The Saga Continues

Today I had an ultrasound to gain a clearer understanding of my situation. The sonogram showed no sign of fetal growth or development. Dr. Pineda explained that the baby's growth has come to an end, but the tissue surrounding it is continuing to grow and produce hormones (hence, my increasing HcG level). As a result, my body has been acting as if the pregnancy is moving forward, when in fact, it has concluded.

Dr. Pineda further explained that, in cases like mine, it is possible for the tissue to attach to my body in a malignant way. In fact, the growing mass could quickly transform into an aggressive cancer. Consequently, the doc strongly encouraged us to schedule an immediate D & C to remove the tissue. Since the ultrasound gave us certainty that the baby is not alive and growing, we now feel comfortable proceeding. The D & C is scheduled for tomorrow at St. Luke's Hospital.

Coincidentally, I started experiencing cramping, sharp pain and substantial bleeding an hour after we returned home from the doctor's office. The miscarriage is now in progress, and it's possible that the tissue will pass during the night. Because we must have the fetus analyzed for pathology, we are hoping that the major tissue holds off until tomorrow. We'd much rather have the doctor preserve it for testing (rather than collect & store it ourselves). After what we've already been through, I'd rather not go there. Either way, the D & C will still be necessary in order to ensure that everything is complete and thorough.

Wade and I are emotionally drained and in need of encouragement and support. We would especially appreciate your prayers. A special thanks to Stacy for caring for Liliana during our appointment and hospital stay. We are so grateful for family and friends who never cease to amaze us with their kindness and generosity.

Blessings to all. ~Ramona

In God's Hands

Okay, so it's been 17 days of waiting for a miscarriage. Although I thought it was happening on January 1st, the hormone surge, cramping and bleeding did not manifest into more. My symptoms stopped that evening and my pregnancy symptoms continued. Almost every day since then, I've felt "on the verge" with spotting or mild bleeding...but still no miscarriage.

To rewind: On Friday, December 21st, my ultrasound revealed that our embryo appeared to be 5 weeks development (instead of 6 weeks) and labs showed that my HcG level slowed way down (when it should have been doubling every 48-72 hours). Because of those results, Dr. Pineda informed us that the pregnancy was ending and a miscarriage was just around the corner.

So here I am, more than two weeks later, after a very frustrating and emotional period of waiting. This morning I contacted Dr. Pineda's office to alert him of my situation. After learning the details, he sent me to the lab for blood tests to confirm that the hormone levels dropped. They call it a "missed miscarriage," where the body somehow misses the signals for a miscarriage and a surgical procedure (D&C) is necessary to remove the remains of the pregnancy.

When the nurse called this afternoon, I was shocked and confused to learn that my HcG level doubled to over 1600 since the 12/21 test. Apparently, the fetus is still alive and trying to grow, despite discontinuing the progesterone treatments. Because the baby has only achieved 48-hours of development in the past 17 days, it is clear that something is very wrong. As a result, the pregnancy is not considered viable. The bottom line: I am still pregnant, but my child is fighting a losing battle for survival.

I have experienced the entire spectrum of emotions today. Although the doctor recommends an immediate D&C to remove the tissue and placenta, I do not feel comfortable with the procedure until the pregnancy has ended on its own. I know the baby is not healthy, and I know the pregnancy is not viable...but I cannot terminate the pregnancy. I plan to wait until an ultrasound or blood test confirm that the growth has completely stopped. I know that this is prolonging the inevitable...but I do not feel right about ending the pregnancy with medical means.

As you may imagine, it is extremely difficult and disheartening to carry a child that is abnormal, unhealthy and destined to die. But as long as he or she is alive, my child is in God's hands. And though I will never hold this precious one, I rest in the knowledge that the Lord with take him home soon. I pray that these final days will pass quickly so that we may close this chapter and move on with the healing process. We find comfort in the fact that God is in control, and we continue to trust in His perfect timing.

New Year's Day

I should have written this morning when I was counting my blessings and dancing around the house, singing "Happy New Year!" But a couple hours ago, I was quickly jolted into a downward emotional spiral--thanks to the raging hormones that accompany miscarriage.

This is not my best hour. I'm so sad and disappointed and frustrated, partly due to losing another child and partly due to the poor timing. After 11 days of looming, the unwelcome event happens on New Year's Day. Come on, no one wants to start the new year with a miscarriage.

