My uterus is beautiful

Those were the words I heard today. "Beautiful, looks amazing" the doctor said as he and the resident/fellow were performing my saline sonogram today. He was referring to that fact that my uterus is all healed up properly and everything has been removed from my septum resection surgery back in June. We are now FINALLY given the "ok" to try to get pregnant after 9 long months of getting diagnostic procedures, an in office surgery, a canceled surgery, a complete septum resection under general anesthesia, multiple blood draws, and a handful of hormone prescriptions with lovely side effects.

There was a small piece of news, though, that wasn't all that positive. During this sonogram, they were also able to visualize my ovaries, both of which are presenting with PCOS (Polycystic Ovarian Syndrome). This is a diagnosis that I had been given many years back and figured that getting pregnant wouldn't be too easy. When I got pregnant this past fall after just one cycle of trying, I was pleasantly surprised to say the least. The doctor explained that I could have had a "spontaneous ovulation" that cycle but it doesn't mean that my cycles will necessarily go back to being normal. If we try for a few months with no success, then Clomid will be prescribed to help me ovulate. We'll cross that bridge in and when it comes.

I'm just so excited that this uterine septum is a thing of the past!!!! Thank you to all who sent well wishes, positive vibes, and prayers along the way over the past few months as this was being taken care of. Now the positive vibes and well wishes can go toward being able to get pregnant and carry a healthy baby to term!

Loss is a lonely place

Almost 10 months have gone by and not a single day passes that I do not think about my miscarriage. Time heals, as they say, but the memory will never be forgotten. As life events have it, they make ever lasting marks on who you are and who you become.

This past weekend I had the pleasure of celebrating with two of my friends as they had their baby showers. When I say "celebrated," I mean that in the most honest sense, not inserting sarcasm. I was anxious about spending a weekend going to baby showers, only to be surrounded by 6 pregnant friends and lots of baby talk. Leading up to the weekend I was hesitant about what state of mind I would end up in afterwards. Much to my surprise, I enjoyed each of the showers and can honestly say that I was happy to be there. Yes, there were moments where my eyes filled with tears, but I changed my attitude and thought process to recognize that I was there to celebrate the joy that is arriving for my friends, not the loss that I had.

Once I was able to step back from these showers, I realized how lonely loss can really be. No one really understands unless they have been through it. The "could've, should've, would've" thoughts go through your mind, as people innocently ask you when you want to have children or if you are trying (something that obviously comes up at a baby shower). They mean no harm when they ask, but I often feel compelled to let them know that we have tried, but it ended in a loss. I say it not to make them uncomfortable, but rather to make myself less uncomfortable and lonely in my loss.

There is a part of me that feels silly still talking about my loss almost 10 months since it happened. I am "over it" in the sense of the intense sadness or heartache, but there will always be a little place in my heart for what could've been. In all honesty I think I talk about the loss and still keep it at the forefront of my mind because of the fear I have that getting pregnant again will not be that easy. My hormone levels are not quite cooperating, I haven't been ovulating, and I've needed to take progesterone to get my period. None of that makes me too confident that getting pregnant again will be as simple as it was before. Maybe the pregnancy I had was the only one I'll ever have? I hope and pray that isn't the case, but in a small chance that it is, well then that is why it'll always have a little place in my heart.

How is it August?

Wow, how did August arrive so quickly? I vividly remember back to the day in December 2012 when I realized that we would need to wait until the Fall of 2013 to start trying again to get pregnant. It felt like an eternity. And here we are today, in August, just days away from the official "Fall of 2013" starting.

I've had enough blood draws, ultrasounds, medications, in office procedures, surgeries, and doctors appointments to really help me pass that time. All of that has been coupled with finishing up my final didactic semester of graduate school, handfuls of weddings, bachelorette parties, bridal showers, birth announcements, and pregnancy announcements. I can't say that all of this has passed without the shedding of a few (or many) tears, but I really must give myself a little pat on the back for making it through without any major breakdown.

