Another Surgery & Thoughts on God

Another Surgery & Thoughts on God

I recently did a post-surgery ultrasound to check to see if my body went back to normal after my surgery in September (due to missed miscarriage). I’ve had so many ultrasounds over the years that I’ve learned to spot abnormalities on the ultrasound even before the ultrasound tech shows any indication of something being off. Unfortunately, this time I was looking at a black mass on the ultrasound screen that I knew should not have been there. 

The ultrasound tech could not confirm exactly what the black mass was and said she would show the images to my doctor to review and he would get back to me within the next few days (due to him being out of the office). On the morning of October 15th I did my own Pregnancy and Infant Loss Remembrance Loss Day at home. That was the first time I participated and although it was therapeutic it was also emotionally draining. So imagine how I felt when later that afternoon I got the phone call that there was in fact something off about my ultrasound. My doctor referred to that black mass and said, “It could either be retained products of conception or it could be an indicator of Persistent Gestational Trophoblastic Disease from a partial molar pregnancy. But we should definitely do a second surgery.” In the past I needed two surgeries from one miscarriage to clear my uterus, which was not a big deal other than the inconvenience of a second surgery. But the main difference between that time and this time is that I wasn’t dealing with a partial molar pregnancy before. 

 

This ultrasound photo is not a picture of my ultrasound, but it appears very similar to what mine looked like with a black mass and cloudy or “snowstorm” appearance surrounding it, typically found with molar pregnancies.

 

 

I asked my doctor, “So what’s the next step if this second surgery doesn’t work and it looks like something is still there or develops more?” My doctor told me that I would need to start the medication Methotrexate. His nurse had mentioned that same medication a few days prior when I asked her a similar question. I had assumed that Methotrexate was similar to Misoprostol, which is a common medication I’ve had just prior to each of my surgeries for miscarriages. Misoprostol is a medication softens the uterine lining to make the surgery process easier. I decided to Google what this new medication Methotrexate was, since I was unfamiliar with it. Neither my doctor nor my nurse fully explained what it was. As I was reading the description, all the words fell away except one…chemotherapy. Methotrexate is in fact a type of medication to treat cancer. 

My doctor wanted me to have my surgery the following day, but I chose to wait a couple days so I wouldn’t have to take time off work. On Monday (October 21st) I went to my usual surgery center. Out of curiosity I asked my doctor how many times I’ve had surgery there, because I had actually lost count. He looked at my paperwork and told me that this was my fifth surgery there. That did not include the two surgeries I had out-of-state in Seattle for my first and second round of IVF. So in total I’ve had seven surgeries related to infertility and miscarriages from 2016 – 2019. 

As of today, October 24th, I’m still waiting for the pathology report to learn what exactly that black mass was. Ultimately this next phone call from my doctor will determine whether I will need chemotherapy or not. I’ve been trying not to worry about it, although the first few days after the 15th were the hardest. I was tossing and turning at night and not getting enough sleep. I told my husband and my Mom. Both of them tried to reassure me by saying “Try not to worry.” But the primary emotion I was feeling was not worry, it was anger.

I was angry at God. I was so angry and frustrated for all of these years of struggling and now He decided to throw in a potential cancer diagnosis. Then my thoughts began to expand out to everyone I’ve known who has battled cancer and how much they suffered. I was thinking, “How could a God allow so much suffering?” God took my Dad away from cancer in 2016 and my mom has survived cancer twice. Then I kept seeing so many commercials on TV for St. Judes Children’s Research Hospital with all those little kids and babies who were completely innocent suffering from cancer. I just could not wrap my mind around any of this.

But I had a conversation with my Mom the other day on the phone that helped me to see things differently. Mind you, I’m not particularly religious. I was “saved” years ago, but after dealing with so much loss over the years my relationship with God was now hanging by a thread. After talking with Mom it helped solidify a thought I had and bring it more to the forefront of my mind. I believe there is a Creator, something greater than us that helped get this world spinning. But as far as a God that intervenes in our daily struggles, well I’ve moved on from that belief. 

