A Tough Few Months

I'm not going to lie; the last few months have been tough, really tough. It took me quite some time to feel like I was beginning to move on from the second miscarriage. It didn't help that the expulsion lasted for weeks after the MVA procedure. Then the whole waiting game starts again; waiting for the next normal period, waiting to see what happens.

I think about wanting to have a second baby every day. This, together with the worry about having another miscarriage has led me to have really bad anxiety, and it became quite bad in the months following the second mis. I saw a therapist/psychologist a few times and it helped to talk to someone else. She helped me acknowledge that whatever happens down the track is out of my control; if another miscarriage does happen, then it is what it is but there's really no use worrying about it now. Much easier said than done, but I'm trying! I'm also trying to do more 'self-talk' to push the anxious thoughts out of my head when they come. I'm finding that listening to music more is helping too. I also did an acupuncture session, which I hadn't had for years since I used it to treat my sciatica when we lived in London, though I'm not sure how effective it was as I couldn't really feel it, though maybe that means it was good?  

I'm hoping that things start to happen again soon, and that we are given some hope that we will have another baby.

Burglary

We were broken into in early February, which didn't help with the bad anxiety I was dealing with at the time. He came in through the window that backs onto the communal apartment bins. We hadn't touched the window for months, and had obviously been far too lackadaisical about it, thinking that it would only be accessible to the tenants in our building. The CCTV footage shows him pressing apartment buttons and being buzzed into the building, perhaps someone thinking that he was a courier delivering a package to another tenant. He took my new MacBook Air, our iPads, sunglasses (including Hunter's Mickey Mouse pair!), Mark's watches, Mark's NorthFace jacket as well as my hard drive, which had photos on it from the last 8 years. Thankfully, the photos on my MacBook are on Hunter's blog, and the photos on the hard drive are on Shutterfly and FaceBook. He also took a bunch of fake diamonds that I had in a handbag, obviously thinking they were of some worth. It would be funny seeing him try to pawn those! A 15yo kid who bought Mark's iPad on the street in the Bronx for $80 the night of the burglary called the next day asking us to unlock it. After some back and forth between his mother and the police officer, he ended up with a juvenile record for admitting he knew it was stolen, though the record will be wiped when he's 18 if he stays clean. We now have an alarm system and renters' insurance, and just have to take solace in the fact that nothing else was taken and nothing worse happened.

Evening Primrose Oil late Jan & Vitex for luteal phase defect

After my second miscarriage, and in my continued angst to find out the causes of the miscarriages, I started reading blogs on the internet that discussed luteal phase defect as a possible cause of miscarriages. The luteal phase is the time between ovulation and when your period starts. It's also when the lining of the uterus becomes thicker to prepare for possible pregnancy. Luteal phase defect is when ovulation occurs later in the cycle and the luteal phase is shorter than normal, so the uterus doesn't become as thick as it should.

Thinking that luteal phase defect could potentially be the cause of my miscarriages, I started reading up on some natural remedies to treat luteal phase defect. One of these was Vitex, which is meant to assist in increasing progesterone levels to allow ovulation to occur normally, in turn increasing the luteal phase. A second remedy that I read about was evening primrose oil, in that it assists in normalising hormone levels that are important for fertility. I was also recommended evening primrose after discussing my miscarriages with a naturopath at a health food store.

I started taking Vitex and evening primrose oil towards the end of January 2015.

http://www.natural-health-for-fertility.com/vitex-for-luteal-phase-defect.html

http://www.livestrong.com/article/367180-how-to-use-evening-primrose-for-infertility/

2nd Time Unlucky

So it's happened again.. another 'mis'.  We found out we were pregnant several weeks ago.  I'd done a test 29 days after my last period on the 4th December and it had come up negative.  I'd then done tests on the 8th, 9th and 12th of December and they all returned very faint positive results.  I was booked in to have my first appointment and ultrasound with Dr Holden on Monday 22nd December, but I was also concerned that there was no increase in the boldness of the lines over the course of those days, so I had bloodwork done twice the following week.  My levels were increasing as expected by that stage and I was hopeful going to meet with Dr Holden on the 22nd. Going by a 'normal' cycle, which I know mine are not anyway, I should have been around 7 weeks. I knew that I wasn't going to be 7 weeks because of the results of the initial tests.  I knew that I must have ovulated very late in my cycle.  Dr Holden said that I was very early, about 4 weeks, and to have another ultrasound two weeks later.

