Dr. OBG gets a reprieve. Sort of.

She called me this morning. I was half hoping I'd miss the call even though I not only carefully thought out the several things I was going to ask her, but even wrote them down. Part of me wanted to just forget about the fight, just do what she said as long as I could and stop when I couldn't stand it anymore. I get why she's prescribed the 'treatment' she has. I know it's arbitrary, hearing her admit that will only cause more tension in the relationship - it probably won't make me feel much better. And I have to make sure to distinguish between my anger at my doctors and my anger at my situation.

I talked to DH about my frustrations last night. I told him I cried at work when Dr. GO's office called to tell me Dr. GO wouldn't be able to call me. In the time Dr. GO spent talking to his receptionists about how he wasn't going to call me, he could have answered my questions, put my mind at ease. I just don't understand how they can be so heartless. DH said it's all about money. This makes sense. The doctors are not interested in talking to you on the phone 'cause they don't get paid that way. They are covering their asses every step of the way. And why should they call if they don't have to. If they can make you come in. You can say no, you don't want to come in, but it's your own loss. You're not hurting them. He made a lot of good points. And I thought about switching from B!ue Cros$ to Ka!ser. Ka!ser, who allows you to email your doctors. And they have an office literally across the street from where I work.

I got as far as looking up obgyn's in that office and was disappointed to find there were only two - neither was as credentialed as the ones in my current office. Frustrating. I could try to go with another obg in my office but I know what a close-knit group they are (because magically, they all know everything about my case and concur wholeheartedly with Dr. OBG) and I would never feel like they were on my side. Because they wouldn't be, they'd be on Dr. OBG's side. Everyone loves her. They've defended her to me before. Everyone hasn't had the problems that I have with a pregnancy though. Everyone hasn't really tested Dr. OBG. She's not that great, I can assure you.

Anyway, I did miss her call. And she left a message. And came very close to redeeming herself. She changed the number of weekly draws again to 8 instead of 10 (without acknowledging that it was a change of course, she acted like this had been the plan all along). And then said the wait would be over in December or January. And that they were just being cautious. And then the money line. The line that I blogged about wanting to hear yesterday. She said "This is just our recommendation. You obviously don't have to follow it. I know you've been through a lot but I think if I were in your shoes I would do this, just to be cautious." I was about to figuratively run back into her arms but then she ruined it by saying "it's just like when we recommended you abstain from intercourse after the D&C." This was so hard to hear. She blames me for what has happened to me. Because I had unprotected sex in the couple weeks after the D&C she thinks she can blame me for this persistent HCG - as if, had I followed her instructions, this would not have happened. It's my fault. This brings me back to posts a few months ago when I explained that I knew back then, for a sure and certain fact, that my HCG was declining abnormally slowly, that I wasn't ovulating, and that the HCG levels never hit zero in those first few months. I didn't recklessly jump back in the sack. I monitored my temps, I peed on sticks, I watched my CM. I watched it all like a hawk specifically because I wanted to know when things were back to normal. This is not my fault. She is using what she presumes are my indiscretions because she can't explain what is wrong with me. I did it to myself I guess. I opened a window for her to say - not my problem, you didn't do what I told you to, all bets are off. But had I done what she told me to, things would have gone the same way. I have never been so sure of anything.

I know crazy things can happen. I know, on a cosmic level, I can't really know anything for a sure and certain fact. But I am as sure as a person can be that that baby dancing back in February had nothing to do with the fate that has befallen me. My fate was locked in as soon as we conceived last October. And my situation now is not the same as it was then. And I hate that she used my situation to threaten me to follow her advice now. I hate that she blames me and is trying to use my own choices to threaten me into submission. If I had truly thrown her advice in her face and behaved recklessly, I think I could understand, but she is not respecting the fact that I did make educated choices. I knew more than she did about what was wrong with me back in March because she wouldn't listen to me and insisted that it could all be explained by a second failed pregnancy. So I had to self-educate. She was ten steps behind. And now that she's finally come around, she's acting like she wrote the book and I'm still the one who is to blame.

My revised plan:

• Not calling her back (she didn't even offer this as an option, btw. No "call me back if you still have questions" or anything. She is obviously not interested. On many levels, I am hating her still).


• Bi-weekly testing for two more tests.


• Monthly testing 'til December


• Stop preventing in Nov./Dec. and start trying Dec/Jan if my levels haven't budged from zero.

UDPATE: The difficulty with a second opinion.

I appreciate the comments ladies. I know a second opinion is way overdue. But here's the problem. The whole group of doctors that are readily available to me has been tainted. I.e. because my case is so rare, Dr. OBG has polled aaaaalllll the other obgyns in my medical group to see if they have any expertise in this area. Finding none, she just signed me up for "molar pregnancy treatment" and everyone agrees with her. I have asked for a second opinion within the group. The answer was "do whatever Dr. OBG says." I called Dr. GO yesterday specifically to get his take on the matter and NOT Dr. OBG's and we all saw how that went. He refused to answer and that call got kicked back to Dr. OBG. It's like the twilight zone. To get a real unbiased second opinion I would have to change my group, would have to find another location (hence, looking into Ka!ser) and might have to change my insurance. Which would require waiting for open enrollment...this winter...by which time I may have the green light even from Dr. OBG & Co.

The second problem is that even if I go through the hoops of finding another group, squaring it with my insurance, and finding a new OBG close enough to where I live or work, chances are the OBG won't have a clue what to recommend (not unlike mine) because this is gynecologic oncologist territory. And there are only two gynecologic oncologists that I know of within a 500 mile radius. One is Dr. GO and the other is his business partner.

So as I see it I'm SOL. Unless I move to a new state. And maybe I should just listen to them. Do what they say. Which I am almost willing to do. I'm willing to wait 6-7 months but I'd like to start the clock at the point of my last MTX injection or when my numbers first hit 5. They want to start anew right now. It's just a matter of a couple months. And who knows if those couple months will even make a difference. I think I'm more worked up over the beauracracy than over the actual wait time, which I understand, to an extent. I'm sure I'll get over it. In the meantime, I really do appreciate your advice. It really helps to get your opinions, readers. Often more than those of the Dr.s. Because you've been there. You know first hand how it goes and you're here because you want to share and learn and help and be helped. Not because it helps your bottom line. And that makes a world of difference!

"HCG Results Day" or "I've had it up to here"

I got my blood drawn last Friday. Morning. So W(hy)TF haven't I gotten my results yet? Every time I call in for my results the nurse says something patronizing like "the doctor will call you back when they're ready, like she always does." And yet....here I sit....almost time for my next weekly draw and I still don't have them. I'm going to call - under the guise that I'm also trying to find out what Dr. GO says about wait time. Dr. OBG said she was going to check with him as to whether the testing/waiting process needed to be 'tweaked' at all. Let us pray.

UPDATE: The nurse called me back. My levels are "still at zero." Which could mean anything coming from Dr. OBG - recall a couple weeks ago when she said "your levels are FIVE! Which is basically zero!" even though the previous week they had been two. So the levels had gone up and she tried to convince me that five was still a good result. I was almost in tears. And recall that the first time my levels were two she said that was basically zero too. And I said "isn't there a lower number, like 'less than 2?'" and she said, and I quote, "not really." Which is obviously crap. Because the next week I did get "less than two" and it was pretty damn monumental, according to Dr. OBG. And recall that she said five weeks ago that "now that your levels are negative we'll do weekly testing for four weeks and then go to monthly." But now that they're at a true zero we're doing six more weeks of weekly testing?? So results that were 5 or 2 weren't really negative enough after all? Basically I draw from all this that 'zero' means whatever the eff she wants it to mean. She thinks she's protecting me by telling me what she thinks I want to hear and assumes that what I want to hear is the best case scenario, but the lack of honesty just makes me so angry. And the nurse said that Dr. OBG wanted me to know that Dr. GO said to go ahead with the 7.5 month plan.

