14 Weeks Pregnant: Nuchal Translucency (NT) Ultrasound, Rejection, and the Early Part of my Second Trimester

Current mood . . .

After my husband left first thing Sunday morning, my weekend turned from relaxing and happy, to glum, lonely, and grim. 

The cat didn't appreciate my smothering affection.

A bright amaryllis to counteract the winter gloom.

On Monday, with my bladder full to bursting, I waited in the ultrasound clinic for my Nuchal Translucency (NT) Ultrasound. The appointment form said to be there 25 minutes early and they were late starting, so I was in agony (a full bladder is required, as this is an external ultrasound, and a full bladder is required to put the uterus in the correct position for imaging the fetus) as the minutes ticked away.

While I was waiting, I was reviewing my emails when I discovered a couple of post updates from the VFC (Victoria Fertility Centre) thread on IVF.ca. In one post, the person said that they had been reading, but not contributing lately to the board, as they were waiting a while before trying fertility treatments again. Then they singled me out (by username) as a hurtful poster! What?! Apparently, the mere fact that I have blog and have shared the link on the board (because I thought it might be helpful or interesting to some people on an IVF board since I had had IVF and read other people's blogs when I was contemplating, in the lead up, and during my IVF treatments for information and support) and the fact that I have posted about my pregnancy from IVF is hurtful.

Now, I'm not the only one posting about pregnancy, spotting, and being afraid of suffering another miscarriage on this board. In fact, I've let my posts be guided by what I've seen from other users on there in the past (I was a reader of this board long before I started contributing on there). There are several posters who post regularly about their pregnancies and even posters who share photos of their babies who were conceived using IVF. Yet I was the ONLY poster who was targeted in this post. Then two people liked the troll's post. Then someone else posted a post agreeing with the troll's post.

What?! I couldn't believe it. Why was I the only one being called out and targeted? And why was I even being targeted to begin with? I never attached photos to my posts, I never told anyone that they had to visit my blog, and my posts were far from gloating that I was pregnant and that other people on the board were not. In fact, I discussed being fearful of joining any other boards like the due date ones, because I was afraid of jinxing this pregnancy (totally irrational I know), and suffering from a second miscarriage in the same year.

So much for finding a safe and supportive place to discuss the ups and downs of fertility treatments with like-minded individuals obtaining similar treatments at the same clinic in Canada. The board did not have any parameters like you were not allowed to post once you were pregnant or anything. I read posts before I started IVF where people had become pregnant from IVF and I felt encouraged. I thought, if it can work for them, then it could work for me too (and one needs encouragement when faced with the dire numbers given before one starts IVF, in my age range the chance of a live birth from IVF is 28%). I didn't think that these posters should shut the fuck up and quit gloating and go and hide in a cave somewhere, because they've been successful and I have not been yet. I thought the board was supposed to encourage people that they can have success with IVF (not everyone will, but some people will). This type of behaviour reminds me of all of the articles I read on mentoring and the progress of women trying to shatter the glass ceiling back when I was practising law. Many of these articles concluded that many women had excellent mentors in men, but couldn't find women to mentor them, and that if women didn't stop tearing each other down and hating each other for success, women would never be able to progress to the highest echelons of their chosen professions. It's a shame that some women feel the need to tear other women down.

Anyways, I went onto the board and wrote one final post "well, no one will ever see me or my blog on this board ever again. All the best to all of you and I hope that you support each other no matter what." This post then prompted several other posts from others saying that I wasn't asked to stop posting and also that there was a pregnancy group that I could join.

Well, to hell with it. I started this blog because I wanted to share my experience with obtaining IVF treatments and any possible outcome from them. There's nothing I hate more than being censored. I refuse to censor myself for anyone. This blog is my truth and if people have a problem with it, then they can just choose not to read it. Besides, I've had nothing but supportive and encouraging responses to my blog via comments posted on my blog, via email, on Twitter, and on Instagram. I have no idea what the hell is the matter with some of these board trolls. If you don't want to read about every possible outcome from IVF, then don't read an IVF board. It's simple.

I'll let Lamont give his excellent look of contempt. That's how I feel about this whole incident.

So, to anyone contemplating using online forums and boards for "support" during the very, very stressful time of receiving fertility treatments and if one is lucky, being pregnant as a result of them, I hope that you have a better experience than I did. I certainly don't need to be singled out unfairly and kicked when I'm already down by someone trolling behind a cloak of anonymity. Anyone who has gone to my blog knows exactly who I am. This is who I am. I don't need to hide behind some user name and abuse others online to feel better about myself.

My cat is a good role model. He doesn't let anything get him down for too long.

So, back to the ultrasound clinic. Feeling very upset and rejected (not that this isn't something that has happened to me my whole life and continues to happen even through what is supposed to be a "happy" time, pregnancy), I proceeded towards the ultrasound room with just the technician (my husband was across the country working again and couldn't make the ultrasound). She advised me to let some urine out right away, as it seemed that my bladder would be too full (I could barely walk). It was unpleasant having to gauge how much urine to let out and then just stop peeing.

The external ultrasound, though was more pleasant than an internal ultrasound in some ways. Just some warm goo on my abdomen and a wand being pressed against various areas of my abdomen until she found the uterus, getting to keep my clothes on (and just pull my leggings down a little), and not being violated by an ultrasound wand for the umpteenth time. The technician looked at the areas surrounding the uterus first to check how they looked before proceeding to find the fetus. She spent about ten minutes zooming into various areas of the fetus.

