what to expect when you're expecting a d&e.

Yesterday, I talked to a nurse at my clinic to ask about the D&E procedure. It was Nurse Special, who's like 80,000 years old. I told her that I didn't think it was humane to perform it when a woman was awake and 100% conscious. She seemed to think I was nuts. She said, "We do it all of the time. It only takes about three minutes." Oh, only three? This procedure is getting shorter every day.

I told her I didn't want to be awake. I didn't want to hear anything, I didn't want to feel anything. She confirmed that I would feel pain. I said, "There's PAIN?" And she said, "Well, I've never had one, but yes, you're going to feel a lot of cramping. You should call the doctor. He's at the other office today."

So I call the other office. The message I give the front desk woman is this: "Please tell him there's NO WAY IN HELL that I am going to be awake for this thing." She takes my number and tells me he'll call me back.

I get the call while I'm at work. In a meeting with one of my staff. I tell her I have to take it and send her off, closing the door behind her. My doctor is not amused by my message. He tells me that when he does the procedure in the office, there's no sedation. If I'm not comfortable with that, I'll have to call my OB. I tell him I don't have one. He says, "I can refer you to someone else."

This I don't understand. I get Versed for my egg retrievals. Why can't I get it for this?

Because, he explains, that part of the clinic is for the IVF side. Not the physician side.

The clinic is attached to a hospital. When I had my hysteroscopy, it was done there. Can he do the procedure at the hospital?

No, he says. I do it in the office or I don't do it at all.

Now I'm in a pickle. The last time I let someone do surgery on my lady business, I came back with one ovary. This after everyone told me that there was no way I'd lose my ovary. That doctor was a complete son of a bitch and the reason I don't have an OB anymore (and why my primary has done my paps/breast exams two years in a row). 

I trust Dr. Smiles. Not because he's a famous doctor who's been on TV several times, but because I know his top priority is preserving my fertility. He's not going to cut anything or scar anything or do anything to compromise my ability to make or carry a baby.

Look, he says, it's really a quick procedure. It only takes a few seconds.

Two things:

1. Oh, so now we're down to SECONDS? Is this meant to comfort me? I'm stuck on the math: Four years. Nine weeks of pregnancy. Undone in mere seconds. Yeah, that doesn't make me feel better.
2. I can't help but think of Hemingway's "Hills Like White Elephants": "'It’s really an awfully simple operation, Jig... It’s really not anything. It’s just to let the air in.'"

Fine, I tell Dr. Smiles. Let's keep it on the books and I'll call you if I change my mind.

I email Mr. Hope. I email the BFF. I talk about this with two of my closest coworkers. Everyone is horrified that I will be awake for this procedure. 

Dr. Smiles had said I could take two Vicodin an hour before. This, he feels, will make me really loopy. 

That's great and all, but here's MY plan: 

I'm going to wear a sleep mask. I do this whenever I have to get an MRI and it helps. If I can't see it, it doesn't exist!

I'm going to load some speed metal on my iPhone and listen to it through noise-canceling headphones. I don't want to hear anything but obnoxiously bad music. I know if I hear the suction as I feel it, it will give me nightmares for the rest of my life.

I might bring a stuffie. Something to squeeze. That something will not be my husband's hand. This is how he lost a close relative, remember? He will be in the waiting room with the BFF, who's coming with us. Yep, I'm bringing her for him, not for me. Me, I'll have a stuffie. Preferably one I don't care about donating to Goodwill immediately after.

So this is my plan. I'm still terrified. I'm not good with pain, physical or emotional. I have such a freakishly good sensory memory that unless the Vicodin really wipes me out, I will remember every single second. I will relive every single second over and over and over again.

But the fear of having someone botch the job is way worse than the fear of pain. I need my ladyparts to work. I need there to be no scarring. I need to know that when we cycle again, there will be nothing standing between us and our rainbow baby.

So, awake it is. 

Let's hope I don't regret it.

miscarriage to-do list, day 2.

Log into BabyCenter and "delete" your family. This will stop all emails related to your pregnancy, including any pesky advertiser emails for things like breast pumps, diaper services, or winning free cord blood storage. Also, when you delete your family, they automatically take you to a list of miscarriage resources. That's convenient.

Log into BabyCenter under the name and password you set up for your husband, because he was totally into the weekly emails you were getting about your pregnancy and the state of your uterus. Delete his family, too. Then log into his email, search "BabyCenter," and delete every email he's received from them, eliminating all painful reminders that for a brief five-and-a-half-week period, you were expecting a baby to arrive this August.

