Monday, May 8, 2023

The Rate-Determining Step

I am not sure if it has come up here before (probably so since I have written about all kinds of things over the years), but there was a significant portion of my life when I wanted to be a medical doctor. Life, my science grades, and my test scores took me in a different direction, and I never tried to retake the MCAT or reapply to medical school. But before all of that, I still learned quite a bit of chemistry. For some reason, I recently remembered the term "rate-determining step," which in the chemistry world refers to the slowest step of a chemical reaction. This step (often?) determines how quickly the rest of the reaction can proceed. My general chemistry professor, Dr. Dopke, explained it something like this: if we decided we wanted to go to the beach in Florida (leaving from Mercer's Macon campus in central Georgia), there would be a few steps involved. We'd need to (1) head back to our rooms/homes, (2) pack our bags, (3) load up the car (and maybe get gas), and (4) actually drive to the beach. Some people lived closer to the Willet Science Center than others, so the duration of step 1 would vary a bit. Similarly, some people pack deliberately, and others throw a few things in a bag and head out. Even with those differences, what would really impact the travel time would be step 4: getting from central Georgia to some coastal area in Florida.

Lately, I have been thinking about how much I shared as we navigated fertility treatments and how quiet I have been through pregnancy (comparatively). Medically, I have been fortunate to have an uncomplicated pregnancy, but I remained guarded because I had gotten my hopes up so many times when we were trying to make embryos and stay pregnant. I also remembered how hard it was to see what felt like the rest of the world moving forward with growing their families while no amount of hoping, praying, or throwing money at the problem seemed to work. While any updates I posted about my pregnancy were met with support and enthusiasm, I didn't want to trigger other people who were still in the infertility trenches. The days kept ticking by, though, and every week was a little better. Then when I reached 32 weeks back in March, my doctor started bringing me in for twice-weekly ultrasounds (thank you, hypothyroidism and pregnancy!) and told me we would schedule an induction for the baby. That initiated a whole new series of worries that maybe there was more wrong with me than I realized. Eventually, I grew to welcome the little visits to see how the baby was progressing--largely because everything looked good at each visit. 

Going back to the chemistry analogy, pregnancy has, in many ways, been the rate-determining step in our journey to grow our family. Cumulatively, the nearly three years we spent trying to conceive were longer in duration than this pregnancy, but there was a conclusion at the end of each month; not pregnant, try again. Each IVF cycle had its own mini-steps where I could provide updates: follicle measurements, retrieval numbers, fertilization numbers, blastocyst numbers, and testing results. Our first two embryo transfers led to short-lived pregnancies, so I always had an update about those as well. With this pregnancy, however, each appointment or update was the same: still pregnant, probably going to have a baby, but no guarantees that some unusual circumstance could strike.

We scheduled the induction for today, and I am writing this post with an IV in my arm. I am getting fluids and medication through the IV, and the contractions are starting but are mild. At my ultrasound on Thursday (May 4), Baby Davis's estimated weight was 9 pounds, 10 ounces. My doctor reported that the baby was still sitting up high, and my cervix was closed. Like for real closed. It turns out this baby is smart like their parents and figured out that life on the inside is pretty sweet. We discussed a possible C-section instead of induction, but I told him I would like to try labor and see if I could deliver vaginally. So, that's where we are at the moment. Ultimately, our goals are (1) a healthy mom and (2) a healthy baby.

After I was all hooked up this morning, our nurse told me she would be watching the baby for any changes while I rested. We have been listening to the baby's heartbeat on the monitors. Before I drifted off for a short nap, I told Richard that I was glad to be in the hospital so if anything did turn south, we would have a team ready to take the baby out and give us both the care we need so we can achieve our two goals. I am surprised at how reassured I am by the sound of this little heartbeat, and I can't wait for the end of our rate-determining step as we proceed into parenthood.

Until that happens, we continue to welcome thoughts, prayers, gender guesses, and funny labor stories. I'm going to take another nap.

Tuesday, January 10, 2023

Anniversaries and Pregnancy

It's been a while. I'm still here and still pregnant. These are both good things, though the holidays and today specifically have been tougher than I would like to admit.

Balancing grief due to pregnancy loss and excitement from a pregnancy that seems to be working out is challenging. The holidays hit me hard as I thought about the two babies who did not make it to see Christmas 2022 with us. Someone encouraged me not to think about the babies that didn't make it but to look forward to the sweet one on the way. Even with such early losses, I never want to forget; it does not seem fair to them or to me. 

Fortunately (at times anyway), I rarely forget something that feels important to me. As long as I can remember, I have always been good at keeping track of dates. Weirdly, I was not a superstar history student, but I can recall dates from my personal life well. This is a double-edged sword on days like today. January 10, 2022 was my first ultrasound appointment that wasn't checking for follicles or looking at the thickness of my uterine lining. (There were so many of those!) After several positive but slow-growing betas following our fresh embryo transfer in December 2021, we had an early OB appointment to check on our embryos. While I was nervous that slow-rising betas could mean an ectopic pregnancy, I was hopeful for good news.

I thought we were in the clear as long as the embryo had implanted in my uterus and not my fallopian tubes, but I learned that morning that a blighted ovum (anembryonic pregnancy) was not only a thing that could happen but a thing that was happening to me. I will never forget my doctor repeating, "I don't like what I'm seeing." Those words still haunt me; I hear them in my doctor's voice because that's how they're cemented in my memory.

A year later, I am 22 weeks and 5 days pregnant with what we hope will be the first child we get to meet in person. But also a year later, I find it difficult to be truly excited about an ultrasound. 

I haven not posted many pregnancy updates for several reasons. One is that I find baby bump shots kind of triggering, though I did totally buy into the silly trend to take a picture with Ben and Jerry's Half Baked ice cream when I hit 20 weeks pregnant (halfway). Another reason is that I have not been able to shake the feeling that the other shoe is about to drop. Pregnancy after infertility is a wild ride, even if the pregnancy itself is relatively uneventful (which mine has been so far, thankfully). It's difficult for others who have not walked this road to understand why I often feel that healthy babies happen to other people, not to me. 

I ran across my letter board in my closet today, and I have not redone it in a year. It still has the same vocabulary-themed message I wrote last January, even though I could have been using it over the past few months to share updates or write about how the baby is the size of various foods or 80's and 90's nostalgia items--I think Furby week is next week!--as reported in the pregnancy apps. Overall, though, we are doing well and hopeful that our estimated due date of May 11 (or somewhere around there because babies seem to do what they want) will be the day we have dreamed about and waited for. Please remember us over the next few months; perhaps I will update again, but I'm always happy to talk outside of the blog about the candy I am eating, how many naps I have taken lately, or what my latest maternity clothing purchase has been (lately it's running clothes!)

Special jewelry my friends have sent to help me remember the journey, our babies, and our incredible support network.

Something that made today great: I checked several tasks off of my mounting to-do list at work! 

Time I woke up: 8:55 am