Post-Op Report

Last time you heard from Breanne, we were on our way to Memphis for an unexpected surgery last week.  As my mother-in-law reminds us, “Y’all can’t do anything easy.” So after work last Wednesday, the “crew” (Breanne, her mom Connie, her sister Caitlin, and me) loaded up the car and headed North.  Connie wanted to come along because her daughter was going under anesthesia. Understandable. Caitlin…well…she said she was just there for the barbecue. As we headed up I-55, Breanne pulled the surgery card and convinced us to make an impromptu trip to IKEA.  Sorry, Cait, but the barbecue would have to wait.

Let me preface this by saying that none of us had ever been to an IKEA, so when we pulled into a parking lot that reminded me of Wal-Mart on steroids, I knew I was in trouble.  The next hour and a half were a blur, but I have to admit – IKEA was pretty impressive.  And Breanne was right at home.  I have a feeling we may be taking a U-Haul with us to Memphis when we come back up for the next transfer.  After a quick stop at Central BBQ, we finally made it to the hotel.  Then, I had to turn around and go get some nail polish remover from Target.  Breanne said she didn’t need nail polish on in case the doctor needed to check her circulation by pressing on her fingernails or something.  Even though I was convinced this was something my hypochondriac wife picked up on Grey’s Anatomy, I made the late-night trip to Target trying to look as unmurdery as possible as I paced through the nail care section.

We arrived at the surgery center early Thursday morning. After prepping Breanne for surgery, Dr. Memphis called me in to see her one more time before heading to the operating room and to discuss the procedure with us.  In short, Doc was going to perform a laparoscopy to remove the two cysts seen on her right ovary at her ultrasound the week before and burn off any endometriosis tissue that had appeared since her last surgery in 2015.  Then, he would do a hysteroscopy to remove the mass in her uterus, which he figured was a blood clot or leftover products of conception.  He then took the time to discuss with us our next transfer, showing us pictures of our frozen embryos. Every visit with our doctor reminds us that we made the right call by coming to Memphis. He’s always so straight forward and open with us.  Once we finished our talk with the doctor, she gave me an awkward “we don’t kiss in public” peck on the lips, and they wheeled her off.

About an hour and a half later, we got the call that the procedure was a success! Evidently her two nasty cysts had resolved themselves, so no need to remove them.  The doctor also reported minimal endometriosis and only had to burn off a few new spots. More great news! It gets better.  The mass in her uterus was leftover products of conception, which he easily removed with no major bleeding.  Now all we had to do was wait for Breanne to pee before he would discharge her. Or so we thought.

As she made her second attempt to use the bathroom, Breanne noticed a hard knot forming under one of her incisions.  The doctor was worried she might be bleeding into her abdomen. Again, “Y’all can’t do anything easy.” They rushed her upstairs for an ultrasound.  If it was just under the skin, it would probably resolve itself, but if it was leaking into her abdomen, another surgery would be necessary. Son a b*****.

On the elevator ride up for the ultrasound, Doc commented on how pale Breanne was looking and grew concerned.  “Is she always this pale?” he asked.  Connie and I both nodded, which got an anesthesia-labored eye roll out of Breanne.  Then as the doctor pinched her unpolished fingertips, I could feel her giving me an “I told you so” face.

We finally made it to the ultrasound room. Good news – the bleeding was superficial! Whew! No additional procedures needed.  On our way back downstairs, the Memphis team wheeled Breanne through the fertility clinic’s waiting room.  As Breanne rolled through, pale and under a blanket with an IV bag hanging from the back of her wheel chair and a team of medical professionals by her side, I couldn’t help but notice the faces of the couples in the room.  I could feel them thinking, “What in the hell have we gotten ourselves into???”

