Adam Louis

This is the fourth of six posts I'm writing about our babies in heaven. Thank you for continuing to remember them with me as we go through the process of naming each of them. They are all loved and missed! You can find the previous three posts here: Emily Grace, Callie Elizabeth, and Luke Daniel.
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The year 2004 had brought our third miscarriage in three years. It felt like we'd been through so much, but we had no idea what was still to come. Our fourth pregnancy would be one of the most difficult and darkest times we would face. (And I'm sure this post will be a long one as there are a lot more details about this pregnancy. Thanks in advance for sticking with me.)

While we had begun some initial testing, it was at this point that we realized it was time to really investigate what might be going wrong. The first step was exploratory surgery, which we scheduled with our specialist on November 12. During the hysteroscopy, the doctor could not see both of my fallopian tubes at the same time with the scope, suggesting that my uterus had a different shape or an obstruction.

The next step was an MRI and and IVP test, which we scheduled for December 2. The tests came back showing the better of the two scenarios that the doctor suspected -- I had a septum (like a wall) dividing my uterus. She told us it's a congenital deformity and that it was likely to be the cause of my miscarriages, considering it can create concave areas in the uterus, making it difficult for a baby to grow. The really good news was that it could be corrected with outpatient surgery.

I wasn't excited about hearing that news, but it definitely gave us something to hold on to. This could be the answer! Maybe we finally had a REASON, medically speaking. We started 2005 with a renewed hope and on January 21, just a few days before my 28th birthday, I had surgery to remove the uterine septum. The doctor also looked for endometriosis, which she didn't find. We felt like we were in good shape to start trying again after some time to heal. I didn't have a regular cycle until March, and then I decided to have my wisdom teeth pulled in April. After all of that was done we were ready.

The positive pregnancy test came on June 9, 2005. It was the start of a roller coaster of emotions, with the biggest ups and downs we had experienced yet. I had still been using the progesterone and following the routine that I explained in my last post, so on day 30 I took a home test. It was negative. It was my fourth time around, though, and I had a feeling otherwise. Four days later I took another one. Positive. I went that same day for blood work. HCG 1266 and progesterone 41. Great news, they said. Things looked promising.

We went in for the first ultrasound on June 20 but saw only a gestational sac. This did not devastate us. We still felt very positive and thought we needed to give it some more time. When we saw the doctor that day, though, we were surprised (unpleasantly so) to discover two things: first, our regular doctor was gone. She wasn't working there anymore and we did not like this new doctor. Second, the new doctor (whose bedside manner was lacking all sensitivity) abruptly told us that the sac looked too large and the numbers were too high. She didn't think the pregnancy would last.

Folks, I don't need a doctor to coddle me or try to make me think things are okay when they're not. But her delivery was awful. I had more blood drawn and we left feeling frustrated, confused, and lost. We had a real connection with the other doctor and she was gone. We went there that day thinking our baby was okay and left thinking we'd lost another one. The news came that night: my HCG and progesterone were still looking very good. We scheduled another ultrasound. In the meantime, we decided to try calling our other doctor, the one who had left. We felt funny about calling her at home but we were so unsettled and didn't know where else to turn. She answered, and she was totally great about it. Even better, she told us she had moved to an office in Houston and that we could follow her there if it was what we wanted. It was.

We kept the ultrasound appointment that we'd already made (June 27), and we went in praying that we would see a yolk sac this time. We did! We were relieved... until Dr Doom came in to tell us again that it wasn't going to work. I know that a big part of the anger and frustration we felt at that time was out of sheer denial, or refusal to accept more bad news. We weren't doubting the doctor's ability to do her job, but we couldn't understand why she did not seem willing to let us have an ounce of hope. Things WERE progressing, and until they weren't, we were going to have some HOPE. After some persuading, she agreed to do another ultrasound in two weeks.

July 11 finally arrived. We had prayed our hearts out. We'd even decided to tell our church family this time so they could be praying with us. And after all that hoping and all that praying, there it was: a heartbeat. Our baby looked amazing. There was the little head, the body, and the arm and leg buds! The baby was measuring 8 weeks, 2 days, and even the doubting doctor seemed surprised. She said that aside from a bit of a fast heart rate, the baby looked fine. Today as I write this eight years later, I'm looking at the cherished ultrasound pictures, paperclipped in my journal, of that sweet little baby. He was our dream come true. Our hearts were so full of love for that miracle.

