acog who?

my ob care is through the military, allegedly at one of their flagship institutions. i'm being seen at be.thesdanaval.medicalcenter. interesting then that at such a premier institution i'm unable to get a NT screen, my requests for same and ACOG guidelines nonwithstanding. apparently, they do sequential testing and only offer NT scans to those women whose 1st trimester analytes are abnormal. while this seems like a good idea, serum anaysis alone only detects 80% of possible aneuploidy, whereas serum analysis + NT scan has a detection rate of 95%. if i were working with a tiny clinic in a remote area that didn't have appropriate equipment or trained sonographers i would understand. but that is not the case, at "the president's hospital." if acog guidelines suggested that only women of a certain age or risk factor should be offered the combined NT and serum screen i would understand. but acog guidelines are clear: "Women need to be aware of all the different screening options that are available, including their detection rates and limitations, so that they can choose the test that's best for them." if i didn't want the NT scan it wouldn't matter. but i do. it is very odd to me that i'm being denied such a simple screen at, allegedly, one of the nation's top medical institutions. what could possibly be the reason for BN to be so far outside the normal standard of care? cost cutting? abortion politics?

i heard the hb today by doppler; i'm 11w. i have a retroverted uterus so it didn't come up right away and i scared myself half to death. i'm going to wait a week before trying again. part of me thought, that as i'd made my 1st maternity clothes purchases this weekend, that it wouldn't be there as payback for such a wanton display of hubris. like DD said in her post, i guess things will be ok but it's hard to mentally work myself around that. if someone asks if i'm pregnant, the answer that feels most right to me is "technically". i feel bad because i feel like it's keeping me from bonding with the lil bean, but i keep waiting for the second shoe to drop. maybe it'll get better in the 2nd tri?

i honestly couldn't say it better myself

so this post might be cheating, but every now and that i come upon a sublime post that says just exactly what i wish i could say, if i didn't sputter out into an incoherent rage each time i tried. i'd like to refer you now to julie's 3/24 entry at a little pregnant for a spot on discussion about what's so insidious and nasty about this whole j.lo twins THANG.

it's not that fraternal twins at age 38 after years of wanting and trying to become pregnant doesn't scream IVF (umm...but it most surely does)...it's the denigrating way she denies it. no one is asking j.lo to be a mascot for IF (for that i'd like to nominate z.braff if only because he's so damn cute!), but if she could just refrain from being insulting in her she-doth-protest-too-much denials that would be much appreciated? k? kthxbai.

how to quickly lose your mind in one easy step

so early this week i reluctantly stopped lov.enox...no longer being hemoconcentrated following my bout with OHSS/paracentesis/abdominal bloating from hell. even though the shot stings like crazy i quite was sad to give it up, because i got pg and stayed pg (so far) while taking it. so rather like a basketball player and his lucky underwear, i wanted to make it to 12 wks before deviating from my medication regimen in any way. alas, not to be. plus, i figured if i was homozygous for MTHFR (and being ashkenazi, it's a reasonable possibility) i would be treating that simultaneously. i've never been tested for clotting disorders, so it's possible. at my appt this week i asked the resident if i could stay on the lov.enox...she contacted the maternal-fetal specialist who essentially said no can do regarding the lov.enox, because if i do have a clotting disorder it won't cause problems until 20 wks or so, and since i'm no longer hemoconcentrated there's really no need to continue the shot. is that supposed to be comforting? i'm supposed to wait until 20 wks to see if a problem develops? Not Even Remotely Comforting.

even more reluctantly i stopped the PIO. a word about PIO. that shot SUUUUUUUCKS. it is thick, and deep IM, and currently my backside is covered in knots and bruises. i even ended up with sciatica down my left leg from multiple deep IM injections into the same area. so, it's not that i like the shot at all. it's that despite multiple assurances that 'the placenta takes over progesterone production at 6-8 wks' i know there are women for whom that is not the case. i also know that you can have a perfectly healthy fetus, but if you don't have adequate progesterone, you don't have a pregnancy, end of story. i also know, that fertility wise, i happen to fall into a rather small percentage of women who need IVF to get pregnant. further, i happened to fall into an even smaller percentage who get severe OHSS. so, at this particular junction i'm *not* interested in playing odds games. however, i can't write prescriptions for myself (yet) and so the best i could do was secure a pro.metrium script for the next several weeks...and i'm sure earn a few "crazy lady" doodles next to my name on my chart.

