Archive for March, 2011

Fertnal: Just call me Seymour…

Thursday, March 31st, 2011

I sure hope that gestating counts as (re)productive, because otherwise this has been my least productive week in years.

My primary experience is fatigue. I sleep 10 hours at night and on good days I get a two-plus-hour nap. You would think that leaves lots of time to run errands and Get Things Done, but somehow I’m not managing any of that. Forget running around; my biggest outings have been driving to the clinic for tests, and walking 2-4 blocks to go eat lunch with Bill at La Mexicana or Aladdin.

What’s most disruptive is the frequency and ferociousness with which these tiny beings demand to be fed. I wake up, feeling an unsettling combination of ravenous and nauseous. My Super Sweetie of a husband slips me a bowl of fresh pineapple chunks as he fires up the stove to scramble a couple eggs and grill a slice of Canadian bacon to go on a whole wheat English muffin.

Please note, this is a man who historically has fed himself cereal rather than a hot breakfast because it’s easier. He’s truly going all out for us, and I’m entirely grateful.

After I’ve polished off the Egg (Mc)Muffin, I’m less hungry and still tired. If I’m feeling ambitious, I head to my desk to try to do a little work, but actually just browse the interwebs. If not, I go lie down to read on the sofa. Either way, it isn’t more than 60-90 minutes before they insist, “FEED ME!” again.

Another aside: my hat is off to you gals who have held full-time jobs or tackled organic chemistry while pregnant. You have both my sympathy and my admiration. Maybe I’m just old, but I don’t think I could do it.

Judging by today’s ultrasound results, our embryos are putting all that food to good use, tripling in size in the last 8 days. “Audrey A” is now approximately 10.6 mm long and “Audrey B” is up to approximately 10.0 mm (1 cm). I asked whether the difference is size is meaningful and Dr. M assured us that it’s probably measurement error. Both have good strong heart rates, at 156 and 139 bpm respectively.

In case you aren’t in to musical theater… no, we don’t know their genders yet, and no, we haven’t discussed naming either of them Audrey. It’s a reference to Little Shop of Horrors, which stars a voracious people-eating plant. Sound familiar?

So our little embryos are 37 days old and growing like crazy. Our next check up is in two weeks. Only ~230 more days to go!

p.s. If you’re interested, you can watch and listen as Dr. M narrates our ultrasound from this morning, including both embryos’ heartbeats:

Get the Flash Player to see this video.




Dr. M described this simultaneous view of both our embryos as “owl eyes”

For reference, also via the UNSW Embryology site, here’s an amazing photograph of a comparably-aged human embryo (click for larger):


Photo of a ~5-week-old human embryo

Here’s what the photographer, Houston pathologist Ed Uthman, said about this photo:

“This photo of an opened oviduct with an ectopic pregnancy features a spectacularly well preserved 10-millimeter embryo. It is uncommon to see any embryo at all in an ectopic, and for one to be this well preserved (and undisturbed by the prosector’s knife) is quite unusual.

Even an embryo this tiny shows very distinct anatomic features, including tail, limb buds, heart (which actually protrudes from the chest), eye cups, cornea/lens, brain, and prominent segmentation into somites. The gestational sac is surrounded by a myriad of chorionic villi resembling elongate party balloons. This embryo is about five weeks old (or seven weeks in the biologically misleading but eminently practical dating system used in obstetrics).

The photo was taken on Kodak Elite 200 slide film, with a Minolta X-370 camera and 100mm f/4 Rokkor bellows lens at near-full extension. The formalin-fixed specimen was immersed in tapwater and pinned to a tray lined with black velvet. The exposure was 1/4 second at f/8.”

Fertnal: Rollercoaster of love…

Thursday, March 24th, 2011

Once upon a time, I thought that “pregnant” is a boolean state: either you’re pregnant, or you’re not. However, I now attest that pregnant is a continuum, ranging from “a little bit” to “WAAAAYY” pregnant, presumably with lots of levels in between.

