Sunday, December 30, 2007

Misunderstood

Okay, so I want to clear something up here. I've been getting some comments from friends IRL who are assuming that I don't want to talk about what we are going through. They may think that this blog gives me a place to express my thoughts and that I don't want them to bother me about it IRL. They don't want to upset me by bringing it up. This assumption could not be more wrong. Maybe it is my fault for somehow giving people this impression, because it has been more than one person, but I don't know.

When I know someone is reading my blog (or at least knows about it because I specifically made a point to give them the url), but doesn't say anything to me, it just makes me wonder if they really do care enough to read it and if they are reading it, maybe they don't care enough to express their thoughts to me or are embarrassed or too busy, or have been abducted by aliens (I can think of a myriad of reasons in my head when I'm not given the actual reasons). I know not everyone will comment using this format and that is fine, I don't expect them to. But it is nice to know when I do talk to these people that they are reading, that they care, and a simple "how are things going with your cycle?" always does the trick. If I don't want to talk about it, I will let you know. If you know me at all, you know I would be honest about that. If I've made a point of telling you about our fertility issues, it means I value your friendship and trust you enough to lay it all out there. It means I WANT to talk to you about it.

This is not to say that many of our friends don't already do this on a daily basis. We do have very thoughtful friends who check in on us frequently, some of who have been through all of this before. And even some who have no idea what this is like who just always seem to find the perfect thing to say. The best feeling in the world is when someone who knows nothing about this goes and educates themselves on their own or asks you questions to show that they want to learn, want to understand. These people make you feel not so alone, justified in your quest to seek medical intervention, and supported like a great sports bra.

And in case this doesn't clear things up, please go read this post (which I also have a link to in my sidebar courtesy of Tertia).

Friday, December 28, 2007

The Peace Lily

We've had this house plant-I think it's a peace lily-for years now and I'm proud to say it is still alive. My brother and sister-in-law gave it to us as a gift years ago and I was terrified that I would kill it because, well, I tend to do that. I get busy (I mean lazy) and forget to water, I over water, I yell at the plant. Just kidding on that last one. But seriously, this plant must be the easiest plant to keep alive because it even droops to tell me when it needs water. Actually, it keeps the other plants alive as well (yes, we have a couple of other plants) because they also get watered when the peace lily droops.

When we first got the peace lily it had some beautiful, white flowers in bloom. I think it sporadically bloomed every once in awhile, but I haven't seen a flower on it for at least 2-3 years. I thought it was done. Kind of like when you get older and run out of good eggs (if you had good eggs to begin with)-I thought my peace lily hit menopause.

And then randomly on Christmas (or maybe it was Christmas Eve) I was sitting on the couch watching tv and happened to look at the plant. It had the beginnings of what I believe to be a new white flower. It wasn't open or anything, but it was definitely a start, a promise of a new bloom. For some reason, I was happy. I don't usually get happy about plants. Just not a plant person. But this one lone white flower that came out of nowhere against all odds to show up right as we were starting a new cycle...yeah, yeah, you get where I'm going with this. I saw it as a ray of hope. I don't know the history of the peace lily or why it carries its name, but maybe it's because it is supposed to give people peace. Not that having a screaming infant in the house would be peaceful, but it would bring peace to my heart and soul and get rid of the achy, emptiness that seems to reside where my heart used to be.

Thursday, December 27, 2007

Super Secret Spies

Last night we went out to dinner with some friends as we had a friend in town visiting for the holidays. It was good to catch up as we hadn't seen some of them for a year. I did have a couple of those moments where I felt completely isolated and slightly out of body because none of them know what we are going through and there were several conversations about their kids. It's like we lead this secret double life that only certain friends and family are aware of. Only instead of something cool like being double super secret spies for some underground organization, we have this secret life of cool needles, syringes, drugs, patches, suppositories, calendars and doctor's visits. Remember that Arnold/Jamie Lee Curtis move, True Lies? We are Boris and Natasha and our weapons are little needles.

Today was a fairly exciting day in our secret spy lives as we received our latest mission (calendar) and weapons (pharmacy order). The needles should arrive this Saturday sometime between 8am and 3pm (they won't give us a specific time as this could alert the enemy as to when they could steal the weapons). We will start injecting the suppression army troops (Lu.pron) on January 1st. What a lovely way to start out the New Year, eh? The tentative launch date (transfer) is January 29th. Sorry, I'm being extremely cheesy today. Must be all the snow around here. So if all goes well (cross every finger, toe, eye, leg and arm I have), we should get a transfer in for January.

Our detailed schedule is as follows (in case you were all dying of suspense):
December 25-started BCP
January 1-start 10 units of Lu.pron per day
January 5-last BCP
January 8 (ish)-expect AF (all dates below subject to moving based on timing of AF)
January 10-Begin Viv.elle patches (estrogen replacement therapy) and baby aspirin
January 16-Blood draw to check estradiol level
January 22-Doppler ultrasound to check lining and blood flow
January 25-Doppler ultrasound and blood draw to check estradiol level
January 27-Stop Lu.pron, continue Viv.elle patches, add PIO injections each morning and progesterone suppository each night. Also begin tetra.cycline at night and then 4 times per day for next 3.5 days. Start me.drol for 4 nights.
January 29-tentative transfer date
February 10-pregnancy test

Monday, December 24, 2007

You've GOT to Be Kidding Me!

Is this a misguided attempt at some crazy couple trying to bring some infertile couple out there a holiday miracle?

And We're Off to the Next Stage of Waiting

I think. I had some light bleeding start last night and it is continuing lightly today, so I called the nurse and was given my instructions. I start BCP either tomorrow (if I continue to just have light bleeding) or on CD3 if it gets heavier with the first heavy day being CD1.