After that visit, we made the decision to make our next appointment with the doctor with whom we felt more comfortable. Even if the news was going to be bad, we preferred to hear it from her. We informed the doctor and had our records transferred to the new office. A week later, on July 18, we made the hour-long drive to the see our old doctor. We were excited to have the ultrasound and get another look at our growing baby. And the baby HAD grown, measuring 9 weeks. And there were the chambers of the heart... but the heart wasn't beating. We saw it as plainly as she did. Our doctor was surprised. We were shocked. It had been only a week -- just 7 days -- since we'd seen the heartbeat, and our baby had died.

After we talked to the doctor for a little while, she checked again just to be sure of what we saw. I appreciate that she did that for us, but we knew it was over. It felt like she was giving us a moment to say goodbye as we took one last long look at the screen. She asked me if we wanted her to print a picture and I said yes. I have that picture here with me now, too, that last precious image of our baby. He looks perfect to me, even though I know his heart wasn't beating and his soul was in heaven. It breaks my heart to see it, but I'm grateful to have it.

Every loss is hard. This one was particularly hard for us. We felt more heartbroken than ever. There had been so much hope and so many prayers -- so many of them answered in those 9 weeks. We were learning to trust a God who loves us and cares about us, and who sees the bigger picture and knows all of the answers to our questions.

I'm thankful that we got to spend as much time carrying this child as we did. We got to see him on an ultrasound screen more times than we had with any other pregnancy. We watched him grow and saw that flickering heartbeat, reassuring us that he was here and he was real. He had lived longer than any of our other babies had to date. And I'm thankful that we got to stick with a doctor who was sensitive and considerate of our needs during that time. On the day of the D&C, she invited us to her office to do a final ultrasound so we could be certain. Again, I know she did that just for us. There was no lingering look this time, and she did that for our benefit, too. Even though I know he'd already gone to heaven by then, we said goodbye to our fourth baby on July 22, 2005.

We've named our second son Adam Louis.
Adam is a name I've come to love in recent years. I considered it for Anna if she'd been a boy. The last name Adams is a family name on my mom's side. Louis is my husband's middle name, and had been his paternal grandfather's middle name as well. Of course I love having a son named after both of them, and I also really like that Louis is a French name. It reflects our heritage and is part of our home state, Louisiana's, name, too. Louis means "famous warrior," and we certainly felt that our little guy was a fighter. Our Adam Louis's name was chosen with lots of love and from a long line of family names from both sides of our family.

Adam Louis,
Your daddy and I are so grateful for the time we got to spend with you. We never got to hold you, but we knew you and loved you so much while we prayed and hoped for you for nine weeks. Thank you for giving us that hope and for teaching us to keep holding on, no matter what. You were worth it! We love you and can't wait to see you again one day.
Love, Mommy

Two Weeks and Two Days

Hello dear friends!

Baby Lily is here and we are all at home and doing well. Thank you so much for all of the wonderful comments about her birth day. Those will be really fun to share with her one day!

So much has happened over the past two weeks and two days -- since Lily Rae's arrival. I will try to give you the short version rather than something that might take hours to read. First let me say that the baby is absolutely great. She is... amazing, wonderful, perfect! I truly am tempted to spend my days just staring at her. She has the deepest eyes, cutest button nose, perfect heart-shaped lips, and the longest little fingers I've ever seen on a baby. :)

We came home from the hospital on Friday night (September 24) after having to wait a few extra hours for her bilirubin results to come in. Lily had a little bit of jaundice in the hospital, but they let us go ahead and go home as long as we took her in to the clinic over the weekend to have it re-checked. The bilirubin got up to 16 and then started to decrease by Sunday, much to our relief. In addition, Lily's birth weight was 8 pounds 10 ounces, but it was down to 7 pounds 9 ounces when we were discharged. She has continued to gain weight since then, though, and this week she was back up to her exact birth weight at her two-week check up. Yay Lily!

