Moving right along

27 weeks or so . . .

My latest OB appointment happened earlier this week.  My doctor was pleased with how things were going.  I should have gained 60% of my pregnancy weight by now – Lo, I had gained 60% of my pregnancy weight.  I should have a fundal height of X centimeters – By golly, I had a fundal height of X centimeters.  Baby’s heart rate should be in a certain range – Woo hoo!  Baby’s heart rate was squarely within that range.  At this point in my pregnancy I get an “A” for average, which is comforting.  At this appointment I also got a couple of shots and had to take a glucose test to check for gestational diabetes.  I really wasn't looking forward to the glucose test, as simply the thought of sugar water makes me gag.  Much to my happy surprise the sugar water was orange flavored and resembled something more like Gatorade than straight sugar-water.  I’m not a fan of sports drinks, but at least it was palatable.  I had to chug 10oz or so quickly and then wait for an hour to have my blood drawn.

I spent the hour pouring my new copy of the DoD’s publication “Pregnancy and Childbirth”, more commonly known as “The Purple Book.”  (If you’re interested in looking at the 230+ page publication in PDF, you can find it here.)  I have to admit – for a government publication it wasn't nearly as dry as I had expected.  It was a little myopic in that the authors wrote from the premise that babies are only born to heterosexual married couples, but at least it did a decent job of covering the physical and emotional aspects of pregnancy and childbirth.  Now that the DoD has repealed “Don’t ask, don’t tell,” maybe the book will be revised to include families that aren't married and/or (sarcastic gasp!) homosexual.

As I've been moving through this pregnancy, I've continued to take a boot camp-style exercise class two times a week.  I try to get a couple of yoga classes in there too, but lately it seems like I always have scheduling conflicts with the yoga classes that I like to attend.  I like the boot camp classes because I enjoy the variety of exercises and I work out best when I have someone else design the workout and tell me what to do.  Despite years of going to a gym, paying for a trainer and even having friends that are certified personal trainers, I am that person who goes to a gym and stands there staring at the Bosu balls and free weights, jump ropes and medicine balls, clueless and directionless.  (I don't do machines.)  These boot camp classes are a lot of fun - the people that show up are friendly, the instructors are motivating without being too tough, and it's never the same workout twice.

Working out with extra weight on my frame, coupled with a change in my center of balance, has made working out increasingly tough, but I continue to do it because it makes me feel good.  If I go even three or four days without working out I feel sluggish and out-of-sorts.  At this point in my pregnancy the instructor has me modify more than half of the exercises we do, but I'm still huffing and puffing and sweating by the end of the hour.  Of course, I'm the only person who attends the class that is currently gaining weight instead of losing it.  That's an odd feeling.

The other people in the class (mostly women) are really supportive of my pregnancy, which is appreciated.  Often times I feel like I'm "getting off easy" with my modifications while they're busting their butts doing the real deal.  I've gotten lots of compliments on being so committed to be being a healthy mom.  I've had some women tell me how impressed they are by my hard work.  One lady even called me a "badass", which I wear in my head as a badge of honor.  Last week in class the instructor praised one of the ladies in the class for doing one last squat at the end of the circuit.  The lady laughed and said, "Well, I have to keep up with preggo over here."  Many of the ladies in the class are moms as well, and all of them have agreed that exercising now will put me in a better place for labor and deliver in January.  They urge me to keep moving and working on my strength, whatever form that may take as the weeks go on, in order to help myself and the baby down the road.

I plan on continuing to work out as long as I'm able.  I have noticed in the last couple of weeks that I really do need to dial some of my range of motion on exercises.  My body is producing a lot of hormones, including one aptly named Relaxin, that causes my ligaments to stretch.  I find that my hips, in particular, are subject to a sensation of slight pulling and stretching lately.  According to my trainer, if I modify my squat and lunge depth I will still benefit from exercising without potentially injuring myself.  I've pulled muscles from working out before - the idea of pulling a muscle (or ligament) while pregnant and 20lbs+ heavier doesn't sound appealing at all.  

