I Left My Harp in Sam Clam's Disco

POP QUIZ

Review the facts listed below. What is the most likely scenario linking these items together?

1. There's a vast mountain of laundry on the unmade bed, waiting to be folded.
2. The memory card on the digital camera has been wiped clean.
3. The refrigerator has only odds and ends scattered on the shelves.
4. It's almost dinnertime and I'm avoiding my responsibilities on by wasting time on the computer.
5. My e-mail box is full of messages from Travelocity and far-flung friends.
6. The kitchen counter is invisible underneath a mountain of unpaid bills
7. Guidebooks, maps, and newspaper articles are strewn from one end of the house to the other.
8. Both Cait's and Jen's wallets are entirely devoid of cash.

If you answered that Jen and Cait are going on vacation, you passed. (But wait, you say. 1, 4, 6 and 8 are almost always true, and 1 and 8 seem rather unwise if they are indeed leaving on a plane tomorrow at an unthinkable hour. Ah, well, that is indeed the case. Such is life.)

It's Spring Break for us both, and it's rather bittersweet. Perhaps even mostly bitter, but we're trying to sweeten it to the extent possible. A year ago at this time, we were eagerly waiting to begin inseminating, trying at last for the child we've both desperately wanted as long as either of us can remember. The week off of school was devoted to painting the house in case I was pregnant by summer and exposure to paint fumes would be unwise. As we primed the walls in the spare bedroom, we wrote messages like "Happy Baby Room" and drew smiley faces in the hideously stinky oil-based primer we bought by accident (and then had a hell of a time painting over the messages so they couldn't be read through the layers of paint).

This year we thought I'd be going on maternity leave this week, with a few weeks to nest and prepare for the birth (the due date was April 10). After the miscarriage, the thought of Spring Break was torturous to me. We decided that the best way to deal with it was to go away, and to make it as fabulous a vacation as we could. So we leave tomorrow for San Francisco, and we plan to relax, eat amazing food, and see a sight or two.

I think we're leaving the computer behind, but you never know when you might find an Internet cafe or a friend's computer! However, I may not post again until the weekend. If you get bored, feel free to stop by and fold some laundry or clean out the fridge.

Life Rubs It In

1. We live in cohousing, and today was a workday, where we do various tasks to maintain the common grounds and spaces. I wore grubby, baggy sweats as befits a day full of grimy chores. As I organized the workshop by cleaning out a ton of abandoned junk, one of my neighbors approached. I could tell by his face that he wanted to pester me about a long standing disagreement, and indeed, when he started speaking, that's what he did. But then he literally interrupted himself, looked at my sweatshirt and said, "Are you pregnant again?"
   
2. We got an invitation in the mail today to Cait's cousin's girlfriend's baby shower. Accidental pregnancy, of course.

Fun, fun, fun.

Good Friday? The Jury's Out - Part 2

Noteworthy item #2: We met with Dr. Reserved (our RE) today, and the outcome of the appointment didn't please anyone. The conventional thinking on partial molar pregnancies these days is that you need to wait 6 months after your beta is negative to try again, as a precaution against the small but real possibility of recurrence. However, from all the Googling I've done, there's no evidence that the risk of repeat moles changes at 3, 6 or 12 months. It's not until you get to some absurd timeframe like 3 years that the risk drops appreciably -- and we're talking about a risk of less than 1% to begin with. I'm willing to wait a few months to allow my body to recover and for the methotrexate to clear completely, but any longer than that seems cruel and unjustifiable.

Armed with this knowledge, Cait and I went into the appointment with the intention of trying to get him to agree to 3 months instead of 6, but apparently he came into the meeting with the idea that we were going to debate 6 vs. 12. Guess who won? He was willing to listen up to a point but did not want to budge on 6 months. He finally said to me, "I'm going to cut this off or we're going to keep going in circular arguments." I kept asking him to justify the need for the extended wait, and he couldn't/wouldn't provide one, but said that it was the standard of care and he had a responsibility as a physician to be prudent. I showed him a Japanese article that suggests shorter waiting times don't lead to worse outcomes, but he was dismissive, saying different countries have different approaches.

