Anatomy Scan - little concerns

The anatomy scan is typically scheduled between 18-21 weeks and this is usually a very exciting ultrasound for parents because

But the anatomy scan isn't done just so Mom and Dad can find out if their baby is a boy or a girl, there is a lot of big things that the doctors want to see have developed properly and at this age

My ultrasound was split into two, the first was over an hour where a not-so-great technician pushed too hard and made me immensely worried for (realistically) nothing and because our beautiful baby girl is as stubborn as her Momma we were scheduled to come back in hopes our little one would cooperate and let the technician get a couple other pictures/measurements. Our second ultrasound was much better, in part because by then we had already spoken with our obstetrician and were feeling a bit more relaxed, our technician was wonderful and although our sweet little girl was still being stubborn they managed to get all the photos/measurements they needed and it was a much better experience to finish the anatomy scan.

During the anatomy scan they found a few things;

First that I have a low lying placenta, this is a pretty common finding at this stage of pregnancy. The concern is with a placenta that is low lying or full placental previa (where the placenta covers the cervix) if I were to go into labor naturally or try to labor naturally the placenta will detach trying to be delivered first (since it is too close or covering the cervix) if the placenta is to detach if has the same results as a placental abruption (which was what caused our stillbirth, although our placental abruption was without reason or cause and just happened). Due to the risk this poses to mother and baby a c-section is typically performed to ensure a safe delivery (I have read of some women who have delivered naturally despite a slightly low lying placenta, however that isn't usually the case) . With orders for pelvic rest and some restrictions depending on the obstetrician, this isn't usually a problem and will typically move away from the cervix before delivery.
UPDATE: after an ultrasound at 23 weeks our placenta has officially moved away from the cervix

The other finding was that our baby girl has a two vessel cord or single artery umbilical cord (I typically refer to it as the single artery), normally the umbilical cord consists of three vessels but sometimes the third one will not develop/will disappear. This can be a soft marker for problems with the heart or kidneys as these organs develop around the same time as the umbilical cord - usually an echo ultrasound is done in the following weeks to rule out any problems with the heart. The other concern with SAU is growth restrictions for baby, doctors usually suggest additional ultrasounds to monitor growth and will deliver baby if growth slows as it is easier to help baby's gain weight outside of the womb than inside. However, in most cases a two vessel cord/single artery umbilical cord has no affect on the baby and is considered a "variant of normal".
UPDATE: as of our echo at 22 weeks, baby girl's heart is perfectly developed and although follow up ultrasounds will be done to monitor her growth as of that ultrasound she is growing right on track and weighing 1 lb 4 ounces at 22 weeks.
At 32wks4days our baby girl is growing well and weighs an estimated 4lbs4oz.

At 23 weeks we were sent to Maternal Fetal Medicine to have another ultrasound and be seen by a perinatologist regarding echogenic bowels (or bright bowels, as the fluid she is swallowing is taking longer to pass through). They did see echogenic bowels at this ultrasound (this was also seen at our anatomy scan and although during our echo ultrasound the week before our very skilled technician looked for this and in her opinion this was ruled out) this is a very common occurence with echogenic bowels because each technician/ultrasound machine sees things differently and often this is a false positive. However most doctors will err on the safe side and if seen will assume it is there.

