Friday, December 28, 2012

felt like home

I am only being semi-dramatic in saying that, but, seriously, the OB MBL and I met with yesterday was awesome. I haven't shared a whole lot (yet) on here about our birth plans, but basically I made the crazy decision to have our baby near where my parents' live. This decision was made after realizing that MBL may not be able to be around as much as he was after Piper was born and, if I have another c-section, I will need some serious help taking care of Piper (and the new baby). My sister lives close to us, but has three precious kiddos of her own and she is the only family nearby. So, after looking at the hospitals near my parents and realizing how awesome it would be to have two extra adults to help me, we decided to deliver near them.

It's a great plan, but it means that I need to establish care with an OB near them so that I actually know someone in the area capable of delivering my baby. So, I did some goo.gling and discovered there was a practice in the area that does a great job of supporting VBACs. I made an appointment so we could meet with them over Christmas break and that's exactly what we did yesterday. It's a practice that has both OBs and Midwives and they explained to me on the phone that the first appointment is always with a midwife and any following appointments will either be with the rotation of midwives or OBs (whomever I choose to see). The midwife was incredible. She was attentive and funny and so personable! When I explained to her my low fluid she listened carefully and even offered to make sure my bag of waters hadn't ruptured, but she added, "It means having to stick a speculum up your hoo-ha which isn't much fun at 20 weeks." As soon as she said the term "hoo-ha" I knew I had found the right practice. And, so, as dramatic as it sounds, going there felt like going home meaning that it feels like the right place to be receiving care. When MBL was teasing me about using my doppler and getting easily scared about something going wrong, the midwife assured me that the last thing they want is for me to be scared about anything, so they want me to call if I ever have any concerns. Music to an infertiles/scared preggo's ears!! The great thing is that all of their VBAC practices are perfectly in line with what I am looking for and I just really feel that they will be able to offer me the delivery I want. Oh, and I promise I will be talking about that very soon!

Now on to even better stuff... Today MBL and I got to see baby boy again. Due to the fact that we were out of town at 20 weeks, my doc went ahead and gave me an order to have an ultrasound done wherever I could get in. It just so happened that the MFM department of the local hospital could squeeze me in today. And, as a bonus, they not only checked my fluid level (the real reason for the scan), but gave me a full level II scan! It was done by both a tech and the doc and it was probably the most thorough ultrasound I've ever received. We told her that we were originally sent for the scan due to fluid and after 10 or so minutes she told me that even though she hadn't done the official measurement yet, she could tell that I did not have low fluid. She said my fluid looked normal today! And, after getting a lot of the images and measurements she needed, she finally took the official AFI and it was 11cm!!! I really wanted to see the number be above 10 and it was!! I actually started to cry. I have been drinking a gallon of water a day, so it was definitely nice to see some improvement. When the doc came in and looked at my fluid he said it looked great and that really true AFI measurements can't be done until after 20 weeks. He also said that it can be difficult to get a good measurement when there is (my) bowel in the way, which there was today and during my two scans with my OB. He basically released me from having to see him again and said I should have an uneventful pregnancy. Considering this guy is the go to guy for high risk pregnancies, I'm inclinded to trust what he has to say. I'm still going to stick with drinking a gallon of water a day and I still want my OB to follow up with me until at least 28 weeks, but all in all I'm going to relax again. I'm even going to start running again (but I'm going to make myself drink 2 extra 20 ounces water bottles after those workouts). We are so thankful for this news!

Have you ever had that a-ha moment when you met the "right" doctor? Do you feel like you receive good or superior medical care? What makes you feel that way?

Friday, December 21, 2012

shoe drop-part two

I left off with an appointment on Monday to speak with the doctor and verify my fluid levels. Basically I just wanted to hear whether or not my baby was going to be crushed to death by my lack of fluid and if I needed to go on strict bed rest. I was also thinking I might be able to find out that all the water chugging I did actually made a difference. Well, my doc was running behind and we didn't get called back for our appointment until AN HOUR after it was scheduled! Then we had to wait another 20 minutes for him to actually come in the room. Piper had been amazing this whole time. She spent some time looking at the tree in their lobby, sitting on my lap playing with my phone, and just goofing around. By the time we got to the room, I could tell she was getting restless and by the time the doc came in, she was in meltdown mode. I mean, who could blame her? I was about to meltdown. It was dinnertime, we had been there for an hour and a half, and there's only so much available for entertainment at a doctor's office. We spoke with the doctor and for whatever reason he thought I was worried about the heart. I guess they couldn't get a good visualization of the baby's heart, so it was in the report that they needed to recheck it. He was trying to assure me that everything looked good, but they would probably just want to do a level II to fully visual the heart. I finally stopped him and said, "Look, I'm not worried about the heart. I saw all four chambers, it looked good. What I AM worried about is my fluid level. I want to know more about that." And finally he realized why I was there.

