Thursday, September 24, 2009
(I'll give you a moment to regain your breath. I hope you were sitting down when you read that!)
I took up residence here when I needed an outlet to talk about our struggles with secondary infertility. During the active stages of TTC, there's a lot to discuss. The daily mechanics of the treatments and the rollercoaster of emotions that accompanies them.
And at least for me, being pregnant and parenting after infertility does not completely silence the aches and pains of what we went through. Is life easier? Yes. Do I think about infertility every day? Hell yes.
Because I wouldn't be pregnant with twins right now if I didn't have trouble conceiving.
And I think about that. Constantly. Among the other ways I have been changed (for better and for worse) by my IF experience.
In my first post, I talk about how this blog is a way to compartmentalize my infertility. Instead of allowing it to seep into every relationship, every thought, and every thing like I did the first time around -- I wanted to get it all out here and leave the joyful areas of my life alone. And I was able to do that with a fair amount of success, which was in no small part thanks to the fact that our journey to #2 and #3 has (so far) been incredibly less horrible than #1.
But I think it's time. For integration.
I will still be writing about parenting after infertility, because it is part of who I am just as much as my tendency to get bruises from bumping into furniture or my weakness for things that have glitter on them.
But I'm going to do it among other topics on my other blog, Sunny in Seattle.
I am probably jinxing myself in a huge cosmic way, not even being out of the first trimester yet. If (God forbid) something bad happens to this pregnancy, maybe I will revive this blog. But I'm doing my best to think positively, to focus on recovery instead of dwelling.
I hope you follow me to my other digs. But I understand if you don't, if that's not where you are right now. It feels rather counter-intuitive to close this blog, which gets more hits than my other one. However I can't manufacture more infertility posts than are truly in my heart, and although I still have much to express, it's not enough to support an entire blog at this point.
Thank you for reading. Thank you for commenting. Thank you for praying, wishing, supporting. Whatever you are striving for in your own life right now, I hope you find your great reward.
And as my Dad would say, I'll see you on the flip side.
Friday, September 18, 2009
They were still measuring ahead, this time six whole days. (Overachievers.) (Naturally.)
So my new due date is April 16, 2010.
That makes me 10 weeks along today.
Now let's see how much longer until I have the courage to stop the progesterone.
Wednesday, September 16, 2009
The best news is that I haven't been spotting in at least a week now. Yippee! Of course there's still a drumroll in my head that accompanies every trip to the bathroom, which I'm guessing will continue throughout the duration of the pregnancy. But it adds that air of drama and anticipation to my day, so it's all good.
Despite the lack of spotting and the increased desire to hurl at every second, I am very nervous about my ultrasound later this week (which has been moved from Thursday to Friday, because again, needing drama and anticipation). I am mostly worried about Vanishing Twin Syndrome, which is when one of the twins... well, vanishes. Except it lacks the X-Files appeal that it may suggest. I am still freaking out about the prospect of double the newborn action, but I'm already attached to these two little blobs, and to only see one heartbeat on Friday -- let's just not talk about it.
I am slowly doing better as I process the likelihood that we will be a family of five in April. I no longer lay awake at night worrying, I manage to contain all of that to my waking hours. I am basically rewriting the future I see for our family. Because that's what we do all throughout infertility, right? Revising that timeline we so carefully crafted for our lives. First it starts on a small scale (from "I'll be pregnant by Christmas with the first of our eight kids" to "Well, maybe the first one by next Christmas") and then it gets bigger (to "I'll have two kids by 40, right?" then "FINE! ONE BY MENOPAUSE!"). In my case, of course, I am lucky to go in the opposite direction. Nevertheless, even though this is a huge blessing, I'm erasing and replacing how I pictured next year. And the year after, and the year after, and all the years until I have three adult children and I finally turn to DH and say, "Well, that wasn't so hard after all!" (Because I have a bad memory by then, of course.)
On the bright side, all of this worrying and processing has kept me from being bitter about the fact that I will never know what it's like to conceive a child without instructions to "don't forget to pay your outstanding balance on the way out." Or the fact that infertility has taken yet another thing from me -- the ability to grow my family one child at a time.
HOORAY FOR NOT BEING BITTER!
(Even if it's temporary)
And now for a question that has been weighing on my mind. Although I have no history of low progesterone, my doctor has me on these
Thursday, September 10, 2009
It's hard to post on this blog about my struggles with processing the news that we are pregnant with twins. Because many of the people who read it are still in the IF trenches. Which sucks a lot more than the worry about how I will manage to gestate and care for two babies at the same time. I don't want to sound... ungrateful. Because DEAR LORD am I grateful. There was a time I thought I would never be a mother. Never know what it was like to parent a child with my beloved husband.
Now, God willing, I will hopefully be the mother of three in seven short months.
I even remember those first weeks of pregnancy with Bean. Harboring the secret hope that there would be twins, because HOORAY! we wouldn't have to go through treatment again to reach our goal of having two kids. Literally, two for the price of one. That would be convenient, no?
But in reality, having twins is not just a fun bonus. There are serious risks to my health and the health of the babies. And when they are born -- well, it was hard enough to breastfeed and stay up all night with one infant, I shudder to think about handling two. The sleep deprivation was more horrible than I ever imagined. Worth it? Of course. But not romantic and cute, as it seemed before.
And it's not like I can call my Mom or MIL when I'm feeling stressed. "Hey guys, can one of you hop on a plane and fly across the country to watch the kiddos so I can shower for five minutes? Super thanks, bye!"
After the initial burst of help, I am going to be on my own, all day, alone with three children under the age of two and a half. I worry constantly (day and night) about how I will handle that, and how it will affect my son, who is never happier than when he's snuggled into my arms.
I realize that this is the direct result of choices I made. The choice to begin treatment again so soon. The choice to continue with the IUI, knowing there was a chance for twins or triplets. I accept responsibility. But that doesn't mean it's not difficult.
When I first started thinking about having newborn twins and a two year old, I began second-guessing my decision to try for another child. I mean, we are a happy family right now, the three of us. After overcoming our initial incompetence at parenthood, DH and I made up some ground and have fallen into a great rhythm. It doesn't feel like another child is missing from our lives, that we are incomplete or unfinished.
I had to remind myself why we wanted several children in the first place. Because although right now, at 18 months old, our son needs nothing more than his mommy, daddy, and a big stick to drag around the yard -- he will eventually want more socialization. Unfortunately, with the distance from our families, he will not have cousins to bond with. The people we have met through our various activities are really fantastic, but we think he will benefit from having siblings close in age. I have one brother, and DH has three siblings. We both have wonderful memories of growing up with them, and we want that for Bean, too.
Prior to this round of treatment, DH and I had actually talked about having three kids, revising our initial plan of two once we realized how much our son rocks. I thought DH was just wanting to further postpone getting the big snip-snip (he's not a huge fan of the concept), but he assured me that's not the case. And the big grin he gets when he whispers, "father of three" -- well, that's enough to convince me. We of course hoped to manage this one baby at a time, but beggars can't be choosers. DH's wholehearted excitement over the prospect of twins has helped my own acceptance, I'm just hoping that I am confident enough to calm him when he inevitably gets to his own freak-out stage.
So although I'm fearful that I won't escape the first 12 months with my sanity, there's really so little of it left anyway that it won't be a great loss. We will survive, and seeing how much easier things become as my son learns new
I do, however, reserve the right to completely panic about the twinklets throughout the duration of my pregnancy, and for an indefinite time afterwards. In fact, I plan on it.
But please always know that this infertile is eternally grateful for this opportunity, if scared out of her mind.
Friday, September 4, 2009
Sadly, these twinklets seem to not have the mercy of their brother, so far at least.
The spotting continues.
It was light at first, I was determined not to be worried. Then it got -- well, I'll spare you the details, but it was bad enough to be worrisome yesterday.
Now it's back to being light and less concerning.
My RE said I can come in today for another ultrasound, if I need the reassurance. But it would be quite an effort to get me and Bean downtown, plus DH would want to take off work to join me -- and as important as the twinklets are, there's nothing that can be done at this point anyway other than calm my nerves, so we are doing our best to stay positive and wait out the weekend.
On the bright side (I guess?), I feel stronger morning sickness today than I have previously. I constantly have the urge to hurl, I can hardly force any food down my throat. Hooray?
My next ultrasound is scheduled to be September 17, just under two weeks away.
Tuesday, September 1, 2009
They must have worked.
I'm pregnant with twins.
