Surgery Bound!

A quick update on what’s going on with us.  We were able to get in to see the urologist who specialized in male infertility today.  I was very anxious for this appointment and hoped it would bring us some more answers as to why Kevin has such a high level of DNA fragmentation and oxidative stress- which may be adding to the reasons we keep miscarrying.  This doctor is supposed to be top notch in this area, and I’ve heard good reviews about him from many people. 

I was most afraid of him saying nothing was wrong.  Fortunately, he did find a Grade I varicocele when examining Kevin.  Grade I means that it is small- not yet visible just by looking.  However, they typically don’t resolve themselves and continue to slowly grow.  Even though it’s small, it is a big possibility that the varicocele is causing the fragmentation and oxidation.  Because of our history and meeting certain specifications, Kevin will be undergoing a varicocelectomy to remove it.  I'll spare you and avoid posting any pictures of the surgery ;)  After three months recovery time we will retest his fragmentation rate and hope against hope that it has resolved the problem.  If the fragmentation rate drops significantly, we will be able to try for a baby on our own again.  There is very good scientific data backing this up.  Couples who suffered from repeated pregnancy loss had a much greater chance of carrying a child full term after a varicocelectomy.  We wonder if perhaps Kevin hadn’t started to develop this varicocele when Jack was conceived.

 

There is a chance that the surgery won’t correct the problem.  If that is the case our only option left will be IVF.  Doing IVF can improve our chances, even with DNA fragmentation, because the embryos are monitored for proper growth (and sometimes tested for viable DNA) before ever being inserted into the uterus.  Also, doctors are careful with the quality of sperm they use to fertilize the eggs.  It is hard for me to wrap my mind around undergoing such a difficult procedure and paying 20,000 dollars to do so, when we have conceived seven times on our own.  I think of all the dozens of injections and the egg harvesting and my blood risks with multiples, etc.  I think of some of the ethical issues that may come up with “leftover babies” and all that other complicated stuff with embryo adoption.  It gets overwhelming quickly- but we will cross that bridge when we get there.  IVF is not a possibility for us at this time, so we will start with the conservative approach and see if the surgery corrects the problem.  If the varicocele is really the biggest issue, maybe we could have many more children without medical intervention (not that I’m getting my hopes up).

All of that being said, the surgery is 3800 dollars and nothing is covered by insurance.  Between the two of us we’re already paying between 200-300 dollars a month for medications and supplements.  I don’t have that kind of disposable income… But I have faith it will work out somehow.  I can’t imagine waiting a year and a half until Kevin is a practicing DPT to pay for this surgery…and just letting this thing grow inside him in the meantime.  We will try our best and I feel the Lord will help us a little at a time to pay for the help we need.

If all goes well we would be able to try again by the start of 2016.  I’m hoping to have another baby when Jack is 5…but that would be best case scenario.  He may be older by the time another miracle comes our way.  It’s hard to deal with an age gap for me emotionally because it’s not what I wanted for my children.  It gets harder every birthday and every month that you’re still not pregnant.  Every loss you think of the recovery time and trying again, and then that ten months it takes to have a baby.  But- God knows better than me, and long term it will be ok.  Our family may not be what we had in mind, but it will still be our family. 

I’m excited to finally have a more tangible problem with a straight forward solution.  Although, I have been giving Kevin a hard time because he gets to be asleep during the procedure and then go home on pain meds.  I think of all the painful procedures I’ve been through since we first got pregnant with Jack and I think “Are you kidding me!? You get to be asleep!”  haha.  I mean I’m happy for his sake, but man…all the injections, even the ones straight into the lady parts, the incisions in my arm, the daily shots in the belly, the pain of miscarrying, or even hearing “try to breathe through the pain of this cervical clamp.” And they put the men out. Hahaha- that’s why women are mothers right? J

We still don’t know how much of a contributor I am to the losses for sure.  So even if we can fix the fragmentation rate we aren’t positive of my ability to carry.  It’s a scary thing.  However, I carried Jack full term so I feel that it’s possible if the baby has healthy DNA.  We will be holding our breath for 9 months but I still think some hope is there.  We are skeptical naturally after going through six losses in a row, but we are trying to pull some hope out of our hearts that have been hardened a bit. 

We have some pre-op labs to do and such, and the surgery will probably be scheduled for late July or sometime in August.  Sometime between now and then I’d better figure out a way to pay for it…Perhaps we'll start a fundraiser called "Aw nuts, his nuts are broken" or "testicle festival" (his idea).

All in all. I’m just so glad that this is what I thought was happening, and then he actually has a varicocele.  Yay for not being crazy.

Thanks for all your love and support!!

