Decision!

Yesterday at the doctor’s appointment my RE told me that I would be released to my OB on December 22 which sent a shiver down my spine… I don’t have an OB here in Atlanta and judging from my requirements, there isn’t an OB in Atlanta who fits the bill.

Call me spoiled but I had the most amazing doctor with Alex. Her name is Janice Marks and she was recommended by my NYC RE. Knowing how worried I was about staying pregnant he recommended that I see Dr. Marks. In his words, “I’ve seen her operate and she takes command” – boy was he right! She is on top of everything, tests for everything, monitors your every move. In essence, she was neurotic about my pregnancy so that I could relax. When I asked my RE yesterday if he knew anyone like Dr. Marks in Atlanta he told me, “there is no other Dr. Marks – she is one of the best doctors I’ve ever worked with” (He previously worked at Lenox Hill with her).

So I called her…and she says she thinks we can do it. I’ll be going back and forth for important appointments like the first and second trimester screenings (the nuchal and that amnio) and then she will want to see me come to NYC around week 34 if all goes well. I’d be induced at 38 weeks.

It might be a little bit of a hassle – uprooting my son for a month…and once I deliver I’ll be far from home – but the relief I feel at knowing she will be in charge of my birth is so worth it.

Mind you, my friend called me today and in the course of conversation let it slip that one her friends had a miscarriage at 8 weeks….that brought me back to earth. This is not a done deal. Some might say I’m stupid for telling anyone let alone the internet but I’ve been through enough struggle, enough loss to understand that this is not something to be ashamed of nor is it something I can control. I’d rather share my journey with my friends and perhaps help someone else out there who is still finding her way through infertility. If I miscarry I’ll be fine – I have enough support and for that I am very grateful.

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January 22, 2007

On this morning I got up, showered, waddled about the apartment packing my bag to take to Lenox Hill Hosptal, charged up my blackberry, made a small video…and left in a cab with C to go uptown for my 8:30 amnio. The procedure wasn’t that bad – it hurt for a second and then it was over. I was 38 weeks and 2 days – had I waited another three days I could have been induced without an amnio but, after all those weeks of bedrest, I was ready. The heartburn was killing me and the kicks were becoming unbearable. It was time to give my little tenant an eviction notice.

C and I left the hospital to await the report on the maturity of the lungs and headed to a burger joint nearby where we stuffed our faces. I knew that I might not eat again for a very long time so…..I chowed down. By this time I was weighing in at 180lbs….a full 50 pound heavier than my ideal weight – not comfortable at all.

We checked in to our labor and delivery room around 12pm…and at 2:30 the doctor ordered a pitocin drip to get things going. I had been 4cm dilated for weeks so was hoping this would be easy and that I would deliver quickly and painlessly. I had planned to try to give birth without an epidural. Frankly the idea of a needle in my spine was gripping me with fear. When I told my doctor that I planned to try without pain medication she laughed at me. “I have 10 patients out of 100 who do not use pain meds and believe me, you are not one of them”. I was offended at the time by her comments and determined to prove her wrong. When my OB walked in to check on me at 7pm I had progressed only only one centimeter. She turned up the dial on the pitocin and broke my water. “I’ll be back after dinner – you won’t deliver before midnight”. Immediately after she left I started to feel very intense feelings – they were contractions and it felt similar to a leg cramp (the kind that wakes you at 4am out of a deep sleep) only in my uterus. I had the anesthesiologist in the room about five minutes early but had sent him away. Now I was desperate. I called the nurse and begged her to find the anesthesiologist. I tried to walk around and breathe through the pain but i couldn’t – it was overwhelming. When the anesthesiologist showed up I willingly leaned over and let him put a needle in my spine. I felt relief almost immediately and professed my love for him. Now I was able to relax, watch some television and feel a bit peaceful. C was with me, helping me calm down. His parents were visiting from England and had stopped by to check on us. They left for dinner and a few minutes later I began feeling pressure…in my rectum. It was if I needed to take a bowel movement – all in the butt and it hurt. It wasn’t supposed to feel like this when you have an epidural – right? I called the nurse and she decided that I needed an internal. It was only 9:00pm so I told the nurse that I wanted to wait for my OB to return. I’d read stories about infection and did not want to have any internals unless it was absolutely necessary. By 9:15 I couldn’t take it anymore. The resident on duty performed an internal and found that I was ready to push – 10 centimeters dilated. When my OB arrived we began. I was pushing, and pushing and pushing when I saw my OB glance at the attending nurse. Something was wrong. The baby’s heartbeat was dipping dangerously. I was in a LOT of pain. I was given oxygen and a neonatal nurse was called. “Push as hard as you can” she told me….and push I did. “How tall are you” she asked – “5.4′ was my answer. “well you push like you are 5 feet nine inches tall – you need to stop right now because you are about to blow your labia in half”. I stopped to let her perform an episiotomy…one that required about 30 stitches to mend…

