Moving Forward

I spent the rest of the week going to the chiropractor, doing long neglected housework, and slowly returning to editing some of the novels that I've been writing. I've also been contemplating escaping town for a while to have a change of scene and society. Sometimes a change makes for a good break.

I rearranged a bouquet sent two weeks ago into a smaller pottery dish I had made with a Japanese kenzan to hold up the now shorter stalks of the flowers.

My nurse coordinator from the Victoria Fertility Centre called today to discuss having an appointment with Dr. Hudson so that we could discuss next steps. I think that at this point I'm not ready to consider any options other than resting and recuperating and preparing for the future in my own time. She said that I can just drop her a line the month before we want to commence the IVF process. So, around day 1 of my cycle before the cycle I want to have IVF in, I would call her. She said that telling her in good time was important because spots for IVF fill up very fast, so they need a lot of notice.

Right now I just want to rest and recuperate.

I painted my nails for the first time since before we started into the IVF process. It may seem frivolous, but any self care at this point is a win. I feel like I'm coming back to life in some ways, but in other ways it's still a big struggle. The stress of the miscarriage and possibly the hormonal changes going from being not pregnant to pregnant to not pregnant abruptly has triggered a mixed episode of my bipolar disorder. I've been continuing with my p.r.n. medication and my symptoms are starting to settle out, but without the medication I can't sleep at night and I'm still irritable, scattered, having mood swings, food taste different, my appetite is increased, and my mind is racing with a flight of ideas.

Spotted nails to match my spotty moods.

We had some delicious Greek food for dinner tonight at The Village Taverna in town and then meandered home.

A trio of dips with pita, tzatziki, olive tapenade, and hummus.

Taking some time to prepare for the arduous process of IVF sounds like all I can handle at this point. I'll keep posting.

My mother and father both tell me to think positively and not feel sorry for myself. I'm trying. Honest.

Resilience

The past week has been very, very difficult. I didn't stop bleeding completely until the end of Wednesday (then I had some rebound spotting on Saturday and Sunday, but this seems to be gone now). I didn't leave the house at all after my lab visit last Monday morning until this Saturday afternoon.

While we were undergoing this fresh crisis in our lives, a box of hair accessories, that I had ordered before all of this drama, finally arrived. I pulled out the gorgeous jewel encrusted hair flowers with no interest or joy. I couldn't envision ever being able to wear something this fanciful again. I put them aside without trying even one on (and usually I can't stop trying different combinations or everything in the box together when I receive a box from Tarina Tarantino).

I stayed in my pajamas until Wednesday, when I decided to get my normal day to day cashmere sweat suit on. I managed to clean a bit, do some laundry, and make dinner for Bill. I was so bloated and swollen. I thought bitterly about how this rounded form was all for naught as I was no longer going to have a baby. That night I couldn't sleep. I was uncomfortable and hot and my mind was racing. I wasn't sure if this was because I had decreased my psychotropic medication (due to a lab test that showed a too high level of it in my blood), or if it was because I slept so much while I was at the most acute phase of the miscarriage, or if it was because I was still very disturbed by the incident, or if I was starting to have a hypomanic or mixed episode. I took some of my p.r.n. medication in the hopes that it would make me sleep and hold off any episode (stress can trigger hypomanic, manic, or mixed episodes and I had certainly had that lately,  physically, psychologically, and emotionally). I still couldn't sleep. I kept on having to go to the bathroom. My body was no doubt trying to shed some of its now excess liquid. I didn't sleep until about 2:30 in the morning (there's nothing like insomnia to convince you that lying in bed for hours on end is the most boring thing ever).

The next day, I was very subdued from the p.r.n. medication and the bad sleep and I felt very depressed in the morning. I couldn't handle the stream of emails I was receiving, along with composing my daily haiku for my other blog, managing my social media accounts, and contemplating what to even do with the rest of my day. I did the best I could with my work and then tried to numb myself with old episodes of T.V. shows so dramatic that they make my problems look positively simple. I did a brief stretch and a very few exercises on my yoga mat.

I was still feeling a pain in my abdomen, that pinched when I bent over, coughed, sneezed, or moved suddenly. I then researched this pain and horrified myself with all the possibilities of what it could be. I tried to reassure myself that it was early days yet and that I would still probably feel pain and strange sensations in the area of my uterus because I had just had a miscarriage. I made some muffins in the afternoon. That night despite taking some of my p.r.n. medication again and some antihistamines, I still couldn't sleep until almost three in the morning.

Friday, I managed to clean most of the house, which I haven't managed to do in a while (unwisely, I wore my cashmere sweat suit and due to my body trying to shed excess water since the pregnancy is now over and the humidity of the day, I ended up completely covered and dripping with sweat, which I usually never experience even with heavy exercise), do some laundry, and make dinner for my husband.