Healing, Hashimoto's, and Getting Help

“Beneath the foulest mother's curse

No child could ever thrive:

A mother is a mother still,

The holiest thing alive.”

-Samuel Taylor Coleridge

It’s been a few months since I’ve written, but I’m happy to say life is getting a little better.  It’s been a rough process recovering from loss #6, but I think I’m well on my way to being as well as I can be.  I have been blessed with everything I need to keep me going and find as much happiness as is available to me.  Some of this writing sounds pretty sad, but it got better as I got some help and it’s turned out ok.

Healing started with getting an IUD placed.  I wanted the IUD because I am so done with losses.  I never want to have another miscarriage.  I want to be done trying for a baby until we have a large reason to believe our next child will live.

I was trying to settle into the idea of inhibiting my fertility temporarily, and then my sweet little nephew was born not even 48 hours after our loss.  Fortunately, there is always a great deal of joy when a new person joins your family, and it swallows the jealousy for the most part.  I instantly loved him with my whole heart.  Yet, seeing such a precious child amplified my grief and I was very aware of my not-yet-all-the-way-empty womb.  It’s not an easy thing to walk into a maternity ward when your own pregnancy has just ended (but it was better once I was in my sister’s room).  It made it very difficult to follow through with the IUD placement, but I still knew it was the right thing to do long term. 

So I geared myself up for the IUD consultation.  It was a bit of a rough day.  Sitting in the waiting room of an OB office is a small form of torture.  Other moms sitting next to you munching on crackers, complaining of how sick and tired they are, and asking you how far along you are.  There are newborn pictures all over the wall and pretty much everything around you seems to be a small trigger saying “Hey, remember how your baby is dead?  Remember how they stopped growing and you’ll never get to have that ultrasound apt with them?”  Once I was in the patient room I could hear nurses whispering outside the door, "Infertility patient but needs an IUD placed? what? Oh well she gets pregnant but she's lost the last 6."  They decided to place the IUD the same day, and made me take a pregnancy test to confirm in the office.  The girl came back beaming “Ok it was negative- so the hCG is all gone and the pregnancy is totally over!  We can place the IUD!”  *thank you for that…this is actually the last thing in the world that I want to do…*

So during the procedure, as I’m trying to breathe through the pain of the cervical clamp, the doctor says “Oh good!  Your cervix is still a little dilated since you just had your baby…I mean, passed everything.” Really?  Do people even know the hurt they can cause? 

Anyway, I got through it and drove myself home and pretty much went  to bed for the rest of the day.  Fortunately the IUD has worked out well and hasn’t been causing me any lasting pain, and it’s non hormonal so it’s safe for my blood.  It’s the best case scenario for our current situation.

I bought myself a little necklace to wear as a reminder to myself of those babies I had lost, and to keep hope for the future. It reminds me that I haven’t given up despite having to take more drastic measures to avoid pregnancy at this time.  I like to wear it on days that I’m feeling extra sad or know I might encounter a difficult situation.  It sounds funny but I feel like wearing it gives me a little strength just knowing they aren’t forgotten.  I'm still their mom.

I’ve been looking forward to Kevin’s urology appointment- trying to hold on to the hope that they might find a cause for the DNA fragmentation, and even more that maybe they could do something to repair it.  How wonderful would that be?  Mostly I’m relieved that from now on, if we think we’ve solved the problem, we can just get Kevin tested again to confirm success.  No more “go ahead and get pregnant and see if the baby lives” kind of confirmation.  Even if that part takes years- it’s better than enduring more losses.  I am most nervous to hear a doctor say “We don’t know why and we don’t know how to fix it.”  That would be most devastating.

I wrote an email to my nurse and asked her if we could do some more thyroid testing.  I started to lose such a crazy amount of hair that I wondered if I was getting chemo and just didn’t know it.  I had tested positive for low tider ANAs a few years ago but the doctors never really tried to confirm a reason why.  I always assumed I had autoimmune troubles with my thyroid.  On days where I felt really thyroid sick I was miserable.  I explained to my nurse, “I'm freezing and shivering all day, I cry easily and feel so sad even about the smallest things.  My hair has been falling out to the point where it's nearly impossible to wear it down because it just covers my clothes.  It never stops coming out in clumps when I shower.  I just have these breakdowns feeling like the rest of my life I'm going to be freezing and sad and overweight and lose all my babies because I can't get my thyroid to function and stop attacking itself.”  Being cold doesn't sound like too rough of a symptom, but it starts to get to you after a while.  Like try standing outside without a coat for 20 minutes in 30 degree weather and see if you can stay in a good mood.  Focusing becomes very difficult, especially at work or in class.

