36w3d and locked up tight

I had been starting to think that F.ranz was going to arrive early. I've felt a great deal of pressure on my pelvic floor, something I never experienced with So.ren. It comes on particularly when I'm out walking the dog. Another thing that occurs when I walk the dog is that I fall down, suggesting to me that I must be very imbalanced (physically, people!), perhaps because F.ranz had dropped.

Well, I went to the OB yesterday, and she said the baby hasn't dropped and that my cervix is as high and tight as a military haircut. That's good news: I need these last three weeks before F.ranz's scheduled debut (1/21) to get some shit done, such as thinking for a real name for F.ranz. And I haven't been able to get anything at all done this week or last week because our babysitter needed a vacation. I appear not to be one of those super-moms who can do childcare and still keep up on emails, Fac.ebook, various craft projects, bill-paying, organic-meal-making, and world-dominating. No, when I'm on childcare duty, that's all I can get done. That and crack a rib, which I did by coughing. It's better now, though apparently it won't be healed for another month or two. Still, I don't recommend it, particularly when neither ibu.profen nor margaritas are available for your use. If they were, I would be exceeding the recommended daily dosage of each.

Seriously, we don't have a name for Fr.anz. I think I am just going to give him one in the delivery room because the mother always wins that battle, right? I keep asking my husband if he's given it any more thought, and he replies, "No," and then goes back to reading or looking at Fa.cebook, which he sometimes calls "working."

What else? Well, I'm up 23 lbs. That seems good to me. No swelling, lots of peeing, lots of heartburn/reflux, lots of weird-ass dreams. I'm finally mostly over my eight-week cough and am eager to get my immune system back. I've been sleeping better and more deeply, meaning I'm no longer willing to trade all of my pregnancy ailments for sleep deprivation, but I don't have a choice, do I?

I saw a lactation consultant in preparation for baby #2, and she was full of interesting information, including a new book for low-supply mothers. I hope to synopsize this for you soon. Some upshots: (1) the number of women who cannot exclusively breastfeed is rising, perhaps because of environmental factors, perhaps because more infertile and/or older women are getting pregnant, both of which are considered low-supply risk factors by IBCLCs, (2) I should feel good about my chances at improved supply this time around, and (3) the hospital-grade pump really may make a difference. She did not think I should aggressively start the galactogogues or drugs until I see what I've got for 10 days or so, nor did she think goat's rue (the one thing I didn't try) would help my particular situation, though I may still give it a whirl. She concurred with me that Regl.an should be banned and domp.eridone should be legal. Really, who could argue with that? Not anyone who's tried 'em both; that's for sure. I went ahead and ordered a supply of dom.peridone from the sketchy internet pharmacy. While I was at it, I ordered Front.line and Heart.gard for my dog because I hate having to get those from the vet. Suck it, vets!

Well, So.ren, the light of my life, will be waking up from his nap soon and demanding waffles. I will tell him that waffles are only for breakfast, after which he will suggest cake as an appropriate substitute. Tonight, we're going down to visit some friends in the 'burbs, eat dinner, play board games, and be asleep by 10. At least I will be. May 2009 be a great year for all of us!

Sad news

I have been meaning to give an update, but I think we'll just pause for a moment: Emilie from Lemmondrops, whose blog I've been reading for about six months, died from sarcoma. She had sons close in age, which might have been part of the reason I latched onto her blog, but she was also a lovely writer and person. If you haven't read it before, it's worth going through the archives.

She had just gone into home hospice care, and the end seemed to come very quickly, but her last few posts seemed as if she were ready. If anyone ever is. Please send your best to her husband and sons.

Monkey!

That's what S. thinks the Ge.ico ge.cko is. He kept exclaiming "monkey" at random times; eventually, we noticed that it was whenever we were passing billboards with this creature on them. At first, I tried to correct him, but now I just roll with it.

I'm 33w4d today -- wow! And I'm still coughing -- boo! I think I'm on the mend this time, though -- really. S.oren got another cold, which I then caught, which seemed to extend my cough, but at least I didn't get the all-over body rash that he's sporting right now. Luckily for him, he's small and cute, and rashes don't look quite as threatening on big cheeks and a burly little physique.

F.ranz continues to rock and roll in my abdomen, which is, by comparison to last time, enormous. I'm realizing that time is growing short and I need to do some rather major things like wash all of Fran.z's hand-me-down clothes, install blackout shades in his room, and get my entire life in order.

To honor your requests, here's a recent photo of my little boy. He's getting a bit surly, just in time for his brother's debut, but he sure is funny most of the time.

32w1d

I don't know why, but 32 weeks feels like a good milestone to me. I think maybe Dr. Google told me that it was a big one to make -- or maybe it was 34 weeks, but let's just go with 32 so that I can feel good about it.

I'm just coming off about three weeks of a cold that really ended up kicking my ass. Being a hypochondriac, I began to think that perhaps I had lymphoma or something, or that maybe I had abruptly become geriatric and would always feel this way. Like, walking up one flight of stairs made me seriously winded. Or even just holding So.ren for five minutes would make me feel faint. Cooking Thanksgiving dinner felt like hiking Mount Whitney in a day (not that I've done that, but I know people who have). And then, yesterday, I started feeling better, just like that. We went on walks; we ran errands; I stood up for long stretches without feeling woozy. Outstanding!

I've finished up my various consulting projects, so I now have a couple of months before F.ranz arrives to do whatever, as long as it doesn't involve spending money, since the end of my projects means the end of my own income stream until I look for a real job in the spring, when there are not likely to be any, it appears. Wasn't that a wonderfully constructed sentence?

F.ranz's debut, incidentally, is scheduled for 1/21/09. I was hoping for 1/22, the start of Aquarius, but my OB is busy that day, and I guess 1/21 is nice in that it'll be O.bama's first full day in office, and all of our problems will be solved. Also, that date turns out to have been my grandmother's birthday. Of the three grandparents I knew (one died long before my birth), I was probably the least close to her, but, oddly, after she got Alzhe.imer's, she became much warmer, so now I think of her fondly. Strangely, I have many more fears this time about a c-section than I did the first time, though I still think I'd rather go that route than a VBAC. I also asked to have my problematic, endometriosis-afflicted right ovary removed at the same time, but I may decide not to have that done -- it seems like asking for trouble somehow.

Very boldly, I've begun assembling the contents of Fr.anz's room. I still feel as if I am tempting fate by doing so. But we've got all the big items, including a hand-me-down crib, a cheery IKE.A changing table, and even diapers. So.ren unwittingly gave his glider to Fr.anz in exchange for the ubiquitous I.KEA Po.ang chair. I think Fran.z will have to have a Scandinavian name, not just to match his brother's, but also to coordinate with the IK.EA palace we've assembled around here.

OB appointment tomorrow; will report in with any exciting or shocking developments. Now that I'm back to being a housewife, I hope to blog more regularly, perhaps even with thematic, well-thought-out posts. I know.

29w1d

It's hard to believe I'm now 29 weeks. I'm now on biweekly visits to the OB. I actually allowed a crib and bedding (hand-me-downs from a friend -- one of the benefits of having kids later than everyone else) into my house, which still seems so presumptuous to me. F.ranz moves a lot, though not right this second (wake up, F.ranz). He's head down. My hematoma seems to be gone (yay!). He's growing right on target. My placenta moved up, and I am no longer in danger of pla.centa pr.evia. My own weight gain has slowed, luckily. I think this is just because my reflux is so bad that I can't eat after about 3pm without dire consequences.

Poor So.ren got a head injury (big hematoma on his forehead), then an intestinal illness right afterward that landed us in the ER at midnight on Halloween. While he only barfed for about 12 hours, I got it and barfed for 24+ hours. The GI diseases you get from your kids seem to be the biggest downside of parenting -- I went years without one, and now I've had like five in the past year. It's not a bad burden to live with.

I find myself wanting to fast-forward a little bit to the newborn days, just to get them over with. I want Fra.nz to be okay and here, and I want to get through the sleep deprivation. I want my reflux to be gone and to stop peeing all the time. In contrast to my first pregnancy, I find I am also ready to get back to tbe booze. It's going to be insane once we actually have two kids in the house, of course, and I'll probably regret saying all of this. And, obviously, I want Fran.z to stay inside until his appointed debut. Speaking of the debut, because F.ranz is head down, I guess I could go for a VBAC if I wanted, but since I had a good experience with the scheduled C, I may just stick with that.

The best thing about my due date is that it means NO TRAVEL for Thanksgiving or Christmas. We are going to try to sneak in a short babymoon in a couple of weeks in Southern California, dropping off S.oren with my father-in-law and stepmother-in-law. They don't know what they're in for. I hope they can keep that little fellow alive. It isn't always easy.

I had a 3D ultrasound of F.ranz last week, but he had his hands in front of his face the whole time, so all of the photos came out even weirder and more alien-looking than the last ones.

Head down, belly out

Wow, that was a long gap of no posting.  I admit to kind of keeping my head down and hoping to get past various milestones, at which I believe there will be smooth sailing.  It hasn't really gone that way, though not much has gone horribly wrong.  Yet.  So, first, I was focused on getting to 24 weeks, which is generally considered the viability threshold, though viability doesn't look that great then, really.  Each week thereafter makes a big difference.

