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03/11/2006
20/20
We agreed that 50's too high. The 50% chance of a recurrence of HELLP, the 50% chance of an extremely premature baby — too high, too foolish to try. I asked Paul what number would make sense. "5%," he answered promptly. "Five is easy, just like 50. 20 would be harder."
And it is.
I'd waited 40 minutes for the doctor to enter, so I had a lot of time to plan my ambush (and to open the biohazard wastebasket and peer curiously within; and to take my own blood pressure several times on each limb, carefully computing an average; and to stack the moist towelettes in the bathroom in alphabetical order according to lot number). No sooner were the hellos said and my chart heaved laboriously onto the desk than I pounced, and asked the question.
20%, the doctor said, when asked what our chances were for another birth before 34 weeks. 20% chance of HELLP or pre-eclampsia again.
Those numbers pertain to treatment with Lovenox, low molecular-weight heparin, an anticoagulant that reduces the chance of troublesome clotting. She talked a bit about the drug; because of its expense, she pulls it out only for patients who really need it, "classic cases like you." (I sat there feeling suddenly all classic and shit, trying to seem refined, a difficult pose to assume when you've just entertained yourself by repeatedly blowing up a latex glove and then letting it go pffffft as you release the air.)
She told me that Factor V Leiden is quite definitely associated with HELLP, and was obviously implicated in the placental infarction that was found after birth. With Lovenox, she said, the chances of a blood clot during pregnancy were not zero, but "extreeeeeeemely low" (extra Es hers). With two daily injections, our chance of a successful, relatively uneventful pregnancy was "very good, the most likely outcome by far." Because Lovenox is so effective a treatment, the only additional monitoring I would be subject to would be non-stress tests beginning earlier and taking place more frequently, and of course my own increased vigilance.
I asked about my risk for a repeat placenta previa, expecting her to wave the idea away, but in fact she did not. She placed my chance at 10%, based on the several risk factors that now apply — had it before, prior C-section, prior D&Cs, IVF, and, now, somewhat advanced maternal age. She looked a little grave when I asked her what happens if I have placenta previa, which usually means bleeding, while on Lovenox. "It's a balancing act," she said, explaining that we would then adjust my dose of Lovenox to the lowest possible level, and then hope for the best.
Hope for the best.
Yeah.
Huh.
She went on to warn me that my risk for placenta accreta, in which the placenta digs way into the wall of the uterus or even beyond, is now elevated, too. Therefore my chance of needing a hysterectomy at delivery is greater as well. (This did not upset me as it might have; once I've finished using it, I would not be sorry to kiss that uppity bastard goodbye.)
Once my uterus was summarily dispensed with, we talked about IVF. She confirmed that I should be on a prophylactic dose of Lovenox during a cycle, with a therapeutic dose to commence upon a positive pregnancy test. I asked, though I already knew the answer, whether having multiples would increase my risk of...well, everything. To bring her out of the dead faint she fell into at the very notion, I broke an amp of ammonia under her nose, then assured her that multiples were the least of our concerns with IVF.
We talked some about risks beyond the immediate postpartum period. Pregnancy itself, she said, puts me at greater risk for a clotting problem, but once the pregnancy is over, and once I've finished a 4 to 6-week course of anticoagulant therapy after delivery, there are no additional implications for my health. Speaking only in terms of clotting, and therefore barring, say, the liver or kidney damage that can occur with HELLP or pre-eclampsia, I need not worry about whether a pregnancy would compromise my health overall.
And I asked her what her greatest medical concern would be if I were to conceive and become her patient. "Multiples," she said promptly, but rallied when I told her I was comfortable mediating that risk. (Our difference in position and perspective was obvious: she was talking selective reduction while I was talking single-embryo transfer.) Her other great concern was previa, a risk we cannot mediate. There's nothing to be done for that, and by the time you know it's a problem for sure, it's simply too late to punch out.
It's just like anything else. When you're just beginning fertility treatment, Clomid and inseminations, you fear you'll never have a child. But once you've been flattened by a few IVF failures, that fear congeals into something harder and colder. When you've never miscarried, you're scared that you might. But once you have miscarried and get pregnant again, you think, Ohhhh. Scared of miscarrying. Gotcha. And, okay, because of placenta previa, I did worry about a premature delivery before I had Charlie. But I know better now what I'm scared of.
