Better Safe...

Sometime last year, I started having heart palpitations--often skipped beats with an extra heavy "catch-up" beat.  I went to the doctor, he did an EKG which looked normal, and I got bloodwork done.  We discovered my vitamin D was low, so we increased it with mega supplements.  My D levels are still lower than they should be, but the incidence of the palpitations has decreased significantly, so I considered the issue behind me.  All good.

Then, sometime last month, I started noticing that I was having chest pain when I lay down at night to go to bed.  Since it didn't happen every night or last too terribly long, I assumed it was heartburn--even though it didn't feel like the heartburn I had when I was pregnant.

With my 40th birthday on the horizon, wanting to lose some weight, and knowing that physical activity can help release pent-up emotions, I got a membership to our local wellness center and began working out.  I began to feel nauseous during one of the classes I was taking, so I stopped doing those and went to just doing the elliptical.  Well, last week, I began having chest pain during my workout that didn't go away until I was done working out.  It's not horrible pain, but it's sharp and nagging.  Still, I convinced myself it was nothing.

Then I got emails, Facebook posts, radio and television commercials, all over the course of two days, discussing how the signs of heart attacks in women are different than for men and include things like back pain, nausea, and what not.  My mind began to wander and wonder--was this a message for me?  I thought about the fact that both of my kids had CHD and that there appeared to be a genetic component.  That would mean there's at least a 50% chance that the issue is from my genes, in which case there could be something going on with me.  I've had high cholesterol forever--even in college when I was 18 and weighed 150, my cholesterol was 206.  I'm certainly overweight, and I've had my ovaries removed.  All of these things increase the chance of heart attack.

I also have a family history of heart disease.  My grandmother was convinced something was wrong even though all her tests came back okay.  They finally took her in for a heart cath and couldn't even get the angioplasty balloon in, so she had quadruple bypass surgery; but she never had a heart attack thanks to her persistence.  I began to worry.  Still not enough to go to the doctor, but it was in the back of my mind.

Not until I woke up today with a sinus headache, mucus for days, and a general blah feeling, did I decide I needed to go to the doctor about this.  After antibiotic and steroid shots for the bronchitis, I had an EKG.  The good news is, it was completely normal.  The bad news is that all of my symptoms sounded very cardiac to the doctor.  And, given my grandmother's history, I was not reassured by the EKG.  So, the doctor sent an ASAP referral to a cardiologist, and I am waiting to hear back about when I can get in.

It is unlikely that anything is wrong.  It is highly likely that it's stress, on top of stress, on top of grief, on top of stress.  But, my family has already been through enough, so I'm getting it checked out.  I don't want to find myself in the hospital, or the great beyond, thinking "woulda, coulda, shoulda."  It's time to step-up the taking care of myself stuff.  Better safe, than sorry.

A Not Entirely Unexpected Complication

Today we went in for a fetal echocardiogram to check out Jellybean's heart.  Turns out it was a good thing we did.  Looks like he (it's a boy!) has some issues, including a VSD.  What the doc saw could be any number of things, so we don't have an official diagnosis.  Instead, I have to go to Detroit for more tests sometime in the next few weeks.  They will get more and better pictures (not sure how), and come up with an official diagnosis.  The doc today did say that she thinks Jellybean will need surgery shortly after birth--not with hours, but within the first week.  Because of that, she thought it might be better for me to birth at the Detroit hospital.  Obviously, we have lots more testing and follow-up before we reach this point, but this adds way more degrees of difficulty to the delivery.  On the plus side, she didn't think it was anything that would require early delivery or a C-section.  That is, she thinks Jellybean can tolerate labor and delivery.  So, that's good news.

The doc today is contacting Lil' Bit's pediatric cardiologist, in part because that's who Jellybean will see after birth, but also because Dr. S is affiliated with Detroit.  The doc today is affiliated with UofM, but we are more comfortable dealing with Detroit since we already know the folks there.  Dr. S is going to work on the fetal referral process to get me on the schedule for the additional testing.  As we go along, I will likely have OB visits with my regular OB, my high-risk OB, and a new OB in Detroit so I will be familiar with them before delivery.

All of this news is frightening, frustrating, and overwhelming.  However, I have some small semblance of calm in that I know how some of this works because of Lil Bit's surgery.  This time, we know the surgeons, we know the hospital, we know the area, etc.  We also have the benefit of knowing early, rather than finding out 6 months in, so we can prepare (Read--plan!!!  Always look on the brightside, right?)  Still, I had been hoping and praying the Jellybean would be "normal."  Instead, it looks like he is already trying to outdo his sister.  This sibling rivalry thing sure starts early!

So, to sum up:  We know there's something wrong, but we're not sure what.  We should find out soon, but we don't know when.  There will be lots of planning required, but nothing I can do yet.  And I'm not supposed to stress.  Yeah.  Good luck with that.

Please Sir, I Want Some More

Yes.  I have just likened having another child with the quest for more gruel in Oliver Twist.  Still, it seems fitting.  After all, I am still finding it hard to believe, given how vocal and certain I was at the time of Lil' Bit's delivery that we were only having one, that I now find myself having passed the "serious consideration" stage and am actively contemplating another child.  Still, that's where we are.  So, I thought you might like some insight into how we reached our decision.

Last week, we went back to the fertility center and met with the doctor to discuss what doing another IVF cycle would entail.  (By the way, did we ever mention that the doc looks like Stephen Colbert?  We just kept waiting for him to hold out his hand and say, "Nation..."!  But I digress.)  Part of the need for discussion was based on the fact that this cycle would be frozen instead of fresh, so there is an entirely different protocol.

