My Second First Trimester – Morning sickness, acupuncture and wrestling with hope

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Before I start gushing about how amazing it is to feel my baby move around in my belly and about how we are loving our midwifery care, I really wanted to reflect on my first trimester.  I think sometimes it’s easy gloss over the struggles when you have such happy news to share, but to honour my full experience it’s only fair to write about the darker times too.  Unfortunately, I’ve had to do this more often than I would like, but I know I am far from alone in this journey.

The first trimester was such a strange time for me.  Arguably, it is the most dynamic time in your body (though I may change my mind once I reach my third trimester…) with hormones constantly on the rise, no fully developed placenta to carry the load of growing your little one (shout out to placentas everywhere!),  morning sickness, fatigue and on top of that you don’t even look remotely pregnant.  At a time when you really could use some help with your groceries, a door held open or for someone to kindly ask how you are feeling, no one really does.  There are no outward signs of the intense and complex processes occurring inside of you.  It feels kind of lonely.

I found myself feeling like an impostor a lot of the time.  Like I was lying about feeling so terrible, because on the outside I looked totally normal.  I imagine it is perhaps similar to what people with a “hidden” chronic illness feel like on a regular basis; ignored, passed over and assumed to be just peachy, when really their bodies are wreaking total havoc on them.  I felt so guilty for not making dinner for my wife (and I normally love cooking) and for basically being a giant lump.  The fatigue just kind of crept up on me.  All of a sudden I was sleeping until noon, even when I was going to bed at 9:00 or 10:00 pm.  It was a struggle to even have a shower some days.  For someone who is always doing a million things, it’s hard to admit that you are tired without feeling incredibly lazy and full of excuses.  I didn’t even believe I was “that” tired until I started to feel like my normal self again in the second trimester.

In general, my second first trimester was a lot like my first first trimester.  All day morning sickness, hating all food, and all of the fatigue.  The picture above was a very familiar view, as it is for a lot of mama’s in those early days.  I lost a few pounds simply because I just couldn’t eat.  Perhaps some of you have had an experience when you indulge in that one certain type of liquor (we’ve all been there, right?) that even a whiff of it sends your stomach reeling back to that god forsaken time you swore off drinking forever?  Yeah, that’s how I felt.  About. All. Food.  Nothing appealed to me.  Occasionally I could stomach some raisin toast, maybe a popsicle.  Apple juice was really good, for like a week, then I hated it.  I would wander the grocery store (which has so many smells, that I couldn’t spend too long there) unaccompanied by my usual well-thought out list for my meal plan that week, and just bought whatever I thought I could stomach.  I happened to also be unemployed after our recent move to Winnipeg, so most of my days were spent watching Netflix, trying to write cover letters and thinking of something I could eat that wouldn’t make me vomit everywhere.

It was a fun time, let me tell you.

I started doing acupuncture every couple of weeks to help with my nausea and to hopefully prevent another miscarriage. The World Health Organization does list both morning sickness and female infertility as conditions that can be treated with acupuncture.  There appears to be some evidence of the benefits of acupuncture for women undergoing fertility treatments (they are looking especially at the potentially benefits for IVF treatment), but it seems much more research is necessary before that’s conclusive.  Even though I knew I had very little control over the situation (which was beyond frustrating for my type A personality), I still wanted to do everything I could to hang on to my little one this time.  Following the acupuncture treatments I only threw up a couple of times and found that it was very relaxing and soothed my nausea for a couple of weeks.  In addition to the treatments, my acupuncture doctor also left some very small “tacks” in place, under a small bandaid for a week at a time.  I had one on the left and right inside ankle, and one on either side of my chest.  They were freaky at first, but it really seemed to take the edge off of my nausea.  It was also comforting to have the acupuncture doctor (who was also a medical doctor) take my pulse and reassure me that it was strong and indicative of a healthy pregnancy.

Wait, did she just say her acupuncturist could tell she was pregnant by her pulse?!   Yes I did!  Here’s one study  I found that verified the theory in Chinese medicine that an expectant woman’s pulse is noticeably different (to a skilled practitioner’s hand) and also changes with each stage of pregnancy.  My acupuncturist not only told me I was pregnant before I confirmed with a blood test, he also accurately predicted the gender based on my pulse!

Despite everything I was doing, I was so worried about losing my baby again.  Pregnancy after loss, especially in those early days is so bittersweet.  Nothing seems worth getting excited about because you know it could all change in a heartbeat.  You are happy, but careful not to be too happy.  I was lucky enough to have a great circle of close friends who I told in the early days, but I didn’t tell too many people, just in case. Instead of feeling like we had a big announcement like we had last time, we refrained from telling our extended family for a while.  It just seemed unfair to get everyone’s hopes up.  It was unfair to get our own hopes up.

I had such a conditional love for my body.  I constantly felt like I was bargaining for the future.  After losing our first baby, bleeding out twice, emergency room visits and taking months to recover from the miscarriage, the trust I had in my body was shaky to say the least.  I tried my best to meditate, stay as positive as possible and to take care of myself, but it felt like it didn’t even matter.  I did my best last time and it wasn’t enough, so what difference could I make this time?

As the end of my first trimester approached, I did feel more at ease with myself and my body.  Slowly, I started to believe that I was truly pregnant and that maybe we would have a little one by the summer time.  I gradually allowed myself to be more positive in conversations about our future, started contemplating maternity leave and began moving some of our previously collected baby things out of storage.  Everyday I was letting myself believe that things would be okay.

It was a difficult time, as it is for many mamas who are experiencing pregnancy after loss.  Having a support system of friends and family was probably what helped me the most.  Just having someone to confide my worries in and share how I was feeling that day, whether it be good or bad, helped me process what was going on.  I don’t know if I could have kept all my fears to myself for all of those weeks, and I’m glad that I didn’t have to.  Even though I was nervous to announce too early on my blog and social media (I was even nervous to announce after my first trimester was over), I didn’t hesitate to tell my close friends and family from day one.  Don’t get me wrong, it was still uncomfortable to be open about the pregnancy early on, knowing full well it may not have a happy ending.  And I totally understand wanting to keep it a secret from everyone because I debated keeping it a secret from everyone until we knew for sure everything was alright.  Of course, it’s a very personal choice and I fully understand both approaches.  In the end, I knew that if my worst fears came true, I would want all of the amazing support that I had during my first miscarriage.

Despite my struggles over this past year, I feel so much gratitude for having a loving spouse and wonderful friends and family.  Thank you.  I feel so lucky.

-K

 

 

 

Moving On From My Big Fat Negative Pregnancy Test

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Well, round two didn’t work.

Following my second round of IUI in August, I had such mixed emotions.  I was much more prepared for my second TWW (two week wait, as it is called in the fertility community).  I was sort of excited, sort of nervous, and just generally conflicted as I described in my last post.  But overall, I felt like I had my shit together and was very familiar with the feeling of “waiting”.  So, like a good fertility patient, I waited.

Until I couldn’t wait anymore.

About five days before my blood test, some crazy switch turned on in my brain and I bought a million pregnancy tests. I just had to know.  It was killing me and I wanted so badly to see those double lines, that I tested every day until my blood test was due.

I fell into a really dysfunctional cycle of apathy, followed by intense hope, passionate excitement and finally earth-shattering disappointment.  My days were busy and distracting, but my evenings were quiet without my wife around (she had to go be super cool and fly helicopters in Manitoba) and my mind was left to dwell excessively on whether I was pregnant or not.  Whether I was broken or not.  Whether I could give us the family that we had always wanted…or not.  Every day I begged the universe to throw me a bone.  Hadn’t I been through enough?

Every night I fell asleep with the comfort of knowing I could take another pregnancy test in the morning. I fantasized about how it would feel to call my wife to tell her the good news and how it would feel to hug my mom and show her the positive results.  It was the kind of hope that was dangerous because the stakes were so high.  I taunted myself with visions of joy and perfection, knowing that they might not ever come true.

Every morning I woke up and grabbed my pee cup to dip yet another pregnancy test.  The minute that followed was excruciating.  My brain flicked rapidly back and forth between the two outcomes.  Positive and negative.  Light and dark.  Joy and devastation.  Success or failure.

And every morning, that one stupid single line stared back at me.

When I got the phone call from the fertility clinic with my blood test results, I was out for my last lunch with my co-workers before my move to Winnipeg.  I knew right away from the tone in the nurse’s voice that the result was negative.  Just as I had expected.  I held my tears back, but my lower lip quivered as I asked how I could continue treatments now that I would be an eight hour drive from their clinic in Saskatoon.  The nurse was very accommodating and said that they would work with me in any way they could.

I tried to be strong and not show how upset I was, but I just couldn’t hold back my tears.  I broke down on the way back to the office and had to see the rest of my patients that day with red, swollen eyes and a broken heart.

I cried all the way home, as I had so often on the highway between Regina and Moose Jaw.

After hearing the news, one of my amazing friends in Moose Jaw, texted me to see if I wanted to come over for dinner.  I really wanted to say no and just crawl into bed and hide with all of my sadness and pain.  But I said yes, because I knew how much better I would feel having a compassionate friend by my side during this time.  She made me dinner and we watched The Office and had vegan ice cream.  I was so thankful that I allowed her into my grieving space.  I rarely ask anyone for help or support of any kind, so this was a first for me.  I was embarrassed and imperfect and in my sweat pants and she accepted me just as I was.  When people say you need to surround yourself with a community of friends and family to support you through your fertility struggles, they aren’t kidding.  It’s an absolute life saver.