So I made it to 24 weeks, and I had an OB appointment a couple of days later.  At 24 weeks, 1 day, I had menstrual-like cramps the whole damned day.  Nothing happened, but I mentioned them to my calm, unruffle-able, Obama-like OB the next day, and she said, "Well, that's not good!" and ordered up a fet.al fibro.nectin test.  It came back negative, which she said should make me feel confident I wouldn't have the baby in the next two weeks, and she also checked my cervix, which was locked up tight.  She said that in her practice she had seen anecdotal evidence that women who had c-sections the first time (and who had no cramping in those pregnancies) sometimes turned up with lots more cramping the next time. But usually it was later.  

So then I got to 25 weeks, then 26 weeks (yesterday).  Then, last night, [TMI ALERT] I woke up with terrible diarrhea and strong cramping -- during the first round of diarrhea, my uterus was rock-hard.  I really thought I might be in labor, but that part subsided.  I did have to keep getting up every hour or so to spend some more time on the toilet, reading the sample ballot for the upcoming general election, which was all I had at hand.  This was particularly irrelevant since I voted early and did not need to be swayed by any new information.  (My policy is to vote "no" on all ballot propositions unless I am convinced by someone who really does his/her research -- usually, my brother -- to do otherwise.  And while I'm on this topic, all you Californians really must vote NO on odious proposition 8!)  I had no fever, nausea, vomiting, etc., and, so far, no one else in my household is similarly afflicted.  How long can that possibly last?

Things were a bit better this morning, though the notion of limited toilet access kept me confined to home (which is fine since I am working on a freelance consulting project).  I spoke to the OB's office, and the nurse said "every pregnant woman in San Francisco" has diarrhea right now.  So that was reassuring, if not pleasant for this particular population.

In other pregnancy-related news, this one is much different from the last.  One, I am tracking 3-5 pounds ahead of the last one, which I do not like.  Also, it shows.  I have a spare tire, and my belly has really popped out.  I swear that I'm as big at 26 weeks as I was last time at 37 weeks.  Obviously, though, I do feel better, so that's probably why I'm packing on the lbs.  Second, last time, my skin and hair glowed like a 22-year-old model's -- this time, my skin is dry and mottled, and my hair is dry and resembles straw.  I was forced to go get my first expensive haircut ever, and I do think it helped.  Third, I am TIRED this time -- I think it's because I pee every hour at night.  I'm not exaggerating.  I don't think I ever get more than a 1.5-hour stretch of sleep.  Maybe the diarrhea-induced dehydration will help.  Fourth, I think my diet and exercise plan were much more exemplary by 26 weeks the last time -- I need to at least start taking some fish-oil capsules or something, lest I give birth to a half-wit.  Finally, as you can tell, I am just much more freaked out by everything.

But you know who's great?  So.ren.  He is getting to be a pain in certain ways (as would befit someone in his toddler phase), but he is so much fun -- he runs all over the place, he says a zillion things, and he's just really happy and fun and very, very cute.  He has started shoving other kids at the playground, sure, and he's also started shrieking "MINE!" and throwing little tantrums if you don't get him his Tra.der Jo.e's cereal bar fast enough (I never should have introduced those), and maybe it's a little annoying that he still says "Daddy" about 30 times as often as he says "Mommy," but he's my little sunshine.

I should change the name of this blog to Chronicles of a Hypochondriac.

Since we last spoke, I have spiraled deeper and deeper into the inferno of hypochondria.  I mean, really, people -- what's going to happen to me when I'm old and actually infirm?  Maybe I'll be inured to it all by then.  Sheesh.

So last weekend, I began having these sharp, stabbing pains in my sternum.  It kind of felt as if I'd swallowed a nail, sideways.  But it just came in little two-second bursts, and I thought it would go away.  But it kept occurring, and on Tuesday morning, I had a bunch of these episodes.  Now, as you know, I'm a big advocate of Dr. Google, believing that most sensible people can take what it gives you with a grain of salt.  But this, friends, was one occasion in which I should not have consulted the doctor, since one thing that came up was aortic dissection, which does have a higher frequency during pregnancy.  Just Google it to see what comes up.  

So I went to the ER to get it checked out.  After all, if I were going to need a 20-hour surgery, those 20 hours might as well start sooner rather than later.  They sent me up to Labor & Delivery because I'm over 20 weeks, and the OB on call said her leading suspicions were damage to the esophagus from heartburn and puking or gallstones.  Liver function tests came back normal, though, suggesting gallstones were not the issue.

I then had an appointment with my regular OB, who was at a bit of a loss but suggested Ga.viscon to soothe the esophagus.  This did seem to help a little, but as soon as I began taking it, I also started getting very strong menstrual cramps and diarrhea.  The first day, they went away.  Yesterday, they lasted the whole day, and I was sure I was going into preterm labor.  As an experiment, I stopped the Ga.viscon, and, lo and behold, no cramps this morning.

But then So.ren and I were in the coffee shop, and I put him down for a second to put a lid on my tea, and then I picked him up -- ohhhh, and I knew even at the moment that I should be bending my knees -- and I have completely thrown out/wrenched my lower back.  I have done this once before in my life, when I was maybe 25.  I am bordering on incapacitated.  Can you even take anything while you're pregnant?  I think one of my friends took Vicod.in or something.  I'll call the OB, who no doubt views me as cross to be borne.

I guess I'll settle in to some hurricane coverage (my parents live in the path of the storm and have some moronic plan to stay there, see if they lose power (almost certain), and THEN drive to their inland weekend house after the storm.  You know, when there'll be downed trees, buildings, power lines, etc.) and hope for the best.

[In other catastrophe-related news, I hit a parked car, doing MAJOR damage (ie, two new doors required) to my car.  I took my car in to be repaired and got a rental car, which promptly got a flat tire as the result of some metal sticking out of the curb near our house.  I think I should just stay inside.]

Our first good look at F.ranz.

Aren't these 4D ultrasounds creepy?  It looks as if F.ranz is dissolving at the edges -- the tech couldn't get a good angle on him.  She said that she wouldn't normally do a 4D ultrasound at 20 weeks, but since I "imaged well," she did.  Whatever that means.

Anyway, there was good news to be had.  F.ranz is measuring on target, and no anatomical abnormalities jumped out.  The tech couldn't even find the SCH, but the doctor was able to, though he said it was "tiny" and looked to be going away.  He said that this was likely to have no effect on the rest of the pregnancy, though perhaps I still have a slightly elevated risk of something occurring.  Additionally, he said it looked like the bleed had been at the edge of the placenta and had NOT lifted up the placenta at all, which is fabulous news.

He said I could exercise but that I should avoid running.  That's fine with me.  He also said I could schedule another appointment with them in six weeks or so to check the SCH, which of course I plan on doing. 

Needless to say, I am VERY relieved.  My regular OB appointment is next week.  I resolve to enjoy this pregnancy!  Until I read a blog where someone has some weird thing happen to her at 24 weeks, and then I'll irrationally worry about that!  

I am a housewife.

Notice that I did not say stay-at-home mom.  That's because So.ren has started his nanny share, which we lined up for a few reasons: (1) there's lots of openings in good nanny shares this time of year, since one kid is often rolling out to go to preschool, (2) I will be working full-time eventually again, and (3) you're not supposed to suddenly pitch your child into a new childcare arrangement when you have another kid, since kid #1 will be traumatized enough already.  Oh, and (4), I thought it would be good for So.ren to get used to being with another boy all day long (in this case, the boy is older, but sharing knows no age limits).  

But since I'm pregnant, I'm just doing freelance projects.  And not really all that many of them.  So mostly I'm an old-fashioned housewife for the next few months.  While I definitely think being a SAHM is a huge amount of work and equivalent to any outside-the-home job, being a housewife is not really all that justifiable, in my opinion.  Maybe my opinion will change as I come to learn the nuances of this august position.

Tomorrow is my 20-week ultrasound.  I was getting nervous because I felt Fr.anz move for a few days, then not for a couple of days, but then I felt him again this morning.  I am determined to relax as much as possible if I have a good ultrasound.  After all, I can just sit around all day, doing yoga and eating bonbons.

And, hey, I have a sort-of-celebrity due-date buddy!  

Clear but lumpy

So the ultrasound didn't turn up any discrete masses, though I was told repeatedly that I have lumpy boobs.  I just want you all to know that they look fine from the outside.  Anyway, it was quite a relief.  They said that the mammogram done in February was very high-quality and definitely showed nothing then, though my boobs were still "quite dense."  I was told to keep having the ol' knockers examined by my OB and to come back for a needle biopsy if needed.  

Thank you for all of your good wishes.  I will now be more vigilant about self-examinations and whatnot.  Maybe I'll see if I can get on the Ch.ristina Ap.plegate plan of an ultrasound once a year and a mammogram once a year, done six months apart.  This is apparently what allowed her to catch her cancer so early.  

I'm off to catch some quick Zs now -- young master S. was up shrieking last night since his canines are coming in.  I hear those hurt.

The night before

Well, tomorrow is my boob ultrasound.  I haven't been as worried about the whole thing as I thought I would be, mostly because in my gut I just think it's nothing.  This may be hopelessly deluded.  I just don't feel a lump, though -- some fibrousness, yes, and it is more pronounced on the left than on the right.  But as longtime readers will surely recall, my left boob appeared to contain at least twice as many milk ducts as the right.  Why, if my right boob had had as many as my left, I might have gotten near a full supply.  (For the record, my right tonsil and right eardrum are also more problematic than their lefty pals.)

We'd had our babysitter from the Midwest come stay with us for a few weeks to help with the transition, but, alas, she had to return to college over the weekend despite our best efforts to enslave her.  It's so sad to me that she was S.oren's best pal, and he won't even remember her.  She sure did an amazing job with him, though -- she's largely responsible for how cheerful and fun he is.  For the next few weeks, I'll be a stay-at-home mom, and then we'll start a nanny share in the neighborhood.