I'm having some very mixed feelings today. On the one hand, this is what we've been waiting for and I'm exited to be starting a new cycle. On the other hand, I'm moody, grumpy and crampy and realizing it has been a little nice to have some of the pressure lifted while we were on hold the last few weeks. Not tracking cycle days, not worrying about medications and doctors appointments (for the most part). Not disappointing our friends and family when things didn't go as expected.

Part of me can't wait to get into this next FET attempt and hopefully actually make it to transfer, but the rest of me is terrified of more disappointment. What if they can't get my lining to cooperate again? What if they find another abnormality and want to do another D&C? What if we go through all of that again and are postponed another couple of months? What if we actually get to a transfer, but none of the embryos survive the thaw? There are so many negatives that keep popping up in my head, it's hard to imagine that this could ever actually work. And yet I'm confronted by the fact that these procedures DO work, by others who have gone through it, by stories of someone who knows someone. It is just hard to imagine it working for US.

I know a lot of people believe in the power of positive thinking or have faith that some higher power will help them through the process and bring them their miracle. I am just not one of those people. I believe in the science, but because of its limitations, I really think what is mostly comes down to is luck and statistics. Eventually, one of these times we will have GOOD luck and things will all align and work out. Right?

Sorry to be such a downer today. I'm just not feeling very merry lately.

Saturday, December 22, 2007

Thursday, December 20, 2007

Un-Update

I know I've been MIA lately, but I just couldn't seem to find 2 minutes to deal with any type of personal matter this week. Work has kept me really busy from about 6:30am until around 9pm or even 11pm some nights this week. The good news is, one of our transactions closed today, so I do feel a bit of a load released off my shoulders.

The other reason for my absence is just that I have no news to report. No AF. No signs of an impending visit. Nada. Nothing. Zilch. The really weird thing is that it hasn't bothered me very much yet (and I'm sure by typing that I will immediately start obsessing about it now). Probably just because work has kept me so busy. But the truth is I have been thinking about it off an on, but rather than a panicked "where the hell is AF???!!!" it's been more of the "hmm, that's interesting, this is taking awhile" reaction. Maybe I'm actually learning to let go of some of my control issues and accept things as they come. Or maybe I'm just exhausted and don't have the energy to obsess over it for the moment.

Monday, December 17, 2007

Post-Op

Today was my post-op and everything went fine. I got a lovely pelvic exam and the RE said everything looks great and I'm cleared for "normal activity" and to call with cycle day 1. Yea! The only curious thing is that I'm still having cramping, lower back pain, etc. Maybe it's just a sign of my impending period and it just happens that it's overlapping with cramps from the procedure? So hard to tell-I just don't trust my body these days. When I told the RE I was still cramping he said that was strange because everything looks normal. That was it-all he said, so I'm assuming it's nothing to be concerned about? He's so weird.

Four more days until vacation!

Friday, December 14, 2007

Another Anniversary

I have scheduled my post-op appointment for Monday morning, but I really have no idea what this entails. I suppose it is just a quick check from the doc to give us the go ahead to start our next cycle when AF decides to arrive.

I am exhausted from my first full day back at work. I have to work this weekend because we have two HUGE transactions closing next week. I really can't wait for next week to be over.

Next week also marks my third anniversary with my current employer. It is ridiculous to think about this now, but three years ago we were concerned about waiting to try to get pregnant for awhile so that I would hit my 2 year anniversary at work right before the first kid was born. At the 2 year mark, the maternity benefits at my work go from crappy to pretty darn good. It really seems stupid that we were concerned about this, but hindsight is 20/20, right?

I've been noticing this week that the two women in my department who are currently pregnant are chatting quite a bit more than they used to. Of course it may just be my uber-sensitivity kicking in and things are no different than they used to be, but it really seems to me like they have a lot more to chat about these days. I pass by them in the halls and imagine them comparing pregnancy symptoms, plans for nurseries, baby names (and on and on and on). It is just another reminder (multiple times a day) that I haven't been accepted into this club that I so want to be a member of. I've submitted my application so many times, each time filling it out more carefully, just to be rejected again. I just hope there's no limit on how many times we can apply. Oh, and I hope the person making the admittance decisions gets fired and replaced with my mom (she would definitely let us in).

On another note, one of my friends just gave birth to beautiful twin girls at 32 weeks yesterday (as some of you reading this already know). I called the husband last night to congratulate them and even while they are going through this really scary time, he still found time to express how they are pulling for us and how they know what we are going through must be really hard. It meant a lot to me. Our friends rock.

Thursday, December 13, 2007

Good News (not great, but good)

I made it into work for about 4 hours today, which is progress. Starting to feel less dizzy and shaky, but now I'm achy and crampy. It's always something isn't it? We did get the results from pathology today and there was nothing abnormal in the endometrial lining tissue. Just "normal" endometrial hyperplasia. So the good news is, I don't have cancer or anything like that. The bad news is they don't have any idea what caused the abnormal lining. Let's just hope it doesn't happen again. So the waiting continues-we will sit here and twiddle our thumbs until AF arrives to start another cycle.

Other than that, not much going on with us. Today is B's birthday, but he doesn't want to do anything to celebrate. Can't say I blame him. It sucks getting older knowing that the clock is ticking and that it is just yet another milestone passing while we are still childless. Of course, he probably doesn't see it that way at all-he's not a big birthday person to begin with. It's just my negative thoughts creeping in.

Wednesday, December 12, 2007

Recovery Revisited

I woke up this morning feeling so-so, but dragged myself out of bed anyway thinking I'd feel better once I got into the office. About half way into work, while sitting in traffic on snow-packed roads, I realized how stupid I was being. I don't know where I got this work ethic that sometimes makes me sacrifice my own health for my job--or maybe it's just a control thing. I felt like crap. I was dizzy, in a cold sweat and nauseas. Even changing lanes seemed to take an incredible amount of effort. So I got off the highway, got back on going the other direction and somehow made my way home without wrecking the car. It was a relief to get back to the house, but then I had to deal with 2 crazy hyper dogs who's day suddenly went from boring to EXCITING! I locked them outside for a bit and then locked myself into the bathroom. I'm guessing it's the antibiotics that are not agreeing with me.