Two beating hearts, two babies measuring right on track.
YIPPEE!! and OH SHIT!!
The irony is not lost on me. The infertile ends up with more children than in her "plans." (Thinking positively that they'll both come home, of course.)
Well played, universe.
And thank you.
Monday, August 31, 2009
But no. It's Pregnancy Hell.
I am finding this first trimester infinitely more difficult than when I was pregnant with Bean. The main reason for this is probably denial -- or more accurately, the lack of it. Last time, my brain took its time accepting the fact that there was, indeed, a small life growing inside my tummy. Because, again, stuff like that just didn't happen for me.
But this time, it seems more within reach. I did gestate, and quite successfully, a 9 lb. 14 oz. child for a full 40 weeks. It is possible, my brain is more prepared for this.
And also, last time the thought of an actual BABY at the end of the pregnancy was quite nebulous. I couldn't imagine what it would be like, holding MY baby, taking him home, feeding him, changing him, loving him with more of my heart than I knew existed. It was far away and foreign. But this time, I am more focused on that moment. Meeting my child and welcoming him/her into the family. My heart is more on the line, knowing what I could lose.
My ultrasound is tomorrow.
Today, I started spotting.
My doctor, predictably, is not worried. (How nice for him!) It's fairly common for women to experience this during the first trimester, it doesn't always mean Bad Things... of course I do know this. But it's not a comfort. Every moment between now and 11:30 am tomorrow is painful. I can't get comfortable, I can't relax.
I am preparing for the worst.
And it sucks.
Thursday, August 20, 2009
While we are in the waiting-for-BFP phase of IF, I think many of us imagine that seeing two magical lines on a HPT will suddenly make things All Better. That attaining the goal, the sweet and precious reward of all of our efforts, will make the world look rosy and we'll shop for itty bitty clothes and share a secret smile with DH when the baby kicks and OH LAWD isn't every second of life just Heaven?
Of course, getting pregnant after IF is a wonderful gift. I don't mean to discount how much happier it is to take a progesterone supplement than a Follistim shot. It's a far, far better place.
But it's not The Cure.
(I apologize if I just got "It's Friday I'm in Love" in your head. Go listen to it on youtube.com three times, that should get it out. Click HERE for the link. Because I care.)
When I was first pregnant with Bean, the triggers for me were just as strong as while we were undergoing treatment. I remember being less than two months along, and I went to get my hair cut. I loved my stylist, she was young and fun and friendly and great at her job. On that particular day, I was greeted with a hug and the exciting news that HOORAY! SHE WAS PREGNANT! I was thrilled at her obvious baby bump, especially knowing that she had suffered two miscarriages in the past. But despite my sincere happiness that she was baking a very sticky bean, and the private knowledge that I, too, had an early life growing inside my tummy, it was a trigger for me. As soon as I got back into my car, I started sobbing uncontrollably.
But infertility had burrowed itself so deep inside of me, that just getting pregnant was not enough to erase my response to the triggers. That's me, Pavlov's dog -- just ring the bell.
Over time, the conditioning weakened and the triggers changed. After Bean was born, there were no more tears when a birth announcement came in the mail, just perhaps a slight stiffening.
When we began to look toward having a second child, I would feel that dreaded physical response only when I saw a pregnant woman who had one child with her. A baby bump alone was not enough to punch me in the gut, which I was grateful for. And my reactions never did seem as strong as they were when we battling IF the first time. Probably because our situation never got as bad.
So here I am, pregnant again. Hopefully for another eight more months. I do feel my triggers slowly -- very slowly -- losing their power. When I see a pregnant women with her kids, I am drawn to stare, with a bit of envy. I wonder if she knows what it's like to struggle to conceive. I wonder what it would be like to conceive with my husband, just the two of us, in private. To not have that heavy weight, that dark burden, that lingering question: Will there be a child, or won't there? To take for granted that there just will be.
On one hand, I can't imagine myself being a grandmother one day (God willing) and still having a reaction to these triggers.
But on the other hand, I can't ever imagine myself not.
Like the graph of an asymptotic function where the line slowly dips lower and lower, approaching zero but never arriving.
It makes me wonder. After you've lived through infertility and felt the pain of its associated triggers, can you ever get to absolute zero? When the only churning in your stomach at hearing of another "accidental" pregnancy is yearning for a bite of that yummy-looking bagel sandwich she's eating? Is it possible to achieve complete extinction from that level of IF conditioning?
Special thanks to my cousin J for the math advice and Truth Be Told blog for the graph image.
Thursday, August 13, 2009
My first ultrasound is 2 weeks and 5 days away. But who's counting? And another month and a half until I'll start renting a doppler so I can listen to the baby's heartbeat at home. DH nodded his head heartily when I asked if we could get one again. "I saw how much it calmed you with Bean," he said. Many women complain about their reliability, or find them useless after they can feel the baby move. But every night, DH and I would sit on the bed and listen to our baby's heartbeat. I could fall asleep relaxed and increasingly connected to our child. For an hour, at least, until he got the hiccups and started kicking the crap out of my liver.
Right now I am totally disconnected from this pregnancy. I am aware of every emotion rolling through my body... various shades of excitement and fear. But it's as if these are occurring on another plane. Because on the surface level, I am very calm now. More so than I have been in months. Like there is just me and DH and Bean and our pooch... not an actual itty bitty person doing somersaults in what is apparently my ginormous womb. (My uterus must be very excited to do its job again, as I already look 4 months pregnant. The kid has enough room to play nine holes of golf.)
I am in absolute denial. I can't even say the word -- when I do, my tongue feels all heavy, and it sounds to me more like pwegwant. I have experienced more than 30 failed TTC cycles total, and even with one healthy son under my belt (literally under my belt, the kiddo can't ever be close enough to his mama -- in fact, I'm hoping he doesn't catch wind of the extra room in my uterus) I still believe that I do not get pregnant.
Other women, yes, they get pregnant. But me? Nah.
I do not get pregnant.
And even if I do look at a belly shot from early 2008 and remember with horror how absolutely humongously pregnant I indeed can get... then I think, Well, but this was too easy.
Compared with the utter torture that was TTC #1, this time in the IF gauntlet was far too quick and relatively painless.
It's almost like the treatment never even happened.
And I am not pregnant.
Monday, August 10, 2009
But just maybe the Universe is on my side, and come mid-April, from my abdomen will spring a real live actual human baby.
Between now and then, I plan to use this blog to talk about pregnancy and parenting after infertility. I first joined the blogosphere when I was pregnant with Bean, and I wished I could have found more women talking about what happens to an infertile after the BFP. More specifically, I felt different than a "normal" pregnant woman, and I wanted validation and support with that.
I won't be sharing baby bump photos, ultrasound pictures, and nursery designs here. You won't find a due date countdown on this site. I've decided to keep all of that kind of stuff on my other blog, Sunny in Seattle. (Which is under construction right now, by the way. Please forgive the dust and debris.) This will remain the place where I can talk about my feelings about infertility, how it affects me as a preggo, and how it affects me as a mother.
If and when the baby comes, I will re-evaluate. But for now, that's the plan. I hope you'll stay.
Saturday, August 8, 2009
On Monday, at 8 DPO, I got a call from a friend asking if we wanted to join her on a walk. I got dressed, looked in the mirror, everything was in place... got the kiddo ready and out we went. When I got home, I caught another glimpse in the mirror, and I had changed. My stomach had popped out considerably. Like I had gone to Old Country Buffet and eaten enough for an entire family. And I started having cramps. Could be AF or the effects of the progesterone of course, but I started to get *gasp* hopeful that it could be my BFP on the way.
On Tuesday, at 9 DPO, I went against my better judgement and used one of those home pregnancy tests. That's the problem with having 12 of them in the cupboard, no cause for restraint. And I got a very faint line. Could have been an evaporation line (false positive), but those are gray. And I swore I saw pink. Took another cheapie test after lunch, same very faint line. Two evap lines? Less likely. A third very faint line that evening when DH was home from work.
On Wednesday, at 10 DPO, I used the digital. DH and I sat on the edge of the bathtub and watched the window with anticipation. Blink... blink... blink...
I called the nurse and arranged for a blood test that morning. My hcg level came back at 33. Which is a rather low number in and of itself, but when taken in consideration that I was only 10 DPO, it's relatively high. According to Betabase.info, the average hcg of a singleton pregnancy at 10 DPO is 16, and a twin pregnancy is 31. You can't base everything off those numbers, because what day your implantation occurred makes a big difference in your results. But looking good.