We learned that I’m finally pregnant on March 9th. In that first week of being “late,” I convinced myself at least twice that it was over. There were days where I just didn’t feel weird, or didn’t feel weird enough. It was easy to imagine that all of the hormones I’m taking could make my body go through the motions even if something went wrong.

By the second week, I finally began to feel pregnant-ish everyday. But then I had at least two scary occasions of cramping and/or bleeding that convinced me it was ending again. My nurse reassured me that cramping is normal and some minimal bleeding can be normal, but after so many years of not getting pregnant, the combination was very disconcerting.

On March 23rd, Bill and I went in together for our first ultrasound. I was really anxious to ask Dr. M about the bleeding, but she began immediately with the ultrasound. I’ve had a LOT of ultrasounds in the last six years and I must not look as carefully at them as I once did. I watched as a couple of ovaries came into view onscreen, but I was still thinking of questions I wanted to ask. I was caught off guard when Dr. M said, “Well, look what we have here!”

I’m thinking, wait… what did I miss?

Dr. M: “You have two embryos here!”

Oh! Those weren’t ovaries; they’re yolk sacs with tiny embryos in them!

First, Dr. M measured the yolk sacs, and then she found and measured tiny white bits that looked like grains of rice, which are the actual embryos. She said the embryos are each right at 3.3 mm and that they are growing right on schedule.

She then said, “Do you see these bits blinking? Those are heartbeats!” And then she switched to audio, so that we could hear the rapid thip-thip-thip-thip-thip of each tiny heartbeat.

Wow.

Somehow, we have not one but two tiny proto-humans growing inside me. And though they’ve existed for only 29 days and are each just ~1/8 inch long, they’ve already built tiny hearts that go thip-thip-thip-thip-thip.

Astonishing!


Our fraternal twin yolk sacs containing tiny embryos

For reference, the UNSW Embryology site has amazing electron microscope images of human embryos at various “Carnegie” stages of development. Here’s what a 30-day-old embryo looks like close up (click for larger):


Reference image of a 30-day-old human embryo

So… twins. We’re feeling a little daunted about how hard this is going to be, but we’re ecstatic to finally have the opportunity to complete our family in one fell swoop. And it’s nice that my clinic statements no longer pronounce the depressing diagnosis of “diminished ovarian reserve.” They now say “twin pregnancy.” Sweet.

Adventias: Moving day, the sequel

Saturday, March 19th, 2011

Two years ago, I moved Gran’mom into Belmont Village, an assisted living facility here in Houston. Sarah’s younger brother Frank was living in Las Vegas, and his wonderful wife, Gitta, died around the same time, leaving him alone there.

Two years later, Frank is needing some of the care Sarah has been getting. A few weeks ago, his daughter Sharon asked Frank if he would consider moving to Houston, where she could help him more easily and he could be close to Sarah. He agreed, and — unlike some of us — didn’t spend months weighing the merits of moving. With the help of much heroic coordination by Sharon, Al, Nancy, and Chrissy, Frank arrived here Friday. (I can’t begin to do their efforts justice here, but my hat is off to them!)

Frank and Sharon
Frank and Sharon woke at 3:30 am to fly to Houston Friday

Sarah and I joined Frank and Sharon for a welcome dinner in Belmont’s dining room, where we enjoyed a merry and emotional hour catching up and scheming entertaining diversions to pursue together in the weeks and months ahead. (Anyone want to come celebrate several August birthdays together in Houston this year? This family has quite the critical mass of them…) Afterward, we sat a while on the flower balcony and enjoyed the fine spring evening.

Frank and Sarah
Frank and Sarah

Frank and Sarah

Finally, we were all ready to part company for bed. But before we left, Frank made plans to join Sarah for breakfast, and we all agreed to visit again soon. I know moving is hard, but I’m overwhelmingly optimistic about Frank’s arrival here. Not only will Frank have better access to good medical care and better supervision with family in town, but also the potential for Frank and Sarah to entertain each other is enormous. This could be fun!

