Baby overload

This is by now a cliche complaint. I hear it a lot. I see it a lot. But I have to say it again because I can't stop thinking about it: there are far too many babies around for me to maintain any kind of contentment with my life. Yesterday, e.g. I organized a happy hour for a departing colleague. It was supposed to be several close co-workers, one of whom might bring her 2 month old. I could handle that. One baby, maybe none. Hopefully none. Hopefully her husband would get home in time to babysit while she came out to the bar. But no, the baby came to the bar, as did the new dad. And then another baby and new dad arrived, uninvited. But certainly most welcome. By everyone but me. I secretly despised that he showed up despite having utmost regard for the guy and great admiration for his little one. And I tried to rally but felt so defeated. I almost felt like I was being fake, like I had reverted to my college bar days when I was trying to play it as cool as possible around people without looking like I was trying too hard. It was strange to feel so awkward around people I know so well and even worse was the reminder of the reasons behind the weirdness and the knowledge that they knew what I must be thinking. They had their babies. Their beautiful babies. And I didn't. Mine didn't make it. It is so grossly unfair and they can't help but enjoy their fortuitous lives right in front of my face. They can't help it. What else do I expect them to do? I can't expect them to keep their babies in a cave somewhere and never bring them out or talk about them or show them off to our other friends.

Would I have felt less awkward if I had never told anyone? Maybe. Am I still glad the girls know? On the whole, yes. But all that has happened still taints what should be happy occasions and, I fear, may change our friendships irreparably. Of course, friendships tend to change anyway when one couple in the group has a kid. But now that all of the couples in our lives have kids, we're on the losing end of the changes.

What I particularly hate is when one of the new mothers insists that DH and I should really come over and visit in a more intimate setting, or that I should come over for lunch more often, or to watch the game. Doesn't she know how that stings? Doesn't she know I don't have it in me to want to spend any more time around her happy family than I have to? One reason this all really blows is that i love babies. I think they're adorable and the more I'm around them, the more I know I'll be able to handle it. The more I long to have one in my life. The more excited I become about being a mom. And it's certainly good that I'm having these realizations. But as much as I love and adore each and every baby we know, the love does not stop my heart from aching. It can't overcome the longing, jealousy, self-pity, anger, or frustration. I have to get away from it after an hour or two or I think I might spontaneously burst into tears. I spent the whole evening being 'one of the guys.' Hanging out in the 'singles' crowd - not really singles, but those without kids. There has to be a term for that right? Oh, yeah - it's childless. I hung out with the childlesses. And felt right at home.

I went up to my 6th floor office after the happy hour and happened to look out my window at the street below and the two new moms were strolling their babies down the street, right out my window, perfect view. They just happened to be on that side of the block, within that segment of the sidewalk when I looked down. It was a warm beautiful night and there's not much I wouldn't have given to be with them. Or even to be one of them. And I am not one to wish I was someone else. I like who I am, generally, and sometimes covet what people have, but I don't think I've ever wished my whole person away. But in that moment, I might have given up on myself if it meant I could experience what they must be experiencing. And part of it was not just jealousy over their babies but jealousy over their friendship. Over their new shared experiences, their new bond. I think of myself as closer to both of them than they are to each other. Or at least I was...

There's an annual company bbq coming up next month. The manager made a big deal about children being invited for the first time this year since there have been so many new babies in the group in the past year. I play a key role in summer recruiting and I really should be there. But I can't get my head around wilfully putting myself in that position.

In recent months I've thought - once my beta is negative, I'll have a more positive outlook. I won't be so self-pitying or jealous. I won't have so much anger. I'll have excitement and hope. It is negative, for the moment, and somehow I still can't shake the despair. It has lessened, but I still have so much fear and apprehension at the inevitable challenges before me - no matter what the numbers say, I can't get to where I was pre-BFP. I can't reclaim that optimism and giddy excitement. That innocent hope, free from the dark realities of loss. Free from the understanding of the vast uncertainties that spiral out of control so quickly and mercilessly. I probably never will. My babymaking spirit is doubtless forever dampened. I am happier today than I was a month ago, but it is still so so difficult. And on top of the difficulty, I worry about what my attitude is doing to my friendships, work relationships, marriage, and my own psyche. Maybe it's just that. Maybe I need a change of attitude. Or maybe I just need a break from all the babies.

It's about damn time.

HCG is TWO! Which means negative!..........!!! AAAAAAGGGGGGGGGGGGGHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH

I mean Dr. OBG said it means negative. I protested, "isn't there a lower increment, like 'less than 2?'" She said "not really. Two is negative" I'll take it. I can't really believe it. In fact, I don't dare believe it. It could still come back up. But that seems less likely by the week thanks to this very-light-but-still-respectable AF I'm having and the fact that I haven't had a MTX shot in weeks and that I've been religious about prenatals! I know that people have an upsurge in HCG sometimes years after a molar pregnancy or choriocarcinoma (more typical is an upsurge within the first 6 months of a negative result), so I am not making any rash assumptions here. Just very greatful that I'm on the track towards normalcy.

I just keep thinking about it and smiling. What a change from the last six months.

Dr. OBG herself called to deliver the news, after talking to Dr. GO. They agreed I should get weekly tests over the next 6 weeks and evaluate as we go. I am hoping with every fiber of my being for the best. It's funny - because there is a risk that the levels could go back up, this is really just one more step on the path, just like any other drop in the numbers. But it feels more momentous to have your doctor say your HCG is negative. And that I should expect wonderful AF more regularly now. Wonderful wonderful AF. Let's hope!

And another weekend bites the dust

I’m a rebel patient this week. I should have gotten my beta draw on Sunday. But I get my draws in the lab in the town where I work, rather than the town where I live. So I decided to postpone until today…when I’m back at work. 'Cause why waste the gas? So no news there until tomorrow.

I had a boring weekend. I always feel a little guilty when that happens. Don’t get me wrong, all appearances would suggest that it was quite productive. I got caught up on gardening and housework, worked out every day, took the dogs out a lot, introduced the new fur baby to the dog park, watched movies with DH, things like that.

But I feel like I didn’t do the three-day weekend justice. Like I should have gone somewhere. Done something. Like it doesn’t count if you don’t have a story to tell when you get back to work the next week.

