Dragonflight Dreams

In case you missed it on social media, I’m pregnant!

Currently I’m a bit over halfway through (due in August). It’s true that pregnancy itself is a whirlwind journey, but even getting to this point was also a long road. I had asked if people would be interested in reading a post about that, and the answer was overwhelmingly yes, so this is that post. It also serves as a sort of explanation for why this blog fell by the wayside for much of 2017 and so far this year.

—>>>>>>>If you are squeamish or don’t really want TMI details, I’d advise you to stop reading now. Otherwise, buckle in, because this is going to be long and rambly.<<<<<<<<---

Going off the pill

We got married in fall of 2015. And we wanted to enjoy a little bit of time as a married couple before bringing kids into the picture. We’d already been together 6+ years at that point, so we didn’t feel the need to wait too long. So in the summer of 2016, I officially went off of birth control. Now, I had been on some form of the pill since I was 19, and had never taken a break or gone off it, so I wasn’t sure what to expect. Overall, not too much changed, aside from the length of my period. I had been on the shorter period pill, and to suddenly go from only 3 days of bleeding to 6 or 7 was not a plus. Ian’s comment on this: “You normally bleed a whole week each month?! That’s like a 4th of your life!” Yes, dear; it’s called the female existence.

My first 2 cycles off of the pill were fairly standard. 28 days, then 30 days. Then… 49 days. This led to lots of home pregnancy tests (negative) and wondering where the f*** my period was at if I wasn’t pregnant. I asked my OB/GYN at the time about this at my annual exam soon after. She said it was normal for the body to take a few months to sort itself out after going off of birth control (we found out later this is not true, but more on that further on). And since my cycle wasn’t being predictable, I started using ovulation test kits to see when exactly I was dropping eggs and likely to get pregnant (SO MUCH peeing on sticks!). My next cycle was not so crazy long, so it seemed my body was getting itself under control.

Pregnant!

In December of 2016, I took a pregnancy test around when my period was expected, as usual. (side note: I still haven’t decided if those early detection tests for a few days before your period are a blessing or a curse). Except this time, there was a second line in the result window. Cue a holy shit moment. I immediately called my sister for a freakout. She told me to get a few different brands/kinds of the tests and take a few more – including a digital one, because there’s no ambiguity in those results. So I grabbed a bunch more tests at the store, and then had to wait until I actually needed to pee again (you’re not supposed to chug water to pee in order to do a pregnancy test because it dilutes it). I ended up taking 4 tests in total, but they all said the same thing: I was pregnant!

It was a Sunday, and were about to head to Charleston to visit family for Christmas the next day, so I didn’t actually get to call my doctor’s office until later that week. They asked me about my dates (ovulation and expected period) and whether I had a positive test, then said congratulations and said they’d see me next month (when I was around 8 weeks). I hadn’t realized there was such a time gap in the prenatal care process; I think I literally said “but what do I DO until then?!” in a kind of panicky voice. Other than no drinking alcohol, I didn’t really have to change much (I don’t smoke or do drugs, don’t like sushi, etc.).

We enjoyed a very awesome Christmas vacation sharing the news, and getting to know my little nephew who was around 3 months at the time. Then it was back to Austin for the waiting game. My boobs were super sore at this point, and the dreaded pregnancy fatigue had crept in. My sense of smell seemed a bit heightened, but luckily nausea wasn’t too bad – in fact, most days were fine on that front.

Not good news

We went in for our first prenatal appointment mid-January 2017. The ultrasound was exciting – we got to see the little bean for the first time! But there were three downers. First, my doctor noticed what she thought was a dip in the shape of my uterus – what’s called an arcuate uterus. She called in another doctor for a consult, and he agreed that’s what it looked like. An arcuate uterus would not be a big deal or issue, it was just a variant on the shape of the uterus. More of a curiosity than anything else, since they agreed it looked mild.

Second, she said she thought my thyroid felt enlarged during my exam, but had me swallow again to check. She didn’t mention this further after that, so I assumed all was fine on that front.

