Hold my hCG

Said to Luffy last night as we were getting into bed:
I’m actually hesitating a little, on telling my family, because I feel too good. Like, am I really pregnant?

My body:
Hold my beer hCG


Yesterday, with the looming prospect of spilling the beans for the first time, I was taking stock of my body. At 5w4d, I had the following symptoms: tender breasts, hunger, and a bit of fatigue. And as I watched my boss yawn about 5:15 yesterday, I realized that I was actually losing the fatigue a bit. I went on to power through teaching a tough exercise class, putting an obstinate preschooler down for bed, and still outlasted Luffy come bedtime.

What if I’m not pregnant anymore?

Luffy suggested I take one of my leftover pregnancy tests tomorrow [this] morning and I happily agreed. Who am I to deny myself the entertainment of peeing on sticks?


I did indeed take another test this morning and gleefully reported to Luffy that not only was a I still pregnant, I had one of the mythical dye-stealers! That’s when your hCG level is so high, the test line steals dye from the control line and it’s like the holy grail of positive pregnancy tests. Satisfied, I went back to happily envisioning telling my parents this evening.

As per usual though, I simply needed to wait a bit. About mid-morning today, the “feeling too good” statement came back to bite me as I was sitting on the couch, trying to focus on my breathing and not hurl. It took herculean effort, as well as some Saltines and a gingerale, to bring the nausea under control. So much for being blissfully symptom free.

On the plus side, I feel crappy now, so I must really be pregnant!
said every crazy pregnant woman ever

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A small milestone

It’s Thursday! I am still pregnant and spotting-free right now! Hooray!

Not that it means too much. I’m still just 4.5 weeks along or so. But still. Small things, right? When you’re looking at a process that extends 280 ish days ahead of you, you just gotta focus on the small milestones.


I went ahead and scheduled my first prenatal appointment for April 30th. I should be just over 7 weeks at that point. I’m looking forward to it and have to keep reminding myself to be patient. I want to go now! Screw patience! Then I remind myself that there’s truly nothing to be seen at this point. Just a dot, then a blueberry. It still won’t be much at seven weeks and change, but we should definitely be able to confirm heartbeat by that point. I mean, fingers crossed, if all goes well.


We haven’t told anyone so far. Unlike last time, we’re content to hold the news to ourselves this time. Part of it is the miscarriage, I’m sure. I can’t speak for Luffy, but I know another part of it, for myself, is that we’ve been through this before. We know exactly what lies ahead. I know how interminable the first trimester feels. I know how the third trimester will drag then seem to speed up as we hurtle towards the due date. Then time will come to a crashing standstill with the arrival of a newborn. All of that lays ahead of us, so what’s the rush in spreading the news?

All that being said though, my family has been planning to visit us for Easter for about a month now and I’m very excited by the prospect of telling them in person. I haven’t decided how exactly I’m going to tell them. Something big? Like an Easter “present”? Or should I go low-key and just blurt it out? Haven’t decided yet.

I had the thought that I should wait to tell them until after I visit the doctor, confirm the heartbeat and things like that. But then I realized that I didn’t exactly wait until after that point last time. In fact, I told them just a little earlier than I will end up telling them this time. So I suppose I have a pass on that particular source of guilt.


And that’s about it. All in all, I’m feeling pretty good. I’m yawning a lot more in the afternoon now. I have a bit of cramping (I’m actually sitting with a heating pad right now) and of course I’m visiting the bathroom a lot now. I have a touch of irritability, unfortunately. I hate that part. New this time around: each night before bed, my mind races with thoughts and … worries? Worries isn’t the right word. I’ll just be lying there trying to sleep when all of sudden I’m like did I close the garage door?! Or I need to return that library book, it’s due in a week, can’t miss it. Impending deadlines like that.

A mini comparison

I realized last week, when I was blathering on about how much more or less positive my pregnancy tests were/are, that I could simply show you guys. It never occurred to me, but yes, I do still have all the pictures. (I do delete all of the negative ovulation test pictures, lol, but I like having the pics of the positive pregnancy tests.) So! It’s time for a little comparison post!