So here's to staying healthy and active as I move into the last 12 weeks of this part of the journey . . .

Showered with love

Zac and I spent about a week in Minnesota at the beginning of October.  It was a great time of year to visit.  Yes, there was some rain and some cool temperatures, but it's to be expected as the state moves fully into autumn.  The leaves were changing color at such a rate that even in the space of six days I could see a noticeable difference.  We've spent the last six autumns in either Hawaii or San Diego, and both Zac and I miss fall.  I miss the changing weather and the changing menus and ingredients.  It's hard to want to put on a crock pot of beef stew while baking home-made dinner rolls when it's 85 and sunny.  (Apparently while we were in MN the weather in San Diego shifted and it feels like SoCal may have turned the corner into fall as well.)  I'm looking forward to the next six months of mostly lovely San Diego weather.  At least living in San Diego I won't have to worry about trying to get to the hospital in a possible blizzard come January.

My sister and mom threw me a baby shower while I was home.  It was an amazing afternoon.  One of my biggest regrets I have each time I go home is not being able to see as many people as I want to.  The shower was a perfect opportunity/excuse to get 20+ women whom I love and admire into the same place at the same time.  Did I get as much time talking to individual people as I wanted?  No.  But at least I got to give everyone an enthusiastic, prolonged hug .

We went around the room at the beginning of the shower so people could introduce themselves and how they know me.  It blew my mind the wide cross-section of women that were in attendance.  They included:

*My mom

*My sister

*My grandmother

*My aunt

*Cousins

*My mother-in-law

*High school friends of my parents, who have known me since birth

*Members of my church who, again, have known me since I came into the world

*One of my parent's neighbors whose children I used to babysit

*One the aforementioned children (who is now in her early 20s - yeesh)

*Children of my parent's high school friends that I've grown up with

*One of my mom's co-workers (of 25+ years)

*My brother-in-law's mother

*Law school friends

*Former co-workers
*Friends from high school

Some people knew me as an infant.  Some have only known me as an adult.  But all of them were there to share in the joy and excitement of me becoming a mother, and that meant everything to me.  It sounds cliche, but while the gifts were lovely and generous, I simply wanted to spend the afternoon with them.  There were stories, jokes, a couple of emotional tears (mostly mine) and lots of laughter  When it was done I was equally energized and exhausted.  The shower was my reminder that when the time comes, and I'm finding my way as a mother to our new baby, that I have a strong support network behind me who I can draw on for advice and understanding.  I couldn't have asked for a better way to spend an afternoon.

And did I mention that there were four different kinds of bars laid out for dessert?  It's not a Minnesota party without a pan, or four, of bars.

  

Halfway

Week 20-ish, a few weeks ago

It's hot in San Diego.  Too hot.  We're in the middle of a late-summer heat wave that is taking its toll on my desire to do anything but watch the US Open tennis tournament from the air conditioned confines of my living room.  (I do work while watching tennis, so it's not totally wasted time.)  The weather gods must have a copy of our calendar, and a sense of humor, since they waited until the day my parents arrived to unleash their blast furnace of horror.  I suppose I shouldn't gripe about the weather when it's gorgeous here 87.5% of the time, but I'm still not happy that the meteorologist on the local tv station said we've got another six or seven days of this on top the week that we've already had.

We've cleared the last couple of hurdles that I was concerned about for the pregnancy.  We had our genetic counseling appointment, which revealed that I am at no greater risk of having a child with certain conditions that the general population.  Yay, average-ness!  The accompanying ultrasound was equally uneventful, as the doctor saw the things that he wanted to see.  Spine looked good, the baby was measuring correctly for that point in the pregnancy, etc.  It was strange watching Baby move around so much inside my tummy and not feeling a thing.  How could Baby be in there doing somersaults and I not sense any sort of movement?  Zac was delighted throughout the ultrasound.  I think it was the first time that the image actually looked like a "baby" to him and the flurry of fetal activity was reassuring that things are going well.