Two hard pushes later and they could see the head. My husband was watching our baby crown – and getting a bit choked up. Push, they all yelled….and then C yelled, “push!”…and I told him to shut the F up. Poor guy – I was at the end of my rope…when suddenly he was out. Alex was born at 10:31pm on the evening of January 22, 2007 at Lenox Hill hospital in NYC. At that moment I was in a daze…and quite frankly afraid to meet him. I felt shy! They put him into my arms and we gave each other a look like…”oh it is you…you are the one I’ve been kicking/you are the one who has been kicking – you are the only I’ve loved all this time”. It was so emotionally overwhelming. They took him off to be cleaned and weighed. His heart rate had been dropping because he had his hand on his face the entire time – which was also the cause of my back labor.

Immediately after giving birth they asked me to get up and walk around. I started to move but felt very ill. They would not let me move to my room until I could walk there myself but that seemed impossible. As soon as I stood up I fainted and fell to the ground. Needless to say they wheeled me to my room…where i waited until 4am for the return of my baby boy. I couldn’t sleep – I just wanted to hold him and kiss him and stare at him – which I did. Once I did get some sleep I was rudely awoken several times by nurses who needed to massage my uterus (the thought of it still makes me sick) and apply huge ice compresses to my …ugh what do you call it….vaginal area?

None of that mattered – our son was here and I’ve never felt more happy in my life. It took us 25 embryos, 3 IVFs, 2 clomid cycles and about 75 thousand dollars out of pocket but all of it was worth it. Every single tear, every minute of feeling terrified, all the pain and suffering was worth it… Nothing even compares.

IVF #3 – a conclusion of sorts

Monday, May 29 was a Memorial Day.  C and I returned to NYC that evening.  The week ahead was sure to be rough – we were putting our cat to sleep that week and I was going to get the final word from the doctor that my HGC level had indeed, like the month previous, fallen.

I had one more HPT test left in my medicine cabinet in the apartment.  When I told C that I might as well use it up – he said, “why do you keep torturing yourself”.  He was right but an HPT in my hands is like a pipe full of crack to a crack addict.  I peed on it.  Quickly the line second line indicating pregnancy became very, very dark.  What in the hell as going on here!?  Neither C nor I could believe our eyes.  Could it be?  Once again our hopes were raised.  I was kicking myself – what about all that wine and the sleeping pill!  

My hopes were quickly dashed the following morning when my period began.  I went to the RE’s office around 8am, gave blood and waited for their phone call.  It finally came at 1pm – my husband was also on the line.  I had stopped taking phone calls from the doctor at work.  C and I decided that he should learn the news first and then inform me.  I heard the voice of the nurse..and stopped her in her tracks.  “I’ve started my period, so I know what you are going to say” I informed her.  “Well, that isn’t your period – your levels went up to 51”.  I couldn’t believe it.  