So you'd think that now that Fall is just around the corner I'd be super excited to start trying again. Truth is, along with that excitement comes a feeling of being anxious and scared. I chart, and temp, and use OPKs, and look at the due date prediction calculator; all to try to grasp some sense of control over the situation. As I learned back on November 28th, 2012, much of this is out of my control. My body has been through a lot in the past year and I can't expect it to just cooperate on command. In the end, if a little medical intervention is needed, there is no shame in that.

I guess there is no real point to this post other than to give a quick update on where things stand today. I'm eager and anxious to have exciting news to reveal, G-d willing, in a few short months!

A bag of mixed emotions

July 3rd is just around the corner and instead of packing a bag for the hospital, I'll be packing a bag to head down to the shore. This isn't how things were supposed to be, but it is just the way things ARE.

I have mixed emotions about next week and what to expect. Will I be sad on Wednesday because I should have been delivering my 1st child? Will I wake up as if it just any normal day? Will Eric feel a sense of loss that day? I really do not know what to expect about how I will feel and I am trying hard to not put any expectations on that day.

Milestones dates, I have realized, can be tough. Just last week, on June 23rd, I was saddened by the thought that I should have been celebrating my best friend's 30th birthday that day. Her life was tragically cut short at the age of 27 and since then there have been many milestones during which I have shed some tears. The tears come from a place of missing her, but also from the "should haves" and would haves."

I don't know what next week will bring, but I am going into it with no expectations and no pressures.

Struggles

I need to preface this post by saying that I know I am not facing infertility, nor do I know the agony of what it is like to struggle for years and years to have a baby, looking month after month at negative pregnancy tests. What I do know, though, is what it is like to struggle with the aftermath of a miscarriage, going through a D&C, having in office procedures, outpatient surgery, and also being "benched" for a few extra months due time timing conflicts, all while getting news on what feels like a daily basis about yet another friend being pregnant. No matter what the struggle is to get pregnant or stay pregnant, it is still a struggle to the person or couple going through it.

I came across this article today on a forum I am a part of and felt compelled to share it. I think it takes a very honest look at the emotions that are coupled with the struggles to become pregnant.

ten words that describe infertility

Hold your thoughts, prayers, and good vibes

Thank you all for your positive thoughts, good vibes, juju, prayers, and well wishes for what should have been my surgery on May 14th, but unfortunately you'll have to save it all for June 4th.

Last Monday I started to feel run down, had the chills, scratchy throat, basically the normal routine for when I come down with a cold or strep throat. I made it to the hospital for my surgery Tuesday morning, still not feeling great. By the time I made it to pre-op and spoke with the Anesthesiologist, my throat was pretty swollen and my fever had gone up. The Anesthesiologist didn't feel comfortable putting me under since this was considered an "elective" surgery and really could be done at a later date. She felt that my airway was already compromised with a swollen throat and if she had to intubate me it would only make matters worse. Needless to say, I wasn't willing to risk my ability to breath!

I'm a little bummed that I couldn't just put the surgery in my past and start moving forward, but by no means would I ever want to compromise my health and safety. So tune in June 4th for attempt #2 at surgery.

Start of a new chapter

Tomorrow starts a new chapter in this process and one step closer to being able to have a baby.

I can't believe that 5 months ago I sat thinking and feeling like my surgery day was so far away and now that day is tomorrow. The surgery marks the beginning of the process of being able to TTC (trying to conceive) again since my uterine septum should will be removed. G-d willing, Dr. E (my new RE- long story!), will be able to remove all of the septum tomorrow and I should not need any further surgery.

The procedure is scheduled for 10am, so I will be arriving by 8:30. If all goes as planned, I should be out of surgery by 11, in recovery until noon or 1 and on my way home by 2pm! Considering I am supposed to finish my dinner tonight by 8pm and not eat or drink after midnight, I'm thinking I'll be one  hungry girl by the time I get home tomorrow. Possibly pizza and french fries will be my treat?

So when can we start trying again you ask? Dr. E prefers couples to wait 2-3 cycles after surgery before trying again so that the line of the uterus can grow back nice and strong and heal properly. We will take his advice for sure- I mean, he did go to school for a million years to learn all that he knows right? So for once, I will stop advising with Dr. Google and will just listen to my own doctor on what to do.