He did agree to double-check with a colleague and see if he would support a shorter wait - but since this is the guy who's been advising him all along and we haven't liked his input much so far, we are not hopeful. However, the receptionist saw how upset I was when we went back to the waiting room and got Nurse Cheery to meet with us (behind closed doors) and she said she'd try to get another doc in the practice to weigh in and possibly help our cause. So there's some hope, but it looks like there's a strong possibility we won't get to insem again until September or October -- one year after the D&C.

I would just like someone to provide a rational explanation of how the extra wait can benefit me. I only see the harm.

Good Friday? The Jury's Out - Part 1

Today is a noteworthy day on more than one count. First and foremost, I had another beta today and for the third week in a row it came back as "less than 2". (Why they can't measure lower than 2 at my lab is a mystery to me.) That's the standard for considering a molar pregnancy to be resolved. This should be cause for rejoicing... but I'm feeling rather flattened. Because molar pregnancy is the nightmare that never ends: devastation followed by more bad news, followed by waiting, waiting, waiting, and the ever-present sceptre of recurrence and more bad news. Even when you get to zero (or "less than 2") you still have lots of waiting ahead of you. But it is a milestone.

Maybe it's not just me...

Born Worrier + Miscarriage =

Paranoia....

Following the miscarriage in October, my capacity to agonize about all things reproductive has increased to dizzying proportions. This is not good, since worrying is a genetic predisposition in my family, and I got extra helpings of that gene. Now I'm like a worrying superhero: "Faster than a 911 call. More powerful than a box of kleenex. Able to leap to dire conclusions in a single bound. Look! It's a cloud; it's a pain... it's WorryWoman!"

And it doesn't take much to get WorryWoman to don her cape. Yesterday I got my period. It's the first potentially ordinary period since the D&C. Before this there were the days of endless bleeding followed by an eternity of sludgy spotting in October, then nothing, nada, zip until last month - but last month's period turned out to be more like a miscarriage of the remaining molar tissue - and that's a story for another post.

Anyway, I digress, which I assume you're used to by now. I was talking about the bleeding that started yesterday. WorryWoman has a sidekick, HyperAttentive Gal, who is capable of noticing even the most trivial of details, and HAG was on the alert as soon as my period began:

• I didn't spot before it started. I always used to have a teeny bit of warning spotting. But this just started with bona fide bleeding!
• My dead giveaway PMS symptoms were missing. I wasn't craving potato chips and other junk. [That's because you were ALREADY EATING tons of crap! - Ed.] I didn't think everyone hates me!
• Day 2 was always my heavy flow day with accompanying cramps. This time I barely bled until Day 3!

WW's ears had perked up at the first shrill warnings from HAG, and by the time HAG got rolling, WW had leapt to the logical conclusion that SOMETHING MUST BE WRONG. So imagine her terror when the bleeding today just kept getting heavier and heavier.

The small part of my brain that WW and HAG haven't totally colonized is trying to maintain a sense of calm and rationality, noting that this really is only the first period I'm having since the hormones and wayward cells ran rampage over my uterus, and it's only logical that it might not be exactly like my periods before the pregnancy and the mole. The sane voice in my head (is that an oxymoron?) also says that these are not exactly terrifying symptoms (unlike warm, red, infectious streaks running up your arm). Today's heaviest bleeding is nowhere near the level that would require medical attention. Even so, WW is on the job, fretting anxiously away.

When you get down to it, I think that all the worrying is a substitution for, or an outgrowth of, frustration. Frustration at being reminded yet again that I am not in control. Although the drama and crap have subsided, things are still not "normal" with my body. Part of me wants to scream, "Yo, universe! Cut it out! We get the message already." But a part of me recognizes that clearly I haven't really learned the lesson or I'd be more, well, sanguine about such developments. (Sorry, couldn't resist.)

Anyway, all you denizens of blogland can rest easy tonight knowing that Worry Woman and Hyper Attentive Gal are on the job (keeping me from resting easily).