Feeling a bit of rage coming on over all of this (I am really thinking more seriously than ever about getting a new OBG) I called Dr. GO immediately for an explanation. Dr. OBG is clearly uninterested in talking to me. The receptionist at gynecologic oncology told me I'd have to make an appointment for this kind of conversation. I called BS...as politely as possible. I told them I'd been talking to him about my case over the phone for months and had already come in once and that I was pretty sure he'd be ok with a phone conversation. I am pretty sure. And I have SO had it with this cryptic arbitrary treatment and testing schedule and lack of honest communication. I HAVE HAD IT. Goddamnit, I want some answers - I've gone six months without any and now I want some. Real ones, not sugar coated, not overly conservative, I don't want textbook answers if I'm not a textbook case. I want customized treatment. Or at the very least, the facts. Plain and simple. I want someone to explain to me the logic behind a 7 month wait. It would be nice if Dr. OBG could justify changing her mind from four weekly tests to TEN but I'm sure that's asking too much. Call me demanding but this is my fucking life they're messing with. Good lord, if AF hadn't just ended I'd swear I was PMSing.

I also wish someone would say - "it really is up to you, these are just our recommendations" and then explain their recommendations. If they don't want me going to the internet, then perhaps they should provide some reasoning. Curiosity is human nature. So when they tell me to wait 7 months and don't tell me why, of course I'm going to second guess and do research on my own. I'd like them to at least acknowledge that I have some understanding of and control over my own situation, even though their recommendations are (arguably) more medically sound than anything I could come up with. It would be nice if they could just be a little more respectful of what I'm going through. Maybe then I'd respect their opinions more. And even if they don't say it, I'm hereby changing the protocol and doing bi-weekly blood tests instead of weekly. I'm going on with my bad self. Don't try to stop me.

UPDATE II: Dr. GO's office called back. A receptionist. She said "Dr. GO COMPLETELY agrees with Dr. OBG" and that if I have any other questions I need to make an appointment. I asked if I could make an appointment to talk to him on the phone. "No, you'd need to come in." I said I didn't understand, I only need a five minute conversation with him and coming in would take an hour and a half and I just don't have the time with my job in this economy. I actually said the words "in this economy." And I wasn't bluffing, I actually don't have the time. This is part of the reason I'm changing to bi-weekly testing. I have a lot going on at work and a great deal of pressure and the added risk of getting a pay cut if I don't put in enough hours in the next few months.

Am I being unreasonable? Will someone please tell me if I should tone it down (or up - maybe i just need to grow a couple)? I wouldn't take no for an answer - I just kept telling the receptionist yes, I understand what the plan is, I just need a rationale. No one has told me why they've agreed on this treatment plan. I need to know if Dr. GO thinks I have GTD, is that why the long wait? I feel like crying, I just don't understand this. Are they afraid to give me an explanation? Afraid they'll get sued? Afraid to tell me too much? Afraid it might cause "patient anxiety?" Was he lying when he said "feel free to call with any questions?" Fuckers. I feel trapped. And helpless. As if having something like this happen to me isn't traumatic enough. Now my own doctors won't even talk to me.

Smugness

I went to visit my primary care physician yesterday. I've been with my medical group almost two years and this was the first time I ever saw her. I went because of the tick bite I got a week ago. Just by looking at it she said doesn't think it will result in lyme disease. I'm not too worried anymore since the tick came out immediately (apparently you have till the stroke of 36 hours to get the thing out or your risk goes up) and I haven't had any symptoms of infection. She said I could get a blood test in about a month if I wanted to - just to make sure I'm not infected. I asked whether, if I were infected, the antibiotics they would prescribe would still be effective that late in the game. She said yes, they're effective even in late stages. "To cure lyme disease?!" I said, in disbelief. I was under the impression that you needed to take an early course of medication to cure the disease and that if you wait too long it becomes chronic and you can only 'manage' it from there. My mom's doctor gave her a purely prophylactic round of antibiotics when she was bitten. Dr. PCP seemed perplexed by this and insisted that lyme disease could be cured at any stage and so-called chronic lyme disease is a myth. Oh. My. God. I thought - I have the nutty doctor that thinks debilitating diseases are all in people's heads. Now I do think that some people whine entirely too much about common innocuous ailments and allergies. But when people talk about lyme disease symptoms, I believe them. I don't think of it as the kind of thing people make up or complain about just to get attention or have something to talk about. Suggesting that lyme disease can be cured in one two-week dose of meds at any stage of the disease was a little much for me to handle. Don't get me wrong, I'd love for it to be true, but it's fishy. I've known people with the chronic version of the disease. My parents know people with it. They're not big on whining or made-up ailments and they said the day of the tick infestation 'you do NOT want lyme disease.' Why would people say that kind of thing if it could be cured in a week? I'm so confused. Who says real doctors are more reliable than Dr. Google? That's crap. Google is a genius.

I also went for an HCG beta today, you know, while I was there near the lab. Why not? Apparently Dr. OBG needs me to be stuck as often as possible. So now I await results (in on Monday). I saw two pregnant girls in the lab's waiting room and one with a new baby girl who was overly adorable. She had those socks with the little black mary jane print on them so it looks like she's wearing shoes. But she had the socks in her hands 'cause she wasn't really into the idea of wearing them on her feet. They were far more fun to throw. All three of them were brand new moms. I could tell without even talking to them. There were some obvious hints like - their husbands were there (for a blood draw? really?) and there were no other kids in tow. But they also had this look about them. Nervous, excited, proud, and ignorant. Blissfully ignorant. As I struggled to look away, to control the longing that crept across my face, I braced for the wave of emotions that was sure follow that kind of sight - the sight of babies everywhere, you know the one (and as an aside, it always seems so odd, like "what a strange coincidence, I was just thinking about how bad I wanted to be a mom - what a coincidence there would be THREE new moms in this very room! The universe has really turned against me!" But then I realize. I am ALWAYS thinking about how bad I want to be a mom. So the coincidence isn't a coincidence at all. It's really just inevitable.). And the emotions came. Sadness, anger, fear, jealousy - all dreadful things. But I sensed something else this time. I don't know if its the first time I felt it or if this was just the first time I noticed it. It was "smugness." I felt smug in the knowledge that I now possessed. Somehow more learned and prepared for pregnancy, motherhood, life.... Not a little idiot that goes about insensitively posting the joys of ultrasounds on FB or complaining bitterly and unabashedly about how awful pregnancy (or even AF) is. There's a sadness to the loss of "fertility innocence," but there's also wisdom and freedom. With knowledge is power. Power to not be one of those women. Freedom to appreciate every last angle of pregnancy if it ever returns to me. Would I give up all of this to be one of those ignorant innocents? Well, it would mean I could have a baby. But how could I wish ignorance upon myself? How could I wish to not know in all ways possible how very special a baby is or how precious and worthy of respect the process is? How could I wish to not be sensitive to others' needs and emotions or not to be able to understand their pain? How could I wish not to have learned the lessons that I'm learning? Would I give it all up for a blissful pregnancy? It's hard to say. When all is said and done, I might be at peace on some level that I suffered a loss. Like the amount of time and frustration I've endured was a reasonable price to pay for the perspective I gained. But I will always be a little angry too.

I don't talk a lot (at all so far?) about weight which seems to be a common topic for a lot of gals around here. This makes sense as it is a key component of reproductive health (among other desirable things). I try not to focus on it or identify too much with my weight 'cause I had a pretty extreme eating disorder as a teenager that almost killed me. In fact, it's the only thing I really worried about when we first started TTC. My AF's stopped when I was 'sick' and started up again when I got better. I wondered then, and still do now, what kind of damage I did in the interim. And just thinking about getting obsessive about my weight (diets, counting calories, watching the scale, etc.) sends me into a cycle of despair, "brings me back," so to speak to the singular most depressing and destructive episode of my childhood.

