Tag Archives: RPL

Tenure

Well, it’s official! I somehow managed to miss not one but TWO calls from the university president to my cell phone this weekend, though as a result I now have the call recorded on voicemail and can listen to it on repeat.  I got the call in front of my husband and kids and did a wild happy dance while I was listening to it, so of course my three-year-old asked for it over and over again that night: “Mama, I want to listen to when you got tenure again.” (My heart, it melts!)

We celebrated at a local Italian bakery.  S had cannolis for the first time at his friend I’s birthday party at daycare this week, and apparently cried when he couldn’t have seconds.  I gave him the choice between ice cream and cannolis, and he chose cannolis, but then once we got there wound up more interested in the fruit cake and chocolate mousse.  What could I say… eat your heart out, kiddo!  Maybe we’ll do this again if I ever get promoted to full professor. 🙂 Here’s the photographic evidence:

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Friends, SO MUCH LIFE has happened on the tenure track. In case you’ve missed the tally along the line, here’s the cliffs notes version of what didn’t go into my tenure packet…

Year 1: Adopt a dog! Get married!
Year 2: Start infertility testing. Last grandparent dies. Get pregnant! Buy a house! Baby girl dies in the middle of the second trimester.
Year 3: Lots of infertility/loss testing/treatment. Get pregnant again! 
Year 4: Baby boy S is born!
Year 5: Start trying for #2. Miscarriage. Father dies suddenly. Miscarriage. Mother has major surgery #1. Start recurrent loss testing.
Year 6: Pregnancy #5. Mother has major surgery #2. Baby boy L is born!
Year 7: Somehow… tenure!!!

It’s been quite a ride, and since I’ve been busy thanking everyone who helped me along the way this week, I wanted to make sure to give you all a big, giant THANK YOU.  As I look back down that list, I would definitely not have made it through years 3-6 without this outlet.  I am so grateful to those of you who have been with me, cheering me on, for part or all of this journey.  It’s been a wild ride, but I couldn’t be more grateful to be where I am now, and to have met such amazing people along the way.

Tenure/Pregnancy update: End-of-summer edition

30 weeks pregnant and all was well at our monthly ultrasound this week.  Little guy is bopping around in there, currently lying sideways across my belly.  My husband and I have settled on a default name (unless we come up with something we like better by the time he is born) and are setting up the nursery.  I don’t remember at what point we did all this with S, but I think it was later.  I do remember that this was the point in my pregnancy with S at which our dear friends offered to throw us a shower, and I broke down in tears and just couldn’t handle the idea of planning for a living baby (the upshot was that we agreed on a “sip-and-see” a few months after S was born, which was a lovely compromise).  Some days I still can’t handle the idea of planning for another living baby (how lucky can we possibly hope to be???), and some days that’s all I can think about.  I still feel plenty of pregnancy impostor syndrome — like, this pregnancy isn’t actually going to last, there’s not actually going to be a new baby, it could all come crashing down at any moment.  But I’m at least able to act more normal this time around, mostly not responding weirdly to people’s innocent inquiries about whether this is our first (standard answer: “No.  We have a 2.5-year-old at home”) or jibes about how we’ll have our hands full with two boys (standard answer: “I sure hope so!”).

On the tenure side, I submitted my materials to my department today!  Hooray!  Now comes a long, long wait.  If I’m lucky, I’ll have a final answer by May 2019, and if I’m not lucky, I’ll have a final answer by December 2019.  The big steps in the process are:

  • This fall the department solicits letters from experts in my field around the country/world who can comment on my research portfolio.  This process typically takes a couple of months, as I understand — it happens in two stages, the first of which involves sending letters asking people if they will agree to write letters, and the second of which involves sending letters asking them to actually write the letters and then waiting for the responses.
  • Hopefully by the end of fall, but possibly later if there are delays, my department will have collected all of the external letters and will meet to go over all of my materials and vote on my case.
  • After my department has made its recommendation, presumably sometime in the spring, my case will go to a university-wide faculty committee for evaluation.  This committee currently includes members from the departments of English, Music, Gender and Sexuality Studies, Economics, Sociology, Chemistry, and Biology — there’s also one from Earth and Environmental Sciences, but she can’t vote on my case (unfortunately, since she’s the most qualified to evaluate it) because she’s officially my faculty mentor.  I go to the end of the line for the university-wide committee this year, since most faculty start at the university in the fall, but I started in the spring, so I’m on a one-semester-late review schedule.  This is the main reason for uncertainty in when I’ll get an answer about my tenure case — they will review my case in the spring if they have time, but if they are overwhelmed with fall cases they aren’t obligated to review it until next fall semester.
  • After the university-wide committee votes on my case (if the vote is positive), it goes to the Board of Trustees, and then the university president.  If I’ve gotten positive reviews at each stage up until this point, it’s usually a rubber stamp at the upper levels, but there was a case in recent memory that was positive at the department and university level but was overturned by the president, so there’s always the possibility that something weird will happen.  Since the Board of Trustees meets only a few times per year, this is another potential source of delay, depending on when the university-wide committee reviews my case.

