Well, I’m back. It’s only been 4+ years since my last post! I went to nursing school and have been working as a nurse for a little over a year, and recently graduated with my BSN. I work at a hospital on the pediatric floor, mainly in long term acute care. Basically, I get to hang out with all the babies who are ventilator dependent, and I adore them. I’m significantly healthier than I was 4 years ago, when we decided to take a nice long break from anything fertility related. I’m also still playing with Skyward Symphony, so my music degree isn’t going to waste!
 |
| RN, BSN, summa cum laude |
 |
| My gorgeous family in 2023 |
Looking back, it was definitely the right choice to pause fertility treatments; we needed to focus on Jack’s needs for a while. He ended up being admitted to the state hospital in 2020 and stayed there for 7 months. He is now doing a million times better and just finished his first semester of 7th grade. He fixes all of his teachers’ computers. I’m so proud of Jack! Aidia is the most wonderful ray of sunshine and is excelling in first grade. She just turned 7 years old! She is the biggest cat lady I’ve ever met in my life. I continue to feel lucky every day for my rainbow baby.
I can’t believe my baby just turned 7. Time is going too fast. The days are so long but the years are short. Like every other mother, I'm worried I'm missing it and not doing enough for my children- not teaching them enough.
I went back to therapy nearly two years ago. I’ve been much more careful with myself as we’ve discussed the possibility of trying for a baby, as I now know how traumatic this tumultuous journey can be. I had specific goals to accomplish before I was willing to dive into anything fertility related again. Therapy has been a huge thing for me- I’ve tried to engage in a healing process, instead of crawling back to therapy after exposing myself to even more trauma. I’ve been slowly working through what I’ve experienced, and unraveling how it might affect the decisions I make now.
I’m trying not to get too emotionally invested in this process or outcome either way. I just want to take baby steps and see what everything is looking like. See what our chances look like on paper. It’s too much emotional pressure otherwise. Right now, a baby is still a pipe dream. There have been many months where I’ve gone back and forth between “maybe, maybe not.”
It’s not the same economy that Jack was born into. I work full time nights as an RN. I would be lying if I said I didn’t grit my teeth and wonder how we would hypothetically manage. How would I go part-time? What about childcare, breastfeeding? Pumping at work?! How would I work overnight if I had a baby, or ever sleep during the day? Wouldn’t working dayshift be even harder due to childcare? Would I even survive working nights without caffeine? I now have one child in junior high and one in first grade. Their expenses and needs have expanded over the years. Do I want one child in high school and one in diapers? A 3rd child would mean less room in a 3-bedroom house, and less of Mom to go around. It would mean less money for upgrades, first cars, college, or vacations. It might stretch us to our limits.
With my history, I have to entertain the possibility that I might be too sick or too high risk during a pregnancy to continue full time work. I take around 7 prescription meds to manage chronic conditions, and I would need to stop all but 1 or 2 if pregnant. That’s going to feel like it’s going to kill me all on its own. It is hard to imagine making it through a 12+ hour shift without at least an Aleve. I’m willing to push through the pain I go through fibromyalgia sans medications, but I am worried about how difficult it will be. This is less important, but I’ve spent over a year working hard to reach my goal weight. What if a pregnancy wrecks all of that work? My likelihood of gestational diabetes returning is also high. It’s a lot to consider.
Working at night affects your circadian rhythm, which regulates hormones. The research on working nights while pregnant being associated with miscarriage, pre-term labor, gestational diabetes, intrauterine growth restriction, etc is terrifying (though they haven’t proved causation). I remember when I first started nights my period was all over the place for a couple months as my circadian rhythm was adjusting. The risk scares me a lot. Rearranging my whole life to reduce the possible risk also feels terrifying.
Babies must be on Aidia’s mind also. She asks me for a “roommate” at least twice a week. I explain that it’s not always easy for everyone’s body to have a baby and she tells me to pray harder! I love her sweet little spirit and optimism. She came bursting in my room the other morning and explained that she had solved the problem and we could just ADOPT a baby! Like it was as simple as driving down to the animal shelter. She told me she didn’t even care if was a boy instead of a girl. She would definitely be the world’s best big sister.
Though we’ve been trying to focus on “baby steps,” our consultation with my RE cost a few hundred dollars and THEN it felt like “oh ok this is for real.” My doctor wanted to repeat a bunch of tests. I’ve been working with this same doctor since our 4th loss and trust him completely. He said I was brave after all we’ve been through to come back and even try for one more baby. I don’t know if I’m brave or actually just stupid. He emailed me a copy of his notes and I can’t believe the pages and pages of tests and procedures we’ve had in the past 13 years. I almost forgot what it took to get Aidia here.
