My Story - The Fourth One (Part 1)

I have been absent from my blog for a while. I needed to take a break. I needed to take some time to heal before sharing my fourth and hopefully final miscarriage story. I think I am finally to the point where I am ready to share it. This blog is named for our baby boy that we lost in July. The following is his story and I dedicate the next two posts to him with all of my love. 

Two months after all of the follow-up appointments from the third miscarriage, I decided I was emotionally ready for another pregnancy. I went back on Clomid the beginning of May. My experience on Clomid this time around was much harder, with some intense ovarian pain.

We went up to my parents' house for the Memorial Day Weekend. At that time, I was three weeks into my cycle and had started the progesterone. I noticed, on the trip up, that I was craving salt and french fries - not usual for me. I felt quite tired over the weekend but thought it could be due to the progesterone, the drive up, work etc. Throughout the weekend the ovarian pain continued and I decided that if it didn’t let up by the time I got home I would call Dr. J’s office and have her check for an ovarian cyst. 

We had a great weekend with my parents. Before we left my mom and I were sitting and talking. At one point she touched my hand and recognized it was very warm. She turned to me and said, “I think you are pregnant. My hands always got hot when I was pregnant.” I hoped she was right, but was afraid to hope too much because I didn’t want to be disappointed. That night on the drive home my husband and I stopped and had dinner. I felt sick afterwards, like pregnancy type sick. I started to wonder if my mom was right. As I was still one week away from being able to test, I had to wait it out. All the while the symptoms were intensifying dramatically, especially the nausea, which I knew was (ironically) a good sign.

As the week went by, the ovarian pain eased off a bit. I tried to not get my hopes up too much about the possibility of being pregnant because I didn't want to be disappointed. Deep down I was excited but I was also anxious and scared. Scared to be pregnant for fear I would miscarry again and scared that I was wrong and wasn't really pregnant. I wanted to be pregnant, but the miscarriages had caused conflicting emotions. Finally, the following Monday June 3rd, I faced my fears and decided to pick up a HPT. I still technically had one day before I was supposed to test, based on when I started the progesterone, but I was getting anxious and knew that I needed to know. My husband hadn't come home from work yet and I figured if it was negative I could discreetly throw the test out and not worry about it. I took the test and watched as it turned positive. I immediately called my husband, who was on his way home, and told him the news. He was excited. My next call was to my Mom. I told her that her suspicions were correct - I was pregnant.
  
The following day I notified Dr. J’s office about the pregnancy and they put the orders in for my HCG blood draws. I went to the lab the following day, Wednesday, on my way to work.

With each of the previous HCG tests, Dr. J emailed me with the results and only called if something was wrong. This time, for reasons I’m still not sure of, her office decided to call to tell me everything was fine. I was pleased to know the results so quickly, but the first time they called me it scared me to death. One of the medical assistant’s called while I was at work. I had my cell on mute and didn’t see that I had missed a call until I had finished for the day. When I noticed I had missed a call from Dr. J's office, I assumed something was really wrong. I was so nervous and scared, I could barely enter in the password to my voicemail. When I finally got to the message, I heard the cheerful voice of the MA telling me that my counts were really good – a 347! That was over 100 points higher than my first HCG count in my last pregnancy. I knew this was a good sign and I was thrilled and incredibly relieved and grateful!

Two days later, after my next HCG test, Dr. J’s MA called me with the results of my second count. This time I was more prepared and wasn’t quite so terrified when I saw that I had a message from her office. My second HCG count was even better – 864. The count had more than doubled, and was higher than any measured count from my prior pregnancy. Again I felt very reassured, relieved and grateful!

With all of the increases in HCG levels and my natural progesterone plus the supplemental progesterone, I started to feel even more pregnancy symptoms. I had the cravings, aversions to food, fatigue with alternating insomnia, moodiness, sensitivity to smells and nausea – boy did I have nausea this time around. Zofran, crackers, Preggy Pop Drops and prayer got me through it but it was really rough some days.

About ten days after I learned I was pregnant, we flew to Arizona for a family wedding. I had been warned by my sister to take my Zofran before we left because pregnancy does strange things to your stomach when you fly. I was glad I listened. The way down was manageable except I kept smelling very strong body odor that was grossing me out -  thank you extra sensitive pregnancy nose. I know it wouldn’t have turned out so well if I hadn’t had the Zofran in my system. While in Arizona I pretty much lived on Zofran. It made the intense nausea manageable and made me feel somewhat human. Unbeknownst to me at the time, I hadn’t been drinking enough water and was starting to get dehydrated. I had no idea how easily you can dehydrate while you are pregnant in the summer. Each of my prior pregnancies had been in the winter so dehydration wasn't so much of an issue. On Saturday night, just before the wedding reception I started to spot. I was terrified and pretty much a nervous wreck inside the rest of the weekend. My husband and I prayed together, but I was still scared stiff. At that time I was almost six weeks along and I couldn’t bear the thought of losing another baby, especially away from home.

