7 Weeks and Other Stuff

I’ve got so much going around in my head at the moment. There’s no particular point to this post, it’s just a news bulletin style update 😉

Family Matters

My brother took an overdoes of his anti-psychotic meds in the early hours of Saturday morning. He is (amazingly) ok, was discharged from hospital yesterday and is currently staying with my Dad. It makes me so sad to see my brother struggling like this. His whole adult life has revolved around addiction, depression, and in recent years, psychosis. He is almost 6 years younger than me, and I left home at 16, so the majority of my memories of him are of an excitable little boy. It makes me feel so very sad that he has never been able to get on the right path as an adult, and it makes me angry at the same time that even now, at the age of 32, he still seems incapable of looking after himself and making baby steps towards living a healthier life. He eats badly, takes a daily cocktail of prescribed drugs, smokes (has almost set fire to his flat on several occasions combining smoking with sleeping pills), stays up until the early hours of the morning and sleeps most of the day. His whole lifestyle is out-of-whack. At the end of the day, I know that the only person that can change his approach is him. So until that happens (if it ever does), I just remind him gently to look after himself and tell him I love him. What more can I do?

My Meds

I mentioned that the EPAU prescribed me baby aspirin and progesterone to take during this pregnancy. I have always been staunchly anti-drug and I probably only take a paracetamol once or twice a year. Paracetamol was all I took for childbirth with both of my sons (for the record, it doesn’t even take the edge off a contraction, but it was worth a try). Because of my upbringing, and my exposure to depression and psychosis in my mother, my uncle (mum’s brother) and later on, my own brother, I would never touch an anti-depressant or any other pill that affected my brain chemistry. I know these medications make a normal life possible for many, many people, but for me they are a total red zone. But I’m getting off the point. I did some research on aspirin and progesterone when I got home, before taking anything, and decided almost immediately that the aspirin was a no-go.

Aspirin has been shown to help women with recurrent miscarriage who have a blood clotting disorder. My blood was tested for all forms after my 4th consecutive loss and my blood was clear. No clotting problem. So what if you don’t have a clotting disorder? I found studies to show:

Buffered aspirin causes less birth defects than regular aspirin. [er, less birth defects??]
Aspirin may interfere with implantation and cause birth defects.
Aspirin does not improve implantation rate and reduces follicle growth.
Aspirin does not prevent miscarriage in women without thrombophilia.

Since I do not have thrombophilia, and aspirin DOES cross the placental barrier (which means your baby gets the aspirin as well as you), I’ve opted not to take it. Yes there are just as many studies that show it does help, but the thing is, someone once said to me:

There’s not much you can do to hang onto a bad pregnancy and there’s not much you can do to get rid of a good one.

Given that drug addicts, alcoholics, chain-smokers and other people with less severe, but still far from perfect lifestyles, have babies all the time, I’m inclined to agree.

If I am going to lose this pregnancy, I’m going to lose it.

For every woman out there who says “I had 4 miscarriages, and a healthy baby when I took aspirin!” how can you ever know that it wasn’t just that her 5th baby was the healthy, strong one? Especially those of us that are trying later in life. It is a fact that egg quality is diminished with age. I accept that some (maybe most!) of my eggs are past their expiry date. Aspirin isn’t going to change that.

I know a lot of people will disagree with this, and with my choice, but it’s the choice I feel better about. And if I do miscarry, which I may well, I don’t think it will be because I didn’t take a baby aspirin each day.

Which leads me onto my other medication: progesterone suppositories.

Wow, these babies are something else. Having never even seen a suppository before they are a revelation. A pellet of vegetable fat that melts in your bum (or vagina). The progesterone is absorbed through the squillions of blood vessels in those two tubes.

The progesterone was a real dilemma for me. My main issue with being given them was that no one had ever tested my progesterone levels.

That’s right. I’ve been given a dose of 400mg per day, and no one knows what my actual levels already are.