We think we know what hurts, and then something worse hurts more.
I was sitting on the exam table looking at the pain scale hanging on the wall — you know, the one with the faces — thinking about this. If you'd asked me before our first IVF what possible outcomes I expected, I'd have drawn you something like this:
Sure, I knew the statistics for miscarriage, but I also knew that it was more likely our cycle would fail, as 57% did that year for my age group, than that I'd get pregnant but lose it. It all seemed pretty straightforward, downright binary. We'd win or we'd lose.
And we lost. On our second cycle, I knew a lot more about what could go wrong. Based on my experience, my appreciation for the subtleties was a bit keener.
I'd thought I knew how it would hurt. But my scale should have gone to 11.
Still, I was getting better at this. After some careful recalibration, I was ready to take on our third IVF cycle with a scale that would address any eventuality:
I was pretty sure a drawn-out miscarriage would just about do me in. Fortunately, it never got that far. Unfortunately, I failed to predict the need for a smiley face to represent the frightening possibility of never — not just on this cycle, but ever — carrying a child genetically related to me.
By our fourth IVF, I had no more zero; enough had happened that "no hurt" wasn't an option. Having a baby was still the best possible outcome, of course, but all of the other possibilities seemed, at that point, equal: a loss or a negative would have meant adoption or donor egg. Those were options I could live with, if not immediately feel excited about.
And, you know, I was mostly right. Baby of any description — known to his familiars as Charlie — has made me a solid two, most days trending to one. I am happy. It's not the unfettered happiness of zero, the kind of joy you can feel before anything really bad has happened, but rather the relieved contentment of knowing you've weathered a ten and are little the worse for wear.
"Hurts little bit" indeed.
So I sat there thinking of Charlie, thinking of two, wondering whether I can stand to risk it, and trying to imagine what the scale would look like if we tried again. It came out looking a little like this:
I know what the best possible outcome is; even that, though, comes at a price. And I know what the worst is, unlikely though it be. (Paul wouldn't be caught dead in a hat with a veil, no matter how fervently I might wish it.) It's what happens in the middle that feels so fuzzy. Short of the worst, what's the worst that could happen? What would hurt most? How would I cope?
I simply can't say, and it's pointless to try. What makes the exercise pointless is also what makes it so scary: You don't ever get to pick.
It's hard to know what to do with this information. I am trying to keep it in perspective by reminding myself that I was actually at greater risk while I was pregnant with Charlie. After all, the same conditions applied then; we just didn't know about them. And because we didn't know about them, we couldn't treat them. We didn't know we should be on alert. I didn't think a stomach ache could be such a big goddamn deal.
Now that we know and can treat the problem, my odds of having a successful pregnancy are much greater. It is true that I'm at risk again for severe pre-eclampsia, but it's also true that if it develops in subsequent pregnancies, it tends to happen later, although this is not a hard and fast rule. It's true that I will probably have gestational diabetes again, but I've been advised to get my blood sugar stable before even trying to conceive, so that will be taken in hand. About possible placental implantation problems, we can do nothing — I'll be far too busy counting every last grain of brown rice to devote any energy to moving that messy old thing.
We're better equipped now to deal with the consequences, and therefore more likely to have a good outcome — in fact, a better outcome, a later birth, a healthier mother and child.
20%. Sure, I'm scared now. I should have been then, too. I just didn't know it yet.
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Oh my dear. Now I understand why it took a few days to post that. Hell, that would have justisifed a delay in posting of anything up to a decade. I am sitting here stunned by the impossible choices in front of you, and I can only hope that at some point, one path will stand out with greater serenity or a feeling of rightness than any of the others.
I cannot begin to say how much I feel for you both.
xxx
Wow that is a lot to think about. Good luck with your decisions. I can't imagine being in your shoes right now. Take care
It's a lot...I'm sorry that you don't ever get to be blissfully zero again.