The third issue caused my heart to sink a little. My doctor said our baby’s heartbeat was at the low end of normal. She wasn’t concerned just yet and it could turn out fine, but was having us come in for another ultrasound in a week just to check. This is the news that stressed me out. Everyone tried to tell me “well, it’s still in the normal range, so don’t worry yet!” but I couldn’t shake the feeling that this was not good.

The next day I get a call from a nurse at the doctor’s office. She says she has the names of the endocrinologists my doctor wants to refer me to. I said “what are you talking about?” Apparently the doc wanted me to follow up on the thyroid thing with a specialist just to be sure. She just hadn’t actually told me that. I was both miffed and worried about this. But I called the specialist and scheduled an appointment for early February, the soonest they could get me in.

A few days later I had just the slightest bit of blood on the tissue when I wipe after going to the bathroom. It was barely there, and didn’t reoccur, and I’d been told multiple times that spotting is normal in early pregnancy, so I tried not to worry about this too.

Around this time my nausea went all the way away, which I just took as a relief.

Miscarriage

At our follow-up ultrasound, the news was even worse. The ultrasound tech was oddly silent, and then went to get the doctor on duty (my doctor was away at a birth). He looked at it, and explained to me the red and blue colors I was seeing, and that the fact they weren’t traveling down to the baby meant there was no blood flow to the fetus and no heartbeat. I’d had what is called a missed miscarriage, where the fetus had died inside me but not been expelled. I was crying, Ian was clutching my hand. They gave us a few minutes alone to collect ourselves, then had us sit with a nurse practitioner to answer our questions and go through our options going forward. She was very sympathetic and patient, and stressed that it wasn’t anything I did that caused the miscarriage, it’s just a thing that happens to 1 in 4 pregnancies. Logically, it helps to hear that, but emotionally it doesn’t really make a difference.

We had three options for removing the now unviable fetus – wait for it to naturally flush out, medically induce the uterus to flush it out, or go in for dilation and curettage (D&C) surgery to have the doctor remove it. And it does have to come out, because it’s basically dead tissue sitting in there, and your body will still think you’re pregnant until it’s gone. We decided to take a day or two to think about it.

The only surgery I’d had before was my wisdom teeth out when I was in high school, so the idea of a D&C scared the crap out of me. We opted to try medically inducing it to come out. This involved another doctor’s office visit, where my doctor would place 4 pills up inside my vagina for them to dissolve and induce bleeding and contractions. She walked me through what to expect, and said she’d call in a Tylenol 3 pain prescription for me (tylenol + codeine) in case I needed it.

Nothing much happened at first. Then I started getting cramps. They were mild for an hour or so, and then stronger. I started bleeding – normal period amount at first. But the cramps kept getting stronger and the bleeding kept getting heavier. I had Ian call the pharmacy to check on my Tylenol 3 prescription, because it looked like I was going to need it. He said they had no record of it – my doctor had forgotten to call it in. At this point, it’s after 5pm, so the doctor’s office is closed. I call the afterhours nurse line and explain that I need a pain med prescription, but she says they can’t call those in over the phone. So it looks like I’m SOL. Then she calls back a little later and says she can call in a Tylenol 3 prescription, but nothing stronger. I’m like – that’s what I was supposed to get in the first place! So Ian is off to the pharmacy to get my meds while I huddle in a ball and go through sanitary pads like gangbusters (tampons are a no-no for this process).

So much blood

The next few days were probably the most horrifying. There was just so much blood. And not like thin dribbles. I’m talking there were clots the size of baseballs coming out. Even the heaviest of pads were no match for those. Once or twice, when I just stood up normally to do something, I could literally feel a clot come out, overwhelm the pad, and slide down my leg before I could even get to the bathroom. Ian had to bring me changes of underwear and pajama pants a time or two to the bathroom door. Sometimes just the gap in time between when I finished showering and could get pad-lined underwear on was long enough to cause a mess. Or sometimes the nighttime heavy duty pads just weren’t enough for even a short sleep cycle. Pro tip: Shout gel stain remover is great.

If there was an upside, it’s that the T3 did help with the cramps for the first day or so, and then those lightened up. But the bleeding continued at what I thought was a crazy pace, but the nurse at the doctor’s office assured me it was normal and I didn’t have any of the warning signs that something was wrong. All the bleeding meant that I was generally pretty tired and weak, though. Plus, my boobs were still sore from being pregnant, which I still think was just unfair.

