36 Weeks, Cholestasis & Induction

Yesterday I hit 36 weeks. Holy cow I feel so lucky to have made it this far.

While yesterday was a huge milestone, today is even bigger. It’s our last day hanging out with Nora before BBS arrives because…..I’m being induced tomorrow :0

A few weeks ago we scheduled my cerclage removal for tomorrow, Monday, the 19th. I’ll be 36 and 2 when the stitch comes out. But my doctors were torn on when I’d actually go into labor. My OB thought I’d go that day, while my MFM thought I’d go a few days later.

We don’t need to guess anymore because they decided as a team to induce me after the cerclage is removed (assuming I don’t go into labor only own). That’s nearly 14 weeks (3 1/2 months) of bed rest for BBS and I. Wow!

You might be wondering why they’d induce after I’ve come this far. Late last week it was confirmed that I developed cholestasis of pregnancy.  About 10 days ago my entire body started itching like crazy. At first it was mainly my hands and feet, but then it spread everywhere. 4 benadryls + an ambien couldn’t make me fall asleep through the itching. It was horrible. I called my OB’s night nurse and told her my symptoms. The next day my doctor sent me for lab work to test my liver function and bile acid. The results came in confirming the condition, UGH. Below is a quick overview of what Cholestasis is.

According to What to Expect:

Cholestasis is a liver disorder that most often occurs late in pregnancy, typically during the third trimester. While it  occurs in just one to two pregnancies in 1,000, it can cause complications in your newborn — which is why it’s important to recognize the symptoms and talk to your doctor if you think it might be affecting you. Fortunately, early diagnosis and active management by your doctor can help ensure you and your baby have a safe and healthy pregnancy and delivery.

A quick biology lesson: Bile, excreted by the liver and stored in the gallbladder, helps your body break down fats into fatty acids that your intestines can absorb. Cholestasis is a condition that slows down the normal flow of bile into the gallbladder, causing a buildup of bile acids in the liver — which in turn spills into the bloodstream, causing intense itching. Possible causes include:

Hormonal changes that occur during pregnancy (especially in the third trimester): Extra estrogen can increase cholesterol levels in bile and decrease gallbladder contractions.

Gestational diabetes: This disease is often associated with a higher risk of cholestasis.

Genetic disposition: If an immediate family member has had cholestasis during pregnancy, be sure to tell your doctor.

Gallstones: A collection of small stone masses in the gallbladder caused by imbalances of bile (pregnant women are also more at risk of gallstones due to increased estrogen levels) can also be the cause.

With regular prenatal care and monitoring, your baby will likely not be affected during pregnancy and after delivery. Studies have found little increased risk to babies when their mothers have only mild cholestasis and low amounts of bile acids. However, in cases when maternal bile acids are higher, cholestasis can increase baby’s risk of a low birth weight, a slightly lower Apgar score, lung immaturity and preterm delivery — which is why early diagnosis and treatment are so important. In extremely rare cases, stillbirth is a risk, though it may be prevented if labor is induced before week 38.

I can’t believe I’ve managed to add more goddamn lemons to my pile. But there you have it. Because this condition can put BBS at risk, we’re opting to induce at 36 and 2. In a perfect world, we’d wait until 37, but BBS’s non stress tests have been a mixed bag. So we’re choosing to be safe than sorry.

So this is it my friends. I thank you from the bottom of my heart for all of your love and support on this journey. Please send your continued good vibes my way – pray for an uncomplicated delivery and that BBS makes his debut healthy and happy.

I’ll post more once he’s born. But please be patient with me. Even though I’m being induced, he might not arrive until Tuesday. And even then, we’re going to want some family time to process this whole journey. If BBS goes to the NICU I expect that we’ll be quite busy with that – but I’ll do my best to post updates here for you all.

With all my love and thanks!

I heart how Maisey’s lurking in the corner of this pic. Haha

Trip Down Memory Lane

Update: We’re still chugging’ along (knock wood). My next ultrasound is on the 30th. Fingers crossed everything remains stable until then.

As BBS’s impending birth becomes more real to me, I can’t help but think back to when Nora was born. So much love. Love like I’ve never felt before.