so my last PIO was thurs eve and i woke up yesterday (sat) with a small amt of pink spotting. i spotted all day. you can imagine the lovely state i was in. i think i put so much progesterone up my vag that i'm suprised it wasn't stuck shut. by yesterday eve my attempts at remaining calm had failed me and i paged the IVF dr on call (mind you i have been passed off to OB at this point, but at my appt last week i was really unimpressed with the level of knowledge they seemed to have regarding early pregnancy, complications etc.). thankfully they returned my call and i drove an hour to the clinic on sat night at 7pm for a thorough wanding.

science babe looked great. waving it's little arm and leg buds, bobbing it's ginormous, egg-like noggin. it's father has a ginormous head, the ramifications of which are just becoming clear to me now. hb 164. i'm sure the collective IVF team thinks i'm just a big pile of crazy at this point, between the begging for shots, wheedling for pro.metrium, saturday evening scans, etc. etc. etc. however, in my defense, spotting 3 days after discontinuing PIO will cause panic. it just will.

oh well. this gets better, right?

Ok

i begged, borrowed and stole my way into a quick sono this AM and it is still there. Someday, at some point, this will seem less tenuous. i hope sometime sooner rather than later.

crazy doesn't necessarily mean wrong

so, i've decided not to rent or buy a doppler until another U/S confirms a hb. Ditto for any maternity clothes, including bella band. so, i'd better not gain ANY MORE WEIGHT until i have another u/s or i will be utterly without clothings to cover my shocking paleness with.

i guess i'm happy that i haven't had any morning sickness to date (the only thing i had vomiting with was the OHSS) but a little bit of pukiness just to let me know things were OK wouldn't be terrible. famous last words i know, but i thought i'd put it out there.

tomorrow i have OB "orientation" at beth.esda na.val. possibly the most inconvenient place to get to EVER. i can't wait to see what the orientation entails...if it's anything like the IVF orientation was, i'd call it a solid waste of my time. but i'll go if i can get another sono out of it. *crosses fingers*

it has occured to me recently that perhaps t.o.m cr.u.i.s.e was not so much crazy as just more brilliant than our feeble minds could comprehend...seriously. if i had his kind of $$ to throw around i would not hesitate, pass go, or collect $200, but instead simply dash my bruised, knotty PIO heinie down to the nearest sonogram store and plunk down some cash.

sono glow=2.5 minutes

i am utterly exhausted all the time, as well as vaguely nauseous and more than a little backed up. my body, it is a wonderland.

my mind, however, is a deep black pit. it wonders if i should fabricate symptoms to go to an ER where i can spend 5 hrs waiting just to get a sonogram to tell me there's still a hb. it's a good thing i'm too lazy to listen to myself much.

i'm contemplating renting a doppler, but i can't tell if that will lessen the crazy or make it worse :?

ba-thump

we transferred two but there was only one, measuring 7w1d (i'm 7w2d), hr 145, otherwise normal looking for an embryo the size and shape of a bean.

***exhales***

i know it's shortlived, but i'm hoping the sono glow lasts at least 24 hrs. :)

oy

well, the hb scan is weds am and i am brimming with DBT's for the occasion. my head is going to be a particularly unpleasant place to be for the next 36hrs or so.

does being on PIO mean any m/c signs are masked? does anyone know? i'm just wondering...

back from haiti

typical depressed look of a malnourished child. this child is at a refeeding ctr


sad child with severe kwashiorkor at orphanage



giving tetanus vax at a health fair



i am back and hoping to relax. i am exhausted, and everyone keeps telling me how exhausted i look.

to my knowledge i did not m/c while i was there, which just makes me super pissed at my mom for basically telling me nonstop for a month that going = automatic m/c. i want to confront her about it but i'm too tired to tip at windmills right now. so, basically i'm avoiding her.

