Thursday, February 23, 2012

Good News...I guess?

I just got back from my jam packed day with Dr. Stephenson. I really really hope this is the last of any testing or uterine procedures I have for a while. The lower half of my anatomy sure has been on a hell ride the last few years!
First on my plate was the hysteroscopy/biopsy where she got up close and personal in my uterus clicking away with her camera. I opted for no meds, since I had an ultrasound and follow up with her afterward and wanted to be coherent and not have to rely on my husband for all the details. I could only imagine what he'd tell me if that were the case!
Everything looked great. I had a small "bridge" as she called it where my septum was removed but its vascular and definitely nothing to remove during a surgery. Phew! Minimal scar tissue, large uterine cavity, and I do NOT have PCOS. I had plenty of follicles on both ovaries and a think uterine lining.
All of my blood work is normal. No blood clotting issues, no thyroid issues and everything looks great on paper. But we are still missing some pieces of the puzzle. She needs the chromosome / pathology results from the miscarriages. They just received them this week and will be sent to CA now. If there was clotting in the placentas then I will be on heparin and if not....well that means there is nothing medically wrong with me that I can't carry a baby full term. But that also means that there is nothing to change as far as a plan for me.
So here are my next steps:
Folic Acid 3xday
Baby Aspirin 81mg
Clomid 25 mg starting day 3 of my next period, which should be in two weeks from now. Go luck again...the only time I've ovulated on my own without meds in my entire reproductive career was yesterday..when I am benched from getting pregnant.
I'll go on day 10-12 of next cycle for a follicular ultrasound and follow up with her to get the results of those remaining tests. We will then discuss what will happen if I do get pregnant again. So I guess the good news is that so far there is nothing majorly wrong...but I can't stop from thinking, then why have I miscarried 3 times in a row? Why didn't they make it? I guess I may never know.
I need to get myself into a positive mind frame because I am scared.
I am scared to get pregnant again.

Tuesday, February 21, 2012

Testing, Testing, 1. 2. 3.

My initial consult with the "miscarriage whisperer" as she's been called in books was a few weeks ago.  I wanted to document some of the tests she is running on me and for reference to anyone else finding themselves in this position. I feel like every six months I go through test after test after test...
*Restesting Fetal Chromosomes.  I had my first and third miscarriage tested. I think for the second one I was in such shock that it happened again that I just had my husband take care of arrangements with the funeral home and didn't even think about testing. Anyways, they were not able to grow cells from either culture therefore no results were found. Hospitals keep tissue in wax blocks for 20 years. We are having those wax blocks extracted and sent to California to see if they can get DNA from the tissue. I am not holding my breath too long for these results as many times they still are not able to get results.  I will also be able to find out the genders of the babies so I know that's going to be a hard pill to swallow. I have my hunches so hopefully knowing if I was right will give me some closure. We'll see.
*She also wants to take a closer look if I really do have PCOS. I've retaken some hormone tests,  fasting insulin/glucose and will have an ultrasound of my ovaries on Thursday. She has taken me off the metformin too. The newest clincal research study just proved that Clomid is still the number one drug to induce she is taking me off metformin and I will be on Clomid once I can try to get pregnant again. It was hard for me to accept going off if since I don't ovulate without it...but man oh man did that drug make me sick for the past two years- so I don't miss that!
*Thyroid numbers.  She will treat a TSH number over 2.5 and my last two non-pregnant numbers were 3.08 and 2.8. The numbers climb higher during pregnancy so she wants to look closer at that.
*Re-testing all non-inherited blood clotting tests.
*Hysteroscope to look for scar tissue, infection and residual septum. And yes, I will be awake and watching with her.
*Endometrial Biopsy
I go Thursday for the hysteroscope/biopsy/ultrasound and follow up. Fun day, huh? I am anxious so send your prayers and good thoughts my way please. Just as my luck has gone these days the hospital where I had my D &C's screwed up and only sent out my slides to pathology...and never sent the wax blocks out for the DNA. So I won't have those results as they are just being sent now. Should have been done 4 weeks ago. I was so mad when I found out, but I guess at least they found them as many times they are lost. I am TRYING to stay positive in 2012...My luck has to change at some point!
I have been given the red light in trying to get pregnant until she has a plan for me. It's so hard having the red light! She has told me I will be on Clomid and I do know I will be monitored and followed very closely next pregnancy.  In the meantime I'd love to ask a certain Mr. Cruise if I could have his ultrasound machine on stand by for when the time comes...

Wednesday, February 15, 2012

My nightmare continued....