I had another ultrasound a couple of weeks later.  This would be the ultrasound that a normal woman who conceived her baby in a normal way would have normally at this time in her pregnancy.  I am abnormal (I'm spectacular!) in terms of my age and I certainly didn't conceive this kiddo in the normal way, so I've had more than my share of ultrasounds.  But each ultrasound was for a different purpose so once again I found myself at the hospital.  Only this time I had consumed 32oz. of liquid one hour before the procedure to aid in . . . something.  A bit uncomfortable, but not as bad as I had thought it was going to be.  My parents were in town for this appointment, so they came along to get a look at the new grandchild I am incubating.  Once again Baby was measuring as Baby should.  The organs looked like they were coming along well.  Kid was still moving all around, but with a little less real estate than a couple weeks prior.  It was fun being able to share that appointment with my parents.  They were able to be with my sister throughout her pregnancies and spend lots of time with her two boys.  I want them to have as much time with this grandchild as possible, even if that's while the kiddo is in utero.

I've officially started wearing maternity pants.  That makes me feel mildly ridiculous.  I keep catching glimpses of my changing body in the mirror and thinking, "Isn't it nice that my reflection is pregnant?"  I still feel disconnected from the goings on.  Maybe when I start feeling something from within that I can clearly identify as baby-generated.  Right now it still feels like I'm watching tv at the ultrasound appointments and the belly is just a Hollywood prosthetic designed to make my character look pregnant.  I wasn't sure how Zac would feel or react to my changing shape, but happily he seems more than charmed.  He rubs my belly and smiles while we watch tv.  He giggles when I'm drying off after a shower and studying myself in the mirror.  He randomly reaches out and pats the bump while we're running errands.  You think you love someone, then they do things that make you love them more.  It's a delight to go through this with him, and I can't wait to be parents together.

Forecast called for showers

We just recently returned from Minnesota for some family visitation and a baby shower.  I remember putting together my sister's baby shower for her first-born.  The late fall/early winter of 2007/2008 was a chaotic time in our extended family.  There were birthdays, births, serious illnesses, baptisms, weddings and deaths.  It was a whirlwind of emotions but I distinctly remember the excitement of planning Megan's shower.  I had decided to construct a tiered cake out of out disposable diapers, adorned with flowers and ribbons.  I was living with my Grandpa at the time, and I set up shop at the dining room table to put it together.  It took a certain amount of engineering and creativity, plus trial and error, to get it the way I wanted it.  My Grandpa looked on with bemusement as I made various attempts at constructing it, de-constructing it, re-constructing it and finally decorating it.  Even he had a to crack a smile when it was completed.  Yes, it was mildly ridiculous, but it was also an expression of joy held together with tape, pins and a lot of love.

I've gotten over a lot of the guilt and sadness of leaving home, but not when it comes to my sister.  It still pains me that I am not within driving distance to be more present in her life.  There is something about physical proximity that makes it easier to spend time together.  The telephone and Skype are great, but that requires scheduling.  Living in the same city means dinners at our parent's house, running to the mall together, helping out with the kids.  It's much more spontaneous and if you don't see each other today, odds are you are going to see each other the next day or the day after that.  All of those little things, those day-to-day things, you know about.  It too easy to let time slip away when you're separated by thousands of miles.  Suddenly it's been two weeks since you've touched base and the phone calls reveal all sorts of things that you have missed in each other lives.  

