They plowed our street today about noon, leaving me with plenty of time to get to the OB’s office for my ultrasound.

The enire time I was at her office, I kept reliving the blighted ovum of yore.  Same parking lot; same appointment time; same room; same sonogram machine, same sonographer.  (For miscarriage #2 I only had my sonograms at the hospital so I am sure that anxiety will come later.) 

This time, insead of an empty sac, we had an actual baby.  An actual baby with a heartbeat (176bpm), moving arms, and a squirmy body. 

Old wives’ say lots of puking and/or a high heart rate mean a girl.  It’s too early to tell (and what the hell do old wives know anyway, right?) but I have both of those.  We will name her, if it is a her, after my husband’s bubbe; if it is a boy, we will be kind enough not to name him after a Jewish grandmother.     

I am having my “first” (like this is the first time and M.D. will examine my bajingo) OB appointment on 31st of January, and the nuchal-fold test — that I specifically had to request?? — sometime later that week. 

Holy fuck — and I didn’t even need to kill the snowplow man. 

WARNING: This is a TMI post. You will not be able to un-read it, so if TMI-y things tend to bother you, do not keep reading.

I knew about the sore breasts, the fatigue, and the nausea. I did not know about the constipation. It is in all my books as a “symptom” but I thought with my history of ulcerative colitis that I would cancel out the constipation and end up somewhere around normal. I was wrong.

It turns out that the progesterone capsules I shove up my bajingo twice a day can cause constipation. Even more dramatically, Zofran — the drug that allows me to only dry-heave my way through the work day instead of barfing myself silly at home — also causes constipation. The two of them teamed up and it is not pretty.

The only other time I have had this happen was post-miscarriages when I was pleasantly doped up on pain medicine every four hours. I took Colace (a stool-softener) then, too, and while I was uncomfortable, I was not physically miserable. This time, I fear I started the Colace too late.

I blew out my boh-poh.* I can barely walk and can only lay down in certain positions. I am bleeding and I am seriously considering putting an ice-pack on my ass. Why was I not warned that this could happen? With colitis, I thought not going to the bathroom for a day (or two?) was good news; this was not good news. This is horrible. Awful. Painful.

I am now taking fiber, Colace, and drinking lots and lots of fluids. Prune juice will make me ralph, but milk-of-magnesia is looking better and better. Hopefully, something will work and my boh-poh can heal.

My third ultrasound is tomorrow morning. Did you know that when you are very nervous you tend to clench your boh-poh? Why, neither did I until today. I have been practicing “conscious muscle relaxation” that I learned years ago in yoga. I am sure this is exactly the situation my teacher intended it for.

*My four-year-old friend Maya taught me this word. Some of you may know the same anatomy by the terms “butt-hole” or “anus” but I prefer “boh-poh” — it has a nice ring, eh?

I intentionally booked all my appointments and meetings for this week. First, being this busy helps to take my mind off of the ultrasound next Monday. Second, if I get bad news at the ultrasound, I can fall apart and not have to reschedule anything.

I know. I am such a freaking optimist.

After two miscarriages, the best I can do is realist. Things might be fine but they might not, so it is best to just try and take things as they come.

It is amazing to walk around campus and realize that everyone I see, even if their mothers were not wanded, was at some point a healthy first-trimester pregnancy. They had a head, a body, and a strong heart. They grew and developed and grew and developed and were born. This process is such a normal thing — every child or adult you see is a testament to its success — but it feels like it is continually out of my grasp. I have never had a “good” ultrasound. I had an early ultrasound after I started spotting in pregnancy #2 to ensure that the sac was in the uterus. I also had a 5 and something-week ultrasound with pregnancy #2 that showed a sac and yolk sac, but it was too early to see anything else. Those were the “okay” ones; every other ultrasound I have had either showed an empty sac at 10+ weeks or an embryo with a very slow, non-viable heart rate. I think realistic is pretty good, all things considered.

My boobs are still killing me, the gaggyness is getting more pronounced, and if I don’t eat or if I smell something funny, I get hit with nausea. The Plan is still working, even though I freaked out this morning when the test line was a wee bit lighter than yesterday. I forgot, however, that I got up and peed in the middle of the night; when I took another one this afternoon, it was back to being very dark. How can a 6-week pregnant uterus make you have to pee so much? It must be the hormones more than the physical weight, right?

On a totally non-related note, I heard a rumor that tonight is the last “Office” recorded before the writers’ strike. (Sniffle)

I have been playing phone tag with my allergist’s office for days. I have not been in to their office since this time last year, when I was a few weeks pregnant with pregnancy #1. I finally spoke with them today to find out why they are not refilling my vial of immunotherapy drops. Apparently, it is because they want me to redo all of my skin testing.

Me: “Why do you need to redo all of my skin testing?

Office Lady: “Well, we just want to make sure that what is being put in your allergy vial is still what you are allergic to.”

Me: “Why would it have changed?”

Office Lady: “After the baby is born, sometimes the mother’s allergies change — new things can pop up and other things can disappear? Pregnancy is a very powerful thing!!”