So we did a new thyroid panel and sure enough- Hashimoto's Thyroiditis.  It’s not really a surprise.  My mom and grandmother have it.  I’m sure it’s only a matter of time before my little sister has it (sorry Mads).  But I was frustrated to have my suspicions confirmed.  Hashimoto's or Graves disease can cause miscarriage.  Normal range for antibodies not indicating an auto immune disease are 0-3.9, mine was at 57.5.  So it appears that I have been dealing with more than just hypothyroidism, but a “suicidal thyroid” as I call it- which guess what, is associated with miscarriage.  I swear if we get one more risk factor for miscarriage I might lose my mind.  I tried to list all our risks, even just to keep any new doctors in the loop.

Leiden Factor V (blood clotting)

MTHFR (folate problems, blood clotting, and lots of other “associated stuff”)

Low Protein C and Protein S (blood clotting)

Hashimoto’s Thyroiditis/Hypothyroidism  (I won’t list all the things this crappy disease does to the body, but suffice it to say that it is associated with miscarriage)

High level of DNA fragmentation in the sperm (infertility, recurrent pregnancy loss).

And we still need to get karyotyping of our chromosomes done for both of us.  They have to rule out that we don’t have Chromosomal Balanced Translocation.  That’s another explanation.  I will be so relieved if our chromosomes come back normal (please oh please oh please.)

I thought I would feel relief after getting the IUD placed. But I didn't.  I kept waiting for the settling feeling to come.  I know we can't get pregnant for a while.  Not until we figure everything out.  We need a break.  So why can't I settle into the idea of my life with Jack getting older and no other children coming?  I feel so weighed down with sadness.  Mourning our loss and trying to accept that the odds for the future are not in our favor.  I think I'm really starting to believe it might not happen again.  I think peace about the situation will come in time.  I'm just not there yet.  Even considering adoption is a headache.  So many factors, so much money, and so many reasons that it’s not a possibility for us at this time in our life.  I try to reassure myself  "We're not having more kids right now.  That's ok.  There are lots of other good goals in your life to focus on.  You are still young.  Even if it takes years and years more, either to give birth again or adopt, it will be ok.  The age gap will be ok.  Your heart will be full again and this empty feeling won't consume you in the years to come."

That dumb doctor that placed the IUD put a lot of doubt in my mind. Basically even if we had the money and resources to do IVF with ICSI and did embryo testing to see if it's viable- there is no guarantee that I could carry the baby.  She didn’t seem convinced I could carry to term. 

I kept telling myself- I have to start trying to get better.  For my sake and for my family's.  I missed a few doses of Deplin after the miscarriage and I felt that depression hit hard.  One night, all at once, I was overcome by my grief and anguish and my exhaustion.  I was so devastated to know that the auto immune problem was real, and I was angry.  Why do I have to feel so thyroid sick and exhausted all the time?  It makes simple daily tasks feel so difficult and it makes it so hard to lose weight, so hard to feel good about myself.  I feel so lonely in my situation sometimes

In that moment where I felt overwhelmed, I literally thought my heart would break.  I was going to die in that moment, right there sobbing and shaking on the floor from a broken heart.  Not just about babies, but about my life.  I want to feel healthy.  I don't want to dread going to church or going out in public.  I want to feel more stable, I want to have peace.  I can make millions of to do lists and goals but how can I reach them when I feel so alone and devastated.

I do believe things will get better.  I plan on writing about them as they do.  I need time to heal.  Time to get healthy and get my health problems under better control.  Time to process 6 losses within less than 3 years.  Time to be at peace and understanding with my situation and find acceptance.  Time to develop faith.  I feel like I have gone backwards sometimes when I dread going to church and avoid praying in general.  My heart just feels too broken to open it up to pray and believe- it's easier to feel hardened and angry.  But deep down I know that doesn't do any good.  That's not what I want in the end.

Perhaps I needed to hit rock bottom before I was ready to rebuild.  Well now I know this is where we have to start.  This year can still be a year of progression and wonderful memories.  Maybe I will be less "thyroid sick" and find better treatment.  Stay on folate therapy and feel like a person again.   I can lose weight, and find meaning in my career that has shifted drastically toward healthcare.  I can continue to develop my musicianship wherever it is allowed for in my life.  We can find doctors to help Kevin with his health.  I can be a daughter, sister, wife, mother, aunt, and every other title that means so much to me within my family.  I can build my relationship with God and learn to trust Him so much more than I do now.  My heart is broken and hopefully ready to be taught.  I try not to be just pessimistic.  It's hard coming out of another loss and feeling sick, but I want to be happy and live life a piece at a time. 