Run through the list of people you updated yesterday to see if you missed anyone. Realize that there are still three women from your old, in-person Resolve support group you haven't told about the loss. Also a family friend who may or may not be reading your blog. Four more people to tell, and that should be everyone, right? No, there are two others from that support group you told, too. Or is it three? Do a quick count. Realize that a whopping 24 people knew about your all-too-brief pregnancy. More, actually, because you're just counting the people YOU told, not the ones your husband told, or the ones that were told by the people you told. Even so, 24 personal contacts seems excessive. You thought you wouldn't care about having to tell these people about a miscarriage. (You were wrong.)

Overanalyze every little twinge and cramp. Why do you feel like you're about to get your period? Are those miscarriage cramps? Oh, no, you just need to go poop. Visit the bathroom to confirm. Yep, those were poop cramps. Later, after you've scrubbed your hands in hot, soapy water, explore your cervix to check for bleeding. None of that happening (yet). Breathe out a sigh of relief.

Consider having sex with your husband. There's nothing sexy about  miscarriage, but you've been craving physical closeness with your husband since you first knew the pregnancy was in trouble. It's been months since you've been intimate (that's IVF for you!). Worry not about the sex itself but what happens if you happen to orgasm. You've been told not to because it could cause uterine contractions. Will those uterine contractions be strong enough to expel a fetus that you're trying to hold in for five more days? Decide to remain celibate.

Get morbid. It's weird to you that you're carrying a deceased, grape-sized fetus in your uterus, isn't it? Weirder still that you're taking her on vacation. But that vacation was already planned. You look forward to this vacation every year. The hotel is nonrefundable! You have to go. Have to. But what will happen to her over the next five days? Even though your doctor told you to drink your face off, you can't help but feel doing so would be toxic to the baby who no longer is. I mean, you get that she's gone - that her little heart is no longer beating - but still. She is in your womb. What effect does alcohol have on a fetus that is no longer growing? Is this something you need to be concerned about?

Call your clinic to see what options you have for the D&E. You can't fathom having to be conscious for the evacuation of your first and only pregnancy. It seems cruel. Inhumane. Get a message that reminds you the office doesn't open for another hour. Fuck. You'll have to call back later.

Move forward. This is happening. It's really happening. On some level, you know this. On another, it hasn't fully sunk in. But it will. If not now, then soon.

and the newest member of the miscarriage club is...me.

The first thing I noticed at this morning's ultrasound was that the sac looked much, much bigger. For a second, I thought, "Oh, look! It grew!" But then the ultrasound tech started measuring Nugget, instead of pointing out where her heartbeat was, and I knew.

Nugget was gone.

I said, "There's no heartbeat, is there?"

"No," she said. "How did you know? Had you stopped having symptoms?"

"Actually, those have been worse," I told her. "But my hCG levels have been off from the start."

"I'm so sorry," she said. "Truly."

"It's okay. We've been expecting this."

And we have. I wasn't shocked. I didn't cry (not then, anyway). If anything, I was more worried about Mr. Hope, who'd been dreading this appointment all week. 

We went to the smaller waiting room, where we'd sit until we could talk to Dr. Smiles. I texted the BFF. "No heartbeat," I wrote. "Waiting to see the doctor."

Not too long later, a nurse led us back to his office. She told us how sorry she was and gave us the Sad Face. I told Mr. Hope, "This is almost worse - how everybody reacts." Then Dr. Smiles walked in with his version of Sad Face and it was like a little knife in my heart. We'd been in this together, after all.

We talked next steps. I was clear that I wanted the D&E. (Quick side note: the more standard procedure is a D&C, which includes scraping the uterus. My clinic doesn't do this. They use suction to clear out what people in the biz call "products of conception.") Then I said, "There's a complication. I'm heading out of town on Thursday and I can't cancel my trip."

"We can get you scheduled for tomorrow," he said. "And then you can leave for your trip on Thursday."

But all I could think was what if? What if there were complications? What if there was a lot of bleeding? Or cramping? Or worse?

I said, "Can we do this after I get back?"

Mr. Hope says the doctor gave me a look here, but if he did, I didn't register it. At any rate, he said I could. I asked him if I should stay on the hormones until the procedure. "You'll want to," he said, "if you want to make sure you won't bleed."

So now I'm off PIO and the Lovenox but will stay on the estradiol and progesterone suppositories until Sunday afternoon. At that point, I'll start inserting tablets into my vagina that will soften my cervix and open it up. Two at first, then four that night, then two again the next morning. An hour before the procedure, which is scheduled for Monday, I'm to take Vicodin.

