1 Down, 2 To Go

Today marks Week 12, Day 6 of my pregnancy, which – depending on which books you read – is either the end of the first trimester or a week before the end of the first trimester. At any rate, my chance of miscarriage is now pretty slim, though that doesn’t seem to stop my near-constant state of paranoia.

After my miscarriage in March, it turns out it took me a little longer to get over things psychologically than expected. Part of the battle was not having dealt with – and therefore not fully appreciating the different phases of – grief. Part of the problem was getting thrust back into the unknown of Trying To Conceive. I like data, and (for good reason) doctors tend not to go testing every last option until you’ve been “trying” unsuccessfully for a year. So, each month I made do with what data I could track at home, which was repeatedly largely outweighed by the concerns of whatever issues we “might” have – endometriosis? low motility? hostile uterus? The list is endless.

Thankfully (maybe?) I had other health issues to distract me in the process. When we first started trying to get pregnant, I became acutely aware of all my little aches and pains. They’d been things I just sort of tolerated and lived with for a while, but when you’re looking for every possible clue that you’re knocked up, you suddenly become aware that those headaches are probably a little more frequent than they should be, that your stomach doesn’t feel quite right, and that your energy levels don’t seem to follow the patterns they should based on lots of other factors. In hindsight, I think the aforementioned miscarriage lead to a bit of depression (which has since resolved itself thanks to a new pregnancy (yay!) and a couple of months with an excellent therapist), which may have also been affecting those energy levels.

I had long assumed I had a ‘sensitivity’ to gluten, but with such a thing becoming so trendy now, I wasn’t sure if I was really carrying on my family legacy (we have a lot of celiacs and other food-related issues in my fam) or if I was straight up crazy. So, I saw a gastroenterologist and he suggested a super easy blood screen. A couple weeks later, I hadn’t heard anything, so assumed it came back negative. I decided to call anyway, just in case, and it turns out the screen was positive, that they had called and left a voicemail, and somehow it evaporated. After that, I saw the doctor again for a follow up. He advised I go ahead and start my gluten-free lifestyle ASAP and scheduled me for an upper GI (small intestine) biopsy to confirm the diagnosis, which came back positive, too. Finally, I had an answer. I had celiac, which was the likely source of lots of these issues I’d been dealing with, even though I had previously stuck to a “gluten limited” diet. Turns out that last 10% really mattered.

After my diagnosis, I was advised to see my GP for additional followup. The GP would run some extra tests, including a micronutrient test to check for deficiencies, since my small intestine was badly damaged and had been unable to properly absorb nutrients for goodness knows how long. My GP suggested I might want to put my conception efforts on hold until we could adequately asses the state of my health. I joked that it might be a little late for that particular cycle (I had all the data I possibly could, remember?), and we set up an appointment the following week for me to come in for an extensive blood draw to send to the lab.

The morning of my blood draw, I got to leave a little later than usual. The appointment was for 9, and I was usually at work by 8:30. Mr O had already left for the morning, and I was just dawdling around, getting ready in a slower-than-usual fashion. Right before I left, all the water, coffee, and smoothie I’d had that morning started to work their way through my system. For whatever reason, I felt like I “might” be pregnant, and decided to use this as an opportunity to take a pregnancy test. I took the test, stared at it for a minute, then realized I needed to brush my teeth and get out the door. Right before I left, I looked at the test again and saw the faintest little pink line of all time. Slightly unsure, I took a picture and texted it to Mark and one of my best friends. They both saw it too. Whoa. So much for skipping a few cycles, huh doc?

I asked the nurse if she could do a blood pregnancy test while I was there. She said since they didn’t have an on-site lab, the results would take a day or two, so I didn’t push it. Instead, I called my ob/gyn later that morning to 1. tell them I thought I was pregnant again (I was still doubting that stick) and 2. ask if I could get some progesterone supplements, like, ASAP, since I was wanting to do everything within my power to reduce my chance of another miscarriage. They congratulated me, and asked if I wanted to do a blood test to confirm. Heck yes I did, so I stopped on the way home, let the lab tap my other arm, and went home to stare at the morning’s stick.