The perinatologist at the Maternal Fetal Medicine clinic told us that although it is strange to see two things that are different and he stressed that "different doesn't mean abnormal" the single artery umbilical cord and echogenic bowels were not connected and more than likely would just be a variant of normal. He did go over what the echogenic bowels could indicate; cystic fibrosis or down syndrome, a rare infection that could have  passed through me to the baby (all of which typically have other markers, which our beautiful baby girl doesn't have), there is also lesser concerns like a possible blockage that they'd fix after birth or that she may have swallowed a bit of blood which would work through eventually and not be a problem. According to the perinatalogist there is a huge likelihood that it will either disappear before she is born and/or cause no problems. He didn't suggest further testing (which includes blood work to check if we are CF carriers, we would both need to be carriers to give her a 1 in 4 chance of having it. Blood work to check if I've been exposed to any of the infections, but the test isn't good enough to tell when I was expose if I have been at all - which the only time that matters is during my pregnancy and the amnio to test our baby for these things which have no treatment until delivery anyway and increases the risk of loss to 1 in 200 a risk we are not willing to take since it wouldn't change anything). We have an ultrasound scheduled in a month, at the beginning of the third trimester to see how she is doing and hopefully that the echogenic bowels have either gone away or at least gotten better, as well as rule out any possible markers that are assosiated with CF or downs. Although we pray and hope that she will be healthy and that she will not have to experience the difficulty that growing up with cystic fibrosis or down syndrome, I am grateful that (for the most part) these are not "incompatible with life".
UPDATE: As of 30weeks our ultrasound with MFM no longer showed echogenic bowels and although they will continue to watch her it is believed to have cleared up on it's own.

While I wish that we didn't have to worry about added concerns for our pregnancy (as I am already considered very high risk) I am grateful that in both findings there is a great likelihood that aside from extra ultrasounds/monitoring, our baby girl will be just fine.

I will continue to update this throughout our pregnancy as there will be many future ultrasounds and follow up.

xo, Anne.

The NT Screening (Part 2: the ultrasound)

While there was a lot of importance in this ultrasound, much like every expecting parent I assume, we were still very excited to see our little rainbow baby. My obstetrician's office booked me at a location I hadn't been at and of course I was a little nervous but after driving the hour? to Okotoks for two late pregnancy ultrasounds with our first I am not too picky about where we go as long as it is good (Okotoks by the way was a wonderful experience, two of my favorite ultrasounds with our sweet boy) and this location didn't disappoint either.

Typically fathers (or partners, support person ect.) are left waiting while the technician's go through measurements and focus on the important work that these ultrasounds are all about before getting that loved one from the waiting room and sometimes even before showing Mom much. This routine, while understandable, makes me very anxious and I know it affects my wonderful husband too, afterall we have had him come in to the dim ultrasound room to good news as well as devastating news. However at this practice he was invited in immediately, and I was so grateful that even if we were to get bad news that I would have him there with me and I wouldn't have to face it alone at all like I have so many times before. Luckily it wasn't bad news, for which we are so grateful and blessed, once the technician put the wand to my belly our little baby popped up on the large screen on the wall and we watched in absolute amazement of our beautiful little baby. He or she gave the tech a lot of trouble, moving around so much that she had to try multiple times to get the measurements she needed and our baby's heartbeat (she was only able to get that at the very end) a healthy 163 bpm. Our technician was wonderful, as she did her work she showed us our baby from head to toe and gave us so many detailed pictures of our little one. She showed us our baby literally pushing and kicking around, I can't wait to feel those same movements, and it was every sort of amazing that I had hoped for and more. I was beaming and we couldn't stop talking about our beautiful baby.

This location did the full assessment there, unlike others that send the information to your doctor, and met us in a private room to discuss the results. It was so great to walk out of that appointment not only with the visual reassurance that our baby was growing healthy and strong but also some pretty great reassurance that things are going just as they should.

We celebrated with a great lunch and spent the day (and every day since) looking in awe at the beautiful pictures we got to take home of our little rainbow baby.

We are so blessed.

xo, Anne.

The NT Screening (Part 1: the test and results)

I have had two early ultrasounds leading up to this one; one in the emergency room at 5weeks and a perfect dating/confirmation ultrasound at 8weeks but seeing our baby at 12weeks took the cake thus far.

In my first pregnancy, my only one without the high risk label, my first ultrasound was at 12 weeks but it wasn't for the big screening they do now, instead it was for confirmation and dating purposes and what a beautiful ultrasound that was.

