Thursday, November 29, 2007

An upnote - a few people get it right

I am a negative person by nature. Not something I am proud of, but it is what it is. I think it is important when I spend a few days dwelling, that I then step back and consider what is not so bad.

In particular, since I have bee more recently obsessed with the loss of my fertile friends, I want to spend a moment thinking about a few people who I can count on right now, and who have been exceptionally generous-- listening to me, and supporting me over the last few months.

1.) My two old college pals S. + H (ha, ha... like the stamps). We drifted apart while I was living in the midwest, but we are finally starting to rekindle our friendships-- and for this, I am so grateful. H. lost her mother in 1998 under really tragic circumstances. Because of this, I think she has a good grip on how to talk to those who are going through something that is both painful and private. And S. is currently breaking up with her decade long partner. We are both in that place right now where we never thought we would be. A bit of a living nightmare. Selfishly, I am glad to have friends that can relate to what I am going through, even if our circumstances are different.

2.) My two great friends, S. + A, from grad school who live out in Seattle. S. had a miscarriage the same time as me (the first one). They had been TTC with a known donor (DIY) for about 4 months. She is pregnant again, but understands how hard it is - both because of her miscarriage, but also because as a same sex couple, TTC is harder. Now they are waiting on an amnio after recent blood test came back at 1 in 3 chance of downs. My heart goes out to them. They are that couple. The couple that really should have kids.

3.) My mom - god, I never thought I would say that, and I may change my mind next week, but she has been really great. She loves a good challenge, especially one with drama, lots of medical terms, and a chance to dole out sound advise to a child. She slips up know and then, but for the most part, she is rockin' the house with the support. Way to go, Peggy!

Wednesday, November 28, 2007

Beers in the afternoon and the epidemic of pregnancy

Yesterday was rough. And since all of my friends are either knocked up, new parents or lame, I decided to treat myself to a burger and a buzz after teaching my morning class (no worries, I did not have to go back to teach:)

MMMMM, Guiness os so good. It sustains me in the winter. I am not a huge beer fan, but the dark stuff is so smooth and delicious. So I had a great lunch, alone-- which I seldom do, but always enjoy. After, I stopped in at a few local boutiuqes and picked up a few x-mas gifts.

One store is a DIY place, handmade stuff and the like. Now that I have decided to ditch all my friends (ill, I hate myself) I have become slightly more gregarious. Even with that, I am still pretty introverted. Regardless, I struck up a conversation with the co-owner of this store. Turns out that we live VERY close to each other and she lives across from this woman that I know, but never really got to cultivate a friendship with. I was siked. Yeah me, some new neighbors, our age without kids! So I asked about M. (the woman we both know) and she says, "Aw, she's great. She just had a baby, like a month ago." And I say, "Wow, I guess I haven't seen her in a while. That is soooo great. Umm, I better go."

It is a freaking epidemic. I have been ambushed. I am totally surrounded. Not only my friends, but my potential friends are already all dirtied up with baby talk. Am going to have to start hanging out with 20 year olds? What does a girl have to do to score some DINK friends?
(DINK = Duel Income, No Kids)

Post-op appointment was shady - BLURG!

Had my follow up appointment for my septum resection yesterday. It didn't really go as I hoped. So of course now I think that I either forecasted it, or caused it, by my recent feelings of despair.

My RE did an ultrasound. In the former location of the septum there was a big black splotch. She thought it could be a blood clot or residual septum. I am keeping my fingers crossed a clot and hoping I can pass it during my period.

I lost it. Of course.
I talked to my mother later in the day and she was shockingly supportive and understanding. At one point where I was telling her how this is straining my relationships with friends, I said something to the effect, "Well she doesn't have a magic wand shoved up her twat twice a week and get nothing out of it." My mom just took it. She also gave me some really good advise. She said that I need to give myself permission to focus on this right now, having a baby. She said that the job applications can wait. She said that the trip to Egypt can wait. It just felt good to hear someone say it.

Tuesday, November 27, 2007

Self-alienation feels so right

A list of reasons why I have decided I am totally cool to not have any fertile friends in the form of a list of things that have been said to me in the last few months by by these same fertile friends:

L: It just seems like this is another reason why women get pitted against each other. I can't help it that you can not get pregnant.
Response I would given in hindsight: I can get pregnant... over, and over and over and over. But my body kills them. Big freakin difference.

