Saturday, October 30, 2010

Finally...

Well here we are..... almost 6 months later and we are now well and truly pregnant! The first 3 months were nerve wracking. Once we had passed the elusive 8 week mark we both felt a little more confident. I most definitely felt a huge sense of relief seeing the 12 week scan, all in proportion and wiggling it's little butt off!

I has been a massive journey for both of us. Mike was still very nervous and cautious at the 20 week scan what with the memories from previous scans. We have both decided we don't want to know the sex. We will both be very happy just to have a happy, healthy baby.

I was quite ill throughout the first trimester which was a shock as I hadn't even been a little queasy with Jasmine. The second trimester has been much better energy wise although I have had a few irritating weeks with hay fever and hives! Our due date is the 5th March 2011.

I am very keen for a natural birth. However after a Cesarean, the high blood pressure in the last pregnancy and the potential auto immune disease there have been some questions as to if this will be possible. Thankfully on visiting the hospital specialist he advised he did not think it was an autoimmune disease. He thought that perhaps the blood reading may have been distorted due to my hormone instability at the time (having just had a miscarriage). He said that I had no other symptoms of autoimmune and that while he would do some tests to rule out any clotting risks he did not consider this a problem. He advised that I may have a tendency to gestational hypertension but that we would not know if this were to be an issue in this pregnancy until the later stages. He did not see any barriers to me having a natural birth other than going past term. If I go over my due date as I have been induced before and had a C-section before they will not induce me they will move me straight to a C-section. The midwifes at the hospital are happy for me to pursue a natural birth too! So there it is! We will just have to wait and see! Fingers crossed this little one wants to come early!

Conception

Determined to do all I could to ready my body for the next round of ovulation I continued with the acupuncturist. She prescribed Chinese herbs to aid in the build up and break down of the blood lining before and during the period so as to thoroughly cleanse the uterus. She also prescribed herbs to build up the lining in preparation for ovulation. I was diligent in endeavouring to keep my diet as alkaline based as possible (no coffee, no alcohol and lots of greens, nuts, and fruit rather than fats and sugar). I also took the minerals recommended to me by the naturapath.

My period appeared as scheduled on the 29th May. Which brought anticipated ovulation to the 11th June. Both Mike and I were very keen to give this a 'red hot go'. We had waited two cycles and with the news about the autoimmune disease and the potential solution we felt more in control. At the same time there were some complications! Mostly that it was an incredibly busy time! With Jasmine's Birthday on the 3rd June there was much to organise, bake and fun to be had! It was then my Mum's 70th Birthday on the 13th. We hosted a Birthday party for her on the 13th June however she arrived to stay with us on the 11th June - OVULATION DAY! So, the week leading up to we ensured we had sex daily. Ovulation day we managed to sneak in two cheeky ones and each day for 3 days after; just to be sure! Sending my Mum to the shops for emergency things we had forgotten kept it quite exciting!

Then there was the wait. Were we, weren't we? Would we make it this time past 6 weeks? I had started taking the aspirin from the potential date of conception just to cover all bases. The wait was made worse by the fact that just on 5 weeks Mike had a business trip to the UK! So right across the time that I would find out 1) if we were pregnant and 2) the weeks in which I was most likely to miscarry Mike was on the other side of the world!! It was ok though. We spoke every day. I did an early test and got a faint positive result. Three days later I did another test and it was most definitely positive! Off we go again!!!

Wednesday, July 28, 2010

ANA AutoImmune Disease?

A nerve wracking weekend. I rang for the results of the blood test on Thursday and the receptionist told me that I would have to make an appointment. I asked if that was really necessary? Did I have to come all the way there and pay for an appointment? Could he not give me the results over the phone? She said that was not generally his policy but she would speak to him. She came back on the line and said that I would need to make an appointment. I made an appointment for 9am Monday which was the first I could get in. Did that mean that there was something wrong? What else could go wrong?

I rang back. Saying I was stressed and worried. The receptionist reassured me that the results were not urgent and they had been in since Wednesday and if so the obstetrician would have called me straight away. However that there was something to be discussed. Oh no, another ring of fire to jump through?!

Monday 9am. Apprehensive and with anticipation I was hideously early for my appointment. The obstetrician said that the results had found that I had a possible strep infection in my urine - quite common apparently. Not something to overly worry about but something to get rid of before I am pregnant again.

