14w1d Bleeding at 13w6d weeks pregnant

Last post I wrote Monday morning, expecting to go and have my nuchal translucency scan later that afternoon. We were planning to take a short holiday trip across the island and in the course of packing became a bit late and had to rush to the scan. Turns out the day started as it meant to go on, as I had gotten the times mixed up and our appointment was not 1pm but 4pm! So that would delay our trip (5hr travel time). We went home, double checked the pack-list and grabbed all the things we had forgotten, then hopped around to my parents' place for a cup of tea and a debrief.

In the car on the way there (4pm) the ultrasound clinic called and apologised: the OB/tech (who is the best in our province, but is private = expensive = only using her for some scans) had to rush to the hospital to deal with a woman in labour. So. No way to have the scan. I started to get agitated as I knew that the scan would only be possible up to 13w6d, and although the ultrasound clinic wanted to re-schedule me for the next day we would be out of town by then. Plus Hubby sort of still didn't really want to do the scan at all. I could try and get my midwife to organise to have the scan at our holiday destination (fun). Or the clinic said they would try and swap another patient so I could get a slot on Thursday, which would be the last day I could have the scan by my count - going from the date of conception. Or we could just not do the scan and only do more blood tests later in trimester 2. Then the receptionist was telling me I had my dates all wrong and I was actually not that far along and I could possibly wait even further. She wasn't really listening to me, just telling me I had it all wrong. Not helpful! I know the date of conception down to the hour for crying out loud!

So, with that, we started out trip and I tried to put if out of my mind. We were only really away for a day, but managed to get in some mountain biking and sailing. Both of which freaked me out. The mountain biking was supposed to be a gentle, flat ride along the banks of a beautiful river. Well, it turned out to be a thin gravel track that went UP and DOWN. I have never ridden that sort of track before and couldn't really control my bike well on the multiple down-hill segments with the gravel skidding my bike out from under me. Long story short I had a panic attack as I thought I was about to crash / roll over / tumble into the river. Oh, and I was having a low (hypo) at the same time! What fun! I was unable to stop from panting these really deep fast breaths and wheezing and trying not to cry and feeling sick and my arms and legs just locked up like stone on the bike. Hubby looked after me and got juice and a muesli bar into me. I recovered ok and we were able to bike back slowly. I did feel much better on the way back as I knew what to expect of the terrain, and Hubby showed me a technique with the brakes which helped me control my bike better.

The sailing was fun although at the first turn I thought we were about to tip over and squealed like a mad thing! hehe The lake was a bit choppy and it was just the pair of us on this tiny little yacht. But very cool experience. Boy did I sleep well that afternoon. We cooked a lovely BBQ at the motel that evening and had cheesecake for dessert.

The drive back the next day took a little longer as we headed up to another city to collect youngest-step-son from his friend's place, then drive us all back home. On the way back I got a bad headache that was awful by the time we got home. I managed to eat some dinner then went straight to bed with 2 paracetamol.

At 2.30am that morning (Thursday 9 Jan) the Dexcom woke me up with a noisy beepy alarm: low. I trundled out to the kitchen to get some juice, as has become my custom in the wee hours of the mornings, and took a detour to the loo first. And there it was. Bright red. Bleeding. No pain, just a feeling I can only describe as numbness, like my heart just sank. I knew that if this was going to go badly, there would be nothing anyone could do about it, and that it would hurt a lot. With no baby at the end.

Aware enough to realise that the low could be part of the problem, I drank down some juice and went back to the bedroom to wake Hubby and tell him. After about ten minutes he asked if I was still bleeding so I went back to check, and it seemed to have mostly stopped. We live 5 mins from the hospital so it would have been foolish not to pop up there and get checked out. Yay: A&E in the middle of the night; my favourite :-/

Thankfully the ER waiting room was blissfully empty and quiet. I rang the bell and the triage nurse came out. I gave her my name, how many weeks pregnant I was (13w5/6d) and the fact that I was bleeding. She took us straight through to the triage room behind the automated security doors, and asked me questions while Hubby filled out the paperwork. From my answers the triage nurse was able to determine that I had a "light bleed" but it would be worth checking anyway, and that there was not much they could do except wait in circumstances like these. She slipped a cute little pulse/ox meter on my finger and announced that at 99% oxygen saturation that was a good sign.

