Friday, June 19, 2009

The Ultimate Roller Coaster Ride

This blog has been silent on the topic of additional children for a long time, and it has been completely idle for the last 2 weeks. Silence might mean one of two things:
-You have nothing to say
-You have too much to say

For us, it is a case of the latter. The last few weeks and months have been full of changes, but nothing compares to the last two days, when our little apple cart was roughly upturned.

When I started my masters program, R told me that there was no way she was going to have another baby until I’d graduated. She wasn’t explicit about whether that meant she she could be pregnant before graduation, as long as the baby didn't come until afterwards. For reasons beyond our control, there was no baby and no pregnancy until all the exams were over.

Not quite a year ago, we asked our doctor to refer us to the Regional Fertility Centre to help us to have another child. She faxed a request to them and we were told that we would be contacted. Several months passed with no word.

Several more months passed. We asked the doctor if she’d heard anything, since we sure hadn’t. She contacted them again for us. Finally the RFC contacted us for a consultation. Because we had moved from Ottawa and had changed clinics, we couldn’t jump back into another treatment cycle without stepping through their procedures. Tests were ordered, time passed, and we had another meeting with our doctor. While the RFC generally recommends IVF (because of its higher success rates), we pushed to do IUI again, since it had proved effective for us before. The waiting times for IVF are several months, but we were able to go into an IUI cycle immediately.

In our experience with fertility treatments, this was probably the first time ever that the waiting period for something was shorter than we expected.

We began a cycle in April and after several weeks of self-administered shots and frequent trips to the radiologists, we were faced with a difficult decision. The hyperovulation medications had been overly effective, and R had 3 full-size follicles poised to release (desirable) and 3 more medium-sized follicles that could also release (undesirable). In these circumstances, the chance of a multiple pregnancy was about 1 in 3, approximately double the average rate for IUI (15%). Having been informed of the risks, we decided to ahead with it anyway.

Few children can say that they were present for their siblings' conception. Scotty may get to be one of the few, since he came along to the clinic on the big day – May 11.

You are supposed to do a home pregnancy test 17 days later and call the clinic with the results. We did a test 13 days later with the most sensitive home test that I could find. I remember it was a quiet Sunday morning. R came out and gave me the tester because she didn’t want to look at it. A negative test is one pink line – a positive test is two pink lines. I saw one thick pink line and one fairly faint line.


Yup. Pregnant.

It’s hard to compare our reaction this time around to the first one back in September of 2006. I remember R calling me at work back then and the sudden blast of relief that gushed over me. It was so wonderful. This time was weird. We just looked at each other and we said something like, “OK, but how many are in there?” Your standard test kit doesn’t have an additional little dial that says “Singleton – Twins – Triplets – Quadruplets – Madness.”

We were excited, but mostly we were uneasy. Optimism crept in with time, but we still felt like we should refer to the unborn as “the baby or babies."

It turns out our unease was warranted.

Producing too many eggs in one cycle can make a woman feel quite ill. In fact, there is considerable danger if the symptoms of Ovarian Hyperstimulation Syndrome (OHSS) are quite severe. R experienced a mild-moderate case and some symptoms may persist through the first trimester. Then the pain in her side started.

The pain has been kind of mysterious, but she was quite worried that it might be an ectopic pregnancy -- perhaps a tubal pregnancy. She was frustrated that the RFC was not particularly interested in following her case because they have set up all their schedules for IVF and IUI doesn't quite fit in. For example, the clinic does an early ultrasound for all IVF patients to check for ectopic or multiple pregnancies, but they would not requisition one for R, even though her risk of these conditions was roughly equivalent.

Finally, our family doctor came through for us with a requisition to get an ultrasound for a date that fell just after the 7 week mark. That date was the day before yesterday. I came to the radiology lab to attend the appointment, but their policy does not permit guests into the room to see the monitor until the exam has been completed. After 25 minutes of sitting in the waiting room, I started to get uneasy. Suddenly, instead of getting called in to witness the little heartbeat like 2006, R came walking back out.

