Depression, Anxiety, Seeking Help

As long as I can remember in my adult life, I have suffered from depression, anxiety.  While depending on life stages it impacted me differently.  Manifested in different ways.  I learned how to put on a 'happy face' and function through it.  In my quiet moments I was sad, I was scared, I was nervous, I felt like I wasn't happy with myself.  

In January of 2020, I had sought help from a mental health provider to be officially diagnosed and start some type of medication to help.  I was at a very low point,  angered easily, crying spells, worried often.  While I was still able to carry a job, maintain the house and get out of bed, I was miserable.  I felt my relationships, especially with my husband and my children were suffering and impacted by my mental state.  I knew if I continued down that same path, nothing positive would come from it.  It pained me to see how low I had let myself get. 

Back in early college I had been placed on Lexapro and while I made the negligent decision back then to go off cold turkey and not talk about it, I was determined this time to give it a go and make it better.  With the help of my provider I was placed back on Lexapro and told that I had Major Depressive Disorder and Generalized Anxiety Disorder.  I knew those diagnosis were coming and that I needed to prioritize my mental health.  My provider suggested I try therapy in conjunction with medication for full benefits.  At the time the therapist she recommended and my insurance were going to equate to a very expensive treatment sessions.  With impending thoughts of starting to try for another baby summer of 2020, and not knowing what our fertility future looked like financially, I didn't want to also be spending hundreds of dollars monthly in therapy bills.  I opted to only do medication at that point. 

Fast forward though months of infertility, miscarriages and an emotional roller coaster I came to realize that it had all become too much.  And while I was better with my little white pills, I wanted... needed... had to be better.  When the thoughts of the world being too heavy, too much to manage, that those around me could be and would be better off without me as a burden creeped into my mind I had to seek help.  I am blessed to have the support of friends, family, co workers who all were able to direct me towards finding a therapist that would be the perfect fit.  I couldn't be more thankful, happy and blessed to have been connected with Jolie Vega at Seasons Mental Wellness P.C.  

In June of 2021, I had my first appointment with Jolie and have been going weekly ever since.  The relief, the validation, the ground I have uncovered over the past few months has been life changing.  Jolie while a therapist specializes in infant loss, miscarriage, infertility.  All of the things that have compounded over the past 8 years and lead my already unstable mind into a furry of emotions.  

8 years is a very long time to go down the path of infertility, loss, post partum depression/mood disorders, and pick it all up to go again.  I should have, I wish I would have talked to someone like Jolie from the beginning.  While I wont bore you with all that we discuss some of the main life changing realizations I have come to is...

* Grief is all encompassing.  While I move through the stages of grief for not only the loss of each cycle but the loss of our babies, the loss of our embryos, the loss of time.  I am continually bouncing between the stages and it manifests in different ways.

* Exposure to triggers.  My unit I worked on through a majority of our 8 years of infertility/loss was Mother/Baby.  While my co-workers were amazingly supportive, I was continuously exposing myself to one of my triggers of anxiety/depression.  These families while a good portion were beautiful caring loving families we would have patients who were drug addicts, homeless, incarcerated, CPS involvement, one night stands, and I couldn't help but think why NOT me?! How can these women have a baby and a pregnancy and I cannot.  I leaned into my overwhelming thoughts in my head of how difficult it was to go and be happy while surrounded by these scenarios while at work all while going through what we were.  I opted with the help of my manager, family and therapist to seek other areas that would bring me joy all while not exposing me to my constant trigger.

* Replace the word but... with and.  I need to allow myself to have multiple emotions, responses, and it is possible to feel polar opposite emotions at the same time.  

While I still have so much to work through and feel like we could all benefit from therapy to uncover our past, our minds and how to do the work to process and be happier.  I want to encourage those who might be on the fence of seeking someone to talk to, just try it!  I am becoming a happier, more content better person through this self discovery. I don't have it all figured out (never will), but I know whole heartedly I am headed in a better direction than I was a few months/years ago.

Boy Mom!