Addendum to post below

After some consideration and Googling yesterday, I decided that watching a lump to see if it got worse went against everything I learned from infertility, which is, in short, that you should deal with stuff sooner rather than later.  I may be wrong, but what I tell people is that no one ever regretted going to the RE now instead of in six months.  I mean, hey, if you go to the RE and then get knocked up on your own, you can be one of those annoying people who tells everyone else to just relax.

And Dr. Google shared a few insights with me.  One, 70-80% of lumps found during pregnancy are NOT cancerous.  Two, you can treat breast cancer during pregnancy without harming the fetus (under most conditions).  Three, women with breast cancer in pregnancy do as well as those who are not pregnant -- for the same stage of cancer.   But, four, cancers are often detected later in pregnancy because people delay and because they're hard to find.  And since, five, you can get a mammogram in pregnancy, I called the office back and left a message that I want an ultrasound and/or mammogram.  Ideally, they'll just find a fluid-filled lump on ultrasound.  But if not, I could at least get going on anything else that needs doing.

Update: The first appointment for a breast ultrasound is 8/19, so I'll have to stew for a couple of weeks.

Why is there always a 'but'?

So I had my OB appointment today.  I liked the doctor, though the digs were a step down from the deluxe hospital clinics I used to frequent.  She did an ultrasound and said that the baby looked good -- and VERY active -- and the SCH looks as if it's absorbing.  She didn't measure it this time, but it did look more opaque and less black than before, so I saw what she meant.  They'll measure it for real at my big u/s at 18-20 weeks.  I then have the option of getting it ultrasounded at every appointment or just assuming it's all going fine.  Which do you think I'll choose?

BUT!  She found a lump in my breast.  Now, I had a breast exam in late June by my old OB, and I had a mammogram in February.  Neither of these facts made this OB say, "Oh, no problem."  We're to watch it.  Maybe I should have demanded a u/s right then.  I'm going to consult Dr. Google and then decide what to do next.

Missing: underpants, shoes, camera charger, toiletries, the bibs, and the thing we kept the bibs in.

Unpacking continues.   Some things are missing and unaccounted for, including a material portion of my underwear collection.  And I can't find my camera charger anywhere.  

Fr.anz continues to be alive for the moment (heartbeat in the 140s).   I have an OB appointment next week -- not sure if I'll have an ultrasound then or not.  Allow me to share with you the conversation that got me this appointment.

Receptionist: Dr. C. is taking new patients, but she's scheduling into October.

Me: Well, I'm pregnant.

Receptionist: She is still scheduling into October.

Me: I have a blood clot!

Receptionist: Could you come in tomorrow at 3:45?

Now, I had to take a later appointment because I needed to wait for my new insurance to kick in, but I was impressed with the magic a blood clot can work.

Our dog -- poor fellow -- is having a very difficult time making the transition to city life.  He almost bit someone on the street yesterday.  He's never bitten anyone before.  And there's been lots of growling and barking, too.   Bring in the Dog Whi.sperer!

Off the road (briefly)

Well, friends, the past few weeks have been hectic.  On our trip to California, we got stuck overnight in Denver and majorly delayed the next day because of mechanical issues.  Once we arrived, the rental-car people tried to cheat me (and failed -- ha!) and all of our luggage was MIA for an hour, then miraculously appeared.  We drove up to Sonoma at peak rush-hour traffic, only to find upon arriving that the bag containing my stuff and So.ren's stuff was back at our house.  My husband drove the whole way back to get it that night.  Things have gone more smoothly since.

There's been lots of unpacking, and I flew back to the Midwest and drove the dog back to SF, arriving yesterday.  We leave again tomorrow for a wedding in Colorado.  As of Sunday, though, we'll be here for real and can settle in.

I have no idea how F.ranz is doing.  I've been too afraid to try the Doppler.  I know, weird.  My boobs still hurt and I feel very nauseated late in the day, so I'm hoping that's good.  I did have some noticeable cramping yesterday, however.  I'm trying to get a doctor's appointment for next week or the week after so I can get an ultrasound.  I joined an SCH group online, which helps, even though not all of the stories end happily.

So, in short: new house is great; dog is confused; So.ren is great.  Sears.com sucks -- don't order anything from them.  Just trust me on that.

Update: I finally broke out the Doppler.  Fra.nz appears to be in there for the time being -- heartrate in the low 150s.  That's lower than what he had a couple of weeks ago but still seems normally.

More of the same

The ultrasound showed F.ranz with a strong heartbeat of 167. His growth is right on target or slightly ahead. He looks like a "real" baby now. His amniotic fluid looks good, and he has plenty of room.

But the clot is larger: 1.25cm x 3cm x 4cm. The doctor (my favorite MFM doctor there -- I wish I'd had him done the CVS, if I had had it done at all) said it was a "medium"-sized clot. He said there was really nothing to do except keep our fingers crossed, and I'm not supposed to jump around or otherwise jostle myself excessively. I should get a repeat scan in six weeks, which I interpreted as one month, since that's as long as I can wait, I think. We'll see if I can get in somewhere in SF. The doctor said that the clot could have stabilized or still be growing. There are clots that are smallish but have torn away a big part of the placenta, and there are clots that are very big but resulted from just a small tear. We just have to watch the clot and watch the baby's growth.

There's really no way for me to describe how attached I feel to Fran.z and how scared and guilty and terrible I feel all at the same time. We're in our empty house right now, cleaning up. We fly out to SF tonight.

Miscellany

The full CVS results are back, and Fran.z, should he remain installed until an appropriate debut time, is chromosomally normal. Just two more days until my next ultrasound. I continue to have pregnancy symptoms, so I am taking heart, though I also have occasional old-looking blood and some mild cramping I wish would go away. I keep telling myself it's bowel cramping related to the fact that I now drink Milk of Mag.nesia every night because of the heartburn situation. MoM works wonders on the old esophagus! Chewable antacids are allegedly the same thing as MoM without the laxative properties, but based on extensive personal experience (such as the 10,000 Tu.ms I've ingested) I think that's a load of hooey.

The movers were supposed to come today to pack up, but they got stuck in Wisconsin. So they claim they're going to do it all -- pack and load -- tomorrow. I'm not sure that's physically possible.

I've discovered the wonders of Fre.ecycle. People will take anything! And they'll come pick it up from your house! Really!

In other news, I joined Fac.ebook and bought a M.acBook P.ro. Soon, I will be able to converse with the young people.

For those keeping score at home...

...I'm still bleeding occasionally, but I think it looks like older blood, and it's fairly diluted by CM (thank you, I'll be TMIing here all week). Maybe this is wishful thinking, but it's what I've got. I keep reminding myself that the doctor emphasized that the blood in the clot has to come out somehow, and that all evidence suggests that this is blood that is disintegrating. Still hard to see blood of any type while pregnant.

I found some stories online where people had SCHs that were, like, 12cm long. So I'm grateful mine ain't like that.

Off to throw ourselves a going-away party. (Don't worry -- we bought cheese trays and the like from the local grocery store, and I am not expending any effort whatsoever.)

Some good news

They were able to get FISH results (and, presumably, will get the full CVS results) on Fra.nz. No trisomy 13, 18, or 21, and Fr.anz is indeed a boy, as I suspected. (Okay, and my suspicions were mostly informed by my knowledge that more boys are born from singleton blast transfers -- 64% boys vs. 36% girls.) If Fr.anz makes it, we'll never be paying for a wedding! (I will, out of convenience, hew firmly to tradition on this one. )

News but no real prognosis

I had my ultrasound this morning. The good news: the baby had a heartbeat of 162. The bad news: the clot was larger. The MFM doctor said she would have expected this -- since I'd rushed right back to the hospital when I was bleeding, I probably wasn't done bleeding, so it was not surprising that the clot had grown. The hope is that it is done growing and will start to break up.

She felt that there were two pieces of positive news -- the heartbeat, which indicates that enough placenta is still attached well that the baby is getting what it needs, and the fact that I am not bleeding out my hoo-ha much at present. She thought that if the clot was still actively bleeding, the chances were that I would still be bleeding out bright red blood.

I asked about the baby aspirin, and here's the explanation she gave me. Baby aspirin is used in infertility treatments because there's a theory that aspirin prevents little clots from forming in the uterine lining. But when you have a big clot, you want it to go ahead and clot up so that the bleeding stops. She said there were other ways of looking at this, which is why some people end up being told to remain on it. But that answer satisfied me. She did say that the change that the aspirin causes in the platelets is permanent and that platelets live for 7-10 days, so the effects from stopping the baby aspirin wouldn't happen for a week or so.

Even if this resolves, she said I would still be at risk for PROM and placental abruption, as well as possibly IUGR, so I will need to get monthly ultrasounds. She also still called the clot "small," though it looked pretty big relative to the sac to me. But I hope by Thursday next week (when I go in again) it looks smaller.

Oh, Dr. Google, can't you get your story straight?

I put myself on bedrest yesterday, which of course left my schedule wide open for consulting with Dr. Google about subchorionic hematomas and other matters. Here are some of the searches I performed: (1) subchorionic hematoma and CVS; (2) subchorionic hematoma small; (3) subchorionic hematoma and bedrest; and (4) subchorionic hematoma and aspirin. I also posted questions on the message boards I frequent. And then I emailed a close friend who knew I was pregnant and who is a connoisseur of bleeding during pregnancy, and she hooked me up with a friend of hers who'd had a major SCH but had a good outcome in the end.