A week after the pill insertion, I had a follow-up for another ultrasound to see if it had been successful – if, amidst all the blood, the fetus and tissue had also come out. While the remaining amount of tissue was somewhat smaller, it was still hanging on in there. I had the option of another dose of those meds, or going for a D&C. I chose another round of meds, figuring a) I knew what to expect now and could handle it and b) surely with the amount of stuff coming out, the remaining tissue would also have to be flushed? Plus I’d been reading about D&C’s and they still scared me.

I was not thrilled about it, though. When I got back to my car after the appointment, I scolded in the general direction of my uterus: “Just get out already!! You already up and died on me, just let go! Move on!” There were some angry tears, but I pulled myself together to drive back home.

Since I knew the drill, I was able to just pick up the prescription and insert the pills myself at home instead of having to make another doctor’s appointment. This was as messy as you’d think, considering the bleeding from the first dose was still happening. I still had Tylenol 3 from the first round, so no hiccups there. Cue bad cramps and heavier bleeding again. It was generally more of the same, though once or twice I was so lightheaded from blood loss I had to lay down for awhile.

Around this time I had to also go see the endocrinologist to check on my thyroid. I didn’t take any T3 that day, because I wasn’t sure what would interfere with their exam. I was pretty miserable. The nurse who did the preliminary stuff was awesome, though. I don’t remember how it came up, but I shared that I had just had a miscarriage and was in the bleeding/cramping stage. It turned out she had just gone through almost the exact same thing, and was also on Tylenol 3, and let me have two since it wouldn’t interfere with anything they were doing. She was a saint. And it turned out my thyroid was absolutely fine, according to both an x-ray and hormone levels, so one less thing to worry about overall.

At the follow-up ultrasound after my second dose of crampy meds, unfortunately the news was not as good. The fetal tissue was STILL hanging on in there somehow, despite the veritable flood of blood that was meant to move it. At this point the only option was to schedule a D&C.

How were we handling the miscarriage emotionally? It was strange. Of course when we got the news we were sad and disappointed and a bit heartbroken. But at the same time, it happened so early in the pregnancy that we hadn’t really wrapped our minds around the idea of the baby as a person-to-be, just as an it. Plus then we were swept up in the practicalities of dealing with the miscarriage, so had other things to focus on. We would check in with each other about it occasionally, but for the most part we both were sad but ok, and ready to move on and try again. We had a ways to go before that yet, though.

Surgery #1

I don’t remember much about my surgery date. I know I was super nervous the day before, but as we had to get up so early to be at the surgery center I was still half asleep. Ian was with me, of course. My doctor came by to say hello and answer any last-minute questions. She’d talk with Ian after the surgery, before I was awake, to tell him how it went. Then the IV went in and out I went.

My D&C was an ultrasound-guided surgery, meaning there were no incisions for scopes. The ultrasound is from over the skin, and the doctor’s tools go up through the dilated cervix. So when my doctor talked to Ian afterwards and told him it had gone well and she had gotten everything, she likely thought she was right, based on what an ultrasound could show.

So that was that, we thought. Off home to sleep, and bleed some more (because I hadn’t had enough of that already! But surgery on your ladyparts will cause that, too). I slowly recovered and bled less, and we started thinking about next steps to try again for a baby.

At my post-op follow-up appointment, I expected to just go in, be given the all clear, and get back to babymaking. But instead my doctor dropped the “I’d like you to see a fertility specialist” bomb. Apparently, during my surgery she had encountered an obstruction that made it difficult to remove the tissue. She no longer thought my uterus was arcuate, but that I had something called a uterine septum – basically a wall down part of my uterus. She wanted me to see the specialist for this reason.

Why she didn’t say a word about this to Ian at the time of surgery I have no idea!! It seems like that’d be the relevant time to share that information, yeah? We’d thought for two weeks that the worst was behind us, but then this. Because of this, and the other miscommunications with her during this whole process, she is no longer my OB/GYN.

I had a little cry in my car, and that feeling of dread was back in the pit of my stomach. But I went home, and made the appointment with the specialist.

