9

only 4 more points to go!

16

No joke. Seriously. My hcg is now 16.

Repeat tomorrow morning.

I fear a second methotrexate shot is looming after all these weeks.

Unfreakingbelieveable.

Monday hcg report #5

To recap, here are the dates and results of my weeks of hcg labs documenting my treatment of either ectopic or missed miscarriage through methotrexate injection:
February 28 - hcg 500
March 3 - hcg 417
March 10 - hcg 1300
March 13 - hcg 1600
March 14 - Methotrexate shot
March 18 - hcg 2800
March 24 - hcg 1600
March 31 - hcg 560
April 7 - hcg 185
April 14 - hcg 58

Hopefully April 21 will be the last blood draw and my cycle will return. I've been having some heavy brown spotting/clots/stringy tissue stuff going on the last 2 days, so hopefully things are getting in gear...

Hopefully one of the last hcg updates

My hcg on Monday was..........185! This is very good, but I still have to keep going in until it reaches 0. I'm hoping that will only be 1-2 more weeks. I had some potentially ovulatory symptoms earlier in the week (sore boobs, o pains), so maybe AF will show up in a week or so. That would be AWESOME.

quick hcg update

Just a quick update...

my hcg was down to 528 yesterday, so that is really good. I told myself I would be happy with anything below 800. Now I just hope it continues to go down all the way to 0, as last time it got down to 20 before it became stagnant.

Physically, I'm feeling pretty good. Breast tenderness has gone away and spotting is down to almost none.

Emotionally, I feel pretty good too. I'm sure I'll hit a plateau again after this is all over with, but for now I'm just trying to focus on getting healthy and enjoying my current family. I've gained about 8 pounds in the last 2 months, so I'm starting to exercise and eat more consciously in an effort to shed that weight before pool season!

I want to send a special hug out to my online friend Melissa, who is really struggling right now with the nightmare that is infertility. I'm thinking of you and hoping you are ok!

New lab results

The methotrexate seems to be working. My hcg today was 1600 down from 2800 last Tuesday. Now begins the weekly labs until it's down to 0. So....a long way to go yet. Last time I did this after my D&C, my hcg started at 710 and it took 6 weeks and one more methotrexate shot to get it back down to 0. So I'm anticipating a long haul before this is all over. Then I'll probably get another HSG just to make sure my tubes are indeed ok and there is nothing left inside my uterus. I know that surgery would have been the easy answer, but after hearing a story on the radio over the weekend about a woman in London who went in for leg surgery and came out with a new anal sphincter muscle (I am not kidding!) by accident, I am VERY glad to be avoiding the hospital!! Even if it does take longer...

It's so strange to be hoping my hcg is zero. I should be thrilled with an hcg of 1600. Oh, if only the world made sense and things were that easy!

Lots of snow up north for our Easter weekend - 8 inches at my dad's house. It felt like Christmas not Easter!! I'll post some pics of our egg dyeing party soon :)

And the decision is made...

After 2 more phone calls with my wonderful midwife, we've decided it makes the most sense to go ahead with the methotrexate today. I'll have labs done again on Tuesday and again after I get home from vacation. If the numbers are going down significantly, no need for further treatment. If not, I'll have a second shot of the methotrexate and continue monitoring until the hcg is negative for pregnancy. This is very familiar to me, as it's exactly the treatment I pursued with my retained tissue following my d&c 2 years ago. Fortunately, I know I don't have any adverse reaction to the methotrexate, so that's positive. And she assured me again that it's very safe to take and that it has a very short half-life - meaning it will be out of my body quickly. I will take extra folic acid for the next couple of months following treatment, as methotrexate completely depletes the body of folic acid (which is why some doctors say to wait 3 months before TTC again after usage).

I asked her how this will read on my file and she said probably it will be recorded as "possible ectopic" or "undetermined non-viable pregnancy." So I probably will never know for sure. And if I've learned anything at all during the past 2 years, it is exactly that. There is just so much the medical community does not and will never know about the human body. For a control-freak like me, that's a hard pill to swallow. But one that I'm learning I must try to accept.

