Progesterone

So, in talking with my OB at my 12week appointment a couple of weeks ago, it sounded like getting my progesterone injections would take a bit of ordering time with the pharmacy, but wouldn't be a big deal. I was instructed to call them to make sure they got the prescription order and that we're set to order for when I reach 16weeks. Everything seemed fine and like nothing to worry about, until I called my usual Safeway pharmacy to check on the status of my prescription.

First, the tech told me they had ordered and received it, but since I had never picked it up they sent it back to the warehouse. Um, what? I never received a call saying I had anything to pick up. Oh, but wait, this is weird, she said, we can't get it any more. What? Like it's delayed because they are out of stock at the moment? You said you ordered it and had it but sent it back. This is weird, she said again, no, we actually never ordered it, and we can't order it. The pharmacist will call you to go over this. Huh? So I get a call from the pharmacist, and sure enough they are not allowed to order that item, but good news, my insurance covers it and it's only a $40 copay (versus $3500 out of pocket if insurance did not cover it...thank God they do!!).

Okay, I can handle this, don't stress. I still have a couple weeks until I have to start it. I'll just ask one of the coordinators at work who our patients typically use. They all take progesterone shots, we have to have that info. So I get the info for a couple of compound pharmacies, one from my OB, and the other from a coworker. The one from my OB gives me no info except that they don't work with insurance and it can take a while to get my prescription set. Okay, stressed. I don't have an extra $3500 a month to pay for this stuff. I'll have to figure out the whole generic thing my OB said we could resort to if needed. But I call the other compound pharmacy and this place is so helpful, and gives me so much more info. They don't work with insurance either, but their out of pocket cost is only $105 for four injections worth of meds, and no cost for shipping if I can't pick it up myself. Okay, we're on the right track, so I give her my info and let my OB office know I may go through them. But then I ask if the $40 copay through my insurance is for four injections as well. Yup, and what a cost savings that is!

So I'm still on the hunt for a pharmacy, one that will take my insurance, and nobody has given me any other names to call. So I just start calling all the pharmacies I can think of. Bartell's. Walgreens. Bartell's is a no go. But I feel like I've struck gold when I hear back from my local 24-hour Walgreens and they say they can get it and they take my insurance. Hallelujah!!

I race over after work, get myself registered, and they're even cool enough to call Safeway to have the prescription sent over to them. I let my OB office know that's the route I'm going and I am so excited. Finally I got this figured out and I'll get it in time!

Until 9:05pm that night (we're at Wednesday now of this week), when I get an automated message from Walgreens saying that my prescription that was ready to pick up tonight has actually been placed on hold. What?!? I quickly call back (for one I knew I wouldn't be able to get it that night, and two, they assured me they could get it!). The pharmacist explains this is actually something that only the Specialty Walgreens Pharmacy takes care of, so it's out of their hands. And no, he doesn't know where the specialty place is located.

Great, I feel like I'm back to square one. I try calling the 800 number I found online for the specialty place, to figure out if they have my prescription and where they are, but they have limited hours. Ugh, I have to wait another day when I feel like time is running out. Stress is back. Ugh.

Thursday (yesterday), I ask the coordinator at work if she knows where the specialty pharmacy location is located. Oh ya, there's only one in the US, and it's in Texas. Great, now I have to pay shipping fees? And I still can't find info on whether this is room temp stuff, or refrigerated, and how long it lasts and if that's just once opened or from the date packed. Yeesh.

Finally I have a moment to call the 800 number again, and oh my God they already have my prescription on stat processing, they've got my info, insurance is confirmed to just be the $40 copay, and they don't charge for shipping! Woohoo! Finally, everything is set with a place that for sure can take care of me. I confirm that they won't be shipping to my home (last thing I need is my meds stolen the day before I need to administer them...and packages have gone missing before), and they only ship to my OB so I'm all set there. They'll call me if there's anything else that I need but it will either ship Friday (today) or Monday. Woohoo! My 16week appointment is the 11th so I can pick it all up then, and I'm all set. Thank goodness!

Now, the next thing is picking the best time to administer this stuff. I'll have to take it at about the same time each week, alternating butt cheeks as it's known to be a bit painful (joy). I think I can do it myself, but the injection needle is 1.5" long!! But that is all going to be in a blog post at a later time...when I do my first injection. There will be pictures!

