We have a rather concrete plan now – no sit-ins required.  In fact, the doctor even admitted that he was more frustrated with our case than he has been in a long time.  At least we’re not alone in the frustration department.  The good news is that I don’t warrant surgery, and with the low hcg numbers we’ve had, a d&c and/or laparoscopy probably wouldn’t have been able to find the actual problem anyway.  I am getting an injection of methotrexate tomorrow morning, which is actually a chemotherapy drug.  I’ll get a pretty mild dose which will have the effect of killing off whatever it is that’s still hanging around.  I’ve actually had this treatment before in a different scenario, and it worked pretty quickly – actually the same day.  I’m hoping that by Saturday I will be feeling much better.

I can tell that my body will not handle many more days of this without making me either very ill or extremely uncomfortable, so it’s good that we get to be done with this tomorrow as far as treatment goes.  They drew blood today (of course) to run a CBC to make sure that my liver and kidneys are functioning properly, which means I’ll be unlikely to have any complications from the medicine.  They’ll also re-check the hcg level from that draw, and I’ll have to go in early next week for another hcg level check (of course).  If blood-letting were still a time-honored medical treatment, I should be healthy as a horse right now. 😉  Then we’ll go back in two weeks for a follow-up in office with the doctor.  It’s been a long month, but I think we’re finally getting to wrap this situation up.  Finally.  Does anyone want to say it with me?  Finally.  🙂

My husband is a wonderful, handsome guy.  Don’t you agree?

He adds pizzazz and sparkle (and special additions to photography compositions…) to my life.

He adds joy and fun to my life.

He makes every day an adventure, and I am lucky enough to tag along.

Happy Birthday!

The lab results from yesterday show that my hcg level actually rose to 40, which is not enough to indicate an ongoing pregnancy but is enough to indicate an ongoing problem.  The doctor has determined that now is the time to step in and do something, so I am going in tomorrow afternoon for further evaluation to determine what that intervention will be.  Although the nurse said there might be multiple treatment options, the last thing the doctor really mentioned as an option last week was a d&c.  He might do an ultrasound or more blood work tomorrow, but we should know what his plans are before we leave (at least I might not leave until I have concrete news…).

My husband and I scuba dive, which I highly recommend to anyone who enjoys water and watching things like Shark Week.  There are a few rules to scuba diving, the most important one being breathe normally.  At no point should you ever hold your breath while scuba diving.  Most of the other rules apply to bottom time and how long your body will need to decompress to release the nitrogen that builds up in your system while you’re under water.  For most dives, you have to stop on your ascent at around 20 feet deep and hang out for about three minutes.  It’s the only time you’ll find a whole bunch of divers sitting still holding onto an anchor line; otherwise we’re on the bottom looking for fish, coral and assorted underwater oddities.

Decompression stops are generally the “boring” part of a dive because the only activities are watching the three-minute count down tick by or watching the antics of your fellow divers trying to figure out whose watch or computer is beeping the frantic doomsday warning.  It’s easy to forget that decompression stops are vital to your health.  If you have patiently read through the dive jargon to this point, here’s my point: we need decompression stops in our daily lives, too.  No matter what you are immersed in, you have something that builds stress in your system just like nitrogen builds up in divers, and you have to get rid of it.  You can’t stay under forever or you will die; divers know that it’s a pretty horrific possibility and a great motivation to sit still for three minutes.

I am obviously dealing with grief, but in an average week, I can accumulate a huge amount of stress at work and trying to accomplish all the things I put on my to-do list.  It is a proven fact that I will go completely nuts (usually something along the lines of an old-fashioned hissy fit) if I don’t release that pressure effectively.  My family can testify that I am queen of the throw down tantrum – I mastered it before I turned two.  I  have learned the hard way that I need to stop and decompress, and I have learned several ways to make a good decompression stop.

The most important one for me is to attend church.  At least once a week, I know I will be able to spend time with lovely people, and I will be reminded that my focus has gone wonky through the week.  (This one’s for my GVBC friends.)  Someone or something will remind me that it’s not about me and that I should be about God.  If you are a Christian and you don’t attend church, what are you waiting for?  If you’re not a Christian, decide what your life’s focus is and get to it.  Better yet, go to church with a friend that you love and admire for their sincerity of faith and find out what it’s all about.

I also have a few ways to decompress on a daily basis.  Most of those involve humor.  I love a good laugh, and those can be hard to come by when everything around you frustrates you.  I have no less than three goofy blogs in my RSS feed that are guaranteed to make me laugh at least once a day.  Engrish.com remains my favorite, but my dad turned me on to ThereIFixedIt.com, which runs a pretty close second.  Invisible Cats is hit or miss for me in the humor department, but it’s existence proves that there is an inordinately large cat presence on the interwebs.  Of course, for animal humor, I rarely have to look further than my own yard.  There’s a pretty good bit of offensive language, but DamnYouAutoCorrect.com will make me laugh until I cry since I only look at it about once a month.

