Thursday, February 27, 2014

An update on me, since the partial molar pregnancy.

Well physically I am doing great.  The first day or two after being released from the hospital I felt pretty terrible:  exhausted, still shaky, racing heart, etc.  But every day for the next week, I felt my strength coming back and was feeling better and better (probably thanks to the iron pills!).  The 2nd week I started feeling tired again, but after my thyroid levels came back at a normal level I started to feel much better (maybe it was psychological?).

My HCG levels have been falling quickly! 

Upon admission to the hospital HCG was 650,000+
Upon discharge HCG was 150,000+
10 days later HCG = 1,351
1 week after that HCG = 317
*edited to add* 1 week after that HCG = 135
                          1 week after that HCG = 70
                          1 week after that HCG = 42
                          1 week after that HCG = 27
                          1 week after that HCG = 19

I have to continue to have my HCG checked weekly until it has reached a negative level (depends on the doctor, this can be <5 3="" a="" and="" at="" check="" checks="" consecutive="" continue="" for="" has="" it="" level="" monthly.="" nbsp="" negative="" or="" p="" then="" they="" to="" weekly="" will="">
Tomorrow is already 3 weeks since losing the baby.  And the day after tomorrow is our 5 year anniversary of losing Mary Grace.  It's just so surreal.  I would have never thought after losing 4 babies back to back and then having 2 more healthy children that we would have lost another.  Of course it makes me think what the future might bring.  I'm not getting any younger, but I do turn 34 this year and then of course the next year I become....duh duh duh....."of advanced maternal age".  Normally that wouldn't really phase me except that I kind of tend to already have complicated pregnancies.

Emotionally, this loss has been very different for me.  This time I just haven't really been releasing many emotions until they just can no longer be contained and I explode.  After the explosion with Ian which I wrote about last time, I went to confession and really made a resolution to control myself better....or at least try to be conscious of the times when I am getting upset, so that I can decompress before it gets to a nuclear level!  And for the most part I thought I had been doing a pretty good job.  But Isabel has been expressing some concerns, so I need to do better.  I see weekly confession in my future for awhile just to help me to stay on track!  I need that sacramental grace!!!

Emotionally, so far it has also been easier to have a lot of pregnant women around me (aside for that first HCG check at my doctor's office).  I have 5 good friends who are currently expecting babies this spring and summer!!  And thankfully by God's grace He is really helping to spare me from feelings of jealousy that I have had in the past after a loss.

So we are doing pretty good overall.  Spring and summer are obviously very busy for us with the garden, and that has already started to serve as a good distraction and even a way to heal.  Yesterday Isabel and I started our indoor seeds of peppers (hot and sweet), onions, basil and tomatoes (4 different varieties).  Those little seedlings are a fun project ...watching them sprout and grow, tending to them with water and light...setting them outside to harden them off to the elements when they get big enough. 

Hmmm....kind of like raising a garden of children! 


Tuesday, February 18, 2014

The Third Gift of Prayer: taking the baby home.

As soon as I had been admitted to the hospital I had a gut feeling that things were not going to end well in this pregnancy.  And I began to have thoughts regarding what we would do with the baby's remains if the worst should in fact happen.

For some reason I could not bring myself to ask the doctors about taking the baby's body home, even though I was given multiple opportunities.  A doctor would come in to brief me on my condition and always asked, "Do you have any questions about anything?".  I guess I thought it was such a bizarre request- wanting to take home a tiny 3-4 inch baby.  I could barely even fathom discussing it with my own husband for fear he would think me super weird.

But while I was in the hospital I happened to read this blog post at All You Who Hope.   It had been posted over 2 weeks before this time, but God led me to read it in His time and in this place.   And then I understood that taking my baby's remains was exactly what I needed to do.  So I gingerly approached Rob and he was in complete agreement (I honestly don't know why I had been so hesitant to approach him before)- and then I got up the nerve to ask a doctor if this would be possible.  They assured me it could be done and that they would work through the paperwork and legalities to make it happen.  Along the way however, it became apparent that there was a newer hospital policy that had been put into place that remains could not leave the hospital with a patient but must go through a funeral home.  The doctors and nurses frankly told me they disagreed with this policy and they even tried to find some loophole, but in the end, there was none and the rules were the rules.

