it’s been a while…

i do not actively blog any more.  my passion sort of fizzled after having brian.  also, i went through a lot of muck trying to conceive again last year and just didn’t feel like i had a lot of positivity and encouragement to share.  however, if someone happens to stumble upon this blog, especially for support through infertility, loss, or a difficult pregnancy, i’d like them to know how things turned out for me.  so here goes my update.

most of 2016 was hard for me.  i do not want to rehash my infertility woes in this post, but see immediately proceeding posts to read about the muck.  i was not in a good place.  hubby and i {mostly i} decided it was time to move to a new fertility clinic.  the one we used to get pregnant with brian operates more like a business than a medical facility with the goal of trying to help couples build a family.  i couldn’t take the nickel and diming any more – after having lots of bad luck and feeling like my doctor {and the other doctors and nurses} really didn’t care about me, i could not keep forking over thousands of dollars for fees not billable to insurance.  we had things all ready to move to a new, smaller clinic that was establishing a presence in town.  in the meantime, we had one last ovulation induction cycle at our {soon to be} former clinic as a trial to see if we could transfer a frozen embryo on that type of cycle vs. a classic FET cycle since i kept having allergic reactions to something in the FET protocol.

so, i took letrozole and used gonal-f, triggered with ovidrel, and just had sex.  i couldn’t even bring myself to pay the extra $160 non-billable fee for an IUI.  besides, i knew this drill… we did this type of cycle several times before moving to IVF to conceive brian, and it. just. doesn’t. work.  at least not for me.

well, surprise!!  as sure as i was that my period was coming – sore boobs, cramps before menstruation – we actually got pregnant!  10 days after triggering, something possessed me to pee on a stick, and there were two lines.  hubby didn’t want me to call the clinic that day.  we’ve had so many chemicals, why bother.  a dear friend who had been walking most of the struggle with me last year encouraged me to call anyway.  i did, had my first beta draw that day, and my hcg was 11.  my estrogen and progesterone were also pretty low.  whomp whomp.  nurse denise kindly told me not to expect this to turn into a viable pregnancy.  that was a wednesday.  she told me to double my progesterone suppositories and originally told me to come in the next monday for repeat labs, but then said she would feel better if i came friday.  i actually got a call the next morning saying that dr. wing wanted to check my levels that day (thursday), so that if everything went up, he could administer intralipids that friday.  {side note: intralipids are sort of a controversial treatment – in theory, this IV administration of fat and proteins is supposed to keep your immune system from going crazy and attacking the embryo.}  surprisingly, my hcg, estrogen, and progesterone all experienced a decent increase the next day.  for the next 3-4 weeks, i had a lot of blood draws to keep tabs on hormone levels and a lot of intralipids.  eventually, we had our first ultrasound and saw one tiny little baby, measuring perfectly on track with a strong heart beat.  i still can’t believe it… i got pregnant by having sex {yes, with letrozole and gonal-f too.  but sex.  and no FET}.  this was definitely healing for me.

my pregnancy was scary, and we were high risk… again.  sigh.  i had a bleeding scare at 11 weeks.  my OB’s nurse had me come in for an ultrasound.  i knew it was a bad sign when the tech left the wand in my vagina and walked out of the room to get the doctor on call.  their assessment, a damage to the lining of my uterus that could cause a miscarriage.  i was immediately sent to the high risk doctor {i was supposed to see them the next day anyway for my initial appointment and NT scan}.  turns out my OB’s office just had crappy equipment and the “damage” to my lining was actually a blood vessel that they couldn’t pick up the blood flow on.  my time at the high risk doctor was supposed to end after making sure the repaired separate uterus didn’t compromise the integrity of my cervix, but by that point i had been diagnosed with intrahepatic cholestasis of pregnancy (ICP), so i had appointments with the high risk doctor for the remainder of the pregnancy.  ICP is a liver issue that can happen during pregnancy.  my liver was too busy trying to process high levels of estrogen and progesterone that it couldn’t keep up with processing bile, so bile acids spilled to my bloodstream.  this is super, super dangerous for the fetus, like causes stillbirth dangerous.  believe it or not, my OB did not want to diagnose me as having cholestasis despite lab results to prove it.  he was acting under one of the four high risk physicians who has a wildly different idea of what constitutes ICP.  so, at 20 weeks pregnant, i set out to find myself a new OB.  the new OB listened to me, explained what he knew about ICP, and treated me for it.  this OB is still in the same hospital network and had to work with the same high risk physicians, but he consulted with a different doctor at the high risk practice who agreed that i should be treated.  the most important treatment for ICP is early delivery, and for me, that meant 36w4d.  there was a lot of swirl leading up to my induction date.  apparently the high risk physicians said the baby couldn’t be born before 37 weeks unless i had an amniocentesis to prove lung maturity, even though my new OB had been telling me all along that delivery needed to happen at 36 weeks.  my OB continued to keep tabs on my bile acid levels during weeks 35 and 36, and they continued to rise.  he decided it was best to stick with the original plan for induction at 36w4d.