I did find out that it's room temp storage, and it lasts 5weeks from opening. So I don't have to worry about that any more. Whew!

Still so much to figure out, but man, what a headache! And during a time when I am seriously trying to not stress about anything. A calm body is a happy body that Baby 2 can feel secure in. And I really want, and need, everything to work out this time.

Because I got a lotta love to give.

Awkward

It feels harder to tell people that I am pregnant this time around, and yet telling people makes being pregnant that much more real. Which is something I need as I still at times feel like, wow, am I really pregnant? Yah, my boobs hurt and the nausea sucks and we've seen this little one on ultrasound twice now, but I don't feel baby yet, and I'm not showing yet.

I thought that it felt awkward to tell people so early because I was so afraid to lose again, like I was jinxing things. But I do need to recognize this little one's presence in our lives now as it is definitely very real. So then why is it so awkward to tell people at times? I realized at work that what makes it awkward is when people don't know our history. Typically the first question when someone finds out is, 'is this your first?' Well, no. And then I tell them about Korbin and it's as if I have the plague and they suddenly can't get away from me quickly enough. So awkward.

I wish people weren't so afraid of loss. It happens, in many different ways, to everyone at some point in their lives. So really society shouldn't teach us to ignore loss, regardless of whether it's in one's own life or someone else's. Talking about loss when it happens is so much easier than trying to sweep it under the rug, at least for me. I don't expect constant hugs and 'I'm sorry's', just listen and let me get it out. It's even more awesome when people have the courage to ask questions.

Now, I get that it's not that easy to take in bad news from others. Heck, I don't always know what to say right away when people tell me of their losses, especially when it's unexpected. But I certainly won't my hide from them when they tell me.

Okay, rant over. I think I'm ready to start telling more people about our good news, and hope that no one else runs away when they hear what we've gone through to get to this point again. Hopefully I'll be able to continue being patient if people do turn and run the other way. Either way, we need to look ahead and be positive about this new chapter we're in now, this new little one who will hopefully stay in our lives a bit longer.

Because I got a lotta love to give.

Keeping Korbin Present

Being pregnant again is most definitely not all rainbows and unicorns. Not only am I a paranoid wreck a lot of the time, but I hold extreme guilt now, as well as an increase in my grief from missing Korbin. This makes being excited for Baby Love 2 difficult as I struggle to look forward to this one while still keeping Korbin's memory present in our lives.

It kind of started with the lock screen on my phone. It's been Korbin's footprints since I went back to work last year, something I want to see and remember every single day. Yet I wanted to put up an ultrasound shot of Baby 2, but I most definitely did NOT want to replace Korbin's foot prints. That would be like moving on, which would be forgetting. And as I've said a million times now, we will never Korbin. But just like any family, you keep up the pictures of your first child and just add to them with the younger ones. I seriously spent an entire evening trying to resize two pictures on my phone (thanks to the new and 'improved' operating system) and finally succeeded. Korbin's footprints remain, but are now accompanied by a picture of little brother or sister.

Getting new ultrasound pictures is exciting, but a feeling of deep-rooted guilt always surfaces when I start to feel excited about Baby 2. Basically, I recognize that I'm thinking of Korbin less, as I concentrate on Baby 2 more. I'm desperate to never forget Korbin, but I struggle with how to remember him as my memories are of just his sudden and tragic end. Especially now that we're in the second trimester. Every day closer to 24wks5days brings more intensely horrific visions of Baby 2's end, and flashbacks to having Korbin for too short a time. At any given moment, I'm struggling to fight back tears as I feel the raw grief I haven't dealt with in some time. Almost daily I have a horrific vision of what we went through, leaving me in tears on my way in to work. The emptiness returns, and I just cry. My feelings of missing Korbin are so intensified right now, and being pregnant emotional just adds to the hot mess.

All of this just pushes me to beg Baby 2 more and more to hang in there, don't give up, please don't leave us. It becomes difficult much of the time now to be positive or excited about the future. Especially since we had a child, but we don't know the experience of bringing our child home, or changing diapers or doctors visits. I honestly can't imagine what it could be like to have a child with us because all I know is being pregnant that leads to emptiness. Plus, I'm paranoid, anxious, scared of what could happen. That every tiny thing I feel means the end again. It's hard to enjoy being pregnant when feeling so out of control. I just can't seem to trust that things are fine until the next ultrasound shows the heart still beating and my cervix fine and no contractions.