So -- off to get a shot of low-dose chemo!

Decisions, decisions

Labs came back not so hot - hcg is still slowly rising, but definitely not enough to indicate a good pregnancy. 1300-something on Monday and 1600 yesterday :(

Here are my current options:

1) Do nothing - risking tubal rupture if it is ectopic

2) Methotrexate - today or Monday - which would be appropriate treatment for ectopic, but might not get rid of uterine pregnancy tissue. Would need weekly hcgs until negative.

3) D&C - would obviously get rid of any uterine tissue, but would not deal with possibly ectopic - so could need methotrexate afterwards if hcg continues to stay elevated after the surgery.

2) Go in Monday for another sono to try one more time to determine uterine or tubal pregnancy - and then make treatment decision.

While I wish I could consider it, doing nothing seems irresponsible. I would be devastated to lose my tube and a ruptured ectopic is a true medical emergency.

Complicating matters is the travel plans we have to leave for MN on Thursday. Scheduling surgery prior to our trip is seeming unlikely.

I called for a second opinion from my RE, although when I spoke with him on Tuesday he said he was going out of town for Spring Break, so he may be gone already - and will definitely be gone next week. My midwife was going to talk to the doctor on call at my OB's office and call me back with his opinion.

I feel like I'm doing everything I can. My initial reaction is to wait until Monday for one more sonogram. If, after that, things are still inconclusive, then I'm leaning towards the methotrexate. I have already had 3 uterine surgeries in the last 3 1/2 years (C-Section 8/04, D&C 3/06 and hysteroscopy 12/06). I *really* want to avoid another if at all possible.

Any ideas?

The Waiting Game continues

More labs this morning - but won't hear until tomorrow. Jenna went with me and she was quite interested in the whole blood drawing process. She wanted to know where her blood was and if the nurse could poke too and get her blood out.

Funny thing is, I'm starting to *feel* more pregnant the last 2-3 days: super sore breasts, starving all the time, and I feel like my tummy is starting to bloat. I guess that would make sense since my hcg has been increasing. I'm not feeling too optimistic about it - really - even after reading some pretty inspiring stories on misdiagnosedmiscarriage.com. I've been spotting pretty heavily for 3 days now, too.

Thank you to everyone for reading my blog and being so supportive. It really helps a lot!

I haven't filled my Zoloft yet. I don't know what I'm waiting for. Maybe I'll do that today before pre-school is over.

Update #2

Saw the doctor, who basically said too early to say. I'm going back Thursday for more labs.

Early pregnancy diagnostics just plain suck if things are at all questionable. It's just too early to tell anything and doctors are never going to give any definitive information until they are 100% sure. Which I do understand completely, even though it sucks to be the patient. Waiting is the worst!

I did talk to the fertility doc also - he called me personally, for which I am so grateful. He said it's probably not going to be possible to do a hysteroscopy with a d&c if that's what is needed - because it's difficult to determine whether the tissue is pregnancy-related tissue or scar tissue. He said, however, that if the pregnancy ends up being ectopic and is treated with methotrexate, that it might be worthwhile to do a hysteroscopy again to just make sure everything looks normal.

So....for now we wait. I really hope this is all resolved before next week. It's Spring Break, Jenna's school is out, and we have an Easter trip planned to Minnesota.

Update #1

Sono is done. I have to go BACK in 30 minutes to see the doctor - because she was at lunch when I finished - which is annoying. Didn't see much on the sono - small "something" that might be a sac in the uterus but too small too tell, and an area on my right ovary that the tech assumes is the corpus luteum, but again, can't rule anything out. I asked what an ectopic would look like on a sono this early, and she said probably nothing. She said often they never actually see the ectopic, just assume that's what it is if hcg is still present and there is no sign of any uterine development. I asked the tech what to expect (because I believe they usually know just as much as the doctors), and she said probably I'll have to keep coming in for labs and sonos until one of the following things happens:

1) Hcg goes down to 0 on it's own with no interventions

2) An ectopic is seen on ultrasound - or it is assumed ectopic - and treated as such.