C: I am disappointed and pissed that I can not use a midwife because of my epilepsy - Can you tell me the name of the Dr. who gave you bad advise so I don't go to him?
Response I would give in hindsight: Don't come to me with your sob stories. Lesson number one - having kids is nothing like the bull-shit lines we've been fed since we were kids. I know that all too well. Not everyone gets the glow, the perfect birth, etc. Some of us don't even get the kid. So suck it up, go to your OB and don't bother me with questions I can not answer. Remember, while you were getting knocked up, I was getting fetus #2 vuc-u-sucked from my womb.

L: I know exactly what you are going through because when I was in my thirties I wanted kids like crazy but there was just no partners around.
My response: Well, actually, it is nothing like that. There is a big difference between not having a partner and your body being physically malformed in a way that prevents successful pregnancies.

N: You can have one of my kids. Take your pick.
My response: I think they might be a little attached to you by now.

C (at a social gathering): Pregnancy is really just on inconvenience. I am just tired and hungry all of the time.
My response: Chin to chest. Don't make eye contact with anyone. Block it out. Inconvenience? Is she kidding? F-off.

Goodbye friends. You can get updates from my husband, but I would rather you did not care, because I know that ignoring you is shitty. I am a total asshole for this. But it is the best I can do, even if it is nasty at best.

Monday, November 26, 2007

Sinking, sinking, sunk...

I like to think I do a pretty good job of keeping my chin up. I have had a lot of ups and downs through this whole process (we all have). One of the more distinct moments was when my diagnosis was finalized. I knew that the septum and a pretty large adhesion were preventing me from carrying a pregnancy. It was a moment of clarity. I remember calling my husband on my cell, weaving a dodging a small army of pregnant woman, for the first time with a huge grin on my face. It was a septum.

Even leading up to the surgery I felt pretty good. Scared, but good. A septum could be "fixed." Rumor has it your uterine cavity is close to "normal" after a resection. We'll see about that.

Now the surgery is over, and I feel like I am just bottoming out. I thought I would be happy, but I find myself unsure all over again. What if I had a successful resection and I still can not have kids? God, I am even scared to write that down in fear that it will come true! I just have this wretched forecast in my head. You know the one-- where my thirties are consumed almost entirely by my inability to have children. I am way past down, I think I am sunk.

Even worse, I truly believe that none of my friends or family are capable of helping me. I decided, with great certainly, that I am really ok with alienating all of my fertile friends. 1.) I don't want to feel sad and angry every time I see them. 2.) I don't want to feel guilty about that sadness and anger. 3.) I don't want to be constantly reminded of how self-consumed I have become. 4.) I don't want them to have to tip-toe around me, editing themselves. 5.) Alienation is just speeding up the natural process of what children will do for our relationships regardless. They will have kids and we will not. Their lives will change drastically, and ours will be the same. 6.) I can hardly take care of myself-- I have no more energy to expend on tutoring them on how to deal with me. Besides, I don' believe there is a way to deal with me. 7.) I don't want them subjected to the same thing I am now, and unsupporting friend. They can't figure out how to deal with me and I have no clue how to deal with them.

"Normal" people are allowed to be happy for their friends, supporting them through pregnancy and child-rearing. But that has been taking from me. Along with two potential children, now my friends have been eaten by this whole mess too. And today, I don't even care. I just want to be alone.

Based on the above drivel I have decided to see if my insurance will cover therapy. I have never had therapy before, but based on some of the more disparaging imagery that seems to pop in in my cap these days, I think it might be a good idea. I have tried to go to some support meetings for recurrent loss, but unfortunately, they meet on the nights that I teach. So instead, I'm headed for the couch...

Saturday, November 24, 2007

Having to try so hard for something you are sometimes ambivalent about

A good friend of J.'s was in town for dinner last night. Like us, D. is an artist. She is the kind of person who makes a living by hopping around the world from residency to residency. She is well respected and has also taught in many institutions, only once on the tenure track (by choice). I envy her sometimes for knowing so clearly what she wants, and for being so independent.