The Ecstasy and the Agony

Wow! This is my lucky day! Julie - yes, that Julie - read my blog and liked it! I feel like Sally Field at the Oscars: She likes me! She likes me!

But, d'oh! I had messed around with the settings last night and accidentally turned off the comments. The horror.... I could have had a comment from one of the IF blogging goddesses, but I blew it. Woe is me.

A Bowl Full of Mush

I had planned to blog about the way that fertility hurdles seem to cause some women (myself included) to become hyper-domestic in other regards such as cooking, crafts, etc., but the Great Rice Debacle makes this an inopportune time to investigate this phenomenon. So I thought I would muse about some of the other changes the miscarriage and the molar pregnancy have wrought upon my psyche and behavior, such as the fact that I only wear black underwear (I guess my crotch is in mourning?) and eat a lot more take-out than my stingy self ever permitted before. However, it seems that one of the most significant changes the past 10 months have wrought is that my attention span and my ability to think clearly are pretty much... gone.

Therefore , I'll take this time instead to put in a little product endorsement. Pyrex is some kick-ass kitchen technology. Like those famed watches, "it takes a licking and keeps on ticking." (Maybe it has something to do with ending in "-ex"?) I am very fond of the little bowl I abused in the micro-mishap, and thought it was beyond all hope in its singed condition. Yet, with a little soaking and scraping, it's almost like new:

Alas, I am not so sure about my brain!

Don't Believe Everything You Read on the Internet...

Contrary to some assertions, it is inadvisable to cook rice in the microwave.

Jen didn't want to cook it the normal way because she was afraid she'd burn the bottom of the pan....

--Guest post by Cait

ARGH!!!!

Our flaky Internet issues at home have shown up again, this time affecting both PCs. The battery on Cait's Mac is dead and it will take a couple of weeks to get a new one. The firewall at school blocks Blogger, so I can't post there. And the computer in the Common House suddenly doesn't recognize my USB drive, so the posts I worked on last night for a loooooong time are inaccessible. Waaaaaaaaaaaaaah!

Someday I'll post something interesting again.

UPDATED: I actually can post at work... hope it doesn't get me Dooced. I put in the two posts I wrote offline last night and back-dated them to match when they were written.

Deja Vu

This morning, Cait said, “I wonder what the disaster du jour will be.” I immediately told her to bite her tongue, though I secretly worried that she might be right as it seemed like I was headed for yet another sinus infection. My throat has been quite sore and I woke up today so dehydrated that I felt like an old book whose pages crumble into dust as you leaf through them. Those of you who share my membership in the Bloodletters R’ Us club know that’s never a good sign. Indeed, when my favorite tech (the one that I will allow to draw blood from anywhere – if he said, “Your earlobe looks good today,” I’d say “Go for it!” confident that he could remove the needed sample painlessly) worked on my elbow, it required so much poking and prodding that I had to call Cait on my way to work to report it. On the good news side, our favorite nurse reported that she was able to schedule an appointment with Dr. Reserved for us on our day off next week, and she’d confirm the time when she called with the results of the beta.

As usual, she didn’t call. The results line is open from 2:00 –3:00 for patients to call in, but the nurses usually call you. In the beginning our nurse was pretty good about calling the number I specified, but about six weeks into the merry-go-round she started calling numbers seemingly at random. If I asked to be called at work, she’d call the cell. Ask for the cell, get a message on the answering machine. I finally gave up asking. Now that the beta is negative, she sometimes doesn’t even call at all. Since I have other doctor’s appointments to schedule, I decided to call in for my results. Luck was with me and she was the nurse on duty.

“Oh, hi, it’s me,” I said, sure to specify my last name, as a few weeks before she’d brightly told me that my estradiol was up and my FSH was right where we wanted it – and then realized I was a different Jennifer. “Did Dr. Reserved give you – ”

She interrupted me. “You’re not going to like this. It’s not good.” “Wh-what is it?” I stammered, caught off guard as I always am by the land mines in this lousy journey. “34.”
Unwilling to acknowledge the nightmarish news she’d just revealed, I returned to my original line of inquiry. “Well, anyway, what time is the appointment next Friday.” The nurse, hereafter known as Cheery, wouldn’t let me get away with that. “That’s all changed now. We’ll have to find out what Dr. Baltimore recommends. But I’m having the lab run the test again just to be sure. I’ll call you back as soon as I hear.”