When you look at Charlie and what a happy ending you eventually had with him, it must be very tempting. But very scary still. I know I wouldn't mind trying again in spite of the threat of miscarriage or worse just because the two we have are so incredible. And I didn't have any complications, just sheer exhaustion and normal twin discomfort.
Good luck making this decision. We'll all be waiting with bated breath to hear what you two decide.
Oh my god, your pain scales are brilliant. The cat face slayed me.
Good luck on your journey through the Gray Zone.
Wow. Jeez, that's intense. You are a great writer and thank you so much for sharing. I am learning a lot from you. It's my first time visiting you and I will be back. Your illustrations are great.
Good luck with everything. I wish you many happy faces.
Wow, Julie. Talk about Scylla and Charybdis. Good luck with whatever you decide; frankly I'm just stunned that you can take it all in. I wish you the best.
You once said that you looked forward to embarrassing your children by dressing funny around their friends; if you didn't make it, maybe Paul would reconsider the hat and veil? So he could fulfill his duties as both mother and father?
Seriously, I wish that I had something helpful to offer you. This morning, my two-year-old said to a sister, "Thank you C. You so nice to me." I nearly melted from the sweetness of witnessing my babies love each other and I can't help wishing that for you. You and Paul seem to be such warm-hearted, even-keeled, survive-it-with-humor parents that I want you to reproduce as many times as you can stand. Only you two can decide which risks are palatable enough to swallow. There is no correct answer here. Julie, you have such a way of cutting through the crap to find true value that you will be just fine, regardless of the decision or the outcome.
wow I can't wrap my brain around what you have to wade through. Our prayers are with you. Don't worry we go to a gay church so I doubt there are any lightning bolts there for you.
How you do that thing with the funny and the smart and the writing and the graphics, wow man, you're just so damn good at this blogging thing.
Wow. So much information to process. I wish you all the best with your decision.
I have to say, the charts might be the most amazing things i've ever seen. I'll never be able to look at the boring ones in the hospital the same way again.
What an extraordinary weight of possibilities to carry around. I can only imagine how the tugging and pulling from each side must conflict in your heart and head.
Thinking of you,
Bugs
You are famous aren't you? You are like some hip damn writer for the New Yorker or something. Because you shouldn't be able to turn any incident into humor and compassion all of it. Damn girl you are talented. Wait are you John Stewart?
I'd like to say, "Oh I know 5 women who had the exact same thing and there second babies were born just perfect to a healthy mom at full term".... Can't say that, sorry. I'm glad you're informed and not just wanting to have another baby at any cost. We need more women like you in the world (hmm...actually, that's maybe a frightening thought afterall). Best of luck with your decision, my thoughts are with you.
As always, your amazing power with words has me in awe. My thoughts are with you as you make a very very hard decision. I wish you the best no matter what you decide.
Julie, How do you feel about your doctor? I don't just mean competency, I mean how would she treat you if you were a high maintenance patient? I avoided a doctor in my group because he acted like I was a PITA, what with all the cramping, bleeding, etc. Do you get any vibes from her?
I delivered my IVF twins at 33 weeks after having been hospitalized for two weeks. At that point, things were obviously not as scary as they were for you with Charlie, but they were scary nonetheless. I obsess regularly about whether I could ever put myself through it all again. That's why I'll be paying close attention to how you and Paul reach your decision. Thinking of you.
Wow Julie, on the one hand I'm elated for you that the risk has gone down from 50%, but on the other I see the unique pain of being in the gray area, with no clear answers, and the terrible heartache that exists there.
AND I am once again feeling like you've put into words what I could not, when you're talking about never going back to zero. It's like a loss of innocence or naivete, once I got over the immediate pain of my miscarriage that was what I was most heartbroken about - that I could never again be pregnant and blissfully ignorant of the bad things that could happen. Thank you for your eloquence - it just feels good to be in the space of women who understand.
AND thank you for '11' - I always think about Spinal Tap when I want to recalibrate any scale I'm confronted by. It's obvious that some scales go (or should go) to 11.