Part of me feels like I should just minimize the grief of this whole thing and focus on the blessings in my life. After all, there are so many things for which I am thankful. But the counselor in me knows the importance of allowing myself to "go there"--to experience the emotions in order for healing and closure to occur. So I'm going there, and it's not fun.

I guess this is a poignant reminder that we should expect real life every day--that holidays are not exempt from the brokenness of the world. It is a reminder that we need God all of the time. Of course, I already knew these things, but now I'm painfully aware.

And as I sit here--writing, reading, editing and experiencing the ebb and flow of emotion--I notice glimmers of joy and hope trying to push through the sorrow. I feel the hand of God holding me close, assuring me that everything will be alright. And as difficult as it is to lose a ninth child, I trust that this plan is good and His timing is perfect.

Romans 8:18 says: I consider that our present sufferings are not worth comparing with the glory that will be revealed in us.

Here's to future glory. ~Ramona

Winter Wonderland

This has been a wonderful winter day. We played in the snow, went sledding, enjoyed hot cocoa and learned that our pregnancy is cruising right along. Praise the Lord, all is well!

My HCG level was 1782, just a bit shy of the desired 1800 mark. My labs were done a couple hours earlier than normal, and that may account for slightly lower number. All in all, we are thrilled to know our baby is healthy. Although we still have a long way to go, this is a good sign. I'll be six weeks on Friday, and we have 0ur ultrasound at 2:20pm that day.

Thank you for your continued prayers and support. We are so grateful!

Lab Tests Tomorrow

The weekend is coming to a close, and I'm looking forward to the results of my blood tests tomorrow. Despite my not-so-hot bloodwork on Thursday, my pregnancy symptoms (especially nausea and sensitivity to smell) are going strong. I'm hopeful that the baby is experiencing healthy growth and development.

My HCG level was 452 on Thursday, which means it should be around 1800 tomorrow. God willing, it will be right on target (or higher). I'm praying for good news. I can't imagine that God would provide this incredible miracle, only to take it away. However, stranger things have been known to happen.

Right now, I'm thanking God for this pregnancy and praying that we will meet and know this child on earth.

In His grip,
Ramona

Updates

I just received my lab results from this morning. My progesterone level is great, thanks to the supplements. However, my HCG level is not as high as we had hoped. It is within the "normal" range, but somewhat on the low side. Please pray that this is just a temporary lull...and that all is well with our growing baby. I'll have another lab test on Monday morning. So, it's time to wait and pray (the story of my life). Thankfully, our calendar is full, and I have plenty of distractions.

I must admit that I'm taking this news pretty hard, even though everything may be fine. Things tend to have a negative slant due to our history of miscarriages & loss. Plus, my emotions are running high after being at the hospital & seeing my friend Kate. She is experiencing a difficult complication following her brain surgery. Please pray that she would quickly and fully regain motor control on her left side. For more info on her status, visit http://katesnodgrass.blogspot.com Her situation is very close to my heart.

Thank you so much for your support and encouragement. I feel like a basket case today!

Blessings,
Ramona

Bittersweet Days

I haven't said much about our upcoming Frozen Embryo Transfer (FET), because I've been trying to focus my thoughts on life's little joys instead of the daunting procedure ahead. With plenty of exciting activities on our calendar the past few weeks, it's been fairly easy to keep my mind occupied. But now I can't help but contemplate the road ahead. We're less than 72 hours away from my hospital visit, and the preparations are in full swing.

With the big event drawing near, my emotions have been running the spectrum. Although I am hopeful that the FET will lead to a pregnancy, I am also afraid of a negative outcome. Since this is our last assisted reproductive procedure, there is more riding on it than ever before. In addition, I am supposed to be stress free--both before and after the procedure. Apparently Murphy's Laws are in full effect, because our life has been anything but relaxing the past few days.

Liliana has been sick since Tuesday evening, and she has been miserable. Her coughing bouts were so severe last night that I was in her room every 15 minutes. No exaggeration. I tried bringing her into bed with me, but she had even more trouble sleeping in our room. We pray that tonight will be much better. Caring for a sick child is both emotionally and physically draining.

