I was trained as a scientist, and all through university I heard this message: reach for the obvious; expect the expected. It doesn't mean we should shut out the possibility of strange and awesome things, but we should come to unorthodox conclusions only after rigorous investigation of the more likely alternatives. The lesson was always summarised using the same, well-worn aphorism: "When you hear hoofbeats..." the lecturer would begin, and we'd roll our eyes. "Yeah yeah, we get it. It's not the Serengeti."

A beta of 23.8 at 16dpo can go several ways - and the extreme ends of the spectrum do contain heartwarming urban legends and tragic horror stories - but almost all the area under the curve is taken up by chemical pregnancies and blighted ovums. Since I heard our hoofbeats, those are exactly the breeds of horse I've been expecting to see.

Today, looking at the screen, my first thought was, "Fuck me, there's the heartbeat." A few seconds later, it was followed by, "That's far too slow," and "Wait, wait - I'm watching my own pulse." SOB started by running through all our positives - the pregnancy has grown and the hCG has gone up but - and here he hesitated in that awkward manner people have when they're about to say something upsetting. And I heard my voice, and it was gentle and calm, "You'd expect to see a lot more at this stage."

"Yes," he agreed, and we paused. "I think we should keep you on all the medication and do another hCG reading on Tuesday."

"Even though we have no heartbeat at eight weeks four days, our hCG doubling time has deteriorated from 2.5 days to about a week, we are measuring even further behind in dates than we already were, and we have now fallen well off the bottom of your already overly-generous reference range?"

"It's still growing. The hormones are still going up."

Clearly, we have very different definitions of the word "over". But one more blood test will do no harm. It's not like you can call this "limbo" anymore - rather it's "waiting til Tuesday to discuss options for miscarriage".

And expected or not, you know it hurts to get mown down by a half-ton of steel-shod equine.


34 Comments

Adrienne said...

I don't know what to say, Bea. I'm sure this limbo feels almost worse than the alternative. Thinking of you, and hoping that your doc's optimism (or at least the hesitance to call it now) is rewarded on Tuesday.

Aurelia said...

Bea,

I am almost afraid to post this, but if there's no heartbeat, and your numbers are going up, is it possible you have a partial molar pregnancy? I learned about it a long while back when I had a similar problem...if I'm wrong headed just ignore me, but it might be worth asking your RE?

VanillaDreams said...

Bea,

I'm sorry you didn't get better news today. The waiting, the not knowing, and getting no definitive answer is the hardest part.

It doesn't sound good, does it? I'm all for hoping for the best, and all that...But I have to say, I'm kind of surprised by what your doctor is saying... He won't give a definitive yes or no answer, and seems content to let you linger on...

I don't know, perhaps all of my RE's are just a lot more harsh and lack bedside manner? My doctors are usually pretty blunt.

So, during the ultrasound, can they see the fetus clearly? Actually a fetus, or just a fetal pole and/or yolk sac, or what exactly? If they had to date the pregnancy by how it looks now, what would they say it is?

Just wondering how many weeks you are actually measuring behind now -- and what are you beta levels at currently?

Anyway, again I'm sorry that you didn't get good news today.

Please keep us posted on what happens.

Take care of yourself and your hubby.

xx
Nilla

Jess said...

Oh dear, Bea. I'm so sorry. I wanted a miracle so bad for you.

Take care. Rest. Relax. Cry. Don't relax. Just do whatever your heart feels like doing.

:(

Bea said...

Ok - Google Says:

Molar and partial molar pregnancies are associated with abnormally high, extra-fast-rising levels of hCG and rapid rates of (abnormal) growth. We have opposite.

Also, Google images says my ultrasound looks more or less like a normal 6-week pregnancy might, which, whilst not really great at 8w4d, is at least not bunch-of-grapey or snow-stormish. So I think I'll take the bold step of crossing "molar" off my list of things I should be worrying about. Plus, it's rare, and there are so many more likely explanations. Hoofbeats etc.

Just before too many people start saying they're still hopeful: 8w4d, hCG 5000-ish, pregnancy measuring 6wks-ish, doubling time 7 days (possibly already tanking?), no heartbeat, symptoms going from vague to gone over last week. So. Yeah. What's your definition of "over"?

Bea

Ellen K. said...

Oh, Bea. I'm not sure what to say. But I am fervently sending you my best wishes.

Karaoke Diva said...

How frustrating. This is exactly how I felt when a (well-meaning) friend tried to talk me out of the D&C because "things could still turn around". Things could turn around, but I think when you know, you know.