Anyway, I weighed 132lbs last year when I got pg. For the 15 years prior to that point I was a die-hard gym rat and ate pretty healthfully. I continued those healthy trends through the pregnancy. And post-miscarriage it's all gone to hell. Almost overnight. I almost never go to the gym (I used to go every day of the year, no exceptions). My only exercise is walking my dogs (an hour most days). I eat nothing but crap. Lots of sugar, more and more caffeine as the weeks pass, chocolate, wine, processed carbs, etc. I don't have much patience or time for cooking or packing a healthy lunch so I just eat processed non-perishables throughout the work day. And coffee. Did I mention I'm drinking more caffeine lately? Thank god I'm taking pre-natals or I would have probably expired from malnutrition months ago.

So you can imagine my surprise when I got on the scale and saw: 126. What?! The scale must be wrong. How could I have LOST six lbs by being a flabby, lazy, gluttonous oaf? I know this is the kind of thing that makes people hate a person - like from the looks of it, I behaved badly and was rewarded by weight loss. But this kind of thing doesn't happen magically. There has to be a reason. And since it's definitely not that I'm taking care of myself, I think it's the stress. The Unhappiness. The Depression. I'm a grazer so by all appearances I am ALWAYS eating. But maybe I'm still not eating enough. Or maybe the anxiety is better at burning it off than I fully appreciate. Maybe my appetite is suppressed. Or maybe the scale just really was broken and I'm making something out of nothing. It wouldn't be the first time.

Fudging It

I've said before I'm a fan of the little white lie. I'm not a shameless and unabashed user. I'm just a simple fan. I'm not an addict, but sometimes it's just the thing.

So here's my latest. In order to throw the few friends of mine IRL that know that I eventually will be back on the TTC bandwagon off of the pregnancy watch trail (after all, my m/c was SIX MONTHS ago, I should be halfway through my next pregnancy by now) I'm telling them all (all four of them) that my doctors are recommending I wait a year before TTC again. So I'm fudging expectations in the longer wait direction. At the same time, I've devised a plan to fudge reality in the direction of a shorter wait. It's not bulletproof. And it's nothing spectacularly clever. I'm just going to be assertive with Dr. OBG. And negotiate. If my levels stay at less than 2 in four weeks (rather than six) I will ask if I can start testing monthly. How could she say no? My veins are collapsing under the weekly pressure for chrissakes (and I'm not afraid to tell that story....or to cry). Then, if, after 4 or 5 months the levels are still under two, I'll ask if I can start TTC again. If by then there hasn't been one blip of evidence of recurring GTD and she STILL says no, well - one of our condoms might just happen to break. Because that would be ridiculous.

I'm getting WAY ahead of myself. After all, I only got one less than two result. And Dr. OBG is always giving me harsh reminders that this is my BODY we're talking about - don't try to make it into a science experiment. So I have no reason to think she'll help me out. But while I know I shouldn't be foolish with my body, it doesn't belong in solitary either. It doesn't deserve to be punished like this. It may be ready in, say, 5 months to grow a new life and why-god-why would I stand in its way when that's the only thing on earth that I feel like I have yet to achieve before I can feel truly fulfilled? And when, while I'm young enough, I'm not that young. If I'm going to have m/c's I need to be able to move on more quickly from them. And even if we assume the unlikely - that this was a partial molar pregnancy - six months is still a long wait to prescribe. Or at least standard. 7.5 is arbitrary and ridiculous.

I'm still waiting for Dr. GO to come through. I want him to be my second opinion but I'm afraid he might be biased - not wanting to step on Dr. OBG's toes. Maybe I should call him myself. I've thought about divorcing myself from Dr. OBG completely, but the problem with that is that I've invested in her. My history is laid out in all its glory, fresh in her mind and she is bound to be particularly attentive when and if I do get pg again. "Attentive" as in "early and often betas and u/s's" which I would love, nay, absolutely require to maintain any semblance of sanity next time around. On the whole, do I wish I had gone with another OBG? Yes. Unequivocally. There are a number of things I don't like about mine. We don't gel. She doesn't get me. But she's smart and while she's not perfectly right for me, she is good. And her office is really really convenient. And I've heard wonderful things about her from people who have had successful pregnancies.

Here's an analogy. I got married in January, and I've changed my last name for ALL relevant purposes except health insurance. So I'm still Astrid Maiden-Name at the Dr.'s office. And my reasoning is - I was in the middle of a pregnancy and m/c at the time my name was changed over, there was a lot of follow up work, changing my name in mid-stream on my health insurance, given all the OBG office visits, oncology visits, infusion visits, lab visits, prescriptions, phone calls and bills being mailed, etc. would have been a monumental headache for me without any redeeming gain. I feel similarly about Dr. OBG. Could I be marginally happier and feel more comfortable with someone else? Yes. Is she that bad? No. Is it worth switching mid-stream? So far not.

As long as I'm getting ahead of myself I should address what I would tell my four friends-that-know if I ever do get viably pregnant. If it doesn't happen for a year, notwithstanding earlier attempts, then I won't need to do any explaining. If it happens on the first few tries, I'll just explain that either a) an accident happened or b) things were going better than the Dr.'s expected and we were given the green light. (Look at me being all optimistic!) I have a feeling they'll all have forgotten by then, or even moved on from being such fixtures in my life - even six months seems like a lifetime away and plenty of time for friends to become distant or forgetful. This thought is one of the things that makes me so sad. The concept that I want to be pregnant, not just as soon as possible because I'm getting impatient, but because I want to be pregnant in my current life situation. It's really the perfect time. And I was so so close. I have a bunch of first-time new mom friends, I have parents young enough to have fun with their grandkids and for the grandkids to remember them later in life, my sister is potentially moving to town this year, and DH and I are finally established, have a house and great careers, and are ready, right now, to welcome the new responsibility into our lives. We're also relatively young. I was thinking today that I wouldn't have wanted kids any earlier. That I am going to be the type to get better with age and that I will be a better mother than I would have been at 25 or 26. So I have no regrets, just wish it would happen soon!

In the way of some explanation as to why the long wait - some of my commenters have been asking and I apologize for not setting out the details. When HCG levels don't decline appropriately after a m/c or D&C, i.e. when HCG levels go up or plateau after the pregnancy is over (instead of coming straight down in a matter of weeks), doctors suspect that the pregnancy was a molar pregnancy or that some remaining placental cells have developed into gestational trophoblastic disease (GTD) which can manifest in anything from a benign growth of cells (like a tumor) to a metastatic cancer. HCG is a marker for the disease so when someone is not viably pregnant but their HCG stays elevated after a m/c or even a full term pregnancy, it's an indication that this GTD could be persisting. When my HCG levels plateaued, the doctors treated me with chemo to stop the cell growth and hopefully send the HCG down as a sign that the GTD was 'cured.' And my levels did go down, slowly. Arguably more slowly than they would have if it was GTD that was actually causing the plateau. But GTD is, in a rudimentary sense, cancer. Uncontrolled growth of cells. And it can come back, even after HCG has gone to zero. So if what I had was GTD, the doctors want to keep checking my HCG, for 7.5 months, to make sure it stays at zero. If I got pregnant within that time, it would be difficult, if not impossible, to tell if the rise in HCG was due to GTD or the pregnancy. And if it was GTD on top of a pregnancy, the consequences could be dire for me or the baby or both. After six months the chances of a recurrence of GTD go down to an infantescimal amount. Although the risk never really goes away completely - like any cancer.

I understand the arguments in favor of waiting. I understand this is my health we're dealing with. But I also have not received a concrete diagnosis of GTD or a molar pregnancy. What I had could have been left over tissue from the m/c or just a ridiculously slow metabolism of HCG. And even if it were molar, it would have to have been a partial molar because NO evidence of a molar pregnancy was found in my post-m/c pathology report. And the typical wait time after a partial molar is 3-6 months. Not 7.5. And I'm willing to wait until, well, December-ish is my goal. But not until next February.