Thankfully the spotting stopped by the next day, the day we flew home. On the way home we had a plane that was having major problems with the air conditioning.  As in, the air conditioning was kaput during the first half of the flight. There's nothing like being pregnant and trapped in a crowded aluminum cylinder at 30,000 feet with the hot sun beating down and no air conditioning. The flight crew apologized to us for having a plane that was probably a toasty 85-90 degrees inside for the first hour. To a pregnant lady like me it might as well have been a 120 degrees. I got sicker and sicker and more dehydrated by the moment. I have never been prone to air sickness, but it was all I could do to not throw up everywhere. I didn't want to gross myself and all the other passengers out with the smell of vomit on a hot plane. I was also afraid that once I started throwing up I might not stop until we landed. Instead, I fanned myself madly with the emergency landing instructions, prayed and drank all the juice and ice water the flight attendant would give me. I have never been so glad to land in my whole life. We exited the plane as soon as humanly possible and got into the nice air conditioned airport.

The next day I felt horrible. I had an awful headache and was still feeling the effects of dehydration despite drinking tons of fluid. I decided to take the day off work and just rest. That afternoon, I began to spot again - quite a bit. I called Dr. J's office and they scheduled an appointment for me the next morning. I was terrified and spent the whole night, hardly sleeping, certain that I was going to miscarry.

The next morning my husband and I went to Dr. J's office. I was so nervous and upset that I felt even more nauseous than usual. Dr. J came in with a clinical fellow she was training (Dr. D). Dr. J spent some time before the ultrasound preparing us to not to be disappointed if we couldn't see a heartbeat. Dr. D performed the ultrasound. As she zoomed in on the baby, Dr. J just about jumped with excitement and pronounced, "we have a heartbeat!" I was shocked and started to cry. I had been so convinced that I was miscarrying that I never imagined we would see a heartbeat. What was even better was that the heartbeat was normal for six weeks gestation and the baby was measuring right on schedule. We were thrilled and felt incredibly blessed! Dr. J instructed us to schedule a follow up appointment for a second ultrasound in two weeks.  

I waited out the next two weeks. I continued to feel really sick and nauseous. I was grateful for the sickness because I knew it was a good sign. With the positive ultrasound results I felt reassured about the pregnancy. The spotting had stopped since my last appointment and I was starting to feel optimistic. The first week went by smoothly. The second week was a little rocky as I started to feel anxious about the pregnancy again. I have since read that anxiety is very common in pregnancy after miscarriage. Hopefully I will remember that the next time around.

Our second ultrasound occurred on July 2. I headed to Dr. J's office, alone this time as my husband had to work. I felt more confident than last time because I hadn't had any spotting for a couple of weeks. Just prior to going in to see Dr. J I stopped by the restroom. Much to my shock, I had started spotting on the way to her office. Needless to say I was really relieved that I would have another ultrasound shortly. Unfortunately for me, Dr. J was running behind and I had to wait. The whole time I felt the fear and anxiety building. Dr. J finally came in. I told her about the recent onset of spotting. She performed the ultrasound and noted that the baby and gestational sac looked good. She didn't see any blood coming from the sac. She suspected the spotting was tied to dehydration, caused from a very hot summer. As Dr. J continued with the ultrasound, she could see a good strong heartbeat. My fear and anxiety melted away. Dr. J turned on the volume so I could hear the heartbeat. It was the most beautiful swooshing sound I have ever heard! I had dreamt about that day and it had finally come. The baby was still measuring right on track - exactly eight weeks. I was so happy and grateful. Dr. J printed out the ultrasound pictures for me.

With two ultrasounds showing normal gestational development and strong heartbeats, Dr. J gave me an excellent prognosis (chance of success was 93 - 95%). She then released me to the care of my regular OB. I had selected a doctor at University Hospital (Dr. S) that I had heard really good things about. I was very excited to see the regular OB because it meant that the pregnancy was stable and progressing. I scheduled my first appointment with the OB for just over two weeks later - July 19th. At that time I would be almost 11 weeks. I was so happy, it was surreal. This was really happening and I was further along than I had ever been and had a strong pregnancy too. Life was good... it was really good!

My Story - The Fourth One (Part 2)

During my final visit with Dr. J, she told me nausea usually improves sometime in the ninth or tenth week of pregnancy. She was right and I was relieved to start feeling better. The pregnancy seemed to be progressing smoothly and I was so excited.

My appointment with Dr. S (my regular OB) occurred when I was 10 weeks 5 days. I was thrilled to be in the double digits and felt like we had reached a major milestone! My appointment was first thing Friday morning and I made it right on time. My husband was running a bit late but was on his way. The nurse called my name and escorted me back to an exam room. She did the preliminary check in with my vitals etc. The nurse then handed me the prenatal packet. This was real and I was excited. Dr. S and his nurse practitioner came in and introduced themselves. Dr. S is the head of general OB at University Hospital. I had heard wonderful things about Dr. S and I was impressed with him right away.

Dr. S decided to do a quick ultrasound in his office. Since I had experienced so many previous miscarriages he wanted to give me some reassurance by seeing the heartbeat again. One of the things that really impressed me about Dr. S is that he connected with me on a human level. He was compassionate. He understood that because of my miscarriage history I needed a little more reassurance than someone who has never experienced pregnancy loss. The clinic where Dr. S saw me had an old ultrasound machine. (This clinic had a new machine on order and had borrowed an old dinosaur from another clinic while they waited for the new one to arrive.) As Dr. S performed the ultrasound he thought he could see the heartbeat. However, because the baby was still quite small and the old dinosaur machine couldn't do an internal ultrasound, he suggested that I head over the hospital to have an ultrasound in the maternal fetal medicine department just to confirm that everything was OK. Dr. S was confident that using the high quality ultrasound at the hospital we would see the heartbeat very quickly. Because everything had been going so well and Dr. S and my husband and I were all convinced everything would be fine, my husband left for work and I headed over to the hospital.