So here I am back on the couch with my laptop having spent most of the day responding to work emails and trying to ignore the ball of snow/ice walking around the house that is now our mini schnauzer (we have a yard full of snow and every time she goes out, it sticks to her fine undercoat like velcro). I have been fighting exhaustion all day, but I'm afraid to sleep for fear I won't be able to fall asleep tonight (which happened last night). And I'm finding I don't have the patience for work that I used to. I've been noticing this phenomenon for some time and I wish I could control it better. Some days are better than others, but add in a constantly crashing laptop today and I found myself needlessly exasperated by everyone else's stupidity (not that they are stupid, I just have no patience).

So, as great as I thought I was feeling yesterday, turns out I'm not quite 100%, physically or emotionally (you were right, Meg!). I think I will be better once we get moving on a new cycle (even if I go crazy and EB comes out again when I go back on Lupron) because at least then I will feel like we're making progress, doing something proactive. Today I just feel empty.

Tuesday, December 11, 2007

Recovery

Just a quick note to follow up on my recovery. Still feeling pretty good today, just a little sore. The main problem is that I can't seem to keep my eyes open for more than 30 minutes at a time. I didn't sleep much yesterday once we got home from the clinic and I'm thinking that it may be catching up to me now. I'm glad I decided to take today off of work because I'm not sure I would have made it all the way in today without passing out at the wheel (not to mention another snow storm creating the likelihood of a 2 hour commute this morning).

B took Molly (our big puppy) to daycare today so she would be out of my hair, but left Scout (the little dog) home with me. It took Scout about an hour to settle down after B left with Molly, but then we both crashed on the bed for an hour or so before moving to the couch. So, just here resting up for the day and hoping I get my energy back tomorrow. I am a little worried about what's going on at work given some of the email traffic I'm seeing--my immediate boss is out of the country this week and the senior manager who's covering for me through today threw her back out this weekend and isn't exactly 100% (yikes!). I have a feeling I'm going to need a lot of energy to deal with the next couple of weeks at work.

One thing the RE mentioned yesterday was that he thought my cycle would likely begin from the spotting I had after coming off the FET meds the weekend before Thanksgiving. That's not the impression he gave us at our regroup, so here I was thinking I was having a crazy long cycle and worry about what that meant (did the meds forever screw me up and I'll never have regular cycles again?!?). If he's right about this, I should get AF sometime this weekend or shortly thereafter which means I can go in BCP on CD3 and will get my calendar for our next shot at FET. I'm really, really hoping my lining is great this go round and that the D&C wasn't for nothing.

Oh, and we were told to expect results from pathology by about Thursday, so we can call Thursday afternoon to see they have received results. Not sure exactly what I'm expecting from this, but I'm curious. Just hope I have time to call them while at work on Thursday because they don't answer calls after 4:30pm. Wish my office kept those hours!

Monday, December 10, 2007

AN ENEMA!!!!!!!

I'm happy to report that the D&C went better than expected. The nausea was kept to a minimum (thanks either to the anti-nausea meds they gave me or thanks to the fact that I wasn't already feeling so crappy like I was before the retrieval), I'm not nearly in as much pain as I was expecting, and I'm not (TMI) bleeding nearly as much as I expected. I am still feeling the effects of the anesthesia and just a bit out of it, but it isn't too bad.

I had trouble sleeping last night (big surprise) and was pretty tired and nervous this morning. We got to the clinic at 6:30, sat in the waiting room for about 5 minutes, filled out some paperwork and then they prepped me for the procedure (started an IV, hooked up all the machines to monitor my vitals, etc.). We met the anesthesiologist who simply reiterated the information we had discussed yesterday. At 7:30 they wheeled me back to the operating room, raised the bed up and were helping me onto the table. I started to feel dizzy, commented on that fact, heard the anesthesiologist say "that's the medicine I gave you," and that was it. I vaguely remember some comment during the procedure about adjusting the level of anesthesia, but I can't be sure if that was a dream or not (and I forgot to ask about it afterwards).

I woke up in the recovery area and it was about 8:30. I remember thinking it was later than I expected because the procedure was only supposed to take 30 minutes, but maybe it just took that long to start coming out of the anesthesia. I was in the same area where I was to recover from the retrieval, so I knew where I was. The nurse came over pretty much right away and asked if I was feeling okay. I told her I was feeling some cramping so she added some pain meds to my IV and I fell back asleep.

I would open my eyes for about 5 seconds, look to the right of the bed to see if B was sitting in a chair waiting for me to wake up (wondered why he wasn't sitting there yet), and shut my eyes and succumb to the sedation again for another 10 minutes. This happened a couple of times. Around 9:00 the nurse came over again and I asked her where B was. She said she would go get him. He came in and said he was starting to get worried and was about to let himself into the recovery area to find me. I'm still not sure why they took so long to go get him because we didn't ask. Maybe the nurses were just busy? Then they sat me up in a chair for awhile, gave me some water and some fluids and just made sure I was doing okay.

