Off With His Head!

Well, it would seem that my Inner Drama Queen likes it here in la-la-land and has once again appeared. Maybe it's a Tuesday thing. Maybe it's just that time of year. Or, maybe I'm genuinely losing it and she's taking over a la Jekyll and Hyde.

Suffice it to say that I have found myself wanting to yell, "Off with his head!" several times today. Honestly, no one really deserved it, but She Who Must Be Obeyed doesn't understand the niceties of society that there are in fact very few offenses that would warrant that. (In reality, I'm a staunch death penalty opponent, but she didn't get that message.)

All of this peevishness (I love that word) arises out of our meeting with Dr. Uterus. Surprisingly, very little had to do with the technical details that we discussed. He confirmed our suspicions that it was just again Stroke of Bad Luck, which while eminently unsatisfactory in terms of a concrete answer, is probably the best that we are going to get. We talked about doing pregenetic implantation diagnosis (PGD) on our totscicles and he was quite honest that they have never attempted it on frozen ones, although it wouldn't be out of the realm of possibility. He also recommended against doing it since it is so untested in frozen ones, which made sense. We talked about what further testing we can do (none) and the protocol for an FET cycle.

The thing is, it was just being in his office that had already started to set me on edge. Our last visit when we were told that our second baby in a row had died is apparently still very fresh emotionally. It all started to come back before we even saw him. I was also annoyed by the poster in the room with the picture of twin babies with the glowing ad copy gushing about how in a few months a couple he helped were preparing for twins! Dear God that was discouraging. He's been helping me for almost TWO FREAKIN' YEARS and I have twins all right! Twin miscarriages!

Now, lest you get the impression that I blame Dr. Uterus, I don't. I know it's not his fault, it's not Dr. Freak Out's fault, it's not even our fault. I know that he's doing everything within his power to help us. I don't deny that or under appreciate that for a second. Our history can really be chalked up to random bad luck. I also know that with those posters he's doing what everyone in America does - he's selling something. But, I found it so offensive today considering that I have done everything that is asked of me and I still have nothing to show for it and his advertisements make it sound so easy, so quick, so simple, so without pain.

The discussion of the FET protocol also annoyed me. He prefers to do a mock cycle first - with an endometrial biopsy for your parting gift at the end! - before doing the actual FET. I did the quick calculations and of course figured out that we're talking about two months - one month in which I have no hope of getting pregnant just to see if my uterus can be tricked into thinking its time for pregnancy and then one month in which the frozen totscicles are thawed and transferred. The thing is, once I decide to get started again, I don't want to go through a mock month. It's a wasted month (even though yes I understand that it is necessary)!

Being the inquisitive little one that I am, I also asked what the mock cycle entailed as far as drugs and monitoring. The good news? No monitoring. The bad news? I would have to shoot myself in the ass again with the goddamn progesterone. WTF!? And this is just during the mock cycle! I would have to do it during the FET and during the 2WW! This really pissed me off. I have no problem doing it when I know that it will help with a possible pregnancy, but I really resent having to do it for a mock cycle. It's like what else is required of me? Walking on hot coals? Climbing Mt. Everest? Finding the cure to cancer?

But, even this was not enough to rouse my Inner DQ to her full fury - and what did rouse her will probably appear to you to be the most inocuous thing. While we were getting ready to leave, Dr. Uterus stated that I have taken on a new position in his practice. I am now the patient who has such rotten luck and bad outcomes that I am next in line for the divine miracle, the run of better luck, whatever. His patient who used to occupy this throne is now 9-weeks pregnant with a "beautiful baby" and his pride and thrill was evident. It was like a sucker punch to me. I know that it was meant as a story of hope - see if she can do it, so can you! - but it just came across to me as this mockery of all that I've been through. I had a pregnancy that he declared beautiful and then it went horribly wrong. To me, it was like going through it all over again.

I know that's not how it was intended and I didn't tell him what I thought. I know he genuinely thought it would make me feel better. I'm just one of those people who those kinds of stories don't. I did share with Sweetie, though, hoping that he would understand, would give me some comfort. Nope. He got frustrated with me and accused me of being envious. (Envy is now a four-letter-word in our household). I agreed with him. I am envious and I don't like that I am, but I am. I feel it and get over it. But, when I looked for comfort and validation, he instead chided me like I was a 5-year old. It ain't easy being green.

