Details

Bear with me while I take us back in time, all the way back to the beginning of last week. I am a big fan of the Ineffable Now and letting the dead past bury its dead and all that, but if I don't tell you what transpired between then and now I am afraid that you will have no idea what the hell I am talking about. Some of this you have heard before, so excuse the repetition but... narrative flow, baby. It is all about the narrative flow.

Last Monday the Crappiest Ultrasound Machine in the Universe (TM) showed that the embryonic heart rate had dropped from 107 bpm the previous week to 93 or something equally disturbing. Immediately following this ultrasound I met with a new obstetrician, my old obstetrician having fled the little office of horrors with the coming of the new year. The new OB saw nothing wrong with a declining heart rate and started scheduling me for CVS testing, per my initial request. In his world I would not have been seen by a physician, phlebotomist or phax machine until I showed up at the perinatalogist on April 12th.

So, either he truly believed that embryonic heart rates do not need to steadily increase during the first trimester (in which case he is utterly incompetent and I pity his poor parents who must have been so proud when he got into med school) OR he was patronizing me (meaning he knew that I would most likely lose the pregnancy but did not feel he needed to share this tidbit with me.) Now, in the general scheme of things I can imagine scenarios in which women (some women) might prefer to just go about their hapless selection of nursery accessories until they miscarry one horrifying day, but I AM NOT ONE OF THOSE WOMEN. Among other things, if I do not do genetic testing on this pregnancy I will never know what caused embryonic demise, thus I could be dooming myself to any number of terrible reproductive decisions going forward.

So I jettisoned Dr. Loser and made appointments for another ultrasound and a consultation with a new new obstetrician. That was last Monday.

Tuesday I went for the ultrasound and saw that the embryo measured 6 weeks 2 days (rather than 6 weeks 6 days or, if you wanna get REALLY specific 7 weeks and 2 days per transfer dates) and the heart rate was 74 bpm. You are no doubt too busy to google this for yourselves, so I'll just go ahead and tell you that the miscarriage rate for this situation is in the neighborhood of 100% (+/- two standard deviations to allow for the possibility of, like, divine intervention.)   

Therefore, Wednesday morning found me leaving the new new OB's nurse a message so rambling and incoherent it could have been scripted by the Unabomber. Thankfully a nurse called me back within a few minutes and, even more thankfully, she was willing to overlook the fact that I was not technically a patient of theirs. She listened. She comprehended. And then she put together a reasonable course of action.

To wit: an immediate hcg check followed by a repeat on Friday (last Friday.) Once Friday's result was available I would meet with the doctor Friday afternoon and most likely have an ultrasound with them.

I cried because she was so nice and so efficient and so responsive. Then she cried because I was crying. I doubt this sort of thing happens with a proctology practice but I do not want to be guilty of gender stereotyping so I will leave the possibility open. Still, I doubt it.

Wednesday's hcg level was 13000 and something. What does that mean, you ask? Nothing.

Friday's hcg level was 16000 and something. What does that mean, you ask? Well, nothing much. It confirms that the pregnancy is not developing properly but it also indicated that it most likely will not be going anywhere on its own anytime soon.

I met with the new new OB Friday afternoon and fell madly in love with her. She is so SMART. And she has a sense of humor. And she was a genetics counselor before she went to med school and, you know, we have genetic issues so that is a nice synergy right there.

We talked and talked and I explained my whole obstetrical history and we put together a long term plan and a short term plan and heavenly choirs sang.

Unfortunately, their ultrasound machine was in use and we waited and waited and the person did not leave. So my new best friend suggested I just come back in on Monday. And that sounded fine to me because, as I told her, I was certain that there was no longer a heartbeat to be found and I was equally certain there would still not be a heartbeat on Monday. So, it didn't affect my weekend one way or the other and it was too late at that point to schedule anything further so I would have had to come back anyway.

