28 days later

It's been four weeks. Incredibly, my period showed up today, almost right on time (usually I have 26-day cycles). I'm surprised only because I thought my body would take longer to kick back into gear. But no, we're back in business, earlier than I'd expected.

Here are a few random thoughts:

1. Overall, I recovered from the D&C very easily. However, my breasts were still really tender for five days afterward, and I didn't feel like myself (read: not pregnant) for about a week.
2. I read and intend to post a review of Rebecca Walker's new book Baby Love: Choosing Motherhood After a Lifetime of Ambivalence. The summary: this book annoyed me. More, hopefully, on that later.
3. I have a few new phrases in my vocabulary. They include, "my first miscarriage," "the second time I was pregnant," "my second D&C," and, my favorite, "I am down two pregnancies and three embryos."
4. Today in Whole Foods I really enjoyed pushing past an extremely fertile woman (two babies under the age of 2) in order to grab three boxes of tampons. Fun!
5. On the bright side, I have lately enjoyed tuna, tequila, and running. I have stopped taking all vitamins. I have painted my toenails with abandon, done a shoulder stand in yoga without caring, and bought clothes without worrying that soon, they may not fit.
6. On the less bright side, I have still not returned to my pre-pregnancy (#2) weight. As I was miscarrying I gained a few pounds, and I have not dropped them. (Lest you think I sound like Bridget Jones: years ago I lost nearly a third of my body weight, and it's important to me to maintain that loss. I do that by trying to vigorously police my weight and dieting when I exceed the maximum weight I can tolerate. I am still not skinny in the least, and as I've said in the past, I'm a girl who enjoys my chocolate cake.)

This has been a difficult and hectic month for me -- aside from the obvious, I've also been dealing with a now-somewhat-abated family health crisis. As a result, I haven't yet adequately mourned my embryos -- I'm sorry, I can't call them babies. Next week I should get the pathology results back from my doctor's office, and that should provide some closure. It seems the results could show a few things:

a) Down Syndrome. This is actually the best scenario, as it explains the cause of the miscarriage and doesn't indicate anything about the prognosis of future pregnancies, theoretically.
b) Genetic translocation. This would indicate something about either my or the donor's genes, in a more permanent way. Since the donor has a number of births, it would probably be me. So not good.
c) Nothing. If the pathology can't explain the miscarriage, that's bad. Either it could mean I have some kind of clotting disorder that prevents blood from getting to the embryo (diagnosed by blood tests, treated by injections that may not be proven to work). Or it could suggest I have a uterine malformation that could explain both the miscarriages and the infertility. (Treatment: surgery.)

Never have I hoped for Down Syndrome more.

No longer pregnant

It's over. The D&C yesterday was a bit painful, but the pain was brief, and overall it was a piece of cake. (I was in and out of there in less than 45 minutes.) Unlike last time, every person in the office I saw offered their condolences. It's funny how much of a difference that makes.

I spent the remainder of the day on the couch, sleeping, watching quality TV like "Celebrity Fit Club," and eating won ton soup. I was pretty knocked out by the drug cocktail they gave me, but haven't had any pain. Today I'm back to normal.

This time was much less physically draining, but I don't know where I am emotionally. I'm still stunned that this happened again. When this first started happening last week, I thought, I have never been inclined to read a book like When Bad Things Happen to Good People until now. When I mentioned this to someone else, she said, "I just keep thinking of Job." The night before the D&C, I was up for a couple hours in the middle of the night, thinking, reading, and crying. I tried to re-read Job, though my attention span was a little lacking. He has everything -- kids, servants, land, etc. Then he loses it all, and asks God why. Eventually he gets everything back -- twice as much as he had before.

That first pregnancy felt like everything to me. I was so excited; I distinctly remember driving on the freeway being so thrilled with my secret. I was devastated when it ended. And the second pregnancy was really a savior: it came at a very dark moment as my hope was eroding. I was so confident it was going to work this time, especially given my HCG levels. I was superstitious about numbers, about the fact that it was my last IUI attempt before moving to IVF. It felt like everything had finally fallen into position.

So you'll forgive me for not sequestering myself in a corner this time, sobbing constantly. I've done that before. And I really don't know what to do with this experience. I don't think it was my fault; I don't feel there are any lessons to learn; I wouldn't have done anything differently. I am still in shock.

The doctor will analyze the pathology of the tissue she removed yesterday, and we'll get the results in about five weeks. If it's a common chromosomal abnormality, they don't worry too much, but if the tissue has a more unusual genetic variance or is genetically normal, then they'll want to test me for a bunch of other things.

In the meantime, I am taking a big fat break. Last time I miscarried I tried again as soon as I could, and I didn't stop for 12 consecutive cycles. I was a woman on a mission. Now I am really excited about having some serious time off -- time to sit in a hot tub and not worry that it's frying my eggs, time to drink whenever I want and not worry what half of my cycle I'm in, time to eat raw fish, go running, get back into shape, and travel. But most importantly, I am excited about getting back to my pre-TTC self. This process has been so hard on me. It's warped my priorities and made me a crazy person, and it's hurt my relationship. I'm ready to put the bun project aside for a while so I can get my life back.

