Perthes disease

Its been years since I posted anything on this blog. Some days I almost forget about how hard it was going through in-vitro and the complications and surgery. All I have is the scar on my stomach to remind of the battle we went through to have Mason. Here we are 5 years later and we have a new battle to fight. Sometimes it's easiest for me to process things by writing them out so here is Mason's Perthes story:

It's been almost six weeks since the day we were told, "Mason's X-ray is not normal". Mason started having pain in his hip on a Sunday evening and by the next morning his pain was so severe he couldn't move without yelling out in pain. We took him in to our pediatrician thinking that maybe he had sprained his hip during his busy weekend of soccer, jumping on the trampoline and playing on the jungle gym at church. He had an x-ray and we were told there were possible signs of avascular necrosis (AVN) but we would need to wait 10 days to have a repeat X-ray before we would know for sure. It could be AVN or there was also a possibility it was a tumor or an infection. My heart was so broken. My precious boy had already been through so much in his life. I had such an overwhelming feeling of: "This isn't fair." I wanted to yell at God and tell him: Not my Mason. Pick someone else for this. He deserves better than this. More than this. I felt like I could cry an ocean of tears. I pleaded with God to do a miracle and heal our sweet boy. Ten days passed and we had another X-ray. The radiologist and the doctor gave us the news, "He most likely has Perthes disease." 

Legg-Calvé-Perthes disease (LCPD) is a form of osteonecrosis of the hip that is found only in children. Mason looks totally healthy on the outside, but on the inside, his bone is dying. Part of me felt relief knowing that it probably wasn't a tumor or the "C" word. But the Perthes diagnosis felt heavy. Mason could no longer play soccer. No more jumping on the trampoline. No recess. No P.E. No jungle gym. No more playing on his scooter. How would we tell our 5 year old that he can't do all of his favorite things any more? 

It's so incredibly painful to see Mason's soccer cleats sitting in our garage. We bought them in a bigger size so he could wear them for more than a season of soccer. Every time I look at them I'm reminded that he will never wear them again and I won't see him running up and down the soccer field again. 

Seeing other kids running and jumping feels like being punched in the stomach. Driving by our pediatrician's office makes my heart ache. We used to be able to handle all of our problems there. Get an antibiotic, get a shot, get a sucker. Little problems. But this, it felt so big. We're now seeing an orthopedic surgeon at Children's hospital. We're talking about surgery and we're talking about a wheelchair. I feel like I'm living a life parallel to the one I expected. I'm grieving the loss of that other life. The one where Mason is still playing soccer. The one where he can run and jump and play with the other kids and he doesn't have to sit alone in the office at school during recess.

I'm still working on accepting this new normal. I came across a picture of Mason and I from 6 weeks ago. It was taken the day before Mason's diagnosis. I look at myself in the picture and I think, "You have no idea. You're world is about to be turned upside down." That woman in the picture is so naïve. That woman in the picture thought that infertility and the complications that's followed- that was the big struggle. The big struggle was over and now all we needed to worry about were the daily struggles of having 3 kids. Tantrums and juggling schedules, mountains of laundry and dishes that fill the sink. 

Last week I got an email from Mason's teacher. She mentioned that Mason had been discouraged because he couldn't join the other kids in an activity. He told her, "I never get to do anything anymore." It was a hard day. There have been so many of those lately. I don't want my sweet boy to feel left alone and left out. So I talked to the school and now Mason gets to bring a friend with him to the office to play with Legos during recess. The first day he was so incredibly happy that he didn't have to sit by himself while the other kids played outside. He was smiling ear to ear when I picked him up from school. I emailed his teacher to tell her how happy I was to see a smile on his face. In her response email his teacher said, "Yay for small victories!!" I've been thinking of that each day. Celebrating the small victories. If I've learned anything in the last 6 weeks it is that. The challenges and the unknown seem so daunting but I celebrate those small victories like never before.

I know that I serve a good God. The same God who I prayed to every night as we struggled through our infertility and through complications and surgeries. And He is the same God who gave us our precious miracle, Mason. We're praying Mason makes a full recovery. We're praying for strength and courage because this journey may take many years. For now we will take it one day at a time and we will celebrate each and every small victory.


Mary Ann 

It's a BOY!