D. had arrived from a visit with family in D.C. and talk for hours, really, about how hard it was to be the sibling without kids. And it was not because she wants them, but rather because she longs for adult conversations with her siblings and parents. Basically, she arrived at our house having heard little other than conversations about how great it was that Jimmy went in the potty and Sally makes big sentences, but can't jump as high as the other girls at gymnastics. When you are a person who spends 99% of your time with adults, it is pretty hard to feel engaged with people who spend 99% of their time with children. And vice versa.

I have experienced this in my own family. When I was in grad school I was a rock star. I was so proud of what I was doing and how well I was doing it. It was really the first time in my life that I excelled academically and I wanted to share that with my family. But visits home at the holidays never involved my parents bothering to ask how I was doing, rather I had to endure endless conversations about my sister's wacked out husband, her daughters bed-wetting, and the fact that my sister had managed to get knocked up one more time by a man she was about to separate from.

And the fact is, when I have children I want to continue to have adult conversations, I want to listen intently and care about the lives of my friends who don't have kids. I think there has been a real shift in parenting. My mother always maintained adult relationships. If we were around, we were expected to entertain ourselves so my mother could have a moment of sanity by talking about something other than diaper rash. These days it seems like people are obsessed with their children, but even worse, expect that all of their friends should be obsessed with them too. Back off, give the poor kids some room, let them learn to entertain themselves, make-believe and all that good stuff. By having an adult conversation and dismissing your kid from the spotlight, they might have a brief moment where they learn something about the world on their very own-- and you might get a chance to be you as yourself for just a sec.

I fear that if we never have kids, the gap between me and my friends with kids will become so wide that I can no longer jump over it. I fear it especially when it widens so quickly. I have lost one friend already because she was so unwilling to understand why it was so hard for me to see her pregnant after my miscarriages. Now my other good friends are pregnant and the distance is beginning, only exacerbated by my history.

Does there really have to be an us and them? Can't people with children bother to ask about their friends lives who do not have kids? And can't the people without kids be generous enough to understand that a persons life changes with kids? That you may have to be a little more patient with them...

So here I am, some days ambivalent about having kids because I am scared having children will make my brain mushy-- and on the other hand, having to work so hard to bring a child into this world. I am working really hard for the one thing I fear the most. It is quite a paradox.

Friday, November 23, 2007

Blurg Again!

Years ago my older sister would probably have been the first person I would have gone to with my problems, especially with my miscarriages. But we have grown apart over the years, mostly because she creates a lot of unnecessary drama in her own life, and in my opinion, has failed repeatedly to protect her children emotionally. She also kind of can't stand her own kids, and it is just really sad to see. I accept that I have been unnecessary judgmental of her, but it is too hard to watch her stand in front of a moving train over and over again.

So yesterday, my sister and her daughter and I were building a little house out of popsicle sticks and A. (niece) says, "Mommy, did you tell Dit (me) about Betsy!!" My sister pauses and kinda frowns. A. asks again. I say, "Let me guess, is Betsy pregnant?" Yep, with twins. She got married about 3 months ago. My response, "Well isn't Betsy a little greedy." (Blurg, who am I?)


My sister and I have yet to speak directly about my situation. She gains her intel from my mom in favor of speaking to me directly. I have tried a few times to reach out, even if slightly, but she never takes the bait. Her response to the above conversations was - "well, that's why I hadn't said anything. You know you can have a pick of any one of my three." I say, "Unfortunately, I think they might be a little attached to you by now."

I know she is trying to help, and I am sure her joking response was more of a nervous reaction than anything, but why is it people like us are such freaks that no one ever knows what to say to us? And why is it that 90% of the time I feel pissed or saddened by their failed attempts to console me? Why is it that I feel like I spend more time talking to my friends and family about how to deal with me than actually getting the support I need?

When this all began, I took the approach that I wanted to be a silence breaker. I did not broadcast my problems, but after the second mis, it seemed stupid not to tell the people who care about me what was going on. But now I am starting to see why people keep quiet. It isn't about shame, or feelings of failure. It is because people have no clue what to do with you. Some of my friends have even pulled away from me.

I have almost zero experience dealing with grief, or supporting my friends who are dealing with it. So chances are I would be pretty bad at it too.