This visit to the surgery center was definitely easier and more pleasant than my last 3 visits (retrieval and 2 visits after that to deal with the effects of my OHSS). But there weren't any funny stories resulting from this visit. About 3 days after my retrieval, they had me come back into the surgery center to get an IV with fluids because I was very dehydrated, nauseous, constipated and still in pain. After 2 bags of fluid, I still wasn't feeling better and the RE was getting a little concerned that there might be something else going on (i.e. appendicitis) that they couldn't diagnose. B was on the phone with Mom explaining to her that they wanted me to go down to the emergency room to get checked out just in case and that they might give me an enema to help with the constipation. B was on his cell phone and Mom was on her cell phone coming down from the mountains and it wasn't the best connection. To back up a bit here, B was sitting in the waiting room in the surgery center which is a tiny little room with about 8 or so chairs. So because of the bad connection, Mom was having trouble hearing and B had to keep repeating "an enema," "an enema," getting progressively louder until he was practically screaming "AN ENEMA!!!!!" throughout the building. Luckily Mom finally heard that because B's next comment (he told me later) was about to include some very bad curse words. Isn't it great how this journey brings people closer together?

I'm not sure if he was going to stop by anyway, but we did ask to talk to the RE after the procedure while I was in recovery. He came by and asked how I was doing and that was about it. I had to ask him if the procedure went well, how long it would take to get results back from pathology, etc. Strange that a doctor wouldn't think to tell you these things without you having to ask. I asked him if he found an alien in my uterus or anything like that hoping to get him to crack a smile or something. He did kind of joke back that "no, we didn't find any aliens, but the pathologists will tell us for sure." One of these days I'm going to drag enough conversation out of him that he begins to resemble a normal human being with normal emotions.

Sunday, December 9, 2007

Nerves

Tomorrow is the D&C. The last 3 weeks since our regroup actually went by pretty fast. I wasn't really even thinking about the D&C much this weekend until the anesthesiologist called this afternoon. He was great and I think he might be the same one I had for our retrieval. He assured me that they would add an anti-nausea medication to the IV cocktail to try to prevent another exorcist scene like I had after the drive home from the retrieval. I don't want to repeat that experience. I tried to keep busy today, which was easy because I'm just a big bundle of nerves right now. I do realize this is a fairly common procedure, but it isn't common for ME.

We have to be at the clinic at 6:30am tomorrow, but I'm not too concerned about the early hour as I hope I'll spend the rest of the day sleeping off the anesthesia. I'm planning on taking Tuesday off of work also to recover and I'm really hoping I'm ready to go back to work on Wednesday (okay, kind of hoping).

It has been a little disturbing that AF still hasn't shown and I'm now on day 50 (?) or so of my last cycle. When I asked the RE if this was something to be concerned about, he didn't really give me an answer. He just said that if he were concerned, his recommendation would be to "take a look in there" and that is what we are doing tomorrow anyway. So I'm trying not to worry about it, trying not to make it into something it isn't. I did, however, spend most of the night last night dreaming of getting my period. I mean, really, can't I at least have more interesting dreams? It's bad enough that this stuff is all I think about and all I can talk about, but do I really have to dream about it too?

The good news is, my sore throat has completely disappeared. I'm giving credit to the Halls Defense vitamin C drops, the 1 glass of OJ a day and the 2 glasses of wine I had with dinner Friday night. I wish I could prove that wine cures sore throats. I'd be filthy rich!

Saturday, December 8, 2007

The Element of Surprise & Managing Expectations

Yesterday at my pre-op appointment, I had to put down a $2,000 deposit. I expected this expenditure because the surgery coordinator had walked through every piece of our payment for the D&C with us when we scheduled the surgery. I knew it was a deposit and that we would have to wait for the clinic to mail us an insurance claim form which we would then send off to the insurance company and hope for the best.

After the appointment, it was down to the lab for the zillionth blood draw of the year for an ironic HCG test (like there's any chance of actually being pregnant right now...). The lab tech drew blood and then said "that will be $90." Okay, I know $90 is NOTHING in the grand scheme of things. It is probably the smallest amount we have paid for anything during this journey. But I KNOW there was no mention of a $90 charge for an HCG test as a pre-requisite to the D&C when we talked to the surgery coordinator. She mentioned the cost of the anesthesia, surgery center charge, doctor's charge, etc., etc., etc., but no $90 charge for a pregnancy test. It is so amazing that there is always an element of surprise to everything we do with this clinic (is it like this at other clinics?). I've mentioned the element of surprise to various nurses before and the comment is always some excuse about how they can't predict all of the variables that may occur in any one cycle (I will come back to this excuse). But this was not a variable in a cycle. This is a standard test that is REQUIRED before ANY D&C that is done for ANY reason.

Every time something like this happens, I'm haunted by something our RE said at our first consult. He mentioned that some patients are comforted by how controlled every thing is in his clinic, that they don't have to chart temperatures, track dates, etc. because the clinic does that all for you, tells you what to do and when and you just "show up." He seemed to believe a lot of women LIKE giving up control and letting the clinic "take the reigns" and take care of everything. I didn't think too much of this conversation at the time, having just come off a couple of failed IUI cycles with my OB where I felt like everything was up to me (and I failed miserably). But really, I like to be in control of my own destiny (who doesn't?), which is what makes this infertility stuff so frustrating in the first place. This is the first time in my life that I can remember not having the ABILITY to make something happen if I really wanted it to happen (other than wanting to have ESP as a kid and staring at a pencil on a table for hours at a time willing it to move with the amazing power of my brain).

So back to the many variables of a cycle conversation(s). The main RE at our clinic has been doing this for approximately 20 years. I know the human body is complicated, but don't you think he's probably run into most if not all of the variable responses to the different medications and protocols by now? I also know each person is different and each person's reaction to different medications is different. HOWEVER, I keep thinking that they have some huge file somewhere that tracks all of this stuff and wouldn 't it just make PERFECT sense to put all of this information on their website where you can search for different scenarios (enter your protocol, age, etc. and see all the "maybe's" of what could happen--good and bad). And then you could prepare yourself for all of the possible things that could go wrong and prolong your cycle, cancel your cycle, cause a pregnancy to fail, etc. Maybe this is just my simple mind's way of expecting some way to process information and manage my own expectations. Maybe it's the accountant/consultant in me who has been taught to manage other people's expectations with some dose of reality. They must not teach this very well in the RE world.