After my surgery we went to one final appointment with Dr. R. I wished that he would have been an OB/GYN so that I could have stayed under his care for the duration of my pregnancy. Instead I had to find someone new. I wanted to use Dr. K because he had sent me for the CT scan when I had my PE and he had been a part of my surgery. Doug said the decision was up to me, even though he knew of another doctor that was very close to our house. Picking Dr. K is a decision I still regret.

At our first official OB appointment, I was 12 weeks pregnant. I had to fill out all the usual paperwork, which included questions like: "Have you taken any medications since you became pregnant? Have you undergone any medical procedures in the past 6 months that required hospitalization?" I nearly laughed out loud. After the paperwork was turned in, we went to the room where I first met Dr. K. That had only been 6 weeks before, but so much had happened, it felt like a lifetime ago. Dr. K walked in and made a few jokes about me and my complicated pregnancy. Then he pulled out the doppler and we got to hear the melodious sound of our baby's heart beat. Then he invited us to join him in his office. He gave us some information on how many deliveries he does, and a few other things that I only half-listened to. I brought up some questions that I had. One related to the night sweats that still plagued me. He told me that was due to my overstimulated ovary. He
finished up the appointment and sent us on our way.

When I was 17 weeks pregnant, Doug and I went in for an ultrasound. It was of course, the big one. We would find out if we were having a boy or girl. I had said all along that I didn't care at all what the gender was, I just wanted a baby. A healthy baby would be a bonus. We decided, since Dr. K's office didn't do an ultrasound until 24 weeks, that we would pay the money and have a 3D ultrasound done. It was a lovely place with pictures of babies and pregnant bellies on the walls. The sonographer took us back to the room, and I laid on the table. Then before she had me raise my shirt, I quickly explained that I had to undergo surgery and had a large scar. She was much more gentle than Dr. K had been as she searched to find our baby's heartbeat. She recorded the sound of the heartbeat and then it was time to look at our baby. I was somewhat worried about what I might see, as I had doctors tell me about the potential of birth defects due to my surgery. But I saw a perfect baby. And the sonographer saw something too. "It's a boy!" She exclaimed. I looked at Doug's face. He had tears in his eyes. I had tears in mine. It was a wonderful moment that I'll remember forever.

The second half of my pregnancy was very different than the first. It was uncomplicated. I finally got to enjoy being pregnant. I got to decorate the empty room in our house and turn it into the nursery that I had been dreaming of. I spent as much time with Meredith as I could. She had been my only baby for so long, and I wanted to cherish every minute of it. We took walks together, we played together, colored together, danced together, cuddled on the couch together. My little baby girl was going to be the big sister and I could wait to be a family of four.

Bittersweet

I awoke in the recovery room to the sonographer ripping the bandage off my stomach. I listened intently. It was nearly impossible to focus because I was in so much pain. But I heard it. The sweet melody of my baby's heart beating. "We have a fetal heartbeat," she said. I said a prayer thanking God. I asked one of the nurses standing over me if I could have something for the pain, and he informed me that he was injecting my IV with Morphine. Then I passed out.

I woke up just as the recovery cot was being wheeled into my hospital room. Doug stood up and hurried over to me. He said some encouraging words, but all I really remember is that he kept repeating "I'm sorry" over and over again. His eyes watered up as he looked over my body. I was whimpering in pain and trembling uncontrollably. The recovery nurse set up a Morphine pump next to my bed and patted my foot before leaving the room. Doug told me everything Dr. R had told him. They had taken my right ovary and the fallopian tube. My ovary had, in fact, torsed and had begun bleeding into itself. It had grown to be the size of a softball by the time they had removed it. In order to remove my giant blood-filled ovary, they had to make a 6 inch vertical incision down my abdomen. But, we still had our baby.

