It's so hard when its not easy

Fertility Drugs

2010-06-10T13:26:00.000-06:00

I'm sitting here inside my house with the A/C on and feel like I want to take off my clothes and sit in an ice bath. I've only been taking Provera for 2 days as well as having acupuncture and that finally brought on AF (Aunt Flo) at day 36 (CD36). Hello Auntie!!

So, no more Provera. Now, it's onto the Clomid that I've heard so many lovely things about from so many other women. That's right....I'm entering the Clomid zone. Enter at your own risk!! I've told my husband that he may want to consider moving in with his mom for a few weeks and I will let him know when he is needed. :)

This is the first time I've taken fertility meds. In the past, it was easy to get pregnant, but not so easy to keep the pregnancies continuing (5 m/c). Now, we have been trying and going into our 6 month with nothing happening so I thought I'd amp it up a little.

The plan is to go back into my RE's (reproductive endocrinologist's) office on day 12 of my cycle (CD12) to monitor the follicles. Since I don't normally test when I ovulate (those tests drive me crazy), we are starting then. The nurse did mention that Clomid can make your cycles longer or shorter so we will see how it all turns out.

Going to see my acupuncturist and being treated for spleen deficiency and having little needles placed in my forehead, under my ribs and down my inner legs has somehow been helping, too. I am taking the herbs she recommended for the spleen qi deficiency and have felt more accepting of myself and positive. I bruise very easily so hoping they will also help me in that area.

I'm seriously considering taking myself off of the 20 mg. of Celexa that I currently take daily while doing this monitored cycle. It does help me get through the bad days. As long as I force myself to go to the gym every day; I should be okay. I consider it as medicine for my anxiety and depression that has been around ever since these reproductive problems began.

Well, I'm going to go lay under the fan for a few minutes now and dream of little sweet babies.

Baby dust to you all!!!!

Stress and it's effects

2010-06-07T15:18:00.000-06:00

As if all of the infertility stuff going on isn't enough, my dad has been ill. He has congestive heart failure and went through a triple bypass and is now waiting to have a pacemaker installed. I am trying to spend as much time with him as possible, but it's pretty tough since he is a few states away.

When I am stressed, I tend to break out in hives. Lovely! This may be an automimmune response that is messing with my hormones, as well. I intend to find out at my next reproductive endocrinologist appointment.

In an hour, I will leave to have acupuncture done with a fertility acupuncturist in town. It will be interesting to see what she says about the reason my cycles have become so long (28 days to 40 days last month and now on day 34!?) since I started seeing her.

Turning 35 two months ago put the fear in me so maybe it is more of a psychological issue than anything. You know, the whole "you create your own reality" phenomena?

I am just ready for it to be over. I'm sure many of you have felt this same feeling. I do want to say over and over again that I realize how lucky we were to fall pregnant easily with our daughter. Things would be so much worse if we didn't have her.

After our 2nd loss at 16 weeks in 2007, I became extremely depressed. I saw a psychiatrist, a nurse practitioner, a LMSW counselor and had lots of meds prescribed but nothing seemed to help and I didn't seem to really connect with any of these caretakers. My reproductive endocronologist recommended a grief counselor to me and she made a huge difference in our lives. She just seemed to "get me" and not judge. She had gone through her own loss of a child (he was 18). I couldn't even imagine that. Sometimes I feel that I had to create some extra space in my energetic body and get rid of fear that I was holding onto. As soon as I started to see her and follow through with EMDR (eye movement desensitivity response, I think) and the exercises she recommended, I fell pregnant with Caley. I don't think it was a coincidence. Another book that helped me was reading "Women's Bodies, Women's Wisdom" by Christiane Northup. She had a remarkable grasp on the psychosomatic system as it relates to fertility.

In fact, I need to get that book back from a friend. I think it would prove valuable yet again.

Facebook | Daily Yoga Posture

2010-06-06T19:21:00.000-06:00

Facebook | Daily Yoga Posture

This is my Facebook group about yoga.

Yoga has helped me so much in my life, but specifically throughout my fertility/infertility journey.

If you are a beginner, this is a great place to start.

Namaste, the light in me honors the light in you.

This helped us get pregnant with our only successful pregnancy to date.