That night I got my period, like goddamn clockwork.  I had a perfect twenty eight day cycle, probably for the first time in my whole life.  Ovulation on day fourteen, menstruation after day twenty eight.

After a really long sleep, I woke up with a feeling of calm and acceptance.  Don’t get me wrong, I was still crushed and shed a few more tears that day, but I also knew that I had another chance in only two weeks.  I could wait another two weeks.  Just a little bit longer.  One step closer to our dream of having a family.

I called the fertility clinic to let them know about day one of my cycle and the nurse arranged for an ultrasound in Yorkton, SK on day thirteen of my cycle.  That was the closest she could get to Winnipeg.

Hey Katie, why didn’t you just go to the fertility clinic in Winnipeg?  I mean it’s way closer, right?

Excellent question, dear reader.  Turns out the two month wait list that I was told about a couple of months ago when I requested a referral, is actually a nine month wait list.  Yep, you read that right.  Nine. Months.

There was absolutely no way we could wait that long.  Our only option was to continue to go to the clinic in Saskatoon.  Which meant a lot of driving was in my future.

On day thirteen of my cycle, I drove five hours to Yorkton for a ten minute ultrasound.  From there I had a few choices: 1) drive back to Winnipeg, with the chance of having to turn right back around and be in Saskatoon the next day for IUI; 2) stay in Yorkton and do whatever people in Yorkton do for a few hours; or 3) continue to drive to Saskatoon and hope that my current cycle was the same as my last.  I opted to continue my drive to Saskatoon and hoped it was the right call.  I had a lot of podcasts to listen to anyway.

Of course, as my luck would have it, an hour outside of Saskatoon I got a call from the clinic with some good news and some bad news.  The bad news was that my IUI would be in four days, meaning I would have to turn around and drive back to Winnipeg.  The good news was that I had not one, but TWO follicles developing!  I was on top of the world!  I felt like some sort of fertility goddess!  This would potentially double my chances of getting pregnant, with a very small chance of having fraternal twins!

As I did a big ol’ U-turn on the highway and headed back from whence I came, I couldn’t even be mad.  This was excellent news!  I finally felt like I was catching a break.

Three days later, I jumped back in my car and drove eight hours to Saskatoon and treated myself to a nice hotel.  I had a bath and relaxed and meditated.  I set three alarms that night so I wouldn’t miss my early morning appointment.

As I was laying on the procedure table after my IUI, I popped in my headphones and did a ten minute meditation from my Expectful app.  I drove back to the hotel and put my legs up against the wall and was inverted for an hour and focussed all of my attention and energy on my nether regions.  I don’t know of any studies linking being upside down after insemination with successful pregnancy and it’s probably totally in my head.  But there are benefits from that position in the yoga world and it felt right to have a little downtime before my eight hour journey back home.

It’s been almost a week since that IUI appointment and I’m cool as a cucumber.  Next week may be a different story, as we start to close in on my blood test date.  With a bit more distance from my miscarriage, lower stress levels, acupuncture, meditation, yoga, lots of rest and potentially two eggs available, I feel a lot more confidence in my body this round.

“New sperm, new egg, new oppourtunity” is a saying I saw on a fertility message board somewhere along the way, and I really like it.  It makes me feel like I’m not trapped by what has happened to me in the past.  I had a miscarriage, but it doesn’t define what my body is capable of.

Here’s hoping third time is a charm.

-K

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Holding on to Hope – My Second Round of IUI

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No one in the history of menstruation has been as excited as I was to wake up at 3:00am to go pee and discover that my period had finally come back.  I practically cried looking at the toilet paper and couldn’t fall asleep for an hour afterwards from all my excitement.  It had been 28 long days since my hCG levels were negative and I had stopped bleeding from my miscarriage.  Much like every phase of a fertility journey, it felt like an eternity.  It seemed like for the past couple of weeks my mantra was “any day now, any day now”, trying to live in the moment, but desperate for the future.  Finally, I had some tangible hope of moving forward with this process.  My period meant a new cycle and another opportunity to try and start our family.

The last three months had been so uncertain, I felt like I was taking a back seat to everything that was happening in my body.  Each day felt like it got longer and longer as I waited for my body to get back to normal.  No one could tell me what exactly to expect or a normal timeline of how my miscarriage should be progressing.  My nursing brain understood this, but it was frustrating to experience nonetheless.  Questions about my prognosis were rarely answered with any satisfaction, so I was left to wait and Google on my own.  If I had a dime for every time someone told me “everyone is different”, I’d have enough money to pay for an IVF treatment.

My first period was very normal, though I had some flashbacks to my bleeding episodes from the aftermath of my miscarriage.  It irked me to wear a diva cup and pads again.  After the first dose of misoprostol back in April, I had worn some kind of feminine protection every day for just over two months.  I was not excited to feel the crampy, bloaty, leaky sensations that come with menstruation, but I was so relieved to feel normal again.

Ten days after my period started I went for a follicular tracking ultrasound, to confirm that I had an egg developing.  Last time, I had to have a repeat ultrasound as I didn’t have an egg that was ready.  Much to my surprise I had a follicle (egg) in my left ovary measuring 14 mm and ready to go!  The nurse from the fertility clinic told me that the insemination was scheduled for August 15th and that I had to take my Ovidrel injection 36 hours before the appointment.

I was just vibrating with excitement at the news.  I couldn’t believe everything was finally happening.  It was as though someone had hit the fast forward button on my life.  We would finally have our chance to try for our rainbow baby.

The insemination went off without a hitch.  I drove 4 hours for the 10 minute procedure, but I didn’t care.  It was what I had been waiting for these past three and half months.  I would have driven to the moon and back if it meant getting pregnant again.  I held my legs tightly together as I drove home and propped my hips up for the afternoon.  I also had a couple of orgasms…it couldn’t hurt, right?

And then I started yet another waiting game.

It has been five days since the insemination and I am remarkably calm.  It may help that I am very distracted by our impending move to Winnipeg on September 1st.  My wife has already started her helicopter training in Manitoba, so I get to deal with the final arrangements of packing and cleaning our house.  I am grateful for the list of things to do though, it keeps my mind focussed on the future.

I’m in a weird place where I’m almost sure that I’m pregnant, but I also don’t want to get too excited just yet.  I keep picking up on mild pregnancy symptoms that feel so familiar to me that I could just cry with joy.  Yet at the same time, I’m not sure I fully trust my body after what we’ve been through. I have been strangely exhausted lately (despite sleeping very well), I have very little appetite, and I swear my nipples are a bit bigger and darker than usual (bet you wanted to know about that, hey?).  I’m re-watching Friends (for the millionth time) and I came to the episode when Rachel finds out she’s pregnant and had a good cry fest.  So I think it’s safe to say that my emotions are pretty labile as well.  I keep fantasizing about looking at the pregnancy test I will take in about a week and seeing that magical second line show up.  Then again, maybe I’m just making everything up.  I want so much to be pregnant right now that everything seems like a sign.  I want to believe, but I don’t want to have unrealistic expectations.

Don’t get me wrong, I know how strong a positive mind set is, but I guess my positivity is tempered by my recent trauma.  I had so many hopes and dreams and expectations that blew up in my face over the last few months.  I don’t know if I can go through that again.  At the same time, I know my body is ready for another baby and I’m excited about that.  I want to look forward to the future, but I also want to be okay if it just doesn’t work out this time.  Is it possible to manifest your desires and still be realistic at the same time?

Speaking of manifesting your desires, I have started listening to the “first trimester” meditations on my Expectful app.  Maybe that’s ballsy, but I felt so triumphant when I switched over from the “preparing for conception” setting.  I want to give myself permission to feel like this could be real and if I am pregnant I want to let my little baby know that they are safe and loved.  During my meditations, I sit with my hands around my lower belly and send all of the light and love I can muster down there.  I know that anxiety and worry are only going to work against everything I’m trying to achieve.

I also allowed myself to purchase a couple little baby items.  To be honest, I can’t resist a good sale and I was wandering around the Sears that is closing down here in Moose Jaw.  60% off stuff?! Yes please!  I found a nursing wrap and a little newborn lion toy that was in the colours of our future nursery.  My initial instinct was to feel silly and walk to a different section, but then I caught myself and realized it’s okay for me to be excited.  It’s okay to do a bit of nesting and planning for the future.  God knows, I’ve had enough precious moments ripped away from me, so if buying a little lion toy puts a smile on my face then so be it!

Like I said, I’m in a weird place.

I feel like I’m playing tug-of-war with my future on one end and my past on the other.  Half of me wants to leave behind all of my suffering and think that this time will be completely different.  The other half of me wants to protect my heart from being broken into a million pieces again.  I just finished putting myself back together and while I am so ready to see double lines on that test and deal with morning sickness and puking and uncertainty and fatigue, I also want to be careful.  My future is forever tainted by the experience of my miscarriage.  I feel like I have done a lot of work to shrink my fears and anxieties, and I’ve finally arrived in a place of healing and acceptance.  But that healing will never permanently erase what I have gone through.

