Posts Tagged post-infertility pregnancy

“Morning” sickness (preg ment) – UPDATED

OK, I will just say up front: if you are not really feeling like reading about pregnant people, and especially not about whiney pregnant people, then this would be a very, very good post to skip.

I will start off with the usual disclaimers.  (1) Being pregnant is better than not being pregnant when you want to be and thus I do not expect even one smidgen of sympathy from anyone in that position, or actually anyone else for that matter.  (2)  If you are in early pregnancy and nervous then you want to have morning sickness and in that case my expectations for sympathy are also really low.

Having gotten that out of the way… I don’t feel so good.

I actually started getting nausea already during the 2ww which was just fine by me because it let me hope that actually I might really be pregnant (even though I swear not to think that during the 2ww).  For the first couple of weeks I had the “fun” nausea where I would feel kinda nauseous if I hadn’t eaten for a while, but would have a good appetite and eat and afterwards would feel fine.  Ladies, if you are in the morning-sickness-wishing camp mentioned earlier, wish for that kind of morning sickness.  That is a good kind.

Now I have the kind where I woke up this morning because I started to retch in my sleep.   Where no food of any kind holds any interest to me, but I have to eat because otherwise I get a horrible stomach ache.   Where every mealtime I sit and wrack my brains about what sounds like it might be appetizing enough that I can choke some of it down.  Where I have to carry a baggie around with me in case I need to throw up in public. Where the nausea never, ever ends.

Except Saturday morning, when I woke up and blessedly was not nauseous.  I felt great.  I felt like myself.   I felt full of energy and ready to tackle the day.  Except for the fact that I was, of course, as a good infertile, immediately paranoid that I felt good because The Baby Is Dead.  Even though I knew that if the baby had died my HCG would not go down so quickly that I would be insta-better.  But in any case I only had to feel that paranoia for a few minutes because as soon as I got up to go to the toilet the nausea came back.  Dang, if only I had enjoyed it while it lasted.

Of course, the good thing about the morning sickness is it makes it easier to believe that this might be the Little Embryo that Could instead of yet another in the long series of Little Embryos that Couldn’t.  But here’s the thing that I am really, really hating about the morning sickness.  It is completely sapping my ability to get anything done.  I am working from home right now and I haven’t been able to work for more than an hour a day for the last 4 weeks.

Week 1 was just after transfer, when I had really bad cramping and the only thing that calmed it down was lying in bed with my hips and shoulders square, a position in which it was impossible to work on a computer.  Week 2 was after we flew back from the clinic, during which I thought I just had the world’s worst case of jet lag, but actually, as I found out at my 2nd beta, my thyroid had given out.  Week 3 was spent in full-on no-thyroid zombie mode waiting for my appointment with the local RE so I could get thyroid meds.  Then as soon as the thyroid meds kicked in, bam, it was week 4 and the all-day nausea fest made it pretty much impossible to concentrate.

And now I’m looking at another 4 weeks at least of this, and I gotta be honest with you.  Every day I say to myself, one day at a time, you made it through another day, this is just what you have to go through to get a baby, it won’t last forever.  But at the same time I don’t know how I am going to make it through another 4 weeks of this or more.

OK, no worries, I can play the other side of this argument too.  Billions of women before me have been pregnant, and lots of them have had morning sickness.  They all sucked it up, kept working, took care of kids, etc., so why can’t I?  I’m not even throwing up that much, I am just really really nauseous.  So even though I feel miserable I feel no actual right to be miserable.  I feel like I am just a wimp who can’t hack it.  In fact, today I had the dreadful thought which I decided it would be wiser to just immediately erase from my brain, that maybe God had kept me from getting pregnant until now because He knew I couldn’t take it.

At the same time I think about the last 4 years and the 8 IVF cycles that happened during them.  Each of those cycles cost me at least 3-4 weeks of health and sanity.  Each of those, too, did damage to my career because I couldn’t work like other people could while I was cycling.  And that makes me feel like I haven’t been pregnant for 4 weeks, I have been pregnant for 4 years.  Somehow all the effort – especially the major physical effort – that went into all of that has made it much harder for me to suck it up now.   When does the easy part come?  Because I can’t really take it any more.  I feel like I am doing the world’s longest IVF cycle.  Even though I know that lots of women would kill to be in my place.  Even though I know that I would kill to be in my place. I’ve got no excuses.  It’s just how I feel.