3) An abnormal uterine pregnancy is developing and I either have a d&c or m/c on my own eventually

4) A miracle occurs and there is actually a developing uterine pregnancy

I'm not holding out much hope for #4, but the sono tech said not to rule it out yet. She said my hcg of 1366, while low and not doubling normally, is still in the normal range for 6 weeks. I found that hard to believe, so I came home and looked it up. Turns out, she was right:

3 weeks LMP: 5 - 50 mIU/ml
4 weeks LMP: 5 - 426 mIU/ml
5 weeks LMP: 18 - 7,340 mIU/ml
# 6 weeks LMP: 1,080 - 56,500 mIU/ml
7 - 8 weeks LMP: 7, 650 - 229,000 mIU/ml

I also called and left a message for the head nurse at the fertility clinic. As this is turning into a more complicated deal, I'd really like to get a second opinion on how to proceed that will be best for my continued fertility options. I'm awaiting their phone call, and hope to schedule an appointment this week with him.

Possible ectopic

Nothing seems to ever be simple with my body.....(((sigh)))

My beta hcg is now up to 1366 - which is not good. It's obviously not high enough for a viable pregnancy at 6w2d, which is what I currently am at. I have a sonogram at noon today to rule out ectopic. I did start spotting a little bit this morning, but it's nothing to write home about.

Everything I've briefly read about ectopic pregnancies in the last 10 minutes since I got the phone call make me think that's probably what I've got --- other than I've had no pain symptoms, which I guess is good because it means it hasn't ruptured yet if it is indeed ectopic. I'm trying not to get ahead of myself here, but I can't hep worrying that I'm going to lose a tube over this mess. :(

My body just likes to put up a fight, I guess, in the reproductive area. Nothing, and I mean NOTHING, is ever as it should be.

I'll update after my sono in about 3 hours...

Come on body!

It's been 2 full days with no progesterone, but still no bleeding. Not even a hint of spotting. When I've used progesterone support for medicated cycles in the past, AF usually arrives on the 3rd morning after the last pill. That would have been this morning.

Part of me wonders since I had so much spotting 2 1/2 weeks ago (when AF was due), that perhaps there's actually not much more in my uterus to come out? Maybe it was more of a "chemical pregnancy"? Assuming 527 was my highest hcg and it hadn't already started dropping when I got my first beta, that's still pretty low for much embryonic development. I think I remember reading somewhere that at a beta hcg of 1000, a transvaginal u/s can usually only see a yolk sac and possibly a fetal pole.

Here's my hypothesis: I'll start bleeding when my next period is due - which is around March 14.

Here's my plan: On Monday, I'll get another beta to see how much my levels are dropping and tell Julie I want to wait it out until AF is due to see if anything happens. She'll probably want me to come back in another week (which would be March 17), which is fine. I *really* don't want another d&c - especially since it's so early and I don't think anything actually began developing. Although... I think if nothing has happened by the 17th, I might call the RE and see if he could do the surgery and do a hysteroscopy at the same time, just to check things out in there with the camera. I'd rather my RE do the d&c then the idiot obgyn who botched up my first one two years ago. Unfortunately, my midwife (who I LOVE) can't do them, and I don't particularly like any of the MDs in my regular practice.

My breasts are still pretty tender, which I'm sure is related to the progesterone supplements. But I defintiely don't "feel" pregnant. I wish I had some more internet cheapies at home - I'd take one to see how faint the line is. I can't bring myself to go Walgreens and spend $10 on a test I'm hoping is going to be negative...

No news apparently is bad news ;(

I am so, so, so very sad to report that my beta had dropped to 417 and therefore I am not, in fact, going to have a viable pregnancy :(

Nurse says to quit the progesterone and I should start to bleed in a couple days. If not, she scheduled an appt for me on Monday to see my midwife.

I feel like I'm going to die.

