The Joy that Was and the Joy that Wasn't

Tuesday, September 8, 2015

Wednesday, August 26th, was quite a day.

It was the original due date for the baby we lost in January.

It also was the day that I found out that I was pregnant again.

Talk about a lot of feelings, right?

Obviously, Ken and I were over the moon excited about the fact that yes, we were going to have a baby! We decided not to tell a lot of people because it was so early, but we did tell some close friends. I called my doctor and they told me to come in for labs on Thursday. My first HCG level (HCG = the hormones that indicates pregnancy) came back at 126. The number itself kind of means nothing, other than yes, I was definitely pregnant. What matters is that in early pregnancy, the HCG should double every 48 hours or so. I had my labs redrawn on Monday, 96 hours later, which meant that my HCG should have been roughly 500.

It was 277.

I had been waiting all day for the phone call that would tell me that our baby was growing, growing, growing! I felt good. I was feeling the early signs of pregnancy; I was exhausted, my boobs hurt, I wanted to eat the couch, that kind of thing. I was surprisingly not anxious, given what happened the last time I was pregnant. In fact, I was really proud of myself for not being a neurotic disaster about all of the untoward things that could possibly occur during a pregnancy. The fact that my HCG would not double did not even cross my mind. This baby would be fine. Statistically, there was a very low chance that I'd have a second miscarriage. And come on, the universe owed me this after the shitshow of last winter, right?

When I heard the news from my nurse coordinator, who by the way, I am convinced is an angel on earth, it felt like a punch to the gut. This baby was not okay. Or, we didn't think it was okay. There was no way of knowing until the next HCG level was drawn, but my nurse was honest and told me that it wasn't looking good. My numbers had not even increased 50% every day, let alone doubled every 48 hours. I would just have to wait and see. I got this information shortly after leaving the house to go out for the evening, so I didn't turn around to go tell Ken. Instead, I sobbed for 20 minutes and then drove to Philly. Given the situation, I ended up having a really good time that evening, but once I got home, my exterior shell crumbled when I told Ken what was happening and I spent the rest of the evening in bed.

So, against my better judgment, I took to the internet to do some research. Surprisingly, the internet had a lot of good, happy, stories about women whose HCG was wonky who then went on to have totally healthy, normal, babies. Also, I learned that HCG doubles every 48-72 hours in only 85% of pregnancies. I did and redid the math. If I had doubled every 72 hours instead of 48, my 277 would be okay! And 277 was well within a normal range for a very early pregnancy, even if it hadn't doubled. And it had gone up, so that had to be reassuring. By Wednesday, I had convinced myself that yeah, this baby was totally fine. I'd be due in early May, right after the school year ended for me. I wouldn't have to be pregnant all summer. It would be great.

I had my blood drawn on Wednesday morning and then proceeded to menacingly stare at my phone, willing it to ring for the rest of the day. I knew that my nurse wouldn't call until after 3, but by 3:00, I felt like I was going to throw up, pass out, or pee. I did none of the above, and my phone finally rang in the middle of a lecture about infectious diseases and antibiotics that I wasn't really paying attention to anyway. I went into the hallway.

"Alison, I'm so sorry. Your HCG dropped to 134."

I crumpled into a chair in the hallway and tried to remember to breathe. I felt like my body went numb, or that I wasn't a part of it anymore. The nurse said a lot of very kind things and I just kept saying, "Okay," because even though it wasn't okay at all, it was all I could think to say. She told me that I had to come back on Friday. I hung up the phone, walked back into lecture, quietly packed up my things, and left. Then I got to my car and burst into tears.

I just couldn't believe that this was happening again, and I couldn't believe the insane pace at which it was happening. And I also couldn't believe that after the initial grief and shock, I felt... fine? Not fine. Calm. Semi-numb. Sad, but functional. Well, semi-functional. I spent the entire day in bed on Thursday. After my lab draw on Friday, I came back home and went back to bed for hours. My life plan at that point was hour-to-hour, and was generally take a Klonopin, fall asleep, wake up a few hours later, take another Klonopin, repeat. I also kind of forgot to eat unless Ken put food in front of me. So yeah, semi-functional.

My only hope and wish at this point was that my HCG would continue to drop precipitously, so that my not-very-long-national-nightmare would end quickly and that I could get on with my life. I knew that I could not handle another protracted miscarriage in which I had to have two D&C's, separated by a dose of misoprostol. See also: The longest few months of my life, during which I may as well have been in some kind of fugue state because I don't really remember anything between January and April. When the call came on Friday that my HCG was down to 39. I had instructions to come in this Friday if my period hadn't returned. Fortunately, I won't have to do that, as it seems that my reproductive system has decided to at least cooperate a tiny bit this time.

Like I said, the 26th was a big day. The week that followed was a whirlwind, a roller coaster, a crazy experience that ran the gamut from the ridiculous to the sublime. I'm sad, I'm frustrated, I'm scared. I'm in disbelief, but not denial. I'm concerned. My biggest fear is that I will continue to get pregnant, only to lose our baby, over and over again. My fear is that no one will figure out what is wrong, or even worse, that there's nothing specifically wrong or fixable. It's just shitty lucky.

My gut is telling me that there is something we can do. Something to be discovered. Clearly, I can get pregnant, and I am so grateful for that fact. The trouble seems to come after that part, and the medical community at large knows far less as to why that happens than it does about getting people pregnant in the first place. I know that my history of PCOS, endometriosis, and autoimmune/inflammatory arthritis certainly aren't helping things, but since we know so little about all three of those things affect pregnancy, aside from the fact that all three increase your risk of miscarriage, making the leap to some kind of cause is difficult, if not impossible. Because I'm me, I went into triage mode and made an appointment with a reproductive immunologist in north Jersey for the beginning of October. Maybe, just maybe, he'll have some ideas. (At the very least, he's a DO, so I know he'll be awesome.)

It is incredibly exhausting to carry so many diametrically opposed emotions. I was so sad at the thought of my original due date coming and going and not having a baby to show for it. I was overjoyed when I found out that I was pregnant again. I was devastated when I learned that once again, I wouldn't be bringing this particular baby home. And now I'm relieved that I don't need extensive medical interventions to let this extremely unfortunate event pass. The joy and sorrow, intertwined, reminded me of this poem by Khalil Gibran called Joy and Sorrow, one of my favorite poets, authors, and thinkers. My favorite line is this:

The deeper that sorrow carves into your being, the more joy you can contain.

That is keeping me afloat. At the end of this, I will be overfull with joy.

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