I can only hope that this time will be different.

-K

 

The Miscarriage – From Naivety to Reality: Part 3

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The two weeks following the misoprostol were difficult to say the least.  I smiled less, I cried often.  I did my best to put on a brave face at work, but on the inside I was broken.  My bleeding was a constant reminder of our loss.  I felt empty.  I was empty.

I had gotten up for work on a Friday morning, almost two weeks after the misoprostol, and felt like I was finally seeing a small light at the end of our hellish tunnel.  I had hardly bled at all the last two days, and I finally felt like I was getting back to “normal”.

That afternoon at work, I felt a sudden gush of blood into my underwear.  I had a diva cup inserted, so I was a little taken aback that I had filled all 30 mL of it and then some.  I carefully made my way to the bathroom to empty the cup and then carried on with my day.  I didn’t think much of it, until an hour later I felt another huge gush of blood.  What the hell was going on?!  I thought this nightmare was coming to an end.

I waddled my way to the bathroom and discovered I had filled my diva cup yet again and bled all the way through my panties and leggings.  I embarrassed and scared.

My clothes were too blood-soaked to put back on.  I still had to see another three patients that day, there was no way I was going to sit at my desk with no panties and blood everywhere.  I tried to maintain my calm, as my mind flicked through the various outcomes and consequences of what was happening.  The nurses at the fertility clinic said that if I soaked a pad an hour, for two consecutive hours, then that was cause for concern.  Maybe the bleeding would slow down and everything would be fine.  I didn’t want to jump to conclusions.  I put my diva cup in and found a bag for my bloody clothes.  I talked to my manager and explained the embarrassing situation.  As I explained to her what happened I started crying and she told me to do whatever I had to do.

I grabbed my purse and walked to my car.  The second I stepped foot out the front door, I felt blood running down both of my legs.

Oh my god.  I couldn’t believe that my miscarriage wasn’t over.  It was only getting worse.  I didn’t think that was even possible.

I sat in my car and broke down.  I had no idea what to do.  I couldn’t go anywhere because I had no panties and blood streaming down my legs.  I didn’t know if I should go to the hospital, but even still I had blood leaking down my legs under my dress.  I would have left a trail of blood behind me and who knows how long I would have to wait.

I called one of my co-workers from inside my car.  I don’t even remember what I said to her, I was just crying and hyperventilating.  She got me an extra pad she had in her purse and a garbage bag to sit on.  I called my wife and she talked to me in the kind and calm voice that she uses when I’m freaking out.  I started to breathe and get my head straight again.  I felt physically fine and I knew I could drive home safely.  I just needed some goddamn panties and a pad and then I could figure out what to do next.

I drove the hour from Regina back to Moose Jaw trying to convince myself that everything was going to be okay.  I pulled into my driveway an as soon as I got up out of the car, blood was leaking out from the pad and running down my legs.  I ran inside to my bathroom and took my diva cup out.  I had filled the diva cup again, completely soaked the pad I was sitting on and there was blood everywhere.  I went into full panic mode, sobbing and shaking uncontrollably on the toilet.  I knew I was bleeding too much.

My poor wife started cleaning up around me and asked if we should go to emergency.  I still couldn’t think straight.  Deep down,  I knew I had lost too much blood that afternoon, but I wanted to check with the fertility clinic before I went into emergency.  Being a nurse, I didn’t want to go to emergency without a good reason.  I got into the shower to wash the blood off my legs.

I called the clinic and the nurse confirmed that I should go to emergency.  I heard some worry in her voice as I told her about how much blood I had lost that afternoon.  We gathered our things and headed to the hospital for my first emergency trip ever.

The emergency room was like everything else in Moose Jaw: small and quiet.  I was thankful for that because as we sat there I started to feel dizzy. A nurse took my vital signs before admitting me.  My pulse was 134.

I had never been a patient before.  After being assigned a room in emergency, I sat at the edge of the bed, adjusting to my surroundings.  Somehow, laying down on the stretcher would have been admitting there was really something wrong.  I was feeling better now that we were at the hospital.  My wife and I talked lightheartedly, to distract ourselves.  My bleeding had slowed quite a bit in the last couple of hours, which was encouraging.  I felt a bit silly for even being there.  Maybe I wouldn’t need a D&C after all.

The doctor on call was actually my family doctor.  It was a relief to see a friendly face.  He said that we would do some blood work and a speculum exam and the decide what to do from there.  My blood work was drawn by an awkward lab tech and we continued to wait, listening to the buzz of the emergency department around us.

My doctor came back in to the room a while later for the speculum exam.  Ugh.  I knew it had to be done, but I was not looking forward to it.  I laid back and scooched to the edge of the bed, with a wedge pillow under my butt.  I made a joke about how many people had been up in my private bits lately that I really didn’t care anymore.  But that was a lie.  I did care.  It was invasive and awful.  I hated it.

The doctor saw what he thought could be blood clots or products of pregnancy, but he wasn’t sure.  He wanted to do an ultrasound to confirm what was going on.

I walked down the hall to the ultrasound room.  The tech did an abdominal ultrasound first.  She said I still had a bit of urine in my bladder and that I should empty it in order to do a transvaginal ultrasound.  Oh great.  My favourite.

I went to the bathroom that was attached to the room and peed.  I stood up to wipe and gushed blood all over the floor.  How much blood could I possibly have left in me?!  I tried my best to wipe up the floor.  I told the tech what happened and apologized profusely.  I was overcome with embarrassment.

The transvaginal ultrasound was bloody and awful.  I felt so exposed and there was nothing I could do about my bleeding.  I just laid there and stared at the ceiling wondering what I did to deserve this.  The tech was very kind and said that it wasn’t my fault when I kept apologizing for bleeding everywhere.  She said she couldn’t tell me anything she saw on the screen and I would have to wait for my doctor to tell me the results.

As I walked back to my room, I felt another gush of blood.  That continued for the next couple of hours as we waited for the results to come back.  I finally resigned myself to laying down on the stretcher.  I felt tired and defeated.  I just wanted some answers.  I just wanted this nightmare to be over.

The doctor came back into the room and shut the doors.  He told me that the ultrasound had shown some retained tissues from the pregnancy.  He said that though my condition was not emergent, it was urgent and that I would need a D&C the next day.  My worst fear was coming true.  I immediately asked if I would be under a general anesthetic and he said that likely I would be.  That made me feel marginally better.  I started to cry for the first time since being admitted.  I had done so well putting on a brave face.  But that all came crashing down when I knew that a D&C was inevitable.

Somehow we managed to sleep a little bit that night and then we headed to the hospital bright and early the next day.  After checking in, I put on a hospital gown.  It was then that I really felt like a patient.  I sensed all of my autonomy and confidence slowly drain out.  I suddenly had so much empathy and respect for patients I had looked after in the past.  I never truly realized how powerless and frustrating it was to be a patient, especially in a hospital setting.  In the whirlwind of crap that I was dealing with, I felt a small pang of gratitude to have had that experience.  The nurse in me knew that this experience would probably make me a better nurse down the road.  Maybe it’s strange to have felt that just from the folds of an uncomfortable, snowflake-patterned hospital gown, but that’s what I felt.

As an aside, who decided that snowflakes were a good pattern for like every hospital gown ever?  Ew.

The gynecologist who was going to do my D&C came in to speak with us regarding the surgery.  His smile was nice, but his eyes and body language said that he didn’t really care all that much.  He wanted to do another ultrasound, as I had bled a considerable amount last night, just to make sure the D&C was still necessary.

Sure enough, the abdominal ultrasound showed small patches of white in my uterus, indicating that there were still tissues present.

As I began to ask him questions about the procedure, I quickly discovered that he had no interest in informed consent.  I asked him when my period could be expected to come back and about the risks of the procedure.  He said he didn’t know when my period would come back and that there were no risks to a D&C.  I asked about Asherman’s Syndrome, which is a rare complication leading to infertility, and he just waved his hand at me dismissively at me saying that it was nothing to worry about.  He also said that I could just as easily take another dose of the pill and not have the D&C at all and that it was up to me.  He left the room for a few minutes to let us decide.

Well, great.

For the umpteenth time in this whole process, I was glad to be a nurse.  I was already decently informed of the risks of a general anesthetic and had done my own research on the D&C procedure.  But I kind of wanted to discuss it with a real live doctor who specialized in gynecology to make sure that I was making a good decision.  Apparently that wasn’t going to happen today.  It’s no wonder people regularly turn to “Dr. Google” and message boards on the internet.  If you get stuck with a doctor who doesn’t care about you, unfortunately you don’t have anywhere else to turn.

My wife and I talked about what we were going to do.  I was really scared of the D&C.. Though it was irrational, I kept having horrible thoughts of never waking up from anesthesia.  Any surgery is risky and I wanted to avoid those risks, if possible.  Still, but clearly the pill did not work for me the first time and I really did not want to go through all of that again.  Again, I was stuck choosing the lesser of two evils.

The gynecologist came back into the room and asked if we had decided because the anesthesiologist was on her way and if we weren’t going with the D&C then she wouldn’t bother coming.  His tone made it very clear that we were at the bottom of his priority list.  Apparently the schedule of the anesthesiologist was more important than this critical decision to have surgery or not.  I looked at my wife and then told him that I would have the surgery.