2010-06-06T17:42:00.002-06:00

2010-06-06T14:15:00.001-06:00

Just planted a garden for the first time. As I was digging, raking and preparing the soil; I was reminded how much preparation we need for our gardens. When I planted the seeds; I was careful to treat each seed with gentleness and mindfulness. It was an exercise in trust just like when we prepare ourselves for a baby and trust that we will one day be able to hold that precious miracle. I promised myself that as I watered, pruned and took care of this garden; I would be reminded of the miracle of new life and that it is possible.

One of "those" days

2010-06-06T10:45:00.000-06:00

Do you ever have them? Days where you feel like all hope is lost and you just want to stop fighting. It seems like a relief to even begin to let the thought in and accept that maybe you weren't meant to have any children or any more children.

Well, today is one of those days. I'm on day 33 of my cycle which is pretty abnormal. Last month, I had a 40 day cycle and thought it was just one of those things. Before my surgery and even after the first 3 months, I was 28 days like clockwork. I'm wondering what in the world is going on inside my body.

You know the worries. "What if I'm peri-menopausal now on top of everything else?", "Maybe I'm going to need IVF", "I should start looking into surrogation in India" or "My husband was adopted. Maybe we should just adopt".

The sad thing is that I'm sure many of my friends and family have thought this about us and our situation many times. I try not to put too much worry into their concerns. I know they love us and we love them, but this is our journey. I electively underwent a C-section pre-pregnancy in order to carry another one to term.

But, then, there are stories that are so inspiring and bring tears to my eyes. I just found out that a fellow Abbyloopers friend. Well, I should mention that Abbyloopers are women just like me all over the world. Most have lost multiple babies, found out that they have incompetent cervix (IC) and that a traditional TVC has a high rate of failure (pre-term delivery) so they opted to undergo the transabdominal cerclage. A transabdominal cerclage is a serious abdominal surgery. The surgeon makes a 2 1/2" to 4" (depending on the woman and if she is or isn't pregnant) in our abdomens in order to reach the top or neck of the cervix (os). They then place a band of very strong material around that neck so that it can never dilate again. This means that we will all need to have C-sections. Some RE's and maternal fetal medicine specialists (MFM) think that this is too invasive. The general consensus amongst those of us that have had this procedure done is that we are not willing to take the risk of having another baby die in our arms so we elect to have this procedure done.

And, most of the time, our insurance covers it. Their thought is that we would be extremely high risk to go on and deliver a pre-term baby in the future without this procedure. Believe me, they have doctors on their boards that study the statistics. The statistics for a transvaginal cerclage are between 80%-85%. This may be okay for most women, but for those of us that have been in that other 15%-20%, it isn't acceptable. With a traditional transabdominal cerclage, the success rates are 95%. (I should mention that there is also a procedure called a laparoscopic transabdominal cerclage done through tiny incisions in the belly button and pubic bone, but that success rate is slightly lower than that of the traditional TAC.) Finding a very experienced doctor is crucial because it is possible to get the band too tight resulting in difficulty becoming pregnant or too loose resulting in pre-term delivery. I found the "cream of the crop" in Dr. Arthur Haney who has been doing these operations for 23 years. He, personally, has a 99% success rate.

Well, you know what? I'm beginning to feel a little more optimistic now after going through all of that.

You know what it reminds me? It reminds me that I am not alone. That there are many other women and doctors out there that have been through what we have with themselves or their patients and that care. They truly care. There is a sort of bond between these women and doctors that is like a sisterhood. I trust my doctor implicitly and can't wait to be one of his success stories.

Now, onward soldiers!!! :)

On the road again...

2010-06-05T20:27:00.000-06:00

So, it's been a long time since I have written on this blog, but I plan to document our journey more frequently now.

What to catch you up on....hmmmm, where do I start?

We carried our last pregnancy to 22 weeks only to deliver our son through my transvaginal (TVC) cerclage. He was 10 oz. and 9 1/2 inches and he lived for 25 minutes in our hands.

We had a memorial service for him and buried his ashes next to his brother's ashes at a tree close to a pond by our house. My friends from my Mullerian Anamolies group were so gracious and bought me a gorgeous bracelet with each of my lost babies names as well as our earth angel and a spot for the next baby. They planted a beautiful Burr Oak down the street at a park. They donated to the March of Dimes in our honor (Jenny, specifically). They sent cards and 1 even wrote a small handwritten book. (Thank you, Kristen!!)