Thursday, November 22, 2007

Blurg!


This post has me thinking about women, work and children (and the expectations thereof.)

Just before Thanksgiving one year ago, J. and I decided to start to try to conceive (TTC.) We were in the car. We were on the Pennsylvania Turnpike heading east, toward home. At that moment, everything shifted for me. The way in which I viewed my future began to shift, my goals shifted. I started to back-off of some of the things I had been doing for years, particularly the things that caused stress in my life (mostly volunteer organizing stuff.) I started to look at a bigger time-line-- one that involved a few years pause where I conceived and began to raise our kid(s.) I started to think more seriously about my own health, seeing an acupuncturist for ongoing migraines and digestive issues. I had done everything to plan. Rockin' partner, check-- graduate degree, check-- house, check-- insurance, check-- moving in direction of profession,umm, good enough-- still under the age of 35, check. It was the sequence I had always imagined. And I just assumed I would be quickly rewarded for my diligence.

So this is what people don't get about infertility and recurrent miscarriage. Now that my body is not following the trajectory I had hoped, I am stuck in limbo-land. If I get a tenure track job this year, I risk not knowing for years if my surgery was a success and risk never having children, ever. If I don't get a tenure track job because I fail to assert myself completely because I anticipate having a roomie, and then fail to ever carry a pregnancy to term-- then I am twice screwed-- no dream-job, no kids.

Is there ever a time when a man has to deal with a dilemma? I am sure there are cases when it happens, but does it ever happen because of infertility? J. and I are linked in this process- 100% linked. But his ability to take a job, or hold off is not tied to the success of my U, but mine is. Perhaps that means we are only 99% linked in the process. And that last 1% stinks to high heaven!

Blurg!

Wednesday, November 21, 2007

I Measure My Miscarriages in Bricks

This is a very strange correlation that just revealed itself to me as i was browsing through my photos. After my first miscarriage I feverishly build this brick patio in our backyard to distract myself (yep, I'm a real hard-ass.) My acupuncturist told me to "take it easy" but hauling these bricks around seemed to be the only thing that settled me. It is my most distinct memory from the time of that loss.


In late August, during my second pregnancy, I was told by my RE during an ultrasound that there was no heartbeat. J. came to pick me up. We drove half a block and pulled over. I absolutely sobbed on his shoulder. It was that wrenching, hysterical, can't catch your breath kind of sob. When I occasionally opened my watery eyes, I was looking straight at the image below-- the stacked, but porous wall of a parking garage. It is my most distinct memory from that time.


So I guess you can say I measure my losses in bricks. Hopefully, I'll never have to do it again.

To all of you out there with Perfect Uteri

Just to get it straight - I AM NOT INFERTILE. Well, not really, I think. If it were 1852, I would be infertile. But today we can poke little holes in people and root around with a camera. We can also insert tiny, little scissors into a woman's uterus and snip away the wall that divides it in two, making for a remodeled, and hopefully functioning, unit. I hope it works for me. Right now, it is too soon to tell. So I can get pregnant, repeatedly, but my body is a babykiller.

But here is the point.

I have, since May 2007 to present, suffered 2 miscarriages due to my septate uterus while all of my friends (and I really do mean that) have gotten pregnant on near the first try and taken that pregnancy to term. I am surrounded by a festering ring of fertility. I am the statistic. Girls, stay close. You wanna have a kid, stick with me. I am the percentage, the one you hope you are not. I got the shitty end of the stick - so you go ahead and grab the good end. I can take it.

Problem is that people who have kids, and pregnant people, are really bad at talking to people like me. They say really dumb shit. They call their pregnancy a failure because they developed gestational diabetes (the same friend is currently holding her self-incubated son.) Another friend contacted me all upset because she was turned down by a midwifery practice. They will not take her as a patient because she has epilepsy. She is all pissed because now she will have to delivery her kid in a hospital (safety first!) Ummm, guess what. I can't really deal with this. Fact is, your experience will ultimately end in bliss. Mine, repeated tragedy. I don't mean to minimize anyones feelings, but I can only be so generous. Remember who you are talking to, and be sensitive to that. Because, frankly, it hurts like hell-- and in the grand scheme of things, I have had a pretty easy go at it.

