Tuesday, November 4, 2008

Infertility, injections, ultrasounds, blood work, etc...

Updates:

We went and met with the MFM doctor. The genetic counselor was great. Very attentive, caring and most importantly she listened. The doctor was good. She was patient and answered all of my questions about a subsequent pregnancy.

There is just one thing, she said it was a "fluke" accident and highly unlikely to happen again. Strike one.

Then she referred to Ethan's death as "fetal demise". I quickly corrected her and stated his name was ETHAN. Strike two. I know the medical term is accurate. But, to a grieving Mom this medical term is very impersonal, and sterile. My son would've had a great chance for survival if he would've been born alive. He was a fully formed baby.

There is no strike three. So, we'll see what happens and will decide whether to consult with her if and when I become pregnant (fingers crossed).

This takes me to my second update. Yes, we have begun the fertility treatments again. I am currently on CD 9. I had my ultrasound yesterday and I had 4 follicles. So, my RE has increased my dose to 150 IU of Menopur. I hope they grow. I remember with Ethan I only had 1 mature follicle and that turned out to be my beautiful baby boy. So, I was a bit down because 4 follies is not very good and also my E2 was only 74. Up from 24 on CD 3. I have to remember all I need is 1 follicle. I hope this works. Please keep your fingers crossed and say a prayer for us. We return Thursday to see how my follies and lining are doing.

I was also informed by my fertility doctor that I will have to be on heparin if I get pregnant. Apparently, I have lupus anticoagulant present. This puts me at a higher risk for clotting. I also have one copy of the MTFHR gene mutation. I'm OK with this, I would rather know this now than later. I will do whatever it takes to maintain a healthy pregnancy and at the end hold a living baby in my arms. More shots, sure bring them on.

Also, I am not telling anyone about our TTC journey this time. I want to keep it to myself. I'm not sure I want other's to think I've "gotten over it". Some people at work think as soon as I have or begin trying that I'm all better. I'm not, I miss my baby more than ever. I will never be over it, and even if I have 10 more babies after Ethan it will never replace him. I will always be a Mommy to a baby boy that died. I don't cry as easily anymore. I've noticed I try to control it a bit more. Actually, I can control it. Especially at work. But, also this TTC journey is harder, there are times I don't even know if I can go through this again.

And finally, we had a wonderful time in California. It was beautiful, the weather was perfect. Disney and Universal Studios were great. And of course, we went to the beach. We were in Malibu and we actually saw a couple pairs of dolphins swimming pretty close to the shoreline. It was beautiful. I will post some pictures, if I figure out how to do it. And Jason picked up some rocks for Ethan. He started this right after Ethan died. He will collect rocks and write Ethan's name on it and take it to his grave. We have a whole vase filled with rocks and messages for Ethan. At one point he said, "Mommy, Ethan would've had fun with us if he were here".

Missing you Always, Ethan. We love you!

Sunday, November 2, 2008

"El dia de los Muertos"

The day of the dead.

Being of Mexican descent, I am well familiar with this holiday. As a child, I don't remember celebrating it all that much, unless we were in Mexico. Sometimes our customs are washed away in an effort to assimilate into American culture. But, now as an adult, I really want to embrace this holiday, this day of celebration. After all it is a day of celebration, a celebration of life. It is a day of remembrance. A day to remember those who have died.

Last year, we went to the Arts Center here in town. There is an annual celebration, filled with exhibits, altars, crafts for the kids. We were there last year. And the year before, we were in Mexico during this time. Lil Jason was able to participate in all of the festivities. It's as though we were being primed for our own day of the dead. I've exposed him to death from the beginning. I never sugar coated death, I never told him the all too common phrases to describe death. I have no regrets about this. Death, the word in in itself is not a dirty word yet in this culture, we often find other terms to describe it. As if doing so, will make the pain less.

I've taken him to cemeteries, to visit our family. His great grandparents are buried in a beautiful, serene, quaint cemetery in Mexico. At times, I've asked myself if all this "death exposure" is healthy for him. I've concluded, it is. Death is a part of life. Death surrounds us. We can't escape it. We can try to pretend it will not happen, but I don't want this for him. I want him to know yes it happens, and yes it will happen again in our family. And yes, we continue to live. And we actually do survive. Death and life are intertwined. By confronting death we can learn to live and value life. Life is fragile, and by recognizing this we can learn to see the beauty of life.

The grief, the agonizing pain. It is still here, it is more controllable, but is still here. Quietly awaiting it's unleashing.