I talked with DH about this, and he pointed out that it was probably cheaper to dispense the drug as a just-in-case than it was to take a blood test to confirm whether you needed it.

Just to put the dose in perspective, progesterone increases throughout pregnancy and at the end of the third trimester the placenta produces a maximum of 250-300mg per day.

So er, why do I need to take 400mg in the first trimester??

Apparently progesterone is safe even in high doses, so women are given lots of it just-in-case.

Except:

Maternal progestin intake associated with increased risk of hypospadias.

Right.

However, I have a caveat for the progesterone. I know through my extensive research that cortisol (the stress hormone) is made partly from progesterone. That’s right – when you are under stress, your body ‘steals’ progesterone to make cortisol, and therefore lowers the levels of available progesterone in your body.

This has a huge impact – high stress levels could mean not enough progesterone to sustain implantation, and it could cause a shorter luteal phase. In fact, I know through my own charting that on the months where I was especially stressed (the one year anniversary of my missed miscarriage being a case in point), I started spotting as early as 9dpo, even though my period pretty much always arrives at 14dpo.

Not only that, but my missed miscarriage showed that growth stopped at just short of 9 weeks. Many, many times I have looked back over my journal at this time. The only thing that stands out is how stressed I was trying to cope with a 2 year old and a 9 month old. I was one of the first people in my group of local friends to have two children. While they were all handling 2 year old tantrums with two hands, I was trying to appease 2 year old tantrums while feeding a baby. I was trying to stop my 2 year old running in the road while pushing a pram. I was trying to contain a crawler and a toddler everywhere I went and they were both active, curious boys who were into everything. I was a mess. I was crying every day, angry most of the time. I had no support from family. We had no childminder or babysitter. 24 hours a day, every day,  I was on call and it was exhausting. My friends seemed to think I was making a fuss about nothing… but they didn’t have two boys 21 months apart. Looking back, I can see that I was suffering with depression (maybe I should have taken some pills, ha ha). But, at the time I just alternated between anger and tears. Morning sickness was the icing on the cake. And then my baby died. Stress? Chromosomal defect? I don’t know. But it makes me nervous enough to think that my stress levels may interfere with my progesterone levels.

However, I still can’t justify the dosage. 400mg when I haven’t even had my levels tested??

So I reached a compromise. I’m taking 1/4 of the dose each day. I chop up my suppositories. I get a little bit of extra progesterone, just to help out if I get anxious or stressed (like when my brother ODs on anti-psychotic meds), but not so much that I’m freaking out the balance of my natural hormone levels. I’ve had no side effects and barely any “leakage”, so all is well.

Again, not everyone would agree with this, but that’s the way I feel most comfortable approaching things.

Pregnancy

Before I got pregnant this time, I had this vision of how things would be once I got my BFP.

I’d be a smiling, glowing, woman, eating wonderful healthy foods, with an immaculate house and two happy and wonderful children.

However, it seems I misjudged things.

I am totally unable to accept that I am pregnant because I am worried about getting emotionally invested in something that is going to disappear, my house is mysteriously NOT immaculate, my children squabble just as much as they always did and I am achieving a big fat lot of nothing because moving around seems to exacerbate my nausea.

Sigh.

Actually, my ‘morning’ sickness has been considerably less than it was with the two boys. By this time I was unable to even enter the kitchen and the only thing I was able to eat was Rice Krispies and junk food. It is much, much better than that (which again is a source of worry). Generally I am fine most of the day, with waves of genuine sickness. I have also noticed that I am OK as long as I eat fruit and veg. Ha ha ha! Who’d have thought it? I am actually sicker when I eat junk food 🙂

I was in fear of losing the green smoothies, but actually they are one of the few things I can eat without feeling ill afterwards.