so, on june 14th, i reported to L&D at 7:30 PM for cervadil.  my nurse told me it would cause strong period-like cramps in my low abdomen and back.  when i was induced with brian, cervadil was a nonevent, i was expecting it to be the same this time.  well, an hour into it, the cramps appeared just as described.  they lasted throughout the night, and IV pain meds were not touching them.  at 4:45 AM on june 15th, i paged the nurse begging for more pain meds.  she said no, that the cervadil could be removed and i could get an epidural and they would start pitocin.  one problem, there were two people ahead of me for an epidural, and one of them was a c-section.  at some point in conversation, it came out that the cramps i was having were actually contractions, but they were not regular, so i guess my nurse didn’t take them seriously.  shortly after 5 AM, my nurse removed the cervadil and checked my cervix, it was only 2 centimeters.  i got up to wash my face and brush my teeth in preparation for the epidural – i knew i would be stuck in bed after that.  i was still in excruciating pain, and the epidural was taking forever to show up.  at 5:30 AM, i got up to pee.  after i was done urinating, i felt liquid running down my leg.  i knew i was not peeing on myself.  besides, who pees down the side of their leg while on the toilet?  that seems almost impossible.  i wiped up some of the liquid with toilet paper, it was tinged pink.  i yelled into our room for hubby to call the nurse {i did have to yell as he was still snoozing}.  she causally shows up 10 minutes later to confirm it was indeed my water breaking.  at this point i think i’m dying through contractions.  my nurse still didn’t take me seriously, she said they will hurt worse now because there is no water to cushion the blow.  she didn’t check my cervix again.  she leaves the room, and my only pain coping mechanisms were squeezing hubby’s hand off and swearing like a sailor.  around 6 AM (i don’t know what time exactly as it was all a total blur at this point), my crappy nurse returns and barks for me to get on my side.  apparently the baby’s heart rate was dropping during my contractions.  i was ordered to breathe too.  i told her i couldn’t and that i needed oxygen.  the oxygen didn’t make a difference, but i wore the mask anyway.  at some point i demanded she find a doctor or an anesthesiologist because i knew my pain was not normal.  she snickered at me and asked why.  she still didn’t check my cervix.  she at least stayed in the room to monitor the baby.  finally, around 6:15 or so, i told her something was coming out of me.  she asked if it felt like i had to poop.  the answer was yes.  i was still on my side and she asked to look between my legs.  she immediately told me to keep my legs closed and paged for everyone to show up – extra nurses, a baby nurse, a NICU nurse, a doctor, and a table of instruments for the doctor.  yeah, turns out i was in transition after my water broke, and my inexperienced nurse still didn’t pick up on that.  the doctor on call from my OB’s practice was in the OR with the long awaited anesthesiologist finishing up a c-section.  so, the OB on staff at the hospital had to be found.  she walked in, and several nurses helped me turn to my back because i was in too much pain to do it myself.  they put my knees/legs in the stirrups, i pushed one and half times, and baby austin entered the world at 6:24 AM {along with a giant gush of amniotic fluid, might i add… so the nurse’s explanation about less amniotic fluid to cushion the contractions was not entirely valid}.  the OB on call from my OB’s practice walked in to deliver the placenta.  my OB showed up an hour and a half later – still in shock from delivering without an epidural, i was super snarky and told him he missed the whole thing, that delivery did not go as planned, and that i did not have an epidural as planned.  i can say that recovery after this birth was much easier and quicker than with brian.  austin basically birthed himself, and i had way less drugs and pain meds, which had to be helpful. 

i struggled a lot, emotionally, throughout this pregnancy and am still struggling postpartum.  i spent the first 18 weeks in denial that i was actually pregnant and that another baby would be joining our family.  i also hid the news from most of my friends.  once i finally started to share about being pregnant, i was diagnosed with ICP, and spent the next 16 weeks living in constant worry.  now that the baby is here, we’ve had a lot of challenges with feeding.  breastfeeding was not going well because austin was too sleepy to eat, then he was diagnosed with a milk protein allergy, leading to my decision to wean.  a couple of weeks later, his intestines still seem to be a hot mess, and i’m regretting my decision to wean.  i have a few other health challenges that i’m trying to sort through – following up with the GI to make sure my gallbladder and liver are fine/healing post ICP, a small hole in my left retina, i’m overdue for a filling, and i’m trying to avoid a D&E for retained products {again}.  while none of this is life threatening, the combination of all of these issues plus a fussy newborn and a toddler in the terrible twos has almost sent me over the edge.  

to be totally honest, i’m still struggling with these challenges in the context of my faith.  i didn’t get pregnant when i wanted.  when i finally did, i had a scary condition, despite praying that my pregnancy would be free of complications.  i also prayed the entire time that i would be able to breastfeed, and that didn’t pan out either.  i definitely feel removed from God.  i know my expectations are probably too high in terms of living problem free, i am a perfectionist after all.  the Bible promises that we will have trials in this life, and it tells me i should rejoice through all seasons.  i know a lot of women are still waiting to become a mom, and would take small health challenges and formula any day to achieve motherhood… so, i guess i need to be grateful.

i’ll close by adding some of the verses that carried me through pregnancy with austin. to all those who are still suffering through infertility, loss, or a high risk pregnancy… keep running the race and keeping the faith. 

and the Lord, He is the One who goes before you. He will be with you, He will not leave you nor forsake you; do not fear nor be dismayed  {Deuteronomy 31:8}

have I not commanded you? be strong and of good courage; do not be afraid, nor be dismayed, for the Lord your God is with you wherever you go  {Joshua 1:9}

fear not, for I am with you; be not dismayed, for I am your God. I will strengthen you, yes, I will help you, I will uphold you with My righteous right hand  {Isaiah 41:10}

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