Throughout the pregnancy, since the boys first knew they had said they wanted a "sister" they wanted a GIRL.  I had very little 'feeling' on gender, felt swayed by the boys desire for a sister and questioned if maybe this time it was a girl?  The first trimester was a bit more rough with nausea, food aversions and exhaustion... However, I was 8 years older than the first time I was pregnant with Jackson so I doubted my logic.  That evening surrounded by family, Easton, Jackson, Derrick and I opened a box of balloons to see BLUE! Boy mom here I come.  While I was so excited to have another little boy in our family the look of disappointment and sadness on Jackson's face was heart melting.  Still to this day at 28 weeks they will comment "I wish we were having a girl", they will slip up saying she/her/sister when talking about the baby.  I know though once he is here that they won't be able to think of anything other than how perfectly he fits into our family.  I truly believe God gives us the babies we need.  And, I was destined to have all boys, I couldn't be more excited for it!!

Boy Mom!!

Jackson was less than trilled it was not a SISTER

The Tiniest Baby, The Growing Hope

June 10th Derrick and I went into the office for our first ultrasound of this pregnancy.  We were so nervous.  Not wanting to expect, hope, or think of what might or might not be shown.  There it was... Our baby.  The tiniest little blob, with a flicker of a heartbeat.  One would think this would offer me full reassurance that all was good, but in our past we had seen a heartbeat and still had a miscarriage.  So I couldn't fully relax.  I wanted to in the worst of ways.  

Very bloated from the injections

Cloud 9, but nervous as heck

Our Sweet Little Miracle

The next few weeks were difficult.  Wanting a play by play but knowing that wasn't possible.  I wanted a window into my uterus to show me if the heart was still beating, if the baby was still growing, if my body was doing ENOUGH.  I started going to therapy With Jolie Vega on June 15th and wow was that over due.  We will discuss this further in another post, but the reassurance from a non bias therapist was just what my heart needed to rationalize and validate my fears.  

July 1st, 2021, almost one year exactly from when we miscarried our third baby.  From when this saga of trying for another baby started we were still on the emotional roller coaster of living appointment to appointment.  The ultrasound thankfully showed a growing baby measuring right on track.  I was 9 weeks, and trying to rest assured that two ultrasounds showing growth, heart beat and no reason to think that anything from here on out would cause any derailment in our story.  

9 Week Ultrasound

Colorado Vacation

Pregnancy Announcement Photo

We spent the Summer busy with the kids, traveling, baseball games, VBS, work, friends and swimming.  In the midst of August through my weeks of therapy I uncovered my intense need for a career shift of departments.  I moved from my home unit of Mother/Baby of almost 12 years, to Employee Health at Bryan.  I needed away from my trigger, I needed less stress on my mind.  

September 16th we had our 20 week ultrasound.  While excited to find out the gender I was nervous that there might be something discovered during this ultrasound that would indicate something wasn't right.  The ultrasound tech, I am sure could sense my nervousness, she talked me through the exam that things were beautiful.  Our baby was growing, all fingers and toes were accounted for, and baby was wanting to not show its face.  Once we finally got a chance to see the face I knew... baby was a spitting image of his brother Easton.  I was determined it was a boy at that moment.  

The sweetest little button nose

Baby on his head

I HATE the Number 39!

This cycle I had decided to "test out my trigger" which means I take a pregnancy test daily after the trigger shot (hcg pregnancy hormone is the main ingredient) to watch the level slowly leave my body in the days after and hopefully start to rise again.  

Testing out the Trigger Shot

11 Days Post Trigger Shot - very very faint

I watched the second line go from a solid line to a shadow, but then something happened... It didn't fully ever leave.  It came back.  On May 23rd prior to heading to brunch in Omaha with some girl friends I took my morning pregnancy test and it was darker than the day before.  I ran to Derrick and said I think this might be for real!! I think I am pregnant.  The whole time in Omaha all I could think of was the desire to take more tests, have my blood drawn and know the outcome of this sweet little baby growing in me.  Once I got back into town I stopped by Target and bought a bunch of different brands of tests and of course headed straight for the bathroom.