I've always felt that it's harder to stay than it is to go.  When you stay somewhere and someone leaves, there's a vacancy in all those places that they used to be.  When Zac leaves on his trainings and deployments, I believe that I miss him more than he misses me.  Why?  Because I'm used to running in to him in the kitchen, I'm used to jockeying for position while brushing our teeth at the sink, I'm used to curling up together as we fall asleep.  When he's gone, I am fully aware of his absence and all the parts of my day-to-day life that he isn't there for.   But out there - at his trainings and on his deployments - I was never part of that reality.  I am not "missing" from that experience.  He's training, he's working, he's focused on a mission that doesn't include me.  So while he certainly misses me, it's a different type of loss for him than it is for me.

That's similar to how I feel about my relationship with my sister.  She is used to Minneapolis with me there, being no more than 10-15 minutes away, crossing paths at our parent's house, going to events together, hanging out at her house, spending time together in all of the places that we shared for the first 27 years of her life.  And then I left.  It's the same world she has always lived in, except I'm not in it.  On the flip side, Megan never lived in Oklahoma or Hawaii or California with me.  She hasn't been a first-hand part of the journey I've had as a military spouse. Up until now I know that's been tough for her, and for me, but not being together for my first pregnancy has hit her harder than any other aspect of our separation.  I can feel how excited she is for me, and how desperately she wishes she could share this particular journey with me.  

I wouldn't trade my life with Zac for anything, but it's hard feeling like you've left your sister - your best friend since her birth. I know growing up that we thought we'd always live near each other and have kids that were the same age.  We would raise our kids to have the same amazing relationship that we enjoyed with our cousins.  I didn't stay in Minneapolis.  I didn't have kids at the same time as her.  And in all likelihood her kids will be more comfortable with my cousins' children (whom they see regularly and who are the same age) than mine.  That wounds me. 

Sometimes Megan thinks she needs me more than she really does.  She's stronger than she thinks she is, and while I know that her current road is challenging (PA school, two kids, working, trying to find time to spend with her husband) it is one that she will not only handle, but excel at navigating.  One of the silver linings of separation is that has forced us, both of us, to grow.  We know how to be sisters in the same city, we're learning how to be sisters with many states in between us, and hopefully someday we'll be living closer to each other once again.  

Feeling normal-ish

17-ish weeks . . .

I'm about 17 weeks along now, and I haven't had any morning sickness yet.  My OB says that I'm probably in the clear as far as that goes, but he cautioned me that sometimes his patients that don't experience negative side effects during the first trimester get "pregnant" in the third trimester.  [His emphasis.]  I'll cross that bridge when/if I get to it.  Right now I feel . . . normal.  Well, normal-ish.  I'm tired more than usual, but I'm a girl who has always loved her naps and sleeping 8 hours a night, so I'm not really sleeping any more than I did before.  I still have a relatively normal appetite.  There are occasionally days where I'm feel like I'm not that hungry and have to remind myself to eat lunch or supper, only to discover after one bite that I'm famished and devour the whole meal.  The other day I ate an entire half-pound hamburger, plus some of the fries.  Zac looked on with bemused horror.

My body is starting to change, some.  I'm starting to show, if you know what I looked like before.  If you were just meeting me for the first time you'd probably think I just like Dairy Queen too much.  (For the record, yes, I do like Dairy Queen too much.)  I've had to start wearing jeans that are one size larger and I've basically sworn off close-fitting tops for a while.  Once I look "pregnant" I think I'll be more comfortable wearing things that accentuate my belly.  Right now I just feel obnoxiously bloated and chubby.

I took the first couple of months of the pregnancy off from strenuous exercise.  I went on walks and attended some yoga classes, but I kept it pretty low-key until we got to 12 weeks and my OB said that things looked good.  I've started back up with the strength training and a little more intense yoga classes in the last few weeks and I do feel better, more like me, since I'm exercising again. My yoga instructors and trainer know that I'm pregnant and modify my workouts accordingly. It is a strange feeling, though - I exercise, eat right, get plenty of sleep and instead of losing weight I'm gaining it.  As I exercise I am finding that my balance (which wasn't stellar to begin with) isn't as good as it used to be.  I'm assuming this will get increasingly worse as I start to look like a small planetoid.

