It's all over but the bleedin'.

Hcg 115. Game over.  Not too surprised -- after the bleed on Thursday night, on Friday I passed something suspiciously... embryo-like.  I had this wild fantasy that maybe it was one of twins (really, self? With those betas?) but yeah, no.  Honestly, I knew it was over then.

At least the timing is actually pretty good. I'm about to go to Vegas for a week for a conference, and now I won't have to bring shots. And I can drink coffee, and take the antihistamines I've been denying myself for the past two weeks. And it is blessedly not dragging me through beta hell, meandering across and down in a laggardly fashion -- that's a damn good sharp plunge.  Almost as if I'd, you know, passed the entire sac on Friday.  So I hope that's a sign that this will be over cleanly.

If not, though, I'm going to Vegas equipped. In my cosmetics bag I have a DIY uterine evacuation kit, leftovers from the last round: misoprostol, Zofran, painkillers. If this drags on in a painful way I can take care of it quickly. I probably won't use it, but I find it incredibly comforting that I have it.

Well goddamit.

Lots of bright red blood. I don't like this.

8w ultrasound

No heartbeat. Game over.

I'm okay. Disappointed, to put it mildly, but okay. For the past ten days I've been worrying about the fact that she thought it was likely identical twins -- two yolk sacs, one gestational sac  -- and I am not a great candidate to carry twins, for a variety of reasons. But in retrospect, it turned out not to be an issue, huh?

Sigh.

Now I just stop my meds and wait for it to... pass. I was pleased and surprised to be given prescription pain-relief. My last doc didn't offer me that, but then again the miscarriages were much earlier last time. I hope this doesn't hurt too much. My theory is that doing it naturally will be less painful than taking the misoprostol. We'll see.

Just... damn.

I didn't even know I was supposed to be worrying about that.

Turns out I have Asherman's Syndrome (a.k.a. intrauterine adhesions or scarring of the uterus.) Impossible to tell whether it was caused by the c-section and then went on to cause the miscarriage and subsequent D&C, or whether it was caused by the D&C.

There I was all worried about my estrogen and follicles, when I should have been worried about my uterus.

Well, fuck.

I'm not sure what comes next. The online Asherman's support group say that it's very important to be treated by an experienced surgeon. There's one a few states away, near where my sister lives. I could go up there, I guess. I don't know. Maybe I should do a freeze-all cycle first. I'm 38.5 and not getting any younger. I don't know. It's all so exhausting to think about.

I would just like one fucking thing to be easy, thanks.

Today's beta

560. Progesterone, 23.

Since it's not going down in an orderly fashion, I'm going in tomorrow for a scan. Hopefully, we will get some reassurance that whatever cellular clusterfuck is happening in my pelvis is occurring in my uterus, not in my tubes.

I'm just so goddamned sad. I didn't really think that things would turn around with this beta. I mean, I may have had this very complicated scenario in my head involving a disappearing twin, but I didn't really believe it. I just. hoped.

Just waiting, now.

Thank you, everyone, for your kind commiserations. It really does help.

I'm pretty okay. I talked with my RE last night, and he agreed that there was no real reason to keep taking the PIO. We'll be checking my hcg again on Friday; hopefully it will be going down on its own in a peaceable, orderly fashion. Hopefully then my progesterone will also fall; even though I'm no longer supplementing it, since I did ovulate my body is likely producing some on its own and I won't bleed until it shuts down production.

Last night, I:

1. Had a glass of wine;
2. Let myself use my laptop in my favorite position, with it balanced on my stomach otter-fashion;
3. Did not have a 1.5" needle jammed into my ass.

So the evening was not without its redeeming features. This morning, I had real coffee, with real caffeine.

I don't know. Three chemical pregnancies, one with a barely-there beta, two with decent enough but non-doubling betas. Once might be misfortune, but twice starts to look like carelessness. Chromosomal issues? Immune issues? Does it matter? Should I just keep slinging embryos in there and wait for one to stick? Obviously one did stick, three years ago.

I'm tired. I'm sad. I'm displeased that I have such a strong feeling of anger towards myself for being optimistic, for believing that dark line 4dp5dt, for typing information into a due-date calculator. Part of me says "Oh, really, you knew better than that. An old campaigner like you should know by now that two lines on a pee-stick do not necessarily equal a gurgling infant nine months later."