Unfortunately, the weekend ended with me and DH in a fight. It was pretty bad. The kind where we end up sleeping in different rooms. And, for the record, that NEVER happens. In fact, I can’t even remember it happening once during our 7 yr relationship, though it’s been threatened a couple times. I was being a dog-training na.zi and he was being distant and depressed all weekend about work (in fact, he was gone for half of the weekend, which may be why we didn’t make any real plans) and our frustrated worlds just collided. He let the new puppy in when she barked, which is exactly what you don’t want to do in these early stages if you have any hope of teaching them that barking won’t get them anywhere. So I told him not to do that and reiterated how important it is to be consistent and he said he didn’t have time this time, he'll be consistent tomorrow, and I refused to be ok with that because let's think about the meaning of 'consistency' for a minute. Plus, this is one of those situations where an ounce of prevention is worth a pound of cure, it's a little inconvenient now but my god it's so worth it in the long run to have a well-behaved dog. He freaking blew up. He was running up and down the house slamming doors and yelling at me not to f—with him. I have never seen him quite like this. I was a little scared, for the first time ever. Even the poor dogs were cowering in a corner. I went looking for them ‘cause I was on my way to bed and I found them, after a concerted search (I have never ever had to search for these ‘velcro’ dogs) huddled together behind the couch – I had never seen them like this. They were so affected by the yelling and our hostile behavior, they were scared. I took them to bed with me and they both fell asleep in my arms. I felt so protective, I almost locked DH out of the bedroom. He came in later and tried to put his hand on mine. I didn’t let him and he left to sleep in the guest room. This is monumental for us. Not sleeping together is like the telltale sign that things are not right. Like I said, it has never actually happened. And when it's gotten close, I usually am beside myself with grief, crying and the whole bit. Last night I didn't have any urge to cry. I was just mad. How dare he.

He came in again this morning. He seemed apologetic, we seem to be fine again, I think we both know that we both overreacted…but he never apologized. And I certainly didn't feel any need to.

The reason I recount this in such detail is because it was not lost on me the parallels one could probably draw between this incident and life with kids. The different attitudes towards discipline, the way kids will be affected by fights between their parents, the feeling I had as I went to bed last night that the dogs were my priority, screw DH – he can sleep wherever he wants. Hopefully we will find a way to work through this kind of thing (and maybe avoid it altogether) before we do have kids. I think the dogs will recover a lot quicker than kids will. And it was no picnic for me either.

In any case, I get to work this morning, late, and first thing, my due date buddy g-chats me to tell me she had her first of, count 'em, four baby showers this weekend. Awesome! And she’s telling me all about the plans for next weekend’s shower and I could have just reach through the screen and punched her in the eye. Instead, when she told me her DH is getting a taco truck to do the catering at the next shower I actually typed “careful, there’s nothing like listeria to ruin a baby shower.” And then I actually hit 'enter.' One more example of how easy it is to lose it when you’re typing instead of talking.

The very next thing that happened is that I got an email from a co-worker on maternity leave with, count-'em again, three pictures of her 8-week-old. She was asking if I and another new-mom co-worker wanted to join her for lunch this week - she warned us that the baby would probably be awake the whole time 'cause he hasn't mastered sleeping in the stroller. Yeah, sign me up. I can't freaking wait.

ICLW Summary

This is my first ICLW and I've already decided that it's one of the greatest ideas in the blogosphere. It's so wonderful to hear from you all - thanks so much for visiting. I think a summary may be in order, just to see if I can catch people up in a few short paragraphs.

My LMP was Oct. 16, 2008. In November I found out I was pregnant. In early January at my first u/s appointment I found out I had suffered a missed miscarriage very early (~5.5w). I had a D&C and that should have been the end of it. DH and I started BBDing a few weeks after the procedure in an attempt to try again. I was temping the whole time and was convinced I wasn't cycling at all. I was also taking HPTs semi-weekly and when, 9 weeks after the D&C, the HPTs were still turning up positive, I called my OBGYN. We quickly deduced from serial HCG tests that my levels were in the 40's and that I was not viably pregnant so we started waiting for the HCG to drop. And it did. Very very slowly. And sometimes it went up, but never more than 10 points. And so my OBGYN sent me to an oncologist who thought I might have gestational trophoblastic disease. I started methotrexate injections. Which seemed like they were working, but the numbers were still dropping so slowly that it was hard to tell. Now, almost five months after the D&C, my HCG is still positive (it was 5 after the last draw) and I have four injections of methotrexate under my belt - which means waiting at least 6 months to try again, even if my HCG ever does reach zero, to make sure the poison is out of my system. The doctors are not sure if this is all a result of a partial mole, a second failed pregnancy, or just a very slow metabolism of HCG. I just finished a course of Provera and am anxiously awaiting the arrival of AF - not sure if she will show though with HCG still in my system. I am "off treatment" (meaning no MTX) for now but if my HCG goes up, we will start a more powerful course of chemotherapy.

In the way of a micro-level update for those who have been following the blog, this is day 5 after finishing the last Provera pill and I guess I'm experiencing what I might describe as spotting, but it's very light and almost not even noticeable. NO other symptoms of AF. If she doesn't arrive, it will be difficult to know why. HCG? Ashermans? Stress maybe?

We had another lay off at work today. More drama this time. It certainly has helped to put things in perspective. One more reminder of how lucky I am.

Relatedly, I've been really good at seeing the silver lining lately, I think I'm still on a high from the last HCG result. So much so that I'm afraid to go get my next draw Monday. I don't want this feeling of hope to be extinguished. I don't want to view the world through my glass-is-half-empty lense anymore. I want to be inspired by challenges rather than defeated by disappointments (because aren't they really the same thing, approached with different attitudes?). I want to look forward to the next day and attack it. I don't want to dread or fear or hate or pity myself. And I think this is what my experiences over the last 6 months have taught me. That each day is a new chance, things can change in an instant, I've been taught perspective and the value of hope. Acceptance of uncertainty and of my own lack of control. And today I can look at this all as a gift. Because my HCG is FIVE! But tomorrow, it might be 25 and I will see it all as my personal hell. And maybe I will realize that I haven't learned much at all and that my optimism was illusory.

Honest Scrap Award

I made it my blog homework to finish this much-delayed post before ICLW as I think it's a nice way to introduce myself, set out a few details of my life that you can't find in my sidebar, and showcase a few blogs that I find particularly noteworthy.

First, many many thanks to MeAndBaby for this fabulous award. It was really a very gracious gesture and I treasure it. May I find in myself the honest scrappiness that others have seen in me. And may I use it wisely and help it to grow throughout this journey of mine. And now, dear readers, I shall pass it on.



The Rules:

* Choose a minimum of 7 blogs that you find brilliant in content or design.
* Show the 7 winners’ names on your blog and leave a comment informing them that they have been awarded Honest Scrap.
* List at least 10 honest things about yourself.


10 Honest Things About Me:

1. I'm a worrier and sometimes my 'realism' gets a little pessimistic. But thankfully I have found that acceptance of the uncertain comes with maturity.

2. I quit caffeine in the summer of 2008, about seven months prior to my wedding, exclusively in preparation for the TTC process. I haven't been drinking much caffeine since. And I miss it. I love caffeine. But I'm not going to start up again notwithstanding that my TTC process may not resume anytime in the near future because I hate the idea of going through withdrawal again.

3. I am a huge, religious, and unapologetic fan of many (but by no means all) reality TV shows. My favorites are American Idol, America's Next Top Model, Hell's Kitchen, The Bachelor(ette), SYTYCD, and Apprentice. This is something I get really excited about. I will skip social engagements to make sure I see the next episode as soon as possible and thank GOD for DVR. Sometimes I question my priorities when I'm shusshing DH to make sure I don't miss a moment.