After my oophorectomy, I began having night sweats. I had never had surgery, so I didn't know if it was something associated with the recovery process. The day after surgery, I slept more than I ever have in my life. The only time I woke up was to vomit. The nurses kept coming in and asking when I wanted to take my shower for the day, but I didn't know where I would get the energy to just get out of bed. I passed on the shower that day and the food. The next day was somewhat the same, except the nurses told me I had to get out of bed at least a few times and walk down the hallway. I was high risk for blood clots, so I needed to avoid being completely sedentary. Each time the nurse would peek her head into the room, I would try to find the motivation to sit up, but it just wasn't there. The thought of walking all the way down the hallway, seemed almost as absurd as running a marathon. I decided I would wait until Doug returned to the hospital after work that day to take my first walk. When he arrived, he helped me from the bed and my legs almost collapsed beneath me. I was in a full blown sweat before we even reached the door. When I peered down that hallway I felt completely overwhelmed. I decided I would take it one step at a time. Just the way I had taken everything so far. One step at a time, with Doug by my side, holding my hand. Reaching the end of the hall, I almost expected a medal. Doug and I turned around to go back to my room and my legs gave out again. Doug held me while I regained my strength to keep going. One step at a time.

On the day I was supposed to be discharged, I actually didn't want to go home. The place that had been like a prison before, had become my haven. Doug worked long hours, which would mean I would be alone to take care of Meredith and myself. I was terrified. I couldn't muster the energy to get out of bed, let alone tend to someone else's needs. I would also have to begin giving myself shots. I had somehow avoided it up until that point. I had also avoided eating for the past week, as everything that passed my lips, came right back up. I had been on numerous anti-nausea medications, which had helped me to keep down water, but that was all. Not only that, but I didn't have a stool to sit on in the shower and I would need to stand the entire time. This seems insignificant, but at the time, it was unimaginable. That day, I stayed in bed up until the last possible minute, before I crawled into the wheelchair to head home.

The first day home was rough, even with Doug's help. I had planned on taking a shower as soon as I got home, but I was worn out from the discharge process and the drive home. So instead, I thought I would take a short nap and shower later. It was 10 o'clock at night before I finally made it in. I felt much better after, but that didn't last long. I woke up in the middle of the night drenched in sweat. Much worse than what I had experienced with the pulmonary embolism. I couldn't even go back to sleep because I felt so gross. The sheets and my clothing were stuck to my body. Each time I would drift off, I would wake up shortly after in a puddle of sweat. I googled "night sweats after oophorectomy", but all the results were from women who had both ovaries removed and were thrown into early menopause. "Maybe my body is going into menopause," I thought. "Maybe my other ovary isn't doing what its supposed to do. Maybe I have another PE. I better Google that. Or could this still be a result of the OHSS, since my remaining ovary is hyperstimulated?" So I typed "night sweats after unilateral oophorectomy pulmonary embolism OHSS". No matches. When I found out that we would need to undergo IVF, I found numerous websites, message boards, support groups and medical websites. I found information about the procedure and its risks. I found comfort in reading message boards and blogs written by other people who were going through the same thing I was. They all had the same feelings I had. These people knew exactly what it was like to deal with negativity from "friends" during such a difficult time. It made me feel good to know that other people out there were also being stabbed with needles on a daily basis. And instead of conceiving our child in the privacy of our bedroom, our baby had to be put together in a lab, then given a safe place to grow inside my uterus. This time I couldn't find comfort. Nobody online was discussing having to do shots for a year longer than planned. No one was talking about seeing a pulmonologist for the rest of their life. Or the strange feeling of loss knowing that an ovary was missing. I felt alone. And as much as I tried to be thankful just for having my baby growing inside, I was feeling angry and sad. I felt angry that instead of a normal pregnancy, I had to go through IVF. And instead of getting to celebrate my positive pregnancy test or seeing my baby's heart beating the first time, it was all overshadowed by complications. I felt sad when I thought about everything my little tiny baby had endured. A tiny person was counting on me for everything. To provide a safe home. To give nourishment. I felt I was failing miserably.

Oophorectomy

I received a call from Dr. R on Saturday evening. He had been notified of the results of my most recent blood work and my condition was continuing to worsen. He let me know that it was imperative that we move through with the surgery and that it would take place the next morning. It was also crucial that I receive a blood transfusion and the placement of an inferior vena cava filter prior to the surgery. I was terrified. I knew I wouldn't be able to sleep that night. Throughout all my complications, Doug had been by my side. Every night I had spent in the hospital, he had been with me on a tiny pullout chair. He was my rock. I needed him that night more than ever. I needed him to hold my hand. I needed him to talk to me about insignificant things so I wouldn't have to think about the insurmountable hurdle that lay ahead the next day. And he did.