The triage nurse took me around the corridor to a private room and a cheerful ER nurse arrived. She was really sweet and gave me "points" for knowing what my blood type was! She took my blood pressure, temperature and pulse and they all came back normal. Next in came the doctor who asked similar questions: when did it start? (2.30am) how many pads? (none!) do you have any pain? (just some mild pressure and ache as I normally have had that I associate as being normal for me being pregnant. Is this your first pregnancy? yes. Any allergies? (no) etc.

Both the doctor and the nurse agreed that the low blood sugar (hypoglycemia) could have maybe had something to do with the bleed, but it could also have to do with the mountain biking or exhaustion. They listed it as a threatened miscarriage and explained gently that the only thing they could do is check for the heartbeat with ultrasound (a strong and healthy heartbeat was present immediately! The most wonderful news in the world!) and do an internal exam to gauge the blood loss and possible cause. They took a urine sample and tested for signs of infection but everything came back negative. Swabs were taken although the results of those won't be available until next week at my GP's office. So in all, it seemed mild, although they noted that it could progress further. They told me to take it very easy for the next four days, and were happy that I had the NT ultrasound that afternoon. We were sent home and I didn't sleep very much for the rest of the night worrying about every little twinge and ache I felt. I was rolling over very carefully!

In the morning I felt fine. Hubby went to work and I tried to do as little as possible. Mainly this consisted of calling all my healthcare providers to get their advice:

First up, the midwife: she listened carefully and asked me more questions. She promised to contact the on-call specialist at the hospital for more advice, but she advised me to get in touch with my diabetes nurse to adjust the pump settings as she suspected the low blood sugar of being a potential cause.

Diabetes nurse: I got her on the phone the second try (a miracle! It sometimes takes days to get through to her as she is soooo busy with patients). She spoke to me for a good 20 mins and we made adjustments to the basal rates of my midnight to 6am rates. In the two days since, I have lowered these rates even further and I am very close to having a night sans-hypos! Yipee!

Midwife again: she called back and advised that the Charge Midwife at the hospital had advised more frequent monitoring (I think that means Doppler?) and I should come in on Sunday (tomorrow) to the Labour and Delivery ward where my midwife was having a clinic. So that will be an experience. I certainly didn't expect to be going there this soon. Oh, and I also have an appointment booked with the hospital OB. Finally.

Later in the day, we went to the ultrasound clinic for the NT ultrasound scan. I told the OB what had happened the night previously and she immediately got to work looking for the baby and any potential problems. She found the baby straight away (it's hard to miss now. I even have a mini-bump!) and found the probable cause of the bleed too: I have a low-lying placenta. It's completely covering the "exit" and she told us that it could easily be disturbed or aggravated by sudden jostling movements. Such as bike riding. Boo. I love bike riding! She went on to say that at 13 weeks it was too early to diagnose placenta previa as it will most likely migrate up higher, however I should have it checked at 20 weeks to make sure.

Knowing what had caused the bleed was such a huge relief, although the OB did say that I can expect more bleeds which freaks me out a bit. I have been being very careful with my movements since then, but I am still active.

Then the checks for the baby began: she did the NT measurement three times throughout the 20 min scan just to triple check, and each time the result came back just slightly over 2mm. If the result is 2.5mm+ then that strongly indicates Down's Syndrome as the likelihood of potential heart defects causing excess fluid is much higher in that case. So, passed that one.

And then she started looking at everything else. I had only really thought to worry about the NT check, but she was looking for the correct number of arms! I hadn't thought about that! It was all fine. We saw two arms, two legs, five fingers on each hand. The spine. The CRL was 7.71cm and this put the fetus at about 13w3d (3 days slower that what I thought from the conception date). She measured the head size and looked at the brain, stomach, bladder, legs, knees, and the mouth which was swallowing. We could see the stomach filling with liquid as the scan went on! She took at few photos for us and seemed much happier and more interested this time, probably because there was so much more to see.

She checked the rest of my uterus and found a fibroid (towards the top, I think?) in the uterine muscle itself. Apparently this is of no cause for concern at the moment.

