Insidious IF

It’s been six days since I was released from the RE.  Six days since we saw that undeniably human-shaped fetus wiggling around in my womb.  Six days since I had some reassurance that something might go right for once.  Apparently six days is about all the unassisted hope I can muster.

I’ll start by adding that (thankfully) I have an appointment with my therapist this afternoon.  Seems we’ll have plenty to discuss.  And here’s an additional caveat that if you’re in a fragile mental space this post is not for you.  If negative thoughts, frank discussions of miscarriage, and angry rants are not in your best interest right now, then stop reading here.  It’s about to go downhill quickly I’m afraid.

Dear Lord how do you survive the constant worry?  Since being released from the RE last Wednesday, I’ve already come to feel mentally battered and beaten into a pulp.  After becoming accustomed to the weekly reassurance of good-looking ultrasounds at the REs, the prospect of no more ultrasounds any time soon is enough to push me over the edge.  These past few days I just can’t stop reliving each of my miscarriages.  I can’t talk happily about this pregnancy (though I’m trying for the mister’s sake).  I can’t even allow myself to do anything about the fact that my pants are starting to get too snug.  All I think about is what it would feel like to have a new pair of maternity pants or a belly band arrive the day I start miscarrying.

I know the worry will never completely go away (like, for the rest of my life), and I know that is normal.  That one of the few things fertiles (including my therapist and OB) have said to me in the past several weeks that hasn’t immediately made me want to punch them.  It’s true, in the worry regard I’m likely as normal as the mister’s kid-spouting cousin.  All new parents worry about the health and well-being of their children.  As much as I’d like to argue that the fact that I have three children I’ll never meet makes my worry worse, that’s just not productive and, most likely, not true.

I guess, more than anything, I’m just frustrated with the medical industry and it’s total disregard of worry as a treatable medical complaint.  After starting to embrace a future where I would NEVER have to look an OB/GYN in the eyes again (GPs can do a regular pap, people!), the piss-poor hands-off attitudes of these “specialists” have me irate.  If one more medical “professional” tells me something is not “medically necessary,” I plan on sending them all my counseling bills.  Nickle and diming me on a 5 minute ultrasound is just costing me and my insurance company that much more for mental health services.  Infertility is an insidious ass and invades each and every aspect of your being; to deny me an NT scan, additional blood work, or an extra ultrasound because I don’t fall on the right side of their actuarial tables is a daily middle finger.  Where were these medical professionals when I was diagnosed as infertile at 25? Where have they been the last 4.5 years, the last 3 miscarriages, the last tens of thousands of dollars?  I was breaking their projection models then, but instead of extra testing I got a swift kick in the behind and a “good luck, you’re on your own.”  And, what doctor thinks I WOULDN’T gladly pay out of pocket for extra monitoring after all the time, money, and heartache was have put into IVF?  WHY do they insist that I must come off Lovenox because, “ouch, those bruises look painful, you really don’t need to keep doing that!”  You know what is painful?  Miscarriage.  And I’m not even talking the mental pain…

I’m a mess because of tomorrow.  It will be my first (and likely last) appointment with the maternal fetal medicine doc, and my first true OB consult with my OB (previous visits have been coded as GYN).  I’m expecting a several round knock-out fight, and don’t quite know which of us will come out on top.  My RIs plan got me PG, my RE takes the credit and calls the RI a “witch doctor,” the OB tells me I’m normal and on “crazy” and “unnecessary” medications, and the MFM (who I’ve not yet met) will almost surely tell me I’m wasting his time by being there.  So much for the added peace of knowing you have a whiz-bang team of experts there to guide you through the bumpy ride.

Ultrasound at 9w 2d

The human-shaped blob, complete with placenta and umbilical cord.

All the while, I’m terrified.  I look at my latest ultrasound, I see the human-shaped blob, I recall what it looked like to see the blood flowing through the umbilical cord, and all I can think is, “Wow, it’s big.  This miscarriage will surely hurt worse than the last one.  Especially if they send me home from the ER with a collection jar again after declining to do an ‘elective’ D&C on a Saturday.”

And then, other times, I look at that ultrasound and it all melts away.  Yes, I’m furious that it’s all I have to hold on to.  I’m concerned it is all we will ever get to see and hold of our little one.  I worry that this is as good as it will get.  But, some small part of me still squeals with delight to see that blob with a head and flippers.  Am I really justified in my rage, or am I just becoming an overbearing mother that wants to order the million-pack of school pictures already?  And then I sigh and scold myself for thinking too far ahead.  For opening up to hope.  For too easily dismissing insidious IF.

9 thoughts on “Insidious IF

  1. I wish I could tell you that any of this anxiety gets easier (maybe it will, eventually), but at 12w6d, on the cusp of the supposedly safe second trimester, I still have frequent moments of being a basket case, of living in denial, of worrying that if we buy anything baby-or-maternity related it’ll be so painful when we have return it. We’ve had bi-weekly u/s until now, and after our NT scan tomorrow, will be moved to monthly scans. But we’ll definitely be investing in a doppler to preserve what shreds of sanity we have intact. Sorry, I feel like I’m not being very helpful, but I understand SO much of what you’ve written.

    As for your rage, I totally think that you are justified. It’s not ok that you have to go to this place, and rage and yell to get the care you need – emotional as much as physical – but it so often goes that way. I’ve pushed for whatever interventions and observations I can get, for my peace of mind, and I think finally I have a care provider who understands that they are looking after my nerves as much as the physical health of my baby.Don’t be afraid to advocate for yourself. At the very least you have the right to a NT scan!