Dr. Google knew nothing about search (1) -- apparently, this is a freak accident. Regarding (2), Dr. Google had some very contradictory information, but the evidence overall suggests that a small SCH is better than a big one, though the key detail may not be its nominal size but rather how big it is relative to the gestational sac, which, in my case, I don't know. Apparently, my age is working against me here -- women over 35 with SCHs are more likely to miscarry (though let me remind you again that I still have no gray hair, suggesting that I am an incredibly youthful 36 -- why, if you look at me before you put in your contacts, those crows' feet and smile caverns are barely discernible). But women whose SCHs appear after 9 weeks have a better shot at avoiding miscarriage. And let's just say here's another reason not to smoke.

Regarding (3), it seems that most people do get put on bedrest, though there is conflicting data on whether it matters with SCHs. My clinic didn't even put me on bedrest after they'd somewhat frantically rushed me in yesterday, but I called an audible and put myself on bedrest until the next scan. I performed query (4) because they told me to stop the baby aspirin I was on for my FET, and I got myself all confused because I thought aspirin was supposed to help avoid or possibly solve blood clots, but then I could also see how thinned blood would mean extra bleeding, which could expand the hematoma. Dr. Google was all over the map on this one, but when I posted the question on a high-risk pregnancy board, all the people who'd had SCHs who replied said they'd been taken off it, too, even if they remained on He.parin or similar. So while I still don't get why this is the case, I will accept it.

As you might imagine, lots of blog posts and message board posts came up in my searches. And, MAN, some people have HUGE SCHs and bleed out massive clots. Like, one woman said she had a clot as long as her forearm and twice as wide. I'm not particularly squeamish, but let me tell you that that would freak me the fuck out, and I would have to seriously consider fainting.

My wonderful babysitter stayed until So.ren had to go to sleep last night, and she came early this morning to wake him up and will remain here until he goes to sleep. My husband comes back in the morning, and then we'll get the scan.

My bleeding has slowed, though of course I have been mostly prone. I did recently get up and do some moving around (and -- TMI -- I had to take my second Zo.fran poop since yesterday, and those require awful straining), and I got a bit of semi-fresh-looking blood. The MFM doctor had told me I had to get rid of the blood in the clot somehow, so it would probably be coming out, but I just want it to be decidedly old-looking, you know? Like, brown and world-wearied.

But I'm trying to be positive. I definitely still have all of my pregnancy symptoms, such as feeling like crap in the afternoon/evening and getting major heartburn, despite my being on Pr.evacid. I hope we get good news tomorrow, and then we can figure out what to do about our extensive moving/travel plans. We'll do what we need to do, so long as Fr.anz (fetal name) stays in there.

Thanks for all of your kind comments, too, and if you made it to the end of this post, wow!

I am a terrible person

So my bleeding got heavier, and I went back to the clinic. Let's start with the good news: the baby still has a heartbeat, and the clot that they found behind the placenta is small.

The bad news: if the clot expands, it could cause a miscarriage. This was definitely caused by the CVS.

I hadn't wanted to wait for an amnio (or -- god forbid -- skip such tests altogether) to see if we had any chromosomal issues, so this is 100% my fault. I don't usually pray, but I am praying a LOT right now in the hopes that this clot resolves on its own in the next couple of days.

I go back on Thursday for another scan.

My cervix: the bane of doctors everywhere

Wow, amnio is a lot easier than CVS. They had to try the transvaginal route because of the location of the placenta, and, as you may recall, my cervix is extremely challenging. I'd kind of thought/hoped that since I am now 10w2d, my uterus might have come up a bit and straightened things out. Alas: mangling still occurred. Two passes were needed. And she only got the edge of the placenta, meaning the gobs of blood in the syringe were mostly from my uterus. Thus, the CVS may not even work.

And now I'm having some bleeding. I think this is probably because my uterine lining was messed with, but it is still worrisome. If it keeps up, I will call. I ordered a home doppler and just tried it out this morning, and I couldn't find the heartbeat. Now, I'd just seen the heartbeat a half hour before, but this still worries me, too, of course.

For now, I'm going to lie down and relax and hope that everything is okay.

The calm before the mayhem

There's lots going on, though it isn't particularly interesting. Today is my last day at work. We close on our (ten million trillion dollar) house today, too. Tomorrow is my CVS. We're throwing a going-away party for ourselves on Saturday. The movers arrive next Tuesday to pack up our shit; next Wednesday, they load the van. Next Thursday, we fly to San Francisco. Next Friday through Sunday, we'll be at a wedding in Sonoma.

We move in to our financially injurious house on July 17. On July 19, I fly back to the Midwest to pick up our dog and drive him to California (since he's afraid of things as minor as hardwood floors, we felt that flying might be too much for his little brain). From July 24-27, we'll be in the mountains of Colorado for another wedding.

I'm excited but a little bit nervous about living in Bern.al Hei.ghts. It's sort of the Pa.rk Sl.ope of SF -- you know, where I'd be taking my life into my own hands if I were seen feeding a baby formula in public. But, like Par.k S.lope, it probably gets a bad rap on that stuff. And given that I cannot spend five minutes in conversation with another parent without revealing that S.oren is the product of IVF, everyone will know about my unnatural ways soon enough.

I'm sad to be leaving this job. Of the jobs I've had, I loved my first one and this one. And I've really loved the benefits package here, so if you're in the Midwest and need infertility coverage (and a good IVF clinic), you might want to apply.

In closing, here's a recent shot of my boy, who occasionally takes some steps on his own and employs many signs (most often "help" -- lazy bastard).

Will report in after CVS.

So happy!

My friends TLB and Brando, long-time (and I mean LONG) IF sufferers, just welcomed their hard-earned daughter Libby to the world. Congratulations!!!

OB appt. #1

Today, I saw my OB. Two things made me happy about this visit: (1) I weighed less than usual, which I didn't expect since I've been eating way more than I did the last time around, though possibly still less than usual, and (2) although I'm just 9w1d and have a severely tilted uterus, we heard the heartbeat (165). I'll be ordering up a Doppler post-haste.

The one downer from my visit was that some retard (I suspect Jim in Scheduling) had cancelled and rescheduled my CVS and had not told me. And the rescheduled date was, oh, after we move. I demanded that they rectify the situation. Stay tuned. I will really freak out if they don't for a variety of reasons, including (1) I would miss the window for a CVS and (2) I have my insurance here but not my CA insurance next month, meaning no CA doctor's visits except for the ER until August 1, and I don't think you can get a CVS done in the ER.

We spent the weekend in the TX Hill Country with my parents for their 40th wedding anniversary. It was fun, and So.ren is now beginning to walk. Also, I killed a scorpion with my bare hands (and a wastebasket).

Never again will I help other people!

So, yesterday, I sandbagged again. The day before, I'd moved books and boxes out of special collections from the main library on campus. All in all, I was feeling both virtuous and manly. And occasionally not nauseated, since the physical activity helped to quiet my overly sensitive vagus nerve.

Well, today, I woke up to SPOTTING. Now, although I am a big whiner, I have been lucky enough never to have had spotting before, and I thanked my difficult cervix for this. So of course I panicked. And called the OB resident on call, who told me everything was probably fine and that if it wasn't, they couldn't do anything anyway, and I was like, "I'm an IVF patient! I have to have an ultrasound!" So she reluctantly said I could come in and recommended I try the ER first since L&D was very busy.

Part of the reason it was busy, you see, is that the floods have shut down all but one bridge going from the east side of town (my side) to the west side of town (the big hospital's side). So I suspect the stress of the uncertainty whether they could get to L&D drove women into labor. Anyway, I went to the ER, which has been totally remodeled and is extra-deluxe, and I insisted more than once that I was not leaving until I had an ultrasound. ("I'm an IVF patient!", I repeatedly exclaimed by way of explanation.) One of the nurses' daughters had done IVF, so we talked about that. I told them I needed a transvaginal u/s due to my severely tilted uterus, and I think this piece of information frightened off the staff ER physician, who said he was no expert.

So up to L&D I went, where I met the OB resident on call, who looked awfully familiar and who, it turned out, had made my c-section incision with So.ren. She totally liked me in person even though she had clearly thought I was insane on the phone. She tried a transabdominal u/s, but, guess what? It didn't work. So we went dildocam and saw the heartbeat. She wasn't adept enough with the u/s machine to measure it, but it looked fast enough to me. And then she had to rush off because the woman in room 3 was 9cm.

I've been instructed to take it easy. My husband has to get to the municipal airport shortly to take a puddle jumper to the main airport in the region since that road is closed and the detour involves going 287 miles (vs. the 25 it normally involves).

Anyway, moral of the story: don't help other people, or you might spot.

In non-uterine news...

...we made an offer on a house in Bern.al Heig.hts in SF yesterday, and it was accepted. Surprisingly, this house is larger than our current house here in the Midwest. Inspection is occurring as we speak. If all goes well, we will officially move in mid-July. Inconveniently, mortgage rates shot up today due to inflation concerns. Awesome.

Speaking of the Midwest, I have one word: FLOODING. I've been sandbagging (well, tying sandbags with wire) and am about to go do some more. Apparently the university here has already laid one million sandbags.

Ultrasound update

I had a very bad feeling going into this ultrasound for two reasons: (1) some weird cramping I'd been having and (2) my lack of debilitating, soul-crushing, will-to-live-ending nausea. So I steeled myself for the worst, and when the ultrasound cam was first showing nothing but endometriomas, I wasn't even that surprised. I mean, hey, maybe the embryo had implanted in my appendix or something.