I hate that my story continues. I wish I could say that everything worked out fine. Its been a year and a half of tears, frustration and anxiety. Tears of sadness for everything I keep going through and tears when thanking God I have my daughter. I never thought it would be this hard...
Soon after my second miscarriage I had scheduled an appt. with Dr. L at the fertility clinic since "Dr. Bad Luck" ob/gyn thinks that two miscarriages in a row right at the second trimester is normal. Dr. L. said since all my tests came back normal for a second time the answer had to be my misshaped uterus and we had to take a closer look. A saline ultrasound revealed that I had a large septum down the center of my uterus. The good could be removed through surgery. If the baby implants on or too close to the septum there will be limited blood supply/nutrients and can cause miscarriage. The miscarriage rate with a septum is about 90% without surgery. After surgery it drops to less than 10%. I didn't have to think twice about it since FOR SURE this had to be the answer to my problem! I could have jumped on his lap and hugged the man. Finally someone told me I had something I could fix! Surgery went perfectly. I had a new roomy uterus and felt like the dark cloud over my head shifted out of the way just enough to let just a little sunlight through.
Two weeks post surgery I am in his office asking to for another saline ultrasound to have everything checked out. I was paranoid that he didn't get everything during the surgery (sometimes women need two surgeries to correct a septum). I had to make sure before I tried to get pregnant again. The ultasound tech said "he did too good of a job" your uterus is "perfect". I was ready to get pregant again...and five days later I did. Pregnancy #4...with a new outlook in the back of my head thinking...everything is fixed...I am fine. If only I had a crystal ball.

Back to Dr. Bad Luck's office I went and was allowed ultrasounds before every 2 week appointment to avoid the torture of having them put that dreaded dopplar on my stomach. I can't handle that anymore. Unless the baby is flipping around in my stomach the moment they are putting the wand to check for a heartbeat I don't want it done. I was armed this time with progesterone suppositories, metformin, baby aspirin and my Mom at every appointment so I wouldn't be alone. Things were going great. Strong heartbeats at every ultrasound and I was starting to show. And then it happened again. This time at my 13 week ultrasound and 3 days before Christmas.  The second she put it on my stomach I saw the tears well in the ultrasound tech's eyes as those dreaded words came out again..."I'm so sorry". I looked at my Mom and saw pure sadness. The baby wasn't moving and was curled up in a ball. How could this happen again? How could God do this to me again? I just saw the baby 13 days before and it was perfect. It was waving at me and had the most perfect little nose when looking at its profile.  I can still picture it perfectly in my mind. All the hope I had - gone in one short second.

Off I went for another D & C. I just absolutely could not believe it. Dr. Bad Luck had nothing to say, other than...try again and this time maybe I would be put on heparin injections since maybe I had some undetectable clotting disorder.  Three weeks later I sat across from Dr. L at the fertility center and he had nothing to say to me since he already fixed my uterus. I don't believe them. Something is causing this. The chances of miscarriage after 10 weeks is like less than 5% and I've just had my third in a row. And to top off my bad luck they couldn't grow cells on the fetus again for testing. Merry Christmas to me.

I can't sit back and do nothing. No one is going to take control of this situation but me. I have to do everything I can and then put it in God's hands. So I researched a ton and made an appt with Dr. Stephenson.  She is the director of the Recurrant Pregnancy Loss program at U of Chicago Hospital. I feel good about this. She has dedicated her life to research and helping patients like me - and there are very few doctors in the country that specialize in this. She was wonderful in my initial consult. Although she did say this is a tough case she is going to do everything she can to come up with a plan for me. She took 21 tubes of blood from me that day with more tests to come (I have my follow up next week and will talk about that in my next post). Whatever happens from this point forward I will know I am with the best Dr. and I have done everything I can. I have a wonderful husband, miracle daughter, 3 angels in heaven and supportive friends and family so I know I am not fighting this alone.
So what was supposed to be 3 easy steps as I wrote in my first post has taken me...oh I'd guess about 147 steps so far. Whatever it takes me I will do. Whatever tests and injections and plans are laid out for me I will get through. Afterall, I think it will be worth it...Don't you?

Thursday, February 9, 2012

My Blessing and My Nightmare...