Shattered, I began walking toward my 3:15 meeting, and then turned around to get a Coke and some Girl Scout cookies. I mean, what’s the good of giving up caffeine yet again if this shit keeps happening?! In the meeting, I told my incredibly supportive co-workers about the phone call and tried to integrate this turn of events into my consciousness, with little success.

Ten minutes into the meeting, my phone buzzed. I grabbed it and ran into the hall. As soon as I answered, Cheery said, “You’re going to kill me. Did they have trouble getting blood from you this morning?” Feeling the wound on my elbow, I croaked, “Yeah.” She replied, “It was a dilution error. They didn’t have enough blood. It’s less than 2. You’re fine. And Dr. Reserved will see you at 8:15 next Friday.”

About an hour ago, my heartbeat finally returned to normal.

x-$129 =

:)

Tuesday evening, with my sister safely home, Cait and I began looking forward yet again to our first relatively stress-free weekend since the beginning of October. (Cue ominous music.). But Wednesday morning as we packed lunches and ate breakfast I smelled gas by the stove. I’d smelled it earlier in the week when I cleaned behind the stove (don’t think too highly of my cleaning skills; it was only because an errant tofu sausage had rolled irretrievably under the oven one day last week).

When I returned from work that afternoon I called the gas company and reported a possible leak. The guy who showed up looked quite skeptical and said he didn’t smell anything, although I could still smell the gas. But he waved his tester around behind the stove, and within 30 seconds it went off like a combination Geiger counter-air raid siren. He was oddly stone-faced and impassive, and after several deafening minutes, I was forced to ask if there was a leak. Still expressionless, he said, “Oh, yeah, you’ve got a big leak.” He told me to call a plumber (to my astonishment, as I’d naively thought the gas company would repair a problem with the gas line, but nooooo) tied a big, red “DANGER” tag to the front of the stove, and left.

Figuring the rest of the week was now shot to hell, as we could no longer cook and one of us would now have to take more of our rapidly dwindling leave to stay home for the repair person, I looked up plumbers on the web and called the first name I recognized. To my astonishment, they said they could send someone that afternoon! Lo and behold, there was a knock on the door within half an hour, and an affable gentleman quickly put an end to the toxic plume that has probably been polluting our house since the day we bought it, for the low price of $129. (The repair, not the house.)

That I can type the words "the low price of $129" is a testament to the way our lives have changed in the past two years. I am a known tightwad, but the last year has wreaked havoc on my entire life, including my neuroses. Oddly, despite spending an amount I am not allowed to calculate on sperm, high tech squirting, and the aftermath, we are in a better financial position, so it really is ok. Secondly, the aforementioned aftermath is costing so much that $129 seems a mere bagatelle.

I'll take a bagatelle over ominous music any day.

I Know I Want a Baby, but I'm Not so Sure about a Teenager

My mom called me at work today and told me they just found out that my 18 year old sister has been missing for two days. She went to London for Spring Break to visit a friend, and this morning the friend called my parents and said, "When is she coming?" My parents spent the morning checking with airlines and filing Missing Person reports, and then called me to see if I could help them investigate her laptop which she conveniently left behind.

We've done a lot of snooping in her cell phone and Explorer history (note: if you ever want to do something illicit, CLEAR YOUR HISTORY!!) and the most likely scenario is that she ditched her friend to meet up with a much older man -- a teacher from her school, no less. I don't find it weird that she hasn't called my parents, though they do. DUH! Like you're going to call Mom from your tryst with a lover! But all of us who are young enough to remember the idiocy of the late teen years are still a bit baffled that she didn't at least cover her tracks and let her friend in London know what was going on. We are still somewhat worried, but there's not much we can do.