Fertility specialist

The earliest the specialist could see me was the beginning of March 2017, so I had a bit more waiting game on my hands. The first thing we did was sit down and go over all that had happened. She was the one who told me that no, it’s not normal for the body to take months to adjust after going off the pill. She suspected rather that I had a very mild form a PCOS (polycystic ovarian syndrome), which meant my cycles were irregular. No big deal, but if I ever wanted to regulate my cycles more exactly we could. Then we did an ultrasound – one of the up-the-ladyparts wand ones, not the over-the-belly ones. I don’t know if it was the different equipment, or the fact she was a specialist, but she immediately saw that indeed, I did have a uterine septum, and a big ol’ honking one at that.

Fun fact: Females all start out with two uteri when developing, and they eventually merge into one uterus and the membrane that divides them disappears. It’s when that membrane doesn’t disappear all the way that you get uterine anomalies like a small dip (arcuate, which the original doc thought I had) to a partial wall down the uterus (uterine septum) to actually having two separate uteri when they don’t merge at all.

So, the bad news: I did indeed have a uterine septum, and that would make having a baby difficult because a) it wouldn’t have room to grow past a certain point due to the wall and b) the septum itself is membrane, not tissue, so it can’t support blood flow if the fetus attaches there. The specialist was 99% sure this is what had caused my miscarriage.

Also bad: there was STILL fetal tissue in there! My OB/GYN had NOT in fact gotten all of it out like she had said, and now it was in danger of necrotizing inside of me (this was the final straw that made me switch OB/GYNs).

The good news: the septum could absolutely be removed, and my uterus would be ‘normal’ and healthy and able to support a baby afterwards.

Despite the bad news, this was the best I’d felt in weeks. Yes, there was still a hurdle, but there was a clear solution and plan of action, and finally an explanation for why I’d had a miscarriage. Plus this specialist was very no-nonsense and clear in her communication, and quick to dispel bullshit, which I always appreciate.

Of course it wouldn’t be that easy though. Before the surgery, she wanted me to get a scan done with dye injected so she could see exactly what she was dealing with before going in. But the lab that runs those scans won’t perform that if your blood test has positive HCG values (pregnancy hormones). And since I still had tissue hanging on in there, my blood work kept showing HCG. I was sent for blood work every week for I think 3-4 weeks to see if it would go down enough to do the scan, but eventually it was clear it was not going to go down to zero and we had to do the surgery without a scan.

Surgery #2

It was now April 2017. My surgery was the second week that month. This one was a bit more involved. I had to fast past a certain hour the night before – not even water was allowed. I also had to take a colon cleanser to make sure my digestive system was cleared out. It was basically a weird-tasting juice-like drink. That part wasn’t terrible, but the aftermath was not fun. There would also be two incisions for this surgery – for scopes/tools and for gas to inflate my abdomen so they could see/move around as needed. One was in my belly button and the scar is not really noticeable. The other was farther down on my pelvis and nobody but my husband or doctors will ever see it. But I’d be lying if I said I wasn’t even more scared/nervous about this surgery than the D&C. Especially because removal of the septum could leave scarring, which would not be good for pregnancy chances.

My surgery was supposed to be early afternoon, but we had to be there in the morning due to hospital procedure. I was the specialist’s second surgery of the day, and that one ran very late, so I didn’t actually go into surgery until I think around 4pm. Given the fasting and my emptied out system, this was already kind of miserable. And then the first nurse I had botched the IV line insertion. I already hate needles, and this hurt like a mo-fo, so I was a really nervous wreck/not happy camper. Oh, Ian also had a bad cold at this time, and I was paranoid about getting sick while recovering from surgery, so he was wearing a breathing mask and dealing with sniffles and head fuzz. Add in the boredom of a prep room without even a TV, and it was just NOT FUN.

Luckily, the surgery itself went smoothly. I remember the anesthesiologist starting my meds, and being wheeled down hallways and into the OR. Some bright lights and people bustling. Then… I was waking up groggy back in the prep room. Someone was bustling around my feet. I was not allowed to wear contacts for the surgery, and Ian (not currently around because they hadn’t brought him back yet) had my glasses, so I couldn’t really see anything. The nurse lady saw I was awake and started talking to me. She had something in her hands and I asked what it was. She said “I don’t know how you made it to your age without knowing what this is.” I explained I couldn’t see because I didn’t have my glasses, and she laughingly told me it was a sanitary pad, which she then proceeded to change out with what I assume was gauze/padding/whathaveyou from the surgery itself.