Scan

I am going to call the clinic today and book a scan asap. DH is away next week, and I can’t wait until he gets back. I need to know that this baby is currently growing properly, especially as it was so small at my 6 week scan. I think once I’ve had confirmation that the size is OK (if indeed it is), I will be able to relax just a tiny bit.

Things To Do

I have a massive mental list of things to do. I have done none of them. This is partly down to vague nausea, and partly down to not being sure if this pregnancy is viable. I know I need to get past this feeling of inertia and lethargy, but after spending the best part of the last year on infertility forums, it is very, very difficult to imagine that anyone has a good outcome after getting pregnant.

I am hoping that if the next scan is good, I will be able to get moving.

Because I really do need to get moving, after such a long, long time waiting.

We Have a Heartbeat :-)

Scan

Firstly, my apologies for the long time it took me to update – I only get to post in the mornings!

So… wanna hear all about it?

I waited at the EPAU for 65 long minutes to see a consultant. I think my sonographer was in training, because when I finally got in there, the consultant kept telling him what to do…

He hadn’t turned the screen properly away from me, so I could just about see what he was doing as soon as he started. Straight away I could see the little black hole that was the pregnancy sac. But it was empty. He moved in and out, it got bigger and smaller, but there was nothing inside.

He turned to me with a smile, and spoke with an indeterminate accent:

This looks very good here.

He pointed at the black hole.

I figured his training wasn’t going too well, given that he was reassuring me already and he had yet to find an embryo.

He then said he would have to use the “wand” if it was OK with me (that’s the vaginal probe or vag cam), but the consultant stepped in and told him to use the ‘other’ probe.

Ahhh yes, you are very slim, you see! I must use this one!
Yes, yes
, laughs the consultant, she is slim so the other probe is better!

He held up another probe for me to look at and grinned at me.

I couldn’t believe how cheery they both were, given that no one had yet seen any evidence of a baby.

Then suddenly, with the new probe for skinny people, a shadow appeared in the black hole. My heart leapt – there was something there.

He zoomed in and out of the layers of the shadowy area and then there it was – I saw it at the exact same time he did.

A flickering light. A tiny flashing area. A beating heart.

I gasped.

Can you see?
A heartbeat! There’s a heartbeat?
Yes, yes…

He holds the probe still and watches me while I watch the flickering light on the screen in complete awe.

And then I cry.

And my stomach bobs in and out and the baby disappears from view.

I manage to contain my tears long enough for him to find the baby again, take a photo and print it out.

Their smiles say everything.

The baby measures 4mm, which is a little on the small side, but the presence of a heartbeat at that size is just AMAZING.

They want me back in 4 weeks for a repeat scan. In the meantime they have given me aspirin and progesterone suppositories (nice).

For once, I might just take the drugs without question.

So now what?

As you can imagine, I came out of the hospital walking on air. I felt so relieved.

But old habits die hard. By the time DH and I were sat on our own and the boys were in bed, all the fears and doubts were creeping back in. Having been through a horrendous missed miscarriage, I can’t shake the fear that this baby could just stop growing at any time, and I wouldn’t even know.

I have achieved hardly anything over the last couple of weeks, feeling like my life was on hold because I needed to know if this baby was OK in there.

I can’t spend the next four weeks doing the same, and then the four after that, and so on. I can’t live in limbo.

So we have made a decision.

We will book a private scan in two weeks, just to check that everything is progressing as it should through the time that I lost the pregnancy before.

In the meantime, I’m going to try not to think about the millions of adverse outcomes (missed miscarriage, miscarriage, genetic defects, bad test results, bleeding, physical anomalies and deformities, placenta praevia, stillbirth, death in labour (me or the baby or both)), and instead focus on the one good path:

That I am pregnant, and that at the end of September this year (or soon after) we will be a family of five.

I went to sleep last night thinking of all the hearts beating oh-so quietly in our house. Mine and my husband’s, my two boys, and deep inside me, in miniature form, the brand new heart of a miracle I’d long ago stopped hoping for.

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