Our next appointment is in a week, when we meet with a genetic counselor.  My OB offered to refer me strictly based on my age.  He said that he had no other concerns about my family history to warrant a referral, but that if I wanted it he would sign off on it. Zac and I want to know.  We understand that there is no 100% certainty with any of these tests, and we also know that many conditions are not screened for, but if there is something wrong, serious or relatively benign, we want to know.  Certainly the future of this pregnancy is dependent on what we learn.  (Since it has been in the news lately, I've been thinking how maddening it would be if Zac and I were stationed in Texas and learned that the baby wouldn't make it to term, or die within a few hours of birth at that genetic counseling appointment.  If we wanted to choose to end the pregnancy we would be very close to not being able to due to Texas' 20 week rule.  The thought of the state telling me what my husband and I can and can't do for our family is absurd and insulting.)

Once we get past the genetic counseling appointment I feel like I will be able celebrate this pregnancy a little bit more.  I haven't mentioned the pregnancy on social media yet, and I'm pleased that the people that I have shared the news with have shown great restraint in not mentioning it on those platforms either.  There are people I simply haven't told, just to limit the number of people I have to un-tell in case things don't turn out well.  I've even postponed posting these first few blog entries that address being pregnant, waiting for that time that I feel comfortable that most of the hurdles have been cleared.  I am cautiously optimistic that that time will be soon.

Getting my Qi right

The second un-published post (8 weeks along) . . .

- - - - - - - - - 

I find that when people find out you're newly pregnant they always ask two questions: 1.) When are you due/How far along are you?, and 2.) How is the morning sickness?  The neat thing about question number two is that people get to ask that question each and every time they see you, even if it was only a day or two ago.  Over and over and over again.  The upside is that it gives me plenty of opportunities to find something wooden and knock on it, "No, nothing yet."

No, no morning sickness yet.  And for that, I am thankful.  One of my girlfriends had experienced debilitating morning sickness.  She had to take time off of work, take medication to keep anything down and actually turned a pale green color for a few weeks.  It wasn't a pleasant experience.  Most of the pregnancies I've heard of have included some morning sickness, but one of my girlfriends told me that she hadn't experienced and morning sickness with her daughter.  I am not presumptuous enough to think I'm going to get through the first trimester without tossing my cookies or being overwhelmingly nauseous at least once, but I am grateful that I have made it to eight weeks with nothing but an acute sense of smell.

Maybe the settled stomach is the result of acupuncture, which I started immediately after our last failed IUI and have continued through my pregnancy.  Maybe the entire pregnancy is the result of it.  After all, it is the only thing I did differently for this cycle.  My acupuncturist told me that my belly was too cool to carry a baby and I had some Qi (pronounced chee) blockages in my abdomen that needed to be addressed.  So we worked on getting my Qi and my blood flowing.  Occasionally I'd put a heating pad on my belly for a hour or so - a few times a week.  I found it interesting that one of my girlfriends, who is Japanese, had given me the same advice, without telling her what my acupuncturist had said.  When I told her I had trouble conceiving she immediately guessed it was because my belly was too cool.  She told me to put a heating pad on my belly as well.  I figured if I was hearing it from two different sources, it could hurt.

I was hopeful that the acupuncture would help with fertility, but I was surprised to find how good I felt overall.  Most notably, I began to sleep really well at night.  I have always been a light sleeper.  I was too hot, I was too cold, I wasn't tired when I turned out the light, little things woke me up and then I couldn't fall back asleep.  When I started acupuncture, those things either went away entirely or were seriously curbed.  Since I was sleeping better, I felt more energetic during the day.  I used to crash around the 2-4pm time frame each day, sometimes falling asleep while I worked on my laptop.  No more.  I felt great in the afternoons and used that time of day to work out which, in turn, made me feel even better.  I also found that after a few acupuncture treatments that my abdomen was free of the tightness and discomfort that I noticed while I was doing yoga.