More concerning the ANA section of the blood test that looks for autoimmune diseases showed a reading at a low level. They tested the DNA for Lupus and other such diseases but these cam back as negative. So a potential autoimmune tendancy? What is that exactley? A healthy immune system recognises and destroys foreign objects like viruses and bacteria. With autoimmune diseases the immune system attacks objects that are not foreign. While there is no known cause as yet it is thought that several triggers such as hormones and stress may cause the autoimmune cells to accumulate.

The obstetrician assured me that my reading was low indicating that I may very well not have a problem with this in later life. He said that there was no definite evidence to say that this reading was causing the miscarriages. However, it has been known to be linking to early miscarriage in autoimmune disease sufferers. He also said that luckily there may be a fairly simple remedy. A 1/2 dose of low level slow release aspirin a day. Low enough a dose not to harm the baby but enough to thin the blood so that the autoimmune cells cannot gather. However he did caution to tell me that this may or may not work; if we did have a successful pregnancy that it may not be down to the aspirin it may have been successful anyway; and that I would probably have to take aspirin in any other pregnancies as a precaution.

So a diagnosis and a potential solution! I was quite happy with that. For a while I didn't think of the longer term implications for me and was just hopefully for the pregnancy. Looking into autoimmune disease on the Internet a little more scared me. It is not a nice disease. And can be particularly painful. There is no cure and no remedy just management. Also I was worried to hear that often autoimmune levels were not constant and that it is prone to flares which can be triggered by pregnancy, stress, environment... the list goes on. However now with a little time under my belt and quite a bit of reading I figure there is little I can do about it other than keep healthy, stress less and roll with the punches. A little like most things in life; you can't foresee them and you are not in control you just have to deal with them as they come.

East and West

Desperate to try anything I looked to cleanse and balance my system to give my body the best chance I could to try again. Having done all I could to try and identify any reason my body may have for rejecting a baby in having the blood test I sought out more alternative therapies. I began seeing an accupuncturist who specialises particularily in fertility and pregnancy. I also saw a naturapath consulting on diet and well being.

While I understood that western medicine often does not approve of the alternative methods of practice (although my obstietrician was quite positive about giving accupuncture a try saying 'It can't hurt!' ) I somehow expected for alternative therapies to be more accommodating and supportive of each other. Not so it seems! My natuarpath was extremely sceptical of what my accupunctuist might be prescribing me with chinese herbs and my accupuncturist was critical of the dietry advise that naturapath gave. This made it quite difficult to find my way interms of the advice I chose to take. I desperately wanted for someone to just say, ' Here, do this and that will fix it!' not so apparently.

The naturapath prescribed a Fit For Life diet. Fruit only in the morning until 12 oclock but not acidic fruit - apples, pears, bananas, pineapple in small quantities. Then lunch and dinner the key was food combining. Meat, Potatoes, Pasta, Cheese, Eggs and Bread all on their own with either vegetables or salad. No combining of the above. The philosophy behind this is that the stomach after years of abuse! is having trouble processing the multitudes of combinations we present it with and so is not functioning effectively or absorbing the nutrients from the complex food efficiently. No tomoatoes, no bread and no potatoes in an effort to cut out acidic and carbohydrate foods to make to body more alkaline. She also prescribed magnesium, collodial minerals, a probiotic, Himilayan mineral salts mixed with water and a plant based bowel cleaner. I stuck with the lot for a week. Then after speaking to the accupuncturist who advised against the bowel cleanse I stopped that. I kept going diligently with the diet for about another 2 weeks and slowly the food combining dropped off again. I do believe in the philosophy of it. It is just so hard to do consistently without a complete and total change of life.

The accupuncturist was great. I also believe that there is a lot in much of the ideology behind the chi or energy flow in accupuncture. She also prescribed chinese herbs to coinside with my period to help cleanse the uterus and then to help build back the lining strong and healthy for the next attempt. Her reasoning behind her advice against the bowel cleansing was sound and reinforced what I felt my body was saying to me. I would recommend accupuncture for anyone in my situation most definately.