I held my breath. Was it dead? No, it was moving quite vigorously. It had a heartbeat (130 beats per minute at the time she measured it, but their heart rates fluctuate all the time just like ours). I don't know why I was surprised. I can't seem to grasp that this thing might actually make it. I just can't stop reliving that horrific miscarriage that I suffered six months ago. I know I need to get some counselling to help me process this fresh grief in my life, but I'm just so exhausted and overwhelmed right now.

I asked her "so it's alive?" She said "well it certainly appears so." This was a relief to hear.

I tried to relax, but my bladder was uncomfortably full (still) and increasing in volume by the minute (they tell you to drink a litre of water an hour before the appointment and not go to the washroom after, which for me and my efficient kidneys is torture).

As she scanned over the fetus, she showed me the head, the torso with its clearly visible spinal bones and heart that I could actually see beating, the arms and hands, and the little legs and feet (crossed at one point). I couldn't believe the thing (as my husband and I have been calling it) had all those little parts in such detail already, even though it was only supposed to be the size of a peach. The technician measured it head to rump at one point and it was 11.6 cm, which is just over 4 inches. It's so much bigger than the last ultrasound I had. She took some other measurements too since the fetus was constantly moving around (it also measured 9.2 cm and 14.2 at other points, so who knows how big it actually is). The thing was 13.5 weeks when I had the ultrasound. 7.4 cm or 2.9 inches is the average crown to rump length at 13 weeks. 8.7 cm or 3.4 inches is the average crown to rump length at 14 weeks.

But the purpose of this ultrasound was actually to image the area at the nape of the neck and check how much fluid was pooling there (too much can indicate Down Syndrome). The fetus would not cooperate and the technician thought that maybe it couldn't get into a good position because my bladder was still too full. She told me to go and urinate again, but only partway again, because they still needed a partially full bladder to do the external ultrasound (the bladder holds the uterus in a good position for imaging when its full).

I went to the bathroom down the hall again. My bladder felt like it was going to burst. I let out about half of my urine as instructed. I was left feeling unsatisfied and still uncomfortable. I returned to the ultrasound room. The technician spent another ten minutes poking around with the wand until she finally had the shots of the neck area that she wanted. She said that my doctor would have the ultrasound report in a couple of days, but the actually diagnostic conclusion would not be reached until they had compiled the first blood test (done), this ultrasound (done), and my second blood test (I'll be doing that January 3rd). A little while after that, a report would be sent to Dr. Down about the risk factor of the fetus having some genetic abnormalities like Down Syndrome.

The technician handed me four photos that had she printed from the ultrasound (you're not allowed to use a cell phone at all in the examination room, so I couldn't take pictures or videos). I waddled out of the ultrasound room and back to the bathroom again where I could finally empty my bladder. What a relief.

Profile of the fetus hanging out in the uterus with a measurement crown to rump of 9.4 cm.

This picture has the measurement of the fetus as 11.6 cm.

The thing is waving for all to see.

A foot floating around in amniotic fluid.

My husband was very upset that he couldn't be at this ultrasound either. He teared up on Google Hangouts when I was describing the ultrasound and seeing the thing's heart beating and its various little body parts. I wished that I had more photos to share with him and that I could have taken a video of the heart beating (that was such a reassuring sight to me). The separation has been very difficult on us, because we're very close and used to spending a lot of time together, but particularly so, as we've been going through this stressful time of an early pregnancy, after IVF, and with a recent miscarriage to keep us terrified.

I've spent the rest of the week  running errands and cleaning the house to prepare for going to stay with my in-laws for Christmas (my husband will meet me up there on route from Halifax) and then we'll be going together to Vancouver for a couple of days before returning home. I feel absolutely exhausted from trying to get everything done before leaving. My sister has kindly agreed to take care of our place and the cat. But I'll definitely miss my little grouch.

Don't let the door hit you on the way out and turn out that light, lady. Some of us need 18 hours of sleep a day!

I didn't go to acupuncture this week. I'm going to leave it till early January (a month after last appointment, since I'm in second trimester). I went to the chiropractor for another adjustment this week. Normally I'd only go once a month, but I've been having trouble getting my neck and back to settle down after being away from the chiropractor for so many months and with all of the stress and changes from pregnancy. My neck and back are less sore than they were, but still quite stiff and sore.

Still haven't bought anything maternity related. I'll do it next week . .  . or maybe one day . . .

My biggest physical symptoms now are skin itchiness, some eczema (getting better now that I'm using hydrocortisone), some constipation and nausea (though less than before), frequent urination, some sleep problems, and exhaustion (this interferes with my day to day life the most, besides the anxiety and depression that I've been continuing to experience.) Physical symptoms though are strangely more pleasant and easier to deal with (for me at least) than mood ones, even if it's pain or nausea. Mood symptoms like anxiety and depression are bedeviling because there is often not a lot that one can do to help them and they can be far more distressing.

I actually made it out for a 5 km walk on Wednesday. I haven't been having much luck with feeling well enough or energetic enough to go for walks (or do anything) lately. I hope that this will change soon.

Should have brought a snack on my walk. Oh well, I found some carrot cake. I used to love carrot cake, but sweet stuff hasn't been nearly as appealing as it used to be for me while I've been pregnant. Strange.

