Why Me? Now What? (A Personal Journey Through Infertility)

Saturday, September 16, 2006

Fibroids Suck...

I've said it before, and I will say it again... Fibroids Just Plain Suck. I think I'll get a T-Shirt saying so, or start a smear campaign warning others... either way, I want those vascular masses to suffer.

Tuesday's appointment went fine. The babies appeared to be cuter than even just 2 weeks earlier when we did a quick Ultrasound to peak in and check that everything was ok. Yup, Dr. Okeane seemed to be feeling just a little bit more confident about my condition this time, a reaction I welcomed after all the worrying as of late. He scanned over the fibroid next... and his look quickly registered concern at the shear magnitude it had become. It was hard to tell... it's size and positioning, on the small machine in the office, but I was scheduled for a follow up at the Maternal Fetal Centre next week, and would be able to get a better view of what exactly we were dealing with at that time. Again he threatened bed rest... something that I know is an eventuality, but surely he didn't need to start warning me at only just under 16 weeks! So I had mild cramping on and off for the last few days, it certainly wasn't excrutiating, and I had 24 weeks to go!!!

As I walked out, I felt confident that I wouldn't have reason to be back for another checkup until 3 weeks later on October 5th, the day I was asked to come back in...by then I would be nearly 20 weeks and past yet another important mile stone. I was a confident women preparing for a busy week at the office... now that I got the all clear from the Doctor, I really needed to make an effort to prepare for this weeks meetings. I had an important client flying in for meetings on Friday, and needless to say, I had been a bit preoccupied, but I would put my head down and get organized.... starting tomorrow; I was WAY to tired to start today!

When I awoke on Wednesday, I found it more awkward than usual to get out of bed. Each turn or roll seemed to bring on a unique tinge or stab of pain... but eventually I got myself upright and starting my day. I felt stiff... like I had slept on the floor in a cold sleeping bag, the weather HAD turned for the worst, with the rain falling for the first time in weeks... this cold and wet weather must have aggravated the mild case of arthritis I carried with my as a ruminant of my youth. Brought on by competitive sport, I have come to accept the way my joints remind me of a severe weather swing... achy and sore even before I catch a glimpse outside at the day's forecast.

But as the day progressed, so did the discomfort. The mild cramping turned more intense, and the sharp pains I felt when I awoke seemed to follow every time I moved. Thank God I was seeing Leslie later that day, she would work her magic and get me feeling normal again! But by that afternoon, even Leslie's combination of needles and analysis didn't dissipate the uncomfortableness I was feeling. At 7pm... as I rolled around on the floor in agony after discovering that there was no more Tylenol in the house (The only approved pain relief I was granted due to the babies) Mike got up, drove through the rain, and became my Knight in Shining Armor returning with the Econo Bottle with the easy open lid to help ease my pain. After popping 2 of these Extra Strength saviors, I laid back and attempted to fall asleep.

You know it's bad when the next day, you are literally scheduling your next opportunity to pop the little red pills on Microsoft Outlook. The bottle said "1-2 every 4 hours, not to exceed 8 pills a day." Since I had woken in the middle of the night to pop 2 more, I had 4 more pills to last me until 8 pm that night... how would I schedule them to be the most advantageous? It was as though I was solving a mathematical mystery, or at least the Rubic's cube. I studied, compared time tables... and finally settled on a total of 7 pills over the 24 hour period...after all I WAS pregnant, and probably shouldn't take the entire maximum dose right? Only taking 7 made me feel less of a junky.

I made it to 8pm (Hurray for small victories!) and then replotted my strategy for that night's sleep... I really didn't want to take more than necessary, but I was still in SO much pain... but even after taking 2 pills in desperate need for sleep (since the night before was met with a constant shifting and turning in search for a more comfortable position), I discovered that if I thought LAST night was bad, I hadn't seen anything yet. Every movement was excrutiating.... sharp pains were intermingled with pressure that I didn't even know existed. It truly felt as though my innards were being physically pulled down through my cervix every time I stood up. Trying to remain still didn't seem to help much either, since after several moments of relief, my current position would become unbearable and I would search for one that could sustain me a bit longer. By morning I knew I couldn't get through another day with this pain, and realized that amid appointments and Client meetings I would have to arrange to get in to see Dr. Okeane for a suggestion on what was going on, and what I could do to stop it... I just couldn't ignore the pain any longer.

By 9am I was sitting at my desk, calling the doctor... hoping to get an appointment before having to pick up my client (I received a bit of good news on the drive in, when he called to say he had missed his first flight and would be arriving a few hours later...) I now had until just after 1pm to see Dr. Okeane and head back to the other side of town to pick the client up at the airport.

