Uncommon Julia

It's an Easter Miracle!

A resurrection!  Just not the one we usually associate with the holiday.  For the first time since (carry the three... plus two...) October of 2006, I got my period.  Shocking, I know.  I was fairly certain that I'd have to wean Caroline completely and get back on traditional birth control pills before I had a shot in hell of having a period again.  But in the spirit - nay, the theme - of proving me wrong, my body opted for a surprise re-opening.

So surprised was I, in fact, that I had no supplies on hand.  It was like being a 12-year-old all over again, what with the improvising.

I'm encouraged that my body seems to have the wherewithal to do this.  Given the not-great/not-awful report from my last HSG, I wasn't sure.  And, given what I've seen today, it may be a one-day-only event.  But it's a start.

I don't know that this has any real significance, beyond the fact that it's just nice to function with a "normal" range.  I had grown accustomed to thinking that life with Asherman's required surgery of some degree to get back to an operational standpoint.

We still suffer from what I'm calling "economically-induced infertility".  Well, by "we", I mean "I".  Todd, I believe, is done having kids and is perfectly okay with that.  Me?  Well, I think I've come to accept two facts: 1) In my heart of hearts, I'd like another. 2) The odds of us ever being able to do that are just a sliver from nil.  Surely admitting that will get me a step closer to acceptance.  Right?

The First Bite

Apparently, prolonged absence is part of my "process".  I know that makes for crappy blogging, but I'm certainly in a "do what you must" phase right now.  If you're still tuning in, you'll be happy to learn that I actually received a bit of good news today.  (I know!  I was shocked, too.  I made them double-check that the name on the file really was mine.)

Today I went to see my RE to have a heart-to-heart about my latest batch of uterine scars.  I was fully prepared to hear bad news and leave with surgery scheduled.  But to my surprise and great pleasure, I learned that my scarring isn't bad at all.  He has no concerns at all about any necrotic or calcified tissue and says surgery can wait indefinitely.  In fact, he said, were it not me, he wouldn't even deem surgery absolutely necessary before attempting pregnancy. (To be clear: we are NOT trying for another baby.  Not now, and perhaps not ever.)

Since it is me we're talking about, he suggested we take our time dealing with Caroline's tootsies, any possible genetic issues, health insurance quandaries, and the general questions of whether or not we even want more children before scheduling an appointment to plan surgery.

He also felt that the mini-pill could be preventing me from having a period, rather than just the scar tissue.  Once I've weaned Caroline (which is now not something I have to rush), I can go to a regular birth control pill and likely start regular cycles again.  [Insert grinning here!]  Yay!  Periods!  Who knew how much one could miss them?

As for my formerly-retroverted, newly-prim-and-proper uterus, he said there may very well be scar tissue in the abdomen, or that it could have just stayed upright for no good reason.  Apparently, that's not unheard of, especially after c-sections.  We may plan a laparoscopy in conjunction with the hysteroscopy whenever we get around to it.

But for now and the forseeable future, I can check my uterus off the list of shit to deal with. 

Now... onto the next bite: Caroline's intake work-up with Early Childhood Intervention is scheduled for tomorrow, followed by our appointment with the pediatric orthopedist on Monday.  Don't worry, I'm chewing slowly.

A Rough Go of It

Sorry for the silence.  I don't think I'm doing so well.  Caroline's potential issues and my Asherman's have resurrected the Habitual Trauma Searcher.  One minute I'm coping just fine, the next I'm crying after a relatively reasonable phone conversation with a nurse. 

People keep telling me not to do any searches regarding Caroline's developmental progress.  I understand their good intentions.  It's true that searching through Google and assuming that every dire possibility applies to you or yours isn't healthy.  But I also have to say that if it weren't for the internet and a respectably discerning eye when it comes to what may or may not apply, I wouldn't be where I am today.  Sometimes, it's just you out there hollering in the dark and advocating for yourself.