I'm very nervous about travelling while pregnant (the books keep saying that now that I'm in the second trimester I should "feel great" and be peeing less and be "back to your old self" regarding energy, but so far that has not happened for me). I keep having horrifying thoughts of something happening to me while I'm away, an illness, a miscarriage, an accident, but I guess I just have to go for it or I'll be trapped in the house forever.

I am 14 weeks pregnant today (apparently the fetus is supposed to be the size of a lemon this week, though I don't know how that's progress from the size of a peach, at least it isn't with the produce that we receive in British Columbia where a peach is almost always larger than a lemon, but whatever, other charts say the thing is the size of a nectarine and that it was the size of Meyer lemon last week, so who knows). I'm travelling to meet my husband to spend Christmas with him and his family. Hopefully, as my lithium levels continue to climb on my new higher dose, I'll start to feel less anxious and depressed, but at Christmas this would seem like a miracle to me.

If only I could fly instead of having to take airplanes . . .

13 Weeks Pregnant from IVF- Spotting, Physical with Maternity Doctor, and Trying to Deal

Current mood . . .

My weekend consisted of trying to cram as many waking hours with my husband as possible and sleeping. Early Sunday morning, he left again and I fell into my usual morose Sunday state. Besides ruminating on the past and anxiously contemplating the future, I also watched some documentaries about people with worse problems than me and cried profusely. I made some chicken soup and it did not lift my mood.

Chicken soup for the shattered soul.

Monday, was an even darker day, as I stayed at home all day, exhausted, depressed, anxious, and tearful. I had had plans of leaving the house for a walk, but I just couldn't do it. Then, Monday night, after watching a celebrity overdose on drugs in a documentary, I discovered that I was spotting. My heart stopped (the entire pregnancy I have been checking every time I go to the bathroom, expecting that I'll be bleeding and that another miscarriage will be just around the corner, but this is the first time I have found anything this pregnancy).

I was certain that this was the beginning of my second miscarriage in six months. I frantically texted my sister, who had had some spotting in her pregnancy (before she went on to have my healthy and happy niece) and started to comb through various forums on pregnancy and several of the pregnancy books that my sister had lent me. I determined that since I did not have cramps or a lot of blood or blood that looked fresh (mine looked old), I could wait until the morning and then call my maternity doctor for advice. I would not have to go into emergency at the hospital and wait six hours to be seen (or more time perhaps- deplorable). My sister tried to calm me with encouraging messages about how she had had spotting (and more than me) but had gone on to have a healthy baby, but I did not sleep well (not that I have been sleeping well since I started the IVF journey).

All I could think was how is this happening to me again. What is with 2016?! Make this year from hell end.

Tuesday morning, my mind was surprisingly peaceful. I thought, well, if I have another miscarriage, I'll just die and then my tortured mind will be released from this prison of a body and my problems will be over (I just didn't see how I'd ever survive a second miscarriage at all, let alone six months after the first). It was then that it started to dawn on me that perhaps my low lithium levels had done more than I thought they had. I was clearly unstable and in a mixed episode (bipolar people can shift between various states including stable, depressed or low, manic or high, and mixed which is like an agitated depression). My husband had said last week that he thought I was in a mixed state, which I vigorously (and with much profanity) denied. But it seems that he's right. I have been depressed, very anxious, not sleeping well (but who knows if this is the pregnancy), having mood swings, and very irritable. Normally, I would treat this with a p.r.n. medication like Loxapine (which works really well for me, but not for some other people). However, though it is apparently safe in pregnancy, I'd like to see if the lithium levels rising since my dose was increased take care of this episode without the need for further drugs (it has some hideous side effects). I'm only just exiting the first trimester and I'd like to minimize the number of drugs I take if possible. Obviously, if things worsen though, I'll have to start taking Loxapine, so that I don't destabilize further and risk self harm, hospitalization in that hell hole of a psychiatric emergency ward (the psychiatric ward in the hospital is fine, but you usually have to languish in the emergency psychiatric ward for 4 day to 2 weeks or more to get into the hospital proper), or even death (bipolar people have a very high rate of suicide compared to the general population).

The cat channels my irritability well.

I called Dr. Down's office first thing on Tuesday morning and reported to his superb MOA that I had had some spotting the previous night. I didn't even have to ask her if I could come in that day (even though I had my physical examination with Dr. Down scheduled for the very next day). She immediately asked me how soon I could be there and told me to come down. Dr Down was very kind. He took out his handheld Doppler and found the fetal heartbeat. It was still there. He also examined my cervix and said that it felt normal and as it should during pregnancy. He questioned me over whether I had had further bleeding that morning (I had not) and if I had any cramping (I did not). He said that he thought that everything should be fine. He said that during pregnancy, the cervix is very sensitive and has such a blood supply that even the slightest bump (from an internal ultrasound for instance or sexual intercourse) can cause some bleeding, so likely either my ultrasound the week before or sex had done that and that I should not be concerned (hard to do when you've had a miscarriage only 6 months earlier). His MOA told me that I could always call her if I had any questions or needed to come in and she would always get me in. I was so grateful to both of them for being so kind and accommodating.