All of this of course will depend on whether my HCG levels stay in check. The TTC start date is somewhat of a moving target. If my HCG goes up and I do have further complications with GTD, the clock might start over. The timeline will be adjusted either way as we go along, probably. And ultimately, it's my decision. Right now I'm just trying to decide which course of action - which version of 'fudging it' will least anger Dr. OBG.

The longest months are yet to come I fear

I spoke to Dr. OBG this morning regarding my exciting weekend. She thinks whatever I passed was just a blood clot. She said (TMI alert) blood clots can be up to the size of your fist or an orange and it's completely normal for them to be adorned with whitish, tissue-looking stuff. (/TMI) She wasn't worried and didn't think it was rational to suspect it was anything else. She was unimpressed with my theory that it might have been a mass of undifferentiated tissue growing from the placental cells left in my ute after the D&C...like a tumor. I'm glad she didn't think that was it. That would make me really fear a recurrence - and I really did think that's what it was. But in retrospect, the blood clot theory makes more sense.

But then came the real downer. First some history: Four weeks ago she said we should test weekly for four weeks and then go to monthly. For four weeks I have gone in dutifully and my levels have stayed below five and finally went down to <2. Today she said - weekly for six more weeks. And then (this hurt) monthly for SIX MONTHS. Six months AFTER the six weeks. So, by my calculations, 7.5 months. Eff.

I'm struggling to accept this. Especially since there's a glimmer of hope that it will be shorter. Dr. OBG said she was going to talk to Dr. GO and see if the plan needed tweaking. And as I've mentioned, Dr. GO is pretty liberal with the 'trying again' stuff. He's the one that kept telling me I was fighting the clock. And that MTX is out of my system in a couple days. So there's a chance he'll say "Dr. OBG, you're being ridiculous. 3 months is more than enough." But there's probably a greater chance that he'll defer to Dr. OBG out of professional courtesy. Because after all, it can't hurt me - physically - to wait 7.5 months. And after all, I'm just a patient. A three or four month overkill isn't going to affect their lives at all.

But I might go crazy waiting that long. I just have to remember that whatever the plan turns out to be, it's for my own good. And that I really ought to follow directions - even if I don't agree with them - for once (I'm really bad at following rules when I don't think they're coming from a rational place - this is in general). And I have to remember how much I wanted this - a real start date, no matter how far in the future, that I can rely on. As much as it's possible to rely on anything in this process, anyway. And I have to remember that each passing month will be another reminder of health (hopefully) and I will have to remember to value that health and cultivate it in preparation for trying again. But it makes me so scared that the time will be wasted. And so scared that at this rate, I'll never have a healthy pregnancy...like I said, it won't kill me to have another loss or two in my lifetime. I'll still keep trying. But at the rate of one try every year and a half, I don't know that I'll ever have the opportunity to have a healthy pregnancy before my eggs run out. And no this may not ever happen again, this persistent HCG stuff. And yes it really did happen and even though it may be over, I have to respect the past and potential complications. And just wait. But as we all know, waiting is the worst.

A "graphic" weekend, get it? Proceed with caution.

DH and I headed to my parents' for father's day with the dogs. They live in a cabin in the beautiful woods near the beautiful ocean and we were staying for the whole weekend. Nice right? On our way to the cabin we stopped to let the dogs out of the car to do their thing and get some water and stretch our legs. We found a quarter mile trail out into a marsh and thought - perfect. We'll take a 15 minute break and get back on the road. As we walked from the road onto this trail I felt like I was passing through the wardrobe into Narnia or something. It was like a majestic wonderland of tall grasses, colorful wildflowers, blue skies...everything was bigger than life, purely natural and beautiful, and in stark contrast to most of our drive and civilization in general. The worrier in me started to think about ticks. I seriously pondered whether the walk was a good idea, given the tall grasses. But we'd hiked these foothills countless times before without ever seeing a tick (note: we had never tried this particular trail - if you can call it a trail at .25 mi). I had started to think this area was just not a place ticks liked for whatever reason. And the trail was well-maintained. But those grasses were tall....and it was breezy my friends...

We reached the end of the quarter mile in just a few minutes. I looked down at our new fur baby and the enchanted dream we had wandered into turned into a sort of bizarre biblical nightmare. She had two ticks crawling along her back and another one on her leg. I started to freak out. I HATE ticks. I hate them because I'm scared of lyme disease. I am way more ok with bugs than most people I know. But ticks I can't handle. And I had never seen that many in one place before. Which says a lot because I've been really outdoorsy all my life.

We had to go back the way we had come, there was no other option. I winced, I checked my clothes quickly and DH and the other fur baby. I made sure the dogs stayed close to us on the return trip. As soon as we got to the car I started combing through our clothes and the dogs and found three or four more of those suckers. I was really starting to get anxious about this. How many more were there that we weren't seeing? How many were already burrowing into one (or all) of us? How did this happen? What a stupid idea that walk was!

When we got to the house we explained everything to the parents and found about seven more as we peeled off our clothes and threw them directly into the washing machine on our way to the shower. I only found one that had bitten me. And it had barely bitten me, it came off easily and didn't leave much of a mark. The dogs looked fine (thank you Frontline) and DH wasn't really affected either physically or psychologically by the whole thing. He has this feeling of being invincible. And he doesn't respect the unknown - he expects it will all be fine. And he's pretty ignorant about which bugs are innocuous and which aren't, preferring to rely on his invincibility and not worry about any of them.

In the midst of the panic I was feeling about having been bitten and not knowing the full extent of the infestation, I was standing near the washing machine talking to my mom...and that's when I felt it. A 'gush.' I've heard this described to me by people who have m/c's but I had never felt it. It was unmistakable. I excused myself into the bathroom and it was pretty scary. Blood was everywhere. As if I wasn't grossed out enough by the day already. And it wasn't stopping. It was like a 'light hemorrhage' but I had no pain anywhere - not even any cramping beyond the mild AF cramps, and it eventually did lighten up. But not before I passed....something. Tissue. And, like, a mass of it (I know this is gross, bear with me, the worst is over, pretty much). It really freaked me out. But was a relief at the same time. Maybe this is THE END of my m/c - maybe this is why my HCG persisted for so long. Tissue was still growing itself 6 months after the D&C. And it finally died and my HCG hit negative. And FINALLY, FINALLY, the stuff was expelled. And now maybe I am really all better. Back to normal. The size of it, paired with all the bleeding, really scared me. I thought back about the cramps I had had earlier in the day - they hadn't felt like contractions, but they were about 20 minutes apart and a fairly similar rolling sensation each time. And I've never felt contractions before so how would I know. But I was pretty sure I would have had to be at least a little dilated for this mass to come out.



Recall my parents have NO idea about the pregnancy or m/c. I was in no position to examine what had just happened or 'save' anything (wince) so I just carried on with the weekend. Bleeding heavily, but not out of control. And anxious now about both ticks and the bleeding and tissue. I was an absolute mess.

Somehow I rallied for father's day. Sort of. Well really I just acted like a crazy person straight through. I've been combing through my hair with my fingers for almost 48 hours straight, obsessively washing things - clothes, the dogs, the dog's harnesses, my shoes, (that effing trail, what was I thinking!)....I even left some stuff in the washing machine for the next time my parents run it - I couldn't bear to put anything that hadn't been sterilized back in my bag.

So I had the happy occasion to call both Dr. OBG and my PCP this morning. PCP doesn't seem very worried since I don't have any symptoms of infection so I don't see her until Friday. Dr. OBG hasn't called back. I called about abnormal bleeding and she doesn't call me back? What if I was still light-hemorrhaging? For all she knows, I could have been dead by now!

