The Second hCG Test Results, Thyroid Testing, and More Acupuncture

As mentioned in my last post, I was scheduled for a second hCG test this morning at Life Labs. At the same time, I had my thyroid levels tested (TSH, Free T4, Free T3) as I suffer from hypothyroidism and optimum thyroid levels are crucial to the success of a pregnancy and the development of a fetus (thyroid levels that are even slightly off of optimal can lead to miscarriage or harm to the fetus like brain damage).

But first, let me go back to yesterday. I received a call at 8:00 AM from my nurse coordinator at the Victoria Fertility Centre. She was very concerned by my elevated TSH level (this test was added onto my Monday hCG test after the fact by Dr. Hudson). The level of 5.17 was on the high side. She advised me to increase my levothyroxine (thyroid) medication. I told her that I had already put in a call to my endocrinologist and I would be receiving advice from him.

My endocrinologist specializes in thyroids. In fact, that's the only gland he deals with, unlike many endocrinologists. I had to fire my first endocrinologist after a series of bad experiences and his failure to bring my wayward thyroid under control (which led to an escalating level of health problems and having to take a leave from my job which I was eventually laid off from as my absence stretched out from weeks to many, many months). It was difficult for anyone to stabilize my thyroid (a family doctor, a naturopath, and an endocrinologist all tried without success.) However, my current endocrinologist after time and patience managed to do what no one else could and achieved optimum thyroid levels in me. Yes, my thyroid is considered brittle, so it can just flare for no reason. Yes, I still don't have a confirmed diagnosis of what exactly my thyroid disorder is (it's "suspected" Hashimoto's Thyroiditis or Disease). Yes, my thyroid is slowly dying and the levels need to be tested relatively often and the medication adjusted regularly to maintain my thyroid levels. And yes, I'll be on medication for my thyroid the rest of my life. But, he's taken me off the wild thyroid rollercoaster ride that I was on for years and has given me back some semblance of stability. And given his hard work and expertise, I would never take advice from anyone else on whether or not to increase my thyroid medications, especially not based on just a TSH level.

My endocrinologist doesn't believe that TSH levels are useful at all. He called into Life Labs and added on Free T3 and T4 level tests to my blood test that was done on Monday after I called him (and the results popped up Tuesday online- see above). His assistant has managed to squeeze me into his tight and always overloaded (and very wait-listed) schedule tomorrow. He will tell me if I need to adjust my thyroid medications (I take levothyroxine and liothyronine- he's one of the few endocrinologists that uses this adjunctive therapy for difficult cases of thyroid disease) and I will only listen to him. I used my requisition from my appointment with him two months ago to have my thyroid levels tested again this morning to ensure that he has the latest numbers for our appointment tomorrow (I wasn't supposed to see him for another month, but he insists on seeing any of his patients who become pregnancy immediately to ensure that their thyroid levels are perfect, to decrease the chances of miscarriage or damage to the fetus from suboptimal thyroid levels).

When I pulled up my sleeve to get my blood test this morning, I could still see the mark from my blood test on Monday. But I get blood tests so often, it's just routine now.

Waiting for my blood test.

First vial.

Second vial.

My fancy arm dressing.

After my blood test this morning, I wandered to the pharmacy across the street, Forbes IDA, which has a great selection of natural foods, dried fruits, nuts, dark chocolate, Dutch licorice, and interesting spices and random items that come and go. I killed some time there (and picked up some prune juice since my intestines are still very sluggish).

From the pharmacy, I had a good view of the "snake building" as I call it. That's where that lab is (and the Chamber of Secrets).

I drove to my next appointment of the day, which was my once weekly acupuncture session of one hour with Stephanie of Elements of Health. I arrived early and read one of the numerous books in the waiting room and had a glass of water. She has an excellent selection of books on hormones, reproductive health, pregnancy, etc. in her waiting room.

Waiting for acupuncture.

Stephanie asked what my number was on my hCG test. She said that 440 is a very good/solid number for the first hCG test. I asked her if it's true that hCG numbers should double in 48 hours. She said that that's what they look for and if it doesn't double then it's a red flag that something could be wrong (but not necessarily- sometimes the number will catch up a little later/ sometimes in the ultrasound three weeks later everything is okay despite hCG numbers that were not doubling). She said that I'll probably not have to take another hCG test after this one, unless the number on this test doesn't look as it should (that's what happened to me last time I was pregnant and then I had to keep returning to the lab until my hCG levels were in the non-pregnant level to ensure that my body had actually aborted everything and I didn't have lingering tissue or an ectopic pregnancy).