It was a long two week wait, which crossed over Xmas and NYE.  A few days before Christmas I'd felt like my symptoms had weakened, and that I didn't feel as pregnant because I wasn't as nauseous or hungry.  We arrived at the 51st location of Columbia Medical for the sonogram on Monday 5th January.  I told the sonographer that I had previously had a miscarriage and to tell me if things didn't look right, as the last time the sonographer had kept telling me to speak with my Dr rather than giving me a conclusive answer.  As soon as the screen came up I knew it didn't look right.  We were expecting a foetus and heartbeat by this point, and there was only a small blurry mass of tissue, with nothing inside.  I knew it was another blighted ovum.  I think I had been expecting it, not only because of my lack of symptoms but because we know so many people who have had miscarriages in a row.  It's very sad and upsetting, but as Mark keeps reminding me, we must think ourselves lucky and move on quickly.  It was very early days, and we have a beautiful little boy who reminds us how lucky we are every day, and that is something very special.

I had the MVA (Manual Vacuum Aspiration) procedure on the Friday of that week.  It was much more painful than I was expecting.  The five injections in my cervix were extremely intense, especially the last two, after which I thought I was about to faint!  I felt fine and normal once it was over, and took the rest of the day off from work.  I barely had any bleeding following the procedure until the following week, when I started getting spotting and then heavy bleeding on the Thursday.  We went away to Mexico that Saturday, and unfortunately I was bleeding heavily and expelling large clots for the first half of the holiday, which wasn't conducive to a bikini break!  Thankfully, it subsided towards the end of the week.  Two and a half weeks after the procedure, the bleeding is only just tailing off, which is frustrating, but I know it's the process my body has to go through to ensure that it's ready to go through a cycle in 4-5 weeks and for us to be able to try again after that.

N.B. I found this paper on MVA, which goes into the detail of the injections etc. that I had during the MVA http://www.ipas.org/~/media/Files/Ipas%20Publications/MVAPAIN2E09.ashx

A Bump in the Road

Having not had a period whilst I had been breastfeeding, I wondered how long it would take my body to have a cycle. I'm not sure if I had been ovulating while I was breastfeeding, as I hadn't fallen pregnant in that time. I had gradually dropped feeds from our return to NYC, coming down to two feeds in the two weeks that I had in NYC prior to returning to work. Hunter was on formula for the two day feeds and still being breastfed morning and evening. In April, I dropped the evening feed to a formula feed and then finally in May I dropped the morning feed to formula. Two weeks later on 23rd May, I got my period. We were going on holiday to Turks and Caicos the next day, so I was a bit annoyed that I was going to have to deal with it on holiday as I'd heard from friends that the first period you have after pregnancy and breastfeeding is long and heavy. I needn't have worried, as it was a very light period and only lasted a couple of days. Looking back now, I wonder if that wasn't enough of a 'clean out' for my body to be prepared to carry another baby.

I did a pregnancy test twenty-nine days after the 23rd May, but it came back negative. I was a little disappointed, but thought that it would have been miraculous if we'd fallen pregnant first time around after one period again. A week and a half went by and on the Tuesday, I started to feel a little bloated and crampy. I also noticed that I wasn't able to run for as long at the gym, which was a similar symptom that I'd had with Hunter. I did a test that night and the test came back with a very confused blue screen; you couldn't make out any lines at all. I told Mark that night that I thought I was pregnant and he was very excited. I did another the next morning, and it came back very pale but positive. Mark was so excited that he started telling people we were pregnant. I thought it was too early to start telling people, but didn't see the harm in it given that we had had such a smooth ride with Hunter.

