On the Mend

I am less pregnant than I was on Monday.  That's good news! The results of my blood test on Monday showed a continued rise in my hCG level from the Friday before, but I was told that's normal even a few days after the initial methotrexate treatment.  What my doctor was hoping to see was a 15% drop in my hCG level between day four of treatment (Monday) and day seven of treatment (today) and my drop was 34%.  Never have I been so happy to be not (less) pregnant.  I'll need to have weekly blood draws until my hCG levels hit zero, but my follow-up exam indicates that I'm recovering from the ectopic pregnancy as well as my doctor was hoping. 

Today is the best I've felt in two weeks, especially compared with this last week.  My doctor warned me there would be a lot of cramping, but my gosh, I wasn't expecting flashbacks of my labor with Soren.  Remember those contractions that really started to hurt?  That's what it felt like.  I looked at my body and wanted to scream at myself, "There's not even a baby in there!"

As particularly painful and uncomfortable as that first wave of cramping was, I've never experienced being so comforted by my own child like I was by Soren.  Chris was out with Oliver and Soren had just woken up from his nap, so I pulled him out of his crib and laid in my bed with him.  I held him tightly and clasped his fists in mine as my tears fell onto the soft, wisps of curls forming on the back of his head.  I was sure he'd want to get up and play, but he contently lay there snuggled with mom and thankfully oblivious to my pain.  I was so thankful to have this sweet little boy to hug and hold.

Tylenol, the only pain-reliever I was allowed to take, was also a great comfort.  It was enough to take the edge off and allow me to be functional, but there were periods this past week where let's just say I was grumpy.   I can't wait to be back to my normal self. 

Ectopic Pregnancy Treatment

My hCG levels have continued to rise, so despite another inconclusive ultrasound, my OB was confident that I have an ectopic pregnancy and the best course of action was immediate treatment.  Surgery was not an option since she couldn't tell where the egg had even implanted.  Treating with an injection of methotrexate, which is essentially a cancer drug, is the best option, even though I'll need follow-up testing and additional doses if the first one doesn't work. 

I was hesitant to immediately pursue any sort of treatment though.  If the egg hadn't implanted where it was supposed to, how could it even survive?  It just didn't make sense to me. I felt like immediate treatment had to be unnecessary.  But that's the unfair part about an ectopic pregnancy I learned.  The egg usually continues to grow despite no chance of long-term survival and the fatal risk of eventual rupture.  Even though I wasn't in pain, "wait and see" was not the recommended approach.

So I could put my options in perspective, I asked my doctor what happened to women with ectopic pregnancies "back in the day."  Before ultrasounds, doctors had no way to detect an ectopic pregnancy early on, she explained, and they were usually diagnosed when a woman showed up in the emergency room with severe abdominal pain and then they were treated with emergency surgery.  Before the era of modern surgery - women often died.  Chris and I appreciated her bluntness. I opted for the injections of methotrexate.

Before I could start on the methotrexate, I needed another blood draw to test my liver function, so Chris and I went out for lunch while we waited for the tests to come back. It's rare Chris and I have a quiet meal together, just the two of us, and I appreciated even more having that break in between what was hours of waiting, prods and pokes and consultations with doctors and nurses.  We talked about how frustrating it is to come so close to what should have been a healthy, complication-free pregnancy and how sad Chris is about not having more biological children when he thinks about what great kids Oliver and Soren are.  I sometimes feel like I'm throwing in the towel too early, but my heart just isn't in it anymore. 

As much as I'm looking forward to moving on, I need to focus in the immediate future on getting better.  With a prescription of Zofran on hand in case I become nauseated, I'm taking it easy the next couple of days and am keeping my fingers crossed this round of treatment is successful. 

Technically Still Pregnant

Despite how upset I was to learn that I was miscarrying, once it happened, I wanted it to be over.  I've already missed spent as much time at my OB's office as I have at work and I'm ready to go back to my normal routine. Except that I'm still technically pregnant.  The physical symptoms I was experiencing indicated a miscarriage, but blood tests showed rising levels of hCG, a hormone produced during pregnancy.  My OB suspects I have an ectopic pregnancy, which means the fertilized egg implanted in my fallopian tube instead of my uterus, and thus can't survive.  I haven't decided which is worse, knowing the reason for the miscarriage or knowing that there was likely nothing wrong with what could have grown to become our baby other than that the cluster of cells missed landing in the right spot. 

