I had the appt scheduled for June 9th for my consult with the MFM specialists. Well, wouldn�t you know, two days before my appt, the drs office calls and says they have to cancel my appt with the specialists on Thursday! ARGH! I made this appt at least a month ago, and I have no idea when they will be able to give me a new appt---they said they have to �work on it and call back�. This was the appt when they are supposed to give us the Official Final Results of all our testing, both on Lucas and on me. They are also supposed to help us come up with a Plan of Action, since I have made it very clear to them that I DO want more children (and sooner rather than later). They said the dr had a meeting and had to rearrange her schedule---which meant my appt was cancelled.
I was NOT happy about my appt being cancelled, to say the least! I also had to tell my friend that she does not need to watch my kids Thursday morning, but I hope she can still do it whenever we might get a new appointment---and since we don�t know when that is going to be, I don�t know if she can help me out or not!
I called the next day to find out what they could arrange for me---June 21st was the next available appt, but I could not take it. My kids were having end of school special activities and I could not justify making them miss school because my friend could not take care of them that morning and put them on the bus for me, etc. So I had to wait until June 24th for my consult. You do what you got to do!
During this waiting time, the genetic counselor called me to tell me that the chromosome tests were done. They did not find anything wrong with Lucas! I suspected that, but it was great to hear them say it! Then later she called to tell me that my chromosome tests came back normal too! That was great news too!
June 24th, I went for my appt with the specialists---it went very well. The genetics counselor came in first (with a med student in tow, which was fine with us). We already knew that the chromosome tests for both me and Lucas had come back normal. We showed her Lucas� photo album, and talked about his birth. I cried some too, and the med student kindly produced a box of tissues. :)
Then Dr Baker came in---she is the perinatologist and the senior dr of the high-risk team. She remembered us from our pregnancy with Eric (7 yrs ago!), and asked how he was. :)
She had previously reviewed all our medical reports and test results, and she said her conclusion was that Lucas�s death was indeed from the true knot in his umbilical cord! We asked about the placenta report, and she said that she had read it and was not concerned about the condition of the placenta---the small area of hyper-maturity she believes IS related to the back-up of blood flow due to the cord knot. Is she 100% sure of this? Maybe not 100%, but pretty darn close.
I was very glad to hear her say this---it was my gut feeling about it too. One of my drs in Keene had expressed concern that there might be something else going on because eight yrs ago we had lost our first baby Ezra to complications from placenta problems, and they wondered if there could be a related placenta problem with Lucas�s situation? But Ezra�s report tells of a much worse placenta than Lucas�s report, so Dr Baker did NOT think it was truly the same problem.
I asked about the fact that the cord knot had tightened, when one dr had told us the cord should be slippery enough to prevent it from tightening on itself. Dr Baker said that even though the cord is slippery, it may not always be able to slip the knot loose after the baby pulls it tight. She really believes this was simply a freak accident, and she told us not to waste a single minute worrying about the possibility of it happening again---the chances of that are so minute!
We showed her our pictures of Lucas, and she appreciated it. She was glad we had his foot prints and hand prints, and she said our picture album was very nice. Both Dr Baker and the genetic counselor commented on how beautiful Lucas was. It�s always nice to hear people say this; after all we think he was so beautiful too. :)
Then we asked about trying again---well, I should say that we stated that we were determined to try again! LOL! Dr Baker was very understanding. I told her that one of my drs in Keene said we should wait about 6 months, but I wanted to know if she thought really that was necessary and why. Because I obviously feel that it is Not necessary to wait that long! Dr Baker said that if I was 24 and it was my first loss, she would advise waiting that long---more for emotional healing than just physical healing. Physical healing from an easy birth such as Lucas�s doesn�t take long, but
emotional healing will go on for a very long time.
Dr Baker then said that there is no magic number of months for the emotional healing to take place---which I totally agree with! I said that at the same time I feel that getting pregnant again has always been a big step in my healing process. I have always found that the longer we waited (or just didn�t get pg) the harder it got for me to deal with, but getting pg again always made me feel like a new person! She said she understands that we know a lot about grieving losses, since we�ve had so many. She recognizes that we know what we are doing, we know what we want, we know what works for us, and that there is really no reason to have to wait if we don�t want to.