Me: “So I hear. Don’t worry, I had a miscarriage. And then another one a few months later. I am quite sure I was not far along enough either time to change anything.”

Office Lady: “Oh, er, uh, oh, ummmmm, I am so sorry. (Dramatic pause; quite sure I am able to hear a pin drop in background.) Ummmm, can you stop by tomorrow to pick everything up and just meet quickly with the nurse practitioner? We obviously need to update your records.”

Obviously.

Let me preface this post with this: I really, really, really want to be pregnant.

Today I had to start making plans for my European trip in March and now I am very excited to travel.  I went last year and had an amazing time, even though Mr. MC was not able to go with me.  This year I will travel to Spain and France and the trip will be amazing (I should know as I did most of the planning myself).

If I am pregnant (2 more negative HPTs today) this cycle, the trip is not going to work because I will be too far along (ha!! she thinks: wishful thinking!) to travel internationally.  I was pregnant the same time last year (miscarriage #1) and had a trip to Europe planned for the same time that my OB was not very happy about.  A moot point because I found out I had a blighted ovum two weeks later, but I don’t think flying around the world in the third-trimester sans husband is ever really a good idea.

So, I would not go so far as to say that I do not want to get pregnant this cycle.  If I am, I will be thrilled.  If I am not, however, this probably means that I can go to Europe.  Given my history, I feel awful for even letting a part of me be okay with not being pregnant, but the truth is, a part of me will be okay — perhaps even a little happy? — if I get pregnant in the next few months instead of this month.

“You can lay your head back on the ground
And let your hair fall all around me
Offer up your best defense
But this is the end
This is the end of the innocence”

– Don Henley, “The End of the Innocence” (1989)

I think the most difficult thing about my first miscarriage, aside from the immediate emotional and then physical pain, was that, to quote Don Henley (and, really, who doesn’t love a good Don Henley quote??) it was the “end of the innocence” in my life.

Even writing this, I feel weird, because my life had not been perfect or simple up to then. True, I have a fantastic marriage, a (usually) challenging and fulfilling job, a supportive (if somewhat nutty) family, and by most accounts I am a very lucky person. I do not want for food, shelter, companionship, or love. I worry about things but I don’t really worry about things. I am very aware of how good I have it.

Yet I also have some major things in my life that are not so good. I have two chronic illnesses, clinical depression and ulcerative colitis, that kind of suck. My depression, thankfully, responds very well to Prozac and, if I am taking the proper dose, is completely under control. The UC is a little more prickly and requires lots of doctor visits, fistfulls of medicine (up to 40+ pills per day), regular colonoscopies, and usually lands me in the hospital every couple of years. The drug that has saved my life many times over, Prednisone, also has unpleasant side effects such as sleeplessness, bloating (doctors refer to it as “moon face”), and dramatic weight gain (which is hard to lose because it also screws up your metabolism for months after you stop taking it). Still, while I am the first to tell you that UC is not fun, I could still honestly say that “it could be worse.” Even when laying in the hospital being pumped full of steroids, anti-inflammatory drugs, and waiting for an early morning colonoscopy, I still felt that “happily ever after” would not fail me (yes, again a Don quote from the same song).

I can pinpoint the exact date when I found it would: Monday, October 2, 2006. Yom Kippur.

I was, at least I thought I was, 10+ weeks pregnant by this point. I was scheduled to have my first ultrasound. This was my first pregnancy and I was SO happy. I got pregnant after 5 months of trying, called my doctor, and was scheduled for my first prenatal appointment (yes, that fateful day when I willingly gave my demographic information to Enfamil, aka “Satan’s Henchmen.”) My husband went with me and, according to my doctor, everything looked good. I could schedule my first ultrasound at my earliest convenience.

I had a horrible feeling that something was wrong starting a few weeks before this. The books I had stated convincingly that all women fear that something is wrong and that this was “normal” and “to be expected” for a first-time mom. Well, in my case, my instinct was right. There was something wrong: there was no baby.

I started getting really nervous a few days before the sonogram, but I tried not to let it bother me. We told close family friends about the pregnancy; we bought a rocking chair. The morning of the scan, I distinctly remember walking through the parking lot to my doctor’s office repeating my mantra: “75% of pregnancies are fine. 75% of pregnancies are fine.” This is one reason why I was still “innocent” — I still thought that I could be on the winning side of the statistics. Everything would turn out okay, right? Everything (mostly) had before in my life. I would be in the 75%+ percent of women who saw the positive pregnancy test and then had a healthy baby. Why should I think any differently?

This is and was the worst part, for me, of miscarriage. The loss is awful, the physical pain is wrenching, but the hardest, and saddest part, is that it changes your world view. You don’t think “everything is going to work out just fine” again. Your optimism, your naivety, your “innocence” are replaced instead with pessimism, fear, and cynicism. You will never be caught off guard because you have changed and you will forever see the world through different lenses.