    Having said all that, I can also see the advice that no, even when our babies arrive safe and screaming, the worry doesn’t stop. It’s kinda the job description of a parent I suppose. And I’m trying to find the strength to trust in my care providers enough to believe that just maybe, this pregnancy *will* actually go ok for once. That my body can do this. That right now I’m, well, normal…

    None of this is easy. It’s so much harder than I imagined it would be when I was filled with despair over my previously barren status. I’m right there with you. Sending you strength as you face these battles with doctors and your own fears. And hoping like crazy for that little blob of yours!

    • Serious hugs, hun. Thanks for offering support and commiserating! I did buy a doppler (first ever PG purchase) but so far I can’t find the heart beat. I know that’s normal given how early I am, so that’s not particularly contributing to the worry, but I still would feel better if I could find it!

      I’ve been shopping around for OBs and, sadly, I think I’ve found the best I’m going to get in this area. And, I’m already driving over an hour to get to him. Moving to a rural location last summer has really forced me to reimagine my definitions of “good enough.” I’m being told an NT scan isn’t necessary since I’m under 35. And, actually, my huge IF workup is actually working against me because he keeps saying, “Well, we know you don’t have this clotting issue or that genetic defect predisposition because look at ALL THIS stuff you’ve had tested already!” I plan on not taking no for an answer tomorrow when the NT discussion comes back up, even if my insurance makes me pay for it out of pocket (what else is new, right? It’s gotta be cheaper than IVF…)

  2. You need a different ob. I know how hard it is to find one, but his attitude is unacceptable. My saving grace this pregnancy has been having an OB who literally “hands out ultrasounds like candy.” I’ve had, no lie, at least 12 so far, only 3 from the RE. And my baby is perfectly healthy. You need someone who understands your anxiety and is willing to bend over backwards to reassure you, no matter what that entails.

    • I hate being all excuses, but I literally have *NO* idea how to go about doing that and have almost zero hope that a better option is out there. This is now my 5th OB, after the 4th one denied me a D&C because it was a Saturday…

      I’m driving over an hour to this guy, and they are the only practice within 2.5 hours of me that deliver at a Level 3 NICU and share their practice with MFMs. Hell, the closest elective ultrasound place is a 2.5 hour drive away, and I’m already planning the trip. I think a lot of people (myself included before we moved here) have literally NO idea how difficult it is to get adequate medical coverage in some more rural areas of this country. The counselor I’m seeing specializes in IF and therefore sees several local IF couples. After telling her of my experiences with my OB she said that I’m actually with the best around. Most within a 1.5 hour drive of us will offer a 20wk anatomy scan and that’s it. If baby doesn’t cooperate you’re buying everything in greens and yellows, too, because they won’t let you back in for another. IF the MFM agrees to keep me on as a regular patient (OB has already said that’s unlikely) then I will get closer monitoring, but that’s a very big “if.” I plan on asking tomorrow if this is all an insurance issue and, if so, agreeing to accept to pay all charge out of pocket. But, flat out, my IF counselor said she’s never heard of anyone in my area getting u/s’s beyond an NT (if over 35) and one anatomy scan around 20wks. She was actually impressed how many u/s’s I’ve gotten from my RE, as that’s not been her experience in the area. The only reason I got that many from the RE was because our last loss was at 9w2d so they agreed to keep me up to that point…

      I’m all ears if anyone has ideas to offer on how to find a more willing OB and/or how feasible it really would be to work with an OB over 2.5 hours away (where there is a bigger city and more likelihood of having success finding a more aggressive doc).

      • Oh, and I should mention, no matter how far I travel to an OB the MFM practice I’m meeting with is my ONLY option. My state is divided up into a network of “Regional Perinatal Centers” and I live right in the middle of a gigantic 9-county grouping that is served by one center an hour away. I’m actually lucky to be that close, as some on the borders of the zones travel upwards of 3 hours to get to a MFM and Level 3 NICU.

  3. The worry never goes away. I often worry that he stops breathing or that I’ll drop him and he’ll die. And if I’m not worrying I feel as though I’m in a surreal dream and that I’ll suddenly wake up and all of this was make-believe. I hope it eases on you a bit and you get that NT scan!! Keep us posted. It seems ridiculous not to give it to you even if you pay out of pocket. Your baby looks adorable, hope to get another pic soon 🙂

    • Thanks, Audree. I’m so sorry you are still dealing with these worries, but I totally understand.

      I guess that’s a huge part of my fear right now. No idea when I’ll next get to see the blob with a head. :-/ Hoping it’s not 20 weeks!

  4. I’m six months now myslef and I’ll tell you, the worry does not go away. My nightmares of stealing other people’s children because I was barren have now changed to nightmares of no longer being pregnant. I wake up having to actually feel my belly and wait for her movements in the middle of the night to reassure me… Our scars will always be there, but i am told they eventually do fade…. Hang in there! Thanks for the update! 🙂

  5. I am so sorry your doctor has no compassion and I really don’t get why you can’t have a NT. I was given extra ultrasounds because of my IVF with past miscarriages. My OB office apparently showed extraordinary compassion where yours just plain sucks. I would tell them I was terrified and they would give me the ultrasound. I felt a little better once I was past the point of my previous m/cs but never fully comfortable until I held her in my arms. One thing that will get better is soon you will be able to get the heartbeat on a Doppler by yourself. I suggest you rent one and then you won’t need your OB but I what I really want to say is for you to find another doctor. Do you really want these people delivering your baby? I wish I could kick them in the shins for you… or maybe you could kick one of them the face when you are in the stirrups? Totally deserved!

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