After all of these breakdowns I started coming to the realization that I might need to get some real help. 

My mom called me to try and convince me to get some extra help.  She pointed out all the things about me my whole life from the OCD tendencies (there are a couple real ones) and my driven attitude to fix things, the constant feeing of fight or flight, intensity and breakdowns, lack of energy, slow metabolism.  She told me she didn't want me to live with this high level of anxiety anymore, or depression, or feeling of general “crumminess.”  In my gene pool there are many people with other associated problems: GI problems, trouble sleeping, MTHFR, neurological problems, turrets, etc.  There is a lot of anxiety in the young children in the 3rd generation.  I wasn’t interested at all in medication, but I trust my mother because I know she has my best interests in mind.  

The health food side of me was somewhat afraid of anti-depressant medication because I do believe that many problems can be managed with a healthy lifestyle and without drugs.  I don't think all of my type A personality traits boil down to anxiety, but I know some of them probably do.  But I decided she was right and there was a line to be drawn.  I shouldn’t dread waking up in the morning and spend my time writing list after list.  My mom brought up my high school days where I would write in my journal 3-4 hours a day- two lines of print per line on the paper.  She said I can't even see past it, but I don't need to be living with that level of anxiety.  She wants me to be able to be happier despite any deficiencies (serotonin or otherwise) and not miss out on this time in my life.  I should be able to breathe easier.  I shouldn't get down on myself so often that I always feel inadequate.  If I did take something to try and help balance- I wouldn't take it during the next pregnancy, so I hope I wouldn't be dependent.  I wouldn't take it breastfeeding either, if I could get that far.  But breastfeeding gives such a great oxytocin boost anyway right?  I felt great when I breastfed.  This was a prayerful decision.  I was very afraid of side effects and dependency.

I shouldn't want to stay in bed all the time.  Or have anxiety about needing to go to the grocery store the next day,  Or be in the vicious cycle of stress to get up, anxiety even about getting dressed, about going to work, about trying to sleep, about trying to get up, etc etc.  Activities of daily living shouldn't be stressful.  Ask my husband, I do even get anxiety about trying to figure out what to eat sometimes.  I'll cry over it, even though I know how ridiculous that is.  My other health problems don’t help the situation.  The more I read about it the more I realized this may be a reality for me.  I read that in depression, the limbic system sends an emotional signal that is inappropriate, so like:

Sad signal when there’s nothing to be sad about

Signal to stay awake when we’re tired

Guilty signal when we’ve done nothing wrong

Feel really guilty over something very small

Fear signal when there’s nothing to be afraid of.

This can distort reality as most people will try to attach these emotions to what is going on in their life which gives false perceptions about reality.

I’ve felt like a hypochondriac for a long time, but I think all of this may actually be related.  Hypothyroidism and chronic pain (like my back) are also known causes and contributers.  My sleep, appetite, energy have all been bad lately.

I decided I want to laugh more at home and be happy for my son.  I feel like I'm usually not pleasant around him unless I fake it.  Fortunately I don't struggle with thoughts of hurting myself.  That's only happened once or twice in my life during bad panic attacks. I think the hardest part is admitting "I might have a problem."  I just didn’t want to be dependent on medication by my mid 20s for chronic problems. 

I'm learning that it's ok to be treated with medicine.  For my thyroid, for my chronic back pain, for a folate disorder, for GI problems, for fertility, maybe even for anxiety and depression.  It's still taking care of myself and trying to be responsible for my health.  I need to be more regulated.

I finally had the thought, “I want to be able to take Jack outside and not be exhausted to the point of tears just thinking about it.”  That’s when I decided to go to the doctor.

The doctor started me on a low dose of Zoloft.  It was a rough appointment to get through (especially because I work with the doctor) but I wanted to at least try it.  The first few weeks I didn’t feel any different really.  I thought it must all be placebo for people.  But now that it’s been a bit longer, I am really starting to feel, better.  I have much more stable moods, I get better sleep.  I am able to handle lots of things going on without having total meltdowns.  My chronic back pain has decreased immensely (even though I don’t really understand how).  I have enough energy and confidence that I’ve been able to work on eating healthier and being more active. I’ve worked hard at it the past two weeks and I’ve lost five pounds!  I feel like everything is stabilizing a bit more.  It is a wonderful feeling.  Now I don’t mind being on some medicine because I have more better days.  I still have hard days too, everyone does, but I’m having MORE better days.  I’ve been able to take Jack out for more activities, and we’re having more fun together.  I really only share this because I know I have some readers out there with similar problems, and even though I’m early in this journey, I’ve learned that it’s ok to get help!  It’s ok to be happy!