The most interesting part about this weekend is that my mind has been so saturated with anxiety and potential horrible outcomes to the respective incidents that I can't possibly focus on everything bad that could happen or every bad thing it could mean. It's physically impossible for my mind to worry as much as it thinks it needs to. That's good for me. So my worries of choice are two: 1) what the H@!! came out of me? Does this mean scar tissue? Fibroids? Endo? A second m/c? Were these past few days not really AF (I knew it was too good to be true)? Are my problems just beginning rather than coming to a close? And 2) although the chances of lyme disease are remote, according to Dr. Google (the only one who would see me today), what if? It's a pretty crummy thing to have happen. Is it worth taking two hours off of work and a prophylactic round of antibiotics that make you vomit just to attain some peace of mind?

And a final thought that came to me yesterday...

When I was young, I thought infertility was a black and white thing. Like once you wanted to have babies, you'd find out soon enough if you couldn't and that would be that. Someone would tell you, point blank, with utmost conviction in no uncertain terms, that you cannot ever have kids. And you would be very sad but then you would know and you'd be able to move on. Plan accordingly. Adoption, surrogacy, child-free, there were still options. It never occurred to me that the concept of fertility could be so rife with uncertainty and frustration and so demanding of patience and time and money. And it makes me almost wish I could know. For good. Will it happen for me? I'm not yet at the stage where the cost (the potential of having all hope removed) would be worth the benefit (knowing.). But I imagine if things don't go well in the next year or so, I will get there. I am the type that would rather know than not know. It surprises me even that I would want to wait a year...but for me (a pessimist), hope is such a rare thing to come by so I guess I'm embracing it where I can find it.

Twisted

This AF is a doozie. I am in SO much pain. I should NOT have worn the almost-white chinos to work today, I feel like I need to be super cautious whenever I move or sit or stand or exist. And please note that I am not complaining - I say this all with glee in my heart and tears of joy in my eyes. What a twisted world this is.

I seriously had cramps so bad yesterday that I could barely breathe for long periods of time. And I relished every minute of it. At one point I became aware that a bizarre, twisted, unintended thought was crossing my mind - AF is so wonderful, I feel so healthy, that maybe I don't even want to get pg again. At least not for a long time. I just want to be healthy. And without overriding anxiety about maintaining some fragile state or ridding myself of unwanted disease. But it was just a flicker of a thought, not a real one that I consciously crafted and mulled over - just a flash of insanity lashing out from my currently aggrieved but very much functioning uterus. Probably a result of my semi-asphyxiation. Of course I'm excited to dive in again. The possibilities seem more real every passing moment. But I will approach with trepidation. LOTS of it. So maybe it won't be so much of a dive as a sticking my little toe in. Then another, then my whole foot...I'll probably think and blog more about my next TTC process when it gets closer. I don't want to count my chickens or get ahead of myself here.

AF has also triggered my normal onslaught of "follow-up" worries. Now that the big fears have been swept out of the way in one fell swoop - my HCG did go to zero, I did get AF, I probably don't have Asherman's (or at least not severe Ashermans)....what else can go wrong? Could I have scarring still? Will I miscarry again? And more importantly, why? What is wrong with me? Are my eggs or DH's sperm (or the combination) incompatible with life? Could I have endo? Will I have a(nother) molar? An ectopic? Haywire HCG? Could I have irregular cycles now that I've had a m/c? Will this AF go on for weeks and weeks indicating that it is not, in fact, marking a return to normalcy? Did I actually have GTD? Or left over tissue....or a second pregnancy....was any of it molar? Will it recur? How long should I wait to TTC again? What if my doctors say 3 months? Will I be ready that soon? What if they say a year?

I told DH all the news. He was relieved. He doesn't know much about the medical details I've been navigating over the past...well, almost a year now since I quit bcp's. And probably because of that he feels very scared when he learns that I'm not well, when my body doesn't work. He doesn't know the why's or the when's or how's and because it makes babymaking seem like a somewhat grotesque process, I try to avoid the details with him and he doesn't ask for clarification. But I have to say, I was relieved at his unbridled relief. Especially when he said to me "you better start saving for daycare." It didn't bother or surprise me that he said "you" instead of "we" because he's been on my case since my last Coach purchase about fiscal responsibility in our household. Mostly jokingly. And he's right. I can be pretty materialistic when I get the bug. Which is roughly once a week. But mostly I wasn't bothered because he was talking about how we needed to save for DAY CARE. Which means we would need a baby first. So I tested the waters a little: "I will. I hope we ever need it." You'll have to excuse my late-night wine-inhibited grammar. I think I got the point across 'cause he said "me too. me too." I think he's starting to actually want kids. Like not just because I want them and because I'm brave enough to handle it and obviously equipped judging from how well I do with babies and how well I've done with the dogs (I think he really compares kids to dogs - our friends think he's crazy). Like he wants to have a kid already. HE does. For him. It's something he wants in his life independent of my interest in it. I think it was a sign of that anyway. He's probably starting to get tired of waiting. He's probably starting to feel like we better get to it. It was a huge relief. This week, in a year of hell, is full of relief and I intend to continue soaking it up.

"HCG Results Day" or "All Hail the Arrival of AF"

No joke. That's what it feels like. Like the arrival of a sacred diety. Or Hayley's commet. Today is a day exactly 5.5 months from my D&C and exactly 8 (count 'em) months since my LMP. And now, today is my new LMP. CD 1. I am almost crying. I wondered if this day would ever come. And how it would come, and what I would do and how I would feel. I imagined how happy I would be. And oh how happy I am. I am sleep deprived, I am frustrated by work, I am all tore up after wrestling with chicken wire for 4 hours yesterday in the interest of protecting my precious fur babies, DH is leaving for a few days. But I could not be more gleeful. AF is here.

Related good news is that the uptick in my BBT roughly two weeks ago that sent me into a cycle of despair and caused me to put away the thermometer was probably ovulation. I feel like a kid at the best Christmas of their life.

Wasn't I just posting yesterday about how I didn't have any AF symptoms? Isn't that weird? Well they all seem to have set in at once. Woke up with cramps, had a backache last night but assumed it was from building a freaking fence - which would make sense, right? I'm feeling heavy and bloated and a little nauseous. My boobs are not sore. Which makes me think...why were they sore the month before I got my BFP. I thought it was an AF symptom since I got it both during the month I got my BFP and the month before. When I saw only a faint line and assumed it was an evap line. The next day there had been no line. I'm starting to wonder if I had a chemical pregnancy before my BFP. Which would be good and bad. Bad 'cause it means my m/c was a second m/c. Good because it means my body is capable of flushing out HCG in a timely manner and the past 5 months were a fluke. You see, I am PETRIFIED of getting pregnant again so any sign that I will not have to go through this again, however attenuated, I will latch on to. I don't know that I could handle another year-long ordeal. I don't know if I could cope with another m/c that turns into a months-long waiting game. I don't know if I could cope with spending my child-bearing years going through year-long attempts and disappointments. I could handle more m/c's. I don't know if I can handle another possibly-cancer diagnosis resulting from a m/c. So I am scared that my body doesn't metabolize HCG effectively but am hoping it was just a fluke.

This certainly helps me to set my sights on trying again. I can't try again anytime soon because of the recent MTX injections and because my folic acid is likely still depleted and because my HCG could come back up if my so-called gestational trophoblastic disease shows itself again. But I can now focus on BBT charting, pinpointing the day of O so when we do try again we'll have some focus, FEELING NORMAL (which is vastly underrated, just like AF and getting a trim, among other things), getting healthier (read: drink less), training the dog, working on my relationships, working on work, and a myriad of other things I need to catch up on both practically and emotionally. Who knew AF could be such a motivator?

UPDATE: Beta results are in.

LESS. THAN. TWO!!!!