Genetic screening was previously reserved for "at risk" mothers, although I don't believe that it was as easy and risk free as it is now. Now, all expecting mother's are offered something called the First Trimester Combined Screening (FTS) which is a voluntary screening that simply assesses the risk of genetic abnormality. This screening takes the mother's age and details on her present pregnancy, conception, any previous pregnancies and family history then combines that information with the results from blood work and a teeny-tiny measurement of the fluid behind the baby's neck during an ultrasound that little measurement is called the Nuchal Translucency measurement (NT) and is typically done between 11weeks and 13weeks6days of pregnancy. From what our technician told us, these measurements and numbers are found in all pregnant women and each woman's normal is different than another but typically a high measurement can indicate a chromosome condition or birth defect. When combined together they can provide a risk assessment, with which you and your doctor can then decide if pursuing additional testing is necessary which can be more invasive and risky. This is a personal choice and a positive result still has the likelihood of a healthy baby just as a negative result cannot guarantee a healthy baby, this is just to give parents and their medical team the ability to decide if further screening is necessary. There is a background risk given, based on maternal age and an adjusted risk given after reviewing and putting together all the information gathered.

When my ob offered this screening (both in my last pregnancy and with this rainbow baby) I talked to him as well as my husband about this screening, and spent a lot of time weighing the risk and results. Since it is non-invasive there is no risk to the baby but I knew that a positive result would cause me to worry even if I knew that the likelihood was still in our favor. I also knew right away that even with a diagnosis of any chromosome abnormality that I would never abort our baby (I hold no judgement to parents left facing a diagnosis which is "incompatible with life") but with all we have been through, providing no risk to me or suffering to our baby - I see no reason to end my baby's life especially if only to possibly save me from pain. I've had to say goodbye to my full term, perfectly healthy son and although I pray to never have to go through that pain again I know that I would rather that than choosing to end their life. Not to mention you do hear of beautiful happy endings despite poor prenatal diagnosis and I just couldn't live with the what if's.

I knew that even if there was a positive result, after crying my guts out and worrying ridiculously, that we would be able to mentally and emotionally prepare. We would be able to learn about it and prepare ourselves, our parenting and our life styles to better suit our child's possible needs. I like feeling prepared, I also liked that we would be able to find out if our baby was developing properly and it didn't hurt to get another chance to see our precious baby.

So we agreed to get the screening done and are so blessed with our results.

We were able to confirm that our precious baby is developing just as he or she should; both hands and feet, arms and legs are seen. Heart activity is present and at a rate of 163bpm. Baby's skull, brain, and abdomen are visible and appear to be normal as well as his or her stomach, kidneys and bladder are visualised. The ultrasound confirmed that amniotic fluid is normal and that everything is where it should be.

While our background risk, based on my age, was already negative my adjusted risk was into the 1:20,00-150,000 over the three; trisomy 21 (down syndrome) 18, and 13 (which are typically "incompatible with life"). At this point there are no fetal abnormalities or real risk of a chromosome condition and I was given a negative result with which we will not be pursuing additional screening other than the 18 week standard ultrasound.

One healthy, growing strong, little baby. We are so blessed.

xo, Anne.

First Appointment

Written June 5, 2013

Last month I wrote about our plans to go back onto Clomid and my upcoming appointment with my obstetrician, I didn't expect us to get pregnant that same month and after getting two beautiful positive tests before my appointment I was ecstatic (and anxious, as always) to tell my obstetrician the good news. 

"So I take it things aren't going well?" my ob asked as he sat down, I could barely contain the smile that was beaming across my face "Actually...". He was very happy, I knew he would because he has always been very hopeful in our ttc journey - he has been there for 3/4 of my pregnancies and we have been seeing him for the last 3 years. "I really think this one will be it" he told me and I wholeheartedly hope that he is right because we cannot stop loving this little baby already. I left his new office with a boatload of congratulations, a battery of blood work, an ultrasound booked in a few weeks and my next appointment already scheduled.

