Thursday, December 30, 2010

Why Does it Always Have to Be So Hard?

Where to start?

Tuesday was the one year anniversary of my losing Trey. I can remember almost everything about that day in vivid detail - what I wore, what time I called the doctor's office asking for an ultrasound, the list I made of things to ask which I then never needed, playing a game on my iPhone in the waiting room, joking with the ultrasound tech, answering her questions as she turned the screen away from me as if somehow that would save me from having to find out my baby had died..............

The day actually went okay. I was and still am sad and if I think about it too long I start to cry but I think that's normal. I think being pregnant again helps because I have hope that this will be our live, healthy baby.

It was back to Dr. Coulam's yesterday and the ultrasound went really well. The baby had a bit of a growth spurt and is now measuring a few days ahead. The heart rate was 171 so that is right on track as well. What wasn't so great was my blood work which once again came back showing elevated natural killer cell activity. The doctor doesn't understand why it keeps going up instead of going down since I have had the intralipid treatment.

She suggested I come back Monday for another intralipid IV and I asked if it has a better chance of working the second time around of if it would be worthwhile to try IVIg. She said that the IVIg is super expensive and I, like a total naive idiot, said that my insurance had agreed to cover it. She said in that case it was definitely worth trying that over the intralipids to see if I had a better response.

Back in July I had gotten prior approval for Gammagard as a treatment for recurrent pregnancy loss and so with that in hand I figured piece of cake. WRONG! The pharmacy called Blue Cross and they said that they would deny the claim. The pharmacy relayed that to me and so I called Blue Cross. Over and hour later I was told to call CareMark who administers my pharmacy benefits (despite me only having a Blue Cross insurance card which makes zero mention of someone else handling the pharmacy benefits). Anyway, a call to them and half an hour later I have confirmed my pre-approval for the IVIg and yet somehow now there's extra conditions such as it has to be ordered through a retail pharmacy and billed through my pharmacy benefits, not my medical benefits and on and on with a whole bunch of stuff that makes zero sense to me. A call back to the pharmacy yields the statement that they don't believe they will get reimbursed. At this point I give up for the night. It's exhausting and stressful (no wonder my natural killer cells are elevated) and something doesn't seem right about having to fight so hard for something that could potentially save my baby's life.

I spoke with the pharmacy again this morning, this time with a reimbursement specialist who agreed to all CareMark and check on if my pharmacy benefits really will cover the medicine like they said they would. Of course, it's now been hours since I spoke with her and I haven't heard back so that's probably bad news right? Or, was it good news and now she's just trying to find a nurse to come to my house to administer the IV?

I wish things didn't have to be this hard.

Monday, December 27, 2010

And Now, Nothing

Ugh! I haven't thrown up since the breakfast incident on Friday. What the heck? Sure, sometimes I feel a little nauseous but I'd rather have the full-on vomiting. I've also been eating more this pregnancy than any of my previous ones. In the past, I've always lost quite a bit of weight in the first and even second trimesters. So far, I haven't lost any. Today at lunch I ate an entire tuna melt whereas with all four other pregnancies I would have had a hard time even eating half. What does all this mean? Probably nothing as what is that thing I keep hearing? "Every pregnancy is different." But, what it really means is that I just have more things to feed my worry.

Last week I ordered a doppler and according to the United States Postal Service it should arrive today. I know I'm crazy for thinking I'll be able to find the heartbeat when I'm just eight weeks pregnant tomorrow but I'm crazy like that. I need some reassurance and it doesn't help that in the past my ob/gyn has always been able to find the heartbeat with a doppler sometime in the eight week. Please pray that I can find it and that it's still there to be found.

I hope everyone had a great Christmas. Mine was good and I even managed to get through two family celebrations without spilling the beans. I think we're going to wait until closer to Valentine's Day to tell everyone, although that seems so very far away.

