Papa died in the minutes before midnight on July 25th.
July 26th came quickly...a day that would have already been overwhelming as we all processed the passing of Robert's father.
But it was also day with so much weight for us...more than anyone around us really knew.
We had been cycling since June...when Papa was diagnosed with cancer. All of the shots, the meds, the preparation...led us to the 26th. We couldn't change the date...it had to be then.
On that day we transferred two perfect little ones...an amazing birthday gift. There was NOTHING smooth about the transfer though...there were delays, worries about overstimulation with bloodwork and vitals taken immediately before, a last minute change in the method of transfer, what seemed a gallon of water to beinhaled consumed rather quickly, and then an uncooperative cervix to top it off and trust me...the tenaculum is NOT my friend...ouch.
On that day we transferred two perfect little ones...an amazing birthday gift. There was NOTHING smooth about the transfer though...there were delays, worries about overstimulation with bloodwork and vitals taken immediately before, a last minute change in the method of transfer, what seemed a gallon of water to be
My acupuncturist was there with me...as always...trying to keep me calm and relaxed...ha, ha, ha. No, but seriously, she did a great job. We left and decided to top the day off with an In-N-Out burger...nothing.better.than.that.
The next two weeks were full ones--a road trip to Arizona to visit Robert's aunt and uncle. A lovely stay that was relaxing and enjoyable and not to mention, a good distraction.
The following week was the week before school and a week full of training days, prep days, sitting in on interviews, and then grade level lead stuff.
Oh, and don't mind my blood test was mixed in there, too.
THEE blood test.
The blood test was done at a time when it would be definitive...16 days past egg retrieval or ER, when most home pregnancy tests would be accurate at 12-14 days past ovulation or ER. The morning of 15dpER, I was done. Put a fork in me, DONE.
Did I say DONE? I couldn't wait any longer. I had started spotting the night before and trust me, seeing any blood at all is no fun when you are desperately hoping to be pregnant.
4wk1d
I tested early that morning because I was up for the umpteenth time peeing, spotting, and saw this immediately...
Of course, the tears started to flow and I brought the stick to Robert who was dead asleep. He glanced at it with one eye open, closed it again, and just smiled. He grabbed me and we held each other tight, knowing that we were pregnant.
Pregnant for the moment. And with all we've been through we know that we have to cherish and be grateful for each and every moment this little one was with us.
4wk2d
Blood tests that day showed all of my hormone levels were great...maybe even a little too good. Spotting continued...light brown, to brown, to dark red. Hmmm...not good.
5wk5d
Bright red blood FLOW. You've got to be kidding me. It was late, right before bed...when I felt the gush. It was enough to fill a pad and I knew that this amount of blood, this early was NOT a good sign. I cried in the bathroom for quite some time before Robert found me. We decided we couldn't wait for the ultrasound scheduled for a few days later...we needed to be seen immediately.
5wk6d
The following morning we would have our first ultrasound. And we saw this...
Yep...see those TWO little black circles? Those are the gestational sacS. Yes, TWO sacs.
With a yolk sac inside of each.
With a fetal pole inside of each.
TWO babies. GULP. While that was a definite concern, the more immediate concern was the location of one of the sacs.
One chose a prime location, nestled at the top of my uterus (the one on the left in the above picture). The other, decided on his/her way out that he/she might stick around for a while after all and made a last minute implantation at the VERY bottom of my uterus (the one on the right in the above picture...and you can see the outline of my uterus which shows it's very close to the bottom), very close to my cervix. For those that don't know female anatomy...picture the uterus like an upside down pear...top bigger, wider, good. Bottom narrower, not so good. And at the bottom lies the EXIT...the cervix.
Of course, in true Danna fashion, my RE had "never seen an implantation like this."
Nice.
He wanted me to be assessed by my perinatalogist, a maternal-fetal medicine specialist, here on known as my "peri" ASAP. We tried to get in to see him that day, but he was swamped...and didn't really know the severity of the situation.