On Friday, at 12 DPO, I went back for a follow up blood test. They want to see your hcg number double in 48 hours. Mine was 109. So it more than tripled. According to the same web site, the average hcg of a singleton pregnancy at 12 DPO is 37, and a twin pregnancy is 66.
I am, it would seem, with child.
It's extremely early, I am only 3 weeks pregnant today. (Due date is April 22, for those of you playing along at home.) And there has been so much devastating pregnancy loss in the community lately, that the fragility of my condition isn't lost on me.
I'm not excited yet, but hopeful. Please pray for me and my little one.
Thanks for holding on with me.
Thursday, August 6, 2009
Tuesday, August 4, 2009
Now this is a difficult post to write, because I have to first get around my defense mechanism that is screaming THERE IS AN 80% CHANCE THAT YOU ARE NOT PREGNANT! DO NOT GET YOUR HOPES UP! THEY WILL CRASH AND BURN, AND RUNNY MASCARA IS NOT A GOOD LOOK FOR YOU! As if my mascara won't run when AF arrives, just because my "hopes aren't up." Actually I hardly ever wear mascara these days. This whole situation is really just beyond sad.
But all I have to do is look over at Bean to be reminded that, well, miracles do happen. So this post is necessary.
Today I am 9 DPO. And my
Flashing back to my pregnancy with Bean. Even after two awesome betas and a tiny little heartbeat, I still was not excited to share our Big News with other people. I wanted to keep it just between me and DH, preferably until the child was born. In fact, although we did end up telling family and friends earlier than we had wanted because of the timing of a visit home, I kept tight-lipped at the office until a coworker eyed my belly in the kitchen area one day when I was 14 weeks along and asked loudly, "Are you pregnant?!" I immediately decided it was finally time to tell my boss.
I think this reluctance comes from many factors. Although we had let that team of highly trained, specialized medical professionals invade the most intimate part of our marriage, I still felt like IF was something DH and I had weathered largely on our own. I also appreciated the support I got from the few family and friends who knew about our struggles, but really it was just the two of us in the trenches. It seemed like the result, this baby, was now a part of our private space, and it was hard to suddenly let others in.
Second, part of the wounds of IF left me feeling like no one would care that I was pregnant anyway, so why tell? While I was isolating myself during treatment, frozen in the moment of BFN, everyone else was going on living. Getting married and having lots of children. Everyone was wrapped up in the exciting changes in their own lives, so why would they bother to take notice of mine? Absolutely ridiculous and unfair to my very caring friends. Lots of faulty thinking to be explored under this one... I'll save that for a rainy day.
And finally, of course, was the denial that this was actually happening after so long. And the fear that it would suddenly be yanked away.
So to make a long story short (too late!), especially during the first part of my pregnancy, I was still quiet and feeling reserved about the whole situation.
This time is entirely different, of course. I am open about our treatments, willing to share and generally in a better place overall. Generally.
DH asked me the other day, "So how are you going to deal with your blog, if you are pregnant?"
Of course this is something I struggled with before I even started this blog. I knew I wanted a place to share, vent, and get support -- as others hopefully feel the understanding and encouragement I give them on their blogs. But how to do it? Totally anonymously? That would be easiest, of course. I could be more open about things, knowing that no one IRL would find my words.
But I finally decided that even though I try not to give too much identifying information on here, I still wanted to share my web site with my friends and family. Let them decide how much (or how little) they would know about my uterus. I guess pseudo-anonymous is the best way to describe that?
I'm not sure how many of them actually read this blog, as they are kind enough not to bring up my uterus in conversation. But I always assume that they are, just to be safe.
So while I don't want to go posting a BFP picture in the first hour of its reveal, I also think it's unfair not to tell you the results as soon as possible, seeing as you have been so wonderful in taking this journey with me so far. And if I experience another chemical pregnancy, or a miscarriage, I'm sure I will want to blog about that anyway.
I guess I'm just asking for a little patience with me... I don't know the right way to handle this. A BFN, I do know the right way to handle. Chocolate, a box of tissues, heating pad, and the latest installment of "Twin Peaks." But the BFP territory is much less known to me, especially since I am now Out of the IF Closet.
I promise to update as soon as I can. I'm not sure exactly what day that will be, depending on how things play out, but if the news is good, it will be before the baby is born.
Saturday, August 1, 2009
Monday, July 27, 2009
As perfectly as having a catheter shoved up your hoo-ha can go, at least.
Isn't this fun?!
We showed up at 8:30 am for our *ahem* deposit. Then we had over an hour to kill before our IUI. I knew my brain was going to start bleeding if I heard another John Secada song piped into the waiting room, so we decided to bolt. Fortunately Jen had suggested beforehand that we go to Grand Central Bakery down the street. DH and I both got coffee (decaf for me -- not giving the pregnancy fairy another reason to pass me over) and bread pudding. Yum.
We got back around 9:45 am. DH and I read our books while we waited: "If you Deceive" for me and "Firestorm: Allied Airpower and the Destruction of Dresden" for him. I thought it would be funny if we sat down and started reading each other's books. You know, DH getting engrossed in a romance novel with two lovers on the front, their bodies passionately entwined under a Scottish tartan thing. Not that anyone there would have noticed. Infertiles are generally a serious bunch in these waiting rooms. The tension! Even my karaoke version of a Mariah Carey song went unappreciated.
The nurse who performed the IUI was friendly. It went smoothly, no problems. DH and I stayed another 15 minutes after our menage a trois so I could keep the old hips propped. Then it was off to our romantic anniversary brunch!
DH had made reservations for the two of us at Salty's on Alki Beach, which is famous for its amazing brunch buffet and views of Puget Sound and downtown Seattle. I was reminded yet again that although I have many talents, buffeting is not among them. There's just too much pressure when you have limited stomach space and an enormous spread of food that stretches around the room. How do you know you got the best combination? Plus, I generally don't like breakfast food or most seafood, and well... yeah, this was a seafood breakfast buffet. Didn't really think that one all the way through. Nevertheless, I did find some delish dishes to nosh, and the view really was spectacular. Not to mention the company.
Now I am 1 DPO. I feel like I've had this giant "1" following me around all day, like the "U" that followed Lionel Riche around on Sesame Street while he sang "Stuck on You." That totally freaked me out when I was little, it was all clinging to him and he looked upset trying to pry it off. I assume he got that thing off eventually, but as a kid I was worried! Anyway, yes, the TWW has begun, and I feel every second of it.
This wait will be different, as it's the first cycle I am on progesterone following ovulation. My blood test did not indicate that I have low progesterone, but Dr. Downtown's motto is, "Why not?" (My answer: "Umm... my time, effort, and money. Not to mention the lovely leakage. But you're the doc!") So anyway, this progesterone is going to throw off all my normal symptom analysis. And I was also looking forward to the shorter LP that comes with injectible cycles, but now I'm wondering if the progesterone supplements will lengthen it again? Time will tell.
Just because I'm a downer like that, I constantly remind myself that even under the best conditions, the most optimistic success rates for IUIs with injectibles is 20%. So a whopping 80% chance that I will have to do this again next month.
I'm exhausted already.
Sunday, July 26, 2009
If you'd like to wish us luck on our IUI this morning, comment below.
But I won't hold it against you if you do neither.
I might, however, love you a little bit more if you do both.
Friday, July 24, 2009
Okay, not really.
I'd miss the last season of Monk.
I know, I could get the DVDs later.
But it's not the same.
Get on with it!
The follies are also looking great. One on the right ovary is 17 mm, then a 16 mm and 15 mm on the left. With the right being my "lucky" side, I'm thrilled with this outcome. Hoping for one -- ONE! -- perfect little baby.
I will trigger tonight right before bed, and if I can ever get through to the clinic to schedule the appointment, the IUI will be on Sunday morning.
T-minus two days.
Edited to add: HOLD YOUR APPLAUSE! I just learned from Dr. Google that when the lining is 15 mm or greater, it may be too thick for implantation. And could be related to my endo. Shite.
And again: I emailed Dr. Downtown about my concern over the thickness of my lining. He maintains that Dr. Google did not specialize in fertility and said that he is still optimistic. I am struggling to be the same.
