The Ritual and the Emergency Room visit

The Ritual

Friday night I lit the Shabbat candles and said the prayers that thousands of women have said before me. Mr. Jem and I broke the bread and drank together as part of a ritual to recognize the sorrow of losing our embies and asking G-d for hope and for G-d's help when we are feeling so sad, so powerless.

We read how the tribes of Israel were founded not just by patriarchs like Moses and Abraham, but by women like Hannah who faced infertility and who prayed and asked for G-d's help. It brought me comfort to know that I am not alone. Not only do I have all you wonderful women and men on the interweb, but even the Torah/Bible has stories like ours, stories of barren women who cried out in the pain of their loss, who prayed and hoped (and finally got what they wanted - a baby). I'm still waiting for my own happy ending.

The Emergency Room Visit
I'm not yet feeling 100% hopeful, mostly due to this ectopic pregnancy that landed me in the Emergency Room Saturday night. Let me explain.

Saturday I ate normally but was experiencing some pain in my abdomen and an urgent trip to the bathroom in the morning. I felt better in the afternoon and Mr. Jem and I went with a friend on a walk at 4:00 p.m. Half-way (1 hour) through the walk (an easy hike) I started feeling very light headed and dizzy, so much so I had to stop and sit down more than once. I didn't feel hungry, but thought it might help to eat. Food usually makes me feel better.

We went to my favorite Pizzeria. I always order a bowl of soup because the pies take a while to come. It was minestrone and I didn't eat the beans, as I read that eating gassy food was not a good idea on Metho.trexate. Just before the pizza arrived my abdominal pain got really bad. Mr. Jem ran next door and bought me Ginger ale. The pain got so bad that I had to tell Mr. Jem and my friend R that I needed to go home. The pizza arrived, MR Jem and R ate a piece each while we paid the bill and we left. This was around 7:00 p.m. I called the clinic and was connected to the on-call doctor, Dr. Alternative. She asked me a bunch of questions (how sever was the pain, etc.) and said she wanted me to go to the Emergency Room.

At the ER they saw me pretty quickly. I explained what was going on (ectopic pregnancy, Metho.trexate on Wed, being monitored by my RE) to the Intake Nurse, the Doctor, the ER nurse and the nice sonographer. Was only mildly annoyed by the questions like, "When was the date of your last period?" and "When are you due?"

My answers: "Period? Irrelevant. I did IVF and we transferred three embryos on January 7." "Due date? I wish. This is an ectopic pregnancies. My HCG was too low and hasn't been doubling."

Oh, the other thing is they kept referring to Dr. Alternative as "Your OB" - Again, "I wish I had an OB. She's an RE at my fertility clinic."

Sigh.

They drew more blood (and put in an IV line - oww!). Two hours later I learned that my HCG was 350 - double the number (150) from Wednesday, just as Dr. W had said might happen.

Everyone at the ER was great. I especially liked the nurse, a cutey named Max who had a wonderful bedside manner. Oh, except when he tried to insist on putting in a catheter for my u/s. I told him no, I would drink lots of water and it would work. Luckily my argument won. It took about an hour to see get an ultrasound. U/S - via belly and vag - came back clear. Big sigh of relief. No exploding ovaries or tubes. Yay!

The ER doctor called Dr. Alternative with the results. She wanted me to stay for observations, but he said it wasn't necessary. My pain was mostly in the upper abdomen and was most likely a reaction to Metho.trexate. That was my conclusion, too. I am glad that they took the situation seriously, tho. Better safe than sorry.

So they sent me and Mr. Jem home. We got home around 11 p.m. Luckily, Mr. Jem had eaten a couple of pieces of pizza when I was on the phone with Dr. Alternative at 7:00 so he didn't starve. No pizza for me! Wasn't even hungry.

Today (Sunday), I've been relaxing and not eating much since. Ginger ale is my friend. Got two calls from the clinic - one from Dr. Alternative and another from the nurse. I feel very well monitored and taken care of.

I have to go for another Beta tomorrow (Monday). Hopefully we'll see the numbers go down. G-d, I hate saying that. It's so wrong. So, so wrong on so many levels.

So, as a result. I didn't:
- Get a mani/pedi like I wanted to
- Go to a charity event tonight that was taking place on a huge docked ship. Mr. Jem didn't go either, which made me feel bad. I guess IF is f'ing up both our lives.

Yes, folks, I want my life back. I want to feel normal. I want to be able to exercise, to have a glass of wine, to drink coffee, to take rigorous hikes, to have sex again. For fun.

Okay, thanks for letting me vent.

Yet again, IF is an @sshole (this is how comedian Doug Benson closes his podcasts I Love Movies).

Calm before the storm?

I feel really good today. So glad to have resolved the ectopic, or at least made a decision and taken action. I don't know what the next couple of weeks will bring. Dr. W said to expect my HCG to go up on Sunday, but then come back down after that. Also, cramping is not uncommon. Oh, joy!

Yesterday on the way to the appointment I listened to the Hope_for_Haiti_Now album. Jennifer_Hudson's version of Let_It_Be is so beautiful, made me cry, put everything in perspective. I feel so lucky to have a job I love, be married to a sweet, funny man. I have a roof over my head, food to eat. I have two charming cats to love me. I have a close family who support me.

A peace has descended on me again. I feel I can focus on my work. I'm even planning travel for work down to So Cal for the week of Feb 8th. As a bonus, I'm hoping to see a college friend, fellow IF'er, who is PG after her IVF (but multiple IUIs and miscarriages). Other bonus: I can avoid going to her baby shower, which I'm not sure I can handle. One-on-one, yes. A bunch of fertiles fawning over my friend, not so much.