Speaking of things I thought would never happen. I got a message from Dr. not-my-usual-OBG saying 'congratulations, I know this has been a long wait to get this good news.' I listened to the message twice. She rehashed what the office usually does for molar or GTD pregnancies: I would need to get negative (less than two) tests for three weeks in a row, then monthly tests all negative for three months in a row, then test negative every three months for, and get this, she said "for three months" in a row. Which puts me at roughly six or seven months from TTC again. But if what she really meant was test every three months for "three negative tests in a row" then they're talking more like a year away from TTC. Hell's to the no. I think I can swing a six month wait but since there was no confirmed molar tissue and since my levels, while slow, pretty much came down on their own, I don't know if I can wait a year. Fortunately, the dr. qualified what she said by mentioning that since I'm far from a usual case (I never thought that might be a good thing) I may have worked out another plan w/ Dr. OBG and I should follow her advice. Dr. OBG, before she went on vaycay alluded that it would be more like a three month wait. Dr. GO seems to think I can wait three days and be fine. So I'm still holding out hope for the 6 month wait from the last MTX shot which would mean around December/Jan. I will talk to Dr. OBG when she gets back. The last thing I want to do is doom myself to another experience like the one that is hopefully drawing to a close.

This seems like too much good news for one post. Or even for one day. After discovering AF this morning I asked myself, what good thing have I done to deserve this? It must have been wonderful. And then I realized - I think I've been through enough. So much that I can confidently say - I deserve this. Good or bad behavior, it's time for me to get some good news. It's enough that I am me, weathering my experiences, to afford me a little peace of mind once in a while. I don't have to do anything to deserve it. Other than survive.

Misc. musings on FB, chicken wire, and HCG.

There comes a time in every IFer's day when she must ask herself: is Facebook really worth it? For me that time came this morning at 8:15 when I stumbled upon my due-date buddy's baby shower pictures. I am SO glad she lives 1000 miles away. I mentioned last post that I thought I was doing ok with this whole due date business, but seeing her, all pregnant and happy, seeing her doting friends and hearing about the gifts from her elated husband made me all but tear up right at my desk. It should be me too. I deserve it too. I did everything I needed to do. I could have told at 7 weeks too. I could have been 8+ months too. I could have been having a boy too. Just wait 'til she actually gives birth. I might just fall apart.

The new fur baby is getting out of our yard now. So we're 'touching up' the fence with some beautiful 1" mesh chicken wire this evening...or I mean "poultry netting" as it's called these days. God it looks horrid. But crossing my fingers that it works because now an annoying situation has turned dangerous. It's all I can do to keep from leaving work right now, at 10:30am, to go finish the job and keep an eye on things. DH returned from work yesterday evening and upon being attacked with kisses by only one dog, the original fur baby, ran around frantically trying to find the new one. He called her name around our very small lot and eventually heard a quick repetitive "thump, thump, thump" against the back fence and discovered our poor girl stuck between ours and our neighbor's backyard fences (there is about 10 inches of space back there, don't know how she even managed to fall between them). Her tail was wagging uncontrollably against the boards at the thought of having DH home! She seemed unhurt so he tried to pull her up and out, tried to get her to grab onto a rope with her teeth so he could haul her out that way, and as she was having none of it, he had to remove a plank and let her walk out into the yard. Fur baby 1 was noticeably distraught at losing his buddy but the escapee acted like nothing had happened, she had simply found a 'secret hideout' where she sat and waited for her people to come home and give her a big hug.

Since the first fence incident is the event that precipitated The Big Fight, DH and I stepped around this new situation gingerly. How 'bout attaching some lattice? We both agreed that would be nice - DH has some tiny grape plants he eventually wants to plant where she's been jumping up. The lattice could extend the height of the fence by a good 2 feet which ought to do it. But no, DH won't be ready to plant the grapes for a while and he wants a particular type of framed lattice so it won't look horrid and all of this could take weeks - or even months. Ok then, how bout more chicken wire? No it looks so very ghetto that DH can't stand it. Ok I said, well, there's this in-ground electric fence that we could get and it's really nondescript. You can't really see it in your yard - you bury the wire and it works by triggering a "static correction" collar around her neck every time she steps out of bounds. It won't be intrusive and it will have the added bonus of keeping her from digging in the garden. We agreed this would be the best solution. So I went to PetSmart and purchased the 'stubborn dog' pet safe system. It was in a locked cabinet. It's not a cheap item. And it involves a shock collar. So they keep it locked up. Right away, just looking at the box, I had a sinking feeling. By the time I got home and started reading the directions, and staring at the two-pronged static inducing receiver on the poor dog's collar I had to say something: "DH, I'm starting not to like this idea." It's really not a big deal. Just a little flick of static when she goes the wrong way. She'll probably get hit a few times with it and then never have to be "statically corrected" again. But I knew there had to be an easier, less guilt-ridden way. The other problem with the 'in-ground' wire is that it's more obvious and cumbersome than you might think. You have to run it a certain way around your yard, twisting and splicing the wires just so in areas that you don't want activated, and then you have to somehow run the wires back indoors to connect them to a receiver. We have less than 100 feet that we need to reinforce so this production, paired with the shock collar, and the price of the thing ($220 - and this was not even the deluxe system) seemed like an overreaction. So we went back to chicken wire and are now installing two feet of it - not extending above the fence but protruding out from the top of the fence at a right angle. So if she tries to climb the fence, she'll hit the wire overhang and won't be able to get over. If she aims for the wire overhang itself (which is pretty high if she doesn't have the fence itself to launch herself up), it's too flimsy to support her weight so the idea is that she'd just fall back into our yard. Query whether her second try at this (after the wire has been all but flattened against the fence) could be a success... My only answer is that she seems to have been readily offended by the first chicken wire monstrosity so I think she may not go that far. If she does, we'll cross that bridge when we get to it.

I'm supposed to get AF this friday according to the first day of my very spotty artificial Provera-induced LMP. Saturday would also be acceptable. After that, it's 'late.' I have NO symptoms. Not even the all-in-my-head symptoms to obsess about. I usually have plenty. I am discouraged. I assumed that of course once my HCG was negative, I would get AF on schedule. I had hoped the Provera really would kick start my cycle. So far I'm not convinced. But I'm getting ahead of myself. I guess I should worry about HCG really being zero first. I got stuck today. Results tomorrow.

Fertility Friend, my old friend

I have done a good job of convincing myself that my pregnancy was not meant to be. It wasn't healthy. It was a mishmash of genes wrongly combined that would generate tissue but not a living, breathing, or feeling being. It was not a baby. At no point did it develop into a person. There was never a heartbeat. I was not meant to give birth this July so there's no sense in getting all worked up about my rapidly approaching missed due date. I wasn't meant to be carrying a baby right now so there's no sense in getting jealous of my due date buddy's facebook posts and ultrasound pics. My situation is totally different.



Yesterday I was on FF, because while I'm taking intermittent breaks from BBT, I still use FF to record the dates of things like my beta numbers and MTX injections, etc. I don't know why I did this, and I really deserved what I got for doing it, but I hit "pregnancy tracker" - which I started using when I got pregnant. I hadn't even thought about it until now. But there it was, so I clicked on it. And I saw my ticker. It's a line of eggs and egg shells with a tiny yellow fuzzy chick making it's way from 0 to 40 weeks. I remember my excitement as it passed the 6 week mark. Then the 7th. And 8th. And finally the 11th when I was going to get to see my baby. And all the nausea and hiding and lying and not drinking would all be more than worth it.