Meditate, pray, send good vibes, do whatever you do and hope that she's just being COLOSSALLY STUPID.

UPDATE: She finally called home mid-day on Monday and is on a plane home now. She was unaware of the chaos she had generated and stunned to discover that police from four jurisdictions had been searching for her since Friday. The main thing at the moment is that she is OK and will be home in a few hours. Thanks for your concern and good wishes.

Pink + Pink + Pink + Frills =

Gag!

It turned out that the anticipation was worse than the reality. The shower was not the happiest or most comfortable two hours of my life, but it was far from the worst. There were a couple of moments where my stomach was tied in knots, but for the most part it was ok. I was able to be happy for K. and admire the gifts (and be reminded yet again why I do not want to know and/or publicize the gender of my future baby in advance: the place looked like a Mary Kay convention. Blech!). I am also pleased to report that I did not eat myself into a stupor to cope with the stress. I did have a bit more Coke than might have been prudent, but I was relatively restrained about the chips and such. (Could that have had anything to do with the fact that there wasn't really anything there that sets off my junk-food frenzies? Naaah...)

On my own fertility front: It seems that I ovulated last night! First time since July!

Tomorrow, Tomorrow, I Hate Ya, Tomorrow

One of the fun things about my pregnancy was that I was pregnant at the same time as a friend of mine at work. K and her husband had struggled with infertility for years, so as I began TTC, we compared notes and empathised with each other through OPKs, scheduling doctor visits (so much fun for teachers)and 2WWs. Each of us was scared that she'd get pregnant before the other, so we were delighted to get pregnant the same cycle. K was due 1 day after I was.

Because of her struggles and an earlier miscarriage, she spent the first trimester quite worried about the future of her pregnancy. I engaged in a typical amount of worrying about my own pregnancy, but was reassured by early ultrasounds and mounting pregnancy symptoms.

We abruptly switched places at the end of September, when she had a good OB appointment and an excellent ultrasound. I had two worrisome midwife appointments followed by a devastating sonogram. In the horrid weeks and months that followed, K has been a big part of my support system, sharing her miscarriage experience with me and keeping track of the nightmarish twists and turns of the molar pregnancy ride. She never brings up her pregnancy unless I do, and has been kind, concerned, and thoughtful in every way imaginable.

I have a harder time with the rest of our co-workers, the majority of whom seem to have forgotten entirely that I was pregnant, too, and that our pregnancies were so intertwined (at least in our minds). They will gush over her or make comments, thinking nothing of the effect the comments have on me. It's unrealistic to think that the world will stop because we lost our baby, and I still have so much joy for K, her husband, and their soon-to-be daughter, but it's still hard for me when I am so frequently reminded of what I'm missing.

Tomorrow is her shower. Coincidentally, tomorrow is one month to the day from my due date. I think tomorrow is going to suck.

Cancer? How about a Virgo? I'll even take a Taurus!

News flash: Getting pregnant can give you cancer.

No, you're not reading the Weekly World News. It's really true. Little did I know that trying to get pregnant can lead to the Big C. In fact, cancer was the farthest thing from my mind when Cait and I had our romantic, candle-lit, tender babymaking session clinical, stirrup-straddled, fluorescent medical IUI back in July.

But lo and behold, hydatidiform moles are a precancerous condition, and if beta hCG levels do not drop appropriately (or heaven forfend, rise) it's quite possible that the nasty little trophoblastic cells have decided that they are no longer content merely to be in the uterine cavity, but prefer to invade the uterine wall itself. From there, they can spread out and colonize the lungs or even the brain. Sounds like science fiction, but it's cold, hard fact.

If your betas don't behave, the first course of action is usually one or more methotrexate shots in the butt. Treatment protocols vary. You might get a shot a day for five days, or perhaps weekly shots, or sporadic shots depending on the progress (or lack thereof) of your betas. If you're really, really lucky, your betas will stall out completely or rise repeatedly, at which point the doctors will want to bring out the big gun: full-on chemo. I myself barely escaped this fate by the skin of my teeth. More on that later.