After an hour and a half wait, I was wheeled to the operating room.  The bright white lights and air of sterility greeted me, reminding me of my scrub nurse days.  All of the staff were women, which made me feel slightly more comfortable.  I walked to the operating room table and laid down as the anesthesiologist started asking me questions.  Through a veil of numbness, I felt the hustle and bustle of nurses attaching cardiac and vital signs monitoring to me.  I thought of all the times I had prepped a patient for surgery and realized how nervous they must have been, as I put a blood pressure cuff and a warm blanket over them.

I looked up at the ceiling covered with fluorescent lights, a sight that was becoming all too familiar to me, and the anesthesiologists face came into view.  Her eyes looked kind and I imagined what her face looked like underneath her mask.  She asked me if this was my first baby.  Hearing the word “baby” made me burst into tears.  Since the miscarriage everyone had referred to the “products of pregnancy”, which while medically useful, is a very dehumanizing term.  It was like everyone just wanted to pretend that my baby was never there.

I hurriedly explained through my tears that I really wanted this baby and that I was a nurse and that this was not how I ever imagined things would turn out.  The anesthesiologist wiped tears from my eyes with the flannel blanket and said that everything was going to be okay.  This happens to a lot of women.  You’ll have another baby, she told me.  I felt so ashamed of how my body had failed.

She announced that she was giving me a dose of midazolam, which I was so grateful for.  Everything got fuzzy and I felt wonderful.  All of my worries were suspended temporarily as I unknowingly drifted off…

The next thing I knew, I was flicking my eyes open in the recovery room.  The lights were dim and I felt the pressure of the cuff on my arm, as my nurse took my vital signs.  She said that my wife was waiting for me at the end of the hall.  I was so thankful to have woken up.  I felt relaxed and a little dizzy.

I dozed off and woke up to my wife coming in to the room.  I was so happy to see her face.  She read to me a little bit, as I slowly had some apple juice and the most amazing piece of toast with peanut butter on it.  Seriously, guys.  That toast was out of this world.

I walked slowly to the bathroom for the obligatory pee before I was able to go home.  I got my discharge instructions and felt like a princess as a porter wheeled me down to the front door.  I hoped that all of the kind staff I encountered was some sort of nursing karma for the compassion and care I’ve shown my patients over the years.  Either way, I was grateful to step into the sunshine and go home.

The next two days were full of sleep, tears, Netflix, cuddles and comfort food.  I was anxious about taking too much time off because I wanted to save my sick time for future fertility appointments.  I wish I could have taken more time off to really process what happened to me.

I let life whisk me away and I kind of left my emotional health in the dust.  I’m dealing with it as best I can now, with meditation and exercise.  Everyday is a little bit better, but if I’m being honest with myself I’m far from being in the clear.  I put on a smile because I’m pretty good at faking being happy, but I know deep down I have some healing to do.  I’ve been more gentle and compassionate towards myself than I ever have been in my life, which is an area in which I’ve been wanting to grow for some time.

People have said to me that everything happens for a reason and that this experience will make me a stronger person.  I’ve been told that it will happen when it’s meant to happen.  I’ve been told to focus on the positive.  I’ve been told that everything has a silver lining if you look hard enough.  But you know what?

Fuck that.

There is nothing good about my baby dying.  There is no positive thinking that will take away the pain of losing her.  I did not need this traumatic experience to become a stronger person.  I was already strong to begin with.

-K

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The Miscarriage – From Naivety to Reality: Part 1

Well, there’s no easy way to say this, so I’ll just say it.  We had a miscarriage.

I was diagnosed with a missed miscarriage at 8 weeks 5 days, and after confirming the diagnosis I had a medical abortion with misoprostol (brand name Cytotec) at 9 weeks 5 days.  After two weeks of bleeding from the medication, I started bleeding extremely heavily and was advised to go into emergency.  After some tests and an ultrasound it was determined that I had retained some products of the pregnancy and had to undergo a dilation and curettage procedure (D&C).

Needless to say, these last two weeks have been hell for me and my wife.  It’s hard to remember back to the days following that positive pregnancy test.  All of the joy and excitement we had when we found out we were pregnant is such a stark contrast to the devastation we feel now.  It feels like I was living a different life.

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I found out I was pregnant on my birthday and it was the best gift I could have received.  I could hardly believe that it had worked the first time!  It was a dream come true.  Sounds like the beginning of a picture perfect movie, right?  That’s what I thought too.

Truth be told, I actually had an inkling that I was pregnant the day before my birthday.  The two week wait was killing me and I really wanted to be prepared for the news from the fertility clinic.  At exactly two weeks, I was to go have blood work done to check my hCG levels (the pregnancy hormone) and then the fertility clinic would call me the same day with the results.  I decided to take a Clear Blue pregnancy test the night before the blood work, just to see what would happen.

I peed into a cup (much easier than trying to aim for the stick!), dipped the stick, sat on my bathroom floor, and started my timer.

The indicator window was blank for the first couple of minutes.  Of course.  It’s exactly what I thought.  It didn’t work, I’m broken, we’re gonna have to shell out another $2000 next month to do this all over again.  Ugh.  Nonetheless, I continued to stare and stare and stare at the stupid window right until my timer went off.  All of a sudden, the faintest, palest, shadow of a second blue line started to appear.  I stared at that silly pregnancy test from every angle, in every light, straining my eyes to make sure what I was seeing was correct.  I could hardly believe what was happening.

I was pregnant.

My cute Pinterest-y plans of telling my wife the good news quickly went out the window as I yelled her name from the bathroom and started freaking out.  When she came in, I was still sitting on the bathroom floor, next to my pee, waving the pregnancy test in the air like a crazy person and I kept asking her, “Is this real?!  What if this is REAL?!”.  It was all very romantic.

As an aside…who are these amazing women who set up adorable photo shoots and blindfolded taste tests to surprise their partners with their big news?!  I couldn’t imagine holding on to such exciting information long enough to plan something so delightfully elaborate.  My original plan was to give my wife a set of baby Converse shoes (so cute!) when I told her that we were pregnant (which I had wrapped and stored in my underwear drawer for the last couple months, because I’m a planner like that).  She loves Converse, it’s the only shoe she wears other than combat boots.  She even wore them at our wedding!  How cute would that have been?  I had imagined it all perfectly, and after I told her the precious news we would embrace and smile and be filled with joy.  Rainbows would shoot from the ceiling and doves would fly gracefully down from the heavens to mark our celebratory moment.

Yeah, that didn’t happen.  Like, at all.

The next day, after the blood test, I watched my phone obsessively waiting for the actual confirmation from the fertility clinic that the pregnancy test was positive.  I was secretly very excited, but I also wanted to make sure that it wasn’t a false positive.  I watched and waited, and watched and waited some more.  Unfortunately, despite leaving a voicemail for the clinic, no one got back to me with the results that day.  It was pretty frustrating, but I decided I would just take another pregnancy test (or two!) and get confirmation myself that evening.  I picked up a First Response dual pack (way better than Clear Blue, in my opinion) with a digital test and a line test.

The second I got home, my pants were off and I went straight to the bathroom with a cup.  I waited anxiously, but it didn’t take long for a very clear “Yes +” to show up on the digital strip and the brightest, clearest pink vertical lines to show up on the other strip.

Okay, I really am pregnant!!!

I could hardly contain my excitement and we immediately contacted our parents with the great news.  This was really happening.

I was just glowing for the next few days.  My heart was full and I felt incredibly blessed to have had our IUI work the first time around.  I think I was also equally shocked that it had actually worked the first time around.  I’m sure a lot of other couples weren’t so lucky.  I received a call from the clinic, that my hCG levels were excellent.  I had to go for a second set of blood work 2 days after, just to ensure that the levels were rising appropriately, as hCG should double every second day at the beginning of a pregnancy.

My second set of hCG levels were sky high and I was starting to feel all of the lovely first trimester symptoms.  My boobs were gigantic and I could smell EVERYTHING.  I felt like a superhero.  For anyone who knows me, I definitely do not need help in the bosom department, but it was nice to feel the changes in my body.  It made everything feel so real.

Around 5 weeks is when things really started to get fun.  I started having the worst morning sickness, that quickly upgraded to all day sickness.  I was exhausted and I hated all food.  Seriously.  I tried all the standard remedies for morning sickness like soda crackers and ginger ale, but nothing really helped.  I couldn’t imagine eating anything, but at the same time I was starving and having food in my stomach really settled the nausea.  As you can imagine, I was pretty miserable, but also knew that all of the symptoms were a constant reminder of the life growing inside me.

At 7 weeks and 1 day, we had our first ultrasound scheduled.  We had the familiar drive up to Saskatoon, but I was over the moon that we were about to see our little (very little) baby.  My wife and I chatted about the future and continued our plans that had been brewing for our little family since we received the news.  I was so excited to see our baby and maybe even hear a heartbeat!

In the clinic, I laid down on the table for a transvaginal ultrasound.  That early in the pregnancy, a transvaginal ultrasound is much more accurate than an abdominal ultrasound.  Within a few seconds our doctor found our little tiny baby.  He or she was really in there!  My heart just about burst with love for this tiny being that was only the size of a strawberry.  I asked if we could hear a heartbeat too, but the doctor said that she was having some difficulty finding it, but that it was probably nothing to worry about.