6wk1d
My perinatalogist would perform an ultrasound and be just as floored. Not only were these two implantations very worrisome, but now a large, huge, MASSIVE hemorrhage filled my uterus, distorting both sacs tremendously. The upper sac where we saw a yolk sac and a fetal pole on Tuesday, appeared completely empty. The lower sac where we also saw a yolk sac and a fetal pole now appeared to be IN my cervix, but still with a fetal pole and yolk sac...and no heartbeat yet.
But it was still a little early for that.
It appeared to be a heterotopic pregnancy...a twin pregnancy with one in the uterus (appearing to be nonviable as the ultrasound showed it as empty) and one outside of the uterus, well, in my cervix, which was considered nonviable, despite the fetal pole being seen, because of the location. A cervical pregnancy is one that canNOT be allowed to continue...PERIOD. Heartbeat or not. If allowed to do so, my cervix would eventually split in half and I would bleed out...a life-threatening case. The only treatment my peri knew was to administer an injection of Methotrexate, a chemotherapy drug that kills cells...to essentially expel the pregnancy.
Problems? Well, 1) you lose both babies, and 2) if it doesn't work (and it's only 80-90% effective), you are rewarded with a complete hysterectomy.
Needless to say, I left the office that night hysterical. I literally could not breathe. I hyperventilated all the way to the car. I knew in my heart that there was a baby in the top sac even though it wasn't visible and while I knew the one at the bottom could not be saved...I prayed for a miracle...that we could save both babies...
...somehow,
...someway.
...somehow,
...someway.
6wk2d
Needing some normalcy, I went to work after a week of being at home. Crazy, I know. I was still bleeding and technically not supposed to be there, but I needed to be there.
That afternoon, my peri and RE had managed to schedule an MRI to be absolutely certain of the ultrasound findings. It was to be done without contrast and with contrast--contrast being the dye used to allow better images. This dye is not safe for use in pregnancy, period. The technicians did not know it was a twin pregnancy and thought it was "just a nonviable singleton" in their words. I told them no, there were two and possibly the one at the top of my uterus being viable. I begged them to not use the dye unless absolutely essential and they agreed that they would try to avoid using it.
I sat there in the MRI machine and prayed over and over and over again...if there was any chance that we could save one or both babies, "please don't let them use the dye, please don't let them use the dye."
Needing some normalcy, I went to work after a week of being at home. Crazy, I know. I was still bleeding and technically not supposed to be there, but I needed to be there.
That afternoon, my peri and RE had managed to schedule an MRI to be absolutely certain of the ultrasound findings. It was to be done without contrast and with contrast--contrast being the dye used to allow better images. This dye is not safe for use in pregnancy, period. The technicians did not know it was a twin pregnancy and thought it was "just a nonviable singleton" in their words. I told them no, there were two and possibly the one at the top of my uterus being viable. I begged them to not use the dye unless absolutely essential and they agreed that they would try to avoid using it.
I sat there in the MRI machine and prayed over and over and over again...if there was any chance that we could save one or both babies, "please don't let them use the dye, please don't let them use the dye."
Please Lord...please.
And thankfully, they did not need to. A little sign to us that maybe, just maybe, we were about to witness a miracle.
We traveled to my peri's office after the MRI for another ultrasound and to hear the results of the MRI. Ironically, the MRI was inconclusive according to my peri. The radiologist was so focused on the massive blood pool in the center of my uterus (which he called a fibroid tumor) that he neglected to really look at either of the pregnancies...[enter choice word here].
You have GOT to be kidding me.
You have GOT to be kidding me.
My peri sat down next to me and put his hand on my shoulder. He said, "You know, the results were inconclusive so we're just going to have to really confirm this with ultrasounds before we proceed with treatment. I'm so sorry you are going through this. Really, I am. You guys are like family and I just can't believe this is happening." He and my RE had spent the entire day frantically calling and talking to other doctors, trying to find someone with experience treating a case like mine.
They found ONE peri and a treatment that would most assuredly save my uterus...but still take both babies in the process. I sat there in disbelief...trying to fight back the tears and I did a pretty good job.
