I couldn’t sleep this morning.
Which – to be honest – is not unusual. Over the last few years, I have transitioned from being a night owl to an early bird. I like those calm, quiet, morning moments where it’s just me and the rising sun (and in the past a weak cup of coffee, too).
On Saturdays like today my eyes crack open at the time I usually get up for work (sometimes a little later if I’m lucky), and I lay in bed and think for a while. Then I get hot, usually have to pee, and after that getting back in bed makes me feel restless. I crept past my wife and sleeping dog and carefully pried open the door (not that she’d hear it if I wasn’t careful – I envy her deep and peaceful sleep), and snuck into our guest room where I usually blog in a little tan rocking chair glider. It looks like it is for a nursery – one day I hope it is – but I am obsessed with rocking chairs so in the meantime, it’s just mine.
This week was hard. For a lot of reasons, many of which are unrelated to the baby making process. First, I’ll go back to last weekend when we left off.
On Saturday, my wife and I went to a local Ronald McDonald House with some friends and family and made breakfast for the families staying there. They told us that the families often rush to appointments and don’t stop for a warm breakfast, so we felt really grateful that we could provide them that opportunity. We made hashbrowns, pancakes (gluten free and regular), bacon and finished in a really fast amount of time without a single argument or raised voice (which you may expect when a big group is dancing around one another in an unfamiliar kitchen trying to prep breakfast in less than an hour). When the families started filing in, I tried to stay in the back because I found myself getting surprisingly emotional – especially when one dad stopped to talk to my mom and fill her in on his daughter’s really rough journey and requested prayers. I say “surprisingly” as I’ve noticed my emotions wane ever since I’ve been far into the lupron shots. I don’t know if that’s normal, but I’ve cried a lot less and been less emotional. But on Saturday morning, that certainly wasn’t the case – I’m not sure if potential baby or situation were to blame – probably both.
The experience was awe inspiring. We watched parents and children who have gone through things that probably make our fertility journey seem like a small blip on the radar to their atomic bombs, but still they ate, and smiled, and enjoyed one another, and remained strong and fearless. It certainly didn’t make me feel bad for feeling bad about the tough parts of this journey – but it provided prospective and helped me to remember to remain strong.
We’d like to keep up that spirit of doing for others. A while back, I’d wanted to spend some time getting to know folks at a Muslim cultural center. They’d even ask if I’d be willing to assist teaching English on the weekends – something I’m still very much interested in if they need me. I think I’m going to reach back out, and have a few other organizations in mind to assist with as well. I want to find activities that bring even a tiny amount of light to others, so if you have any favorites or suggestions, please send them in my direction.
So the weekend passed pretty effortlessly. On Sunday we had a wedding for a coworker, and on Monday we had a barbecue at my parent’s house (where my cousin and her daughter currently live with my parents and sister) so it was a really nice day surrounded by family.
On Tuesday, I had a quick bloodwork appointment in the morning. I got a call back midafternoon to let me know that…..*drumroll* our HCG level had increased TENFOLD and gone from 21 to 226! The nurse sounded positive and said that she thought that was a GREAT sign and I immediately called my wife who squealed on the phone. We were SO excited. She told me she wanted me back on Friday for an ultrasound to ensure that the embryo wasn’t developing in one of my tubes to cause the overall lower numbers, but she was really happy about the increase and said she felt like the odds were more in our favor at that point. She did tell me that due to the point at which we were, we may not see anything on the ultrasound on Friday and not to let that concern us (a sentiment confirmed by my best friend – a nurse practitioner who doesn’t work directly with patients undergoing fertility treatment, but does see them for their ob/gyn care afterward – so she’s a fountain of information).
The next few days progressed painfully slowly (especially with a LOT of drama at work which caused me an insane amount of stress for two days – stress that will likely continue on for the next two weeks) and finally Friday arrived.
The morning started out a little rocky when our dog woke us up at 5am shaking and panting only for us to find out that she had the “diarrhea sweats” and she proceeded to go to the bathroom three times in the house before making it the short walk outside to the grassy spot where she goes to the bathroom. So our Friday morning started out with a bang (I guess kind-of, almost literally).
Because of all of the commotion, I ended up five minutes late to the appointment and they ended up taking two other couples ahead of us (even though my wife got there on time – we drove separately so we could each head right to work from the appointment) so we didn’t end up being seen for a half hour after our scheduled appointment time (which made me – probably very unnecessarily – grumpy). By the time the doctor came in to our ultrasound room, I was already on my back, feet in stirrups, ready for the visit. He proceeded to talk to me for about five minutes in that position before starting the ultrasound. I was expecting the same cautious optimism that we’d been experiencing, but he started out by putting his hand on my shoulder and saying “you know, you’ve been making me nervous with these numbers.” He then proceeded to tell me that there was a possibility of this baby developing in one of my tubes and if that were confirmed today that they’d look to put me on something called methotrexate to cause the pregnancy to end.