So I just stumbled on this today and want to share it with all of you out there with perfect uteri. Here are some really helpful hints on how to deal with people like me (I edited it a smidge). I found it on RESOLVE - which is a national association for Infertility.
  • Don't Tell Them to Relax - no amount of relaxing would have dissolved my septum. Nor will it help other people who are struggling with various known and unknown cases of infertility.
  • Don't Minimize the Problem - Talking about all the petty benefits to being childless is a sucky thing to do. (sleeping in, not getting barfed on, going out for beers)
  • Don't Say There Are Worse Things That Could Happen - Great. I already feel shitty, now you are reminding me to feel guilty about my own pain...
  • Don't Say They Aren't Meant to Be Parents - I don't believe this crap anyhow.
  • Don't Complain About Your Pregnancy - This is the motherload. If I have to explain why, then you may possibly be too insensitive to be anyone's friend. Hope your kid loves you, because you are a piece!
I can not tell you how to talk to me, or anyone like me (but this article might help.) If a friend slowly pulls away from you during your pregnancy because of their infertility - don't assume that she wants your kid. Seeing pregnant people is really hard for me because it is a constant reminder of my own failure. It is not that I want to be you. It is that seeing you reminds me one more time that i have been forced to adjust the very way in which I imagined my life would be. Miscarriage and infertility are a different kind of grief. They are grief that is ongoing, with intermitted moments of hope, and some really painful drops into despair. It is exceptionally hard for me to feel joyful for my fertile friends right now. I do the best that I can.

If you can have children with ease and have never suffered a miscarriage you can never, ever understand what it is like to be me. That is all there is too it.

Tuesday, November 20, 2007

Septum V. Bicornuate in MRI

MRI finally determined that I was not Bicornuate, rather Septate. First is the original MRI. The uterus is at the very center and looks like a heart or a butterfly. The second image I point out the determining factors. I had a Lap/Hyst to remove the Septum on November 14th. Still waiting for follow-up images.



Learning to advocate for myself

I AM NOT A DOCTOR - I GIVE YOU THIS INFORMATION AND ADVICE BY HAVING BEEN THROUGH IT AS A PATIENT. ALWAYS TALK TO YOUR DOCTOR FIRST!

Once I was tangled up in all of this TTC, miscarriage, bicornuate mess, I started to realize that I was going to have to learn to be a better patient-- at least one that knew how to advocate for herself. And the way I learned how to do that was through research and support. In particular, the MA Yahoo list saved me a lot of time and heartache by putting me in contact with other women who were going through or had gone through the same thing.

I had suffered the loss of my first pregnancy on my 32nd birthday, May 31, 2007. I lost my second on August 28, 2007 (this was a "missed miscarriage/abortion" which I will get into another time.) After the first loss, I was diagnosed with a Bicornuate Uterus by way of trans-vaginal ultrasound. I had both kidneys (good news, since MA's can be associated with renal anomalies.) After my second, I had to have a D&E and then wait for my hormones to back off and my U to get back to its "normal" be it mildly, jacked-up state.

Throughout the process I was marked by a particular medical taxonomy, a series of associated tags that were meant to help define what it was that was going on with me. Some were part of the diagnosis, some were kinds of tests, some insurance jargon, some... who knows. Here is a short list of the language I was forced to learn so I might understand where I was standing, medically speaking:
  • Unknown, Expanded Problem Focus
  • Threatened Miscarriage
  • High Sev of Prob
  • Bicornuate
  • Fetal Demise
  • Reeval Mod to Sev Prob
  • Recurrent Loss
  • Missed Abortion
  • Uterine Anomaly
  • Mullerian Ducts
  • Uterine Septum
  • Adhesion
  • Laparoscopy
  • Hysteroscopy (See image at bottom of post. That thing that looks like a ray-gun is what they use to look in your U)
  • HSG
So there you are, the beginnings of a whole new language that you best become conversant in if you have been diagnosed with a Mullerian Anomaly (MA). More importantly, you need to know that different anomalies effect both fertility and pregnancy outcomes very differently. Some are just watch and wait situations, others have surgical options with much improved results.

