Thankful

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As I lay in my hospital bed this Thanksgiving morning, my perspective is a bit different compared to previous years. I'm not distracted by the hustle and bustle of traveling, cooking, setting tables, entertaining, shopping, or visiting. Being confined to a bed with lots of times to just think has made this a different holiday. I always take time to be thankful for the family I've been blessed with as well as sweet friends, good food, and many other trivial things; however, this year is much different in a great way.

I could never count the blessings and miracles we've been given in the past month alone. My eyes have really been open to the day to day blessing received that I typically take for granted. I'm also extremely aware of the larger blessing given to us in recent weeks. Blessing through the Lord's hands, blessings of compassion and love from family and friends, and blessings of prayer from people we may never meet.

For all of that, I am overwhelmingly thankful.

Give thanks in all circumstances; for this is God's will for you in Christ Jesus.
1 Thessalonians 5:18

Twin Pregnancy: Water Breaking Prematurely at 16 Weeks

A little over three weeks ago, on Friday, October 31, baby A's water broke. 

Early that morning, I woke up when Chris' alarm clock went off at 3:30a.m. and then a few times after that when he hit the snooze button. When I woke those different times, I noticed some pressure-type feeling I was having, but nothing too alarming or severe. I attributed it to a full bladder and the babies moving about. So around 6a.m., I finally got out of bed to use the restroom. I don't work on Fridays, so I planned on going to the bathroom and getting right back into bed. 

Well, those plans changed mighty fast. 

The bathroom is only three steps away from my side of the bed and when I stepped onto the tile, I felt a gush of water come out of me. There was no mistaking where it was coming from or what it was. I'd read in the past that some women feel as if they "use the bathroom on themselves." No. Thats not even remotely accurate. It was obvious. It was a gush of water that seemed to never stop.

I immediately turned on the lights and started yelling for Chris. I was yelling his name and screaming in desperation, "No! No! I don't know what to do! What do we do? What's going on?" I remember feeling like I should cry, but all I could do was scream. God knew what was going to happen that morning and instead of Chris leaving for work at 5a.m. as he usually does, he was still in bed that morning. 

I was only at 17 weeks, the end of 16 weeks actually. We had not planned for emergencies at this point because it was so early in the pregnancy. All we knew to do was go to the ER. So I threw on some jeans, my glasses, and the closest pair of shoes. I somehow remembered to grab my purse and then we were in the car. The hospital we needed to be at, the main labor and delivery hospital that my OBGYN is associated with, was at least 25 minutes away, but I'm pretty sure Chris got us there in 10 minutes. I was still in shock for the entire ride. The ride seemed to take forever, but no time at all. I don't remember what I was thinking in the car. I don't remember the ride at all. I don't even know if we talked. I remember getting in the car at home and getting out of the car at the ER entrance. That's it. 

I explained why I was there to the clerk, she immediately called the triage nurse. I heard her say, "Twin pregnancy, water broke at 17 weeks." I was starting to freak out again after she began to ask for things like my insurance card, license, date of birth… I immediately told her my husband could take care of all of this, he was parking the car, and I needed to be seen NOW. She was understanding and at about this time the triage nurse had made her way up to to get me. She took me into a little room and sat me down to start asking questions. 

As soon as I sat down, the adrenaline and shock of the situation left my body. I lost it. I cried. I was crying so much it was an extreme effort to answer any questions the nurse was asking me. Chris came into the triage area about this time and seeing him triggered even more emotions and tears. I was lost. I thought of how hard we'd worked to get to 17 weeks pregnant and knew it was all over. I was hopeless and devastated. 

They then moved me into an ER room where I changed into a gown and was immediately put on IV. After I was somewhat settled into the room, the nurse came in with the doppler to listen to the babies' heart rates. Up to this point all I knew was that my water broke and I figured the babies were either ready to come out or already gone. I didn't know. All I know is that it was the most beautiful sound in the world to hear both babies' heart rates in the 150's. We still didn't know what was ahead, but we did know we had two babies with strong heart beats. 

Ultrasound eventually came in to look at the babies. She couldn't say much, but we were able to see the screen. I watched baby B move and wiggle around as per usual and noticed baby A looked a little tight on space. We eventually found out that baby A's membrane ruptured prematurely. Medically speaking, it's called preterm premature rupture of membrane (PPROM) - which means the rupture happened before 37 weeks. In our case, it happened well before 37 weeks - extremely prematurely. 

After the nurses received orders from my OBGYN, I received a catheter (eek!), I was moved from the ER to the labor and delivery unit, and I was placed in a slight trendelenburg position. At the time, I didn't realize what was going on, but looking back I realize they put me in labor and delivery because it was most likely that I was going to go into labor within the first 24 hours and I would deliver 17 week old babies that wouldn't make it.