Ian was shown back, and I was reunited with my glasses. He had talked with the specialist. The surgery did go well, though it took a little longer than expected (it was now about 8pm). The fetal tissue had started to go necrotic, and it was harder to remove than anticipated. But she assured him that this time, it was ALL gone, along with the septum. The only other thing she noticed was that my gallbladder was a little large, but that was a nonissue if it hadn’t caused any issue before now.

Recovery

Recovery from this surgery was hard. First, I was bleeding again, because surgery on ladyparts. And again, no tampons, only pads. Fun. Second, I had a balloon stint in my uterus- to keep the raw uterine wall where the septum was removed from adhering to the opposite wall while healing. It was saline-filled, and added a noticeable and slightly uncomfortable pressure to that whole region, particularly my bladder. Very like the bloated feeling you get during PMS. Third, since they had used gas to inflate my abdomen during the surgery, there were painful side effects from that. Basically, they can’t get all of the gas back out after doing so, so it’s just loose in my system, moving between muscles, organs and tissues until it gets absorbed and works itself out. And that movement HURTS. I could not go horizontal for a few days, not even to sleep, because that caused the gas to move around and that was PAINFUL. I had to sleep propped up with pillows, and still sometimes needed assistance getting in or out of bed, or a seat. On top of this, I had two sore incision sites that made any flexing of ab muscles painful.

I was also on a cornucopia of pills: pain medication (good ol’ T3 again), anti-bacterial medication, and estrogen to help my uterus heal. There was an anti-nausea medication in case I needed it from the combination of the other three, but luckily I didn’t. These two weeks of recovery time were kind of a blur nonetheless.

My post-op follow-up appointment was stress-free this time. My blood work was back to normal – no more HCG, no infections. The stint was removed no problem. An ultrasound showed that my uterine wall had healed well – no scarring! And confirmation for me at last that yes, everything was out this time. I had one more round of pills (progesterone) to kick start my cycle into normalcy after all of that estrogen, and then once I had my normal period, we’d be clear to start trying again. I would be staying staying with the specialist until I had a confirmed pregnancy and was past the 8 week mark, just to troubleshoot any other issues that might come up.

Trying again

And of course they did. My first two cycles after the septum removal were a normal length (30 days) though much heavier than I was used to. The combination of no septum blocking things and more exposed uterine wall unfortunately has equalled more lining to be shed every month. A bit of a bummer, but a small price for a working uterus. We were also doing some house renovations at this time: all new flooring throughout and new master bathtub/shower, so there was a lot of stress and work related to that – but a welcome break from body-related stress.

Then things went weird. I had a cycle that was only 21 days, which is rather short. Then I had a cycle that was only 17 days – super short, to the point of it being too short for the uterus to prepare for a pregnancy properly. This was my suspected PCOS rearing its head and confirmed.

I got kind of mad at my body at this point. I pretty much yelled at my abdomen “why can’t you just work like you’re supposed to?!!” Probably more than once. It’s super frustrating to go through all of that, be told you’re set and body is healthy, and it still doesn’t work like it should. I can kindly be called a control freak anyway, and having my own body doing this was an added level of angst I didn’t need or welcome.

So I found myself on fertility meds – just a short/small dose to regulate when my ovaries were dropping eggs and get them on schedule. The pills themselves were not too bad. They upset my stomach some, but it was only a span of 5 days each time. The worst part was that for every round, I had to go in and have an up-the-ladyparts wand ultrasound on a specific day early in my cycle, which by the way is when your period is. So I got to combine the misery of a period with the uncomfortableness of a vaginal exam. Not pleasant. But they have to check for ovarian cysts before letting you do a round of these pills, so it was mandatory.