4. It's ridiculous how much I love my dogs. I love them more than I ever imagined possible despite always having been abnormally empathetic towards animals. I miss them when I'm at work or even when I'm in the shower...in fact, when DH and I are walking them, sometimes one of us will have to pick one up because we miss them way down there on the ground. I once heard a new mom say, in a very honest moment, "I wonder when I will love my baby more than I love my dog," and I used to worry that that could be me. I'm over it now though.

5. I love to sing. I used to perform, growing up, and now I miss it so I sing at pretty much every opportunity I can get. Which is usually limited to the car, the shower, and the occasional karaoke night. I am one of the few people I know who genuinely loves karaoke.

6. I have sometimes thought, from a purely selfish standpoint, that it would be better to be divorced with a kid than divorced with no kids. Obviously it wouldn't be better for the poor kid to go through a divorce...I think it just says something about how much I want a kid.

7. Recently, I have begun to make purchases and plans - specifically clothes purchases, a camera purchase, vacation planning, whether to refinance the house, when to buy a new car - keeping in mind that there is supposed to be a baby or two in the picture soon. I feel bad about this, like I'm jinxing it or should just live each day for what it is instead of dwelling on what I don't have. But some of these are big ticket items or require planning ahead and do take foresight. So they are a constant reminder of the pregnancy and children I don't yet have.

8. Relatedly, after I found out I was pregnant, my shopping habit and a lot of my attachments to inconsequential material things (shoes and anything Coach, e.g.) abated almost overnight - just as quickly as food aversions and morning sickness descended. I think my sense of perspective and priorities settled in. And it's stuck. I've only purchased two pairs of shoes since last fall. Okay, three. I still have my moments.

9. I am ridiculously open. I can't seem to use much discretion when I'm talking about myself to people I trust and sometimes to people I shouldn't trust (I'm also very trusting). A few people IRL know the whole story of my m/c and the bizarre aftermath - even two co-workers - and while I sometimes wish I could hide behind a veil of secrecy, the vast majority of the time I'm glad I'm open.

10. I have heard mothers say many variations of the following: "the first time I held my child, I finally knew what the meaning of life was." A friend of mine (a mother) said this was 'crap,' - that it was too much pressure to put on the poor kid and would mean that life is just a vicious cycle of living for the next generation with none being happy or sufficient on their own. But I don't think it's crap. I think it's a beautiful, inspiring, and romantic notion and it keeps me in this game.

I give this award with great enthusiasm and admiration to (in random order):

1. Kim at Baby Shmaybe?




2. babyinterrupted at baby, interrupted




3. Bluebird at Little Bluebirds Fly




4. Waiting for Baby at Why Can't I stay pregnant?




5. Mrs. Hammer at ...Expect Miracles...




6. Babychaser at The Baby Chase




7. Echloe at Non-Elusive BFP

Good news and bad news

Good news:

Beta HCG is FIVE! Despite having started prenatals and stopped MTX.

Bad news:

Maybe that means we shouldn't have stopped the MTX so soon...will ask Dr. GO about this asap.

Potentially counterveiling good news:

I'm done with my course of Provera, so something could happen to help things along any day now. Zero symptoms though. Does anyone know if it's normal to have NO symptoms (no cramps, no discharge, no sore bbs, none of that "impending AF" feeling, etc.) the day following 10 days of 10mg of Provera? Or would I be feeling it by now if it was going to bring on AF?

More salt

DH and I have a group of friends from college that we hang out with two or three times a year. New Year's, summer bbq, that kind of thing. One couple had their baby last year - the kid is now about 10 months and they are the luckiest parents on earth. He is SO happy and content and just good, all around. We went to that couple's house today for a get-together and found out, when we saw couple #2, that they too are joining the Parents Club. I was caught totally off guard, I remembered her being a lot skinnier last winter but neither me nor DH had heard anything about the news...then I ask "what's new" not wanting to put my foot directly in my mouth, and she announces she's expecting twins in November. Awesome.

So we spent all afternoon fawning over the baby and talking about pregnancy and motherhood and it was all a bit much. But I handled it fine. Until.....

We were leaving and there were a couple pregnancy books by the door and the hostess says: "Well I got these out for [couple #2] but she said she already has them....so they're free for the taking if they could come in handy someday!" She actually left them out long after couple #2 had left and then brought my attention to them in case I might want them. It would have been super cute had I not been in the midst of a fertility nightmare. But as it were, I was devastated. DH said to me, nonchalantly, "oh is there something you're not telling me?" he was just playing along. And I said, somewhat bitterly, which they can interpret any way they want I really don't care, "I'm pretty sure I won't be needing those any time soon." Which is true. Because I won't be pregnant any time soon. AND because, and I wish I could have said this, to sort of express my pain, I too have the books already.

I cried in the car on the way home. Not too much, but it was surprising to me that I let such a little thing get to me. People are going to get pregnant, have healthy babies, talk about them, and even inquire about me and DH in round about, and not so round about, ways. I get it. I'm ok with it. I have time. I have a good life. I've accepted that I'll be waiting for a bit before trying again. But the tears came anyway.

On an interesting side note, at one point DH asked the husband of couple #2 on what side of the family the twins came from. He said, "we've been getting that question a lot. It's actually not from either side." And then he kind of trailed off. Which makes me wonder...IVF twins? He also mentioned at one point "it's really a blessing." And it wasn't a throw away cliche line - he said it like he meant it. So maybe they had trouble? Don't know, wasn't going to ask. The husband said they didn't know yet if the twins were fraternal or identical, which raised an interesting question in my mind since I have so far had the fortunate liberty to not have to learn anything about IVF: From what I've read it seems a sometimes side-effect of IVF is multiples. Which makes me think IVF twins would usually be fraternal. But again, I am admittedly quite ignorant. Does anyone know? Are IVF twins typically fraternal? Or are they just as likely to be identical?

One more thing, my phone rang during the party. I got to it too late and listened to the message. And it was the bridesmaid I talked about in my previous post, wanting to regale me with stories of early pregnancy and relief at having gotten this far. Awesome.

I'm really glad to be home.

Friday night musings

Thank you so much to the thoughtful commenters to my "Another wait" post. It helps me more than you know to know that this is not such a freak occurrence and that it can be overcome through 'normal' avenues. Thank you, thank you for sharing your experiences. This is one of the primary reason I started blogging and it has given me some much needed perspective and hope.

I've been back on prenatals for a few days and I'm going in for a beta draw tomorrow. Crossing my fingers, but my gut feeling is - no appreciable change. I almost don't even want to know the number since, if it goes up to 10 or 15, I'll be in utter despair when really, it's still a plateau. I don't expect it to have gone down. As Tash and Jen observed, something generally has to come out before the numbers go to zero. After my first MTX injection some tissue was expelled and there was a precipitous drop in my HCG levels. No more tissue since and no change in beta levels. Coincidence? Don't think so. I am hoping that the provera helps with this (only two more days worth of pills! I'm so excited to see if AF comes, it's like Christmas!) but understand that surgery may be in order, though I will do almost anything to avoid it.