I can't tell you how relieved I am that she has done so well, especially since the last two weeks have been quite difficult for me as far as recovery goes. I'm not really sure why, but things seemed to go haywire as soon as I left the hospital. During the first weekend at home I started having shortness of breath and chest pain, which made it almost impossible for me to get any rest. I would wake up gasping for air and terrified that I was going to stop breathing. My blood pressure shot up (which is very uncommon for me and never happened during my pregnancy) and my ankles and feet began to swell quite a bit. With all of that going on plus the recovery from my c-section, I felt absolutely horrible. There is no way I could have made it through that weekend if I hadn't had my mom and sister here to help with the baby.

After making a few calls to the doctor on call over the weekend and trying to avoid the ER, I went to see my OB first thing Monday morning. She immediately sent me over to the ER to make sure I didn't have a pulmonary embolism. I was pretty freaked out at that point, but the CT scan of my chest turned out clear. The ER doc has had me following up with a cardiologist as well, and so far my echocardiogram and blood tests have all looked good. Over the past couple of days my swelling and blood pressure have also decreased. It's frustrating to not know why everything went crazy, but I'm just beyond relieved that I actually am starting to feel normal again. For a while there I felt like it would never happen. Every day is getting better now and I'm able to enjoy this precious baby girl more and more.

My mom is still here, thankfully! She has helped me out so much for the past few weeks. I truly don't know how I would have been able to make it through the days and especially the nights without her help. She is an awesome Granny! I know Lily will miss her as much as I will when she goes back home this weekend.

Breastfeeding has been a struggle all its own for the past few weeks. Again, Lily Rae is fantastic. She is such a good baby and I've been amazed at how patient and adaptable she has been through all of my trials and errors. We started out pretty well with nursing in the hospital, but we had to supplement with formula for a few days after we came home to get her over the jaundice. Besides that, I had to dump my breast milk for 48 hours after having the iodine for the CT scan. We went through a very rough patch afterwards where I had to continue pumping and giving her the milk in a bottle while my breasts were on the mend. I'm happy to say that for the past three days we have gotten back into a good nursing routine! I'm so proud of this baby girl for sticking with it and not giving up while I struggled. Nursing continues to be a challenge but I am persevering.

I have to admit that, all things considered, this recovery time has been one of the toughest things I've ever been through. Of course it has a huge reward and it's worth every tear and every small setback. Simply looking at her sweet face and remembering all it took to get to this point are all I need to do to find the motivation to press on. I know it will be at least a few more weeks before I truly feel better. I really can't help but wonder what in the world people were talking about when they told me that c-sections were "no big deal"!

We are hanging in there and making progress every day, and that's a huge improvement as far as I'm concerned! Thanks for thinking of us and for praying for Lily's safe arrival. I still can't quite believe that this beautiful girl is here in our home and is ours to keep. Thank you, Lord!

Soon I will post some of our favorite pictures of our little bundle of joy from her first two weeks of life. She looks so different from those very first images in the operating room! Here is one of my favorites until then...

My Story - Part 3

Pregnancy #4
The next pregnancy was in June of 2005. Feeling very encouraged about having fixed a problem, we were on cloud nine. We were a little nervous, of course, but we felt like this would be The One. My first blood tests looked great – HCG was high and progesterone was good. It was time for what had become for us the dreaded first ultrasound. The ultrasound showed only a gestational sac but we weren’t too terribly worried just yet, especially with the good blood tests. The worst part of the visit was when we discovered that our beloved doctor had moved away since our last visit! We were very sad and to make things worse, we REALLY disliked the other doctor at that office. The new doctor totally squashed our hopes when she said she thought the numbers were too high and the sac looked too large. Even though I loathed her bedside manner, I was sure she was a skilled doctor, so we tried to keep ourselves level-headed and just hear all the facts. We had blood drawn again and a few days later heard that the numbers still looked great. We were so confused.
Now we were dealing with a new problem – finding a new doctor. Not because she gave us bad news, but because our personalities just didn’t click. At all. We had another ultrasound at that office with the hopes of seeing a yolk sac – and we did! But Dr. Doom stepped in and again said not to get our hopes up. She said to come back in two weeks and then we should know for sure. Two weeks later, it was the best ultrasound we’d ever had. The baby measured at a little over 8 weeks and we could see a heartbeat and even tiny little leg buds on the body. The doc had to admit that the baby looked great! We breathed a huge sigh of relief but were still thinking we wanted to change doctors.
After some investigating we found out that our other doctor had simply moved to another practice in the city. We gave her a call and she kindly invited us to visit her at the new office. About a week later we went to see her and she did another ultrasound. I remember it was the toughest day of our whole infertility experience at that time. The baby had grown to 9 weeks but the heart was no longer beating. No one knew why. We had no clue that something had gone wrong. We were devastated. A few days later we had one more ultrasound to be certain that there was no change. It was definitely over, so we scheduled another D&C for July 22, 2005. We felt we were back at square one.
The next few months were filled with more doctors: a high-risk pregnancy doctor, a genetic counselor, our fertility specialist, and even a urologist (to check my husband’s sperm for fragmentation – that didn’t pan out). It was really disheartening to see that our specialist was just about as stumped as we were.
I have to admit at this point that I was very, very frustrated. It made me angry that we had thus far tried everything the doctors could think of and we were continually given the advice, “Try again and see what happens.” That’s extremely hard to hear. I want to keep trying to have a full-term pregnancy, sure, but as I keep trying we keep losing one baby after another. That’s just not ok with me. We are very serious about being cautious and wise about these decisions. We refused to try unless we had made some change that hopefully would work. We’ve never had an “accidental” pregnancy. It’s always very well thought out and planned according to our treatment. When we don’t want to get pregnant, we use protection. Along the way we’ve never been told by a doctor that this just will never work out.

