after learning of the DS diagnosis, and it just really got me craving that experience again. I can't wait to be pregnant. With my daughter we had all of the beautiful experiences up until 28 weeks, and they were oh so wonderful. The only part that really wasn't fantastic was the last week, when I was getting so sick, although I didn't know what was happening. When I say "beautiful", I don't mean that I wasn't sick or exhausted or anything like that, but I really did enjoy being pregnant. I think that is one more reason I mourned so hard for the last third of my pregnancy that I (and my daughter) never had. I was looking so forward to the rest of that pregnancy and even delivery. I know that sounds crazy to all those people who experienced that in a way that allowed them to take it for granted. And I don't begrudge them their ability to complain about their experience, although there have been times when I did. It's just that I really was looking forward to experiencing my body doing what it was created to do, to proving to myself just how strong I really am. I felt betrayed that my body instead showed it's inability to do what I still believe I am created to do. How can God create me with such a sense of purpose that drives me to be a mother, and yet my body seems unable to do its part? I guess I did learn just how strong I could be. Just not in the way I thought I would. It takes a lot of strength to have a preemie.
So today I am aching for not only the experiences I had during my first pregnancy, which were overwhelmingly positive, but also the experiences I dreamed of and have been missing ever since. I really hope this first round of progesterone works. Dr P didn't seem extremely confident that it would, but obviously he thought there was a chance or I don't think he would have tried it. I feel like if this doesn't get me to ovulate, then I really am entering the world of infertility. At this point, I feel as though I'm teetering on the edge. I have one beautiful daughter and had no trouble getting pregnant with her, only because I cycled and ovulated immediately after coming off BCP. My body had that assistance. I guess using the progesterone really isn't any different than that. But if this doesn't do it and I have to move on to Clomid, that, to me, is an infertility drug. I hesitate to put myself in that category, because we haven't been "trying" very long. However, we really haven't even been able to "try" because I knew that I wasn't ovulating. I also hesitate because I don't feel as though I have the right to put myself in the same category as friends who have tried for years to get pregnant, and have had innumerable tests and treatments, some of whom have eventually been successful and some not. But I am afraid of entering that world. I did feel a bit validated at my dr's appointment when Dr P said that he was putting the appointment in under "irregular cycles" because that's why I came in, but also adding "infertility" since we had that conversation. At least "infertility" isn't just a word in my head.
My husband asked me yesterday how hard it would be on me if we found out I really couldn't get pregnant. This might sounds like a leap to some, and it is, but in context I knew where he was coming from. We have discussed adoption as a possibility for our family if our next pregnancy is as difficult and/or short as the first one. Both of us feel like it might be a calling for us somewhere down the road and, while that's as far as the conversation had gone, it's in the back of our minds. When our daughter was in the hospital and I didn't yet know what the likelihood was of the same thing happening again would be, we promised each other that she would not be an only child. If it wasn't safe for me to be pregnant again, then we would pursue adoption. Now, we both know that we could pursue adoption for a variety of reasons, not the least of which might be that God simply calls us to do it. But He when he asked about how I would feel if I was unable to have another baby, he said that if that were the case, he would be sad, but that it would seem like God intended that to lead us into adoption. I told him that I feel like the idea of being unable to have more biological children makes me want to cry, even just talking about it, but in the big picture, I feel the same way he does. I don't want to think about not being able to carry another baby inside my body, and it would be harder than I care to think about, but I do trust that God has a plan, and if that's a part of it, we will walk that path in good faith. But just for the record, I don't want to. :) I'm willing to consider adoption even if I do have another baby if that's what God wants! I am so looking forward to watching and feeling another life growing inside me, and to allowing my body the opportunity to get it right next time. I can't wait to see my daughter as a big sister. She loves babies, and while I know one living in our home would be more challenging to her, I know she would be great at it. Only time will tell just when that will happen. Hopefully sooner rather than later!!