*****  UPDATE ******

After I wrote this post, I rooted around in my purse to get out my sea-bands in the hopes they might help.  They are actually cheap-o knock-offs called Queaz-Away (it is really hard to find real Sea Bands in the country where I am living) and they make my wrists hurt after I wear them for a while, so I had taken them off and stowed them away the day before.  But I put them on and within 10 minutes I had gone from definitely-will-puke-any-second-now to just-kinda-nauseous. Took them off when I went to bed, put them back on when I woke up in the middle of the night and couldn’t sleep from the nausea.  This morning I feel not too terrible.

I decided that:

a) I am never taking the sea bands off again except to shower!!!!

b) I need to change my attitude, I may not be able to change the nausea but I can change how I think about it to make myself less miserable.

c)  I can always eat pretzels and drink ginger ale.  I am going to stop making myself eat “real” meals and if this baby is just baked out of high fructose corn syrup, salt, and white flour, so be it.  When Mr. Nishkanu says “what do you want for breakfast honey?” I will say “pretzels and ginger ale please.”

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So, you did IVF and it worked. What now? (preg ment)

This post is an expanded version of a previous blog post on The Stirrup Queen Ballroom.

I can’t say I am really an expert on this topic, since until now I have never managed to make it past the 7th week.  But I do have a few small suggestions.

1. Some of the scarey things that could happen to you don’t actually mean a thing with regards to the health of your pregnancy.

The first and most important suggestion, which you really must follow, especially if you are spotting or your symptoms are going away and you are afraid you are miscarrying, is to race right over to  A Beautiful Day and read her classic and extremely informative post: When IVF Works: What the RE Doesn’t Tell You.  Go ahead, go do it, this post can wait.

Now wasn’t that exceptionally informative and reassuring?

2. You might not feel 100% happy, and that’s OK.

So, now that you’re back, let’s sit down and have a heart-to-heart about how you are feeling.  Giddy?  Excited?  Elated?  If so, good for you!!

But if you have a lengthy infertility battle behind you, and especially if that battle involves prior losses, here are some words that might also describe you: terrified, numb, freaked out, anxious, sad, angry… unfortunately, these emotions, too, are par for the course for the post-infertility pregnancy.

In my recent 2ww, I had accepted my infertility and was OK with whatever would happen.  As I said to my friends after the transfer, “60% chance I start building my family with DE, 40% chance I start building my family through adoption.”  When I POAS’d the day before the beta, while I was waiting for the test I sat with my eyes shut, imagining a blank result and chanting mentally “We are going to adopt!” But within 30 seconds my husband said “There’s a second line!”

My first reaction: incredulity.  My second: shock.  My third: numbness.  I sat with that numbness for a day or so, poked at it a bit to try to find out what was going on, and unearthed a deep, smoking pit of terror.

I was OK with a BFN.  I was OK with moving on to adoption.  I am not OK with losing a baby once it has shown signs of preferring to stick around.  The stakes are now much, much higher.

And so I wake up at 3 AM and stare at the ceiling and wonder whether there will be a heartbeat at the 7w ultrasound.  Whether we are enjoying the first short weeks of a very long acquaintance.  Or whether we are already getting ready to say good-bye to the little life that we created.  Dr. Google says insomnia is a common early pregnancy symptom, according to What You’re Not Expecting When You’re Trying to Expect.  Maybe Mr. Nishkanu is pregnant too because most nights when I am awake, he is lying awake right next to me.  He is normally a pretty resilient, unworrying kind of guy but now he is looking drawn and tired.

And after 2 or more years of finally being OK being around pregnant women and young families, I find myself again reverting to that earlier heated jealousy of pregnant women.  Yes, I am ashamed to admit it, but I am jealous of pregnant women who are farther along than me, who can be more sure than I am that their baby will live.  Today I saw a woman in her 4th or 5th month, wearing a tight shirt that showed off her mini-bump, looking happy and energetic, and I thought to myself, “She has probably never had a miscarriage. She probably thinks everything will be fine.  And everything probably will be fine… for her.”  Yeah, ok, I know it is time to get a grip.