But... I don't want to be that person. I don't think there's anything particularly evolved about being cynical and pessimistic. Optimism is the more difficult path, and the better one. I should be proud that I managed to be so excited and happy. But I can't help looking back and wincing at myself, shouting back into time shut up shut up shut up close that browser window, girl, you're not going to need that mei tai.

Maybe it's my Jewish cultural conditioning, the idea that rejoicing about anything is like waving a red flag at the evil spirits and saying "come get me". Maybe it's an ugly streak of my psyche that snottily finds anything preferable to being a fool.

Beta #4

567, for a doubling time of.... 105 hours.

Yeah, it's over.

Thanks for stopping by, hope.

I guess, technically speaking, this will be a chemical, not a miscarriage. Hurts a lot more than the last one did, though.

I can't believe how well and truly fooled I was by that early, dark test.  Bitter!me says: I can't believe I fell for that.

Now I just have to hope it's not ectopic.

I fucking hate the next few steps, to wit:

1. The passing of the physical products of conception
2. The bills for the failed cycle come rolling in.

Fuck.

10dp5dt:: Good thing I kept the receipt for those booties!

Beta was

wait for it

8.

Doc wants me to stay on meds until Monday and re-test. I'm partially "wtf" but I guess it's not a big deal to give it another 48 hrs. I mean, 3% is not 0%, right? All I have to lose is a few days of time; I wouldn't give it two weeks, but I'll give it two days.

Now my hope is for a swift, clean chemical. No hanging around for weeks making unhelpful amounts of hCG and preventing me from trying again. And, for the love of god, please not ectopic.

In the "disappointing" category also: doc wants to wait through a cycle before doing another frozen transfer. I find the waiting-around cycles particularly grinding, and was hoping we could rush straight into another FET.

26w3d: lilacs out of the dead land

All month I've had the slightly itchy feeling I'll be glad when April's over.

Today is April 30, the one year anniversary of the end of my first pregnancy. I mean, it probably isn't the anniversary of the end; April 30, 2008 was a Wednesday, and the pregnancy probably ended the Thursday prior, which I guess would be April 24. But it was the end of my thinking I was pregnant, and that's the important part, as anyone with a blighted ovum or headless fetus could tell you. It's not what's there. It's the end of the dream, of what you want to be there.

The Maryland Sheep & Wool Festival is this weekend, again. We were planning on going last year, but by Saturday I was spotting and by Sunday I was bleeding and cramping but good. This year? I don't know. We love the Sheep & Wool Festival, but these days my feet get sore really fast. And we've got stuff to do, lots of stuff, tiny-guy's-room stuff.

I'm... I don't know. Breathing quietly through this day. The little guy has given me several reassuring thumps. If he were born today, he'd have about a 75% chance of survival and a 60% chance of escaping with no or mild neurologic disability.

The time between last April 30 and November 20 was the darkest I've ever had. Is it depression if it's about something real, and it goes away when the real thing goes away? Because since November I've had so many waves of realizing what a weight I was under during those eight months, how heavy and dark the hours were, how good it feels just to feel good, how light it feels not to be afraid of quiet time and my own thoughts. My joy has been so palpable not just because of what I have, my happiness and excitement for our life with this upcoming little boy. It's also about the lifting of pain. It feels so good when it stops.

Can't help but think about what this whole experience has meant to me as a person, as a parent. I am not at all convinced that it has made me a better person, but it has made me a different person.

This baby I am carrying, this tiny guy, my little fellow, our son: he is not better than our little solstice baby, the boy or girl or nothing that I was carrying, due December 23, 2008. But he is different. He is someone else entirely.

And the life that we will have together, kinehorah, is not the life that due-on-December-23-me would have had with Solstice Baby. But this is the reality we have, and I think it is going to be pretty damn wonderful.

I'm sorry that I couldn't be with your four-month-old self, little Solstice Baby. I really, really wanted you. But you couldn't be around, and that reality couldn't be ours. Now I am so very glad to be here with our little guy, our summer baby.