After all of this, I’ll get a yes or no answer: either yes, I can keep my job essentially forever (barring unlikely circumstances like a major failure to meet my duties or major reorganization of the academic structure like eliminating my department), or no, I’m fired and I have to go look for another job.

It’s a long time to be in limbo, and many faculty find the uncertainty torturous.  My goal is just to try to relax and let the process play itself out, and allow myself to be distracted by the hopeful new addition to our family in November.  It’s the sort of setup that could either be really great (because I’ll be so busy with a new baby that I won’t have time to fret about tenure) or really awful (because being home with a new baby is psychologically challenging and so is waiting for news about your tenure case).

But either way, both of these big projects are looking like they’re in good shape at the moment, so I have to focus on that.  And now that I’ve turned in my materials, they have something else in common too: there’s essentially nothing I can do to change the outcome of either at this point.  The work I’m submitting for tenure has been done and documented, and this baby is baking away and the only thing I can do is to take care of myself and wait to see what happens.  I should avoid doing stupid things, like starting a feud in my department or suddenly becoming a binge drinker, but otherwise I have to accept that I have little to no control over the outcomes of either my pregnancy or my tenure case at this point.  And that’s hard for someone who likes to plan and act!  But if nothing else, my experience with pregnancy loss and infertility have given me plenty of practice at waiting, accepting lack of control, and dealing with difficult outcomes.  So, I’m pretty sure that whatever happens, we’ll make it through.

Houston, we have a heartbeat!

It’s been three years and three pregnancies since I last saw that little flickering on the ultrasound screen, but the good news is that today I got to see it again!

Since I love me some stats: I’m 6w6d, both according to LMP and ovulation date, and the fetal heart rate was 125 (anything over 120 is great).  The CRL and gestational sac both measured 7w0d, so right on target.  And there was only one embryo in there (phew).  As a point of interest, I’ve now gotten pregnant four times in a row on the right side, which suggests that that’s the only functional side left thanks to the scarring from my first pregnancy.  The summary: everything looks good so far.

Given my history, the RE wants to see me weekly until I graduate to co-management by my local OB and MFM.  So after the ultrasound today I called both of those offices to set up my first appointments.  I’m also supposed to re-start Lovenox, and possibly progesterone depending on the results of my blood test today.  Fun, fun, fun!

I also sent in the waitlist form for campus daycare.  We never sent in the form for either of my last two pregnancies, since we figured there was no point before seeing a heartbeat, so it felt like kind of a big step to do it today.  But with spots as hard to come by as they are (since they only take four infants each year), it’s important to do it as soon as possible.  It’s a little awkward now that we’re part of that tiny community — the director will see the form, and she knows us now, but I’m sure she deals with knowledge of early pregnancies (and losses) all the time.

So, even though my face is pounding with the Sinus Infection That Will Not End, I’m pretty excited.  Not too excited, mind you… I’ve been here twice before, and only one of those ended well, but it’s a really big step in the right direction to get past the point of my previous 1st-trimester losses.  And seeing that flickering little heartbeat… well, I can’t help but think about that tiny little life just starting to take shape.  It’s hard not to get just the slightest bit attached.  I hope we get to meet it some day.

Good betas

Well, I’ve got good betas.  Friday’s number: 926.  Monday’s number: 2500-something.  Doubling time: just under 48 hours.  Right on the money.

Of course, I’ve been here before.  At least three times, to be precise (we didn’t have betas drawn for the fourth pregnancy, so I don’t know if they were good or bad).  One of those times resulted in a live birth, and the others didn’t.  So, while this is an encouraging development, I’m not exactly counting any chickens just yet.