Salt was poured on the wound today. One of my bridesmaids had a m/c shortly before I did. It was awful to hear (I was still pg which must have been difficult for her) and she was a great help to me when I ultimately had a similar experience. She was the first person I called from the Dr's office when I found out there was no live baby inside me. I thought of her before DH even. She had gone through a D&C and I needed to hear support and advice from someone who had been there. She had a fairly uneventful recovery from the D&C and waited a couple cycles. She's an eternal optimist. She's four years older than me. She is now announcing her pregnancy. I really am happy for her. In a way that I can't be for friends that have no concept of how difficult a loss can be to overcome. I have noticed lately that I definitely have a happiness bias against people who are so blissfully ignorant. Like my bridesmaid deserves for me to be happy for her, but my due date buddy that announced her pregnancy at 7 weeks, had no m/s and is having a blissful time of it - I cannot be sincerely happy for her, try as I might. Although I am happy for my bridesmaid, genuinely, it hurts too.

Update on the furbabies, my primary distraction these days - they are getting along pretty well. I left them alone together for about 5 hours today. I hadn't planned to, I was hoping to work from home, but not only could I not get internet at the house this morning (rare) my cellphone also broke. It was like the universe had conspired against my wanting to make sure I was a good dog mommy. DH is out of town so I left them alone. I have observed them alone together periodically over the last two days and was fairly sure everything would be fine, but not as sure as I wanted to be. So I was under undo stress all morning and bailed from work as soon as physically possible which probably impressed no one. But ensuring the health and happiness of my pets is something I take very seriously so it was important. Luckily, everyone is fine. They're getting along with minimal jealousy and annoyance. It's funny how much pressure I put on myself to make sure the dogs are perfectly happy when there is probably a normal, albeit trivial, amount of stress or unhappiness that is perfectly acceptable and won't scar the dogs for life. For example, I always feel so bad when DH and I leave for work in the morning and DH reminds me: "why don't you feel bad for us? we have to go to work all day." And I put so much energy into making sure fur baby 1 doesn't feel like he's being replaced that I am giving him more attention now than I did before we got fur baby 2, if that's possible.

To be perfectly honest, I have had my moments. I imagine this is a little like postpartum depression would feel. We anticipated getting a second dog for over a year. I stressed over every decision we've made about every dog we've looked at, I've scanned the shelter websites daily. I find "the one" and have anxiety for days that we won't be able to make it happen, they might not accept us as adoptive parents. Especially since we have to convince them that fur baby 1 and fur baby 2 are a good match. We finally bring her home and I am scared out of my mind at every yelp and every instance of the new dog pushing the old one out of the way, every time I struggle to handle two dogs on the leash instead of one, I am ridden with fear that: I did the wrong thing. One of my new mom co-workers had a similar sentiment about her new baby. She said that for the first 2 days after his birth she thought, "I have made a huge mistake." My other new-mom coworker swears this will not happen to me because of what I am going through to conceive a child, but I am totally, utterly prone to depression and I have no doubt that I am at risk for PPD. At least a mild case. And that is what I think I am experiencing with fur baby 2. What the eff have I done? But as the minutes and hours pass, I am more and more encouraged that this was the right decision. She is a puppy (10 months) and brand new to the house and has abandonment issues and has been cooped up in a 6 x 8 kennel for the last month (for a part border collie, this has to be a clinical form of torture) so I have to keep reminding myself that the few characteristics I have reservations about will work themselves out, just as they did with fur baby 1. But this is not a blog about dogs so I will try to wrap this up by saying, I love them both and am excited for all the days and years we will be spending together.

New Plan

I am supposed to stop treatment now. The Dr. GO receptionist said. She said stop treatment and "observe." With possible follow up MRI and D&C. Hell's to the no. No more D&C. One of the doctors at Dr. OBG's office even warned me against it with some unsolicited advice: "You know, there's a lot of damage that can be done from an aggressive D&C....a lot of damage...." I. don't. want. another. D&C. I don't know why he was trying to warn me against it. It was preaching to the choir and I told him so. Maybe Dr. GO has been pushing for it.

On the upside, I can start prenatals again.

Also, I got another fur baby! Fur baby one is having kind of a tough time though which breaks my heart. They're duking out the pecking order. I thought fur baby 1 would come out on top no question. He's small, but scrappy and has the largest sense of entitlement I have ever seen. Fur baby 2 seemed pretty chill at the shelter, but she's younger and bigger than fur baby 1. And now she's interested in taking charge all of the sudden. She's goofy and playful and is overwhelming fur baby 1 a little. I imagine it will sort itself out. They're not drawing blood or anything. Neither are breeds known for being aggressive. But fur baby 1 is my whole life, pretty much. Aside from DH of course. It breaks my heart that this might stress him out and I worry he'll have anxiety over it or that it will change his unbelievably great personality. He's pretty persnickety though. Fur baby 2 is not being mean, just overly friendly and Fur Baby 1 is used to having his own way and his own space. They got along pretty well at the shelter...I hope this gets better.

Another wait with a side of obsessive deductive reasoning

I ended up being ordered by Dr. GO to get my beta HCG drawn last night. Lame. Really, what is the point? The day 4 result is historically meaningless. So I went and the 'bad boy' of the lab techs (same one who gave me an unauthorized standing order to get HCG draws - I know, scandalous) tried to set me up to get my results faxed to me. However, that process seems to have been derailed. Apparently lab results are super top extra secret and it is a pain in the ass to get ahold of them. So I called Dr. GO to get my lab results this morning. The receptionist said that while she had access to the results, she couldn't disclose them until the doctor has had a chance to review them and she wasn't sure whether he had.

However, she also said she had tried to contact me earlier today to answer my question about how often to get tested from here on out. Now, my question wasn't really how often to get tested, I know that depends on what the results are and whether treatment continues. My question was whether to get tested yesterday and I had tried to explain that I shouldn't need to get tested until Thursday. But in true form, the receptionist had totally misinterpreted what I was saying and made up her own question. Anyway, she said she had asked Dr. GO about my non-question and he had said that I should get tested once a week.

Giveaway?

Does this mean Dr. GO did review my results this morning and determined they're not low enough that another MTX injection is in order? Weekly draws were going to be the outcome if the MTX had not gone to zero. So does this mean a non zero result? If the labs were near zero the answer would have been, "it's working! test friday and get a MTX injection," right?

Or was he confused by the question, knowing that I know that the real answer is "it depends," and just gave a safe answer that doesn't really mean anything.

Or the third option: I am, characteristically, overthinking the issue.

