12/8/2011

At the beginning of the week, I had three people make pregnancy jokes based on my vivid dream and a patty melt desire.  Then this morning I found myself unable to tolerate mint.  I have a Mirena  IUD, but figured a little reassurance never hurts so I dipped a pregnancy strip.  Now, I’ve done this twice before since I had the IUD and it was nice and reassuring to see that negative result.  A bit different this time, the strip showed the test line before the urine had even gotten to the control.  Unexpected would be an understatement.

Called obstetrician’s office and they called back about two hours later and scheduled me for an ultrasound about half an hour later.  Went in, checked in and was still reasonably calm.  I find it a bit prophetic that I’d set a post on the idea of Just Another Day in Wileydise to post that day, but I was approaching it all pretty calmly.  Had called and told Paul and he said to just breathe and wait until I had information.  I figured it was likely early enough that if it was ectopic (high risk with an IUD), it could probably be easily managed without too negative health implications hopefully.  I figured if it was a chemical pregnancy or otherwise miscarrying, I could deal with that and understand it as part of the risk of getting an IUD.  I figured that if it was a viable intrauterine pregnancy we could figure out making it work even though it wasn’t planned.  Really thought I was ready.

Then the tech started the scan and I saw two gestational sacs.

She measured two gestational sacs.  She said she couldn’t comment on anything or even confirm that I was seeing two separate pregnancies or whether they were in the uterus.  She did label them right side gestational sac and left side gestational sac, so between that and having previously seen an early twin ultrasound, I felt pretty sure it was two.  When she finished, I went back upstairs to see the doctor.

My blood pressure was 160/98.  It’s normally about 105/58 or so.  The tech who took it seemed a bit concerned by this, but said that they would probably just check it again.

The nurse and the doctor came in and asked how I was or something to the effect and I responded with, “my blood pressure is a bit high.”  The doctor said she thought she knew why and I for some reason thought this meant she knew something was pathologically wrong and had seen on the ultrasounds and so asked what.  Apparently, she just meant the knowledge I’d just gotten.  I then asked her if I was right in thinking I’d seen two sacs there.  She confirmed this to be the case.  Only one of them had a measurable fetal pole, but the other one could either not have one because it is not developing or not have one because it’s still too early.

Apparently knowing the days I bled or spotted doesn’t help in the least bit in dating the pregnancy as they typically have nothing to do with ovulation when you have an IUD.  The one measurable fetal pole was 5 weeks and 6 days, but apparently size is really hard to measure at this gestational age, so could be anywhere from about 4 to 7 weeks. 

It was a bit of an interesting balance as an appointment, because we were both looking to find the right point between getting me all the information that I needed for the sake of my understanding and not borrowing trouble or worrying about something that we may never get to that point.  My OB knows me well enough it seems that she gets that I have a lot of questions and like to understand as much as possible, so I’m feeling as informed as I can be in a situation that is definitely unclear.

So, where do we stand? 

·         I am currently pregnant. 

·         I am pregnant enough that looking at beta HCGs won’t really give any good information as to the viability

·         There are two gestational sacs

·         The IUD is out now which improves the range of outcomes

·         I do not have an ectopic pregnancy

·         We will do another ultrasound in a week to look at the growth of the two potential fetuses

·         My cervix is closed and looks good

So right now the only directions are to start taking prenatals (I finally stopped a month ago as a great example of irony) and allow time to pass until the ultrasound and appointment next week.  My doc's nurse actually stayed in the room while we were talking so she could be up to date as I'm supposed to call with any questions at all that I have.  My doctor has said she will definitely keep answering my questions and provide as much information as is possible.  I'm supposed to call immediately if I have bleeding or cramping because while there is nothing we can do about a miscarriage, knowing is good. 

As you might can guess from my oversharing with the internet, I’m a fan of discussing and working things out through talking, so I discussed this with a couple friends more or less while it was going on (in addition to Paul who despite his wonderfulness and awesome nature is definitely male).  One of them asked me after if I was ok.  My answer: “yeah, I really am.  Still definitely a lot of stress, uncertainty, fear, worry, apprehension, anxiety and the like, but I know where we are now, I know what the plan is, and I know it will be fine even if it isn't now.”

I’m having trouble thinking of an uncertain situation I’ve been in before where I’m unclear what sending positive vibes or rooting for would mean, but I’m not sure in this case.  I definitely don’t want a miscarriage, but I can acknowledge that is would be simpler in many ways.  A singleton pregnancy would be less risky than twins, but I can’t imagine myself rooting for that either.  So I think I’ve settled on I’m accepting whatever reality will be and I will deal with it as it comes. 

I debated whether or not I should write this.  On some level it seems odd to write about a pregnancy that is more likely to result in loss than not (how’s that for some scary statistics, and I thought normal miscarriage stats were bad), but even if I do miscarry (the main reason it’s so likely is apparently because of insufficient lining due to the IUD), that won’t unmake it happen and will still affect my thoughts and the like.  My main worry for sharing is that I really don’t know if I could stomach any more sympathy from people in our lives.  I know that sounds even weirder, but it’s true.  But there are only a handful of people who I know that read this and I would definitely tell them regardless, so it seems to make more sense to document my thought process and feelings than to not.

In terms of telling people in normal life?  My thought is wait as long as possible because there are a lot of people that just don’t ever need to know if it does end in miscarriage.  We might tell our parents/siblings at Christmas if next week’s ultrasound shows progress, but it definitely isn’t a happy go lucky pregnancy and will only be telling people who are central to our lives and need to know as such rather than just for congratulations or the typical responses.

It’s been almost four hours since the ultrasound and my pulse finally feels about normal.  You know what?  Life happens.  We respond.  And that’s the beauty.

And one more last thought (and yes, the idea on one more last is funny).  Am I odd that it’s the second one that blows my mind?  I mean the idea of being pregnant on an IUD with an almost one-year-old seems like it should be pretty mind-boggling, but that seemed manageably so.  It was the presence of a second one that really just ran me over like a Mac truck.

I’ll let you know how things go either way.  Interesting fact: they don’t give you copies of the ultrasounds apparently when they anticipate you are going to miscarry.

Oh and yes, I do see great irony in this happening right after I'd basically come to the conclusion that I shouldn't be pregnant again for the sake of sanity.  And no, I'm not ready to think about the insanity aspect yet.  What's nice is for some reason my fear of babies dying doesn't extend to miscarriage.  I see that as more of an inevitability or something, so not having the obsessive thoughts of last November/December.

One positive is hopefully this will quickly get me over the fear of going to the OB by myself.  As I've said before, the appointment where the demise was found was the first time I went to the OB or the perinatologist by myself between either pregnancy.  Well, I went by myself today and since the only time the schedule worked for next week was during Trajan's winter performance, I'll be by myself again.  Luckily, Paul has been really supportive and helpful in my thinking all of this out over such a short period of time and I really think that's a large part of the reason I can say that I know that I am ok. 

Speaking of Trajan, regardless of whether we end up telling the grandparent types, I am pretty sure we will not be telling him unless it is at a point where there's basically no other option.  It may be selfish, but I don't want to hear him explaining death again.

Notice that I'm no longer even calling anything "last thought". 

And yes, I totally get that intentional termination is an option.  That said, I just can't do it and have no desire to.  I can't consciously choose to kill my child.  I know what it is like to lose a child in reality, not just as an idea, and I know that I am not strong enough for that.