When I was told to get into emergency immediately, I wasn't truly prepared... Emergency? Was it really that bad? Apparently Dr. Okeane was off today, but one of his counterparts was on call for Emergency, and I had been instructed to make my way there... and fast. My world started spinning... I had called Leslie earlier that morning to get her suggestion on what to do, and she had suggested this may be the outcome...so I trusted that it was what was needed. 10 minutes later I was in the car, having arranged for a colleague to pick up my client if I was not able to do so, and had alerted both my husband (who was leaving work immediately and would meet me there) and my inlaws (who I needed to call and alert since we had dinner plans for the following night, that I was now unsure we would be able to keep). Moments after arriving at the hospital and talking to the Triage Nurse in emergency, I was given a flashy plastic bracelet in case I suddenly forgot my name or birth date, and was asked to wait for a bed to come available. I sat to wait, and seconds later Mike walked through the door... looking worried, sorry and frazzled all in one. I think I caught him off guard when I shakily reported to him that I was driving myself to the hospital... memories of the last few months had flooded back, and you could tell he was simply worried that another terrible twist was waiting in the wings. Mike's parents showed up too... unable to just sit at home after my call earlier, they wanted to be there... to do something... and so we sat...made small talk... and waited.

2 hours went by, and I convinced Mike's parents to head out... there was no need for all of us to sit there in the bustle of the Emergency Room Lobby... they had things to do, and we promised to report back as soon as we knew anything. Almost on queue, as they walked out the front doors, my name was called to the nurses station, they had a bed for me and we were moments away from relief!!!

From the moment I was ushered into the back to a private room and asked to change into the blue robe and matching housecoat it was a barrage of tests, questions and consultations. Doctors... Interns...Specialists... Technicians... some nurses with warm blankets (the ones I liked the best) and others carrying specimen cups and needles (ok... they weren't my FAVORITE, but they were very nice too). It was a whirlwind that left both my husband and I in a bit of a daze. They ruled out an ectopic pregnancy (Duhhh), gallstones and liver failure fairly quickly. Then they checked on the babies, and they seemed fine despite all the chaos of the last 72 hours. One tightly wedged in a corner of it's amniotic sac appearing to be sucking his thumb, and the other doing somersaults beside him, they were as content as they had been days earlier in Dr. Okeane's office. So if everything looked fine, what the hell could be causing all the pain and pressure?????

The Fibroid.

It wasn't until being wheeled down to another department for a closer more detailed ultrasound did they spot the concern... the large fibroid we had been alerted to at our 13 week Nuchal earlier last month was sitting proudly now atop my uterus. It had grown some, although exact measurements were not taken.... it was evident that it had literally shoved my uterine cavity to the far left, and was causing the increase in pressure. Not only was this beast wedged against my liver and rib cage, but it had invited a friend to the party. There resting at the middle of my pubic bone, right above the birthing canal, was a newly grown fibroid. Smaller than the other, it's position would explain the intense feeling of pressure and dropping at my cervix... it certainly confirmed the previous decision by doctors that there was no way I was having these babies the old fashioned way. A C-Section was now most definitely in my future.

And so there it was, the explanation for my torturous pain... so once the Gynecology Resident and Intern confirmed that my cervix was tightly closed and high (confirming that despite the pressure, I had not started to dilate-Thank God), they realized 2 things.
  1. This would be a painful and long pregnancy.
  2. That pain management was the only thing they could do for me, since surgical removal of the fibroids was impossible until after delivery.

After 6 hours of tests, getting increasingly hungry, tired and most of all in pain (since I hadn't taken any Tylenol since early that morning), I was told they were preparing to admit me to the Gynecology Ward for observation and pain control management. I was stunned. They wanted to keep me at least the weekend... placing me on and IV of Morphine to see if they could get the pain under control before tapering me off to Tylenol 3's and hopefully sending me home. She jokingly said they hoped not to have me as a guest for the next 25 weeks, and that they would do what they could to have me comfortable enough to go home early the following week being able to manage it with oral medication and the elimination of Morphine.

As she left to start the paperwork to transfer me from my now familiar bed in Emergency to my new home on the 20th floor, and Mike outside making calls to his parents and my colleagues updating them on the news and canceling dinner plans made for both that night and the following evening, I sat in silence wondering how and why this was all happening. I didn't like the idea of adding stronger drugs than necessary to my system, for me or my babies... surely it couldn't be good. I know the Dr. said it was safe, but was it truly necessary? I have a strong pain tolerance, perhaps at times to strong... or stubborn, I'm not sure which... but was this supposed to mean that my babies were to ALSO have this tolerance? Had they suffered enough? Should I let them administer the IV of powerful drugs and let all of us get some rest????