God was with me from the second I got out of my bed that morning at 6a.m. He continued to be with me and my little babies through that day and days to come. I did not go into labor. I did start to have very mild, barely noticeable contractions the following day, but they quickly subsided. I received three different antibiotics which successfully kept infections away. Infection was a main concern as it would most likely pose a great danger to both babies and myself. I'm still susceptible to infection with an open sac, but it was most likely to occur in the first seven days following the rupture. 

I've been in the hospital a little over three weeks now on bed rest. Both babies continue to have strong heart rates and are growing! My belly has doubled in size and at the latest ultrasound they were measuring over 20 weeks! Up to this point we have received countless miracles thanks to the power of prayer. In the past two weeks, all three of us have remained stable. Baby A is still without fluid, but is growing. Baby A does constantly have a full bladder and is making fluid, but because of the unhealed rupture, it leaks out. 

I pray daily and multiple times a day that God will place his healing hand on the ruptured sac. The concern with lack of fluid is decreased lung development as well as muscle tone. Although this has not happened yet, I do know God has been with both these little babies and me; we're just so happy to be at this point with growing babies. 

Baby B is in a separate sac that's currently full of fluid and not effected by this situation. 

Our current goal is to make it to 24 weeks, which will be the week of Christmas. At 24 weeks I will receive steroid injections that will help with Baby A's lung development. And 24 weeks is the point at which the babies are viable if they are born. 

I plan to document and share updates on this pregnancy via my blog. I hope you all follow along and I ask that if you have any time to please lift up my little babies in prayer. Specifically praying for baby A's need for fluid, resealed sac, and no infections for any of us!

This isn't the situation we pictured, but I know God had a plan set out for these two little babies before they were even thought of by Chris and me - and that gives us a great peace. 

Journey to Baby: First Cycle with RE // Part II

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Journey to Baby: First Cycle with RE // Part I

I took my HCG "trigger shot" on the night of CD12 (June 15, 2014) and our first IUI was scheduled for the morning of CD 14.

So that morning of our IUI we went in for part one of the visit - the husband's part. You know. So he did his thing. Now, we had the option of collecting the specimen at home as long as it gets tot he office within 30 minutes, but we lived 20-25 minutes away from the office and I just didn't want to take the chance. Of course it's a more comfortable way of doing things, but my comfort was in making sure all those swimmers stayed alive and swimming. I wanted them to go straight into the cup and then straight into the hands of the lady cleaning and preparing them for the injection. That's what made us most comfortable.

So the cleaning of the sperm - which is to concentrate only the rapid-motility sperms - took about 45 minutes. So we left and had breakfast as our little guys were being prepped for the long race!

Once we returned to the office, we were immediately called back to the "IUI room" - a small room with the typical exam table - stirrups included, the exam lamp, and a sink area. Very small and minimal. Much like any gynecological visit, I had the pleasure of removing the lower portion of my clothes and covering up with a paper blanket.

Shortly after undressing, the nurse practitioner came in for the procedure. She handed me the vial of our swimmers to double check information - that is was indeed my husband's and not someone else's. Time out - this is my biggest fear. BIGGEST! The idea that samples and specimens could get mixed up. For this reason, I scheduled all our appointments for 7a.m. insuring we were the first. I know it's very unlikely - especially since this office is so small, but it's a legit fear. Luckily, that day we were the only couple doing an IUI. Shew! The information checked out - it was my husband. So we moved forward. I held the little guys and kept them warm in my palm while the NP got set up.

The IUI procedure was a combination of getting a yearly physical and the HSG I had back in October 2013. It was very quick. Painless. Mildly uncomfortable at the worst (mostly because of the speculum). Once that was in place, a catheter was inserted into my uterus and on the other end of the catheter was a syringe. She took the swimmers from my warm grip, immediately placed them in a syringe, and just like that, our little swimmers were injected directly into my uterus. I felt a little bit of cramping, but honestly nothing compared to the HSG. And then it was over. I was instructed to continue lying down for 15-20 minutes and then I would have an ultrasound.

The ultrasound was just to double check that there was indeed some fluid on the ovaries - indicating ovulation was imminent and everything was done correctly. And it was. Bring on the two-week wait (TWW - a common acronym for women with infertility).

I had a week between my IUI and my next appointment. Which felt slightly odd as I had spent the past week or so either at the doctor's office or at least giving myself shots of some kind. So it kind of felt like a vacation. Exactly a week later I came in for blood work to test my progesterone. A certain level of progesterone indicates if ovulation occurred. That's it. It does not indicate pregnancy - just ovulation. The higher the number, the better quality of the egg and/or the more likely that there was multiple eggs released. I can't recall my exact progesterone level this cycle, but it was satisfactory - I want to say just above the recommended number. So I definitely ovulated. Yay!

