"Some women are just so eager to get pregnant again very quickly. I have to advise against that."
He didn't really explain further, perhaps because I was just shaking my head "no," implying that it was the last thought on my mind. Truth was, I was just terrified that we wouldn't even be able to try again. After the hyper stimulation and hospitalization at the beginning of this pregnancy, I wasn't sure there were any options for us other than IVF -- which was a financial non-starter.
After all, the last time we saw our fertility specialist, leaving from an ultrasound, he shook our hands and said, "I'm so glad you ended up with twins because I didn't know what we would have done next."
That was a very honest thing to say. The injections nearly killed me, after all. Even if similar medications were an option, was I up for that? And I knew my husband was terrified that I'd go through that again.. or that the complications could be even worse.
But over the next few days, I was aching to speak with the specialist. On the other hand, I was terrified to even bring it up to Brad. We were both still having breakdowns on a regular basis. I didn't want him, or anyone else, to think I was just trying to move on. Still, I was overwhelmed thinking about it and questioning our future. I couldn't keep this to myself.
So, the day after the memorial service, I did as I usually do and just blurted out, "I need you to promise me.. that you'll do whatever it takes to try again, if we can. I know you're scared, and I know we may not even have any options left.. but if we do, I need you on board."
He was confused, and taken aback by the abruptness. He definitely wasn't 100 percent on board yet.
"I don't want you to go through that again. It scares me."
I went on with a speech about how I could die from anything at any time. But going my entire life and never again feeling the way I felt when I first held my son and daughter.. or when I saw my husband become a father -- that's what scares me.
"Brad, I need you to know this isn't about replacing them.. or pretending it didn't happen. I love them so much, and I miss them more than I thought possible. But I need a plan... All of our plans were about them or for them. Buying a house, picking colors for a nursery, birthing classes, quitting my job... I have nothing to plan. Everything is up in the air, and I need something.. anything.. to feel grounded right now. I need to know if we can try again, or if I need to accept that it's over."
That, he got. "Then let's meet with the doctor to see if we have any options left."
Monday, one week after delivery, I called the specialist. As the nurse answered, I started to explain who I was.. "This is Carol Shilor.. I had gotten pregnant back in September.. with twins.." I felt my voice start to shake.
Oh man, I was about to fall apart on the phone. Deep breath. "But I went into preterm labor and.. and we lost them both."
She simply responds, "Oh hon. I'm so sorry."
I continue, "I know we can't try anything for awhile, but I wanted to meet with the doctor to see what our options are."
To my amazement, she responded that he could see us Wednesday. I paused for a moment. No. Two days from now? I barely made it through this phone call. So I scheduled it for two weeks out instead.
Of course, a few days later I was kicking myself, as I was growing so impatient.. wanting to know one way or the other.
Finally, the day had arrived. Our appointment wasn't until 3 pm, and I felt uneasy as each hour slowly ticked by.
Brad and I both left work early, and rode together from our home. As soon as we pulled out of the driveway, I felt my eyes conjuring up tears. I was simply thinking to myself, "I cannot believe we're going back there. That we might be going through this all again; or that we might be told we're done, and that it's time to give up."
I took a deep breath and pulled it together before Brad could notice I was unraveling.
As we arrived to the office, every step down the long hallway to his door filled me with anxiety. This waiting room was filled with pictures of babies, and memories of my pregnancy. This was going to hurt.
We walked in and the nurse immediately asked, "How are you?"
I sighed, "Well, not good.."
She popped up, arms outstretched, "You need a hug."
So there I was, hugging a nurse as she leaned over the reception desk. So not my style. But she was probably right. I needed it more than I hated it.
As we sit in the waiting room, I turn to Brad, "I guarantee he forgot we said no IVF before. He's going to recommend it."
Moments later, we get called back. We're left to wait for 5-10 minutes, but it felt like 30. The doctor finally emerges as the office door opens slowly. He walks in looking almost as depressed as I felt. He looks up at me and outstretches his hand for a handshake.
"What else can happen to you?" he mutters as he sits across from us. "I'm very sorry."
He proceeds to ask me what exactly happened; as in, how labor progressed. Without looking up from his file he responds, "Classic incompetent cervix. You've earned yourself a cerclage."
I remember thinking how much I hate that they call it "incompetent." It just makes it sound as if I could possess an amateur cervix. My cervix is playing T-ball while I'm trying to get into the Majors.