My husband, upon returning home, mentioned that this was the first time he was starting to see me emerge again. I hoped that with the exercise of cleaning the house for a large part of the day that I would sleep. I tried taking my psychotropic medication later than usual and had one of my p.r.n. tablets and went to bed. I managed to fall asleep earlier than the past two days and then I slept solidly for five hours and then slept another five hours.

I felt so much better when I woke up on Saturday. I actually felt semi-normal, something I didn't think I'd ever feel again. We had breakfast, listened to jazz music (Oscar Peterson plays the Cole Porter and George Gershwin songbooks, the first music I had listened to since the miscarriage news was first broken to me by my nurse), had some tea, had lunch, and then we actually went out for a walk. This was the first time I had been out of the house since the lab on Monday morning which was a brief in and out and before that the lab several times the week before and an appointment with my psychiatrist.

We walked through the Ross Bay Cemetery, along the water to Gonzales Bay, and then back home along Ross Bay in Fairfield. The day was sunny and sweet and I was in something other than pajamas or my cashmere sweat suit, even if it was just workout clothes, my hair was clean and combed, and all of my new Tarina Tarantino hair accessories were pinned madly into my hair as if an explosion of floral proportions had occurred from my brain and the remnants were scattered all over the top of my head for the whole world to see. Well, an explosion did happen in my brain the last couple of weeks, it wasn't floral, but the flower accessories with their crystals shining in the sun were a much more visually pleasing rendition of my mental meltdown than my venomous spiders, silverfish, and earwigs would have been.  Towards the end of our walk, a woman stopped me to complement me on the hair accessories and ask if it was a special occasion. I didn't tell her that it was a special occasion, it was the first time I felt like I could actually still be me again and envision a future that didn't involve six feet of polished wood in the shape of a box that goes underground, being a shut-in in a dour black cashmere sweat suit and worn sheepskin slippers, or going completely off the rails again and becoming my old self, a thought scarier than any other.

New hair accessories to celebrate a sunny day and emerging somewhat from complete gloom.

I bravely let my husband book a reservation to the restaurant that we absolutely loved when we tried it for the first time with our sweet friends who live in town. We made sure to reserve a half order of the Bejing duck because we couldn't stop thinking back to its succulent flesh with crispy skin on thin pancakes, with Chinese onion, cucumber wedges, and plum sauce. I changed into a pretty cotton eyelet dress and we went downtown for dinner. The restaurant, Bejing Bistro, only had us for half the meal and then one other table, so it felt like my husband had reserved the whole restaurant, so I wouldn't feel so overwhelmed by being out in public (which I had been afraid of).

The restaurant has a beautiful exposed brick wall.

After a delicious and much Instagrammed dinner, we walked over the Bay Centre and looked in the Bay for sheets (we had discovered the night before that our second to last set had deceased and we couldn't handle the pressure of only having one set of sheets left). We managed to find some sheets after a long search and much debate. Then we looked at the women's clothes and I actually found a new maxi dress, perfect for the summer and the trip to Europe that's still up in the air. I also found a linen shirt, a discovery that I was particularly thrilled about (n.b. my great grandfather founded the linen guild in Ireland back in the day and linen obsession seems to have come down strongly in my genes). The dress was on sale to my surprise when the woman rang it through the till.

I felt so grateful to not only have a husband willing to take care of me through the bad (including shopping, cleaning, cooking, soothing me, being patient with me, and taking me to the lab), but to lovingly fan my embers until my flame started to come  back to life and started to burn again and have the power to conquer my small world and eventually the world. It may seem silly being excited about finding a dress and a shirt and sheets at the Bay, but the reason why I was so amazed and excited and happy is because dead people don't need clothes or sheets and for a while I couldn't envision ever living through my present circumstances, so I knew that this was a sign that I was coming back to life, that I still have fight left in me, that I will rise again from the ashes.

Saturday night, I only had half of my p.r.n. tablet and tried to go to sleep, but after a pot of delicious jasmine oolong tea at dinner, I couldn't sleep. My mind was racing, alive with the events of the day, the possibilities of the future, and how I was going to get from where I am now to where I want to be. I left the bed more than once and tried to take time away from the bed until I was tired, but I just wasn't sleepy at all. Eventually towards 3:30 a.m., I fell asleep, but I awoke about five hours later, wide awake, and couldn't fall back asleep. So, I climbed out of bed and went and had tea. Unlike most mornings, I was wide awake.

My husband and I had a lazy Sunday morning. Well, he did, while I wrote my haiku, managed my social media, and then started working on my blog post for this blog. It was cathartic and I cried while I wrote part of it. My husband was worried and wanted to know if I needed him, but I told him that I was crying with relief, because I was so happy and amazed and hopeful that I was coming back to life after the biggest body blow I've ever experienced in my entire life. I didn't think I ever would and if I ever did, that it would be this fast.