Monday, May 31, 2010

Reasons

Hopelessness and helplessness. Wanting to find reason, something to blame. Self blame. Self preservation. Survival. Base living. Getting up each day. Trying to be the best I can be for my husband and for my little girl. Little more of me to give. Sense of self fragility; at the mercy of nature like a mainsail flailing in the wind.


Reading and more reading. What did we do before google!

The information I found on the side effects of Mirena, the IUD I had fitted, scared and dismayed me. When I visited the doctor she had advocated the use of the IUD. She promoted the ease and effectiveness of it as a form of contraception. She gave me a brochure which outlined the benefits. I remember reading it but not looking to carefully into it content that my doctor would not recommend anything that would disadvantage me in any way.

If I had known the possible side effects of Mirena I would never have chosen to have it inserted. This link explains in detail the ins and outs of this particular IUD http://www.fwhc.org/birth-control/iudinfo.htm
However in short - 'Mirena can cause ovarian cysts. Some women using the Mirena stop bleeding altogether. Usually their menstrual period returns when the IUD is removed. Mirena can cause weight gain, headaches, increased blood pressure, acne, depression and decrease in sex drive.'

Could this have directly contributed to my problems? Quite possibly.

After seeing my obstetrician he said that there was no clear reason as to why I may have miscarried both times. He gave us the option of running further tests to see if there may be a potential problem or if in fact we were doubly unlucky. He mentioned there were 3 levels of testing available. Blood tests for me, chromosomal test for both Mike and I and then a fertility clinic. I decided that at this point it was probably worth getting blood work done on me just to check everything was ok. The fact that we had already produced one child was encouraging but the recurrent miscarriage baffling. We decided not to progress any further with testing at this point. Part of me didn't want to make a big deal of it all and just cross fingers for third time lucky.

In the meantime I busied myself with getting as well as possible. I began regular acupuncture. I saw a natruopath. I changed my diet and began taking mineral supplements. I banished alcohol and coffee from my diet and tried to be as alkaline as possible! I drank apple juice in the morning (supposedly apples aid in the production of estrogen!) and ate grapefruit for breakfast! (aids in the production of progesterone) I ate almonds and brasil nuts and tried ever so hard to keep food combining simple but interesting. The occasional sugar treat was all I allowed and even that I felt guilty about!

The blood tests took quite some time to come back. We had decided to wait at least one cycle before trying again. Even though the obstetrician said there was no harm in trying straight away I felt that I needed to give my body a chance to recover; for the endometrial lining in the uterus to build back up.

Thursday, May 20, 2010

Indicators

If I look back on it there were certain indicators that things weren't right.

The week before the 2nd miscarriage I definitely got run down. I thought I was just picking up a cold that Jasmine had had but I now think they were signs that my body was struggling to cope. I had a touch of a cold but also had mouth ulcers and diarrhea. On the Friday I also remember feeling conflicted. That is probably the best way I can describe it. I had a melt down. Lost it with Jasmine when I shouldn't have. Things felt turbulent. That dreaded Saturday morning I woke up in a mood. Sluggish, struggling. I didn't have that nauseous feeling that had started in the mornings and I felt strained and tired like I hadn't slept.

We did more tests. On the Wednesday the Hcg levels confirmed that the pregnancy was terminating. The levels went from 250 on Friday, to 89 on Monday down to 36 on Wednesday. Pre conception levels are anything under 5. I researched and researched. In a way I felt relieved that my body was, in some way, behaving somewhat normally. In another way I struggled to face each day and kept myself to myself not wanting to talk to friends or family and admit yet another disaster.

Back in the ring.

And so I bleed and then to my surprise and pleasure I ovulated! I was human after all! Maybe I really could be a woman again!

I had spoken to the obstetrician about trying again for a baby. He had said that we could try as soon as we felt we were ready. Straight away if we wanted. So why not! Off we went! Every day for about a week! Mike thought all his Christmas' had come at once! I kept a positive head but tried not to have any expectation so as to avoid disappointment if things didn't pan out.

Easier said than done. After 7 days I couldn't wait any longer. I bought a pregnancy test and thought well I may as well try. I was disappointed when it came back negative. I didn't think I would be but the head and the heart are two different things. So I waited. Hopefully in the next week my period would arrive which would mean things were definitely back to normal and we could try again soon.