As an artsy-fartsy personality, I also write or crochet or craft to decompress, although the punching bag is probably the best physical activity for decompression stops.  I haven’t been able to whack it in a while, but it has returned to a usable place in my basement and is just waiting for me to feel well enough to put on my boxing gloves.  (Yes, I have boxing gloves, and they are pink, and they are fabulous!)  It feels really great to hit something as hard as you can, especially if you yell or grunt at the same time and have a tendency to repress your emotions.  If you haven’t tried boxing, you are welcome to try out my punching bag.  An added bonus is that this activity also involves comedy once I realize how ridiculous I look and sound as I take out my frustrations on an inanimate object while wearing pink boxing gloves, but it really is a great physical release.

Although I just listed a lot of activities that aid in decompression, one factor I can’t stress enough is to share with your friends.  All the time that I held back or even hid what I really felt was miserable and oppressive.  Sharing your struggle to survive your particular circumstances will make the burden lighter and lighter.  I don’t mean that you have to spill your guts all the time to everyone, but at least develop a bank of friends that you can call when a hissy fit looms on the horizon.  My best friend shared “Newsies” and cookie dough with me and turned a crappy week into a much better weekend.  Seeing my friends at church reminded me how blessed I am to be loved.  Now here’s something to get you started on your own decompression stop:

This last week has pushed every limit I thought I had physically, emotionally, mentally, spiritually… Every bit of medical news we have is ambiguous with a hint of menacing, and there is no definitive end in sight.  I have reached the ledge where I am ready to dive into self-pity, and it’s hard to look away from that abyss when I am so frustrated.  I have been running a fever for almost a full week.  This is now the fourth week of continual bleeding, and my hcg level on Thursday was 30 (from 29 on Monday).  It’s hovering around the same level without dropping, which means we’ll have to wait it out at least another week unless my fever spikes over 100.5.  The fever is frustrating on several levels, the first being that I feel almost as bad as when I had the flu – the bright side here being I have no sinus or upper respiratory congestion.  At least I can breathe, but I can’t convince the doctor that 99.5 for me is like 100.5 for people with normal body temperatures.

The nurse encouraged me to try to relax and rest, which I have to do because an hour of activity makes me so tired I need a two hour nap to sit up again.  I have missed another week of work, which isn’t the end of the world, but it does mean that my world is going to stink when I try to get caught up again.  I can’t keep up on housework or do the few big things that need to be done before we can finish a few home improvement projects.  I had finally gotten my feet under me, and now I’m back on my duff indefinitely.  I hate to lose the momentum I had going because I was finally accomplishing some of the bigger tasks I had put off for so long; it was huge boost for my confidence to have those tiny bits of accomplishment every day.  While I wouldn’t call myself super-productive, I don’t do forced inactivity very well.

My husband asked me what I wanted the doctor to do when I expressed my extreme frustration about the situation.  I think what I really want from the doctor and/or from God is a definitive end or a plan, as in, “If your hcg level is still this high in this many days, or if your fever isn’t gone by this day, we’re going to take this action.”  I feel like if I had a deadline, I could talk myself into waiting a bit more patiently.  Watch and wait, possibly for another week or two, is fraying my emotions and my ability to endure anything else.  With the addition of hormones that are completely out of whack, I feel like I’m a step past completely out of control.  It’s hard to comprehend that God IS in control of this situation.  It’s terribly easy to ask him why without accepting his answer, “I am God, and you are not.”  (Read Job; it’s the only answer he ever got from God.)

This week is a “Why me, God?” week.  When will I have suffered enough for this to be over?  If we had to lose this baby, too, why do I have to go through this extra physical complication?  If there’s still an inkling of a chance that we still have a baby, why did we have to go through two weeks of hell to find out?  Why even allow the hcg numbers to stay elevated if it’s only going to break my heart open wider with false hope?  What purpose is this serving, and why can’t it just end?

But those are the human questions, and they’re the wrong ones to ask from a spiritual standpoint.  The tougher questions are, “What am I learning about God through this, and why am I refusing to accept that lesson?”  I wish I were obedient enough to ignore the why’s and the self-pity all the time and just rest on God every moment.  It’s incredible that in a week I have experienced the certain knowledge of the presence of God through an incredible time of corporate worship, and I have experienced the wholly human folly of doubting his power and his plan.  How ridiculous am I that I will argue with the creator of the universe and tell him this plan is no good for me?  When is he enough for me that I can just wait for him and accept that he is God, and I am not?  I am glad for the short-term relief of being honest and asking God the questions, but now I need the long-term knowledge that I can rely on God no matter what.  Now I have reached the no matter what, and at least this time I’m not running away – I’m just having a hard time waiting gracefully.