She said it is entirely up to us to start ttc again whenever we are ready!!! I am so relieved she said that---I am 34 already, and we�d rather Not spend a lot of time waiting when my biological clock is ticking! We did talk a little about age 35 being a big deal in the reproductive world---not that you can�t have babies after 35, but our eggs are getting older and risks of birth defects increase after age 35. I DON�T need any more risks than I already have!
One thing Dr Baker did want to do was one more blood test. I have had testing for clotting disorders done twice in the past, but this is a newer test in the same category, and she�d like to have it done. She said if the results show I do have a type of clotting problem, it is an easy fix---they will put me on blood thinners! But we can still go ahead with ttc.
So after that we went down to the lab for my blood draw. This really nice gentleman was going to do it. He asked me how I was with blood draws, and I told him that I don�t like them, but I don�t usually faint. I of course had to mention how the first time I got pg and had my blood drawn, I felt woozy, so they let me go outside for fresh air, and I promptly barfed on the sidewalk! LOL But that has never happened again, and I have had more needles than I can count since! He told me he took 13 vials from some other woman, and I looked at him with eyes big like �yikes!� He�s also counting out vial after vial for my blood draw and I said, �you shouldn�t have said 13 vials.� He said �oh, no, you don�t need that many,� but he stopped after he had 8 selected for me! I don�t think I have ever had that much blood taken at once!
But then he said he was still learning to draw blood, so maybe he should get a more experienced person to do it. Another woman came in and she did the draw while the man watched. It really wasn�t bad---we talked about babies and losses the whole time, and before I knew it we were done. The lady told me she had 3 losses herself. It amazes me (and saddens me) how common pg loss really is, I�ve heard about so many in recent months. I think perhaps many times people don�t feel free to talk about their loss until someone like me brings the subject up. :( This lady encouraged me to not give up, she said she was sure someday we would have another healthy baby! :)
Oh, I almost forgot, we also stopped in to see Rachel, the RE�s nurse who I have such a bond with. She assured me that if we had trouble getting pg again, we should call for a consult and they would do whatever they could to help us conceive. Since there are no genetic issues, I would probably be allowed to take clomid again if need be. We will likely ttc for a few months on our own, but I doubt I will wait more than 3 months before making the call (if needed). Rachel said they certainly won�t be making us wait a yr before we could take clomid again, but we would want to discuss dosage with the RE of course.
When we left, I told Truman that I was so glad that all these doctors are �on our side!� I felt very positive about how the consult had gone. If it were not so dang far away (1.5 hr drive one way) I would have all my pg care up there at DHMC. But the next best plan for future pregnancy is to have my care set up locally, plus have some level II u/s and some follow up visits with the high-risk specialists. I already know that my insurance will cover this arrangement (and hopefully it won�t change before we get pg again). So all in all, it was a good visit, and I felt a lot better afterwards.
I still find myself getting all weepy at the smallest thought of Lucas, but that is to be expected. After all, I�ve hit the two month mark, and that always seems to be when the shock finally wears off and the reality of my loss hits me like a train wreck. It doesn�t help that I got my period yesterday too, so the hormone drop just adds to my funk. But I try to look at it as this is a new cycle and now we can ttc in earnest!
I know I will get through this somehow, and I am not forgetting all the wonderful support from all of my wonderful friends!
Oh, and my blood test results came back normal---no sign of clotting disorder! Yay!
* * * *
So the next cycle we were ttc in earnest---but just when I thought I was getting ready to ovulate, on day 19 AF showed up! Like what the heck is up with that? So all our �activity� was for nothing! And I had a nasty UTI to boot! UGH!
I was pretty bummed, so I emailed and phoned the RE's nurse, since she told me to contact her if I was "feeling frustrated". She had told me that they could probably give me clomid again based on my past history. They would have to get it ordered by the next day so I could have it in time to take it this cycle, if they are willing to let me have it. But apparently, the dr said no, not until after they see me again. So I have to schedule an appt, and you can guarantee that will not be tomorrow unless there is some miracle! So this cycle will be on our own, because by the time we see the dr, it will be too late to take clomid.