Sorry for the length (and the whining and the peevishness), but rarely is a long story made short. Sweetie is going out of town tomorrow and I am grateful for the time to myself to reign in the Queen so that she can't go all half-assed crazy.

Twenty Questions

Thanks to everyone for your wonderful thoughts and wishes for getting me out of my funk. I'm feeling much better now that I had a stress-less weekend and was able to have some good conversations with Sweetie (plus lots of snuggling).

We have our appointment with Dr. Uterus tomorrow to discuss what happened with this last miscarriage and we've been dutifully preparing our questions for him.

Here are some of the biggies (with my own commentary, of course):

- What really were the chances of this happening two times in a row?
I'm more and more convinced that this was probably more common than he would have led us to believe. I don' tremember exactly what he said, but I got the impression that it was very unlikely that it would happen twice in a row.

- Do we need to have additional testing on either us to see if we have 'sticky chromosomes' that predispose us to nondisjunction problems (which in turn cause those pesky monosomies)?
While this wouldn't be something we could fix except possibly through donor gametes, at least we'd know.

- What are the chances that PGS on our remaining six totscicles will destroy them?

- How successful is the PGS test in finding chromosomally abnormal embryos and can it be done on 5-day thawed blasts?
If it is only 30% effective, for example, it may not be worth it.

- Do we need to do any immunological testing, even though both miscarriages were chromosomal?

- What are our chances of conceiving naturally?
I want to this know because frankly, there hasn't been a time that we had a legitimate shot at pregnancy while we were trying naturally. The first year we tried, my tubes were blocked. It was like I had my tubes tied. Nothing was getting through. The two times I have gotten pregnant, it was through ART and the months that we were 'off' I was either benched with ovarian cysts or getting over a miscarriage (which does wonders for messing up your cycle). I want to know if we have a legitimate chance even though ART may be a faster process - if it works.

- What are the protocols for doing an FET (which we would likely do next)?

- What is the thaw rate that the IVF lab has for frozen embryos?
Just because we have six on ice, doesn't mean that all six would make it through the thaw which really kills me, but what can you do?

And, before I head back to the padded cell, I'd like to say a little word about statistics. Several of those questions up thar can only be answered with statistics. I have come to eye statistics warily and with much suspicion over these two years. Statistics really aren't that useful to me anymore because they really don't help predict anything with respect to me. I've had lots of things happen that statistically had a very low probability of happening and yet happen they did. So, while they're somewhat helpful, I tend to make decisions now based upon the worst case scenario, not the statistically predicted one.

They also set me up for even more disappointment when something that should have a low statistical chance of happening (like a second monsomy miscarriage in a row) happens. Not only are you grieving that you have lost another pregnancy, but you are angry because statistically, this wasn't supposed to happen (don't even get me started on the statistics of miscarriage after hearing the heartbeat. That to me is the greatest travesty of statistics of them all.)

So, while I've pretty much given up on statistics, they are a necessary evil. I'm also stuck with them since Sweetie, mathematically-minded guy that he is, lives for statistics. I may ask Dr. Uterus, though, not to give us any more specific predictions about the chances of us having another miscarriage. We tend to take what he says as gospel so when it doesn't come to pass, there's another disappointment to handle.

Are there any other questions that we should be asking? Any thoughts would be greatly appreciated!
image: Dom Dada

It's Not the End of the World As We Know It

It may come as a shock to you, dear reader, that I have been known to be on occasion ... well, ... um, a Drama Queen (*snort*). My little Queen gets out and runs around when I'm particularly stressed, or tired, or emotional, or usually, all three. When my Inner DQ gets started, heads will roll, Henny Penny will run around screaming about the sky falling, the Rabbit will be late, dogs and cats will live together and general mass hysteria will be right around the corner. In other words, I will feel as if the cosmic shit will hit the fan at any moment.

It's rare that I get truly riled, but it happens every now and then. I realized on Tuesday that I was getting close to that line. To be perfectly honest, I was a bit of a mess last Tuesday. I was already depressed which in turn made me more susceptible to crapitude should anything the least bit bad come down the pike - which it did and it was a doozy. It didn't help that earlier in the day I had emailed my pregnant best friend laying out my tale of woe and I received a response back that I, - and this is a direct quote, "sound great!". Yep.

