Second Opinion

I finally made the appointment with MFM doctor for Thursday December 1st.  The appointment is to get a second opinion about what I need to do to prevent what happened with Lindsey from happening again.

I trust my doctor, she is aggressive with her treatments, she is caring and understanding and she is experienced.  I just don't want to put all of my eggs in one basket so to speak.  I just felt a great desire to see another doctor to reaffirm that we are doing the right thing for our baby.  I am prepared to do whatever I need to to ensure that this baby comes home with us and live a happy healthy life.  If that means I need to be firm with the receptionists and nurses at my doctor's office then so be it.

Sadly, the more well-known and experienced MFM doctors are no longer in the Rockford area so I am meeting a new doctor on Thursday.  We will be doing an u/s to check on the baby and also checking CL. I am anxious to see if my CL changed at all since my 12 week appt.  Apparently the cervix changes length often but I am still hoping for a great number that isn't less than my previous 4.8cm.  After the ultrasounds we will have a consult with the doctor to get his opinion on what he thinks needs to be done for me.  We are definitely going forward with the cerclage no matter what the specialist says.   I am more concerned with the timing of the cerclage and the starting of the 17P injections.

17P injections are thought to prevent preterm labor, which is always a concern with my history and with the cerclage.  My doctor wants to start them at 17 weeks but I would prefer to start them a week earlier at 16 weeks.  16 weeks seems to be a fairly common time to start them so I don't see why that would be an issue.  Since I ended up in the hospital at exactly 18 weeks 2-3cm dilated I just feel that the earlier we do the cerclage and injections the better.

For the cerclage at 14 weeks the bag of water is smaller, there is always a risk of rupture during the cerclage procedure so I just feel the earlier the better.  Again, it seems fairly common to have the cerclage done at 13-14 weeks.

On another positive note, my m/s is slowly decreasing!  I haven't vomited in 2 weeks!!  Of course I am still on Zofran and get nauseous sometimes but it's much better lately.  I am going to slowly try to decrease the Zofran but I'm afraid to do so on days that I am not at home all day, especially when I am at work for fear that I will get sick and won't be able to function.  I still have all of the other fun symptoms though; sour stomach, heartburn and sometimes things tend to just come back up and burn my  throat but I can usually just swallow it back down….such a fun topic!

I am exhausted from the long holiday weekend that isn't even over yet!  Going to try to sneak a quick nap in the car on the way to the family's house!  I was just up too early today making Crumble Top Apple Pumpkin Pie, Cranberry Fluff and Three Cheese Balls for today's festivities!

Baby Pics & 2nd Appt.

Well here's the good news!  Baby is growing wonderfully, 12w1d but baby is measuring a day ahead so that's great.
HR 160 bpm (baby heartbeat)
CL 4.8cm  (cervical length) - great so far!

We had an NT scan done also which screens for trisomy 21 (downs) and 18.  You can see the little space on the back of the baby, the black space is what they measure, the width.  We only did the test because our doctor says that it can catch treatable things, like problems with the placenta.  We are anticipating no problems but it was fun to see the LO on the screen for so long!

All the u/s together probably took 20-30 minutes!  We got to see the baby sucking its thumb and kicking its arms and legs!  I really really enjoyed the time we could watch and it definitely helped me bond to this LO.  The baby looked so content just laying there and kicking, loved it!

Then we got down to business.  The main concern is the cerclage.  My doctor is planning on doing it after 15 weeks but I disagree and would like it done around 14 weeks.  The more people I talk to that have had a cerclage have had them put in around 14 weeks and sometimes earlier.  She would like to start me on 17P injections (progesterone) 17 weeks but I am thinking about asking to do it at 16 weeks because that seems quite common as well.
She was very open about us getting a second opinion but now I'm worried we won't be able to get in to MFM (maternal fetal medicine) doctor in time since I am 14 weeks in just 2 short weeks!
We just want to do what is right for the baby, I love and trust my doctor but I just feel the need to double check everything.  She is 60 years old and has a lot of experience but younger doctors also have something more to offer, they have more recently graduated and may be more up to date on new procedures and protocols.  I would really like to hear what they each have to say and make a decision based off of that info.  Guess I'm going to be calling the doctor's office first thing tomorrow morning to discuss it!

POAS

I just wanted to share my pee stick pics!  I just loved to watch the lines grow darker each day!

"Morning" sickness

This is something that not every pregnant woman has to deal with, vomiting and nausea during pregnancy.  Some say that I am lucky to experience it because I have symptoms and sometimes I agree, but if I could have a healthy baby without all of this, I would do it!  I know this isn't a pleasant topic but I really think most people have no idea how bad this can be for some people and I certainly struggle with it.  If you are squeamish or don't care to hear about vomit you may not want to read this post!!