Thursday, July 23, 2009
This morning was my first follicle check since starting the Follistim. For those of you who haven't needed a bunch of people in labcoats present when you conceive (but I highly recommend it... sexy!), the doc was looking at two main things during this ultrasound: the thickness of my lining, to make sure it is substantial enough to support implantation; and what size my follicles are. When the follicles are big enough, they will have me give myself a trigger shot of HcG in order to force ovulation. Then the IUI is timed 34ish hours later, which is when ovulation should be occurring based on the trigger shot timing. And then, wham bam thank-you-ma'am, I am with child.
Or that's the theory, anyway.
So on to the appointment. The doc was pleased to find that my lining is measuring 13.1 mm. This, my friends, is impressive. For reference, 10 mm is the point considered more than adequate by most REs, so clearly mine is kicking some major ass. I am thinking of having my uterus host a seminar on growing such an impressively cozy home for potential embryos. Just to help offset the cost of the medication.
Now, drumroll please.... the follicles.
Right side: 14 mm
Left side: 15 mm and 13 mm
Some of you are nodding appreciatively, while some of you are thinking that this makes about as much sense as that bizarre fog beast thing on Lost. For the latter, a bit more explanation. (About my follicles, of course. You are on your own with the fog beast.) The doc saw three dominant follicles doing their thang in my ovaries. One on the right side, two on the left. Those are their measurements.
On the generic clinic paperwork I have, it says that the doctor will have me take the ovulation trigger shot when a follie hits 17-18 mm. Which is right in line with what my previous RE had me do. However, Dr. Downtown has noted specifically that he wants me to trigger at 16 mm. Unfortunately I didn't see him today so I couldn't ask him why so early. But his partner (who read this in Dr. Downtown's notes) said that I should come back tomorrow for another check, and if we hit the magic number, it's trigger time.
It also means: the possibility of triplets. In fact, the doc specifically stopped to discuss with me that each follicle is a potential baby. I loved that he did this. One of my biggest pet peeves about infertility is when doctors DO NOT monitor the follicle development and DO NOT inform the couple of how many eggs could potentially be fertilized by the IUI. I find it extremely unethical and sloppy. (This is what I believe happened with Jon & Kate Plus Eight, by the way.) Before DH and I started injectible treatments two years ago, we sat down and discussed what our opinions were on this subject. Because we didn't want to face the possibility of higher order multiples -- and selective reduction is not an option we'd personally consider -- we agreed that if I had four or more follicles, we would not proceed with the IUI. I realize all too well that it is costly and inconvenient to have follicle checks during treatment, but the consequences are just too severe for the parents and the children when the "off chance" occurs and there is a basketball team in there. I'm sorry for going off like that, but it's obviously a subject that hits a nerve for me. (And yes, I realize that triplets would still be higher order multiples and a risky pregnancy. And yes, one embryo can split into identical twins naturally and unexpectedly anyway. I'm just talking about being informed and carefully weighing these life-sized decisions.)
*stepping off soapbox*
So we will be going ahead with the IUI. Personally I'd be surprised if all three follies make it to ovulation, especially based on this questionably early trigger. I have to go to the office tomorrow for another follicle check. The doc expects them to be big enough for a trigger shot late on Friday, with an IUI early on Sunday. Which happens to be our wedding anniversary. Harry Potter, out. Turkey baster, in. Romance, anyone?
And just for fun, let's remember our first Follistim + IUI cycle back in May 2007, shall we?
Outstanding lining, three ripe follies, Olympic Gold swimmers, a perfectly timed IUI.
Edited to add: I emailed Dr. Downtown as the brilliant Martha suggested. He explained he was concerned that waiting an extra day would give time for a fourth follicle to mature, which is definitely too many. Excellent point! Ideally I would like 2-3 follies between 16-18 mm tomorrow morning, then I would be happy to trigger tomorrow night.
Tuesday, July 21, 2009
After the little whine-and-cheese party I threw in my last post, I'm feeling better this week. Which I'm sure is in no small part due to my hormones recovering from the AF swing. But today I'm going to be positive for a change and share the small blessings that have brought me back up from the most recent low.
* Yesterday, the mailman brought the giveaway package I won from Martha at A Sense of Humor is Essential. I am sipping coffee from the mug as I type this post, and if you were sitting next to me, you'd catch the light, summery scent of the body lotion.
* Speaking of the mailman, I also got two new cloth diapers in the mail yesterday. They are so adorable that I almost nibbled them to pieces right out of the bag. Even DH likes them, and he
* April of April Showers Blog Design finished the first draft of the new look for my other blog, which has outgrown its theme. It is WAY too cute. Coming soon!
* I am halfway through the second book of the MacCarrick Brothers series by my favoritest author, Kresley Cole. I was so giddy reading it last night that DH commented with a smile, "I think I'm going to have to commission more Kresley Cole books for you."
* Hubby is in a great mood, too. He says it's because I'm happy, which always makes him happy. But I'm thinking it might also be a bit of IF denial (He asked: "Is it just me, or does it seem like we are NOT in the middle of a treatment cycle right now?" Answer: "It's just you.") or even GASP! some of that elusive hope that I am so lacking (He asked with a grin and wide eyes: "Can you imagine, we could be holding a newborn baby in nine months!" Answer: "Only if one of our friends is getting knocked up this month.").
* I got an email from one of the moms in my preschool group. (I am "out of the IF closet" with them, and they have been so wonderful to me!) She said she's been thinking about me and wants to offer support any way she can, especially knowing that my family is far away. Totally, totally sweet.
* My calendar is jam packed for the next couple of weeks, and not just with doctor appointments! I will definitely need the distraction. Among the highlights, more outings with bloggy buddies! Involving two of my favorite things about Seattle, no less: the amazing cupcakes and the beautiful outdoors.
* DH and I are celebrating our wedding anniversary on Sunday. I have the babysitter coming over, we are going to see Harry Potter and then get dinner. I am so excited! For gifts, we got ourselves tickets to see the play Wicked in early September. I can't wait to go out on the town with my man.
* As I was leaving a MOMS Club activity yesterday, I felt especially grateful for the wonderful women I have met out here. I wasn't thrilled to move in the first place, especially to somewhere so far away and unknown to me as the Pacific Northwest. Of course I researched schools, housing prices, commute, amenities, etc. in picking exactly where to live in the Seattle area. But the one thing that is difficult to assess beforehand is how well you'll mesh with the locals. I had low expectations of fitting in, being a consummate Midwesterner myself. But wow, I would never have imagined how friendly and welcoming everyone has been to me.
* The pooch got a bath, she's super soft again. It's impossible to be too sad when there is a fluffy white creature lounging around your couch. You know, resting up after a three-hour nap.
* My happy little toddler loves his mama more than anything in life. Cuddles to prove it.
So what is making you happy today?
Sunday, July 19, 2009
Not the injection part. That was actually even easier than I remember. I found it incredibly empowering to give myself the first shot last night. As I've mentioned before, I used to have a terrible phobia of needles. I've known from a young age that a medical profession was not in my future. Generally they prefer if you don't pass out at the sight of your patient's blood.
But that was before infertility.
Now: I'm so BA (that's "badass," for those of you without an 18-year-old sister-in-law), I didn't even wait until the Follistim was room temp before shooting myself up. The most painful part was when the alcohol swab touched the cut on my finger. Yeouch.
Total badassness aside, I have been blindsided by how much this treatment cycle SUCKS. Partly financially, but mostly emotionally. I guess infertility treatment is like childbirth. You develop selective amnesia about the event, so that you'll do it again in the future when the time comes.
I thought -- having been there, done that, got the t-shirt -- that this would be a relative walk in the park. That the biggest challenge would be finding a babysitter for the munchkin on my endless trips to the doc.
Putting this much time, energy, and money into the dream of growing our family... well, it's overwhelming. The pressure, the waiting. To know. Yes... or no?
I feel my defense mechanism kicking into place. I am now, at CD 4, one measly shot into the protocol, completely positive that I will NOT get pregnant this cycle. I just can't let myself hope it will work.
And I've already seized on The Why, because this helps my defense mechanism sell this inevitable failure to the rest of my mind. It's because my dose of 75 ius is lower than the 100 ius that I was on when I got pregnant with our son. Too low.
It doesn't matter that this dose was recommended by our doc, and was entirely what DH and I wanted at our consultation meeting. To lower the risk of multiples, which scares the beejezus out of me almost as much as another BFN.
It is The Why. No sale, do not Pass Go, do not collect $200.
End of story.
I'm already planning to email Dr. Downtown and asking him to up the dose to 100 ius -- or even 125 ius -- for next cycle.
Which is also the last IUI treatment cycle that we can afford.