All of this is why I continually refer to Baby 2 as Baby 2. Korbin is and always will be our first. No matter what. And no matter what, Baby 2 is our second. Is and always will be. One is not more important than the other, and we are at least incorporating both children into our lives by doing this. Hopefully the next step will be incorporating Korbin into Baby 2's life one day. Hopefully.

In the mean time, I'm far from fine. And yet it feels like people assume that because I'm pregnant, I am totally over what happened last year and pregnant ladies and newborns are my new favorite thing again. That could not be further from the truth. I 'm still jealous. Especially if the person is having a boy or the newborn is a boy. Extremely. It sucks. But it's from how much I hurt inside knowing I'll never get to coo over Korbin in adorable outfits or change or feed him. Being pregnant again does nothing to lessen any of that pain. In fact it's just intensified as I'm just reminded moreso now of who I'm missing in life.

Being pregnant again is no quick fix for grief and loss. I just grieve for Korbin more now.

Because I got a lotta love to give.

The Perinatologist

Yesterday we had a marathon of appointments (that thankfully went more quickly and ended sooner than we had anticipated) in order to meet with a perinatologist to review and discuss our case history, have the Nuchal Translucency Test done, and have my regular 12week appointment with my OB. What I did not expect was how anxious I would feel walking into the perinatologist's office.

Despite my continued near constant nausea and sore boobs and even constant need to pee, part of me was almost convinced this one's heart had stopped and we were going to lose him or her. Thankfully, the ultrasound was first thing, and the heart was beating beautifully!

Here's a healthy heart rate of 156, yay!

Upon seeing this, I immediately relaxed and just enjoyed watching Baby 2 sleep, suck a thumb, and even get the hiccups during the ultrasound. What really, seriously made me overjoyed was how the ultrasound tech began complaining that Baby 2 was tucked away in a far corner of my uterus, barely reachable by the ultrasound probe. She had me turn from one side to another to try and use gravity to move Baby 2 away from this corner, I then did a set of sit-up-toe-touches as quickly as possibly, and then even had to go empty my bladder to maybe change the angle of my uterus. Baby 2 did not move a bit, and the tech said, 'This is a stubborn one.' I immediately replied with, 'I am okay with that!' She probably didn't appreciate my enthusiasm about her difficulties in getting the proper pictures, but oh my goodness Baby 2 is really paying attention to our plan of action! Being stubborn equals staying in and not wanting to leave my body for as long as possible, and I am completely overjoyed to have that 'problem' as we'll have a planned c-section anyway, and hopefully this means it will be right on time at 36 weeks. That's what I'm choosing to believe.

Here's Baby 2, tucked away :)

The tech told us everything looks totally normal, yay! This ultrasound measures a specific piece of the neck to see if it is too thick or too thin. If outside a specific set of measurements, there is a higher risk the baby has Down Syndrome, but it's never 100% definitive. At this point we could have done all kinds of crazy extensive blood work to go along with the ultrasound, which would also tell us if Baby 2 is normal genetically or not. But for us, as with Korbin, the results don't change a thing about how much we love and want this child with us. With or without Down Syndrome, or an extra thumb digit, we love and cherish Baby 2 and want this one with us just as much. Thankfully the testing has become much less invasive these days, taking the risk of harming the baby out of the equation when deciding if testing is needed. But we still don't need it.

After this ultrasound we met with a perinatologist, who, I have to say, was really great. Here is a medical professional who actually knew the basic details our case and did NOT ask the dreaded question, 'How's your baby doing now?' I can't tell you how many nurses, front desk staff, and MAs have asked me that question since June 1, 2012. So not okay.

