Another setback

I guess I anticipated the idea that I might need a methotrexate (MTX) shot. But after the 27 two weeks ago, I guess I let myself get too optimistic. My HCG was 28 yesterday. Suddenly it made sense that the HPT I took yesterday looked eerily the same as the one I took the week prior. The first hint I had that something was amiss this morning was when my Dr. left a message in which she did not disclose the beta result. She said she wanted to discuss the results. I immediately concluded that this meant one of two things. Either the results were not good and she wanted to discuss possible next steps to encourage the HCG to decline. Or the results were so good that she wanted to caution me against TTC again too soon, as that is her style. Then I thought, whenever I think I've covered all the bases, I inevitably miss one. I also thought, either result is good. At least we'll be getting somewhere. But now that the first possibility has been realized, I am alarmed, saddened, and angry. More upset than I thought I would be. I had planned a happy hour for tonight with two of my new-mom co-workers and right now I don't want to look at or talk to either of them. I definitely don't want to discuss this with them and have devised a secret plan in my head regarding how to get out of it.

I have to leave in 15 minutes to go to a doctor's appointment. The dr. is doing an u/s and as I've alluded, thinks a MTX shot is in order. I immediately jumped onto the internet to do some 'research' and have concluded that I hate the idea of a MTX shot. I just don't know if I hate it more than I hate the idea of waiting longer for the hormones to go down. I have to get another blood test to make sure I'm 'fit' to receive the MTX. And in the back of my mind lingers the possibility that in a couple hours it won't be the MTX I'll be worried about. Like she'll find something else during the exam or the u/s that explains everything. Could be good or bad if that happens.

The reason I hate the idea of MTX is that it's chemo and it strips folic acid out of your system. Thus delaying the TTC process. If I really did ovulate and am on the verge of a bleed, maybe I should just ride it out. Maybe I'll ask her about that if there's no sign of infection or anything like that.

UPDATE: I went to the Dr. She did the u/s and found an abnormal mass that she said was either a blood clot or the (largely reabsorbed) gestational sac from my second failed pregnancy. Sad and frustrating but perhaps good to have maybe identified the culprit? I don't want to hope that there's any basic explanation to all this. So far I've been so disappointed. And the idea of it being a second failed pregnancy scares me. A lot. And makes me think I'll never have a healthy one. And at the rate this process has gone (it has not been a 'simple' m/c) I don't know how many of these I can go through. Even if I'm ok with a dozen m/c's to get one healthy child, I don't know if there are that many 6-month periods left in my fertile life. I guess there are. But i really did not want to wait till my late thirties.

I made the mistake of asking a question about what else the problem could be - could anything else be causing the persistent hcg? Or could the tissue we think we found signal anything else that might be wrong. "You should never ask a doctor that question," she said. "There are a THOUSAND things it could be. I don't see any reason to go into it." Ok, thanks, I feel much better.

So methotrexate, she said, is the best option. She said that's what she would do. So that's what I did. I had a lot of questions and she wasn't really interested. I got some of them answered, but most of them I felt I couldn't push on without making her mad. For example, she said it's IMPOSSIBLE to ovulate if your HCG hasn't reached zero. This would make my whole EWCM + temperature shift that was the subject of my last post meaningless. And maybe it was. Maybe it was progesterone supporting my second doomed pregnancy. But maybe she's wrong and my cycle is kicking back into gear. It's a horrible position to be in to feel like your doctor doesn't condone your asking questions. But by the end of the conversation, I too had reached the conclusion that MTX would be the best option.

I had to go down to the oncology infusion department for the injection. Instead of baby and parenting magazines on the tables, there were catalogues for picking out which wig you want to wear when your hair falls out from the treatments they give you. I didn't have to look at pregnant women anymore. Or pregnant women with their young children and their husbands all in tow as is usually the case. Kids asking when the baby is coming, dads reading about how to raise a happy child. Nine months pregnant women with three other beautiful blond healthy children playing in the waiting room. How different their experiences must be from mine. How easy it is for some people. It was not only a relief to be out of the obgyn department, but being at infusion made me more grateful for the health I do have. At least I am not fighting for life. Seeing people who were made me feel a little selfish and self-absorbed for being so consumed by my TTC process.