After the ultrasound, we had a brief consultation in her office.  Our doctor said all of the measurements looked excellent and right on track for how far along I was, but that the lack of a measurable heartbeat was “mildly concerning”.

My heart dropped.

Those were the last words we wanted to hear and though I was trying to focus on the positives, I was devastated.  What happened to our picture perfect movie?  I was supposed to see our little baby, hear their precious little heartbeat, smile loving into my wife’s eyes, glistening with tears and feel a deep sense of joy at the life being created inside me.

Instead, I felt scared and disappointed and cheated.

All of the wind was taken from my sails and we had a pretty quiet drive back home.  We had another ultrasound booked in a week, to confirm that everything was okay.  It was slightly early to hear a heartbeat, so I clung on to the fact that the measurements were good and we saw little flutters of movement on the ultrasound screen.  Maybe everything will be okay after all.

With the Easter weekend quickly approaching, we decided that we would go ahead with our plans to tell our family.  We don’t see everyone back home very often and we really wanted the chance to tell our loved ones in person.  Even though I knew miscarriage was a possibility, I just couldn’t believe that it would ever happen to me.

Miscarriage is one of those things that happens to other women.  Friends of friends.  The fertility nurse who did my IUI just had to look at me and I got pregnant.  Clearly, my body was ready to make a baby.  I wasn’t in a high risk group.  I was only 29 years old.  I had taken my pre-natal vitamin for three months before trying.  I slept well, exercised, went to yoga regularly.  We had minimal processed foods, tons of fruits and veggies.  I had cut out caffeine and alcohol long before our first IUI.  I had switched all of my cleaning and personal products to brands that did not contain phthalates and all of those other nasty chemicals that aren’t recommended during pregnancy.  I made my own deodorant, for god’s sake.

I had done everything right.  But I guess it wasn’t enough.

On Easter Monday, we drove back from Edmonton and stopped in Saskatoon for our follow-up ultrasound.  We were cautiously optimistic.

I laid down on the table for the trans-vaginal ultrasound and immediately my eyes were glued to the ultrasound screen for any sign of our little baby.  I still felt so very pregnant.  The doctor scanned and scanned and kept doing sweeps of my uterus.  The doctor was very quiet.  Deep down I knew that something was wrong. I felt my wife’s hand on my shoulder.

“I’m sorry.  I don’t see anything.”

“What do you mean?” I said, knowing what she meant, but refusing to believe it.

“I just don’t see anything.  Last time there was a fetal pole and now I can’t see anything.  I’m so sorry.”

She removed the ultrasound wand and I sat up.  She said she would meet us in her office down the hall.  I turned to my wife and said, “I guess this is why people don’t tell early” and burst into tears.

I felt ill. I could hear the blood pumping through my ears.  My throat hurt so much from holding back a flood of tears.  I just wanted to break down, but there were other patients around in the office, so I tried to keep my composure.

As we sat down in the doctor’s office, the first thing she said was that it wasn’t my fault.  That should have made me feel better, but it didn’t.  I was devastated.  I felt like everything was my fault.  How could it not be?

She presented our options.  I felt bad for her.  I’m sure this was one of the worst parts of her job.  I was only half listening, trying to process how our lives and future plans had just shattered all around us.  In that moment, I couldn’t imagine any sort of abortion procedure.  I said we would just wait for the miscarriage to happen naturally.  She said it may take a week or two.  I couldn’t think.

My wife drove home and I cried.  I couldn’t think of what to do except to start telling my close friends and family that we had miscarried.  I couldn’t speak.  I didn’t want to call anyone or answer the phone.  I just texted through my tears.

I miscarried.

I found out I had a miscarriage.

I just found out I miscarried.

Every time I typed that word, it looked more strange, as words do when you stare at them too long.  I think it helped me accept what was happening, in some small way.  With every person I delivered the news to, I felt another piece of my heart break.

I felt a deep shame and embarrassment.  Like I had let everyone down.  Everyone was so excited for us.  We had a trunk full of baby gifts already.  A bassinet, blankets, little toys, a diaper bag.  I felt stupid for having those things.  How foolish to start planning so early, when I knew full well this was a possibility.  I still haven’t taken those things out of my trunk.  I can’t.

I immediately understood why people choose not to tell anyone they are pregnant until the first trimester is over.  In that moment, I wished we had done the same.

When we finally got home, my wife and I collapsed onto our bed a cried together for a while.  I was upset that she hadn’t shown much emotion, as she was trying to hold it together for us, but as soon as she started crying I wished she would stop.  Her tears made this nightmare real.  Her sadness broke my heart almost as much as losing our baby did.  We held each other for a while and eventually the tears stopped.

__________

The following week was a confusing mess of hope and devastation.  As I regained my critical thinking and started to adjust to our new circumstances, I explored the options for handling the miscarriage.  My initial idea of allowing the miscarriage to happen naturally, was seeming more traumatic by the day.  With my hCG levels as high as they were and the pregnancy as far along as it was, it could take weeks to miscarry naturally.  I’m pretty tough, but I’m not that tough.  I couldn’t imagine dealing with all the pregnancy symptoms (which were still in full force at this time) and just waiting day after day for bleeding to start.

My other options were to take a pill to induce the miscarriage or to elect for a surgical dilation and curettage procedure where they remove the pregnancy products and lining of the uterus.  Both options sounded awful, but not as awful as waiting for endless weeks for the miscarriage to happen naturally.

In my next post, I will write about the next steps we took with our miscarriage.  There are no easy decisions and no “one size fits all” approach when it comes to a miscarriage.  I will go into detail about how we came to our decision and the resulting events, but I don’t think I can handle much more crying today.

My hope is that my writing here may provide some comfort for women and couples who are dealing with the same experience.  I personally found a lot of comfort in reading the various miscarriage discussion pages and threads out there, so I hope to return the favour.  I have found that it helps knowing that you are not alone.

I also hope that reading my experiences here will be a reminder that although pregnancy can be a very joyous time, it can also be very traumatic.  I think it’s important to remember that everyone has a story.

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This was our first ultrasound.  The little blip between the green crosses was our baby at 7 weeks 1 day.  At the appointment, I remember making the ultrasound joke from that Friend’s episode, when Rachel couldn’t see her baby on the ultrasound screen.  But I definitely saw her.  And I loved her.  And I was already imagining a life with her.  I know she was very small and brand new, but for a few weeks I was her mom.

-K

 

 

 

The Pregnancy Test Wait – The Longest 14 Days Ever

I took it easy for the first couple of days after our insemination.  I really wasn’t sure how to feel.  Part of me wanted to be so sure that it had worked and that positive thinking could only increase my chances of pregnancy.  Another part of me wanted to assume that it had not worked and start getting ready for my next cycle to try again, to avoid a massive disappointment.  To the world, I was calm and cautious.  I was constantly telling my wife that it probably didn’t work, but really, truly, deep down I knew I was fooling myself and that every fibre of my being wanted to believe that it had worked.  It was a confusing time, to say the least.

Every time I was hungry or tired, I would think that it was an early sign of pregnancy and get a boost of excitement and joy.  And then I would immediately get a wave of sadness because I knew I was just trying to convince myself desperately that it had worked.  And then the next minute, I was telling myself that it HAD to have worked, I was so healthy and everything was so perfectly timed.  One of those 40 million sperm just had to have found their way around my uterus.  They just had to.  I wanted to try and get off the fertility emotional roller coaster as much as possible, but unfortunately it was pretty unavoidable.

Distraction became an excellent tool for me during these two weeks, and I focussed on the things that I could control: taking my pre-natal vitamins, eating healthily, going to yoga and trying to decrease the harmful chemicals in my environment in preparation for a potential pregnancy.

I had been taking my pre-natal vitamin (along with vitamin D, vitamin C, magnesium and evening primrose)  pretty religiously since Christmas, as I have read that it’s a lot more effective if you start before you’re actually pregnant.  A baby develops it’s neural tube during the first four weeks of pregnancy!  It is so amazing to me that something so critical is being formed so early in life..  This little ball of cells that is the size of a poppy seed is just laying the foundation for a human brain and spinal cord.  No big deal.

In addition to my pre-natal vitamin, I also decided to adopt a plant-based diet for my pregnancy.  I have been vegetarian for a long time now, but I have been noticing sensitivities to dairy products and I have been hearing that dairy isn’t all that great for us in large quantities anyway.  Of course, diet is something that is very personal, so I’m not advocating one way or the other, but for me switching to a plant-based diet just made sense.  It’s made me add in even more fruit and veggie options and I feel really great.  We’ll see how everything works out with potential pregnancy cravings and such, but pickles are vegan and I’ve found some really amazing vegan ice cream substitutions already, so I think I’m set.

Yoga has been an amazing addition to my life.  I have practiced on and off for many years now and getting back into it recently, has been awesome.  I feel more calm and grounded, not to mention I have killer triceps (well, I think so anyway) from all of those downward facing dogs I have to do.  I am aiming to stay as active as possible throughout my pregnancy, not only for myself, but for the baby as well.  There’s lots of great evidence that exercising while pregnant is not only good for moms, but it’s good for babies as well!

