Tittle--My Sneaky Hummingbird

We contacted Dr. Pritts, told her about what was going on with my body and our planned trip. She told us to come in for day-11 u/s to see if she could get an idea of what my body was doing. Unfortunately, we didn’t have any follicles waiting to release any eggs, but we were excited that my body had at least attempted to have a cycle on its own. Jon and I enjoyed our trip to Faith’s Lodge, celebrating Oscar and Bella, knowing that when we got back home we were going to start fertility treatments again to bring home Oscar’s and Bella’s little sibling.

In late November 2009, Jon and I began going back to our fertility doctors. We were more cautious this time. We knew we COULD get pregnant, but now we wanted to try our hardest to only conceive and carry one baby. We discussed this with the doctors and we moved ahead with our treatment cycle. As my follicles grew bigger, Jon and I decided that we would trigger early (when our lead follicle was between 16 and 17mm). The chances of an egg being released from a follicle that size was 85%, much lower than if we had continued medications. Jon and I were okay with reducing our chances; we much preferred not getting pregnant over having a multiple pregnancy again. We triggered, we had our IUI’s and we waited.

Two weeks later we took a home pregnancy test, received a positive, called our fertility docs, went in for a blood draw to confirm. My results came back at one-quarter the level they had been with Oscar’s and Bella’s pregnancy. Since that pregnancy started with four, I figured we had conceived only one child. The day we took our home pregnancy test, Jon looked up online how big a baby at 4w gestation was. The article he read said that the baby was about the size of a period at the end of a sentence. He said that Period wasn’t a very good nickname, so how about Dot? I thought Dot was fine, if we knew already that we were carrying a girl, so we decided on Tittle (the dot above a lower-case I and a lower-case J).Three weeks later, at our head count u/s (7w gestation), I was shocked to be told I was carrying twins.

I said to Dr. Olive, at least 4 times, “There’s only supposed to be one.” We had triggered early. We had reduced our chances of even conceiving one child. How in the hell did we conceive 2? As is standard protocol after the 7w u/s, if all looks good, we were released from our fertility clinic. We were now in the hands of the high-risk clinic. We had an appointment set up with them for 16 days later to discuss what had happened with our prior pregnancy and how we were going to move forward with this one.

While I was still in shock that we were carrying twins, and so frightened that we would lose these twins just like we lost Oscar and Bella, over the next 1.5 weeks I began to accept that starting with 2 was very different than starting with 4, I would have flashback and grief and jealousy throughout this pregnancy (why couldn’t Oscar and Bella have lived like these two did?), decided to resurrect the nickname Dot, we continued the weekly tummy shots that we started at 4w gestation…and then the spotting started.

I was so scared. I had just come to terms that we were carrying twins. Luckily, I had a previously scheduled appointment with the nurses at the high-risk clinic. We spoke about the spotting I was experiencing and the nurse reassured me that it was all within the realm of normal. Over the weekend, however, the spotting changed in color and consistency, and it made me worried that I was going to lose Tittle and Dot.. On Monday morning I called the high-risk clinic and left a message that I wanted an u/s to determine what was going on. When one of the nurses returned my phone call, she told us that the fellow on-call didn’t think any useful information would be able to be seen on u/s. I was in shock. This nurse and this doctor, both of whom we worked with during Oscar’s and Bella’s pregnancy, told me I couldn’t be seen? I said to this nurse, “I’d like to know if I’m miscarrying.” She may have been following the doctor’s orders, but she knew us, she knew the anxiety that pregnancies following a loss can be filled with and it felt like she didn’t advocate for us at all. I hung up the phone with her and started crying. Not only was I crying because I had already bonded to the pregnancy and to Tittle and Dot growing inside of me, but also because it felt like, to the high-risk clinic, I was “only” 9 weeks along and my kids didn’t matter, despite the fact that I had an appointment scheduled with them in two days.

