ChezPerky

So, here I am in perky-land. I did hear back from my nurse yesterday in the early afternoon. She was really funny about it too, because I'd said in my email that I was sorry for pestering her with an email, but I'd forgotten my cell phone and couldn't really discuss gory details about that stuff from my very-open cubicle. So when I answered the phone, she said, "Hi, you don't have to talk, it's Mary, just listen."

Anyway, we chatted for a bit and she's not so concerned about the spotting, even though it's heavier. She said that sometimes as the placenta is burrowing further down into the lining, there can be some spotting, but even sometimes there's still a little bit of shedding of the uterine lining in other parts of the uterus, which can lead to some bleeding. She agreed that either nothing's wrong and G-d is laughing at me, or something's wrong and they can't do anything about it anyway. She did offer to have me come in today for my ultrasound instead of tomorrow, but if I did that, I wouldn't have my doctor at the ultrasound, plus it wouldn't change anything, really. It would still be a matter of nothing being wrong or something being wrong that they couldn't fix.

What she was worried about was the cramping. Tuesday night and last night had I cramping that easily rated an 8 on a pain scale of 1 to 10. I'm pretty good with pain, having had at least a dozen kidney stones in the last decade, so when I say I'm really in pain, I mean it. She told me I should do my best to go home and lay down last night and tonight. She didn't think I needed to take time off of work. And I think she was mostly telling me that for my mental health more than for any physical benefit. At least, that's what I'm hoping, since my husband wasn't home last night and SOMEONE had to feed and bathe the kid (we have an almost-three-year-old foster son, if I haven't mentioned that before) and get him in pajamas, and send him to bed. Actually, he practically sent himself to bed, because I fell asleep while he was watching TV. He woke me up when his program was over and said, "Eema, it's over, it's time for bed." So cute. I yawned all the way through his bedtime stories and singing the bedtime shema (the shema is a prayer we say three times a day, including bedtime, so we sing it with him at night). Once he was in bed, I passed out on the bed again.

Yeah, I'm still THAT kind of exhausted. I don't know what the deal is, but I'm hoping that the second trimester burst of energy isn't a myth. Actually, I'm mostly just hoping I make it to the second trimester. And the third.

I'm not all kinds of pessimistic, but I'm a little tired of G-d messing with me, too. I keep wondering if I should be making plans for an IVF cycle in the near future… is this pregnancy really going to be that short-lived? I wonder if this all works out if I'll re-read these thoughts in a year and think I was far too pessimistic, or if I'll think I was justified in my hand-wringing. Sometimes I wonder what my future self will think about my present self. It's a bit weird to think about, actually.

Anyway, the point is, all is well. Still cramping. Still spotting. Again. I'm sure everything is fine and I'll look at the ultrasound tomorrow and wonder how on earth I could have been even a little worried. For now, though, allow me a tiny bit of hand-wringing.

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I'm not sure how I'm feeling. Nervous, I think. I'm spotting very heavily every evening now. By morning, it's gone or so light it doesn't matter anymore. Cramping has gotten worse, too. It has gone from barely noticeable to "ohmygodowowmakeitstop!" I'm not really certain what to make of this, to be honest.

I suspect that either nothing is wrong and I'm just going to have to learn to live with this, because, I mean, why on earth would G-d want me to actually enjoy pregnancy anyway? Or, something's wrong, but there's nothing they could do about it anyway, so I need to let it play out and figure out how it will resolve itself.

I have an ultrasound on Friday. Suddenly, I'm not expecting sunshine and light.

I sent a neurotic email to my nurse asking if she could lend any insight, but I haven't heard back from her yet. I suspect I won't hear back from her for a while, as I think she does clinical work in the morning. When it comes down to it, I doubt she'll have much to say, not because she's not smart but because I'm pretty sure I'm right: Either there's something wrong and they can't do anything about it, or nothing's wrong and G-d is laughing at me. Hah hah.

Also, I'm tired. Tired doesn't even begin to cover it. I've never felt so shattered in my life. I can barely keep my eyes open and it's not even noon. Last night at 8 o'clock I would gladly have hit myself over the head with a hammer just to get some sleep. But G-d really is laughing, because he's also making me an insomniac. I can't stay asleep for long stretches. And no, it's not a bladder thing, because that's not been what's been waking me up. VERY FUNNY, G-D! I get the joke, now cut it out!

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Sorry I didn't update on Friday; it was an extremely busy day at work and I didn't have the energy to update over the weekend.