I thought that the solstice due date seemed so right: I was born in November, I love the fall and early winter. It's a time of year when I'm comfortable and happy. Summer makes me fussy and restless, trapped in our few air conditioned rooms, constantly scuttling away from the oppressive heat. But the baby we got is a summer baby. He is his own baby, and this will be his time, whether I like it or not. Maybe he will love the summer. Maybe he will love sports, or bagpipe music, or a thousand different things that I cannot even fathom being attracted to. He came along on his time, not my time, and he will be his own baby, and then, kinehorah (I have said that more often during the past six months..) then he'll be his own child, his own boy, his own man, someone I cannot imagine, someone I could not even make up.

I can't wait to meet him.

12dpt3dt: beta day

It wasn't a big shock to me that the beta was negative. Of course I had been peeing on sticks all along, and although I know that some people get negative HPTs right up until their betas, that's rare. And rare things are... not common.

So here I am. It's amazing to me that I am now in the category of "two failed IVFs". Shouldn't I at least get partial credit for the miscarriage? Like, a D-? But no. Unlike horseshoes and nuclear weapons, close don't count.

I get one more try before my insurance runs out. One more try before IVF moves from "expensive" to "cripplingly expensive" and possibly "unfeasibly expensive".

I'm sore, emotionally and bum-wise. Over the past two days my bum has tipped over from "pretty much okay" to "owowowowow".

I'm sad. I'm scared. But this isn't the suckiest point of my journey.

Below I would like to submit My ratings of the suckiness of negative cycles, in ascending order ot suckitude.

6. BFN, home inseminations #2-8
5. BFN, home insemination #1
4. BFN, IUIs #2 & 3
3. BFN, IUI #1
2. BFN, IVF
1. 6w4d miscarriage

At least this time, unlike last time, I don't have the overwhelming sense of having been a sucker.

On the plus side, I managed to avoid both Chatty Phlebotomist and Inappropriate Lab Administrative Assistant and got my blood drawn by Ultra-Sweet Lab Manager. Also, after two months of metformin, I have effortlessly dropped 5 lbs. That might not seem like a big deal, but it's extremely difficult for me to budge even small amounts of weight without going all-out no-carb, and I'm pleased to have a bit more room in the ol' jeans.

Now I stop the progesterone and wait to bleed. Then a new cycle begins, hopefully without too much delay. I think I'm going to do an IUI next cycle, just to keep a hand in, y'know? Just a single IUI because I can't see blowing over $1200 on something with such a low chance of success (and yet, somehow, blowing $600 on the same chance seems perfectly reasonable. Hey, it's only half as crazy.)

The auguries were really great this cycle, too. Stupid auguries.

On that subject, I offer the following dialogue with The "Softscape" Promotional Magic 8-Ball that I got at some trade show:

Me: Why didn't the embryo implant? Was it something I did?
Softscape Magic 8-Ball: VERY LIKELY
Me: Is this ever going to work for me?
Softscape Magic 8-Ball: CANNOT FORTELL
Me: Am I going to lose my fucking mind?
Softscape Magic 8-Ball: PROSPECT GOOD

Maybe I've just been asking the wrong augurs. This one seems bang on.

Today

Along with thoughts of my own much-loved mother, Mother's Day makes me think of all those who are sore and tender today: the motherless daughters, the might-as-well-be-motherless daughters, and of course the childless mothers.

So here's a special dose of love for all of those who had to learn to do without their birthright of mothering. And another again for those who are still standing in the aisle with itchy feet and fading smiles waiting to be mothers, whether they are waiting for the grand biological conjunction or some bureaucratic unraveling.

As for me -- well, I'm a lot happier than I was last week at this time. Last Sunday was physically my most miserable time, and I wish I could go back and tell myself that in a week I'd feel so, so much better.

The week was pretty good, distractingly busy, although Friday was a bad day. I finally went for the followup bloodwork I'd been putting off, to check that my beta has gone down to zero*. I was supposed to come in on Tuesday but whatever, I didn't want to get a beta of 11 and have to come back two days later. I had >10 blood draws last month. The crook of my arm is finally starting to heal up and all that jabbing isn't half as much fun when it's to verify only how pregnant you aren't.

Anyway, I've been reasonably chipper, but going back to that hospital was damn depressing. It's taken me most of the weekend to get my balance back.

Got an appointment for Wednesday. I just want to know what's going on in there. I want to know if my hugely swollen ovaries have slimmed down and migrated back to where they're supposed to be. I want to know if my uterus managed to expel everything it was meant to expel. Mostly, I want to know whether I can count today as CD8. I want to know how long till I can try again.