The lab tech who asked me for the $90 unfortunately had to deal with my not so positive reaction of "HUH?!! What is this $90 you are referring to? I was NOT told about this $90. Why is everything such a friggin surprise in this place?! Over and over and over!!! It is always SOMETHING. Jeez!!!" To her credit, she took the rant well, was very sympathetic and I could tell she felt really bad. She said they get this type of reaction A LOT. She also pointed me to the comment cards in the lobby (which I had never noticed) and assured me that the comments do get addressed. I plan to fill out about 50 of these comment cards.

What would you put on a comment card that certainly won't fit nearly as much as I've written above in this post? How do you express the frustration, anger and amazement in just a few short words? It reminds me of those posters we used to see in certain teacher's classrooms about writing your complaints in a tiny, tiny box. It's a joke.


Thursday, December 6, 2007

Shoo sore throat, shoo! (and other random thoughts)

Three days and counting since I first felt the beginnings of a sore throat. I've spent every minute since willing it away, drinking OJ, taking vitamins, working out, thinking positive thoughts, sacrificing rats. Okay, not the rat part. Just 4 more days until my D&C which means 4 more days to get rid of this bug that is trying its best to be the next detour on our road to babyland. My pre-op appointment is tomorrow in the middle of the day, sandwiched between back to back meetings at work. Sounds like fun, huh?

I'm actually quite excited that tomorrow is Friday. This week was incredibly busy at work and I think I handled the stress quite well, if I do say so myself. We are going out to dinner after work tomorrow with some friends to a tapas/wine bar, which I'm SOOOO looking forward to. No big plans for the weekend other than a little holiday shopping, some work on my niece's Christmas present, and hopefully a lot of rest.

It's supposed to be cold and snowy all weekend. B and I have been building up miles on United for years now and actually have more than enough for two free tickets. We've talked about using those miles for a trip to Hawaii to replay our honeymoon, but just can't stomach planning anything for fear it will interfere with a cycle. We had actually talked about taking a break and taking that trip had our first FET failed. But when the FET was cancelled, all I wanted to do was move forward and get back on track as quickly as possible. It's so frustrating getting that United statement every month and watching the miles just sit there. Poor, sad, lonely miles. They just want to be used.

Tuesday, December 4, 2007

One of Those Days

It happened again. Another coworker announced a pregnancy. I don't quite understand why I don't just expect these announcements by now. I mean, you would think I'd be used to it and just expect that everyone around me is pregnant. Call it a survival instinct, from now on I'll just assume every woman I see is pregnant and every man has a wife who is pregnant. Or maybe I should just spend all my time in bars where people are drinking and obviously (hopefully!) NOT pregnant. Yes, that would be productive. I will quit my job and just go sit in a bar all day long. Sounds like a perfect plan. Anyone want to join me?

Monday, December 3, 2007

Bubble Girl

The surgery coordinator at our clinic said something that's been haunting me ever since. If I get sick (a cold, or otherwise), we will need to reschedule the D&C. It's been kind of in the back of my head since she said it, but it is totally in the front now and won't go away. For some reason, today was the day at work where everyone seemed to show up sick or talking about a family member who is sick. I think I should go to work in a bubble the rest of the week. Do they sell those on ebay?

Sunday, December 2, 2007

The Sunday Blues

I hate Sunday nights.  I've hated them since school days when I would dread having to go back to school Monday morning.  It wasn't because I hadn't done my homework (usually).  It was just that the freedom of the weekend was gone and I was now subject to the structure of responsibility and the clock.  Not much has changed.  Now I dread going back to work Monday morning-not because I don't have my work done (usually).  But the freedom of the weekend is gone, again.

This Sunday is worse.  Maybe it's because we spent a carefree weekend in the mountains with no schedule other than a dinner reservation.  The snowstorm didn't bother us (the dogs were kenneled and we didn't have deal with snowy, icy walks), we didn't have access to the internet, we didn't have to check our blackberry's, and our phones hardly ever rang.    As we drove home from the mountains this morning, I could feel my mood slowly shifting.  As much as I love our house, it was depressing to come back home to unfinished holiday projects, laundry, responsibility and the calendar.  Maybe this Sunday is worse because this weekend was blissfully free of infertility reminders.  Sure we saw an occasional kid or two here and there, but they just don't seem as widespread in the mountains (at least not in the bars!).  Or maybe this Sunday is worse because my schedule shows a work week full of meetings that will keep me from getting the rest of my work done.  It is only the second day of December and it feels like year-end is rushing towards me like a freight train.

And yet time is also creeping by every so slowly (how is that possible?).  It has been over two weeks now since our last cycle was cancelled.  Two long, long weeks.  And there is another full week to go before our next step (the D&C).  I am still waiting for AF to show.  She is delayed for some reason, maybe the airline lost her luggage or maybe she ran out of gas and missed her flight.  Either way, I wish she would hurry.  The RE said the D&C will not change my cycle at all.  We can start the next FET with the first AF after the D&C.  I highly doubt AF will wait a whole extra week before showing (wouldn't that be great?), so I really just wish she'd arrive now to bring the next time that much closer.  COME ON ALREADY!!!

Wednesday, November 28, 2007

"Infertile. Please be sensitive."

I've been staying away from my blog the last two days mostly because work has kept me really busy and I honestly haven't thought about it too much (too much is a relative term). That is until this afternoon when I showed up for my dentist appointment and there was the hygienist freshly back from her maternity leave with brand new baby pictures all over her work station. Lovely. She also looked about 10 years younger than me (or maybe that's just my bitter brain at work).