I checked in at the maternal fetal medicine department and waited to be called back. As I sat in the waiting room, I watched a couple come out and announce to their family the results of their gender ultrasound. I was excited to be there in a couple of months myself.

The technician came in and called me back to a room. She had me lie down on the exam table and prepared to do the ultrasound. I watched the large television screen on the wall that was connected to the ultrasound machine. As the technician scrolled over my belly I saw a beautiful side profile of our baby. I was amazed how much the baby had grown and how incredibly clear the picture was. I was savoring the moment. Nothing could have prepared me for what I was about to hear.

As the technician focused on the baby's chest, I couldn't see the rhythmic flickering of the heartbeat. I thought maybe I was missing something. The technician indicated she was having a hard time finding a heartbeat on this little one. She would need to do an internal ultrasound. The technician left me alone for a couple of minutes to get ready for the internal ultrasound.

The technician came back in and began the internal ultrasound. She focused in again on the baby's chest. Still no cardiac motion. She turned on the microphone and listed for the heartbeat. Nothing. The technician turned to me and said, "I'm really sorry." I didn't know what to say in response. I was in complete shock.

The technician left the room and the attending maternal fetal medicine doctor called Dr. S. After informing Dr. S of the results, they patched him in to talk to me.

"Does this mean my baby is dead?" I asked Dr. S in a state of shock, horror and disbelief. Dr. S replied, "Yes Caroline, the baby is dead. I am so sorry." I had been watching the ultrasound and knew there was a problem when I didn't see the strong, rhythmic flicker that had become so familiar with our previous ultrasounds. Even after seeing this ultrasound with my own eyes, I still couldn't believe it. I wanted to scream "No!" I sat there numb as the tears started to roll down my cheek. This was the baby that had been given a 93 - 95% chance of success. This was the baby that had been right on with all of the milestones and was developing perfectly. This was the baby that was healthy. This was the baby I supposed to be able to hold. This was the baby that was supposed to make it. This was the baby that was supposed to be...

Dr. S suggested that my best option would be to have a D&C. Due to the size of the baby and the fact that I hadn't begun to show any signs of miscarriage, he was concerned that miscarrying at home would be quite brutal on me.

I called my husband and through my agony and tears, relayed the horrible news. Neither one of us could believe what I had just been told. The technician returned to the room and told me I could leave when I was ready. I thought to myself, "Where do I go? I just found out my baby is dead." I was in such a state of shock that I was afraid to drive. I pulled what was left of myself together and walked out into the hall. I found a chair and sat down. I called my parents and told them what happened and then I started to cry again. Usually I am quite a private person, but for the first time in my life I didn't care if people saw me crying. I was reeling from the shock and pain.

As I was sitting in the hall, I looked up and noticed Dr. S was coming toward me. He had apparently finished with patients in the other clinic and had come over to the hospital to do rounds. He stopped right away and again expressed his sympathies to me. He then talked strategy and told me they (meaning him, my RE and maternal fetal med) were going to do a "full court press" to figure out why I couldn't stay pregnant. I appreciated his kindness and his willingness to be assertive in finding a solution to our problem. Even though it was a dreadfully hard situation, it helped knowing I had this medical team in our corner.

After speaking with Dr. S, I found my way over to a little chapel around the corner. As I walked in, it was dark except for the light shining through the stained glass at the front of the chapel. The chapel was empty. It was a small room. I sat down and offered one of my most heartfelt prayers as I began to sob. I told God that I knew he had always been there for me and that now, more than ever I needed him to get me through this. I told him that I didn't know how I would do it but that I knew he did. I pleaded for his help and comfort.

After a few minutes of praying and sobbing, I felt like I was finally in a position where it was safe to drive. I walked out of the little chapel and looked down the hall towards the maternal fetal medicine department. I thought about how much life had changed in the two hours since I had walked through the door. I turned to leave and then remembered that I didn't have a picture of the baby. I walked over to the maternal fetal medicine office and asked for a picture of the ultrasound. They were happy to oblige. I'm really glad I have a picture of our baby. The pictures from the hospital were the clearest ultrasound pictures I had and it makes what I went through more tangible somehow.

On my way home I received a call from my husband. His boss, after learning about what happened that day, was very understanding and encouraged him to take the rest of the day off. My husband and I spent the afternoon together and tried to get through a small part of what was facing us.

Over the course of the weekend, we decided that I needed to have one more ultrasound before I had the D&C. I called Dr. J's office on Monday morning. They were wonderful and got me right in. Dr. S had left town for a couple of weeks and I felt like I needed to have Dr. J confirm what I had been told on Friday. Dr. J had been through my two previous miscarriages with me. Somehow I needed to hear the news again from her.

When I met with Dr. J she expressed her sympathy. She conducted an ultrasound and confirmed that the results we received on Friday were correct. Meeting with Dr. J gave me some added comfort and peace about going forward with the D&C.

Since Dr. S was out of town, one of the RE fellows  (Dr. D who had been with Dr. J at my first appointment in June) was scheduled to perform my D&C. Dr. J gave me her full confidence in Dr. D and her ability to perform the D&C.