So, by the time I found out that we had yet another monosomy which I had been led to believe would be quite unusual, I was fit to be tied and certifiable. I genuinely believed that we had the crappiest luck on the planet, we were doomed to having only furry children, and perhaps strangest of all, that Dr. Uterus was actively jinxing us by continuing to give these sunny pronouncements on high about how it will be better next time. See how whacked out I was?

Wednesday morning rolled around and I rolled around in bed while petting a purring kitty and getting fur everywhere. I knew what I had to do and my choice was solidified through the morning. I had to take a Mental Health Afternoon. And that is exactly what I did. I went shopping at Nordstrom with my Christmas gift card but didn't find anything. I'm so cheap these days that spending $150 on a jacket just seems decadent. I also don't get that Thrill of the Bargain that I do at my favorite consignment store.

I quilted, I worked on the photo album of the quilting process that I will give to my best friend along with the quilt (this being the same friend who thinks I sound great), I started planning the cross-stitch pattern that I want to make (a first!) and I vegged. In my PJs. I also did some good old fashioned emotional thinking and came to a few good conclusions:

1) this is by no means the end of the world. I'm not dead. Sweetie's not dead. Our parents aren't dead and we're going to Paris in a matter of days.
2) it probably isn't as unusual to have two monosomies back to back as Dr. Uterus would have us believe.
3) we have options for the totscicles that we have left, such as PGS (as Denise so rightly pointed out)
4) we can see if there are any screenings for either of us to determine if our chromosomes are pre-disposed to nondisjunction (which is the cause of these abnormalities); and
5) again, this is not the end of the world. The Sky is Not Falling.

Once I had that good talk with my Inner DQ about these revelations, she quieted down. I think she has gone back into hiberation for a while. At least I hope so. I would hate to wake up one morning with Pinkey in my hands hitting curled-up hedgehogs through croquet hoops.

Lightning Strikes Twice

For some reason, I recently have kept running into Ben Franklin's definition of insanity. Insanity is doing the same thing over and over again and expecting a different outcome. Oh, Ben (or Albert Einstein, depending upon which website you reference) how right you were.
image: Shivayanamahohm
If by trying to get pregnant, over and over again, and then getting pregnant and miscarrying over and over again we can be said to be insane, then today's karyotype result for this second miscarriage seals the deal: it was yet another monosomy. Two random chromosomal miscarriages in a row. If I had this luck in the lottery, I would be a rich woman.

We have an appointment with Dr. Uterus to discuss the results next Tuesday. I am particularly annoyed that he had told us numerous times before that it was highly unlikely that we would have another monosomy. I think he needs to just stop giving us predictions because each of them have not turned out in our favor. Sweetie will be with me, so he can keep me from being a harpie while trying to get answers out of our very nice RE who's optimism keeps smacking me upside the head.

I'm just afraid that I know the answer that Dr. Uterus will give us: it was completely random, there's nothing we can do about it and nothing we can do to prevent it in the future. I don't know how many more times I can stand having a miscarriage, let alone one for a random chromosomal event that isn't supposed to happen every time I get pregnant. How does lightening strike in the same place over and over again. Is it insane or are we for standing in the same location?

I haven't been able to find any real statistics on how common (or uncommon) it is to have it twice in a row. I know that it is the most common of all chromosomal abnormalities, but that alone is no longer particularly helpful. Has anyone had two monosomy miscarriages in a row or know someone who has?

Unraveling

I thought I was doing pretty well last week. I had reached the point where my trip somewhere wasn't ruined by the sight of a lady with the tell-tale bulge. I was calm, serene - but the dam had to burst sometime.

Things started to unravel Friday afternoon. I hadn't slept well all week, I was working extremely hard on a project at work that is easily the most important of my career (no pressure!) that also happened to be extremely challenging, all while trying to make the most of my 'down time' at night with self-improvement and overall creativity. Needless to say, by the time Friday rolled around, I was exhausted - mentally and physically. I suspect that this set me up for being unable to handle all of the crap that was thrown at me.
First, on Friday I realized that come the beginning of next month, it will have been Three Long Years since we officially threw out the birth control and began planning who was going to take our new little urchin to day care. No matter how I looked at it, I could not see the positives - all I could see was that three years later, it's still just me, the guy and the furry beasts. Sure I can get pregnant! Sure my tubes are clear! So far, it hasn't done me a damn bit of good. I found this utterly depressing.