The next morning (a Friday), I waited eagerly for the doctor’s office to call with my results. When my phone finally rang, I quickly picked up and stepped into one of the conference rooms (I work on an open trading floor with precisely zero privacy). The nurse said she got my results back and immediately asked me if I had any cramping or bleeding. No? “Oh, well when was your last period? Your HCG is really low, so you might actually be miscarrying”. I tried to tell her I thought I was a little “less pregnant than my cycle date might indicate” since I was pretty sure I knew exactly what day I ovulated and that it was not precisely 14 days after my last cycle started. She didn’t seem confident in my answer, and suggested we “take another test on Monday, just to see, before ordering any prescriptions”.

Well, there went my weekend plans! I spent the afternoon terrified, looking for ANY signs I might be miscarrying, and simultaneously googling my HCG level along with the number of “DPO” (days post ovulation) I thought I was. I may or may not have also sent Mark to Rite-Aid for more pregnancy tests, and proceeded to take another Friday night, 2 more on Saturday, 2 on Sunday. They kept coming out positive, but I was still worried. Mark told me the lines were getting darker, but still, I was paranoid. Finally, Monday morning, just before going to the lab, the line came up quick and dark, and I felt confident. I explained my worry to the lab tech, who wished me the best as she poked, drew, and sent off my sample.

A couple of hours later, I called the doctor’s office to urge them along. The lab told me it would be 4 hours, but I was impatient and still a bit paranoid. The nurse called back shortly thereafter. “Well, your results came back and your HCG is up to 74! You must be the earliest pregnancy I have ever seen in all my years of doing this!” I can’t remember exactly, but I may have shrieked. I definitely started grinning and breathed a huge sigh of relief. From there, we discussed a progesterone prescription, which I wanted, like, yesterday, since I had already “known” I was pregnant for, like, 4 days by then, and also scheduled my first ultrasound. It was early in the day and Mark and I were both at work, so rather than calling our parents, we simply emailed them to share the good news.

The next few weeks were pretty flawless. To be honest, I didn’t feel many pregnancy symptoms. I also continued getting blood tests every 6 or so days to ensure my HCG levels were rising on track, which provided regular reassurance. By the 7th week, I had started feeling a little nausea, and had a lot of food aversions, but nothing too bad. I even asked on a pregnancy forum of “morning sickness was just nausea, or if people actually do puke, too”. That same week, Mark’s parents arrived from England for the holiday they booked early this year, and aside from a bit (ok, I guess a lot) of tiredness, everything was ticking along nicely. I had my ultrasound, and it happened to be the same tech that we saw when I was diagnosed with a blighted ovum. She remembered us, and said she’d been rooting for us. She started the ultrasound and almost immediately said “there it is, I see a heartbeat!” We were so excited and relieved, and just couldn’t stop smiling. So much so, i didn’t even care that I got poked and prodded in pretty much every way imaginable over the next hour or so. It was all a blur, but it was all awesome.

After my appointment, we met back up with Mark’s parents for lunch and a day trip to the local apple country. We got some (gluten free!) apple pie, and then headed back home for a nap. The next day, we kept things relaxed, mostly hanging out at home, while I ran some errands, and then continued with the same pace on Sunday until we were headed out for dinner at a local brewery. Right as we were about to leave, I stood up and felt something. I wasn’t terribly sure what, but it really felt like something was weird. I went to the bathroom, sat down, and out came a huge clump of tissue followed by a gush of blood. Based on the shape of the clump, I was certain it was my fetal sac and that I had just miscarried again. In my freaked out state, I fished out the clump, and put it on a few layers of toilet paper. I started shouting for Mark, so he could come in and give a second opinion. He wasn’t sure what to make of it, but agreed my assumption sounded possible, so I asked him to tell his parents dinner was off and that I needed to call the doctor immediately.

Once I got ahold of the on-call midwife, I explained my situation – about my miscarriage, about how far along I was in my pregnancy, that I’d just had an ultrasound 48 hours earlier, and that I had passed a large clump of tissue and a bunch of blood. She was concerned, but said that given my ultrasound, it would be incredibly unusual for me to have miscarried so quickly without any pain or bleeding in between. She suggested I follow up with my doctor in the morning for an ultrasound, or, if I was happy to pay the copay and wanted more immediate peace of mind, then I should go to Urgent Care. Of course, Mark and I picked the more immediate choice, and made our way to the clinic.

