Sunday, September 28, 2008

The birth of TER.

Timothy Edward (formerly known as Fwed) was born on 09/18/2008 at 1:48pm, weighing in at 7lb 5oz, and 20 inches long. My BIL was joking about how we talk about babies as if they're fish!

Here's how it all went down:

I first noticed contractions that felt different from the BH I’d had all along in the pg when Ant woke me up at 4am. They were about 3-5 minutes apart, lasting 15-20 sec. After a while when I couldn’t go back to sleep, I got up to finish up some last minute work stuff, and have something to eat. The contractions spaced out quite a bit, to about 10-15 minutes apart, so I figured we were either in for the long haul, or it was false labor. Until I went to the bathroom and there was some bloody mucus on the TP… I got a big smile on my face and thought that we probably would be having the baby that day. More than a week sooner than I had been anticipating (I was 39w6d).

By the time I finished up the work stuff at around 10am, I was having contractions that were 4-5 min apart, but only about 30 sec long. I hopped in the bath for an hour and only had 3-4 more, so in my mind more evidence that we were in for a long day. When I got out, they were 2-3 min apart but only 30 sec or so, so I thought they would space out... they also weren't that uncomfortable, I was just stopping and leaning on something through them, then getting on with what I was doing (which did include a little bit of packing, turned out to be a good thing). I started having to lie down for them at around 12:15 - and then my water broke at 12:20. Called the doctor, and they said, "come in RIGHT now". I still wasn't convinced because although the contractions were coming pretty quickly they were still fairly short, and I wasn't finding the pain unmanageable in the least. But I decided they were probably right.

We ended up leaving the house at 12:48. Got stuck in traffic on Storrow Drive (figures!), at which point Mark asked if he needed to flash his lights etc and try and get through. I said no, but did have him call smartraveller to find out how long we were likely to be stuck for. Fortunately it was just a short jam due to some road work, so we were on our way in about 5 or 6 minutes. We also discussed how we should handle the car – should we both go and park it, should Mark drop me off, or should we leave it out front? I said I didn’t think I could make it from the garage, so either he should drop me off or we should bring the car right out front. By the time we got there Mark decided on the latter based on his assessment of how I was doing. (I had started pushing out more gushes of amniotic fluid just as we were getting through the traffic jam).

We were actually treated as a medical emergency when we did get to the hospital; there were a couple of guys out front who helped me into a wheelchair, and got us an express elevator up to the L&D floor. The receptionist there didn’t seem to have quite the urgency that Mark and I were feeling, she was asking for our insurance info! I told her my contractions were 1-2 min apart, and finally she seemed to get it and got someone to take me into triage. Once I was up on the bed in triage after discarding my amniotic fluid (and meconium – the fluid was definitely greenish) soaked towel, I climbed onto the bed. Almost immediately, I felt my uterus starting to contract from the top and push down – without my doing a thing! I told the nurse that I had to push. A midwife came in, checked me, “yup, fully dilated +2 station” and rushed me to a delivery room. The pushing phase was nothing like what I had imagined, where I would get a break in between pushes to recoup, and wonder at what was happening. Even the pushing contractions were right on top of each other. At one point they had me try and push more slowly, until the baby’s heartrate started dropping, which for me was the best motivation EVER to push as hard as I could and get him out. He did come out, just one or two pushes later, and only 13 minutes after we’d entered the room. Mark said, “It’s a BOY!”. So Timothy Edward had made his appearance.

Because he came out so quickly I had a lot of tearing, so they spent about 3 hours stiching me up and trying to stop the bleeding (all of which was honestly way more painful and uncomfortable than the delivery itself), which was unsuccessful and I ended up in the OR for about 45 minutes at 7pm to finally get everything back together. Turned out I had a second degree perineal tear, labial tears, and a vaginal tear which was what had been oozing and they couldn't find until in the OR.

It’s funny how so few birth experiences seem to go as expected. I got to experience the natural delivery I was hoping / planning for – yet at the same time because it all happened so fast, in some ways I didn’t get to experience it. I had a Nora Jones CD I was planning on listening to while laboring in the hospital, to help me relax through the contractions. That never even made it out of the bag! As I mentioned, there was no time for me to think about, marvel or wonder at what my body was doing during the delivery because the contractions were so incredibly intense. Don’t get me wrong, I’m not complaining – in fact I’m rather in awe of how it all happened. It just happened so differently from what I had imagined, since I started contemplating a natural birth when pregnant with Ant.