Which brings me to my appointment yesterday. By the way, if you were paying attention you will notice that I went to either an obstetrician or a radiologist FIVE times last week. This is why my insurance company hates me and their entire actuarial staff camps at the mailbox each month, waiting for me to miss our premium by a day so they can cancel me. Ha! Fat chance! Not with my soon-to-be-patented Toast Rack Chronological Bill Payment System.

The first thing I heard upon arrival is that my doctor was not there, as she was out delivering some other patient's baby. Mazel tov.

The ultrasound tech brought me back to the machine and tried to enter the relevant information into her SUPERSUPER Deluxe Sono7000.

Date of last menstrual period? I did IVF, so, well, I guess you could say BLAH, but the last ultrasound said BLAH but the one before that gave a due date of BLAH so...

Is this your first pregnancy? Ha! Sorry! No. Ha HA HA! It's my millionth. Not really, but, it feels that way sometimes. No, this is number 8. Wait, sorry. 9. Ninth.

I decided to cut to the chase and told her that we were not going to see a heartbeat so chop chop let's just move it along, shall we?

So she started the abdominal scan and immediately said, "Oh but there is the heartbeat right there."

And I looked at her screen and then I looked at the WALL-MOUNTED PATIENT VIEWING SCREEN (how classy is this place?) and sure enough blip blip blip. I sighed really loudly and said that it was probably just me. And she said no, she was seeing it not hearing it. And I said, yeah, something like this happened three pregnancies ago and it looked like the embryo had a heartbeat but actually it was a vessel of mine that we were seeing. And the embryo was just a disintegrating string of tissue.

Whereupon she measured the heartbeat and it was, more or less, exactly what it was last week. In the upper 70s. Then she measured the embryo and it had grown a week to seven weeks exactly.

At which point I screamed Medic! and one of the partner OBs came in. She agreed we were all looking at a heartbeat. She agreed it was really fucking slow. She asked if I was taking baby aspirin and I said, uh, well, I WAS taking all this stuff but then, um, the last ultrasound practically showed X's for eyes so I, er, stopped taking everything.

Which is when she punched me in the leg, pretty hard, and said, "Oh just take the damn pills! And come back on Thursday."

So I did. And I will.

On an editorial note, I would like to add: am I supposed to be learning patience? Is that the Great Lesson in this? I assume I must be missing something, otherwise I would not have to keep repeating the same miserable experience over and over again. I have never heard of a heart rate just staying ludicrously low and steady while the embryo grows. It was REASONABLE to expect the embryo to have died since the last ultrasound. Why is the cosmos fucking with me? Any suggestions?

Comments

[Brandee]

yikes! Have you done the requisite googling to see what could possibly be going on???? Because? Google? Better than a medical degree. I have no idea what to wish you or what to say....so. just. wow. On another note, sounds like you've found an OB practice to stick with.

[Yatima]

Jesus God almighty, how horrific and bewildering and scary for you all... I vote divine intervention, this time by a BENEVOLENT deity, maybe Epona, the Celtic goddess of horses and successful pregnancies pulled off against all odds...

[Tine]

Holy crap! Just when you think you know what's going on and are prepared to deal with it....

Here's a thought: Perhaps it is YOU who is f*cking with the cosmos. You've certainly earned that right.

I'm going to keep sending you good juju. You've earned that, too! Hang in there, dearie.

[TB]

I have no idea how maddening and excruciating this must be for you. As someone for whom patience is not a strong point (understatement of the year), I would not be handling things as well as you have. Just know we are out here in cyberland hoping that you continue to find the grace and strength you need to meet each new day, or each new hour whatever it brings.