Even worse, my mom called me Thursday afternoon with the sad news that my Gramcracker is dying. It seems that she has no more desire to fight. According to the hospice nurse, Gram has less than a week to live. Mom is in Michigan with her right now, and things continue to go down hill. Please pray for my family as we try to celebrate her life while grieving her final days. Losing a loved one is difficult on so many levels.

On a positive note, Wade's parents have arrived in St. Louis. Once again, they have graciously accepted the role of caring for Liliana during my hospital stay and recuperation. What a blessing they have been throughout our fertility treatments!

Praying for healing, peace, sleep and babies. ~Ramona

One of Those Weeks

I'm having one of those weeks where it seems like everyone around me in pregnant or giving birth or planning with the full expectation of success. Sometimes I feel completely alone in this infertility struggle. I know it's not true, but I sure feel isolated sometimes. It's so crazy that there are women like me who consider every child to be a miracle and then other women (some of them my previous clients) have several unwanted children all with different daddies. This is just one of those things that is beyond my comprehension.

At the same time life seems so unfair, I also know that God works in all of these situations for good. Romans 8:28 "And we know that in all things God works for the good of those who love him, who have been called according to his purpose." Therefore, even the toughest things in life benefit the Lord's kingdom in some way.

Maybe it's just my mood swing making me sentimental and somewhat negative (yes, the rollercoaster has begun). Either way, I'm having a "down" week. I'll bounce back, not to worry.

Time for my shot. More to come...

Hello, McFly!?

I totally had a McFly moment last week and forgot to include the results of my bloodwork and ultrasound. Unbelievable!

My hormone levels (beta HCG, progesterone, follicle stimulating hormone, luteinizing hormone and estradiol) were exactly where we want them to be going into IVF. Dr. Pineda's nurses seemed excited to tell me about the results--so that's definitely a good sign. As for my ultrasound results, the sonogram showed 21 antral follicles on the right and 22 on the left. Knowing that antral follicles are an indication of the potential number of eggs that may be produced, this is incredible news!

During my previous IVF, 26 stimulated follicles yielded 11 eggs. Ultimately, only 2 viable embryos were available for transfer. For that reason, I am very interested in increasing the numbers so that more embryos may be produced. According to Dr. Silber's nurse, we may be able to enhance the process with some changes in the medication regimen and timing; however, we'll need to be careful not to overstimulate the ovaries (which can be very dangerous). It's a balancing act, but Sherman Silber is world renowned for a reason.

Tomorrow is our meeting with the great doctor. We hope to leave his office feeling more confident about investing $16K on this process (for the 2nd time). Fortunately, we know this is our only option for conceiving a child and it's ultimately in God's hands. Thank goodness for that!

Here's to many months of good news! Blessings, Ramona

Let the Fun Begin!

Our IVF target dates are almost two months away. Yet, the fun begins this week! If you want to know the "ins and outs" of IVF...stay tuned, my friend. In the coming weeks, you will get the low down on what it's really like to go through the process. No hold barred!

My cycle began today (which may be TMI, but you have to know that to understand how the whole thing works). On the third day of the cycle, Dr. Silber's patients begin birth control pills. I know it seems counter-intuitive to ingest something that inhibits pregnancy when you're yearning for a child, but that's how the doctor controls the timeline from here on out. My cycle has to be exactly on target for both the egg retrieval and embryo transfer. That's why the medical team takes control this early. More opportunity to work out any glitches, I suppose.

Starting Wednesday, I take the Desogen for 16 days (to create a "short cycle"). I will also have my blood drawn at St. Luke's to get a baseline reading on my Day 3 hormone levels. My progesterone, HCG and estrogen should be within normal ranges at this point. Friday, I will undergo an ultrasound at Dr. Pineda's office. (Normally IVF patients have the ultrasound completed at the hospital, but my insurance does cover "diagnostic" ultrasounds...so do it this way to avoid unnecessary out-of-pocket expenses. Trust me, there will be no shortage of expenses.) Both the bloodwork and the ultrasound are standard procedures before IVF.

We meet with Dr. Silber on March 14th for a consultation. I plan to ask him how this IVF process will differ from that in December. I'd also like to know how he plans to alter the medication regimen to help produce more high quality eggs. It seemed to me that we should have produced more than two viable embryos when I began with 26 antral follicles. We were hoping to have at least four embryos (two for transfer/implantation and two to freeze for a later date). I'd really like Dr. Silber to make adjustments to enhance the process now that we know how my body responds to the medication.