My husband and I finished reading a book recently, well, it was an audiobook, A First Rate Madness: Uncovering the Links Between Leadership and Mental Illness by Nassir Ghaemi. It discussed how people (politicians mostly in this book) who experienced tragedy and adversity in their lives, generally became much more resilient and stronger than those who had smooth sailing their whole lives. I don't know why I've been given so many tests in my life and I'm quite frankly growing sick of them, but I do know that I am resilient and this incident has certainly reinforced that view for me. I will live to fight again. I'm just not quite ready to join the fray again.

After a so so sleep that went somewhat late into Monday morning, I spent the rest of the morning partly writing and partly trying to get help to log in to my online profile to review my mobile phone bill (Canadian mobile carrier unnamed, but there are very few and they're all awful, so take your pick and no I didn't forget my password, they have periodic problems with their system locking people out and then you get to spend 50 minutes on live chat resetting your password with two different agents, in addition to the time you spend before and after that live chat, but I digress since this is an IVF blog and not a blog about how much I hate the telecommunications industry in Canada).

I then had lunch and walked to a different Life Labs location, nearer to my house, with my new requisition for just one hCG test, rather than a standing order like in the past (that one ran out). I had booked an appointment for 1:30 and arrived five minutes early, feeling winded from only a 23 minute brisk walk (recovering from this miscarriage is harder than I had ever imagined).

The instructions on the website say to go to the check in desk immediately, even if there's a lineup, and to tell them that you have an appointment. I walked in and there was a room full of people waiting, but no lineup, so I told the harried lab technician that I had an appointment, but she dismissed me immediately and told me to sit down, without inquiring when my appointment was or looking at my requisition. One waiting patron told me that they were all waiting. I tried to explain that I was told to tell the check in person that I had an appointment. The woman to my right was visibly pregnant and was there with her husband and presumably their little daughter, who spent most of the time while I waited, stroking her mother's rounded stomach. I found this view in my peripheral vision particularly torturous considering that I'm recovering from a miscarriage. I tried to breathe in the pain and just sit with it as meditation teaches us. There was no room in the little waiting room of this lab and one woman kept hitting me with her feet when she crossed her legs. The small child became increasingly bored as we all sat and waited to check in and became louder and louder. We were all packed into the limited chairs like resentful sardines. It was such a beautiful day outside, the perfect June day, but inside it was like the seventh circle of hell with no WiFi and harried and reluctant vampires.

The lab technician took the first woman away for her blood letting.

Finally, a second, more bubbly lab technician appeared and she checked in the woman in front of me who had an appointment and then went to enthusiastically pierce her vein. I was checked in next by her after she had finished with the previous woman, since I had an appointment and the loud and growing family didn't and the old person who walked in around then didn't (and the previous lab technician was still taking buckets of blood from the woman two before me). The lab technician took my blood. It was uneventful, but gawd the lighting in those labs is awful.

This fluorescent light . . .

. . . doesn't improve my mood or selfies.

In any event, my blood wasn't taken until almost 1:50 p.m. so I won't bother going through the trial of trying to book an appointment online again, since it doesn't seem to make much of a difference, at least not at that location. Guess I'll choose yet another different location next time.

Chagrined, I left the lab and walked from James Bay to downtown and met my husband outside of his office to have an ice tea across the street. Somewhat refreshed, I walked to the Bay Centre and then up Fort Street, wandering in and out of random shops, before I returned home feeling less owly (and I will say that having a random guy greet me as "hello, goddess" on my way home, further improved my mood).

Natural light in my living room, rather than harsh lab lighting.

My nurse from the Victoria Fertility Centre had emailed me while I was waiting to have my blood drawn to ask if I had had my blood work done yet. I emailed her that I was still waiting, despite an appointment. I confirmed with her after I left the lab that I had had my blood drawn and she said she would check my results the next day (they won't be posted until after she has left the office) and call me. She also said that she had made an appointment for me to meet with Dr. Hudson in about a week and a half if I can make this work.

Quite frankly, I don't know how I feel about this prospective appointment with Dr. Hudson. Apparently, one doesn't get their period again until about 4-6 weeks post miscarriage, so there's an ovulation somewhere in there (and therefore a chance to conceive, although there are various sources that conflict over how long one should wait before trying to conceive after a miscarriage, especially due to risk of infection of the uterus immediately post miscarriage). Newer research has shown that waiting several months after a miscarriage to conceive has no appreciable benefit to the potential fetus compared to just trying right away.

