It’s complicated

I’ve been doing a terrible job keeping this blog updated at regular intervals. I think I’ll just have to accept that and do the best I can. But, part of the explanation is below.

I’m 20 weeks today. Technically just about halfway there. The babies are doing quite well. Both are healthy sizes and weights and, while they are starting to differ in size, their sizes are still close enough to one another that it’s not an issue.

However, around 16.5 weeks I learned that my cervix had become short. Very short. As in .6cm short, when it should be 3cm or above. At that point the MFM doctor who oversees my ultrasounds (since I was seeing midwives) said she was very concerned, but that, at the end of the day, there was nothing they could do, so I’d have to see what happens. She said if it was a singleton pregnancy they could have placed a cerclage (a stitch in the cervix to keep it closed) but that it was not recommended for twin pregnancies. (I later did some research and ultimately agreed with that assessment, as the risks outweighed the benefits.)

I was pretty devastated, especially because no one really seemed optimistic. The common refrain was wait and see. They did put me on pelvic rest and reduced activities, but there was not much else. They don’t prescribe bed rest much anymore, or rather, doctors are moving away from that unless the situation is extreme because bed rest itself can cause a slew of problems. Granted, once I got to the point where I could do some research, I was seeing that people with my cervix length were being put on hospital bed rest, yet my doctors were not recommending it. The discrepancy in recommendations was disconcerting.

One of my best friends did some research after I called her in tears and found women who’d had cerclage pessaries placed instead of the cerclage. The pessary is essentially a silicone ring placed around the cervix to help hold up the uterus and/or alleviate pressure on the cervix caused by the pregnancy. It is also non-invasive; the cerclage stitch is a minor surgery (and runs the risk of infection), whereas the pessary is just inserted like a diaphragm. So at the next emergency appointment I had less than a week later, I asked one OB about it and he didn’t think it would help, but referred me back to the MFM and she not only thought it was a good idea worth trying, but went ahead and placed it. It was painful to me, as the actual pessary is large, but you don’t really feel it once it’s in.

Emotionally, all of this has been very hard. Learning that there is something wrong, something that you can do very little about, is very hard. Learning that my risk of losing the babies is around 80% given my particular cervix length, is very hard. I try to be as positive as I can, but the reality of the situation is too heavy sometimes. When I told my mother, one of the things she said was that I can’t live in fear, that I can’t live in the fear of it. That has been helpful, but again, I still have my moments. The few people I have told all say some version of needing to be positive and then talk about normal pregnancy things. I appreciate that, but sometimes those conversations are difficult. I know they are trying to make me feel better, but I can’t ignore the reality of the situation.

At my latest appointment three days ago, I learned that my cervix is at about 1.2cm. So the pessary has helped a little. The cervix is still quite short, but it is something, and at this point I will take anything I can get. I am still on pelvic rest and significantly reduced activities. No prolonged standing, no lifting. I can walk around the house, but need to sit as much as I can, laying down is better (though not for too long). They also put me on vaginal progesterone when this started (to support the uterus and prevent contractions), and I still take that.

At those last appointments (I meet with a regular OB and an MFM, no midwives anymore, which is another story) both doctors said that the goal right now is to make it to 24 weeks because that is the point of viability. There were lots of “if we can make it to 24…”, “we want to get to 24…” etc. That hit me really hard. That, and how one of the doctors felt almost 100% certain these babies would be born quite early, again, if I made it to 24 weeks. It’s one of those things where, I recognize the reality of the situation, but hearing it put so plainly struck me, and I’m still dealing with the impact. There is so much uncertainty on whether I will even make it to 24 weeks. With each week that goes by, another hope, dream, and desire for this pregnancy goes out of the window. No homebirth, no midwives, dwindling chances of natural delivery, no normal. At this point I just want the babies to stay in, but instead of hoping for 39-40 weeks, I’m at “let’s just get to 24, anything past that will be a bonus.” The NICU is now very likely to be in my future, and, realistically, it’s likely to be a long stay for the babies, which comes with it’s own risks and consequences, health-wise and developmentally. I just want two healthy babies and it’s not clear whether that will be the case.

I feel them move often. It used to fill me with excitement, but now it is mixed with a bit of anxiety. The lowest baby, Baby A, is very low, and their head is constantly rubbing against what is now the open funnel of the top of my cervix. I was told that the bigger they get and the more they move up against it that the more stress there will be on the cervix. I want moving, active babies, but every time Baby A is very active it makes me nervous. I hate feeling that way.