It just so happens (or maybe it's no coincidence - ay, there's the rub) that searching for information on tip-toe walking, W-sittting, and curly toes leads to many mentions of terms like "contracture".  It sends me right back to our diagnosis with Thomas.  And I mean RIGHT BACK THERE.  It isn't a pretty place.  PTSD can be an ugly thing when it comes to flash-backs.

I can say all this knowing full well that no matter what, Caroline is not Thomas.  She is infinitely healthier.  I know that.  But that primal desire to protect her and do whatever it takes to keep her well and happy - it just takes over.  And it's quickly followed by that feeling of helplessness and failure that comes from knowing you cannot control everything.

Ugh.

I'm setting up some phone conversations with my therapist from the days of yore.  I need to climb out of my own head for a bit.

Cooter Cobwebs, The Remix... Yet Again

Once again, we mark the passing of my biennial pilgrimage to my local radiology clinic to visit the soothsayer known as the HSG.  If you ask me, everyone should have their cervix threaded by a catheter and their womanliest organ flooded with contrast fluid whilst they lay on a hard table and tilt their pelvises this way and that.  It's a real kick in the pants.  Or the crotch.  It's You Choose the Metaphor Day at Uncommon.

Having become somewhat of a professional connoisseur of this particular procedure (this was my fifth one), and the world-recognized expert in all things hysterosalpingogram-related (go ahead, just ask Google)... wait just one minute there, sister!

[I used to be inundated by google-search hits about HSGs.  Sure, most of them were misspellings, but still.  I must have fallen off the first page because I haven't received traffic from an HSG-related search in weeks!  Hmph.]

Where was I?

Ah, yes: on a cold hard table.  This time 'round, the technician was more forthcoming than usual. Perhaps she was wooed by my wrap sheet - I mean medical history; a two page Word document that I created and update for occasions just like this.  She even used big words like "occlusion" and didn't side-step my direct questions. 

I'm not a doctor, but I play one on TV, so I wasn't surprised at all to see a very clear clump of scarring on the right side of my uterus, taking up to perhaps 45 or 50 percent of the cavity.  At one point, I could even see the strands of scar tissue reaching from the side to the top (that's fundus, for you pros). 

"Your tubes are both open, but clearly your doctors will want to evaluate this area here," said the tech, " and decide how to proceed." 

Clearly.

It's amazing how much blase calm comes with having been down this road.  I barely skipped a beat as I phoned in the results to Todd and hurried home for some work deadlines.  Really, the only interesting (that's potentially frightening, for you pros) thing about it was the fact that my historically fall-down drunk tilted (that's retroverted, for you pros) uterus was not.  It was standing upright, making the translation from screen to my brain much easier than when it's upside-down and viewed from a outsider's vantage point.

But what's wrong with that? you ask.  Well, as it was explained to me, once tilted, always tilted.  Even after pregnancy, the retroverted uterus will limply sag down to its normal position like a deflated balloon.  Unless... unless something is tethering it into place.  Something perhaps like scar tissue between the outside of the uterus and the abdominal wall.  Something that just might correlate to the deep dimples I have at each end of my latest c-section incision where the sutures never released.

Again, I'm no doctor, but it did get a little eyebrow raise out of me.

I should hear from the actual medical professionals entrusted with my care before the end of the week.  Then we'll have to decide a number of things, like timing, financing, and whether or not I'll have to wean Caroline in order to go through the follow-up hormone treatment.

Meh.

Olivia

When I was a teenager, my mother and I would attend a church luncheon for Mother's Day.  And at the luncheon, after a prayer, they would start things off by singing a song, "I Was There to Hear Your Borning Cry"*.  And my mother would cry.  And I would roll my eyes in that teen-aged way that simultaneously said, "Mom, stop embarrassing me!" and "You're a giant goober."  And then I would cry, because I always do when my mom does and because really, even as a teenage girl, the song got to me.