Into the ultrasound room we went, hoping for clear confirmation. Immediately, my peri and I were in utter and complete shock when we saw the screen...because the uterus being examined then and there was ENTIRELY different from the one the day before. He even asked me, "Is this even the same body? Is this YOUR uterus?"
And yes, it was.
The hemorrhage had formed a very large, but more organized circular pool in the center of my uterus and was no longer pushing on the sacs. The upper sac was now clearly visible with a yolk sac, fetal pole, and a beautiful little heartbeat. The lower sac, now appearing IN my uterus, very low lying, but in my uterus, not in my cervix. That sac was misshapen, still had a yolk sac present within, but no visible fetal pole remaining...a.k.a. no baby. Still, there was a chance the fetal pole was there, but not clear due to the shape of the sac and the angle. But in an instant, the fear of a cervical pregnancy almost diminished completely.
And we had a heartbeat.
Thank you God.
Thank you God.
6w5d
I would have another ultrasound and the results were just as shocking. The low lying sac, was now gone. The clot still there, in all it's ginormous glory, and the other sac, still with a little heart beating away. Not only that, but for about 5 minutes the doctor thought that little heart beating had a counterpart beating right along side it...an identical twin in the same sac.
I would have another ultrasound and the results were just as shocking. The low lying sac, was now gone. The clot still there, in all it's ginormous glory, and the other sac, still with a little heart beating away. Not only that, but for about 5 minutes the doctor thought that little heart beating had a counterpart beating right along side it...an identical twin in the same sac.
Um, this is not funny. Seriously.
After spending much time viewing the sac at different angles, he determined, no, it was the same baby...just one. Not two. At least he was pretty sure.
[Exhale here.]
7wk1d
A few days would pass and I would have yet another ultrasound. This one confirmed the findings and the low lying pregnancy was indeed gone. My peri said it had either collapsed and was not visible, it had been reabsorbed, or I passed it in all my bleeding. We officially had one viable pregnancy and had lost the other.
7wk5d
My RE had returned from vacation and while the ultrasound showed the baby was doing great...the clot was still huge and very worrisome. My RE was concerned...and not optimistic at all. I continued to bleed, dark red, dark brown...a sludge of sorts with lots of clots. This hemorrhage was working its way out of my body and the fear was it would release in one swoop and take the baby with it. Fortunately, the baby was not in the path of the blood, but still...that didn't mean it couldn't overtake the baby at this point because it was so much larger than the baby.
8wk6d
This ultrasound was a big turning point. While we expected the clot/blood pool to still be rather large, what we saw instead was a much smaller, more organized clot. It was no longer larger than the baby and the gestational sac, but now was about half the size of the gestational sac. Amazing. My bleeding had slowed down to spotting brown and I was allowed to return to work half days for the week to see how my body tolerated it.
9wk5d
With my RE out of town...again (I do love this man regardless)...he wanted to make sure I was seen by my peri. The ultrasound was just perfect...truly. The clot...GONE. Now, this was an abdominal ultrasound and there was the possibility that the clot was not visible due to the angle, but my peri really doubted we would find anything different with a vaginal ultrasound. Truly a miracle. Truly.
10wk5d
The ultrasound on this day would confirm that the clot had indeed continued to organize, reabsorb, and was no longer visible. My RE said there was an area on the scan that COULD be where the clot USED to be...but that it was really hard to tell. It simply was not there anymore. He was amazed. Absolutely amazed.
And that was it. I was finished with my RE. There was a gift from him to us...a baby gift...hugs...and then the tears. Just like that, we were to say good-bye, turn around, walk out the door, and leave FOREVER. Leave the people, without any kind of closure, that would make our dreams come true not once, not twice, but THREE times over. How do you just say good-bye and walk away from that?
Well, I could NOT. The tears flowed and I could not stop them as we walked out through the main lobby and to the elevators. I'm sure the women waiting were wondering what horrible news we had just heard, but the truth was it was tears of joy. Tears of thanks. Tears of good-bye.
A GOOD good-bye...but a good-bye nonetheless, and one I was clearly not ready to deal with.