*I still don't know the results of the bloodwork due to my doctor's ever-bitchy office assistant. I'm thinking of scheduling a consult with another practice just so I don't ever have to talk to her again. I like my doctor a lot, but his staff is abominable.

Stuff that happened yesterday

Kind of funny
One of my coworkers stopped me in the hall to tell me how fabulous I look after having lost all that weight. I was just boggled. I mean yes, I did lose ten pounds in about a week, but only after I gained ten pounds in a similar time frame. Maybe I can make big bucks selling my OHSS-and-pregnancy-loss diet.

Not so funny
Flicking open my Google reader yesterday and seeing a picture of an ultrasound, 6w5d. I would no more than have winced if it had been on one of the many TTC blogs I read, but it wasn't -- it was in a blog belonging to a high school friend, so I was totally unprepared. 6w5d... why does that sound so familiar? Oh, right. Yesterday I was supposed to be 6w5d. And what's that due date at the bottom of the screen? Yup. To the day.

Huh, thought I. So that's what the ultrasound was supposed to look like.

I think anyone who's ever lost a pregnancy is familiar with the "shadow pregnancy"^* problem. In my case it was easy to solve. I just unsubscribed to his feed. High School Friend and I haven't been close in the past 15 years, and I can live just fine without the blow-by-blow here.

I will admit that after I unsubscribed I went back and stared at the picture for a while. Oh. So that's what it was supposed to look like.

In other news, my pee stick was blank this morning. Mostly I'm glad, very glad; the swiftly falling levels mean that chances are excellent that my uterus is clearing out nicely all on its own. And the faster they fall, the sooner we can start again.

Still, I felt a tiny sigh. There is no longer anything pregnant about me.

Never mind. On the whole I'm feeling fine. I never would have believed you if you'd told me last Wednesday that by the following Tuesday I would be feeling pretty darn good (of course, last Tuesday I still thought I was pregnant). The situation sucks , but I knew the rules when I sat down at the table. The fluke was that I was pregnant for a little while, not that I lost the pregnancy.

I'm trying to be grateful for the glimpse I had during that little time. The world really was a different place, and it all seems a little cold and dull and mundane back here on the other side. But it's not, really, it's all just as warm and rich and wonderful as it was before. I just hope that it's not too long until I get to put on those emerald-tinted glasses again.

^*I believe that the term "shadow pregnancy" was coined by the ever-apt Bri at Unwellness.

My weekend

Saturday
All day I kept eagerly rummaging in my nether reasons to see if I'd begun to bleed. Nothing, nothing, nothing.

Saturday night we went to Target. All week I'd been planning a trip to Target after the Friday ultrasound, after we heard a heartbeat. I was going to do a victory lap around the maternity clothes and even walk casually through the baby department.

Well, I love Target. I was not going to miss my Target trip just because I was suddenly unpregnant, dammit.

We went and had a good time. Bought dog biscuits and I'm suddenly unsure what else, but I know there were like five bags, so we must have bought some other stuff as well. Had a good time despite the fact that they clearly made a mistake letting me in the door, because every other woman there was visibly pregnant. One of the men looked a little suspicious, too.

When I stopped at the bathroom on the way out, I had begun to bleed, just a little.


Sunday
Woke at 7:30 cramping like a mofo. Hobbled to the bathroom and realized that I was beginning to bleed in earnest. The next four hours or so weren't pretty. I guess I'm lucky in that with my period I don't usually cramp that much, which is to say that I had no idea that cramps could be this painful. Naproxen and heating pads didn't make a dent. I had to just breathe through them. The nice part was that in between cramps, when they stopped, they were completely gone and I felt totally fine, until the next one hit.

Bled heavily until around 11:30. Being up and walking around made it somewhat better. B made us delicious buttermilk pancakes and bacon and we took it out on the porch.

The next part I am putting in invisible ink for my more sensitive readers, or anyone who simply does not desire to read about the contents of my uterus. Select the text with your mouse if you wish to see it, you gross thing you.

While eating breakfast, I felt something utterly unlike a period cramp -- a sharp lancing pain that made me gasp. I went upstairs to the bathroom and passed three clots each about half the size of my fist. Then I suddenly felt much, much better. Not just physically but emotionally. Can't really explain it.