I went to Mass with Jason on Friday, 10/31. And when I looked over to the right of the altar there was a cloth scroll hanging from the wall, it had all of the names of the deceased for our parish this year. Ethan's name was there. I immediately felt that familiar pain. The sorrow, the grief. The scroll read, We remember in Prayer. It hurt, but it also was comforting to know that I am not the only one remembering my precious baby. Our pastor said that 7 of the 32 names on the scroll are of babies and stillborn babies. 7. It should not be.

Ethan should be here. Alive and kicking right now. But he's not, he's dead. He's buried in a cemetery.

I miss you so much Ethan. There are no words to describe it. Oh the agonizing pain. How can anyone go on living after their baby has died?

However, today I will remember, I will celebrate his life. He was alive for 32 wonderful weeks. He kicked, he moved, he reacted to my voice, to my touch. He reacted to music. He would move all over whenever I played Jennifer Lopez or my favorite Mexican singer, Juan Gabriel. He was alive. And I will remember and celebrate his life. He has touched my life and the life of many during his time here.

Ethan, Mommy misses you so much and I love you with all of my heart and being. We love you so much. Your big brother asks about you constantly. You are alive in our hearts. Sweet baby boy, Mommy and Daddy love you so much. We want to thank you for coming into our lives, even if it was only for a brief moment. The time we had with you, we will cherish forever.

Tuesday, October 21, 2008

California...Here we come!!!

Yes, we are leaving for California tomorrow. We are taking our 6 year old to Disneyland and Universal Studios. Vacation, yay. We decided to do Disney during his fall break. Spring break is usually a very busy time in the hospital where I work, and trying to get time off during this time is almost close to impossible.

I was pregnant this past spring break and promised Jason we would take him somewhere for his spring break next year. I remember telling him, "We'll take you and your brother to Disney."

Right after Ethan died, Jason asked, "Mommy are you still going to take me to Disney?"

Me: "Of course, Jason, why do you ask?"

Jason: "Because when you were pregnant, you said you would take me and the baby, but now that Ethan has died are you still taking me?"

So, yes we're off to California. Ethan is not here anymore. But he will be with us, in our hearts, while we are in Disney. Now and forever.

Sunday, October 12, 2008

"The Mecca"

I have an appointment tomorrow with a maternal fetal medicine physician. I'm excited, I want to be proactive with my next pregnancy. Not that I wasn't with Ethan, but this time, I want a physician who will not overlook anything.

When I got pregnant with Ethan, my fertility doctor released me to a high risk doctor. He recommended one of the doctors at the University high risk practice, his wife delivered with one of the doctors. So, I went there, feeling confident. I arrived and it was not what I expected. It was a very busy practice, it's at one of the teaching hospitals. I should've ran as fast as I could when I arrived, but I didn't. I waited forever to see someone, finally I meet with the nurse who does an extensive history and then tells me to make another appointment to actually meet Dr. Y, I was supposed to see Dr. X. I tell her this and she assures me that maybe next time I can switch to see Dr. X. But, she doesn't have any openings. She proceeds to tell me that over the course of my pregnancy I will see various doctors but Dr. X will be my primary MD.

Fine, I stay I make another appointment. I make it to my next appointment. Dr. Y walks in to my room, she's very soft spoken, meek, nice enough doctor. Again, I repeat my history and stress that this was a much anticipated pregnancy, a miracle baby for me. When we did IUI, I only had 1 mature follicle, and I thought it wasn't going to work. Only 1 follicle, well it turns out that's all I needed. And that 1 follicle ended up being my precious Ethan. She assures me she will do everything in her power to help me maintain a healthy pregnancy. She proceeds to do her exam (for a small woman she's kinda rough) and obtain my history, after a 2 hour or so appointment I leave there feeling confident. I am after all at the "mecca" of high risk pregnancies, and they got in under control. I will continue to take my blood pressure medications and so forth and they will do their job and monitor my precious, miracle baby.

Fast forward a couple months, all is going well, I'm still frustrated when I go there because it takes so long for me to actually get into my appointment. I arrive early every single time but still have to wait forever until I'm actually seen. But, I don't want to come off as pushy so I say nothing. After all, I'm pregnant nothing else matters. I've made it past the much awaited 12 weeks, I'm walking on clouds.

I have my first ultrasound there, I had a couple ultrasounds with my fertility doctor. All appears well, the subchorionic hematoma that was present at first is now gone, reabsorbed. I am told I can now exercise moderately to help control my weight, I have hypertension so weight control is an important measure to ward off preeclampsia. I'm at higher risk for preeclampsia since I have preexisting hypertension. But can you believe it my blood pressure is better than ever. Perfect. All seems to be well.