After Jon comforted me, he called our fertility clinic. He explained what was going on with the spotting, that the high-risk clinic wouldn’t see us and we had an appointment scheduled in 20 minutes. As soon as we arrived at the fertility clinic we were brought back to an exam room and in a short amount of time Dr. Olive came in to perform the u/s. I couldn’t see the screen, but Jon was able to stand behind Dr. Olive the entire time. Jon knew before Dr. Olive said anything, but he didn’t want to believe it. There was only one heartbeat flickering on the screen. Dr. Olive said that he could see where the bleeding was coming from, that Dot and Tittle didn’t share a blood supply and that the one twin’s death shouldn’t have a negative impact on the other twin or the rest of the pregnancy. I was devastated. I had just been feeling good about carrying twins. I had already bonded with Dot and Tittle, and now one of them was dead. Due to a malfunction with the u/s machine at our 7w u/s with Dr. Olive we didn’t even have a picture of both kids while they were alive.

We left the clinic and got into the car to drive home. I called the high-risk clinic back, as I wanted to find out what MFM we’d be seeing on Wednesday, so that I could let Dr. Olive know that information. Luckily, I was able to leave a voicemail for the nursing staff, otherwise I probably would have yelled at someone for refusing to see me. Instead, I left a message something to the effect of, “I just thought you’d like to know that another one of my children has died and thought you’d want to know. Also, I need to know who I’ll be meeting with on Wednesday so that Dr. Olive can speak directly with that doctor about the useful information he found on the u/s he just performed for me.” I eventually received a call back, and the nurse apologized for our loss, but it didn’t make it better.

I asked Jon if he would attend my appointment with Julianne that was already scheduled for that afternoon. I am so grateful and thankful that I was able to see her that day; that I had someone able to help me so soon after I found out that our child had died and to start the process of now grieving three children while pregnant with one. I don’t remember much of that appointment. I think I was still in shock and so scared that I would miscarry completely.

Jon and I already had a list of questions to bring with us to the MMF appointment, but one question quickly got added to the top of the list. Jon and I knew this pregnancy would be filled with anxiety, nervousness and the need to be taken care of physically as well as mentally. Based on how we were treated, by not being allowed to come in for an u/s, Jon and I questioned whether or not we should have found someone else to care for us. Yes, I was high-risk for diabetes, but I still could have worked with April Eddy, the diabetes educator at the high-risk clinic. April said that there were a few doctors in the area that might consider me as a patient, but we wanted to give the high-risk staff an opportunity to defend themselves.

We arrived at the appointment and were seated in a room with the MFM, the fellow we’d be working with throughout the pregnancy and THE nurse. The same nurse that told us we couldn’t come in two days prior to find out that one of our children had died. The appointment began with us, basically, being asked why we thought we were meeting. I responded by letting them know that before we even talk about that, we needed to talk about what had happened on Monday. Jon and I explained, without using any names of the people involved, what had happened and what we needed our caregivers during this pregnancy needed to provide us. Dr. Tyler (MFM) let us know that anyone that had read our chart should have let us come in for an u/s. We explained that both the nurse and doctor involved knew us and knew what had happened with Oscar and Bella. I don’t remember exactly how she responded, but felt vindicated that THE nurse knew she should have advocated for us with the doctor to let us come in. Jon and I then continued on with the rest of our questions about what our care would be and how it would be provided throughout the pregnancy.

I may be wrong, but I think that night, or the next day, Jon and I had to figure out which twin died: Dot or Tittle. We used the nickname Tittle first and added Dot after we found out there were two. I don’t remember the discussion, nor do I remember when it happened or how, but we determined that Tittle was sneaky. Not a lot of people know what a tittle is and by all statistics we were only supposed to conceive one child, so we decided that Tittle snuck in and then snuck back out to go to Heaven. Over time, I came to think that maybe Oscar and Bella wanted a sibling to play with in Heaven so that they didn’t miss out on any of the fun of having a younger sibling.

Continued on Gus--My Little Duck