I just don't know how I feel about proceeding with this loaded process at this point though. Yes, I could just charge forward and try to go through the IVF process for real this time, but when I only experienced the first hormone, Estrace, I hated it (though it's impossible to tell how much the symptoms were side effects vs. actual pregnancy symptoms, it was a double whammy of estrogen), and from what I've read of the many other hormones I'd have to take and the painful swelling of the ovaries with multiple ripe eggs and the harvesting process, I don't know if I have the strength to survive the process right now. Plus, what if we don't get pregnant that first round and I'm so demoralized by this fresh failure of my fertility that I just can't handle it and I give up completely? Or what if we do become pregnant with IVF and then I lose the fetus again? Would I be able to survive a second miscarriage so close to my first one? Or what if we do conceive and then I have to wait another three months to go anywhere for a vacation? At this point, I feel like I need a break and that I can't just take a break here. I need to get away. My husband, as usual, has a very busy and unpredictable schedule and doesn't know when he can go to Europe, so our plans are up in the air because of not just his schedule, but also this whole fertility mess. I guess in time we'll figure out what to do.

My lab results were posted online in the evening. My hCG level was less than 1 or normal (as opposed to an abnormal reading, which indicates pregnancy or some stage of miscarriage).The last time I had an hCG test was exactly one week ago and my level was 8 (still abnormal).

So, now we must decide how we will proceed with this process. Stay tuned for what our next move will be. Don't worry, even if we go to Europe soon, you can follow us on our travel blog.

Numb

Friday night through Sunday morning, I bled more heavily than I've ever bled in my life (and I've had about a dozen surgeries in my life).The pain was so intense, that even with leftover anti inflammatory and pain killers from my last surgery and a heating pad and several heat packs, I had a lot of difficulty surviving the painful cramps and spasms. During Sunday, the bleeding lessened and I tried to get up and watch TV with my husband, but I felt dizzy and out of it and kept falling asleep sitting up.

I had difficulty getting up Monday morning to go to Life Labs for another round of blood tests. My husband took me, as I was still feeling really weak and out of it. Around 8:00 a.m. seems like a magical time when one barely has to wait at all and I was in and out of the now too familiar lab in about fifteen to twenty minutes.

I'm getting sick of this view.

Oh, is this the first day of summer? Swaddled in cashmere, I couldn't care less.

I returned home and went to bed and slept until 3:00 p.m. easily. I could have slept more, but I forced myself to sit up, so I'd hopefully be able to sleep tonight. Plus, I still hadn't posted my haiku and I wanted to write another post for this blog, since I hadn't posted one since Friday.

Food tastes weird and unappealing, I'm having trouble drinking fluids like I normally would, and I have no interest at all in self care or anything at all. I still have the last remnants of the cold I came down with a week ago when I was filled with hope, being pregnant naturally for the first time in my life. Now a week later, I feel numb. I have a strong urge to flee, but no energy or drive to think of where to go or to survive a journey there. Besides, no matter where I go, I'll still be there and it's myself that I can't stand.

I've become a mute. I don't want to talk to anyone. And no one knows what to say either. Anything that anyone says offends me and being a recovering lawyer, I can twist their words into a razor sharp scythe that I can then use to wound them.

My mother, who only wants to encourage me by calling me and talking about my miscarriage, only makes me feel more hopeless. I never knew that she had had two miscarriages leading up to finally giving birth to me, but this fact only made me feel more despondent. I've only ever been able to get pregnant once and I'm eight years older than she was when she was going through that difficult journey. The chance that I'll ever get pregnant again naturally is almost zero and then if there's the possibility that I could have yet another miscarriage, why would I ever attempt this when I feel like I've barely survived this latest tragedy in my life? And if I ask for the doctor's help in getting pregnant again and put all that time, effort, hormonal agony, and money into that and then I lose that baby, how will I ever continue to live?

Even my husband, who is going through a hell of his own, can't completely understand what I'm going through, because he's only dealing with the emotional and mental fallout of the miscarriage and doesn't feel abdominal cramps, the gush of blood, and the physical weakness I'm feeling, mixed with the intensified emotional hormone fueled surges of rage mixed with complete and utter despondency, hopelessness, and defeat. If it weren't for him shopping, bringing me things to eat and drink, and taking me to the lab, I'd be huddled alone under a pile of cashmere decomposing.

The cat is bewildered by me taking to bed even more than usual, but being a cat, isn't completely against it. He slept with me all day and is now sitting beside me on the couch as I work on my blogs.

The Victoria Fertility Centre called me in the late afternoon to discuss my latest blood test results. My hCG is down to 8 (from 28 on Friday) (it must be below 5 for me to stop having tests done). I must repeat the lab test in one week. They are sending me a new requisition as my current one expires in three days. When I feel "up to it," I'm supposed to call and book an appointment with Dr. Hudson to discuss what I want to do next. But no treatments can be done until my hCG is below 5 (which is will likely be very soon). My progesterone is at 1.0 (it was at 2.5 on Friday). My TSH is at 1.84 from 1.34 on Friday.