I rang Dr Holden's office and booked in to have an appointment with him on the 14th of July, which would be my 7 week mark and first ultrasound. That weekend was July 4th and we had been invited to go to Long Island to stay with friends. I still couldn't believe that I was pregnant, so I did another on the Saturday and it came back much bolder this time around. It was a long week's wait for the ultrasound appointment and when it finally came I was quite nervous. Up on the screen, Dr Holden pointed out the gestational sac but said that it looked like it may be too early to see a foetus. We had a quick chat about next steps, which he said would be to take blood that day and then again a few days later to see that my hCG levels were increasing appropriately. After that, I would have a viability scan the following week to make sure that everything was progressing as expected. I asked him if there was a chance that it could be a miscarriage and he said yes, but that we would see.

I had the blood results come back on the Friday. Dr Holden said that the hCG levels were increasing nicely and that the next step would be to book in for a viability scan. I was quite confident going in for the viability scan. I thought that everything must have been progressing as expected if the hCG levels were also. I knew straight away that something wasn't right when I saw a big blob on the screen with nothing inside. The sonographer was being very aloof when I asked her if it was a miscarriage, saying that I would need to speak to Dr Holden. It felt like she was treating me like idiot. I had more blood done and I remember crying to the nurse, Patti. She was trying to reassure me, saying that nothing was certain yet and that Dr Holden would be able to give me more information. I knew that it couldn't be good. I had been expecting to see a foetus and a heartbeat, but there was only an empty sac. I called Mark as soon as I was out and he didn't quite understand it at first. He just thought that I meant it was too early to see anything. I told him that it didn't look good and he started to realise the same. I hopped in a cab and went home, but ended up going back into work because I needed to take my mind off it until I spoke with Dr Holden. He called me in the afternoon and told me that it was "a mis". I felt numb. He was speaking in such a soothing tone that I thought he must have dealt with this many times before. I couldn't help but cry. We spoke again that evening and he explained in detail what my options were. He told me that I had three options; I could wait until the tissue expelled itself, which could take weeks, or I could take some meds to expel the tissue, which should happen 24-48 hours after taking them, or I could have a D&C, a surgical procedure that has some risks (though extremely rare), such as puncturing of the uterus. I decided to go with the meds. They didn't work the first time around, so I had to take them again a week later; apparently I was part of the 3% who they don't work for the first time. A week later, I only expelled for a day. I had a sonogram a couple of days later, which showed tissue still there, so Dr Holden gave me a prescription for different meds to expel the remainder. Nothing happened. We went away on holiday to Barbados to get our visas processed (I was changing jobs in the middle of all of this) and luckily nothing happened while we were on holiday. The day after we arrived back, it started again and I expelled blood and gross-looking tissue for two weeks straight, beginning my new job right in the middle. A couple of weeks past and I started bleeding again. I thought it was my period, but I've since learnt that there has to be around a four week gap (at least) for a proper hormonal cycle to occur. It went on for a week, and then almost a week later I started bleeding again. I got in touch with Dr Holden and he told me to book in for a sonogram to see what was going on. The sonographer told me that there was still a lot of tissue remaining and said that I would need to see my Dr as soon as possible, as the tissue may have been there so long that it could be difficult to remove. Dr Holden was busy the next day, so I was booked to see Dr Perera, another Dr in his team, at the hospital to have an MVA (manual vacuum aspiration). Dr Perera said that she wanted to have another look inside my uterus before she began anything to make sure that it was the correct procedure. She pointed to the remaining tissue on the screen, showing that it was taking up most of my uterus. She then said that she was going to bring in another Dr to get a second opinion about the procedure. The second Dr came in and they both agreed that it was best to do a D&C in the operating theatre and put me under a general anesthetic in case of excessive bleeding and also to make it more comfortable for me, in case the remaining tissue was difficult to extract. I was booked in to have the D&C the following week with Dr Holden.