Good luck in sorting this stuff out. I have total confidence in your wading through all this pain and coming out the other side.
xoxo Amanda Lynn
Just wanted to pipe in about never being a 0 again. I felt that way, too. I often would describe it to people by saying, "You know how you used to sleep before you had a baby -- like you would just lay your head down if you were really, really tired and go to sleep, and you didn't know how awesome that was? That's how I feel about Joy. It's like I'll never be as joyful as I was before all this loss and fear and heartache". It wasn't that I was depressed, it was that I had known what true sadness was, and I thought that joy had been tainted by it.
I don't want to sway your decision, and I know what a terrible spot you are in, because I've been there, but the Joy? It's back to a 0 over here. Seeing my boys, the love they share, the understanding they have for eachother, and the way they treat their sister - it has put me squarely back at 0, maybe even -1. Because, I've learned, cheesily enough, that without that pain, I didn't know what Joy was. I wasn't at a 0 before the losses, I was at a 3. NOW, I get it. And the 0, it's so, so worth it, now that everything is AOK.
I wish you luck with your decision, and I don't envy you. But, I have a feeling you'll be back at 0 sometime really soon!
Ah, statistics. I'm going to give my 2% of a dollar here since you are allowing comments, but my respect for you (and your ability to make the right choice) is tremendous.
Statistics are numbers. You, Paul, Charlie and the kitty(ies?) are living things. Lots of things have at least a 20% chance of happening - heck, that was the chance of our getting preggers each month (hahahaha - in the "early 30's") back before we knew anything was wrong - and did that happen?!? (okay, so maybe that's not the best comparison - but I knew I had seen that number before, so I looked it up.)
The chance that you & Paul might divorce is higher than 20% (awfully close to that bad 50 number) even without you being extra crazy on certain medications. But that didn't stop either of you from the choice to commit to a life together when you thought it was right. You will do what is right for you. You might doubt your decision - you might change your mind several times along the way, but that is part of the luxury/torture of life. We'll never know if we made all the right decisions, but we will live with them.
I am happy for you that you have the luxury of choice. You can move beyond those snotty little white coats in training who decided your future without much thought. I would LOVE to read a post some day when you go back to visit Charlie's dedicated lifesavers (and that *&%$#&*@# "teaching" physician) with #2 in tow.
Thank you for sharing so much.
My goodness, another incredible post. The writing, the graphics, the honesty, the ability to articulate such a highly emotional ordeal *and* be funny too...wow.
As there is a 90% chance I'd say something ignorant, I won't even hazard an attempt at advice. But I will most certainly be thinking about you--all three of you--and hoping for the best possible outcome.
This Is Spinal Tap: the funniest movie ever.
Good luck!!
Oh Julie.
I read this and thought "20%? Well that's a no-brainer: she should do it." Which is not a recommendation at all, but rather, a sad commentary on what this IF has done to me.
I concur with all the other commenters that you are brilliant. And I wish you good luck whatever you decide.
What they said.
Huh, well, good luck with all that.
Seriously, I hope you come to a decision you're comfortable with & are able to get back to the 1 or 0 face on the scale.
20/20 & Hindsight - it is weird that the combination of those 2 things doesn't make the decision process any easier.
You are like a PSA for teen sex, only for HELLP - you have a 100% chance of avoiding a repeat by abstaining from trying, but you have a pretty high level of risk abatement by using prophylactics.
The one thing that rattles around in my brain is whether you (if your eggs had not been so impacted by your first stimulations) might have avoided miscarriage in IVF/converted to IUI with the addition of the lovenox at that point. And, so, that combined with the change in RE locale you used for Charlie, if you'd avoid the miscarriage part of the pain scale? Again, just spewing words from my brain, but I've wondered for a while about that.
Was there any discussion about why the wait for the lovenox at a positive beta as opposed to the beginning of stims, like others are doing? Again, (in my brain, I'm thinking this:) what if lovenox would aid in 1) mitigation of the E2 levels/associated clot risks, and 2) the establishing of a pregnancy because clotting isn't happening before an embryo has taken hold?
Anyway, I'm sorry the numbers weren't 5 or 50 to make it an easier decision, but it sounds like your meeting went pretty damn well - compared to the news that you were given just after Charlie was born. There are things that you can do to mitigate the risks, and at one point I didn't think you'd ever hear that news.
