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).