By the time Mike and the doctor returned to my room I had my answer. I would not choose to be admitted. There was no need to take up a hospital bed to be medicated. I didn't want to use the "top down" approach. I wanted to start with less drugs and add more IF necessary. We talked, Mike stood in silence, still scared but knowing that there would be no convincing me otherwise if I had decided it was what was right for me... and the doctor listened and nodded in understanding. She agreed to release me on 1 condition... I would take the Tylenol 3 (2 pills a day, to a maximum of 4 times a day... Ahhhh the familiarity of it all!) but if over the next 48 hours, the pain was not controlled, I was to return to the hospital and immediately admitted for observation... there would be no more day trips to the hospital this week. I had this one chance to get the pain under wraps this weekend, or they would do it for me by Monday. And with that, we gathered my clothing, took the prescription to the pharmacy, stopped by Wendy's for something to eat, and retired to bed at home. By 9pm that night I had taken my second dose of pills, felt woozy and relaxed and for the first time in what seemed like forever, fell asleep in comfort.

This morning I awoke feeling well rested and more confident that the pain was now being controlled by me and not the other way around. I have a follow up appointment with Dr. Okeane on Tuesday...I'm sure he will be surprised to see me, but by then I hope the pain will be gone and I can report that the Tylenol 3's have been placed back in the medicine cabinet...

It's been a crazy road thus far. Last night as we drove home from the Hospital Mike asked me if, looking back I would have moved forward with IVF without removing the fibroids knowing now what I have experienced... my decision was easy. Yes, I would have... every doctor has told me that the babies are likely happy and unaware of the beast growing alongside of them... the pain has been something I have had to deal with, but the babies haven't... and in that sense, I don't regret moving forward. Yes, the pain is more intense and more "everything" than I ever imagined going into this journey, but blessed with carrying identical twin babies makes every ache and pain some how worth it.

24 weeks to go... hopefully more good than bad, less sleepless nights than those of peace, all in preparation for our little miracles to be welcomed into the world. Who WOULDN'T deal with a little pain for the prize at the end of the journey?

Tuesday, September 12, 2006

So Much Time Has Passed...

Over a month since writing last... so much time, and so many things have transpired over this last few weeks, yet I have found little time to sit down and write about them.

Today, I find that time, settled into our new home, at least as settled as one can be when surrounded by boxes to heavy to lift in my condition. Mike has been working alot, making it difficult to get things unpacked before I find myself begging for sleep at only 8pm. My mother came into town this last weekend, to help with some of the "new house" chores... lining the drawers with that protective bumpy plastic, putting my linens away neatly on the top shelves of the linen closet... all the things I surely would have left for weeks due to the enormity and boringness of the tasks. And so, I sit... surrounded by boxes; contemplating the last weeks while trying to find a comfortable spot on the couch where the babies aren't making it completely unbearable.

The babies... they're doing fine... seem to be growing strong and progressing as expected, right on par with the singleton charts out there. They seem content enough, and at the last few ultrasounds have been busy poking each other in the head vying for attention by the technician when measuring and counting heartbeats... already competing, a sign surely of things to come.

Things haven't been exactly smooth sailing these last 5 weeks though. There was a scare at 10 weeks... out of the blue, in the middle of the night, I awoke to a gushing of blood... so much so that it soaked not only the bed but the towels I used to move myself to the washroom to call the doctor. At 3:00am I am sure he wasn't thrilled to hear from me, but his concern was genuine and he ordered me to either make my way into emergency immediately (however a 4 hour wait in reception may result) or get into a horizontal position, monitor the bleeding and get into his office first thing in the morning. We chose the latter... with the bleeding stopping after about 20 minutes... and when we arrived the next morning to the doctor's office, they discovered.. nothing. The babies heart's were beating away... there was minimal blood pooled in my uterus, that I was warned could cause some cramping, and I was sent home with no real understanding of what could have been the result. It wasn't until my High Risk OBGYN appointment 2 weeks later that they confirmed I wasn't RH negative, potentially causing a risk to the babies if our blood was incompatible... and questioning if this could have been partially explained by the loss weeks earlier, but everything seemed to be progressing, so I was told not to worry.

Not worry... it's funny, how you immediately become protective and worry about your children even before they enter this world. I check on them daily (After ordering a doppler from an online company to help reassure me that they are both still doing fine). The galloping of their little heartbeats have become easy to find... side by side... on either side of my stomach. Sometime last week they both decided to move to the right, perhaps bored with their recent surroundings... but the presence of the massive fibroid made it difficult for them to get comfortable. After hours of sharp shooting pains I can only equate to their little legs kicking this swollen tender mass of tissue, they realized it wasn't worth it, and have moved back to their rightful home just to the left of my belly button.

I have another appointment today, they are watching me closely... something I find reassuring... we'll see today how much weight I have gained.... it was 11 pounds as of 2 weeks ago. Surely I have gained a few more despite my lack of hunger and my inability to eat more than a small portion at each meal before feeling as if I am about to explode.

I'll write more now... now that I am "settled" and the computer is back up and running. I find it therapeutic to re-hash the moments... makes everything seem so much more real; and makes March seem in some strange way, that much closer.