I have pretty severe m/s (morning sickness - doesn't necessarily occur during the morning!) this pregnancy, as I did with Lindsey.  It started a little after 6 weeks where all of the sudden I was vomiting at all hours of the day.  Some mornings I would wake up just to throw up in the trash can next to my bed.  One of the most unpleasant things to vomit has to be stomach bile, it's what you throw up when your stomach is empty, it's yellow, acidic and has a horrid taste as you can imagine, oh and it also burns as it comes up!  I think the absolute hardest times for m/s is when you first start experiencing it.  I wasn't on any meds for it and it's weird to go from feeling completely normal to not being able to keep anything down.

I pretty much stuck to liquid foods in the beginning because they are so much easier to deal with if they come back up.  Things I ate were: apple sauce, yogurt, jello, chicken broth, juice, ginger ale and that's about it.   As you can imagine, when I finally was able to eat I could eat for an hour straight if I allowed myself to!  People have all of these little tricks of what to eat or do to help decrease m/s, well those stupid little things did not help me!  I seriously felt like I had some nasty food poisoning because as soon as I would eat something I could feel my insides just squirming and I could tell my stomach was not happy that I was trying to put something into it.
I eventually called a nurse at my doctor's office as I got to the point where I couldn't even keep a sip of water or ginger ale down and I knew I was getting dehydrated.  I just felt sick, weak, and exhausted to the point where I seriously considered going to the hospital to get fluids and something for the nausea.  However, eventually I could eat and drink in the evenings, maybe my body just got so hungry it gave up and let me win for a little while!

Well, ever since about 7 weeks I have been on a generic Zofran which is used for pregnant women and people on chemo.  It helps me a lot but I still have days where I am very nauseous and sometimes still vomit.  I take them 2x daily but they only last about 6 hours so by the time the evening hits I am done moving around.

The smells are one thing that can still get to me.  I feel like I have a constant bad smell in my nose.  Everything stinks to me most of the time; perfume, soap, fabric softener, some candles, air fresheners and I'm pretty sure I always find a bad smell even if there isn't one.  It's actually really hard because I feel like walking around with my sleeve over my nose most of the time!  Smells can actually make me vomit.
Last pregnancy my m/s started decreasing slowly and was pretty much gone by 15 weeks.  I am hoping the same thing will happen this time or even sooner!  15 weeks is only 3 weeks away so I am almost there!!

Fears

I told myself and my dh that we would be positive with our next pregnancy.  We would celebrate it every day and not live in fear as we did with Lindsey from the first day we found out I was pregnant.  We were always waiting to buy things, waiting to tell people, waiting to pick names, always waiting.  I didn't want to act like something would go wrong this time.  I know the possibilities, believe me, they lurk in the back of my mind but I do my best to deal them!

I am fighting the urge more and more every day to wait and wonder, instead of celebrate.
The first thing is getting through the first trimester or at least making it past the early stages.  After my first 8 week u/s I was much more confident that things are going to be ok.

Being on progesterone I am more scared.  The progesterone keeps the pregnancy going and my fear is always a repeat of my first m/c where it was missed for 2 weeks because I was on progesterone and nature could not take it's course.  However, with my last pregnancy I was also on progesterone and everything was fine.  That is just a very real fear for me and the one that I am struggling with right now.

The next big step will be the second u/s, which is on Monday, November 21st.  I will be 12 weeks and 1 day so we should be able to see a bigger baby and hear the heartbeat again!  I just love watching them squirm around on the screen!
Another thing taking place at our next appt. is getting a baseline cervical length.  There is not much weight on my cervix at this point (it really starts with significant weight at 18-20 weeks) so we are just going to check it and see if or how it changes after the cerclage and as the baby gets bigger.
I am feeling confident that the baby is doing well since I have had no signs of anything being wrong.

We should also be discussing and scheduling the cerclage at the appt. on Monday.  I need to start networking with other cerclage moms because I am terrified about the whole thing.  I have heard tons of success stories but also a few unsuccessful stories that just scare me to death.  There are risks during the procedure, after and every day after that.  I know it's going to be hard emotionally and probably physically as well.  I worried about complications after the cerclage; contractions, infection and bleeding.  The cerclage is a huge step in this pregnancy but I know that I'm going to need a lot of support because it is going to be terrifying for us.  BUT we hope that it is the thing that will help us to bring this baby home next spring!

Second & Third blood draw

The results of my second draw (taken 9/28) was given to me on Thursday 9/29.  My progesterone had dropped to 20.5 BUT my hCG rose to 585!  It more than doubled in 48 hours so that is great!

The progesterone concerned me more than anything and caused me to panic inside a little.  What does this mean?  Could something be wrong with the baby's genetics again, like my first pregnancy?  The nurse reassured me that this happens all the time in healthy pregnancies and is not always an indicator that something is wrong.  They wanted to repeat the progesterone levels to make sure it wasn't a lab variability.  I went in that day for another progesterone blood draw.  By now my arm was black and blue but not painful.  Since my veins suck I usually only get blood drawn from my right arm.  I make sure to drink plenty of water before my draws to ensure they can get the vein with no problem!
There is nothing worse when getting your blood taken when they have to dig around for the vein, ouch!  This time was actually more painful than normal, probably from being stabbed two times previously in the past week!