We did one round. No pregnancy dice. We did a second round. And I thought we had success, as I had a positive home pregnancy test. But two consecutive blood tests showed that my HCG, while present at first, was going down. I’d had what is called a chemical pregnancy. The egg and sperm get together enough to start sending your body signals, but the embryo never implants, and you just get your period a few days later than you normally would. This is where the early result home pregnancy test came back to bite me, because it was only a few days later I got my period and if I had waited to test it probably wouldn’t have registered as a pregnancy and gotten my hopes up.

Aside from that disappointment, my next ultrasound for the fertility meds showed that I had an ovarian cyst. I know, right? The hits just kept on coming. So I could not do another round of fertility meds just then, but had to go on medication to dissolve that cyst first. Guess what kind of medication they use to do that? Birth control!! Yes. The absurdity of it. Actively trying to get pregnant, and here I am on birth control for two weeks to get rid of the cyst. It worked, the cyst was gone, so now I just had to wait for my period again and we could get back on fertility meds. We did one more round, but still no dice.

We’re now in early November 2017, by the way, so everything up to this point happened in less than a year. And the mental and emotional toll finally caught up with me. I was just TIRED. My business had been struggling and not doing well because for most of the year I was literally bleeding and laying in bed. I was tired of pills and wands and blood work. We’d just finished up a major kitchen renovation, which had been stressful. And honestly the schedule inherent in trying to get pregnant (having to get action on certain days regardless of whether you both feel like it or not) was also wearing on us. So we opted to take a break from fertility meds. It was good timing, as Thanksgiving was coming up, and I didn’t want to deal with the upset stomach that came with those pills on T-day.

Pregnant again!

And of course, that’s when it happened. In early December 2017, I got a positive pregnancy test. After everything, it was when we had decided to take a break and not try so hard that it happened. We were thrilled, but there was also an air of tentativeness about it. We didn’t want to get our hopes up only to have them crushed again. So this Christmas, we didn’t tell anyone – I didn’t call my mom or sisters, we didn’t tell his family that was in town. But despite our anxiety, my blood work kept coming back good, and my pregnancy symptoms were strongly rearing their ugly heads. We had our first prenatal appointment this time around the day after New Year’s – at about 6 weeks. Everything looked good on the sonogram, but we had another appointment in two weeks to follow-up before the specialist would transfer us to my new OB/GYN’s care.

Happily, our 8 week appointment was also fine. My blood work levels had continued to be where they should, and the baby’s blood flow and measurements were all where they should be, too. I think we both heaved a big sigh of relief. It looked like this baby was here to stay, and we could worry about the normal things: like becoming parents.

This pregnancy has been a wild ride all its own. I had pretty much constant low-grade nausea all through my first trimester. Not enough to throw up, just enough to ruin my appetite and make my stomach uneasy – ALL the time. I also had the sore boobs and fatigue again. The second trimester has been much better. My nausea went away and my energy came back. I’m in full on nesting mode right now (nursery is painted and baby furniture has started to arrive!). The food cravings and aversions are crazy!! I couldn’t eat chocolate for the longest time (I know! Cruel!), and anything even slightly spicy kind of wrecks me. But plain ol’ Kraft mac & cheese? Give me that for every meal. Fresh fruit has also a constant. I crave fast food/greasy food less, which is probably not a bad thing.

I’m still having a hard time shaking the trepidation with each doctor’s visit, even though everything has been fine. We just had our 20-week checkup recently, and me and baby girl (girl!!) got A+ grades all around. I haven’t had the sinking sure dread feeling that happened before my miscarriage at all, but it’s still a relief to get confirmation that everything is going well in there. I’m past the halfway point now, so likelihood of another miscarriage has gone down to almost zero, barring an accident of some kind.

Looking back is funny. We’ve dubbed 2017 either Hell Year or the Bleedening, depending on the mood. I’m pretty sure I single-handedly kept Kotex in business last year. And it was by far the WORST year I’ve had in my freelancing career. But at the same time, a lot of good came out of it. Going through all of that together brought Ian and I closer. I had to lean on him a lot more than my norm, and he never faltered. He also never once expressed anything but support no matter how TMI or gross goings-ons with my ladyparts got. And now our house is like-new in a lot of ways, and I have a functioning uterus growing a healthy baby girl we’re eager to welcome. The journey to get to this point was rough, but I am really looking forward to all motherhood will bring.