Before this phone call with the receptionist I wasn't sure whether I preferred 1) a close to zero number + more MTX or 2) a higher HCG number and no more MTX right now. After the phone call, I realize I would prefer option 1, the low HCG + MTX. But I guess not by a lot. A non-zero means I can stop taking MTX, drink with abandon, test once a week, see what happens with the provera, maybe start the clock on the 6 to 12 month wait before TTC again, and possibly conclude that what I have might not be cancerous. But it could also mean more lethal chemo along the way if it does turn out to be cancerous. It's really a lose-lose. I just can't get my head around how long this is taking to resolve itself. It's become a mind-blowingly huge chunk of my life.

Dr. GO will get back to me, the receptionist said...

UPDATE: Dr. GO didn't get back to me, but Dr. OBG's assistant did. Beta is 8. Again. Will this never end? No seriously, will it never? This is so disturbing. Its 4.5 months past my D&C with FOUR MTX shots, which, admittedly, may have had no effect (but then, how to explain the precipitous drop just following the first injection...). How is this possible? And what does it mean when the gynecologic oncology receptionist says "this certainly is an interesting case." It's oncology, is this really an 'interesting' case, relatively speaking? Am I a freak of nature in some kind of alternate universe? Should I just accept that my HCG will never get to zero during my reproductive years and I have no hope of having a baby? Is this a sign that my hormonal system is so jacked up that even if I get pregnant again, my body won't function properly and it too will fail? Or is it part of the choromosomal fluke and not likely to happen again?

Actually, having talked myself up about possibly not having to do another MTX in the first part of the post, I'm kind of ok that it's still at 8. But not totally, but I could use a break. And really, I have no basis upon which to declare myself free of MTX this week since I still can't get either of my doctors to call me back. Eff.

In other news, I'm taking a trip to the dog shelter this afternoon to take my mind off 'things' and possibly add to our family. But this adds it's own kind of stress. DH wants a big dog. I want a small one. DH always does what I want so I want to to it his way this time and get him a big dog. But it's SO impractical for us. And there aren't any big dogs at the shelter that fit our criteria. So we may end up doing things my way once again. And I will have to somehow deal with the guilt that will inevitably ensue.

Work is busy, that helps get my mind of this too. So I will carry on. Still hopeful. Still thankful the numbers didn't go up.

In the news: celebrity adoptions

Here's the latest celebrity adoption buzz.

And here is a really insightful, informative, NYT article addressing the myth and reality surrounding celebrity adoptions, debate style. It's focused primarily on international adoptions.

Insensitive billing practices

I was doing so well at forgetting about it all. I had a nice Mother's Day with my wonderful parents and husband and the dogs. No babies or talk of babies or innuendos about babies. Well almost none. At one point my mom's friend, who I had just met that day but who knew that I was a newlywed, was flipping through a favorite cookbook and put her finger on some chili recipe. She looked squarely into my eyes and proclaimed "When I was pregnant, my girlfriend was pregnant too, and this was the stuff that was going to put us into labor." Oh and there was that time when I was holding our dog and my dad goes "your baby has a tail."

But other than those harmless quips, totally forgotten about. I have even resolved this week to only test my beta HCG once. Thursday night. Which is all we need to decide whether to do MTX #5 on Friday or to give it a rest.

I even had a beer and a glass of wine. I've focused on work, focused on our plight to adopt a second dog. I've talked about other things, even with the friends that know.

And then I got home and opened my mail. And there was a bill for the last few months of medical service co-pays. The first line item was my D&C for a "missed abortion." There was another for my post D&C u/s. And included in the envelope, for my convenience, was a brochure for a whole series of prenatal classes. How to give birth without pain meds. How to give birth with pain meds. How to make sure you are producing enough milk. How to make sure you're producing nutritious milk. How to choose a doctor for your baby. It went on and on. With pictures of smiling pregnant women in cute maternity clothes and happy attentive doctors. I just don't get it. Is it that uncommon for people to lose their babies? To need a D&C or a MTX injection? Is it so uncommon that the envelope stuffers figure it's worth making a few people sad if it gets the majority of people, the 'normal' women, needed information about classes on how to create life - something that women have been doing far before HMO's and alternative birth plans were devised? Is it really so rare that offense becomes merely an incidental, annoying side effect of the most efficient envelope stuffing practices? Is it so hard to exercise a little more discretion? Clearly they've identified a pregnancy-related visit. That's why I didn't get ads for fiber supplements or sports-medicine therapies. Is it too much more of a step to realize that I LOST MY BABY AND WON'T BE NEEDING THE CLASSES JUST NOW? Maybe stuff a pamphlet about antidepressants or grief counseling in there. That would be good. Thanks.

I'm going to bed.

UPDATE: regarding drinking. I thank Kim for her concern in the comments. That is one of the things these forums are good for, to watch out for one another. I also came to this community looking for anticdotal evidence of what other people experienced walking down the same (or similar) paths. So I should use this opportunity to document the advice my doctors gave me about drinking. Being quite suceptible to side effects myself (a therapist once called me "somatic") and a huge fan of wine I asked several people in the doctor's office about their advice on this matter. Dr. OBG said "wait until your levels are zero" which I think had less to do with the effects on my liver and more to do with her annoying textbook approach to my non-textbook case (see also her insistance on testing me for HCG levels on days 4 and 7 as if I had an ectopic pregnancy). So I asked the nurse administering the dose who said, "a couple days....I wouldn't drink tonight." Dr. DO also said the stuff was gone from your system within days. I do not take the health of my liver lightly. As I said, I'm a huge fan of wine and hope to be able to drink it well into my old age. I mentioned the drinking more to suggest that I am becoming less obsessively rigid about and consumed by the situation I'm in. And the two drinks were consumed over two days. I should mention that after the first dose of MTX I waited one week and then resumed my nightly wine glasses with no ill effects according to the subsequent metabolic work up. But, to be sure, I plan to stop drinking from now until Friday when we decide whether to progress with the MTX and will certainly insist on another metabolic workup this week, just to be safe.

My latest anthem

Beta is 8. And all eight points are taking their toll.

The days are tough. Yesterday I had a draw for three different labs - I swear they took out almost a pint of blood - then MTX injection #4, then I picked up my 10 day Rx of Provera at the pharmacy. Dr. OBG set me up with all of this in the morning (despite an emergency delivery, thanks again for sharing Dr...couldn't you just say you have an emergency? Do you have to mention you'll be delivering someone's baby? Just in time for mother's day?) saying "it'll be like one-stop-shopping." It was. I was in and out in about an hour, far better than the previous Friday when I had to make two stops, each taking over two hours. I was actually able to squeeze in some work yesterday.

Still no office plant.

