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Diary Of A Lost Pregnancy, Part 8: Zero Is The Target

On September 17, 2014, I went for a routine 8-week prenatal check-up. It was the only routine thing I would do for more than two months.

During this time, I e-mailed a small group of people. Some were aware of the pregnancy, some had plans with me that would need to be broken, and still others simply asked after my health on the wrong day. This is the eighth of 11 such messages. They have been edited to remove identifying information and inside references, but otherwise remain largely unchanged.

November 4, 2014
Dear Friends,

Don't concern yourself - the title of this post ("Trending Down") is not a reference to my mental state. It is, rather, the way the midwife described my hCG levels. In the two weeks after the D&C the measure of pregnancy hormone in my blood dropped precipitously from more than 16,000 to just 78. As of last Friday it was down to 26. At that level, I might get a weak positive on an old-school home pregnancy test. Anything less than 5 is considered non-pregnancy level and zero is the target.

Zero is the target because of a consultation my midwife had with the pathologist. While not 100% ruling out the possibility, the pathologist does not feel there's a need to be concerned about molar pregnancy at this point. If this seems like comforting news to you, you should probably stop reading now because the truth is that nothing has changed for me. I still have to have weekly blood tests until the magical level is reached, and although it should only take another week or two it could take longer.

I don't know the exact circumstances that would trigger a revision of the diagnosis, but I assume that if the levels fluctuate or hover at some low-but-non-zero number I'll be following the molar protocol of ongoing testing until some medically reasoned condition of unmolarity is met. So another week, another vial of blood, another wait to find out whether or not I've hit rock bottom.

Buried in a flurry of communications from my midwife was a bit of heartening news, although I realize it may not seem so to those outside the situation. When I consulted with the obstetrician just before my surgery, he asked whether I was interested in chromosomal testing on the products of conception. He said that in about 7 out of 10 cases there is a clearly-identifiable chromosomal abnormality that caused the embryo to stop developing. My initial reaction was no, this wouldn't be of any use to me. However, I didn't know my husband's feelings on the subject and didn't want to pass on something that could give him closure. I requested the tests.

Since that time, I've been dreading the results. I realized quite soon after that the information was more than just irrelevant to me. It was an invitation to revisit some of the darkest thoughts that possessed me in the early stages of this ordeal. My mind immediately latched onto everything I'd done that could possibly have contributed to the loss. Was it because I got a massage? Consumed alcohol and ibuprofen before I knew I was pregnant? Used a different face wash or moisturizer than I did last time? These thoughts were not rational, but they were very real. And if I'm honest, there was a comfort to them. It's attractive to think I could've stopped this if I had just exercised a little more control. It's certainly better than thinking it's all dumb luck or worse, that it's the logical conclusion to my reproductive life. I'll be 40 years old next month; maybe I just left it too long.

Fortunately, I will not have to revisit these unhealthy thoughts because chromosomal analysis was not possible. I don't know why this was the case, nor do I care. In accordance with my provider's digital records policy, I received an abbreviated copy of the pathology report. It included a description of what was recovered, which I will reprint in the next paragraph. A warning that the description is graphic and may be upsetting to some.

"Received fresh, labeled with the patient's name and designated on the requisition as "products of conception," is a 13.0 gram specimen consisting of a 5.0 x 3.5 x 0.8 cm aggregate of pink-tan spongy membranous tissue admixed with blood clot. No fetal parts are grossly identified."

I don't know that much can be inferred from this description. It doesn't reopen any of the questions that have caused me so much pain. It doesn't give any definitive information on when the loss occurred or why it may have happened. It doesn't even confirm exactly what was lost. What it does provide is cold confirmation that this pregnancy was not healthy, and that by extension it is not healthy to keep revisiting it.

I realized as I sat down to write this that it's been less than two months since the first ultrasound. That doesn't seem possible. It's as though an extra lifetime is hidden in each hour. It has been so long since I was excited at the prospect of being pregnant, and I really like being pregnant. With a little luck, I am a week or two away from leaving these strange shadow lives behind me.

Best,
nj

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Previously:
* Diary Of A Lost Pregnancy, Part 1: No Fetal Heartbeat.

* Diary Of A Lost Pregnancy, Part 2: Firing Squad Or Hemlock?

* Diary Of A Lost Pregnancy, Part 3: Remember The Challenger.

* Diary Of A Lost Pregnancy, Part 4: Mommy, What Does Bupkes Mean?

* Diary Of A Lost Pregnancy, Part 5: D&Cs Suck.

* Diary Of A Lost Pregnancy, Part 6: The Garage Doors Of Fresno.

* Diary Of A Lost Pregnancy, Part 7: Like A Pelvic Game Of Asteroids.

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Monday: A show stopper.

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Comments welcome.



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Posted on January 29, 2015


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