But then there it was -- one clearly visible sac, and then a clearly visible heartbeat. The stats: heartrate of 130, measuring perfectly on target at 7w1d. Due date: 1/25/09. I hate January, so it would be nice to have something good happen then. My husband's flights were cancelled yesterday and then again this morning (fucking Midwestern weather), so he actually got to go to the appointment with me.

While in the waiting room, I did read Conceive magazine, and, let me tell you, I really wished it was Infertile Whore.

Regarding my nausea, it comes in waves and prompts vomiting about once a day. I occasionally feel totally fine, particularly if I've just had a cup of genmaicha green tea, which sounds disgusting and which you're really not supposed to drink while pregnant because it interferes with folate absorption or something, but it works magic on my tummy. I feel worst in the late afternoon/evening and best in the early afternoon. On the HG boards, some women have HG hit them as late as 8w, but I'm crossing my fingers that I just have normal m/s, which is NOTHING compared to HG. I realize it's annoying to have people say shit like that -- like, "Oh, I'm sorry you have a cold; I also felt bad when I had CANCER." But that's what I feel like right now, just comparing my experience now to my experience last time around.

Next up: I am scheduled for a CVS on July 2.

A post about not much of anything

So, basically, I'm just sitting aroud, waiting for my u/s on Monday. I have been experiencing waves of nausea, but they may be psychosomatic. As soon as I do anything physical -- like go on a walk or take the garbage cans out to the curb -- the nausea goes away. Same thing if I get engrossed in conversation or work. So who knows? I have been having INSANE dreams, but that's probably just the PIO. And I'm tired and pee often, but that's not different from my normal life. Occasionally, I POAS, which just confirms that I have hCG in my system.

IV.F Connec.tions has been down for a few days, and I'm going through withdrawal. I visit a couple of other boards, but those also have fertiles on them, and sometimes I just want the comfort of IVFC.

More self-improvement needed

One of the things I've learned from infertility is not to weigh in so blithely with what I "would" do if I were in a situation I've never been in (or even one that I have been in, but where there were a variety of possible actions to take, even those vastly different from my own). I count that as a plus of infertility -- taking me down at least a tad on the know-it-all scale.

I've also made specific tactical adjustments, such as never asking someone when they're planning to start having kids or trying to figure out if someone is knocked up. I didn't ever really do the latter, anyway -- I always find it annoying when people (almost always women) are all eagle-eyed at parties, trying to figure out who's not drinking and then gossiping with others about it. I mean, maybe we notice some nondrinking or a slight belly pooch, but if the woman is pregnant, she'll tell us when she's ready.

But I've realized there are a couple of things I need to change. First, I tend to assume that anyone who has had one child can easily have another (unless I happen to know that the first required lots of ART). Second, I also assume that nothing bad ever happens to proven fertiles -- no miscarriages, no blighted ovums, no genetic issues, nothing -- even though I know fertile people who have had all of these things.

I bring this up for two reasons. One, a friend of mine is about to have her second child, and this made me remember that I very nearly asked her a year ago when she was going to have #2, not knowing she'd just had a miscarriage. So, like, I would have easily asked her this, even though I'd never do the equivalent with someone who didn't have any kids yet. By chance, I didn't ask, and then a mutual friend mentioned the miscarriage.

Second, the fertile friend I was complaining about a few posts ago just found out that she had a blighted ovum. She said she'd felt something was off -- like she had almost no symptoms -- and then she had the 9w ultrasound, which found the blighted ovum. If she'd been infertile, of course, they'd have found it earlier (small perk). She seems very at peace with it, but it did make me feel like a jerk who is accumulating bad karma. I felt slightly less like a jerk when she said that in a way I was lucky to have done IVF, because I wouldn't have any blighted ovums or chromosomal issues. And I was all, like, "IVFers still get all that crap, too, homes. Insult to injury, etc."

In happy news, though, we are going to a baby shower this weekend for some pals (hello, pals!) who have won the Infertilympics and are 37 weeks along with a very-hard-earned baby. Like, really hard-earned. This will be the most welcomed baby of all time. Wahoo!

Ever forget your own birthday?

Yesterday was my birthday (36), and, boy, was it a non-event. I worked my ass off all day and didn't eat lunch. Local pal MSF did bring me some delicious takeout from our favorite restaurant for dinner.



We put in an offer on a place in San Francisco in our old neighborhood, Potrero Hill. I don't think we'll get it because the asking price was at the very top of our range and the realtor thought it would go over. Still, stay tuned. It's big (1900 sqft) for that area and price range and was mostly redone in 2006. It's on a kind of busy street and at the edge of the residential part of the Hill (i.e., the other three corners of the intersection it's on are commercial). Here's a photo my brother took of it.

I do not feel pregnant AT ALL. I keep thinking something has gone wrong. I have POAS a few more times, but of course my hCG levels have been high enough that HPTs would keep coming up +++ for a while even if I had had a miscarriage or something. I'm not saying I want to be flat-out sick with HG like last time (which started at 5w4d -- ie, today). Maybe a few waves of nausea and the occasional puke from about 7-11 weeks. That would be fine.

For you HGers out there, I am taking proactive measures as recommended by the fabulous gals on the HER boards. I'm taking 25mg B6 three times a day and half a tab of Unisom at night. I have a stash of old Zofran at the ready and an ability to get a prescription filled immediately if needed. (Relatedly, I also still have Colace ready to go to in order to ease the side effects of Zofran -- essential.)

Updated: Well, there is no way we are getting that house. We accepted the counter-offer, but the other bidders accepted the counter-offer AND are paying in all cash (!) (ie, they don't require a mortgage loan at all) AND waived the right to an inspection. Fuck that!

Beta #2

The results are in. Beta #2 was 636. They needed it to be at least 448, so this looks good. While the beta is on the high-ish side for a singleton (according to the oracle, Betabase), the doubling time is right on the median for this range: 37.84 hours. That all sounds good to me.

Next stop: ultrasound on 6/9. I felt queasy yesterday (but a different kind of queasy than last time -- this one was more of the needing-to-eat-constantly kind of queasy vs. the food-equals-feces kind of queasy of fall '06), but I feel fine today. Well, not totally fine, since a certain one-year-old decided to indulge in a few screaming episodes last night, during which I ran out of options and just played with him from 11pm to midnight. Anyway, I'm glad to feel okay today since I would have been extra-bummed to get HG at 4w2d.

I have felt some waves of something going on in my entire abdominal region, and sometimes I feel woozy when I bend over or stand up. Also, I am feeling extremely emotional, but that could just be because my life is on the stressful side these days and I'm about to move away from a place I like a lot. But I got all teary thinking about Ted Kennedy's brain tumor, which I might do normally, but, really, I am on the verge of losing it at any news, good or bad, and at any gesture in my direction, either compliments or slights.

Other than that, not much to report, except that I feel incredibly, incredibly lucky.

Beta #1

Thank you all for your very kind words of support on the post below. I love the Internet.

Beta #1 (15dpo) came in at 264, which they described as a "nice level." My progesterone was at 56. I find it very odd that my progesterone was somehow only at 18 the last time around -- maybe I absorb the ethyl oleate version better? Betabase is down right now, which is maddening but probably good for my productivity at the office.

Beta #2 on Weds. morning. Ultrasound (assuming we get that far) will be on 6/9.

If I start feeling sick, I can call them and demand Zofran at any time. I'm assuming I will start to feel sick at some point next week, so I'm cranking out a huge amount of work this week. I need to get through about 6/10 here at work, but then I can take it a bit easier for the rest of the summer.

Yay, little blastocyst!

One way to lose that IVF bloat

So my mother, who is visiting, came down with this gastrointestinal bug on Friday that put her totally out of commission. I'd heard of a few other people around town with this, too, so it must be sweeping the area.

Yesterday, the day we were going to have So.ren's first birthday party, both my husband and I came down with it, me worse than him. We had to cancel the party. My husband had recovered by about 7pm, but it took me until this morning. I guess it's just a matter of time until So.ren gets it. It was a very painful stomach bug -- like where your tummy and intestines actually hurt -- and I don't want my little fellow to have to go through that.

Because of my puking, I was worried about keeping down the es.trace. I wondered how big of a problem this would be, and this is what finally forced me to POAS. And, lo and behold, the second line came up. It seemed a bit faint for me for 8dp5dt, but it's a little darker this morning. Holy crap!

Beta is tomorrow. I know lots of people on the Internets lately (in buddy groups and blogs) who seem to be getting strong, early HPT BFPs and then to have low-ish or nondoubling betas, so I am very cautious. Also, I have a sharp pain on my right ovary for some reason.

But: whoa!

Updated to include photo of HPTs.

A trip down memory lane

I've never been so afraid to POAS before. Let's recap:

- Natural cycles 1-20 or so: By paying attention to my body during the luteal phase for the first time and wasting dozens of hours (possibly days) reading early-pregnancy-symptom posts on the Internets, I consistently convinced myself that I was pregnant, and thus peed on sticks with increasing desperation/sadness from about 9dpo onward. If I had taken the money spent on HPTs and invested it in Warre.n Buff.ett's Berkshi.re Hatha.way, where each share currently runs about $120,000 (or what I have probably spent on HPTs - what a racket!), I would be wintering in Fiji by now. Oh, sure, you could claim I ought to have learned and not continued to indulge my hopeless fantasies of pregnancy, but I guess I was just the Bara.ck O.bama of POAS back then.

- IVF#1: We had transferred one CRAP blastocyst, so I knew it was going to be BFN, and I just POAS to get it over with. Out of habit, I may have tested more than once, but I really didn't have any hope that round -- I'd lost it all the moment we showed up for ET and were told the sorry results of our embryo culture. And, you see, I already had years of desperately Googli.ng things like "late implantation BFP 18dpo" behind me, and I therefore managed to put away the pee sticks after some reasonable point.