My pregnancy is progressing nicely. Week 29, I fail my glucose tolerance testing. I get a call from the clinic. I'm told to meet with a dietitian, I do as I'm told. Follow my diet, check my glucose 4 x a day. All is well. I have an appointment with my doctor, I go in, I have an ultrasound at 30 weeks. They are concerned about IUGR since I have hypertension. All appears to be well. They send me over to the clinic again, I wait almost 3-4 hours to be seen. This is really starting to piss me off. WTF. But, then I remember I'm pregnant, I shrug it off.

The door opens, it's Dr. G. What an ASSHOLE!!!!

The first thing out of his mouth is, "What are you going to do for birth control after this baby?". I go on to explain that this isn't really a problem for me since I have infertility issues. He checks the baby's heart rate tells me all is well. My blood pressure is under control, and tells me Dr. Y, whom by now I've become comfortable with, is no longer practicing. She was also pregnant, and had to deliver early. My appointment last maybe 5-10min. I realize, he didn't mention anything about the ultrasound I just had, or what the plan would be for the rest of my pregnancy. Nothing about non stress testing, nothing, zippo! Now, mind you I now have gestational diabetes and preexisting hypertension. As I'm walking out, one of the nurses tells me I have gestational diabetes I tell her I know, I've been to the diabetic teaching and I am testing as instructed. She is the 3rd person to tell me I have gestational diabetes. I want to scream, "Aren't you guys reading my chart, who the hell is following my pregnancy". Now I'm really pissed, and I have to go through this for the rest of my pregnancy.

I call my husband and tell him the latest. We agree to switch back to my regular OB whom I've known forever. I call her and she agrees to treat me, she also takes care of high risk pregnancies. We finally switch at 32 weeks. My first appointment with her is May 20th, the last day I heard my baby's heartbeat.

We have left the clinic, the mecca of high risk pregnancies, or so we thought. We are so happy, we're almost there at the finish line. Dr. J is wonderful, gentle and her staff is great. She tells me that she will begin NST twice a week. I question why I need this and she tells me even though all is well, she wants to make sure it really is. After all, I do have hypertension and now gestational diabetes, she also tells me she will see me weekly and by 34 weeks twice a week and she will repeat an ultrasound then. She also tells me she will not let me go beyond 39 weeks.

May 20th was the last day I felt Ethan. I remember it so vividly. I came home, happy I was finally getting the care I needed. I put Jason to bed then curl up and begin to read all of the handouts I just received at Dr. J's office. As I look at the pamphlets I run across one for pregnancy pictures. I write down the number, I'm thinking I will do this soon. After all, this might be my only pregnancy. I'm eating strawberries and fruit dip, it's my bedtime snack. I feel Ethan move, boy is he moving. I contemplate video recording my belly as it ripples because of his movement. But, I don't. Our camera needs charging. I sit in bed, and attempt to listen to his heart rate with my stethoscope but he kicks it. I get the hint and leave him alone. I go to bed, happy, thinking "Wow, this is really happening, we are having a baby".

Ethan died that night. This I know for sure.

I wish I would've known about hyperactivity being a warning sign. I'm a nurse, why didn't I know this. I live with this everyday.

I do have a list of questions to ask her, the maternal fetal medicine physician. One of my coworkers, works as a L&D nurse and she recommended her. She told me she's very conservative and thorough. When I called to make my appointment, her receptionist appeared to be genuinely concerned and professional. She explained what would take place during the first visit. She encouraged me to bring a list of questions.

I also had tons of blood work done per my fertility doctor's request. We had an appointment with him last week. He is checking different labs to check for blood clotting problems. He agreed to begin a cycle of injectibles in November. We are going to do Menopur and IUI. I hope it works.

Monday, October 6, 2008

National Pregnancy and Infant Loss Remembrance Day

National Pregnancy and Infant Loss Remembrance Day
Pregnancy and Infant Loss Remembrance Day: Take Action
October 15th is National Pregnancy and Infant Loss Remembrance Day in the United States.

More than 25,000 children are stillborn in the United States every year leaving mothers, entire families and communities devastated.

Estimates of the rate of occurrence of stillbirth make it at least as common as autism.Stillbirth is not an intractable problem. Greater research would likely significantly reduce it's incidence, but good research requires good data. H.R. 5979: Stillbirth Awareness and Research Act is under consideration by Congress. This proposed bill would standardize stillbirth investigation and diagnosis, thus providing more data for the needed research. Better research means fewer children born still. Lobby your Congressional Representatives to get this bill passed! The government funds research on breast cancer, heart disease, AIDS - why not the death of babies?

On October 15th, remember the thousands of unfinished children lost and the families who remain to grieve them. Honor them by taking action.