I took 20 days straight without a day off to do training and to get my CNA.  I’m just waiting to do my state boards at this point.  I’m happy to put my energy towards something useful and it is a good distraction.  I loved learning how to be of more help to our patients in the hospital.  I've learned a lot through my CNA class.  I don't like the reputation it seems to have of being a low class or "gross" job. It is hard work, and not glamorous, but I really feel like it is a sacred calling. To care for a human being at their most vulnerable, or most miserable, or at the end of their life is something that should be respected. The job should be carried out with kindness and compassion. It is so sad to witness any abuse, neglect, or anger toward those in need. Treat people like people and be thankful that your occupation can include so much service to others every day.

Mother’s day is coming up, so I’m bracing myself for that.  It’s a bit of a hard day.  I pretty much don’t go to church on mother’s day, just on principle.  Haha, ok it’s not really on principle, but the past two years church on mother’s day has either caused me to have a panic attack right before or right after church, or I found myself trying to choke down one right in the middle of a meeting.  It’s one day a year that I just give myself to stay home and ponder everything I need to.  I feel like it’s ok to stay home during the meetings and pray and take the time I need to mourn.  Take time to be thankful for Jack the way I should be.  And to be thankful for my own mother. 

A happy mother’s day to all of you out there- whether your babies are here with you or not, “A mother is a mother still, the holiest thing alive.” <3

Picture with my sweet nephew Holden.  I long to be a mommy again, but being an auntie is pretty great!  Thankful for these little ones in my family.

Surprises

Surprises of all kinds come at different times of life.  Sometimes they come with ironic timings; such has been our recent experience.  The first surprise I want to talk about is somewhat of a positive surprise.  Even though it’s “bad news,” at this stage of the game, diagnosing the fertility problem is a huge blessing no matter what the problem is.

A test came back from the clinic that revealed our losses may have been caused from Kevin’s side this whole time.  I don’t think we were expecting that at all, but I was so relieved to have a new diagnosis to follow since my health issues have been treated and treated and never changed the outcomes of our pregnancies.

Kevin has an abnormally high amount of Fragmented DNA in his sperm, more than a third of them in the sample that was tested.   He also has a high level of oxidative stress.

We started doing some research about this problem and found lots of interesting information:  

-If the level of DNA fragmentation exceeds 30% then a couple’s chance of delivering a baby, through Intra Uterine Insemination (IUI) treatment, fall from 19.0% to just 1.5%.   (I would add conceiving the old fashioned way as well, IUI is just a way to help sperm meet egg)

-Increased levels of sperm DNA fragmentation can cause recurrent pregnancy loss and increase the risk of cancer in offspring (including childhood cancer).

-What happens when Sperm DNA is damaged? When a sperm penetrates an egg, the DNA of both cells combine together. The female’s egg contains many DNA repair mechanisms, which attempt to repair sperm DNA damage incurred during the sperms journey to the egg. These repair mechanisms can mask the effects of damaged sperm DNA during the early stages of embryonic development, such that embryos created through IVF/ICSI will appear normal to the embryologist in the laboratory.  The more serious consequences of sperm DNA damage can manifest later in fetal development and lead to early miscarriage.

The most important thing for us would be getting a much higher number of healthy sperm.  Sometimes this can be accomplished with vitamin therapy.  It kind of depends on the cause of the fragmentation.  It’s weird in Kevin’s case, because most of the risks for it don’t apply to him.  He’s not old, he doesn’t smoke or drink, he’s not exposed to lots of toxic chemicals, he hasn’t had a high fever (at least not since 2012 when we started having losses), etc.  

I do wonder if he has had some sort of long term illness that we haven’t known about.  Lots of his physicals since he was a kid have shown a small amount of blood in the urine not visible to the eye, but no one has known why.  We will most likely meet with a urologist who specializes in male infertility through our clinic.  I think it’s possible Kevin has had this problem his whole adult life and just not known it.  In which case, I would think the most likely cause would be varicocele (an enlargement of veins within the scrotum) If this is truly the case for Kevin, there is a surgery they can perform to correct the problem, which has a high success rate.  So I am hoping this is where his problems are stemming from (because there maybe an actual solution) We read that a varicocele usually causes no symptoms.  Here is some more research that really intrigued me.