I ask about the donor embryo program. We only have one left on ice. Can I get matched with another set so that I will have more to transfer?

Absolutely, he tells me. I just need to email the UnproRepro to set it up. 

(Fabulous. I thought I was done with that one.) 

We're looking at March, he says, for our next transfer. Of course it will be March. My anniversary month. The month I have a two-day work trip three states away. A speaking engagement, no less.

But okay. March isn't that far off. I can hold onto March.

Dr. Smiles tells me to drink my face off on the trip. "That's already on the menu," I assure him.

Then he tells us how sorry he is one last time, and sends off to check out. I tell the front desk woman that I need to schedule "a procedure." She looks at my file and gets it. She's sorry and Sad Faced, too.

But here's where things get weird: I ask if I should stop eating and drinking at midnight, and they tell me no. The nice nurse from earlier walks by and says, "Oh, no, we prefer you to eat a light meal." 

"No twilight sedation?" I ask.

"No," they tell me. "Not for an office procedure."

Huh. I really thought I was going to be out for this one.

I ask how long I should to expect to be there. 

The nurse says, "We always say an hour, but really, it takes no time at all. More like 15 minutes."

Four years, we've been trying. Four years and a nine-week pregnancy, and they can undo it all in a quarter of an hour? 

And this is when I start to lose it. 

Mr. Hope and I say our goodbyes and walk out the door. We pass a bathroom in the hallway and I duck in. "You're going to start crying," he says.

"No, I'm not," I say, but I totally do.

All of my hopes. All of my dreams. All of it, gone. Fifteen minutes of vacuuming out my uterus and I will be returned to my pre-pregnancy state, almost as if it had never happened.

Except it did happen. For five and a half weeks, I was a pregnant woman. I was a mother. There was a tiny human growing inside of me. I still carry that grape-sized, stalled-out baby seed in my body. 

We walk back to the car. And, because we are two fat people who have a tendency to feed our feelings, we swing by the little bagel shop near the clinic to load up on carbs. On the way home, we stop at my favorite pizza shop. The universe defaulted on my no-pizza-until-13-weeks pact, so fuck it. I'm eating the pizza. 

At home, I clear out some work emails and make my to-do list. There is so much that needs to be done, but I can't focus. I don't want to work. I want to shut down.

An hour later, I climb onto the couch next to Mr. Hope, and we start binge-watching a sci-fi show we like. I check work emails to make sure I'm not missing anything crucial. 

At some point, the vet calls to tell me that Precious Pup may still need the surgery that we thought he needed Friday but then was told he didn't. The story is always changing. We were told one thing and then another and then a third thing today. I ask a lot of questions. My voice is sharp and I can hear the panic in it. I tell the vet that I don't understand why they keep changing the story and I'm going through a miscarriage to top it all off and I can't even right now -

I toss the phone to Mr. Hope, lock myself in the bathroom, slide down to the floor, and cry my eyes out.

There is so much going on in my brain, I can't even begin to process it all. I was a mother, and now I am not. (For now. Hopefully.) I'm going to have to go through all of it again. The preparation. The transfer. The five days of waiting, waiting, waiting until I can test. Getting positives. Hoping they turn darker. The nervousness of the beta tests. Hoping (praying?) the numbers rise appropriately. Knowing I will be gutted if they don't. Or, worse, what if I don't get a positive test? What if I transfer two more and neither of them take? 

I was emailing a friend earlier who had a negative cycle after a miscarriage and I said, "I can't even imagine how hard that is." And I can't. I can't imagine going through a loss like this, waiting for a second chance, and not even making it to first base. 

And then there's this:

Unless there is some major miracle brewing in my future, I will most likely never have a biological child. And yes, I knew that was my fate. And I'm okay(ish) with it. 

But being okay(ish) with it and then having to accept that your very last shot - that beautiful, unexpected blastocyst created from your egg and your husband's sperm - having to accept that it's gone, gone, gone -

It hurts. It hurts more than I thought it would.

As I type this, I hear Mr. Hope crying in the other room. I should go to him right this second. 

I'm afraid that it might break me.

We've been through so much together, Mr. Hope and I. But this? This is one of the worst things. One of the hardest. I don't even think I've begun to fully hurt yet. And I can't imagine the pain of Monday if I need to be conscious during the procedure. I need to call the clinic about that tomorrow and see what can be done.

For now, I need to go to my husband. I need to hold him. I need to let him know that he isn't going through this alone.

That we will get through this together.

We always do.

dreams of my mother (and other charming nighttime tales).