Game Plan

It's been a good day. I'm on day 73 of my cycle with no sign of ovulation, so I've been frustrated, but I saw both my chiropractor (who is fantastic) and, finally, my OB/GYN. Dr S, my chiropractor, is basically making adjustments to support overall health, as well as reproductive health, and has me on a couple supplements to support reproductive and, specifically, ovarian health. She is also a good friend and, although I am still not ovulating, I always feel better after seeing her. She is incredibly smart and well-educated and it's nice to have someone to talk to who knows their stuff and talks to me like I know mine as well. She makes me feel like more of a partner in my own health than most doctors, which inspires me to to charge of my own well-being.
 My OB/GYN  went well, too. It took a month to get in and I was worried that he wouldn't do anything more than send me on to someone else. I considered making an appointment with a dr I knew would get me in sooner and would probably do an ultrasound to check for PCOS (polycystic ovarian syndrome) at the appointment, which is my first guess as to why my cycles are so irregular. I decided to wait it out and give Dr P a try before going elsewhere. I'm glad I did. Although he didn't check me for PCOS, he did say that he felt like he didn't need to do blood work at this point because he would recommend the same course initially, regardless of the results. So at this point we have a plan and if that doesn't work, the we can do some testing before proceeding with more specific treatments. I would like to know eventually if PCOS is something I need to be concerned about, but at this point, if I can ovulate with the least invasive scenario, (and the least cost!) I'll be happy. We discussed a variety of possibilities and Dr P even drew me a flow chart on the exam table paper, which I proceeded to tear out and bring home with me so that I could share it with Matt. :)
So here's the plan. Because of my multiple blood clotting disorders (MTHFR and Factor V Leiden Mutation) I have to avoid hormones, especially estrogen, so we're trying to avoid having to go on a birth control pill to regulate my cycle. With my daughter, I got pregnant immediately after coming off the pill, when my cycle was still regulated. However, this time I know more about my body, so the pill is out. So we're going to start with a 10 day course of progesterone to see if that will stimulate a period. If I have a period, then I might be able to ovulate afterwards. That's not a sure thing, but because I did ovulate coming off the pill last time, Dr P thinks it's a definite possibility. If I don't have a period he will try FSH shots. I don't know much about this yet, except that it increases the likelihood of multiples (...) Also, if I don't have a period at that point, PCOS is off the table. On the other hand, if I DO have a period, PCOS is a possibility, and he will give me 18 days to ovulate on my own. If I do, we can repeat this process multiple times as we need to until one of those ovulations results in a pregnancy. If I DON'T ovulate on my own, we will then likely proceed with Clomid to stimulate ovulation for 3 cycles. If the Clomid doesn't stimulate ovulation, we can increase the dose to try again. BTW, Clomid also comes with a 10% chance of multiples... After one premature birth, multiples does not sound like a good idea to me, but I guess of that happens, God definitely meant it to...
So that's that current plan. Can you see why I liked the flow chart version?
Another interesting point that Dr P made was that being on a baby aspirin can actually suppress reproductive hormones a little bit. My MFM (maternal-fetal medicine dr) who delivered my daughter when I had HELLP syndrome, wants me on a baby aspirin while trying to get pregnant, and then blood thinner once I get a positive test. So I started that baby aspirin in the middle of this "cycle". I'm wondering if that is the reason this cycle has become so long. Maybe if I hadn't been taking that I would have continued to cycle? I don't know the answer to that. But unfortunately, I need that medication to prevent blood clots. Sp the plan is to stay on it until a few days after starting my period, then come off it until I ovulate, then start it again, just in case I do get pregnant that cycle. Can I just say that it's a little irritating that I have these diagnoses and situations that require conflicting treatments? Hopefully, "a little irritating" is all it is and we don't have too much trouble from here on out. I am glad that I've already been charting my cycle, so I know how to tell if/when I have ovulated. If you haven't looked into the Family Planning Method, I definitely recommend it! I use a book called Taking Charge of Your Fertility. Excellent and informative.
I told Dr P today that I feel like at this point, I'm just taking things one step at a time. The issue of not ovulating and getting pregnant is giving me something to focus my energy on besides the anxiety of staying pregnant, which, after my experience with my daughter, will definitely be on my mind from the moment I get that positive test! So, one thing at a time for now. We'll just keep taking one more step and one more step until I hold that sweet baby in my arms! I know God has it all planned out, and I am trusting that he has the best interest of myself and my family at heart. I took my first progesterone pill on the way home this evening, so here goes nothing!