Below, we have my very first positive pregnancy test:

It was taken at 11 DPO. It’s faint, but there, and the line would progressively get darker. (I seem to have shown remarkable strength and only tested two additional times, once with the same type of test to see the line progression about two weeks later and once with a digital. Though perhaps I simply deleted the rest of the evidence.)

Below, we have the positive pregnancy test from my miscarriage:

It was taken at 8 DPO. EIGHT DAYS PAST OVULATION. Do you see what I mean now? There’s just no way my hCG levels should have been that high at eight days past ovulation, what would be, at best, one to three days after implantation. Most resources say that implantation occurs 7-10 days after ovulation, so you do the math. For further comparison, a test I took Sunday, at 13 DPO, looks very similar.

Below, we have the first positive test from my current pregnancy:

It was taken at 10 DPO. It’s super, super faint, but there (especially in person). Also, notice how it’s lighter than that first pic up there, the one from my first pregnancy at 11 DPO? That made me really happy.

Thanks for being my sounding board. Lining them up like this really does highlight how incredible that January test was, for whatever reason. Let’s just say that I’m happy my current tests follow my healthy first pregnancy much more closely. Here’s to some happy thoughts that this little bean sticks around!

Please bear with me

… as we dissect the minute details of my menstrual cycle. It’s basically a compulsion at this point, since I had a miscarriage last time. I keep comparing my cycles, where I am now versus last time, and I finally decided to put it out on “paper.”

Here, ladies and gentlemen, is the calendar from my miscarriage cycle:

And here is the current calendar:

I know it seems anal retentive to lay it all out like this, but I think it’s really helpful. For instance, I realized that the day I started spotting in January (otherwise known in my head as the day after my Well Woman’s exam) was CD 30 or, more importantly, 13 days after ovulation (DPO = days past ovulation). 13 DPO was yesterday, for this cycle, so yay! I’ve already passed one milestone of sorts. This layout also makes it clear that I miscarried 17 days past ovulation last time, which is this Thursday. Another hurdle to get through.

I can’t say why exactly it makes me feel better to know I’ve already passed the point in which I started spotting (which is honestly probably truly the day the miscarriage began), but it does. Because it was hazy in my brain (was I 4 weeks along? 5 weeks? how many days was I pregnant again?), it makes me happy, in a way, to see that I never reached 5 weeks. (5 weeks along is about 21 DPO, just in case you were wondering. I know, I know, there’s so many variables to keep track of.)

Anyway, I like having it all laid out in front of me.


Obviously I’m still pregnant. I have no worrisome symptoms to report at this point. The fading breast tenderness that I worried about last week has come back with a vengeance. I definitely don’t remember having this level of tenderness when I was pregnant with the dumpling. In fact, I recall feeling distinctly normal in the early weeks, though the fatigue set in pretty quickly. I will be very interested in comparing these two pregnancies – assuming that this little bean sticks around.

(And yes, I feel like I’ll make that caveat nearly every single time I write. Again, it’s a compulsion. Though my archives tell me I had it last time too, so perhaps it’s just a Belle thing.)

Looking at the calendar, I’m actually thinking about delaying my first OB visit until the beginning of May, when I’ll be almost 8 weeks* along. My doctor always does an ultrasound the first visit (yes – even at that one from 4 weeks precisely). I had originally planned to just delay until I’m at least 5 weeks along – no point in going to see him if I’m going to miscarry early again. However, it got me thinking about what my ultrasound looked like last time, at 6w3d – a blueberry. And while we were able to confirm a heartbeat at that point via the tiny, pixelated flickering, it would be kind of nice to wait until the point where you can hear the heartbeat and the fetus looks less blueberry-ish and more baby-ish. Like I said, I’m definitely not calling until after I pass the 5 week mark, so my resolve may fade by then as I anticipate getting a look, any look, at the baby. We’ll see.