The next morning, the first thing that needed to happen was a blood transfusion. The nurse told me that my fever would break shortly after the transfusion. I also started feeling better. Next I would be wheeled down to have the inferior vena cava inserted. An inferior vena cava filter (IVC filter) is a type of vascular filter that is implanted into the inferior vena cava to prevent fatal pulmonary emboli. The process of placing the filter was pretty frightening, because the doctor had to slice into my jugular vein and feed the metal filter into place. Then another x-ray was performed to be sure it was where it should be. My little tiny baby was only 8 weeks old and had already been through so much.

Soon after I arrived back at my room, Dr. R and Dr. K both came in to discuss the surgery. The surgery was considered exploratory, because they were pretty sure that the ovarian torsion was causing the problems, but couldn't be positive until they got a look inside. Most likely they would be doing a unilateral oophorectomy, which is the removal of one ovary. They told me that there were significant risks involved with doing this surgery. I had just had a pulmonary embolism a week before, but there was no other option but to operate. The anesthesiologist came in shortly after and told me that doing anesthesia on a pregnant woman puts the baby's life in jeopardy. He told me that it could cause the baby's heart to stop. Dr. R told me that he would have a sonographer in the recovery room to perform an ultrasound to check for fetal heartbeat immediately after surgery. I was about to undergo a procedure that could stop my baby's heart and there was no way for me to avoid it. I had to just sit with Doug in a hospital room for an hour before the surgery knowing that it might be the last hour I ever got to be pregnant. I wanted to talk to my little baby and say how sorry I was for what was about to happen.

I was wheeled down stairs with Doug by my side. I prayed and I prayed. And then I prayed more. I didn't care what happened with anything else, I just wanted my baby to survive. I handed Doug my glasses and he gave me a kiss. As they wheeled me towards the operating room, I felt so alone. I wanted my husband holding my hand walking with me down that hallway, but instead it was just me watching him disappear into the blurry backdrop of the hospital. The anesthesiologist started to administer medication into my IV, and he told me to count back from one hundred. Instead I said a prayer for my little tiny baby.

Ovarian Torsion

First thing Monday morning, I called Dr. R's nurse Beverly and told her my symptoms. We made the trip back up to his office so that we could have an ultrasound. Dr. R told me that most likely the pain I had been having was due to my uterus and my enlarged ovaries fighting for space inside my body. As he prepped me for the ultrasound, I prayed that I would see my tiny baby's heart flickering, letting me know everything was ok. Just seconds later I saw it. I also got to see my little tiny baby kicking and moving. I breathed a sigh of relief like never before. Dr. R had been right. He gave me a new ultrasound picture and I stared at it the whole drive home.

I continued having intermittent pain throughout the next few days, but now that I knew the cause, it hardly bothered me. I enjoyed being home and spending time with my daughter. She gave me lots of hugs and constantly told me how much she had missed me when I was in the hospital. But she also told me she had enjoyed getting to spend time with all her grandparents. I was thankful to have had such wonderful family to take care of her.

I woke up at 4am on Thursday morning with the worst pain I'd ever had in my life. And that's an understatement. In fact, when I was 14 I had been in a car accident where a minivan had literally rolled on top of me, shattering my pelvis. At this point, a van rolling on me sounded quite pleasant. On a pain scale of 1 to 10, I was easily at 100. I was trembling and vomiting and whimpering on the side of the bed. I contorted my body into every possible position I could just to try and get some relief. I tried taking Tylenol, but vomited it up just minutes later. Doug tried asking me questions, but I couldn't even get the words out to answer him. I propped pillows behind my back and found a position that made the pain bearable. I must have been exhausted because I actually fell back asleep in the strange upright position I had gotten myself into. Hours later I awoke to an even greater pain. I writhed and whimpered on the bed. It was morning by this time and Doug paged Dr. R. I started vomiting again. Doug looked panicked. "Let's get you in the car, we're going to the emergency room," he told me. By some strange luck, Meredith had stayed the night with her grandparents that night. I grabbed a pair of pants and hobbled down the hallway to the garage, stopping to throw up every few feet. Doug rushed around the bedroom looking for his keys and wallet. His phone rang and it was Dr. R. He was in the middle of an egg retrieval. Doug explained the situation. "I'm taking her to the women's center or the ER. Which one do you want it to be?" Dr. R asked Doug to take me to his office. "I don't think you want her there looking the way she does," Doug said. Dr. R told Doug that taking me directly to the women's center at the hospital wasn't feasible at this point, and that the ER could be a very long wait. Doug said he would take me into the office.