April 24, 2012

As I'm typing, M is fighting sleep by crying for the 4th night in a row. As frustrating as that is (and it's very frustrating) I wouldn't trade the challenges of parenting for anything in the world. There is no doubt that M is our miracle girl. She was teeny teeny tiny when she was born -- 1 lb 11 oz. She was born 12 weeks early and was small even for her gestational age. But the more I learn about my body, the more I learn just how truly she is a miracle. Many women with homozygous MTHFR, one of the genetic mutations I have, have difficulty carrying pregnancies past the first trimester. And they often don't find out the cause until they have had multiple miscarriages. The fact that I was able to conceive and then carry my pregnancy as long as I did really is miraculous, given what I now know.
When I listen to M cry that she wants out of bed or throw a tantrum, as two year-olds will do, I can't help but think of her first five days spent on her ventilator and feel grateful for those lungs that are so strong and that have never given her any trouble since being discharged from her 12 weeks in the hospital.
As a family, we don't have the luxury of taking what we have for granted, but that's something we have come to appreciate. The funniest things strike me and remind me of how good we have it and how close we came to not having it this good. For example, on Easter, while helping M empty her eggs, I looked at a little Butterfinger egg and was struck by the memory of her first Easter picture from two years ago, taken by a very special NICU nurse when she was a few weeks old. M was surrounded with Butterfinger eggs the size her of hand. Those same eggs now fit right in the palm of her hand. So yeah, even Butterfinger eggs remind us that we're living a miracle!

Beginning a Journey

Hello Poppy Seed

My daughter,
Who not so long ago
Was a poppy seed to pollywog
That grew inside of me,
Is newly pregnant.

I imagine
The million moments of
Carrying, calming, feeding,
Adoring, worrying,
Astonishment
Holding on
And letting go

That are stored in her now
Like chromosomes on a gene,
Too intricate,
Too detailed
To map.

Already I recognize
The way she walks—
Protective,
The way she speaks
About other things
But is never unaware
Of the precious secret
She holds inside.

You are blessed,
Little poppy seed.
You will grow
In a nourishing womb.
You will be born into arms
That yearn for you,
Held close by a bond
Formed long ago.

In a lifetime of achievements
And failures
I am most proud
Of this beautiful mother/daughter
Who started as a poppy seed
Inside of me.

Maria Brady-Smith, October, 2009

Matt's size 11 wedding ring

This poem was written by my mom shortly after she found out I was pregnant with our daughter, Mya. (Hopefully she doesn't mind me posting it here :) ) My husband, Matt, and I were newly pregnant and read that, at that gestation, she was about the size of a poppy seed. Thus the inspiration for the poem and blog title. When I think about that stage in our lives, I think about how naive we were, and about all we had ahead of us that we didn't know was coming yet. Mya was born the following March and just 28 weeks 1 day, weighing 1 lb 10.8 oz. It's hard for people to imagine a baby that size, and it's hard for me to remember her at that size, but my husband's size 11 wedding ring fit over her arm, up to her shoulder. Now, at 2 years old, it barely fits over two of her fingers.

The first time I met Mya after she was born.

I wish I would have started blogging or journaling at the beginning of my pregnancy, or at the beginning of our NICU stay, but now, two years later, is the first time when I have felt that the whirlwind has died down enough to try it out. So here goes nothing. I am beginning at another beginning: the beginning of trying for baby number two. This is a whole new experience for us. When we decided to try for a baby the first time around, I had no known health issues, no complications, no reason to think everything wouldn't go smoothly. This time, I have a history of pre-eclampsia/HELLP Syndrome that cause Mya's early arrival, and have recently been diagnosed with two separate blood clotting disorder: homozygous MTHFR and Factor V Leiden Mutation. Research is emerging, but is seems that the Factor V is likely at least part of the reason for the HELLP Syndrome. Along with that information, my cycle is very irregular (meaning I don't ovulate very often) and I have an appointment with my doctor coming up soon to determine whether there is a separate reason for that. I have my theories, but I'll have to wait and see. So at this point, getting to the point of holding baby number two in my arms feels like a step by step process with lots of unknowns and each stage. Will it be difficult to get pregnant? Will I be able to carry a baby to term this time around? Will I end up on bed rest or be able to continue working during my pregnancy? I have no doubt that we'll get there, but I'm just not sure of the path God has in mind for us.  This blog is my documentation of our journey.