I will say this about secondary infertility, though. There is certainly a comfort in knowing that no matter what the outcome this time around, I am a mother. That role is not in question. DH and I will be raising our son together, God willing. It may not be the family as I've always pictured it, but my darkest fears are not even remotely as dark as they were with primary infertility.
In the meantime, my Frank's Big Ones cookies have arrived. I've heard them described as larger than a baby's head, and I wanted to see how they compared to my toddler's ginormous noggin.
Pretty damn well, I'd say.
Thursday, July 16, 2009
My AF has arrived, blessedly on time. (Taking pity, perhaps?)
And now the time has arrived for pinching, poking, pinching, poking, praying, pinching, poking, pinching, poking, praying, pinching, poking, prodding, pinching, poking, pinching, poking, prodding, final poking, inseminating, more praying, inserting, praying, inserting, hoping, fearing, inserting, praying, inserting, fearing, hoping, inserting, worrying, inserting...
You know, conception.
One of my friends asked that I explain my protocol as I go along, remembering that not all of my readers have been initiated into the World of IF. So here's the low-down, it's pretty simple.
Starting on the Saturday, I will inject myself with 75 ius (units) of Follistim once a day. Follistim is an FSH (follicle stimulating hormone) drug that works directly on the ovaries to produce more/better follicles. It mimicks the natural FSH that women's bodies produce. A follicle, by the way, is the little house that the egg grows in while awaiting ovulation. We can't see the eggs in ultrasounds, so we just have to trust that there is a good one in every follicle. Normally, a woman produces one mature follicle each month, it releases the egg at ovulation, and when the egg gets fertilized and implants in the uterus, you have a baby. On Follistim and other drugs, you often end up with more than one mature follie (and thus egg), which explains the increased risk for multiples.
After five days of injections (so that's next Thursday morning), I will go in for blood work and an ultrasound. This is to prevent me and DH from ending up with our own TLC show in which the entire world is witness to the end of our marriage and a haircut so horrendous I would be mortified in like ten years when I looked back on the show and really SAW my hair with fresh eyes. Cute kids, though. Anyway, if I have too many follicles ready to pop, we will
How is Follistim different than Clomid, which is taken orally? Clomid blocks estrogen receptors in your brain, fooling your body into thinking you aren't producing enough, so it spurs more natural FSH production. The ideal result, like Follistim then, is more/better follicles. However, Clomid works indirectly on the ovaries (through it's trickery) as opposed to directly on the ovaries like the FSH drugs. So Follistim is a heavy hitter in the ovulation-inducing category, with a greater chance of success.
When my friend Mary was going through her IVF, she kept her FSH drugs in the fridge next to a carton of eggs for good luck. (Did I mention the meds need to be refrigerated? In case you were thinking Mary was nuts or something.) Considering the intent of the medication, I thought this was very clever! And it obviously worked, as she now has two beautiful children as a result of that IVF. Unfortunately, we only have fake eggs in our fridge right now. But I'm hoping for the same bit of luck.
ETA: Dr. Downtown just let me know that my prolactin level came back at 12. The normal range for women in general is 20 or less. So it's perfect! Gee, heard that one before... Cynicism aside, he's given us the green light for this treatment cycle. Barring any scary discovery tomorrow during my baseline ultrasound and bloodwork, of course. (cue dramatic music)
Monday, July 13, 2009
So it looks like our "Hail Mary" pass fell a little short. The clock has run out, no more downs, blow the whistle, game OVER. Thanks for playing, it was a team effort.
Technically, the cycle isn't quite over yet... AF is due on Thursday, and hopefully that's when she'll come, so we don't have to redo our beautiful medication / IUI calendar. But although the axe hasn't fallen, the AF lumberjack has buttoned his red-and-gray flannel shirt, rolled up his sleeves, and he's sharpening the blade with my name on it.
(Apparently I could have also titled this post, "Convoluted Infertility Metaphors." AF lumberjack? Really?)
Bizarre imagery aside, indeed this cycle was not the miracle we've been hoping for. I'm surprised at how depressed it's made me... I didn't expect to get so emotionally invested in a last-ditch natural attempt. I guess because everything was lined up perfectly this month -- from ovulation to timing to progesterone. When it will stop surprising me that we can't pull this off on our own, I have no idea.
But with that being said, let's move on to the winning.
So waking up to the knowledge that I am not in the early stages of gestation obviously put me in a foul mood. (Aside: When first I typed that last sentenced, I accidentally wrote "fowl mood." Which I guess means I was craving chicken, and as anyone whose ever been with child knows, pregnancy hormones and chicken do NOT mix. Which is another obvious sign I am not knocked up.) With my grumpiness polluting the house, I think DH was only too happy to hop in the car and go to work this morning -- although he'd never say so, God bless him. So I did the only thing that a reasonable woman WOULD do in my situation.
I got on the computer, and I ordered some chocolate.
Not just any chocolate. I've been hearing the buzz around the IF blogosphere about Frank's Big Ones Bakery. It's a new shop on Etsy, recently opened by Kymberli's husband Frank. As soon as I read about them and saw pictures of their delicious goodness, I knew -- if AF cometh, so do those ginormous cookies. And alas, the wheels are in motion. The silver lining on my dark cloud.
Then I got a note from Martha at A Sense of Humor is Essential. Guess what, you will never believe this...
... I totally won her Pay it Forward Giveaway!
How's that for turning my mood around? So generous of Martha, I can't wait to get it in the mail. And making it all even sweeter, she is sending a special package to Michelle at TO BABY AND BEYOND, whom I nominated because I thought she could use an extra pick-me-up right now. How frickin' awesome is that?
But, the winning doesn't end there. This morning Bean and I had the pleasure of meeting Coffeegrl and her beautiful daughter for cupcakes and coffee. The only thing better than enjoying cupcakes and coffee is doing so with a bloggy buddy you are meeting in person for the first time! It is so neat to see the people behind the computer screen, it brings a whole new level to sharing their slice of life. Blogging rocks, people. But I don't have to tell you, of course.
And last but not least. I strapped Bean in the car seat to head home after our fun excursion, and I searched the backseat to find something to occupy him. I found an old CD flip-book thingy. I unzipped it so he could play with it... and what do I discover...
My Sarah Brightman Dive CD!!
I thought it was loooong gone, and I've been meaning to replace it from iTunes for ages. Saved myself $10! I listened to it as we drove, I still remember all the words. It totally reminds me of high school, and my friend Sarah. I think she first introduced me to Sarah Brightman, which could be why I have the association. Or because they both have the same first name. I'm not really sure.
So the lesson of today: You win some, and you lose some. But if there's chocolate involved, you're always a winner.
Thursday, July 9, 2009
Is it good news, doc?
But it's not as simple as that. Because there are two main outcomes, and neither one really helps you sleep better at night.
The first, which is what DH and I have heard most of the time: "Wow, those are some good looking internal girlie parts." My ovaries have gotten more compliments than all the rest of my parts put together. (And, fortunately, they are all put together. And they will hopefully stay that way for a long, long time.) This would initially seem like the ideal outcome, right? Ones reproductive organs being lavished with such praise as beautiful and gorgeous? Hormone levels being so spot-on that they are textbook? Well, sure... if you don't mind undergoing MORE tests... because sorry ma'am, you are still not pregnant, and we still don't know why not.
In the second scenario, you hear the words you've been dreading: we found a problem. And it's PCOS/endometriosis/high FSH/blood clotting disorder/MFI/*insert fun term here*. Which I don't deny is usually crushing news. But on the (small) positive side, you now know the enemy. You (hopefully) won't waste time on IUIs if both your tubes are blocked. It is easier -- although not on an emotional level -- to plan treatment when you can point to something and say, This is the culprit.
When we were undergoing testing with Dr. Lou (this is the nickname I'm giving our St. Louis doctor -- am I clever or what? Wait, don't answer that), as I said above, he was thrilled with all of our test results. Except the laparoscopy, where my OB/GYN who did the surgery found a small amount of endo. However, both of these doctors agreed completely that due to the location of the endo and its mildness (fortunately neither said this while I was sucking down Motrin on the couch, moaning and clutching my heating pad for dear life, or they both might have been rendered infertile as well), that it was NOT a factor in my infertility.
The best explanation that Dr. Lou could offer me as to why I was not pregnant was: "Nature is inefficient."