11wk5d
This was my first visit with my OB...who was VERY eager to hear where we were at. You see, his last update was from my RE in the middle of the madness of trying to find a doctor who had seen a twin heterotopic pregnancy. He knew I was having an MRI...and that was it. Talk about leaving someone hanging!
So in about 2 minutes, I gave him the Cliff's Notes version and he breathed a huge sigh of relief. The appointment was great. Even on his archaic ultrasound machine, we saw that beautiful baby again, and everything looked great. My cervix was behaving for the moment...measuring a little over 3cm and still closed and firm. Still, my OB didn't want to risk waiting too long for the cerclage placement, so he scheduled it for the end of the week, at 12wk2d. Preventative cervical cerclages are typically placed between 12-14 weeks, before the baby and the gestational sac fill the uterus completely. Once that happens, the risks of the procedure multiply.
And based on everything he saw, he says he felt really good about this pregnancy...that we've had our "adventures" already and hopefully that was the end of it. He even made the prediction that with modified bedrest after the cerclage and then full bedrest at 20 weeks and all other measures put into place (swabs for infection, 17p injections or suppositories starting at 16 weeks, preventative cerclage, biweekly cervical measurements)...that we should make it well into the 30's...35 weeks is what he is saying...and maybe even beyond.
No NICU time.
Still, I am not holding my breath...I know how things can change on a dime and I don't want to get too lax here. I will believe the whole 35 week thing when I see it people.
If we hit the 30+ weeks gestation...it will be a success. Truly.
12w1d
We had our nuchal translucency ultrasound and it went fabulous. The baby looked great and the nuchal fold was 1.10mm...which is completely normal and puts us at a very low risk for Down's or Trisomy 21. The baby's anatomy, the placenta, the amniotic sac/fluid level, gestational sac...everything looked perfect.
I declined the bloodwork portion of the screening because the pregnancy started off as a twin pregnancy and due to the higher hormone levels, the chance of the bloodwork coming back positive would be too great and give us a false positive result. The truth is, the bloodwork, the ultrasound...nothing would change anything. We will carry this little one until he or she is ready to come into this world. If something is horribly wrong, we will walk that road until it comes to an end, on it's own.
12wk2d
Cerclage insertion day.
The procedure went very well. My cervix was "a little loose," but he was still able to place the cerclage high enough and secure enough. So much so that he says, "Once that cerclage is in there, I don't worry too much about the length of your cervix." Truth be told...this man's cerclage's don't budge. At all.
My recovery was NOT so great. Actually, it started off fine and for the first two hours I was feeling good. The morphine caused me to itch all over, but a quick shot took care of that.
And then came the nausea...and the throwing up...and the inability to pee...and then the uterine cramping and irritability from the surgery and my full bladder...and then the catheter and 1.5 liters of urine they managed to get out...and then some bleeding.
Finally I was able to stand, walk, and go to the bathroom on my own.
So they released me. It was all I could do to NOT puke in the elevator or on the way to the car in the wheelchair. But as soon as I got IN the car...BLECH! Threw up the whole way home and for the next 3 hours...until about 7:00pm that night. I felt like a truck had run me over...truly.
My cramping continued over the weekend. Every time I stood...my uterus would ball up and become rock hard. If I lied down...it would release.
Ah, my cranky arse uterus was back. This "uterine irritability" as they call it, started with my girls at about 13 weeks. So it's earlier and just one baby...but still the crankiness is here.
12wk5d
With all of the cramping, my OB wanted to check my cervix and the baby just to make sure all was ok. Mia came in the room with me, while Daddy was in the car with a napping Juliana. We heard the babies heartbeat...the cerclage felt fine and so did my cervix. My OB reassured me that the cramping was just going to be there...and that I needed to stay off my feet with the weight off my cervix as much as possible.
And that's what I've been doing all week. The irritability is still there...but I do have some quiet times. A return to work is not looking so great...especially considering today's outing of 3 hours to look for costumes and get the girls' clothes and shoes for dance, just about did me in.
My whole lower half has been extremely sore since I got home. I can't imagine what it will do to me being on my feet all day with my kindergarten class.