Can't wait to see our little baby in three weeks and praying that he or she will be our rainbow baby.

xo, Anne.

Fingers Crossed

Saw my obstetrician yesterday, he told me that miscarriages are common and that this one has no relation to our previous losses nor does it hold any consequences for a subsequent pregnancy. We discussed testing briefly but ultimately decided that if a second miscarriage occurs then we will follow up with a battery of blood work on both Dyl and I - just so I have a plan, which I am grateful that my OB understands how I my head works. He gave us the go ahead to start trying to conceive, which I was happy to hear, he is very positive for my next pregnancy and said that he believes we shouldn't have trouble conceiving again.

I was beaming, a little terrified, but so thrilled.

He suggested that we try for a few months without jumping back on Clomid, while we know the 100mg worked last August it also wreaked havoc on my body and it is best for my body if we can avoid Clomid when we can. If after 4-6 cycles I haven't conceived and want to go on the Clomid I can, and if my cycles get weird on me again to see him immediately for a plan - but he seems to really think that this year will be ours and his positivity only added more hope to the bucket, while there is still a voice in my head telling me how impossible all of this is, I know I still have a lot of hope to hold on to and no reason to doubt my body.

So here we are jumping back onto the trying to conceive train, since I was expecting to get the go ahead for next cycle (but secretly hoping for this cycle) I had already gotten back to my proper sleeping and eating habits, I am back on the prenatal vitamins and have begun charting again. I still have a pile of ovulation strips for my Clearblue Ovulation Kit but haven't committed to them entirely yet. 

Fingers crossed.

Back Into the Ring with Clomid

I've spent weeks waiting and anticipating yesterday's appointment with my obstetrician, trying to organize my thoughts and questions, wondering how it would go and what my obstetrician would say. Weeks of being nervous and I was so incredibly anxious as I ran five flights of stairs to his office - then nothing, the anxiety faded as I sat waiting for the nurse to call my name.

So after a breif catch up with my obstetrician he told me he was going to up my dose of Clomid to 100mg (versus the 50mg I did during my first three months on Clomid last year). I did ovulate on the 50mg, so I am hopeful that we conceive on the 100mg dose. Also much like last year he is also sending me for the day 21 progesterone bloodwork to confirm ovulation, I'll be able to call the office for my results instead of booking an appointment and waiting.

I must admit I am a bit curious and nervous of taking the higher dose, I know Clomid comes with a mess of side effects and I was lucky enough to miss most during our months on 50mg but I wonder how I'll react on the higher dose and hope it won't be as rough as I am expecting. Regardless this is all such a small price to pay if in the end we bring home our baby.

I am so hopeful of these upcoming cycles, almost so much that I cannot wait to start. I know that these three cycles are a tad more stressful because if we do not conceive during the three rounds on Clomid my obstetrician will have to move me to the fertility specialists. But I am doing everything I can not to think about that and instead keep positive.

This will be our year, so many people are praying and hoping for us.

Waiting

As if on cue the part of me that wishes for my former life and teases me of its happiness went away and on Thursday last week I had finally given up so Dyl called to book an appointment with my obstetrician, want to take a guess at when my appointment is?

July freaking 30th!!

Blahh, I know he is very busy but it just sucks that we'll have to wait that long before anything can start again. I mean, of course we'll continue not-avoiding pregnancy but its difficult to achieve the desired results without ovulation which is what it seems my body has gone back to.

I'm just so disappointed, this essentially means two months wasted and I'm so tired of waiting.

If my period doesn't show up before my appointment I'll reach 5 months late, the longest I had gone last year was 3 months before we started to progesterone pills and clomid cycles and that period was unbelievable – because my body isn't skipping periods it is still building up a lining and when ovulation doesn't occur nothing is telling my body to stop so it keeps building, I don't want to think how bad it's going to be this time.