The next day was the day of my D&C. My husband and I arrived at the hospital at 8:00 a.m. I have a hard time with general anesthesia – it makes me really sick and groggy. Because of this I opted for conscious sedation. I didn't want to sleep through the procedure and in spite of the effects of the sedation didn't allow myself to fall asleep. I emotionally needed to be awake to say goodbye. Going through the D&C was a very difficult experience for me. It seemed to be such a horrible and unnatural way to part with someone that I loved so very much. I hope to never have to do that again.

At the admonition of Dr. S and Dr. J, we requested genetic testing be performed on this baby. We met with Dr. J about three weeks after the D&C and she reviewed the results with us. We learned that I had been pregnant with a genetically normal baby boy. To this day we still don't know why we lost him. I have undergone additional tests but have yet to find specific answers to explain this pregnancy loss. We have since met with the head of maternal fetal medicine (and Dr. J.), and have come up with a game plan for the next pregnancy.

Each of the miscarriages has been hard for me and I have grieved each of them afresh. This last one was particularly traumatic because we had every reason to hope and plan for a healthy pregnancy and baby. It has taken me a long time to find a place for it. It is slowly getting better and I am grateful to be where I am. I don't think there is a day that goes by that I don't think of and miss our baby boy. 

My Story - The Third One

I had been told that sometimes right after a miscarriage it is easier to get pregnant because the body is already in pregnancy mode. I was thrilled in January to have a positive home pregnancy test. I wasn’t so naive this time about a pregnancy succeeding, but I was grateful never the less. It was Martin Luther King Day and my husband was home from work so we were able to share the news together. We were both excited yet cautious. I contacted Dr. J that morning and shared our news. I was instructed to go in for two quantitative HCG draws 48 hours apart. If the levels looked good and doubled as they should, I would have a viability ultrasound at approximately six and a half weeks. 

I went in for my first HCG count two days later. After my last experience with the HCG counts I was a little nervous. I prayed the whole way there and the whole night and didn't relax until the result came back the next day. My first HCG was 238 which is good. I was incredibly grateful. One hurdle down, one more to go! The second one was conducted 48 hours later and came back at 642. Second hurdle passed, we were on a roll! With the HCG counts looking good, we were given the go ahead to schedule the viability ultrasound. I scheduled the ultrasound for February 5^th, our anniversary. After the very difficult anniversary we had last year, I was more than ready to have something exciting to celebrate this year.

The next couple of weeks found me feeling quite pregnant. Once I had the positive HPT, I began taking my Progesterone supplement. This added to my symptoms, but I didn’t care how nauseous I felt or how many times I had to use the bathroom, I was just incredibly grateful to be pregnant.

February 5^th came at what felt like a snail’s pace, undoubtedly because I was awaiting it with eager anticipation. With my HCG counts and my symptoms, I was confident everything was progressing normally. My husband met me at Dr. J's office. Dr. J came in and conducted our ultrasound. She found a good intrauterine pregnancy but the baby was measuring small, about five weeks instead of six and a half. Because the baby was measuring small we weren’t able to see a clear heartbeat. Dr. J thought, initially, the small size could be because my dates were off. She told me not to worry but to go ahead and schedule a follow-up ultrasound in a week or ten days. Even though Dr. J was calm about the situation and I trusted her, my heart sank and I was concerned. I had been so convinced that everything would be going well that the ultrasound news felt like a real blow. I went home that night and cried and cried. It took me several days to feel hopeful again. Off and on during the following ten days I had spotting. At first we thought it was a result of having the ultrasound, which had been done internally, but as it lingered I had some concerns.

We had our follow-up ultrasound appointment on February 15^th, the Friday before a long weekend. I figured some extra time off, over the weekend, would give my body a chance to recover after the ultrasound and help reduce any spotting. On the day of the ultrasound I was exactly eight weeks. I knew that with the gestational age, the baby should be large enough to easily see a heartbeat. I had finally stopped spotting and had regained hope that everything would be okay and we would see a lot of progress.

My husband and I were very pleased to be able to see the baby. Due the their appearance we affectionately gave them the nickname “Little Bean”. Little Bean had grown a few more millimeters since the last visit and my husband could clearly see the tail and the head. We were quite pleased until we heard the measurements. The baby was now measuring five and a half weeks, only a little larger than last time. We listened while Dr. J searched for a heartbeat. To our great disappointment there still wasn’t a clear heartbeat. I started to grow uneasy and I could tell Dr. J was concerned. She finished up the ultrasound and asked me to get dressed. She told us that she would be back shortly to talk to us.

I remember vividly when  Dr. J returned. She sat down, looked us straight in the eye and said, “I am concerned.” Due to the slow growth of the baby and the inability to find a clear heart beat, she was fairly certain the baby had a chromosomal abnormality. She said the prognosis wasn’t good. When we asked her for a percentage, she gave us about a ten percent chance. We were heartbroken. Dr. J requested that we schedule another ultrasound in one week and told us that there was a chance I would miscarry before that appointment. Dr. J was headed out of town for the long weekend, but she told us to stay in touch with her office if anything happened before our follow up appointment.

After my appointment I called close family members and told them about our situation. It was decided that we would pray and fast as a family for our Little Bean. We were praying for a miracle. I knew that Dr. J was an expert in her field but I wanted her to be wrong this time. My husband and I went home that night and cried and cried together. 