They didn't come. Well not when I thought they were due. I felt myself going down again. getting sad, depressed, struggling to put on a brave face. On the off chance I did another pregnancy test just to rule out that faint possibility.

It came back positive!!! I was shaking!! I hadn't expected that! I had to go out and buy another one just to double check! Yep positive again!! I tried to keep my head. There was still a hell of a lot of risk but hey it's hard not to be happy when this is all you have wanted for the past 4 months!! So many emotions all barrelled into one. Happiness, relief, fear, anticipation, trying to remain positive but not too positive. The date was Wednesday 28th April.

On Thursday I visited the doctor. She was happy for me. I was beaming. I couldn't help myself.
She sent me for blood tests just to confirm pregnancy and also as I mentioned I was worried about progesterone levels being high enough to maintain the pregnancy; again on my insistence.

On Saturday we all took a trip into the city to the Wildlife Park and had a great time showing Jasmine the crocodiles and watching her pat kangaroos. We went to lunch and were about to head home when Jasmine needed the toilet. I popped her on the loo and then went myself. As I put my hand down to wipe it was like slow motion. Bright red blood. A fair amount. I said 'Oh no please' but quickly had to conceal my emotion as Jasmine was still in the room with me. I wiped again and there it was more blood. It was 2pm in the afternoon. I went out and told Mike.

Like a dream we went and got the car from the parking station. We drove home. Speechless. Tearful. I rang the doctor. The nurse looked up my blood test results from Friday and said that the Hcg levels looked good and were in range and that my progesterone levels were also fine. She asked if I had cramping. I said no. She asked if the blood was red or brown. I told her bright red but only when I wiped. She said that bleeding in pregnancy can be common and not necessarily a sign of miscarriage. She advised that if the bleeding got heavy or I had cramping to go to the hospital as the surgery would be closed.

That night the bleeding eased off. There was hardly any. I started to wonder if everything was ok. The next morning the same. Nothing. I started to believe that maybe the baby was ok. We went about our day. Trying to keep positive.

At 2pm there it was again. More blood. Bright red and thick. This can't be right. But what could I do. Nothing just wait. No cramping. Maybe that was a good sign? I was scheduled to have blood tests again on Monday they would tell me what I needed to know. I waited patiently.

On Monday I think I knew. More blood. Two days ok but three days can't be good. I went early for blood tests and rang the doctor. She told me she would ring me with the results that evening. She explained that what we were looking for were the Hcg levels to double. My blood tests on the Friday had shown a normal and healthy pregnancy. If the Hcg levels doubled on this test then all good if not then I didn't even want to think about it.

I don't know how I got through that day. Waiting, trying not to stress. Trying to stay positive. If this wasn't a miscarriage then all this worrying wouldn't be doing the baby any good. I kept my head up and did what I had to do. By 8pm that night I was an anxious mess. Finally the phone rang. I picked it up after the first ring.

It was not good news. The Hcg levels had more than halved. I broke. Not again. Not again.

Anything but normal.

The week after the d+c I felt fantastic. Lighter, relieved. Finally the nightmare was over. Or so I thought. I was determined not to get obsessed about getting pregnant again but to try and live healthily and enjoy this extra bit of time/ life I had before getting pregnant again.

At the same time I began to realise that physiologically there was quite a lot I didn't know about the body and how and what happens during conception and pregnancy. A friend lent me a book and I began to do some reading. While I thought during this time that I was quite relaxed I now look back and realise that perhaps I was still going through the motions of grief and acceptance. This time was made especially difficult by the fact that many of my friends were now giving birth to their second children or were announcing they were pregnant. I now realise that I became quite depressed and before I knew it was drinking and smoking quite heavily as a distraction to the angst and sorrow I was feeling.

Two months went by and I had not yet had a period. I began to worry even though I knew stress may well only make things worse. After a trip to the doctor, with her telling me that this is completely natural, that my cycle may take months to return and that stress would only delay things, I managed to convince her to send me for blood tests and and ultrasound. I had had some pain, which I thought may be ovulation or period pain but with no evidence of either.

The 6 week ultrasound in the last pregnancy had shown evidence of a cyst on my right ovary. This had not been present in my pregnancy with Jasmine and so had developed in the last 18 months. The obstetrician had explained that it looked like a dermoid, a usually benign tumour that typically contains a diversity of tissue including hair, teeth, bone. He said that it was not anything to worry about at the time of the pregnancy but that it may grow and that they do have the risk of being cancerous later in life.