Believe it or not, I feel more at peace with this concept that God does not intervene. I still believe there is a usefulness to prayer. It can be a way to socially connect on a deeper level and to set positive intentions together. Prayer can also bring us the quiet contemplation we need to help us to potentially find solutions to our problems if we choose to use prayer in that way. What I no longer believe is that praying hard and often leads to the outcome we want. I prayed so hard for each of my babies and set all my intention on positive outcomes. It was suggested to me by various people that perhaps I wasn’t “praying hard enough” or that I needed to “pray more.” I think my issue at the time was my idea of God was changing yet the people around me continued to talk about God the way I used to view Him. These past several years I felt like giving up on my faith. It took me so long to develop a new view of God that He could simply be a Creator and not necessarily an intervener. For me at least this brings me a sense of comfort and peace.

I should be getting my pathology results here soon. I will let you all know what they are once I get them. For now I will be taking it easy resting after this recent surgery. I went back to work the following day after my surgery, which I think was good for me because it serves as a good distraction. I’m trying to take it easy this first week as far as movement goes, by taking a break from exercising. I feel pretty good but have some twinges of pain here and there. I’m going to try to stay optimistic while I wait for my results.

Thank you for reading. 🙂

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Have your spiritual beliefs changed over time through your infertility struggles? If so, how have they changed?

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Featured Photo Image Source for Ultrasound Picture: MedPix National Library of Medicine
URL:
https://medpix.nlm.nih.gov/case?id=7fd9d54c-da23-4248-bb30-bd4993d6efb9

Results from Anora Test

Results from Anora Test

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My husband and I were debating whether to do the Anora test from this pregnancy loss. We’ve done the test before with two of our other miscarriages. Both of those tests determined that the embryos had a chromosomal abnormality caused by maternal origin. One had Trisomy 15 and the other had Trisomy 16. My other miscarriages we did not test. At first he and I were leaning towards not doing the test for my most recent loss this September, because we assumed it would be the same exact scenario of a Trisomy due to maternal origin. We believed it would have been a waste of time and money. But my doctor had a good reason to try to talk us into doing the test again.

 

Now that we have recently found out I have the MTHFR gene mutation, my doctor wanted to determine whether this embryo had a chromosomal abnormality. He said, “If the embryo does not have a chromosomal abnormality we might have you try Lovenox.” Lovenox is a medication used to help during pregnancy for women who have a MTHFR gene mutation. He said that he would talk to my out-of-state doctor as far as the next steps after the Anora results.

 

When my doctor called me several days later with the results he said, “It was a triploidy of paternal origin.” This was the first time my egg quality had nothing to do with the chromosomal abnormality. But unfortunately, now we also have a chromosomal abnormality issue from my husband’s side (paternal origin). So I’m unsure whether I will still need to take Lovenox or not as a precaution with my next pregnancy. That’s one of the questions I need to ask him. He explained there were two YY chromosomes in this embryo, in other words two sperm had entered one egg. I remembered that the clinic I went to just prior to my current doctor believed this pregnancy was either one of two things; 1) pregnancy with multiple embryos, or 2) a molar pregnancy. 

 

But he confirmed this was not a pregnancy with multiples, and that it could be a partial molar pregnancy. A molar pregnancy is bad for several reasons. I was feeling very overwhelmed because I had done prior research and understood that molar pregnancies could cause some serious complications. Even with the D&C surgery, it is possible the partial molar pregnancy could have already triggered issues in my body.

 

A partial molar pregnancy, from what I understand, is when the cells of the baby can mutate within the mother’s womb and cause tumors within the uterus. The worst case scenarios for a molar pregnancy is permanent infertility and/or cancer. Even as I am writing this now I paused my typing for a few moments and I feel a sense of dread. Two terrible possible outcomes. So why does my doctor think it might be a partial molar pregnancy? He said one of the possible complications of a triploidy of paternal origin (the results of my Anora test on the embryo) is a molar pregnancy. And one of the possible complications of a molar pregnancy can lead to something called Persistent Trophoblastic Disease (PTD), which is caused when tissue from a molar pregnancy isn’t completely removed. 