In the meantime I was instructed to start progesterone just in case because they did not want my levels to fall too low because that can compromise the pregnancy.  I picked up my progesterone on my way home but wanted to hold out starting them until I got the results the next morning.  I know from experience that you cannot start and then stop progesterone supplements.  Friday morning they called to say my levels dropped even more to 17.5.  Little to say I started the progesterone as soon as I hung up the phone!
I was assured that this would take care of my levels and they would likely increase as soon as I start the progesterone.  I would likely be getting rechecked next week, the week of 10/3 to make sure the levels in fact did go back up.

They went back up after my next blood draw!!  YAY!
Then at my doctor's appointment on 10/26 they were all the way up to 24.5 which is great for me.  They had better be up with an extra 200 mg of progesterone taken daily!

First things First

After my BFP on 9/24/11, I called my doctor first thing Monday morning.

I was instructed to come in for betas and also requested to have my progesterone levels checked.  What I mean by betas is checking hCG levels and progesterone is the hormone that maintains a pregnancy and I have a history of dropping levels of it.

This went smoothly, you just stop in the doctor's office for a blood draw and they call you the next morning.  I was guessing I was very very early, only about 3 weeks 6 days on 9/26.  I use very sensitive HPTs, 10 miu!
The next morning I got my results from Monday and it was great news!  My hCG was 241 and progesterone 22.2.  My doctors like to see progesterone in the 20's so that was great!  hCG levels are more difficult, as the only way you can tell if they are good is if they double every 48-72 hours and should never drop.

This is where the difficulties began with my doctor's office.  The nurse who initially told me to come in for the blood work instructed me to come back in 48 hours for the second blood draw.  The nurse that gave me the results Tuesday morning told me that I didn't need to come back and that I wouldn't be see until I was 8-10 weeks.  I was taking a nap at the time and answered the phone a little groggy and my head just wasn't clear or I would have had a fit right then and there.

In the past I have always had second blood draws because it is important to make sure hCG is doubling and I have always had close to 6-7 week viability u/s so I was a little upset.  The nurse seemed to have no idea that I had a history of m/c and that I am a high risk patient.
I was pretty upset and angry because this is not the first time that I have had issues with the nurses not knowing what is going on.  One nurse actually asked me if I was bottle feeding when she was setting me up for the SHG in July, you should feel confident in your doctor's office, not afraid of what they are going to say or not say!  Another thing is that sometimes the nurses call me 2-4 times to tell me the same thing that another nurse has already called about!  Things like this have been going on since I first started going there in Fall 2010 and this was just the last straw.  I couldn't deal with an office who was so unorganized during a high risk pregnancy.  Little to say I had had enough and wrote a comment card to the office about my concerns.

Wednesday morning I called back and firmly stated to the receptionist that I am a high risk patient, that i want my levels redrawn and that I want a viability u/s.  I promptly got a call back from one of the nurses that I like talking to and she told me to come in for another blood draw that afternoon.  Of course, I was working until 7pm so I had to figure out some way to leave for an hour or more!  She explained everything I needed to hear and answered all of my questions.  She gave me a timeline of when things would occur and helped set my mind at ease.  The only thing that my doctor was not going to do was an early u/s.  I understand that and I only had to wait until I was 8 weeks so not a huge deal, right?  It may actually be better that way!

Here are my HPTs from 11DPO - 14DPO.  Isn't it amazing how the lines change daily!?

BFP!!!

I wrote this after getting my BFP.
On Saturday September 24, 2011 I got a BFP!

It was so light that I could barely see it and really thought that I was imagining things.  After sending the pic to a Dh and a friend, they both confirmed the line was there!  Thanks, for saving me during my freak out time btw.
Thankfully I had just received more HPTs in the mail from a friend an hour eariler…….I continued to POAS 2 more times that day just to confirm that the line really was there.  I really worried each time that the line may have disappeared, lol.  I was 11 DPO when I took that test and had only been holding my urine for about 1.5 hours.  Usually you use first morning urine because it will have a higher concentration if hCG but I thought "What the heck? Let's try it!".  I had gotten a BFN just the day before so I was in shock.  I somewhat knew that implantation takes place a little later for me than some women so it would be rare for me to get a BFP at 10DPO.

I had an inkling that I was pregnant but I was in denial, more to protect myself from disappointment than anything.  There is not much harder than seeing a BFN when you are TTC and if I could convince myself that it was going to be a BFN then I wouldn't be so upset.
I had cramps and I was exhausted since a few days after O so I had a feeling something was up.

Spent the weekend celebrating and called my doctor on Monday 9/26!!

Can you see the line??