Last Wednesday, around 7:00 in the morning as I lay on the operating table, numb as a sofa from the ribs down and exposed as a fish to all the world, I felt so removed from everything that was going on.  I was in clinical mode - one which I'm sure a few of you are familiar with.  It's a coping mechanism whereby you render everything into facts.  Analog.  Simple yes or no answers that keep emotion at a distance and try to make the whole situation - good or bad - manageable.  I lay there talking calmly with the anesthesiologist about what I did or didn't feel, analyzing the sound of my increasing and decreasing heart rate, jokingly placing bets with my doctor about Caroline's size (she won, by the way, nailing it to the ounce), and even calmly reflecting on how much more "with it" I felt this time compared to Hannah's birth.  But I didn't feel emotional.

Not until Caroline Olivia drew her first breath and screamed out to the world, myself included, that she was here.  In that moment I felt all of the emotion on the moment wash over me and I began to cry.  And then I laughed at myself for feeling caught so off guard by the joy.  And then I cried some more.  And when they held her over the drape for the first time, I looked at her messy, screaming face and felt overwhelmed by relief and pure, unadulterated love.  I thought immediately of that song and of my mother's reaction.

And then, with her father's classic sense of comic timing, she dripped a glob of bloody, mucousy eew on my lips.  I tried to push it off using my lips, as my hands were otherwise occupied with gadgets and monitors and IVs, but it didn't work.  "Get it off!" I scream-muttered to Todd.  He laughed and wiped away the stuff on my lips but inadvertently left some on my chin.  I had to ask the anesthesiologist to get it off later.

* To be fair, I don't recall the "where demons dwell" part.  My church may have cut that part out or I just have fuzzy memories.

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I'll write a more in-depth birth story later, but suffice it to say it was wonderful.  I have a big, healthy baby girl and I have my uterus.  I have a great husband, and family and friends who filled our room every moment we allowed them.

It's been a week, so I already have some product recommendations, new nursing tips, and funny-yet-horrifying poop stories (mine, not hers) to share with you.

Caroline is everything I remember loving about an infant, and nothing I remember hating (namely the reflux).  And Hannah is acting out no more that can be expected.  Plus, she loves her Baby Sister with an intensity I honestly did not expect. Her minor outbursts are aimed solely at me and Todd, never at Caroline.

For now, I'll have to settle for sharing a few pictures and I'll shave the stories for future posts.

Many, many more on my flickr account.

Game Plan

My doctors have spoken and we have a game plan.  Fifth verse, same as the fourth.  We will basically follow the same plan as with Hannah's delivery.  The c-section will take place in the regular OR, rather than in the maternity ward OR.  My doctor will have her partner assisting, who's done a fellowship in oncology, as well as the staff oncologist on stand-by.  We will have all of the necessary staff to perform any drastic measures like uterine artery ligation, should they be needed.

The good news is that all my doctors concur that there is reason to be suspicious, but no hard proof of an accreta.  This means we're actually, potentially, in better shape than with Hannah, despite the bi-lobed placenta/lots of vessels situation.  How awesome is that?!  In fact, I daresay no woman has faced the possibility of life-threatening hemorrhage and hysterectomy with more smiles and glee.

The only slight change regards the date.  Instead of August 2nd, a Thursday, we're looking at July 31st or August 1st when my doctor's partner is available.  So we've just under four weeks until Baby Sister makes her arrival.

Speaking of the actual child... would you like to see some FREAKIN' AWESOME 3D PICTURES?!  Of course you would.  And I am only too happy to oblige. (Okay, for some highly annoying reason, Typepad won't let me insert the images.  So I'm linking to Flickr.

A New Kind of Special

I'm home, safe and sound.  And I have the preliminary results of yesterday's MRI.

No one is surprised that the MRI report suspects "myometrial invasion"... in other words, either an accreta or increta.  But I do have to put my own special twists in, so not to be outdone, this time I apparently have added a bilobed placenta into the mix. 

They theorize that a bilobed placenta occurs when the embryo implants in a less-than-desirable location (in my case, likely an area that had previously been compromised by surgery and scarring).  In an attempt to find greener pastures, the placenta begins to migrate toward healthier tissue and atrophy in the middle.  I happen to have one lobe anterior and one lobe posterior, with a network of vessels communicating between the two halves.