However, later in the day I finally got over my initial disappointment and realized that this works well for us anyway. I really wanted time to focus on getting back to a healthier lifestyle (healthy eating, regular exercise, taking my vitamins and having a proper sleep schedule) I was so good a couple months back but when things started to slip with my cycles I stopped caring so much. I've already spent the last few days shifting my habits back to healthy and I feel great, I'm certainly looking forward to how great I'll feel in six weeks.

We're also about to embark on a big renovation so I'm excited I'll be able to fully participate and it is summer time – the mountains are calling me constantly to go hiking and this year is the centennial anniversary for the Stampede and since I'm not going to be pregnant I'm planning to really enjoy it. As per usual, I could still enjoy hiking and Stampede while pregnant and probably even help out a little in the renovations too but since I'm not going to be pregnant I might as well celebrate it right? It's just how I deal with the disappointment (you can see me doing the same in earlier entries as well)

Anyway, I guess that is about it for now, I'll be around.

Better then Good

At the end of January, I finally met with my wonderful obstetrician where we talked about my last few cycles (perfectly on time & regular, no questions asked), he gave me two options and his opinion. He suggested, because my cycles had seemingly returned to normal; we could either carry on trying naturally or go back onto three months of Clomid. He suggested the first; our age and the return of my regular cycles were on our side and I (while briefly disappointed) understood and couldn't agree more. Since everything seemed to be going well why not give it a go, the first 3 rounds on Clomid were incredibly stressful & difficult on my body if we had even the slightest chance at conceiving on our own it was worth a shot. He told me to continue charting & follow up with him in six months if we hadn't conceived, we left the office almost bewildered. Almost a year after the possible PCOS diagnosis, we were leaving his office with the chance at a natural conception, as if the last year never happened.

Although we're coming home with some pretty awesome news we're actually going to take the month off because I'm scheduled for dental surgery and the pain medication could be dangerous for pregnancy. So we're waiting, but my obstetrician says that we'll be safe to start trying after my next cycle which is great.

I couldn't have come up with a better scenario for this appointment, I'm hoping by the next time I see him I'll be happily pregnant.

Feeling a bit Lucky

My appointment went well, I was right and I did ovulate this cycle which means that this dose of Clomid works for us – I know we are lucky with that. My obstetrician reviewed my blood work which came back beautiful and showed that I don’t have PCOS, although the ultrasound last spring showed poly-cystic ovaries, I do not have the syndrome which is good because there are so many struggles that tag along with PCOS and I think we have our hands full already. He is not entirely sure why my body will no longer ovulate on its own, although I have a feeling it may be residual shock/stress from the ectopic pregnancy. Who knows, but I have a feeling we're going to look into it after we have a successful pregnancy.

Since my period came along all nice and regular we were told to start Clomid tomorrow and carry along just as we did before. If my period is late and I'm not pregnant then I can either wait for it to start or take another round of progesterone pills to induce it, then Clomid and well, you know how it goes. I have a total of three cycles (I've just started my second) before I need to take a break from Clomid as consistent use of Clomid can cause the uterine lining to be too thin (and we need that nice and sturdy to keep that baby stuck) he's suggested a three month break if these next two cycles are unsuccessful. In that time we are still welcomed to try and with no foreseeable reason to why I am not ovulating on my own there is always the chance that my body will restart naturally. But after three months we can reattempt another three cycles on Clomid, if by then we have still not conceived he’ll refer us to a fertility specialist and go from there.

I had to take a moment to register all the information, fertility specialist? My fears of IVF reared its ugly face, but my obstetrician assured me that I am far from needing it and that artificial insemination would probably be the extent for us. Great news, all great news – would it be annoying that I consider us so lucky, despite all the loss and struggle because I do feel lucky, at least most of the time.