It was one of my fertility doctors, Dr. W, that recommend acupuncture to me in the first place.  A middle-aged, white, male, American military doctor - not someone that I would usually think would be supporting of alternative or Eastern treatments.  There are two fertility doctors at the clinic, and usually I worked with Dr. L.  I would occasionally have appointments with Dr. W, but not very often.  The lead-up to an IUI is a delicately timed process, requiring regular blood tests and ultrasounds to figure out when the right time to perform the IUI occurs.  By virtue of timing I had my last appointment going over blood results before the IUI with Dr. W.  It was a Friday morning in the clinic and it was really quiet.  It was the day that residents go to some sort of weekly training, and because Dr. L had the day off they had scheduled very few patients.  This gave me lots of time to chat with Dr. W.

As he went over my blood work at looked at the ultrasound of my follicles, he asked me all sorts of questions about our journey through infertility.  He asked if I had tried any alternative treatments, including acupuncture.  I told him no, but that a friend of mine had sought it out when she was struggling with infertility and now they had a healthy baby girl.  To my surprise he told me that he was a licensed acupuncturist.  He had come to acupuncture in a strange way.  Within the last decade more and more of his infertility patients were coming to him saying that they wanted to try acupuncture.  Some of them were already using it.  He was worried that his patients were exposing themselves to risks, plus he was concerned about how much money it can costs for regular, consistent treatments.  (Which are not covered in most cases for military family members.)

It turns out that the U.S. Military has an acupuncture licensing program available for its doctors.  The military has found that acupuncture helps wounded warriors with everything from phantom limb pain to PTSD.  Dr. W signed up for the training as a skeptic.  His goal was to obtain the information he needed to discredit the practice and bring this back to his patients.  He said he sat smugly in the room, secure in his knowledge of Western science and medicine and how it was superior to the myths and mysticism of alternative remedies.  As he told me about this, he laughed at himself.  "After a week," he said, "I was a convert."  He said the class opened his eyes to his ignorance and narrow-mindedness.  He began offering acupuncture treatments to his infertility patients to supplement some of their regular appointments.  If he had performed an IUI on a patient, he would offer them a relaxation treatment to help their anxiety and help with implantation.  (You have to lay there for 30 minutes after the procedure, so why not?)  He also found that the acupuncture helped his patients that were in their first trimester that were suffering from severe morning sickness.  A acupuncture treatment often meant they had 2-4 days of relief without drugs.

"I know you aren't having your IUI until tomorrow," he said, "but if you want to see what acupuncture is like, I can give you a relaxation treatment right now.  Then you can decide if it's something that you want to pursue."  Dr. W explained the process, how it works, and showed me the needles that he uses.  I was interested.  Why not?  What could it hurt?  I felt like I was coming to the end of my fertility journey, so I figured I had might as well try something else.   Dr. W placed a few needles in my body and I could feel the strange, dull, ache in the insertion points that he had described.  It was so . . . weird.  Not painful or uncomfortable but odd.  It's rather hard to explain.

I had the IUI the next day.  It didn't work.  I sent an email to my friend who had used acupuncture for infertility and asked for suggestions on how to find someone reliable.  I spent some time online, made some phone calls, and finally settled on a clinic not too far from our home.  Before my initial appointment, I filled out a six page questionnaire with all sorts of unusual questions.  Questions about my tongue's appearance, my stool, my sleeping patterns.  Do my fingers and toes get cold easily?  How often do I get heartburn?  All sorts of questions that I've never had a doctor ask me.  I brought the answers to my first appointment and went over them with the acupuncturist.  