The rest/reduced activities is hard too, especially because it is just me. I have to rely on others so much more now, and I realize I don’t have as many people as I thought I did. Or maybe I do and I just can’t see it. I don’t know. But simple things like washing dishes, making food for myself, picking up something I dropped, I can’t really do. Cleaning is not often. Laundry is not often. I know in normal pregnancies these actions can become hard, but they are especially hard in this case because of the added stress they place on the cervix. I have to be strategic about which days I shower (since daily is too much) and when I wash my hair because of the prolonged standing. I order food far more often than I used to, which helps in terms of staying off my feet, but doesn’t help my budget that is getting tighter and tighter as I’m still in the process of closing on a condo (which has hit another delay).

I had a fleeting moment where I wondered if I’d made a mistake in not waiting to do this with a partner. The moment was in passing, but it was very real. When you think about having a baby on your own, you know that there’s a chance things might not go smoothly, but I don’t think you think about it seriously, or you do and think you can handle it. I knew there was a possibility things could not go smoothly, but I assumed the chances were small. But here I am.

I’m actually still staying with friends at the moment because of the last-minute condo debacle from two months ago when the last one fell through at the very last minute, leaving me homeless. They have been helping me a lot, but that is not forever. They’re actually out of town currently and all the things I can’t do or need help with seem magnified, and representative of what it will be like once I move into my new place.

I’m fighting the urge to just withdraw from everything and everyone because this situation feels so isolating. I don’t feel like I can talk to a lot of people about it, for the aforementioned reasons. Telling people about the situation also takes an emotional toll on me, constantly recounting the issue. That and, on the flip side, it feels like I’m being a burden when I express concerns about the realistic aspects of this. Some days I’ve considered joining an online forum, but some days I have a hard time reading other people’s experiences. It’s a mix of hope and heavy that I’m not ready for yet, though I feel I would find support there. I’ve read that working on your registry or continuing with baby planning can really help during this time, as it gives you something positive to focus on. I’d started working on my baby registry and buying some clothes around 16 weeks, but both of those have been on hold because they are emotionally taxing right now.

On the flip side of all of this, I am happy that I have made it this far. I’m 20 weeks. A little less than 3 weeks past when I first learned about the short cervix. I’ve made some progress. The babies are healthy. I’m committed to doing whatever I need to maximize my chances. Their chances. Every morning I tell myself that I can do this. Every morning I say out loud that we are all going to make it through this. Sometimes my resolve is shaken and my faith in those statements is thin, but I say them anyway.

So that’s where I am now. Just counting every day that goes by as a success and one step closer to my first goal of 24 weeks.

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Uncertainty

So another gap in posts. This one was a bit intentional, largely because I was concerned about miscarriage, and more than just my general (elevated) concern.

A few days after I got to 8 weeks and graduated from my fertility clinic, I experienced a weird gush of vaginal fluid. While I was at work of all times. There was a little blood in it, but barely…and then that was it. Nothing. I freaked out initially, but then, after quickly looking things up online, saw that it may not be a major issue, but only a doctor could tell. So, somehow, I went about the rest of my day. But the following morning I decided to call the midwives group I was going to be seeing and spoke to a nurse. Based on what I told her, she thought I was having, or had, a miscarriage and told me to go straight to the ER.

Many hours later it turned out everything was fine, that maybe it was a blood clot. Both babies and sacs looked good. Heartbeats good. I was sent home and was to follow up with my doctor in a week or two.

After that, I had some bleeding, and passed what I assumed were clots/old blood. So, it just became a waiting game. Everyday was filled with a little worry due to uncertainty at what was happening. As such, I couldn’t bring myself to post.

I had a 10 week sonogram at my first midwives appointment and everything was ok! Not only that, but they were really moving around, which was amazing to see. I was a bit awestruck. That appointment (and the persistent nausea) really made me feel better and felt like a little weight (of worry) off my shoulders.

So, here I am now, a day shy of 12 weeks, and I just had my NT scan. The results of that were worrisome for one baby, so they’re doing a more descriptive blood test (NIPT). I have somewhat mixed feelings about this, but I’m honestly just glad they’re looking alright and moving around. I also don’t want to do any invasive testing because, at this point, what is, is, so I’ll just see what happens when they’re born…When written like that it seems really blasé, but I’ve actually thought a lot about this and, short of a lethal condition, I will deal with whatever comes as it comes when they’re born.

I can’t believe I’m nearing the end of my first trimester. While I know it’s still early and we’ll have to see how things go, I also know that, statistically, my risk of miscarriage is fairly low. I’ve been able to focus less on that and more on other things, which is nice. Every time I see them, I feel a little better. Since they’re twins, I’ll be seeing them often, even with being in midwife care.

All of this has seemed to go by really fast. It’s amazing to me, that I’m here at ~12 weeks.

Wow.

1 month later…

Clearly it’s been longer than two weeks. More like a month. A lot has happened in this past month, both in this journey and in other parts of my life (including being in the process of buying a condo, which is stressful to say the least). So I’ll just get right to it.