I was checked in, and put in a gown and bed. We’d been instructed to put the retrieved tissue on ice, and bring it with us if we could, which we did. We showed it to the admitting nurse, and then brought it with us to the room. As we waited, we heard the nurse talking to someone outside, and heard him utter the phrase “it didn’t look like fetal tissue”. We were still anxious, but did look at each other with relief after hearing that. The doctor came in shortly thereafter and had me describe the situation again. He had an incredible bedside manner, and put me at ease immediately. He also said they would order some tests, so someone would be by shortly to draw my blood (I was an absolute pro at that, by now) and that they were calling in the on-call ultrasound tech to check things out. Once the ultrasound tech arrived, I got wheeled over to the other side of the clinic, and Mark was told to wait in the seating area nearby. The tech initially told me she was not allowed to give me any results, that she just took the pics, sent them to the doc, and he would review them for me. So, I was going to wait some more. However, about 2 minutes later she said “yep, there’s the heartbeat.” Apparently that “I can’t give you the results” thing is just a CYA protocol. If it’s bad news, she doesn’t want to be the one to give it to you. But if it’s good news, she’s happy to share. If she sets the expectations low to begin with, I don’t really know which it is. Ultimately I didn’t really care – my baby was there, with a heartbeat, and just a little bigger than it had been 2 days earlier. She even let Mark come in and see a quick picture. After that, we waited in the original clinic room a little longer. The doctor came back and said my initial tests looked ok, and that there wasn’t much they could do, so I might as well go home and just follow up with my own doc in the morning. We left, got dinner, and when I saw my doctor the following day, he confirmed the bleeding and tissue was completely unexplained, but that everything was fine (ultrasound was good, cervix was closed, etc). So, my “threatened miscarriage” was thankfully just that – threatened. I spent the rest of the afternoon catching up and drinking smoothies with a friend, and have since observed my doctor’s order to avoid any high impact activity.

Two days after my “threatened miscarriage”, the double-edged sword that is “legit morning sickness” kicked in. Right at 8 weeks, I woke up, started sipping coffee, and puked. I had some breakfast, and puked. Oh, so this is what happens. The next couple of weeks, that would happen intermittently. Sometimes in the morning, sometimes at night. It seems to follow no pattern – no trigger food, no trigger time, it just happens. The last couple of weeks have been especially bad. A couple of weeks back, between Friday night and Sunday morning, 1 out of 5 meals had stayed down, and that was only because it was a second breakfast I had after losing my first. When I saw my doctor for my regularly scheduled check up last Monday, I discussed the increasing sickness issue, and he advised anti-nausea meds. I tried to hold out, but a few days later, finally caved. They do help, though I’ve still found myself sick a few times since starting them, and I’m still experiencing nausea even when I’m not being sick. Every time I’m bent over the toilet, losing another goodness-knows-how-much worth of grocery money, with my eyes watering and fearing that the feeling might never end (though thankfully it usually does a few minutes later), I remind myself this is a “good sign”. Later, I think back and worry I am lulling myself into a false sense of security. I guess that’s pregnancy-after-a-miscarriage for you. Or maybe just pregnancy in general. Constant paranoia. I’m hoping now that I’m hitting that “magical” second trimester, the sickness ends for good soon, but friends and the internet are quick to remind me that it sometimes lasts much, much longer. Maybe the food aversions will at least go… between needing to be gluten free and all the foods that make my stomach turn, my options are currently feeling limited. I’m currently relying heavily on Rice Chex, fruit popsicles, the occasional salad, and potato chips. It’s a far cry from my pre-pregnancy diet, which was pretty much protein and veggies exclusively. My doctor reassures me that total calories and hydration are the most important things, and that I shouldn’t worry myself about what I’m eating. So, I guess I will indulge in some more of those gluten-free pancakes…

Every time we have an ultrasound, Mark and I feel a wave of relief. Most recently (last Monday), our little fetus was even looking very human-like with limbs swimming around and a discernible head and body. The relief lasts a few days, until something else sparks paranoia (I’ve continued to spot and bleed throughout, which is always a bit frightening). At this point, I would gladly get an ultrasound twice a week if I could. We’ve got another one coming up this Thursday, so I’m hoping that the combination of being in the second trimester (or close enough) and another little moving image will keep me at ease for good, but let’s be real here… there’ll be plenty more paranoia for the next 27 or so weeks…  So I guess I’ll hope that at least the morning sickness and exhaustion wear off sometime soon, instead.

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