But my point is,  if you are feeling negative emotions instead of the sense of elation you expected to feel, this is totally normal for post-loss (including post-infertility) pregnancy.  If there’s one thing a person learns from infertility, it is that the dice don’t always roll in your favor, and there are no guarantees now, either.   To be honest, I think to some degree the post-infertility pregnancy attitude is simply more realistic than the naive innocent person’s.  Yes, it could go wrong.  And it could break your heart.  Life is like that.

3. There are things you can do that can help to make you feel a bit less anxious, if that is a problem for you.

Nevertheless, after some initial hyperventilating panic, I started to find some things that made differences for me – small differences, but important ones.

I found this article on dealing with fear in post-loss pregnancy incredibly helpful, especially this piece:

“When a fear is a remnant of past experience, it isn’t necessarily a predictor of future events. Your worries are not foolproof evidence that something terrible is actually going to happen. How can you tell? Try to separate out which fears are arising from your imagination and memories of what happened before, and which fears are arising from cues you are actually observing or tuned into. If a fear is coming out of imagination or memory, discount it. It’s not real.”

When I read this, it really helped me to make a mental separation between the fear and trauma from past pregnancies and the current one.  This pregnancy isn’t necessarily doomed, just because the last ones were.

I also remembered that one characteristic of anxiety is that it is often based on desperate attempts to run away from the frightening emotions that are driving the anxiety. Sometimes it helps to stop running, face your fears and clarify them, and find out what you’re really afraid of, rather than leaving them as a big, foreboding, unclear mass.

When I actually sat still and let myself really feel the bad feelings that were welling up instead of covering them up with numbness and racing thoughts, I realized that part of the issue was that I am still really traumatized by the awful D&C that I had after my last miscarriage. It was a collision course of incompetent and uncompassionate care – even Mr. Nishkanu is still traumatized from watching me cry while a bumbling nurse tried over and over again to place an IV in my hand, until I started passing out from the pain (at which point she started complaining about me being a bad patient). I promised myself that if I have a miscarriage this time, I will find compassionate, competent caregivers, and if any of my health care providers start causing me unnecessary pain or treating me rudely I will insist on getting treatment from someone else. Once I had done that, I felt a lot better.

As Katie suggested to me, some women find it helpful to repeat positive  affirmations to themselves, such as “No matter what happens, I am pregnant today,”  “My baby has a good chance to live,” or “My body is taking care of my baby’s needs.”  They work best if they are things that you can really believe – if you are scared of a miscarriage “I won’t have a miscarriage” probably won’t do much for you, but “I will find peace, whatever happens” might.  You should note when constructing an affirmation for yourself that your subconscious doesn’t understand “not”, so something like “I will not let fear destroy my pregnancy” might get turned subconsciously into “I will let fear destroy my pregnancy.”  It’s therefore best to formulate your affirmations as positive statements, eg. “It’s safe to enjoy my pregnancy.”

A lot of women who have worries about their pregnancy get comfort from living one day at a time, reminding themselves that no matter what happens, they are pregnant today.   It can also help to break the pregnancy up into smaller goals – make it to the second beta, make it to the 7w ultrasound, make it to the end of the first trimester… and celebrate every small victory you make it through.  From my experience with miscarriage I can say that I never regretted the time I was happy and I thought the pregnancy would work.  If anything, I wished that time had lasted longer.  So I don’t think you need to feel that if you are enjoying your pregnancy now that you will regret it later if something goes wrong.

I find The Anxiety + Phobia Workbook a good source of longer-term coping strategies. I am working on the strategies suggested there for consciously blocking obsessive worrying but I’m not particularly good at that yet…

Being kind of a research geek, I also found it comforting to read about Denise Cote-Arsenault’s research on how women who feel when they are pregnant after loss in an attempt to educate health-care providers about how they should treat these women. Her article “One Foot In, One Foot Out” explains the coping mechanisms that women use to deal with post-loss pregnancy. My favorite part of the article was this:

“Although the metaphor, One Foot In – One Foot Out [i.e., that women do not fully commit to the pregnancy], seemed ubiquitously applicable, each woman’s response and situation were quite unique. These differences were easily shared and accepted by the other participants, sending the message that getting through the pregnancy was so difficult that no one would pass judgement on how it was managed. How to ‘do’ pregnancy was certainly individual and each woman, not others, knew what was best for herself.”