Friday morning I had my ultrasound, two days shy of six weeks gestation. They were able to see the gestational sac, but weren't able to see a yolk sac, fetal pole, or heartbeat. None of that is surprising. My doctor is happy to have seen what she did see. She would have liked to see a yolk sac, but wasn't concerned that she didn't, and she hadn't expected a heartbeat and said that occasionally fetal poles are visible that early, but it's rare. Therefore, the news so far is good news and we'll know more at the second ultrasound. Next ultrasound is Friday, September 1.

Dr. T. said it was no problem to keep taking Allegra (and a good thing, too, because I was going to laugh very hard if she told me to stop it), but told me to ease up on the codeine. My husband (a pharmacist) can't figure out why she's squeamish about the codeine, but my guess is that it's a 1st trimester thing. Last week I had only one can of caffeinated Coke. Today I'm drinking a caffeinated Coke out of pure necessity. I feel okay about this. I admit that no caffeine would be better in the first trimester, but I think I've done really well with caffeine consumption. Most sources seem to suggest that keeping caffeine consumption under 300 mg/day is reasonable. A can of coke has about 60 mg of caffeine.

Friday after the ultrasound I came into work and had an extremely busy day. Thank heavens I had already finished all the cooking that had to be done for Shabbos. When I got home I realized I was spotting again and decided not to freak out. This has been happening in the evenings and I'm not sure why… maybe over exertion, I dunno. We had a lovely shabbos dinner with a houseguest and several other dinner guests. Saturday morning I woke up not feeling fabulous. I had been up much of the night coughing and sneezing (yay for allergies!) and woke up exhausted and queasy. I spent most of the day feeling a bit out of sorts.

Had a lovely "girls' night out" after Shabbos. There was much pregnancy talk, as one woman there had four kids, one had one kid, and one was pregnant with her first. Of course, I'm not spilling my beans just yet, so I had to keep my mouth shut, but I DID get some OB names… I found out who Julie sees and she happened to mention who another of our mutual friends saw during her pregnancy, which made me feel a lot better, since I was able to get some recommendations and honest opinions without having to suggest that I have a need for a doctor just yet.

Sunday I was completely and utterly exhausted. And hungry. Oh, so hungry! I don't believe I have ever experience hunger so pronounced in my entire life experience. I could absolutely not get enough to eat. I would eat a little bit, get full, and fifteen minutes later I was starving again. I ate every couple of hours, trying not to overeat throughout the whole day, but I know I completely blew it. I just could not stop the hunger pains. After two weeks of feeling queasy (probably from the prometrium), this was quite a change.

Today I am back to normal on the hunger front, but so ridiculously exhausted I can barely keep my eyes open, even as I'm typing this. Good thing I can touch-type, right?

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First, I should say that I don't think I'm bleeding or spotting anymore. I've gone about 36 hours without noticing any and I've been looking pretty closely, morbid or gross as that may sound. I'm still cramping but not nearly as often, nor as severely, so that's also a plus.

Yesterday I kept having to leave my desk to pee. "Aha!" I thought, "A pregnancy symptom!" Yeah, but um, then I realized I'd had about 4 liters of water to drink that day. So yeah. Not quite. So now I'm wondering if severe, unquenchable thirst is an early symptom of pregnancy. I don't think so, and I've never heard of it, but I'm kind of curious. Because I was THAT kind of thirsty yesterday. It's not every day that I drink 4 liters of water!

Also I'm queasy. Not really nauseated yet. And I'm not throwing up. But my stomach is a little skiddish.

There's a theory that it's possible I will stop getting migraines when I'm pregnant. Well, so far that hasn't proven true, but the other day I read something that suggested that migraine relief is primarily in the 2nd and 3rd trimester, so I wouldn't be getting that benefit yet anyway. Yesterday I had a horrendous migraine. There are, of course, limited things I can take for it, so there wasn't much relief other than sleep. I'm truly hoping that the theories work out and that I'll be migraine-free in the second and third trimesters. You know, if I make it that far.

My allergies are ridiculous. This is another one of those "theories". The theory is that since pregnancy is a state of immunosuppression and allergies are an immune response, allergies are often better during pregnancy. Again, this is more likely to happen during the second and third trimester when the natural steroid levels produced by your body are increased. Yet another reason to pray that someday I make it to the second trimester and beyond.

In other news, I'm a bit ambivalent about my current status. On the one hand I want to be excited. On the other hand, it doesn't seem real yet, and I don't really trust it. I'm hoping that if all goes well at my ultrasound on Friday, I'll be able to allow myself a little tiny bit of excitement.