Line coming back into view

The next morning I called Tiff Vasa NP office and told them my exciting news.  We did labs that afternoon and I wasn't prepared for the number I got back.  Hcg was 39, progesterone 68.5 (still on progesterone shots).  While 39 is definitely pregnant, I was pissed, I was scared, I had seen this number before and it resulted in miscarriage.  The rest of the day I was shaken, depressed, had no hope and was for sure that this would end up just as my other babies did.  I was an emotional mess of tears, the boys were so concerned and tried to help comfort me.  In that moment I had to share with them why mommy's heart was breaking yet again, how scared I was and they held me.  My 7 and 3 year old held their mommy while I cried.  

Getting a bit darker

Jackson & Easton comforting mommy

Wednesday, May 26th I had repeat labs drawn, I was a nervous wreck.  I wanted to know but I didn't want to know at the same time.  I didn't want to confirm my fears were real.  I was working that day 7a-7p on Mother/Baby, I walked down to get labs drawn mid shift but had planned to not open them until I got home from work.  I didn't want to have to continue working or receive more bad news while surrounded by new families and happy situations.  I saw Dr. Friesen on the unit that morning and he tried to ease my fears by saying, "It could just be really early".  I knew he was possibly right but I knew there was a chance just as before this wouldn't go well.  After my shift I walked out to my car in the parking lot alone and opened my phone to see my lab results.  To my surprise my hcg was 115 and progesterone 63. This baby was trying so hard to stick.  I felt excited, guilty, nervous, love. 

Couldn't stop testing

Daily Medications

Labs again Friday, May 28th showed my hcg was 298 (more than doubled in 48 hrs) and progesterone was 83.5, also nice and strong.  Tried to become cautiously optimistic.  Although, my heart just wanted to protect and not allow positive emotions.  My family did the best they could to distract, encourage hope and offer support.  June 4th, I went in for more labs, Tiff Vasa NP said they looked great and feeling good about it.  Hcg was 4158, progesterone 64.5.  We scheduled our first ultrasound for June 10th.  Praise the Lord, Derrick could go with this time. 

Back to the Grind

March 22nd, 2021 we started cycle day 1.  Trying Femara PO and Progesterone IM. We did a few ultrasounds on 4/5/21 showing lining thickness of 8.1mm, and follicles at 11.4, 10.3, 9.4, 9.1 (and multiple others on my left), on my right was a 11.2, 10.0, 9.0 and about 10 more smaller. Estradiol was at 52.1.  We decided to continue to let them grow and repeat ultrasound in four days.  That Friday 4/9/21 I went in for a repeat ultrasound my lining thickness was 10.1mm. Follicles on left were 15.5, 6.6 and a few smaller, and right 5.8mm was my largest and multiple other smaller.  Estradiol had increased to 230.3 which was looking much better.  

A gift from a dear friend to hold on to and pray with

We continued to do ovulation predictor kits at home and on 4/11/21 had a peak test and triggered that afternoon.  Sometimes I just had the urge to see a double line, so post trigger shot I would test to see the bright two lines, although artificial from the injection. We started progesterone on 4/14/21 and kept our fingers crossed that our good looking follicles would bring us a strong conception. 

Positive HCG after Trigger Shot 4.12.21

Heading into the two week wait, we were back in the same spot that we had been so many times.  We kept busy with social outings (as much as we could with COVID still lumming). April 25th, 14 days post trigger we took a pregnancy test and again a single line.  We stopped progesterone shots and waited for my cycle to start again.  Right back into another round.

3 Days Post Trigger Shot 4.14.21

7 Days Post Trigger Shot 4.18.21

9 Days Post Trigger Shot 4.20.21

11 Days Post Trigger 4.22.21

April 29th, 2021 we started yet another cycle day 1.  This time we were going to step up our game and try Femara PO, Follistim SQ, and Progesterone IM.  Follistim was able to be filled at a local pharmacy compared to when we had tried with Jackson for our IUI and IVF rounds we had to drive to Omaha to fill all the vials, this was so nice to only drive across town.  