She studied my answers solemnly and had me lie down on the exam table.  She took my pulse at in three different locations on both my left and right wrists.  She pressed around in my abdomen, silently making notes in her head.  For the first time I became acutely aware of a tightness in the lower left quadrant of my abdomen.  It's always been there, but not anything I ever thought about except when I'm doing yoga and it sometimes pulls.  But after taking the questionnaire I found myself being very aware of my body, and paying attention to things I hadn't thought about in the past.

After examining me, the acupuncturist told me (in her delightful French accent) that my belly was too cool to carry a baby.  She described it as having three burners (like on a stove) in your tummy.   You want all three of them to be on a simmer-like low-heat setting for babies - not too hot, not too cold.  She also wasn't happy with the tightness in my abdomen.  She said we could work on getting my blood and my Qi flowing and that it could help with the fertility.  I figured what could it hurt?  All of our Western medicine attempts hadn't worked yet.  We were getting to the end of wanting to keep trying.  Maybe this would be the thing that would work.  Or not.  But at least it would be trying something different.  (In addition to our usual Western medical assistance.)

I went every week for three weeks.  Then every other week, then down to every third or fourth week.  I felt great.  My energy levels were up, the tightness in my abdomen went away.  I no longer had nights where I woke up from sleep because I was too hot or too cold.  I could sleep a solid 7-8 hours, feeling rested in the morning.  Even if the acupuncture didn't help with fertility, it certainly helped with everything else.  I crossed my fingers as we went in for our next IUI cycle.  Maybe this East-meets-West thing will work.  I continued with the acupuncture after the IUI treatment, figuring that I should keep those burners on low to keep my belly baby-incubating-friendly.  After a few weeks and the positive pregnancy I test, I told my acupuncturist that it appears our team effort had paid of.  She was delighted when I told her and we both laughed with excitement.  I've continued with acupuncture every three weeks or so, and I wonder if it's one of the reasons I've had a relatively easy first part of my pregnancy with no morning sickness.

Regardless of it whether it worked or it's all in my head, the fact is that I'm pregnant and feeling good.  And that's all that really matters.

Cautiously optimistic

Now that we are where we are, I feel like I can go back and post some of the entries I typed up while we were in the wait-and-see period.  Here's the first one (6 weeks along):

We had been here before.  Almost a year ago.  In the exam room, waiting for our first ultra sound.  The stick I peed on said the IUI was successful.  The bloodwork had said the IUI was successful.  Our first successful fertility treatment in almost three years.  We walked into that six-week ultrasound not knowing what to expect.  What to see.  What to feel.  I laid there on the table with Zac sitting next to me, idling chit-chatting, waiting for the doctor.

A resident, whom we had never met, breezed in the room, cheery, smiling.  She introduced herself as she pulled on a pair of gloves and told us excitedly, "We should be able to hear a heartbeat today!"  Zac and I exchanged looks.  We hadn't expected that.  We hadn't known what to expect, honestly, but certainly not that.  I had purposefully stayed away from reading pregnancy guides or researching things on the internet.  I had let the first few weeks after the IUI to move along in a normal manner, not wanting to over-think the idea of being pregnant. I figured I would wait until the first ultrasound to get some sort of confirmation that I should perhaps learn a little more about being with child.

The doctor prepped the machine and started the exam.  Within seconds her face fell.  The smile vanished and was replaced by a look of concern and disappointment.  Zac instinctively reached out for my hand, which made me catch my breath.  We knew.  Even though we had no idea what that first ultrasound was supposed to show, we knew she wasn't seeing it.  The doctor moved the probe around some, trying different angles.  She said nothing and after a moment gave us a resigned look of sadness.  "There's no heartbeat," she said.  "I am going to go get your doctor."

The resident and the medical assistant left the room.  Zac and I didn't say anything at first.  Finally I mumbled something about not realizing that we would have been able to hear a heartbeat at this appointment.  Zac said that he, too, was surprised that we should have been able to hear that.  "Well, I guess it didn't work," I said with a sigh.  I didn't know how to feel.  We had zero expectations walking through the door, we had our expectations raised by the announcement that should hear a heartbeat, and now in a manner of seconds they had come crashing down around us.  It was the shortest, most devastating roller-coaster of emotions I have ever had.