Finally, the 8th of October arrived. I went through to the operating theatre after pre-op and was put under general shortly after. I woke up as if nothing had happened. I rested in the post-op room until Mark arrived, and was told to take it easy for the rest of the day. I didn't have any pain or cramping as I was told I might, so didn't need to take any painkillers at all. I couldn't believe how good I felt after the D&C and really wished I'd done it right at the beginning to save a lot of time and emotional energy. It was a huge relief to know that it was finally all over. I still feel the loss, but I am grateful that it did not progress to a foetus, as I think it would have been much more devastating to see the beginnings of a little baby itself. It was a bump in the road that went on for months and months, but hopefully we will have another little one with us soon enough.

D Day - Delivery Day

This post has been sitting in draft for some time, and unfortunately I can tell that my blog might get somewhat neglected now that Hunter has arrived!  Spare time is precious these days, and it's usually spent making sure I have a shower and getting Hunter and myself out of the apartment each day for a good wander with the stroller, either down to Tribeca to see Mark or to Wholefoods, Buy Buy Baby, a pharmacy or to have a 'what's happening in the world' catch up with someone... but I'll go back to D Day before I carry on with the most recent weeks.

On the day of Hunter's birth, we arrived at the hospital just before 6am.  There was barely any traffic on the West Side Highway so it was a very quick ride up to Columbia Medical University / NY Presbyterian Hospital in Washington Heights, past Harlem.  Mark and I had a nervous wait in the maternity reception before we were asked to go to the pre-op rooms, which was followed by another anxious wait.  Of course, naturally you're still thinking about what could go wrong at this point; will the c-section go smoothly, will he be healthy, what will he look like, will he have a birth mark all over his poor little face etc.!  I changed into a hospital gown and had a cannula inserted.  The baby's heart rate was being monitored, as well as my contractions, which had apparently already started although they were too mild for me to notice anything physically.

We were originally due to go in at 8am, but that came and went.  We were told by our nurse that there had been two emergency caesareans that had taken priority in the operating theatres, so we had to wait until we were told anything further.  Finally close to 10am, after what seemed like an eternity, we were told that we would be going in shortly.  Dr Holden arrived at the reception desk and we waved a quick hello.  I'd had to go to the toilet several times due to nerves, as well as the drip running through me.  Unfortunately, I hadn't been able to eat anything after midnight, so I felt quite clogged up when normally my breakfast would get me moving!

Dr Holden came to collect me and Mark was to wait until they had done all of the pre-op stuff, such as my epidural etc..  He had been given his own hospital gown to put over his clothes and would be picked up when they were ready.  I walked in with Dr Holden, the anesthetist and the rest of Dr Holden's team.  Dr Holden asked me to sit on the hospital bed facing him and to slouch.  He helped by putting his hands on my shoulders, and the anesthetist inserted the needle with the anesthetic that was to numb the area where the epidural would be inserted.  I felt a tiny prick, which wasn't painful at all.  Dr Holden then told me to be very still for the epidural, which was going in next.  I was quite nervous, but it was over in no time and they quickly spun me around to lie on the bed.

A big blue sheet was drawn up in front of my chest so I couldn't see past it.  The anesthetist was on the right side of me, monitoring the anesthesia by what I was able to feel.  It was taking longer than expected to take effect, so they tilted my body so that my head was lower, allowing gravity to move the anesthesia more efficiently.  Mark came into the room shortly afterwards and stood on my left side.  He started peeking over the sheet and despite being asked to sit down because "many dads have been known to pass out", he actually tried to convince them that he would be fine because of all the fish he has gutted!