I woke up the next morning and decided that I wasn’t going to grieve until I knew for sure that I would miscarry. I spent the day trying hard to keep myself busy and not think about the possibility of losing the baby. Sunday came and I was feeling quite nauseous again. I was certain this was a good sign. We had many people praying for us, I had received blessings and I knew that if it was God's will he would heal this baby. Everything seemed to be okay until Sunday night when I began to spot again. I had a sinking feeling that this was it.

Monday morning I awoke to more spotting which was followed by mild cramping. Throughout the day, the cramping increased as did the bleeding. I knew I was headed in a bad direction. I spent a lot of the day crying.

On Tuesday morning I was still bleeding and cramping, but hadn’t passed any tissue yet. I decided to call Dr. J’s office and ask to see one of her partners as she was still out of town. It just so happened that the head of the department had an opening that day. When I met with the department chair, he did an ultrasound. He confirmed I was still pregnant but still couldn't see a clear heartbeat. He told me that even though things looked bad, he had seen worse pregnancies go on and end up okay. I was in wait and see mode and only time would tell, but I felt some hope. I had taken the day off of work to give my body and the baby every advantage in continuing on with the pregnancy. My husband had a mandatory meeting at work that day so I was on my own. I stopped by my favorite place for high calorie food, In-N-Out, and ordered a rare treat of an animal style cheeseburger, fries and a shake. I figured any extra calories wouldn’t hurt Little Bean. I went home ate my fatty goodness and laid low.

Since being given the grim prognosis by Dr. J, I had offered many tear filled prayers. I had told God that I would accept his will for this pregnancy, but if possible I really wanted this baby to live and be healthy. My faith and trust in God was making the pain I felt bearable, but not necessarily easy.

About an hour later the cramping intensified to significant severity and I felt a lot of pressure. I knew this was it but I was blessed with a very calm presence and clarity of thought that can only come from above. All of the trauma I had experienced with the first miscarriage was gone and I was amazed. I passed the tissue and was able to retrieve what I needed for the genetic testing that I knew would come. I carefully placed this in a container and in the refrigerator. I called Dr. J’s office and let them know that I had just had a miscarriage. They scheduled an appointment for me to see her the following day. I then called my husband. Because he was in meetings, I had to leave him a message. I felt so bad telling him on voicemail, but I wanted him to know as soon as possible. 

I was so grateful for the peace and comfort I had during this miscarriage, especially since I was by myself. After my first miscarriage I was terrified to experience it again. I knew that our prayers had been answered in the way God intended for this baby and pregnancy.

My husband came home as soon as he could. We cried again together. It was a hard night, but was filled with many tender moments. Our grief over the loss of the babies has brought us closer together. I am more grateful for my husband now and love him more than ever. We've walked this journey together depending on each other.  
 

The following day I met with Dr. J. She examined me to ensure I had passed all of the pregnancy tissue. She also examined the pregnancy tissue and confirmed that I had indeed retrieved all of the necessary tissue for the genetic testing. The tissue and the baby were sent away for two types of testing, the first was a traditional karyotype performed at the lab and the second was an investigational type of karyotype testing that used advanced microscopes to analyze the baby’s tissue. The latter was a study that the was being conducted at the University on recurrent miscarriages. We qualified for the study which meant the second test didn’t cost us anything. I appreciate the opportunity to participate in studies, especially when there is a possibility of gaining information. Dr. J scheduled two follow up appointments with me, one in ten days to make sure I was recovering from the miscarriage okay and the other was in three weeks to discuss the genetic results from the baby’s karyotype. 

My next follow-up appointment was fine. I physically was recovering well but emotionally was starting to struggle. The perspective I seem to find at the time I miscarry always seems to be challenged a few weeks after losing the baby. By nature, grief isn’t logical and when you top that off with rapidly changing hormones it is a Molotov cocktail of emotions. The hormonal changes are always the worst. One would think that after having so many miscarriages I would be used to this, although I expect it and dread it, it is hard for me Every. Single. Time. 

I try to learn from each miscarriage and grief experience so that I can handle the next one a little better. The first one I was very unprepared for what I would face emotionally. I had felt loss and grief before, but pregnancy loss is in a whole different class. The loss I felt and depth of grief was all new to me. After this third pregnancy loss I became trapped in the anger stage of grief. I tried and tried to get out of it. I was angry this had happened again. I was angry that other people who didn’t want to be pregnant were pregnant. I was angry that people with self inflicted health problems were pregnant. I was angry that teenage girls who couldn’t care for themselves let alone a baby were pregnant. I was angry that drug moms were pregnant. Honestly, I was angry anyone could be pregnant. 

After struggling for several weeks, I decided to go see a counselor. I had actually gone in to see this counselor a few months after my first miscarriage. At that time she left the door open for me to return if I ever wanted to. I went in and met with her for a few visits, to get some perspective again and to receive assistance in getting out of the anger stage of grief I had been stuck in. Thankfully with the good advice I received and blessings from above I was able to move on and heal. 

At our next follow up visit with Dr. J, we discussed the genetic results from the baby’s karyotype. Little Bean was a little girl. She had what is called complete trisomy 22. This means that instead of having two chromosomes on the 22^nd chromosome, our daughter had three. My husband and I went through genetic testing which revealed completely normal karyotypes for both of us. This meant that what happened to our baby was a completely random occurrence. I was reassured with these results for two reasons. First, I knew had our baby lived she would have had a very difficult life because of the trisomy 22. Every major system in her body would have run the risk of being malformed and had significant problems. Second, with this being a completely random occurrence, we had hope for a successful pregnancy in the near future. Dr. J was especially hopeful and her hope rubbed off on both of us.