I also wanted to record a conversation that has been bugging me all day.  I was walking to a faculty meeting in a different building with my department chair, who also happens to be the closest member of my department to me in age, and with whom I am friendly.  He is currently the only person in the department who knows that I have had three miscarriages, including two since S’s birth.  As we headed over to lunch he said: “Oh, I just sent you an email about this, but remember my recent postdoc X and his wife Y?  Well, X just sent me the news that Y is 9 weeks pregnant and wanted me to share it with everyone!”

I said, “That’s great. [pause] Wow, 9 weeks… oh, to be that optimistic… But, good for them.  I’m happy for them.”

And he just kept talking, as though it was nothing.

Now, I know and like this guy.  I don’t think he meant to upset me.  But it was upsetting.  I was able to handle it OK in the moment, I think… I only expressed the twinge of wistfulness about feeling confident enough to announce a pregnancy to an entire department of your former mentors and colleagues at 9 weeks(!).  But… I would much rather have gotten the news by email, in the privacy of my office, where I could work through my feelings without needing to respond in the moment.  There was no reason for him to bring it up with me in person, other than general cluelessness surrounding my feelings about early pregnancy.  I get that he was excited for his former mentee — my colleague is a father of three young kids, and just loves babies and little kids.  I just wish he had been even a little bit sensitive to the fact of my previous losses, when clearly it didn’t even occur to him that this news might hit a nerve for me.  It made me feel lonely, and reinforced the reality that most people, perhaps especially men, don’t understand the emotional impact of pregnancy loss, particularly recurrent pregnancy loss, on women.  What it communicated to me was that he doesn’t see my losses as a big deal, and doesn’t even understand that they might be a big deal for me.

Of course, it helped that I was able to hear the news while I was pregnant, rather than two weeks ago when the testing and treatment seemed to be dragging out interminably.  It’s amazing what an emotional roller coaster every pregnancy is for me, even the fifth one.  You can bet I wasn’t in the mood to tell my chair that I was pregnant (I mean, 5 weeks is basically like 9 weeks, amirite?!), but at least I was able to feel a little bit hopeful, and then getting the news of good betas later in the day helped me feel even more hopeful.

Now I have to wait two weeks for that all-important heartbeat ultrasound, since I’ll be traveling from the 12th to the 16th of the month.  Please keep sending good wishes, especially until then!

Pregnancy #5

It’s been quite a week at our house.

Sunday and Monday we started to notice a weird rash on S’s face.  I put Aquaphor on it and forgot about it until I picked S up from daycare on Tuesday, and his daycare teacher told me he’d been scratching himself all day and seemed really uncomfortable.  “I think he has allergies,” she told me.  Then it clicked.  I’d been on amoxicillin for a week, courtesy of a nasty bout of bronchitis / sinus infection, and we’re still breastfeeding twice a day.  S had a reaction to amoxicillin when he was four months old, but his pediatrician had downplayed it and told us it was probably just a viral rash and not a true allergy.  Well, apparently it was a true allergy.

I frantically called the pediatrician’s office and my doctor’s office and after a couple of hours.  From the pediatrician: give him Benadryl for a couple of days, no breastfeeding for 48 hours after my last dose of amoxicillin, and bring him to the ER if he gets worse.  From my doctor: don’t stop the amoxicillin since your bronchitis was so bad (although the next day they called back to say that I could stop it after all, ugh).  By this point, we were already looking at a minimum of three days without breastfeeding, only a week and a half before I was to leave for a five-day trip.  It was unfortunately abrupt and not at all the way I’d wanted to do it, but it seemed like weaning was in order.  It’s after his second birthday, and I didn’t want to confuse him or stress him out with an off-again, on-again breastfeeding relationship.  After one evening of extreme weepiness and irrational irritability towards my husband on my part, I’ve been OK.  S has taken it well.  Surprisingly, he is more insistent about asking in the morning than at night, but there has been no crying or tantrums.  He accepts it when I say, “Mama has a boo-boo and can’t nurse.”  The first time I told him that, he looked really sad, but then I said, “big boys who don’t nurse get an extra story at bedtime,” and he brightened considerably.  So, I guess we’re doing this.

OK, OK, clearly I’m dragging out the punch line of the post.  I’m really glad I decided not to risk the MRI contrast this week after all.  My period was due on Wednesday, which came and went with no signs of a period at all.  I know my cycles inside and out at this point, so I was pretty sure yesterday, but I waited to make sure it wouldn’t start today, and then stopped by the drugstore to buy a test on my way home.  Lo and behold, two strong lines, right away.  Here we go with pregnancy #5.