Sixth ultrasound today at 9:30. Per usual, I have no idea what we'll see. I know this weekend I only had a couple of weak uterine twinges where Nugget implanted, which made me nervous. The daily knock-knock from the baby has been comforting to me during this limbo. Then, yesterday, I had a series of strong knock-knocks. Three sharper twinges in a row each time. They felt a little like the implantation cramps, actually. I hope that means Nugget was snuggling in for the long haul.

The past three nights I've had the most vivid dreams/nightmares. Saturday night, I had this horrific one in which a doctor whose name I couldn't pronounce (in the dream I actually took a picture of his door with my phone because I couldn't remember OR say his name) told me that most doctors wait their whole life for a patient as "special" as me. "You will never carry a baby to term," he told me. "There is something in your body that attacks the fetus. This baby inside of you, it will never make it. You will never be a mother."

You don't need a PhD in psychology to decipher that one. But later, in the same dream, I am wandering the streets of this lakeside town looking for my dead mother. I eventually find her. She doesn't look dead - she looks like a normal person - but in the dream I knew she was dead. I tell her about what the doctor said and how I think that it's because her genes were broken and that's what I inherited. She was eating popcorn or some other snack and was all, "Whoa, that's intense." Because yes, when I encounter my dead mother in a dream, she acts like a college-aged stoner.

Sunday night saw me locking Mini-Hope in the trunk of a car - to be fair, she voluntarily got in, but then we forgot about her - and Mr. Hope trying to rescue a stray tabby that was covered in fleas. Literally, I looked down and saw the cat's fur and it looked like it was moving, there were so many fleas. Mr. Hope was wearing a sweater and the fleas started nestling in that as well. I was panicking and kept saying we'd need to walk around until we found a shop where we could get them both dipped (the cat AND Mr. Hope).

And last night? There was another crazy vivid dream, though less nightmarish. It had a plot, as most of my dreams do, and when I woke up and was like, "Okay, three in a row," I knew I'd write about them. Only now, sitting at my laptop, I can't remember last night's to save my life.

I know that vivid dreams are a common pregnancy symptom, but from what I've read they're the result of hormonal changes. I'm on a shit ton of hormones (2 mg estradiol 2/day, prometrium suppositories, PIO) so that doesn't necessarily reflect Nugget's current state of being.

Other "symptoms": The soreness of my boobs waxes and wanes (this morning they're super tender, but at times I feel nothing - I walk around the house mushing them in my hands and just hoping they'll start to hurt). Sometimes I get heartburn, but not often. Harold has been behaving himself lately, so that's been nice, but at the same time, I'm like, "Well, what does this MEAN?" Oh, and I'm thirsty a lot. I've been drinking a ton of fluid and yet I still wake up dehydrated almost every morning, but it's been really cold and the heat runs all night (even though I have it set at 65) so maybe that's why?

The biggest thing is that I'm tired all of the time. Over the weekend I thought I was coming down with something because I'd just get dog tired in the middle of the day. Granted, I had a Friday like you wouldn't believe - I won't go into details, but I will say there was extended drama over Precious Pup's vet visit and about four hours where we thought he needed emergency surgery but then didn't in the end - so maybe the exhaustion is from life itself. I wouldn't be surprised.

I'm hoping that Nugget has lived to see another week. If she can just hang on until next Monday, I can get the MaterniT21 (non-invasive) blood test and see what's the what with her chromosomes. (Or his. Nugget could be a him. The baby implanted more on the right but the yolk sac implanted to the left of the baby, so this is why I think Nugget is a girl. Either that or it's wishful thinking.)

In my fantasies, we get that test and it comes back clean, and I'm just this weird medical mystery where everything looked bad but we still end up with a healthy, happy little baby. I know this isn't the likely ending (I said "in my fantasies," remember?) but I want so desperately for this happen. I've been in pregnancy limbo for a full month now, which doesn't sound like that long but feels like an eternity. And even though the sac looked small too weeks in a row, the baby's heart beat strong both times. I hang on to that heartbeat. I have to.

Right now, it's pretty much all I have.

losing my marble.

Y'all know by now that I love a good story, right? Well, have I got a story for you!

Our fifth ultrasound was scheduled for 9:30 a.m. yesterday. Of course, this was the morning that we had our first real snow of the season. We live in an area that doesn't see a lot of the white stuff, and drivers start freaking out at even a sugar dusting. So, we planned on leaving about 20 minutes early to accommodate.

An hour later, we'd barely made it from the first Interstate to the second. (It usually takes us 20 minutes to reach the second one.) I try to call the clinic to let them know we're going to be late. Their phones are down. It takes us about six tries to realize it's not OUR phones that aren't working.