After a few more minutes of monitoring and finally a successful pee, the doctor gave us permission to head back home.  There was no angry tweeting at C-Spire on this ride home (unlike the post-retrieval ride), but there was a very low tolerance for stupid, as she so lovingly put it. The nurse sent us home with a basin in case Breanne got sick.  As we pull into the neighborhood, Breanne says, “Bring the basin inside and put it by the bed for the night.” I responded, “Oh, in case you get sick?” She glanced at me with that go-to-hell look that she has perfected over the last 29 years and said, “No, Brennen, in case I wake up in the middle of the night and decide to wear it as a hat.” For better or for worse, right?

Breanne’s recovery is going well.  She’s still sore but getting better (and happier) every day.  Now, we wait for her next cycle to start in 4 to 6 weeks so we can begin preparations for FET #2.  Until then, we’ll have our Disney trip to keep us occupied along with the to-do list Breanne created on post-op day 3 titled “The Spring Purge.” Prayers…

It’s Over

“It’s over. It’s over.”

That’s all Breanne could really say the day everything hit her and she finally broke.  She had been strong throughout the whole ordeal, and up until that point had somehow held it together.  With every doctor’s appointment, every hCG test that wasn’t rising properly, every ultrasound that showed that the pregnancy wasn’t progressing as it should, and even the miscarriage, she managed to stay positive and focused, able to see the silver lining in this dark cloud of infertility.  Still, I knew at some point it would hit her.  It needed to hit her.  Otherwise, how could we move on?

The miscarriage happened on Christmas morning.  Yes, you read that correctly – Christmas morning.  Certainly not the holiday we had in mind.  We were opening presents at Breanne’s parents’ house like we do every Christmas morning, when all of a sudden she started cramping.  Being the trooper that she is, she was able to make it through breakfast and opening presents before retiring to her old room to sleep off the cramps.  So while Breanne was incapacitated, I headed outside to fry the Christmas turkey on our 80-degree Mississippi Christmas morning.  About an hour later, I got a text from Breanne.  She was in the bathroom…miscarrying.  My heart sank.  Not because we didn’t expect this – we did and had prepared ourselves – but the timing of it seemed like a cruel joke.

She said the rest of the day was a blur for her.  If you remember from my last post, Breanne LOVES Christmas.  We have a tradition of eating Christmas dinner with the Ivy crew (her mom’s family) and playing games afterwards, so Breanne was determined not to miss out on the festivities.  So I passed her her straightener and make-up bag through the bathroom door so she could slowly get ready, she “hopped on the saddle” (a term I wish I had never learned), and we headed over to the Ivy’s with a bag of feminine products and pain relievers in hand.  Breanne wasn’t quite herself while we were over there – she even relinquished her duties as Dirty Santa coordinator to her sister.  At that point, I knew she didn’t feel good!  Despite the difficult timing of our loss, we wound up having a great night surrounded by family, which is exactly what we needed.  It turns out that having the miscarriage occur on Christmas Day was a blessing in disguise.

We had an appointment with Breanne’s OB/GYN the Tuesday after Christmas.  The ultrasound confirmed that the pregnancy was officially over.  There was no longer a sac.  Ironically, we looked at each other with relief.  After what we went through on Christmas morning, we had hoped the worst of it was over.  Her hCG was still measuring at 3,100, so we were instructed to keep checking it every week to confirm that it was continuing to decrease.  A plateau or rise meant a D&C (surgery).

The next day was Breanne’s first full day back at work since the holidays.  I had taken the entire week off, so I walked her to her car and climbed right back in bed.  A few minutes later, Breanne was back home.  I knew something was up.  I greeted her with a “Well hey there!”  She just stood in the doorway to our bedroom, shook her head, and started crying. And even though my wife always gets bummed every year when Christmas is over, I knew that wasn’t what the tears were for.  She had finally broken.  And in a way, I was relieved.  She’s such a fighter that she often blocks out her emotions to keep her mind focused on the process and our goal of being parents, but sometimes it’s good for her to stop fighting and just feel. And when the tears slowed down long enough for her to speak, she whispered, “It’s over. It’s over.”