the hb scan is weds am and i am really really nervous about it. i know it isn't everything...it's just another hurdle in a long line of hurdles, but i'm putting alot of stock in it for some reason. i feel like i might be able to relax if i "pass" that test, if i don't...i don't know what i'll do. get by, i guess.

greetings and salutations

greetings from haitiland! i find myself with access so i'm updating. it is really hard to describe the country in a blog so i'm not even going to try. but some inadequate descriptions follow: in jeremie, the land, the views are gorgeous. from some vantages it even has a terraced/italian look to it. jeremie still has trees and they are wonderful, flowering, heavy with blossoms and fruit. roosters are everywhere as are skinny dogs (btw: total myth that roosters crow at dawn. they crow all the damn time). the poverty is beyond measure. dwellings built of concrete and corrugated tin and aluminum poles as people get money...so alot of people live in partially constructed homes. just a room sometimes with walls, sometimes with a roof. on the negative side, the people here even the small children seem so aggressive everybody wants something and the want it hard. you get followed everywhere. "asked" for a date, marriage, money, food, a treat, the shoes off my feet. i must look like a big white dollar sign to them. i've been to very poor places before but i don't know that i've felt so poked and picked at before. needled. there are a couple of returned pcv's from ghana and they say that in ghana, which is just as destitute if not worse, the adults have more pride don't assault strangers for things but the children will. i dunno. i've never been to ghana but i know what they mean.

today i went to an orphanage/respite home for children that was essentially straight out of something you would see ior imagine from dickens minus the evil care provider. some of the children there are orphans or abandoned, others are dropped off because they are sick or because their parents or care providers can't look after them because the care providers themselves are sick. it's hard to even describe it because it seemed so surreal that even though i only came back a few hours ago it's hard to even think about it. there were 4 large rooms filled with white iron cribs lined up front to back in rows, maybe 50 cribs per room. there was an infant room, a toddler room and two older kid rooms. the infants were all (every single one) way below weight for age. malnourished, no fat under the skin or sometimes the shiny skin from when the edema leaves after kwashiorkor, and the skin itself was absolutely covered in bites, scabies and eczema. most only had fuzz for hair. we went crib to crib and fed infants what had to be some kind of gloppy pumpkin porridge goo from a spoon. most were fed while in the crib on their backs. then they each got water from a cup. there was a baby i probably held for 4 hours straight while i fed and held other kids, i don' t know the name or age but i'm guessing a very tiny 9mos old? there was a blind older child from malnutrition and a really really sick 2-3 yr old with kwashiorkor, a massively edematous belly and feet. he let me rub his palms. all of the staff was so well intentioned but there were few of them and so many children.

having adventures when what i really want is sleep

the last few days i have been just exhausted. bring-tears-to-your-eyes exhausted. and then i think about all the work i have left to do and it makes me want to cry all over again. i know my hold on your sympathy is precarious, if indeed there is any for me at all. after all, i am an infertile with a BFP, so i'm lucky. and i know i am, even though it doesn't really make me want to cry less.

this friday i'm going to haiti on a medical outreach trip, so there will be radio silence for a week until i come back. the suitcase is filled, and i haven't yet packed any clothes. i think this is a problem. between meals, snacks, gifts for my hosts, tp, baby wipes and the veritable pharmacy i am bringing with me (including 2 injectable meds with associated paraphenalia, mind you) there's no room left for clothes. frick. my mom is convinced (and has zero reservation about telling me, very very frequently in fact) that i should not go, and that going will cause either m/c or birth defects. she says i shouldn't go in the 1st trimester because "all of the organs are forming." which is true, but so what? it also means if i actually do m/c or have a baby with defects, i will never be able to look at her again because i know she'll think it's my fault. always, somewhere in my mind i'll be thinking that somewhere in HER mind is the idea that the trip caused it. i have my RE's blessing...my mom can bite it for now.

i have the hb scan the week i get back, on 3/5. i am nervous as hell for that. i'm going with my sister so at least i have that going for me...she's an excellent support person. i'm not sure if i should wear earplugs and close my eyes and just have j tell me in the car on the way home how it went or what. otoh, if it goes badly i'll probably want to have some conversation with the poor resident about what comes next. so, i am very glad my sis is going with me but i am NOT looking forward to the appointment. yet, i can't just not go either, or my brain would explode from angst. sounds like fun, eh? bet you wish YOU were on my little brain hamster wheel.

notes about haiti from hereFACTS ABOUT HAITI:
Haiti's ecology has been significantly damaged since its independence in 1804. Only 7% of the country's original forest remains unscathed by deforestation. Most of the trees have been cut down and used as firewood for heating and cooking. Some wood has been sold to surrounding island nations to provide much needed income. Massive soil erosion has also occurred due to the vast amount of deforestation. Thus, much of the soil in Haiti has been depleted of vital minerals.

