Our NIAW Pregnancy Announcement

So, at 15 weeks (with a belly measuring over a week ahead of that), it's getting ridiculous to expect that we'll be able to continue hiding the pregnancy for much longer. Therefore, despite learning about our most recent terrifying complication, we've gone forward with announcing our big news. We're kind of rolling it out in phases, especially since we're not terribly frequent users of Facebook, so we've been telling some of our nearest and dearest by email. It's better than carrier pigeon, I guess, plus it allows me to be as overly-detailed and wordy as I want! I kind of feel like a belly picture or ultrasound printout actually wouldn't be worth a thousand words in this case, know what I mean?

A few paragraphs from our email that touch on infertility awareness appear below. I started with a Very Short description of the events that led us here, and ended with what I hope didn't read as a heavy-handed public service announcement. Anyway, here is how we combined telling people about our bun in the oven with National Infertility Awareness Week:

...

...I wanted to tell you this story rather than just shouting from the rooftops "We're having a baby!" for a few reasons. First of all, infertility is pretty common. I hope that we have already soaked up all the bad mojo on your behalf, but in case we didn't, please know that you are not alone. Not every couple is made up of a man and a woman to begin with, and even that is no guarantee of success. Assisted Reproductive Technology (which is a huge, varied, and growing field) is becoming more and more accessible, particularly in states where it must be covered by insurance.

Also, I expect that many of us will become parents someday, and of course I hope that you find it an enjoyable process from start to finish! If this is the case, please, please, please do not forget that not everyone is so fortunate. Harry and I are so grateful that the technology for IVF exists, and that it worked for us on the very first try - in one sense, this makes us very lucky indeed. But there's nothing lucky about infertility overall, and the stigma attached to it is really unacceptable. We want you to know that we experienced this problem and this process, that we survived it together, and we want to thank you for the support you offered simply by being our friends during this time.

...

That last sentence goes double for you, fellow bloggers.

You've Got to Ac-Cen-Tchu-Ate... Oh, Shut Up.

I'm not feeling so great today.

I mean, I'm fine physically. My morning sickness is diminishing every day to the point where I routinely get hungry before I get nauseous. I'm tired, but no more so than usual. In terms of aches and pains, the biggest thing I have to complain about is a totally unrelated blister on my foot (darn you, cute shoes!) Honestly, if it weren't for the belly that's getting harder to cover up every day - and which I keep spilling soup on - it would be possible to actually forget that I'm pregnant. In fact, these past few days have been downright boring, symptom-wise. And boring is good, because boring is normal, normal is not traumatic, and not constantly experiencing traumatic events means that I have a fighting chance of getting back to the person I was before this whole crazy mess started.

Yesterday was a different story. It was far from the worst-case scenario, but the news of my placenta previa just kicked me right to the curb again. The pattern of my behavior is roughly: feel happy ---> see doctor/find out something is wrong with my body ---> plunge into crippling depression ---> over a long period of time, start gradually feeling better ---> feel happy ---> see doctor/find out something is wrong with my body ---> etc. This problem was greatly compounded during my IVF cycle by a negative experience with my egg retrieval procedure, which made me feel like the medical staff who were telling me all these bad things about my malfunctioning body were not in fact kind people who were doing their best to help me, but rather judgmental, heartless cogs in a reproductive endocrinology assembly line that was processing patients with approximately the same level of care that Henry Ford used on his Model Ts. (Okay, that was harsh. What I mean to say is, Henry Ford used way more care on his precious horseless carriages than I felt my RE's office did during my retrieval. I'm still really pissed that they took what was already a bad situation and made it worse, and no, obviously I have not gotten past it yet.) Everyone I interacted with yesterday was very kind, thorough, and optimistic that we will ultimately have a good outcome. That's wonderful, of course, although it also makes things a little harder to wrap my head around because when I look back at the totality of my experience since my diagnosis, there's no one villain that I can point to and say "You! This is your fault!" There's no mustache-twirling Giver of Infertility who I can fantasize about punching in the face. There's just bad luck, and good luck, and I have no way of predicting which one will finally tip the scale.

Anyway. I could start linking to a bunch of research I did yesterday about complete placenta previa and why I'm slightly mystified that my doctors are so pessimistic that mine won't clear up before delivery (many do! really! and they are quantified in peer-reviewed studies that are published in major medical journals!), but I think I'll save that for another day. My guess is that I'll start to feel better slowly over the next few days and weeks, right up until my next appointment can tell me that the baby is eating my lungs or shaped like a dragon or something else equally unpredictable and horrifying. We'll have to see.