The hcg level dropped to 29 as of yesterday, so we are at least headed in the right direction.  The only kink now is I am running a fever, which is not a big deal unless it sticks around for awhile or goes any higher.  My body does not do fever well, so I feel like poop.  Other than that, I’ll go back on Monday for another blood draw to check the hcg level.  Again.  And hopefully I will feel a little less like poop tomorrow.

Forewarned is forearmed, so walk away now if you don’t want physical details.  We went back to the fertility specialist today for a follow-up and a next step discussion.  We were supposed to see another doctor tomorrow who might have taken a different tack, but her office called Friday to tell me she had resigned.  So no appointment tomorrow; we may wait a while and see if she turns up somewhere else, but I wonder if maybe God just shut that door to leave just the one open.

Today was largely what I expected: based on the hcg level last week, they drew more blood; the doctor reviewed the results of trying lovenox; and he recommended IVF based on the idea that maybe our embryos aren’t implanting in the right place.  Before I explain the blood work, we are going back in October to start the tests needed to begin IVF, which would put us somewhere in January starting the first cycle.  Given that our most recent loss isn’t really completely over yet, we would have to wait another month to start the process, and that would have put us waiting for a pregnancy test right before Thanksgiving if we started the IVF procedures as soon as possible.  We could end up pregnant anyway, but I’d prefer not to intentionally schedule a potential pregnancy (which I mostly see as a potential miscariage) at the start of the holiday season.  Christmas sucks enough for me without scheduling potential disasters to happen at the same time.

Now the blood work: I went last week for a repeat hcg check to make sure that the level was dropping.  It should be below 5 to be considered negative for pregnancy; anything over 25 is considered positive for pregnancy.  It was 46 last Wednesday.  That was slightly less than half of the highest level I had, but it was 54 the week before, which means it barely dropped over that week.  I’ve never had the level not drop to negative a week after a miscarriage.  It is not really unusual for it to take several weeks to drop back to negative, but it is unusual for me, and most of the people whose levels remain elevated for a while had hcg levels well over 1000 when they miscarried.  We won’t get results from today’s blood work until tomorrow because the person who processes the lab work was out of the office and will return in the morning.

Before anyone goes nuts and thinks that the hcg level remaining elevated could be a good thing, it’s not.  Remaining slightly elevated without going away is often called a missed miscarriage; in clinical terms it means that some “products of conception” remain somewhere in the body, which can cause a lot of fairly disgusting complications, infection and internal bleeding being among them.  So continuing to show positive on a pregnancy test does not mean we may still have a viable pregnancy.  There are plenty of chat room stories of women who had miscarriages but discovered several weeks later that they were still pregnant, but even they point out that the hcg numbers then continued to rise dramatically like they should have to begin with. All things are possible with God, so I can’t say he wouldn’t do that, but I can tell you I will be furious with him if that were the case for us right now.  I’m very sure it’s not because of the next explanation.

This is the part that I warned you about, so you have one more chance to walk away.  I have been bleeding for three weeks at this point.  I started bleeding lightly about a week before we got the news that my hcg levels were dropping.  The day after that news, I began what I assume to be the miscarriage, which was much heavier bleeding and cramping.  It slowed down after several days, and I expected it to stop in about a week, which is what I have done all but one time a few years ago.  That time I continued spotting (different from bleeding), but we had a negative hcg level.  I am still bleeding, and it even picked up the pace yesterday.  The doctor would like to watch this for another week or two to see if it resolves on its own.  The alternative is moderately invasive surgery.

I am SOOOOOOOOOOOOOOOOO frustrated right now, and I have no idea what to pray for.  I find that I am once again almost hoping that there’s a problem.  Surgery would mean a d&c and laparoscopy to try to find the pregnancy, and that is obviously not an ideal situation.  But surgery could possibly mean that they find the pregnancy, which might be useful in determining a definite course of action.  If it’s in the uterus, it would tell the doctor that IVF is not a good idea; if it’s outside the uterus, it would tell him that his hunch is right and we stand a pretty good chance of success with IVF.  While a natural resolution is obviously better, I have no words to describe what the potential for another two weeks of bleeding does to me.  Because of the low hcg level numbers, there’s really nothing to see by doing an ultrasound or pelvic exam, so the only option is to wait and watch.

If the hcg level has continued to drop based on today’s blood draw, then by next week it should be negative, and maybe this will end soon.  So I guess that would be the best news tomorrow.  I suspect that it will not be the news I get tomorrow, but that may just be the crazy hormones talking.  If the hcg level continues to hover for the next week or two, or if I develop any symptoms of a complication, then we will definitely be doing the d&c.  I just really want this to end immediately.  I started typing that sentence with “need” instead of “want,” but I realized that the only thing I need is to let go of this and wait and trust God to keep me sane.  Far easier said than done.  I’ll let you know what we find out tomorrow.