I can't even picture ever going back to the fertility clinic again or having anything done to me ever again. I would never survive another trauma like this. I feel like I'm barely alive as it is. And while I'm sure my body, which has withstood a lot of trauma and surgeries and my brain which has suffered from a full gamut of emotional states, might be able to survive another miscarriage, my heart would reshatter along the fault lines from this latest horror and like tempered glass, would not be able to be reused and my life would just end.

But what kind of a life is this when I can't ever look forward to having a child of my own, while I watch everyone else around me effortlessly (and often accidentally) having children of their own (and not appreciating how lucky they truly are). The only thing that seems appealing at this point is death. Unfortunately, I didn't lose enough blood and I'm stuck on this hellish planet contemplating why I'm even here and how much longer I'll have to suffer for. I don't know how I'll ever gaze upon my little niece's face again or that of any other child, when even seeing children or hearing them, fills my eyes with tears and my heart with black despair.

In the mean time, I'll just sit here alone, staring off into space, my mind struggling, and my body still, numb, in a world that I've suddenly discovered is actually flat. I am in complete conflict. I want a child (or ideally two) more than anything in the world, but I'm terrified that I'll never be able to have one (or two) or what the cost will be (financially, emotionally, physically, time wise) to get there if it is even possible. At this point, it seems like a choice that no one should have to make and one that I am too exhausted and beleaguered to make.

Heartbroken

I finally had some cold medication and some antihistamines two nights ago. I slept about twelve hours.

Yesterday, my husband worked from home and I spent the majority of the day in bed. He went grocery shopping in the late afternoon and made me eat dinner. I'm so grateful that he was able to take care of us, because I'm not even able to take care of myself right now.

I had trouble  writing my daily haiku, not publishing until the evening, and when I did, it made us both cry anew:

At sunset I'll kiss
you goodbye- sweet child, I'll hold
you in my deep thoughts.

I was growing worried because I was still having a lot of abdominal pain, but not a lot of bleeding. I was quite lightheaded too. As I mentioned in a previous post, my mother had an ectopic pregnancy (before I was born) and almost died. I tried to follow the nurse's advice about staying hydrated, but it was difficult as I was very exhausted and nauseous.

When my husband and I tried to watch trashy reality shows last night to distract ourselves, we were struck by how vacuous and pointless everything seems to be. Where do we go from here?

I had a restless sleep and awoke early today to go to the lab again to have another round of blood tests. This morning I was having my psychotropic drug level tested, kidney function (standard with psychotropic drug tests) measured, and the same hCG, progesterone, and TSH tests.

My husband took me to Life Labs. I felt like bursting into tears when the lab technician asked if I'd be returning every two weeks to have my medication level tested (that's what the standing order said). I won't be, because I'm no longer pregnant.

I feel (and look) like I've been through the wringer.

I was in and out of the lab in 25 minutes, as we showed up at 8:00 a.m. and the majority of the Centrum Silver crowd had not showed up yet. Or maybe it was because people didn't want to get a blood test done on a sunny Friday.

Who wants their blood work done on a day like this?

My husband and I returned home in almost complete silence.

He worked from home while I stared blankly into the distance, tried to distract myself with inane television shows, and attempted to write. Any level of focus was difficult though and I was close to tears many times though not as hysterical as the two days before.

I keep on saying "I can't believe it," as if that will alter the fact that I'm no longer pregnant, hopeful, optimistic, a prospective mother, whole. I feel broken. Shattered. Numb. Nothing seems to have any meaning anymore.

I started bleeding more in the late morning, the cramps worsened. By the afternoon the cramps were very steady and painful and I was bleeding even more.

I checked for my blood test results online around 1:00 p.m. and they were not up. I sat ensconced on the love seat, heat packs over my tortured abdomen, bloated and filled with acute cramps.

I had emailed my nurse coordinator at the Victoria Fertility Centre in the morning about having the lab test done and I waited for her to call to discuss the latest results. Unfortunately, the results did not appear in full until 6:00 p.m. when the office was closed. I called the after hours number to ask when I should have my next test done.

My hCG had dropped yet again from 82 to 28. Pregnancy tests detect a level of about 25 and I have to fall below 5 before I can stop taking these blood tests (and so they know that nothing remains that could cause problems/requires surgery). The progesterone had gone from 19.1 to 2.5. This indicates that I am suffering from a miscarriage, as do my physical symptoms.

The nurse advised that the new levels seemed as they should be for what I was experiencing and that I should repeat the lab test on Monday.