Also, you’ll notice an asterisk up there by 8 weeks. I already have a due date conundrum on my hands. If you plug my LMP into a due date calculator that doesn’t take cycle length into account (which is likely what my doctor’s office will do), it says I’m 5w1d along, with a due date of December 8th. However, I ovulated on CD 23, a full week behind the “average” cycle. When you plug that information into a due date calculator, I’m 4w1d, with a due date of December 16th. Now, I know due dates aren’t an exact science, but it does feel a little odd to not know exactly how far along I am, especially since all of the pregnancy apps break it down day-by-day.

Speaking of apps, I used two with my last pregnancy: Ovia Pregnancy and BabyCenter. I plan to use them again this time, but I realized TODAY that they don’t number the days the same and I’m not sure I can deal with that dissonance. For instance, Ovia Pregnancy calls the first day of the week 4w0d and goes 4w1d, 2d, 3d, 4d, 5d, 6d, 5w0d. BabyCenter on the other hand, calls the first day of the week 4w1d and goes 4w2d, 3d, 4d, 5d, 6d, 7d, 5w1d. I… don’t know how I missed this last time. I really hope, for my own sanity, that it was a software update by one of them because how did I go 38 weeks of heavy usage last time without noticing?! Luckily, I don’t think I’ll be as obsessive about checking them this time around. Plus, it’s not like I know precisely how far I am either, so what’s a day +/-?

And suddenly there were two… part 3

Or is this more like 2.5? I’m not really sure, but you probably know where I’m going already…

Weekend intuition confirmed: I’m pregnant.

It’s very faint. Luffy missed the lines on both tests, though I can’t hold that against him because yeah, it’s super faint. But! I’m really comfortable with that, almost pleased with it. The results are fainter than my positive test with the Dumpling (a test which was taken two days later, cycle-wise).

I didn’t ever really mention it, but after I wrote about being sure my dates were off or something as the explanation for the strong positive at such an early date, I stumbled onto another theory: the high hCG level was an indicator for the miscarriage. High hCG could be an indicator of lots of things, including multiples (which OMG) or fetal abnormalities (like the egg missing genetic material or an egg that was fertilized by two sperm). Now, I know I can’t scientifically or precisely say how high my levels were, but I can say that eight days after ovulation (with the day of the positive ovulation test being day 0), my levels were high enough to produce a no-questions-asked result on a test with a threshold of 25 mIU/mL. Eight days! Then, I got a positive result on a digital test five full days before my expected period. The digitals aren’t as sensitive and mine in particular only detects about 60% of pregnancies at that point (according to their website anyway, which isn’t always the best of resources).

So what I’m saying is that while it’s definitely possible I just had my dates wrong, my levels were far too high for that. Even adjusting the dates back a bit, my hCG levels were high. And while it could have been nothing, it also just might possibly have been an indicator of the un-viability of the pregnancy.

All that said, I’m very happy with my squinter at T-4 days until my expected period. Now I’ll just keep some happy thoughts in my head to hope that this little bean sticks around. Happy thoughts!

Intangible.

It turns out we didn’t have to wait that long.

The results from my labs came back yesterday afternoon. My hCG level was ridiculously low (4 mIU/mL*). Especially considering the strong initial positives I got, the level is low enough to indicate a miscarriage. I go back next Monday to have my labs redrawn. We want to make sure my hCG level drops completely.

And with that, my second pregnancy truly is over.

I have restrictions for the next month or so, to make sure my body heals properly. Since I was pregnant, my doctor wants to make sure my body returns to its pre-pregnant state. We have to put our attempts at conceiving on hold for a while, again to give my body time to heal.

We’re doing ok though, honestly. My doctor commented that we were in great spirits, considering. And we really are. In our minds, this is a good outcome. Clearly something happened during conception, be it chromosomal issues or a botched implantation. A clean miscarriage is a much better option than a complicated, risky pregnancy. It definitely throws a wrench into our timeline, but we’ll adapt.