[reenie]

You know when you're lying on the table waiting to fall asleep before your D&C so you can get it over with and get on with life, but all the while you're wishing with all your might that this isn't really happening, and maybe if you try really hard you can get the world moving backwards and time will just flow in the opposite direction and everything will be alright again?
Well, when I read your "Not Good" post...that was what I was feeling for you. My heart stopped for a beat and I just closed my eyes...wishing with all my might that this wasn't happening to you. I just prayed that this will somehow work for you and you'll be able to watch your child grow and thrive. I don't know what else to say...I'm sure you know much more about low heartrates and what they mean than I do since I haven't done any research on it...but I know that miracles happen. I'm praying for a miracle for you.

[jen]

I fucking hate limbo. I hate fucking limbo. If there's a lesson to be found in this, you're a much better person than me (which I'm sure you are anyway). Wishing you . . . I have no idea. Wishing that Thursday somehow makes it here faster than it normally would.

[Molly]

How freaking bizarre. This just gets weirder and weirder. I'm hoping . . . HOPING this turns out well and thinking of you. How infuriating.

[Sheridan]

Excuse me, but, fuck! Julia! What the hell is going on??? I'm not sure what you are supposed to be learning from all of this. I'm as confused as you are.

But also, quietly, discreetly ecstatic that all is not lost just yet.

[SarahA]

That is one hell of a set of circumstances. You're still in my thoughts.

[Aimee]

Wow is all I can say...
A

[Ninotchka]

I couldn't help but laugh at your "x's for eyes" comment. Julia, how you manage to keep your sense of humor is truly admirable. As for the low heartrate. Well, shit. I want it to be good and only good news. Right now I've no clue. I'm just hopeful.

[Jen]

Holding onto tiny shards of hope for you.

[Kel]

Sorry the rollercoaster has taken an unexpected twist. Hang in there (I'm not sure how...optimistically? realistically? miraculously?), just hang in there and know we are all thinking of you.

Kel

[Catherine]

Praying for a miracle...... Hugs,C.

[Cat, Galloping]

Oh gosh, all this unknown when all you really want is answers. But, like Jen, holding onto tiny shards of hope for you.

[Jody]

Well, yes, clearly the cosmos is fucking with you.

And part of the fuck-fest is that knowing it's a fuck-fest doesn't give you insight into the future. It could end well, it could end poorly, you can't possibly know. Even what you suspect (impending doom) starts to seem implausible, because this? Is just bizarre. Totally, utterly bizarre.

The part I can't wrap my mind around is the slow heartrate and the growing embryo. That part's just...amazing.

Are you reconsidering the possibility of divine intervention? Because you know....

How you're managing to get out of bed and take care of Patrick is beyond me. I'd be curled up in the fetal position trying not to think or feel anything at all, for fear of my body exploding into tiny shards.

[Soper]

Shady Grove = Kool Kid.

You are growing a Buddah. He is Zen, and relaxed, and has no need to get all worked up and shit.

Keeping my fingers crossed that he kicks it back up a notch....

[Cricket]

My crystal ball shows you breaking the uppity fuckity muck ultrasound machine Thursday and you have to wait until Monday. Then dimwit partner #3 says to tell Junior to lay off the 'ludes.

[Scully]

I cannot type swear words as I'm on the office computer.

But I'm sitting up front with you on this roller coaster ride, as my stomach stays in the air as we lurch to the ground and I'll keep sitting up front with you.

I must post from home so I can type swear words.

[Anna H.]

Holy shit.

Wishing that Thursday would get here soon and hoping, oh hoping for you Julia.

xxoo

[KatBT]

Holy shit!
The universe really is fucking with you, isn't it! I can't believe this. Lesson or no, this is just insane and you must be sick with worry. Ugh!

On the upside, you've met an OB who was a GC so she's gonna totally understand the translocation. No matter what the outcome of this PG, sounds like you have a winner there.

Another thing to think about... after about 5-6 weeks the HcG isn't supposed to double any more, and at some point, maybe 7ish weeks but I can't remember exactly, it actually starts to go DOWN. At least that's what my OB told me... since I was having blood drawn once or twice a week my last pg (my now dd Hope.) I swear, this translocation thing has turned me (a lifelong needle-phobe) into a beta addict... I was getting track marks my last pregnancy. I'm NOT kidding.