- IVF#2: I'm not sure why/how, but on this cycle I convinced myself that my two 3-day embryos had implanted, and I imagined numerous "symptoms," such as bigger b00bs, noticeable veins in b00bs, cramps, and a hard lower abdomen. I figured out later that the reason I had felt a hard lower abdomen was that I had been clenching my abdominal muscles at the time. What a moron. Anyway, because I was so "symptomatic," I peed on LOTS of sticks. And when I say LOTS, I mean a number higher than 10, possibly higher than 20. For a failed cycle, that gets expensive and really just adds (self-inflicted) insult to injury.

- FET#1: I decided to POAS a couple of days before my official test just to get the bad news over with. Back then, my clinic had you bring in a cup of your own pee (always fun to drive around with), and they'd basically put in their own stick (or, actually stick-equivalent, since I think it was round or diamond-shaped or something) to see if it came up positive, and only then would they deign to draw blood. Now everyone gets a real beta, it seems, which makes me feel like I can fit in much better with people who go to other clinics. Anyway, I really had NO expectations that it had worked, and I almost hyperventilated when I saw the double lines for the first time in my life. (As an aside, I had toyed with the idea of peeing after trigger in a fresh cycle just to see what the double lines looked like, but I decided that I wasn't quite there yet. I'd seen double lines on OPKs, so I embraced that as my lame substitute.)

Which brings us to where we sit now: in the dark. I don't think this FET worked, maybe because despite the fact that I tried to replicate everything about the successful cycle, I had given away my Anji CD to a fellow IVFer and forgotten about that until it was too late to order another one, and I therefore failed to listen to it this time, and perhaps my failure to visualize my lining growing and my blastocyst implanting has caused everything to go FUBAR internally (I am, after all, fully capable of anxiously turning my intestines to jelly or preventing myself from sleeping even though I'm really, really tired. I also feel empathetic nausea when someone describes to me his/her own nausea, and sometimes if someone (usually my husband) tells me he/she just took a dump, it makes me need to take one, too. TMI - live with it!). But I am also kind of looking for symptoms, in spite of myself, and occasionally I think I've found one, and then it goes away. Or it turns out to be something like the hard abdomen. And I am also very aware of the fact that it's really progester.one that makes most of the early symptoms happen, and we IVF gals are shooting that shit up daily in high doses.

So I guess that's why I'm afraid to POAS -- because I have that feeling of hope/desperation again. Even though I shouldn't. I mean, I have my boy now, and I also have a fresh cycle with my beloved clinic scheduled for next month if needed. A kid and a plan -- really good stuff for infertiles. If I never have another kid, I would still feel enormously lucky every remaining day of my life. (Uh, but that doesn't mean I don't still feel SEETHING jealousy/rage when a friend of mine gets pregnant easily; boy, do I. A fertile friend of mine is now pregnant with #2 seven months after #1's debut. On purpose, at least. But why the rush? I almost felt it was a personal affront to me and her other close friend who's had several miscarriages in trying for #2. Fertile friend, who knows I'm cycling around now, keeps saying it'll be fun to be pregnant together. I feel as if that will anger the capricious fertility gods and jinx everything. But I digress.) I guess I just got attached to that beautiful blastocyst, and I want it still to be there. Or something.

Armchair psychological/psychiatric analyses welcome. And thank you very much for your advice and support already.

PS: I did purchase a bunch (9) of HPTs yesterday at CVS, and acquisition is a necessary step towards POAS, of course. I'd thought I had some in stock, but when I checked I realized that OF COURSE I had peed on every stick in the house when I'd finally seen the double lines.

PPS: After I first posted this, I remembered that I DREAMED about POASing last night. I dreamed that it took place at the clinic and involved an 8x11" piece of paper, which then said something like "hopefully positive." I was so happy. Then I woke up and was happy for about five seconds before realizing it was a dream. Those sorts of dreams are my least favorite. I almost prefer the ones where something really bad is happening -- like that I accidentally killed someone or got a really unflattering haircut -- and then you get to feel sweet relief upon awakening.

Happy birthday and progesterone dreams

So.ren is one year old today! He is feeling much better after being on antibiotics for his eye discharge and ear infection for a few days. His babysitter brought him this amazing scrapbook of his first year. I teared up because I'm a mess of (artificial) hormones these days.

Speaking of artificial hormones, I have been having insane progesterone dreams lately - I'd forgotten about them. I am feeling no symptoms and am afraid to POAS, though I want to do so before my beta on Monday. I'm in a buddy group on a message board online (yep, I still do that shit) for people who did FETs around the same time, and a woman who did hers the same day as mine POAS this morning and got a BFP. Last time, I did an HPT 6dp5dt, which would be tomorrow. I doubt I'll do it.

I think I would have preferred to test on Friday or Saturday since my husband will be here, but we're hosting parties both of those days, and I don't feel like wallowing in self-pity while hosting. Then again, maybe I should POAS so that I can booze it up if I get a BFN. Actually, that won't really work - it wouldn't be appropriate to get totally bombed at either of these events, since one is a graduation reception and one is So.ren's first birthday party. Sigh.

And I don't really want to POAS on Sunday, since my parents will still be in town, and I haven't filled them in on the current cycle. But maybe I'll do it on Sunday anyway since my husband will be in town. Or maybe Monday morning before the blood test. Anyway, stay tuned.

Wow, I am definitely going crazy.

Yesterday, when I was taking the bus home, I got kind of excited as we approached my house because I wanted to see it had sold yet. And today I checked my own blog for an update. Apparently, I no longer think that I am an agent in my own existence.

Still no symptoms to report. Feeling pessimistic. I just want that excellent blast to have implanted its excellent self in my presumably excellent lining.

My little boy turns one tomorrow. Wow! Here's a recent photo (note that he was illegally already facing forwards since that position was much easier to execute in the rental car.)

20th anniversary party

The 20th anniversary party for the IVF clinic was very enjoyable. I found myself tearing up while one of the doctors - who's been there since the beginning - talked about infertility and all of the milestones they've reached at the clinic (such as pioneering elective single embryo transfers).


Here's some coverage of it - interestingly, there is a companion piece in which the reporter who covered the party reveals that she was one of the first IVF babies born in the state. I will be interested (and probably maddened) to see what comments get posted on this story and in other local stories.



As far as the blastocyst-on-board goes, I am experiencing zero symptoms. I feel like my normal self, albeit a very tired version of my normal self since So.ren developed conjunctivitis and possibly an ear infection yesterday and was up off and on all night. I haven't been able to scan in my blastocyst photo, but it looks something like this (image swiped from here). I'm a little afraid that I overdid it on Saturday, what with the IVF party and taking the dog for a walk and hosting a dinner party, but, of course, fertile people would do all of that plus drink a gallon of malt liquor, go skateboarding, and put in a few hours on the third shift at a uranium-enrichment facility.

One aboard

I now have one excellent blastocyst floating around inside of me for the time being. Out of the 7 thawed, there was one excellent blast, which is all I wanted to transfer anyway. There was another fair blast and a good morula, and everything else was rated as poor. All except for the excellent blastocyst were discarded. The transfer itself went well, relatively speaking. The new digs for the clinic are quite deluxe, too.

I ran into a colleague there. Ha! She didn't have her husband with her, so I think this must mean she had an IUI. They make you bring an escort if you do any procedures that involve drugs.

Tomorrow, they are having a big 20th anniversary open house, and the nurse said they are expecting more than 1,100 people. We're planning to attend.

Interlude

Like a one-legged man at an ass-kicking convention, I've been so busy that I haven't had a second to think -- really think -- about my FET. Then my Outl.ook calendar popped up with a reminder that it's tomorrow (like I'd forget -- well, maybe I would, actually), and I just thought: HOLY SHIT. Fortunately, I have a lot left to do today, tonight, and tomorrow morning, so I can't really agonize the way I like to.

But HOLY SHIT! (assuming there's something to transfer, etc.)

Unfrozen!

I just got the call with the thaw report - all seven embryos survived the thaw; now let's just hope they're successfully growing to day five. My transfer on Friday will be at 11:15, but we have to be there at 10:45. That means that if my husband's redeye is late to Chicago, he'll miss the first connection here, which means he will not land until 10 or so. Let's hope he makes the connection!

Unfreeze

For some reason, the word 'thaw' never comes to my mind first when I'm thinking about the FET process; instead, I think 'unfreeze.' And for some reason, I can't stop myself from thinking it or, sometimes, saying it. Weird.

Anyway, I think my little embryos, frozen in the pronuclear stage at day one, are being THAWED today. Cross your fingers for their little embryo selves make it through and start growing like gangbusters. And keep those fingers crossed that at least one of them is a breathtakingly beautiful blastocyst on Friday.

Our weekend in Chicago was fun, and So.ren, worn out from our visit to IK.EA on the way home yesterday, slept for three hours in the car. He occasionally squawked or moved so I knew he was still alive and didn't have to pull over to check. My husband gave me my first PIO shot yesterday, and I successfully gave myself the second one this morning. I keep forgetting whether I've taken my Es.trace, so then I take another one, which means there have been some days where I've probably taken four instead of three. Let's hope this doesn't matter.

T minus one week (fingers crossed)

I had my ultrasound and pre-op appointment this morning.

Lining: 8mm and on target.
Antral follicles: 25 (not sure why they track this in an FET, but I do like to know)
Cysts: 1, but it isn't big enough to worry about (allegedly) and should go away with my increased es.trogen intake.