For all those who are reading this, I'd appreciate any good vibes you can send my way (and to my surgeon too!) tomorrow!

Decisions, Decisions

Frustration.

Frustration sums up where I feel I am at right now. If you asked me 2 years ago when we thought we would start a family, I would have said that we would start trying in the Spring of 2013. Fast forward to the 1st day of graduate school in 2011 and suddenly we are told that our program no longer will be over in December 2013, but instead it will go until May 2014. Ok, deep breath, not the biggest deal in the world. Baby plans could get pushed back a few months if necessary.....or maybe moved up a few months. 

Fast forward to summer of 2012, baby plans are back in conversation. I come off the pill in August, we start trying in October, and October 25th we find our we are pregnant! WE ARE EXCITED!!! November 26th rolls around and the excitement plunges as we learn there is no heartbeat. D&C is completed on November 28th. Now where do we go?

A conversation with my Grad School Program Director reveals the frustrating reality that baby plans (post miscarriage) will have to be put on hold again until August 2013 if I plan on graduating with the rest of my class. Ok, I can handle this, just a short 9 month set back (filled with dozens of births and pregnancy announcements of friends). 

So that leads me to where I am today. I've been approached by my Grad School Fieldwork Coordinator to ask about my "baby plans." To sum it up, if we plan on TTC again this fall, I will have to reconsider my fieldwork placement. I was fortunate to be placed at a top notch Spinal Cord & Traumatic Brain Injury Rehab facility here in Philadelphia. Some people would kill to have a fieldwork experience there. The reality though is, if I end up being pregnant this fall, this facility will not be an ideal place for me to be. It is very intense, fast paced, and physically demanding. Not an ideal situation for what could potentially (hopefully) be my 1st trimester. 

My fieldwork coordinator has presented me with 3 options:

1) Switch fieldwork locations now (and give up an opportunity to be at one of the most highly regarded facilities in the area) in anticipation that I may be pregnant this fall

2) Don't switch now, but take the chance that if I do end up getting pregnant, they may have to move me to a different facility in the middle of my rotation (which puts me at risk for not graduating on time)

3) Push back baby plans another 3 months and complete my rotation at this facility. 

I know in the grand scheme of things, waiting another 3 months is not all that big of a deal. However, it has been an emotional roller coaster and I want to make sure that I make my decision based on the right reasons.

Three Down, Five To Go

Today marks 3 months since the day we found out our little peanut did not have a heartbeat. 3 months since the miscarriage and 5 months to go until we can start trying again.

I would say that time has gone by quickly, but then again, isn't that what we always say in hindsight? In the past 3 months I've busied myself with work and school, have signed up for a 1/2 marathon in April and a 10 mile race in May, and have spent some time starting this blog. In those same 3 months I have also experienced the announcements of new pregnancies for 3 of my friends, the birth of a baby girl for another friend, and have learned of many other friends who are "trying" now and will most likely end up being pregnant before Eric and I can even start trying again. As much as what happened to me (us) sucks and my heart sinks a little when I hear this type of news, I am no less happy for my friends in their starting of a family.

Five months seems like an eternity, but I know you'll hear me saying "wow, time flew by" when the end of summer arrives. In order to break up what seems to be a long five months ahead, I need to have things to look forward to and mark on the calendar. The first of these things occur on May 14th. This may sound weird, but May 14th is my septum resection surgery, and I am strangely excited for it. Maybe that is because it marks a milestone in the process of being able to "try" again? I can bet though that this "excitement" will turn into anxiety as that day approaches. Other, and probably more exciting, things on the calendar in the next 5 months include; end of Spring Semester, end of Summer Semester (which concludes the classroom portion of my Masters degree!), 3 bridal showers, 3 bachelorette parties, 3 weddings, various 30th birthday celebrations for friends and hopefully a vacation squeezed in there at some point.

Now that I have put down on paper cyberspace all that I have going on in the next 5 months, there is no way that time will slowly creep by. I may blink and it'll be end of summer before I know it!

New Normal

A girl on my online loss group asked today "How long is this going to suck for?" I admire her openness to asking such a simple, yet possibly so deep, question.