The number of crazy chemicals in our environment is a bit scary.  I hate to use that general term (and I am also aware of the naturalistic fallacy when it comes to “natural”and “organic” products), because there are a lot of chemicals that are completely safe and very useful.  But one need look no further than the BPA madness from a few years ago to see that there are not a lot of safety regulations in place for many home and personal products.  Without being too obsessive (which is definitely easy to do when you start reading product labels) I started to cut down on the obviously harmful cleaning and personal products in my life.  We started purchasing unscented products and made more use of our Norwex cleaning cloths that just use water to clean.  I ditched my deodorant and found an amazing homemade recipe (I told you I’m a huge hippy!) that actually works very well (full disclosure: I sweat a lot, so I can tell you that with a high degree of confidence).  I also have only been purchasing shampoos, lotions and make-up products that are paraben and phthalate free.  In general, as I run out of a product, I just don’t replace it with anything.  I have cut down all of my personal products quite significantly (my wife can gladly attest to this) and just try to use less of everything!  I know that I can’t get rid of every harmful chemical in my environment, but I figure it’s my due diligence to make sure everything is a safe as possible.

I’ve been listening to a great pregnancy and birth podcast (check it out here, if you’re interested) lately that had an expert in pre-natal psychology on for an interview.  Yep, pre-natal psychology.  As in, the psychology of babies still in the womb.  Well, that totally blew my mind.  Of course, I know that babies had brains and some level of consciousness before they emerge into this crazy world, but I never thought that there was an entire field of psychology dedicated to it!  This expert brought up the very interesting point that parenting really starts from the moment you’re pregnant.  He spoke about how important it is to sing to and talk to your baby in the womb, and even mentioned some “games” that you can play with baby when they start really being active.  This really resonated with me and reinforced my efforts to foster a happy, healthy body for my future baby to share.  It was so motivating to think in a small way I was already a mama!  Well, maybe a mama.  I started brainstorming ideas for how to connect with my child before he or she was born and started daydreaming about my wife and I singing our baby to sleep every night.

Aaaand, just like that I was back on the fertility roller coaster.  The two weeks just dragged on and on.  I mentally crossed off each day, counting down until I could go for my blood test and find out if our dream was coming true, or if I should start getting ready for my next cycle.

-K

P.S.-I do not receive any compensation for the above recommendations (let’s face it, I’m not that cool), they are just experiences that I wanted to share from my heart to yours! 🙂

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The Appointment – What it Feels Like to be Inseminated

I woke up the day of our big appointment full of excitement, but also full of disbelief that we were actually going to do this.  Today.  Like, for real.  At the same time, I was hesitant to let myself get too excited, so I brushed off those feelings and tried to just focus on getting ready for our big trip.

I had been pretty calm, cool and collected (maybe my wife’s personality is rubbing off on me) for the past couple of days, and my current excitement was definitely at odds with my desire to be calm and level-headed about the whole thing.  Over the past few days I had received so many well wishes and questions about how I was doing, and I was never really sure how to respond.  I suppose most people would have expected me to be incredibly excited, but I was feeling more reserved and almost apprehensive about the situation because the outcome was so variable.  Believe it or not, IUI only has about a 20% chance of working the first try (which is about the same success rate as the old fashioned way), which to me meant that there was an 80% chance that it wouldn’t work.  I saw this appointment as yet another stepping stone in our journey.  A stepping stone that could easily disappear or just continue to move further and further away, if things didn’t go according to our plan.

I know, I’m a big downer.  But if you prepare for the worst, then nothing can disappoint you, right?

We jumped into the car and got my last coffee from Starbucks (a delicious latte with almond milk!) and made the familiar 2 hour trip to Saskatoon.  My feelings cycled between nervousness and excitement during the whole trip, as I tried to wrap my mind around what was happening.  I could tell my wife was also excited and nervous, because she was acting just a bit sillier than normal.  Upon arrival at the clinic, we paid our $350 clinic fee (cha ching!) and our $100 storage/admin fee (cha ching!) and sat in the waiting room.  The nurse let us know that our sperm was being thawed, which would take about half an hour, and that we would be taken into the office shortly.  Tired from my erratic feelings, I rested my head on my wife’s shoulder and watched some TV while we waited.

As I was just getting into “The View”, the woman sitting next to us in the waiting room started talking to us.  She was very pleasant, about our age, and just casually offered us her brother’s sperm.  Yep, you read that right.

Seriously.  I could not make this stuff up.

We were initially a little taken aback (you know, with her being a complete stranger and all), but to be fair, it’s not the first time that we have received an offer like that.  When some of our male friends found out we were trying, we got offered sperm by the bucketful (usually as a joke, but not all the time).  But we’ve never received an offer from someone we didn’t even know!  She was very friendly (if clearly a little nosey) and also prefaced her offer by saying she could just mind her own business, if we found her request insulting in some way.  We just chuckled, thanked her sincerely for her offer and let her know we had already picked a donor.  We continued a bit of polite conversation and my wife mused on how that conversation with her brother might go.

Some people may have found this offer offensive, but I actually found it rather encouraging.  I’m sure it took a lot of courage for her to even strike up a conversation with us, let alone make the offer that she did.  So to us, a total stranger offering to help us (a clearly gay couple) start a family was a beautiful sign of support and compassion.  It really warmed my ovaries to see such a genuine gesture from a complete stranger.

We were called into the office by a nurse, who instructed me to take off my clothes from the waist down and lay on the table.  As I was getting ready, my anxiety and excitement came flooding through my calm and collected barricade and everything started to feel very real .  What if this actually works?!  What if it doesn’t work?

The nurse came back into the room and started up the pleasant type of conversation that medical professionals start when they are about to touch you in a very private area.  She was asking us about our jobs, as she told me to scooch my butt to the edge of the bed and put my legs up into the stirrups (a la Pap test, for those familiar with that lovely procedure).  She continued making small talk as she drew the sperm sample up into a pipette with a long cannula (thin tube) attached to it.  She warmed the speculum under the tap, lubed it up and let me know she was going to insert it.  Seeing my discomfort, my wife came to my side and put her hand on my shoulder.  I heard the familiar clicking of the speculum as she expanded it to access my cervix.  She then inserted the cannula into my uterus, squeezed in the sperm, removed the speculum and we were done.

That’s it?!  We drove 2 hours for that?!  As my sister-in-law so eloquently put it, “What were you expecting?  Streamers!?”

The nurse told me to lay flat for 15 minutes, then I could put my clothes on and we were free to go.  Our fertility doctor popped in a couple of minutes later and let us know that the thaw went well, there were 40 million sperm in the sample and that everything looked great.  It was hard to believe there were 40 million of those little swimmers, just paddling their way through my uterus.  Surely that would be enough.  While we waited, my wife and I debated whether we should have a little nookie.  We had heard anecdotally that orgasm can really help draw the sperm up into the uterus and fallopian tubes, and we wanted to increase our chances of conceiving as much as possible.  It appears that the research is split on whether it actually increases pregnancy rates or not, but it can’t hurt, right?  Anyway, I was far too shy, so unfortunately you guys won’t get to hear the titillating details of a medical office romp.  According to this interesting article, there is a little bit of research to support higher sperm retention and motility towards the ovary following female orgasm.  If there is a next time, we may have to give it a try…for scientific purposes of course.

I was given a requisition for blood work to check my hCG levels two weeks from that day.  The lab would deliver the results that same day to the clinic, and the clinic would then call me with some very good news or some very disappointing news.  If it was good news, then I would go for one more blood test 2-4 days after, just to ensure hCG levels were progressing normally.  And if it was the news I was dreading, I would just call them on day 1 of my cycle and start this whole process all over again.

I put my clothes back on and waddled my way carefully out of the clinic down to the car.  I know it’s silly, but I really felt like the sperm were going to fall right out!  We spent good money on those babies, so I wasn’t about to let them get away!  I spent the next few hours moving cautiously, raising my hips when I could and crossing my legs with much more force than was necessary.  My wife just laughed at me, and rightly so, I’m sure I looked ridiculous.  When we got home, we relaxed in bed (with my hips up on a pillow, of course) and cheered on my left ovary to do it’s thing.

Over the next few days, I was hyper-aware of anything going on “down there”.  Any little flutter in my lower abdomen or tiny cramp convinced me that it was the beginnings of a baby…until I realized it was actually just gas.  I knew that it was too early for anything to really be happening, but my anticipation really got the better of me.  I was torn between wanting this so badly, and knowing that it probably wasn’t going to work the first round.

The next step was just to wait.  We had to wait 14 long, grueling days until we could find out if we had made a baby or not.  We’re pretty good at waiting by now, but it felt like there was a constant battle between my mind and my heart, optimism and negativity, hope and reality.  During the next couple of weeks, I found myself frequently putting my hands on my lower belly and just sending as much love as I could to everything that was going on down there, hoping that it would be enough.

-K

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The First Day 1 – Follicular Tracking and an hCG Injection

After putting in our order for sperm (which ended up being $1667.75 for two vials, by the way!), the next step was just to wait!  Unfortunately, we had a little longer to wait that we would have liked, as we went to Mexico over the Christmas holidays for our honeymoon.  Due to the risk of Zika virus, our doctor recommended we wait until 2 months after our return date to try to get pregnant, just in case.  That was a little bit discouraging, as we had already waited three months for the consult and have been wanting to have a family basically forever.  But, better safe than sorry, I suppose.  So, by my calculations (I had been tracking my cycle for the last 5 months) we could “start trying” the first week in March.