My PIO shots start Sunday. I say that as if they will just start on their own. Hardly!

I also reserved a spot next month among the fresh cyclers in case this one doesn't work out. If it doesn't work out, though, I might still cancel the fresh, but I thought I should go ahead and have that as an option before we move. Also, as I've mentioned, I do love that twilight anesthesia they give you at ER.

Today, So.ren and I are driving to Chicago to meet up with my husband, see some friends, and, on the way home, go to IK.EA. Good times!

Misery loves company, and there ain't none

So.ren's molars appear to be breaking through - he's been SHRIEKING since about 8:30pm. I've given him ibupro.fen, ora.jel, and a bottle. Each seems to help, but not for long. This is when it would be especially nice to have my husband here, even if both of us ended up staying up all night.

When we were in California back in October, we were staying with some friends who had a then-11-month-old who had molars coming in. I guess he was shrieking, too, so they'd put him in another room and let him scream (after comforting him a few times and giving him ibuprofen) until he'd pass out. They are experienced parents. They also have a big house. I don't think that plan is going to work for me for both mental (too afraid to NOT listen to him) and logistical (house not big enough to sequester screams) reasons.

At times like these, I remind myself how much I wanted him. It does seem to help. I think that if I'd had a baby easily, I would ONLY complain instead of complaining and then having a reality check. Hey, something infertility is good for!

The best thing about that trip is that it's over

If I tell you that I plan to take So.ren by myself on another plane flight, just go ahead and lock me in a padded room. There will be NO MORE FLYING SOLO WITH BABIES around here. Being a prodigy, So.ren has already, at 11 months, learned to throw tantrums, shake his head no, and attempt to do every single thing I don't want him to do (e.g., grab coiffed white hair of old lady in front of us), and all of these skills were on full display. At one point, I stood up with him in the back of the plane by the bathrooms for 50 minutes. Good times. I also shed a few tears during that period, I am embarrassed to admit.

Also, my fingers appeared to bloat up a bit - either from something related to travel or from the Es.trace - and I could NOT get my ring off of my right hand for about 36 hours. It hurt. Finally, I yanked it (and some skin) off today, and the world is looking much rosier.

On deck for this week: ultrasound on Friday, followed by driving to Chicago with So.ren. At least if he's shrieking the whole time, we won't be bothering anyone else.

I'm sorry; I wasn't paying attention. You see, my cervix hurts.

Well, that laminaria left a crampy legacy, despite the fact that I took it out last night. I've found my attention wandering today, and not even because I was near the Internet - rather, it was because my cervix kinda hurts. I hope it will be the easiest, breeziest ET of all time on 5/9.

Last night, I had a very difficult time going to sleep because I have this mild-but-irritating dry cough. Well, this turned out to be an even more unfortunate twist of fate because poor So.ren got food poisoning and barfed repeatedly all over his crib and sleepsack and blanket bear, and this, in turn, understandably made him feel upset. I am running on so little sleep right now that I think I might have hallucinated my entire day so far. So.ren seemed fine again this morning, so I'll keep my fingers crossed for a blissful night's sleep tonight and a much-needed trip to the gym in the morning.

On Thursday, we're off to Southern California for my father-in-law's birthday and a wedding. This will be my first time flying solo with So.ren. I think he's too young to drug, unfortunately.

I would still like to know how someone discovered that seaweed dilates cervixes

I just refreshed my memory of my last laminaria placement by reading about it. This time, I asked the assembled parties (RE, nurse, ultrasound tech) how someone discovered that seaweed opens the cervix, but I didn't get an answer because it was comedy hour in the clinic today, and they were sharing some inside joke at the moment.

This time, as before, the RE wanted to try a "sounding," where they try to thread the catheter through just for the heck of it. He actually did manage to get it through my hairpin turn (or, as he called it, "mountain road") of a cervix, but it wasn't easy, so we went ahead with the laminaria. Novac.aine was again injected into my cervix. Various implements were shoved here and there. The RE elected to use real seaweed instead of some synthetic version because the real seaweed is longer, thereby allowing him to cram it further in. He succeeded, which may make transfer a bit easier this time, though I will still have Dem.erol and B.uspar to take the edge off. I also have Ty.lenol 3s for use tonight if I need them (or for barter if I don't). I am definitely crampier this time from the laminaria - last time, it was a breeze. Maybe I was drunk or something.

For those of you keeping score at home, here are the highlights of the upcoming schedule:

Now through 4/30: Es.trace, 2x/day; also baby aspirin, which I'd forgotten about
On 5/1: Up the Es.trace to 3x/day
On 5/2: Ultrasound/"pre-op" appointment to check lining and ensure no ovulation occurred
On 5/4: Start 50mg (1ml) PIO in ethyl oleate 1x/day. All 7 embryos will be thawed - they are PN1s (pronuclear, frozen at day 1) - and put into culture.
On 5/9: Assuming embryos thawed OK and have cultured successfully, transfer one blastocyst (God and other deities willing).
On 5/10: 20th anniversary party for IVF clinic. With a bunch of infertiles, you'd think that they'd serve some booze, but it's 2-4pm, so I'm guessing not.
5/10-5/17ish: 2wfw (two-week fucking wait; at least the 5dt 2ww is really more like 10 days, and I will totally POAS by 8dp5dt)
Post-5/17: If pregnant, live it up before you start puking! If not pregnant, start drinking!

So.ren got his second-to-last rabies shot this morning; the last one will be on Cinco de Mayo. FYI, 7:30am may be a good time to go to the ER, but by God if you let it slip to 7:44, all hell breaks loose and you'll be there 1.5 hours.

Game on, bitches!

AF arrived this afternoon, so I am going to count tomorrow as my first "full-flow" (and hence Es.trace) day. Now, FET cycles aren't as exciting as fresh cycles, which offer much more monitoring, but I'll be sure to weigh in with detailed descriptions of the nausea and bloating I get from Est.race.

Currently worrying me: (1) what if the embryos don't survive the thaw?, (2) what if none of them makes it to blastocyst? (note: based on past experience, I have insisted on a blast transfer since it is my belief that if my embryos don't make it to blast, they don't have a chance), and (3) what if one of them implants upon my c-section scar, which I've read is a form of ectopic???

Anyway, here we go again. Enjoy the ride!

Four down, two to go

So.ren has now endured four rabies-related shots (one immunoglobulin, three rabies vaccines). He'll have two more, but at least we get a week off before the next one. FYI, the best time to go to the ER for the shots seems to be around 7:30am.

I made the bat guy come back, too, to check things out. He brought his tween son, thereby ensuring that someone (in this case, my mother) would make a Bat.man/Rob.in joke. They pulled out some insulation from the basement and found some large droppings indicating big brown bats, which have a wingspan of 16 inches or so. They plugged up the hole that had apparently let the bats in, and he assured me that we wouldn't turn out to be one of those houses where there are, like, 500 bats hiding somewhere.

So.ren has some molars coming in, it appears. He's been a little crotchety, but that may also be because I continue to prevent him from hurling himself down the stairs, smashing the Ti.Vo remote through the glass door, eating toxins, and diving into the toilet. I know I'll be glad when he's 11 and still loves me, but right now I have moments of envying my friends who have girl babies. So much calmer! One of my friends said that she realized her house was childproofed for girls and not for boys when some little boy came over and grabbed a highball glass from a low shelf, whereas her daughter never did that. So.ren proved the wisdom of her observation when we were over at local friend T-Bone's house last night, and he tried to overturn several houseplants that her daughter had never touched. This was after he'd removed two different grates from heating vents and overturned the dog's water dish. It's a good thing he's cute.

Good vibes to Single Tracey

Today, Single Tracey is having an FET. Please go over and wish her good luck!

Update: I think I am a curse or something - Tracey's FET was cancelled because the embryos didn't survive the thaw. Go over and give her some support.

Really, I tried to avoid being a bad mother (at least in this category)

We live in an old house. It was built in 1843 as living quarters for farmhands or something like that, and while it has had many modern conveniences added since then, it is still, at its core, an old house. One typical old-house problem it didn't initially have, however, was bats. But we added insulation, thinking we were being all green and shit, and it turns out that bats totally LURV insulation, and in the winter of 2006/2007 we started hearing noises in our attic (which is a teeny-tiny crawl space). They were chirruping and scratching noises, and I gamely tried to convince myself that they could be from, say, songbirds or a benevolent elf. Then my coworker said, "Oh, they're probably bats," and I got on the horn STAT with the local pest/bat people. Actually, I think I didn't do anything until I found a dead mouse in the house, and then I casually mentioned the attic noises to the pest guy who came over, and the next thing I knew I was paying something like $600 or $700 for "guaranteed" bat service, which involves the bat guy plugging up all the places bats can get in and also putting in one-way valves that let the bats out but not back in.

The "guaranteed" bat service involved a checkup six months later to make sure there were no bats. No one came to check, but I was on it. I kept calling them and asking them to come check. Then it was winter, and I heard those same noises in our chimney area. The dog always seemed unconcerned, and I now know not to trust him.* The bat people said they couldn't check until the snow was off the roof. Well, this winter SUCKED ASS, and the snow was on the roof until recently. I called again. They said I was on the list. And then, finally, the bat guy came last Thursday and did some checking and plugging (for which I paid $93), but he said he didn't see any signs of bats.