He looked at the report and said something along the lines of how it was low but not too bad and they see that all the time. Now, I knew from my research that my level was not "normal". It was low. Not critical, but definitely something they needed to pay attention to. I explained to him that I was scared and that I wanted to make sure my baby was ok. He then agreed to recheck my levels right then. Over to the ultrasound machine we went. Baby was moving all over when we saw him, which was actually a relief because I thought I had been feeling him all day, but didn't want to say for sure. The doc then began measuring the pockets of fluid and explained that if he saw one greater than 5cm, he wouldn't need to measure any more. We saw 3, 2, 2, 2. 9cm. The same as it was a week earlier. At least it hadn't gone down, but this meant that it wasn't a one time occurrence, this meant that I actually did have low fluid. The doctor said it wasn't critical, but that I would need to be rechecked every few weeks. He shook our hands and showed us the door. I didn't get ANY of my questions answered. At that point Piper had had it. She was fussing and squirming and the doctor was rounding out the end of his day. I tried not to cry as we made our next appointment. The receptionist informed me that she couldn't get me in for 3.5 weeks even though the sheet said 2-3. I tried not to panic on the drive home and I tried not to lose it when I started googling "low amniotic fluid 19 weeks". I talked to my mom and tried to figure out what I should realistically be doing or not doing. It's hard to figure out the balance between how much I should freak out and what I can do to help the situation. My mom was a great person for that. She told me that I should be freaking out--being in the 5th percentile is not good. BUT, she also said that there are things I can be doing which will hopefully help the situation. She told me to sit as much as possible and rest up. She told me to ask for help when I need it. She also told me that I did not need to call a perinatologist, but that it did seem like my doc was open to monitoring me closely (plus I'll be seeing a different OB next week--part of another story). I feel like I needed permission to sit on my butt and rest up. I also felt like I needed permission to relax and take it easy. My mom gave me that. She also helped assure me that although my situation is not the best, it's also not the worst either.

So, there you have it. I can relax now because the other shoe has dropped. It's almost a relief because I know what caused it. I have low fluid and will need to be closely monitored for the next 20 weeks. I will need to pray daily that I'm able to keep this little man cooking until at least 36 weeks. And, even better, I can pray that I'm able to get my fluid up to the normal range and can still go for a VBAC. I've been drinking a minimum of a gallon a day since Monday and also trying some other tricks (baths, laying on my left side, upping my protein). Here's hoping I get good news next week!

Have you ever experienced a complication while pregnant? How did you deal with it?

Thursday, December 20, 2012

my shoe drop-part one

When you get pregnant after infertility/loss/ART you tend to feel like you are always expecting the other shoe to drop. Always holding your breath waiting to see if the news from the next phone call or appointment will be positive or negative. I spent my entire pregnancy with Piper waiting for the other shoe to drop. I held my breath between betas and then I held my breath between ultrasounds. I kept telling myself I would just hold my breath a little longer... Until 15 week, until 18 weeks, until 24 weeks. I basically had a countdown in my head at all times of how much longer I needed to stay pregnant in order for her to be OK. And the funny thing is NOTHING ever went wrong. But, I managed to rob myself of ever really enjoying my pregnancy. Even as I sat in a labor and delivery room, strapped to monitors, with a baby bassinet in view, I just could not imagine the reality of getting to bring a baby home. I ended up with post partum anxiety because of it. I had never really mentally prepared myself for a real live newborn in my house and, in the end, that's exactly what I got. It was all very alarming.

Fast forward to this pregnancy and, in light of what happened with Piper's pregnancy, I vowed to ENJOY this one. To enjoy every little milestone. One good beta? AWESOME! Another good beta? GREAT! Heartbeat? WOOHOO! A baby with limbs? YES! Negative first and second trimester screens? JACKPOT! Gender scan? IT'S A BOY, YAY! I even kept up running. I had to give it up a bit in October, but that was more because all I wanted to do after work was sit on the couch and try not to feel nauseous. I ran two 5ks (at 8 and 15 weeks) and even managed to only drop a minute off my PR. I was maintaining 15 mile weeks and feeling good about how chill I was being about everything. Somehow, I was enjoying my pregnancy! And I had even managed to accept that I would be bringing home a new baby in May. I was so blissed out on my pregnancy happiness that I didn't even give a second thought to my anatomy scan at my doctor's office. I had, after all, just had a private scan to look at the gender 2.5 weeks prior and everything looked great, so why should I worry? And then the other shoe dropped. Or maybe it just tumbled. Either way, it fell.