This gave me quite a bit of time (or at least it felt that way) to get everything ready.  And by everything, I mean my body.  I began a pretty rigorous schedule of yoga, weight training and healthy eating, to try and give us the best chances of conceiving.  I figured, if I’m healthy and my hormones are normal and my cycle is consistent, how could IUI not work the first time, right?  I wanted to use this time to really get in the mind frame of having a baby, and also try to set myself up for the best pregnancy possible.  Have I mentioned that I’m a planner?  At the same time, I was trying to live in the present and not get ahead of myself with the endless questions that lurked in the corners of my mind.  What if it doesn’t work the first time?  Or the second time? What if it never works?  What if my body isn’t good enough?

Not wanting to go down that road (because stress definitely does not help increase fertility), I buried myself in reading pregnancy books and working out.  I tried to look at this extra waiting time as a gift instead of a drawback.

The next step in the IUI process was to call the fertility clinic on day 1 of my cycle (the first day of my period), upon which they would give me an ultrasound appointment for follicle tracking.  As a woman who normally dreads her period, I was so excited when Aunt Flo came to visit!  I nervously called the nurses at the fertility clinic and they gave me my first ultrasound appointment scheduled for day 10 of my cycle.  Yay!  The purpose of these ultrasounds is to see if you have a follicle (which is the part of the ovary that holds an egg) that is developing appropriately.  This allows the IUI procedure to be scheduled naturally and very accurately.  No point in tossing a bunch of sperm in my uterus, if there is no egg to be seen, amirite?

On day 10 of my cycle, I showed up at the ultrasound clinic very early and very excited to start what felt like the first real step towards IUI!  Once again, it was my favourite transvaginal ultrasound.  The tech was very nice and had me insert the ultrasound wand myself and was very discrete about everything, but it was not the most wonderful start to a day.

Later that day, I received a call from the clinic which I anxiously answered and heard the rivetting news that I would need yet another ultrasound.  To be honest, I wasn’t completely surprised because I do have a longer than normal cycle, about 30-33 days.  The first ultrasound had not shown enough follicular development, so I was scheduled to come back in on Monday after the weekend.

Apparently, my left ovary had gotten it’s crap together over the weekend because after my ultrasound on Monday I had a date for my IUI appointment!  March 2, 2017.  My left ovary had a follicle that was developing nicely.  I was so nervous when I got the call from the clinic and I just repeated what the nurse said to me a million times to make sure I heard it correctly.  I probably sounded like a rambling idiot, but I just couldn’t believe we actually had a date!  I might be pregnant in a couple of weeks!!!  Tears welled up in my eyes and I called my wife right away to tell her the news.  If a phone call for an appointment can make me cry, can you imagine the effect pregnancy hormones will have on me?  I’m sure lucky my wife thinks I’m cute.

The final step before the IUI appointment was not something I was particularly excited about: an injection of hCG (human chorionic gonadotropin).  This injection induces ovulation within 24-36 hours, so the idea is that you take it 36 hours before the insemination so that the sperm is waiting in the fallopian tubes for the egg to arrive.  An egg can survive for about 24-48 hours, whereas sperm can live up to 5 days!  So gross, right?  I like to think of hCG as a little kick for the egg to jump out of it’s follicular home and find a sperm friend!

I can’t even count the number of injections I’ve given to patients over the years, but I have never injected myself with anything and it was kind of freaking me out.  I went to the pharmacy on my way home from work and picked up the medication.  The brand name was Ovidrel and it was $96 for one dose (cha ching!).  For that price, this stuff had better work.  I was pleasantly surprised to find it in a pre-filled syringe pen, which meant I didn’t have to use my cool nursing skills drawing it out of a multi-dose vial.  The injection was to be done at 10:30pm on Tuesday, as our IUI appointment was for 10:30 am on Thursday.  The Ovidrel is supposed to induce ovulation within 24-36 hours, which is why the IUI procedure is scheduled for 36 hours after the injection.  My wife and I are basically grandmas already, because 10:30 pm is waaay past our bedtime, but of course we made an exception for something so important.

At 10:25, I began preparing the syringe, which just required a little flicking and clicking of the dial to ensure the correct dosage.  It was a subcutaneous injection (which means it goes below the skin, in some fatty tissue) and I didn’t have any trouble finding a pudgy bit on my tummy.  I cleansed the area with an alcohol swab, took a deep breath and plunged the needle in.  Seeing how freaked out I was, my sweet wife offered to give me the injection for me, but I figured it might hurt less if I did it myself.  I slowly injected the Ovidrel and held the needle in place for a full 10 seconds after finishing, just to make sure the entire dose was delivered.  It wasn’t nearly as bad as I thought it was going to be, thank goodness, but it wasn’t high up on my list of things to do on a Tuesday night.

On top of all of this, I had to rearrange my work schedule around all of these various appointments, which again isn’t a big deal in the grand scheme of things, but also increases the stress of the process.  I’m lucky that I have a decently flexible job with vacation days and a supportive manager and staff, otherwise I’m not sure how we would have been able to do it.  Our big appointment on March 2, meant we both had to take an entire day off of work, as the clinic is 2 hours away.  But we really didn’t care too much about that, as it meant we were one more little step closer to starting a family.

-K

P.S. – If you’re enjoying reading our journey so far, you should follow me  because it’s gonna get juicy soon!  If you scroll up, you should see a box show up in the bottom right hand corner where you can enter your email address.  Thanks for the support!   ♥

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The Pick – Finding Our Dream Sperm Donor

Now that we knew the direction we were headed, it was time for the fun part: sperm shopping!  To be honest, we weren’t really sure what to expect from the whole experience.  Was it just like a big Sears catalog or something?

Actually, yeah, that’s pretty much exactly what it’s like.

There were three sperm banks that were recommended to us by our fertility doctor: Repromed, Fairfax and Outreach Health Services.  Our doctor had said that all the sperm banks have fairly comparable prices (higher prices were for extended genetic testing and “open” donors who were willing to be contacted in the future) and the quality and testing of the sperm is all federally regulated. So, we just started browsing through the different catalogs to see what exactly this process was about.  Everyone I talk to about this always wants to know: what do you get to know about the donors?  Are there pictures?!

You get to know pretty much everything you could know about a person, without actually meeting them.  And yes, we get to see some pictures too!

The Repromed sperm bank, for example, shows the race, maternal and paternal ethnic ancestry, blood type, hair colour, eye colour, skin tone, height, weight, bone size, education, occupation, interests, CMV status, if the donor is open to future contact (or not) and donor portfolio (which includes more details on family history, personality and some pictures of the donor’s eyes/ears/hair/lips/body type and a blurred out photo of the donor, to protect privacy).  And then, if that’s not enough, there is the option to upgrade (for an extra fee, of course) to see extended donor profiles that include a temperament report, donor essay explaining why they wanted to donate, audio recording of an interview, donor likeness photographs and staff impressions.  The other sperm banks had a similar set-up with the bulk of the donor information available on their website (sometimes you needed to create a login to view the profiles) and then additional information available at an extra cost.  The American sperm banks even let us see pictures of the donor from childhood into adulthood!  It was just like Facebook!

We began this whole process knowing very generally what we were looking for in a donor: some post-secondary education (both my wife and I have a couple of degrees and we value education very highly), overall good health, good family history, creative and somewhat talented in the arts (both of us love music!), intelligent and active.  So, basically the perfect man.  Should be easy enough to find, right?

I sometimes get overwhelmed picking a movie on Netflix (that’s now my wife’s job, thank goodness), so to preserve my sanity we started with some criteria that were easy to narrow down.  After coming up with a “short list” of donors, we could then move on to the other aspects of the donor.  As we quickly discovered, it didn’t take much time to get bogged down in the various personality traits and specifics of each donor.  To us, the easiest criteria to narrow down was the Rh factor and CMV status (more on this below!), since they were a simple “positive” or “negative”.  Making a baby never sounded so romantic, right?  Rh and CMV aren’t often considered when a straight couple decides to start trying to have a baby.  In fact, I know lots of people that don’t even know their own blood type, let alone the blood type of their partner that they are trying to get pregnant with!  At around $800 (or more) a pop, we figured we would go for perfection and pick our dream donor.

Rh factor (short for “Rhesus factor”) is a protein present on the surface of red blood cells.  This protein can be present or absent in people, which is where the “positive” and “negative” comes from when talking about blood type.  I have O negative blood, which means I have O type blood and no Rh factor present on my red blood cells.  According to Canadian Blood Services, only about 15% of Canadians are Rh negative (with similar statistics around the world).  This means that our choices for an Rh negative donor will be quite significantly limited.

So, what’s the big deal?  Why does that matter when picking a sperm donor?