After that the flow slowed right down. I've had intermittent cramping, but nothing like this morning. That can't be it, there wasn't enough, too easy -- but I feel like something happened, and for whatever reason I have been feeling much better, even a little peaceful. My sweetie's practical explanation is that my ridiculously high hormone levels have finally settled down. She might be right about that. Whatever the reason, I'm grateful.

Edited to add: I'm the luckiest girl in Girlville. Just walked into the bedroom to find that the woman I am blessed to call my own prepared us a spontaneous Beltaine feast, to be served in bed. Now she knows that I love eating in bed like I love ... well, there just isn't anything I love that much.

The food is so lovely I had to take pictures, which will be posted shortly. White wine, beautiful beets, this interesting clam-potato-fresh dill-homemade lemon mayo salad with avocado curls, and the prettiest fruit salad you've ever seen.

I am the luckiest asshole ever.

Gotta go eat.

No, wait.

I had that completely wrong. My memory's never been fantastic.

My dramatic blood-draw swoon and doctor's visit was on Sunday, not Thursday. I don't remember Thursday's blood draw at all. I have no idea what I did for any portion of the day on Thursday. Probably watched some episodes of Scrubs and surfed the internet.

Goddammit.

Light reading for today

Decline of Serum Human Chorionic Gonadotropin and Spontaneous Complete Abortion: Defining the Normal Curve.

Quadratic curves not really my thing, but the tables were pretty easy to read. It looks like the wheels probably fell off this thing last Thursday, the very day of the 1,111 beta. It does put a special spin on my Tuesday claim that "I'm glad to say that I am much much better -- I have been steadily improving since last Thursday." Well, duh. No wonder I was feeling better.

Can't help replaying the events of that Thursday. The night before was the height of my misery (also, not-so-coincidentally, the height of my hCG). By the morning I was exhausted and so sore. I crab-hobbled my way to the blood draw lab. As soon as I sat down everything started to swim and (apparently) I turned dead white. The very sweet lab manager got me a paper cup of water and suggested that I go upstairs and see my doctor. I assured him it was my very next step.

I wasn't on his appointment schedule, and he visibly winced when he saw me. We sat in the waiting room until all of his other patients had been seen. Then he sat down across from us and gave us the don't-ask-to-be-admitted peptalk. Telling us how if I could just tough it out it'd be fine.

He was right, because by that evening I was already feeling a little better. Ha. Ha. Ha.

Whenever this thing pooped out was probably not related to my swoony fit in the blood draw lab. I've had vagal events like that before. I'm sure the proto-placenta-trophoblastic-cells-whatever (embryology also not my thing) detaching was just a biochemical blip and I didn't notice its happening in any way. I kind of want to pretend that I did, though. I would like to have had that connection, at least.

Anyway, having the date and approaching another table in the paper tells me that tomorrow's hCG should be around 18-23. That perfectly jibes with this morning's faint-but-visible line (my tests detect 20 mIU). The last bit trails off slowly, but by next Wednesday I should be completely in the clear, with a level <5.

I know things don't always exactly go on schedule, but I feel better having an approximate timetable.

Why I Love My Peesticks

When I peed on a stick Wednesday morning, I knew I was being naughty. Using a qualitative test to judge hCG levels is not recommended, and it was just a waste of a perfectly good peestick.

I am so glad I did. If I hadn't we would have gone in for the ultrasound this morning. The ultrasound would have been inconclusive -- something that looks like a sac and pole, but no heart beat. That's not at all unusual for 6 weeks 2 days gestation. Now, probably I would have asked for more bloodwork to test the progesterone levels. If I had I would have gotten The News via telephone in the late afternoon, or I don't know, maybe they wouldn't have given me The News over the phone, maybe they would have made me come into the office, and I would have known exactly what that meant and it would have been torture.

In another dimension, I might not have asked for repeat bloodwork. They don't do it routinely once you start ultrasounds. Since the ultrasound would have been inconclusive, they'd have had me come back in a week, or even two weeks. All that time I would have been taking progesterone shots, which would have kept my body from bleeding on its own. I could have easily spent another two weeks believing this was viable and googling "6w2d ultrasound no h/b sac". I am unutterably grateful that I did not have to go through that.