I had lunch with my sister that day and then babysat her child while she went to an appointment. Tuesday was my first time leaving the house since Friday. I returned home feeling relieved from my visit to the doctor, but also very worried. My husband, stuck on the other side of the country found the whole incident terrifying, especially because there was absolutely nothing that he could do and I was again having to go through this whole pregnancy experience alone.

Lots of fruits and vegetables. That's what I've been craving.

Wednesday, I had my physical examination with Dr. Down. As usual, whenever I show up at Dr. Down's office, I have to give a urine sample to his MOA and I get weighed (I was still down 0.2 pounds from when I started hormones for IVF on September 1st). Dr. Down didn't have to do a PAP test since I was up to date, but he did a swab, examined my cervix again to check it was still okay (it was), did a breast examination, listened to my heart and lungs, checked my blood pressure, and felt my thyroid. He also used the handheld Doppler to listen to the fetal heartbeat again. It was still there (I don't know why, but this always surprises me- I guess I'm just not over that miscarriage). He had less tests to do on me, because I already went through so many in the lead up to IVF with Dr. Hudson at the Victoria Fertility Centre. Dr. Down said that he had absolutely no concerns for my pregnancy at that point. I asked him for a refill of my stomach pill (Omeprazole for acid reflux), which he gave me. I also asked him what I could use for my eczema, which is not responding to my regime of rosewater and coconut oil. He said I could get over the counter hydrocortisone cream 0.5% or 1% and for anything below my neck, I could use Betaderm (prescription). I really appreciate how thorough and knowledgeable Dr. Down is and how he takes his time and make sure that you have all of your questions answered. His MOA is wonderful too. She booked me in to see Dr. Down again in a month from then in January and told me that in between if I have ANY concerns at all to call and she would get me in if necessary.

At Dr. Down's office.

Ready for my physical examination.

Wednesday afternoon, I had a teeth cleaning and routine examination at my dentist's office. This proved to be uncomfortable as my gums were a bit inflamed (common in pregnancy from the hormone changes). The lovely hygienist told me to use warm salt water to swish around my mouth to help the gums settle down. I did this at the very beginning of the pregnancy and it really did help, so I've taken this up again. In any event, there were no problems with my teeth and I was told to come back in six months. I booked my appointment a bit earlier than that, as six months from now is around when I'm due (if I make it that far, I still feel far from certain).

Thursday evening, I went to the chiropractor for another adjustment. I'm not quite as locked up in the neck and back as I was last week, but still very tense, sore, and uncomfortable. Lying face down for a while with heat on my back and the electric stimulation machine on proved uncomfortable due to my still quite tender breasts. After the adjustment, I booked for next Thursday, before I leave for a week (I still feel anxious about travelling right now, but it's booked, so I just have to try to brave it I guess).

This week, I haven't felt as nauseous as I did the week before. I have had some feelings of nausea, some constipation, and some headaches, but mainly physically I have been feeling exhaustion and having trouble sleeping (hard to separate how much of this is the pregnancy and how much is the mixed episode). As mentioned above, my mood symptoms, anxiety and depression, have been more distressing than the physical symptoms. Hopefully, those will subside with time.

One can learn a lot from a cat, relish the sun when it's out, rest, nap, repeat.

I kept on intending this week to go and look for maternity bras in an attempt to ease into buying something for this pregnancy and to perhaps ease some of my shoulder, neck, and back pain. But I just haven't been able to do it. I keep on having the irrational fear that buying something for this pregnancy will jinx it and then I'll lose the pregnancy and own something that I don't need. Totally irrational, I know. But last pregnancy I bought a couple of things at Value Village for the pregnancy and then I miscarried a few days later, so I can see where my brain is making the connection.

As a note to those going through fertility treatments, I have actually found the largest amount of support, understanding, and commiseration has come through my use of the IVF.ca board for the Victoria Fertility Centre (there are many different boards for different clinics and on different websites for fertility treatments and infertility though), keeping a blog (some other women do this anonymously), and through Twitter and Instagram where I have shared my journey through diagnosis, miscarriage, and IVF. I didn't think that so many people would respond to my story online who don't even know me, but it seems that there are a lot of people silently struggling with infertility or who know someone who is. Their words of encouragement and comfort have meant a lot to me, especially when I have failed to hear what I needed to hear from those who I do know (unless you've been through infertility, it's impossible to understand the struggle and the feelings and therefore it's very difficult to say the "right" thing and some people don't want to talk about it at all because it makes them uncomfortable). For those people going through this is very difficult and painful journey, I encourage you to go and look at some of the boards or blogs where people have shared their experiences with infertility and fertility treatments. You might find some comfort in knowing that you're not alone, even though it might feel like you are, because you don't know anyone who is going through it or who has gone through this (or at least not anyone who's talking about it). The boards allow you to have an anonymous nickname if you want to contribute or you can just read what others are saying (I was skeptical about what I'd get out a board and I lurked for a while just reading but I entered into the fray and found that I actually did derive comfort from talking to other people on the board going through the same thing as me). Humanity is out there, even if it might not feel like it is after some of the things that people may have said to you while you're on this lonely journey. I have chosen not to go through this journey anonymously, because I believe that unless people start talking about this pervasive issue more, improvements to the lot of those suffering from infertility will not happen and people will be left to suffer the lonely "shame" of being broken and infertile (and insurance companies will continue to get away with denying people's legitimate claims for fertility drugs under their insurance plans like they did to us, not that we've given up yet). The more that people speak out about this growing and very hidden health issue, the more that can be done to improve the lot of those with infertility and perhaps future generations will not have to suffer so much stigma, shame, and loneliness (and as my fertility doctors says, perhaps more provinces will cover or contribute to fertility treatments, so that more people can afford to actually have them done).