Friday, July 18, 2008

Gotta love that uterine irritability!

I'm going to put up a few posts over here rather than at Phred/Fwed because my in-laws read that blog as it's mostly about the kids - but there are some things they just don't need to know!

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I have been lucky so far this pregnancy not to have experienced the series of contractions that I did starting at 25 weeks in my first pg. I've had plenty of sporadic contractions, to be sure - I noticed them starting at about 12 weeks. But nothing serial, that lying down or drinking wouldn't fix. Until yesterday that is. They started at about 12:45, I actually noticed them while I was standing in line to get lunch. And they continued. And continued. About every five minutes apart. I hadn't had much to drink since the morning, so I swigged about 20oz of water, and lay down on the floor of my office for a bit. Nice to have an office, I must say! They did stop while I was lying down, but started back up again as soon as I got up. I tried lying down again for a longer time, and they disappeared again - as long as I was on the floor. I decided to call my doctor's office after about three hours of this - they had been telling me to call if I had more than four in an hour, and at this point I was running at 10-12/hour. I wasn't overly concerned, as these felt just the same as all the other contractions, and I wasn't feeling any other labor-ish symptoms. I was a little annoyed, though, when it took the nurse an hour to call me back! We discussed a little, she eventually said that I should go home and call again later if they were still continuing. I almost agreed to that, but then figured I that at work I was only 5 minutes away, and I'd rather just go in at that point and get checked out than have to deal with going in later in the evening when it would be much more of a trek. She agreed that it would be reasonable for me to come in, so off I trotted.

When I got to the office, I was again kept waiting quite a bit longer than I would have expected. When they finally took me back they followed standard procedure - pee in a cup, weight, BP, and listen to the baby. I was still having contractions, but they were a little further apart at this point. Funnily enough, I often have one just as I'm lying back on the table and the nurse always comments about how "that's the baby". I don't have the heart to tell her that no, it's actually my uterus (it's doing the same thing this time as last, when I get a contraction it's all bunched up on my right side). Anyway the doc showed up a few minutes later, took a swab and checked my cervix. Long and closed, as I had suspected, but it was nice to have the confirmation. So off home I went.

I have noticed a lot more contractions today, including an almost constant one the whole time I was walking back from lunch. I think I must have just hit the point where my uterus is saying okay it's time to get ready now. Hopefully I'll be able to continue to manage the contractions just by drinking and lying down when needed (I did spend another few minutes on my floor today when I was tired of the effort).

Interestingly, when I was at the gym this morning doing my little weight lifting routine, I didn't notice any contractions at all. Perhaps I need to stop working! ;-)

Tuesday, January 22, 2008

The end.

It's time for me to stop posting here. I have officially kicked hypothalamic amenorrhea's butt. Whupped her to the curb. So I feel like without that, there's really not much to post here anymore. I will continue to post over at my other blog, http://phred-fwed-schweffel.blogspot.com, so if you're interested in following our story, come visit over there.

I will still post HA related things here from time to time, as I come across them in my reading/research. But that will be it. I'm also going to migrate some of the older non-HA related posts over to the other blog as well.

Thank you very very much for all the support, advice, and free shoulders you've provided me over the years! You guys are the best!

Thursday, January 17, 2008

Hypothalamic Amenorrhea Cure???

I started this blog over two years ago, hoping to connect with other women with hypothalamic amenorrhea, hoping to get advice when I was going through treatment, and subsequently, to help those who are struggling today.

I have not been keeping up on the research of late. But, when I was looking for information for a woman I met through the hypothalamic amenorrhea bulletin board at fertilethoughts about whether there was any advantage to using Femara (letrozole) over Clomid, I came across an abstract that I think is quite groundbreaking.

The article, “New protocol of clomiphene citrate treatment in women with hypothalamic amenorrhea”, offers the hope of using Clomid not just for ovulation induction, but to actually restore normal menstrual cycles! I actually purchased the article so I could read the details of the study they performed, to see if I agreed with the conclusions they drew in their abstract, and also whether Clomid was the only treatment used, or if there was concomitant decrease in exercise or increase in weight.