After I told my husband, I called my mom.  I told her I was pregnant, and her immediate response was, “You didn’t tell me!”  Oy. 🙂 (I went on to point out that I was in fact telling her at that very moment, and I had only found out myself about five minutes before, so I’m not sure when exactly she would have liked me to tell her!)

At the moment I’m just sort of going with the flow (though not literally, thankfully!).  I’m not really excited yet, I’m not really scared yet… it’s just another positive pregnancy test.  My fifth.  I’ll feel a little sheepish when I call my RE’s office tomorrow, because she had told me to hold off on TTC until the hysteroscopy was completed, but she told me the day after the OPK turned positive, so it was just a bit too late.  Hopefully I haven’t doomed myself to another preventable miscarriage and the delay of the surgery that would have fixed the problem.

With every positive pregnancy test comes a little bump of hope. Smaller each time, I think, but still there.  Wish me luck.

Delayed gratification

I used to think I was pretty good at delayed gratification.  I mean, I have a PhD, which means that after college I basically said, “You know what, 17 years of school isn’t enough.  Let’s sign up for more school, which gets harder and offers less and less specific feedback as you go, with no promise of success or a lucrative job in the field that you love at the end.”  I took that leap of faith, and there were times that were hard, but ultimately it has worked out pretty well.

I think the difference between doing a PhD and being in the long haul for fertility tests and treatments is that I really loved what I was doing when I was doing my PhD.  So, sure, there were setbacks and difficult times, but in the end, I knew that I was doing something that I found challenging, awe-inspiring, and worthwhile with my time.  The journey was worth it, even if I didn’t reach the destination I wanted to reach.  Having pregnancy-related issues is a horse of a very different color.

Or is it?  I mean, yes, it’s a slog.  Much more of a slog than grad school ever was.  I go from panicking about my ticking biological clock to the physical discomfort of tests and treatment to disappointment after disappointment as my period arrives or the next miscarriage starts.  Every positive pregnancy test brings a cocktail of elated hope and terror and resignation.  Every two week wait is an exercise in patience and acceptance.

But, would I choose anything different?  My options are either this, or giving up on adding another much-wanted member to our family, or pursuing a totally different mix of hope, terror, elation, stress, and cost to add another family member a different way.  And while this happens, I’m going on and living my life.  I’m working hard at a job I love.  I’m being the best wife and mother I know how to be.  I’m raising my one living child with all the joy and commitment and love that I’ve been saving up and bubbling over with.  It’s hard.  But it’s the path that feels authentic to me given the choices I have.

Cultivating acceptance, cultivating patience, cultivating cautious hope in the face of setback after setback.  This is the work of the current phase of my life.

What’s motivating these reflections this week, you might ask?  I was supposed to have my MRI tonight, which was supposed to let me move on to the next thing, the hysteroscopic surgery to remove the adhesions and possibly fibroids that my RE thinks might be contributing to my recurrent miscarriages.  But my RE neglected to mention that she was ordering contrast for the MRI, which you can’t have if there’s a possibility that you might be pregnant.  And since I last saw her the day after a positive OPK result, there’s a possibility (a remote one, to be sure) that I might be pregnant, but of course it’s too early to tell for sure (my period is due on Wednesday).  So I called her office today, trying to find out whether the MRI might still be worthwhile without the contrast.  But she was on an international flight, and the nurse wasn’t helpful, and ultimately I just wound up having to reschedule the MRI for next week.  Then I called to reschedule the follow-up appointment with the RE, which I need to do before we can move forward with the hysteroscopy, and she doesn’t have an opening for another three weeks!  So there goes another wasted month.

I felt so frustrated today.  I wanted to complain to someone, but there’s nobody I see on a daily basis other than my husband who knows what I’m going through, and I try not to complain too much to my husband because I hate to stress him out on my behalf.  So instead I’m trying to put my frustration into context.  It’s not really frustration with this one test being rescheduled.  It’s frustration with the entire process of five years of four pregnancies and three miscarriages.  It’s frustration with watching other women get pregnant around me with their second or third living child.  It’s frustration with a medical system that feels so impersonal, with the uncertainty of never being sure that what I’m doing is a necessary or sufficient approach to adding another living child to our family.  It’s frustration with my life not going the way I want it to despite my very best sustained efforts over a long period of time.  And today it just bubbled over during the string of multiple phone calls with my doctor’s office and the radiology line.