*I can save you the googling. The typical hCG range for a women who is 5 weeks pregnant is 18 – 7,340 mIU/mL. It varies a lot due to late implantation, plus the fact that it doubles so quickly during early pregnancy. The pregnancy test I used can detect hCG of 25 mIU/mL. And remember, I got a glaringly obvious positive result the first time, implying I was well above the minimum of 25 mIU/mL when I tested the first time. I agree with my doctor’s conclusion. Even without another blood draw for a comparison point, it’s pretty clear that my levels are dropping.

No news

I really don’t have any further official news since Monday.

I started the progesterone Monday evening. The heavy bleeding subsided Tuesday morning, though I’m still having what I would consider heavy spotting. And I’ve done a whole lot of googling, from what little information I can glean from my patient portal. A whole lot of googling.

[And here is where I will put a pinpoint as a warning for all of those who are trying so hard to conceive or those of you experiencing loss or the tenderhearted among us because we are about to have a real tough conversation, you and I. Fair warning.]

The way I see it, I basically have three diagnoses on the table: (1) threatened miscarriage due to low progesterone, (2) threatened miscarriage due to chromosomal abnormalities, (3) subchorionic hematoma or SCH.

In the first case, low progesterone is the cause of the bleed and the pregnancy and baby are otherwise viable. I have already been prescribed a progesterone supplement and was shocked to see that it’s a three-month prescription. I suppose I would have to be on it for several weeks, until the placenta takes over production, though I would obviously need to clarify that with my doctor. Honestly, this is probably the “best” outcome though it seems somewhat unlikely given I’ve already carried a baby to full-term without the need of progesterone supplements.

In the second case, a miscarriage is the final result. This may take a while to play out, considering my bleeding has stopped at this point (so I’m definitely not actively miscarrying at this point in time). I’ve already had two ultrasounds and we’ve seen development between them. I could be experiencing a blighted ovum where there’s actually no baby to begin with. The baby could simply stop developing. My body could refuse to finish the job, so to speak. I’d need medical intervention at that point. Though it may take a while to unravel, I’d say that this is my second best diagnosis if only because it’s a clear-cut resolution and a clean slate.

In the third case, an SCH is the only complication of an otherwise viable pregnancy. This is where things get really complicated and unsure because the outcome depends largely on the size and placement of the SCH. Resources vary vastly in their prognosis and long-term outcome, though they unanimously say that many women with SCH’s go on to have healthy pregnancies. Some resources mention bed rest or activity limitations (for instance, no lifting anything over 10 pounds which would mean that I wouldn’t be able to lift the dumpling). No exercise. Some exercise. Pelvic rest, including no orgasms (which, dang, that would suck). But then again, other resources make it seem like a perfectly normal and simple complication. And I can’t find any information on whether these limitations are for the entire pregnancy or just while the SCH is actively bleeding. This will probably come off as callous, but I do not want this baby bad enough to not lift my preschooler or not teach my exercise class or not have sex for the next nine months. I am not that desperate.

And so, we’re just waiting to see what happens. I haven’t heard back from my doctor on the results of my labs from Monday (which is beginning to drive me bonkers). I keep thinking that the ultrasound on Tuesday will provide some answers until I remember that – through all of this activity – I will only be six weeks along. We may not even verify a heartbeat on Tuesday if only because it’s too early still. Gah!

Anyway, all of this… deluge of information is just my way of trying to wrap my brain around this. I truly thought I was having a miscarriage on Sunday and I have already grieved in a way. The idea that this pregnancy could continue just doesn’t compute. And when I think about trying to continue the pregnancy in face of dire statistics and heavy restrictions and poor fetal outcome…. well, I’d just rather not, thanks. But then, did I really just think that? And what if there’s never a definitive diagnosis, which is probably just as likely a scenario as any other. What then??

I have no idea.

I guess we’ll just have to wait and see.