Step 1 - Get Married
Step 2 - Get Pregnant
Step 3 - Have a baby and live happily ever after
Repeat steps 2 and 3
Sounds easy, right? Not so much for me.
When I completed "Step 1" in 2007 I never imagined my TTC journey would take me to where I'm at now - a spot in the "Recurrent Pregnancy Loss" Program with one of the top specialists in the country. I want to document for myself what I went through and where I will go on this journey. I find comfort and assurance in reading other's stories so I finally drummed up the courage to put my own out there.What a journey its been so far.  Here's where it all began...
My husband and I got married in fall of 2007 and I immediately stopped my birth control. I just had a feeling it wasn't going to be easy for me to get pregnant. I was right. Fast forward 9 months later and I still wasn't ovulating. 60 day cycles combined with a abnormally shaped uterus diagnosed after a HSG got me a ticket straight to Dr. L at the fertility center. Stress and anxiety towards getting pregnant immediately entered my life. I was diagnosed with mild PCOS and a temporary diagnosis of "bicornuate uterus"  after some preliminary tests. I was told if I did get pregnant I could be at risk for miscarriage or preterm labor.

It was my first IUI with a Clomid and Metformin mix that I became pregnant. Relief. Happiness. Nervousness. It was a textbook perfect pregnancy ending with a C Section and my beautiful daughter, Nora. 7lb. 8oz. You always hear people say they never thought they could love something so much, but its true. She is my blessing.

A little over a year later my husband and I decided to try for another, since of course in my head I already envisioned having trouble conceiving. I certainly have had my fill of trouble, but not in the way that I had originally thought.
Pregnancy #2 happened quickly, and I was only taking Metformin so I didn't need any interventions with Dr. L. I was nervous as usual, but things were progressing normally with great looking heartbeats and ultrasounds through 12 weeks. We stuck Nora in a Big Sister shirt and told all our family and friends. Everything was roses and daisies until I went in for my 16 week appt and they couldn't find a heartbeat on the dopplar. I immediately went into panic mode and they wisked me next door to the ultrasound room. She put the wand on my belly and immediately fell silent. It was like I was in a dream...totally removed from the situation and in disbelief as I sat and stared at the baby lying still on the screen. I was alone. I wanted to go home and hug Nora and never let her go. Questions came flooding out...why me? what happened? was it something I did? and to be honest one of my first reactions was, when can I get pregnant again? The baby stopped growing at close to 14 weeks and my Dr. recommended having an induction and delivery since once the fetus reaches a certain point, D & C's become more tricky and dangerous. My husband and I spent the night in the hospital and at 6:30 the next morning I delivered the baby. I didn't want to look, I didn't want to hold it. I just wanted it to be over.  When the priest came into bless the baby both he and the nurses repeatedly asked me if I was sure I didn't want to hold it. I insisted "no" because I just wanted to move on. They warned me that I may regret my decision later and they were right. I regret it. In hindsight I would have looked so that I would have the memory of our baby on that day.
Six weeks from then I met with my ob/gyn to discuss what happened. I will now refer to him as "Dr. Bad Luck" since seemed to be his answer for everything. Nothing came back abnormal on the pregnancy loss panel. Cells were not able to grow on the fetus for chromosome testing.  I was told it was a case of bad luck and to try again. Don't they know I am a planner? I like to have things planned and follow them. I like to know what's wrong so I can fix it. This was not in my plan! But I accepted it and thought that this surely couldn't happen again, right? Wrong again...

I became pregnant for the third time rather quickly again while on Metformin alone. This time I hid it, only telling my parents and a few best friends. I doubt those who saw me by 12 weeks were fooled, but I was scared to death to have to backtrack and face people if it happened again. We heard the heartbeat loud and clear at the 11 week appointment and when I went back at 13 weeks it was reliving my worst fears all over again. I was by myself  in the room with Dr. Bad Luck and they are having trouble finding a heartbeat. The ultrasound showed the baby stopped growing about 11 weeks. I was floored and shocked. I could NOT believe this was happening again. I sobbed on the phone with my best friend, in disbelief that I was going labor and delivery for a D & C. My husband then had to call his parents and tell them I was pregnant and that I miscarried all in one conversation. I was adamant about getting an answer. I made sure they ran every test and all were normal. No blood clotting issue, no autoimmune problems, normal karyotypes on me and my husband, nothing. I researched online and decided I couldn't sit back and let this keep happening. I made an appt back at the fertility center with Dr. L. What worked the first time with Nora could work again and maybe he could find an answer for me other than back luck. He wanted to take another look at my misshaped uterus. Was it bicornuate (cannot be corrected) or a septum (corrected via surgery)? He believed this was my problem and why I was miscarrying. Finally! An answer to my problem! This could maybe be fixed and all would work out! Or so I thought....