Let's help pass H.R. 5979.
Action Steps:

Step 1. Use Your Blog to Enlist Others-Copy the contents of this entire post and publish it on your blog immediately.GOAL: Enlist 10 of your readers to spread the word

Step 2. Use Your E-mail to Enlist Others-E-mail 5 bloggers and nicely ask them to publish these action steps on their blog. Consider contacting celebrity bloggers, political bloggers, medical bloggers, or bloggers who are not part of your reading community. Email friends and family to inform them about this bill and to ask them to honor your baby by participating in the world-wide October 15th Wave of Light.
GOAL: Enlist 3 bloggers outside of your normal blog sphere to spread the word in other online communities.

Step 3. Help Pass the Stillbirth Awareness and Research Act-By October 15th, publish a post on your blog supporting H.R. 5979 Stillbirth Awareness and Research Act. For maximum impact, title your post: "Stillbirth Awareness and Research Act."

Ask your readers to lobby Congress to pass this research bill.

GOAL: 1,000,000 Google results for "October 15th" or "Pregnancy and Infant Loss Remembrance Day".

The MISS Foundation
International Day of Remembrance
Bill H.R.5979
Stillbirth Research

Sunday, October 5, 2008

Stillbirth Awareness and Research Act of 2008

Stillbirth Awareness and Research Act of 2008.Here is a link explaining the bill at Washington Watch. You can read the bill (it is surprisingly short and straightforward) and leave comments. There is also a link (on the right under Take Action) to contact your Representative.

This is from Ya Chun's blog (serenityjoy.blogspot.com).
You can use my letter as a template or write your own, better note. It sure would be swell to get this HR 5979 passed by this year:

Dear ,

I am writing to ask you to help get HR 5979 Stillbirth Awareness and Research Act of 2008 through the Committee and passed before the end of this year. ***The longer that Bill 5979 takes to pass, the more children that will die needlessly.***

This bill will legislate the standardized tracking of stillbirth data. This data can then be used to research and attempt to understand why seemingly healthy pregnancies suddenly end tragically. I held my child, a fully formed baby who died in my womb. Neither the doctors nor the autopsy can not explain why or how this happened. A unified reporting system throughout the country can help to track these deaths, in the same way that other deaths are tracked.

Please do everything in your power to get HR. 5979 through Congress. And please think of us, the grieving families around the world, on October 15th, the International Stillbirth and Pregnancy Loss Day of Remembrance.
Sincerely,

Friday, October 3, 2008

One more time

Well, we've decided to try to conceive once again. My 36th birthday is quickly approaching. We need to do this again. I have to muster all the courage and go forward with another round of injectibles and IUI. We have an appointment with our wonderful RE this coming Monday, Oct. 6. I'm excited and nervous. I will walk into his office and remember the last time I was there, I was pregnant with Ethan. I remember seeing him for the first time there, in that office. I was 6 weeks pregnant and I saw him, my little peanut with a wonderful heart rate of 181. Amazing how I remember every single heart rate reading we ever received.

My RE will be changing offices soon, his practice has really expanded and he's moving to a new location. I wish it was ready so I wouldn't have to go there again. It's very painful.

But, we must go forward with another cycle and have faith that one day I will deliver a LIVE baby. I have to try to do this again, for me, for my husband and for both of my sons living and in heaven. My six year old son is mortified of the thought of me being pregnant again, no we don't discuss this with him.

During the summer, we were getting ready to go the gym and my shirt was a bit tight and he looked at me and asked, "Mommy are you pregnant?", I was shocked to hear him ask this. I replied, "No, I'm not. Do you want Mommy to be pregnant again?" and his answer, "NO! I don't want another baby to die". It broke my heart again. My sweet pumpkin, I don't want another baby to die either. But, most of all I want you to know that not all babies die.

He's wonderful, full of energy and full of questions. Every time we see a pregnant woman he will hold my hand and look at me. I smile and tell him, "Jason, it's fine. Say a little prayer for her and her baby". He's very intuitive.

The plan: BCP this month to suppress the cysts, I have PCOS. I hope to begin the injectibles in November. In the meantime, I'm trying to lose weight and exercise. I did begin exercising in the summer. It was my way of coping. I'd get on the elliptical and cry and cry. I'm sure the people there thought I was nuts. And actually I was, I was crazy with grief.

I also made an appointment with a high risk Maternal Fetal Medicine doctor. I'm not using the high risk practice I went to when I was pregnant with Ethan. That's a whole different post. Overall, I'm excited and of course very nervous. I forgot to mention, if we do manage to get a BFP we plan on consulting with Dr. Jason Collins in Louisiana. He has studied umbilical cord accidents. I spoke with another Mom who went to him and she swears by his practice. I'd be interested to know, anybody else out there that has went to him?