So that's the medical aspect. The emotional side of this is more difficult for me (and most IVF patients). We're getting ready to undergo a process that has an extremely high cost with about a 50% success rate. That's a bitter pill to swallow. But then again, you can't put a price tag on the life of a child. And we did get pregnant with our first IVF attempt, which is a fact I'll definitely hold onto during the coming weeks. Being positive and relaxed is crucial to success.

This is where you have to have faith. The wondering and worrying can drive you crazy! I read an article today, and I just have to share it. Here's an excerpt from "When Everyone's Pregnant...Except You" by Deborah Bohn on BabyZone:

Dr. Madeline Licker Feingold, PhD, a reproductive medicine psychologist and fertility counselor based in Berkeley, California says, "The level of depression and anxiety in the infertility population is the same as in cancer, heart disease, and HIV-positive patients. Infertility is much more difficult than people may think."

Let's be honest, baby showers, like weddings, can be tedious affairs—it's enough to drive an older mom nuts, so imagine how it feels to someone who's struggling to have a baby of their own. Imagine putting a starving person in a room full of food they're not allowed to eat. It's simply torturous.

I wish I had a dollar for every time someone told me about the friend of their cousin's back in Wichita who tried desperately to have a child, went on to adopt three children, then miraculously got pregnant on her own a few years later. Somehow this miracle baby myth was supposed to give me hope that it could happen for me, too. Well, it didn't give me hope. It made me angry.

And so did all the unsolicited medical advice. I was instructed by people with no medical training whatsoever to prop my legs up after intercourse or make sure my husband wore boxer shorts. But the best one by far . . . the one every childless woman hears is this, "Just relax!" Basically it's implied that we're sexually frigid and that loosening up a little will result in a positive pregnancy test.

"They'd never say something so crazy to a cancer patient!" Dr. Feingold says. She recommends either explaining to the pseudo-physician that you or your husband has a medical condition that no amount of prickly-pear juice or Pilates will cure. Or you can end the conversation on the spot with, "That's fascinating, but I'm working with doctors and considering all the options available to me."

And that's what I'm doing, folks....state-of-the-art in vitro fertilization and old fashioned prayer. I've got a world-renowned IVF specialist overseeing my medical care, and I've got the Lord overseeing my doctor and me! What more could I ask for? So my prayer today is that I will glorify God through this process, and that He will bless us with a child (or two)!

Here's to a healthy pregnancy in May! Bless you, Ramona

My Heart is Outside My Body

Photo: Darling Liliana plays dress up with princess outfits. According to this fashion diva, layers are in this Spring.

Today has been very emotional for me...again. It seems like each 24 hours is filled with every mood in the unabridged psychologist's handbook.
One minute, I'm sensitive and sobbing over a silly TV ad about a dog...the next minute I'm so irritable that I want to jump out of my skin. It's getting to be quite frustrating.

I don't mind being sentimental. It's actually a nice change of pace for this even-tempered optimist. I'm usually not a touchy-feely and misty-eyed girl, but I can handle it for awhile. However, the anger and irritability have gotta go! My moodiness is wearing me out, and it seems to be interfering with my relationships. I know I must be hurting the people around me, and there's no doubt that Wade is experiencing more drama than he would like. I apologize, honey...sincerely and publicly!

In addition to being a walking billboard for psychotropic meds, I find myself fearing that something bad will happen to Liliana. As Elizabeth Stone writes, "Making the decision to have a child is momentous. It is to decide forever to have your heart go walking around outside your body." I agree with that sentiment 100%.

I love and adore Liliana more than I ever thought possible. And I truly believe that she is our miracle child. Because she is so very precious to me, I have begun to develop intense anxiety about losing her. As a professional counselor, I realize that my fear is a result of losing our third baby and knowing that we may never have another biological child. As a Christian, I understand that I should be clinging tightly to God and holding loosely the things of this world. And I know I should be pouring out my grief before the Lord and trusting Him to take care of my family. Even so, I'm having a difficult time bringing my mind and heart together on these matters. I'm trying, Lord, You know I am!