The blood tests came back showing little progesterone which indicated that in 2 months I had not ovulated. Based on the pain that I had been feeling in the past week I pushed for an ultrasound. The doctor was reluctant however finally conceded due to the presence of the cyst and my insistence.

The ultrasound showed a small amount of unidentifiable fluid in my uterus which contained some tissue. There was no change to the cyst. I was devastated. What was this thing? Was it left over from the pregnancy? Was this why my hormone levels were not going back to normal? Did this have anything to do with the miscarriage in the first place? Could this be a new pregnancy?! I daren't even think that way.

The obstetrician could not identify what this 'thing' was. He said it was unlikely that it was left over from the pregnancy or that it was a new pregnancy due to the absence of Hcg pregnancy hormone in my bloods. We waited a week and did more tests just to make sure. With still no return of my cycle and no Hcg in my blood tests we decided that another d+c was needed to check and remove whatever this thing was. While under anesthetic the obstetrician would remove the cyst from my ovary as well.

On the 30th March I went back into hospital. It was like dejavue. Had I not just been here? Done this? Only I underestimated it this time...

I thought that as the procedure was relatively similar that the recovery would be the same. I was mistaken! The operation took longer due to the removal of the cyst therefore this meant more anesthetic and I don't do anesthetic well! Also the obstetrician had mentioned that to remove the cyst they pump gas into your uterus so as to see better the area they need to work on. He had mentioned that this may cause some pain.

Oh my goodness. What an understatement! I have never ever felt anything like this! I was very groggy and in quite a bit of pain although they had given me anti nausea drugs and heavy painkillers before my husband came to collect me. Just before he arrived I was sick and struggled to stand for the pain. However when Mike arrived with Jasmine I saw the shock and concern on her little face.

She didn't like seeing me there. Hooked up the tubes and drips. Pale and worried. She kept pulling my hand and saying 'Up Mummy - Let's go!' I should have stayed longer but I couldn't do it to her. I pushed myself to get dressed and while Mike took Jasmine to the car they wheeled me downstairs in a wheel chair.

That night the pain was tolerable. As morning dawned and the painkillers and anesthetic wore off it was immense. It was the gas more so that the scars in my abdomen that reduced me to a screaming mess. I rang the hospital at 6am telling them I couldn't move, couldn't breath for the pain. They explained that it was the gas that had been left in my body. Apparently they try to pump as much out as possible but inevitably there will be some left over. Gas rises and so was trying to escape my body! I could literally feel it rising through my body - into the tips of my shoulders and under my diaphragm. Moving from lying to sitting would cause it to rip through my body reducing me to yelling fits of 'Help! help!!' as I couldn't move either way to elevate the pain. Luckily my Mum was able to come and take Jasmine away as there was no way with Mike back at work that I could even look after myself let alone her.

It took 36 hours for the gas to escape my system and the pain to subside. The only thing that made it all worth while was that I started to bleed. Finally. What looked and felt like a period. Maybe now things would go back to normal.

Friday, May 7, 2010

The 23rd December 2009 - 2 days before Christmas..

In October 2009, less than a month after having the IUD removed, we fell pregnant. It was a once again a little earlier than we had anticipated but needless to say we were ecstatic and excited. As I had not had a period since having the IUD removed we needed to do an early ultrasound for dating purposes. At what was about 6 weeks we went for an ultrasound, the size of the foetus was judged to be about 5 and a half weeks and there was an identifiable but 'weak' heartbeat. We were told that it may well just be too early for the heartbeat to be established as the heart, internal organs and circularity system only form at 6 weeks. Another ultrasound was scheduled for 8 weeks.

On the day that we were moving house (I guess that is how confident I was that nothing was wrong) we had an ultrasound booked for 8am. We all, my husband, my 18 month old daughter and myself, traipsed down to the clinic. Lying on the table, my little girl was patting my tummy saying 'Baby in Mummy's tummy'. It was only as I realised that the radiologist wasn't showing me the pictures that I thought maybe something might be wrong. After about half an hour she told me the heartbreaking news that there was no heartbeat; that the pregnancy was not longer.