So overall it has been an absolutely exhausting week. Good news in the end, out little one is still going strong, kicking up a storm in there.

Thanks for reading this far. Here are some pics as your reward:

Our little one dancing and waving and kicking!

Here you can see the brain and the mouth, nose, and the right arm and hand.

My mini-bump. I can just get my pants done up. And those are stretch jeans too! Gone with a blue inset 30 for my Animas pump at the moment.

Slightly belated: 7w6d ultrasound

Sorry to keep you all waiting so long, my only excuse is that I have been exhausted. Like, take a nap at 3pm exhausted!

Great news: we had the "8 week" ultrasound done on Thursday 28th 2013 when I was 7w6d.

Here is a piccy:

The size of a raspberry? Kidney bean?

If you need help deciphering the picture, the line between the two little white crosses is the crown to rump length CRL 1.29cm, and the head is down with bum up. The left curve is the back, and the interesting fluffy parts on the right is the umbilical cord, and perhaps arm and leg paddles? Who knows. We saw a good heartbeat of 164bpm which the OB/sonographer said was right on target. She also looked a bit bored but basically told us that everything looks right on track.

I have never been so relieved to see some flashing, pulsing pixels in my life.

Hubby filmed it on his phone, so I will try and post the video up sometime too.

When the OB checked my ovaries, she said they were still quite swollen, and even asked if I had been overstimulated. They were big and empty looking. She said they were still recovering, but I hadn't expected that to take so long. Who knew the ER would be so damaging to them?

In other news, we had another chat about the ante-natal testing, and Hubby basically came to the conclusion that I will worry like a crazy woman unless I know, and I came to the conclusion that if it was really that important to him I could live with not doing the testing. End result is that we have agreed to do the testing including blood screening test and nuchal translucency ultrasound scan. I am pretty relieved about that. It means a great deal to me that should we find anything, I can have time to prepare myself.

Symptoms? Yes. Plenty.

Sheer and all-encompassing exhaustion is the major one at the moment. I am fine (sort of) and awake one moment, and the next I am the walking dead. lol. Mostly I can get through the day, but I am taking some serious cat-naps in the weekends.

No morning sickness. And that is the way I have decided it shall stay! There has been a little bit of mild nausea, but it's actually more like what I would describe as extreme hunger. As a diabetic I don't get hungry, like ever and this is because I am and have always eaten on a regular schedule. On the rare occasions when I have experienced hunger (from illness etc) I never really recognise it as such, and it instead feels a lot like a cold, slightly nauseas feeling radiating out from my sternum/high-stomach area. It's not an "I'm about to puke" feeling, and it usually goes away with application of noms.

I am sneezing a lot at the moment, not sure if it's hayfever or just irritation from the increased blood supply to well, everywhere including my nose that's doing it. It's tolerable but if it gets much worse I will have to look and see if I can take any hayfever meds... don't like my chances though.

Peeing is my new hobby. My record at night is 3 times. And none of those was caused by a low or low alarm.

Prunes and kiwifruit are my new best friends, as are bottles of water.

My diabetes is being...predictable. Well, almost. It's not terribly stable, in that I am going low multiple times per day (and night), but the predictability comes in the timing of those lows. They tend to happen about 2hrs post meal. My DNE nurse put my I:C ratios up for all main meals a couple of weeks ago when I was still having quite a few highs. At the time I thought the increases in I:Cs were a bit late, since I could already tell that my blood sugars were dropping. And now they are tanking multiple times per day, however the insulin doesn't kick in soon enough if I take it when I start eating (I know, I know, supposed to take it earlier!) and I am still getting a noticeable rise in blood sugar after a meal. Trouble is by the time the bulk of the insulin is kicking in, the food is wearing off and that's when I go low.

When I was last on the phone to my DNE she recommended that I eat a lot MORE food and a lot more fat and protein, especially for lunch. Well, I have been trying that for a week now. I feel stuffed to the gunnels most of the time and have regained half a kilo (after losing 1.5Kg in 2 weeks which is what got her so worried). I do get more hunger feelings that I am used to, however I cannot really handle eating this quantity of food PLUS all the emergency food I am eating/drinking to get my blood sugars up when they go low.