Fortunately for me, my placenta is not low-lying, so I do not have vasa previa, which would be much riskier.  Nor do I have a velamentous cord insertion, which means that the umbilical cord does not insert directly into the placenta, but rather into the membrane of the placenta where it loiters unprotected for a bit before entering the placenta.  Alas, I did not know until after a thorough google search that I didn't have the cord insertion problem, which caused more than a few hours of concern as words like "fetal exsanguination and death" practically leapt off the page and danced through my head.

We may now, however, have an explanation for my strange spotting episodes over the past month or so and maybe even for the heavy bleeding incident very early on.  Or not.  No one can really say.

I am currently waiting for my OB and my specialist to have a phone pow-wow so we can develop a specific game plan.  It should be some variation on Hannah's birth: a very planned c-section with a full OR, a couple of radiologists, a gynecological oncologist, the director of anesthesia, and a nice supply of blood waiting in the wings.

Our big questions at this point revolve around timing (balancing baby's maturity with the need to avoid spontaneous labor) and overall risk, as it may be further complicated by the bilobed placenta.  But I can sleep over the next few days as I wait for those answers because that's just a variation on what we've done before.

As for yesterday's procedure, well, I'm afraid it... well, it sucked.  It sucked big, hairy monkey balls, as my husband would say.  The day started out just fine; we were at Texas Children's Hospital, which as you would hope, is staffed by generous, compassionate folks.  We weren't asked to fill out obscene amounts of paperwork, and they even called us back for our ultrasound a half hour early!  The ultrasound lasted for about an hour and a half, and the technician was lovely.  We didn't learn much about the placenta, but we did learn that Baby Sister is also measuring quite large (although, we all know how unreliable those predictions can be at this stage).  At 34 weeks gestation, she's measuring at least two weeks ahead, and they estimated her weight at 6 lbs. 2 oz.  With six weeks left until her due date, that's pretty freakin' impressive.  Of course, she could just be long-limbed with a giant noggin.

We had to wait quite a while for the MRI, but that was no big deal.  There was even a humorous moment when we were preparing to enter the MRI "environment" and Todd thought he was going to have to put on a gown.  I should have let him think that was the case, just to see the look on the nurses' faces.

They told me the MRI should take between 15 and 20 minutes, if everything went smoothly.  But it did not.  It ended up taking more than an hour and a half, including two breaks to rearrange everything.  It was brutal.  Awful.  Really, really bad.  I can easily say it was the worst non-invasive procedure of my life.  I moved quickly from discomfort to outright pain, with contractions and pressure the whole time.  Baby Sister barely held still for any of it and they needed fluid in my bladder, which only served to make things worse.  At one point, they were actually having me hold my breath during a contraction.  By the end of my third and final session in that god-forsaken tube, I was thoroughly shaken.  I needed a lot of help getting up to a sitting position, and as soon as Todd was within reach I began crying.

The doctor said he was sorry that it took so much longer than normal, and then he said he wanted to do another ultrasound.  By the time we were done and I'd put my clothes back on, it was peak rush hour Houston traffic.  Oh, and I hadn't eaten since 9:30 that morning.

Don't get me wrong, I still prefer a thorough evaluation and I thanked the doctor.  But it was really an awful thing to have to endure, and I can say that having been through some truly horrible situations, both physically and emotionally.

So, there you have it.  You know as much as I do at this point.  Come Thursday, after my next visit with Dr. Save-a-Ute, I should know more.

A Teensy Bit of Whine

It's verboten, I know; to complain about anything pregnancy related when it's such an obvious blessing to even be here.  And yet, I worry.  And gripe.  And I would completely understand if you'd rather not stick around through either. 