Coming soon: miscarriage number 2

No heartbeat on today's ultrasound, so I'm having a D&C tomorrow morning.

The universe is awfully rude. Not only do I have two embryos with no heartbeat, but I also have a bad cold coupled with zero miscarriage symptoms and still-present pregnancy symptoms. Good times.

Anniversaries, part 2

Today is the anniversary of what may now have the distinction of being my first miscarriage. And since I seem to be the subject of the world's biggest practical joke, it is also Take Your Children to Work Day at my office. Whoo hoo! Plus, there's this whole, 'is my pregnancy going to fail and when' question. Good times, really.

It's hard to know what's going on with my body: my breasts are still quite tender (I keep feeling myself up in the night to double-check), my mild nausea is still around (though is it ebbing? Is my stomach unhappy because I'm upset? Hard to tell), and my temperature is still really high (98.8 this morning, about as high as it ever gets.). I've had no spotting since Sunday, when I had a minuscule amount, and pretty much no cramping. WTF?

Emotionally I don't even know where to begin. Last time I was a mess from the moment I had the bad ultrasound. This time I'm numb and in shock. I feel like, I'm not sure I can afford to go there again. It just seems so obvious. This last two week wait made me crazy. I was tired of being depressed and despairing even when I was depressed and despairing. I identified with what Max's Mommy wrote about being sick of her infertility:

I'm tired of me. I'm tired of thinking about This all the time, writing about This all the time, talking about This all the time. I'm tired of hanging out at my very own personal Pity Party. The chips are stale and the music never changes. (For some reason it's Come On Eileen by Dexy's Midnight Runners. Makes me want to jam an ice pick into my eye socket. Repeatedly.) And don't get me started on the guest list, a boring navel-gazing crew which consists solely of Feeling, Sorry, For, Myself.

I'm kind of there, too. (But I love "Come On Eileen," and the cookies at my party are always fantastic.) Maybe -- probably -- my somewhat stoic black humor will evolve to massive fits of sobbing. But when you pile upon the logistical challenge of getting pregnant as a lesbian, a miscarriage, a year of unexplained infertility, the reluctant decision to have one more IUI and then move to IVF, and then a second probable failed pregnancy that -- just to pour some kosher salt into the wound and stir it around real good -- would have yielded not one but two children: I mean, if that isn't the universe flipping you the bird, what is?

I'm Jewish but not very good at it. In Jewish tradition, you light a Yarzheit candle in memory of someone's death. Judaism doesn't have a ritual for miscarriage, nor does it even recognize a person's existence until something like 40 days after birth. But I always thought I'd light a candle today for last year's miscarried embryo. But given where I am now, I'm not sure I can do it. Last year, after I miscarried, I went to the beach, wrote a letter to what would have been my first baby, said the Mourner's Kaddish, and cried. The letter, the ultrasound picture, and the positive pregnancy tests are in an envelope labeled #1.

I cannot believe I may have to label a second envelope #2 and #3.

Unkind universe

I wish I had good news to post, but I do not. Today's ultrasound showed almost exactly the same thing that my 7-week ultrasound did last time.

The main difference: this pregnancy started off as identical twins (thus explaining the high HCG numbers), but one twin is very small and has no heartbeat. Unfortunately, the surviving twin is one week too small (measuring 6w1d, as opposed to 7w1d) and has a slow heartbeat (115 -- they'd like to see it at 140). My doctor gave me a 95 percent chance of miscarrying. I am scheduled to go back in a week to see if anything's improved, but this embryo basically grew 2 days worth in 8 days based on the last ultrasound.

If I end up having a D&C, they'll run some tests on the tissue to see if they can figure out what went wrong. (I wasn't able to do that last time, since I passed the bulk of the pregnancy before the D&C.)

I am in complete shock. I was so sure this one was going to work -- I feel more pregnant than last time, and I just felt the universe couldn't do this to me twice. Apparently, I was wrong. I simply cannot believe this is happening again.

Countdown

Last week I came home from a super-relaxing yoga class and noticed some spotting. Of course I totally freaked out, even though the amount was small. I've been having menstrual-like cramps throughout this pregnancy, which didn't worry me until I saw the spotting.

I called the doctor's office and was told to monitor the spotting and call if my cramps or spotting worsened. The spotting went away for a bit, but when it came back I called my doctor's office and was able to go in for an ultrasound. (On a Sunday morning -- I am very lucky.)

I was six weeks exactly, and there was some good news: first, I am indeed pregnant; second, the pregnancy is in the uterus, and third, the embryo measured 5 weeks 6 days (the machine has an error rate of plus/minus 4 days), which is perfect. We didn't see a heartbeat, which the doctor said was okay because it was a little early (he said seeing a heartbeat would have been "a bonus"). But seeing that ultrasound was a huge relief. At least now I know what not to expect next Monday, when I have my next appointment.