AND HERE IS THE MOST IMPORTANT PART - YOU MUST MAKE VERY SURE YOUR DIAGNOSIS IS CORRECT!! Here is some advise on how to guide yourself and your doctor through that process:
  1. A diagnosis of BICORNUATE can be a kind of "catch-all" diagnosis by a doctor that is likely not well versed in MA's (it's ok doc, you probably only bump into us once or twice a year!) Even if you are told to jump back in the TTC wagon, take a break and find a reputable RE with MA experience to confirm your diagnosis.
  2. Ultrasound is not an appropriate tool for making a concrete MA diagnosis. Sure, it can establish the existence of an interior division in the uterus, but it fails to visualize the exterior contour of the uterus, and this is KEY to a proper diagnosis.
  3. Pay attention to your body and trust your instincts. The way in which your problems are presenting is likely an outcome of your particular anomaly. Are you getting pregnant, but having repeated early losses? More common for SU's, less for BU's. Match the symptoms to the anomaly.
  4. Learn everything you can about MA's, and don't be afraid to show your Doctor how informed you are. Ask lots of questions. Prepare for your appointments as you would a test!
  5. HSG, or Hysterosalpingogram, may be your doctors next course of action. I have been fortunate enough to never have to endure one (heard they can be wrenchingly painful.) HSG may be needed for a variety of reasons, but remember, like ultrasound, this test will only visualize the interior cavity of your uterus - NOT THE OUTSIDE. And the reason why that is so important is that the inside and outside are not required to match. A HSG of a Bicornuate and Septate Uterus may look very much the same. They can only then be distinguished by seeing if the fundus (top of the U - see diagram above) dips to follow the cleft of the interior, or is rounded in shape.
  6. MRI can be a good diagnostic tool, but not always. MRI, if preformed by an experience technician and the films read by a radiologist who actually understands the difference between particular MA's, can reveal the exterior shape of the uterus - particularly the fundus (top of the U - see diagram above.)
  7. The end of the MA diagnostic line for many is a procedure called a Laparoscopy/ Hysteroscopy, also lovingly referred to as a Lap/Hyst. In the procedure a reproductive surgeon uses laparoscopy to see the outside of your uterus, while simulaniously performing a hysteroscopy to see the inside of your uterus. Inside seen, outside seen - DONE!

Got an MA?

No matter what MA (Mullerian Anomaly) you have - this is something you DO NOT want to miss out on!
http://health.groups.yahoo.com/group/MullerianAnomalies/
JOIN NOW and get support you need and the best advise ever from people who have been through it already!


Monday, November 19, 2007

What the hell is a Bicornuate Uterus anyhow?


A Bicornuate Uterus is also referred to as a heart-shaped uterus. You may have been diagnosed with this. That diagnosis may have happened during a miscarriage. You may have only had an ultrasound to make this determination. You probably never knew this about yourself. It was probably told you you by a doctor you would never see again. That doctor may have created a rudimentary drawing on a scrap piece of paper for you to show you the shape, then wrote it down, B-I-C-O-R-N-U-A-T-E, then told you to go home and look it up on the internet. They might have tapped you on the knee and said, "don't worry, many women have this and have very uneventful pregnancies. You'll have lots of kids!"

At least this is how it happened to me.

In a follow up visit to see a midwife, I was told we should just try again. Not only that, there was no need to wait, no reason to investigate the diagnosis further. No biggie - just try again.
So we did, and in 2 cycles I was pregnant again. At that point, I was in the begin research Mullerian Anomalies. I was just learning the what, why and how I was born like this (and you can too if you click here.)

Before I knew I was knocked up again I had made an appointment with a Reproductive Endocrinologist - here on and ever referred to as simply, an RE. Arriving in her office pregnant was frowned upon, for the RE is meant to help you get pregnant-- once pregnancy occurs the RE gives you the boot. So my RE was pretty casual with me, said congrats and warned me that we would not be getting to know each other very well. But I felt really scared about this one, and she could tell I was not feeling like this pregnancy was a taker.

A month later during my 7 week ultrasound, the first time I was supposed to see the heartbeat, the shit hit the fan. "Sorry, this pregnancy is not going to work out. There is no heartbeat." So I guess me and this RE were going to get to know each other.