Tomorrow we leave for Houston and my MRI.  In one of her last acts as resident relative, my MIL is watching Hannah all day.  I'm more worried about the physical discomfort this time than I am about the actual results.  (Or, perhaps this is a mental distraction to focus on something other than what the test might reveal.)  I'm expecting troubling results.  But I'm also expecting to find said results less troubling since I've been through this before, done my homework and have a proven doctor who I trust to do everything she can to save me, my baby, and all my parts.

But, as I recall, the actual MRI itself is not so much fun.  I tend to lose my breath after laying flat on my back for only a few minutes... and that's on a bed.  This will be a hard table.  And there will be a heavy apron thingie laid across me.  And then they'll put me in a hole for a long time and ask me to do absurd things like hold my breath.  I'm worried I'll freak out.

And this brings up a related item.  I feel drastically less comfortable this time around than I did at the same time with Hannah.  This baby is so ferocious that I have my hands on my belly 90% of the time, moaning out loud, without regard for company or passing strangers, as I try to keep her from bursting forth alien-style.  My skin has given out and let loose a handful of giant, thick stretch marks.  My hips feel like they may let loose and let my legs fall right off like a misused Barbie.  And last night, Baby Sister actually punched my sciatic nerve (I think that's the one) so hard that my entire left leg went numb for two minutes.  And then there's the non-stop contractions.  And the leukorrhea.  GAH!

So there.  I'm thrilled that I'm having another baby.  Thrilled that she's a she.  Thrilled that Hannah will have a sister.  And I feel more calm and relaxed about her actual arrival than I ever did about Hannah's.  But nothing is ever completely easy, and this pregnancy is no exception.  So there.  I said it.

Please say some prayers for me tomorrow.  It would be nice to have one less thing to bitch about.

Whee! (and this time, without sarcasm!)

The oracle has spoken!  Again!  For the fourth time.  I'm digressing...

Having been awarded my honorary radiology degree, my radiologist invited me to join in the celebration today as we admired my FABULOUSLY remodeled uterus!  My GOD, but it was attractive!  Perhaps even better than the time I made the cover of this (relatively unknown) publication!

I'm telling you, people, it was textbook.  It was triangular.  It had two, open tubes.  It even sat relatively straight in my pelvis this time, which it doesn't often do.  There were no blockages, no masses, no uneven sides or protrusions.  No "filling anomalies".

She's not allowed to give the final word, but we did a little high-five afterward, and I'm thinking that's a good sign.

EEEEEeeeeeeeeeee!!!!!!

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And, then, when I called Todd to tell him the good news, he rewarded me with more: He was contacted by an investor in California who loved his Web site* and wants to use him to purchase between 20 and 30 properties before the end of the year!!!!!!!!  We're not counting our chickens before they hatch, but HOT DAMN!

*That would be the site that his fabulous and talented wife orchestrated with the help of a reader and her company.  The site that has content so well-crafted as to cause the agent to call my husband and offer him large sums of money.  [That, my dear friends, is the sound of self-congratulations.]

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AND, we're expecting an offer on my best friend's house.  The one who is going to give birth any day now.  We would LOVE for them to be able to move prior to the immanent arrival.

This reminds me: My next post should be about the most fabulous experience I've ever had at an event that involved the word "shower".

So, to reiterate: WHEEEEEEE!!!!

Whew!-ish

Last Friday I got my period.  It's my first home-grown period in well over two years.  And I'd be lying if I claimed I didn't do a little dance of joy when it arrived.  It means I had a grade-A, normal-for-me 30-day cycle.

I called to schedule my post-op HSG for tomorrow.  If history repeats itself, I should be able to tell just by looking at the screen if we're in the clear.  (You didn't realize I had a degree in radiology, did you?!)  I'm trying to remind myself that we're just looking for "good 'nuff", not perfect.  But it's hard not to hope for the best.

It'll be interesting to see how Todd and I react to (I'm being positive here) the news that we're ready to try again, should we so choose.  I have no idea where we stand on this issue right now.  I'm thinking the most logical thing to do would be to wait until we're situated in the new house in December.  But then again, logic has never been our strong suit when it comes to all things baby.

Either way, wish me luck on my way the oracle.