There was a knock at the door and my doctor, the resident and the medical assistant returned to the room.  He gave me a sad smile and patted my knee.  He also examined me, to confirm what the resident had learned.  "I'm sorry," he said, "but it looks like the pregnancy wasn't viable. You made it about five and a half weeks."  "Ok," I said automatically, "So now what?"  The doctor said we could discuss the next steps in his office.  As they somberly excused themselves from the room so I could get dressed, I sat up and Zac stood next to me.  We were silent for a moment.  Finally I looked at him.  "Are you okay" I asked him.  For the first time I noticed the redness of his face, the welling in is eyes.  "I'm fine," he answered.  "What about you?"  I paused, and the tears came and fell down my face as I smiled at him.  "I'm about as fine as you are."  He squeezed my hand.  We would be fine, but for now we were sad.  So very sad.

- - - - -

So we had been here before.  The six week appointment.  The appointment that we now knew held the potential of a heartbeat.  I was anxious.  Zac was anxious.  We forced ourselves to talk about anything other than pregnancy as we sat in the waiting room for our appointment.  Finally our name was called.  Our medical assistant was excited for us, peppering me with questions.  "How have you been feeling?  Any morning sickness yet?"  I gave her a half-hearted smile and short answers.  "I feel almost normal and no, I haven't had any morning sickness."  I must have made it clear that I wasn't interested in talking more about my condition because she replied with an surprised, "Oh," and left it as that the remainder of the walk to the exam room.  Yes, I'm pregnant, I thought to myself, but I've been here before.  It doesn't always work out.

Another resident we had never seen came in to the room.  Same routine - introduction while putting on gloves and prepping the ultrasound machine.  Medical assistant at the ready.  Zac by my side.

I knew what I was seeing before anyone needed to explain it to me.  A flickering.  A rapid flickering on a tiny jelly bean in my abdomen.  A heartbeat.  I said nothing, but I knew that at least we had cleared one more hurdle.  The resident smiled, "There's a heartbeat!"  He turned on the audio and let us hear the pulsating heart of the embryo.  He continued the exam, printing out photos and explaining some of the things we saw on the screen.  Zac and I murmured appropriate, "Cool" or "Oh" as he explained what we were looking at, but our excitement was subdued, which I think confused the resident a bit.

My doctor joined the exam and happily confirmed that everything looked good.  "So now what?" I asked.  "So it looks like you're having a baby!" the resident proclaimed, trying to pry some positive energy out of Zac and me.  "I'll be excited in nine months when we have a healthy, live birth," I told him wryly.  My doctor shook his head and smiled.  Knowing my personality from our history of treatments, and the miscarriage, he knew that I wasn't going to be jumping for joy at the pronouncement that I was pregnant.  He knew I was cautious, maybe overly so, and at the very least pragmatic.  The risk of spontaneous abortion continues through the first trimester.  My age meant that we still needed to do genetic testing.  There were possibilities that we still weren't going to have a baby.  But my doctor smiled at me broadly and patted my knee.  "I'm giving you medical permission to be cautiously optimistic."  That did it.  I had to smile and chuckle.  "Alright," I told him, "since it's doctor's orders."

- - - -

So there we were, walking out of the hospital almost a year after the miscarriage, but this time with a printout of a picture of a tiny jelly bean.  We had more hurdles to clear, but the first one was over.  In two weeks we would have another one.  The eight-week ultrasound.  If everything looked good I "graduated" from the infertility clinic to the regular obstetrics clinic. Then there would be a ten-week ultrasound.  And genetic testing.  And then, based on those results, decisions.  So many hurdles yet to clear.  But, on doctor's orders, I was trying to be cautiously optimistic.  After all, doctor's orders, right?