So we began to look for a funeral home that would be able to pick up the remains from the hospital and bring them to the funeral home and then release the remains to us.  The "big" funeral homes were not able to meet this request due to more red tape.

By the time we learned this, I had been released from the hospital after leaving Francis Marie's body in the care of my nurse who assumed personal responsibility for it.  This nurse's name was Kim and I am so grateful for her compassion and willingness to look after the body to make sure it got to where it needed to go.

At this point we called our pastor who was very gracious to make a call for us and found a funeral home that would help us.

This was the third gift.  After getting the doctors to agree to an induction, after delivering at the critical moment before a D&C would have taken place, and then being able to bring the remains of the baby home- these are all gifts the Lord has given us.

Doors that He opened at just the right moment so that it was neither too soon, nor too late for the gift to be given, but the perfect moment for the gift to be received. 

Isabel made a Valentine to be buried with Francis Marie.  It is both beautiful and heartbreaking.


It reads:
Little Baby up in Heven
Pray for our family since you had to die to save mom
So plese pray for our family
And plese tell Lord Jesus Christe to send blessings to help our family
not to be sad
Happy Valintines Day
So sweet, so sad, yet such a gift.

Tuesday, February 11, 2014

The Raw Emotions of Losing a Baby.

The night I came home from the hospital was initially full of joy and hugs and little ones happy to try to return to normalcy with Mommy home.  But that didn't last long.

I was so grateful that we had been blessed with a meal that night because I was too weak and exhausted to really even stand for very long.  As we sat down to eat, that's when Isabel just starts pouring emotion from her seven year old little heart.  "Why would God give us the joy of a baby only to take it away!?"  From her tiny little frame came this desperate voice, almost shaking her fist at God as she threw her arms up in the air.  I held her close and tried to explain that we can't understand some things this side of heaven, but we can think about Jesus' suffering and do our best to unite our suffering with His. 

My little Isabel,....way too experienced at losing siblings.

That night as I sat on the couch with the kids watching a children's show before bed, Rob walks in from locking up the chickens in their coop and hands me a note.

Something killed Wynona and I can't find Dora.

Our baby chickens...

My mind started reeling, but I sat perfectly still.  I couldn't say anything.  We couldn't tell Isabel yet.
It was too much.  Too much loss for one day.

The next morning I got up early and went out to look around the coop for signs.  I saw the black and white explosion of feathers near the tractor shed that had come from Wynona.  I half-hoped to see Dora come flying down from a tree, waiting to be let in with the other chickens....until I looked out into the field and saw the mass of reddish-brown feathers that had been Dora's.  I stumbled back inside, numb, angry, sick to my stomach.  And I sat on our garage steps and cried like a baby. 

I cried for two stupid chickens.  And for our dead baby.

I had held it together very well at the hospital and I was literally full of wonder and awe at the delivery- I cried with joy and relief at answered prayers then.  But on my garage steps I sobbed for the loss of it all.  The loss of another baby we will not get to know.  The loss of sibling joy over a new addition to the family.  Memories unmade and already lost.  It was cruel to lose a baby.  I went inside and told Isabel what had happened.

The day continued without much incident from there until just before dinner time.  Ian came into the house grumpy and I thought I had gotten him settled down until I saw him intentionally smash the exersaucer down  on Caroline's hands.  All of the emotions that had been building inside me exploded out of me; directed in deep, deep anger and rage at this little three year old.  He was in tears and I cried and apologized to my shocked husband.  My heart was pounding out of my chest and my pulse was 125bpm.  I excused myself to calm down.  Then I apologized to Ian and of course, he looked up with his giant blue eyes and forgave me.

I was lying in bed that night trying to figure out how to accept this cross better.  Surely all these emotions come with grief and loss, but I'm not carrying my cross well if I am sinning by screaming at my 3 year old.  I begged God to help me do better.  What can I offer up if I keep making a mess of the cross You've given me??  I have to keep looking for the gifts, the blessings in this thick muddy mess of loss.

Saturday, February 8, 2014

A letter to our friends.

A letter to our friends. 
The following was written to be shared with anyone who has been praying for our situation over the last few days.  And for those who may not have access to Facebook or Blogger. 
It is meant for you.  Thank you.  You have been such a blessing to our family.