I'm hoping and praying this next appointment sheds some more information, maybe even some GOOD news for you. Is there any chance that this is a viable pg? I'm gonna go google low heart rates now.

Thanks for the update. I'm sending you all the warm loving vibes I can. I so wish this wasn't happening to you. It's sheer agony, I know.

~Kat

[m]

Love your OB, hate that you are still in limbo here. Struggled but managed to make it through the whole post without jumping to the end--honoring the narrative flow! Wish there were more I could say or do--other than a general shout out to the universe--Hey! WTF?!

[Lioness]

Well fuck me but this is unbearable, I don't know what to wish for anymore, I mean I do but it didn't make sense anymore and now it still doesn't but it makes less less sense than bfr I read this and I am NOT making sense at all but what are you supposed to do, just wait? ARGH!!! Oh Julia, bloody hell! Here's hoping for divine intervention, why not, everything else seems to have happened already.

[ManhattanAnne]

OH MY GOD!!! The universe is seriously fucking with you. Like you maintained your equanimity so well in the face of certain fetal demise that they thought they'd make things UNcertain and see how well you cope with that. But you know what you've got here now, hon? You got yourself a Briar Rabbit type situation, one Steve and Patrick have already taught you how to handle. So I say you get back on the meds and tell fate to bring it on. I'm now going to be even more OBSESSIVE about checking this blog. WIsjing you every kind of luck.
-Anne

[ManhattanAnne]

OH MY GOD!!! The universe is seriously fucking with you. Like you maintained your equanimity so well in the face of certain fetal demise that they thought they'd make things UNcertain and see how well you cope with that. But you know what you've got here now, hon? You got yourself a Briar Rabbit type situation, one Steve and Patrick have already taught you how to handle. So I say you get back on the meds and tell fate to bring it on. I'm now going to be even more OBSESSIVE about checking this blog. WIsjing you every kind of luck.
-Anne

[Bella]

Just torture.

[Emily]

I hate nebulous - drives me to distraction. My stomach is in more knots than yours. I'm sitting here very quietly waiting with you on the edge of my seat, literally holding my breath. And holding your hand the entire time and sending a lot of prayers your way.

Love,
Em

[tracy]

Jesus H. Christ. How do you stand it?

[Crystal]

Julia, I think we went through this before, and I'd be pretty damn sure SG made sure you had a comprehensive clotting/immune workup before this whole mess, but I've recently learned, the "normals" have all been redefined in the last years, as expected more immune/clotting factors have been discovered.

Hell, woman, I don't have anything more conclusive than a low SRP, and a "very high risk" CRP (by the new standards), and a paternal family history of every vascular disease known to man. But it still takes me baby aspirin to get pregnant, and stay pregnant anymore, and judging from the developmental and physical issues babies 2 and 3 have recently been diagnosed with, it may take a hell of a lot more than that for me to actually produce a normal, healthy child (were I so inclined to do so, at this point, not so much, because being scared shitless has finally overwhelmed my baby girl lust)...

Also, did you know that you can have normal clotting/immune results while not pg, and the problems don't show up until you're pg? Or vice-versa? It's all really, really fucked up.

Whatever happens, consider begging borrowing or stealing a full immune/clotting work up a la Dr. Beer NOW, WHILE YOUR BODY STILL THINKS YOU'RE PREGNANT, and then if something happens this time, wait at least 3 months, and have them repeated. And then another 3 months, just to be sure your body is no longer responding to the vertible hormonal cocktail that is pregnancy. And then repeat 1 year post....

I had a funny feeling a long time ago that there was more than one issue going on, but you were tested, I'm almost certain. Still, things change. Results change, particularly with people with immune/clotting issues because the aging process itself is related to the progression of these diseases.

It still may be another false lead, but maybe not...