Pregnancy #5
After another full year of tests and doctors and with a new plan we attempted another pregnancy. It came along in July of 2006. I had previously been diagnosed with the MTHFR mutation and had been on extra folic acid along with baby aspirin for years. But the high-risk pregnancy doctor I started seeing suggested that we have tests to check for any blood clotting disorders. After reviewing the tests he thought it was possible that, although my homocysteine level was not unusual, I may have problems related to Thrombophilia, and thought that using the blood thinner Lovenox during pregnancy might help me. I immediately started using the Lovenox injections in my stomach when I found out I was pregnant. It wasn’t a pleasant thing to do every night, but I felt if it worked that it was a small price to pay.
Unfortunately it didn’t seem to help anything. I woke up the morning of August 8 feeling crampy and I had started bleeding. I had blood work just to verify that the numbers were dropping and that was miscarriage #5. It was over pretty quickly as I was just a few weeks along, and I did not have a D&C.

Pregnancy #6
This was my last pregnancy to date and it began in November, 2006. It was really more of the same with the doctors, blood work, and Lovenox injections. The HCG and progesterone levels looked good but the ultrasounds never did. We had a lot of them and although we did see some progression of the gestational sac and yolk sac, we never did see any growth of the baby. After 2 weeks had passed and we could still see no development, we knew that once again it wasn’t going to happen. I had a D&C later that January of 2007, just a few days before my 30th birthday.
That last pregnancy did bring about a few more changes. After a few visits with our trusted specialist where the three of us basically looked at each other and shrugged our shoulders, we realized that maybe it was time to move on. We have no hard feelings toward her but it was just time. I think she was truly out of ideas. We decided to seek out a different doctor. We felt like we had exhausted all of our options locally and decided to find another fertility specialist downtown. We began seeing him in July of 2007 and he has scheduled many tests and a couple of surgeries over the past year.
Here’s a quick rundown:
August 2007: Hysterosalpingogram (HSG) test – another dye test to check that my fallopian tubes are open and to look at the uterus by x-ray.

October 2007: Endometrial Function Test (EFT) – basically a biopsy of cells from the uterine lining. http://www.med.yale.edu/obgyn/kliman/resources/AIA%20vF.pdf
Those samples along with some of the tissue samples from past miscarriages were sent to a doctor at Yale University. The biopsy showed Glandular Developmental Arrest (GDA) but the overall diagnosis did not identify one problem that could be linked to all of my miscarriages. It was a little like getting punched in the stomach. Instead of one problem, we likely have several problems that contribute to recurrent miscarriage. (From what I understand, GDA is a problem where at certain stages of your cycle, the glands in the uterine lining cease to go through their normal changes or development.)