I, like all second time parents to be, am worried I couldn’t possibly love another tiny human as much as I love Nora. But, after what BBS and I have been through, my love for him is already immense and it’ll just keep growing from here. I can’t wait to meet him (well, you know what I mean – I can’t wait for him to be done cooking and then meet him!).  I’ve been so heads down and focused on the immediate task at hand, that I lost sight of the joy in carrying and growing another human life. Don’t get me wrong though, I only allow myself to enjoy it in measured doses for fear of jinxing everything. Some of the fun things I’ve done recently are ordering decor for BBS’s nursery and personalized thank you cards for him. It’s been really nice to feel happy instead of scared and worried.

In the meantime, I never published Nora’s entire newborn photo shoot. There are lots of duds in there for sure – but I don’t even care anymore – I’m overwhelmed by love (and pregnancy hormones!) and want the world to see them all.  Hope you enjoy (esp the few that include Maisey — she’s such a character)…

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(Photo credit goes to Kim Lind Photography)

 

 

I’m 11 Months Old Today!

I can’t believe I’m 11 months old today! Mom tried to take my picture with the bear and age block on the rocking chair just as she’s done in past months, but I had other ideas. Check out the video below, haha!

I just spent a week on the east coast at my uncle Chuck’s house with all of my mom’s family for Thanksgiving. We had a blast. I got to hang out with all of my cousins and play the entire time! Mom posted a ton of pictures below for you to see.

I’m officially walking more than I crawl. My mom says I’m a force to be reckoned with. I have some serious ants in my pants and I love keeping her on her toes throughout the day. I’m super curious and adventurous — which means I’m often getting into things that mom says are “no-no’s”!

I babble and sing like it’s my job. I can say “dada”, “mama”, “mai-mai”, “E-I-E-I-O”, “Hi” and I can growl like a pirate “arrggh”.  I clap along to “If you’re happy and you know it” and I wave my arms like a crazy person for “Where is thumpkin?”

While I’ve made a lot of progress on the moving and communication fronts, I still have NO teeth! lol And I’m still a picky eater who wants everything pureed to a pulp. What can I say, I like what I like!

I met Santa Claus at the mall and helped mom and dad put up our Christmas Tree. It’s been an action-packed month! I wonder what excitement my 11th month will hold………

 

 

 

Curiosity Killed the Cat

2014 is shaping up to be a fine year — much better than craptastic 2013!

As you know, we’re finally pregnant (yay!). So many of you have reached out to offer your congratulations. I can tell that people are genuinely giddy with happiness over our baby girl.  A number of people sent me messages saying that they haven’t been this excited since they found out that they, themselves, were having a baby! It warms my heart to know that you all have been on this ride with me.  Through the bad, and now the good!

A number of people have asked me for details on the whole process. Rather than answer the same questions over and over, I’ll just list them all out for you. Here goes…..

1. Are you using a surrogate?
No, we did not have to go the surrogate route.  I had triple negative breast cancer, which means the cancer was not hormone driven. Which means I’m not on hormone blockers for 10 years post chemo. Which means I can safely carry a pregnancy. That was my belly bump in the last post 🙂

2. See, I told you you’d get pregnant when you least expected!
No, this was not a surprise pregnancy. This was a well thought out, and highly planned pregnancy. We used our frozen embryos and availed ourselves of the best medical science has to offer!

3. So IVF worked the first time you tried after cancer and chemo?
Sadly, no.  This was our third embryo transfer post chemo. We did a transfer last summer, another last fall, and then this last one — which worked — in April.

4. What changed? Why did it work?
I have no earthly idea to be perfectly honest.  I will tell you this though — after the first two transfers failed, we ditched our original IVF doctor and moved over to Dr. Mitch Rosen at UCSF. Dr. Rosen has gotten all of my girlfriends pregnant — the man is truly a genius. As much as I hate to admit this next one, I think the 6-week cleanse also helped. My body was fairly clean and in good shape at the time of the third transfer.

5. Are you having twins? So many IVF pregnancies are multiples.
We did transfer two embryos, but I am carrying a singleton pregnancy.