PS - having done lovenox for 2+ weeks after a surgery (for prevention of clotting), I can say it was amazingly simple to use and left me with none of the bruising that I've heard of for so long by heparin users. Heparin (used to clear clots in a PIC line I had) would leave me looking like I'd been hacked like by an axe-murderer after a nick with a razor blade in the shower. On the other hand - or leg, as it were - none of that with lovenox. Like all playing with needles there is a technique to it, though.
Forty minutes late? What does your doctor think she is, an RE?
I think you answered your question in the last sentence. You were in as much danger before, you just didn't know it. Now that you know, hopefully you can manage it. Sounds like you're in pretty good hands already.
Wishing you the best whatever you choose.
Go for it. I did. The shots don't hurt when you are pregnant, but hurt like a B**** after... Yeah. I could not even complete the 6 weeks after my 2nd daughter (5th pregnancy) was born.
Really, life is about risk, and if you want a second, do it. You'll regret it later if you don't. We have our 2 biological, we will adopt if we want more, and are FINE with that. Hope you find your fine.
Erika
Hmm...I like 20 better than I like 50. And it seems like more of a combined 20...not an individual 20...which again, I like better. But reminder - I am not you. So I can't decide for you - but I agree with whomever said that the bitch infertility totally changes your mind. That and having had a second one - that too, makes a big difference. Either way - you not only rock - but I continue to love you Julie. Thank you for making everything make so much sense.
Good luck. Whatever your decision - we're all here to support you!
Delurking to say:
I'm that annoying person at the office who ignores the bleary, hung over looks of colleagues on a Monday morning and chirps out "Happy new week" to people who are obviously unhappy about the new week, or the fact that I am alive. That being said and with you now duly warned:
When you consider an 80% chance of having a Paulette or a Juliette, maybe a Charlene (please, by all that's holy, DON'T!)...
I'm not in anyway suggesting that your fears over a negative outcome are illegitimate and you are right to consider all the variables, not the least of which is your own mental, emotional and physical health. But, I keep thinking about that 80% chance and this grin creeps on to my face...
a grin my coworkers dread when they see me coming on a Monday morning.
I'm sorry to hear that you didn't get better news. I wanted to warn you though about the possible bleeding in early pregnancy caused by Lovenox.
I have "low positive" "AntiCardioLipin Anti-Bodies". I was already taking low dose 81 mg Aspirin for my first cycle in Oct/2005 when my RE decided to add in Lovenox injections because of the ACA discovery.
I believe approximately 26 days worth of Lovenox cost over $800.00 US. !!!!! Just a word of warning there. (I hope you have 100% drug coverage like we do!)
My RE also told us that Heparin was also available for us to choose, he just said go with the Lovenox because they come in pre-filled syringes, and it would be one less syringe for us to have to deal with! Heparin, though, is apparently MUCH cheaper -- and I've been reading up on the Pros and Cons of Heparin or Lovenox, as I'm trying to decide if I should try Heparin with my next upcoming pregnancy.
With my pregnancy in Oct/2005, a few weeks after we got our official BFP, I started to bleed, extremely heavily! :(
So of course, as soon as the bleeding occurred, I was put on strict bed rest, and taken off the Aspirin and the Lovenox.
I continued to bleed off and on heavily for a few weeks, during that time the babies were developing fine, and we saw the heartbeats on ultrasound.
Unfortunately, after I had been off the blood thinners for a few weeks, and the bleeding had pretty much stopped, we went for another follow up ultrasound to discover that both babies had died in late November 2005.
We were not able to confirm what caused the deaths. My RE is convinced that there was just something wrong with chromosomes, but I find it hard to believe that out of 26 eggs retrieved, 23 eggs fertilized, and THREE perfect grade 1 8 celled embryos transferred, that 100% of those three were ALL chromasomally abnormal. :/ I just can't convince myself that would be true. Although I suppose stranger thins have happened as well. :/ All three embryos even implanted, but one turned into a blighted ovum.