Last night, DH was drinking a juice glass full of port, his poison of choice, and said the words that I have feared hearing out loud since realizing my pregnancy had failed: "I'm not sure I want to have kids." I turned away from him, angry, sad, in disbelief that he'd say something like that in the midst of what may be one of the most difficult periods of my life. He got all defensive asking why shouldn't he be free to express his opinion. He said he doesn't want to work anymore. He said that he was scared. And therein lies the problem. He said he wasn't sure. But what he meant was that he was scared and tired of his job. I'm ok with him being scared. I'm okay with him getting another job. And even if that was all he meant, I get bothered when he says something like "I don't know if I want to have kids" because it shows that he has no concept of what a remark like that does to me, especially at a time like this. It was enough to send me off the deep end.

I was uncontrollable. The pain was uncontrollable. The tears just streamed for a good hour. I shook. I sobbed, I wanted to throw up. I was so angry and so scared and when I finally worked up the ability to form a sentence I said: You don't have any idea of what I'm going through. All the appointments, taking time off of work, the drugs, the side effects...and worse than all that is the anxiety and the waiting and worrying and the frustration and disappointment and unfairness. Every minute of every day I am thinking about this and it hurts. I just want to crawl out of my skin sometimes or not wake up tomorrow to the realization that things are the same. And the only way I can get through it is to think it will all be worth it someday.

"It will be worth it, it will, we'll do it, it'll be worth it someday, I'm sorry, I'm sorry..." was his response. He quickly realized that he'd been an insensitive ass. But the damage had been done. I was sent deeper into this depression I'm in. He has been further alienated and marginalized in this quest of mine to conceive. I know it's fairly common for two married people to have slightly different opinions on the subject of kids and how many kids and when. And I don't think our different opinions are insurmountable. He's more scared than me and he hates his job more. Big deal. We'll get over it. I just wish with every fiber of my being that this clusterF can resolve itself soon so we can move on with our lives together. So I won't be such a basket case. The 2WW will be nothing compared this.

My beta yesterday was 8. That's after three MTX injections which started when my beta was 28. It's down ONE point from one week ago. Down two points from three days ago. It's so hard to tell if its working. But it is a new low and I am thankful for that.

I used to love Fridays, until they became chemo-treatment-day

Everyone (except the office plant department) got back to me today. Dr. OBG called first and said "I'm not ignoring you," and I believe her, I think we've both realized that she can't do much for me anymore, and she hadn't heard from Dr. GO...but did she really have to say "we've done everything we can!"??? It makes me feel like I've run out of options and now they're just going to do the best they can to make me comfortable till this whole thing does me in.



Dr. GO on the other hand, is Mr. Fabulous, I've decided. He called and said, sure, take MTX this week. I'm also starting Provera today, 10mg/day for 10 days. If my HCG levels are zero as a result of this injection, take two more weeks of MTX. If levels are still around 10-15, we're stopping MTX to see what happens. If the levels go up, he will conclude GTD and do an MRI and more aggressive chemo treatment will ensue, possibly surgery. If they stay the same, he's going to look farther into whether we need a more sensitive test. Apparently sometimes run-of-the-mill HCG tests can accidently pick up certain antibodies, or cross reactions of different hormones and things like that. So he may have to call a more sophistocated lab. He actually did research on this this morning before he called me. Which is very nice. But scary that this is such new ground, even for him. How strange. Maybe I'll end up in a scientific journal.

I am relieved to have a plan at this point and to have Dr. GO sanction today's MTX treatment. My standards for what makes me relieved have gotten very very low, as you can see. Like, I might have cancer, but I feel better than I did yesterday 'cause at least we have a plan! At least there is hope.

I've always said I would NOT want to know if I had terminal cancer. Even as a kid I remember thinking this. I just would not want to know. And I always thought it was because I would not be able to deal with the thought of dying. That such a thought would depress me so much that I don't think I could cope. But I realized just today that it's not the knowledge of death that I would be so desperately trying to avoid by pulling the wool over my own eyes. It's the absence of hope. Despite being a pretty pessimistic person, I am realizing that I place great great value on hope, sometimes without even realizing it. And there are plenty of things to be hopeful about in my life currently - I think that's what keeps me going. Hope that I will move on from this, hope that my cycles will regulate, hope that the next time I will have a normal pregnancy. Hope that there will be a next time. Hope that my parents will live to see their grandchildren. All of these things are not only entirely possible, but probably quite likely.

But, back to reality, I should point out that the term 'likely' doesn't mean much to me after this experience. "Likely" I often equate to "more likely than not" which typically refers to a more than 50% chance. I was likely not to miscarry, and even if I did I was likely not to need a D&C. And then even if I did, my HCG was likely to go down normally. And even though my HCG is reacting abnormally, I am likely not to have GTD, but it's looking more and more like I do with every beta draw. So statistics are dead to me.

But I still have hope.

Assertivity

I never heard from my OBG (Dr. OBG) yesterday. Which only mildly pissed me off until it occurred to me this morning that I would not hear from her today either. It's her day off. And tomorrow is Friday. The day she signed me up to get my fourth dose of MTX having never consulted my gyn-oncologist (Dr. GO) who is not in favor of continuing the MTX unless it's working which is hard to tell at present. So the first possible time Dr. OBG could return my call is conceivably after I undergo my fourth, possibly unnecessary, dose of MTX. The realization of this fact, paired with the fact that Dr. OBG knows when my MTX injection is and knows that I want to talk to her and still has not made an effort made me spectacularly irritated. I know yesterday I was all about "up the dose," but I am now questioning whether it's working at all and I really don't want to subject my poor system to more MTX than is necessary. And I would like to start Provera as soon as possible, per Dr. GO's instructions, which I also planned to raise with Dr. OBG. These are important, time-sensitive decisions, she is flying absolutely blind having admittedly little experience with GTD, and I have given her every opportunity to respond to my concerns. I am over it. I am seriously considering dealing only with Dr. GO and then going to someone else in the department when this whole thing is over, should I ever be lucky enough (and brave enough) to get knocked up again. I think all I will have say to my new OBGYN is "my last pregnancy was a partial mole" and I will be signed up for an early u/s and serial beta HCGs. I don't need Dr. OBG's help.



So first thing today when I got into the office, I called Dr. GO's office. "I would like a call back from Dr. GO please regarding my treatment." He will supposedly call me back. (1 point)


I also exercised self-help to an office plant sitting in a dark corner by the elevators which I assumed no one would miss. (1 point) Our offices have big fish-bowl windows facing inward towards the hallway so a lot of people put plants in their windows to try to maintain some semblance of at least partial privacy, futile though this may be. I used to have a ficus that I had brought from home but I had to take it back home the other day to re-pot it. So I figured I'd give the poor little plant next to the elevator some light and put it in my office. But the plant-waterer-guy came around and told me that he had to take it and return it to its dark corner since it had not been 'assigned' to me and had the wrong color pot. Apparently the pots inside peoples' offices are black and the ones in the lobby areas are copper. (PS there are plenty of copper-potted plants in peoples' offices) Really? You're taking my plant? I felt like crying right then and there. It was too much. This is one of those days when the welled-up tears are sitting just on top of my eyelids, ready to spill over at any minute. Like if I just blink real hard, I will actually produce a tear or two.

