Ending Endometrin

The doctors assistant called me today and it looks like I'll get to stop taking Endometrin very soon.

I was given 2 options, either start the progesterone oil shots now, or come in for bloodwork tomorrow to determine if I even need progesterone supplements at all.  They said if my progesterone level is above 20, there's no point in me taking anything.

Well duh, I want to know what my bloodwork says!  I think it's rather ridiculous that they just have you on the supplements without ever checking to see if you need them or not.  Extra medications can't be good for your body if your body doesn't need them, and it's certainly not good for the wallet.  I'm rather amazed that I'm almost 8 weeks into this pregnancy, with bleeding complaints, and twins, and no one has checked the level of this vital pregnancy hormone.

If my progesterone level turns out to be really high, I'll probably taper off the endometrin.  2 a day for a couple of days, then 1 a day, and then none.  The last thing I want to do is shock my body in any way by suddenly stopping a supplement.  If I do still need something, I'll probably taper down the endometrin while starting the shots.  Give my body a couple of days to get the progesterone fully into my system with the shots before fully stopping the suppositories.

Grrrr.  In 2 weeks I see my OB again and hopefully graduate to his care.  I just hate feeling processed by this clinic all the time.

7w5d ultrasound

Woke up nice and early for my date with Wanda this morning.  Here are the results -

Both babies have caught up in size.  They measured 7w5d and 7w4d so yippee!!!  Heart rates measured 144 and 147 so those are perfect as well.  Woot!

They are definitely fraternal.  They are far apart, each with their own private survival system.  The placentas are attached in 2 different places, they are unlikely to ever fuse together or anything like that.  So in terms of gestational safety for twins, this is the safest twin situation.  As much as I desperately want to bring both home, there's some comfort in knowing that if something horrible should happen to one of them, the other one might still be saved.  Had this been the case with the girls, we might have brought one of them home.  Not very likely, but at least it would have been worth attempting.

Here's the bad news - I'm going to bleed again.  She found some blobs near the cervix that are likely going to dislodge and create some dramatic and scary looking bleeding.  Fortunately, these blobs are NOT where either placenta is located so it's most likely not going to affect the babies at all.  It will freak the fuck outta the mommy, but probably won't touch the babies.  The problem area is closest to Twin B.  Even though it's pretty far from B, if it gets more dramatic and causes some harm there, Twin A will still be quite protected from it.  But again, it doesn't look like it will touch either of them.

So I'm not looking forward to when that happens, on the other hand, I'm REALLY glad to have some warning.  It's going to make it so much easier to intellectualize instead of straight out panic when it starts.  I can know what the blood is, where it's coming from, somewhat predict how long it will last, and be fairly confidant that it's not disrupting the Maybies.  In logistical terms, I'll be able to flush it away without worrying about what it is that I'm flushing.

I told her that I've basically put myself on modified bedrest - I'm not in bed, but I'm not doing a damned thing either.  She said "that's probably wise".  I also told her about my video shoots this week and that my camera equipment is 15-20lbs.  She's not thrilled about that so we're looking at putting my equipment on a hand truck so I can roll it in from the car, and I'll take advantage of any gallantry that the men at the shoots choose to offer in moving the stuff around and loading it back into the car.

I talked to her about Endometrin.  I really don't like any foreign objects near or in my crotch right now considering I've lost to infection before, it makes me leak constantly so I'm wiping myself raw out of fear, and as far as I can tell, we haven't even tested my progesterone level to know if it's even necessary.  The concern is that if I stop taking it, or if I switch to the oil and that takes some time to absorb, my body might interpret the sudden drop in progesterone as the end of the pregnancy.  Sooooooo she's looking into some options.  I dunno, maybe taper down the endometrin while starting the injections or something.  But it's also something that is generally stopped around week 10 anyway so it might not be worth switching course for only another 2-3 weeks.  We'll see.

I also asked how a huge clot is able to escape through the cervix intact.  She said that it's likely the blood leaked through the cervix, pooled in the vagina and clotted there before passing.  So that explains that!

Overall, she's very pleased with everything.  She says I've dropped to the 5% or lower chance of MC category which I just can not wrap my head around.  My brain simply can not make the switch from "maybe" to "probably".  Especially with so much bleeding that's already happened, and knowing it's going to happen again.  The good thing about the bleeding - it means I get to look in my little guys a LOT more often than I would without it.  I have another ultrasound scheduled for next week, and I should call my OB and schedule my first appointment with him for a week or two after that.

So I'm having a pretty decent day!

Still standing

Not much to report but you've all shown so much concern (thank you!) that I feel I should give everyone an update.

For the last 24 hours or so, I would describe any discharge or blood when I wipe to be of the "residue" category.  Brown, not much there, but it's consistently there.