Stephanie said that if the numbers look normal on the hCG test today, then I'll be waiting for an ultrasound at the Victoria Fertility Centre in about three weeks (this is earlier than people with "normal" pregnancies get an ultrasound and they get theirs at one of the lab/imaging places around town). Unless there is abnormal bleeding or something that seems off, my first ultrasound will be at the Victoria Fertility Centre. If there is abnormal bleeding or some other concern, then I would be sent to one of the imaging places in town. Sometimes people with seemingly normal hCG numbers go for their first ultrasound and then they can't find a fetal heartbeat or the sac doesn't look right and that's when they find out that they won't be having a baby after all. I don't know how I'm going to breathe for the next eight months (if I'm lucky enough to make it that far).

Stephanie put needles in my lower legs to connect to the meridians that support the uterus, my chest to calm me during this anxious wait for my next set of hCG results, and into various points in my head for my headaches from the medications (temples and between the brows), calming (between the brows), and then the top of the head for lifting and holding and supporting the pregnancy. Nothing went in my stomach or anywhere near it since the pregnancy is confirmed.

On the treatment table at acupuncture.

I find it really helpful having someone knowledgeable and not only experienced, but personally experienced to talk to about IVF matters. I have really found Stephanie to be a useful resource (in addition to her training and skill as an acupuncturist).

Needles sticking out of chest and my head everywhere.

I spent the hour on the acupuncture table trying to meditate and focus on my breathing with various degrees of success (and failure, as my mind swept me away over and over again and I fretted and catastrophized).

Needles removed, I'm ready to leave acupuncture.

#carselfie

I returned home and spent time doing housework and writing. My husband asked three and half hours before we had agreed to check the results whether they were up yet. I said that I hadn't checked and continued with my day. I didn't want to keep checking like I did on Monday. That only increased my level of anxiety. I need to try to not let fear dominate my life. But it's really hard. So much is riding on this blood test. It's not like it's just some routine thyroid level test or medication level test. I want to know if the fetus is actually progressing or if we'll be left like we were on our second hCG test in June, finding out that the fetus is not growing for some reason or another, a wait to do another test, and then the confirmation that I'll be miscarrying, again. I know that sometimes everything goes right for a pregnancy, but when so much has gone so wrong for me, especially in the last few years, it's hard to believe that I could ever have a normal or good result. And even if I do, when will I ever be able to relax and breathe? I've always been anxious (and I have a diagnosed anxiety disorder), but a series of bad events in my life has made being anxious a protective habit.

My hCG test was done approximately 48 hours after the first one (give or take ten minutes in the time I scheduled the appointments for), so my hCG level should have roughly doubled. My hCG was 440 on Monday morning, so it should be 880 or so this morning. I feel sick with worry.

At 2:00 PM,  my phone rang. I ran to find it. It was the Victoria Fertility Centre. My heart stopped. One of the nurses there was calling (not my regular nurse coordinator). I interpreted her tone as grave and I stopped breathing. But she was just calling to say that while I was on the list for them to check for result before the end of the day, since they leave at 3:30 PM and the results are not in yet, it looked like mine might not be in before they left. She said that if I didn't hear from them, I would hear from them tomorrow morning instead. It was very nice to have a courtesy call like that (you don't get that with other types of doctor's offices), but I'm so highly anxious right now that I had trouble recovering my heart rate for a while after that call.

I texted my husband about the call just after 2:00. It was one hour before we were originally going to check for the results. He suggested that we just check to see if they're up yet, since he couldn't concentrate either. I logged in to the My eHealth website that displays Life Labs results online. All of my results were still pending, hCG and thyroid levels. AAARRRGGGGG!!!!

At just after 3:00 PM, our original appointed time for checking the lab results, my husband and I called each other and I logged on. The results were still not up. The wait is agonizing.

Even though we said 4:00 PM for checking the results again, at 3:30 PM I logged in to get my thyroid results from two days ago to put up on the blog and the summary page said that the results from today were final. I called my husband and then I opened up the first test summary. It was my thyroid results. They were similar to two days ago (unsurprisingly). But this was not the test that was making my heart leap into my throat and my breath catch. I wanted to know what the hCG number was.

I opened the hCG test results holding my breath. They should have been around 880 if they had doubled, which would be a good sign. The hCG number posted is 925. I couldn't believe it. My husband and I both let out sighs of relief. I am four weeks and five days pregnant today.

Obviously it's too soon to relax, but at least this is one step forward. As my husband said, we're now in uncharted territory. We've never had a second hCG test that was at the level that it was supposed to be at. The Victoria Fertility Clinic was closed when the results were posted, so I'll have to wait until tomorrow morning to hear from them what my next step will be. In the mean time, I will go to the endocrinologist tomorrow at noon. Also this week, I must go to the Victoria Fertility Clinic to pick up more medication, so that I can maintain my Estrace (estradiol) and Endometrin (progesterone) regime (until 9 weeks gestation). I am not looking forward to more than four weeks more of supplementary hormones (the side effects remain troublesome and at times quite intense), but to keep this pregnancy I would do anything.

And now we wait . . .