Well, that’s where it gets a bit complicated.  Obviously, an Rh positive and Rh negative couple can still have a baby (otherwise our population would be a whole lot smaller!), but the complications come when the baby is Rh positive and the mother is Rh negative.  This is called an Rh incompatibility.  If the mother is exposed to the fetal blood (normally the placenta prevents mixing of maternal and fetal blood) through trauma, amniocentesis or bleeding during pregnancy, then the mother will create Rh antibodies.  These antibodies are designed to damage Rh proteins and can cause problems in future pregnancies, if future babies are also Rh positive.  The maternal antibodies can damage the baby’s red blood cells and result in severe anemia (very low hemoglobin).  Confused yet?  If you’re nerdy like me, this is a nice FAQ page from the American College of Obstetricians and  Gynecologists about Rh incompatibility.  There is treatment in the form of an injection that mothers can receive to prevent formation of these Rh antibodies that is given in the seventh month of pregnancy and after delivery.  Our fertility doctor told us that it’s not the end of the world if our dream donor happens to be Rh positive, but it would just mean having those injections and slightly higher risk than finding an Rh negative donor.

I promise we’ll stop with the biology lesson soon, but one more thing!  CMV status.  Cytomegalovirus (CMV) is a fairly common virus that does not present with symptoms in people with healthy immune systems.  It can be problematic in people with weakened immune systems, as well as babies who are infected before they are born (this is called congenital CMV).  Congenital CMV can cause premature birth, lung/liver/spleen problems, small size at birth, among other symptoms.  There is a very, very low chance of transmitting CMV through a sperm sample, but the risk is not zero.  Therefore, it is worth considering when selecting a donor.

Now that we had our short list of Rh negative and CMV negative donors, we narrowed down based on our other criteria.  We were left with about 5 donors.  All had good education, good family history and positive personality traits like confidence and creativity.  On paper, they were all perfect men with glowing DNA.  So, where do we go from here?

After some discussion, we decided that we wanted to find a donor that was very similar to my wife.  It was important to both of us that she feel connected with the baby, so finding a donor that shared some of her key personality traits and interests seemed like a good place to start.  My wife is delightfully dorky (in a Battlestar Galactica kind of way) and she is very talented with all things math related.  Her intelligence makes me swoon and her nerdy comments make me roll my eyes on a regular basis.  Picking a donor that was similar to her, would be as close as we could get to have a baby that shared both of our DNA.

With this in mind, we narrowed our short list down to our dream donor.  He had a bachelor’s degree and works with computers (nerd factor: check!), blonde hair and blue eyes (just like my wife!), he enjoys theatre and acting (artsy factor: check!) and was open to the child contacting him in the future.  On that note, we had some debate around whether we wanted an open donor or not.  I felt very strongly that we should give our child the oppourtunity to reach out and contact him in the future.  We can’t predict what will be important to our child, and I wouldn’t want to regret having closed that door forever.

At the end of the weekend (we spent two days making our decision) we came to the realization that as much as we try and control the variables, the nature of creating a child is that DNA is all random anyway!  We can’t predict if our kid is going to end up with my brown eyes or our donor’s blue eyes.  But any way our child turns out, he or she will be so, so loved.  And that is what’s really important.

-K

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The Decision – Known Donor versus Anonymous Donor

My head was still spinning from the consultation that we had that morning, as my wife and I settled into bed (where we do most of our important things) and cracked open our respective laptops.  For the next few hours we researched and read and hypothesized and discussed and freaked out (well, I did anyway, thank goodness my other half is always cool as a cucumber) about how we were going to get a baby in my belly.

Now, we didn’t want to ignore the recommendation of our fertility doctor, but we did want to see what other options were out there before deciding to spend $2000 a month on IUI treatments (cha ching!).  Also, being the modern day hippy that I am, conceiving in a sterile clinic environment seemed very…sterile.  Not really a thought that gets my uterus going, ya know?  We had always jokingly tossed around the idea of finding a friend and just getting them to, you know…ahem…and then letting a turkey baster do the rest!  We weren’t really sure about the viability of this option (or why everyone insists on using a turkey baster), given the obvious legal issues, but we still wanted to explore options fully before we committed.

It seemed to us that we had two options to get pregnant: (1) a known sperm donor (and turkey baster); or (2) IUI with an anonymous sperm donor at the clinic.

Now, before we dive into the legalities of known donors and turkey basters (seriously, has anyone ever actually used a turkey baster?!), there is a really important question to be answered: how do you tactfully ask for a dude’s sperm?  Well, if you’re like me, you just have a couple of beers and bring it up jokingly in a conversation with your guy of choice and just see what happens!  That way if things get awkward you can just laugh it off and not make your friendship weird forever.  Chandler and Monica had a slightly different approach to this situation.  Despite my lack of conversational grace, we did receive a couple of offers from male friends who were happy to help us become parents.  This made us really hopeful that we could make this more natural and economical method of baby-making work for us.  That was until we saw the other side of having a known donor.

We started delving more into this topic by simply Googling “known sperm donor” and every variation of that phrase that we could think of.  Surely lots of lesbian couples before us have considered this option and there would be plenty of resources for us to follow in their footsteps, right?

Wrong.

The lack of information out there about known sperm donor law was pretty disappointing.  Actually, the deeper we searched, the less we felt sure of anything regarding both LGBT and fertility law.  Our main concerns were: (1) ensuring equal parental rights for my wife; and (2) ensuring that the known donor could not try to claim parentage in the future.  As we sifted through news stories and blogs, we found quite a few alarming stories of lesbian couples who had their known donor change their mind and try to claim parentage of the child after the birth.  I couldn’t imagine a more devastating situation.  Unfortunately, in most of the circumstances, these couples had not done their due diligence and had a known donor agreement (here is an example contract) in place and also had not consulted a lawyer.  My heart broke for these families who had trusted a friend, only to be betrayed in the worst way.  Clearly, the birth of a child can have a profound and unpredictable impact on everyone involved and not always for the better.

So, as long as we had a known donor contract and a legal consultation, we were good to go, right?

Wrong again.

Apparently, there is very little legal precedent for cases of lesbian couples using known sperm donors in Canada, though there are a few cases that have come up in the States.  That means that even with the legalities in place, it still may be possible for a known donor to try and claim parentage.  Regulations on parentage are by province.  Alberta and BC have made some laws that prevent sperm donors from trying to be parents, but the rest of the country is really falling behind in LGBT parentage legislation (this is a decent article from June 2016 with more details).  Ontario updated legislation (for the first time since 1978!) in November of 2016, to be enforced starting January 1, 2017 that ensures equal parentage rights for LGBTQ2+ and straight couples alike (a quick overview on this law is here).  I guess late progress is better than no progress?  Regardless, we weren’t confident in our rights here in Saskatchewan and didn’t really know where to go to clarify the law.  We did email a fertility lawyer in Regina, but never got a response.

A billion articles and websites later, our eyes slowly began to glaze over and our hearts sank a little as we realized that either way we went, this was not going to be a simple process.  From what we could surmise from the piecemeal information on parental rights for LGBT couples in Canada, it appeared that we would need a known sperm donor contract drawn up with a fertility lawyer.  Following birth, my wife would need to declare parentage either through a legal declaration or a second parent adoption.  Both of these options would come with decent lawyer’s fees, though we weren’t sure how much.  Given the lack of precedent, there was still a slim chance that there could be legal complications down the road.  We really did not want to take that chance, never mind that the lawyers fees could potentially be far more than the price of IUI.

Whew…ya’ll still with me here?

That leaves us with the intrauterine insemination procedure recommended by the fertility clinic.  The pros of this option include: full parental rights (with no chance of the donor changing his mind and trying to claim parental rights of our child in the future) and safe sperm that had been washed of any STIs and genetically tested.   An added bonus of this option was also the opportunity to choose exactly the donor we wanted, from blood type to eye colour to whether or not the donor allowed contact with children in the future.  The cons of this option include: conceiving in a clinic environment, paying approximately $2000 per cycle (cha ching!) and having to do a bunch of travelling and taking time off work for various appointments (which is peanuts in the grand scheme of things, but still not ideal for us).  Overall, this was the most straight forward and legal option.  We seemed to be leaning in this direction, but our only hesitation was the price and inconvenience.  We were hoping that the cost would be a bit lower, or that there may be a home option.  Turns out there is an at-home IUI option (through the Repromed Sperm Bank…more on this later!), but it’s twice as expensive as in-clinic IUI because you have to use two vials of sperm each cycle!  Ain’t nobody got money for that…well, at least we don’t.

Needless to say, we were overwhelmed at the reality of the situation.  The other day, I had a patient ask if I had children and I told him cheerfully that I didn’t have kids yet, but we were planning to have one soon.  He told me that trying was the fun part.  If only he knew.

After watching too many episodes of Friends and eating some pizza in bed, we finally made our decision: we were going to go the IUI route.

This option afforded us the most security and parental rights, which was very important to us.  It was a relief to finally have decided that going through the fertility clinic would be the best option for us.  I think every couple is unique in what is important to them, and for us the biggest deciding factor was guaranteeing our parental rights and ensuring the safety of the sperm sample.  Fortunately for us, we have been saving for a couple of years knowing that we weren’t going to be able to have babies the “old fashioned way”, so the cost is not as big of a burden as it may be for other couples.  That being said, we don’t have an endless supply of cash, so if IUI doesn’t work within a few cycles then we may be back to the drawing board again.

Now on to the next step: picking a sperm donor.

As a side note, I could not imagine navigating this process with anyone other than my lovely wife.  She makes me laugh and reminds me to not take anything in life too seriously.  I’m so lucky that I will get to raise a child with this woman.

-K

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