An ectopic pregnancy is serious, but luckily hasn't reached the level of emergency yet and there's a chance my body will sort everything out on its own.  If not, after my next ultrasound and a blood draw to test my hCG level, my OB hopes to be able to treat me with methotrexate instead of surgery.  With either scenario, I'll have multiple OB visits over the next couple of weeks to make sure the treatment worked.  I didn't realize this process could drag on for so long. 

This experience is helping me feel more at peace with our decision to pursue adoption.  It can take longer to conceive after an ectopic pregnancy and I'm more likely to have another one, so I'm relieved not to add that to the long list of all the things I worry about.  Instead of feeling frustrated at the prospect of starting over, adoption gives me something to look forward to. 

Soul Searching

For two weeks I let myself be excited about expecting another baby.  How could I not?  Chris and I had wanted another baby and it was exhilarating when we decided we were going to go for number three.  When I found out I was pregnant, it's simply my nature to go into planner mode.  Chris and I talked about childcare, maternity leave and what to do about the kids' rooms.  I started a running list in my head of all the things we needed to tackle before Christmas.  Then dizziness, cramping and spotting ensued and by the time I rushed to the doctor in the middle of the work day, I knew in my gut the pregnancy was over.  I was crushed. 

When I talked with my OB, she asked me what our plans are for trying again, and I told her I didn't think I wanted to. Chris and I had talked about adoption before, although we'd never seriously looked into it.  She looked at me and very compassionately said, "I think adoption is a wonderful option. You were not happy when you were pregnant." I wish Chris had been there to hear her say that. I had never kept quiet my dislike of pregnancy, but it was a sentiment even I never took seriously.  My doctor hadn't seen me in a year and a half, yet my unhappiness was one of the things she remembered about me.

If anything good can come from losing a pregnancy I really did want so badly, it is that it forced Chris and me to do some soul-searching.  We want more children, that we can agree on. But where should we go from here? We could wait a month or two and try again. And I would most likely have a successful pregnancy, or I could possibly not. Or we could talk seriously about adoption.
I had to be honest with Chris that not only did I prefer not to be pregnant again, but that I thought it would be too hard on our family if I did.           

I'm ready for a new direction, but, honestly, the unknown scares me.  I don't trust that Chris is yet emotionally committed to adoption as he assures me he is.  And we both worry about the money, waiting and uncertainty involved with the process.  This is a moment in my life where I wished I had a crystal ball and could catch a glimpse of the future and see if adoption works out for us.  I've acknolwedged to myself that I really have no desire to ever be pregnant again, yet I don't know if I would ever be at peace stopping at two. 

I think about the wonderful family I have and how lucky I am that I have two happy, healthy and lovable kids.  Chris and I can continue to have a great life even if we stop now.  We developed a comfortable routine based on a two-kid family, each kid has his own bedroom in our cozy little house, we have daycare figured out and we live a comfortable lifestyle.  All outward signs tell us, "Stop, you have it good!"  Yet even if I don't want any more biological children, my heart knows I'm not finished having children.  So the soul-searching continues. 

Our Loss

Chris and I had been looking forward to finally announcing the news that I'm pregnant, but sadly, I suffered a miscarriage. Although it occurred rather early in my pregnancy, it still has been heart-breaking. In the relatively short amount of time we had since learning I was pregnant, we had begun to imagine a future with a second child, full of limitless hopes and dreams. I know with time we will move on, but in the mean time, I (particularly) struggle with disappointment over what could have been and the fear of this happening again. I'm emotionally exhausted and tired, but am otherwise physically fine.

We're not looking for explanations about why I miscarried or theories on a greater meaning, but simply support as we move on. Although it's sad to lose a pregnancy, I don't want this to be something that should stay a secret or be talked about in a hush-hush manner. The experience is extremely personal, yet I don't feel secrecy helps my healing process or others who've had a miscarriage.