I will see Dr. P again tomorrow, at 13wk5d, and he will give me his recommendations...but I'm guessing I'm out...for good.
Weeks 6-10 were nothing short of a nightmare. I can hardly believe that one person can manage to have so many random, rare complications...then I realize it's me and I just have to laugh...what else can I do? It's been such a rollercoaster of emotions...to think back to the night before the MRI when I thought I was losing my babies AND my uterus and then not 24 hours later finding our prayers answered in miraculous fashion...just amazing...a true miracle.
A few days would pass and I would have yet another ultrasound. This one confirmed the findings and the low lying pregnancy was indeed gone. My peri said it had either collapsed and was not visible, it had been reabsorbed, or I passed it in all my bleeding. We officially had one viable pregnancy and had lost the other.
7wk5d
My RE had returned from vacation and while the ultrasound showed the baby was doing great...the clot was still huge and very worrisome. My RE was concerned...and not optimistic at all. I continued to bleed, dark red, dark brown...a sludge of sorts with lots of clots. This hemorrhage was working its way out of my body and the fear was it would release in one swoop and take the baby with it. Fortunately, the baby was not in the path of the blood, but still...that didn't mean it couldn't overtake the baby at this point because it was so much larger than the baby.
8wk6d
This ultrasound was a big turning point. While we expected the clot/blood pool to still be rather large, what we saw instead was a much smaller, more organized clot. It was no longer larger than the baby and the gestational sac, but now was about half the size of the gestational sac. Amazing. My bleeding had slowed down to spotting brown and I was allowed to return to work half days for the week to see how my body tolerated it.
9wk5d
With my RE out of town...again (I do love this man regardless)...he wanted to make sure I was seen by my peri. The ultrasound was just perfect...truly. The clot...GONE. Now, this was an abdominal ultrasound and there was the possibility that the clot was not visible due to the angle, but my peri really doubted we would find anything different with a vaginal ultrasound. Truly a miracle. Truly.
10wk5d
The ultrasound on this day would confirm that the clot had indeed continued to organize, reabsorb, and was no longer visible. My RE said there was an area on the scan that COULD be where the clot USED to be...but that it was really hard to tell. It simply was not there anymore. He was amazed. Absolutely amazed.
And that was it. I was finished with my RE. There was a gift from him to us...a baby gift...hugs...and then the tears. Just like that, we were to say good-bye, turn around, walk out the door, and leave FOREVER. Leave the people, without any kind of closure, that would make our dreams come true not once, not twice, but THREE times over. How do you just say good-bye and walk away from that?
Well, I could NOT. The tears flowed and I could not stop them as we walked out through the main lobby and to the elevators. I'm sure the women waiting were wondering what horrible news we had just heard, but the truth was it was tears of joy. Tears of thanks. Tears of good-bye.
A GOOD good-bye...but a good-bye nonetheless, and one I was clearly not ready to deal with.
11wk5d
This was my first visit with my OB...who was VERY eager to hear where we were at. You see, his last update was from my RE in the middle of the madness of trying to find a doctor who had seen a twin heterotopic pregnancy. He knew I was having an MRI...and that was it. Talk about leaving someone hanging!
So in about 2 minutes, I gave him the Cliff's Notes version and he breathed a huge sigh of relief. The appointment was great. Even on his archaic ultrasound machine, we saw that beautiful baby again, and everything looked great. My cervix was behaving for the moment...measuring a little over 3cm and still closed and firm. Still, my OB didn't want to risk waiting too long for the cerclage placement, so he scheduled it for the end of the week, at 12wk2d. Preventative cervical cerclages are typically placed between 12-14 weeks, before the baby and the gestational sac fill the uterus completely. Once that happens, the risks of the procedure multiply.
And based on everything he saw, he says he felt really good about this pregnancy...that we've had our "adventures" already and hopefully that was the end of it. He even made the prediction that with modified bedrest after the cerclage and then full bedrest at 20 weeks and all other measures put into place (swabs for infection, 17p injections or suppositories starting at 16 weeks, preventative cerclage, biweekly cervical measurements)...that we should make it well into the 30's...35 weeks is what he is saying...and maybe even beyond.