On Saturday night, two days after the bat guy was there, we looked up and saw a BAT flying around the house. I suggested that maybe it was a songbird or possibly a Wonder Twin in the form of a bat, but it was a goddamned bat. We had no idea where it came from. After it had been flying around for a couple of minutes, I thought to shut the door to the upstairs, but could we definitively say that it hadn't been upstairs, where So.ren was sleeping? No. My husband got the bat out the front door, and thought it maybe looked hurt, but he also might have hit it with the broom.

I called the pediatrician on Monday to report the bat incident in the hopes that they'd say something like, "Oh, that must have been the benevolent elf species of bat, which is never rabid; don't worry about it." Instead, they said, "Take So.ren to the ER immediately for immunoglobulin and the first rabies shot. Then go back on day 3, 7, 14, and 28." So we (my mother and I) did.

Here are my recommendations from this experience:

1. If you have a bat in your house, catch it. (How? I don't know.) This will allow you to have the bat tested for rabies, which may mean you don't need to have any shots or subject your poor, tired, squirmy, SCREAMING child to such shots.

2. Do not go to the ER around dinnertime. You'd think people would be at home watching television, but, no, TiVo means that they can go to the ER at dinnertime. I think I'll try 8am for shots 2 through 5. (Why do we have to go to the ER for every shot? I don't know.)

3. If they offer to weigh your baby, accept. This way, you'll know that it's 24 lbs. that you're holding for hours, which means it was totally fine to skip the gym.

4. If you do catch a bat in your house, you can call the police about it. (This according to the family in the waiting room next to ours. I suspect the police then called animal control, but hey.)

And that, dear friends, is how I am currently FAR IN THE LEAD for bad mother of the year. I'm really looking forward to shots 2 through 5. No, really. Damned CDC guidelines. (Better safe than sorry, though.)

* The dog has been living a lie. This morning, my mother found him sleeping on the couch. He has never tried this when we're there, and when we come downstairs in the morning, he is always standing on the floor. My mother apparently snuck up on him since the guest room is on the first floor.

Reunion with dildocam

When I was in my early 20s, I worked in a very demanding job, as I have mentioned before here and often mention in public as a way of legitimizing my existence. As a consequence of the long hours in that job, I neglected my health. As a consequence of neglecting health matters such as regular teeth-cleaning, I ended up with the first cavities I'd ever had. Once I was forced to go to the dentist for an emergency visit because I had a visible hole in one of my molars, I found that not only did I have my first cavity, but I also had 23 additional cavities to keep it company. Some teeth had more than one cavity. I ended up having four root canals, which were done by this insane guy with dyed-black hair who barked at his little assistants (who were uniformly Asian) but was very quick and effective. For the rest of the cavities, my regular dentist scheduled me for fillings in groups - that is, I would come in, have one section of my mouth numbed up by nova.caine, and then get those cavities filled. Over time, I found that I was no longer afraid of the nov.acaine shot and in fact kind of relished the moment when that long, sharp needle would slide into my jaw. I thought they would never bother me again. That was incorrect. I've had a few fillings replaced recently, and I did NOT dig the needle at all.

You know where I'm going with this. With IVF, I got used to the needles and the dildocams, and I even felt a bit tough since I could give myself my shots without flinching, and giving up some blood for e2 levels was hardly worth even sighing over. I won't say I ever enjoyed the dildocams (if you did, you may want to keep that to yourself), but I did get used to them. But by the time I had to give blood for one of the pregnancy-related tests (glucose?), I had grown soft again and may have even clenched my teeth as the needle was sliding into my arm.

I had my midcycle ultrasound this morning to check for scarring from my c-section or other abnormalities. This was my first dildocam adventure since I was about six weeks pregnant with So.ren, and I found it deeply uncomfortable. That said, the clinic has moved to some shiny new digs, and they had a monitor installed on the ceiling that you could watch from the examination table. Here's what we saw:

- Lining was plush, striped, and, according to the ultrasound technician, "beautiful."
- Antral follicles were at 25, which was lower than the 29 or so I'd had during my first fertility workup, but I am three years older now, and so are my ovaries. I felt happy about 25 in case we need to do another fresh cycle.
- C-section scar had some fluid in it, but the RE claimed that it wasn't enough to leak back into the uterine cavity and disrupt the ambience.
- There was a HUGE ovulating follicle on my right ovary - I've never had any midcycle monitoring before (outside of fresh IVF cycles, when you don't have a dominant follicle), so this was interesting. I thought it was a tumor at first, but instead of being upset, I just felt this was typical behavior from my right ovary. I believe this means I am ovulating on day 12 instead of day 14. It's nice to see an uptick in productivity from the old reproductive system.
- The right ovary had several endometriomas on it, but they are small at the moment. We'll see what happens after they get all juiced up on Es.trace.

So that's the latest. Now, we wait for my next AF to arrive, and then I'll start the Est.race. The clinic is ordering me some PIO suspended in something lighter than whatever it is normally in so that I can use 25-gauge needles instead of the thicker 22s. I requested this since I will be giving them to myself due to my husband's inconvenient geographic location. I'll need to figure out a place to hide the needles from So.ren, who would be delighted to find a hazard that held the possibilities of both injury and overdose, and the people who will be looking at our house once we get it on the market.

This blog may liven up again

I talked to a nurse at the IVF clinic today, and here's our tentative plan:

- Get preliminary ultrasound on 4/1 to check condition of uterus.
- When period arrives in mid-April, start Es.trace 2x/day.
- 4-5 days after period, get laminaria placed, left in place for four hours, then removed, leaving a much more agreeable cervix to work with.
- 2-3 weeks into the Es.trace-taking, get an ultrasound to check lining.
- Up the Es.trace to 3x/day, add PIO or suppositories, which they say have now been proven to be as effective or nearly as effective as the shots.
- Tentative FET date: 5/9 (a Friday, so my husband could potentially be there).
- Four hours before FET, gobble ibuprofen; one hour before FET, take Bus.par and Dem.erol; feel happy.
- Dive back into the 2ww!

Mmmmmm.....I can just taste the hope and despair already!

I thought I was kind of joking about the fears

My husband left for California yesterday. This morning, at about 6:45, I heard a bunch of sirens. I didn't think much of it, since the emergency services in this town tend to overreact (though I'd certainly feel as if my emergency were being taken seriously if I had been the one to call for an ambulance and received, say, four). But when I got to the gym, MSNBC had a breaking news alert that there was a shooter in our little city! So.ren was semi-safely ensconced in the gym daycare, where the child-to-caregiver ratio was about 15:1 at that moment. I turned to the local news station and got more info about the shooter, who killed his wife and four kids. On our side of town. And he was still at that moment thought to be on the loose.

And then everyone at the gym was huddled in corners, and many people were crying. It turns out that the wife was an early-morning regular at the gym and the coffeehouse next door. And the husband had recently been indicted for embezzling hundreds of thousands of dollars from his job to support his cocaine habit. And all four kids were adopted. Not like it would be okay if they were biological; it just somehow seems even more awful that they were adopted.

The man apparently crashed his car into a sign on the interstate and burned alive. I'm not sure why he couldn't have just done that first instead of killing five other people.

Fear, denial

My husband moves to CA on Sunday. I've been ignoring that fact fairly successfully, although I have been pushing him to get some manly tasks done (e.g., cleaning the gutters) before he goes.

I have some irrational (or maybe partially rational but still weird) fears related to being a solo parent. One, what if I die in my sleep? Actually, this is probably the best-case scenario of my worst-case scenarios, since if I were asleep, it would mean So.ren would be in his crib and more or less safe until the babysitter arrived to find my cold, dead body. I am more worried about, like, falling down the stairs while holding So.ren, who is now totally mobile and EXTREMELY INTERESTED in anything hazardous. So what if I fell down the stairs and got knocked unconscious, and So.ren either got hurt or was okay but crawled into the fireplace or chewed a power cable and then the dog ate both of our bodies? I need to think of some system for alerting people that I am still alive at appropriate intervals (end of day, start of day) so that they can send in reinforcements to check on our welfare if needed. The dog, incidentally, would be completely useless and not one of those heroic pets who calls 911 or alerts the neighbors by barking "SOS."

Also, what if I am somehow responsible for injury or death befalling So.ren? My husband is usually the delinquent overseer (for instance, while he was "watching" So.ren the other day, I returned to find So.ren halfway up our very steep stairs while my husband was emailing and thought the baby was still in the room), but what if I start developing similar habits? More realistically, what will happen to So.ren if I am so afraid of his getting hurt that I don't let him do anything? His muscles might atrophy and he could lose all social skills.

Wow, that sounds insane. I hope by verbalizing my fears, I will be inoculated against their coming true.

We also decided not to do an FET until May for a few logistical reasons, such as that we have to go to my father-in-law's 70th birthday party and a wedding in late April, right around the time we'd be getting the FET done, so why not just wait until May? This sort of blithe toying with the schedule probably ensures that it won't work.

[Pictured above: So.ren at 10 months, ready to dive off the couch and go in search of hazards.]

Well, that was nice.

I may have mentioned before that I actually like my insurance provider (or maybe it's just that I like my coverage, which is very good, which then means fewer fights with the provider). Anyway, I just called them to find out how much fertility coverage I have left since my plan has a $25K lifetime limit, and I'd obviously used up some of that for tests, two fresh IVFs, and one FET. (Conveniently, since my hospital/clinic is the largest one in the area and the provider is also the largest one in the area, there are negotiated rates with the hospital/clinic that are much lower than list prices, and the negotiated rate is what gets counted against your lifetime limit.)

It took the phone rep a while to find the answer (which was that I have about $5K left), but after telling me the details, she then paused and very kindly said, "And good luck!" I temporarily felt warmth for my fellow man.