I received the placental pathology report back and it told us that I not only had an incompetent cervix (which we knew from my first pregnancy with my daughter as I needed a transvaginal cerclage at 16 weeks), but that I had an infection which I probably ended up getting upon getting the TVC placed at such a late stage with funnelling and only 2 cm. of cervix left. The more cervix that the doctor/surgeon has to work with, the better.

It was awful, honestly. And, it has remained so except that I have an amazing baby girl to brighten my days.

I started taking an anti-depressant after his loss and that helped me to get out of bed and lead a normal life.

I researched what had happened and discovered through my research that my OB was wrong in not giving me a preventative, but an emergent cerclage. I talked with 2 very well respected perinatologists and 3 very well known reproductive endocrinologists and all reiterated the above which makes me so stinking sad and angry. You know, the whole "what if" game?!

I decided to go ahead and get a rock solid cervix for our next pregnancy BEFORE becoming pregnant. That's right, folks!! After 3 2nd trimester losses and 2 early losses, I am STILL trying to have my own baby. Some may think I'm crazy, but I feel confident that this can happen.

I flew to Chicago from CO to have Dr. Arthur Haney, the head of OB/GYN at University of Chicago Medical Center, place a transabdominal cerclage (TAC). This was in February and we've been trying since then with no luck.

In the middle of this I celebrated my glorious 35th birthday which is not the best in the maternal world. Now I am labeled as "advanced maternal age" on top of everything else. :)

We are on our 5th month of trying and I talked to my reproductive endocrinologist (RE) who told me that he thinks that I am fertile, but understands the chronological age concern. My husband doesn't seem to be concerned, but he does have 4 years of living left to do to catch up with me. Yes, I robbed the proverbial cradle.

So, next month, I'm amping it up. I am going with the Clomid, hcg trigger shot and follicular monitoring. I feel optimistic leaving it to the hands of the professionals.

I'm also doing some alternative things to help with stress, etc. I practice power vinyasa yoga and have for the past 9 years. I have also started acupuncture and am starting to meditate....(ok, well, it's on the list of things to do starting on Monday. :)

I will write here about the ups and downs of our journey. I look forward to sharing with you amongst our trials and hope to support others that are on the same path.

Namaste (the light in me honors the light in you),

Jess

34 weeks!!?! Is this real?

2008-04-03T00:32:00.000-06:00

So, we've made it this far. It's thrilling yet extremely scary to know that my baby is healthy now and could easily survive outside of the womb. She's breech so that has me concerned. I assume that there is a reason for this presentation and am not of the mind to try a "version" (where doctors exert physical force in order to turn the baby to the normal vertex position). The cerclage is scheduled to be taken out during the 3rd week of April so we're talking 2 1/2 weeks!! I find out tomorrow if a C-section will be scheduled due to the breech presentation. What can I say? We are ready to be parents. Our house is completely "babyfied". Caley has it all, the chic crib, pack 'n play, swing, jumper, tons of clothes, blankets, burp cloths, bottle warmer, Diaper Genie....it goes on and on. I try to imagine the moment when our eyes meet for the first time. I know that my imagination will not do the actual moment justice. It is a magical moment for every mother. This pregnancy has taught me to live in the moment, to be grateful for what is happening right now, to be still, to trust and to accept that I can't control my situation, only respond to it. I plan to start a Caley blog once she's here. There will be so much more to write about....so many firsts. Thank you for sharing with us thus far. Peace.