Of course, after an hour on the road I had to pee. Badly. Remember how I said this pregnancy peeing is no joke? So I asked my husband to pull off at the first exit. He obliged. The exit ramp is covered in slippery snow. The car's brakes lock up. We're going slowly but it's clear that we're about to hit the big orange HVAC truck in front of us. Mr. Hope tries to go around it. No such luck. We sideswipe the truck in extreme slow mo.

The truck moves off the exit ramp and into a lane. We follow suit. There are horrible scraping noises and I realize that the accident has completely destroyed our front right tire. I tell Mr. Hope to stop driving. He keeps moving anyway. Finally, he reaches a place where he won't cause more traffic issues. We sit there, stunned.

I still have to pee.

I tell my husband I'm going to walk to find a bathroom. And then trudge maybe 1/3 of a mile in the snow until I find a little salon. It's closed, but as luck would have it, the woman who's there to open it has just pulled in as I am knocking on the door. I tell her what happened and she lets me use the bathroom. Then she says I can wait there until help comes. I thank her and say I need to get back to my husband.

I trudge back. By this time, my feet are freezing and slightly wet.

The police have been called. Mr. Hope has called the insurance company. When I get back, I dial AAA. They inform me that I have only purchased a Basic membership, so it will only cover the first three miles of towing. Each additional mile will be $4. I could've sworn I purchased the Plus membership. They tell me I did not.

I cancel the tow.

The cop arrives while I'm on the phone with AAA. He tells me he's calling a tow because we have to move our car. I'm all fine, whatever. I'm still trying to figure out how we're getting home and if we're going to be able to get our ultrasound.

Mr. Hope decides he's going to call AAA and play dumb and see if he can upgrade our membership. He wastes like 20 minutes on this endeavor. No go. Meanwhile, I'm grabbing a reusable grocery bag from the trunk and loading up all of our stuff - the GPS, the EZ Pass, car chargers, etc.

The tow guy that the cop called shows up and tells us he's taking the car to his collision center. But I don't want the car to go there. I want it to go to the awesome body shop that's less than a mile from our house. Tow guy says, "I'm not AAA."

The tow guy starts hooking up our car. I tell him that I don't authorize him to take it anywhere. He says, "I don't need you to. He did." Pointing to the cop.

This is when I kind of lose my shit.

I start screaming at the tow guy that he can't take my car, that my car needs to go to MY body shop, not his, and that I'm not getting into a truck with him.

The cop is talking to the guys we hit. I stomp through the snow over to him and ask him what's happening. I say, "You told me you were calling a tow truck. You didn't say I couldn't pick where the car was taken." He says, "I told you that you have to move your car." I say, "But I don't want my car taken there. I want to get home." He says that's not how this works. We're blocking a travel route, see. It's dangerous. I say, "Can't he just tow the car to that lot right there? So it's out of traffic?" Cop says, "He's not AAA."

I walk back to Mr. Hope and start crying. Like, wailing. Hysterical crying. I start talking about how I'm eight weeks pregnant and I need to get my ultrasound and I have to get home so I can get my ultrasound and why can't they help me?

Tow guy takes off with our car. Cop asks us if he can give us a ride to someplace warm. I tell him no. I walked somewhere once, I'll walk there again.

I head back to the salon. On the way I call my mom's best friend, who's been like a second mom to me for years. We're going to call her Bossy, but in the best possible way; she's a woman who gets shit done. I say, "There's been an accident. We're fine but stranded about 20 miles from home."

She says, "I'm in the shower. Give me ten minutes and I'll call you back."

So we wait in the salon. Mr. Hope calls the body shop and fills them in on what happened. They get the other collision center's number from him and tell us they'll take care of everything, including getting our car towed to their place AND rolling the cost of it into our insurance claim. (WE LOVE THIS BODY SHOP!)

Somewhere in all of this, I have called my clinic's sister location. Their phones ARE working. I tell them what's happened and they tell me they'll let my clinic know.

Eventually Bossy calls and gets some information from us as to where we are. I tell her about the missed ultrasound. She tells me to call my clinic and ask how late I can come. "If they'll take you, I'll drive you there."

So I call the clinic and miraculously get through on their previously broken phones. It's about 11:15 at this point. The ultrasound tech leaves at 12. We're only 12 miles from the clinic. They ask the ultrasound tech if she'll stay a little late to accommodate me. She says yes. Score!

Around 12, there's still no sign of Bossy. I call to see where she is. She's just gotten onto the first Interstate. She had a work emergency she had to take care of.