6. Are you having a girl or boy?
Girl!

7. When are you due?
January 3, 2015

8. Do you have a name picked out?
We have it narrowed down to two names, but that’s as far as we’ve gotten.

9. What are the two names?
Nice try! We’re keeping that secret 🙂

10. How are you feeling?
Knock wood, I’m feeling great. I’m 18.5 weeks along and, much to Paul’s chagrin, am fully embracing nesting! We’ve already started converting our guest room into the nursery.

11. Are you working?
Not in the traditional sense. At the moment,  I’m simply enjoying this whole experience. I’d say I worked pretty darn hard to get to this point, so I’m cherishing every moment of pregnancy. Come January, I’ll be a full time mommy to our daughter. I hear it’s extremely tiring, yet rewarding work. I cannot wait for my new job!

 

Oh Baby!

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Well, after a long 4.5 year fertility battle, with a bout of cancer thrown in for giggles, I’m so thrilled to let you all know that I’M PREGNANT!

Baby girl Sieminski is expected to arrive on January 3, 2015!

As a long time infertile, I wasn’t sure this day would ever come. I have to pinch myself every day to be sure I’m not dreaming. Paul and I are beyond happy and excited. We feel like the “pause” button on our lives has finally been un-clicked.  We’re no longer in a giant holding pattern! Woo hoo!

In other news, Maisey is quite excited about this latest development (she just has a funny way of showing it!):

 

 

 

 

 

 

 

 

 

 

 

Random Thoughts

My last post on whether I think IVF caused my breast cancer garnered some responses that perhaps the cancer is what caused my infertility issues. I’d be lying if I told you that thought hadn’t crossed my mind once or twice — but here’s why we are still going with a donor egg:

Our 1st IVF only yielded 4 embryos.  We transferred 2 in fresh and got a big fat negative pregnancy (BFN).  We froze the other two embies and later transferred both in a Frozen Embryo Transfer (FET) round. That resulted in a chemical pregnancy (the one where I was pregnant for about a day then my body got rid of it because the embryo would not have gone on to be a healthy pregnancy for whatever reason).

Our 2nd IVF only yielded 4 embryos.  We transferred all in fresh and got a BFN.

Our 3rd IVF only yielded 2 embryos.  We transferred all in fresh and got a BFN.

Our 4th IVF only yielded ONE embryo. We had to freeze it right off the bat because my hormones were too wacky to do a fresh transfer.  We put our last biological totsicle on ice until my hormones settled and then we did the FET.  As you know, it was a BFN. (it’s like the record is on repeat, huh?)

When you get breast cancer, many patients do IVF prior to chemo because chemo destroys all of your fastest growing cells, of which your follicles and eggs are some of them.  We didn’t bother with this given our history. My last IVF only got us ONE damn egg. What’s the point in spending more money trying to eek out one more shitty egg before I nuke my body?

So post chemo — could I potentially get my miracle baby from an egg of my own? Assuming that chemo doesn’t irreparably destroy the few eggs I have? Yes, sure, anything is possible. But I prefer to be a pragmatist.  I’ve been diagnosed with Diminished Ovarian Reserve and Poor Egg Quality. My IVF history is proof of the diagnosis! We’ve gotten a second opinion from UCSF (we actually tried to do an IVF round with them, but I failed to stimulate well, so they converted me to an IUI instead). We also got a third opinion from Dr. Schoolcraft (Giuliana Rancic’s doctor) at CCRM (Colorado Center for Reproductive Medicine) — and he is supposed to be the top in the country at this stuff.  Everyone agrees with my diagnosis and all of the doctors suggest that we move to donor eggs.

Not that I am trying to justify what we are doing — I just wanted to give you all the full picture. An IVF stimulation in somebody my age, should produce way more eggs than we were getting. You’d expect to see at least 10 or so is my best guess. So our best rounds at 4, were really low in comparison. Then the fact that none of them took, indicates that the embryos were all of poor quality (ie. wouldn’t have gone on to be a healthy baby) so my body did it’s job and rejected them.

In other news, my medical oncologist, Dr. Smith said my hair would all fall out on the 14th day after my first infusion.  Well, today is the 13th day post infusion, and I have no signs of losing my hair. Maybe I’ll get lucky and it won’t fall out? Wishful thinking from a self-proclaimed pragmatist?