I may be good at delayed gratification, but this is straining my abilities.  I just hope that there is, ultimately, gratification to be had, and that this journey is worth it in the end.

More procedures

I met with the RE again today to go over the month of testing that turned into three months of testing, and it did not go quite as I’d expected.

From what the nurse practitioner told me after my SHG, I thought there were a few irregularities with lining thickness that showed up, and that was all.  From what the radiologist told me at my HSG last week, I thought there were some hints of synechiae, but that it didn’t look like a big deal.  Apparently, taken together, my RE thinks that these results are a big enough deal that now I need an MRI and a hysteroscopy, and that my husband and I should hold off on trying again until both of those procedures have been completed.

The MRI is to determine whether or not I have fibroids.  Apparently the shape of my uterus on the SHG was irregular enough that she thinks there’s a possibility of fibroids — but she also said that the irregular shape could be caused only by adhesions, which it’s pretty clear that I do have at some level.  I don’t need to do the MRI, strictly speaking, since they could probably figure everything out during the hysteroscopy — but it will determine whether or not the irregularities are due to fibroids before I have the hysteroscopy, which is important mostly so that I know what to expect going into the procedure (since fibroid removal is a bigger deal that adhesion removal).  Then, the hysteroscopy is supposed to go in and fix whatever adhesions are kicking around in there, plus the fibroids if they exist.  Since I have a history of adhesions, and since adhesions can cause RPL, and since I now have two tests results pointing to adhesions in my uterine cavity, she says she thinks we should definitely do the hysteroscopy to remove them before trying again.

In theory, this course of action makes practical sense.  In practice, I am bummed that this testing/treatment process is just dragging out indefinitely.  What I initially thought would be one month of testing (in December) will now be a minimum of four months of testing/treatment, and it sucks.  And I don’t even know when we’ll be able to start TTC after that — it depends on whether it’s fibroids or just adhesions.

One step forward, two steps back.

So, that’s where I am now.  I don’t know a whole lot about timing at this point — I have to call to find out about MRI scheduling tomorrow.  She said she could probably do the hysteroscopy on my next cycle, but only if they can do the MRI *and* schedule a pre-op appointment before then, which means during the next 2-3 weeks.  So, things are a little bit up in the air right now — I have a treatment plan, but I don’t know how long it’s going to take or what to expect in terms of recovery time afterwards.  Ugh.

Anyway, I’m mostly managing to be zen about it — I’m really just discouraged by the long, slow timeline, but it’s nothing I’m not used to at this point.  Mainly I’m sad that we aren’t supposed to TTC until this is over.  It just feels like so much wasted time that I don’t have. But, all of my other tests looked good, including ovarian reserve, so I’m trying to remind myself that a few months here or there are unlikely to make a difference in the long run and that this currently looks like the best route to a new healthy pregnancy.

I’ll keep y’all updated.

HSG #3

Well, folks, do I get a prize for surviving my third HSG today?  They are always super-fun, of course, but actually today’s was basically a non-event — catheter/balloon placement was not even a little bit painful.  Not sure whether the difference is due to having had a full-term delivery since my last one or whether I just had a magical doctor doing the placement, but hey, I’ll take it!

As for the results, they were very good — better than I thought I could expect, really.  Both sides spilled dye almost right away, and the radiologist told me there was really only a little bit of scarring noticeable and only slight dilation on the left.  I don’t know if it’s even possible, but this HSG seemed much better than the one three years ago, when the dye only partly spilled and they told me I had a partial hydrosalpinx on the left.  So, good news, I suppose!  Although also no magical interventions to help this process go faster, presumably.

There was one thing that came up on the HSG that I am interested in asking my doctor about when I see her next week to debrief about this 3-month testing ordeal.  The radiologist pointed out to me some synechiae on the fundus of my uterus.  They were pretty obvious — it looked like a little notch taken out of the top of my uterus with little fingers poking out on either side.  He said, “With a history like yours, I’d be surprised if there wasn’t a little scarring,” and seemed to mostly downplay it.  But scarring and uterine irregularities are some of the main known and treatable causes of RPL, so I’m wondering whether it’s significant enough that the RE might want to do something about it.  I’m also wondering why it didn’t show up on the SHG I had in December.  So, that’s something to bring up at my appointment on Tuesday.

And with that, I’m done with testing.  Hooray!  No obvious major problems, which is good in a way, but which also means no obvious solutions.  I’m sure I’ll update more after my follow-up appointment with the RE this coming Tuesday.  I’m expecting she’ll just tell me to go away and try on our own for six months or something, but who knows?  I am turning 35 this weekend, so maybe she’ll be more likely to want to intervene to step up the pace?