Please pray that I would grieve well and glorify God in this process. Pray that the Lord will calm my fears and replace my doubts with wisdom and courage. Please pray that my personal relationships would be strengthened through this trial, and that my love for the Lord will grow each day.

Thank you for being here with me through one of the most challenging times of my life. God bless you and yours!

It's the Real Deal

The debilitating exhaustion has officially set in. This afternoon, I fell asleep for over an hour and could not wake up to respond to Liliana. I could hear her getting up from her nap and moving around her room, but I could not move a single muscle. I felt like I had been drugged!

I remember being very tired with my other pregnancies, but not to this degree. When I was carrying Liliana, I worked full time and had to take a quick nap right after lunch every day (usually in my car, of all places). Now it feels like I'll literally pass out if I don't lie down.

Wade's somewhat concerned about it, and rightly so. He heard Liliana today and went in to get her before I could muster up enough energy to move a finger. He wonders if he'll come home from work and find Liliana cooking dinner (okay, maybe not that extreme--just running around the house while I'm conked out). I'm sure I'll rise to the challenge when he's at work. It's just another necessary adjustment of this wonderful process.

Change of subject: Today our family was on the prayer list for our corporate prayer at church. That means one of our pastors prayed for us by name during each service. It was so beautiful (and just a bit strange) to hear him pray for our pregnancy and the health of our unborn child... along with Liliana's spiritual needs. Everything felt so real all of the sudden. Also, so many supportive friends offered hugs and words of congratulations. It was one of the sweetest Sunday mornings we've ever had.

May you have special moments with family and the Father on this day, the Lord's day. Ramona

It is Well

"Making the decision to have a child - it's momentous. It is to decide forever to have your heart go walking outside your body." -Elizabeth Stone

Any loving parent would say this is true. And for me, having a child was the best decision I've ever made. There is nothing more challenging and rewarding than parenthood. That's why I'm so willing to go through the pain and discomfort of IVF.

So far, the process has been a bit of a rollercoaster, but nothing unbearable. It would be much easier if I weren't battling this upper respiratory infection. Today I have the abdomen (and the waddle) of a woman in her 2nd trimester. Bending over is tough and chasing a toddler is out of the question. We have called in the parental troops to help us get through the next week.

In addition to taking two oral medications and three meds by injection, I go to St. Luke's Hospital each morning for bloodwork and ultrasound monitoring. You know it's your 2nd home when the nurses and technicians greet you by name.

At this point, follicle stimulation is going smoothly. A great number of follicles are reaching maturity, and my hormone levels are in the normal range. Now the big question is when the egg aspiration and embryo transfer will take place. I should know the dates & times by this afternoon.

Thanks for continuing to lift us up in prayer. It is so evident that God is blessing this process. Now let's pray He grants us a pregnancy!

Bless you! Ramona

The Drama Unfolds

Another day of enjoying the holiday season and baking with my little helper, Liliana. Today she discovered the joy of licking the spoon after mixing cookie dough. She is such a precious gift, especially in the midst of these topsy-turvy days. Tender moments with Liliana are constant reminders of the reason we are so willing to go through difficult treatments to have more children. There is nothing on earth better than being a mommy.

Things are looking up on the IVF front. I had bloodwork and an ultrasound this morning, and the results were better than anticipated. As of yesterday, even the great Dr. Silber was unable to explain the bleeding. The nurse said they had never seen anything quite like it. Through analysis of my hormone levels and ultrasound images, today Dr. Silber concluded that my uterine lining was shedding (hence, the bleeding) at a very odd time in the cycle. As a result, the lining is now only 4mm. It needs to be 8mm in order for embryo implantation to occur. Everything else looked great: multiple follicles are growing (slowly but surely) and hormone levels were within normal ranges.

All in all, we plan to charge full speed ahead, praying that at least 10 eggs mature (preferably more) in time for extraction and that my lining doubles in size by Dec. 20th. If the lining does not reach 8mm, Dr. Silber will extract the eggs, fertilize them and freeze them for a later transfer. The freezing technology is so advanced that less than 1% of "pre-embryos" are lost during the process. Worst case scenario: we create embryos this month and transfer them at a later date. Although that situation would be somewhat disappointing (since we'd really love the New Year's gift of pregnancy), we still wouldn't lose all the time, effort and resources we've invested so far. We're very thankful for that!