My husband was supposed to make it back late Thursday night, about 10:30 PM. Then a series of serious delays from bad weather at various airports across Canada made it seem that he wouldn't even make it back that night and would have to return Friday (then leave early Sunday morning again). Then further delays made him catch the flight back to Victoria to arrive home at 3:00 AM (so a monstrously late night and a very long day for him).

This living apart for most of the time is very, very difficult, but especially so when I'm feeling unwell mentally and physically and I'm going through something that is scary and foreign, pregnancy after a very foreign and expensive lead up having IVF). I didn't sign up to go through pregnancy alone and it's really hard to have to go through this largely alone (we didn't know that he'd be commuting across the country for months on end when we were going through IVF). But at least he hasn't abandoned me altogether as some unfortunate women experience this with their cowardly bastard ex-partners who leave them in the lurch. I just wish that he was around more (and so does he), so that I had someone to talk to and share the experience with in person rather than via Google Hangouts. Every night, I text him a picture of a page from a day by day pregnancy book that we have, so he can read a little about where the fetus is at in its development, but it's just not the same as having him beside me in bed and reading the book out to him and looking at the pictures together (as we do in our very limited weekend time together).

I'm 13 weeks pregnant today and since there are 40 weeks in a lot of pregnancies, I have time yet to go. Hopefully, later in the pregnancy, I'll have my husband around more and I'll feel more secure and less like I'm alone on the moon.

The orange family has a cat just like us.

12 Weeks Pregnant

Current mood . . .

As the first trimester comes to an end, I know my risk of miscarriage is going down to around 1 %. However, my perceived risk remains high. In other words, I remain terrified that I'll lose this pregnancy like I lost my last one. I think that once one has had a miscarriage, that fear is higher than it would be in other pregnancies. Add a foreign process like IVF to the mix and the fear of miscarriage will be even higher (especially when you have a specialist quoting terrifying statistics at you about your chance of miscarriage at your age- 20-25%- and your chance of having a live birth from IVF- 28%).

The cat's look clearly says "please rescue me from this Stage 5 clinger. I can't take it anymore."

I still haven't bought any maternity clothing, though I have virtually nothing that fits me. I feel like it will jinx things. I keep wondering why nothing will fit. Yes, I'm three months pregnant, but I haven't gained a single pound since I started the set of hormones for this round of IVF on September the 1st (in fact this week I was down 0.2 pounds below my starting weight). My body must be doing some interesting rearranging internally. Maybe a week from now I might invest in a maternity bra or two. For clothing, I'll wait for boxing day sales. I've heard that maternity clothes are expensive (not that it's news to me that being a woman is expensive).

Making things more difficult for me, my blood serum level of lithium dropped below a therapeutic level when I tested it this Monday at the lab. This has of course not improved my mood, which has been destabilizing for a while (as my blood volume increases with pregnancy, my requirement for lithium rises and therefore my current dose become insufficient to stabilize my bipolar disorder). And then there's my family. Neither of my parents have expressed any interest at all in my last ultrasound (8 days ago). Neither of them asked about it, asked if the fetus is still alive, or asked how I'm doing. It's as if they could care less. It's natural to want your parents to show an interest in yourself and any children that you may have, so it's bewildering and heartbreaking when they don't. After years of dealing with family turmoil, dealing with this while I'm hormonal and not properly medicated is almost more than I can bear. Other members of my family who promised to help me with something while my husband was away then went back on their word leaving me alone and unable to do certain things. It's been a very upsetting week.

At least I can always rely on Lamont, even if he looks like a grouch sometimes.