I have faith this is going to work. I definitely have pregnancy symptoms -- crazy tender breasts, a bit of nausea, fatigue, low energy, crankiness. The spotting is gone, and here's hoping I can remain calm for the next six days and two hours.

What happened last time

I was cautious. I barely told anyone, even my family, and when I rubbed my belly, I said, "I hope I get to meet you."

Thus it was not entirely a surprise when, seven weeks pregnant and on a one-day trip to Los Angeles, I looked at the toilet paper after peeing and saw a tiny, miniscule amount of spotting.

The following day was my "viability check." This is the ultrasound they do at around 7 weeks to check the pregnancy -- is there a heartbeat, is it ectopic, etc. Even before the spotting, I was counting the hours before the appointment, as I knew that if you see a good heartbeat at that first visit, your risk of miscarriage drops from 25 percent to 5 percent. And when that day finally came, the office people gave me a big book about giving birth at the local hospital -- stopping once to swap out the first book they provided after realizing I was an elderly gravid -- before the ultrasound. Or in other words: before they knew if I was going to need it. Which, it seemed, I would not.

I will never forget how Dr. Unsympathetic squinched her face looking at the screen. The ultrasound revealed a week-smaller-than-expected embryo and a slow heartbeat. This, coupled with the spotting, was not good, but she was optimistic and sent me off for urine and blood tests and instructed me to return in a week. Only later would I learn, from reading my own medical records, that on this day she had recorded the phrase "possible embryo demise." Information that might have been useful if she had actually uttered it to me. (The good news, I suppose, was that I was pregnant and it was not ectopic.)

The following day, as I continued to spot, I called her and asked, how likely am I to miscarry? Her answer: 70 percent chance of a miscarriage. Hey, now that's information. Over the agonizing following week I barely held it together, shying away from children, painfully aware of my fading pregnancy symptoms, and petrified the increasing blood would begin flowing uncontrollably while at work. One week later, the follow-up ultrasound revealed what I already knew: the embryo was dead. We scheduled a D&C for the following day.

That night, I woke up with very strong cramps and knew the miscarriage was beginning. Over the next two hours I sat on the toilet, watching the products of my conception fall into the bowl. The bleeding was so heavy that I could barely leave the bathroom without making a complete mess. And though this experience was unpleasant, the fact that I was emotionally prepared for it made a tremendous difference. And since I knew I was going to the doctor the following morning, and since a close friend who had two miscarriages had told me what to watch for, I didn't worry too much as I sat there, cramping and reading magazines. All I can say is: thank god this did not happen at work, as it would have been absolutely horrifying.

The following day I brought my iPod to my appointment. When the D&C started, I pressed play on Coldplay's "Speed of Sound." Forty-five seconds later, it was over.

Note to medical staff everywhere: when a lesbian couple comes into the office with one partner pregnant, you can pretty much guess it's a wanted pregnancy. Therefore, when said pregnancy is miscarrying, it would be polite and decent to offer your condolences and express sympathy. A, "I'm sorry this is happening to you," would suffice. Instead, not a single person in that office ever offered emotional support to me; the closest was the one man in the office, a nurse midwife, who guided my partner over to me during the D&C and held my shoulder. He won the decency award that day, but unfortunately the competition was pretty pathetic.

After returning home, I spent the rest of the day lying on the couch. Friends brought me food. I was back at work the following day, ("what was wrong with you?" one boss asked. "A stomach bug," I lied -- I had decided a email reading, "I'll be out of the office Thursday having the remnants of my brief pregnancy sucked out of my uterus" might be uncalled for) and I was able to resume my normal activities immediately.

When I got pregnant last time, I asked Dr. Unsympathetic if I needed a blood test. She said it wasn't necessary, given that I was having pregnancy symptoms, had a positive pregnancy test, and missed my period. Yet those blood tests might have yielded information about how successful the pregnancy was destined to be. Certainly they would have been useful this time around, when I could have used them as a basis for comparison. (Pregnancies destined to miscarry seem to have lower HCG levels at first, and the rise seems to be slower. The general consensus is that last week's numbers are both high and rising nicely, so that's a comfort.)

This time, I've bid farewell to Dr. Unsympathetic (so long! don't let the door hit you on the way out!) and am hoping both for more empathy and, more importantly, better results when I go for my viability check (at my fertility doctor's office) on April 23. You can bet I'll be counting the hours again.

Second blood test is back

They want your numbers to double in 48 hours. Mine TRIPLED!

My HCG level was 520 on Tuesday and was 1,564 yesterday.

I'll have an ultrasound (the viability check -- the appointment that showed the problem last time) on April 23.

Thank you for your kind wishes. They mean a lot to me.

First blood test

It's back, and my HCG level at 16 days past conception/ovulation is 520. I'm going back on Thursday for a second round. Cross your fingers that it rises nicely!

A picture's worth, etc.