January 2008: Laparoscopy – Our new doctor wanted to do an exploratory laparoscopy. I could understand why. We had transferred hundreds of pages of our medical records to his office with tons of tests and some previous surgeries, all done by other doctors. His main areas of concern were the shape and condition of my uterus after the septum surgery, and the possibility that I may have developed any scar tissue or endometriosis. It did seem like a big deal for me to have yet another surgery just for a big “maybe,” but at the same time I knew that it could help. I was glad after it was over and we got the report. The doctor was able to use a laser to clean up the scar tissue that had formed where the septum had been (basically creating another septum although smaller) and he did in fact find and also clean up some endometriosis. That was a first for me. I had never been diagnosed with it before, but I do know that it can appear later even if it didn’t exist before. The doc definitely seemed pleased that we’d gone ahead with the surgery.

My Story - Part 2

Pregnancy #2
There were very hard times that followed that first experience. I was still nervous about trying again and afraid of what might happen. It was hard to escape the sadness of my situation and the feelings of emptiness and loss. My sister had her second baby boy that December and I got to be in the delivery room for that amazing experience! As thrilled as I was then and as much as I adore that 5-year-old and his big brother today, it was hard not to feel that same old pain.
In February of 2003 I found out I was pregnant for the second time. My fears came true when things progressed much like the first pregnancy. We knew for sure that things weren’t going well when the ultrasound at 11 weeks didn’t look good. This time I scheduled a D&C (in March, 2003) after I started bleeding the next day. I didn’t want the trauma of what had happened to me before. I definitely don’t feel that the surgery is an easy way to handle it. You still have the emotional pain and sadness, and you have to recover physically but for me it did take out the guessing and saved me some physical pain.
Of course, the worst part about miscarriage #2 was that now we realized we might be dealing with a problem. I’d had two very similar first trimesters and it seemed unlikely that it was just a coincidence. In August of 2003 we started seeing a fertility specialist. We live near a big city, but we were glad to find a good place that was just 15 minutes from home in our smaller town. We really liked our doctor and immediately felt a connection with her. My husband and I both had lots and lots of tests run to see if there was anything obvious that might be causing us problems. The tests revealed nothing “bad” – in fact they showed that my husband’s fertility was fantastic. Sure, that’s great news, but it did make me feel… well, crappy. I was pretty sure already that the problem was with me and it was really easy to let the guilt creep in. Fortunately, my husband reassured me that this was our problem and we would get through it together, no matter what any tests showed.

Pregnancy #3
The next year was really hard. It hadn’t taken us long to conceive either time before but now it didn’t happen until a year later, in September 2004. I’d spent the whole year counting cycle days, using progesterone supplements, having blood drawn twice a month, and taking pregnancy tests. This time, however, the pregnancy didn’t advance very far. I was only 6 weeks along and the HCG levels never got very high. I had the miscarriage at home and the next week we decided to go on a vacation. It was definitely time to get away. We spent a wonderful week in New England that October, making good memories in the midst of very difficult times.
After we got home we began talking to our doctor about having exploratory surgery. She thought it would be a good idea to have a look at my uterus and see if I had any kind of “structural” problem. We scheduled a hysteroscopy for that November, and the doctor did find that she could not see both of my fallopian tubes with the scope at the same time. This suggested that my uterus had a different shape than normal, but to be certain she wanted to do an MRI. The two possibilities were either a septum (or division) in my uterus or what was called a bicarnuate uterus. We set up the MRI for the next month, in December, and also did an IVP test – where dye is injected while they watch your kidney function by x-ray. Apparently some women with developmental problems of the uterus may only be born with one kidney, so the point of the IVP was to test my kidney function. My internal organs checked out fine and the MRI showed that I did have a septum, like a wall, dividing my uterus. We actually felt relieved. At last, an answer! The doctor reassured us that it was a fairly easy thing to correct. She was pretty sure that it may be the cause of our miscarriages since the septum creates concave areas in the uterus where it can be difficult for a baby to implant or grow.
(*By the way, I’m writing this based on notes I took in my journal at the time and am not going through the trouble of looking up all the official medical terms. Please excuse me if I’ve muddled it up too much!)
We began 2005 with a renewed hope and I was just sure it would be the year we’d have a baby. In January I had the laparoscopy/hysteroscopy to correct the septum. The doc said everything else looked fine – she didn’t find any signs of endometriosis or any other problem. We were feeling pretty good at that time that after I recovered we would be able to have a healthy pregnancy. I even had my wisdom teeth pulled a little while later so I could take care of that before the baby came along!