Right before the end of the two week wait I bought two home pregnancy tests. One of my best friends was in town and I told her I was going to take them two days before my blood test. I could tell she wanted to ask if it was a good idea or not, but I convinced her that it was, that either way it may give me some info, but that I wouldn’t hold it as absolute. I’d also had trouble sleeping all that week leading up to the test, waking up at the same time every night, and, after doing some researching, found that it could be a sign of pregnancy, with it’s impacts on your hormones impacting sleep. But only for some women, of course. So I had my suspicions that I might be pregnant, but still, tried to be realistic about it. Long story short, the first home test was immediately positive. So immediately, in fact, that I thought I might have done it wrong, so I took the next one, and that one went positive as well.

Two days later I had my blood test and it was positive. The clinic had me come back two days later to do another test, just to make sure, and it was positive again. Each time they said I was pregnant, and that my numbers (hcg) were really high, though no one indicated what that could mean. So, of course, I did some searching online as to what that meant, and I’ll get to that in a minute.

I was a little in disbelief initially. I wasn’t expecting to get a positive on the first try. I was hoping I would, but I was trying to be realistic about it.

After the positive results I was excited, but the excitement was tempered. The adenomyosis diagnosis still hung over my head, making me feel cautious, and preventing me from getting too excited. It was heavy, as I was still dealing with realism versus optimism.

Fast forward to freakouts about weird spotting (which turned out to be implantation spotting) and weird sensations in my abdomen. At some point I just had to let some of the worry go and just accept what may or may not happen.

Last week I had my 6-week ultrasound (still trying to get used to the standard convention timing that adds two weeks) and everything looked good. I also learned that there was not one, but two fetuses.

Two…Twins…

WTF…

That’s why the hcg levels were so high.

That is what I’ve been sitting with the past week. Twins. I was in shock for a bit. I knew it was a possibility, given my hcg levels were so high, but to actually see it was still shocking. I was happy that they were doing well, but shocked because twins were not the plan. As a single woman, twins were not the plan…But, as all things related to kids, plans immediately go out the window. Pre-laid plans mean very little. The universe has other plans (in all it’s randomness, which I know doesn’t make any sense).

The shock has worn off and now I’m just trying to think logically about what it will mean to have twins, provided this pregnancy goes full term (knock on wood) and that they both go full term (knock on wood). Even the doctor said it’s still early, so we’ll have to see, but that they look healthy thus far. I admit, thought, that with the shock being gone, I’m also getting a bit excited about the idea of twins. Stressed, but excited.

Oh, but the morning sickness. How could I forget about that. I had that starting in week 4. I’m guessing it started on the early side because of the twins. I am nauseous from the moment I wake up, til the moment I go to sleep. My sweet tooth is gone (which I suppose isn’t a bad thing). Half the things I normally ate I can’t stomach, and all the other things are only mildly appealing. And I’m extremely tired. I have never been this tired in my life. I take partial naps now, which is huge for me since I’ve never been a napper. I say partial because I don’t fall completely asleep, instead I just hover above sleep most time, but it seems to do the job.

So now we wait and see. Which is what I keep saying. Wait and see. I’m trying my best to just go with the flow and stay relaxed and open to what may come, while taking care of myself…and trying to keep food down and getting more sleep.

A first time for everything

Today was my first IUI and I’m still a little in disbelief.

I’ve been in my thoughts a lot the past few weeks as I prepared. Lots of emotions were coming up for me about the process, emotions I’d tried to put away a few months ago. I was trying to manage the feelings of excitement and optimism, with anxiety and realism. The fact that I have adenomyosis, and therefore a higher risk of miscarriage, makes this a bit tricky, especially because there’s no way to know to what extent it will impact my attempts. It could either impact the process severely, or have no/minimal impact. Also, knowing that, because of that fact, a positive pregnancy test doesn’t mean it’s a done deal. This is true for everyone, but especially true with regard to this condition. So it feels like I wouldn’t be able to give a sign of relief until I was at least 32 weeks. That’s been challenging to sit with. To deal with it, I’ve been trying to be a realist about the process (with an emphasis on “process”), but I felt like it was masking what optimism and positivity I should have. On the other hand, I didn’t/don’t want to be so optimistic that, if a negative test result comes back, and if more than once, I’m not overly disappointed or devastated.

But can you really prepare for that? Can you really prepare yourself for disappointment? Should that be the focus?

I realized it shouldn’t be, at least not to the degree that I was letting it. Right now I’m just going with the flow. Letting what happens, happen, as best as I can.

I was on Clomid last week. That was an experience. My dosage wasn’t that high, but I felt the effects after the first day or so. I don’t normally have emotional PMS symptoms, or rather, it’s never really been to the degree that I notice it, but the Clomid was a different story. Extremely tired, irritable, sudden mood swings…That was fun.

So now, the two week wait.