Friday night we went out with some friends to a local festival. Upon arriving, what is the first thing I see? Very pregnant ladies. Two of them, in fact. Couple that will all of the homeless kitties we saw in the park, and I was in a sad state.

Saturday, we go out to lunch and pick the restaurant mainly based on the fact that it has outdoor dining since it was a gorgeous day. This time, the hostess was pregnant and there was a very pregnant (and extmremely chic) lady there as well. Oh, and the hair salon has a very pregnant stylist (not mine) who had to walk back and forth in front of me. Am I destined to have this thrown in my face? I was officially getting discouraged and depressed.

Today, we went to the grocery store - the new one up the street that I hate with a passion reserved usually for the worst of the worst - and wouldn't you know it? Our checker was pregnant. And, I passed a woman talking to another woman about how she started to show immediately. Plus, one infant, and several six-ten month olds. I think I have officially reached my breaking point.

Talk about hitting you when you're down - I was already feeling depressed this weekend and then I just keep being reminded of the two babies I have lost and the fact that I can't even make it to the bulging stage. I want to be as big as a house! I don't want to be able to see my feet, I want to complain that I look like a whale because all of it means that I'm pregnant with a sentient being who kicks and sleeps and belches, all in my tummy - who will arrive with my eyes and his nose and look like all of the ancestors that we've ever had.

I know that there is an ebb and tide of grief - just like there are hills and valleys in life. I know that last week was the ebbing and this weekend was the tide. It just hurts so much, but there is no detour, no way around it. And, better out than in.

I still wish, though, that I could reach that point where it didn't bother me. I suspect, though, that it's like most things - some days you can and some days you can't. These just happened to be "can't" days.

Great Expectations

Over the years, I have learned to scale back my expectations of what life has in store for me. When you are younger, of course, you expect that you will have the life that your friends or your parents have. You don't expect to have problems or grief or disappointment - at least not until you are old (which back then in my mind was 40).


I have also learned how to handle other people's expectations for my life. There isn't a person that I tell that we don't have children that I would wager wonders to themselves, why not? Luckily, very few are so deprived of manners to actually ask that question. I smile and know what they're thinking, but frankly don't care enough about their opinion to actually do or say anything. Let them think what they may - it is usually far more interesting than the truth.

And then there are those pernicious amorphous expectations that are exuded from society that we almost unconsciously take upon ourselves. For example, Sweetie's employer is building a day care center for its employees. We first heard about it about a year ago when they sent out a survey to employees to guage interest. Sweetie enthusiastically filled it out, indicating that we did indeed have plans to use the day care center. Typically, news of the progress of the day care center would filter down to us around the time that I was pregnant, so that we would begin to plan how we would utilize it. And, then, we would be smacked upside the head for having the temerity to actually make plans and would get a D&C for our hubris.

Now, the day care center is under construction and at first, I had that same feeling that I had to have a child and quickly to be able to use the day care center. After all, weren't they building it because we said we would use it? Luckily, I stepped back and realized that it didn't really matter if we used it or not. It was nice that it was there, but it wouldn't be the end of the world if we weren't able to use it now, soon or even ever. After all, it's just a building.

image: swamibu

A Dark Anniversary

I was in the shower this morning when I remembered the date: April 16. Today, one year ago, I learned that our first pregnancy had ended while we were on vacation. I had gone to Dr. Uterus' office looking forward to seeing how much the little one had grown, hearing the heartbeat again - and maybe, just maybe, being released from his care and into the hands of an OB for the rest of the journey.

Instead, I got a stab of panic when he found that the baby was measuring small for the time frame. It was supposed to be my 11-week check-up and the baby was measuring at 9w2d. Then, I got abject terror when he couldn't find a heartbeat. Then, I got numbness when he said those two little words: "I'm sorry." It was a terrible, terrible day.

I know that today is not that day, but even a year hasn't dimmed the memory, the pain or the heartache. It is all still there, just under the surface.

image: Ashimjara