Friday, December 24, 2010

Two Times

Yesterday I threw up my lunch and today I threw up my breakfast. Today I was at home but yesterday I was at work. The bathroom is oddly situated right in the middle of the office so if I'm in there throwing up just about everyone on my side of the office can hear it. When I came out one of my co-workers asked if I was okay and I said that I was fine, great in fact and have never been happier. Now, that may have been a bit of an overstatement because I'm sure I've been happier, but as far as being happy about throwing up it's true, I have never been happier to throw up.

Today is Christmas Eve and so I can't let the day go by without mentioning my little Trey who I was pregnant with this time last year. The husband and I were putting together toys of SB and QT after they had gone to bed when I started bleeding. Massively bleeding. I didn't know it then but soon I would lose the pregnancy and my little boy. This year I'm still sad, I don't honestly think I will ever not be sad about losing him, but I also have hope for this little baby inside me. Keep growing little guy.

Wednesday, December 22, 2010

Medical Mystery

The ultrasound today went well. The baby is measuring 7 weeks and the heart rate was in the 150s so I was very happy. All seemed well with the baby.

Everything is not as well with me, however. My natural killer cells came back elevated again despite having received the IV intralipids. Since this last blood test should have shown the full effect of the intralipids I was really expecting the natural killer cell activity to be back within the normal range. It's a bit of a mystery why they not only didn't go down but they went up. It makes me nervous. I had another blood draw today so the level's will be retested and if things are still elevated next week I'll receive another IV of the intralipids.

Thursday, December 16, 2010

Joy and Sadness All Wrapped Into One

I couldn't even bring myself to look at the ultrasound screen this morning until the doctor told me there was a heartbeat. It was great to see that little flickering speck. The baby measured 6wk1d and the heart rate was over 120 so I was happy. The last baby's heart rate never got that high. So, I'm happy, thrilled, excited and nervous, oh so very nervous. Once the ultrasound was over I was right back into the great unknowing. I can't feel the baby move, I can't find the heartbeat myself and so I'm just left to wonder if things are going the way they should. That's hard for me to accept.

I'm also a little sad this week. Had I not lost the baby in June I would have been induced this week and would be bringing home a newborn little girl. Also, a year ago today is when everything started to go wrong with my pregnancy with Trey. I had the first incident of bleeding and less than two weeks later we would lose him.

So, I am hoping that today's wonderful news means that we are back on the path to having good outcomes.

Wednesday, December 15, 2010

Feeling Good About Feeling Sick

I swear I have never felt so good about feeling so sick. I've been having waves of nausea off and on and I'm overjoyed.

Tomorrow is the big day.

Saturday, December 11, 2010

Fat Injections

Today I felt a little queasy and I've never been happier. Having lost a pregnancy where I was terribly sick the entire time it makes zero sense for me to want to get sick and yet feeling sick makes everything seem more real. And, I've had two successful pregnancies where I was sick, whereas the one pregnancy where I was never sick ended badly.

The ultrasound on Thursday went okay. For a brief time I thought I might have a blighted ovum. I honestly couldn't see anything in the sac but then things shifted and I could make out the yolk sac. The doc said there was a start of a fetal pole but I couldn't see that. They are dating the pregnancy at 5wk2d and fetal pole or yolk sac measured exactly that. The gestational sac measured 5wk5d, so a little ahead. I return on Thursday for another ultrasound and at 6wk2d we should definitely see a baby and a heartbeat. It makes me nervous just to type that.

After the ultrasound we reviewed my blood work results and my natural killer cells are elevated. Dr. Coulam said that could be from my body fighting off an infection or it could be my immune system reacting to the pregnancy. They drew more blood but I was afraid to wait until next week for the results because if they came back elevated again then would it be too late to treat them? So, we decided to go ahead and do an intralipid infusion just in case. The nurse got the IV in pretty easily, which is amazing since so many people have had a hard time doing that in the past, and then I just sat there for about an hour while the white liquid fat dripped into my arm. I never thought I'd be so happy to be getting fat put directly into my veins. I'm hopeful that if the natural killer cells are an issue that we caught it in time.