At this point, I'm concerned that being on blood thinners either caused the miscarriage, or going off the blood thinners cause the miscarriage. I know that neither is probably a rational explanation, but it's the only thing I've been able to come up with. And of course you know as well as anyone that doctors never have any answers for that!
Anyway, my point is, that Lovenox causing bleeding in early pregnancy is something I've come across a few times, and personally experienced.
I've also heard stories of women who had bleeding on Lovenox, and then their RE's switched them to Heparin, and their bleeding subsided!!
We are going for our first frozen embryo transfer on Friday, April 14th. (GOOD FRIDAY,
Easter weekend, which I certainly hope lives up to it's title!!)
The issue of whether I should be on Lovenox or Heparin for this next pregnancy is definitely something I plan to discuss with my RE.
I hope you are able to find the information you are looking and are able to come to a livable decision.
Just be ever so grateful that you've successfully given birth to your first child -- so now you have all the time and many options open to you. Of course you know, there are many couples still trying to have or adopt their first children. You have been through a lot, so you deserve your son -- but if the health risks would be too great to give birth to another baby, then at least you have adoption, and you'd be able to enjoy it with some peace of mind knowing you have one child already.
Good luck with whatever you decide.
Where to begin, how to say this: Last month I delivered ART twins at 28-1/2 weeks, following months of bedrest. Would have done anything to keep them in longer except die, and that was what I was looking at: severe preeclampsia--liver function, blood pressure and neurological function all deteriorating fast. We wanted 48 hours on steroids and got 24 by the skin of our teeth. Our son is in intensive care and doing as well as you could hope for given the circumstances of his birth. Our daughter died nine days after she was born. We had to choose whether to tell her surgeons to continue to intervene after we were told that she would suffer, it probably wouldn't save her, and if it did there was an 85-90% chance she would be severely brain damaged--never-get-out-of-bed, never-speak, never-have-a-life brain damaged. We told them to stop, and she died in my arms. Crying right now as I write this. Whatever you think the worst possible outcome could be, I will tell you this--it's worse. It's worse than you can imagine.
I was on Lovenox for the entire pregnancy. It may have gotten us to 28-1/2 weeks, but it didn't get us far enough. We thought if we crossed the 28 week mark we'd be okay--better than 90% survival rate, right?--but there's that other 10%, and we were on the wrong side of every statistic from the moment we conceived.
We are done with my eggs, we are done with my uterus, we cannot imagine ever going through anything like this again. Every day we go to the hospital and hold our terribly premature son and pray that he will continue to be okay, and look at the empty spot where our daughter's isolette used to be.
Infertility was easy. IVF and Clomid and IUI and losing six pregnancies before the 8 week mark--that was easy. We didn't think so at the time, but looking back--that was nothing. If we'd known--if we'd known--but we have our son--but if we'd known--
We didn't understand how risky this pregnancy would be. I was negative for the clotting disorders I was tested for, but I couldn't get a pregnancy past 5 weeks without the Lovenox. But no reason to think there was a real clotting problem. We didn't have a reason to expect the incompetent cervix, the preterm labor, the preeclampsia. I was 38, old eggs, that was all. And then we were pregnant, high risk, too late. We did everything we could to get our children to term. And it wasn't enough. The only decision we can look back at and question was the first--to continue to try to conceive when my body had rejected the first six pregnancies. And we wanted a child--how were we to know?
You and Paul have to make your own decision about what risks you can face and what risks you can't. But when you try to quantify those risks--when you try to figure out where "neonatal death" fits on your pain scale--it's not a 10. It's a 10,000.
Oh, Casuarina.
My deepest condolences to you, and my thanks for your post.
Julie, you are obviously a very bright, well-informed, articulate woman who likes to consider all options and plan for every eventuality. While these are admirable qualities, sometimes in life you just have to hold your breath and leap into the unknown.
weeping with Casuarina.
Julie, thanks for continuing to share your experiences with so many people that are going through similar situations. It is very helpful to know we are not alone when faced with these situations. Your courage and experiences are helping so many others navigate these waters. Thank you.
That's a lot to sit and think about when you're not chasing after Charlie. I'm sure you know how much support you have out here, wherever the contemplation takes you.