Coming soon: My contribution to NIAW! Telling friends I'm pregnant! Maternity pants deliberately worn to a burger place for maximum food consumption!

Placenta Previa

Okay. Another appointment this morning yielded a ton of information. In the good column we have:

•  The baby is alive! 
•  And huge! Measuring 8 days farther along than average. 
•  S/he still has a terrifying face. 
•  One of the sub-chorionic hemorrhages is gone, and the other appears to be resolving. 

And, as always, the bad:

• The placenta is covering the cervical opening entirely (known as placenta previa), which will require close monitoring for second- and third-trimester bleeding, and probable early delivery.
• There's a small chance the placenta previa could resolve, but it's very unlikely in my case. 
• Even if I make it to term - or close to it - I'm definitely looking at a C-section delivery.

So, to sum it up, my message to the universe this morning is: what the f*cking f*ck. One step forward, two steps back. Oh, and in case you were wondering, it's a complete previa, meaning that the placenta is entirely covering the cervix and very unlikely to resolve as the uterus grows. (Often, women will be diagnosed with a partial placenta previa and as things get bigger, the placenta is naturally pulled upwards and away from the cervical opening so the problem is resolved. This is emphatically not what is happening in my uterus; near as we can tell - and yes, Mr. Wandy helped make this diagnosis so there were a total of two ultrasound angles and two MDs involved - my cervix is pretty much smack-dab in the middle of my placenta. Worst place it could be.) Now I'm wondering if the sub-chorionic hemorrhages and the placenta previa were all ultimately related to the problem the RE had with the angle of my uterus and finding the right catheter during the transfer, and the embryo implanting lower than it should have. And I'm also wondering if, by some miracle we do have a healthy baby at the end of all this, I'll have difficulty getting a sibling to implant in the future now that I'm almost certainly going to have a big ol' scar right across my uterus. Oh, and did I mention that placenta previa is associated with placenta accreta, where it grows too deeply into your uterus and they can't take it out and then you have to have a hysterectomy?!?


Anyway. Breathe. I probably should have waited to post this until I was a little calmer; the Maternal-Fetal Medicine doctor could tell that Harry and I were starting to lose it a little bit and he said at the end of our visit, "You're doing really well, you still get an A today." I appreciate his optimism, I really do. But there are days I just feel like taking to my bed (how convenient, since bedrest could easily be involved at some point in the not-so-distant future) and this is one of them. Still, let's focus on something positive: I will probably never hear somebody say "Well, Charlotte, it looks like you have a fourth-degree perineal tear from pushing this giant baby through your vagina!" And for that, and our healthy growing fetus, I am very grateful indeed.

Celebrity Pregnancy Watch Mini-Update

This is the last one, I swear...

Giuliana Rancic is totally going to have a baby! This news makes my Monday morning seem way better. The Rancics, who have struggled with infertility, loss after IVF, and breast cancer, are going to become parents via gestational carrier in the late summer. Can I get a HELL YEAH?!?

Celebrity Pregnancy Watch #MillionBajillion

There was a time, many years ago, when I thought becoming famous and having my picture in People magazine was a worthwhile goal. I even saw it as a kind of rite of passage - when I got older, and I could afford to buy platform shoes like the Spice Girls wore, I too would have a shot at that kind of fame.

As I got older, even though I remained an (ahem) avid consumer of celebrity news, I began to thank my lucky stars that I wasn't being followed by paparazzi every time I left the house. It's not that I often forget to brush my hair or get caught doing the walk of shame in a party dress in broad daylight, but I do like to hold on to a small amount of privacy. Especially when my belly is starting to swell into something that looks much more like a giant muffintop than a cute pregnant bump - I'm very, very glad that there are no photographers following me around to be part of a Bumpwatch! story.

So I have compassion for the celebrities who are pregnant now, in addition to a fascination with how these women are experiencing the same baffling and humbling gestational process that I'm going through. And now that we're getting to the point that a normal non-hemorrhaging expectant mother might announce her pregnancy, I think I've decided on my celebrity pregnancy twin. Let's run through the possible candidates first:

Drew Barrymore. An early frontrunner, but her ultrasound pictures in February indicated that she's probably much farther along than me. Still, I have to give it up for a fellow Saltine-lover.