Then there's other people in my life who try to minimize and diminish my feelings of pain and dispute my perception of reality. For anyone reading this blog who doesn't think that this has been the worst year of my life, that's your opinion. This opinion is of course subjective. If I say it's been the worst year of my life then it is. Period.  But for those doubters, here's a summary of my year. I continued to struggle to become pregnant after seeing a fertility specialist in December of last year, my husband was away much of the late winter and early spring for work, only coming home on the weekends, our car stopped working and since it would have cost a fortune to repair it, we had to look for a newer car and purchase it right before we were going to have to pay for IVF, weeks after getting a newer car, I scraped it on the shitty carport at our rental duplex which is not wide enough for our new car (this was my first at fault accident ever in twenty years of having a driver's license), I turned 36 and six years after I had wanted to start having children I still wasn't pregnant and as the six month window that the fertility specialist recommended for trying to get pregnant without fertility treatments ran out, I grew increasingly depressed, I signed up to get IVF on the advice of the fertility specialist knowing that this process is a horrific combination of hormones, physical discomfort, emotional strain, and costs thousands and thousands and thousands of dollars, but I was so desperate to have a child that I charged forward with the process, going to the orientation session for IVF alone as my husband was out of town, I started my first hormone for IVF, my period didn't arrive when it should have and I found out that I was pregnant without IVF, a blood test confirmed this, I then found out that my second set of blood tests was abnormal, I then found out that the embryo was either dying or dead and I was starting to miscarry, I miscarried the only embryo I had ever managed to conceive (my father told me to "stop feeling sorry for yourself" the day I started miscarrying and was crying on the phone when he called), I was disturbed and greatly distressed and depressed by miscarrying the only baby I had ever become pregnant with and spent the summer wandering British Columbia and then Europe trying to move past this tragedy (not just mentally and emotionally, but also physically), I failed to become pregnant again, I had to watch a bunch of people that I know either have children, become pregnant, or live a joyful life with their new babies, I signed up for IVF again, I lost further friends as they failed to care about my miscarriage or support me through the very difficult and foreign process of IVF, I started hormones and went through three months of hormones including spending weeks injecting myself with hormones 2-4 times a day (with my paralyzing fear of needles) and undergoing uncomfortable and foreign medical procedures and a lot of stress all while not having much support from my family and very few of my remaining friends (and paying over $15,000 and having our insurance company deny us coverage for most of our $9,000 worth of prescription drugs that should have all been covered according to our policy), I endured horrifying side effects while undergoing IVF, but none more so than the fear and doubt that it would ever work (when a figure of 28% live birth is quoted to you, you really doubt that it will ever happen, especially if you're a recovering lawyer), I became pregnant and have continued to have nightmares and flashbacks to my miscarriage in the summer which have not allowed me to enjoy the pregnancy at all and have made me terrified of losing it, my husband has had to work on the other side of the country this autumn and will be into the spring, so I'm living with just a cat and have no one to help me or to talk to most of the time, and we haven't been able to find anywhere to move to in Victoria that has enough space to accommodate an addition to our family (and isn't completely unaffordable, rental vacancy is Victoria is not 0.5%, so lower than Vancouver's 0.7% rate now), so I feel totally trapped and hopeless. Just because I'm pregnant again and MIGHT have a baby, it does not take away what happened this year. I may move on, but I'll never forget this year (and that miscarriage is pretty much the most traumatic thing that's ever happened to me (and those who know me well will know that I've had some trauma in my life before that, so that's saying something) and it was less than 6 months ago, so it's going to take time for me to recover from it). But go ahead and judge my year for yourself. I don't care what anyone else's opinion is, because it's mine that matters to me.

Now enough about this year from hell. First, how have I been feeling this week? Physically, I've been struggling with nausea and dizziness still. Friday, I spent the entire day in bed because I was so nauseous and dizzy. I waited until my husband came home to have a shower that day because I was so afraid of falling and hitting my head in the shower. Low blood pressure remains somewhat of a problem still, seeing stars at times and feeling lightheaded. I have had constipation again on and off and some stomach upset. The headaches are not as bad now as they were during IVF treatments and the beginning of the pregnancy. My neck and back are very stiff along with my hips as my body expands and shift around with the pregnancy. I'm sleeping slightly better than I was, but still having trouble falling asleep, mostly due to not liking be in the house alone without my husband at night and going to bed far, far too late. I feel exhausted most of the time and have only been taking some short walks. I feel guilty that I'm not exercising more, but I honestly just can't deal right now. My mild eczema is starting to plague me again and I don't want to use any corticosteroids unless I absolutely have to, so I've been trying rose water and coconut oil- they are not as effective as prescription drugs. Mostly though, it is my mood that has been utterly distressing. I have been so down most of this week. My thoughts have scared even dark old me. And my constant companion, anxiety, continues to accompany me everywhere, whispering to me about everything that could go wrong and how it will go wrong and how I should just stay at home and hide.

Spending the day in bed with the cat didn't seem to bother the cat. He's always down to hang out in bed.

Monday, I had three sets of blood tests, lithium level, thyroid levels, and the first set of blood tests required for IPS (to test for genetic abnormalities). My ultrasound for IPS is coming up on December 19th. I'll be going to that ultrasound alone too as my husband will be out of town.

My eyes were still really swollen Monday morning from all the crying that I did on Sunday.

The cat was not impressed by my blood test bandage or my bandaid over my acupuncture tack.)

Later on Monday, I went to the chiropractor to get another adjustment. My neck and back have been torturously stiff and it's taking some time for things to go back to where they should be and for my body to settle down (I was away from the chiropractor for 3 months while I had IVF and my ovaries were swollen to freak size and it was too dangerous for me to have adjustments).

Tuesday, I drove out to VGH hospital to see my perinatal psychiatrist. We reviewed my blood serum level of lithium and as it was below the therapeutic level, she raised my dose of lithium to the next dose up. Hopefully, this will help with my feelings of depression and anxiety. However, as she said, anyone experiencing the stress that I've been experiencing with the miscarriage, undergoing IVF, having family strife, and worrying about having another miscarriage, would be feeling like this, so she's not going to raise my medication level too much too fast because that won't help.

Hospital lighting is always awesome.

Wednesday, I had an appointment with my endocrinologist to review my thyroid levels and of course my weight. He is of the opinion that I should not gain a single pound during my pregnancy. I know that I was heavy to begin with when I became pregnant, but I don't think it's realistic to expect that I won't gain a single pound over the ENTIRE pregnancy. So far, I haven't gained a signed pound (in fact I'm down 0.2 pounds in the last almost 3.5 months) and I'm three months pregnant, but the second and third trimesters are usually a heavier weight gain time, so I feel anxious about what's going to happen. He says that my thyroid levels are currently perfect and there's no need to change my does of either liothyronine or levothyroxine. He will see me again in four weeks to review my levels again (after I have another blood test of course). He says that during my pregnancy there may be be times when we can go as long as six weeks without meeting, but likely it will be every four weeks for the entire pregnancy (who wouldn't want to be weighed by multiple people and scrutinized every month?). He says that my dose of thyroid medications may double during the pregnancy! I am lucky to have someone who is so competent and experienced with thyroids, because they make a big difference in pregnancy. The slightest level being off can lead to miscarriages (this risk ends at about 12 weeks) and brain damage (the child being born with a low normal IQ- this risk continues into later pregnancy).