So then, feeling defiant, just two days after a pretty serious layoff at my company, I make a call to see if I can get a plant 'assigned' to me. I know this is a petty, self-indulgent request and maybe I should just sit in my plant-less office and be grateful I have a job, but in the spirit of the new assertive leaf I'm turning over, thank you Babychaser, I told the company I wanted a freaking plant, damnit. (1 point) But not in those words, exactly. (-.5 point) They said they contacted the head of some office-plant-related department because apparently getting an office plant is a big production, and someone will be getting back to me.

Then a colleague came in and asked if I can do a speaking event in two weeks. Dear readers, there is NOTHING I hate more than having my health and my ability to conceive in jeopardy. But aside from that, there is NOTHING I hate more than public speaking. I had to take anxiety meds in law school over this phobia. It really effs with my physical health, not to mention my emotional stability. The good employee thing to do two days after a lay off would have been to jump at the chance to be a team player. But I need to take care of myself right now. So I said no. (1 point) But my spine is still a little soft and I also I'd get back to her about maybe doing a different date, farther in the future. (-1 point) Damn.

UPDATE: Dr. GO hasn't called me back so I went to schedule my MTX injection to make sure I could get in just in case that is the best option (-70000 points). And guess what, Dr. OBG hasn't sent the request to the infusion center so I can't get an appointment. I feel like Bruce Willis in the Sixth Sense when he realizes he's dead and no one (except that kid) is actually interacting directly with him. Invisible. Helpless. This isn't working. Maybe I can't become Ms. Assertive overnight. Baby steps.

Oh and the infusion center says it's going to call me back too. So that's like eight dozen calls I have coming. I'm taking guesses on how many I'll actually receive.

Signs

I got my 4-day-post-third-MTX-injection beta draw yesterday. I then had a dream last night that the results were zero. Not "less than 2" or "undetectable," in my dream, my doctor said "zero." Then I proceeded to have a fight with her about whether or not to have another injection. She said no, but I kept reminding her that my oncologist said to do it. She hadn't spoken with my oncologist, which did not surprise me.

(Relatedly, what does it say about how consumed I am with this mess that I'm dreaming about it)


I woke up a half hour earlier than I had set my alarm for. And I temped. And the reading was such that the anxiety set in right then and there. 97.49. Not low enough for AF or the pre-ovulatory period, not high enough for ovulation. Right where it has been every time I get a 'no change' or a just plain bad result. It made my FF chart look like the GTD is fighting back. Not that you can reliably tell this from a BBT chart. But I'm starting to notice correlations. I couldn't get back to sleep.

They are late calling me with the results this morning and this is another bad sign. So far, if I'm the one who has to call the obgyn office, the results are not good. It means the Dr. is checking with the oncologist about what to do next.

You would think I'd start being able to relax a little after these draws. Not get so anxious waiting for the results. Like I'd be desensitized by now. But I'm not. I'm very nervous.

RESULTS: 10. so they went up. By one. Dr. recommends MTX on friday and lo and behold she has not spoken to the oncologist. She doesn't even know that we met, according to the nurse who called. I am so so frustrated. I am tempted to ask why the h-- she is wasting my time, give me something that will kill it. now. I'm tired of pushing my life out one week at a time. It's probably having some effect, just not enough. So up the dose, or the frequency. Whatever, just end this before I go completely crazy. She didn't even call to talk to me. She had one of her nurses do it. F*#ker. And I have so much to talk to her about. Have I mentioned how frustrated I am lately?

ten. there is still hope since the biggest drop seems to happen between days 4 and 7. But I am growing so tired of this tirade. Maybe I will get desensitized after all. I am going to end this by saying that I'm very grateful that the levels have not gone up by more.

In the news: Daily Mail reports on UK woman's molar pregnancy

While molar pregnancies happen to plenty of people, and while I'm a little disappointed that it's being exploited in this particular tabloid, which is in all senses of the word a "tabloid" and known for dramatizing situations like this in a way that makes them seem like alarmist impossible grotesque one-time instances that could never happen to anyone ever in the real world (this of course can happen - to anyone - and I wish it was approached with a little more civility), I think it's good to shed light on this condition publicly notwithstanding that the story does a questionable job of describing the condition. For example, it shows a picture of a 7-or-so month pregnant belly with a caption describing how the woman's uterus expanded with her molar pregnancy just like a normal pregnancy.

I have been shocked at the number of people in my own circle of friends who have never heard of a molar pregnancy. In a striking example, one of my friends is 1) a new mom and 2) has two OBGYN's in her immediate family (her dad and sister) and she had never heard the word before I mentioned it as a possible self-diagnosis. Blissful ignorance at its most blatant.

Sometimes it seems as if there is an effort being made to sweep the problem under the rug, so people don't have to hear about it. I read on some website recently that if a molar pregnancy happens to you, the best thing to tell family and friends is that you simply "had a miscarriage and need to do some follow up work" because the details of a molar pregnancy and its treatment are far "too complicated" for normal people to understand. Seriously? Hard to hear, yes. Horrific and scary, yes. Hearing about a molar pregnancy is a total downer, probably no one would disagree. But too complicated? Come on.

My thoughts go out to this woman, I'm glad her story turned out the way it did. And it did my heart good to read the comments following the story, lots of women can empathize...lots of women with subsequent successful pregnancies.

Who would've thought Preseed has such a long shelf life?

As my expected date for resuming the TTC process gets thrust further and further into the future, I made the depressing move of checking the expiration date on my supplies of Preseed and Pre. We got our BFP on our first cycle using Preseed and at the time I fully intended to use it again during any subsequent TTC attempts. I now question whether that's wise, given the outcome of our first pregnancy. Maybe sperm that shouldn't have otherwise had access to my egg got there precisely because of the Preseed, causing this mess I'm in. Maybe these genetically effed-up sperms would have died en route or missed completely if not for the synthetic pathway I laid for them. And clearly, they should have missed - they were not capable of forming a viable life and instead have transformed into a genetic quagmire of cancerous growth. Isn't this the antithesis of Darwinism?

There's a question here for any of you aspiring PhD's or MDs needing a research topic: can Preseed increase the incidence of abnormal pregnancies beyond the baseline rate by facilitating conception where it would not otherwise have happened? By choosing a popular sperm-friendly lubricant to aid in our TTC process did I unwittingly mess with mother nature and in so doing, bring this catastrophic failure of a pregnancy upon myself? I have not been one to place blame with respect to the miscarriage. I get that it was probably a chromosomal fluke of chance and the subsequent echos of a potential mole have made this possibility even more likely in my and my doctors' eyes. But I do wonder, is there a reason we didn't conceive until we used Preseed? Should we just use patience next time, should we be so lucky to have a next time? To be clear, I am not blaming myself. Or even Preseed. I'm just voicing a hypothesis that popped into my head during my frantic search for answers and the question interests me from a purely scientific standpoint.