Meanwhile I curse the cosmos for it's inhumane cruelty.

[chris]

I think you might have a "fuck with me, universe" sticky stuck to your back. Go look in the mirror. I'll wait.

[Brooklyn Girl]

Good Lord, Julia. I can't think of a thing to say except hang in there.

[VHMPrincess]

Egads....I'm hoping the little bean has decided to take up residence!

[Susy]

I honestly don't know how to respond to this latest development. A big score for Mother Nature, a big effing GOOSE EGG for medical science.

Hang in there, my friend. Many hugs.

[Cecily]

I cannot imagine what's going on. I was thinking some terrible joke about a really, really mellow baby but decided to stop myself. Yep. Dunno. Waiting to find out what's next.

[Karen]

Oh fuck. That's really all my vocabulary can handle after reading that. I seem to be saying it a lot these days, but the universe has been taking some pretty horrible turns. I just hope--well, you know.

*love*

[Mollie]

O....... K.......

Put on your seatbelt. It's going to be a bumpy ride.

[Holly]

Praying this is a miracle in progress. Absolutely amazing that you're handling it with humor, though I shouldn't be surprised by that.

On my knees, begging for divine intervention. Can't possibly wait until Thursday....

[kristy]

julia, i'm so unbelievably sorry. the cosmos just love to fuck with us, do they not?

this same thing happened to me, last month. saw a heartbeat of 93bpm long after i figured the embryo had died. of course, it wasn't visible on the crappy u/s machine, but on the supersono, you could see every blip. i really wish i hadn't seen it.

i don't know what to tell you. i wish i had an answer for why things must drag out in the horrifying way that they do.

thinking, praying for you and hoping for some divine intervention.

[Lala]

Hello Universe? This is not Days of Our Lives! It's Julia's life and her ratings were already good so stop messing with her!

On pins and needles until the next installment.....

[Moriah]

I didn't post when I read 2 entries ago, thinking "a sympathetic comment means nothing," but now that I know it would've been appreciated... Now I must say, OH MY GOD. Hang in there. I'm hoping for the best for you.

[Lisa S (& Riley, Bella, & Adelyn)]

I don't know what to say, but I'm pulling for divine intervention. Lots of prayers are headed your way from me, if it helps. Hang in there.

[Kristin]

Clearly, the universe is fucking with you...and that is NOT fair. I hope and pray your little one is a slow starter and you will be the exception to the rule.

[Laura K.]

Freakin' Frack - don't even know what to say about all that. I'm going to hold out a hope for divine intervention here...or at the very least sanity for you in the meantime.

I will say, though, that I am SO glad that you love your new doctor and staff. She seems to be everything you need!

Hang in there.

Laura

[Jen/VintageUterus]

TOTAL MIND FUCK ALERT!!
God, I'm so sorry. Hang in there. I understand.
hugs.

[Juno]

Great Interstellar Mind Fuck, Batman.

I am not much of a prayer, I gotta tell you, but I am praying for you and Steve and Patrick and your passenger just as hard as my little agnostic heart can pray.

I wept last week, but didn't say anything because, well, what could be said? But you've got one more out here pulling for you.

[BeckyB]

Damn Julia...all I can say is that I hope the cosmos come around this time. Silently holding your hand while you wait for Thursday...

[halloweenlover]

with all these good thoughts headed your way, there must be something good that can come of this. I am hoping hoping hoping for good news come Thursday!

And very thankful that this doctor seems so good and that you have a plan of action for the future. That is always a comforting feeling.

[Kinneret]

No cheery words of assvice here ... just wishing the universe gets off its ASS and helps you out here. Thinking of you.

[Rose]

Oh my, don't know what to say, other than maybe it's a miracle?? I hope for your sake it resolves one way or the other SOON, so that you can move on...

Rose with Ryan, Luke and ?? due Aug/05

[Sarah]

Maybe it's destined to be a marathon runner?
Sarah