We had driven the hospital dozens and dozens of times before. I had memorized every landmark, every sign, every building and I knew exactly how long that drive took. Throughout the IVF process, the egg retrieval, the transfer, the blood tests, the OHSS and the pulmonary embolism I had gotten to know that 15 mile stretch of road. This day felt different. It felt infinitely longer. Every stoplight felt like an eternity. I practiced the breathing I had learned at my labor class when I had been pregnant with Meredith. Doug pulled into the valet area in front of the hospital and loaded me into a wheel chair. Sweat dripped down my face onto the trash bag I was holding. He quickly wheeled me to Dr. R's office, where I was met with stares from frightened onlookers. Beverly walked through the door and called a patient name. She saw me and waved me back. The patient started in shocked as I writhed in pain and hunched over my trash bag to vomit. Beverly looked very alarmed. She quickly got me back to a room and asked me if I could sit on the exam table. I crawled up and started vomiting and shaking. She tried taking my pulse but I could hardly stay still. Dr. R came to evaluate and quickly realized how severe my condition was. I could barely form a sentence, but I begged for him to admit me to the hospital so that I could have some sort of pain medicine. He called the women's center and let them know what was going on. He was fairly certain that one of the cysts on my ovaries had ruptured. He told me they would be ready for me at the women's center and Beverly wheeled me over.

When we got there, I saw familiar faces. The nurses that had taken such good care of me were there waiting. They had told me after the PE, that the next time I came back it better be for the birth of the baby. That had been just over a week ago. Doug and Beverly helped me into a hospital gown and the nurses hurried to start my IV. Once they gave me the Morphine the pain faded away for a short time. I was scheduled to have the Morphine every 2 hours, but it only seemed to last about an hour and a half. Then I was back to where I was before, trembling, vomiting, whimpering. Dr. R came to visit and told me he thought I most likely had a ruptured ovarian cyst, but that there was also the possibility that it was ovarian torsion. Ovarian torsion is the twisting of an ovary, which can result in a loss of blood flow to the ovary. For that reason, Dr. R scheduled an ultrasound. The ultrasound would show if there was appropriate blood flow.

It wasn't long after Dr. R left before someone came to take me down to radiology. The ultrasound showed that blood flow was still evident. However, each time the Morphine wore off, I was still in significant pain.

The next day the pain had subsided enough so that I could be on a lower dosage. Dr. R let me know that he would like me to switch over to an oral pain reliever if my condition continued to improve. That would mean that I wouldn't have to drag my IV pole with me to and from the bathroom. That was good because I was having enough trouble just getting in and out of bed as it was and I didn't need anything else slowing me down.

Over the course of the next day, I felt better. I had started taking Lortab, and was able to move around slightly faster. I didn't need Doug's assistance when getting in and out of the bed either. Dr. R was convinced it must have been a ruptured cyst and was even discussing the idea of me being discharged within the next day or so. That night, I woke up to use the bathroom and I felt feverish. I called my nurse, Elizabeth, and asked if I could have some Tylenol. She took my temperature and seemed alarmed when she saw the reading. She left the room for a minute and let me know she had paged Dr. R. When he called back, he ordered some blood work and another ultrasound of my ovaries.

The next morning I felt feverish again and a general malaise that I hadn't had before. I also noticed a raised lump on the right side of my abdomen, beside my belly button. This time, instead of being taken down to radiology for my ultrasound, someone came to my room with the machine. The technician told me that the blood flow to my right ovary was almost non-existent. It wasn't long after the technician left, before Dr. R arrived. He explained that the values from my blood work were dangerously far from where they should be. He examined me and felt the bulge on the right side of my stomach. He told me that he was going to consult with Dr. K and I was most likely headed for emergency surgery.

Road to Recovery (Or so I thought...)

We headed down to Texas for an exciting weekend of football and relaxation when I was 8 weeks pregnant. The fluid that had filled my abdomen, making me miserable for weeks, was finally gone. I now was at risk for blood clots and had to be on Lovenox shots every 12 hours for the rest of my pregnancy. I had also been told that because of the pulmonary embolism, I wouldn't be a candidate for any type of hormone therapy for the rest of my life. I definitely couldn't go through IVF again. So the baby I was carrying was it for us. But I had always wanted a family of 4, and now we would have it.