Varicocele is the dilatation of the pampiniform plexus caused by the reversal of venous blood within the spermatic veins [1]. Varicocele is an underlying problem in male infertility. The prevalence of varicocele has been reported to be as high as 10~15% in the general population, 30~35% in men with primary infertility, and 69~81% in men with secondary infertility [1]. Many studies have been conducted to explain the pathophysiology of testicular dysfunction occurring with varicocele. The exact mechanism of infertility caused by varicocele is not understood completely. The most likely explanation is that germinal cell dysfunction is secondary to hypoxia from the obstruction of small vessels and venous stasis [2]. The back flow of adrenal and renal metabolic products through the left internal spermatic vein, an increase in scrotal temperature, and endocrinological changes are other explanations that have been proposed to explain infertility from varicocele [3–5].

Additional hypotheses on the mechanisms of infertility in men with varicoceles are associated with increased oxidative stress and decreased antioxidant capacity. This parameter has been linked to sperm DNA damage, such as DNA fragmentation, and correlated with the reduced ability of spermatozoa to fertilize oocytes in assisted reproduction techniques and normal fertility [6, 7].

A varicocele was detected by physical examination and confirmed by Doppler ultrasound in the 92 patients who entered the study. The demographic and clinic findings are provided in Table 1. The mean age of the 92 men was  (range: 22–39) years with a mean duration of infertility of  months 21.6 +/- 9.2.  Eighty patients (84.2%) presented with a varicocele isolated on the left side, and 12 patients (15.8%) had bilateral varicocele. The preoperative follicle-stimulating hormone was measured in 58 patients, and the median value was 4.8 mU/Ml (1.9–25.1). The preoperative testosterone was measured in 29 patients, and the median value was 3.2 ng/dL (1.8–7.3).

In the present study, the patients showed higher sperm count, progressive motility, and normal forms 6 months after subinguinal microsurgical varicocelectomy. Furthermore, there was a large decrease in DFI from a preoperative mean of 42.6% to a postoperative mean of 20.5% 

Is this the only source of our problems?  I don’t think so.  I have obvious blood clotting problems, obvious folate deficiencies, low thyroid problems, etc.  The difference is, all of those issues have been treated with medication and supplementation. They’ve had a close eye kept on them and the docs have been stumped why nothing has changed in the slightest.  We also have always wondered how Jack was such a normal pregnancy when all I took with him were prenatals and baby aspirin.  It makes much more sense that perhaps Jack was conceived with a healthy sperm and had good DNA match up properly.  So maybe it isn’t so much my body, but the DNA in our embryos being broken.  We still need to get our karyotyping done- that would show if we have a problem in our ACTUAL DNA as well, not just healthy DNA getting fragmented.  If the problem truly is a varicocele, that would also explain the high level of oxidation. 

__________________________________________________________________

Now here comes the irony.  The same day we found out about Kevin’s DNA fragmenting, we found out I was pregnant.  This was not a planned pregnancy since we wanted to wait on the test results.

 I had a suspicion our birth control may have failed a few weeks before and had started on preventative medicine including progesterone just so I didn’t underestimate the fertility of my body (I wasn’t wrong).  At this point, we were still considering the cause of our losses to perhaps be from some autoimmune problems.  There is a whole other world out there friends, a complicated world of immune responses and problems. As my mom says, I'm a poster child coming from a family with all the weird auto immune stuff that docs struggle to even identify.  During this two week wait to find out if our birth control actually failed, we got my egg quality testing back, and the results were fantastic. 

The bad news is, my thyroid is not great.  In fact it was shocking at how much it had changed in the wrong direction in just 6 months.  That was really frustrating- what changed?!  But I guess that’s why they call it a disease-the thyroid is just diseased and it gets worse if it feels like it.  I started on new medication to try and get my thyroid back on track.  This made me particularly anxious to find out if our birth control had failed because a functioning thyroid is so essential to a healthy pregnancy.  I would be stupid to attempt pregnancy knowing my thyroid wasn’t even within range.  This is why we ask God to make up for our shortcomings, and our health.  I would continue to pray and say “I am really scared about my current thyroid state.”   

I started feeling very down, thinking “I'm so done, I'm so angry, the universe hates me, I don't want everything to be so heavy and complicated because my health doesn't do well on birth control and I also can't get pregnant.”  It was a bad day, when for some reason, my computer background changed itself to a picture of a positive pregnancy test from my last loss.  I just felt like someone had spit in my face.

I had to start making some decisions in case we were pregnant.  I decided not to do the beta blood draws, because watching those numbers is far too stressful.  I was surprisingly at peace with the idea that I could be pregnant, but I couldn’t stomach the idea of watching numbers in my blood every 2 days.  We also decided I would do the Lovenox injections again- that combined with the Deplin would be an aggressive treatment for MTHFR, so once and for all we could maybe rule that out as the actual cause of loss (as far as we could ever tell). 