In other news, the semester is in full swing, I’ve got two big gen-ed classes and a seminar this semester with >100 students altogether, we just got back from a lovely weekend visiting dear friends in Boston, and next weekend we’re off to Texas for a conference, with kiddo in tow as we visit friends.  S is experimenting with two-word phrases, continuing his “hide and seek” obsession phase, and just generally getting ready to turn two in a couple of weeks.  I’m finally feeling like I’ve come out of the funk of last fall, when the weight of my dad’s death on top of two miscarriages in a row just put me over the edge.

As I’ve gone through all the heartbreak and waiting of the past 9 months, I often just take a step back and reflect on how fortunate I am to have S with me this time around.  He is the light of my life and the apple of my eye and all the cliches in one tiny little toddler-shaped body.  Whenever I am with him, I soak up the snuggles, knowing he’ll be too big too soon. There is never a moment that I take his existence for granted.  I continuously marvel at what a miracle he is.  And he gives me hope that someday this process just might work again and we might add a whole new layer of love to our beautiful family.  I have a lot to be thankful for, and a lot to hope for.

One Month of Testing Becomes Three…

Well, so much for “One month of testing and you’ll be done!”  I haven’t yet seen the RE for a follow-up appointment, but apparently after reviewing my SHG and endometrial biopsy results, she wants to also do an HSG.  But since she didn’t realize it until a week into my current cycle, I have to wait another cycle to get it done.  I guess technically we can try to get pregnant this cycle, and if it works, great… but I’m not optimistic.  At least the HSG doesn’t prevent us from trying next month, so it’s not as though we really lose time, but I was just hoping to be done with testing and ready to move on to planning.

Here’s the recap on the testing results that are in so far: apparently everything is pretty much normal.  The endometrial biopsy was negative, all my blood tests were normal, the SHG showed nothing weird except for a slight thickening of the lining on the anterior wall, which I already wrote about — and if it were anything serious, the endometrial biopsy should have picked it up.  So no answers, but also no identified problems.

So then, what triggered the HSG, you might ask?  I’m not actually sure, since I didn’t get a chance to talk directly to my RE (I was supposed to have an appointment this coming Tuesday, which she suggested over electronic messaging that I cancel and reschedule for after my HSG).  But here’s the story as I see it:

Before the HSG, the APRN doing the test did a baseline ultrasound.  Everything looked just as expected, but she did point out an odd cyst-like thing near but not on my right ovary.  She said it might be a paratubal cyst, and that it looked like it was in the location of my right fallopian tube, but didn’t seem too concerned.  After the test, I mulled it over and remembered that during the 6w ultrasound where we found out I was miscarrying my last pregnancy, the ultrasound tech had seen the same thing, although she didn’t mention that it might be tubal — she just told me that it was a cyst-like thing that wasn’t on my ovary.  Just to back up a step, these two ultrasounds were actually pretty close together in time — we found out I was miscarrying the first week of November, and then the testing cycle and SHG took place right after I had my first post-miscarriage period in December.  So it’s clearly the same cyst-like thing, which was not there in June when I was going through my second miscarriage, but was there immediately after my third (most recent) miscarriage.

Now, combine this with the fact that I had high hCG levels in my most recent pregnancy — the last measurement at 5w was 2700 with a doubling time of less than two days.  At those levels, you’re supposed to be able to see a gestational sac on ultrasound.  But at my 6w ultrasound, there was no gestational sac… just two small irregular lumps in my uterus that the tech said might be bleeds.  And I know that the right side is the side I ovulated on for the pregnancy, and it’s also the side that this possible tubal cyst is on.  So, after remembering all of this, I wondered… is there any possibility that my most recent pregnancy could have been an undiagnosed ectopic, and the thing on my right tube is not a cyst but rather the missing gestational sac?  Obviously I wasn’t in any danger, since the RE did follow my hCG levels back down to zero, so if it was ectopic it resolved on its own (like 80% of ectopics, apparently).  But it seems like it would be an important thing to know to figure out how to proceed — and I already knew I had elevated risk for an ectopic since my second HSG showed scarring of both tubes.  Since I’d been seeing my local OB for the miscarriage, and then went back to the RE for RPL testing, nobody had all of the information, so it makes sense that the RE wouldn’t have considered it.