Final thoughts — I realized I’ve never posted any pictures of our dog, Lucy to my blog. So here are a few. There are a few of her wearing a fleece red jacket. It’s been really cold here in SF lately and she’s been laying in front of the heat vents in our house — so I figured it was time to trot out the little red riding hood. Paul absolutely hates it when I put clothes on the dog — but she looks so damn cute and she seemed cold. Truth be told, she only wore it for about an hour before Paul took it off of her and personally snuggled her to keep her warm! Did I mention how much he hates when I put clothes on the dog? Also, did I mention how obsessed we are with Lucy?! She is our little dog baby!

Well, we are off to Sunday brunch with a friend. One of our favorite things to do is to reminisce about the past — so I’m sure there will be a lot of 2012 recapping at brunch as well as some potential resolution making going on!

Inspiration – Part 1

As promised, on days when I’m not feeling 100%, I will be posting some of the notes that you all have sent to me (with prior permission, of course).

Given all the craziness going on right now between the fallout of Hurricane Sandy and the tragedy in Sandy Hook, I’m finding it very easy to put my situation in perspective. But I do still have my “oh woe is me” days.  On those days, I turn to these notes.

The below email is especially touching to me. It comes from on old high school friend Ann:

Andrea I am so sorry to hear your news. I will admit to you that I have been living my own “hell” for the past 6 plus years and seeing your life via Facebook during that time made me envy you. You are successful and you seem to have a great husband. I guess I assumed you were very career oriented and maybe didn’t want kids yet. My world was completely different. I was extremely happy with my career and husband and had two healthy boys. Then when we thought we were done , I got pregnant. Then found out we were having twins. Sorry if I am rambling but your blog was so powerful to me last night that I want you to know how being strong can get you through this. When my husband and I went for the 18 week sonogram to find out the gender of the babies our world stopped. There was one boy and one girl but the girl had more problems than my numb head could process. Mandie survived the pregnancy and was a wonderful part of our lives for 3 challenging years. It’s been three more lonely years since I have held her but what got me through was my amazing marriage and our family and friends…no matter how sad or down you get, communicate with Paul and keep him close. You can do this! You are in my prayers! You continue to amaze me with your touching story and your blog. I love reading it. You are so strong and so inspiring. My boys pray for you (Miss Andrea) each night before bed and I am always so excited to update them on how well you’re doing. Stay strong and most of all live, laugh and love!

Ann, thank you for reaching out and sharing your story with me. YOU are an inspiration to ME.

Choices

So, I’ve been thinking about it — in life, we all have choices. Well, obviously some are made for us — like getting cancer, Of course, I wouldn’t have chosen that for myself. Nor would I have chosen infertility — but that crap just happened. The choices I’m talking about are what we do from there. How we, nee, I handle stuff like this.  I could choose to curl up and cry forever or face it head on with a positive attitude. To be honest, my tactic so far is a bit of both. I am a strong believer in listening to your body — so when I feel like letting the waterworks out — boy, do I ever. I even indulge in sad-ass movies like “Marley and Me” to really get a good, good cathartic cry in — but then, I move on. I choose to try to be happy and look on the bright side. As much shit as we’ve been up against the past few years — I still believe EVERYTHING happens for a reason.  And, since my diagnosis, I’ve re-connected with so many old friends and become closer to so many more current friends — it’s truly been an amazing experience! So that’s been the bright side thus far!

Anyhoo — the point of this post is that when it comes to choices, as a Buffalo Bills fan — one must *really* choose to be a fan. Because the team has not been good since the early 90’s (for real) and Paul and I CHOOSE not to be band wagon fans. We are all in. Which is a really difficult thing to do, especially out here in California.  I did the math this year, and I’ve been going to the Bills-Backer Bar (called the Northstar in North Beach) for NINE years! Holy crapazoids, that’s a LONG time. In any case, the point is, we stick with the Bills through thick and thin and a lot of people know that about us. A few years ago when we were home in Buffalo for Xmas, we went to a Bills game with one of Paul’s best friends and cousin Jeremy and his wife Sally. We had a blast! Until we all got the stomach flu and puked for like two days straight! lol! That’s when I first got introduced to zophran (sp?) and thankfully, I know it REALLY works as an anti-nausea med! yay! I for sure will be getting that stuff during chemo!