I'm nervous though, because I don't think I was quite prepared for this. I was so absolutely sure that the fourth IUI had failed. I was so sure that the fifth we had planned would fail and I was already mentally prepared for an October IVF schedule. I feel like all of a sudden I'm reaching the end of my safety net at the Fertility Clinic. I have no idea at what point they will turn me loose to an OB, though I suspect it will be 8 or 10 weeks. I don't know if I'll ever see my RE again after Friday. I feel foolish asking, but WANT to ask, "okay, so if this all works out, and I have a baby, how long do I wait before I call you back up and start all over?" I feel pessimistic asking, "Okay, so if this doesn't work out and I miscarry after you've released me, how soon before I can come back?" but I want to.

Worse, I have no idea where to go once I'm released to an OB. I don't even think I WANT an OB. I will not go back to my OB/GYN practice. My doctor really gave me a serious attitude about going to the fertility clinic "behind her back" (I did no such thing). And she makes me feel like an irresponsible person for getting pregnant or even trying to get pregnant, before losing weight.

You know what? I'm fat. I get that. I do eat a healthy diet. I was an athlete for a long time (though no more). I know how to take care of myself. I DO take care of myself. And when I was 22, I gained 60 pounds in 5 weeks for absolutely no good reason and then put on another 30 over the next year or so, again for absolutely no good reason. At the time that I gained that weight, I was at the gym 5 days a week and walking several miles a day to and from the train station. Am I that active anymore? No, I'm not. You know how hard it is to maintain that level of activity with an extra 90 pounds to carry around? The bottom line is, I've finally gotten to a point where I'm maintaining. I'm not gaining weight (though if this whole pregnancy thing works out, I'll be gaining some weight, of course), I'm maintaining. And my primary doctor is completely happy with me just maintaining and told me to stop blaming myself for not doing more. I'm fat. I get that. I also get that I'm relatively healthy. The health problems I do have don't have a thing to do with my weight. I have good vitals, low blood pressure, slightly elevated triglycerides (which is normal with PCOS whether or not the patient is overweight), and good cardiovascular health. My OB has no right making me feel irresponsible for thinking I had a right to try to get pregnant.

So the point is, I'm not going back to my OB/Gyn Practice. Even if I didn't have those personal issues with them, nearly every woman I know that's used them as an OB practice (and I know over a dozen women who have gone there) has ended up induced or having had her membranes stripped in at least one pregnancy. Now, I get that sometimes, that's just the way it goes. But it sure does seem like it is simply the normative practice of the group and that irritates me. It could very well be that if I make it that far, I'll be all about saying "Just take the kid out, please!" But I certainly would prefer that it be a discussion, not something that's taken out of my hands. (I know at least one woman who was told at the end of one of her prenatal appointments with this practice, "by the way, I stripped your membranes, so don't be surprised if your water breaks soon." No discussion. No permission. It just seems invasive to me)

Right. So I don't know where I'm going to go. I feel ridiculous calling so early to find a practice to go to, because gosh there are just so many things that can go wrong at this point! But you're supposed to have your first OB appointment between 8 and 10 weeks, and I'm at 5 1/2 now and I know sometimes there are long waits for first appointments because they are so long. But if I make those calls, then I start committing myself to this whole thing and frankly I'm not quite over the whole, "I'm infertile, I'm never having children" thing yet.

And I keep thinking maybe I'd like to go to The Maternity Center at least for my pre-natal care, but then I realize they're in Bethesda and if I have to deliver in a hospital I'd have to go up to Shady Grove which is far, instead of Holy Cross, which is only 2 miles away, and then I remind myself that I'm getting completely ahead of myself because for all I know, I don't have a real, live baby growing inside me and I shouldn't count my chickens before they hatch. But then I think, well, that's just dumb, of course you should count on this working out. And don't you think ENOUGH doctors have been involved getting me to this point at all? Don't you think I should be allowed to have a midwife who is going to support my desires to have a natural childbirth if possible? Who will be my advocate and not my enemy?

Or am I just being stupid?

Phooey. This is ridiculous. I just need to get to my ultrasound on Friday and ask my RE what she thinks about some of this stuff, right? RIGHT?

Le sigh.

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I had my fifth, and probably final Beta today. 1725.

No, really! I'm still completely cramping, in not very pleasant ways, but the bleeding has slowed to a very slow trickle, which is really helping me believe that this might actually have worked.

I have an ultrasound on Friday. Friday! What on earth will I do with myself with no needle sticks or doctor's visits between now and then?

Deep, deep breaths.

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