Yes, I partially wanted to kick him in the shin for saying that. But truly he is a great doctor and a very nice man, so of course I didn't. That and I have never kicked anyone in the shin in my entire life and can't really imagine myself ever having the nerve. So basically DH and I fell under the category of "unexplained infertility." But I always personally considered us more "suspected female factor." Which is not to be confused with "suspected Fear Factor," which is when you find out that you may have accidentally eaten some pickled bull testicles.
So I hid behind that "Nature is inefficient" explanation for a long time. Even as I did, though, I was obviously conflicted. I would tell people, "I suspect the endo is causing harm." But then, against my usual modus operandi, I didn't do much research on endo or connect with it emotionally as a diagnosis.
When we made the appointment with Dr. Downtown (thanks to Liv for this nickname, I like the suggestion) here in Seattle, I was dying to hear what he would say about the endometriosis.
Or so I thought.
As I mentioned in my post about the consultation, he agreed with what I'd suspected deep down inside -- that it was likely the endo causing my uterus to become a hostile environment for the poor sweet, innocent potential babies.
Which is really too bad, because otherwise my uterus is so loving and compassionate.
I thought this would be a relief. Because seriously, how can the reproductive systems of two healthy individuals be so totally kick-ass yet NOT produce offspring without medical intervention? I finally had affirmation that Something Is Wrong, and This is It.
But you know what? It didn't bring the sense of relief I expected.
I'm angry now.
I'm angry that something inside ME is actively sabotaging my efforts at conception. As I go about my daily activities, washing my hair, getting dressed, eating Frosted Mini Wheats, watching Judge Milian rock The People's Court -- there is this endometriosis inside my OWN BODY that is PLOTTING how to ruin my day/week/year/20s/hopefully not 30s.
I feel betrayed by my body. When before I could simply curse Nature for being a lazy bitch, now I have to point the figure right back at myself. Of course I can intellectually understand that it's out of my control. I can't simply command my endometriosis to Play Nice, Now. I repeat it as a mantra when I start feeling broken: I am NOT defined by my body's ability to get pregnant.
But that's easier to say than to believe.
Do you mind if I crawl back into "Nature is inefficient"?
Wednesday, July 8, 2009
Infertility is the ultimate sisterhood, in my eyes. We come from all walks of life, all ages and circumstances. None of us want to be in this group, and none of us would wish this on the others. But I am so grateful for the women I've met, who have shared their stories, their wisdom, and their encouragement. It's become hard to imagine life without them.
The guidelines for this award are:
1. Put the logo on your blog or post.
2. Nominate at least 10 blogs with great attitude and/or gratitude. Be sure to link to your nominees in your post.
3. Let your nominees know they have received the award by leaving them a comment on their blog.
4. Be sure to link this post to the person who nominated you for the award.
Without further ado...
1. Allison at The Second Time Around. As far as friends go, she's as good as they come. Better than I deserve, that's for sure!
2. Mary at Our Crazy Life with Twins After IVF. What would I have done without Mary when I was going through IF the first time. No really -- WHAT WOULD I HAVE DONE?
3. Holly at Seriously Holly. Like Mary, she was there to pick me up each time I fell to the floor during treatments to conceive the Bean. And she's frickin' hilarious.
4. Jen at Despite the Best Laid Plans.... My guide for all things infertile in Seattle. But more importantly, a sympathetic ear over coffee and bagels.
5. Coffeegrl at Okaasan Mommy and More. Raising her daughter in a bilingual household, doing her best (and a great job at that!) to balance cultures and languages.
6. Liv at The Life of Liv. She has been through a LONG wait to be a mother, and her turn is finally coming. Hooray Liv and your Spanish-word-for-bean (frijole?)!
7. IF Optimist, then... at IF Optimist, then.... She introduced me to cold banana cinnamon smoothies and gave me the heads up on the new Wallace and Gromit movie, for which I will be forever grateful.
8. Furrow at Out the Kitchen Window. She and I are in very similar places right now... hoping what worked with #1 will do the trick for #2. Prayers up for both of us!
9. Nicky at Grad Ovaries. She's currently juggling new motherhood and her career/education. Here's hoping the funding comes through that she needs for her brilliant graduate work!
10. Michelle at TO BABY AND BEYOND. She is struggling to keep the faith during a layoff and her 9th year of infertility. I am holding great hope -- she is going to be a wonderful mother.
Wow, I'm feeling pretty emotional after going through that. *sniff sniff* You ladies are all so wonderful, I appreciate you and pray that all your dreams come true!
Sunday, July 5, 2009
I am now 3 DPO. AF is due next Thursday, July 16. And DH and I know that if we don't get our BFP naturally this time, the next cycle will have a huge price tag. Financially, emotionally, and physically.
It feels good to know that we have a plan, a more proactive approach if and when AF shows her ugly mug. But we secretly hope to be one of "those people" who end up pregnant right before starting treatment. The pressure of $1000+ riding on this month's conception.... it gives you pause, I'll say that much.
In the meantime, I got a nice email from our nurse. First the awesome news -- she has a coupon for a free vial of Follistim, and she's letting us use it! That will save us $250 in meds next month. Hooray! She also attached a calendar of my injections and appointments. At my old clinic, only the IVFers got their own calendars, so I was feeling pretty frickin' sweet when I opened it.
Here are the major dates as determined so far, for posterity. (No, there won't be a quiz. Unless you're really an overachiever and would like one. In that case I'm happy to write one for you. Just speak up.)
July 16 - Day 1 - AF arrives
July 17 - Day 2 - Bloodwork and baseline ultrasound
July 18 - Day 3 - 75 IUs of Follistim (25 IUs less than before to lower risk of multiples)
July 19 - Day 4 - 75 IUs of Follistim
July 20 - Day 5 - 75 IUs of Follistim
July 21 - Day 6 - 75 IUs of Follisitm
July 22 - Day 7 - 75 IUs of Follstim
July 23 - Day 8 - Bloodwork and ultrasound to check follicle growth
(future protocol determined based on results of Day 8)
I can't really say how I'm feeling about all of this. My initial reaction would be to say I'm handling it really well, not bitter (at the moment) about having to go through this instead of just buying a bottle of wine and getting knocked up the easy way. It's a huge relief to be getting the help we (I) obviously need to conceive, and I'm both grateful and excited. But I've also been rather grumpy lately. It's either because I have a lot of repressed IF anxiety, or because I've run out of M&Ms.
Your guess is as good as mine.
Wednesday, July 1, 2009
To schedule them, I called the number for the nurse that our RE gave to us.
Turns out it was the wrong number, which I found out when I dialed it.
I had reached a cruise agency instead.
So now apparently even the Universe is telling me, "What you need to do is to go on a vacation, then you'll get pregnant."
Very funny, Universe. Hope you got a nice giggle out of that one.
Monday, June 29, 2009
Hop along to another stop on this blog tour by visiting the main list at Stirrup Queens (http://stirrup-queens.blogspot.com/). You can also sign up for the next book on this online book club: "Moose" by Stephanie Klein.
Mel weaves the navigating theme throughout the book. How have you navigated your own infertility journey? Discuss some of the highs and lows of your personal journey and ways you saw your story as you were reading the book.
I first got my ticket to the Land of IF in the spring of 2006. Our "natural" attempts at conception had met with constant failure, so my OB/GYN prescribed Clomid. From there we experienced the usual tests as ordered by our OB/GYN and later the RE (bloodwork, HSG, semen analysis, Clomid Challenge Test, post-coital test, laparoscopy) with no concrete diagnosis, although suspected female factor. We collaborated with our RE to determine a course of action; I read books and combed message boards for medical information and personal anecdotes. I felt the need to be proactive, it gave me some sense of control in a situation in which I really had little. We endured treatment after treatment, culminating in our fifth IUI (second one with injectibles) that resulted in a successful pregnancy. Now we are back on the island to TTC a second child. I hoped and prayed -- and dared even thought -- that we would be one of the lucky couples who didn't have to struggle again after primary infertility. That was almost the case, as we had a BFP on Christmas Eve, but it quickly revealed itself to be only a chemical pregnancy. Now we are heading back to the RE for more injections and turkey basting... thank you, sir, may I have another?