So I was to then again come back in a week to do a HCG/beta blood work (which tests for the pregnancy hormone, HCG) to see if infact I was pregnant. I was told HCG needed to be 25 or greater to be considered pregnant. Since this was our first cycle and I was feeling good about it, I requested that the nurse leave the results on my voicemail. I knew the results would be in before either of us got off work and I thought it would be special to listen together. So whether it was positive or negative, we'd be there for each other. Well around 2p.m. I saw I had a new voicemail from the clinic. It about killed me to know that the results were there, but I had to wait. Chris got home a little earlier that evening and we immediately sat down on the couch and pressed play.

I already had a feeling that this cycle wasn't successful. After months and months of trying without success, you get very familiar with what it feels like to not be pregnant. And I didn't feel pregnant, but still had some hope. Maybe it feels exactly the same?

As soon as the nurse started her message, I knew. I could hear it in her voice. She left a very sweet message, but ultimately said my beta test was negative and it did not work out this cycle. She never said what my beta number was, but it was obviously less than 5 (5-25 is considered possibly pregnant and requires additional testing a couple days later).

We were quite for a few seconds. Chris put his arms around me and immediately became the comforter and cheerleader saying it was OK and that we'd try again next time and he seemed to move forward from this a lot faster than I did. I stayed on the cough for a while, just starring into space. I considered all the money, straight out of our pockets, that was spent (and now feels wasted) on visits, ultrasounds, and medications. We also received six bills this day from the lab company totaling over $1,000 - just from our first initial visit. Nothing like rubbing salt in the wound.

This negative cycle really hit me hard. I considered the idea that we may move forward and do two or three more IUIs, but what if they don't work? And what if we move on to IVF and that doesn't work? What if we waste another year or two years and thousands of dollars more and none of this works? What if I'm not physically able to become pregnant? What if none of this works and we waste all this money and time that could be used towards adoption? A thousand "what if's" just running through my mind. I was not myself. I was super negative. And I didn't know what to do next. I was scared to try again and fail.

I took the rest of the evening to be sad. I think that's important to let yourself grieve in these situations. Others not going through this may not understand, but I do. You need the time. It's a tough road to walk and it's not good to suppress feelings - especially when you hurt - because it does hurt. I've said it before - because infertility is such a quite subject, those of us dealing have limited outlets.

Fortunately I had one friend. One. She was going through the exact thing - and one friend was all I needed. Just someone that was there to listen with an understanding ear. Someone who could share similar experiences. Between her and my faith, I made it through my first negative cycle with the specialist. My mom also was scheduled to fly in the following day to visit for a couple weeks - it was wonderful to have her there immediately after getting the negative test to take my mind off of everything.

So between the negative test and my next cycle, it was time to decide what was next - taking a break or keep moving forward. I had no clue what I wanted to do.

Journey to Baby: First Cycle with RE // Part I

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Although our first cycle with the fertility clinic was quite a while ago (early June), sitting down to write about it was difficulty. Mostly because the cycle carried quite a bit of emotions - a roller coaster, if you will. We juggled emotions of joy, excitement, fear, doubt, and hopefulness. At times the days and weeks flew by and other times they crawled. Ultimately, it was disappointing.

I had intentions of keeping you all up to date with each cycle, but when the first cycle ended, I found it difficult to put into words how I felt. Spoiler alert: the first cycle was unsuccessful.

Despite our lack of success, I find it necessary to share with you the exact process and details of this cycle. Going into this whole process we didn't know much other than what I had read online - and a lot of times, when you do your own medical research online, everything tends to vary, contradict itself, or scare the poo out of you. So, if any of your are curious about what it may be like to go through a cycle with a fertility specialist or maybe you're just about to get started with one, hopefully this will provide you with the information, the understanding, or the peace of mind you may need.

My cycle began on June 5th. This was cycle day one (CD1).

On day three of my cycle (CD3) I went to the doctor for baseline ultrasound and blood work. The ultrasound looked great - I had 23 follicles that had the potential to grow. My estrogen and FSH were both at satisfactory levels and I was given the go ahead to start with my medication.

As I mentioned, I had done five round of Clomid in the past. All five rounds were extremely successful with egg growth and ovulation; however, the end result of all those cycles was still a negative pregnancy test. With the help of our RE, we decided to move to a more aggressive medication and complete an IUI (if you are unfamiliar with the process of an IUI, ask you doctor for information or read a little bit about it here). I specifically remember our RE giving the option of continuing with Clomid or moving on to a similar, but more aggressive medication: Follistim. Our RE referred to this medication as The Ace in the Hole for patients who have been unsuccessful and dealt with early miscarriages. I'd read about Follistim. I knew it was similar to Clomid in that it stimulates the ovaries to help with egg production, but instead of a pill, it's an injectable. And I knew it was definitely going to be our next goal. We were sitting in her office for a reason. Time to be aggressive.