The question prompted me to do some thinking of my own. There are few times in life where I have been able to say that something truly, deeply, just downright sucks. The death of my best friend 2 years ago is one time (though I would describe that in deeper words such as pure devastation) and my miscarriage (and aftermath) is another time.

Some days it sucks. Other days it is sad. And then there are the days (which are many) where I am feeling really good.

Overall I would just describe this process as "my new normal." No one can really prepare you for the emotional toll that a miscarriage takes on you. A few weeks post miscarriage I thought I felt like I was "in a good place" though I'm realizing that statement is only relative to the place you were in the previous day. Each week that passes does bring me to a better place, though I know that there may be some bumps along the road of healing. I am told that the memory never goes away, nor would I want it to, and that there will always be a small place in my heart for "what could have been." I am taking this experience as an opportunity to walk away with a few lessons that I can take with me in my journey ahead.

A few of the lessons:

• Don't try to outsmart Mother Nature. You can plan all you want, but Mother Nature gets the final call.
• It is ok to be sad for yourself at the same time as being happy for someone else.
• Friends can come from all over and walk in to your life for all reasons (thanks TB ladies!).
• All of our paths in life to what we want will differ. Some will be short and smooth and others may be long and bumpy.
• People do strange things in the face of loss and grief. I cannot expect someone to understand what I have gone through if they have not walked in my shoes.
• Men sometimes just won't be able to understand! It is not that they don't want to, but they are just wired differently.
• Sushi, wine, and some cookie dough are often the best type of medicine!

Ouch

So I never really had a chance to fill you all in on the wonderful, I mean pretty awful, process of the getting the hysteroscopy done.

On Thursday Jan. 10th, I went to my RE to have the hysteroscopy done to just "look around," or so I thought. When Dr. G came in to start the procedure, I asked when I would need to schedule the follow up surgery to remove the septum if that is in fact when he found from the scope. Much to my surprise he said "well, if I see it in there today I'm just going to remove it." *Enter Panic**

I wasn't quite expecting that response, nor was I really ready for this "small surgery." In hindsight, I guess it wasn't all that bad though it was far from comfortable. Since I was awake for the procedure, I was able to watch everything on a television screen. I must say that it was pretty neat to be able to see inside my uterus! Dr. G confirmed that I did have a septum and he began to try cutting it out. Ouch!!! It wasn't like "OMG!" pain, but just some extremely heavy cramping and bleeding that would last for a few days.

As the procedure came to an end, Dr. G gave the news that he wasn't able to fully cut the septum out and will need to take me to the OR (under anesthesia) to remove the rest of the septum. The good news is that once I have the surgery, we can TTC (try to conceive) again 1-2 months later.

I keep reminding myself that I am in the best of hands with this doctor and we WILL have a successful pregnancy down the road. In the meantime, I am trying to keep myself busy by focusing on work, school, training for a few races, and maybe planning a vacation or two. I've joined a wonderful group of other "loss mommas"on an online forum and have had such wonderful support (and often some laughs!) from them. When I feel crazy in my thoughts, I know I can turn to these ladies who will just get it because they have walked down this same path.

I'd be lying if I didn't admit that my heart aches each time that I find out someone else is pregnant. It is a feeling that unless you have been through a miscarriage, you cannot understand. There are times when even I don't even understand why I feel this way. It is not that I am not genuinely happy for my friends, but that it is a reminder of what I did have for a few fleeting weeks but don't have anymore.  It is almost as if I was part of a club that I was then kicked out of. I will not let the heartache stop me from being happy for my friends or wanting to hear about their milestones because they deserve the blissful, naive happiness that a first time momma feels.

It is 2 months later and the "should have beens" are still in full effect. I should have been 18 weeks today, I should have been finding out the sex of my baby now, and I should have been bringing home a beautiful baby on July 3rd. But I'm not and I just have to believe that there is a greater plan out there for us.

Another Statistic

So by now you may have realized that I am very numbers and list oriented. I like organization and explanations, to a fault. Statistics, in my weird mind, somehow help me understand and cope.