I call the clinic back but their phones are broken again. So I call the sister location. Turns out their ultrasound tech is there until 2:30. If we want to try to make it, they'll see me.

Bossy arrives at 12:30 and I let her know about the sister location. It's a half-hour drive from where we are. "Let's go," she says.

We get there and wait for about 20 minutes before being taken back for blood work. This is around 1:20; we haven't eaten since 8 a.m. I didn't pack snacks because hey, I didn't think we'd be stranded on the side of the road. I am starving. And nervous.

Finally, around 1:30, we have the ultrasound. There's Nugget, her little heart still beating. But I can tell the ultrasound tech is concerned. She takes more pictures than normal. More measurements. She measures the heartbeat. It's 130. Lower than the 144 it was last time. (Later, after I get home, I do some research that reveals low blood sugar can affect the heart rate. Even so, 130 is still in the normal range.)

There has been growth. Nugget measures 12.3. She was 7.3 at the last scan, so they would've liked to have seen her measure 13 or 14. But she's still in the acceptable range.

It's the sac that is not doing so great. No one ever tells us that the baby is measuring this week and that day, they just give us numbers. But you can see what things are measuring at on the screen. By the screen, Nugget is measuring at 7w4d - so, about five days behind. Not catastrophic. But the gestational sac is measuring at 6w4d - almost two full weeks behind. It's small, that's for sure. Nugget is kind of crammed in there. Here, see for yourself:

So I guess all of the water I've been pounding didn't help.

The ultrasound tech says, "Do you want a picture?"

Right there, my heart sinks to my feet. She wouldn't ask us that if she didn't think this was going to end badly.

Yes, we say. We want the picture.

It is still our baby, for now.

We are somber as I get dressed. We still need to talk to the doctor but we both know it isn't good.

It's another 10 minutes before a male voice calls us back. Oh, crap. I'd assumed we'd get to see sunny Dr. Colleague. Instead, we got saddled with Dr. Eyeore.

He is his usually gloomy self. He starts talking to us about how a small gestational sac and enlarged yolk sac typically indicate chromosomal abnormalities. He and his wife went through it. Twice. This, we suppose, is his attempt at bedside manner.

Sometimes a too-small gestational sac can catch up, he says. He's seen it happen. But, this isn't likely. At least not for us. I'm guessing he makes this characterization based on my poor hCG levels in conjunction with the too-small sac.

This pregnancy, he tells us, will declare itself in the next seven to ten days. He says this a few times, actually. I imagine Nugget becoming Foghorn Leghorn and saying, "Well, I do declare, I don't think I'll be sticking around heeyah."

There's nothing we can do, he assures us, just as every doctor has done every step of the way. "Whatever's happening is happening from the inside out," he says, "not outside in."

I ask about MaterniT21 Plus, a noninvasive blood test that identifies a wide range of chromosomal abnormalities. He's familiar with the test. If we make it to Week 10, he says, we can do the test then.

But clearly he doesn't think we're going to make it to Week 10. He doesn't say this outright, but he does say that he's going to send me home with a cup and that once I start spotting he thinks I should start peeing over an old colander so that I can catch whatever comes out. He says, "A baby this size is about the size of a marble, so you should be able to get that and bring it in for testing."

I say, "But Dr. Colleague said my progesterone is too high for that. She said if I miscarry, we'll find out at an ultrasound that the heart is stopped."

He switches gears. Now he's talking to us about giving me four pills to take that will soften the cervix and allow me to lose my marble in the colander.

I say, "But Dr. Smiles said that if I miscarried, I can do a D&C."

He says, "Oh, yeah, we can do that. We're good at that."   <-- not a direct quote but pretty damn close.

I ask him to reassure Mr. Hope that it's a safe procedure. See, Mr. Hope lost a close relative after a botched D&C post-miscarriage. You can imagine how awesome that's made everything that's going on with me right now. Mr. Hope's #1 fear in life: losing me. This is not an exaggeration. He tells me this regularly.

Dr. Eyeore tells him that they're really good at the procedure. That they use plastic instruments so that there isn't any scarring. That other women come to them to have their botched D&Cs fixed all of the time.

Recovery time is minimal, he says. "Nothing in the vagina for a week."

He wants us to come back in a week and a half. Small problem; that's when the BFF and I will be on our birthday vacation. Can we come back in a week?

"Sure," he says. "Even better. If you come in that morning, we might be able to schedule you for the D&C that afternoon."

Since this now sounds like a 100% done deal, I say, "What are the odds that the pregnancy will pull through?"

He says, "I give you five to ten percent."

Alrighty then.