They sat me down in a big lazy boy style chair and asked if i wanted a "warm blanket" or anything to drink or if I wanted to put my feet up. Like I was settling in for a long stay. I was under the impression (from my google research) that I was only getting a shot and that the whole experience would take only a few minutes. I mentioned this and the intake girl said it would probably be an IV and put my left hand between two heating pads to "warm up my veins." I started to wonder if they understood what I was there for. Or if they were about to accidentally give me the 1000x dose and create one of those 'hospital mistakes' like the ones you hear about that end up killing someone or removing the wrong leg.

When the nurse arrived she laughed at the warming pads on my hand and said I didn't need those. Too bad I hadn't just sat back and enjoyed the prior 10 minutes instead of fretting about hospital mistakes - the pads felt quite nice. The nurse closed the drapes around my chair, told me to take off my pants and then told me to grip the side of the chair. "Uh oh," I said jokingly, "is this going to hurt?" "Yes," she said, it hurts. She swabbed me with alcohol and said she was going to let it dry for a minute so it didn't sting as much when she went in. Then she stuck me, and it was like any other shot, not so bad. A little sting, a little burn. Compared to what I was prepared for, it was nothing. I was actually thankful that she had made it sound like it would be super painful. "Is that it?" I said, "that wasn't so bad." She told me that another patient she had had yelled and moaned about it so she tells people it will hurt. It really wasn't that bad but I feared that I would be taken down by side effects. Nausea, cramping, m/c symptoms, hair loss maybe.

None so far except for a couple shooting pains in my pelvic area. Not really cramp like, just sharp shooting pains. Shockingly painful for a nanosecond and then they go away. And I've only had a few. I almost wish I would have more cramping or that I'd bleed or something. Anything to show that its working. My BBT took a serious dive as of this morning. I had been temping in the 97.7 range since the 'shift,' and today it was 97.02. Almost pre-O levels I'd say. Time for AF. But I'm sure my body has other ideas.

I've managed to largely stay off the internet and to get some work done since the injection. The real test will be Sunday and Wedns when I'm scheduled to get new beta draws. I keep hearing that sometimes HCG goes up before it goes down after a MTX shot (ok, so I haven't stayed completely off the internet). That scares me. Even if it's 'normal,' I don't want to hear a higher number. It's SO low right now, it ought to just disappear.

Non internal side effects are also discouraging. I can't drink for a few days. Maybe a week since the MTX puts a serious strain on my liver. Also I can't eat anything (including prenatal vitamins) with folic acid since it compromises the efficacy of the MTX. Related to this, and perhaps the most discouraging is the fact that I can't TTC again for months. Because the MTX depleats folic acid and because you can't take prenatals until HCG goes to zero, and because you want to have at least three months of folic acid in your system before TTC to avoid birth defects and serious spinal neuro problems, there are at least 4 months after the shot during which you don't really want to conceive, even if you can. On top of this, DH's sabbatical will fall right over the time when we might be able to start trying again. So there goes another couple months. I'm actually ok with it though. It takes some of the day to day angst away. I don't have to live day to day and week to week thinking and hoping maybe just maybe things will be improved in the next few days. Maybe I o-ed yesterday, maybe today. I can take a break from that. There's no possibility of getting pg in the next several months (it turns into a 6 month wait if the first shot of MTX doesn't work and I have to get another one). It's sad though. I think about how much my mom wants to make a sweater for her own grandchild and how my dad wants to go to disneyland with them. On one hand its just a few months. On the other, it's a year after we were prepared for the new life. And I won't be pregnant by my original due date, which is depressing. And my friends will probably be pg with their second before I can even start trying, which is depressing. But I have to focus on the positives and the healthy reasons to want a child. It's not a competition, it's not for anyone else. And in the meantime, I have to learn how to enjoy not having those strings and stressors.

I'm less worried about DH's mindset than I used to be. I think he's seen how much I've gone through for this and for him to take the hope away would be the worst injury he could inflict. He did casually say he wanted one kid and not two recently. And said, only half joking 'two is two too many.' But I brought him around, back to the idea of two. And I think if I play my cards right everything will work out. I hate to think I would have to "play my cards" at all and that my DH wouldn't just automatically support me. But kids is a sensitive issue. A very personal one and one that changes your life completely and in unimaginable ways. So I have to be sympathetic, and I'm ok with that.