Trusting Your Body

2008-01-30T15:15:00.001-07:00

The thing is, many of us trust our own bodies. We go through our lives and, unless, we have a sensation that isn't pleasant, we trust that everything is okay. My mission was to trust my body during this pregnancy. I felt that I was "fixed" with the septum resection surgery and I could do as most pregnant women do, that is, walk, practice yoga, do household chores, etc. I was mistaken. It's now been 3 months and I've been on bedrest or modified bedrest. Let me define this for all of you that are thinking, "That doesn't sound so bad." Modified Bedrest-Absolutely no exercise, not even gentle pre-natal yoga, little activity, no household chores, no unnecessary walking. The goal is to stay horizontal as much as possible. Bedrest-Laying horizontally in bed all day/night. Being completely dependent on your husband/partner, family and friends. Only leaving bed to use the bathroom. Now, for the anatomy lesson. Cervix: Bottom of the uterus. This is what dilates and effaces to allow the baby to pass through the birth canal. So, my cervix started funnelling and shortening 16 weeks into the pregnancy. My OB recommended a cervical cerclage. This is where they go in and place a suture around the cervix. Think about a bagel and putting a thick thread around the bagel to "lock" the center of the bagel together. With the pressure of the baby, the cervix dilates normally at the end stages of pregnancy. Mine was beginning to open very early, so the bedrest has helped. Anyone who is prescribed bedrest, begin to tap into your inner strength. Being still is probably the toughest thing to do for us westerners (meaning "Americans") but it can teach us so much about ourselves if we only let it. So, another lesson that God/the Universe is trying to teach me.

Making Amends

2007-11-25T19:33:00.000-07:00

So, I've finally gone to 2 baby showers recently. I couldn't bring myself to attend a few others I've been invited to in the past years, mostly because of self pity but also not really feeling the need to break down in a room full of mostly strangers. They were both for little girls. So much pink!! I realized that even though I don't subscribe to the "pink is for girls" and "blue is for boys" theory, it really does make sense. How else are people going to know what gender your baby with, generally speaking, no hair and no other identifying factors, is? An aha! moment. J and I go to ultrasound again on Wed. I'm counting every minute. 2 days before Thanksgiving is when we lost Luke last year and this pregnancy is exactly as far along as that one was. I haven't seen an ultrasound since week 12. I definitely feel pregnant, though. There has been some clumsiness that wasn't there before, a nice side effect from my ever expanding belly. I'm as sensitive as ever. Someone made a comment tonight about my growth spurt possibly being from eating too much over Thanksgiving. I'm thinking, "there is actually a human being growing inside of me!!" MEN. (Not my husband, thankfully. ;) I broke down the day before Thanksgiving. I was feeling fine one minute and then, all of a sudden, a wave of emotion came over me. It knocked me over and I realized that it was exactly one year ago that Luke had been removed from my body through a D and C. Waves of sadness, acceptance and gratitude rolled through me all at once. It was a cleansing time. Funny how our bodies remember when our minds do not (at least not at that moment). I'm hoping to get lucky and find out if it's pink or blue (hehe) on Wed. I'll have some sugar beforehand to ensure some movement, although with this one that's never been an issue. We have my parents, my mother-in-law and 21 yr. old brother-in-law, all coming with us to the appointment. I'm thinking of paying my lovely ultrasound tech, to give us her opinion, even though it's before the standard 20 week protocol. Only 3 weeks before, though. All the bits are in place, we just need him/her to hold a baddha konasana (yoga pose with outstretched legs) for a few seconds.