Luckily (and I mean it this time), gestational trophoblastic disease is virtually always cured by these methods. And once it's gone, the rate of recurrence is no greater than your original risk of having a molar pregnancy. The analogy I like to use is getting a cold: after it's gone, you're no more likely to get another cold than you were before the first one.

But I hope you never get this kind of "cold".

Whaddaya mean, a mole?

We're not talking about garden pests. Nope, these moles are uterine pests. A mole, a.k.a. molar pregnancy, hydatidiform mole, or gestational trophoblastic disease, is a rare condition that can occur in pregnancy. They come in two variants: partial mole or complete mole.

Your ordinary pregnancy has reasonable odds of resulting in a baby. Moles, by contrast, almost inevitably lead to termination of the pregnancy (whether spontaneous or medical), and only in rare cases produce a living baby. In a complete mole, which is caused when a single sperm fertilizes an empty egg, no fetus is formed, but a placenta composed primarily of abnormal cells is created. The chorionic villi in the placenta grow unusually large (often described as "grape-like" in appearance) and the uterus is filled with clusters of these hydatidiform cells. Complete moles are frequently diagnosed by ultrasound, often after the mother experiences bleeding, when the grape-like cells appear instead of a fetus. If a complete molar pregnancy continues into the second trimester without detection, the mother may experience symptoms such as extreme nausea and/or a significantly enlarged uterus for dates.

A partial mole, on the other hand, occurs when an egg with a regular complement of chromosomes is fertilized by two sperm. (Slutty eggs, letting in two sperm! Don't they know their job is to let in one and only one!?!?!) The excess of chromosomes leads to the formation of a fetus, usually with fatal deformities, plus hydatidiform cells in the placenta. The most common symptom of partial molar pregnancy is spotting, but there are often no discernable symptoms. Partial moles are frequently diagnosed retroactively by pathological investigation of the fetus. Sometimes a partial molar pregnancy is suspected when beta hCG levels remain elevated after a miscarriage or D&C, but the diagnosis can only be confirmed by pathological review of tissues.

Unfortunately, finding out that your pregnancy didn't have a fetus or that the baby died from the chromosomal abnormalities is only the beginning of the fun with molar pregnancies.* The patient's beta hCG will be monitored frequently (up to two times a week) to verify that the levels are dropping at a consistent rate. This can take weeks or months. The goal is to reach a beta of zero. Once the beta drops to zero, monitoring will continue until three successive zero readings have been achieved. At that point, the molar pregnancy is considered resolved, although doctors recommend monthly hCG checks for 3 months to a year to detect a possible recurrence. The recurrence rate is incredibly small, but the possibility exists.

Oh, and the really fun part? You're not supposed to TTC again while the monitoring continues. That's right, you lose your baby and you lose as much as a year or more before you get to try again. Essentially, you can spend more time losing your baby than the average term pregnancy lasts.

That, in an extremely oversized nutshell, is your basic molar pregnancy. Stay tuned, because things can get wackier from here on out!


*In rare cases, a woman can have a twin pregnancy with one healthy baby and one mole. Such pregnancies can continue to term, but the risk of fetal death is significant. Even if one healthy baby is born, the mother still faces long-term monitoring and the possiblity of recurrence.

Trepidation + excitement =

my first blog!

A year ago I vaguely knew about blogging but I doubt I read them with any frequency. Little did I know what the next year would bring and how much blogs would be critical to maintaining my sanity. But even a few months ago I would have been doubtful if you told me I'd be a blogger in the near future.

For the past few weeks, the idea has become more and more tempting. I found myself thinking, "This would make a great entry" or "If I were going to blog, I'd write it like this." But I wrestled with the fear that I have nothing to say, and that the fun of a blog would soon give way to pressure to write. (Not that those fears are gone, mind you.) But inevitably, the power of the Internet sucked me in like Mega-Maid hoovered up the air of Druidia, and... I'm blogging.

I hope that I will have something interesting to say from time to time, and that I'll have a reader or two, and that it will be fractionally as helpful to my psyche as reading blogs have been. Wish me luck!