Thank you for putting all of this in perspective for me. Not just about the choice you have to make, but about the choices we may have ahead of us. We have just failed cycle number 1 of Clomid and tomorrow will begin Cycle number 2. I know that we are VERY early in the process and I so admire the strength and courage that you have had to get this far. Good luck with your decision making.
Causarina, my heart breaks for you. I wish your son the best.
I was looking through my own medical records today, and found a note from a specialist I saw during my "surprise" 2nd pregnancy. I was desparate to find out what my chances were to get a live, not-severely-brain-damaged baby, after my first pregnancy's "catastrophic event" (their words).
At the time, he told me I had a 25% chance of the preeclampsia reoccuring. So I guess technically, my odds were worse than yours. (I'd attribute that to the fact that, since they didn't know why it happened the first time, they couldn't do anything to prevent it from happening again.) 25% didn't seem THAT bad - until I remembered my odds the first time were only 10%. Of course, at that point, I was 11 weeks along. We were going to find out, one way or another.
I was lucky enough to be a 75%er and not have a reoccurrence. But to this day, I wonder what decision we would have made if I wasn't 'contraceptively challenged'. Would I have EVER been brave enough to consciously choose to risk it all again? I can only guess that I would have, eventually. But deep down, I'm relieved I never had to make that decision.
I do agree with the previous poster who said everything in life carries a risk. Driving to the store, going on vacation, eating egg salad - life is all about mitigating risk. No person, no doctor even, can decide what is an acceptable amount of risk for your family. I wish you peace in your choices, and an easy road, whatever the path.
Casuarina, I am heartbroken for you. I'm so sorry that you've lost your little girl. You and your son are in my thoughts.
Casuarina, I am so sorry. I hope that your little boy is able to pull through.
Not everyone who decides not to go for biological number two winds up regretting it.
Foregoing a second biological child so as not to subject yourself, the child you have and your future child to risks beyond the norm is the absolute right decision for some people.
Causarina- i have a 25 weeker who is now a year old. Feel free to email me for support or questions.
What can one say but, "Good luck to you both." You have the information, you're two smart people, it'll either work out, or it won't.
But whatever you finally land on, I wish you both the best possible outcome. You guys have earned it.
~C~
Just wanted to say I looooooved the pain scales. Totally brillant. And I wish you the best, whatever you decide. What a tough decision you have to make!
And thinking of Casuarina and and her family. So very much.
Hang in there -- 16 years of infertility, 9 miscarriages. It can happen, I am proof positive:) I will be thinking of you!
Hey... I was just blog hopping and wanted to say hello.
Oh Casuarina I do hope very hard that your son is ok. What a brave woman you are to share that story. Julie, anything I write after that will seem so facile, but I wanted to emphasise what you said at the end, that at least you know what you are dealing with, that that gives you a much better chance of dealing with it, and that in the end, you, Paul and the doctor clearly between you can make a decision. I won't say "the right decision" as I'm not sure that there is one in this situation.
Thinking of you.
i loved your smiley face pain diagrams (child life specialist by profession) although when i wrote an article for RESOLVE decided i need to start a new field of infertility life specialists-I had a baby- then I had 7 m/c (usually at about 10 weeks!)-and every type of cycle, drug, (fabulous overresponder) etc-(pre-e with 1st) metformin, heparin, progesterone shots-- Luckily i have a 9 mo old boy now-- i want to try for #3 but i am so stinking scared of the "what ifs"-- what if the lovenox 2x a day wasn't really the answer- just dumb luck? sorry for your saga-- i have protein S deficiency and an MTHFR variant- so i am right with you on the thrombophilias-- this was a great read--
Best of luck to you and your family in making a decision and for whatever results from that.
I pulled up this post and started reading it last night then was interrupted by, well...everything. It is now just before 7 am here and I finished reading it, still amazed at how well you can explain to someone else the difficulty of your decision. I already do feel guilty about how easy and (relatively) worry-free they were...and then I read this. I'm so sorry that you have to play this over in your head and your heart. So instead of being comment number 3 last night, I am comment number 50 this morning - but still thankful that you share this with us.