The only drawback of the study was its size – only eight women were treated. However, all eight resumed cycling, and were still cycling six months later! I think that this treatment regimen is incredibly promising for those still struggling.

The study consisted of eight women, five of whom had hypothalamic amenorrhea from excessive exercise, the other three from restrictive eating patterns. (Aside – HA does seem to be due to an energy imbalance – either overexercising, undereating, or a combination of the two. I have been in contact with 25+ other women with HA, almost all of whom (including me) fit this profile). The BMIs of the women in the study were 17.6 to 19.5 – underweight or very low normal weight. Hormone levels were meauserd at the beginning of the study, and were classic HA – low side of normal for e2 (18-25), FSH (2.9+/-0.4), LH(2.3+/-0.3) and progesterone (0.18+/-.2). The age profile is younger than most of us who are TTC – 17-22.

The treatment regimen was 50mg of clomid for five days, followed by five days at 100mg. Ovulation was then assessed by u/s and progesterone mid-luteal phase (with a fairly stringent requirement of >25nmol). Of the eight patients, six of them ovulated and got their period after just one cycle! They subsequently took 100 mg Clomid CD3-7 on the next two cycles. The two women who did not ovulate after the first cycle repeated the initial regiment, and both did ovulate after that.

After the three months on Clomid, all eight women resumed cycling on their own, with no additional medication!!! In addition, there was no change in eating or exercising habits – the deficit in energy caused by overexercising and / or undereating seems to be very strongly correlated with hypothalamic amenorrhea.

For anyone trying to conceive, I would NOT recommend not changing the eating/exercise habits that led to HA – I think it is extremely important that during pregnancy one is not operating at an energy deficit. You would never starve your child after he was born; it is no different to starve them inside the womb. However, I think that particularly for people whose insurance does not cover injectibles, this new regimen is well worth trying.

Three of the women on the fertilethoughts HA board have now tried this regimen, with similar success (although one ovulated on the first cycle and repeated the 10 day regimen with no ovulation the second cycle). Two others have tried a longer clomid protocol than the standard five days, although not quite this regimen, one successful and one not. It seems that it is well worth giving this new regimen a shot before pursuing more aggressive treatment like injectibles. And so far one BFP!

In short, the protocol was as follows:
Bleed induced through bcp (not necessary; two of the women on the FT board did not get a bleed first)
50 mg Clomid CD 3 - 7
100 mg Clomid CD 8 - 12
u/s to check for follicles

I hope that other people in the HA boat find this protocol, and start pushing it with their RE's. The traditional thought is that Clomid does *not* work for women with HA because of the low baseline estrogen levels. But this seems to be different!

Friday, January 11, 2008

non-pregnant? not exactly!

I was feeling very non-pregnant this 2ww. No cramping 6-8dpo, no sore legs during hockey, no strange temperature feelings showering... basically none of the things that clued me in that something might be going on when I was pg with Ant, or last cycle with my chem pg. I was holding out until 14dpo to test after the debacle that was my last cycle as well. I was 95% convinced until yesterday (13dpo) that it would be negative.

Yesterday my temp was up 0.2 in the am, after what I thought at the time could have been an implantation dip on Monday although hard to tell. That was my first inkling. Then, I started having minor cramping throughout the day. I almost wished I had tested so that I wouldn't have my hopes raised only to be dashed today when I did test.

But they weren't. Dashed that is. I got a lovely perfect positive, with the test line in fact darker than the control line. Holy shit, sherlock!

I thought the best way to let M know would be to leave the test out on the counter in the bathroom (on top of the box, so it was obvious what it was). He is such a man - he was in there alone for five minutes before I joined him, when he asked, "So, did you test"

Friday, January 04, 2008

Splitting

I've been thinking about moving my posts about Ant to another blog for a while, and have finally put that plan into action. I'll keep talking about HA / TTC stuff here, and post about Ant at my new blog, http://phred-fwed-schweffel.blogspot.com. You can read all about the origins of the name over there, if you care to. I still just don't feel 100% comfortable posting about him and his antics here - I feel much better about it in a totally new place.