No NICU time.
Still, I am not holding my breath...I know how things can change on a dime and I don't want to get too lax here. I will believe the whole 35 week thing when I see it people.
If we hit the 30+ weeks gestation...it will be a success. Truly.
12w1d
We had our nuchal translucency ultrasound and it went fabulous. The baby looked great and the nuchal fold was 1.10mm...which is completely normal and puts us at a very low risk for Down's or Trisomy 21. The baby's anatomy, the placenta, the amniotic sac/fluid level, gestational sac...everything looked perfect.
I declined the bloodwork portion of the screening because the pregnancy started off as a twin pregnancy and due to the higher hormone levels, the chance of the bloodwork coming back positive would be too great and give us a false positive result. The truth is, the bloodwork, the ultrasound...nothing would change anything. We will carry this little one until he or she is ready to come into this world. If something is horribly wrong, we will walk that road until it comes to an end, on it's own.
12wk2d
Cerclage insertion day.
The procedure went very well. My cervix was "a little loose," but he was still able to place the cerclage high enough and secure enough. So much so that he says, "Once that cerclage is in there, I don't worry too much about the length of your cervix." Truth be told...this man's cerclage's don't budge. At all.
My recovery was NOT so great. Actually, it started off fine and for the first two hours I was feeling good. The morphine caused me to itch all over, but a quick shot took care of that.
And then came the nausea...and the throwing up...and the inability to pee...and then the uterine cramping and irritability from the surgery and my full bladder...and then the catheter and 1.5 liters of urine they managed to get out...and then some bleeding.
Finally I was able to stand, walk, and go to the bathroom on my own.
So they released me. It was all I could do to NOT puke in the elevator or on the way to the car in the wheelchair. But as soon as I got IN the car...BLECH! Threw up the whole way home and for the next 3 hours...until about 7:00pm that night. I felt like a truck had run me over...truly.
My cramping continued over the weekend. Every time I stood...my uterus would ball up and become rock hard. If I lied down...it would release.
Ah, my cranky arse uterus was back. This "uterine irritability" as they call it, started with my girls at about 13 weeks. So it's earlier and just one baby...but still the crankiness is here.
12wk5d
With all of the cramping, my OB wanted to check my cervix and the baby just to make sure all was ok. Mia came in the room with me, while Daddy was in the car with a napping Juliana. We heard the babies heartbeat...the cerclage felt fine and so did my cervix. My OB reassured me that the cramping was just going to be there...and that I needed to stay off my feet with the weight off my cervix as much as possible.
And that's what I've been doing all week. The irritability is still there...but I do have some quiet times. A return to work is not looking so great...especially considering today's outing of 3 hours to look for costumes and get the girls' clothes and shoes for dance, just about did me in.
My whole lower half has been extremely sore since I got home. I can't imagine what it will do to me being on my feet all day with my kindergarten class.
I will see Dr. P again tomorrow, at 13wk5d, and he will give me his recommendations...but I'm guessing I'm out...for good.
Weeks 6-10 were nothing short of a nightmare. I can hardly believe that one person can manage to have so many random, rare complications...then I realize it's me and I just have to laugh...what else can I do? It's been such a rollercoaster of emotions...to think back to the night before the MRI when I thought I was losing my babies AND my uterus and then not 24 hours later finding our prayers answered in miraculous fashion...just amazing...a true miracle.
I have to believe there is a plan for this baby that is nothing short of amazing. I, personally, am not planning anything...I am taking this day by day and that's all I can do. It's still all so surreal and well, the pessimist realist in me just wants to be, well, real about all of this. I find myself so anxious before each and every ultrasound, praying that the baby will still be alive...that there won't be any new complications...that I won't start bleeding again...that we won't have to say good-bye to this little one...that everything will just be normal...and okay.
Today I woke up and I am still pregnant...so very thankful for another day with this little one. Praying we will have an entire lifetime together, but knowing that his or her story has already been written, I will simply be grateful for and joyful in the moment...each and every moment.
And hopeful for what the future holds.