As I'm checking out, I happen to look down and see my hCG level from last Tuesday. It was 2,281, up from 1,591 four days prior. That's the biggest increase we've seen since the second beta. I have no idea why it picked up like that in Week 7. What does it mean? Is it a good thing?

Later, after I put the numbers into a doubling calculator, it shows a 40-something percent increase in four days - well under the 60% doctors like to see. The doubling time is a week. Much better than the 110 days I saw at one point, but still not enough.

I make the appointment for next Tuesday with Dr. Smiles. If Nugget is gone, I do not want to have the follow-up convo with Dr. Eyeore. I want MY doctor.

We get back into the car and head for home, stopping for food along the way. Mr. Hope and I have had no time to process. We've been with Bossy the entire time. Just before we leave the restaurant, she goes to use the bathroom. It's the first time we've had two minutes alone.

"What are you thinking?" I ask.

"That this sucks," he says.

Yep. That about sums it up.

Bossy takes us to the rental car place. We pick up my new car for the next two to three weeks. There's a warning light on. Low tire pressure. They can't fix it, they tell us. But if there's a guy on the lot he might be able to.

So Bossy tells me to follow her. The maintenance guys on a rival rental company's lot are out. She tells them some sob story and they agree to fill my tires for me. I told you, Bossy gets shit done!

There is more drama when I am trying to back out of the lot - it's very tight, I'm great at parallel parking but horrible at backing out of spaces - and then we head home. Only, we have to stop at the body shop first, because the collision center won't release my car without proof of registration.

I don't walk through the front door of my house until almost 5 p.m. Which is about the same time I'd be getting home if I'd worked a full day.

Mr. Hope and I are thoroughly drained. There are people who've been texting and emailing all day asking for updates. I can't tell the story a million times, so I write one email that goes out to a bunch of people. Then I curl up on the couch with Mr. Hope to drink hot tea and watch Netflix.

Later I did my normal Googling thing. I found a picture of a Week 9 ultrasound where the baby was way more crammed into the sac than Nugget is. I mean, you can still see some fluid around Nugget (for now). This baby was being squeezed tight by its sac. The doctor had prepared the woman for miscarriage and sent her off. Three weeks later, she hadn't miscarried and got another ultrasound. The sac had caught up, the baby was a little small but growing on target, and the doctor gave her the go-ahead to start telling people they were expecting. She went on to deliver a healthy son.

Now, I don't know about that woman's hCG levels. I'm guessing they weren't dismal like mine. But you know, it's something. And even Dr. Eyeore gave us a five to ten percent chance of making it. Nugget has pulled off so many miracles so far. I mean, the hCG had plateaued. Then it shot up almost 700 points in four days. That's something, right?

The thing is, I don't even know how I'm feeling. Like, I'm definitely not okay. But I'm not devastated either. Am I still in shock? In denial? It still doesn't feel real. I don't FEEL like I'm going to lose this baby. But I also don't feel like I'm going to have this baby either.

Another week of wait-and-see. Another week of hormone shots and suppositories and pills. Another week of wondering and Googling and performing my version of prayer, which is really a lot of me thinking, "Please, please, please let this baby make it. Please."

Still pregnant, though. At least for now.

what will tomorrow bring?

I've been relatively relaxed all week. Seven days without another blood draw and ultrasound meant seven days I was still pregnant.

Earlier today I got a little worried. I hadn't had a single uterine twinge. Not long after I emailed this to my husband, there were a series of uterine twinges where Nugget implanted. I felt like she was saying, "Hellooo? I'm still in here, you freak!"

Then, all afternoon, I had pressure above my groin area. I Google this, worried it has to do with miscarriage. Nope, just my uterus stretching. Perfectly normal for someone who is eight weeks pregnant.

I get to a place where I think that Nugget is going to make it. She has to, right? But then I end up Googling and reading scary things, like the miscarriage story from a woman who said her hCG levels were wonky her entire pregnancy, and how at nine weeks the baby was crammed into a sac that had stopped growing. If you remember, at my last ultrasound my sac was a little small. WILL NUGGET OUTGROW THE SAC? Is this what happens when you have dismal hCG levels?

I don't know what we'll see tomorrow. I'm hoping for appropriate growth and a super-strong heartbeat. I'm hoping that the hCG levels don't mean squat. I'm hoping that Nugget is strong and healthy and turns out to be our rainbow baby, the one we've wanted and waited for so so long.

There is so much love waiting for you, Nugget. Stick it out and see for yourself.

we've got a fighter in there.