Anyway, this part of the appointment left me a bit freaked out. Basically, this doctor pointed out that when I went in for extreme back pain just a week before giving birth to Korbin, my cervix was not checked, and it was dismissed as a pulled muscle. Because of the lack of information from that appointment, we can't rule out a cervical incompetency after all, and that leaves us with a 30-40% chance of needing a cerclage (stitches in the cervix to hold it closed, in which there's still a 20-25% chance they will fail anyway). New studies show bed rest does nothing to stop labor or slow the process, and even hurts the mother with the lack of motion. And if we were to switch to seeing a perinatologist now, we'll probably never see the same doc twice. The monitoring is all the same, reactions to specific info will be the same, but we will lose the comfort of having a regular doc who knows us and can treat as such. At this point, that is really important to us. 

So, we're sticking with regular OB, Dr. Pray, but will switch to a perinatologist if indicated down the road. Thankfully, this doc did say in the end, despite us wanting to stick with my OB, that she expects a normal pregnancy and delivery at 36weeks. I do like that she can leave us with at least something positive after all the scary and emotional dwelling on previous facts and the lack there of during the consult. But, hashing out the details of last time, and the thought that maybe something could have been caught sooner at my back pain appointment, was really difficult and very emotional for me.

After this we met with Dr. Pray and confirmed our action plan. She seemed happy with this as well, and is so positive for us, which I'm just really latching on to right now. Leaving her office I felt a little better, but still had to ask Ry, 'Are we taking a risk in not seeing a perinatologist throughout this pregnancy?' Translate: are we being dumb about this? Whether we see Dr.Pray or a perinatologist, what will happen will happen, and the measures we'll need to take if indicated are all the same, so hopefully not a huge risk at all. And they don't recommend a cerclage right now so either way we're just monitoring often until somethig shows we need further action. Makes me feel somewhat better, but I'm sure I'll continue walking on egg shells until 24 weeks, maybe even 28weeks...or until Baby 2 is home with us...or who knows how long....

Random pic to bring back the positive

At this point, we know Baby 2 is doing great, and maybe even growing fast like Korbin did (he was tall for his gestational age!). This is something I need to focus on and keep in the forefront of my mind, maybe even include in my meditation/chat we have each day. Keep doing great Baby Love 2! We're already a third of the way to our goal (and at the half-way point to when we had Korbin, crazy!!). Let's keep up the good work together!

Because we got a lotta love to give.

New beginnings

This is going to be a long post, a two-parter even, as I have about 10weeks of pregnancy paranoia to catch up on. Yup, I am pregnant with Baby Love Number 2! And with this pregnancy comes a mixed bag of joy, fear, excitement, paranoia, sadness and hope.

We found out the Tuesday before we left for Australia. Even though it still seemed too early to tell since my cycles are usually longer than 28days, by day 28 I knew something was up. My boobs hurt in that different way. I told Ry, we bought a pack of pregnancy tests, and as the two lines showed up immediately (not even a 10second wait!) I yelled out through the bathroom door to Ryan, 'Holy shit! It's positive!'

I was excited, but nervous too. Can I travel? Will I be okay in Australia? Will I be allowed to go to Boston still for my big test and a conference in a couple of months? What if something happens while I'm on the plane, or in the Outback, or during my test? And that's when the paranoia began.

Every single time I go to the bathroom now, ya I have to pee, but really I'm looking to see if I'm bleeding. Every. Single. Time. Did I have a miscarriage last time? No, but I did have spotting the night before we had Korbin. Bright red, a bad sign for sure. I almost expect to see it now because, heck, we lost Korbin, it could happen to this little one too.

I couldn't get in to check for a heart beat till towards the end of about 8weeks. So, for a month I had to do my best to pretend I wasn't about to hurl at work and suppress the renewed excitement I was suddenly feeling. Not knowing if there was actually a heart beat was killer, too. Could we tell anyone without knowing that uber important piece of information? I ended up telling friends in Australia because I was so nauseous and nothing sounded good and I just wanted to sleep but needed food all the time. That would have been hard to explain!

Finally the big first appointment came and we saw it, that amazing first flicker that brings a whole new set of emotions the instant you see it on the screen. And relief, the relief that this one is alive and healthy so far in its teeny tiny little life. But, the paranoia did not go away with this new knowledge. I still check to make sure I'm not bleeding every time I pee. Yup, every. Single. Time.