The more I thought about it, the more I wanted the clomid because it will regulate my hormones and decrease my chance of miscarriage. I swear that the clomid was the best thing and got my last pg off to a great start! They told me very clearly that what happened with Lucas had NOTHING to do with clomid, so I would be able to take it again if needed. Of course they see nothing wrong with making me wait however long it takes for them to first get me an appt, then make a decision, and so on. Darn it, this makes me so aggravated! I thought they were taking me seriously!
I was able to get an appointment for July 20th. My appt time was 9 am, and we barely made it on time due to traffic. But then we went in a room and waited and waited and waited! At 10 am a nurse came in and explained that the dr had got delayed, and instead of moving all her appointments back in order, she had to do two ahead of us due to time-sensitive procedures. So we would not be seen until 11:20. They gave us two options---one, we could leave and reschedule for another day, and they would give us a $10 gas card to help with travel expenses; or two, we could wait for our new appt time at 11:20 and they would give us $10 in certificates for free food at the hospital cafe downstairs so we could have something to eat while we waited. We opted to wait---we did not drive 1.5 hrs one way just to come home and go back another day, even with some free gas!
So we went and had donuts and fruit and something to drink.
The dr finally was able to see us at 11:30. Right away, she said, "you want to discuss taking clomid". I said, yes! We talked about the dosage I took last November and the fact that it worked in one try. We also discussed the side effects---mine were pretty rough, but at least the clomid worked for us quickly, and the side effects were transient. She said an option was for us try an even smaller dose and monitor my blood levels of hormones, but I am thinking I would prefer to go with the dose that worked for us before. I can't take it this month, since we are too far into the cycle now, but we can start next month if we don't get pg on our own this month. I said I really liked the fact that the clomid regulated all my hormones to get my last pg off to a good start so I did not m/c. The dr agreed on this, since I have had some hormone related issues in past. The fact that Lucas tied a knot in his cord had nothing to do with taking clomid, and aside from the cord accident, I had a wonderful pregnancy!
She did say that when I get pg again, she wants to follow me to 10 wks pg. Then I can see my local OB. Last pg, I told her nurse that I wanted to set up my care locally right away, because I wanted a local dr in case anything happened. The time before, I did not yet have a local dr and when I ended up in ER for heavy bleeding during my third m/c, I had no local dr to follow up with, and I did not like being in that situation. But now that I have been a patient at the local OB practice, that scenario won't repeat again. So in my next pg, the RE wants me to come see her for HCG levels and an early u/s (I just don't want them to tell me they can't find a heartbeat!) After 10 wks if all is well, I can have my appointments locally, and we will plan to deliver locally---she was totally agreed on that. I will also have to go to DHMC to have a couple Level II u/s later in pg, and a follow up with the high-risk perinatologist as well. At least my insurance plan will cover this kind of "co-managed care"! The dr said, "You are a patient of all of us" (meaning all the drs I've been seeing). It's nice that they work together like this to get us just the care plan we need.
She insisted that if I am going to take clomid, she really wants me to see a therapist for counseling as well---I was agreeable to this, I've been considering it anyway, but I wasn't ready to go until I felt it would be most helpful for me. This past few weeks has been a lot harder than the first couple of months were---and it has a lot to do with the fact that the initial shock and denial of Lucas' loss has worn off and I am now facing the harsh reality of it. Grief is like that---but a counselor may be very helpful. I am going to contact one that I saw last year, though she is a long drive away, but she may be able to recommend someone closer. The dr was pleased that I am involved in a loss support group, and wants us to continue with that as well. I forgot to mention that I also have some very good support from some wonderful people in our church.
We also talked about depression---I was diagnosed with SAD (seasonal depression) about 4 yrs ago. In past years I have taken anti-depressants for a few months at a time when needed. But I am not currently taking them, as I don't yet feel the need. I know I can talk to any of my drs if I start feeling like I need the boost again. But it is summertime, my favorite time of year, plus all the sunlight helps me feel good. Not that I don't have bad days---I do have some bad ones, but it isn't like I am seriously depressed to the point of being unable to function. The RE mentioned that she thought I was doing much better emotionally than I was when she saw me last October---and she was quite pleased. Of course, she worried that if months dragged on without me getting pg, and it turns to fall/winter and the short dark days that tend to trigger SAD, then I might not be doing so well. Last Oct/Nov I was a train wreck! It was certainly a combination of things, including SAD and my frustration with being unable to get pg for so long (one yr at that point) compounded by grief over all my losses---and then add the hormonal side effects of Clomid! Yikes! But this is something we are aware to watch for, so we can manage it.