***

Mr. Jem and I are planning a ritual to say goodbye to our embies for tomorrow at sundown, along with our sabbath ritual. There is a wonderful collection of Jewish-based rituals online here, if you are so inclined.

I definitely want to mark this moment. I am thinking of also getting some jewelry to remember them by. I loved all the ideas you all sent.

Thank you all again for all the love and support.

The verdict

Left work early to get to the clinic (1.5 hours from work). It takes me 1 hour, door to door (including the train) to get to and from work. It's another 20-30 minutes to drive to the clinic.

During the u/s with Dr. W, it was clear that there was no sac, no baby in the uterus. Nothing was visible around the ovaries, a good sign that the tubes hadn't ruptured and there was no bleeding.

Conclusion: ectopic pregnancy.

The nurse administered Metho.trexate with two intramuscular injections. Here's what Web.MD has to say about the drug. Dr. W explained that they have been treating tubal pregnancies with this low, low dose of chemotherapy for about 20 years. Beats having a rupture or having to have surgery. My hCG will continue to be monitored - Sunday and again next Wednesday.

The bad thing: Can't even drown my sorrow in alcohol, as alcohol, vitamins, aspirin and other pain killers can all create Metho.trexate toxicity. I jokingly asked if I could take Vicadin, and the nurse didn't say no. She did say to call the clinic and/or the on-call doctor if I had abdominal pain, which is a pretty normal side-effect of the drug (or could mean that the tubes burst anyway).

The silver lining: We're trending in the right direction - 1st fresh IVF resulted in a chemical pregnancy and FET resulted in ectopic. Dr. W agreed when Mr. Jem asked Dr. W. if this meant we were more likely to have a viable, healthy pregnancy next time.

Actually, the real silver lining is having Mr. Jem by my side to make me laugh and to cheer me up.

Jem

Beta #4

hCG = 150. Have an appointment with Dr. W today at 3:00 for an u/s and the shot of doom. Okay, I'm being a bit dramatic, but you all understand.

Jem.

Beta #4 - no results yet...

Still don't know what's going on, but had blood drawn at the butt-crack of dawn, again at the lab, not the clinic. They did an HCG, plus Folic acid, and a CBC (complete blood count). Dr. Alternative said they want to make sure my liver function and other things are doing well before giving me the evil drug that will clear "everything" out.

IVF Nurse called me yesterday, but wasn't able to explain much, except implied that it's not a viable pregnancy and they want to make sure there isn't any more embryonic tissue left that could cause an infection.

I have been having weird symptoms that tell me I might have some sort of infection. I don't have a fever, but, I know this sounds weird, but my right earlobe, where my pierced earring hole is, is swollen and hurts. Plus, when they drew blood on Monday, three hours later I bled when then I took the cotton ball and wrap off. I haven't mentioned this to the doctor or the nurse.

Waiting for Dr. W (who will be back in the office) to call me today with a plan of action. I'll update you when I hear something.

I'm not particularly upset about this whole ordeal, just sorta puzzled. And a little relieved to understand why I was feeling so out of whack.

Jem

Beta #3

Last night I had my blood drawn, not at the clinic, but at the local lab. No problem, except my puncture wounds was still bleeding 3 hours later when I went to bed. Weird.

Now, if you are expecting me to say that my HCG was down to zero, especially after getting my period, well, you'd be wrong.

Dr. Alternative called me this morning. "Uh, well, as you know, you had low numbers: first HCG was 19, then it went down to 17 two days later. Well, a week later your HCG is 109."

WTF?!!!!!!!!!

"As you have been bleeding, I'm worried it's a possible ectopic pregnancy. We'll need you to test again tomorrow and then we'll give you a shot of Metho-trop-something to clear out the (some technical term for anything left of my baby)."

I was stunned and just said, "Uh-huh" and then hung up.

Wait! How could I have an embryo in my fallopian tubes? Mr. Jem and I did not have marital relations this month. We had three embryos transferred into my uterus. If I've been bleeding for three days, how? What? And Where? is this happening?

WTF!!!!!!!???!

I'm waiting for my IVF nurse coordinator to call me back so I can ask more questions. The only thing I feel better about is understanding why I've been such an emotional mess - it wasn't just the loss, the period or the cold. I've been having pregnancy hormones rushing around my poor body. Why couldn't I have gotten 109 for the first beta?!

Again, WTF!! Anyone have any clue as to what's going on? Please, I need your collective wisdom. I don't want to ask Dr. Google.

Jem

How do you mourn your loss?

Friday was crap, more crap with a little whipped cream and cherry on top.

The crap: I got my period.

More crap: I got a cold.

Whipped cream and cherry on top: I had a wonderful session with my therapist, Rose. Caught her up on our IF saga. Used up half a box of tissues telling her of my two IVF transfers, one fresh, on frozen. Of my two chemical pregnancies. Of my wallowing in self-pity, my self-blame (where she didn't want me to go. At all). Of my deep sorrow.

She then said, "Jem, you were pregnancy. Your body was pregnant. It registered this pregnancy in your body. You lost two babies. You are morning these losses. What have you and Mr. Jem done as a ritual to say goodbye to these babies?"

My answer: "We haven't done anything."

Tears just flowed down my face, as they do right now as I type these words.

I brought it up with Mr. Jem. We want to have some sort of ceremony, light candles, say prayers, something to honor these little souls that were not brought into our lives. We want to show how we lived them, how we miss them. We want to recognize how they would have been welcome here, but it was not there time.

What have you done to mourn your loss(es)? What rituals have you done? Do you have remembrance charms for a necklace? Please share your stories and/or ideas.