She asked if I've had any health changes since my last cleaning and as I answered "no," I couldn't help but think that my last cleaning was 6 months ago and not much has changed since then (or, come to think about it, since the one prior to that a year ago). Sure, we've moved on to IVF and have 18 embies on ice, but we're still not pregnant. We still have not had a chance to get pregnant since we started IVF and we still don't have any answers as to why this is.

The experience was topped off with a fun discussion as I was getting up out of the chair to leave:

The Hygienist: So are you doing anything tonight?
Me: Not really, just going to go work out and then probably do some work.
Her: Oh, I can never find time to work out and I really need to lose this pregnancy weight. Do YOU have kids?
Me: No. (bite my tongue and hold back a million things I want to say but I know it wouldn't be fair to her)
Her: I just never seem to have any time now that I have a BABY!

Uggghhh....it just exhausts me. Yet another circumstance of someone meaning absolutely no harm and, yet, having no clue how much their words hurt. Sometimes I think it would be easier if I walked around with a hat or a tattoo on my forehead that says "Infertile. Please be sensitive."

Here's the good news-my teeth are clean and no cavities. At least one part of my body is doing the right thing.



Sunday, November 25, 2007

Deep Thoughts (yes, I occasionally have them) - Warning-possibly offensive

Hopefully I won't offend anyone with this post. If at any time you start getting the slightest bit offended, please stop reading.

Having called myself "pro-choice" pretty much my entire life and, oh, by the way, having a uterus, I'm disturbed by some recent events in my home state. There is a group led by a 20 year old, home-schooled little girl in Colorado that is trying to get a measure on the ballot that would define life as beginning when an egg is fertilized, thereby making "crimes" against embryos prosecutable including certain forms of birth control since it makes the uterus a "hostile environment." This is a cowardly attempt at sneaking in the back door to overturn Roe v. Wade. This story bothers me on so many levels.

First, having grown up in a post Roe v. Wade world, I (and most of my friends) have largely taken for granted our right to choose what happens with our own bodies. It terrifies me to think the next generation (my kids!) could lose this right and grow up in some scary twilight zone flashback in time where women feel they need to resort to back-alley abortions. (Did anyone see that HBO special "If Walls Could Talk?" Scared the bejesus out of me!).

Second, having been very responsible (for the most part) in my younger years, I believe in the pill and in birth control in general. Although it all seems pointless now, I was on the pill for 13 years. And there were reasons other than birth control. Many women use the pill to help regulate their cycles, make their cycles more predictable, and to reduce PMS symptoms. I know having now been off the pill for almost 2 years, that it really did help ease up on the cramping each month and made having a period just a bit more bearable.

Third, having gone the route of IVF, I obviously do not believe that an embryo is a person. Is it "life?" Maybe...well, yes, in a strictly technical sense of the term-in the same way plants are "life," bacteria are "life" (wait, did I just compare our embryos to bacteria?), etc. If put in the appropriate conditions, these things can grow into something I really consider "life." If put into the appropriate conditions (hopefully!), our totsicles can grow into real, live, human beings. But I obviously don't plan on transferring all 18 of our frozen embryos for fear that disposing of them means I'm a murderer. I'm crazy, just not that crazy. And I certainly don't feel like the clinics who do research on embryos and who help conceptually challenged people like ourselves achieve a life-long dream are murderers.

I know this is a really touchy subject, but it irks me that people think they can tell me what to do with my body and with the "fruits" of my loin. I find it particularly disturbing that the measure in Colorado is being led by a 20-year old girl (yes, a GIRL! she should know better) who claims God told her to help embryos when she was just a kid. Seriously? What about helping people who are already PEOPLE, who are suffering, homeless, broke, sick, etc.? Come on, kid.

If this measure (or similar measures which are pending in other states) makes the ballot, please, please, please tell me anyone reading this will vote against it.


Saturday, November 24, 2007

Evil B*tch Goes out to Lunch

B and I spent most of the day yesterday shopping for ornaments and other fun Christmas decor for the HUGE fake tree we bought on December 26th last year.  We put on Christmas music and proceeded to hang approximately 200 glass ornaments on the tree, wind garland around the banister, hang stockings, etc., etc.  B said he's never seen a Jew get so excited about Christmas (I'll save the explanation of this for another post at another time).

We were having a grand ole time and felt like we really accomplished something when it was all said and done.  At the end of the night, we sat on the couch and admired the tree in silence.  This is when the evil b*tch invades my head.  I'll call her EB for short.

One minute I'm thinking how completely content I am and how cozy the house feels with all the decorations and the next...well, I'm sure you can guess.  EB takes over and I was thinking about how my transfer should have been done already, I should have completed my bed rest and had a very relaxing week and we should be sitting on the couch, admiring the tree, AND hoping against hope that the FET actually worked.

Surprisingly, I was able to sleep last night even with these thoughts, but when I woke up, EB was not gone and, in fact, had taken up full residency in my head.  B has learned enough by now to know that I'm not mad at him or something he's done, but really just MAD.  I've never felt anger like this in my life--anger that just sneaks up on me, triggered by nothing and lingers on and on.  Luckily I had a lunch set up with Mama Wannabe and had something for both B and I to look forward to (a fun bitch session for me, and me out of the house for awhile for him).  It was a great 3 hour (!) lunch and was enough to shove EB back into the shadows for awhile.  Thanks Mama Wannabe!

Friday, November 23, 2007

Black Friday Baby Store

What time do the stores open today that sell babies? If I knew where one of these stores was, I would camp out there overnight in 20 below weather to bring home a baby. Is that inappropriate?

But seriously, I love sleep WAY too much to get up that early to shop today. Plus I think it would be a little scary to witness other shoppers in their holiday shopping frenzy in the middle of the night. Do you think there were a lot of car accidents early this morning with so many sleepy people on the road in the dark? Or were they all so excited for the deals (the deals, the deals!) that they were wired and wide awake? I'm in awe of these people; they baffle me.