I did not tell her that I have been in this funk for over a week, and I can't seem to shake it---but if it wasn't that obvious then that's good. I am looking forward to our loss support group meeting tomorrow night---and yes, I finally found a baby-sitter! (the eighth person I called!) I also had a good talk with a couple friends yesterday which helped me some. And now I feel more positive about the "plan of action" we have come up with. I really do feel that my drs are working for me and willing to help me try to reach my objectives!
One thing she said was that she asks all her patients to consider whether or not they can handle another loss. That is a tough one to answer. But I know what she is saying. If you just know that you cannot possibly deal with another loss, then trying to have another baby may not be a good decision. Obviously, there are no guarantees that everything will be fine next time---as much as I hate to say it, I am proof of that! But the way I look at it is this---it is about risk. Am I willing to take the risk of another possible loss and try again? For me the answer is Yes---the potential for success makes it seem worth taking that risk. Of course I HOPE and PRAY that things will go well next time, but if it doesn't then I will have to deal with it---and I will be able to. I am getting to be a pro at this by now! Good lord, I never thought I would be saying things like this! But you almost get to a point where you can stop counting---like what is the difference between 4 losses and 5 losses? Now it's more like "here we go again" rather than total freaking out about how am I going to deal with this. I am not making light of any of my losses, they ALL hurt tremendously----but I also am finding that I have a lot stronger character than I ever gave myself credit for. Maybe the pain causes growth of character, because I would never have dreamed I could make it through anything like this!
It sucks to have to endure this kind of pain, but I am finding that it helps a lot to look for positive things that can come out of tragedy---those positives are the things that keep me going. I've done lots of soul-searching and lots of reading as well, and where I am coming out is that loss IS a part of life. We all will lose someone dear to us at some point. It may be a grandparent or a parent, a sibling or a friend, a spouse or even a child (which I think is probably the hardest loss to have, because children are our future---we expect that they will bury us, not the other way around). Loss hurts, but the secret is in finding acceptance of it. It is a process, and takes a lot of time and energy---it can be three steps forward and two back---but there is resolution to be found. Not that I have found it entirely, but I think I have resolved some of my losses to a large extent, and I just need to keep working through the others till I get to that point with them too.
I also am finding a deeper spiritual meaning to what I have endured in my life. I am coming to a deeper understanding that GOD IS GOD, and He has a plan for my life that I don't understand, but I do have to trust Him to do what HE thinks is best, even when I don't think it is best. This belief is based on scripture which I believe to be the Word of God. I'm not saying I have it all sorted out, but I am coming to some kind of acceptance about my lot in life. If this is God's plan, then so be it. I still have my desires, especially for a larger family, but even that I have to turn over to God and let Him work out his plan whatever it is. Some days this makes all the sense in the universe, and other days I am not so sure about it. But it's all part of the process.
* * * * *
So we continued ttc on our own, and though I didn�t hold out too much hope that we would be successful, I felt better knowing I had the option of taking clomid the next cycle as a back-up plan. That made me feel better about the situation in general, and kept me going. I was not keeping any charts of my cycles (I wanted to avoid that stress), but I have unmistakable ovulation pain, so I looked at the calendar and made a mental note of it. I did take progesterone suppositories following ovulation, which is something the RE had recommended as well. I counted 14 days from ovulation and figured what day I should expect my period to come at the latest. Without progesterone, my period usually comes at 11-12 days after ovulation, but progesterone can give my cycle a couple extra days. If I did not get my period by 15 days after ovulation, I would take a pregnancy test. The 15th day fell on August 8, 2005. That was Lucas�s due date! OMG!
The thought crossed my mind that it would be cool to find out if I was pg on Lucas�s due-date, but then I thought that was just too much to hope for! I would probably be calling the RE and asking for clomid instead---at least it would be on a Monday and an office day!