We stopped every 30 minutes to get out of the car and walk around on our drive down. I felt good. I had spent over a week in the hospital for my pulmonary embolism, and I was so glad to be out in the world again. I was like a prisoner who had been freed.

We got to our hotel and checked in. We were notified that a lavish suite was available and we graciously accepted. The room was incredible. For almost 2 weeks my husband and I had slept in a tiny hospital room. Me in my hospital bed and he on a pull-out couch next to me. I had barely eaten due to the nausea from the ascites, but when I did, it had been your typical hospital food. Now we had a luxurious king size bed, a giant flat screen tv and room service.

We went to dinner and watched as the Oklahoma football team arrived. Excitement filled the room. People cheered and snapped pictures. I noticed as I watched this scene, that I began having minor cramping. By the time we retired to our room, I was only able to take a handful of steps at a time. Doug was concerned and offered to carry me up to our room. I declined and assured him that I would be fine once I got into the giant bed that awaited.

By the time I was in the room laying down, I felt fine. The cramping had ceased. We decided to stay in for the night and watch a movie, then fell asleep soon after. I woke in the night with cramps more severe than those I had at dinner. All I could think about was the "M" word. Miscarriage. It wasn't the pain that kept me up that night, but the worrying. I told Doug the next morning and he asked if I wanted him to sell the tickets to the football game. I told him that I would be fine, as the cramping had stopped, yet again. I got out of bed to get ready, and the cramping commenced, followed by nausea. Doug told me he was going to go to the stadium and sell the tickets and we would watch the game from our room. The only problem was, I needed him to administer the Lovenox. We had done at least a hundred shots so far, starting with the hormone therapy, and Doug had done them all for me. I had tried to do a few myself when I was in the hospital but I couldn't make myself follow through. I decided I would ride with Doug as he went to sell the tickets, so that he could give me my injection.

On the way there, I started feeling better. No cramping. No nausea. I was going through an emotional ping- pong, trying to decide whether or not I should try to go to the game. It wasn't that the pain of the cramping was that bad, it was the thought of a miscarriage. Every time that cramping would start, my heart would sink and I could no longer think about anything but my little tiny baby.

We looked for a place to park the car and Doug did my shot. He got out to sell the tickets, and I told him I felt good enough to walk with him. We got to the street corner and I felt fine. I told Doug I wanted to go to the game. After all, I could always sit down if I needed to. Doug hesitantly agreed to this.

It wasn't until we were inside the stadium looking for our seats, that the cramping began again. We sat down. I was panicking. The cramping was much worse. I was sweating and nauseous. I looked at all the people around us. All smiling, happy and excited. The only thing these people were worrying about was who would win the game. I wanted to be one of those people. I didn't want to be sitting there thinking I was about to lose my baby.

I almost didn't realize the game had started. I stayed seated at kickoff. My husband told me we needed to just leave. I didn't want to leave. I didn't want to be sitting in a hotel room with all these thoughts. I wanted to be one of these people who only cared about football. Oklahoma made a touchdown and half the stadium went wild. I stayed seated. Doug looked over at me. "We're leaving," he said. "We can't stay here." I didn't even fight him. I just got up and walked out of the stadium with him behind me. Doug pulled the car around and picked me up and took me back to the hotel. As we made our way back home, I wondered what laid on the road ahead.

Pulmonary Embolism

The day after my hospital discharge for my OHSS, I had to go back to the fertility clinic for another blood test to make sure my hormone levels were still on track. I continued taking the low dose aspirin and also doing my daily progesterone shots. I had to buy a few maternity clothes because even my t-shirts were too tight around my stomach. I liked the idea of seeing myself in these maternity clothes that I had been longing to wear for the past 2 years. But instead of framing a beautiful baby bump, it was serous fluid accumulating in my abdominal cavity. I had strangers congratulating me on my pregnancy and asking my due date. I didn't even know what to say, because most assumed I was around 7 or eight months along. Telling these people I was only 4 weeks pregnant brought on some bizarre reactions. I tried to tell myself each day that soon, my body would rid itself of this fluid and I would get to focus on just my pregnancy. Soon all these symptoms would disappear and I'd have the baby I'd longed for. That kept me going each day.