I'm still doing the endometrin so I CONSTANTLY feel like I'm leaking.  I'm trying to limit myself to 1 wiping check per hour because any more than that and I'm going to wipe myself raw and that's a whole other category of discomfort.

Told one of my bosses today that I'm not going to be working for a while.  The doctors said it was fine to do pottery, but I also noticed that on the days I did nothing, no bleeding.  On the days I spent a lot of time at the wheel, bleeding.  So doctors be damned, I'm not doing it until I feel somewhat secure again.

However, my video work is picking up.  I currently have 2 video shoots scheduled for this week and the company that I get the gigs through called me to see if they could book another one on Thursday for me.  That's fine, but they need to call the clients and make the schedules work, I don't want to deal with that.  I know that sounds like work, but really, it's not that strenuous.  I interview someone on camera for a half hour and then I film them doing what they do for 45 minutes or so.  The rest is spent sitting at my computer putting it together.  I'm kind of looking forward to the one on Friday, it's a go-kart racing place.  So there should actually be some fun stuff to shoot.

In pregnancy symptom news, most of it has faded away.  Currently 7 weeks 4 days.

• My digestion always has a general "not right" feeling to it.  A little on the hungry side, a little on the full side, a little on the queasy side, it can't really decide what side it wants to be on so it's on all of them at once.  But only a little.  
• When I get hungry, I become starving all of a sudden.  
• Oh!  Spent about 5 minutes last night sitting in front of the toilet wondering if I was going to have a repeat performance of Thanksgiving morning.  We really need to sweep the bathroom floor.  
• I don't really get cramps anymore, but rather the occasional odd gurgle.  
• Shoulders and upper back burn most of the time.  Don't know if that's a pregnancy thing or not.  
• I seem to be low grade tired all the time, but never solidly sleep.  I seem to be up peeing all the time, or just on the verge of being awake at any given moment.  I don't feel like I'm really soundly sleeping.
• It still has no dawned on me that there's a chance I'll make it past 10 weeks.  I'm not sure why.  On the other hand, I can't fully picture going through a miscarriage either.  So I have no hunches as to what's going to happen with this pregnancy.  For once, I simply can't figure out the future.

For the most part, I sit here, just kind of holding still because I'm afraid to jostle anything loose, playing cards on the computer, feeling like I'm leaking, and waiting until the hour goes by so I can see if it's endometrin goo or blood flowing into my underwear.  Real exciting life I've got going on here.

Question about bleeding while pregnant - if the cervix is closed, how does the blood escape?  Isn't that like trying to pour water out of a bottle with the lid screwed on?

Ultrasound tomorrow.

Went to the ER Bleeding

It's never 9am on a Monday morning that these things happen.  No, it's always 10pm on the Saturday of a holiday weekend.

Last night after a late dinner, I went to the bathroom to check in the moisture I tend to feel in my undies every hour or so.  That's endometrin for you.  You always feel like you just started your period but it turns out to be a clear, white nothing.

Not this time.  I had soaked through my pantyliner and when I was on the toilet, I dropped a major clot.  I could seriously feel it slide out of my body and when we looked at it in the toilet (yes, I made K look too because I was that freaked) it was something about the size and structural integrity of a full egg yolk.  It looked like some sort of animal kidney or liver that my parents used to feed our cats when I was little.

Here's a logistical problem that you face when something like this happens.  Do you flush the toilet?  Seriously!  What does a person do here?  We opted to not flush the toilet in case it was something that would need to be retrieved for some sort of testing.

I called the clinic and got my call back from the doctor on call and was given the choice of going to the ER or waiting until the morning and getting an ultrasound at the clinic.  Uh gee, let me think about that, BYE!  And off to the ER we went.

Let me tell ya, when you're 19 weeks and in labor, there's a whole lot more rush on your behalf than when you're 7 weeks and bleeding.

I got all checked in, blood pressure, temperature and oxygen levels measured, and was told to wait, so we waited.  I needed to pee.  But I was really afraid of what I would see if I took my pants off so I held off for a while.  When I finally went, there was still blood, but it wasn't as bad as it had been before.

During all of this, I'm trying to come up with a logical explanation for what's going on.  I'm convincing myself that whatever was in the toilet, if it was a gestational sac, it was only 1 of the sacs.  And that the other one could still be in there and just fine.  I'm basically preparing myself to be told that we've lost one and trying to psych myself up to believe that the other one is fine.

Finally, after about a half hour, we head back to a room and I'm told to strip down.  They set up an IV in my hand and take some blood at the same time.  The IV was a precautionary thing, they didn't actually attach me to any fluids, they just wanted the IV in place so that should I need something later, there's no delay in getting it into my system.  On a side note, every time I've typed IV so far in the post, my fingers automatically finished that to read IVF.