Snooki. Also farther along than me, but I totally get where she's coming from in this tweet, plus I was wearing that exact outfit just yesterday!

Vanessa Lachey. May I present to you: Exhibit A, Mrs. Lachey enjoying a fresh 'n' tasty bag of Pirate's Booty. And, Exhibit B, my own nearly-identical bag of Pirate's Booty. She's definitely due earlier than me, but it's good to see that the 'Booty has such a following among pregnant ladies.

Tori Spelling. Yeah, no. As much as I enjoyed reading sTORI Telling (and I did, oh I did), she's on her fourth child and got pregnant a month after the birth of her youngest daughter. I think if I ever met her we'd have plenty to talk about, but bonding over similar conception stories is out.

Melissa Joan Hart. A late addition to the list, announcing her news just yesterday, I love seeing Clarissa so happy. But it will be her third child, so maybe we're not exactly on the same path in life (yet?)

Reese Witherspoon. Holy A-List, Batman! Reese was the frontrunner for a while because she appears to only be a few weeks farther along than me, there are whispers that this might not have been the easiest process for her, and - like me - she has yet to officially confirm her news with the world.

But the winner is...

Anna Paquin! She announced last night that she's having her first child with Stephen Moyer. If she's announcing now, she's probably due around when I am - maybe a little earlier than me, but I have this whole "you're likely to have an early delivery" thing that might even us out. Plus we have so much in common - she was born in Canada and I have visited Canada, and she won an Oscar and I frequently watch the Oscars ceremony on TV. But! This will be her first child, and she's exactly my age, so I think I'm ready to declare victory here. Anna, if you ever read this, a million congratulations! Let me know when you want to set up a Skype date for mocktails and bump comparisons. May your pregnancy be less eventful than mine, and I can't wait to see your shockingly beautiful baby join the world.

Finally - if you are a pregnant celebrity and I've left you off this list, my deepest apologies. And if you are a celebrity who is due in mid-late October and has managed to stay out of the news cycle so far, congratulations to you as well!

Nice Melons!

Why yes, I did wait to write this post until melons 

were on sale at the supermarket.

So, I  have never been what you would describe as a very voluptuous lady. I started wearing bras far before I actually needed them and dreamed throughout my formative years of someday filling out a B cup. I made it to this goal in my early twenties through perseverance and hard work, but then... I got pregnant.

And 'twas only then, with a bit of help from a torrent of hormones, that I got the boobs of my dreams. (No surgery required! Okay, well, actually, some surgery required. Just not the kind I used to watch on MTV's "True Life: I'm Getting Breast Implants" when I was a teenager.) What once were modest Bs are now full Cs and well on their way to Ds. I'm down to one bra that "fits." I may, very soon, be able to have actual cleavage. I know, I couldn't believe it either. Mammary glands fulfilling their biological purpose FTW!

The only wrinkle is that my tatas are starting to give me away. I saw a friend over the weekend who had seen me last in January, and about five minutes into our conversation, she said - and this is verbatim - "So are we supposed to pretend your boobs aren't twice their usual size?" I guess this whole hiding-the-pregnancy thing is getting more desperate than I thought. (For the record, I mumbled back something about a new bra and she totally didn't buy it, but hopefully I'll be able to announce everything officially after my next ultrasound in a week and a half and feel like less of a liar.)

In the meantime, I'm really enjoying my new rack. And I'm immortalizing this feeling now so that in several months, or years, when my breasts are deflated and wrinkled, I remember those few glorious days of pregnancy when my biggest problem was the size of my knockers. If only it were like this all the time!

Pants, Puking, and Prayers

Pants
They aren't fitting too well anymore. I'm down to one pair of jeans (besides my PajamaJeans™ - no judging) and ~3 pairs of work pants. I have a few skirts that still fit, but I think I'm hiding the bump better in pants because everybody is distracted by my belt buckle and loose shirt and the sweater or jacket I'm wearing over it. That is, assuming I've eaten recently; first thing in the morning they zip up pretty well but then once I have a meal in my belly they are noticeably tighter. I suppose I could just not eat and hang onto my current wardrobe for a little while longer, but that would kind of defeat the purpose of this whole endeavor, right? I have told myself I won't buy any maternity clothes until we get a good report at my next appointment on April 25th, so we'll see how this goes.