Explanation and Our Story

2007-10-13T12:31:00.001-06:00

I wanted to take a minute or 15 to talk about our story. I wanted to explain to those who have trouble understanding why it has been so difficult for me to carry a baby to term. Also, this is something that I needed to do. It just took me 2 1/2 years to get to this point. I guess I'm a slow learner. :) I wanted to do this because it takes a while to explain this and many times, in passing, I've had to explain to people that I had a smaller than normal uterus, which is true. There was not nearly as much space for a baby to grow and mature in my uterus as in a normal uterus. However, I've been met with some comments such as "I've never heard of that before", hence this explanation. These comments have been hurtful at times because when anyone is experiencing problems with fertility, it puts you at an extreme sensitivity. So, I've spent a lot of time at home over these past couple of years, needless to say. Also, let me add that the name of this blog is dedicated to a song by the Dixie Chicks about infertility. Both sisters endured it. When I was in utero (in my momma's belly!), something went wrong, not drastically wrong, I was still born with all fingers and toes, just a little wrong. The funny thing is, I wouldn't discover this until the age of 31 during a pregnancy ultrasound. In every female, ducts termed Mullerian ducts are present. These ducts go through a transformative process during gestation (in utero) in order to form the reproductive tract and organs. There are 11 different types of Mullerian Anomalies, or differences of the uterus. This doesn't include retroverted or tilted uteri, which are just differences in the positioning of the uterus in the body. Mullerian Anomalies are pretty rare and present in only 3% of women. My Mullerian ducts ended up not fusing together totally, which resulted in me being born with a septum in my uterus. A septum is best defined as a piece of tissue with no blood flow (avascular). Septate uterus have either a sub-septum which stretches across the inside of the top of the uterus and comes downard (fundus) or a complete septum which stretches across the top and then all the way down the middle of the uterus to the cervix, where the birth canal begins. Mine was a sub septum extending 2 cm. downward from the top. Septate uteri are associated with a very high miscarriage rate. The miscarriage rate is 80%-90%. This is because the fetus either implants on the septum and quickly miscarries early because there are no blood vessels to sustain the pregnancy. Or, due to intrauterine growth restriction meaning that the baby simply grows out of room to grow or the placenta attaches to the septum even if the baby implants away from the septum, thereby resulting in no nourishment from mother to baby and baby dying in utero. Normally, the uterus stretches like a balloon. When a septum is present, think of a balloon being attached to a piece of cardboard. Because the septum is fibrous and not stretchy, that part of the uterus cannot stretch to accomodate the growing baby as a normal uterus stretches. In the uterus, strong blood flow is invaluable. When a woman gets pregnant, there needs to be blood flow in order to nourish the baby's growth from the placenta. The placenta feeds the baby the nutrients in order for it to grow and go through the transformation process from a ball of cells to a baby. It's truly a miracle!! Jonathan and I had our first miscarriage at 6 weeks in July, 2005, due to the baby implanting on the septum, most likely. We became pregnant again in August, 2006. We were so excited. We were monitored closely because of the loss the year before. I was put on high dose progesterone. The side effects were fatigue and weight gain, fun for me while pregnant!! I found out at a 6 week ultrasound when we saw the baby's heartbeat for the first time, that I had what the ultrasound tech termed a "bicornuate" uterus. I had never heard of such a thing!! Basically, it looked like a heart shape instead of the normal pear shape, on ultrasound. I researched on the internet and found out about what could happen, but chose to believe that we'd be one of the lucky ones that goes close to full term. We went into the 12 wk. ultrasound and felt very confident because we saw our little guy kicking and waving. My parents were with us and it was a very special moment. I was told to take it easy, to not walk, do yoga or lift anything over 5 lbs. because the placenta had moved downward to avoid the septum. This is called placenta previa and it usually resolves itself in a normal uterus as the uterus stretches. I followed the doctor's orders and didn't do any activity. At 15 weeks along, almost into the 5th month, I felt like something was wrong. I won't go into the details. Jonathan and I went into the OB/GYN's office where the doctor examined me and said that everything seemed fine, but when she went to look for a heartbeat with the Doppler, she couldn't find it. She sent us in for an emergency ultrasound. I could tell immediately that something was horribly wrong by the look on the ultrasound tech's face. Our baby had passed away. We had to have a surgery to remove the baby. Fortunately, the funeral service nearby offered to cremate the ashes of the remains. We found out that our baby had been a boy. We named him Luke Donavan Irvin. Jonathan and I held a memorial service with our family. It was a very sad time. Losing a baby is something every mother worries about, but most times they don't have to go through the pain. It affected me for many months. I became depressed which is a natural process of grieving. I joined an online group of women all over the world who were going through the same experiences of dealing with a Mullerian Anomaly. We were referred to a reproductive endocrinologist. He performed an ultrasound and then an hsg, which is where dye is inserted into the uterus and through the fallopian tubes