As an added precaution, Dr. J put both my husband and I on some extra supplements that can contribute to better pregnancy outcomes. I began taking a daily low dose aspirin that can help reduce any small blood clots. We were eager to do anything we could to help the cause next time. We were given the green light to go ahead whenever we felt ready to try again.

My Story - The Second One

After the experience with the first doctor I decided to find a new physician. I wanted to find a doctor who would see me when the need arose and who I felt would hear and meet my needs. I also needed to make sure that the doctor's staff would help, not hinder, the process. I soon scheduled an appointment with another OB/GYN who came highly recommended. When I met with this doctor, I thought he was great but unfortunately his nurse didn’t call me back about lab results, forgot what labs had been ordered and seemed slow to respond to phone calls in general. Call me unfair, but after my last experience with poor follow-up, I wasn’t up for any more of the same. That office struck out too. 

During this time I had a recurring prompting that I needed start working with the physicians at University Hospital. University Hospital is known for excellent medical care and advanced research and treatments. It is a huge medical facility with many different associated clinics. However I wasn't sure what doctor or group of doctors I should be working with and I didn't know where to start. I just knew that I felt guided to be there. I started looking up information regarding doctors that treated miscarriage. I found one in the Maternal Fetal Medicine Department and I called and scheduled a consultation.

At that time I had no idea why I had miscarried. I was told that it was most likely a once in a life time event. In spite of this reassurance, something inside of me just didn't feel settled. It had been almost five months since the miscarriage and I had felt really off ever since. I had been experiencing hormonal mood swings, foggy thinking, forgetfulness, constant fatigue, water weight retention, hormonal migraines, irregular cycles and to top it all off, I had not been able to get pregnant. It was miserable.

The day of my consultation came and I went in and met with the doctor. Even though I wasn't fond of this doctor's bedside manner (it was actually pretty atrocious) my visit yielded some very helpful information. He recommended that I see a Reproductive Endocrinologist (RE) for what he termed sub-fertility. After leaving the consultation, I looked over the list of REs and one name seemed to stand out to me in particular. I called the RE clinic. Much to my surprise and delight, they had an opening in two weeks. I scheduled the appointment and felt an excited anticipation.

The first time we met with our RE, Dr. J, she elicited hope and confidence in me. I knew from her online bio that she had been educated at some of the best schools in the country. During my appointment she reviewed my history and was convinced there was hope for me. It was the first time in five months that I felt hope and I was grateful for such a gift. Before my appointment ended I had a follow-up plan and instructions. Even better, I had a way to contact Dr. J directly with questions (through a secure web portal). No more having to go through the office staff! I knew after meeting her that she wasn't just good, she was GREAT. I felt confident that we were finally working with the right doctor. I had more hope and peace in my heart than I had felt for five months.

The first step in my new treatment plan involved a trip to the lab for several blood tests. I can’t remember how many tubes of blood were drawn that day, but it is a good thing I don’t get sick at the sight of blood. Dr. J checked everything that could be causing a problem - thyroid, adrenals, pituitary gland, kidneys and a basic metabolic panel. I was impressed at how thorough she was.

My next appointment with Dr. J occurred on day two of the following cycle. More blood was drawn and an ultrasound was conducted. When all the results came back normal, I was given the green light to begin Clomid. I was nervous about starting Clomid for several reasons. I had heard horror stories about it and the pharmacist who consulted with me dryly stated that this drug was "not pleasant" (never a good sign). Much to my surprise, my body responded very well to the Clomid. I didn’t feel so hormonal, the foggy brain was gone as was the moodiness. I even lost ten pounds as my body finally shed the water weight it had been hanging on to for months. For the first time in a long time I felt like myself. Clomid was my new best friend! Don’t get me wrong, I had some side effects but compared to the benefits, they were minimal. In addition to the Clomid, I was put on a strict regimen of Progesterone. I was instructed to begin the Progesterone three days after I had a positive ovulation test and either continue it on into pregnancy, if that occurred, or stop if pregnancy didn't occur. I remained on this regimen for three months.

A little note on using Progesterone. Progesterone makes you feel pregnant, even when you're not. This is because it is increasing your natural progesterone level which is one of the first hormones to increase in pregnancy. It has been my experience that when I am actually pregnant the symptoms are much stronger than they are with just the Progesterone. I term how I feel on Progesterone as “faux” pregnancy symptoms. Because of these "faux" pregnancy symptoms, it is an emotional roller coaster. I had to mentally prepare myself each month and somehow find a balance between having hope the Clomid/Progesterone combination would work and not letting myself get too discouraged when it didn’t. This is easier said than done. Every month I had to fight these emotions and would shed some tears when the result was negative. During this time I came up with a mantra that helped me manage these feelings. I would tell myself over and over again, "It's not never, it's just not right now."

A little note on Clomid that I learned from Dr. J. If you are ovulating on Clomid then it is doing its job. Clomid is only an infertility drug in the sense that it helps the woman ovulate more regularly. Since abnormal ovulation is a very common source of infertility for women, regulating ovulation can be very beneficial. However if something else is going on, in addition to irregular ovulation, Clomid won’t necessarily help conception. I also learned that with Clomid, the lowest possible dose that achieves ovulation, should be used. Using higher doses can actually be quite dangerous as problems such as hyper-stimulation of the ovaries can occur.