My ticker says I would have been 34.0 weeks even yesterday. I had even forgotten that Thursday was my "day" - the day of the week that I could call myself one round week closer to having the baby. It made me so sad. And it prompted me to imagine a parallel universe (have you ever seen sliding doors? Kinda like that) where things had gone smoothly. I've been doing that lately. Like during The Big Fight I imagined how my life would have gone had I not married DH. Had I run away that first time he hurt me 8 years ago. I actually verbally warned my eight-years-younger self to forget him when I was at my most emotional and heady a couple days ago. With the baby I imagined we wouldn't have the second dog. I welcomed the increased responsibility and complexity into my life a month ago seeing as how there won't be a baby in the very near future and because I LOVE dogs and really did want a second one at some point. She will be well trained and older by the time a baby arrives, if one ever does. But had we continued to be pg, we would not have embarked on the selection of another dog. It would have been too much chaos. Even for me.



Also, I imagined being pretty big around now. At the stage when people are really catering to my ability to be mobile (or not mobile) and even strangers would be sure I was expecting. And I would love it. I would be done with baby showers, the nursery would be ready, we'd be on a wait list for daycare and would be paying more attention to the schools around here. I'd be closing up projects at work, sterilizing the house, counting the days 'til my 4 month leave. Getting excited about playdates with my friends and their kids. Getting excited about how happy DH would be to have a kid and how much better it would be for him in reality than it is for him in theory.



I don't know if it will ever happen but I wish with all my might that it does. I wonder if I'm going a little crazy and getting escapist about it in the meantime. Is this how split personality disorder develops? One simply cannot stand to live in their own head anymore and subconsciously develops a second existence? That's not quite what I'm doing but it still feels a little crazy. And it is very hard to live in my head.



And is it just me or are a serious number of bloggers in this community announcing BFPs this week? Congratulations to everyone who is. I am so genuinely happy for all of you. And excited in advance for the rest of us.

I am starting to get excited about trying again, even though I don't know when that will be and have no signs that my system will ever work again. Actually, there have been a few hints that AF might be on her way - but I hesitate to even say that for fear of jinxing it - though recall, I don't really believe in jinxing. So mostly I hesitate to say it 'cause I've had a myriad of symptoms over the past 5 months that have proven meaningless time and time again. But every time I notice convincing symptoms that I might be cycling, I think - what a waste. Why aren't we getting back to it? Waste of time, waste of healthy eggs. I just have to keep reminding myself that my head needs this break, my body needs to go through a few cycles, flush itself out. Get through a few months of prenatals. My body has been through a lot. A lot of stress, medications, and hormonal fluctuations. And me and DH need to get back on track after The Big Fight and figure out how not to let that kind of thing happen again (or at least not very often). The dog needs to be trained. I need to seize the opportunity to get better at my job. I need to work at making the wait productive.

"HCG Results Day" or "Has it been a week already?"

The quality of having time both fly faster than you ever thought or wanted to be possible and simultaneously crawl by at an unbearable wretchedly slow pace may be one of those unique characteristics of the IF world. This has certainly been a theme in my life lately.



The Big Fight between me and DH got worse before it got better. But I think it's dissipating now. I am just gauging by the unsolicited kiss goodbye I got this morning. And the fact that he slept in the same room as me last night. This has been a real doozy and I hope never to repeat it. It's been crunchy and ugly and sad, not one of those 'productive' fights where you both learn something and are closer or better off for having gone through it. This was just based on a misunderstanding and a direct difference of opinion and stubbornness (and DH's inability to be logical or sensitive about anything! oh, sorry, and I was trying so hard to be civil about this). I had a dream in the midst of The Big Fight that I had lost my wedding rings. Just plain they were gone. I couldn't find them and I was kind of frantic about it. Definitely a stress dream. I'm not much for interpreting dreams or signs or believing in the paranormal or being superstitious...and if I'm being really honest with myself the dream probably had more to do with vanity and insecurity than anything else (oh no, i broke up with my husband, which means no more wedding ring...but it was so pretty, and i felt so legitimate with it on). But I do wonder if it could have meant something else... Like was it a directive? Was it foretelling of what's to come? I'm not going down that path.



My beta stick yesterday was a bummer. It was my old friend 'perfect shot' guy. I forgot my squeezy stress-ball duck that i usually bring to grip on to ('cause they don't always provide stress-balls in this lab - sometimes you're left just squeezing your hand around itself as tight as you can and I swear I find that so uncomfortable) because I had left it in my 'other' purse. So perfect shot guy (who is aware that I carry my own stress ball around with me for the purpose of these draws and thus asked where the duck was) and I talked about purse fetishes and how his wife has two louis vuitton's and a gucci and some burberries. I usually stick to coach, I said. $450 is pretty much my very highest limit on what I'm willing to spend on a purse and I really try not to do it more than once a year. We also talked about where his wife and I go shopping - there are some nice (and dangerous) high-end malls around this area. I'm going to one of them this weekend to get my hair cut and a father's day present. DH is going on a weekend trip with the boys this weekend, so I will be alone. At the (high-end) mall. This is going to be trouble, I just know it. I might mention here that DH and I have separate bank accounts still.



Anyway, perfect shot guy had to stick me twice. Despite being a perfect shot. The first time, my vein just plain ran out of blood. It was going really slowly and then, all of the sudden, there just wasn't anymore - like when you suck the last part of your drink through a straw and you're left with just bubbles and air going up the straw instead. "I guess that's it," I thought, "you bastards have taken ALL of my blood....There is NO more." That's one way to get my beta HCG to zero.



But of course there was another vein. Because I have two that are available for blood draws. Thank god it's not just the one. The first one, we concluded, is too scarred up and consequently shrunken to get any blood from anymore. It's really taken a beating this year. Poor thing. The second one, which originally was smaller than the first, is now our best bet. You might say it's our only hope since no phlebotomist has ever successfully gotten blood from any vein other than these two. And #2 worked but now I look like a heroine addict. Again.



Dr. OBG is out of town this week and next. So all rules I know about how long it takes for the office to respond and what that says about my levels are meaningless today - this is somewhat relaxing. Maybe I'll get some work done.


UPDATE: Dr. not-my-usual-OBG called me back as soon as she got in this morning. This was very much appreciated by me. The level is back to 2. This has caused me to take a giant sigh of relief but I am still not rejoicing in the halls because she says they really should get to "less than 2" before they can proclaim that I have reached my goal.

Low points

Things seem to be getting worse. Is it the uptick in my HCG? Maybe. Maybe that paired with the five month anniversary of my D&C. And the fact that I started BBT again and my reassuringly low levels have darted up -- and I don't think it's O. I think it's the push and pull of the gestational trophoblastic tissue trying to create the environment of "pregnancy" in my body. In other words, BBT means something different when you're in my situation: Hi temps = hi HCG. Low temps = closer to normal HCG. So high ones always discourage me. I started BBT again after my levels hit 2 to see if I was starting to cycle again. I did it to reassure myself. And it's backfiring. I don't know if I'll continue.



I am trying to find comfort in Dr. OBG's words the other day: "It's probably just the margin of error. Five is basically zero." But I know these things are not true. I know the margin of error is 10%. So it wouldn't cause a swing of 3 points. And as any first grader and some well-trained parrots can tell you, five is not zero. Plus, I am getting the impression that she is hell-bent on telling me what I want to hear. Take for example, the first time I came in after the D&C and explained that I was still getting positive HPTs 9 weeks hence. I knew that my levels were still positive, not newly positive. And I explained this to her. So we tested my levels and what did she say when she called me with the results "We have a positive result!! We'll test again and then do an early u/s...I don't know if we'll be able to see anything but...." I remember thinking - why aren't you listening to me?!?! It's the same thing now. It's not helping that she's being overly optimistic. It's frustrating because I feel like she's trying to pull the wool over my eyes or that she's just not listening and that she should know by now that I'm a smart girl. Mine is the world of a realist. And a pretty sophisticated one thanks to Dr. Google. It makes me feel better when I can trust someone, even if what they're saying is not what I want to hear. I want people to be honest with me. Honestly. And it seems, more than anyone else perhaps, my doctor should be straight with me.