I sat in the office, waiting to be called in by the sonographer. My husband had joined me and we held hands, hoping to come out of that room with a pretty black and white picture of our shrimp-like spawn. I remember telling the sonographer how far along I was, having her smile, and tell me that I was far enough along to use the abdominal probe. I smiled. My husband smiled. She put the goo on my stomach and the room got very quiet. I knew. She quietly asked me how far along I was again, and then told me that she needed to switch to the trans-vaginal probe. I started to panic. I kept looking at the screen hoping to see a baby, or anything resembling a baby, but there was nothing. The sonographer was very quiet and just kept taking measurement after measurement. I asked her if there was something wrong. Still looking at the screen, she quietly replied, “there is not baby, only an empty sac.”

I remember that I started to sob and that I kept saying to my husband “I knew something was wrong.” Time seemed to stand still and speed up simultaneously. I literally felt my heart breaking. Somehow I made it into another room, and called my mom, who wasn’t home, my sister-in-law, and my mother-in-law. I needed to talk to someone who was a mother, someone who could understand how badly my heart was breaking. I was sobbing so much that I could barely talk. My doctor came in at some point and talked to me about a “blighted ovum” or an “anembryonic pregnancy” and about a D&C, but it is all a blur. I walked through the parking lot with my husband still sobbing and gagging (due to hormones and emotions) and somehow made it to the car, made it home, and made it into bed.

This was a Monday and the OR was not open for the D&C until Friday.

I cried until I literally could cry no more. I was sad. I was broken. I was defeated by life. It was indeed the end of my innocence.

The second miscarriage was also difficult, but I approached it, from the second I got a positive pregnancy test, as if something could go wrong. I did not let my guard down, lest I be sucker-punched again. I trust that the physical and emotional pains will heal but I do not believe I will every be the way I was before that day. Perhaps only holding your own healthy baby in your arms can help you believe that life can be filled with “happily ever afters.” I hope so, but that feels a wee bit too optimistic.

REFRAIN: [to the tune of "Wild Thing"]

Dem -er -ol

You make my cramps stall*

You make pain management … grooovy

Oooohhhh, Dem -er -ol

Dem -er -ol, I think I love you.

*I know that Demerol, unlike NSAIDs, doesn’t really stall the cramps. I know that it just interferes with the perception of the horrifically painful cramps, but at a certain point, I don’t really care what is happening biochemically, just that I am not in pain. Besides, it is difficult to rhyme words with Demerol.

D&C #1, Part A (October 2006):

I found out at 10weeks that I had a blighted ovum (i.e. anembryonic pregnancy = no baby but everything else). This was a Monday. On Friday, I was scheduled for a D&C. I came in on Thursday and cried all through pre-registration and the requisite bloodwork, and then came in bright and early on Friday for the procedure. The highlight was definitely the general anesthesia. Awesome stuff, especially the concoction they give you en route to the OR which is filled with sedatives and pain medicine. I woke up. I was no longer pregnant with a sac. I ate a cheeseburger. I went home.

D&C#1, Part B

Nine days later, I start really cramping and bleeding. Bleeding right after a D&C is normal but starting over a week later is not. I had nothing at all right after the D&C, so this was especially dramatic. I was sent to the ER, by which point I was in a considerable amount of pain and the bleeding was getting worse. Not knowing what to do with me, they did a ultrasound to rule out an ectopic and then pumped me full of NSAIDs (no Demerol this time, folks). I felt a little better. The bleeding slowed down. I didn’t have an ectopic. They sent me home.

D&C #1, Part C

Two days later, eleven days after the original D&C, everything really went downhill. What I thought were painful cramps before were nothing compared to what I had now and I was continually bleeding as well as passing golf-ball sized clots. Back to the ER. By the time we reaching the hospital I was really screaming/crying, and they took me right back to a bed this time instead of making me languish in the waiting room. After THE. MOST. PAINFUL. PELVIC. EXAM. EVER. (by a doctor I only remember as “Dr. Bighands”) and another ultra sound, the doctors determined that I must sill have placental tissue in my uterus that was missed in the D&C, Part A. The pain was agonizing and the three doses of morphine did nothing to help (yes, THREE doses of morphine didn’t touch the pain.) The ER doctors decide to call in an OB consult.

The OB surgeon, who was a tiny little woman with tiny little hands, told me that Dr. Bighands didn’t do any measurements, except to note that my cervix was dilated (NO! really??), and she would need to repeat the pelvic exam. I think my hysterical crying was her first clue that this was not going to be easy, so she told me she would give me pain medicine and make sure I was “comfortable” before doing the pelvic. She gave me a concoction of Demerol and Zofran (Demerol can cause nausea). (REFRAIN)

I was admitted, put on a Pitocin drip, and left to “expel” whatever was left in my uterus in the privacy of my own hospital bed. I could have pain meds whenever I wanted (REFRAIN) and I was promised that this would be the end of it. Some nurse sent something I had “expelled” to the lab that was identified as placental tissue, so I finished the course of Pitocin (just to be sure), walked around the maternity ward (where they put me) and looked at the happy mothers and their sleeping babies, and then went home.

I was told this was “bad luck” and that it had no bearing on any future pregnancies. Riiiiiiiiiight.