And that really matters here.  In the end, each of us has to find her own way through – there is no one “right” way for anyone to approach pregnancy.

You might find some comfort out of some of the other measures I mention in my post on Anxiety and Infertility.

If anyone has additional suggestions I would love to hear them – please add in the comments (lord knows I can use some more suggestions myself).

4. You don’t have to read the dreaded pregnancy books to find out what you should be doing, just this next section.

I don’t know about you, but I can’t stand to read regular pregnancy books because they are all so dang happy and positive.  In fact, they seem to presume that you actually will have a baby at the end.  What a crock!   I therefore asked a less infertile friend of mine to report back what you are / aren’t supposed to be doing while you are pregnant.  Let this tide you over until you can stand to look in those books.

  1. Don’t eat: raw or undercooked: fish, meat, eggs (including homemade mayo or soft-boiled eggs), cold meat (including luncheon meat) unless you heat to steaming before popping it in your mouth, raw milk products, moldy cheese (e.g. brie, blue cheese), artificial sweeteners, alcohol.
  2. Take your prenatal vitamins with 800 mcg folic acid.  Also take a calcium supplement, or your teeth and bones will start to suffer while your baby is making his/her teeth and bones.  Most prenatals do not provide enough calcium by themselves.
  3. Do not get overheated (whirlpools, saunas, exercising in hot weather, etc.).
  4. Avoid all your favorite illegal drugs.  Check with your doctor before taking over-the-counter medications. If you are smoking, try to stop.
  5. It’s probably a good idea to take fish oil capsules, but check that they have been tested for mercury first.  In general, fish would be good for your baby’s developing brains if it were not full of toxins; you need to be careful what you eat and it is a bit complicated.  The guidelines for which fish are OK to eat are here.
  6. Reduce caffeine consumption to the equivalent of 1 cup of coffee per day.  And I don’t mean one of those Starbucks Grande cups either.  Be very careful with herbal teas, because many ordinary herbal teas such as chamomile or lemongrass are bad news to drink while you are pregnant.
  7. A healthy diet with lots of fruits and vegetables, low-fat protein sources, and unrefined carbs is always a good idea.
  8. If you are feeling nauseous, frequent small meals are a good idea.  If you are feeling really really nauseous then just focus on getting in enough calories and don’t worry about general nutrition.  “Enough” calories is generally about 300 more calories than you would usually eat.  But it’s not unusual, if you have severe morning sickness, not to gain weight or even to lose some in the first trimester.  Your baby won’t starve, it gets first dibs on the nutrients.  But definitely talk to your doctor if you have any concerns or if you’re having trouble keeping food down.
  9. It is generally OK to exercise when you are pregnant, in fact it is a good idea.  Check with your doctor about the limitations they would have for you.  Chicklet has a great post on what generally is/isn’t a good idea when it comes to exercising during pregnancy.

5. It is OK to complain.

If you have been infertile for any period of time you have probably gone through a period of severe annoyance at women who complain about their pregnancies, and thought to yourself “I would gladly trade my infertile state for your nausea, lady” or even “God, if you let me get pregnant, I will not complain about anything.”  Now a miracle has happened, you have your nausea, and you know what?  It kind of s*cks.   Granted, it doesn’t s*ck anywhere near as much as not getting pregnant does, but that doesn’ t make it a walk in the park either.  It is extremely common for infertile women to feel that they should not complain about their pregnancy, that they have to be happy about all the weird things that happen to their bodies and all the discomforts and anxieties that come with it.  This is not my attitude.  Yes, you should probably not expect much sympathy from people who are suffering from infertility, and it would probably be kind to take your complaints elsewhere.  But I don’t see any reason why, just because you got the short stick and had to walk a trail through hell to get to pregnancy, you now also have to draw the short stick and don’t even get to complain.  Complain away, just be sensitive about who you complain to.

p.s. If you don’t believe me, then please ask A Beautiful Day.

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