The tech starts the ultrasound and is measuring everything, telling us what she sees (spine, femur, heart, brain, and then I start to notice something. My baby, my boy looks way more squished that I am used to seeing. Instead of seeing a sweet little profile shot, I see that my placenta is basically touching his nose and the bottom of my uterus is simultaneously touching his back. MY BABY IS SQUISHED! So, I ask the tech if he looks more squished than normal and in normal tech avoidance, she says, "Well, I've definitely seen baby's that are more squished." And then I start to panic. She has basically confirmed that he IS squished. I try to ask more questions, clearly making her uncomfortable, but I NEED to know why things look the way they do. I watch her measure quadrants of fluid and I try to keep track of the numbers, but I don't know what they mean. I ask her what low fluid means and she says it could be something with the baby's kidneys or bladder. She said she'll look to see if he has fluid in his stomach and bladder which would show that those organs are functioning. She looks at them, but doesn't say anything. At this point I'm almost in tears, terrified at what is going on. I keep asking her if she saw anything in his kidneys and she tells me it's more important for there to be something in his bladder. I press her to tell me what she saw and after assuring her I just want to make sure my baby is okay, she tells me that, yes, he does have fluid in his bladder. Phew. Still, the pictures she prints out confirm that this little boy, MY little boy does not have the "right" amount of fluid around him. I tell the tech how worried I am and ask her for more information, which she refuses to give me, and instead just says that if she saw anything concerning/dangerous she would have called the doctor in. She also says that they will probably follow up with me and have me come in for another ultrasound.

We leave. I sit quietly in the car and then I start madly goo.gling "low amniotic fluid, 18 weeks". It's not good. When we get back to our condo I hop on the laptop and do more goo.gling. I knew that I saw the number 8 on the screen at one point when she was looking at my fluid, so with that in mind, I am able to calm down a little. I read that 8 is not good, but it's not super dangerous, either. And, really, without solid data as to what the tech saw, I can't properly look up information. I call the doc's office every day until I am able to get the results from the nurse. On Thursday. At 5:30pm. She tells me that my amniotic fluid is fine. I ask for the number--93. I then ask for the range for normal--87-202. So, barely normal. She said it's nothing and the doc can go over my ultrasound in more detail at my next prenatal visit in 3.5 weeks. Um, no. I schedule an appointment to meet with him Monday, hoping that the low fluid was a fluke. Praying that after a week of no running and good hydration it will be well into the normal range.

I'll end there for now. I'll have part two up tomorrow.

Monday, December 17, 2012

my gift to the world

Last week I had the incredible privilege of attending a 3 day conference/retreat. It was an awesome experience and I feel so lucky that not only was my current employer willing to send me (without having to take personal time), but my former employer (the host of the conference) paid for the conference AND paid me to attend. But, money was not really my main motivator. I went because after reading the brochure, I knew I NEEDED to go. My job now is very stressful and it would be so easy to get burnt out and forget why I started doing what I'm doing. Well, the conference delivered in a big way and I let KNOWING that I'm not only in the right field, but that I'm deeply interested in figuring out how to continue some sort of part time work after this baby is born.

But, that's not really what this post is about. Twice each day at the conference we were asked to come sit in a giant circle and share a little about ourselves. On the second day, we were instructed to bring in a token that represents our gift to the world. I felt very overwhelmed by this task at first as I don't feel like I've given a whole lot to this world. I mean, I'm just one person in one small area of the country. I try to do good each and every day, but I know that I'm not making global impact with my work. And then it occurred to me, there is something little I can each day that makes a big difference for this world and just so happens to tie in nicely to what I do on a daily basis. So, this is what I brought in to symbolize my gift to the world:

I may not be able to impact the whole world, but I can certainly impact my little corner of it. I explained to the group that my gift to the world is being a good, kind, and patient mama. My gift to the world is being someone my children can look up to, someone who takes care of the ill and suffering, and offers a lending hand to those who need it most. The way I can impact the world the most is just by raising my kids to be good, kind, caring people who try their best. And in order to teach them those skills, I need to model that kind of behavior. My biggest struggle with where we currently live is that all too often I see parents who treat their kids as if they are the world's biggest inconvenience. I see parents hit and scream and belittle their children. I see parents who are not invested in how their children are doing in school or how they can help them reach their full potential. I work with kids who have parents who are the very definition of selfish, putting their addictions and desires ahead of the well-being of their children. It makes my skin crawl. I can't make these parents change, but what I can do is make sure that I am intentional with how I treat my children. Make sure that I am intentional in how I discipline my children. Now, I'm not going to let Piper or her brother get away with naughty behavior, but I can teach them right and wrong without raising my hand or my voice (we use Love & Logic). I may not be able to change the people around me, but I can still make an impact by being cognizant of the impact I am making at home. And that is quite powerful.

I have been meaning to write this post since last Thursday when I had that experience at my conference, but it seems all the more important now considering everything that happened on Friday. I cannot end the grief for the families out there and I cannot make sense of the senselessness of what happened, but what I can do is love the child(ren) I have been given. I can do my best to be intentional about the time I have with them. And I can shower them with a million smooches just so they know that they are loved and treasured. I picked Piper up more times this weekend than I can count and gave her so many kisses that she started telling me, "Mommy, no." It's always felt important to me to let Piper know that she is a great treasure, but it seems a little extra important now.

What do you consider your gift to the world? How have you been feeling/coping the past few days?

Sunday, December 2, 2012

still infertile

After I wrote my last post, I took some time to reflect on where I am on this infertility journey. I looked at the tickers at the top of my blog page and my heart both beams with excitement over how things worked out and, yet, still feels sadness for everyone out there who hasn't been as lucky.

I really wanted to have my babies 2 years or less apart and I can't believe that it's actually going to happen. Because this is a natural pregnancy, I find myself forgetting everything we went through already this year. We started back with our RE last December because we knew that we didn't have time to waste (both for spacing reasons and because of my less than stellar AMH results). We went through 2 IUIs and a full IVF. Heartbreaking BFNs. Then we took some time off and focused on getting healthier. We decided to go with CC.RM and flew out there in August, only to come back and get pregnant on our own!! We were looking at the budget busting, soul-crushing cycle cost of $16,000 and that's WITHOUT meds. When we got our BFP, I was more relieved over the fact that it meant we might actually be able to save money. (Because who knew that TTC meant forking over thousands of dollars).

Getting pregnant on our own, felt to me, like we had dodged a great big bullet. You see, MBL lost his job in May and I've been the sole income earner since then and I don't make a lot of money. And we own two homes (a house and a townhome). And, the reality is that IVF is expensive. So, even though we went to CC.RM and began discussing potential cycles and protocols, I knew in the back of my head that we might not be able to cycle again this year. And, in the way back of my head, I was slowly preparing myself for the fact that my children might be 3 or more years apart. With financial resources as tight as they are/were, I knew there was little chance that we would be able to afford the $16,000 price tag of a CC.RM cycle easily, especially when you factor in travel costs. And I was beginning to come to terms with the fact that the mere cost of TTC might keep me from being able to realize my dream and hope for my family that my children would be close in age. And even though we have the most precious one year old and I knew that no matter what we would one day have more children running around, coming to terms with the fact that IF was keeping me from what I wanted for my family was really difficult.

Then I got a line and another line and positive betas and good ultrasounds and, somehow, I've made it to nearly 17 weeks. 3 more weeks and I'll be halfway. 7 more weeks and we'll be at viability. 20 more weeks and I'll be full term. Tomorrow is December, which means that there are only 5 more months separating me from my due date. I'm still as nervous as ever that something might go wrong, especially because this seems like an easily won pregnancy, but I try to remind myself that the chance of anything going wrong at this point is 0.5%. I'll probably be scared until my ticker says 34 weeks. And then I'll hold off getting scared again until it's delivery time. That's what I've gotten from going through infertility and knowing how fragile everything is.

As a side note, despite the fact that I sometimes joke with my family that this is our "free" baby, it's really anything but. I calculated it one day and we've actually spent at least $18,000 on fertility treatments this year. The good news is that we're looking at a really nice refund check. The bad news is that after spending all that money, it's good old se.x that got me pregnant! HA!

What are your family building dreams? Do you have an idea of what ideal spacing would be for your family? Anybody else want to share their medical bill total for the year?