I tend to rebound fairly quickly, so I know that feeling will not last. In fact, I'll probably be much better by this evening, but for right now, I'm just allowing myself to feel like death.

still waiting...

on my 2nd beta results. I called this morning, but the nurse said they weren't in the computer yet. Never called me back. I am hoping that no news is good news, and I'll try again first thing tomorrow. I'm not really worried about it, I'm sure they are fine - but it'd be nice to hear it straight from the nurse's mouth!

ESP

Ok, so I've always read and heard stories about how children are ultra-perceptive about new babies. We haven't told Jenna anything yet (and don't plan to for a while) and aren't really talking about it in front of her either. But, yesterday, she drew this:



According to her, the title of her book is "Monster Vacation" and the characters are Mom, Dad, Jenna and Baby. Yes, that little blob at the very bottom is "baby."

How many pg tests do normal people keep?

I have a drawer in my jewelry stand that is devoted to pregnancy tests. It has the 3 tests I took when I conceived Jenna, the 3 tests I took when I got pregnant in 3/06 and subsequently miscarried, and now it has 2 more. Sometimes I would also keep ovulation sticks in there if they were especially pretty, and then I would subsequently discard them once AF showed for that cycle. Over the course of the past 3 days I've peeked inside that drawer to admire my two new additions about 35 different times. Such power in those two little lines.

I've been trying to find the right words to describe how it feels to me to want something so incredibly badly and have it be just out of reach month after month after month. And then, finally, it happens. And sometimes it feels like all of those painful months and years just vanish into thin air - like they never actually happened to me. Or maybe like that happened to someone else. But then again, in the very next second, I remind myself that in a blink of an eye I could be right back where I was just 4 days ago - worrying about menopause. I know I'm not out of the woods and there is still so much that could go wrong. I am trying to be positive and just take it one day at a time, relishing in my boobs that feel like they're going to fall off when Jenna slams her head into them, and that increasing saliva that in about a week is going to make me sick.

In a weird sort of way, sometimes I feel like I've let down my other fellow infertility suffers. Like some sort of martyr club we've been in together, with everyone feeling sorry for themselves and bemoaning everyone else's pregnancies. Over the past several years, I've made several "friends" who have also been desperately trying to have their first or second babies. I know how they must feel to hear my news - the same way I felt when a new pregnancy announcement appeared on the boards or IRL. IT'S NOT FAIR!!! And it's really not. Don't I know it.

Steve reacted about as I expected - cool, calm and collected. I'm not even sure he cracked a smile. Typical for him, though. He doesn't get excited very easily about anything. Also, he tends to be very cautious, so I think he's going to be holding his breath until we get heartbeat confirmation. He doesn't want to tell anyone yet, and I want to scream it from the rooftops!! We'll see how long I can hold out...

Symptoms so far include very sore breasts and nipples (which could be partially due to the progesterone), some mild fatigue and some pulling sensations down below. Also, today I noticed the increased saliva, which is usually the precursor to my all-day pregnancy sickness. I'm guessing by the end of the week the nausea will be here in force.

Repeat beta tomorrow at 8:30am. Let's hope for big numbers in both hcg and progesterone!!!

And the results are....

Definitely pregnant!

HCG was over 500 and progesterone at 15, which is really not all that low. They still want me to take the Prometrium just in case, which is FINE with me.

I went shopping with my best friend Amanda this morning. I pulled my test out and handed it to her in the car on the way to the mall and she just about fell over! Just yesterday morning I was telling her about my depressing RE visit and how I was convinced I was going into early menopause. It still just boggles my mind....

I'll go back Monday for repeat labs and probably schedule an early u/s as well. I have a good feeling about this though :)

Thanks for all the kind words and excitement. I'm still in a state of shock!

This Morning's Test

Yes, that's the test line that is so dark. It came up before the control line.

I think I'm starting to believe I might actually have gotten pregnant!!! WooHOO!!!!!

Freakout part 3

I went and got blood drawn around 3:30pm and took a Prometrium when I got back just in case. I'm counting on my progesterone being low - but my spotting is definitely tapering off so perhaps it's going back up :) Got 2 more tests too - I'll take another in the morning.....