I understand that plenty of people have conceived perfectly normal children with Preseed after many cycles and even years of no success. And I don't mean to impugn its benefits and miraculous powers. But I do wonder if it can cause a perverse effect in even a small percentage of the pregnancies it facilitates.

My supply expires in September of 2010. That is far longer than I expected it to last. I don't dare assume that we will be ready to try again by that time (though I fervently hope it will be far sooner) but in any case, it gives me plenty of time to think about our next approach, again, should we be so lucky.

on the right track. for today.

In the way of an update, my betas are back down to 9. This draw was taken before the third MTX dose. So that's a good sign. But we've been down this way before, haven't we?

Symptoms after MTX #3: very very mild. I actually went on a run just following the injection. Same tiny cramps, same occasional and mild nausea and heartburn for a day or two. I've heard of people's systems becoming immune or desensitized to MTX. And since the oncologist recommended against a lot more of it, I'm hoping that this last dose is still having some effect.

Visit to the oncologist & more MTX

The gyn-oncologist was 45 minutes late to a 9am appointment. He had emergency surgery this morning. I guess I was lucky to see him at all, considering. The appointment was just a consult, meant to put my mind at ease and answer the questions my OBGYN hasn't been able to. But it was still a little scary. He said it could be anything along a spectrum of gestational trophoblastic diseases (GTD) from a molar pregnancy to choriocarcinoma (an aggressive metastatic cancer). All of these possibilities are a form of cancer, he said. So what I heard was: "you probably have cancer." But I had already come to terms with this possibility anyway. As much as you really can come to terms with having cancer. And I can appreciate the difference between this kind of cancer and the more aggressive, less treatable kinds. That makes this easier to come to terms with.



He discussed possible Plans B and C should the MTX not work. He seemed to think today's third dose of MTX was a questionable step but said go ahead anyway. He warned against keeping at the MTX since it is a poison and perhaps isn't having much effect. But he also acknowledged that it may be working since my betas have been lower since the treatments began. He was more concerned than I hoped he would be about the fact that my levels climbed from 9 back up to 15 recently. "They almost doubled!" he exclaimed. I guess that's true. But they've stayed there, they doubled once in two weeks and they're plateauing. And really, they dropped in two or three weeks, from 21 to 15. They're not doubling like choriocarcinoma or even like a viable pregnancy.



So the next steps depend on what happens over the next week. If the MTX works, he says to continue to take a couple more doses of that. If it doesn't, he thinks we should do a pelvic scan. If the scan shows tissue that can be taken out, he thinks another D&C is in order (PleaseGodNo). If not, he thinks we should try another drug. D-actinomyacin. He also mentioned a third, the name of which I forgot. He called the trio of chemo drugs "MAC." Probably the "C" in MAC is the one I'm forgetting.



He told a horror story about a girl who had gotten down to zero, decided she didn't want to over do it with the MTX and so she rejected that final dose the Dr. had recommended, and she ended up with HCG in the thousands a couple months later because the GTD had persisted. He told me this to convince me that it's a good idea to get a couple more treatments of whatever drug ends up working even after (& if) HCG hits zero. But he also had a good story about a girl who was about to be upped to a pretty aggressive chemo regimen becuase her HCG was rising and she had a lesion on her liver suggesting the GTD had spread and suddenly, the day before the drastic measures were to start, her levels started dropping. Inexplicably. And she's been fine since.



He had a seemingly reckless approach to TTC again. He said the MTX will be sufficiently out of my system in a month, no problem, probably days. And he seemed to promote trying again in around 3 months, contrary to the 6-12 I keep hearing about. I'm trying to prepare myself to wait 12. But I know that will be difficult. And if I have a doctor telling me three, well, all the better. He seemed similarly unconcerned about the possibility of this particular incidence of gestational trophoblastic disease (GTD) recurring during a subsequent, healthy pregnancy. I asked whether they'd be able to distinguish between HCG from the healthy pregnancy and HCG from a recurrence of the GTD. He said yes, sort of. If the levels stray outside normal limits during a later pregnancy, they can conclude that the GTD has acted up again. What he didn't mention is what in the H#@(( we'd do about it if it did recur while I had a little life inside me. I don't think there's much they can do. Which is why I'm preparing myself to wait a year.



He also said that if this is a molar pregnancy (probably a partial molar in my case since there were NO signs of a mole in the pathology report or elsewhere) I have a 1% chance of this being caused again by a subsequent pregnancy. Which is not large but it is significantly larger than the baseline risk of the general population which is .01-something. He said "it's not like down syndrome, it's more like having fraternal twins." By that he meant that DS is something you carry in your DNA, a mutation - twins is more of a predisposition of your body to mechanically behave a certain way (by releasing more than one egg in this analogy).

He mentioned two possibilities of what it could be other than GTD. One was a subsequent failed pregnancy which is resolving itself. I had been over this before with my OBGYN. It seems so unlikely. But of course preferable to GTD. Although on the other hand, if we're preparing for the worst and treating it like GTD, what good would it do me if it was a second pregnancy after all. I'd still be going through chemo and waiting to TTC again.

The second non-GTD possibility is "phantom HCG." Sometimes, he says, a few hormones can interfere and present in such a way that you get a "false positive" Beta test. So there's nothing producing HCG in your system but whatever the test looks for is there in some amount. We both thought this was unlikely too. I'm not cycling (could be stress, he pointed out), I tested negative on plenty of pee sticks before I got my BFP, and it would be too weird of a coincidence I think. Or maybe the pregnancy threw my hormones totally out of whack and this is phantom hcg...

Finally, for the sake of completeness, I will mention that he encouraged me to try a progesterone trigger, like Provera, to see if AF would come. This would help rule out Ashermans and could clean out my system such that the cells that are causing such a problem are shed. I think my OBGYN had been resistant to try this until my levels reached zero, but the oncologist is going to talk to her about it.

Overall I feel more informed, basically his was a third opinion. And was consistent with the others. And now I'm in knowing hands. And I was comforted to know there are more steps we can take if the MTX doesn't do the trick. But I don't feel any more optimistic about my current condition. I feel increasingly stuck and frustrated. How could the MTX not work? It works for a lot of things, it's supposed to be the go-to drug for someone in my position. It has to work.



I'm glad he recommended against getting a CT scan to look for signs of cancer in other areas of the body - he thought it unnecessary since my levels are so low. I'm also glad he acknowledged that I could have a molar issue - and that this is probably GTD. An almost-diagnosis! Albeit a scary one. My OBGYN kept trying to sweep this possibility under the rug since the pathology report was clean. But he didn't rule anything out either. He didn't say, much to my disappointment - "this can't be choriocarcinoma because your levels would be higher." But he's also not the guy who's been hearing my weekly updates and pulling the strings on my treatment. That guy was too busy to see me. The guy I saw had to familiarize himself w/ my case in about seven seconds and given that, I think he did a pretty good job of reassuring me that this can be resolved.