In any case, back to the story, Jeremy and Sally are our very good family — and the other day I got a package from them. I tore it open with the reckless abandon of a 3 year old! And in it, HOLY SHIT, was a girls-sized number 12 Jim Kelly Jersey (from the early 90 with the awesome bright blue colors — those of you from the ruff buff know what I’m talkin’ about and know how hard it is to get this jersey anymore!). If that was not cool as shit enough, I turned the jersey around and it was friggin’ personally signed by Jim Kelly to me (Kicker, take that! (inside joke))! See pic below! DIE two times over!

Jersey signed by Jim Kelly!!! DIE

SO, the point of this post was “choices”. We all have them to make. Me, I choose to view all this cancer stuff as an opportunity for me to reconnect with friends and to share my story with those about to walk the same path as me and to offer my insight. I also choose to love the Bills no matter what! hahahaha. The latter might seem like a small choice to some — but if you are from Buffalo, it’s nearly as serious as cancer! lol.

My heartfelt thanks go out to Sally and Jeremy for arranging for the jersey. It was the best thing in the world and I wore it with pride today as we got our asses kicked by the Colts!  Below is a short slide show of some of my peeps from the Northstar. Enjoy and mucho love to allof you out there bothering to read this!

xoxo

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FML

Well, this post is nothing but shit. So if you’re not in the mood for shit — stop reading here. This will not end with rainbows and pots of gold.

I started a draft blog post about a week ago and decided to hold on posting it for fear of jinxing the whole damn thing. The post was all about how in all of this shit cancer crap, our silver lining is that our donor was cleared to move forward with her stimulation on October 19th.  We were a little worried about getting away to Kauai before my surgery because we would likely miss her retrieval.  But, Dr. Schmidt and Angela were in constant contact, updating us and reassuring us that we had a few work arounds if we really wanted to get out-of-town for a bit. So, we opted to get away to regroup. The morning before we left, Paul visited Nova to leave a little present for freezing. While in Kauai, Angela texted us that the donor was ready and that her retrieval would be Thursday (today).  As a certified expert on retrieval — having had 4 of them myself, I know that retrievals tend to happen between 11am-1pm.  Mornings at Nova are reserved for blood draws and monitoring appointments. Shit, I could work there at this point — I’ve been through the process so many times!

So, when it rolled around to noon Kauai time, I started to worry. That’s 3pm San Francisco time. Why hadn’t Angela called or texted?  About an hour later my phone was ringing, it was Nova, I went to pick up and the line went dead.  We were shopping at the time. So I put the loot I was about to buy (a cute onsie and baby book for Kim’s newest bundle of joy — I’m supposed to go to her baby shower on Sunday and didn’t want to show up empty-handed — and what is cuter than surfer baby gear?!) down on the counter and asked the shopkeeper to just hold them for a few minutes while I took a call outside.

I called Nova back and told the woman who answer that Angela just called me but missed me, could I please speak with her.  She asked me to hold.  She came back on the line a few minutes later and said, “Hi Andrea, I’ll transfer you to Dr. Schmidt now.” Those are NEVER the words you want to hear. NO, NO, NO.  I want to talk to Angela, not Dr. Schmidt. Whenever he gets on the phone, it’s only to deliver bad news. He is a nice doctor and would never leave it to his nurse practitioners to deliver that crap news.  As soon as I heard that, I pulled Paul by the arm and we went to a bench, away from the Kauai trade winds so that we would be able to clearly hear him on speaker phone. (Kim, sorry, we never did go back into the store to buy the cute onsie and book for your shower — I’ll have to make that one up to you!)

Paraphrasing from stunned memory: “Hi Andrea?” “Yes, it’s me, I have you on speaker phone — Paul is here too” “Hi guys, are you driving?” “No, we’re sitting” “OK, well, do you want to talk now or once your home from vacation?” “Now” (we just look at each other and know where this is headed) “This is not the call I wanted to make, especially with all that’s going on with you two and the breast cancer etc. We did your donor’s retrieval this morning and it wasn’t great.  Out of 20 follicles, she only gave us 3 small eggs.  I’m not loving the looks of the eggs. They seem immature. If they continue to look good, we will put them with sperm and call you with the fertilization report tomorrow, but I am really not liking the looks of this at all. I am so sorry to have to tell you this.”