Since Dr. Smiles is on vacation this week, we had two options for yesterday's appointment: 7:30 a.m. at the usual location to see his PA, or 9:30 a.m. at a different location with Dr. Colleague. Since both locations are 45-60 minutes from our house, we opted for the latter.

It was the first time visiting Posh Clinic's sister location. When we arrived I had to go to the bathroom, because this pregnancy peeing thing is no joke. There, on both sides of the hallway, were these gigantic paintings of sunflowers.

I don't write a lot about my mom, but I will say that sunflowers were her thing. After she died, I started seeing sunflowers in random places, often when I was thinking about her or missing her something fierce. When I saw those sunflowers in the hallway, I thought, "Everything's going to be okay." And then immediately wanted to beat myself in the head, because every time I think something like that I'm sure it's me just tempting fate or whatever. 

We waited a long time for the ultrasound, and by the time we went back I felt like I had to pee again. But I was already undressed. The tech came in, inserted the probe thing, and declared my bladder too full. So, pants came back on and I went for a second pee. See what I mean? Pregnancy peeing is seriously no joke.

Finally, the scan. 

There she was, noticeably bigger. There she was, with a heart beating strong.

Nugget had grown to 7.3 mm. The tech said she should've been 8 mm but she'd grown appropriately since my last visit so she wasn't concerned. The sac was a little small, she noted. The machine registered Nugget's FHR as 144 bpm, which is up from the 119 it was last week.

I didn't cry during this scan, though I grinned like an idiot when the tech pointed out the flash that was Nugget's heart. I still haven't gotten to listen to the heartbeat, but this was the first time I could see it clear as day.

Back to the waiting room until we could see Dr. Colleague. Of all the doctors in the practice, she is definitely the warmest and fuzziest. She's also quite animated. We decided we liked her a lot. She remembered that she did my retrieval and was all handshakes and happy talk.

"The baby's grown beautifully," she told us. "The heart rate is gorgeous."

But what about those pesky hCG levels? 

She said, "We shouldn't be seeing what we're seeing [on the ultrasound] with numbers like these, but we are. So we don't care about the numbers anymore."

She said, "We know what hCG is supposed to do, but most women aren't getting their levels checked every four days. So what do we know, really?"

She said, "I don't want to get your hopes up, When I see numbers like these it usually means miscarriage."

But she also told us about a patient she had in her previous practice that had numbers like mine, where the hCG was super low and slow and never doubled properly. That patient begged her to schedule a D&E, because clearly the baby wasn't going to make it. Dr. Colleague told her they couldn't do that as long as the heart was beating. 

That heart never stopped beating, and she went on to deliver a healthy baby.

"You could be our - I don't want to say one in a million, more like one in a hundred thousand. You could be that one in a hundred thousand who defies all odds."

She told us we didn't have to come back for a week. She said, "I'm sure these ultrasounds every four days aren't doing anything to help your anxiety level."

So we go back next Tuesday. I'm pregnant for at least another week.

We left in two very different places, me and Mr. Hope. I felt lighter, less burdened. Nugget was alive! Nugget's heart was beating stronger! Nugget's stubborn, just like her mama.

Mr. Hope, on the other hand, seemed lower, more burdened. "Talk to me," I said. "What are you thinking?"

He shrugged. "That was good news, I guess."

Talk about a role reversal!

It's like Mr. Hope landed where I've been, in the painful limbo where you just want to know: is the baby going to live or is the baby going to die? For whatever reason, I'm getting more comfortable with the uncertainty, while he's growing less comfortable with it.

I updated the people who needed to be updated. People aren't even sure what to say anymore. They tell me they're "cautiously optimistic" or that they're holding their breath or saying prayers. It's nice and yet at the same time I feel horrible that I've dragged them into this limbo with us. Quirky's response was the best: "Geez!!! I guess there's still a chance?!?"

Guess so. 

Yesterday I was exhausted - I've been SO tired lately - but late afternoon I went into the kitchen to cook. I queued up some Taylor Swift (because obviously I'm turning into a 12-year-old girl) and then proceeded to dance my ass off as I made gumbo. 

Like I said: lighter than I've felt in weeks.

Speaking of, I dropped 6.2 lbs. of water weight in the past two days. I'm only a few pounds up from where I was pre-Christmas. I've upped my protein and veg intake and have been guzzling water like a boss. I've read that sometimes the sac can read smaller if the mother is dehydrated, and I know my water intake hasn't been great the past week. Yesterday I had about 140 oz. of pure water, plus 16 oz. of milk, 20 oz. of decaf coffee, and 12 oz. of rooibos tea. So, yeah. DEFINITELY pumping my system full of liquids!