One of the additional medications we added

We did Femara 5mg cycle day 3-7, and added Follistim 50 units daily for 3 days starting 5/3/21.  Then headed in for our first ultrasound this cycle on 5/6/21, and planned to adjust injections from there.  On 5/6/21 our lining was 7.8mm and follicles were measuring 10.9, 9.1, 8.4 (plus many more on the left), right side had 12.6, 12.3, 10.8mm (and several other smaller ones). Estradiol was 125.2 which showed I was positively responding to the medications. We continued with 50 more units of Follistim and planned to repeat labs. We repeated labs that Saturday at Bryan and it showed my estradiol was 320.8, progesterone 0.3. Tiff Vasa NP who I was working with through these cycles was so excited, hopefully two good ones brewing, and the lower progesterone showed I shouldn't ovulate before our next scan. I went back on Monday 5/10/21 for another scan as we were wanting to closely monitor these growing follicles.  My lining was 14.4 mm and follicles 11.1, 11.7, 10.4 (left), 22.2, 17.8, 13.4mm (right). Estradiol was 317.9. With the estradiol not increasing much more this most likely meant I had one dominant follicle (the 22.2mm one), and some of the smaller ones regressed.  I couldn't help but feel like all of the hype trying to not over stimulate my ovaries had let us down.  Now only one single follicle to put all of our dreams into this cycle.  While I know the average woman only ovulates one, maybe two follicles a single month, I wanted more... to increase our chances of success.  We triggered that afternoon and started progesterone shots 5/13/21.  

Follistim SQ Injections

Me and my old friend

Easton and Jackson being so supportive

Trying Yet Again

After our miscarriage in July 2020 we continued to try for a third baby.  I began tracking my cycles via basal body temperature.  Every morning prior to moving/getting out of bed I would check my temperature and chart it.  After a month I was excited to see a pattern of ovulation and a biphasic temperature shift.  Woohoo maybe I am ovulating consistently.  My cycles ranged from 31-34 days, on the longer side but still having consistent 13 day luteal phases (period of time after ovulation).  

Basal Body Temperature (Biphasic)

We continued trying for a few months this way but were starting to feel like we weren't getting anywhere and I wondered if we would need a little more assistance.  I reached out to Dr. Friesen to do a progesterone check  a few days after what I thought was ovulation to confirm it occurred and thankfully it came back at 14.4 2/5/21. That cycle ended up resulting in a negative pregnancy test.

We decided to try a medicated cycle of Clomid 5mg cycle day 5-9.  We did an ultrasound to see how the follicles were growing on February 26th, it showed multiple follicles 14.2 mm, 12.8 mm, 12.2 mm, 9.3 mm, and lining at 8.52 mm on cycle day 13. They were growing but not quite mature for ovulation, we decided to wait a few more days prior to triggering ovulation and I continued checking ovulation kit at home to watch for a LH surge.  On 3/2/21 we checked an Estradiol level and it was 578.3 (typically each mature follicle will emit 200 , so this meant we had almost 3 mature follicles ready).  Derrick gave me my trigger shot that night. 

Starting 3 days after the trigger shot we began IM shots of progesterone to help supplement.  The two week wait began.  Thankfully I was busy with Vaccination Clinics and we snuck a trip out to Colorado as a family of 4 to do some hiking and quality family time.  Once we returned I tried to wait a few days prior to testing wanting to give as close to 14 days from trigger shot (this is a shot of hcg the pregnancy hormone, testing too early will result in a false positive).  

I took my first test on 3/16 and thought I possibly saw the faintest of lines.  I couldn't quite tell and held it up to all different lights, angles and took another one later in the day.  Since I was fairly certain with the second test I saw something I scheduled a hcg draw for the next morning.  On 3/17 we checked and hcg was 5, progesterone 29.2.  5 seriously?! That is the bare minimum.  I was gutted.  I figured it wasn't super high bc the tests weren't a blazing positive but I was hoping for a better number than 5.  At this point I knew this pregnancy wouldn't end in a positive manner.  We rechecked on 3/19 for doubling times and progesterone was 29.6 hcg 3.  We were experiencing yet another loss.  This time it is called a chemical pregnancy.