Why the paranoia? Well, on the one hand there are the statistics. Losing Korbin put us in the 6 in 1000 who lose a child. The odds of miscarriage are 1 in 4. That is huge!!! It could happen to anyone! Especially me since we are in the 0.6%, how could we not fall into the 25% that have a miscarriage? That's the logic in my head at least. On the other hand, we have the tiny bit of spotting I had the night before we lost Korbin. No cramping. Just spotting, and one instant of it and it went away. Supposedly totally fine and no need to get to the hospital. Or so we thought. These are things that can make one go crazy.

And then let's combine them with all of the things I now know can happen because the beautiful moms and dad's in my support group have gone through them. Still birth, pre-eclampsia too early for viability of the child after birth, heart defects. All things I have heard about and skimmed through in pregnancy books completely ignoring the fact that anything wrong could ever happen to us, that we could lose our precious first-born child, Korbin. It's overwhelming to know what can go horribly wrong and rip your life apart when it does. All just as devastating as pre-term labor but the child not surviving. All things no parent should have to go through, ever.

During my 8wk appointment we went over our action plan for this pregnancy. At 12wks we'll meet with a perinatologist to go over our case history and discuss the need for further action with a specialist. At 16wks we'll start progesterone shots that will happen weekly, and ultrasounds every two weeks to monitor the length of my cervix since we don't know if it was a cervical problem last time. And assuming all goes well, a planned c-section at 36wks. I feel secure in this plan and like that we are still seeing my OB, who knows me, and knows Ryan and our situation (read: fears) this time around. Dr. Pray is positive about making it to 36wks. I need that positivity right now!

What's interesting to me is that, I'm high risk but not high risk. I can still travel through to 36wks as long as everything looks fine. Working out is fine, no limit to activities necessary at this point. But, with the close monitoring, if something creeps up, all that can and will change. But we'll be so much more prepared for it.

This past week I went on a work trip to Boston. Still filled with paranoia, I asked every waitor about their cheeses and meats and sea foods, being ultra careful of thorough cooking and heating and processing. If I was tired, I sat down. I checked for signs of miscarriage at every bathroom break. I chugged water and popped mints to try to keep down the nausea following said chugging of water. And I began to worry about whether we'd see a heart beat at our week 12 appointment. Yes, we saw one at week 8. But what's to say that heart beat still exists? I can't feel it. I can't feel baby yet. This can also make one go crazy in early pregnancy.

Here's where I will really make you think I'm crazy right now: Baby 2 and I have chats about our team work. They usually last about 5min, and mostly consist of me saying like a mantra how much we love and want this one with us. I also go over how we're in this together, and so we've got to work together to make this happen. AKA, I'm really trying to take a chill pill and I need this one to just hang in there right in my uterus until week 36, with a strong heart beat and a loud cry at birth. I thought I was so weird for doing this, until a friend sent me an article another mother who lost her first child wrote. In the article she explained the teamwork chats she had with her rainbow baby (a child born healthy and alive after one that is lost). Okay, I'm not so weird after all. Either way I'm embracing these chats. When everything feels surreal and too good to be true and like this isn't really happening (heck, we weren't really trying and definitely did not expect to be expecting again so soon), I take these moments to focus intently on this baby and sort of meditate on how real this one truly is.

And honestly, towards the end of Boston, having finished my test and maybe learned a few things in the conference and even making some connections with others in the field, I kind of felt on top of the world. A feeling I haven't felt since being pregnant with Korbin. Hopefully this is good, and that Korbin is guiding us through this next chapter in our lives, and is Baby 2s guardian angel. Because this one needs him just as much as we do, to make it into this harsh world alive and kicking and screaming.

We really need this one with us.

Because we got a lotta love to give.

Remembrance Day

Wow, we've already come to our second lost baby remembrance day. Wow! Moments like these kind of freak me out as I realize how quickly life is passing by, and how much I feel I've missed in the mean time.

Thankfully it feels like Ry and I are out of our slump. We are trying to truly live life again; seeing friends, going out into the world for adventures, changing things up. And with that we are figuring out how to still keep Korbin's memory alive and with us. Because he is always with us in our hearts and minds.

Although I'm not able to light a special candle of my own tonight and look at all the things we have left of him, I do have his footprints forever over my heart, and his spirit forever with me as well. I can still remember him. Forever my Baby Love Número Uno.

I got a lotta love to give.