Stormy
Frank brought along Stormy, his charming new companion

Fertnal: A little good news for a change

Wednesday, March 9th, 2011

As you know, Bill and I have been working with doctors to help start our family.

The mind-fuck of fertility treatment is that the hormones you take to sustain a hoped-for pregnancy make you feel an awful lot like you’re pregnant: tired with puffy boobs and a vague sense of fullness. I even start waking up in the middle of the night needing to pee. But through 8 assisted cycles over 6 1/2 years, I felt all those symptoms with no pregnancy.

Just once — when we tried again last fall during our blogging hiatus — things felt ever so slightly different. I felt the same tiredness and puffiness and fullness… and then there were also some cramps. Plus I suddenly and inexplicably became a “tinkler” and the world started to smell funny. But after a couple of weeks, just as abruptly, things went back to normal. A blood test showed that I was — or perhaps, had been — a little pregnant, but not enough to sustain and build a person.

In January, Bill and I mustered enough hope to try One More Time. After weeks of hormone prep, starting the progesterone brought all the familiar signs/not-signs. Embryo transfer was February 28, and encouragingly, this cycle began to feel more like the last one than the 8 that had come before. Again there were cramps, which are ostensibly a “good sign.” Again, I became a “tinkler”. My breasts were not only fuller but occasionally sensitive. The world didn’t smell funny, but I was occasionally struck — by the aroma of fresh raspberries, for example — and my stomach occasionally felt squiggly and unsettled. Stomach bug or pregnancy, it could go either way.

When the alarm went off at 8:00 am on March 9th, I remembered that it was Blood Test Day, and vascillated between getting up and snoozing for a little while. I pondered my body and whether I felt different “enough” to earn good news. But then suddenly, I was Hungry. I brushed my teeth, put in my contacts, and headed to the kitchen. As I started to cook my daily oatmeal, I abruptly realized that I was too hungry to wait 6-8 minutes for oatmeal and toasted some sourdough instead. I felt just weird enough to think it plausible.

As I left for the clinic, I received a handful of text messages — words of encouragement and hope — from thoughtful girlfriends. At the clinic, my doctor found me in the hall and declared she was bringing me a hug “for good luck.” (Have I mentioned that I love Dr. M?) I went home, rousted the husband, and scrambled some eggs for second breakfast while we waited.

At 11:07 am, Nurse A called, bubbling with excitement, to relay “good news”: my lab results “looked great.” The lab had measured the level of human chorionic gonadotropin — hcg — in my blood. HCG is produced by a developing placenta. A level higher than 50 mIU/ml indicates a healthy pregnancy, and last cycle, I only got to 6 mIU/ml. But this time Nurse A reported my level was 238 mIU/ml and declared me “very pregnant.”

Wow.

After crying some joyful tears, calling our parents, and doing my morning meds, we went to lunch at Cafe Express. As we approached the counter, I was struck by the smell of olives, capers, gherkins, etc. and asked Bill, “does their oasis bar smell overwhelmingly vinegary today, or is it just me?” He laughed and said it was me. We sat on the patio in the lovely spring sunshine and I mused that there weren’t just two of us anymore.

Wednesday night, we joined friends Mike, Susan, Rachel, and Rob to celebrate John and Robert’s ninth birthday. As the evening wound on, I began to yawn uncontrollably, and decided it was dark and late and time to go home to bed… and realized it wasn’t even 8:00 pm yet. At only “4 weeks” pregnant, I could already tell this pregnancy could kick my ass.

* * *
They advise us it’s too soon to tell people. It’s very early and things may not progress the way we hope. But we are closer to becoming parents than we’ve ever been before, and we are feeling hopeful. We want to share our hope with you, our loved ones who have been so encouraging through our long, long journey. We’re enjoying having a little good news for a change, and we hope you will, too.