Faint positive

We had a chemical pregnancy back when we did FET (Frozen Embryo Transfer) prior to conceiving Easton, so we had been well versed in what it meant.  Each of my now 4 losses has been different emotionally.  They have each been different circumstances, different emotional place going into it, different support, different spot spiritually.  They each have sucked, but in a different way.  I didn't know how to feel.  I felt pissed more than anything.  Pissed at the world, pissed at our situation, pissed at the timing, I didn't want to be comforted... I wanted to scream and be ANGRY. 

Since the chemical pregnancy in March, we started another cycle.  This time trying Femara as our oral medication stimulant. We have one dominant follicle this cycle and did a trigger shot to help release it.  I have had more physical discomfort and distention this cycle, but hopefully it is all worth it.  I am keeping myself busy with Vaccination Clinics, the boys, and prepping for a busy Summer.  

I am thankful for my support system of friends, family and co workers.  Certain women in my life that are going through very similar struggles to grow their family offer great support in that they know how it feels.  I like to lean on them and I appreciate their being there for me.  Loss, fertility struggles suck and goodness we need a tribe to help hold us together.  It is so easy to get into your head and feel so alone during this all, but we are NOT alone, we just have to reach out and help normalize talking about it and supporting each other.  

Our Third Miscarriage

 2020 certainly has been a year of many questions, and unknowns.  In early Summer we decided to cancel our family trip to Hawaii due to the global pandemic and the strict guidelines on the islands.  Derrick and I have been hoping to grow our family by one more child and had prayed that it would be a smooth and quick process for us.  

One evening in June as we were getting ready for bed, I insisted that Abby needed a bath because she smelled like she had rolled in something rotten in the yard.  I handed her to Derrick to wash her up and he couldn't smell her gross stench.  He cracked a joke "Are you sure you aren't pregnant Steph?".  For a second I stood there thinking hmmmm what would be the chances our first cycle trying after coming off birth control would we conceive?!? I laughed it off and went to bed.

The next day I got out of work early around 12:30.  I went home to change and took advantage of a quiet house to take a quick pregnancy test I had under the sink.  Holy stinking cow!!! It was positive.  I couldn't believe it!  I called and left a message with the OB office to request labs.  Waiting for Derrick to stop home for lunch seemed to take forever.  I quickly panicked trying to think of a witty way to surprise him.  I placed the test on top of his water pitcher in the fridge and waited for him to grab it at lunch.  Tears, and excitement and pure joy.  

Rainbows the day we found out we were expecting

That afternoon I stopped over to the OB office for labs and hcg was 104 progesterone 15.9. We were elated and decided to tell our parents and my sister/brother in law.  Everyone was so excited and so shocked.  We waited for doubling blood draw 48 hours later where hcg went to 248 and progesterone 17.3.  The weekend was upon us and so we stopped back in a few days later for another blood draw.  

I was not prepared for this one.  I was totally caught off guard.  I just assumed that since we conceived naturally and the first two levels were okay and doubling that we were doing well!  When I got the chime on my phone that the labs were in and saw how minimal my hcg jumped I was soooooo overcome with disappointment and heartbreak (hcg 523 and progesterone 11.6).  I caught Derrick before he left to go back to work from lunch to update him.  

The next few days we spent praying that it was just a slow developing embryo, but in my heart I knew that it was not a good sign.  In the mean time we started IM Progesterone 1mL nightly.  On 7/1/20 I had my levels checked again, progesterone 36.8 (high due to injections) and hcg 596.  Confirmed that we were miscarrying.  We verified that the pregnancy was located in my uterus and spoke with Dr. Friesen to discuss options.  We ended up taking cytotec to help assist my body in passing the embryo.  

Derrick couldn't attend the ultrasound due to COVID precautions

The cramping, physical discomfort and bleeding wasn't as bad as I had thought it might be.  But, the emotional toll made up for it.  I was heartbroken, I felt like our chance and gift from God was taken yet again, and I didn't understand why.  I felt naive for celebrating and telling family so early just to tell them a few days later the bad news.  

On 7/23/20 we had a repeat blood test of hcg to verify it had returned to 0 and thankfully it had, no physical complications from the miscarriage.  We were given the green light to start again when we felt up to it.