On the third round of the Clomid/Progesterone regimen, I began to experience stronger symptoms of pregnancy. Although my home pregnancy test (HPT) was negative I was suspicious that I was actually pregnant. At this point I had been trying to conceive (TTC) for nine months after the first miscarriage. I wanted to see a positive pregnancy test more than just about anything. Right around this time I had my three month follow-up appointment scheduled with Dr. J. I decided to discuss my stronger pregnancy symptoms with her then.

At my appointment, Dr. J and I went over my treatment plan and discussed how things had been going. Dr. J recommended if I hadn’t conceived by February (five months after beginning the Clomid) that we move on to a more advanced form of infertility care. I was grateful to hear this. I had heard stories of women who were on Clomid for extended periods of time and I didn't want to use it long term if it wasn't helping me get pregnant. While visiting with Dr. J, I also told her about the stronger pregnancy symptoms. We decided that I would go ahead and have a quantitative human chorionic gonadotropin (HCG) test to see if I was pregnant. The HCG test is more sensitive than HPTs. I went to the lab and had my blood drawn. As I went home I felt hopeful but uncertain. 

The next morning I received a phone call from Dr. J. She told me that based on my HCG results I was technically pregnant, but my numbers were very low and she wasn’t hopeful. Her directness might seem a bit harsh, but one of the things I have come to really appreciate about Dr. J is that she is very honest with me, even when it is hard. Because of the low numbers, I had to go and have a second blood draw in 48 hours to see if the HCG level would increase. I hung up and prayed and cried. I called my husband and then my Mom. We all prayed that if this was right, the numbers would grow. I had waited for such a long time. All I wanted was to know was that I was pregnant again and everything was okay.

I went to the lab 48 hours later and had my blood drawn. The following day I heard from Dr. J again. She told me that unfortunately the numbers had fallen, not risen. She instructed me to go off of the Progesterone and told me that my cycle would follow in a couple of days. I was devastated. It was December 20^th and we were scheduled to fly out for Christmas the next day. I was terrified to go through another miscarriage, especially away from home. My first one had been so traumatic and painful, physically, that I wasn’t sure what I would do if the same thing happened when we were away. I expressed these concerns to Dr. J and she reassured me that it would be more like a heavier menstrual cycle and less like the miscarriage I had experienced previously. 

Even though this second pregnancy was what is technically known as a biochemical pregnancy, it was real to me. That is the thing that still amazes me about miscarriage. I have lost babies at several different gestational ages in the first trimester. No matter how long or how little time I knew about the pregnancy, I have grieved each one. They were and are my babies. I have loved and wanted each baby. I had hopes and dreams for each baby. Was the second pregnancy loss easier than the first because I knew about it for such a short period of time? Perhaps in some ways it was, but it was still a loss of something and someone I dearly wanted.

After the biochemical pregnancy, Dr. J instructed me to schedule an appointment for a sonohysterogram. The sonohysterogram is a test that looks at the condition of the uterus to ensure there aren't any abnormalities that would prevent a successful pregnancy. It had to be performed somewhere between days 6 and 12 of the cycle. With Christmas, our being out of town and Dr. J's office being closed for the holidays, the only time we could schedule the test was on the morning of New Year's Eve.

On the morning of New Year's Eve, I went to Dr. J’s office. I was nervous and still hurting emotionally. I had been told the test was uncomfortable and would cause cramping. The procedure was actually better than I had expected. Dr. J is very gentle and has a calming manner about her. I was given very good news that day, everything was in tip top shape. I felt like I had been greatly blessed. I dried my tears and looked forward to better news in the future.

My Story - The First One

From the time I was a young girl I knew I wanted to be a Mom. I had dolls, more than I could count on two hands, including a couple sets of twins, and I loved each of them. I used to dream about who I would marry and long for the day that I could have children of my own. I dreamed that life would be blissfully perfect, with only minor setbacks.

For most people, life has a way of turning out differently than what we expect. Shortly after high school I started college. I remember being pretty convinced, at the mature and oh so wise age of nineteen, that I would get married around the age of twenty, finish my Bachelor’s degree a couple years after being married and then welcome our first bundle of joy into the world. Nineteen came and was on its way out. It was in that year that I had a change in career goals that propelled me from junior college to a full-fledged university. Before I knew it twenty had passed, as had twenty one, twenty two, twenty three, twenty four (and you get the idea), without a serious marriage prospect. It was during this period of time that I realized my wonderful plan was not reality. I started to live my life to the fullest, hoping and praying that one day my deep desire to be a wife and mother would be fulfilled. College graduations and changes in location, for various vocational opportunities, occupied my mid to late twenties. Finally, at the age of thirty, I met the man who would become my husband. We began to date a year later, and eighteen months after we started dating we were married. I learned that married life is exciting, full of hard work, challenging, joyous and life changing all rolled into one package and I loved it.

A few months after becoming married we decided it was time to start a family. I was thirty three at the time. Much to my surprise and absolute joy, I found out I was pregnant very soon thereafter. I still remember the first time I told my husband. He asked me if I was serious, to which I replied in the affirmative, and he hugged me. I am very blessed to have married a man who wants to be a father as much as I want to be a mother. Shortly after I learned I was pregnant, I found out that my younger sister, who is one of my dearest friends, was also pregnant. We were due a week apart and I was ecstatic! It was her fourth and my first and I knew our children would grow up together and be the best of friends.