I've got Christmas gifts to wrap and a house to clean up so I'm going...........although probably going to nap instead of actually do those things. I'm worn out.

Wednesday, December 8, 2010

All My Love and Good Intentions

My fifth beta came back and it exactly doubled in 48 hours which made me quite happy. It went from 1,417 to 2,834. I was supposed to go back yesterday for a sixth but come on, who really gets six betas? Actually, I would have gone except that my acupuncture appointment got switched to last night and by the time I was done with that I was just too darn tired to go sit at the lab. Also, I am having an ultrasound tomorrow morning and so that will give me more useful information than any beta ever could.

How nervous am I for the ultrasound? So nervous that I think I'm making myself feel sick. Last week we saw the gestational sac but this week we should also be able to see a yolk sac and please, please, please a baby with a heartbeat. I know I'm just setting myself up for disappointment by having such high expectations but can't a baby help it's mother out some and just reassure me just this once?

As for feeling sick, I've been over analyzing every little twinge. Last week I had many incidences of bad cramps, like more than I've ever felt before and so I worried if I was starting to miscarry. Was my lower back hurting so much from lifting QT all the time or was it a sign that I was miscarrying? My lack of appetite I took as a great sign but now yesterday and today my appetite is normal. Heck, last night I ordered and ate a McRib so clearly I'm not having food aversions because if you'd be averse to something it should be a McRib. Monday I felt joyfully sick to my stomach but then felt just fine yesterday and today. Tuesday I felt a spot of pain in my right calf and just knew my body was forming another blood clot. Today, thankfully, no pain at all in my calf.

So, what do I do to try and calm myself down? I put my hands on my stomach and say "I am sending you all my love and good intentions" and I hope like heck that the baby can hear me and is listening. You are very much wanted and very much loved.

Sunday, December 5, 2010

How On Earth Did I Get so Jaded?

I was doing dishes yesterday listening to my iPod while SB and QT danced around the kitchen to Soul Asylum's Runaway Train. I've always liked the line "How on earth did I get so jaded? Life's mysteries seem so faded." Isn't that just so true? As children we are innocent and everything is new, exciting and fascinating. Then one day it changes and you lose that innocence and suddenly you're a jaded adult hoping for the best but often times expecting the worst.

My fourth beta came back Friday night and it didn't quite double. It was 750 Wednesday morning and Friday morning it was 1,417. Now, I know that is greater than the 66% rise that many docs look for and that the doubling time should fall somewhere in between 48 to 72 hours to be normal and mine is somewhere around 52 hours, so well within normal, and yet I'm jaded and so I worry. What if it's slowing down? What if the next numbers fall outside the normal range? Ugh. I wish there was a way to turn my brain off or I wish I could go back to a time when I didn't even know what a beta was.

Thursday, December 2, 2010

Sticker Shock

Let me first say that in no way am I complaining. I am thrilled beyond belief to be pregnant again. However, at my doctor's office yesterday there was a moment of complete sticker shock. I'll break it down:

1. $35 co-pay
2. $50 shipping and handling fee for the blood work
3. $450 paid upfront to the lab for the blood work, hopefully my insurance will reimburse me for some of this amount
4. $15 for gas because the office is 85 miles away
5. $2.50 for tolls

That's a total of $552.50 PER VISIT and I'll be visiting once a week for at least the next 10 weeks. Grand total......drum roll please.......$5,525.00. Holy cats! I am completely clueless where that money is coming from but I'm hoping I have to figure out a way to come up with it because that would mean 10 weeks from now I'm still pregnant.

On to better numbers,

my hcg level at 12dpo was 48, at 14 dpo it was 190 and the latest is at 17dpo it was 750. My progesterone has been between 35 and 45 so that is good too.

In other big news,

During my visit with Dr. Coulam yesterday she not only did blood work but an ultrasound. At only 4wk3d pregnant it seemed almost silly and yet I could see a little tiny circle with a dot showing where the implantation was. It was amazing. Next week I'm hoping to see a baby.