My HSG Results

Yesterday was my HSG procedure; as I mentioned in the previous post since I have irregular cycles (paired with the onset of dizzy spells/nausea in the past few days) my ob/gyn ran a pregnancy test just in case, I could tell both he and I knew I wasn't – which of course I wasn’t but like I said before, you're better safe then sorry. The procedure in itself was quick, quicker then I expected. I did experience cramping, which continued afterwards so I tried to spend the day resting when I could. But the minor discomfort was nothing in comparison to the results we received. To my absolute surprise both of my fallopian tubes are clear, I was beyond ecstatic of course since I assumed there would be some sort of blockage from the ectopic pregnancy over a year ago (imagine me not quite skipping away in a very attractive blue hospital gown). The X-ray images did show the shape of my uterus, previously an ultrasound suggested I had a bicornuate uterus but the shape may also indicate a septic uterus (although in either case it appears minor since I have carried a baby, our first, to term). My ob/gyn intends to look into it (we talked briefly about having an MRI done later) but ultimately decided that regardless he wants me pregnant and told me to start taking my pills.

So I'll see him in a couple weeks after this cycle and we'll see where things go from there.

Information on Hysteroscalpingography (HSG)

On Thursday I'll be heading to the hospital to meet with my ob/gyn for my HSG procedure, but before that I wanted to post a bit of information about the HSG exam; if I feel to add anything when I get home on Thursday I'll edit accordingly. Remember that I am not a doctor and that all the information below is in my own words (or opinions) with the information provided to me from my ob/gyn. I hope that this post, and ones like this to come, will help calm the nerves of someone like me. Always discuss your questions and concerns with your health care provider.


. . . .

An HSG exam is an X-ray procedure that is used to diagnose problems with the fallopian tubes and the uterus. In most cases it is used to find if a woman's tubes are partly or fully blocked, it can also show if the inside of the uterus is both a normal shape and size.

The procedure can be done in a clinic, your health care provider's office or, like me, at the hospital. Since the HSG exam is not safe if a woman is pregnant your doctor will want to book it during the first half of your cycle to reduce such chances ~ since I have irregular cycles my ob/gyn had me take a pregnancy test, if you are unsure don't hesitate to ask, you're better safe then sorry. HSG will also not be done if a woman has a pelvic infection or heavy uterine bleeding at the time. You may be recommended to take over-the-counter pain relief an hour before the procedure and in some scenarios you may also be prescribed an antibiotic to take before the exam to prevent an infection. You may feel anxious or nervous, this is going to sound ridiculous coming from me (a self proclaimed Queen of Worry) but try to relax and keep your mind calm, it is not nearly as bad as it sounds.

Overall it is a rather simple procedure and takes about a half-hour (give and take of course). The set up is similar to your regular pelvic exam but your doctor will then proceed to inject a liquid into the uterus through a tube or cannula. As the liquid moves through the uterus and into the fallopian tubes X-ray images will be taken. Once the images have been made you will be cleaned up and allowed to go, your health care provider will be able to show you your images and explain your results.

After the procedure you can expect to have a bit of sticky vaginal discharge since some of the fluid will drain out of the uterus (while some may also be absorbed into the body) it may be tinged with blood so it is probably a good idea to wear a pad ~ although tampons are not recommended. You may experience small amounts of vaginal bleeding, cramps and/or feeling dizzy, faint or sick to your stomach. If possible, try to make yourself comfortable and relaxed.

The Risks:
Severe complications from an HSG are rare; an allergic reaction which your doctor will detect right away, injury to the uterus or a pelvic infection. If you experience vomiting, fainting, foul smelling discharge, severe abdominal cramping/pain, heavy vaginal bleeding, fever or chills – contact your health care provider immediately.

The Benefits:
First and foremost, the results from the HSG will help give your health care provider a greater chance at determining the right route for you to take in your journey to having a baby. A lot of women express that the first cycle following the HSG procedure is more fertile, the reasoning behind this is because the fluid used during the procedure helps clean out the uterus. This same liquid may also help clear a blockage in the fallopian tube(s) provided the right circumstances of course.

