Tag Archives: Miscarriage

Being in family practice and infertile

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Rose-bud lips, beautiful dark eyes and a head full of hair….just a few things that immediately jumped out at me right after the delivery. The sweet babe quieted as soon as it was put on Mama’s chest. All was right with the world in that perfect moment.

Was this it? The last one? My last delivery?

Last August Adam and I discussed my involvement with obstetrics. We decided it may be a good idea for me to stop taking new OB patients at least until I made it into the second trimester of our next pregnancy. I was scared a patient of mine would have a problem while I was in my first trimester, making me worry that it would happen to me too. Strange, I know….but perhaps for some odd reason I thought if I didn’t take care of any patient’s that had pregnancy difficulties, maybe I wouldn’t either. My partners were very supportive of my concerns and my OB practice was essentially put on hold-at least I stopped taking any new pregnant patients.

Fast forward to my final delivery. Everyone is healthy. It was a “good one” in the grand scheme of things-I commented to the nurses that I was glad all went well as it might be my last. I remember when I came to this practice, my practicing obstetrics was a somewhat difficult transition for all of us. You see, in the state of Nebraska Nurse Practitioners cannot deliver babies…and rightfully so! We are not trained in this sufficiently! It is actually very rare for an NP to do anything really with obstetrics so my asking four Physicians to work with that passion of mine was a big step for them. They have been amazing since day one, allowing me to provide prenatal and postpartum care to my patients and letting me play an active role in the management of their labor as well. I have been doing obstetrics now for 11 years and the thought that the sweet little babe with the head full of hair is the last one is difficult. I just don’t know if I have it in me.

It sounds selfish, I know, but I do not know if (or even if I want to) take care of women getting the one thing it seems I don’t get to have. The one thing my Husband and I want. It’s a very odd feeling, though as this has by far been my favorite part of medicine for over a decade. It’s crazy to think that in a few month’s time the one thing I looked the most forward to on a day-to-day basis became the thing I was least looking forward to. I haven’t decided if this is for good or not. If I stop doing obstetrics, this is likely something I’ll never be able to “pick up” again. It isn’t like crocheting or riding a bike. As I said, it is rare for someone like me to even be as involved as I have been in the past, let alone stop and then just start up again someday. Obstetrics is the most legally challenged type of medicine. Experience, experience, experience is what it’s all about. Once you don’t have that experience, you should stop. This is in the best interest of the patient and the provider.

As with multiple other things right now, I am not even sure how to actually make this decision. After Noelle I knew then that I needed to decrease my involvement with obstetrics at least a little and actually put teaching Lamaze on hold. My Births R Us program has been a big part of my life for over six years. I loved educating and empowering women to be active participants in their labor experience but just couldn’t do it last year. Maybe I should resume teaching and stop obstetrics so at least I am doing some of what I love(d). As a side note, I think part of what made my classes as good as they were is that I am involved with the whole pregnancy/delivery experience. This allowed me to really relate to the couples and use my experiences to really educate them well.

And, I know I need to be realistic also. This is my career so maybe I should just suck-it-up and move forward with everything I have done for years. Perhaps it will work out in the long run. Perhaps I will once again become comfortable with the exposure to pregnant women and sweet newborns. I can’t take away all of the awkward situations after all. There will still be the kids that are brought to the clinic who’s parents act like they are a “nuisance” or a “bother” to them. These times are so frustrating. Why, God, when it seems that they don’t even want their child, can I not have a child when I would definitely cherish it?

I pray God helps me to be more understanding, more empathetic, less jealous and less judgmental….and as with everything else that He helps with this decision…

 

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Stuck

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Our appointment with the fertility specialist last Thursday was postponed until the correct chromosomal testing results on our baby from December are back.

As we wait to find out if we really had a Lainey, or perhaps rather a son, I feel like we are in an alternate universe of some sort. We are stuck in the middle and the world is continuing to go around us. I wish I had it in me to just jump and join everyone. I wish I had the emotional energy.

We have had a couple of people mention that perhaps we just need to stop and breathe for a bit. Four babies, all lost in 2 years is difficult. Emotionally on both of us and physically on me (the hormones alone!). The problem is that I cannot seem to go on with life simply putting all of this aside “until we feel stronger” and more ready to cope with things. It feels like if we know what we are going to do with our future that we can maybe heal quicker, or at least move forward with other things in our life. I want us to soon be able to make the decision as to if we are going to adopt, go down the surrogacy road or remain child-less forever. This is actually something that we both agree on. We need to move forward on this decision soon.

If we are going to adopt we have a lot of work ahead of us and the wait will likely be long as we would be more picky than what others have recommended.

If we do surrogacy….well, that is for an entire different post. What type of surrogacy? Do we make an embryo out of my eggs and his sperm or do we adopt embryo’s? My guess is this is why our appointment with the fertility specialist last week was put on hold. I imagine if we didn’t really have Lainey-if it was not a normal little girl or boy-that the specialist is going to recommend against using my eggs…and perhaps Adam’s sperm as well. Then what? If it isn’t even a child of our genes, why not just adopt? That brings us full circle to how fearful we have been previously about our (albeit minimal) education on adoption we have had so far.

Finally, we could choose to remain child-less. This is an option I cannot even imagine but we are discussing it every day. We’ve discussed changing our lives drastically enough to do mission work in other countries to fill our time that way instead of with a family. Perhaps we could open an animal shelter and devote our days to saving those innocents (we love our fur babies so very much). Maybe we could just travel the world….plan one or two big trips per year and do this every year until we are too old to travel any longer. These are all things we talk about but none of them seem fully satisfying to both of us. None of them will be with us holding our hand saying they love us when we are old and gray….