On the IVF side of things, we learned several important things.
1)  Frozen cycles are only about half the cost of fresh--maybe even less depending the meds my insurance will cover.
2)  There are waaaaaaaay fewer injections.  In fact, it appears as though there's only one med done by injection and everything else is pill or suppository.  It just keeps getting better.
3)  My success rates have not gone down even though I aged.  Because we froze my eggs before I was 35, my success rates are calculated from the <35 category, meaning we're still above 50%.  Also, we have an increased chance at success because we had a successful pregnancy from the same batch of embryos.
4)  Although my doctor would like me to lose 10-15 pounds to increase my chance of success, I actually already weigh 8 pounds less than I did before the last procedure!

All of this was good news, which is to say, it all helped pile us more firmly into the "yes, let's have another" column.  In addition, I got word last week that I got a promotion at work that not only came with a pay raise, but would be a career position that would not require my boss getting re-elected.  Permanency and pay raise also significantly favor the "yes" column.

Figuring out that we were both leaning fairly heavily toward "yes," the next question was when to do the procedure.  After all, since we get to plan this thing, we might as well make it as convenient for ourselves as possible.  Now, my "charge ahead first, ask questions later" personality said to go for it as soon as we could.  After all, there's nothing more frustrating to me than having made a decision, but not being able to move forward or do anything toward that decision.  Still, as we started talking about what certain procedure months would mean in terms of where vacations would fall, how much leave I would have saved up, when the baby would be due, when it would no longer be feasible to travel, and other similar considerations, we realized that waiting was better.  The further we pushed it out, the more leave I would have.  Plus, we would be able to visit family for holidays and go on a trip next summer that we've had to skip the last two years.  Waiting would also give me a chance to lose a little weight and develop some healthy eating habits.  My goal is to stick closely to a modified diabetic diet in an effort to prevent getting gestational diabetes again.  That way, even if I do get it, it won't require me to make too many changes in my diet at that point.

Still, I didn't want to push it too far out.  I really want my kids to have unique, separate birthdays.  Therefore, February was the furthest out I was willing to put the procedure given that Lil' Bit was an early March procedure.  Although, February would be a late October baby and that was really longer than I wanted to wait to move forward and the kids would have birthdays closer together than I wanted, I couldn't fight the seductive list of things we would be able to do if we waited.

Ultimately, the tipping point came when I realized that we were going back to the cardiologist in October to discuss our long term care plan for Lil' Bit with her VSD and missing pulmonary artery.  By waiting until after that visit, we should have a much better sense of the type of care Lil' Bit will need in the future.  That way, if it seems like she will need to have lots of surgeries, it may be worth it to save our leave time and money to properly care for her.  Also, I want to make sure any subsequent children will receive adequate time and attention from us, rather than always coming second because of the time and energy it takes to care for Lil' Bit.  My guess, given that she's asymptomatic at this point, is that she won't need much specialized care--just a lot of monitoring.  Still, since we have the ability to schedule when and if we have another child, it makes sense to wait so we can factor this information in.

Oh, and as for multiples and possible failure, we have decided to have roughly the same attitude we did with our first IVF.  We'll get what we're supposed to have.  If it's none, it's none.  If it's one, it's one.  And, God help us, if it's two, it's two.

So, there you have it.  Barring any bad news this October about Lil' Bit's healthcare, the plan is to reserve a spot for a February procedure, making for an October 2012 baby (or babies!).  More gruel(ing labor) anyone?

Riding the Roller Coaster

Although I haven't shared this on the blog yet, Lil' Bit has had some health issues.  Beginning in April, she contracted RSV.  This led to the discovery of a VSD (ventricular septal defect--a hole in the heart).  Based on some difficulties they had when imaging her heart with the echocardiogram, they wanted to send her for a CT scan of her heart.  She had that test a few weeks ago and we had heard nothing back.  Today we received the results.  It's not necessarily good news or bad news, but it was important news.

Turns out, the reason they couldn't find her left pulmonary artery is because she doesn't have one(!).  Also, when they thought she had pneumonia and then thought maybe it was her thymus glad and other things, it turns out that her left lung is smaller than the right.  So, they may well have been seeing the thymus glad, as opposed to her having pneumonia, as her lung may not go up that high.  As a sidenote--it would make sense for that lung to be smaller since it is being fed by smaller arteries.  The up side in all of this is that she doesn't show any symptoms of these issues causing any problems.  She is growing, healthy, quite active, and developing normally.  Her screaming attests to a wonderful lung capacity, as does all of her jumparoo time.  She's working on crawling, can feed herself puffs she picks up with the "pincer grasp," babbling, and doing everything else either on or ahead of schedule.  So, nothing really to worry about.

And yet, it's extremely hard not to freak out about it.  We are doing our best.  And I find myself repeating a new mantra--there is nothing I did or didn't do during pregnancy that caused this.  As a recovering control freak, it is hard not to blame myself.  But, along with accepting that Lil' Bit is doing fine, I am also accepting that this is just how she is.

Ironically, all of this information comes as we are discussing whether we want to try another round of IVF to have another child (or, given the increased incidence of twins, additional children).  Just more information to add to the equation. Yay!

I am reminded, at times such as these, that I am still getting precisely what I asked for with children--opportunities to go with the flow and remember I am not in control.  I am just along for the ride.  And what a wild ride it has been and, apparently, will continue to be.  Wheee!