She was right, the pregnancy was over.  This chance was over.  But here we are almost 5 weeks later, and even though the pregnancy is over, it feels like the miscarriage isn’t.  We’re still waiting for her hCG levels to drop below 5 and for her cramping and bleeding to stop.  A week after Christmas, her hCG had only dropped 300 points, from 3,100 to 2,800.  We felt so far from the end.  We wanted the bandage ripped off, not slowly pulled back.  A week later, her level had dropped all the way to 850.  We high fived each other when the lab called us with the “good” news.  When people say infertility is like being on a roller coaster, boy are they right!  A few weeks ago, we were praying with everything we had that her levels would keep rising.  Now we are celebrating every drop. She’s now at 59, which means this should all be over in a couple weeks.

We appreciate the outpouring of love we received since we posted that the pregnancy was likely not viable.  I can’t say enough how everyone’s thoughts and prayers are felt and have helped us keep going. We’ll always hold a special place in our hearts for this embryo and the hope it brought us – our first pregnancy!   Now we’re ready to use that hope to push forward to the next step – Transfer #3, coming Spring 2017.

Muddle Through Somehow

A thousand thoughts are running through my head about what to say and how to say it, so I’ll just pick up where I left off.  First, a quick recap – We had a single embryo transfer on November 15th.  Our 10-day post transfer test showed a positive but with a low hCG number of 17.  My hCG continued to rise at a slow rate and finally surpassed 100 a week later.  At that point, we were told to wait another couple weeks for an ultrasound on December 14th.  We’ll begin here.

The ride to Memphis didn’t consist of any hCG talk.  We knew all we could know at that point, so it seemed silly and exhausting to continue rehashing all the details of my low, slow-rising hCG and what it could mean for this pregnancy. As soon as we arrived at the clinic Wednesday morning, they took me back for an ultrasound.  This is what we saw….

6-5-weeks

A tiny gestational sac with an even tinier yolk sac – a speck.  Brennen said, “Wow that’s it!” We had never seen anything on a scan of my uterus except a “fluffy” lining, so this was a special moment for us, despite not seeing a fetal pole.  Then we met with the doctor who laid it all out for us.  Here’s what we knew after our discussion:

  1. The embryo did not implant in my tubes. It implanted in the uterus right where it was supposed to, and it implanted well.  This was great news for us – our first implantation!
  2. Based on the timing of my transfer, I should have been at 6 ½ weeks.  However, based on the measurements of the sac, it looked like I was closer to 5 ½ weeks.  In “normal” conception, some doctors chalk this up to ovulating later than you think you did.  However with IVF, conception and implantation is more controlled.  Implantation can take longer to occur after the transfer, but a week late is pretty uncommon.
  3. Being that I was measuring at 5 ½ weeks, it could explain why we didn’t see a fetal pole; therefore, another ultrasound was scheduled a week later.
  4. My lagging measurements coupled with the low, slow-rising hCG indicated that the pregnancy may not be viable, as it was not advancing at it should. The doctor gave us a 20% chance.

That’s a lot of information packed into 4 bullet points! We were thrilled to hear that the embryo had implanted where it was supposed to.  Until that point, we had never made it as far as implantation.  So although this news was coupled with our poor 20% chance, we were thankful to have made it that far.

For the next few days, I continued my medications (Estradiol and Progesterone) and hung on to that 20% chance.  Still, I didn’t feel connected to the pregnancy.  Partly because I was guarding myself against that other 80%.  Plus, I hadn’t developed any symptoms other than cramps, which were attributed to an expanding uterus.  On top of that, it just felt odd saying the word “pregnant.”  To me, this was a pregnancy, but I didn’t feel pregnant.  I talked to a few of my friends who are mothers, and they all said it takes some big moment to feel connected sometimes – like hearing the heartbeat or feeling movement.  So I guess I just needed that moment, and maybe, I thought, it would be December 20th when I heard a heartbeat, or hoped to.