So on the night of CD 3, I started Follistim injections. Yes, injections. I gave myself nightly shots for six nights in a row. I'll be honest, I was initially petrified. Questioning if I had the willpower to stick my belly with a needle. That first night, I loaded my medication cartridge, filled the pen with my prescribed daily does of medication - which was 75IU - and then just stared at the needle. Several minutes passed as I battled fear and hesitancy. Chris wanted to hang around and watch, but I had to ask him to leave. That's just how I am. I needed to be alone. Most times when I'm scared or enduring pain, I prefer to be alone. After he stepped out, I felt bad. I wanted him there, but I also wanted to do it alone just in case I cried. Or squealed. Once he left, I knew the time was now. I grabbed some belly fat and pushed in the needle… I immediately yelled to Chris, "That didn't hurt AT ALL!" And it didn't! I was amazed and relieved. If you fear needles, it's OK, you can do it! I preferred to give myself all the shots, but if you can't handle it, your husband or RN friend can definitely help you out. The good news is that, it doesn't matter who sticks you - because it doesn't hurt!

In order to not make this post too incredibly long, I'll do a separate post on Follistim - if any of you are interested.

So, I stuck my belly for six nights in a row. On the day after my sixth shot, which was CD 10, I had blood work drawn and a second ultrasound to take a look at how my ovaries were responding to the injections. And they were! I had a total of six eggs growing. Three were on the right and three more were on the left. Unfortunately, they weren't to a mature size after six days of the injections. I had three larger eggs at this time were all 1.3mm - an egg needs to be 1.8mm to be considered mature. My estrogen was also pretty low at this time (I believe in the 60s) which also indicated it wasn't quite time. So I was told to continue the injections for three more nights and then reschedule another visit to repeat blood work and ultrasound.

So I did three more nights of Follistim 75IU and went back to the office on CD 13. The ultrasound that day showed that one of the three larger 1.3mm eggs had grown. It was 1.75mm. The nurse stated that with an egg being 1.75mm, they rounded up - which made it a 1.8mm  - which meant it was mature enough to be released. She informed me that the reason they round up is because the egg continues to grown until it is released. So by the time this egg releases, it would be over 1.8mm. So pending my estrogen level, I was told to take my HCG trigger shot that night and schedule our IUI for two days later.

Leaving the office that day, I was a little bummed out. I was disappointed that out of six growing eggs, only one had grown to a mature size - and it was barely mature! This particular visit fell on a Sunday and we felt kind of rushed through our visit and I didn't really have time to gather my thoughts and voice them. So the next day, I called the nurses line and spoke with my doctor's nurse. She assured me that it was typical and wasn't anything of concern that yes, six were growing at one point, but only one took the lead. This is what happens in most normal cycles. So I took a deep breath and moved on.

I received a phone call a bit later that Sunday stating my estrogen had risen some, but still wasn't great. Despite that, I was still instructed to move forward with the HCG shot that night and IUI in two days.

The HCG (human chorionic gonadotropin) is the pregnancy hormone. A large does of this hormone helps mature eggs complete their growth and release into the fallopian tubes in hopes to be fertilized. I was given an injection of 10,000IU.

Now. The HCG shot wasn't a small needle. And wasn't given in the stomach. No. Flip it and reverse it. This was a long, loooong needle as the medication needed to reach the muscle tissue. And it was to be injected in my rear. I knew I couldn't do it. No way. Sticking a one inch needle in my stomach was one thing, but sticking a two and a half inch, thicker needed in my butt cheek just wasn't something I could do. And I wasn't quite keen on Chris doing it either. Lucky, lucky! for me, my next door neighbor is a nurse. And she was able and willing to give me the shot. Surprisingly enough, this shot didn't hurt either!

The shot was done! 36 hours later we were scheduled for our first IUI. I'll talk about that in the next post!

Journey to Baby // First Cycle with a RE - Part II 

Journey to Baby: Sweet Success

Y'all… we are having TWINS! 

I have a lot of posts I want to share (that admittedly are not typed yet…) for you all to get up to date from our first visit with the fertility doctor back in May up to this point! I'm so excited to share the last couple of months of this journey and I promise I will share soon. 

These little miracles have me constantly tired exhausted and any free time I've had outside of work I've been sleeping. Like hardcore three hour naps in the afternoon - in addition to the ten hours I'm getting at night. So blogging, internet, cleaning, cooking, unnecessarily leaving the house, and life in general have not been happening; however, I'm 12 weeks along and I'm pretty sure (fingers crossed) the exhaustion is slowly lifting (and let's pray the nausea lifts as well)! 

I want to thank all of you who have reached out, shown your support, and provided prayers since I first shared our journey! They work! And God is good! For those of you still struggling, I hope my upcoming posts on how this happened gives you hope. Please know I pray for you all! 

Can't wait to catch you all up and start sharing bumpdates!