I feel like I'm shutting down. Closing myself off. That feeling of wanting to crawl out of my skin or sleep for a few months until this all blows over is not abating. It feels like depression. I'm withdrawing from friends that have kids. And that's a lot of my friends now. I've somehow imputed ignorance and insensitivity to all of them, at least to some degree. How dare they be happy, have their babies, continue to thrive and not have to weather the storms I am weathering? I am particularly withdrawn from the friends that know about my situation. Three out of the four friends that know either have kids under 1 year old or are pregnant. I can't take anything they say innocently. I can't have any sympathy for their problems. I can't give them the benefit of the doubt because they can't understand and it's somehow disingenuous to try to understand or, heaven forbid, assume they do understand. I don't want to be around them. And these are my closest friends - which has to be true because these are the friends I told. It's like I tainted the friendships by saying something. It's like crossing the line with a guy you're really good friends with and then regretting it later because the physical relationship didn't work out and now the friendship is gone too. It feels messy. And ugly. I feel ugly. And sad. And angry that I'm feeling so sorry for myself.



I got a birth announcement from one of my good friends yesterday. I knew what it was as soon as I saw the return address. She suffered a m/c before getting pregnant with the new baby. I have every reason to empathize with her and be genuinely happy for her. She doesn't know about my situation. Last thanksgiving she announced her pregnancy. I was pregnant too at the time and I was so excited about eventually sharing my news and going through it together. And telling her how much I wanted to tell her when she announced hers. And this all hurts now to think about. And I couldn't open the envelope.

How have I become so spiteful?

Today I visited the new mom and baby. The mom is one of those women who have too many pets to take care of but a good heart and she's smart and enjoys her life which means she's someone I generally look up to...except when I notice that her dogs have no water and that her ducks don't either. Who keeps ducks in their backyard? I mean if you have one of those yards which is more like a park...complete with a pond...fine. A ranch maybe, sure. But this is your run of the mill suburban backyard. Those ducks looked kind of sad. Can ducks fly? Maybe they'll migrate as soon as they're able - apparently they're still pretty young. I hope they do.

Anyway, the baby was precious. I held her for about a half hour. I rocked her to sleep. She stayed asleep the whole time and I was gazing into her beautiful little face, holding her tiny body, chatting with her mom and keeping an eye on my dogs in the yard and thinking - this should be me. I am so beyond ready for this life. Why is babymaking taking so long to catch up with me? I can't resist mentioning that as soon as I gave the baby back to her mom she woke up and started crying. I have developed the knack. I didn't always possess it, but after I got pg and after my co workers started having babies, I took notes, I fell into the habit of thinking and acting like a mom. And lo and behold. It does come naturally. So where's my baby?

DH held the baby too. He's adorable with kids of every age and this was no exception...except that I think he gets a little bored with newborns. He's better with "kids" which is good 'cause while I'm stoked about having a baby, I'm not really sure what I will do with a three year old.

I wanted him to say something about how natural I looked or how good I was with the baby. But he said nothing. Probably because we've been in a bit of a tiff since yesterday. About the dogs. Again. The new puppy is lofting herself six feet up onto our fence and landing on the top of it, like a cat. She just walks around on the top beam and barks at whatever she can see below. And then she hops back down into our yard. Clearly this means she can escape. This is something I can't ignore even though she's never actually escaped. If she could escape, she could get hurt. And she could upset or scare our neighbors. It's trouble. And I just couldn't let it go. Or so says DH. He wanted to ignore it. She hasn't escaped yet. She loves us, she won't leave. And if she does, she'll come right back, he said. He's never had dogs. "Don't you think that's a little naive to say?" I responded. I wanted to say - this isn't the old country (he's an immigrant...or was 15 yrs ago) - we aren't related to everyone in a 10 mile radius. We don't share property and pets and kids. We are a private people, like it or not. And we get offended by rude people and we look down on those who can't control their pets and we despise those who think it's no big deal to intrude on others' lives and property. It has to be dealt with." But I said something slightly different. So we put up some chicken wire across the top of our fence. And DH is livid. He hates that I was so stressed out about the dog escaping. He hates that I instigated this 'fix' which is not all that aesthetically pleasing and is sure our neighbor will be mad. Not as mad as if he had a visit from our hyperactive puppy every other day. This is one of those battles that I feel justified in picking. But I know he sees it differently. He sees it as a product of my obsessive anxiety and as evidence that I really do care more about the dogs than him. He thinks this, but he's just being silly. And since I AM right this time, he'll get over it.

"HCG results day" or "I wish I had a Xanax"

I got another HCG beta yesterday. I called this morning and the receptionist said the Dr. would call me back. This means the results are in. If they had not been in, the receptionist would have said "the results are still pending, please call back later." I then got a (kind of rude) message back from Dr. OBG's assistant saying "Dr. OBG will call you back when all the results are in - as she usually does." Like, pipe down and quit calling us. We'll call you. First off, they don't usually call me. They forget all. the. time. I really have had to keep on that office to get my results. And still I've missed at least one that I know of. It's been incredibly frustrating, actually, so imagine my disgust at being talked down to like this after all this micro management I've had to do. Secondly, if the results are now in and Dr. OBG has taken the time to talk to the receptionist about how to respond to me, why didn't she leave the HCG number in the message? It would have taken half a second to check the computer screen and relay the number. Why didn't she? Was she away from the computer and just hasn't gotten back to it in the last three hours?....

...or was the result bad and she's checking with the oncologist about what to tell me? I've said before that a late answer means a bad answer. It always has.

Recall also that it's not possible that the results just aren't in yet, since I would have been told if that was the case. So it's probably a bad result.

I guess that makes sense. I had such a fantastic day yesterday, I'm due for some major disappointment and additional traumatic stress. Well that's not true about yesterday. Yesterday was sleep-deprived and stressful at work and full of angst over some issues with the new puppy. But I got a gentle leader which solved most of my puppy issues and we had the best walk since getting her yesterday evening. (PS Get one of these gentle leader deals if you have a dog that pulls or gets aggressive or anxious on the leash. It will change your life. I'm not kidding. In so many ways. Not the least of which is that you will be more popular in your neighborhood because you will be a more sane, humane, and effective dog parent. And your dog will stop being a terrorist. Which is good for you and your dog. And your neighbors.) So I had such a fantastic hour yesterday. So it makes sense that shit should rain down upon me today. So here I sit. And wait for it.

UPDATE: Level went up three points. It's now 5. It "more than doubled." What an awful outcome. Dr. OBG said she wanted more than anyone to tell me today that it was a true zero! She was so disappointed that it was 5. Not as disappointed as me. But she tried to stay upbeat saying thankfully, no change in treatment - meaning no chemo...yet. Just keep waiting it out is the plan. She was trying to be optimistic 'cause she could hear the disappointment in my voice and my words. The first thing she said was "it's five...which is essentially zero!" Which is BS. It's not zero when you've been waiting for five months for it to be zero and numbers go from two to five. Don't BS me. I asked what the levels have to be for me to start cycling again. She said "less than five," not realizing probably the gravity of that remark. She probably said that 'cause she wanted me to think I'm in the range. But what I heard was that now I'm one point above the 'cycling normally maximum'? I HATE this. On one hand, given the trend in my levels, three points up is no big deal and I'm not super worried. On the other, that little mini AF is behind me, there's no indication that I'll shed any more tissue in the next week, I'm now even farther from my last MTX injection, so if something is still growing it will have every opportunity to thrive in the next few weeks. Let's hope not. I'm getting so tired of this.

In the news: successful frozen IVF transfer after years of failure and heartache

This is a heartwarming story about a couple who convinced themselves that they were condemned to live child-free and on a last attempt at IVF, which they decided to do because their frozen embryos could not be stored any longer by law, finally had a successful pregnancy. They had been suffering from infertility for twenty years before the birth of their daughter. Life truly is miraculous and this is one baby story that I was glad to see. It certainly brought me out of my self-pitying funk.