So we commenced with the ultrasound and – as expected – saw nothing (in tubes or uterus) and he referred to it as a “pregnancy of unknown origin” and said he wanted me back for an ultrasound and more blood on Monday. I asked him what he wanted to see on my bloodwork today in order to feel confident that this could still be a slow, but normally developing pregnancy (one of the three options that he said this could be at this point: the other two being, ectopic, or an abnormally developing pregnancy). He said 1000 would be the minimum that would make him feel confident.
Immediately after, I began texting my best friend who called me and gave me her perspective. She respects the particular doctor I am seeing, but thinks that they could be a bit preemptive in their talk about termination as she said that I could not yet expect to see anything on an ultrasound and that my numbers were still increasing at an appropriate rate (though they did start out low). She said that she thought the doctor’s desire to see 1000 was a bit high, as the rate should be increasing by 50% every two days or so (which would put it around 339 by Thursday and even if it went up another 50% from Thursday to Friday would only make it 508). She said she thought an expectation of truly doubling was good, but potentially unrealistic (her husband is also in OB care, and agreed). She said either way – if the numbers went down or plateaued, I should be concerned and even if they went up the way she expected they should, I could still not walk away from this with a favorable outcome. I was grateful for the different perspective – which didn’t change my level of caution at all – and just began to hope for good news.
When the nurse finally called, her voice was less perky than when we spoke on Tuesday, but more pleasant than last Wednesday. She was very direct. “Your number is at 501. Which is obviously lower than what we were expecting and is not increasing as we hoped. Doctor wants to see you back Monday. And he gave you paperwork to review on methotrexate, right?” She doubled down on the idea that this could be and very likely was an ectopic pregnancy. I was so angry and confused.
When we first began this journey, she told us that the possibility of this happening was so slim, that while she would discuss it, she wouldn’t spend too much time doing so as it would likely never happen. So how is it – that someone with no diagnosed fertility issues – on her FIRST ATTEMPT AT CONCEPTION – has an ectopic pregnancy?
So I called my wife, who I expected to be sad but hopeful, and I could hear little sniffling noises and I asked if she was okay, and she began sobbing. It was heartbreaking, especially since my wife is very stoic and unemotional. I’ve only seen her cry a small handful of times in our relationship (in fact, I can probably count them on one hand), so I began to feel even less hopeful, as this strong and stoic woman felt weak and defeated.
At this point, even with the post-number optimistic perspective from my best friend, we are feeling very sad and nervous about Monday. I am still holding out some hope, and if the numbers increase again by more than 50% on Monday and they don’t see an ultrasound image, I am going to push to hold off on the methotrexate for another few days as there is something called the discriminatory zone (which is 1500 HCG) under which you typically won’t see anything on an ultrasound.
The nurse advised me to watch for bleeding or abdominal pain over the weekend (signs of an ectopic pregnancy) and the doctor advised that if we do terminate with methotrexate or if my body terminates naturally, the soonest we could try again is about 2 months from now.
I mean, we do have six frozen embryos and one covered transfer left, so this isn’t the end of the world – but man, do you become attached quickly. As soon as we saw that faint line, I became so excited by the idea that I could FINALLY be pregnant. We counted down to our (very distant) possible due date, and fantasized about what life would be like with a baby in the spring/early summer. We began to mentally decorate the nursery, and plan for how we’d tell our friends and family. We began to wonder what this TEENY TINY person may one day look like, act like, or…just like. Would they be serious like me, or goofy like my wife? Would they be the kind and caring person we want them to be? Would they love learning? Appreciate art?
I know that it’s early and that most people probably think you don’t have a right to get so attached at that point, but how can you not when you spend so much money and effort getting to this point? How can you not?
So little embryo of unknown origin: I believe that – although it is unlikely – you may still be there, in just the right place in my uterus: slow to show up on the ultrasound screen, like your mama is to almost every event in her life. Slow to develop like your mommy was: the tinier of two twin babies, who people thought couldn’t hear when she was an infant, or was perhaps disabled in some other way (she wasn’t).
And if you’re in a tube or are just developing abnormally, you existed – although briefly – and are deeply loved and very much wanted.
And we will continue on. And we will spread love and goodness in this world – even when we are sad – because that is what we do.