I was a mobile coffin for about a week, then scheduled a D&E. The worst part is that you have these little moments where you let yourself think for just a second that everything is ok-- That the little packet of cells inside you was just playing peek-a-boo, that your ovulation date was off, that the ultrasound machine was busted. Nope, this really was happening to us.

So what I meant to get to is that my diagnosis, done at a hospital during an emergency room visit, with ultrasound as the only imaging, was starting to look like it might be wrong. And what I learned very soon is that the diagnosis of "BICORNUTE" is a kind of catch all for any type of uterine anomaly that appears as though the uterine cavity is divided when seen on ultrasound. Thing is, bicornuate's have pretty good outcomes with pregnancy. More specifically, when they do suffer losses it tends to be second and third trimester. I was having first trimester losses. It just didn't jive.

So I was back where I should have been 2 months prior if any of the small army of OB's, Midwife's or Gyno's that I saw would have even lightly suggested a follow up or second opinion. Here I was, no less than 4 months in to trying to make a roomie. Two were gone, and I was left in limbo. Yeah for our health system!

The Story of My First Mis

J. and I started talking about having children years ago, but we were both still tied up in graduate school, submersed in our work, and not ready to sacrifice our independence. If felt good to think about waiting till the time was right, but we knew children was something we wanted. Despite our wants, I think most of our family believed we weren't the type to have kids. My mother talked incessantly about how we were too selfish to ever have kids, that we had established our lives and wouldn't be able to adjust -- shifting our attention from ourselves to our family. I never really resented that she thought that of us. I just thought it was fun that some day I could surprise her and tell her we were having a baby... And that we did it with our eyes wide open. Not true, I did resent her for saying that. But I knew I could be a really great mom some day. So her slight wasn't going to change my mind.

My grandmother occasionally warned me that my eggs would dry up. And my sister once felt the need to let me know that the rate of birth defects started to raise exponentially after that age of 35, so I better get to it. That was years ago. And I am only now 32.

J. and I joked about how my siblings wanted us to have kids so we could suffer with them. We imagined their envy of our freedom and knew we wanted a few years to be with one another- uninterrupted. J. and I have a very tight bond. We would spend every moment together if we could and very, very, rarely tire of each other. I have proposed to him on more than one occasion our surgical connection. He thinks its weirds. My alternative solution is to make clothes that we can wear together. He is not completely opposed. We don't fight and we share deep intellectual bonds to one another. Yes, I am selfish. I wanted him all to myself for a few more years.

It wasn't till fall of last year till we decided we would make a plan. We had visited friends in Pittsburgh who had a 3 month old. I couldn't stand watching J. hold her. He was so taken by her, and so was I. On the long drive back to Philly we decided. We would begin in the spring.
The funniest thing is I had this ridiculously, conflated plan to get pregnant in a particular month. Here was my thinking: get pregnant in April. Make job applications. Sneak in interviews before I start showing. Give birth in the winter. Have 6 months at home with the kid before my new and amazing and not in Philly tenure-track job starts in the fall. HA! I am such an ass. First I was assuming I would get a job. Second, I was assuming I could get pregnant on command and have the perfect, uncomplicated pregnancy. I could not have possibly been more wrong.

You spend your whole life trying to avoid getting pregnant - and I was really good at avoiding it. I had never once been pregnant, so I wanted to make sure I knew what was about to happen to me and be prepared for it. In the late fall I had a full physical and annual exam to make sure all my parts were in order. When I told my GP we were going to try she just said, " Great! Have fun!" I thought-- easy as that.

I had suffered from poor digestion and migraines for years, so I started seeing an acupuncturist. I had stopped medicating the headaches months prior, because the meds made me feel as crappy as the headache. Turns out the acupuncturist I was seeing, by coincidence, is particularly interested in pregnancy and fertility. So I thought I hit the jackpot when I told her I was there to get ready for pregnancy. With her, I went through learning how to track my temps for ovulation, lots of diet changes, herbs and weekly treatments. Now I know exactly when I ovulate. I have not had a headache in 5 months-- which rocks. But my digestion is still pretty jacked up.