I have told people that I can't and don't want to talk, but some people can't seem to accept this. I just feel like I can't talk to anyone right now, except for my medical team and my husband who is going through this horrific and new experience with me. We never envisioned that our newfound happiness and peace would only last three days. Right now, we just need to to grieve alone.

I usually try to write haiku that are light, funny, or pretty, but all I can think of now is what I've lost. I leave you with today's haiku from my Haiku a Day blog:

Let me linger hours

longer, dreams obscure my pain-

sleep reunites us.

Just in Time for Father's Day

The cold, acute and unmedicated, paired with the earth shattering news that we would likely not be having a baby after all, led to insomnia for both of us. We talked late into the night.

Eventually, exhaustion won over my husband. I tossed and turned and ruminated into the wee hours of the morning.

After a broken three hours or so of sleep, I awoke and was unable to fall back asleep. The torrential downpour seemed like the world's way of trying to wash away our sorrows. It didn't work. Eventually, the downpour morphed into typical Victoria drizzle.

I tossed. I turned. I took my basal temperature. I took my medications. I ruminated. I catastrophized. Then I left the present and retreated to the virtual reality of my phone for a while.

My husband woke up early when I was trying to get comfortable again. He decided he had to take me to the clinic this morning for his own sanity and comfort. My sister had offered to bring me, but I was glad to have my husband (who has the same cold) take me instead, so I wouldn't pass on this plague to her.

Mornings are course the worst time to go to a lab, but if you don't go early enough, you don't get your results before the day is out and then you're left waiting and wondering. The fasting people and the "early bird special" cohort who make up the majority of people undergoing lab tests are all there first thing in the morning. I decided to try to beat the wait by finally trying to book an appointment. I called Life Labs and they said I should register and try booking an appointment online myself, but if I had trouble to call them back and they'd book me an appointment. I wasn't thrilled by this unnecessarily convoluted process first thing in the morning, on very little sleep, with a horrific, unmedicated cold, and the weight of the world and my entire future on my shoulders (and pelvic bones). I tried registering online, but of course the system wouldn't work. I called Life Labs back, only to find out that there were in fact no appointments left for today (when they pulled up the list of appointments and looked, which they could have done when I called the first time).

I couldn't delay the lab test to another day with an available appointment, so we drove to the location of Life Labs where I have my standing order.

Why not wear cashmere pants and fur mukluks in June when it feels like the darkest winter day in your heart?

I predicted it would be an hour wait. My husband, deliberately wearing a dour black suit, predicted 1.5 hours. I waited in line to check in. The lab technician predicted an hour wait.

We found two of the last seats available in the crowded waiting room, filled with patients who would probably have rather been solving sudokus at Tim Hortons or eating dinner rolls at Swiss Chalet. I worked on my blog post, while my husband tried to work remotely. It was difficult though, as cretins around us took phone calls in the waiting room, had alerts chiming on their unsilenced phones, and played loud mobile versions of solitaire with abandon.

This is our worst nightmare.

I retreated to the bathroom for another selfie in their awesome lighting.

My nose dripped, my eyes burned with fatigue, and I had a terrible headache that I couldn't treat. Most of all though, I didn't want to be in public when it felt like my whole world was falling apart, I might lose it at any moment, and that I was just going through the motions of living when I didn't even want to exist anymore.

The wait to move from waiting room to blood drawing cubicle was only about forty minutes. Then I waited about five more minutes in the cubicle.

Natural light or incandescent, doesn't matter, I'm miserable.

Vampires prefer lavender coloured latex gloves.

This time the woman found my vein in one attempt.

Lavender coloured gloves and a lovely blue rubber band to tie me off. Pretty!

Arm candy.

I was out of the lab in about 45-50 minutes total.

The drive home was quite quiet, except for occasional broken philosophical and existential expositions from one or the other of us and heavy sighs.

And then we had to go about our days as if we weren't bothered by waiting on the blood test that would likely confirm that we are not going to be parents. We felt numb, wooden, and raw.

On a side note, I just read two days ago that around 50% of pregnancies in the USA are unplanned. Not a statistic you want to read when you're in our position, twisting in the wind, as cruel fate plays tether ball with your heart.

We checked the lab results online towards lunch and they were not up yet. Agony delayed.

We checked again after lunch. Nothing.

My father called me to ask how I was doing. I told him that I was terrible. He said that I was always terrible and then he told me to look on the bright side. I told him that there was no bright side because in all likelihood I had a dead fetus inside of me or worse yet might have an ectopic pregnancy like my mother had had (and she almost died from hers). He suggested we have lunch soon. I said I didn't think I'd be up for going up anytime soon and in any event that I might have to have surgery. He suggested then that we put it off until the weekend. I was too numb to even cry at his insensitivity.