Puking
I am pleased to report that the month of April has remained puke-free, knock on wood. However, I came about as close as I ever do on Saturday night driving back from Titanic 3D. (Again - stop it with the judging!) I was fine right up until we got in the car and then a wave of nausea hit me with about the same force as the iceberg that caused the actual ship to sink. I was going down by the head and fast, and I have no idea how I kept up the pretense that everything was fine until we said goodbye to our friends and got home. Eventually the feeling passed, but damn, this morning sickness thing is not over yet by a long shot. Overall I'm still feeling much better than I did earlier in the pregnancy, however, so I'm very grateful for that.

Prayers
Not for me (although positive vibes sent across the astral plane are always welcome and will be returned, I promise!) For several months now I've been following the story of Mare and Reid's quadruplets on her blog "Never A Dull Moment." And I have been devastated beyond words by her most recent updates - after a complicated early delivery, she has lost three daughters in recent days. I am sending prayers to every deity I can think of, and then some, for her and her family. I wish there were more I could do to help.

SCH: The Truth Is Out There

No real updates since my last post - the old brown bleeding has slowed down considerably over the past few days, and I have no idea if that's a good sign or a bad sign. But I'm not having strong cramps and heavy red bleeding (knock on wood), so I have to assume that everything is still proceeding as planned.

However. Remember when I said I wasn't going to look up statistics for miscarriage after sub-chorionic hemorrhage? I've kept that promise pretty well, but I did start asking Dr. Google more questions about why these hemorrhages happen in the first place. I understand that none of the doctors and nurses I've spoken with care about the reason because they just want to see what happens next, but now that I have a second hemorrhage, I kind of want to get to the bottom of this. I mean, everything has to have a cause even if we don't know it yet, right? The problem is that there are a ton of possible causes, and they might all be complicating factors, or it might be something I haven't thought of yet. Without further ado, here are the theories I'm considering so far:

- Clotting issues, part 1. I did have that DVT during my two-week wait, and even though my bloodwork came back with no genetic predispositions for blood clotting issues, maybe I do have some as-yet-undiagnosed problem that led to tiny clots in the uterine blood supply that somehow created the bleeds. I should probably go back on the Lovenox ASAP to help resolve the existing bleeds and prevent any others from occurring.

- Clotting issues, part 2. The first bleed (the biggest and scariest) happened while I was on the Lovenox. So maybe I never had a clotting issue in the first place, and being on a blood thinner disrupted the uterine blood supply so it bled and bled and bled in a random weak spot. I should definitely stay off the Lovenox until these hemorrhages have resolved, and talk seriously with my doctors about whether it makes sense to go back on it at all.

- Pregnancy after IVF. There's some talk that SCH might be related to embryo implantation, and of course when you get pregnant using IVF, the embryo is transferred back into your uterus with a catheter rather than traveling down a Fallopian tube and then choosing the exact perfect spot to implant. Perhaps it implanted in a bad spot after transfer, and that caused the bleeding several months later? Doesn't explain the second bleed, however.

- Retroverted uterus. I've been told repeatedly by gynecologists over the years that my uterus is seriously retroverted, or flipped backwards from those textbook pictures you always see. As late as March 28, the ultrasound tech mentioned how far back it was. On March 30 I spotted briefly, and the next morning I was idly rubbing my hand over my belly and realized that I could really feel my uterus in a way I hadn't before. Sure enough, on April 5 I was told that it was no longer retroverted - it "stood up" sometime in the past few days, which tends to happen between the 10th-12th week of pregnancy - and I had a second SCH. It's possible that the action of the expanding uterus switching position put enough stress on the blood vessels that the new, smaller, nearly asymptomatic hemorrhage formed.

- The Cigarette-Smoking Man. It's all a conspiracy, you guys! I mean, our baby does bear a certain resemblance to an alien...

Scan: One Healthy Baby, now with Extra Hemorrhages!

Another week, another high-resolution ultrasound. First, the good news: despite hanging on to those adorable (?) alien facial features, our baby looks great. S/he is 55mm long from crown to rump and has a lovely fluttering heartbeat. This was the clearest scan yet, and we were able to see all sorts of details like fingers and toes and a reassuringly normal nuchal space. Our odds for both Down's Syndrome and Trisomy 18 are nice and low, which is a big relief.

However. It seems that whenever I write about this pregnancy I have to add an addendum of not-so-good news, and today is no exception. We saw the sub-chorionic hemorrhage from March 20th and it's getting smaller - great! And then the sonographer moved the wand over to a different part of my belly and... wait, what's that? Could it be? Why, it's ANOTHER HEMORRHAGE! Ding ding ding! Folks, tell the lady what she's won!