Then there was another half hour or so of excruciating waiting.  Bear in mind, that I'm shaking this whole time.  It was a combo of sugar/caffeine from the real coke I had with dinner and panic.  But that kind of tense shaking is not comfy.  While I pass the time inspecting my hair for split ends and color variations, K just sits in the chair next to me and silently waits.  I don't know how he does that but somehow he does.

FINALLY, the ultrasound tech retrieves me and my bed is rolled into a dark room for a date with Wanda.  But first, they do a topical ultrasound to check my kidneys.  WTF?  Ok fine, have a friggin kidney, but the doctor and I clearly have different priorities.  After we've established that I have kidneys, Wanda shows herself and here we go.

I see 2 sacs as the technician takes a quick look around.  I can see that one of the sacs clearly has something inside of it, the other one, can't see as well.  But regardless, it's there, and that means it's not at home at the bottom of my toilet.  But every time she glances at what's in there, she takes a still picture which pauses things so I can't clearly see if there are beating hearts.  We occasionally think we see some hearts fluttering as she passes by and this is reassuring, but it's not clear.

The tech is extremely thorough.  Much more thorough than the ultrasounds I get at the clinic.  They check both ovaries, including the blood flow through the ovaries.  And finally, fucking FINALLY, she focuses on the gestational sacs and start getting some good looks inside.

Of course, the tech is legally not able to give any conclusions of any kind, but fuck, we're IVF patients, we know what the fuck we're looking at.  And we are looking at Twin A's beating heart. YES!!!  All sorts of measurements get taken and I'm seeing ages like 6 weeks 5 days coming up on the screen.  And we move on to Twin B.  And Twin B is indeed right where it's supposed to be.  And there's beating heart number 2.  OMFG YES!!!!!  I start seeing measurements like 6 weeks 6 days on the screen.  And now K and I are babbling back and forth about how much growth we've seen since my ultrasound a whole 4 days ago and trying to make various diagnoses with each other since the tech is not allowed to join in.

As the panic starts to subside, we head back to my room to await conclusions.  Every so often I still need to wipe and I'm still bleeding a little bit.  A doctor comes in and determines that we're not going to do a pelvic exam, the ultrasound gives more info anyway and why introduce anything up there that doesn't need to be there (thus validating my no penis, no fingers policy during this pregnancy).  I'm told I can go ahead and get dressed and so oddly enough, that's what I opt to do.

After another bit of waiting, the doctor comes in with all sorts of results.  There's some blood in my urine sample (duh) but otherwise it looks fine.  My bloodwork all came in just fine.  And my ultrasound, things look as perfect as they can be.

WTF?  How is that even possible?  How can that much blood, a clot that size, exit my body, and you can't find any evidence of where it came from or what the hell it is?  10 days ago, I passed a clot that was like a smushed pea and they could find the gap where that had come from, but you can't see where a clot the size of an egg came from???  I tell him that I'm picturing all of the lining of my uterus just breaking off in bits and pieces and eventually the piece that's holding one of the sacs in place is going to come out taking the sac with it.  The doctor said that's not what's happening.

Here are the final baby conclusions.  I'm told that the best indicator of fetal strength is the heart rate.  The heart rates are 137bpm and 139bpm - very strong.  So that's really good.  The doctor also says that size and age measurements are not exact sciences at this stage so take those numbers with a grain of salt.  Regardless, we're at 6w5d (Twin A) and 7w0d (Twin B) which is 2-4 days behind actual age, but significant growth from last Tuesday so I'm good with that.

I was told that if I bleed through 2 pads an hour, that's panic time.  But if I have something to panic about before then, I can come in any time and peek in on the kiddos.  I'll likely be doing that every couple of days because I seem to be bleeding significantly every couple of days.  I woke up this morning to quite a bit of blood, but it didn't soak through a pad, and as of 9 hours ago, the kids were fine so I'm sucking it up and not panicking.  Yup, see this face, this is a non-panicking face.  No really, it is.  I always look like that.

When I went to sleep last night (after flushing the toilet guilt free), my big boy kitty was under my arm, my smaller boy kitty was under my other hand, and my mini girl kitty, who never comes up on the bed at night, she was sleeping on my belly.  She was still there when I woke up this morning.

For the next few days, I'm not doing jack shit.  No pottery, no dishes, no nothing.  I'm either sitting or lying down.  Intellectually, I'm fully aware that there's nothing that I'm doing to cause this bleeding, but I don't give a hoot about reason.  I'm sitting here, feeling like I'm having a period and it feels awful.  My brain simply can not wrap itself around the possibility that with all of this bleeding, I might possibly make it out of the first trimester still pregnant.  That just doesn't seem possible.

I'll be keeping my Tuesday ultrasound appointment at the clinic.  Yes, I'm likely going to look in these little ones every 3-4 days because they are scaring the bejebus outta me.