I was being tested again for hCG, progesterone, and TSH to see how the levels were progressing or not. The hCG results didn't show up until the mid afternoon. It felt like the longest day of my life as I kept checking the website. When I saw the hCG results, my heart sank. At 82, they were sinking, rather than rising like they were supposed to. The fetus, or whatever it was, was dying or dead. The progesterone and TSH results were not up yet, but it didn't really matter, because we knew that what the nurse had said yesterday was for sure true, we were not going to have a baby.

Yesterday and today are the two darkest days of my life. I felt too numb and overwrought to even cry after the hCG results. I can't imagine ever getting over this fresh agony in my life. Worse yet, I have to grieve while I still carry a dead or dying fetus in my swollen body with tender breasts and I'm filled with hormones that make me feel even more emotional and irrational.

The ugly feeling I had had in my stomach earlier, worsened over the afternoon. I felt crampy and had stabbing pains in my stomach and abdomen.

The progesterone results and TSH results were posted around 4:00 p.m.. They were not good either.

I went to the washroom after reviewing the final results and I was bleeding. Any hint of a hope I had that the results were in error has been dashed. My body is vibrating with fatigue and emotional stress, I feel like I'm going to throw up, I have a strange tingly feeling across my abdomen mixed with sharp stabbing pains from my stomach all the way down through my abdomen on top of the feeling of cramps like normal menstrual cramps. My head aches, but I feel like I can't take anything. I want to feel it all and say goodbye to the baby that never was. In any event, no painkiller is ever going to dull the pain in my head and my heart.

I called the after hours nurse coordinator number at the Victoria Fertility Centre. She told me that I was in the first stages of a miscarriage by the look of the numbers on my lab tests and the sound of my symptoms. She warned me to have my husband come to the bathroom with me in case I faint from heavy bleeding. She also told me that it's best to shed "the remnants of my pregnancy" at home instead of at the hospital if possible. I should stay hydrated, but if I am bleeding very profusely, if I'm very lightheaded, or I'm fainting, I should go to the hospital. I must repeat the blood tests on Friday to see where my hCG is. And I will have to keep doing this until my hCG level goes below 5. Then I can think about next steps she said.

At this point, the thought of a next step is overwhelming and terrifying to me. It took me a long time and a lot of counselling and soul searching to accept that I could undergo IVF and that I was going to go that route. Now I feel worse than back to square one. My aversion to having IVF is back with a vengeance and I feel like I can't handle the pain, disappointment, physical strain, emotional roller coaster ride, and the possibility that I may go through all of that agony and still not conceive or worse yet, not carry the baby to term again.

I just keep thinking that maybe this just isn't meant to be and I should reassess my entire life and my goals and do something different, leave, and never come back. This has been the most agonizing experience of my life, because it's primarily emotional. I'd take a dozen more surgeries in my life, over this fresh emotional agony. In the fight or flight scenario, I feel like I can't fight anymore and all I can do is flee. But when you're running from yourself, there's nowhere to go.

A Waking Nightmare

I woke up with an awful cold today (courtesy of my loving and generous husband). What a wonderful time for a cold. In the first trimester, when so much development is occurring, pretty much nothing is recommended in the way of over the counter medications, so I'll have to go this one alone.

I went to Life Labs for a repeat of my hCG, progesterone, and TSH levels with my standing order from the Victoria Fertility Centre. They had explained that the hCG should double (every 48-72 hours), the progesterone should maintain, and the TSH should not climb much more (if it was over 2.5, it would be a problem).

I waited in the waiting room of the lab under a mural of some anonymous and fit woman on the wall.

Then I waited some more in the blood drawing cubicle.

The woman who was drawing my blood went with my somewhat less reticent right arm, but still had trouble getting blood from me and after I protested in pain, she abandoned the one site and tried again in the same arm to get a cooperative vein. She eventually succeeded, but I was left with a very handsome double cotton ball and tape look.

I then drove over to the gorgeous old hospital that houses my psychiatrist's office. Who knew hospital architecture could be so graceful?

I waited in the beautifully lit waiting room of the old hospital for my psychiatrist.

My psychiatrist congratulated me and explained that a medical resident would be sitting in on the meeting for learning purposes. That was fine with me.

He said that he had referred me to a perinatal psychiatrist. I said that he had not and that I had had to go to my GP to get a referral because his receptionist had told me that he could not do it. He was baffled. He said that he had just written my referral last Friday and that he was going to have to talk to the receptionist to figure out how his message had become so scrambled. He apologized for the confusion. I was annoyed because it meant that I had had to take another visit to yet another doctor unnecessarily, but that's this medical system for you.