Dear Friends in Christ,

It is the deepest thanksgiving that we wish to extend to you for all the prayers, thoughts, meals, help with childcare, hospital visits and support during the last few days.

On Wednesday, my wife Angela was admitted to UNC Women's Hospital at 13 weeks 3 days into her pregnancy due to a partial molar pregnancy which was causing ever-increasing blood pressures and extremely high thyroid hormone levels.  Her situation was serious enough that her regular OB-GYN in Raleigh felt it was safer for her care to be managed at that point in a hospital with more specialized and experienced doctors.

The doctors immediately wanted us to end the pregnancy due to the potential for life-threatening emergencies such as pulmonary edema, seizures, stroke and thyroid storm.  But at this point Angela was stable so we contacted the National Catholic Bioethics Center for some ethical choices to this situation.  Wednesday night Angela's blood pressure became stable, but Thursday it was back up again and we received the test results that our baby had a fatal diagnosis, also caused by the partial molar pregnancy.  It was decided that we could begin an induction at that time- this was our first major prayer victory as the doctors were initially unwilling to perform anything but a D&C.  A D&C performed with our live baby in the womb would have been akin to an abortion and we could not allow that. 

After speaking with the NCBC we learned that an induction to remove the source of the pathology (Angela's molar placenta) would be morally licit, although the unintended consequence would be the death of our baby.  Because our baby would be delivered whole and intact with an induction, it would preserve it's dignity as a human made in the image of God.

The induction began at 1:30pm Thursday.  By 2:30pm Angela was already experiencing cramping and bleeding, even though the doctors informed us it could take 24 or more hours to complete the process.  By 6:15pm I, Robert, was able to join Angela at the hospital, but I would have to leave by 10:00pm to relieve the family who was watching our other children at home.  Angela soon began to pass some large blood clots and her bleeding picked up so much that around 7:30pm, the doctor was very worried and recommending an immediate D&C.  We asked her to consult with a more experienced doctor who came in and told Angela to push.  By God's extreme grace, she delivered the molar placenta first, and then our tiny little baby; whole, intact, and beautifully and wonderfully made.  This was our second tremendous prayer victory that we know was only possible because of the prayers you offered up to our Holy God for us.  When this doctor delivered the baby, she spoke with such sweetness and joy in her voice, as if Angela had just delivered a live full-term infant!  It was such a blessing, and though we were sad for our loss, there was a sense of rejoicing and awe at the awesomeness of our God to allow our tiniest baby such a dignified entry into this world and passing into the next. 

After delivery, Angela had to have the D&C procedure to remove any leftover molar tissue (which of course, at that point was without ethical dilemma).  She was released on Friday afternoon.

If you are still reading, I apologize for the length of this note, but wanted each of you to know how through your prayers and kindness we experienced graces and blessings even during this tough time.  We are not strangers to pregnancy loss.  This was our 8th pregnancy.  We have 3 beautiful live children:  Isabel (almost 8), Ian (almost 3), and Caroline (almost 1). 

Because our newest baby in heaven was so young, we do not know it's gender.  We decided to choose a boy's name and a girl's name:  Francis Marie.

St. Francis de Sales wrote the following:

The everlasting God in His wisdom has foreseen from all eternity the cross that He now presents to you as a gift from His inmost heart.  This cross He now sends you has been considered with His all-knowing eyes, understood with His divine mind, tested with His wise justice, warmed with loving arms and weighed with His own hands to see that it be not one inch too large and not one ounce too heavy for you.  He has blessed it with His holy Name, anointed it with His consolation, taken one last glance at you and your courage, and then sent it to you from heaven, a special greeting from God to you, an alms of the all-merciful love of God.

Thank you so much for all that you have done for us.  We are so very blessed.

In Christ's love,
Robert and Angela Holmes

Friday, February 7, 2014

Delivery Update.

Our fifth baby arrived in heaven yesterday evening.  Baby Francis Marie was peacefully born sleeping, perfectly formed with the tiniest little Fingers and toes.  God worked out all the details of last night in such a beautiful way.  I will share more when I get to feeling better. This morning I had a D&C to ensure that all of the molar placenta tissue had been fully removed.  I should be released today pending blood tests and if blood pressure stays stable.
Thank you for all the prayers- they are a huge part of the story and why we felt such peace last night.

Thursday, February 6, 2014

The Diagnosis.