My heart goes out to you, Bea. I really do hope things turn around for you.

ms. c said...

Thinking of you, Bea.

Cibele said...

I am so sorry. Just wnat to send you my support and hugs.

Samantha said...

I don't know what say. I was so hoping for good news, but expected you'd get news in any event, after putting yourself through a tortuously long period between scans. I wish that things could have been more definitive, and I'm really sorry that the preponderance of evidence is so bleak. I'll be thinking of you.

The Town Criers said...

Bea--

There are no good words to say. I'm so sorry. And sending a hug across the Pacific to you and Mr. Bea.

Mary Ellen and Steve said...

I am so very sorry Bea. Thinking of you.

Pamela Jeanne said...

Sending you a hug and all kinds of supportive thoughts...

Rachel Inbar said...

Bea,
I'm so sorry... I had something almost identical and mine dragged out until the end of the 13th week. I hope that after Tuesday you can at least start planning your next cycle quickly.

Take care of yourself, I'm thinking of you.

Jackie said...

Bea, I am sorry to read of what seems to be an impending loss. My thoughts are with you and your husband.

Vee said...

Bea, I just couldn't believe it reading your post. When are you going to get a break !!
I am so sorry, sending you a big hug.

Bumble said...

Shit Bea. I'm so sorry hun.

Anonymous said...

So sorry- I can understand SOB not wanting to write a pregnancy off until it's certain but you can't really get on with the grieving until there's a finality to it. Of course I hope it turns around but understand that would seem a miracle. Take care I hope that one way or another your miracle happens soon.
K

Carrie said...

I'm so sorry. You've really been through the mill with this. I wish it was simplier. I wish it was different.
Take good care of yourself x

The Momcaster said...

well that sucketh!!
part of me applauds your grounded approach to all this and part of me is saying, no! keep the hope alive. there' still a sac in there!

i really hope you get ANSWERS soon.

take care (((hugs)))

Jules said...

Bea....NO

All I can offer you is a hug, but it seems so insignificant.

Take Care.

Baby Blues said...

I don't know what to say either. Just know that I'm here for you. Take care.

Thinking of you.

Lut C. said...

Unfortunately, I have to agree with you on the science of it. I'm sorry you're exploring yet another version of 'over', worse yet, a slow-motion version.

serenity said...

shit. Shit, shit, shit.

This is not what I was hoping for you.

"I'm really sorry" sounds so bland.

Really I'm really.fucking.ANGRY at the universe for you.

You deserve so much more.

*hug*

Thalia said...

Although our doc had stopped measuring betas at this point, I remember being made to come back for yet another scan just to check that the embryo was no longer growing before they would do an ERPC, and it was torture, that extra week of injections etc. I wasn't surprised when there was still no heartbeat a week later, but I still remember how much it hurt.

I'm so sorry going through this, Bea. It does sound like it is over, I've run out of urban legends for you. Can you start to discuss options for management with your doctor, or is it too much for you right now? I remember that once everyone would agree it was really over, I just wanted it absolutely over.

Thinking of you.

KarenO said...

Wishing you the strength (and more!) to get through this...

Teendoc said...

In medical school I learned also about horses versus zebras. I'm so sorry but it sounds like what you have here is indeed a horse. I wish it could be the zebra, but it just doesn't look good for that. Please know that I'm really thinking of you during this tough time.

thirdtimelucky said...

Sorry to hear this.

Binky said...

Bea, I just came upon your blog for the first time, and just wanted to say I'm so sorry for what a torture this must be for you.

sharah said...

Fuck. I wish you didn't have to go through this. (hugs)

Piccinigirl said...

oh Bea, I just don't know what to say and I am sorry that I got here so late.
I know that it must be so painful to think that it's over and to be held in this place waiting for others to confirm what you know...
Of course I hope that things on Tuesday turn around, miracles are made, but I also understand you not wanting from us, the people who support you, that kind of optimism because you want us to live in the "real" and "now" with you as you go through this.

all I can say is that I am sorry and I hope that no matter what happens you can feel my support and love from here.

Carol said...

Oh Bea. My heart is breaking for you. I've been through the "we would expect to see more at this stage" speeches. And having to wait a week for another scan just to confirm what I already knew in my heart. It sucks. It hurts. I wouldn't wish this on anybody. I am thinking of you, and wishing you strength and peace. hugs.

Hopeful Mother said...

Bea, I am thinking of you and Mr. Bea. I wish this was different. It's just so unfair to have to go through this...

Meg said...

My love, Bea.

Just that.

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