Thursday, November 22, 2007

Acronym Test

I've seen others do this, but can't remember where, so unfortunately can't give them credit. It made me laugh. Hopefully it will make you laugh too.

I asked B to tell me what the below acronyms stand for. To give him a little credit, I don't think he's ever looked at one message board or IF blog.

AF: Always fertile
IUI: In-vitro uterine insert
IVF: In-vitro fertilization
ICSI: I come so insert (what?!)
BFN: Big friggin nothin (how appropriate!)
BFP: Big friggin pregnancy
TTC: Test, transfer, cope
IF: Infertility
2WW: To wish and wait
DH: Damn happy people
RE: Random embryo (huh?)
ART: Another rough testing
BCP: Birth canal part
POAS: Part ovarian all sperm
PUPO: Please undergo partial orgasm
FET: Frozen embryo transfer
HPT: Human papolone transfer (?)
OHSS: One hysterectomy should suffice

Here's what they really mean (for those of you unfamiliar with the lingo):

AF: Aunt Flo (period)
IUI: Intrauterine Insemination
IVF: In-vitro fertilization
ICSI: Intracytoplasmic Sperm Injection
BFN: Big fat negative
BFP: Big fat positive
TTC: Trying to conceive
IF: Infertility
2WW: Two week wait (between transfer & pregnancy test)
DH: Dear husband
RE: Reproductive Endocrinologist
ART: Assisted reproductive technology
BCP: Birth control pills
POAS: Pee on a stick
PUPO: Pregnant until proven otherwise
FET: Frozen embryo transfer
HPT: Home pregnancy test
OHSS: Ovarian hyperstimulation syndrome

Happy Thanksgiving!

Giving Thanks

10 Things I am thankful for (in no particular order):

1. Our family
2. Our marriage
3. Our friends
4. Our dogs














5. Our jobs
6. The roof over our heads
7. Our vehicles
8. TV
9. Heat & A/C
10. Science & Technology

Tuesday, November 20, 2007

A Small Village on Ice

Had our regroup with the doc and we are moving forward with the D&C. The doc didn't seem to think waiting to see if it resolved on its own would do much good. He didn't see the point of trying to move ahead with another cycle, checking the lining and risk another irregularity. Plus, with the shared risk program we are in, another cancellation would still count towards our allowed 3 frozen cycles and we'd be down to 1 left before having to move to another fresh cycle (and having to go through another round of stimulation medications and a retrieval).

We were told that studies have shown success rates increase after D&C's and that some clinics have even begun to include them in their standard protocols for IVF patients. I thought that was a little nuts, but what do I know?

They will also send the tissue to pathology to see if they can determine the cause of the irregular lining as they cannot tell what it is from the ultrasounds. Going ahead with the D&C was a no brainer for us given these two factors (increased success rates and diagnostic testing). Also, insurance will actually cover this procedure (even with us doing it at the CCRM surgery center instead of the hospital), which is a first for us! It's about time those bi-weekly premiums started paying for something. Of course, we will likely still hit our out-of-pocket max this year, but at least there is a max in our plan.

We scheduled the D&C for December 10th (with pre-op appointment on the 7th). I wish we could have gotten it out of the way sooner, but the doc didn't have an opening until the 4th and I will be too busy at work that week to fit it in. The doctor confirmed that recovery is pretty simple and that most people are able to go back to normal activity the next day. I'll reserve judgement for December 11th as they say the same thing about retrievals and that certainly wasn't the case for me.

Once we do the D&C, we wait for AF to arrive and then start another FET cycle. So we are definitely looking at early 2008 for our next shot at this. I know in the grand scheme of things, waiting another couple of months isn't a big deal, but every set back is hard to take and the waiting is miserable. I've never been a very patient person, so this process has been a true growing experience for me. It is hard to live your life and make plans when you are waiting for a cycle to start and can't predict when it will occur.

I thought I'd go out on a limb and ask the doc what his thoughts were about mandated insurance coverage for infertility treatments and why Colorado wasn't one of the 15 states that mandates this. He wasn't at all interested in discussing that topic, has no interest in politics, and no time for it. Not surprising I guess, but I found that a little disappointing. I guess there is no incentive for the doctors to care whether or not insurance covers the procedures they perform. It's not like he has a lack of patients because of it--his schedule is always booked.

The doc did think that thawing 9 instead of 6 probably makes sense. He said "we have a small village on ice, we've got to do something with them!" Then he made some comment about the embryos getting antsy, making noise, rattling the cages, and disturbing the other embryos. Apparently he thinks our kids are trouble makers, even at the embryo stage! Strange man.

Monday, November 19, 2007

Pictures of my niece, Katie



Pre-Regroup & a Sweater

I'm getting a little nervous for our regroup tomorrow, so thought I'd make a list of questions for the doc.

1. What does he think the "irregularity" in my lining is and what caused it? Could it be a polyp? Could it be cancerous? Will it grow back after a D&C?
2. Why couldn't we see it on earlier ultrasounds?
3. Could we have predicted trouble with my lining thickening on the meds given earlier similar issues with the IUI meds?
4. What are the chances that the irregularity will resolve in its own and how long would it take?
5. Are there options other than the D&C?
6. If we decide to do the D&C, do we have to wait or can it be scheduled right away?
7. What are the risks of the D&C?
8. Is the D&C just a treatment, or can we use it to do more diagnostic testing?
9. Is the procedure done in the CCRM surgery center?
10. If insurance won't cover it at CCRM, can we do the D&C through our OB's office?
11. How long does the procedure take?
12. What is recovery time for the D&C?
13. What is the plan after the D&C? How long before we can start a new cycle?
14. Will the D&C increase our chances of conceiving (i.e. is it really like "cleaning out the cobwebs?")
15. What does the D&C cost (assuming insurance won't pay for it)?
16. What would you recommend we do differently for the next FET? Can we avoid Lupron? Can we add something to help the lining sooner?
17. Since we only have 2 FET's left in the shared risk program, would you recommend we thaw 9 out of the 18 frozen embies instead of 6 at a time?