It snowed Monday night and I admired the raccoon prints in our driveway.

It's unusual to have snow in Victoria or for it to stay for a few days.

Thursday, I went for acupuncture with Stephanie at Elements of Health Centre. She told me that after 12-13 weeks, the sessions usually go down from weekly to once a month. This is good news to me as my coverage ran out weeks ago and $85.00 a session is quite a lot to pay every week.

Before acupuncture.

With chest and head needles in at acupuncture.

Today, I had massage therapy in the morning to work on my neck and back and hips which are all very stiff and sore. My neck keeps spasming and my back is so tight, it's just exacerbating the problem. I'm feeling it all the way up into my right jaw.

As Christmas approaches, I feel increasingly gloomy. I'll get about a week with my husband around Christmas, which will be lovely, but I find that no matter where I go at this time of the year, I feel empty and sad. Perhaps it's true that once you have children you get to see Christmas through their eyes and it brings you a joy that you may have never had or may have lost, but right now I don't have a child to brighten my Christmas and all I can think about is Christmases past and how much I hate this time of the year. No matter how much my husband has tried to make Christmas a happy time of year for me (including proposing to me on Christmas day nine years ago), I just haven't been able to fully shake my past. Maybe if this pregnancy continues and I have a child next year, next Christmas I'll discover the joy of a holiday that's brought me so much pain over the years. I can only wait and hope. . . .

Last Appointment with Victoria Fertility Centre, Ultrasound, Prenatal Testing, and 11 Weeks Pregnant Tomorrow

Current mood . . .

This past week I've spent in various states of hope and despair. With my husband away and the house quiet, except for a yowling cat who protests his absence, I've had an inordinate amount of time to ruminate, catastrophize, and get stuck inside the scary confines of my mind.

The week went from mild end of November to a frosty start to December. It made for beautiful opportunities to photograph the changing weather, a handsome crow, and I gathered some blue spruce and a lone rose to make an ikebana arrangement earlier in the week.

This crow has his beak full of breakfast. The Mexican mock orange bush is in bloom despite it being autumn and not spring.

Not bad for the end of November.

I don't claim to know the art of Ikebana, but I do enjoy arranging flowers and plants with antique ikebana vessels and kenzans.

December started with beautiful frost in the morning sun.

My follow up appointment with Dr. Down, my maternity GP is scheduled for December 14th. This will be a full physical. After reading the materials provided by both Dr. Down and Dr. Hudson on prenatal screening tests, my husband and I decided to go with the publicly funded prenatal test, IPS, which consists of two blood tests during different weeks of gestation (my first one will be this coming Monday when I'm getting blood tests done for both lithium level and thyroid levels- why not get it all done at once? The second blood test must be done between December 29th and February 1st- these are time sensitive blood tests that must be done in certain weeks) and an ultrasound (Nuchal Transparency Test or NT) that measures the fluid behind the nuchal area of the fetus or nape of the neck (excess fluid can indicate conditions like Down Syndrome). The NT is supposed to be done between week 11 and week 13 of pregnancy (as is the first blood test), so I'm waiting for the screening place to call me with a date. The IPS test is somewhat less accurate than the test that one can pay for privately (NIPT which just has one blood test done from 10 weeks gestation forward), but after just spending over $15,000 on IVF, we're not really in the mood to spend another $600 (and yes, we're still fighting with our insurance company to try to recover the drug expenses that they said were covered in our policy and which they now claim were only covered up to $2,500 total instead of up to $2,500 per drug, which would have meant that our entire $9,000 claim should have been covered).

Dr. Down told us that if the IPS test (the publicly funded one) looks abnormal then the medical system will generally fund the normally privately funded test (NIPT). Then if there is an abnormality found on the NIPT test, there is the amniocentesis test that is done in the second trimester and has the highest rate accuracy (but also a risk of miscarriage as a needle is inserted through the abdominal tissue into the uterus to sample amniotic fluid and test for genetic abnormalities). Amniocentesis is only publicly funded and done for women over 40, high risk pregnancies, people with a history of certain genetic disorders, and for people who have been flagged in the previous prenatal tests (like IPS or NIPT) as having a fetus with a genetic abnormality.

I went to acupuncture on Monday for continuing support of my pregnancy and treatment of some of the symptoms including anxiety, stiff back and neck, digestive system chaos, headaches, and nausea. But really, nothing can help me with my biggest problem, uncertainty. Only time can deal with that.

Before acupuncture . . .

During acupuncture . . . (these are just some of my many needles in my chest and head)

Hand needle and forearm tack for nausea.

After acupuncture (in the awesome lighting of the medical building bathroom) . . .