The highs for me had to be the few times that I had hope a treatment would work, mainly when starting a new protocol. I got worse and worse at the "hope" thing as time wore on, but it would show up sometimes anyway. It made me giddy at the first round of Clomid (This is all we'll need, the doc said!). The first IUI (Wow, all those swimmers put just in the right spot, how could this NOT work!). The first round of injectibles with IUI (This is hard core... I'll probably end up with triplets!). And when each one of those failed, the lowest of the lows. Other than the constant and unstoppable arrival of AF, two particularly difficult times for me were hitting the one-year mark and being told I would need a laparoscopy to check for endometriosis. When we hit 12 months TTC, all of the milestones I created in my head came crashing down around me (e.g. I'll have the cutest baby bump next Christmas, or I'll be holding my baby on my next birthday, etc.) and I realized that this was going to be more trouble than I thought. Not only could I not count on being pregnant by any specific future date, I could not count on being pregnant EVER with complete certainty. I was -- I am -- infertile. And shortly after that unhappy anniversary came the recommendation of scheduling a laparoscopy. I was so terrified of surgery that I left the RE's office absolutely shaking. I missed my turn on the way back to my workplace, tried to turn around in someone's ridiculously steep driveway, got stuck on an ice patch, had to call a tow truck, and missed a meeting I had with a client. I laughed about it with my coworkers (who didn't know about my IF), but it was not exactly a banner day. On the bright side, when the time came, the surgery wasn't nearly as bad as I had feared.
Reading Mel's book took me back to those early days of IF when I was learning about hormones and treatments for the first time. Wondering how far we'd need to go to get pregnant, hoping it wasn't to the next step (whatever that might have been at the time). Being unsure of many things, especially wondering if I was strong enough to survive this. This time I am much more familiar with the process, and as I read, I was nodding along instead of nervously marking down questions like I did with IF books three years ago. And there's one thing I am certain of: I am strong enough to survive this, even though it will hurt like hell for a while. I overcame a needle phobia and stabbed myself in the stomach for a week. I'm pretty certain I could fly if I really needed to.
Navigating the Land of IF covered many different aspects of infertility. What topic do you wish had been added or expanded on?
I think the comprehensive nature of the book is one of its strengths; there is something for everyone, and because you often don't know where the path will take you next, it's great to have all topics available (e.g. male factor diagnoses, IVF, adoption, child-free) whenever you need to reference them. That being said, there wasn't a lot covered on secondary infertility specifically. I think partly because the physical issues are the same as with primary infertility, and the emotional issues greatly overlap as well. I certainly wasn't expecting much on this topic anyway -- I bought the book for a refresher as we head back to the RE -- but I would be very curious to see how a chapter or perhaps an entire book on secondary infertility (especially after primary infertility) might read. I am just starting to navigate this area of the island, so it would be valuable to me to have some idea of what to expect. For example: So far, secondary infertility has been a little bit easier for me than primary. (Although still ridiculously high on the Shitty Scale.) I'm almost holding my breath waiting for the same wave of depression that hit me last time to sneak up and crush me. Although I'm certain it's different for everyone, I'd love to hear what have other women experienced as their journey for subsequent children drags on. Any special emotions or pitfalls I should be keeping an eye out for?
The "From Me to You" section—how did that touch you? Have you ever wished you had a best friend in your pocket to get you through a day? What would you say to your best friend in a note if you thought she was going through the same thing?
The book arrived in my mailbox from Amazon.com the same day we were attending a family potluck held by the moms club I belong to. Admittedly, events like these now are immensely easier than, say, heading to a baby shower while I was experiencing primary infertility. But throughout these sorts of gatherings, even with my son in tow, I have a knot in my stomach watching the other moms wrangle their multiple children, seeing siblings interact and play together, and holding my breath in fear that someone will burst out with a pregnancy announcement as my latest cycle is failing. As we were gathering our food and bag to head out, I impulsively grabbed "Navigating the Land of IF" off the kitchen table and flipped through. My eyes settled on the final page of the "From Me to You" section, where Melissa presents a personal note for the reader to xerox and take to a difficult party, offering moral support and permission to secretly feel crappy until safe at home again once more.
As soon as I read it, my heart sighed in my chest, and tears welled in my eyes. It's what I love about Melissa's blog as well -- she simply gets it. She has had a cry in the bathroom at a baby shower, she has stepped outside for a few minutes to collect herself, she has sneaked into the liquor cabinet for a drink. (I picture her using that gum-like stuff from Mission: Impossible to blow open the lock. Although I guess that wouldn't really be sneaking. Maybe she has a special quiet sort of gum explosive that makes a small blast that no one notices.) I whole-heartedly appreciate the support of all my fertile friends and family, I couldn't survive without them, but the comfort I get from the empathy and encouragement of a fellow IFer is unparalleled for me. And I think that's why the letter immediately spoke to my core. Melissa used her beautiful words, again, to remind me that although IF is major suckage, it's not the lonely island it sometimes appears to be. I closed the book, sniffed, and blinked my eyes so my husband wouldn't see my tears and ask me what was wrong. We packed the car, headed off to the potluck, and my heart was lighter than it had been all day.
I absolutely have wished for a tiny infertile best friend to hide in my pocket to help me get through the day. This imaginary IF BFF would no doubt be saying snarky things about strangers behind their backs, which is of course extremely rude (shame on you, naughty IF BFF!) but she would make me snicker nevertheless.
If I had to write a note to a friend going through the same thing, I would probably say something like:
I am so proud of you for coming to this, even though you'd prefer to stay home in bed with your ice cream and DVRed episodes of Wipeout. (Is there anything funnier than watching people getting knocked on their asses?) You are such a strong woman, even when you don't feel like it, and it is kind of you to attend for the sake of the host. You have my permission to pull yourself away, or ignore a conversation, or daydream about those people getting knocked on their asses when you need a break from the celebration. Even though I am not there now, I am with you in spirit, thinking about how amazing you are and praying the minutes tick by quickly. You can absolutely get through this, and when you do, there's a giant tub of ice cream with your name on it. I hope we'll be celebrating your happy blessing one day very soon, and I'll be the guest with the biggest smile. (And cutest dress.) (But not nearly as cute as yours.)
Lots of love,
Sunday, June 28, 2009
1. Max 2 IUIs with Follistim, first cycle in July, ony one IUI per month (not back-to-back). If not pregnant, then...
2. Max one more year "natural" TTC. If not pregnant, then...
4. The end. Family vacation! Wally World, anyone?
Okay, so maybe we didn't quite "agree" on #3. But we are making progress. Gotta love any plan that reduces the worst experience of my life (IF) to four deceivingly simple bullet points.
Does it make me sound twisted... if I admit that I can't wait to stab myself in the stomach with that damn Follistim pen?
Thursday, June 25, 2009
Hoo-ha, meet the new RE. Mr. RE, this is my hoo-ha. A pleasure, I'm sure.
I drove into Seattle with the morning rush. Actually it wasn't so bad. On the way in, I turned up my music REALLY LOUD (which I can't normally do because of my pint-sized passenger) and belted out the lyrics to the Missy Higgins CD that my friend Al had made for me. It was kinda like having her with me for moral support -- thanks Al, I love you! As I drove and sang (using the word "sang" loosely) I could feel my body buzzing with emotion and anticipation. I tried to identify the individual thoughts and feelings, but I really couldn't. I was a giant mess of nerves... leaving Bean home with this babysitter for the first time, wondering how our appointment would go, contemplating whether or not we'd end up with a baby at the end of it all.
The first thing I had to get over was the fact that this clinic is very different than our last one. I loved my RE in St. Louis, and he's the standard by which all others will be judged. I'm sure it's some sort of psychological defense mechanism that I remember only the good things about our last experience with the doctor; the rose-colored glasses of the mind. Going into this office, I was struck by how hard core it seems. Everything from the giant official logo on the building to the super-professional waiting room and fancy offices overlooking the water. This is Serious Business here.
DH met me there and we patiently waited to meet Mr. RE. (Sorry, I have no creative nickname for him like others do for their doctors. If I think of something more amusing I'll be sure to let you know.) Apart from enjoying the comfy chairs and beautiful view, we were assaulted by a constant stream of offensive lite rock ballads from the early 1990s. I sang along with every single song, from Michael Bolton to Whitney Houston, and we pondered what it says about me that I knew all the words. DH and I were both in agreement on that: nothing good. Nothing good whatsoever.
But despite the less-than-happy reason we were there, it's always a nice treat to see DH in the middle of the day. We sat and talked and laughed while we waited... we are truly in this together. As I looked at the other couples, I felt a little guilty knowing that we had a child at home already (although I'm sure some of them did, too). No matter what happens this time, I'll be spending my life with my soulmate, raising our son. God willing, we'll have family vacations and baseball games and high school graduation and grandbabies one day. That blessing wasn't lost on me. Secondary infertility has been very different than primary for me so far... I'm sure I'll have more to say on that subject in subsequent posts.