When I was 5 weeks pregnant, I started having a new symptom. I had a low grade fever. I thought maybe this was brought on by stress. My body was notorious for low grade fevers when I was dealing with stressful situations and lack of sleep. In fact, it was very common for me to start having a low grade fever, and then a week later be in a doctor's office with strep throat. I started trying to get extra sleep and hope it would resolve itself.

But a few days later, I felt much worse. My lungs had started to hurt and I was having even more difficulty breathing than before. I emailed Dr. R. He said the office was about to close, but that he wanted me to come in anyway. I rushed to get Meredith and myself ready as quickly as possible. When I arrived, he checked all my vitals and my lungs. He didn't see anything alarming, and told me that the issues I was having were all most likely from a pleural effusion. Some of the abdominal fluid had made its way into my lungs. This was another condition that should resolve itself, so I headed back home.

Over that weekend, I continued to feel worse. By Sunday, I asked my husband to page Dr. R and let him know that things were not improving. I told my husband that I thought I was coming down with pneumonia. I'd never had so much pain in my lungs before and my breathing was much shallower. My chest was also hurting every time I tried to take a deep breath. Dr. R called in an antibiotic and told my husband that he wanted me to come to his office the next day.

I started the antibiotic on Sunday, and by the time I was on my way to see Dr. R on Monday, I did feel that maybe I was on the upswing. At his office, Dr. R checked my vitals and my lungs. He said that he could hear something in my right lung that was most likely the pleural effusion. He was glad to hear that I felt better after starting the antibiotic, but wanted me to have an x-ray anyway. He also told me that he was concerned that I may have a blood clot, but that it was most likely just fluid. If the x-ray showed fluid or signs of pneumonia, we would assume that was the cause of my new symptoms. If not, we would go from there. Dr. R said he would also do an ultrasound, as I requested. The ultrasound still showed the signs of a single baby growing, but we couldn't see a heartbeat just yet.

Dr. R's office was located inside the hospital, directly above the radiology department, so having an x-ray was fairly simple. I was very nervous though, about exposing my growing baby to radiation, even if I was going to be wearing a protective vest. I was also worried that we hadn't seen a heartbeat during the ultrasound. From all the research I had done, I knew that the chances of having an early miscarriage after IVF were higher than for a naturally conceived baby. I prayed that during the next ultrasound, I would see a heartbeat.

When the results of the x-ray came back, they did show fluid in my lungs, so I simply continued taking my antibiotics. When I woke up the next day, I went in to brush my teeth, and had an overwhelming desire to cough. When I did, I felt a large amount of sputum in my mouth and I spit into the sink. It was red. I had never seen anything like that before, but I was convinced that I had pneumonia, and I knew that could produce rust colored sputum. I told my husband about it and he wanted to call Dr. R. "I'm feeling a lot better and my lungs aren't hurting as much," I told him. "Let's just wait."

The next day morning, was just the same. My lung pain was almost completely gone, but I was still having a pain in my chest when I took deep breaths. The lung pain had been so severe before, that I barely noticed the pain I was having beneath my breast bone. Now it seemed very apparent. My husband told me he was going to email Dr. R. He got a reply within minutes. The doctor told him to get me to the office and he seemed alarmed. He also told my husband that he was out of town and that I would need to see the other doctor in the practice, Dr. K. I didn't want to see a different doctor. Dr. R was so patient and kind and he really listened when I talked to him. But I had no choice.

When we arrived, I let the receptionist know that I didn't have an appointment. She must have already known that I was coming and the nurse emerged almost immediately from behind the door. The nurse led Doug, Meredith and me down a different hallway than I was used to and into a room. Dr. K came in very soon after. He had already been notified of all the symptoms and let me know that Dr. R was worried I may have a pulmonary embolism. He told me he didn't think it was very likely but it was a very serious condition and we needed to be sure. He listened to my lungs and asked me a few questions and told me he wanted me to have a CT scan. "How far along are you?" He asked. "I'm exactly 6 weeks," I told him. He asked if we'd seen the heartbeat yet. I told him no. He wanted to do another ultrasound.