Three weeks after I found out I was pregnant I began to have light pink spotting. It was a Sunday, so I looked up a few medical websites and found out that spotting can be normal during early pregnancy but should be reported to your doctor. I dutifully called my doctor the next morning. I spoke to her nurse who essentially recited to me what I read the night before and reassured me everything would be alright. The nurse instructed me to contact them if the spotting got worse or was accompanied by cramps. At this point in my pregnancy I was six and a half weeks along. The doctor I was seeing at that time had a policy of not seeing new obstetric patients until later on in the first trimester. Two days after my initial phone call the spotting increased and was accompanied by some mild cramps. I called the doctor’s office again. I spoke with the same nurse who rehearsed what she had told me two days prior. Again I was told to notify them if the spotting or cramping increased. Two days after my second phone call, four days after the first phone call, the spotting turned to bright red with strong cramps. Again I called the doctor’s office. This time I specifically asked to be seen. I was told that no one was available to see me that day but that I could come in for a HCG blood draw. I was told I would need to return in 48 hours for another blood draw. The nurse tried to reassure me that she had experienced bleeding with her first pregnancy and everything turned out fine. She told me that I most likely would be too. As you can imagine, by this time I was starting to feel rather anxious and concerned about the whole situation. I left work, cried most of the way to the doctor’s office and had my blood drawn. I then went home, took it easy and prayed that all would be okay. My husband was aware of each of the developments and was very supportive and concerned. After a blessing that night, I went to sleep feeling concerned but trying to be hopeful that all would be alright.

I awoke early the next morning with very intense cramps. I took Tylenol, applied some gentle heat and tried to walk the pain off. Finally after about an hour the pain subsided enough that I was able to go to sleep. I awoke two hours later to heavy bleeding. For the first time I knew for sure that this was the beginning of the end. I called out to my husband. We hugged and cried together. At that time I thought I had experienced the miscarriage. I had no idea that heavy bleeding didn’t mean I had endured the full brunt of the miscarriage. I learned the difference about five hours later. For the first time in my life I experienced hard contractions. I never knew I could be in so much pain without dying or passing out. I was pretty sure I was going to do the latter before the miscarriage was complete. Thankfully for me, it wasn’t too much longer before it was finished and the pain lessened.

I had read and been told that you should go to the emergency room and save all tissue for testing after a miscarriage. I did both. The emergency room staff was helpful and we had a very compassionate and thoughtful physician who performed a thorough evaluation. She did more for me than my own doctor had done to that point. Through that evaluation, I learned that my miscarriage was complete. After the evaluation, the emergency room physician made contact with the on-call physician from my doctor’s office. I was instructed to rest and follow up with my doctor in two days, on what would have been my first prenatal appointment. Because the emergency room physician didn’t know what to do with the tissue I had saved, she instructed me to take it to my doctor on Monday. My husband and I left the emergency room heavier than I think either us had ever felt in our lives. We tried to comfort each other with our gaping broken hearts.

That night happened to be the night prior to our first wedding anniversary. It was a very different anniversary than we had planned. The emotions of that time were so raw. I think it is a time I won’t soon forget. The shock, confusion, disbelief and grief about what had just happened to us was overwhelming. 

At the appointment on Monday, my doctor’s office once again did not fail to deliver a lackluster experience. Because I was supposed to be an obstetric patient, I was scheduled on a regular obstetric day. This meant that nearly every other patient in the waiting room was pregnant and obviously so. I arrived, discretely carrying the tissue, as I had been instructed to do. I checked in. Somehow the message that I had miscarried over the weekend had reached the doctor but apparently wasn’t communicated to the front office staff. After having to wait for nearly an hour, I went up and asked how soon until we could go to a room. I also let them know that I wasn’t feeling well. I had started to cramp again and quite frankly I felt like I was going to lose my mind if I had to sit in that waiting room, with pregnant women, for one more minute. Thankfully, they soon took me to a room. The nurse who took me back asked me the obligatory, “How are you doing today” question. Seriously, patients that have just had a miscarriage need a BIG flag on their chart. I really wanted to say, “Have you read the chart notes on me? How do you think I'm doing today? I have just waited for an hour in a waiting room full of pregnant women who walked out glowing and smiling, carrying a picture of their ultrasound.” At the same time I wanted to know if this was the same nurse who had been so less than helpful in answering my phone calls the previous week. I wanted to tell her that I had received better care from the emergency room, because in the medical community that is pretty much the ultimate insult. 

After being directed to a room, the nurse did a cursory check in and had us wait for the doctor. The doctor came in a few minutes later and was kind. She said she was so sorry and gave us some instructions on what to expect going forward, the rest I needed to get, and gave me a hug. I presented her with the pregnancy tissue to which she indicated she didn’t have a use for it. I had been refrigerating it as I knew that was the best way to preserve it. She explained that, unfortunately, since it had been three days, the tissue was too old to be of any value. I had to throw the tissue away and cried again.

My doctor asked us to check out up front before we left. We did so. The front office staff wanted to schedule a follow-up visit with us in three months. Apparently it wasn’t felt that I needed any follow up sooner. I still marvel at that, given my more recent experiences. At any rate, I politely told them that I wasn’t quite ready to schedule and let them know I would give them a call when I was. The whole time I was thinking I had to find a doctor with better staff and fast.