The week between my two ultrasounds flew by thanks to a trip to New Orleans for the Southern Miss bowl game and, of course, Christmas preparations.  Monday night after work, I was wrapping the last few presents when suddenly I began cramping.  It felt like menstrual cramps, but I can’t say it was much worse than the cramps I’d been having over the past couple weeks.  I took a break from wrapping to sit on the couch and watch Mickey’s Christmas Carol.  When Brennen walked through the door at 7:30 with our Mexican takeout, I stood up to greet him (and get my food).  That’s when I felt it, and my heart sank.  I looked at Brennen and said, “I’m bleeding.” “Bad?” he asked.  “Like a period.” The next words out of his mouth were, “Oh my God.”  I can’t begin to explain or mimic the tone in his voice, but I can replay it in my head.  With those three words, I could hear him letting go of our 20% chance.

(This next paragraph gets a little graphic so skip ahead if you’re not up for it.)

I rushed to the bathroom and experienced what I had never experienced with any period in my 16 years of “womanhood.”  After a minute or so, we decided to call the nurse.  I told Brennen to go to the other side of the house to call her.  I didn’t want to hear him tell her what was happening. Living it was one thing, hearing it was another.  While he was on the phone, I sat there alone in our guest bathroom, bleeding.  I looked around – stared at our hand-wash-only clothes hung across the shower curtain rod, at the succulent that I had somehow managed to kill, at my stained pajama pants gathered at my knees, then finally into the toilet.  There was that moment – the moment I felt pregnant.  Only….I didn’t feel pregnant until I knew I wouldn’t be much longer.

Brennen returned, not grossed out by any part of the female reproductive cycle anymore, with instructions on how to monitor the bleeding.  He also brought with him two Tylenol for the cramping and a Benadryl to take before bed.  After an hour or so, the bleeding had slacked off significantly.  “What do I do now?” I asked.  I honestly didn’t know what the proper protocol was.  I needed to eat.  I needed to take a bath.  But I almost felt guilty going on with my normal routine.  “First, you’re eating,” Brennen said.  So I ate.  Then, I took the rest of the night one step at a time, just like we tackle this whole process.  I took a bath, called my mom, took what was perhaps the most difficult progesterone shot ever, downed my Benedryl, set the alarm for 8:30 when my OB’s clinic opened, said my prayers, and drifted into a medicated sleep.

The next morning, I called the clinic, and the nurse told me to come in right away. By 9:30 we were in the waiting room. The ultrasound showed a smaller gestational sac, an abnormal yolk sac, no fetal pole, and a bleed.  My OB’s prediction – this was not a viable pregnancy.  But she did say that although there was little to no hope in this pregnancy, it still brought hope with it.  My thoughts exactly, doc.

My next appointment is Tuesday after Christmas.  My OB expects the process to have completed itself by then. If not, a D&C may be in order.  My reproductive endocrinologist (fertility doctor) in Memphis called this morning and instructed me to stop all my medications.  So now we’re just waiting….waiting to miscarry.

We appreciate everyone’s thoughts and prayers during our “space between,” and we ask that you continue to keep us in your prayers over the holidays.  This will most likely be our last post until the new year when we’ll tackle the why’s and plan for the next transfer.  But for now, we’ll enjoy the time we have together with our friends and families over the holidays. It seems like life hasn’t been fair to us when it comes to fertility, but we’ve been more than blessed in so many other ways.  And ‘tis the season to remember that!

We hope you all have a very Merry Christmas and a blessed New Year.  It’s going to be a good one! I can feel it!

Someday soon, we all will be together,

If the fates allow.

Until then, we’ll have to muddle through somehow

So have yourself a merry little Christmas now.

Judy Garland, “Have Yourself a Merry Little Christmas”

hancock-christmas

Merry Christmas! (Photo Credit: My best friend Lauren!)