One of the hardest thing with fertility testing is figuring out billing. Usually insurance isn’t contracted so we opt for self pay prices. I call around with CPTs but companies get confused and you get bounced between representatives forever. Sometimes the nurses at the fertility clinic will get on the phone with 3rd party labs and try to figure out costs for me, which is amazing. At the end of the day, you usually have to decide to either take a gamble, or, pay the self pay price and know what you’ll pay. The first blood panel I needed cost $600 out of pocket to run. Insurance covers the CPTs but not the 3rd party lab. So you can bill insurance and hope they cover it, but if they deny it, you’ve lost your chance at the self pay price, and now that $600 would turn into $2000. I was a bit stressed about paying for the blood panel, but in the same week I was offered 3 extra partial shifts with call in pay which basically paid for it. That was kind of amazing timing.
The blood panel was a lupus/ antiphospholipid syndrome extended panel. Despite the autoimmune cesspool which is my family history, I actually tested negative for lupus and APS way back with a hematologist over ten years ago. I had read enough about APS to know it can be really brutal on pregnancies, but always felt relief that I had tested negative and ruled that issue out. I was fine redoing the test if that’s what the doc wanted. I decided to start with that test because I was confident it would be negative and I could mark that off the to do list easily.
Then I learned that APS antibodies can be transient.
I was completely shocked that I tested positive. Granted, looking at my history it makes a lot of sense. Not sure why these things still surprise me but this one really did. This one hurt my feelings because I was so sure it wasn’t going to be an issue.
Just to be clear, I don’t have lupus, just the APS antibodies (which occur more commonly when you have lupus). This is the third condition found in my blood that increases the risk of blood clots. I sat in a stupor and wondered- how did I ever have children at all? How have I never had a blood clot? Should I be taking baby aspirin all the time, like starting yesterday?! How many dormant autoimmune issues do I have that are yet to be discovered?
Basically, antibodies in my blood are mistakenly attacking cardiolipins (which are a fat important for blood clotting). These antibodies can lead to impaired blood exchange between mom and baby, cause placental insufficiency, possible impaired hCG release, and can lead to repeated miscarriages or stillbirth.
I just can’t believe we have another diagnosis working against us. It feels like we have all the top risks for miscarriage. Hashimoto's, endometritis, MTHFR, APS, and Factor V Leiden. Plus on Kevin’s side there is a history of high oxidative stress and DNA fragmentation. I look at that list and I feel deflated. But we’ve beaten the odds before.
The treatment for APS is aspirin and Lovenox in pregnancy- which I did with Aidia anyway until I had a subchorionic hemorrhage with her. At that point I stopped the Lovenox injections and continued aspirin. Since I have other clotting issues here’s a good chance that I would be doing aspirin and Lovenox anyway. Especially with 7 previous losses. So this news doesn’t really change anything, it was just a bit triggering. Bad news never feels good. As far as the idea of going on more blood thinners in a pregnancy…I’m scared of having another hemorrhage and losing a baby to overcorrecting the risk of clots. Aidia survived a hemorrhage. It just feels like the worst game of “guess and check.”
Though it may be brave to face the infertility world again, I also know it is equally brave (if not more) to know when to stop. I’m just not sure which hurdle I’m facing yet.
I read an article online where a psychologist talked out the traditions we have around women, like bridal and baby showers, and how they celebrate the “beginning.” She said “It makes sense that that’s what we anticipate. When we’re done having kids, our perception of ourselves changes. We must navigate the expansion and contraction of ourselves in relation to who we thought we were, what we expected to become, and the reality of who we are…women who don’t firmly ‘close the door’ - be it mentally or physically- can be tormented for years, never letting themselves feel complete or enough.”
I love working in pediatrics. My goal is to someday transfer to working in a NICU and get certified for critical care in that setting. Right now, it feels like there’s this big hole in my heart and I hope that I will be able to heal it to the point that I could work in a NICU without feeling triggered by my own traumatic experiences. The envy can be biting in some situations. I have more work to do before I’m ready to pursue that goal. I always thought that if I could settle my feelings and complete my family, I could be at rest with those emotions and give my all to help others. It probably all runs deeper than that, and tying things up with a nice little bow won’t solve everything. I don’t know what this year is going to look like, but I’m hopeful that I can face it with a little less fear, and a little more commitment to finding peace and satisfaction no matter the outcome.