Initial test results from the CVS indicate that this is a partial molar pregnancy and the baby has Triploidy.  Our second triploid pregnancy.

My blood pressure appeared to go down over night, but today it popped back up.  They started me on a beta blocker that should help some of the hyperthyroid symptoms.  Right now I am hooked up to a heart monitor with 5 or 6 sticky pads stuck all over my chest and sides.

I have been transferred to the labor and delivery floor and they have agreed to do an induction rather than a D&C.

Can't type much as they just placed a pulse moniter on my finger and my tablet always gives me a hard time with

Many doctors have come in today and introduced themselves.  I am so thankful for how accommodating the staff here has been for our request to give the greatest dignity to our little one.

God is just arranging the details for this hard time just beautifully.  I have been blessed by visits from a dear friend today who had just been through a pregnancy loss herself, visits by 2 doctors who share our faith, and my current nurse does as well.  We have had offers for childcare, food, and so many prayers and words of encouragement.

The Lord has placed some bible verses and blog posts right in front of me today that have helped to confirm some of our decisions.

Its 4:16 pm now....going to be a long night.  Thank you for your prayers.

Wednesday, February 5, 2014

13 weeks 3 days and in the hospital

I am 13 weeks and 3 days and now I AM in the hospital. Last night I got lucky and there were no beds available. Today, after the CVS test they admitted me to UNC Women's Hospital where I am surrounded by a number of experts, none of which recall seeing a case that has presented like mine. The CVS test went well. I was extremely nervous that it would be painful like3e my ultrasound with Mary Grace had been, but thanks to God my placenta was perfectly positioned so that he was able to run a catheter right up through my cervix and to the placenta where he suctioned out some cells. Results might be available as early as tomorrow. My symptoms are high blood pressure, hyperthyroidism, tachycardia, extreme nausea especially after eating, cystic thick placenta, losing weight, baby is behind on growth, protein in urine,...I think that is it. The doctors are worried because apparently things can go downhill for the mother quickly with these complications from a partial molar pregnancy. They are worried specifically about: seizures, stroke, pulmonary oedema, bleeding and I think that is it. That's enough right? I still feel jittery, have the hand tremors, a slight headache, and kind of feel a bit of pressure in my head and neck. An anonymous commenter had the wonderful idea to consult the National Catholic Bioethics Center. Thankyou soooo very much for this idea!! My husband called and they were so incredibly helpful in laying out the moral options for this situation. I had no idea you could consult with them- I wish I had known about this service back in 2008 when we had our ovarian ectopic pregnancy.  So basically I think the plan is to wait and see what the CVS diagnostic test tells us.  Then we will know if this is truly a partial molar, and if the baby is chromosomally normal.  Of course Mary Grace had a chromosomal abnormality where we knew she would not live, we still carried her until her natural death in utero at 21 weeks.  The doctors in this case do not believe I would be able to carry this baby far enough for it to survive because my complications would become too severe before then.  The doctors here want to do a D&C.  But truly with a live baby, a D&C would be just like an abortion.  We wont do that even if my symptoms are getting worse.  The National Catholic Bioethics staff advised us that it would be ethical to induce labor to get rid of the placenta if that was in fact the source of the pathology....the trophoblastic placenta is what is causing all the serious health problems.  This would be morally allowed because of the intent to remove the source of the pathology, and the unintended effect would be the loss of our baby.  Because an induction would keep our baby intact and whole, it would preserve the dignity of our child who was made in the image of God.  Other options that are morally acceptable include a c-section which would remove the placenta and baby intact, or a hysterectomy if the doctors were to deem me to have sufficient risk if I kept my uterus.  Obviously if it comes down to one of these options, we would prefer the induction.  I have already mentioned our concerns about a D&C and our preference for induction should things continue to go downhill for me healthwise.  This was well-recieved by a compassionate doctor here but she had to ask the senior doctors if itbwould be "allowed".  Of course we hope that we can keep trucking along and keep me and baby stable....that is the ultimate goal.  Would you continue to pray for the doctors and their understanding of our values? We are so thankful for all of your has really encouraged me to read your comments, emails and texts.  Thank you!  We are comforted by your prayers and by our precious Savior who knows the plans I have for you, plans to give you a hope and a future.