I don't think I can describe the pain. It was like having my heart ripped out of my chest and shattered into billions of glass like shivers. Time slowed, froze and disbelief hung in the air. Somehow you move. Get yourself dressed. Walk out of that place. Blurred. Not seeing. Numb. Reality and practicality kick in. Have a coffee. Sit down. Text people who should know. Cry. Not caring who sees.

I pulled myself together. There was nothing I could do. We had to move house. The removal truck was coming in 2 hours. My Mum was arriving the following day and it was Christmas the day after that. The first Christmas that my 18 month old daughter that would really remember. They needed me.

What followed for me was like a nightmare of practicalities, of keeping face, of not dropping my guard, of trying to keep sane and protect those around me by not falling apart. This was my situation and I see now that maybe it made it worse in the long run as I delayed my grief, hid my fear and denied myself time to heal.

I made it to the doctor that afternoon having moved all the boxes and furniture into the new house. I remember putting on a nice dress. Trying to look normal. Driving to the doctors on my own leaving my little girl with my husband in our new house. It was all so surreal. I was calm, realistic, practical. We discussed my options. Letting it pass naturally or going to hospital for a d+c either publicly or privately. I had been considering a home birth this pregnancy and was very pro natural birth and so felt that giving my body a chance to move through the motions naturally the best option. Getting into hospital the day before Christmas was going to difficult in any case. I went home and cleaned like a demon.

My husband was very supportive. While it can never be the same I don't think for a man, as they ultimately don't bare the responsibility of growing and carrying the baby, he had his own grief and disappointment to deal with. Ever the optimist, he kept positive and was caring and understanding throughout.

Christmas came and went. I put everything I had into it. My family were there and were supportive, understanding and distracting. New Year's came and went and I tried to drown out the pain, the nightmares and the fear. The dreaded anticipation, knowing it should be happening, should be coming, but what and when and why not!? Where was it? Was it still alive? Had I done something wrong? Was it my fault? Did I exercise too hard that day in spin class? Did that half a glass of red wine I had when I didn't know I was pregnant cause harm? Had I been to stressed about moving house? Should I have stopped having a cup of coffee every morning? Could I have done ANYTHING differently? Would it have made any difference? These are questions that will haunt me for the rest of my life; as I am sure they do every woman who miscarries; no matter how much information you read or details you are told to the contrary.

Finally by the 14th January I could bare it no longer. The baby had apparently passed away at 6 weeks and 1 day, a missed miscarriage. It had been 4 and half weeks since then and I had had no bleeding, no cramping, no nothing. Three and a half weeks of knowing and waiting and I could do it no longer. I booked to see an obstetrician and was booked into hospital to have a d+c the next day.

I was scared but psychologically I could not take any more. The procedure was fairly simple. I was in hospital from 7.30am and released at 2pm. I was under general anesthetic for about and hour. My immediate feeling on coming around from the anesthetic was relief. Finally maybe it was all over. Little did I know.

Background, contraception choices and lament.

Having had no difficult falling pregnant with our first child I don't think either of us were prepared for the challenges we faced when we decided to try for Number 2.

Jasmine was an easy trouble free pregnancy. We had decided after 2 years of marriage and a year of travelling that it was time to put down roots and start a family. It happened much quicker than we imagined and we were pregnant within a month of stopping contraception. Luckily we were rewarded with a gorgeous little girl for whom we feel blessed each and every day.

Lulled into a false sense of security, I guess, we started to plan our ideal 'age gap'. About 3 months after Jasmine was born and after discussing contraception with my doctor at the time I decided to have an IUD fitted, Mirverna, a decision I lament now. The IUD was a recommendation by my doctor. A supposedly hassle free form of contraception that is inserted behind the cervix which releases levonorgestrel directly into the cervix to prevent pregnancy. I only wish that I had done more thorough and independent research into the side effects and pros and cons associated. (see article http://www.drugs.com/sfx/levonorgestrel-side-effects.html )

In September 2009 I began feeling uncomfortable. I found it difficult to explain but did think that it was potentially down to the IUD and the level of hormones it was producing. was a little more moody and agitated and somehow just felt unbalanced. As it was nearing the time when we hoped to become pregnant with Number 2 I decided to have it removed and just see what happened. Needless to say we were quite unprepared for what followed.