Of the possible worlds in which this pregnancy isn't viable, I am living in one of the best of them. Granted, it would have been even better if I'd peed on that stick on, say, Monday, or repeated my beta then; we could have seen it falling, and falling betas are never okay when you did a single embryo transfer (they can be less dire if they represent a disappearing twin/triplet in a multiple pregnancy). But I still did pretty well.

Next time you can bet your booty that I'll be peeing on one of those sticks every half hour. As it is, I don't have to give them up altogether. I'm still peeing on one every morning. This morning's was very light, maybe half the strength of the previous one. That's a good thing. The sooner my hCG levels fall, the sooner we can try again.

I don't know yet how we'll try again. I'm not going to do another fresh IVF immediately. I had no idea how hard it would be on my body. I can't risk OHSS and another two weeks off work again. I managed to excuse this last one with a vague "emergency minor surgery" (whatever that means) but I think it'd be a little fishy if I tried that again in 8 weeks. I think the next cycle will be IUI. Chances of success with an IUI are low, which makes it sort of a nice compromise between "doing nothing" and "jumping right back in".

Luckily I have some time to think. Next cycle will probably be minimum 6 weeks from the time I start to bleed, and lord knows when that will be. It's frustrating, not knowing how long I'll be benched. Hey I used a sportsball metaphor, go me. That's a little of the yang energy I need, huh?

Overall, I'm doing okay. I have been "trying to conceive and not pregnant" for 16 months. I was pregnant for 2 1/2 weeks. Really, the pregnant mindframe was the one that was a constant stretch for me. This feels familiar.

Here, I have a perfectly good highway metaphor in my blog name. It's metaphor time.

This is a little bit like driving around lost. You have a limited amount of gas and you have to be somewhere by a specific time. You're driving down this featureless highway and you think you're going in the right direction, but you might not be. Finally there's an exit. Whoopee! Except that it dumps you right back on the same road, which is exactly as inscrutable as it was before. What the heck. Better signage, people. What was the point of that exercise, exactly?

Let's think about this logically

Things that probably caused this pregnancy loss:

1. My finding out the due date
2. My googling strollers
3. My googling area daycares
4. My calculating my sick and vacation days for FMLA
5. My researching area hospitals
6. My mentally practicing telling my parents and 91-year old grandmother
7. My googling "babylegs"
8. My joining one of those due-date threads on an IVF discussion board
9. My looking at all the Burt's Bees "Mama Bee" products on drugstore.com
10. The many hours I spent each day with my laptop wedged on my abdomen, pumping EMFs into Baby
11. The huge amount of soy protein I ate while sick with OHSS
12. OHSS
13. My vaguely maybe-diagnosed PCOS
14. Bisphenol-A
15. Bears
16. Chromosomal abnormalities incompatible with fetal development.

All my the symptoms are now really really annoying. My hip is messed up and painful from having spent a week and a half sleeping sitting up in an armchair. I'm still massively bloated. Burping, fatigue, frequent peeing and aching breasts? Suddenly not quite such a rollicking adventure.

I keep eagerly rushing to the bathroom to see if I've started bleeding. Not even spotting yet. I just want this to be over.

Also, thank you so much for the kind comments. I keep refreshing the page and re-reading them. They really mean a lot to me.

I knew this was a solid chance, especially given the beta drama. But for all my defensive pessimism, the truth is that I was convinced that it would all be Just Fine, that the worrying was a obeisence to the gods in order to make everything work out well. Because, you see, my name is in the opening credits. My narcissism on some level believed that the writers would opt for the happy ending. Doesn't everyone love a happy ending?

Well, fuck. Translation: it's over.

Thanks for the love and support, everyone. Unfortunately, even after all my sunshine-blowing yesterday, this morning for fun I peed on a stick. I've gotten such a charge out of seeing them instantly turn dark.

It didn't instantly turn dark. I went in for a beta. It was 60. It's over.

Special memo to those who have any chance of seeing me in real life any time soon:
I don't want to talk about it in person. Not at all, even a little. I don't even want a long extra-meaningful hug. And if you love me at all you will pretend that you haven't been reading this blog and have no idea of what has transpired over the past two and a half weeks. Yes, it's fucked up, but it's my coping mechanism, okay? Thank you very much.