I swear I’m going to make this a quick thought collection (something I’m really bad at usually!), because I’m at a conference and it’s late.
First: I saw on another blog this week the idea that when you achieve pregnancy after infertility there’s another two-week wait after the two-week wait. Since I assumed I wasn’t pregnant (since I’d been told it was highly unlikely and we’d need to do IVF), I had the easiest two-week wait ever. But this week and next are the nail-biters. I’m being monitored very closely for an ectopic pregnancy, and I’m also at a conference in Tennessee. Two separate nurses had told me that it would be fine to get my betas checked on Tuesday before I left for the conference and then wait until Saturday after I got back. But after they called me with the results Tuesday afternoon (while I was waiting for a flight in the Charlotte airport — chaos!), they called back 20 minutes later and told me that the doctor wanted to monitor me even more closely and that I was supposed to find a lab in Tennessee where I could do the second beta on Thursday.
Why? Well, apparently my first beta was higher than expected (921 at 18 dpo, baby!). This is normally a very good thing… but apparently in the context of a suspected ectopic it’s cause for alarm, because a bigger number means a fast-growing embryo, and things start to get dangerous at around 2000 (that’s also usually the level at which the embryo is visible on ultrasound, not coincidentally). As I understand it, my high betas are a positive sign, since a majority of ectopic pregnancies top out below a level of 1000 (i.e., they stop growing before that point). But for the minority of ectopic pregnancies that do keep growing, they’re the most dangerous kind, since they’re the kind that causes tubal rupture and internal bleeding, which is a leading cause of pregnancy-related death in women. So, yay high betas! But also, ack high betas! Hopefully I’ll have a better idea tomorrow. Apparently the order is in the Quest system (a national system of somewhat standardized laboratories) as a “STAT” order, and my instructions are to call my nurses and give them the phone number of the lab I go to so that they can track down my numbers as soon as they are available. Yeah, this week is a nail-biter indeed.
I’m also adjusting to the concept of being pregnant again. There are several weird things about this pregnancy:
1) We conceived almost exactly 1 year plus 1 week after our last conception. That means that everything is happening at exactly the same time of year as it did last summer. This is seriously messing with my head.
2) I’ve got imposter syndrome on top of imposter syndrome with this pregnancy. In our first pregnancy, we conceived after the relatively benign infertility diagnosis of oligoovulation. But any pregnancy after infertility messes with your head. I remember turning down drinks and thinking “well, this is silly, since I’m not really pregnant anyway.” This year, when a fellow conference organizer offered me a drink, I almost said yes. I’m not sure I can explain my thought process, but it was something along the lines of “I can’t even pretend that I’m pretending to be pregnant right now.” Yeah, I’m not going to be able to translate this feeling into words. It’s just too surreal!
3) I realized yesterday that I’m thinking of this as “Pregnancy #2.” It’s a number. Now that I’ve stuck it on the number line, not even the first one, it seems more like part of a process than like an event that might lead to my first living child. I’ve watched so many people in this space go through so many pregnancies that I think I’ve stopped truly believing that some pregnancies do end well — my “new normal” is believing that you’ve got to slog through an awful lot of misery before you get that shiny living baby. Maybe I haven’t been through enough yet, and I’ll just have to move on to pregnancy #3. When I found out I was pregnant for the first time, I wrote on my chart in all caps “I AM PREGNANT!!!!” This year I wrote “I am pregnant again.” I think I’m going through a lot of the things that second-time moms go through — the first time around I was freaking out about every twinge and bit of gas. This time through I realize just how very, very far I have to go, and how very, very uncertain this pregnancy is. Even with the frenzy over the possible ectopic pregnancy, I feel like I’m just along for the ride at this point. Ectopic? Well, I’ll deal with that. Miscarriage? Well, as long as it happens early. Needles? Bring ’em on. I am just not going through another 4.5-month loss if I can help it.
So much for those quick thoughts, eh? 🙂 Well, we’ve got a plan, we’ve coordinated a set of appointments over the next few weeks with the RE, the MFM specialist, and oh yeah, my local OB. Thing is, I know there’s nothing that any of them can do to help keep my pregnancy healthy at this stage, but at least the constant information will be reassuring (in the best case scenario).
It’s a nail-biter, all right, but I’m happy about my high betas on Tuesday and nervous/excited to see if they’ve ~doubled tomorrow. Wish me luck.