3-5%. This is the incidence in uterine malformations in the general (obviously female) population. Yet another low statistic that I am now a part of.

I don't write this for pity. I write this because, again, it somehow helps me cope and put things in perspective. I know that there are far more serious and morbid conditions that women have in regards to the reproductive system. 

Yesterday I met with a Reproductive Endocrinologist (RE), after being referred by my regular OBGYN. During my D&E surgery, the OBGYN noted a "suspicion of a heart shaped uterus or a possible small midline septum in the uterus, which should be followed up on." Either of these conditions (which are uterine malformations) could be an explanation for my miscarriage. If an embryo implants on the septum (which is not supposed to be there in correct anatomy) instead of the walls of the uterus, it is not able to receive enough blood flow and will stop developing early in pregnancy. After doing a special ultrasound, the RE believes that this (a septum) is what most likely happened in my case. We are hoping for a septum rather than the heart shaped (bicornuate) uterus, because there is at least options for how to handle a septum whereas a heart shaped uterus cannot be fixed, only monitored.

I am scheduled to go back in next Thursday for a procedure called a hysteroscopy (What is a hysteroscopy? ) so that the RE can confirm that I have a septum. Assuming this is confirmed, he suggests following up with a surgery to remove it so that my chance of recurrent pregnancy loss is decreased. 

If there is any silver lining in all of this, it is that I was able to find out about this septum early on in the process of starting a family. If I had a natural miscarriage instead of a missed miscarriage, I would have never had a D&E and the doctor would have never known about the Septate Uterus. Without knowing it was there, I could have gone on to get pregnant again and have yet another miscarriage. Statistics show that over 50% of women with a Septate Uterus have recurring miscarriages.

There is no way to prevent another miscarriage happening from other natural causes, but I will say I am a bit relieved that we may be on the right path to getting some answers.

2 Sided Healing Process

In my original post, I discussed my miscarriage from a medical and physical standpoint. I was fortunate after my D&E to have very little pain and was able to get back to normal activities within a few days. I had looked forward to being able to get back to running, as that proved to be a great outlet for my healing process.

The emotional side of the healing process is a totally different ballgame. Pregnancy hormones remain in your body for a few weeks after the mm/c and D&E, so needless to say I was, and still am, on a complete roller coaster. Ever hear how women can seem "crazy" while they are pregnant? Well, I pretty much fit that stereotype in the weeks after my mm/c. The pregnancy hormones were dropping quickly, coupled with just the general sadness and aftermath of my loss. Finding out you are miscarrying is like being on top of the world, looking forward to this new future ahead, only to have it taken from you in a matter of minutes.

Eric and I had been so excited for our new arrival expected on July 3, 2013. While we only had 9 short weeks to enjoy the idea of becoming parents soon, we had started to really envision our future. We started thinking of what projects needed to be done in our home in preparation for a nursery, we started researching day care options, started thinking of names and we even planned a "baby-moon" to Miami (which we actually just went on this week)! So if you can imagine all of that initial excitement that was going on came to a quick stop on November 26th, you can now see how a miscarriage can take such an emotional toll on a person.

Once we were through the process of the D&E, we shared the news with our close friends and family. The support we received was tremendous at first. During that first week after our loss, we were comforted by kind words and flowers from those that we had told.

In the coming days and weeks, we continued to share the news of our loss with others that we consider to be friends. Even though we shared the news and had support, it still felt like a lonely process. I was saddened and frustrated by the initial concern that some people showed, but lack of concern (or at least that is how it appeared to me) moving forward. It's as if people thought that loss is a one day thing; you lose the baby one day, but then you are back to your normal life the next. Now of course the practical side of me knows that people meant no harm by never following up to see how I (or Eric) was doing, but it was a lonely feeling. I understand that if a person has never experienced a miscarriage, they do not understand that depth of the emotional toll it can take on you. It is a true loss.

It is now 5 weeks since my mm/c and D&E and I feel that I make a step closer to a better place with each day that passes. Not a day goes by that I don't think about how I "should have" been in my 2nd trimester now, or how I should be looking at my belly that is growing each day. I miss being pregnant, though I am hopeful that our time will come again.