I quickly learned that a level of 51 at 15dpo was certainly within range for normal betas but it became clear that this was on the low side of normal.  Only 60% (or something like that) of pregnancies with a beta such as mine went on to become normal pregnancies.  Certainly this would be a singleton pregnancy – twins would probably be a much higher level…but every two days they checked my levels and every 48 hours my beta doubled.  I was given three  IVIG transfusions -there was a theory that my immune system was causing early miscarriages and this would help calm it down.  I was also placed on blood thinners for the remainder of my pregnancy.  One shot of lovenox and one shot of progesterone until week 12.  

When my beta level reached 5000 they stopped testing me every other day and I went in for a sonogram to check for a heartbeat.  I remember I was due to attend an offsite work presentation and had to arrive late.  When I walked in they were already in progress….everyone turned, looked and me and cheered when I told them there was one strong heartbeat place in the right spot in my uterus.  When I told C the news he said, “but what happened to the other ones??”.  That made me laugh – for the first time “be thankful for what you have” became something I could not only understand but live by!

During one of my many visits to the RE for a sonogram and bloodwork I passed a short woman wearing huge black sunglasses.  Instantly I knew who she was…and so do you.  I can’t ethically post her identity here but let’s just say she is a huge star married to a very famous actor.  A few days later while giving more blood I saw her husband (my childhood crush) enter the “wank room” as my husband calls it.  A number of weeks later I saw them both pass me while giving blood – clearly they had come for a conversation after a failed cycle.   She was around 40/41 (approximately) at the time and to my knowledge has never been pregnant again.  At that moment it occurred to me that infertility can happen to anyone to everyone – money certainly helps buy more cycles but can’t make your ovaries work or make that embryo a healthy one or solve implantation failure.  

I certainly digressed…the weeks went on and on – and nervously we waited for magical #12.  We had chosen the most conservative doctor in Manhattan (by ALL accounts) and she did a wonderful job of worrying about me and testing me – so much that I felt that I could finally relax.  We had our nuchal scan (where they measure the back of the neck to check for aneuploidy) at week 11 and all looked fine.  The blood work came back normal…but my doctor was urging me to have an amnio at 18 weeks.  She told us horror story after horror story about women who had great first and second trimester results delivering downs and trisomy babies.  But I couldn’t do it.  I’d come so far and was just not willing to take the 1 in 300 risk of miscarriage that might be the result of an amnio.  When I spoke to the radiologist he told me that results like mine had never – in his 20 plus years of experience – resulted in anything other than a normal child, my decision was made.  My doctor wasn’t pleased but I didn’t care.  I couldn’t take the risk.

In my 20th week they discovered that I had placenta previa – being on blood thinners and having your placenta cover your cervix was not a good combination.  I was put on modified bed rest and allowed to get up four hours a week (which I used stupidly used to go to work!).  On December 7, when I was 31 weeks pregnant, C lost his job – on December 8 my doctor, during a routine examination, found that I had dilated to 1 centimeter, my cervix had shortened considerably and I was contracting fairly regularly.  I was put in the hospital for four days on a magnesium sulfate drip.  That was the most miserable drug I’ve ever been given – it made you feel like you had a horrible case of the flu and every muscle in my body was weak and ached.  I was only allowed to get up once a day to use the toilet.  They gave me steroid shots to help develop the baby’s lungs should it arrive early.  On day 4 I had stabilized, was no longer contracting and  allowed to go home.  I stayed on the couch and in bed for a month and half.  I ventured out for a small walk at 35 weeks and had a massive contraction which sent me hobbling back to the apartment in pain with a very angry husband…and an even angrier OB on the telephone.  When she asked me why I went for a walk I told her the truth – I was bored.  “well the NICU is very exciting” she told me, referring to the Neonatal intensive care unit…my doula called and told me that I should have a small glass of whiskey to stop the contractions.  She urged me not to tell my doctor…and I didn’t.

At 38 weeks I was induced because of my blood clotting problem.  But first, to prove my child had well developed lungs, they made me do an amnio – which I did without hesitation.  I was feeling miserable and wanted desperately not to be pregnant anymore….