My psychiatrist gave me a requisition for yet more blood tests. He will be testing my renal function as well as my blood levels of my medication to ensure they are at a therapeutic level and safe for the pregnancy. Of course, as we discussed, it is really not completely safe to be on most medications for pregnancy, but it is more dangerous if the mother deregulates, has a mixed, hypomanic, manic, or depressive episode, as this puts undue stress on the fetus. Really, it is a balancing act where the lesser of two evils is chosen. In my case, the perinatal psychiatrist who I consulted with two and a half years ago, said that I need to stay on my medication and just be monitored frequently during pregnancy. She also added that while older clinical trials had claimed some increase in birth defects from using the medication during pregnancy, more recent trials had failed to demonstrate an appreciable risk to the fetus versus the risk if I stopped the medication and destabilized.

My psychiatrist told me to keep track of my moods (I do this daily using a mood tracker form) and if they are low, do a QIDS inventory to keep track of what my depression score is week to week. I have done this in the past and it can help to assess how effective any PRN medications you are taking are (PRNs are medications that you add on to your regular medications in times of need for instance for conditions like anxiety, panic attacks, sleep problems, hypomanic or mixed symptoms, or depression).

He told me that if my mood destabilizes, I should book in to see him earlier than the two month follow up appointment that he was going to book for me. When I explained that it was almost impossible to get into see him because his schedule was always so full and that the receptionists almost keep him on lock down, he seemed dismayed that it was so difficult for me to get in to see him. He said that using the keyword "pregnant" was the way to ensure that they would fit me in.

He also said that if I ever had to go back to the hospital due to destabilization of my mood or for a dramatic adjustment to my medication, he could put me on a wait list so that I could skip the horrendous emergency triage for psychiatric treatment (PES) that we have in Victoria, BC. I told him that that would probably take months (how long other patients in the hospital had been on the wait list before being able to go straight to the hospital for treatment without having to go through the seventh circle of hell, PES). He said it should take about two to three weeks. I told him that usually when moods get that bad you don't have that amount of time to wait and you need to hospitalized immediately. He agreed, but he said that all we can do is try to work with what we have in this system. How depressing.

He told me to review my lab test results online and if my blood level of medication drops below the therapeutic range that he gave me, I should call him to get in early to see him. If the level was good, then I could wait four weeks to retest. If the level was bad, I should retest in two weeks. Once I'm into August and see him again, I should probably be testing my blood medication level every two weeks to ensure that the level is therapeutic as my weight and blood volume increase.

I went home and waited for the lab test results to appear online that evening so that I could see where my hCG, progesterone, and TSH were. My husband and I reviewed them together and were instantly concerned.

The hCG level was exactly the same (it should have increased dramatically from the last test), the progesterone had basically halved, and the only good news was that the TSH (which my endocrinologist says is a useless measure that should not be relied upon) was slightly lower.

It was too late to hear from my nurse coordinator, so my husband and I did what anyone would do now, scour the internet for comfort. Some sites seemed to say that hCG could be lower and things could still be okay and that it might not be a reliable measure. Some sites said that we were still at an okay level of progesterone for our number of weeks. We felt really worried though, as we had been told something completely different by our nurse.

In the morning, I called my nurse coordinator. She reviewed my first set of lab tests and then the most recent one. She said the most recent test did not look good at all. She said she'd never seen something like this in her twenty years in the industry (the hCG staying at the exact same number between two tests). She said she was 95% certain I would not have a baby this cycle. She said that it was too soon to tell, but it could be an ectopic pregnancy or the blastocyst could have implanted and then lost steam and that it was just burning out now. She said the only way we could know more was for me to get another lab test done the next day. She was very gentle and sympathetic, but I wanted off the phone as soon as I could. I felt like I couldn't completely lose it in front of this kind and professional stranger.

I was devastated and texted my husband to call me when he could. He called me immediately. I told him the horrible news. He said he would come home early. I told him not to bother, because there was nothing he could say to make me feel better and there was nothing we could do in any event. We were completely helpless and trapped, a position we have been in far too many times in the past six years.

When my husband arrived home (early as he had suggested), we took turns bawling our eyes out. Our dreams are shattered. I feel like I'll never come back from this. The chance that we are actually still pregnant with a viable embryo is less than 5%. Those odds are far worse than the flip of the coin odds (50%) that we were given for becoming pregnant with IVF or staying pregnant after successful IVF, 75% to 80% (and those odds already sounded dicey enough to us).

We then had to tell our currently elated families that their dreams of a grandchild, niece, or nephew had been dashed all in a single lab test. We could hear the helplessness in their broken voices as we tried to keep ourselves together enough to tell them the untellable. Any advice that was given by our families (keep your head up, just relax, don't worry you'll get pregnant again, just give it some time) fell on deaf ears burning with rage and sorrow.

I don't know how I'm going to keep it together enough to go to the lab to have the next test done tomorrow. I cannot believe I'm not in a nightmare, but wide and very painfully awake.