Lab Day #1

I enjoyed the best type of emotional therapy today (well technically yesterday, since it is past midnight).

I went in for my first set of lab work today. It felt strange to go up to the OBGYN office and get handed a stack of six blood work orders and told it will make my life easier to just get a bunch of them now so that for the next month and a half each Friday I can just go straight to the lab (I guess "easier" is a relative term). Now comes the waiting, I am guessing that next Friday when I meet with the doctor I will hear my hCG levels from this week and I will be hoping that the blood they took from my arm today has a level anywhere below 20,000.

So about that therapy....
After Justin was done with class today we drove straight down to the San Diego Zoo. The temperature in itself was heaven. Watching Kaia's amazement as she gazes at the animals never gets old...and she now is in love with the panda bears and how they are always chewing on their bamboo sticks. I think one of the meerkats was dying...but Justin swears it was just taking a rest (on its back, in the middle of the cage, gasping for breath). Otters have more personality than I ever knew, they would not stop swimming back and forth in front of Kaia trying to get her attention...I think they just had never quite seen hair like that before.
Then came dinner in Old Town with the greatest friends ever. Friends and food make all of your troubles disappear (especially when the food includes lobster). I have decided that spending every weekend in San Diego is the answer for dealing with the stresses of life.

The Beginning

I have Kaia, which makes all of this seem so much more survivable. That said...the experience of a molar pregnancy is still awful, and mine is just beginning.

I discovered I was pregnant with my second child at the end of May. I resigned as a high school biology teacher because despite loving my job, I would rather spend my days with my soon-to-be two children than pay someone else half of my salary to watch them so that I could then raise 180 other children.

My first prenatal visit was schedule on July 7th. This would put me at almost 12 weeks pregnant, a little later than I would have liked to be seen. The appointment later got pushed back to the 9th, and I headed in alone...Justin was in Dental school until 5pm that afternoon. When the doctor fired up the ultrasound a blank uterus appeared on the screen. She said that she could not make out the fetus and just saw some movement near the bottom of the uterus. Having seen an ultrasound of an 8 week-old fetus, I knew I should at least be seeing a pulsating heart. However, the doctor did not seem too concerned. She handed me the paperwork to make the appointment for the official ultrasound at the hospital across the street and sent me on my way with a handshake and a "good luck."

I called the doctor the next day to report that my ultrasound could not be scheduled any sooner than two weeks away. I felt this was too long to wait if in fact there was something wrong with my baby. The doctor's nurse insisted things were fine and the fetus just needed time to grow, I was told that I was not as far along as I thought I was.

The bad cramping started a few days later and got worse over the following week. By Saturday the 18th of July, I knew that I could no longer wait until my ultrasound appointment on the 24th. I went into the ER at 11:30 that morning (13 1/2 weeks pregnant). At 9pm that night I learned that my pregnancy was not viable....it was possibly a molar pregnancy and I would need an immediate D&C. "A molar pregnancy????"

For the D&C I was rolled up to Labor & Delivery...not exactly where a mother who just learned of her miscarriage would like to be. After a few hours of listening to other women scream from labor pains, I was taken into an OR an put under anesthesia for about an hour. The D&C consisted of using a vacuum-like device to suction out the inside of the uterus. Due to the possibility of the molar pregnancy, they had to scrape the walls extra closely without puncturing the uterus. Once I awoke and finished vomiting from the anesthetic, Justin and I were allowed to return home at 5am Sunday morning.

I received the call yesterday around 1pm from my operating doctor (who will now be my new OBGYN!! she is amazing) that the pathology reports did in fact show that I had a molar pregnancy. It was a partial mole....not to be confused with the even lesser known complete mole.
In the past 24-hours, my new quest has been to educate myself and others about this molar pregnancy thing...and then set out to kick its butt and continue my mission to bring a new addition to our family into this world.

Here is what I know so far.....
A molar pregnancy is when masses of abnormal tissues grow (the mole) due to a genetic error after fertilization of the egg. In a complete molar pregnancy there is no fetal development, only the placenta starts to form along with the abnormal tissue growth--even more strange is that these tissue grow in grape-like formations. In a partial molar pregnancy, a fetus begins developing, only with severe defects and it is quickly overcome by the growing abnormal tissues. This IS a type of miscarriage....but I wish it ended there.

What occurs with molar pregnancies is that an extra high level of the pregnancy hormone hCG is released from the abnormal tissue growth. After the molar pregnancy is discovered and removed (usually by D&C) the hCG levels will steadily decrease down to zero if in fact all of the abnormal tissues have been removed. If the hCG levels do not drop or continue to increase, it is an indication that the molar pregnancy has turned into trophoblastic disease. Trophoblastic disease is a continued growth of the abnormal uterine tissues and it is usually treated with mild chemotherapy to prevent the spread of the abnormal tissue which would then be classified as a cancer.

My future....
Starting tomorrow I will go in for weekly blood draws every Friday that will track my hCG levels. As of Saturday my hCG level was at 20,000. The first positive sign will be a drop in hormone levels. I will continue weekly labs until my levels have been at zero for two consecutive weeks. I will then be monitored monthly (likely for 6-12months). If my hCG levels stay at zero for an extended period of time, I will be given the go-ahead to concieve again.
If my hCG levels rise or do not start dropping I will likely be given mild chemotherapy treatments to attack any remaining abnormal tissues. There is about a 20% chance that hCG levels do not decline, but the chemo is very effective with a 100% cure rate. If hCG levels rise, they will also do a CT scan to make sure the trophblastic disease has not metastasized to other parts of my body.

Here is my outlook...
I am disappointed. I am disappointed about the loss of a child. I am disappointed that in January Kaia will not have a sibling to poke and prod and try to boss around. I am disappointed that I will have to wait to be told by a doctor when I can attempt to have another child. I am disappointed that I will never be able to go through another day of a future pregnancy without worrying that something might happen again. I am disappointed that I don't know what to say when Kaia puts her head on my stomach and tells me that she can hear the baby inside. Oh, and I am annoyed that I will be spending too many hours of my life in the doctor's office over the next few months (at least it is air conditioned).

I am thankful. I am thankful that molar pregnancies and trophoblastic disease are nowhere near as scary as melanoma and I will take this battle anyday over the reoccurance of my skin cancer. I am thankful for my Kaia, and my family, and my supportive friends. I am thankful for my health insurance. I am thankful for the ability my body has to conceive a child in the first place.

I am hopeful. I am hopeful that people will read this and understand that molar pregnacies do not just end when the woman miscarries, there is a battle with hormones that she then must wage, there are weekly blood draws that remind her of her loss, and there are agonizing waiting periods to hear of how much or how little hormone levels have changed.

I will continue to update my blog as I progress down my molar pregnancy road. I will post my hormone levels and their consequences, and I will not stop posting until my next child arrives into this world.