Tuesday, February 4, 2014

A Problem Pregnancy. *Update* Drat....they are admitting me to the hospital.

Today I went to my appointments at the UNC Women's Specialty Clinic for genetic counseling and then my First Trimester Screening.  The screening is a combination blood test and ultrasound to check for Down Syndrome, Trisomy 18, and Trisomy 13. 

I got an ominous feeling when I saw the ultrasound tech who had done the ultrasound when Mary Grace had passed away....luckily, she called another patient, not me.

I got the really super nice ultrasound tech who had helped with my amniocentesis with Mary Grace.  This guy just instantly puts you at ease.  And when he started telling me about the problems he saw with this pregnancy, and I started bawling on the table, he handed me a washcloth to cry know, the ones they have handy to wipe the ultrasound gel off?  He made me feel as comfortable as I could with the new circumstances surrounding my pregnancy and helped me focus on the positives. 

I'll start with those.

First, baby is alive and wiggling all around with a strong heartbeat. 
The nuchal fold measurements came back within a normal range which means that it is unlikely that this baby has Down Syndrome, Trisomy 18, or Trisomy 13.
I had plenty of amniotic fluid.
The baby's heart and brain looked good so far for this stage of pregnancy.
We got some good pictures.

The bad news:

Baby is measuring exactly 1 week behind.  I am 13 weeks and 2 days and baby was measuring 12 weeks and 2 days. 
My placenta does not look good.  It looks like swiss cheese; very cystic.  It is much "thicker" than it should be.
The Maternal Fetal Medicine doctor came in and said that this looks like it could be another Triploidy case, or it could be a molar pregnancy.  Apparently they are leaning more toward a molar pregnancy since I have a lot of the symptoms associated with molar pregnancy, such as:  spotting, severe nausea, developing complications like thyroid disease, high blood pressure, protein in urine.
They did an extra blood test today called a NIPT which is a new test that should tell us if this is Triploidy or a molar pregnancy.  The results will take up to 2 weeks. :(

In the meantime, my blood pressure at the appointment was as high as 155/112 and I had tachychardia at the office.  Of course, it could have been due to all the bad news.

The MFM sent me immediately back over to my regular OB.  My blood pressure was normal at his office (of course they used the regular cuff on me twice, instead of the small cuff recommended by the MFM office).  OB found +2 protein in my urine and was debating putting me into the hospital!  What?  I was not prepared for that.  He consulted with MFM doc and agreed to send me home but read me the riot act and told me to come back in if I began to feel worse.

I have an appointment with regular OB on Friday.  With MFM on Monday.  They want me to do a CVS test on Monday to try and get results sooner.  Ugh....this is Mary Grace all over again. 

God help us.

Would you please pray for us?

***UPDATE***  5:12pm 
Doctor called and told me I am definitely hyperthyroid right now with TSH levels at less than .005, T3 at 6.9 (normal = 2-3.9) and Free T4 at 2.2 (normal = .7-1.4).  So that is indeed why I feel super jittery and my hands are shaking.  More bad news is that my HCG levels came back very high at 382,854 when they should be in the 50,000-100,000 range for this point of my pregnancy.  This is highly indicative of a molar pregnancy, according to the doc.  Between my regular OB and the MFM they decided to admit me to REX hospital.  However, when they called to get me a room, REX is entirely they debated sending me to UNC (over an hour drive at least), but after I had packed my bags they called back and decided I could stay at home tonight and go straight to the ER if I have any worsening symptoms.  So I am home for the night.

Tomorrow a.m. I will head over to UNC to have the CVS test done (an invasive test that they do instead of an amnio since I am less than 15 weeks).  They are repeatedly telling me to start thinking about having to make some "tough decisions" if my health starts to deteriorate.  We all know what that means.  This is actually turning out to be worse than Mary Grace, because I was "free" to carry her as long as she lived.  With this baby I am already feeling "pressure" to terminate. 

Tried to pray the Divine Mercy Chaplet on EWTN today at 3pm...but I could only sit through it and stare at the tv.  But really felt peace when they said the closing prayer:

Eternal God, in whom mercy is endless and the treasury of compassion — inexhaustible, look kindly upon us and increase Your mercy in us, that in difficult moments we might not despair nor become despondent, but with great confidence submit ourselves to Your holy will, which is Love and Mercy itself.