She wouldn't tell me anything until we could get out into the hallway. My worst fears swelled up in my throat, but she seemed composed. When we were beyond the glass doors, her composure disintegrated.

Through tears, she told me that they hadn't called me in because the case was too complicated and they were going to have to send the results to our doctor, and we would get the information from her. However, after some prodding the technician had confirmed that three implantations had been observed, but there appeared to be an empty sac and another measured a week smaller than it should have with no observable heartbeat.

We left unsure how many babies, if any we might expect. R was in confused devastion and I was following a close second. You see, the technician had congratulated Rachelle on a pregnancy, but she hadn't given any details of a successful implantation or mentioned a heartbeat. We needed more details before we could completely pass judgement on the situation.

I went back to work and R went home to a restless afternoon as she consulted with her circle of confidantes. At about 5:30, she called me to say that our doctor had just phoned her with the results. The doctor reiterated the report about empty sacs and the phrase "no sign of gastrovascular activity."

No heartbeat. By week 7, you should certainly have a heartbeat. The doctor recommended another ultrasound in 2 weeks to follow up, but she made it clear that the probabilities were low that the test would reveal a viable pregancy.

That was it. As far as R was concerned, she thought that it was over.

I still hadn't given up -- but that is typical for me. Things just didn't add up. The technician had congratulated R on a pregnancy and had mentioned three implantations, but all the embryos were described as being inviable. Why would you congratulate someone on an inviable pregnancy? Needless to say, it was a somber mood in our home Wednesday night.

Thursday was a dark day. The plumbing company that was supposed to come back and fix a leak in some earlier work that they did for us got their appointments mixed up and left R hanging around the house all morning for nothing. She was not impressed when I spoke to her on the phone. The plumber finally did arrive in the afternoon.

I called her to check how the work had turned out, asking if she had given the plumber a piece of her mind. To my surprise she dismissed the issue completely. She said, "I don't really care about the plumber, because I just had a wonderful phone call."

My heart jarred to life suddenly.

R had engaged the services of a midwife when treatments started, to see her through the pregnancy and to be her advisor and advocate when the system leaves her uncertain. Her midwife obtained the ultrasound report and clarified everything. Embryo #3 showed a healthy heartbeat of 155 beats per minute. Size was right on target.

This phone call was exactly like 2006 -- all the relief, the jubilation. I was very nearly overcome with all. Over the course of 24 hours we had been through quite the rollercoaster:
-pregnant (need a bigger house)
-pregnant with triplets (need a much bigger house)
-probably miscarrying multiples (don't want to think about houses)
-pregnant with 1 (need the bigger house again)

With each piece of news our life looked to be taking a new direction. We anticipated that this would likely be our last pregnancy, since the treatments are quite a long and painful process. Faced with a miscarriage, we really didn't know where to go next. Suddenly, the way had opened up for us again.

Personally, I have had to mourn those other two embryos as the #3 and the #4 children that I'll probably never have, but I am so, SO happy to have that one little heartbeat in there. Hopefully, they'll let me see you next time, little buddy.

comments:

Linz said...
Ultimate roller coaster ride is an understatement. I was just on it with you reading that post. Oh my goodness oh my goodness. I am so very happy that you are pregnant.

the mama said...
Your dad and I were SOOOOOOO happy to get your second phone call with the wonderful news ! We had been so sad for you both the night before. Oh, what a difference a day makes !! CONGRATULATIONS !!!!

Lisa said...
Crying in Naperville...we are so happy for you! Love to all!

Jennie & Jeff said...
WOW, you guys must be emotionally drained. CONGRATS!! We are excited for you.

Julie Airmet said...
Congrats guys!!

ReeSesPcS said...
Wow! I'm amazed at all you have had to go through. Congratulations! That is SO exciting and I hope R doesn't have to go through too much pain for it all. You guys are an inspiration! We're happy for you!