I also began to question this diagnosis after the appointment, since I had contractions for nearly 24 hours before giving birth, and an incompetent cervix is usually symptom free. I also don't have any of the 'risk factors' for the condition. It's really a chicken or the egg scenario. Did an incompetent cervix induce preterm labor, or did I have preterm labor (simply due to twins) that caused my cervix to dilate and shorten as it would in any labor? But I'll get into that at a later date when I speak with the actual OB/doctor that deals with such issues.
He then added, "You'd probably be fine with a single child pregnancy, but they'll likely put one in anyway, just as a precaution."
Now, the idea of a cerclage doesn't appeal to me at all. In the most general of terms, a cerclage is when they put stitches in your cervix to, in theory, hold it closed for the duration of the pregnancy. However, it has a lot of possible complications, such as bleeding, infection, ruptured bladder, ruptured uterus, etc. All of which could end up terminating the pregnancy you're trying to save. So, there's a lot to weigh out there. And to get the procedure, you have to be put under general anesthesia or get an epidural/spinal. You probably recall that I fought against getting the epidural for the placenta removal procedure after delivery. So... eh. But until I talk to my OB or the high risk doctor, who would actually do the procedure, I'm not going to dwell on that part.
What I was focused on, instead, was that he was talking about any form of a pregnancy as possible. But I glanced down at his file that he was scribbling notes in.. and what jumped out at me immediately was "IVF." My heart sank a little. Here it comes...
He looked up, "Okay, the plan would be IVF."
I expected this, and I understood why. With IVF, they could choose to only implant one fertilized egg (basically no risk of multiples), and they could drain the fluid after egg retrieval, which would remove the risk of hyper stimulation. But still, not feasible financially, and so invasive.
I looked at Brad briefly, then turned back to the doctor. "The problem is.. IVF just isn't in our budget," I sighed. "If IVF is the only option.. then unfortunately.." My voice began to quiver as I tried to swallow my pain back down. "We're done trying."
The doctor stared at me for a moment. "Hmmm. Well then.." He began to fidget with his file, flipping back and forth between pages. Then he started to scribble down a new 'plan.'
"Okay. You want to be difficult," he joked. "Then the new plan is to do what we did last time. We'll just lower the dosage, watch you more carefully, and hope we can avoid the hospital."
I could finally breathe again. At least I know I respond to the medication. It's just going to be a balancing act..
But then I wanted details. "Given what happened, I know we'll have to wait awhile."
"Oh no. You can try again whenever you want. Some people come to me the next month and want to start right away. Others need a mental and emotional break. It's up to you," he replied.
"The doctor at the hospital had told us to wait at least 6 months."
The specialist was unfazed, "The uterus heals very quickly. There's really no need to wait." He paused, then added, "On the other hand, I don't want you to worry about getting older. Your ovaries respond like you're 18 years old. You have plenty of ammunition."
I admit, I chuckled at that. Obviously, I had been worried as 35 is quickly approaching. In reality, even with enough "ammo," I'm still hoping sooner rather than later. After 35, risks for a lot of things go up, and obviously.. the odds are never in my favor to begin with.
"Now, will there be a lot of a cancelled cycles? Like, if I have too many follicles?"
He calmly answers, "I don't think so. I'm not worried about you having multiples. They'll be watching and monitoring you a lot closer now. So I won't freak out if you have three mature eggs release. Odds are, they won't all fertilize, and you'd probably be fine, even if they did."
I glance at Brad who now has a shocked look on his face just from the mention of possible triplets. Still, it's reassuring that the specialist isn't going to try to be so conservative that it impedes a positive result.
As we left the office, Brad turned to me, "You feel better?"
"Yeah. I feel like it's at least possible. How about you? Are you up for this?"
"Yes. I'm on board. I want to try again," he responded -- my partner, through and through.
So, that's the plan. Problem now, yet again, is finances.
Last time, we did an online fundraiser, and our family and friends helped us raise nearly a thousand dollars. It covered most of the medication for that cycle, and gave us the chance to conceive and hold our twins. We are forever grateful for that irreplaceable moment in our lives.
But now, we're still paying for my hospitalization last October and we're about to be billed for the delivery of the twins. I thought it felt bleak before, but I'm definitely anxious about money right now.. And while we could do another fundraiser, we both don't want to come across as taking advantage or trying to 'double dip.' It's something we'll have to think a little more about, but we truly appreciate those who have already told us they'd like to donate if we do. It means the world that so many people care about us, our story, and want us to have another chance. <3
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