On Tuesday, I went to the chiropractor again for more adjustments. My neck and back are torturously stiff and sore. I don't think that the anxiety is helping and obviously with my long absence from the chiropractor things shifted out of place and it will take time to put them back where they belong and for the muscles to settle down from being splinted and stiff. Also, pregnancy leads to many changes in a woman's body, including the enlargement of breasts, which puts stress on the back and neck, the hunching forward of shoulders, and the pelvis expanding to accommodate the enlarging uterus with accompanying back changes and hip changes.

The appointment this week that I was most terrified about was today. It was my final appointment with Dr. Hudson at the Victoria Fertility Centre. I emailed the clinic yesterday to ask if there would be an ultrasound at the appointment today. With all of the anxiety that I've been experiencing about the fetus being dead and me having a second miscarriage this year, I felt that if I could see that the fetus was alive and hear its heartbeat, I might feel somewhat, though not totally, reassured (I'm still not out of the riskiest time, the first trimester). The nurses told me that there would be an ultrasound today.

I slept fitfully last night imagining what I would do if there was no heartbeat. My  husband would not be at this ultrasound and I didn't want to ask anyone else to go along with me in case the worst occurred. I could not stand the thought of anyone else watching me fall to pieces.

I drove out to the Victoria Fertility Centre this morning trying to breathe.

In the car.

I waited for my appointment after having emptied my bladder (at this stage it's still an internal ultrasound, not an external one as it is for later pregnancy ultrasounds where they do require a full bladder).

In the waiting room.

 Dr. Hudson was waylaid in a procedure and I had to wait longer than anticipated. I could feel my bladder rapidly filling back up and worried if it would be too full for the ultrasound. My husband and I texted while I waited. He had boarded his plane and was about to take off. We were both very anxious. I could barely breathe as I stared up at the ceiling tiles and forward at the beige curtain.

In the examination room before ultrasound.

Beige everywhere.

Ceiling tiles.

Dr. Hudson joined me with a nurse and started the ultrasound (luckily my bladder wasn't too full). As usual, he turned the screen so that I could take a lot of pictures for the blog. I couldn't believe it when he pointed out the fetus.

The fetus can be seen as a grey mass in the middle of the black amniotic fluid. The head is to the right (about 50% the length of the whole fetus at this point). The rump and leg below are to the left.

38.4 mm in this measurement head to rump of the fetus.

This cloudy mass is apparently my cervix and the line across is Dr. Hudson's measurement of it. 

The round grey mass in the middle of the black mass of amniotic fluid is the fetus' head.

Another shot of the fetus with the head on the right and rump and leg below on the left.

This measurement of the baby head to rump is 40 mm.

This image shows the fetus' head to the right, its arm in the middle, and rump and leg below to the left.

43.5 mm head to rump measurement in this shot.

It's amazing to think that this fetus is just reaching the size of a fig.

It was kicking. It was alive. I was most definitely ten weeks and six days pregnant. I blinked in astonishment and then quickly took a video of it kicking, so that I could show my husband. He was very disappointed to have to miss this appointment and I knew that he would want to see it (at this stage the fetus is much too small for a woman to feel it kicking, but it's in there moving around all the same).

I took more pictures as Dr. Hudson measured the length of the fetus head to rump several times (see above). It was about 39 mm (1.5 inches) up to about 43.5 mm (1.7 inches), so the fetus is making its transition from green olive (week 10 fruit size or about 31 mm) to fig (week 11 fruit size or about 41 mm). He said that the fetus is a totally normal length for 10 and a half weeks pregnant. I let out a little sigh of relief.

Then he let me listen to the heartbeat.

My eyes welled up with tears as the sound of the steady heartbeat filled the little examination room. It was normal. I took a video of that too to show my husband when he arrived home later tonight. I couldn't believe it. It was alive, it looked normal, it sounded normal, and Dr. Hudson said that he couldn't be happier with how things had turned out. He asked if I had thought of any names yet. I told him that I was still too afraid of think of names, because I was worried that I would have another miscarriage. He assured me that with each passing week, my risk of miscarriage decreases. He said that since everything looks normal, he doesn't need to see me anymore and he is turning over my care completely now to Dr. Down (maternity GP), as well as my endocrinologist (thyroid), and my perinatal psychiatrist.

Dr. Hudson gave me a printout of four of the images from the ultrasound (below- the second image has the heart rate graph on it). I quickly texted my husband, who was still waiting for takeoff, to tell him that "the thing," as we have been calling it, is alive, and to send him some pictures and tell him that I had a video of it kicking and the heartbeat. He was so relieved to receive this fantastic news before taking off on his cross Canada flight to come home for the weekend.

I went down to the drug dispensary in the clinic and gave the lovely technician my leftover items for the demos that they do there for other patients, as well as my full sharps box for disposal (and no, I do not miss shooting up 2-4 times a day). I told her that I would be 11 weeks pregnant tomorrow and that this was my last appointment at the clinic. She gave me a warm hug since as she said I was "graduating" from the clinic. Everyone that we dealt with at the Victoria Fertility Centre (VFC) was a complete joy, competent, and I feel so fortunate that we had this clinic in our city, so that we didn't have to travel to get IVF as many people do (I can't imagine the expense and stress that this adds to the process and I marvel at all the strong people on the IVF.ca VFC forum who are travelling from all over Canada to get fertility treatments done at the VFC). She told me to keep in touch and to send pictures when we have the baby.

I certainly hope that we do.