Anyway, I wrote a message to the RE’s office containing this question, and asking whether I should have the records from my most recent two pregnancies sent to the office.  The RE replied that an ectopic pregnancy was plausible, though difficult to know for sure, and that I should have the records sent over… and that’s when she suggested an HSG to assess tubal patency.  If you’ve been reading my blog for a while, you already know that my tubes were somewhat damaged during my first pregnancy, which we found out during my second HSG.  But since I then proceeded to get pregnant three times on the right side, it’s pretty clear that at least my right tube was still functional.  However, apparently now this cyst thing (or possible gestational sac?) is weird enough that she wants to make sure it’s not blocking my right-side tube.

I’m not actually sure what to hope for in this case.  Part of me is just sick of endless trying to get pregnant and miscarrying, and as I’m turning 35 I’m sort of thinking… I kind of hope it’s blocked, because then we can just do IVF already, and then they’ll do PGD and make sure they’re implanting chromosomally normal embryos and maybe it’ll finally work.  Of course, I’m not exactly excited about doing IVF, so in that sense I hope my right tube looks no worse than the last time they did and HSG and I can just get pregnant the old-fashioned way again.  I’m also just generally feeling grumpy about doing a THIRD freaking HSG, right after I’ve just done an SHG and an endometrial biopsy.  Enough messing around in my uterus, already!

Anyway, much as I’m not wild about the idea of another HSG, I am a sucker for information, and I do want to know whether my tubes have gotten worse or not.  So, I’ll go along with it, and wait for my next period, and do the HSG, and see what happens.  But that means I probably won’t have the results of the HSG and meet with my RE until, like, late February or even March.  UGH.  I hate the slowness with which this sort of testing and treatment moves.

And in other news, I’m currently away for three days at a conference (in Washington, DC), and I miss my little guy something fierce.  I felt so guilty leaving him, especially since he had a fever the day before I left and was super clingy and only wanted his mommy.  I hope he doesn’t think I abandoned him!  I cannot wait to snuggle that little munchkin tomorrow afternoon.

So, that’s where we are now.  I hope all y’all’s new years are off to a better start!

So Long, 2017!

I’ve rarely been happier to say goodbye to a year, but the flip side is that I’m looking forward to a fresh start in 2018.  Here’s the Cliff’s Notes version of 2017, and what I’m looking forward to in 2018:

The Good

  • My son.  He continues to delight and amaze me every single day of his life.  This week at home with him has been truly lovely.  He’s starting to have the patience for longer books (Dr. Seuss’s ABC, Angus and the Ducks, and Do You Speak Fish? are three current favorites), and his sense of humor is just wicked (this week it’s all about the yes/no questions and giggles: Is this hairbrush your dada?  NO!!!!  Is this pillow your dada?  NO!!!!  Is that doggie your dada?  NO!!!!  Totally cracks him up every time).  We have a Solar System rug in his playroom, and he loves running from the Sun to Jupiter to Neptune upon request, and playing Solar System Twister by trying to stand on as many planets as possible at the same time.  He likes to play hide and seek, mostly by hiding in plain sight and dissolving into giggles as we pretend to search for him (Is S under the table?  Is he in the bathroom?)  I could go on and on, but I’ll stop. 🙂
  • Work stuff.  My first postdoc got a job offer!  This was a huge deal, since I have been worried that he would not get an academic job and would be forced out of academia after which I would have been convinced that I ruined his career by bringing him to my rinkydink little college for a non-traditional postdoc opportunity.  Instead, he was offered a potentially permanent job that he would most certainly not have been qualified for before working in my group for four years.  I am so happy for him.  And I shouldn’t jinx it, but my year of supervising three thesis students isn’t going as badly as I feared, and I think they’ll all have high-quality theses come May.  There’s also a light at the end of the tunnel for a really big invited review paper that I’ve been working on for about a year now — it should be done by the end of next week.  It’s a ton of work, but will have high impact, and I’m pretty proud of it.  And as I wrote a few days ago, I totally rocked my 5th-year pre-tenure review and am optimistic about the tenure process that will start next fall.
  • My support network.  Having difficult years really makes you notice all the wonderful people in your life who are around to help you through the crumminess.  First prize goes to my amazing husband, of course, but I’ve also got prizes to hand out to other relatives and friends as well — the list is long enough that it makes me feel good about where I am in life right now.  Having a kid hasn’t totally squelched my important relationships as I feared it might.  I’ve been leaning on them a little more than usual of late, though, so I’ll have to make sure I’m giving back in the new year.