Kage said...
We are thrilled for you, and sorry about all the drama. I had to read your post a few times to completely understand......

Jamie said...
What a relief. The ups and downs can be the hardest thing in the world to endure. Sounds like upward and onward! We're SO happy for you!!!

Jessica said...
Congratulations!!! I am so happy for you guys. Keep us posted and keep blogging!

margo said...
wow...crying in mccall as well. We are thrilled that it turned out like it did. we've seen those ups and downs and our heart goes out to you. so happy that it had a happy ending. :)

jenjakob said...
Congrats D and R!!! So happy you'll have another little munchkin. Can't wait for all the updates for this one!

David and Cheryl said...
That's wonderful news for you three to have a new addition to your family! We're extremely happy for you.
- The Walkers

Anonymous said...
Congratulations! What wonderful news and what a lucky baby on the way to have you for parents. Scott is such a handsome little boy too by the way.
Wishing you an easy breezy pregnancy. You'll love the midwifery experience.
-Olsens in Ottawa

Grandma Walters said...
Derek, thanks for sharing that most tender, spiritual, and finally uplifting narration on this new little baby. I hope you do get to "meet" that wee one on the next visit. We know how dear Scotty became to you both over all the blogs over the months! Please keep us all posted again now that "it" is really on the way. We are so happy for you! Love, Grandpa and Grandma Walters

sheri said...
GREAT NEWS!!!! So happy for you three!!!
(P.S. my word verification says "diesheri". Why would somebody want me dead?)

16 comments:

Linz said...

Ultimate roller coaster ride is an understatement. I was just on it with you reading that post. Oh my goodness oh my goodness. I am so very happy that you are pregnant.

the mama said...

Your dad and I were SOOOOOOO happy to get your second phone call with the wonderful news ! We had been so sad for you both the night before. Oh, what a difference a day makes !! CONGRATULATIONS !!!!

Lisa said...

Crying in Naperville...we are so happy for you! Love to all!

Jennie & Jeff said...

WOW, you guys must be emotionally drained. CONGRATS!! We are excited for you.

Julie said...

Congrats guys!!

ReeSesPcS said...

Wow! I'm amazed at all you have had to go through. Congratulations! That is SO exciting and I hope R doesn't have to go through too much pain for it all. You guys are an inspiration! We're happy for you!

Kage said...

We are thrilled for you, and sorry about all the drama. I had to read your post a few times to completely understand......

Jamie said...

What a relief. The ups and downs can be the hardest thing in the world to endure. Sounds like upward and onward! We're SO happy for you!!!

Jessica said...

Congratulations!!! I am so happy for you guys. Keep us posted and keep blogging!

margo said...

wow...crying in mccall as well. We are thrilled that it turned out like it did. we've seen those ups and downs and our heart goes out to you. so happy that it had a happy ending. :)

jenjakob said...

Congrats D and R!!! So happy you'll have another little munchkin. Can't wait for all the updates for this one!

David and Cheryl said...

That's wonderful news for you three to have a new addition to your family! We're extremely happy for you.

- The Walkers

Anonymous said...

Congratulations! What wonderful news and what a lucky baby on the way to have you for parents. Scott is such a handsome little boy too by the way.
Wishing you an easy breezy pregnancy. You'll love the midwifery experience.
Olsens in Ottawa

Grandma Walters said...

Derek, thanks for sharing that most tender, spiritual, and finally uplifting narration on this new little baby. I hope you do get to "meet" that wee one on the next visit. We know how dear Scotty became to you both over all the blogs over the months! Please keep us all posted again now that "it" is really on the way. We are so happy for you! Love, Grandpa and Grandma Walters

sheri said...

GREAT NEWS!!!! So happy for you three!!!
(P.S. my word verification says "diesheri". Why would somebody want me dead?)

Anonymous said...

congrats. i took three home test n they all showd the same thing just like the picture. i'm supose to get a blood test done to make sure for sure now!