Please pray specifically that at least 10 eggs will be viable at the time of extraction (Dec. 17th) and that my lining would be ideal for implantation of embryos (Dec. 20th).

I truly feel the Lord's hand guiding this situation. And although I don't understand all the drama, I do know that He has something wonderful in store for us.

Say tuned...

Tender Moments

This day was filled with sweet moments. This morning, Liliana helped me with holiday baking. She stood on a chair next to me and mixed ingredients together as I poured them into the bowl. She was so precious with a big spoon in her hand and batter on her tiny fingers. Later, my little helper was also very eager to do laundry. I started the water and added detergent while she threw each piece of clothing high in the air, hoping it would drop into the washing machine. When it came time to fold clothes, she thought it would be fun to hide under the piles and "try on" Mommy and Daddy's articles. Although it wasn't the most efficient laundry session I've ever experienced, it was definitely comical and memorable.

On to IVF: After two evenings of running a virtual pharmacy out of our home, I'm feeling pretty comfortable with vials and needles. With the rate I'm going through syringes and supplies, I suppose we ought to get one of those handy sharps disposal containers.

Someone mentioned that hot flashes may be a side effect of the meds, but I haven't experienced anything like that (I have had them on Progesterone, however). Instead of anything mood related today, vivid and strange dreams disturbed my sleep. I awoke this morning feeling as if I slept 3 hours. And then, after a short afternoon nap (which is a must after spending the day on high alert with my wild and wacky two-year-old), I felt like I had been flattened by a steamroller. My mind was awake, but I couldn't move my body for quite some time. I spent the remainder of the evening pining for Zzzzzs. All in all, it wasn't bad for the first day adjusting to heavy doses of hormones. I look forward to seeing what's in store for tomorrow!

Oh, I would be remiss if I didn't mention that Wade was very sweet this evening in the midst of my exhaustion. He hand-delivered Christmas cards to our neighbors for me and made omelettes for dinner. He's so generous!

I'm going turn in now. Yes, 10:00pm is very early for a night-owl like me.

Many blessings to you,
Ramona

HOPEFUL

Wade and I have been married for four years. Throughout that time, we have experienced countless blessings together. Although we've had our share of trials, our years have been quite beautiful. As our love has grown stronger, so grows our dream of a home filled with the laughter of children. Unfortunately, we have come to realize that having a large family may not be in God's plan for us. Early in our marriage we were diagnosed with unexplained infertility. We yearned for a child and experienced a great deal of grief and disappointment each month that passed with no result. After undergoing fertility treatments for over a year and enduring a miscarriage, we were finally blessed with a precious daughter in 2004.

At this point, we have been "trying" for almost two years, with another miscarriage in 2005. Two years may not seem like a long time, but specialists in this field agree that a woman of my age (34) should conceive within one year. We have been working with a highly regarded specialist since January, 2006, and we have exhausted every treatment option except for In Vitro Fertilization (IVF). After much prayer and deliberation, we have decided to undergo IVF. We are currently scheduled for the procedures (egg retrieval and embryo transfer) on December 17 and 20th, respectively. We are very fortunate that our IVF specialist is considered one of the best in the world, and his medical center is located here in St. Louis at St. Luke's Hospital.

IVF is a very intense process. It can be (and usually is) emotionally and physically taxing, and the financial strain is almost overwhelming for a family on a budget. For those of you who don't know, IVF is very expensive ($14-18,000, depending on the medication needs) with around a 50% chance for success. It is a huge risk, but we know it will be worth it. I wouldn't trade my Liliana for the world, and we already feel that way about future children.

I have already begun taking oral and injectable medications to get my cycle aligned with the target dates. On Dec. 4th, I begin two more meds which will stimulate follicle (egg) growth. Daily monitoring by ultrasound and bloodwork begins on Dec. 8th. [Forgive me if this is TMI (too much information), but it comes with the territory. I am now an expert in a field I never intended to master.] I will try to provide daily updates on this site--for both informational and cathartic purposes. Feel free to leave comments, questions and words of encouragement! So far, my emotions have been steady...but I know from months past that the hormones can send me on an emotional rollercoaster. Poor Wade! He has been so supportive and loving throughout this trial. I thank the Lord for him every day.

Thank you for joining me in this process. Your thoughts and well-wishes are truly appreciated!

Blessings,
Ramona