This evening I went to the supermarket to get three things: yoghurt, strawberries, and bananas. Smoothie time. Well, I pulled into the carpark and since my Dex was still on start-up, I did a quick test. 3.8mmol so I drank a juice, ate an afghan bar and decided to wait. The Dex and Vibe then both started bleating for calibration tests, so I did those too. My brain was foggy but not so foggy that I couldn't do a quick nip into the supermarket. I had a written list and I thought I had just eaten all of my food - turns out my foggy brain had completely forgotten about the pack of jelly beans in the globe box, as well as doing anything sensible like phoning Hubby. Sigh. My brain just gets super fixated on a single thing, in this case I knew that the supermarket had food, and I knew I needed sugar, so that's where I went.

Got a trolley to hang on to instead of just a basket, and started working my way slowly through the shop to get the items on the list. Note to self: do not shop while low. What should have been a $15 trip cost $90!!!! All manner of tasty treats found their way into my trolley! Whoops! Just before I got to the checkout, I started to panic a bit as the low symptoms were coming on really strongly. I must have been looking rather pale as several shelf-packers gave me weird looks. I headed to the drink aisle to get something sweet and fast. Ended up grabbing a bottle of lucozade which is 68g of carbs in a bottle, but no caffeine - I checked.

At the checkout, the woman in the queue in front of me was taking forever. Then she decided to pay using a credit card that wouldn't scan. The receipt finally printed and the checkout-chick tried to fold it up, got is scrumpled up, tried again, and again; there was lots of smiling and laughing amongst them while I contemplated breaking all the social conventions of supermarket shopping by ripping into the lucozade before actually buying it. I had my eftpos card out and ready. I was standing with both feet flat, the trolley wedged against the counter so that I could lean on it. Even in my hazy mind I knew that 3 point support wouldn't tip over! Finally I got my groceries scanned, paid for and bagged, and headed out to the car. Got things loaded in ok, all while the world wooshed and fuzzed around me. A bit of a mix between extreme tiredness and hyper-sensitivity to lights and colours. My brain slows right down and I must carefully check every thought to ensure that what I am doing is correct, will use the least energy until I can get more glucose in me, and will not be liable to draw unwanted attention to me. I am quite good at this (I think) so managed to do a moderate sized grocery shop on a blood sugar of about 3mmol (and it was still dropping at one point, with Dex alarms blaring!) all while no one around me was any the wiser.

Got that lucozade in me, waited, tested and as soon as my brain felt ok, and the test was over 5mmol I drove home.

Hoping to get my DNE nurse on the phone early this week to see what she suggests to sort this out. And eating more is not practical!!! I just do not have room!

Only a could of weeks of work left and then I will be on Christmas holidays. Yay!

Thank you to everyone who wrote comments on my last post with advice and support. I really appreciate you help :D

16dp3dt (aka 4w6d) Cramping

Although I'm not super worried about it at this stage, yesterday and today I have been cramping quite a lot. It's not really bad, but it is quite localised on the right side. I have been reading that cramping by itself, as long as it's not too severe, is generally a good sign.

Still, there have definitely been occasions today where I've had to sit down and catch my breath. It's good to just take a break anyway. I've found that drinking more water lessens the cramping, and it can't hurt. Plus it helps to stabilise my blood sugars.

Which are doing absolutely great today! The new settings my DNE provided me with are working really well and I haven't gone low or high today!

After a late night last night, and heading for another one today, and with teaching 4 hr design classes 4 days a week I am quite tired. Sometimes when I relax a bit my mind just feels like it's full of cotton wool. I am feeling quite clumsy, bumping into stuff. Not sure if it's the hormones or the tiredness, but this fatigue and semi-constant cramping is starting to wear on me a little bit. But it's reassuring at the same time, as it means things are cooking.

Also - not just dull cramps, but sharp twinges. I got one just now and it started on both sides of my lower spine and came around the sides, and then sparked down my right inner-thigh. Gone in seconds, but weird nonetheless.

Feeling positive, but also aware that I should avoid bending and picking stuff up. My Mum had already told me that she had a miscarriage between my sister and I but she let me know that it happened at around 8 weeks for her, before she knew she was pregnant for sure. And that it happened after a day weeding in the garden! So I am cutting out any activity that could stress my abdominal muscles unnecessarily. I mean, why take the risk.