The Bad

  • Two miscarriages.  Recurrent Pregnancy Loss diagnosis.  Ongoing testing with no answers yet.  Coming up on a year of TTC living baby #2.  Oh, and the due date for my first post-S pregnancy is coming up this week.  Blargh.
  • My father died.  I had a complicated relationship with him, which has made it tough to sort through my feelings about his death, but the short version is: it sucks.  I think my grieving process has been largely focused on morbid thoughts about the mortality of my son and husband (also myself), which is not fun.
  • My mother had major surgery two weeks ago (a hip replacement).  Recall that I am ruminating on mortality, so it freaked me out emotionally right from the start.  My mom also lives a two-hour drive away, which is better than a plane flight away, but since she lives by herself she really needed help.  I made three round-trip drives in a week (one overnight stay the day she came back from the hospital, plus two day trips).  Thankfully, she’s on the mend now and I can relax a bit.  But I’ve really been feeling the whole “sandwich generation” thing this year.
  • Work-wise, this fall was a survival semester, in the sense that I phoned it in on a lot of teaching stuff and was kind of a crappy collaborator on a couple of projects.  Mostly I managed not to be too crappy at any one thing, which I feel like I can be at least a little bit proud of when you consider how my semester went.  Another part of my grieving process seems to be occasional irritability, which is out of character for me, and there are a couple of emails I wish I hadn’t hit “send” on — although I have to say that the people on the receiving end did basically deserve them, even if I am usually more diplomatic.  Oh, well…. I don’t think I burned any bridges too badly.  And I did an OK job of circling my wagons and prioritizing critical stuff like my research group and paper drafts, so hopefully I managed to mostly insulate my professional list from my personal problems.

The New Year

  • Getting back on the TTC wagon.  In a way, it feels good to have a fresh start after this most recent miscarriage, and to know that I’m back with the RE who will keep a really close eye on everything and do whatever she can to help us conceive the living child that we’re dreaming of.  I had visions of being a normal pregnant lady at my local OB’s office, but the silver lining of being abnormal is that I get more support and reassurance and can work on developing a plan.  I’m optimistic about our chances of success, since S is proof positive that my body is capable of carrying a baby to term.  I wish I could see the future and know how long it will take and what we’ll have to go through to get there, but I’ve been through enough at this point that I’m also feeling relatively calm and confident that I can just go with the flow for a while.  I am definitely in a much better place than I was three years ago after the loss of our daughter.  It seems like I shouldn’t be, since I’ve had three times as many losses by now, but for one thing I have S, and for another thing I’ve developed a certain amount of resilience.  I have hope for 2018.
  • The push to tenure.  There’s a certain narrowing of focus that happens when you’re less than a year from putting in your tenure packet. I’m in a good place right now: I already have a really solid portfolio of work, and I have a bunch of things in the pipeline, and I know what I need to do before next fall.  I’ve already done most of what I need to do, and the rest is in process.  Some of it is dependent on other people (like my students), but not too much.  I’ll be working hard this year, and I’ll have to prioritize like crazy, but the tenure process is another thing that I’m optimistic about for 2018.  I am so looking forward to submitting my tenure packet next fall and knowing there’s nothing more that I can do.  I think I’ll feel good about the body of work that I’ve accomplished on the tenure track.
  • The adventure of parenting.  I know people say the twos are terrible, and plenty of people will tell you that threenagers are worse, but you know what?  I’ve loved every age and stage of S’s life so far, and while there are certainly challenging moments/days, the thrill of seeing this little person growing up into himself more than outweighs the difficulties.  I am more crazy in love with this kid than I ever knew I could be, and I am looking forward to seeing what new skills and interests and ideas he develops in the new year.  I’m looking forward to getting more insight into his odd little mind as his communication skills improve.  And I’m looking forward to more snuggles and giggles as the toddler years wear on — I know that all too soon he’ll be too grown up for mama snuggles, so I’m soaking up every moment of it while it lasts.  I also love watching my husband surprise me with his parenting ninja skills, and I fall in love with him again every day as I see him growing into an amazing father.  He is so creative and funny with S that it just melts my heart.  Our family is so beautiful right now, and I hope that it will always stay that way — or perhaps even grow in love with a new member on the horizon.

And that’s the year!  Happy 2018 to everyone.  My hope for you all is for a brighter year full of love, laughter, new memories with your loved ones, and wishes coming true.