 

Genetic-events-occurring-in-normal-conceptions-and-complete-and-partial-molar-pregnancies

Image of normal conception compared to complete mole and partial mole. Partial mole shows two paternal sets of genes resulting in in non-viable fetus.

 

PTD can lead to Gestational Trophoblastic Disease (GTD) and this can lead to Choriocarcinoma which is a fast-spreading cancer that starts in the uterus. Needless to say I’m feeling overwhelmed. I asked my doctor how they would know if it was a partial molar pregnancy and he said, “We have to check your blood levels weekly to make sure your hCG levels are dropping back down to zero. If they don’t drop down to zero within a few weeks it could indicate a partial molar pregnancy.”

 

I did some research about molar pregnancies prior to talking to my current doctor, the reason being that my previous doctor said, “It’s either multiples or a molar pregnancy.” With a molar pregnancy the hCG level rises so dramatically it can be mistaken for a pregnancy of multiples. My first doctor said my hCG level was 81,000 when a normal range at that time would have been around 3,000. Clearly my levels were very high.

 

So there is a very real possibility that I might have to deal with the after effects of a partial molar pregnancy. It’s already affecting my plans. I was planning to do my Frozen Embryo Transfer (FET) in December 2019. I was going to do the Saline Infusion Sonohysterography (SIS) procedure to make sure my uterus was good to go with no abnormalities and then be jetting off to my procedure in Seattle. My doctor said, “Unfortunately both [doctor in Seattle] and I think that it would be best to postpone your FET until we rule out a partial molar pregnancy. Two months is just not enough time to figure that out. We will need to do weekly blood draws until your hCG drops down to zero. Once it drops down to zero we will need to monitor your blood levels each month for six months. He and I think that you should wait at least six months before you do the transfer.” Some websites suggested waiting 6-12 months before trying again. The risk of doing it too early is it could trigger the cells to become cancerous. So at the earliest I could do my FET in April 2020. 

 

I have my 2-week post-op doctor appointment here on Thursday. I’ll be doing my first weekly blood draw on that day. My doctor will also be putting me on birth control for a while, I’m assuming until I am ready to start my FET protocol which could be anywhere from 6-12 months from now. My little embryo has been waiting so long already and I hate to think that it has to sit even longer. But like my doctor and I agreed over the phone, “It’s better to be safe than sorry.”

 

I’ve had so much bad luck over these years I’ve come to expect it. I suppose it has become a defense mechanism of sorts. “Hope for the best but expect the worst.” Part of me feels like if I don’t expect the worst then I won’t be mentally prepared to handle it when it comes. Like with this situation for example, I was already learning what molar pregnancies were before my current doctor said this is what we might be dealing with. Initially I was very overwhelmed after that phone call. But what can you do? You just have to follow the doctors orders and learn what you can online about whatever issue you are dealing with. If there is nothing you can do about the situation in that moment you just have to let it be. Personally, I think it’s better to do research shortly before meeting with your doctor so you can at least be prepared with certain questions. By doing that closer to your appointment you are less likely to sit there stewing on potential negative outcomes. Granted, I am saying this about a diagnosis that has not been confirmed as cancerous. I believe if I was diagnosed with cancer I would probably be researching every corner of the internet to figure out how to get rid of it. But for now, I am trying to guard myself against “worst-case scenario” thinking. The best way I know how to do that is to distract myself.

 

I’ve been listening to my audio book and watching TV lately as a distraction.  Maybe I’ll listen to my audiobook while I clean the house. My house could use a good clutter clean, deep clean, and every other clean in between. I suppose that would help me take my mind off of this too. I think it’s so important to lean on healthy coping skills during the times that we are worried about the future. Beyond distraction comes acceptance, learning, and healing. With each new obstacle that comes my way I choose to remain determined to keep moving forward and do everything I can to create our family. I want to look back on these times and know without a doubt I did absolutely everything I could.

 

Thank you for reading. 

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Featured Image Credit: Doctor Reading Results Photo by rawpixel.com from Pexels

Image Credit: Partial Molar Pregnancy Diagram by Phillip Savage on ResearchGate

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