There are other options available that may suite your needs better then the HSG procedure, make sure to discuss such things with your health care provider.








Please note, as mentioned above all information is in my own words (or opinions) based off the information provided to me from my ob/gyn. I am in no way a doctor but hope that what information I relay here will help calm the nerves of someone like me. Always discuss your questions or concerns with your doctor.

We've Got a Plan

My appointment today went better then I expected, better because I always assume the absolute worst case scenario. I adore my obstetrician, he answered each of my questions and he, as always, was incredibly positive for me. He told me I'm at a healthy weight to get pregnant and just to continue with a healthy lifestyle, which is great news for me and my pre-heating “oven”.

He scheduled a HSG test (hysterosalpingography) next Thursday to ensure there are no blockages in my uterus or fallopian tubes (the tubes are the concern since I had an ectopic pregnancy last year treated with methotrexate) provided he sees nothing wrong we carry on.

He prescribed me two medications to use during my cycle, one is a progesterone hormone supplement which will force my cycle to restart while the other is clomid which will cause me to ovulate & prepare my body for pregnancy. I've also been told to start taking prenatal vitamins again, which of course I'll do. On the twenty-first day of my cycle I have to go in for blood work, I'll either be pregnant (great!) or I'm not, if not and as long as my progesterone level is right we'll restart the cycle until I am pregnant.

It's scary and so exciting all at the same time, if we're lucky mid July we could be pregnant! I can barely fathom the possibility right now. Could we really be so lucky? Heck, even if its not this cycle the fact that we may eventually be pregnant is beyond a blessing for us.

I hope everyone else hoping for some sort of good news gets it :)

Five Days

This Wednesday, five days from now, I'll walk into a familiar office and meet with my high-risk OB/GYN. He found me last year, in the emergency room when I was first diagnosed with the ectopic pregnancy. I was supposed to only see him again when I was pregnant, I'm not pregnant. This spring my family doctor requested an ultrasound that suggested I had PCOS, when asked who I would want to work with from there I immediately requested him.

I have a million questions written down, along with every cycle I've had since the ectopic pregnancy. Do I sound over prepared? I suppose that is just how I am – I think way too much.

Generally I am frustrated by the whole scenario; I am perfectly healthy and overall the “textbook definition of prenatal/maternal health” why have I continued to come across these terrible situations (the placental abruption causing us to loose our son, the ectopic pregnancy ending what would have been our second chance and now this, PCOS) Why Me? Why all three? Why our son? maybe I could have accepted all this if at least he was here. Once upon a time I wanted a big family, I'm at the point where I will be over the moon with one child.. it's funny how things change.

Sometimes, I find the whole thing comical – maybe that is a sign that I am finally cracking under it all, I'm kidding. But it's just the thought of what could possibly be next? It can't be just a simple pregnancy resulting in a healthy baby. I don't even care for the simple pregnancy, bring it on, just result in a healthy baby with both of us happy and alive.

Other times my mind is beyond angry; What did I do so wrong to deserve this? No, forget this attitude, it is because somewhere within me I am strong enough and the same goes for anyone else reading – You're right, you don't deserve this, but this is what it is and you will find strength within yourself that you never even imagined was there. You're a champion and someday you'll look back on your life and think “wow, I overcame all of that” just like I know one day I will too.

Anyway, (if you can't tell) I have such a mixture of emotions leading into this doctors appointment. Part of me can't wait; to have answers, to have a plan, to have someone tell me what is reallu going on. But another part of me is so afraid of what I may be told; What if it takes years to conceive? What if we keep loosing? My heart breaks even more at the thought of not being able to be a mother here in this world, not being capable to give my dear husband the chance to be the wonderful father I know he'll be. It's scary, but I can only hope for the best at this point.