Yup, there's another sub-chorionic hemorrhage, on the small side size-wise, but this time it is behind the placenta. It was probably the source of the spotting I had last Friday, which makes some sense, and there's no indication that it consists of anything besides old and clotted blood, so it probably stopped pretty soon after it began. It could be related to the original hemorrhage, but it might not be, and nobody seems to be terribly curious about why this keeps happening. They just keep saying that it will probably work out fine, but blood is an irritant so as long as it's in there it puts me at higher risk for miscarriage, etc. It's particularly deflating because every day I'm passing a significant amount of what are probably the grossest brown clots that I've ever seen emerge from my personal region, so I was all set to go in today and have them say "Wow, looks like you're really getting rid of this thing!" and I would blush modestly and say, "Well, you know, my uterus just knows what it wants" and everything would be happy and we could start telling people and tra la la.

Now, dear Internet, you remain on a very short list of people and places where I will (anonymously) discuss my pregnancy. The big extended-family holiday gathering we're having this weekend? Deflect all questions. The four "glasses" of wine I'll be expected to enjoy as part of our Seder? I'll have to switch my goblet with Harry's halfway through the meal. The friends who are going to come with me to see Titanic 3D in the theater? Distracted by my baggy coat, we hope! Oh well. I always thought it would be kind of badass to just announce a pregnancy at like 5 months along and impress everyone with our secret-keeping abilities, and now we may get the chance to do just that.

Today, it is April 1st

Yeah, yeah, April Fool's Day, I know. But April 1 is also the day I had circled on my mental calendar as THE day, the magical far-away day, that I wouldn't feel sick anymore. By April 1, I would be frolicking in a blooming early-spring garden and enjoying the warmth of the sun on my bare skin. And I would eat, and eat, and eat, like a normal person.

Well, the weather didn't cooperate (the high temperature topped out around 50 and it's been spitting rain on and off), but I was right about one thing: my morning sickness is going away. I didn't wake up one morning to find it had magically disappeared, like some people had told me it would, but it gradually lessened over the past week and then on Friday I woke up feeling strangely... normal. I was still nauseous because my stomach was empty, but it was nowhere as debilitating as it has been. I got up and got dressed and went downstairs and felt better as soon as I had eaten my bowl of cereal. I did not require a 30-minute psych-up break on the couch where I listened to my workout mix to convince myself that I could do this before choking down a piece of toast and heading off to work. Instead, my Friday morning was about as exciting as Rebecca Black's, except that I got to ride in the front seat because, dude, I have my own car!

I've continued to feel sick first thing in the morning or anytime my stomach is empty, but all I have to do is eat, and then it goes away. And oh, how I have eaten. I want you to read this next sentence very carefully, because it seems unbelievable at first glance: this morning I went to Indian buffet for brunch. Do you know what's served at an Indian buffet? Food that has been prepared with spices. Food that is creamy. Food that is not just avocadoes. I ate an entire plate, and then I went back for a second one. And totally finished that too. Harry looked at me and said, "Well, I guess I have my wife back." And in between mouthfuls of saag paneer and mango pickle, I mumbled back "Looks like it." (Oh! And I also tried some of the cilantro that was used as a garnish; sorry, everybody, it still tastes like bitter soap to me.)

So that's the good news. For those of you keeping track at home, I first experienced "true" morning sickness at 5w6d and felt it ease up enough to eat normally at 11w1d. Fingers crossed that this pregnancy continues, and I'll write again when it truly disappears.

Which reminds me... with regard to the sub-chorionic hemorrhage thing, we had a bit of a setback on Friday night when I discovered I was having some pinkish-brown spotting. I have passed a bit of brown clotted blood since the initial bleed, but this was different. Naturally, I was entirely calm and didn't let it worry me. (Ha! That's a lie. Harry and I totally freaked out and I immediately lay down on the couch and tried to move around as little as possible and started Googling statistics and symptoms of miscarriage after SCH.) It stopped as quickly as it began, but I've noticed a big uptick in the amount of nasty, brown, clotted old blood that has been coming out ever since. I have to imagine that's good because it means the initial hemorrhage is getting smaller (right, body? can you do me a solid on this one and help me get rid of this thing?) but we won't know for sure until my next ultrasound on Thursday. Hopefully everything will stay quiet till then.

Oh, and to Allie, who started her IVF journey almost exactly when I did: a million congratulations and best wishes! Hooray!