Most of the water in Haiti is also polluted. This includes parts of the coastal areas, such as the Bay of Port-au-Prince, and most of the major ports and some coastal towns. The water throughout the country is nonpotable.

holding back

my husband lives in sc but is coming up this weekend. we haven't gone out yet to celebrate the bfp; in fact, i was so sure i was m/c'ing a few days ago i called him to tell him it was done. after the beta doubled i said when he came up we should go out to celebrate the bfp. but almost immediately after the words left my lips i regretted them. maybe it is a mistake to celebrate because what if i m/c? what if there's no hb at the ultrasound? we should do nothing to commemmorate it--at least until i get a hb--because what if there isn't one? that would make the whole thing a farce, and celebrating it obscene.

on the other hand, if there isn't a hb, i'll be destroyed whether or not we go out to dinner this weekend. and if i only get a few days/wks of this, shouldn't i at least *try* not to be morbid and enjoy myself, if only for a little while? if it doesn't continue (or even if it does) will i have wasted it completely by spending the whole time expecting disaster?

how do i let go enough to acknowledge (and maybe celebrate) that something momentous happened...but also hold back enough that something of me is left if it all goes to hell? i can't find the balance between holding on and letting go and i need to do both to get through the next few weeks.

it would be nice if i could just go to sleep and wake up 12 wks from now and someone could tell me how it went instead of plodding through it all day after day.

222

today's beta was 222. according to betabase, that's a doubling time of 41.2 hrs. betabase says the average beta for a singleton pregnancy is 196 at 16dpo and the average doubling time is 37.4 but who's obsessing?

*exhales*

i thought for sure i was going to m/c last night because i was so frikking horribly crampy. today is reprieve. it's far from over but at least i got this far. i'm not going for a 3rd beta, so i'm going to assume PUPO, goddamnit, and not see them again until the hb scan. god willing and the creek don't rise, that's the next time i'll go to the clinic.

thanks so much for all your well wishes and good vibes and keep your fingers crossed for me.

anxious, nervous

bah! i'm so anxious for tomorrow's beta. i keep trying to tell myself NOT to be nervous because it won't help and nothing's gone wrong yet so far. plus, if i only get two days to be p-word, i might as well enjoy them, right? plus i worry that being anxious might make me miscarry which is a mindf*ck beyond all mindf*cks. either it will double or it won't. if it doesn't it doesn't necessarily mean its over, and if it does i'm far from out of the woods. bah.

my mental state right now=not too good.

beta

today i'm 11dp3dt or 14dpo
my beta is 99.
this number is exactly average for singletons and on the low side for multiples

cross your fingers for me for 200 or GREATER on weds. (please please please)

24 hrs in peesticks

beta #1 tomorrow...



this was yesterday morning at 9dp3dt. if you squint at it like i did, you can just baaarely make out the second line. it didn't come up right away and at first i thought it was negative. i peed on it, waited, the control line popped right up. and then nothing. i just had this pit in my stomach, trying to talk myself out of it, the advantages; i can sleep late, i learned so much this cycle it wasn't a total waste, the culdocentesis makes a great story for my friends (right?) etc...when i went back a few minutes later there was just a hint of a line, but it was there.

this was this morning at 10dp3dt. i think the line's just a little darker and maybe it came up a smidge faster, but still light. i'd like to thank leah for her idea of writing the times on the sticks.

for comparison

and finally...because i've been peeing on things right, left and forward (the cats are getting nervous)...

9dp3dt or 12dpo

there's a tiny faint line, but i see it. if i pee on something later and it's still there, i'll post a picture.

****nervous****