We were taken into another room and I laid back on the table. Meredith played Hide-and-Seek with Doug behind a curtain as we waited for Dr. K to come in. When he started the ultrasound he stopped right away on a huge mass that was one of my hyperstimulated ovaries. It looked nothing like it did before the IVF. He then moved toward my uterus. He scanned around for what seemed like forever. Doug looked uneasy. I felt like I couldn't breathe. This time it wasn't from the fluid in my stomach or whatever was in my lungs. It was from fear. Fear that I wouldn't see a heartbeat. That I would walk out of that office that day and somehow go on with my life knowing I wasn't pregnant. I strained my eyes but saw no movement on the screen. Then there it was. A tiny flicker. My eyes welled up with tears. It was one of the most beautiful things I'd ever seen, that tiny heart beating. Dr. K then explained that I would be going back down to radiology for a CT scan. I don't even know what he said after that. The nurse had brought me a picture of the ultrasound and all I could do was stare at it.

We headed down to radiology, the whole time I stared down at my little picture. I dressed in a gown and they took me back to a room and I laid on the table. The radiologist explained the procedure. Then he explained that there were risks when a CT scan is performed during pregnancy. My heart sank. I had just seen the heart beating for the first time and now I was supposed to have something done to my body that might hurt the tiny baby growing inside me. I almost got off the table right then. But the radiologist told me that if I did have a pulmonary embolism it was much more dangerous to me and the baby if I didn't have the scan. So I gave my consent.

I sat there after the scan starring at my picture wondering what I had done. Then the technician told me I needed to go back up to see Dr. K. Doug had stayed downstairs with Meredith, where she could play. Dr. K met me as I stepped off the elevator. "You've got a pulmonary embolism," he told me. "You're going to be admitted to the hospital for a week and they are going to give you a drug that will break up the clot. Then you will be on an anticoagulant for the duration of your pregnancy. You'll have to see a pulmonologist for the rest of your life." I was shocked. I called Doug and told him they were taking me over to the hospital and he needed to come upstairs. I got in the wheelchair and looked down at my picture. "I'm sorry little baby," I thought. "I'm sorry you have to go through this."

When I arrived at the women's center in the hospital, I was immediately put on Heparin. Doug called his mom and asked her to come get Meredith. I called my mom and gave her the news and she left work to come to the hospital. My mom was there when the pulmonologist arrived. She was distressed as he explained how severe a pulmonary embolism can be. A pulmonary embolism is when a blood clot lodges itself in the lung or lungs. The problem with this is that blood can't flow freely through the lungs. This prevents oxygen from reaching the lungs and makes the heart have to put more effort into pushing blood through the lungs. It can permanently damage the heart. The pulmonologist, Dr. B, said he would send me to have an ultrasound on my heart to see if it had been affected. I would also have an ultrasound on both calves because in most cases, pulmonary embolism is caused by blood clots that travel to your lungs from another part of your body- most commonly, your legs. I was also told that the anticoagulant- Lovenox- that I would be on during my pregnancy would be a shot that would need to be administered every 12 hours. Then when I was approaching my due date, I would be taken off the Lovenox and an inferior vena cava filter would be implanted. This filter would protect me from another PE during labor, when I would be unable to receive anticoagulants. I was somewhat overwhelmed by everything, but looking at the picture of my little tiny baby made me feel blessed.

Dr. R called me a few hours after I was admitted to let me know he was on his way to the hospital. In the mean time, I was taken for ultrasounds on both my heart and legs. When Dr. R arrived he let me know that the ultrasound on my heart had come back normal and the ultrasounds on my legs showed no signs of clotting. Had he not put me on the low dose aspirin when he did, things may have been much worse.
The next few days in the hospital were tough. I felt like I was in a prison cell and I wanted to go home. The good news was, I had plenty of family and friends to come visit me and keep me positive. Plus, my body was finally ridding itself of the fluid I had been carrying around in my abdomen. Then there was also a trip coming up that Doug and I had planned. Every year we would go to the OU vs. Texas football game and it was something that I looked forward to the whole year. In fact, each year, Doug would tell me I could pick anywhere in the world I wanted to go on vacation, and every year I would pick that football game. The problem was, I had plenty of people who didn't want me going. I felt after all I'd been through I should be allowed to go on a vacation where I could focus on the future. It had been a stressful year and I was in serious need of an escape. Others were worried about my health and traveling so soon after such a serious medical complication. In the end, I decided to go. But it didn't go anything like I had planned.