Dr Holden had already told me that I would feel poking and prodding but no pain.  Soon he said to me from the other side of the blue sheet that I was about to feel a lot of pressure.  It was a crazy feeling, like I was being pushed down into the floor a few times, and then all of a sudden I felt this huge WHOOSH and knew that the baby had come out.  Mark and I had been looking at each other the whole time and had both started crying.  It was such a colossal wave of emotion, like nothing I've ever felt before.  They asked if Mark wanted to go over to see the baby under the heater, where they were cleaning him up and performing all of the required tests, while I was stitched up.  It was very strange hearing his first cry from behind the blue sheet and not being able to see him.  Mark came back around and told me he looked like my Dad, which wouldn't be such a bad thing later in life but I wasn't sure how cute a baby that would make him!  Though, once the swelling from the fluid retention had gone down, he looked quite different and very cute.

Once the anesthesia began to wear off, I started to feel the pain of the incision.  I actually couldn't move out of the bed for two days from the pain, even though I was taking some fairly hardcore painkillers.  They managed to help me out of bed on the third day, so that I could shower and get cleaned up.  I had Hunter in the room with me during the entire hospital stay, as opposed to my room mate who's baby was in the nursery for most of the time apart from feeds.  Mark had been coming up to the hospital to spend each day with us, some days running up along the Hudson. It was a nice feeling being in the hospital with doctors and nurses to help you with everything and give advice.  By Friday my milk came in, which was extremely painful and looked quite ridiculous!  I still felt totally battered and not in any state to go home, so I requested to stay in an extra night.  On Saturday, we packed everything up, left with numerous supplies of things from the hospital (diapers, wipes, baby blankets, giant hospital pants for me!), and made our way home as a family.  It was such an overwhelmingly scary prospect that I was totally overcome with emotion when we came home and cried (happy tears!) for some time!

The Lead Up

So I'm now writing this post following Hunter's birth, and in this sleep-deprived state that I am permanently in at the moment, it is very weird thinking back to pre-Hunter days! 

The few weeks prior to the birth of the baby really seemed to fly by.  It was great having the time off work to prepare, as I made countless visits to various stores, in particular Buy Buy Baby, the huge baby department store on 7th Avenue in Chelsea, which has everything you could ever imagine baby-related.  It was also nice being able to rest up in between.  My hip was still quite painful during the night, so it was good to be able to relax when I wanted to for as long as I needed to.  The weather was scorching and hotter than anything I had experienced in years.  I made sure I drank loads of water each day, and some days were spent inside in front of the air con and fan.  A few days before the baby was born, I didn't leave the apartment until 7pm that evening because of the sweltering heat outside, and even at that time the humidity made it still feel like it was more than 40'c.

The date of the delivery was initially scheduled in for Friday 19th July.  We found this out early in the week prior.  I had always wanted the birth to be as close to my due date (25th July) as possible, so asked Dr Holden if we could move it closer to the 25th.  The dates that Dr Holden was working around the 25th were already booked up, but if someone went in to labour earlier, then I would be able to take their slot.  Closer in on July 17th, a slot on the 24th came up, but Dr Holden had said that the 23rd was better for him, so if a slot was to come up for that day, it would be ours.

On July 22nd, the news of Princess Kate going in to labour was on every channel and people were eagerly awaiting the news of the future King's birth.  I was in the Chelsea Markets with my girlfriend, Lucy, who was over from Australia when I received a call from Dr Holden's secretary to tell me that a slot had come up for the 23rd, the next day, and could we be at the hospital around an hour and a half before our 8am delivery.  It suddenly felt so surreal that our baby was to be delivered the next day, in a matter of hours.  I called Mark and told him, 'We are having a baby tomorrow!'.  He was really excited.  It was so weird to think that we had just one more night of 'the two of us' before we became a family.

Later that afternoon, there was news that Princess Kate had given birth to a baby boy named George. It would have been cute to have our baby born on the same day as the future King, but our little guy gets his own day the day after!