I phoned my Aunt this evening and let her know we're pregnant. She has been a constant loving element in my life, and the happy noises she made can only be described as super-sonic! hehe

15dp3dt Second Beta (aka 4 weeks 5 days)

Second beta test today came back at 453! Woohoo!

This gives us a doubling time of roughly 42hrs, which is right smack bang in the middle of average.

Got a different nurse on the phone this time, but she sounded very positive and said "it's a good number". The relief I felt when I finally got the call was amazing. As you can tell from my previous post, I was getting a wee bit stressy about it. I was just so unbelievably happy that it came back positive that it was like walking on a cloud for about half an hour. After which time the adrenaline rush wore off and the fatigue set in.

They tested my progesterone too and it is 338 so the nurse said I should start weaning myself off the dreaded progresterone pessaries by dropping the dosage from 2 x 3 times daily, down to 1 x 3 times daily until they run out, or roughly 4 more days. Apparently I am making plenty of my own.

I need to go back in a week (next Tuesday) for another HCG test. The only way I found this out was by refusing to let the nurse hang up on me a la "just one more question!" haha I was determined to get the info out of her! Actually, I think the nurses' office must have been fairly busy, as I could hear other nurses talking to patients on their phones in the background.

I enquired about when is appropriate to enlist an ob/gyn and midwife. Nurse said that the fertility clinic has care of us until the 8 week mark which will be 29th November for me. At that time I should travel back up to Hamilton for my first ultrasound scan. Now, don't get me wrong, I cannot wait for this ultrasound. At about weeks today, I'm about halfway there. These milestones are incredibly important and hold great significance to me and my husband, and all those supporting us. But do I really want to travel over mountains for 3 hrs, have an over night stay, pay for a night in a motel, and book a day off work for two people?? Um, no. I asked the nurse if there was anything special about the ultrasound scan, and she thought about it for a moment, they said "well, there is a radiology place that you could ring and enquire if they would do it, but you would have to pay privately for it, just call and see if you can get an appointment for around the 29th Nov and then let us know so we can send a referral note through to you. They will then need to fax the results back to us." If it's less that the cost of all that travel and missed work, then we'll do it.

I keep thinking it would be great for the fertility clinic to provide a flowchart of procedures and appointments, just a general "what could happen" document. Rather than having to wrangle the info out whenever they choose to phone.

Once I got home Hubby suggested we book an appointment to see our GP this week to get his advice, as we may be able to get the scan for free??? I don't really care too much about paying for it, I just want to know that I won't have to travel. We have an appointment with the GP this Friday so I'm hoping I will learn heaps there!

Some more good news: I got my HbA1c result back. 16 Oct = 45 or 6.3% A slight rise, but this was taken after the transition to the pump (still learning) and before the application of copious amounts of crazy IVF hormones.

Not too shabby.

Went to the two elder step-kids senior high school prize-giving ceremony tonight and they both received awards! Very proud. It was cool with Hubby and I, their Mum and her parents, youngest step-son, and MIL. Some big cheers!

The school hall was packed for the ceremony and it got very hot. I was fanning myself with the paper programme, and started to get some really bad cramps, especially on the right side again but moving all over the place. I felt a bit faint, and figured I just needed to cool down and have some water. Which worked very well.

Thank you everyone for your lovely comments and support. It's wonderful to know you are all out there cheering us on! :D

13dp3dt Well, it feels real...

..but will it stick around? Will I get a good beta on Tuesday?

I am pretty calm, and it's sinking in more. I am currently pregnant and I have to keep telling it to myself cos I just don't believe it. I have been to look at the pee-stick several times today. Just to check I didn't imagine that line. Or the phone call from the nurse. I am hoping they will send the results out to me on paper, so I have something tangible to fret over.