Last, I purchased insurance. In my own stupidity and honesty, I admitted to the insurance company a history of migraine, which bumped up my premium terribly. I tried to tell them that I was no longer being treated for them, but they would not concede to drop my rates. I even ordered all of my medical files from grad school to prove to them that I was no longer being treated, but they only pointed to the "gap" in my treatment since I finished school. A "gap"-- is that what you call having no insurance? Of course there are no medical record for the time I was uninsured-- I could not afford to go to the doctor. I chose the best plan that I could based on my needs. I knew we were going to have a kid so I chose the plan with the best birthing rates and privileges. That puppy sang to the tune of $275 a month.

So here I was. All ready to go-- clean bill of health, fully insured, just tapping my foot until April rolled around. I couldn't believe my own impatience. I bugged J. every month leading up till april. I was constantly up to tricks, trying to get him to let us start early. Unfortunately, in my excitement, I had shared all that I had learned about my cycle and so he knew when I was up to no good. He really kept me in line because he, like me, believed that we would get pregnant and have a kid in no time.

It was an easy thing to convince ourselves of. I felt like I had a million reasons to believe I was exceptionally fertile. For one, I had been pretty responsible with birth control. So there was no reason to believe that I ever had any "accidents" that did not result in pregnancy. I only once had a contraceptive issue and used the morning after pill. I was responsible and in control of my body. Besides that, I am built like a breeder, at least according to the mythologies of fertility. I have big wide hips, big ass and boobs and a tiny little waist. There is nothing tom boy about my figure. That Venus De Milo had me fooled. I thought: curvy body, big hips = baby maker. The women in my family are pretty prolific - so I just assumed it was in the genes. But even more convincing was the rate and speed at which all of our friends were able to conceive. We had heard hots of "hole in one" stories warning us how fast it might happen. So we just figured that we are the same age, pretty health and had no reason to think we were any different.

April (late March actually) finally rolled around. I had been charting my temperatures so I had a pretty good idea of what was going on. Tried, no luck. We rolled in to month number two still optimistic. And after the long, impatient wait after ovulation, I turned up pregnant. The first test I took had a positive line, but it was super light. I spent hours online comparing it to images of other positive pregnancy tests. I toted it around the house all day and looked at it in disbelief. I wondered it we were crazy. We had tentative conversations that week - when would we tell people, what kind of birth did we want, how would we find a doctor. We were hesitant to acknowledge it, though I think that is pretty normal.

On my birthday, the last day of May, I started to spot. I was only 5 weeks, barely even pregnant. I panicked and called a recently pregnant friend who i knew had a spell of spotting. She was helpful, but pretty casual about it. In some cases it is pretty normal. I waited till morning to call the midwife that I hadn't even seen yet. It was hard to get care when you have yet to establish a relationship with an OB or Midwife. The midwives were helpful and ultimately sent me to the emergency room. By that time, I was full on bleeding and knew what was happening to me.

I arrived at the ER on a Sunday morning. I had put off going in on Saturday because we live in Philly, a place where ER's are notoriously busy on the weekends. The visit consisted of about 15 pelvic exams by about 10 different people (exaggeration.) J. had his first look at a speculum, which I think he may have been a little disturbed by. There was a lot of waiting, particularly for blood-work. My HCG level was a very low 25. There was little hope that this was anything other than a miscarriage.

After hours, I was finally taken upstairs to have an ultrasound. I was in a large room with the tech, who would not allow me to see the screen or respond to any questions. She was just there to take the pictures. I knew something was wrong right away. She was doing a regular pelvic ultrasound, when she suddenly jumped way up to my kidneys. I started to panic. Cancer was the first thing that ran through my head. What the hell do my kidneys have to do with my uterus?

Next came the vaginal ultrasound. I was really sensitive on my one side to the point that I winced each time she jabbed me. She spent a lot of time and I could not image what she would need to document so thoroughly. Thorough is great, but this was freaking me out. After she left the room I started to cry again. I was running through a list of a zillion things that could be wrong with me.

Not only was I loosing a pregnancy that I so very much wanted, but I was diagnosed with what is called a heart-shaped uterus-- medically known as a Bicornuate Uterus, part of a group of malformations called Mullerian Duct Anomalies. This blog chronicles my journey through miscarriage and misdiagnosis. I hope it will be a good read for those of you out there who are looking for information, just like me.


J. and I sat on this stoop, and for the first and last time made plans for this pregnancy.