in order to see the shape of the uterine cavity. Let me say that most women would prefer a root canal to an hsg, it isn't pleasant. I was told by my RE that he though that my uterus was not bicornuate, but septate. Bicornuate is another Mullerian Anomaly that looks almost the same on ultrasounds, hsg's (x-rays with dye) and MRI, but the outcomes for pregnancy are drastically different. In a bicornuate uterus, the outside contour of the uterus has a cleft or indentation also resulting in less stretching of the uterus. These pregnancies either go into pre-term labor in the middle or third trimesters or they have to deliver between 32-26 weeks by c-section. I was asked if I wanted to have a surgery to remove the septum. Of course I replied an emphatic "YES"! This surgery was done by 2 doctors in my case. The first doctor goes in with a hysteroscope to look at the inside of the uterine cavity and the other doctor goes through the navel with a laparoscope to look at the outside contour. If there is a cleft on the outside, it is labeled as bicornuate and nothing can be done to fix it. If there is a septum present on the inside, the surgeon can then resect it, or try to fix it. In my case, this is when the diagnosis of "septate uterus" was 100% confirmed for the first time. CO2 gas is put inside the abdomen to inflate so the doctors can see and work. In my case, he used a cauterizing wand to remove the avascular tissue away from the top. The other doctor used a light shining through the outside so that my surgeon would know when to stop cutting so as not to create too much scar tissue or perforate the uterus. It is a surgery that you want to have done by a very skilled reproductive surgeon and one that many women with larger septums need to have done twice because of the limited time allowed for the CO2 gas to be in the body. I was put on high dose estrogen to help the scar heal smoothly so that if future pregnancies implanted in that part of the uterus, problems would be reduced. I won't go into the side effects from that, but let's just say it made me into a super b**tch!! Poor Jonathan. He has been such a trooper. I then had a follow up hsg wherein they insert dye into the uterus to look at the shape of the uterine cavity. We were nervous and holding hands, but once we saw the image of the screen, the heart shape was gone and it looked normal!!! The radiologist, reproductive surgeon and my OB/GYN all told me that the surgery was a success. We were told to begin trying to conceive again in 3 months. We were anxious and became pregnant just shy of the 3 month mark in June, 2007 but we lost this one just a week after finding out. This could have been due to normal process, perhaps chromosomal, or perhaps because the fetus tried to implant where the scar tissue was. I was devastated again, but my reproductive endocrinologist assured us that this was something that happens to 1 out of 4 pregnancies. The problem these days is that the pregnancy tests on the market let you know that you are pregnant days before you even miss your cycle. I am definitely on the impatient side, so I have found out with these tests as soon as possible. Many women have very early losses but never even know because they aren't testing early. Dr. Bachus (amazing doc!!) told us to wait a few months and try again. He also recommended grief therapy. So, I started seeing a grief therapist and it helped a lot. I met other women who have been through the same thing face to face. Many times, much worse than myself like having to experience stillbirths or their babies dying 3 days after the birth. We waited 2 months and are now pregnant again, almost to the end of the precarious first trimester. I have just graduated from my reproductive endocrinologist to a regular obstetric doc. We will need to have ultrasounds every 2 weeks to check my cervix and make sure that it isn't dilating too soon. Because of my surgery and having it manually dilated several times, I am at higher risk for incompetent cervix which, if it dilated too soon would result in pre-term labor, and possibly fetal death. If they find that it has begun to dilate, I will have a cerclage or stitch put in to try and hold it until I reach or get near to 38 weeks. Most likely, I will need to have a scheduled c-section because it puts me at risk to have strong contractions and I could never have pitocin, which is used to induce contractions during labor if it isn't moving quickly enough. I feel eternally grateful, firstly, to my husband for sticking by me this entire trying time and for being a rock, really really my rock. Secondly, to my mom and dad, mother-in-law, Phil, father-in-law, Greta and my sisters for offering a shoulder to cry on and words of encouragement. Then, to my doctors and therapists for helping us through this difficult situation. I also feel extremely lucky to be one of the ones who has made it through and has a great forecast. Let me add, too, that I won't be satisfied until I'm holding this baby in my arms. Then, the real worry starts, right!? But, I have a peace that has been developed through these difficult times that I can't control my situation, only respond to it. I also have been asked to be moderator of my online group of 500+ amazing women all over the world, which has been such a blessing. And, this pregnancy came about EXACTLY a year after the pregnancy with Luke. I feel that everything has come full circle, that God has granted me patience and that these circumstances needed to happen because there were invaluable life lessons contained therein. I only had to learn to accept them. I hope that you this sheds some light on our personal situation. Not only that, but I hope that there is some sensitivity to others going through infertility treatments or recurrent miscarriages. There are many many women out there that have these experiences. Thank you all sooooo very much for your support and taking the time to read this. Much love, Jessica