We finally shook hands with our new hope for the future, Mr. RE. We sat down together, and he rendered useless all the time we spent filling out a huge packet of paperwork by asking us to give our history. He struck me as a very sharp man, he was very "quick" with everything (not like rushing us, more like he was processing things in his head very quickly) as we talked history and treatment planning.
In the middle of our consultation, my cell phone rang. Fearing it was the babysitter, I grabbed it from my purse and looked at my caller ID. It was one of the moms from preschool. I was hoping she was calling because she wanted to get together today, and as I would learn when I listened to her message on the way home, I was right! My insides did a little jig of happiness seeing her name on the small screen... and if you've read this post, you understand why. As stressful as the day was, there were a lot of good things happening too.
How did the meeting go? As good as these sorts of meetings can go, I suppose. We discussed what worked and didn't work in the past. He gave me an ultrasound to check out the old uterus and follies. (Hi ladies! It's been a while!) He saw a small fibroid on the outside of the uterus, which he said was a non-issue at this point, and remarked that otherwise my insides are "beautiful." Spotted one dominant follie on my right ovary... hopefully I'll be popping that baby off next week. Who knows, maybe I'll get pregnant and not need to return to the office. HA HA HA! *snort* Excuse me while I recover from a fit of laughter...
He agreed with me 100% that it may very well be the mild endo that's creating a hostile environment for implantation, despite the assurances from my previous OB/GYN and RE that it was not. His suggestion was that we reduce the amount of Follistim this time (to aim for 1-2 follies instead of the 2-3 I got last time, lessening the chance of multiples) and then proceed with an IUI. He wants to do some CD3 bloodwork when my next AF arrives, but he said that he expects everything to come back normal, and if it is, we can go ahead with treatment that same cycle if we are ready. As in: JULY! NEXT MONTH! Otherwise we can think about it for a while longer and give him the green light at any point in the future.
Regarding the breastfeeding issue... this is what I was most nervous about. He did raise an eyebrow when I mentioned I was still nursing. I shared with him that it's infrequent and quick these days, and I would like to proceed with treatments without weaning. He said "on the record" he would advise me to wean first. Mainly because prolactin, a hormone associated with breastfeeding, can inhibit conception. He said if we are investing so much in a cycle, he wants us to have the best shot possible. Which of course I entirely agree with. However, he is willing to go ahead if that's what I want. He suggested that we do some additional bloodwork to check my prolactin levels, and if they are very low, he doesn't see a problem with the Follistim + IUI protocol. I was satisfied and more than a bit relieved with this answer.
He also recommended doing back-to-back IUIs, when you get to meet Turkey Baster two days in a row at ovulation time instead of once. This of course doubles the cost of that portion of treatment. Our previous RE said that when he reviewed the literature, he saw no increased success with the back-to-back approach, and so why make the cycle more expensive that it already was? With him we only did one IUI each time. This doc did admit that the research in medical journals was split on this issue. But his argument was that (again) you are already investing so much in the cycle, what's another $350 to put twice as many soldiers in position? I could see his point if we were doing IVF, which is a lot more expensive and would require financing for us anyway... but an extra $350 is a lot for an IUI cycle, I think. Still undecided on this.
After the appointment, I kissed DH goodbye, called the babysitter to confirm things were a-okay, and hopped over to where Jen works nearby so we could grab some coffee together. When she suggested this last week, maybe it was because I was sappy from AF hormones, and maybe she just wanted an excuse to take a break from work anyway, but I was really touched! As we ordered, she insisted on treating because of my difficult morning, and it was wonderful to debrief with someone who had not only been-there-done-that with IF, but been-there-done-that at this same clinic.
I am such a lucky girl to have these people in my life.
I'm still a swirl of thoughts and emotions, and unfortunately DH is going to be working late tonight to make up for the huge chunk of time we spent at the doc, so we can't compare notes for a while. But so far, here are my thoughts.
1. I think the appointment went just as well as I could have hoped. Other than finding out I was indeed correct that our new insurance is a bastard and won't cover ultrasounds or bloodwork, so each cycle will be twice as much as they were in St. Louis. But everything in Seattle is twice as much as it was in St. Louis, so really that shouldn't be a shocker.
2. The RE and I were on the exact same page as far as treatment planning goes. I'm pretty sure I could be an RE right now, if I could just get past that whole cutting-up-a-cadaver thing to get a medical license.
3. Seeing as the cost of one (yes ONE) cycle is $1500ish, are we ready to start immediately? The chemical pregnancy in December has given me just enough hope to wonder if we should try longer on our own first. I think 51% of me is ready to give it a go, but the other 49% is pretty convincing too.
4. If we do go ahead, do we do one IUI per cycle or spend the extra $350 to do back-to-back IUIs? I'm leaning towards one, especially if the problem is endo/implantation and not the performance of DH's little men.
5. Am I willing to risk the chance of multiples at this point? If we have twins on top of a two-year-old, with no family within 2200 miles to lend a hand, we will be SKEE-ROOED.
I'd love your thoughts, as always. You are so wise!!
Tuesday, June 23, 2009
She smiled brightly and her voice bubbled with excitement: "My doctor said it's just a matter of my eggs not being mature enough when I ovulate. I'm going to take Clomid to help them get there. Then we'll be all set!"
No pregnancy announcement came, no baby bump appeared.
A year and a half later, I was walking down the hall when I saw her leaving a classroom in tears, wrapped in the comforting arms of another woman. A moment later I saw a mutual friend leave the same room, and out of concern I whispered, "Is she okay?"
Our friend frowned. "She did one of those turkey baster things, and she just found out it didn't work."
I sat down in my own class and mulled this over. How unfortunate for her, she and her husband were both generous, compassionate people who would make exceptional parents. They deserved a whole football team of kids if they wanted them. I was sorry they were suffering.
Then followed the thought: I'm so glad I won't have to go through that. When we're ready, it'll happen right away.
Another year or so later, I was sitting in the waiting room at my OB/GYN's office. Although my first Clomid cycle had failed, my doc was entirely certain that those little pills would get me pregnant within three months, and I was all aboard that train. A woman walked through the door with a small child and a hugely pregnant belly.
She handed the receptionist a disposable plastic food container. "I had to use injections to get pregnant with my son, and I have the used needles in this container. I didn't want to throw them out in our garbage in case a child or someone else found them."
The receptionist looked a little disconcerted but took them with the promise to dispose of them properly. The woman pleasantly thanked her and sat down with her son.
I immediately empathized with her struggles, and I looked at her with respect and longing for her happy results.
Then I thought: I'm so glad I won't have to go through that. I'm terrified of needles and wouldn't be able to do it.
Yes, absolutely, most of my response was just plain naivete. Like most women, I had no reason to think I wouldn't get pregnant right away. I had prevented pregnancy for years with such unwavering determination, and I knew all we had to do was pull that goalie and BAM! SCORE!
Parenthood. Just like that.
But I could point to genetics as suggestive evidence of our abundant fertility, too. Between me, DH, and our four collective siblings, at least half of us were "accident" babies.
Clearly we are missing something.
Even now, after having gone through invasive and embarrassing tests, surgery, countless blood draws, pills, injections, IUIs, and lots of head-banging-on-the-wall-WHY-ISN'T-THIS-WORKING to conceive little Bean man...
When I read or hear about other infertile couples TTC their second/third/ninth child for 3 or 4 or more years...
I think: I'm so glad I won't have to go through that.
This time, although there is an aspect of that naivete remaining ("It worked with injectibles+IUI last time, we can go there immediately to get the same results!"), I believe that's much less what it is about.
This time, I am already half-drained before we've begun. I was almost ready to give up on Bean, right before we got our BFP. Many couples do it much, much longer than two years, but I didn't think I had it in me anymore. The treatments were too demanding, my life was on hold, I was hardly breathing as I waited to get pregnant.
I would hate to not give a fair try at producing a sibling for our son. I don't want to be a quitter: "Fine, Universe, you don't want me to get pregnant? I WON'T!"
But I am not starting from scratch here. I am picking up where I left off, bruised and beaten.
But that doesn't mean I can fight forever.
(On a happy note, that classmate of mine did conceive a beautiful daughter on their last-ditch FET cycle, after several failed IVFs. They kept trying faithfully for years and years, and they finally received their precious gift.)