For now we will stay stuck while the world goes ’round until we know more about the baby we lost on December 2, 2014. We will continue to thank God for the blessings He gives us each day and pray for guidance in the coming days.

I, personally, am also looking forward to the first day I make it without crying.

 

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baby=priceless

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It is awful that money plays a role in so many decisions in our lives. Money can be the root of a lot of good….and a lot of bad. Infertility is expensive. I have had people tell me “well, you know…kids are expensive”. This, we realize. But if you have not struggled with infertility, you didn’t struggle with these type of expenses before you had your child. (note: we have not endured the bottom three…..yet).

  • A D&C after a miscarriage is about $6k….we’ve had two in the past year (partially paid for by insurance)
  • Chromosomal testing of your baby that you lost: $2300-we’ve done this twice. (not paid by insurance)
  • Chromosomal testing of parents: about $2k (not paid by insurance)
  • Genetic counseling: $500 (paid 50% by insurance)
  • Fertility specialist consultation: $75-$150 each visit (not paid by insurance). And yes, phone calls cost-but thank God phone calls are an option!
  • Pelvic MRI: $2k (paid partially by insurance)
  • Fertility testing (HSGs, ultrasounds, blood work, hystersonograms, etc): in the thousands and NOT paid by insurance.
  • IUI: $500 (not paid by insurance)
  • Laparoscopic myomectomy with morcellation/endometriosis removal: $75k (praise the LORD for insurance-mostly paid for!!!!)
  • Fertility medications: $500 (not paid by insurance)
  • Missed wages for time off for both Mother and Father: A LOT.
  • Travel for above testing, appointments, surgeries (gas, hotels, food): A LOT.
  • IVF: $31k and $7k more for each additional attempt (this is going to a reputable facility that will do testing of your embryos before implantation). If for some reason they cannot use my eggs, this goes up to $44k initially instead of the $31k (not paid by insurance).
  • Surrogacy: $100-150k
  • Adoption: $36-52k (it can be done cheaper but the wait will likely be longer. These amounts are from the two agencies that if we were to proceed with adoption, we would likely utilize).

Amazing, isn’t it. These are costs before you bring your baby home….then there are the diapers, baby furniture, clothes, college, weddings!!! =) Would we do anything different? Absolutely not. Would we do it all again? Absolutely. Do we regret the money we have had to come up with? No, no, and no. Otherwise, we would be living with an even bigger “what if” in our lives. “What if we had tried _____”….”what if we saw Doctor _____”….”what if we had gone to a different city”. So far we will never say “what if”-because we did.

The question for us currently is “what now?”. As you can see the cost of adoption and surrogacy is absolutely nothing to take lightly and no matter what route we go will dramatically affect us financially. No matter how we try to look at it. Any of the bottom three things listed are overwhelming financially and we aren’t even sure if they are doable. Of course, just like with anything, there is a loan for EVERYthing, including babies! Is this how we want to start our family, though? In an amount of debt that is life-changing and will certainly affect the lifestyle you provide for your child?

But, ultimately our (future) family is worth it.

Please continue to pray for us to know what direction He wants us to go in and for insight on how to possibly finance upcoming steps we may take.

Let me leave you with one last thought:

Having a baby in our arms: PRICELESS

 

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over the edge

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Yesterday I received a phone call that literally sent me over the edge. I feel like we have been hanging on by our fingernails, quite literally and it takes very simple, silly things to break us down. Some of the things are wonderful things but they still trigger the floodgates to open. For instance Adam received a beautiful text from our Niece stating that they sang Noel in church on Sunday and she thought of our Noelle the whole time. He started crying. But, it was a good cry. Still, though emotion is emotion and right now we are emotionally exhausted. 

We made a very important decision about ten days ago. I  have been very forthcoming about our looking into the adoption process and starting this, etc. We also decided to look into freezing my eggs-before they age any further! Gah! I thought 38 was the new 20, isn’t it?! The reality is, though that with each of my birthday’s, the risk of issues increases quite tremendously. My birthday is in June.

At any rate, we called and scheduled a phone consult with our fertility specialist in Denver to discuss this with him. Our appointment is Thursday. His nurse called me yesterday, though asking what type of testing they did on Lainey when we had our D&C. What type of chromosomal testing, that is. It was at this point that I started having some flashbacks of something being said to us last year before the D&C where we lost Noelle. I (think) the OB that did that procedure discussed with us doing a special test on her at the time that required them to draw my blood as well. The whole point is to be sure that if it is a female baby, that it is truly the baby’s chromosomes that you are seeing and not the Mama’s. If the baby and the Mama’s tissue do not get separated appropriately, you may get a false report of normal female chromosomes. No discussion like this took place before Lainey’s D&C. The correct test was not done-meaning there is a 29-58% chance it was actually my DNA that was looked at, not the baby’s! This thought is enough to….well, send us over the edge. Fortunately we can still have the correct testing done for the low, low price of $2300 (insurance will NOT pay). Of course we will pay it and we will know in about a week.

Just the thought that maybe there wasn’t a Lainey. Maybe there was a little boy. Or, maybe it was Lainey but her chromosomes were, in fact, not normal. Does any of this make a difference in anything? No and I realize this but it still feels awful. It feels like our first two babies all over again. Noelle’s loss was not less painful by any means but it really helps to have a picture of your baby, whether it be a little boy or girl, in your mind. And, to have a name to think of when you daydream.

I just hate this. This roller coaster we are riding on. The discussions we are having to have, the feelings we are experiencing. Quite honestly, it sucks and if I used bad words, this whole post would be profane.

Adam says if it was a boy, God has things covered and is calling him Lane! Ha!

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