I started worrying about feeling judged if we found out we were pregnant again already- four and a half months after our last loss, but I tried to remember that our family is no one else’s business.  When people don't get pregnant, they try every month.  For us, it's about the same trying to have another child, except we have pregnancies that last a few weeks. I've kind of come to terms with understanding we are going to have lots of pregnancies and maybe only a couple of kids (hopefully).  My son is going to be 4 in the fall, I'm allowed to try for another. I'm allowed to try for a pregnancy after a loss, or several losses. 

Even though I've accepted that we'll need to go through several pregnancies, I don't want to waste a chance without knowing exactly what we're doing and why, we need to go into a potential pregnancy with a plan.  This is why surprise pregnancies just aren’t an option for us.  My whole goal became “no stress” and I just kept saying, “What will be will be. One or two little decisions won't change the outcome either way.”
 

When I get that positive test, I still feel like it's not real. People say congratulations and it doesn't feel like I deserve it. I stand in line next to big beautiful bellies and I feel like my pregnancy isn't as real as theirs. Like you can be pregnant and still feel like you're trying to be pregnant.  I feel like this situation is so lose-lose. If it's negative I will be relieved and so sad and baby hungry. If it's positive I will be happy yet so full of dread. I don't think that God expects me to not be afraid, but to trust Him reagardless. I repeat to myself often, “God knows more than me. The end.”  And then, there it was:

Two lines.  The second one faint, but before I had missed a period, so we had caught it as early as possible using home tests (the test the day before had been negative).  I had been so sure that we weren’t pregnant after all. I just couldn’t believe it. 

 

   

I was able to post all my thoughts right away on my Secondary Infertility Group on facebook and was met with such an outpouring of love and support from people who actually KNOW how I feel.  That meant more to me than words can say.

All of this was poor timing and right before a move.  We were in the middle of work, packing the house, all kinds of logistics to work out, and lots of hard tests for Kevin at school.  I was nervous about having a bruised and sore belly from those shots during the move.  The idea of lifting boxes with that soreness felt like another needle in the belly. 

We got those results from Kevin’s test back later in the day, after we found out we were pregnant.  What strange timing it all was.  I was hoping there was more reason than just irony, like somehow the baby would be a miracle.  Maybe we wouldn’t have to spend money on all the interventions after all.  Strangely enough, the news let me relax because this baby's fate was probably already determined at conception because of his or her DNA. That meant that there was a chance for hope, and since I was doing everything I could, I didn’t need to worry that one or two decisions would cause a loss.  I told myself, “Your.body knows what it's doing. Relax and let it do its job regardless of how many symptoms you may or may not feel, and trust that if the DNA is good, the baby will be healthy.”

Now let me just tell you how much I hate these blasted shots.  They burn more than any shot I’ve ever had.  I try to ice afterwards but I feel like I can’t get it cold enough under the skin.

In 11^th grade, when we read The Crucible, I remember that I couldn’t get the scene out of my mind where Abigial sticks a needle in her belly to accuse Elizabeth of witchcraft.  I just walked around all day thinking “HOW could you EVER put a NEEDLE in your own belly?!”  And yet, here I was.

Luckily, I have a great friend who is a nurse, who was willing to help me out.  And Kevin learned how to give me the injections.  He gave me his very first shot, and it was terrifying to be the guinea pig, not going to lie. 

lovely Heidi about to put a needle in my belly.

I took these "belly pix" knowing they might be the only ones I would have for the pregnancy

The timing made me feel a bit on edge. Moving is hard work, so is working in general.  I kept thinking “I'm carrying someone very precious and very fragile, I just feel like I should be resting more.”

The move went well, I got nervous every time I exerted myself. And I got nervous about starting aspirin in addition to the lovenox shots, like “I hope I don't overdo it on the blood thinners.”  And let me just tell you how sore my belly was. It is somewhat difficult to move and sit normally when you get a burning shot in the stomach every day and give it no time to heal.

Happy in front of our cute new townhome we're renting

We kept talking about this baby like "she" was really going to be born.  We stopped saying “if” and replaced it with “when.”  I wasn’t sure if that was faith or getting our hopes up.

When some tinted discharge started and I started wondering if the baby was ok, I was crushed times a million. Why does God never see fit anymore to just let one of my babies make it. No miracles. Just cold hard reality that breaks my heart over and over. I've tried to do everything I can for so long I should just quit. Then things got better for a whole 24 hours.  Then I saw a tiny bit of bright red blood again, a minuscule amount, but just enough to make you wonder what is going on inside  Then it would stop. 