Things I have discovered today:

• People are treating me differently already. Which bugs me. Why are you all getting worried about me now, but not the day before first beta? eh? I am the same person!
• People who don't have a clue I'm pregnant treat me the same as always. Which also bugs me. Where is my special treatment already!? Can't win over here. lol
• It should not be possible to forget that something is going on down there. Most of the time, it is painful and crampy (not severe cramping). Plus there are the twinges. I guess that's what you'd call them? Sharper, achier pains that occur all over the place. Anywhere from my hip joints right up to my clavicles. Ribs. And of course the abdomen. Sometimes I can feel a twinge going right um, up me. Sometimes it goes around my uterus. I think. Without an MRI to hand, I am just guessing at anatomy here. Oh and also the firm-en-ing-up of my tummy, and the general inability to button my jeans.
• I gave in the moment we got the nurse's phone call. By that, I mean, I have allowed myself to dream of this child. I have been collecting names. Hubby and I even had the briefest of brief chat about names. I have been watching videos about what happens at 3 and 4 weeks pregnant, and I have downloaded a couple of pregnancy tracking apps. By the power vested in the Interwebs, I am able to determine that my Estimated Due Date should be 11 July 2014. None of these things are what I would consider "safe". I mean, throughout the whole time I have been waiting for this (can't use "trying" as we've technically never "tried" to get pregnant in the traditional sense lol) I have been moderating my thoughts severely. To keep my mind from exploding and my self from collapsing in a crumple of tears, I made a bargain with myself: I could think of certain things (names, due dates, pregnancy details, maternity clothes, nursery decorating ideas) only once I reached certain goals (accepted for treatment, started treatment, positive beta) to protect my mind. My reasoning being that if I didn't think up good, wishful, dreams then I wouldn't be hurt as badly should things go south.
• And now I have gone there. The gates are open and I cannot reign in my insatiable curiosity and dreaming. It is lovely to be able to feel I can now safely think about this sort of wonderful stuff...
• ...But, then I realise that I could lose it all on Tuesday, making the fall so much harder. I hope beyond everything that this, my first pregnancy, sticks, stays, grows, and is healthy. I have never wanted anything so much in my entire existence.
• The centre of my universe has changed. I'm not sure where it was before, but it's now growing in me (I hope).
• My brain can think of little else. Until I do something (gardening, cooking) and forget entirely.
• Speaking of gardening: I did lots. I know, I know - I'm not supposed to exert myself. Or get too hot. And I know. It's bad for the embryo. But it has been the most beautiful spring weekend and I have been so at peace. I was, I think, not able to garden all winter until this IVF was done. Now that I feel positive again (it's been a while since I've felt so energized) the garden is crying out for attention. I drank lots of water, made sure not to over do things, and only went out in the sun for short spells. Oh, and there is another reason why I feel positive about it. Part of the stories the women in my family share include that of doing some crazy, manual labour such as cleaning the stove, washing all the windows, or weeding the garden. So I take the desire to garden as a good omen.
• You may have noticed the word energized in the last bullet point. Imagine having all this energy and happiness one moment, and then the most crippling fatigue so you have to lie down or risk feeling faint the next. Well, that has been my day. I get especially tired towards the end of the day.
• I decided to get tougher on my blood sugars. I really really tried to get in touch with my Diabetes Nurse Educator last week, but we are playing a mammoth game of phone tag at present. Too timid to adjust the basal rates (especially while still on those progesterone pessaries ewww), I spent most of Saturday thinking what I could do instead. First up, I tried doing more correction boluses when ever I went over 12mmol. I also started ignoring the pumps suggestions of "0 units" when I had IOB, and instead gave small conservative boluses. This worked ok, so I then thought up a more permanent method - Oh hey! I will just adjust my insulin sensitivity factor a bit! I went from 1u:4mmol up to 1u:3mmol. This has proved to be too strong especially in conjunction with gardening, so I've just put it back down to 1u:3.7mmol. Let's see how that goes.
• Tomorrow is my first day of work where I will be pregnant. I have a rather unpleasant bunch of students to teach, and I hope, for my sake, that they behave themselves. I will not hesitate to "pop down to the office to get something" if I feel they are upsetting me or getting my heart rate up at all!
• I can count things in pregnancy-numbers now: 4 weeks 3 days pregnant.

So, that is all. Sorry about the rather random haphazard post today. It's nearly 11pm and I am beat. Also, just gone low. Also, getting a twinge right now!

Sing it with me: I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope, I hope Tuesday's beta is a good positive number; strong doubling is what I am hoping for.

Thank you for the flood of support you have offered me. It is truly humbling to know that so many people across the world are supportive. Thank you! :D