I am literally speechless. I hear Dr. Schmidt ask after me — “Andrea? Are you still there?” I mutter yes. Paul takes over and goes on auto pilot. We make light of it to some degree because that’s what we do and that’s our coping mechanism.  But after a few minutes of disbelief lightheartedness, I begin to get sad/angry. Dr. Schmidt so sweetly told us that he is with us, in our corner and he will see this through until we get our kid. But, his words are literally of no comfort in that moment.

Why the FUCK is this happening to us? To me? What the hell did I do? It must’ve been really, really shitty. People have their goddamn limits and I have absolutely reached mine.

We got back to our condo after picking up copious amounts of alcohol. I immediately put on my jammies even though it was 1:30 in the afternoon and I crawled into the closet. Literally. I know this sounds ridiculous/pathetic. But I am in unfamiliar surroundings. I don’t have my dog, My things — nothing. When I was little, I always played inside my closet (must be a blue collar Buffalo thing!). It was like my little secret space. I felt comfortable in there. It was so confined and nobody else could possibly fit in there. Yes, for those of you know who know Paul, this was somewhat of a dick move. We probably should have held each other and cried together because this pain is as much his as it is mine. But I just needed to be alone and in a condo — that is virtually impossible. So I found myself on the floor of the closet (sad, I know). Eventually Paul honed in on me, opened the door to the closet and revealed my hiding spot. I suppose my sobbing gave it away. He came with a peace offering of wine.  He opened the door and I cried and cried and cried some more on his shoulder.

I seriously don’t know why this is happening anymore. I thought that the silver lining that would get me through a bilateral mastectomy and chemo would be the thought of my totsicles waiting to be thawed and put inside me for safekeeping until I grew it/them to full term. That pot of gold was crushed today. I am literally stunned (and SERIOUSLY drunk right now).

Don’t feel too badly for me though. I am writing this post poolsode, gazing out at the ocean, sipping wine and listening to some of my favorite songs (I’m going with Desi songs all the way this afternoon! Soundtrack to K3G, Kabhi Kabhie, Jimmy Jimmy Jimmy Aaja, Jhumka Gira Re and, my dad’s fave: Ramaiya Vastaviya).

Honestly, I’m tapped out. I’ve literally got nothing more to offer any of you. I am lost, absolutely lost. Hopefully a few days from now I will find my way. But for now, I am empty.  I’ve got nothing for you. I’ve got no ending to this tale. It’s all fucking shit.

Just call me Giuliana and Paul, Bill

As you know, there is mucho irony going on here. My mom was Chief of Radiology at Roswell Park Memorial Institute — a cancer hospital, I got my cancer diagnosis in October, which is Breast Cancer Awareness (BCA) month AND I wore my Stella & Dot BCA scarf to my ultrasound appointment — when the infamous biopsy was performed.

The most ironic thing of all — is that I’m OBSESSED with Giuliana and Bill Rancic. They too have been on the fertility shitshow ride — but they were very public about the whole thing. I can’t begin to tell you how much comfort I’ve taken from their journey. But what’s F’d up beyond words — is that I am on the exact same path as them (literally, no joke).

It was one year ago that they went on the Today show to announce that Giuliana had breast cancer and that she found out during her IVF treatments. As part of BCA month, she went public with her story to encourage women to do self exams and to get tested.

Me, I’ve always been a proponent of self-exams. That’s how I found my last lump 10 years ago. Ironically (again) it was the same breast, same location as this one. 10 years ago, however, my test results were benign. My diagnosis was “cyst-y boobs”. OK. Ill take that.

So, last year, after I heard Giuliana’s story, I decided to get a mammogram. I was 36 at the time and figured the insurance company wouldn’t clear me. But since I was undergoing fertility treatments, they did. Yay. Had my mammo — and was all clear. Double yay.

Fast forward to one year later — and I am playing out Giuliana and Bill’s story. Almost to a T.

Let’s hope that my cancer is not fed by estrogen like hers was.  Because that would mean I can’t get pregnant for 5 years. And ladies and gentleman, I am 37 years old. So waiting another 5 years for a baby is just not an option.