The random bleeding episodes were accompanied with the sharp pains on one side (that I kept trying to explain in any other way besides ectopic pregnancy or miscarriage) I kept trying to believe there was hope in spite of the on and off spotting (which may or may not be normal) because some women have it in healthy pregnancies, and I was on a strong blood thinning regimen which would explain why I didn't have this type of spotting before with Jack or my losses.  This was different and terrifying.

I knew God could save my baby. I just hoped he wanted to. 

I posted how I was feeling in my support group, and got a lot of encouragement and love that way.

“This has been such a difficult week. I got my BFP last week when we weren't trying (lost our last 5). The same day we find out my husband's sperm has a high level of DNA fragmentation contributing to our losses along with my problems. I am thrilled to be pregnant but so terrified. I've had on and off spotting for a few days that may or may not be normal and find it so difficult to keep going with real life and work when I don't know if the baby is ok. The spotting may be due to the blood thinners I hope. It is so hard to take a shot in the belly every day. I am getting so sore and bruised, but it would be so worth it. I'm praying God saves this child. Also, we moved two days ago and I am exhausted. Thanks for letting me vent friends. I just want a healthy pregnancy.”

In the end, history repeated itself.  I woke up after having pain through the night.  I started having breakthrough bleeding, lots of red blood and passing little clots.  I eventually confirmed it with a HPT.

How is that picture for a kick in the gut?

I'm devastated that it wasn't our time, again. I think this loss would have killed me if I didn't know there was a new direction for us to follow. If we can address Kevin's problems maybe we can have a healthy baby. 

Could it really be six losses now? Six? But I count, and yes.

One in 2012. Three in 2013. One in 2014. One in 2015.  

God must think I am a pretty strong person but i beg to differ at this moment. I was so ready to have this baby and raise him or her in our beautiful new house. Figure out a way to be a stay at home mom again.

The day I found out, I was scheduled to work.  I understand when no one can take your shift last minute, but I asked seven people and none of them could. I think that was the toughest part- pick myself up and make it through at least one shift.  I was just praying please let someone cover for me.  I knew it wasn’t a good idea to call out sick again because I called out when my grandpa died a couple weeks ago.  And I'm so behind on hours (which I need to maintain our insurance) from taking off time to move and to get my CNA (so I can pick up that position along with being a coordinator at work.)  God give me strength to get through this month so I can continue to support my family.  

At work, I started feeling light headed, nauseous, dizzy, numb, and had waves of pain.  I dreading the thought of getting through a shift and just wanted to crawl into bed.  Fortunately, I left an hour early and was able to call out for the following day.  I had this strange crushing guilt being at work.  It was like I didn’t take any time to mourn and jumped right back into normal life, and that felt wrong.

I looked around my house (not yet unpacked) and felt overwhelmed with emptiness. Usually I can fill that void with thoughts of my family and my boys, but for now, it is emptiness. And shock and horror.  And feeling like, “Ok that's it, God really isn't sending more children to our family.”  I don't want to leave my house anymore but hopefully that will change quickly because I have three weeks straight in March without a day off.

 If I answered honestly, I'm not really doubting the Lord's love for me, but I wonder when will relief come?  When will peace finally come, even if it comes during the emptiness?  I feel so beat down right now, can't find my happy thought. I am glad that it appears to be from Kevin's side so maybe we can stop focusing so much on my blood.

Kevin having the issue makes more sense, and now we've proven even with aggressive measures, they can't make my body keep the baby, so it's likely bad DNA. Tears just continue to come so easily. It's like we could just picture baby coming home to our new house. Why do miracles take so long sometimes? This wasn't even planned; I don't understand why it had to happen.  It's almost embarrassing how many times we've been through this, but what else do you do when you're trying to have babies and there's "always a chance?"

I know I need to go get an IUD so we don't have any more surprises, but I don't want to. I'm mad about it, I just want to have a baby instead.  But the road ahead looks so long. And painful. But hopefully if you take away the losses and just leave the doctor appointments it will be more manageable. If this emptiness ever goes away.

 I start to panic thinking “what if it's not just Kevin's stuff, but my stuff too?  Even if we got a healthy embryo, what if I still couldn’t carry it?  What if the blood thinners were too extreme, what if they made it so the embryo couldn't attach?  What if it is a combination of all our problems with so many variables we'll never figure it out?”  At that moment, I have to ask myself, do I really believe God is in the details?

I still have my fertility and I have my youth. I just need patience and strength to bear this incredibly heavy pain and emptiness that I try to put aside probably 15 times a day in the middle of normal life. Grief is real, and 6 consecutive losses is real grief.

My sweet husband bought me flowers while I was at work, and unpacked these two pictures so that I saw this display when I came home.  I am so thankful for his love and support through our losses.