So many questions (did I miss anything?)...we're going to get our money's worth out of this appointment. I'm sure the doctor won't have answers to a lot of these questions, but we have to ask, right?

This next thought has absolutely nothing to do with what we are going through, but it's been bugging me. We were at Costco last night and I was buying this super-soft sweater. The guy at the register commented on how soft it was and woman who was putting our stuff back in the cart reached over to pet the sweater as well. Then they kept going on and on about how soft the sweater was and the woman proceeded to comment on every other purchase we were making. Do they teach people who work retail to do this? I mean, if I wanted a commentary on what I'm purchasing, I'd be the one giving it. Good thing I wasn't buying anything embarrasing like depends undergarments or something! Regardless, that sweater is getting a good washing before I wear it.

Sunday, November 18, 2007

My Nieces

Today is November 18, 2007. One year ago today, my niece, Ariel was born and passed away. I'm thinking of her and of my brother and sister-in-law today and hoping they have found some peace in the past year. I hesitated at first to post anything about this today as I didn't want to draw more attention to Ariel's memorial day, but I know she is never far from their thoughts. And I couldn't well post anything without mentioning it because she (and they) are in my thoughts.

Two weeks ago today, my niece Katie was born. I have yet to meet her, but I think of her often and I'm busy making her Hanukkah/Christmas gift so that hopefully it will be done in time to ship to Albuquerque. I think of her future and hope that she will love visiting our house and that B and I will be the "cool" Aunt and Uncle (within the ground rules set by her parents, of course).

We have a regroup appointment with the RE on Tuesday morning to discuss the D&C. I have many questions, but really just don't want to think about it too much until then (yeah right). Each morning when I go into the bathroom, I am confronted by the syringes, progesterone oil, and estrogen patches that I'm supposed to be well into by now. It seems ridiculous to want to take more shots, but I do because it would mean being one step closer to finally achieving our dream. I've decided that I am going to pack these supplies away into the box they came in and put them somewhere out of sight until I need them again. I'm tired of looking at them and wishing...

So that's what I will do today along with maybe cleaning out the pantry and grocery shopping for Thanksgiving (and throw in some football watching).

Perpetual State of Waiting (warning-long post)

I'm joining the blog bandwagon because I can't sleep. This isn't a toss and turn for an hour not able to sleep. It is a wide awake for who knows how long, there are now infomercials about infomercials on my 600 channels of Directv, can't sleep. I've found numerous forums for venting my frustrations over the last (almost) 2 years, but this one is comforting because it is utterly selfish. A virtual "dear diary." I have G and K to thank for enlightening me to the convenience of blogging.

A little over a year ago, B and I came to terms with the fact that we may not be able to conceive naturally. This wasn't an easy thing to accept since our diagnosis was "unexplained infertility." B's guys are healthy, my natural reproductive system is as reliable as a swiss watch, and still...nothing. I never realized that "unexplained" could be considered a diagnosis. Doesn't a diagnosis mean they've pinpointed the problem? In the world of infertility, "unexplained" means medical science, as advanced as it is, cannot determine what is preventing us from conceiving. The medical profession's way of dealing with this little dilemma is to experiment. Here is a (not so brief) synopsis of our experiences with infertility treatments.

Science Experiment #1 (and 2, 3, 4, & 5): The intrauterine insemination ("IUI"). In this procedure, the man's sperm is collected (warning...by nature, some of these posts may be graphic and as any infertility patient will tell you, any privacy or prudishness was dropped at the door of the infertility clinic, so welcome to our world of not-so-private parts). If I had any artistic ability whatsoever I would insert a cartoon here of a couple dropping their private parts into a box at the front door of the clinic.

The clinic takes the man's "sample" and "washes" it to remove debris, dead cells and any guys that aren't swimming. The sample is then placed into a catheter which is inserted inside the woman and deposited in her uterus. An IUI is meant to provide a little help to get the sperm where it needs to be in order to fertilize the egg. Of course, it doesn't solve all problems such as blocked tubes, inability for the sperm to fertilize the egg, or problems with implantation of the embryo in the uterine lining.

Most reproductive endocrinologists ("RE's") recommend no more than 4-6 tries at IUI's because the success rates diminish to nothing at that point. We spent our 5 (I think) tries at IUI fervently wishing it would work because we didn't want to move to the next step.

Science Experiment #2: In-Vitro Fertilization ("IVF"). During IVF, a woman injects herself with multiple medications on a daily basis to stimilate both ovaries into producing multiple, similar-sized, follicles. She undergoes numerous vaginal ultrasounds and blood tests (requiring daily visits to the clinic) to determine when the timing is exactly right. When the time is right, she takes a "trigger" shot which prompts the follicles to mature in precisely 36 hours. Exactly one hour before this is to occur, she undergoes a surgical procedure whereby a long needle is inserted through the vaginal wall into each ovary to carefull suck out each egg one at a time. The embryologists then look at the eggs under a microscope to determine if they are mature and then combine one egg with numerous (I think it is in the hundreds of thousands) sperm to see if it will fertilize. The woman begins estrogen and progesterone therapy in addition to an antibiotic and baby aspirin to prepare her body for pregnancy. The eggs that fertilize (embryos) are monitored to see if they will begin growing (i.e. through cell division) and the ones that look the most promising are placed into the woman's uterus (referred to as the "transfer") using the same procedure as an IUI.

Science Experiment #3: Intracytoplasmic Sperm Injection ("ICSI"). For cases where the sperm isn't up to par or (lucky us) in cases of unexplained infertility, the embryologists will manually inject one sperm into an egg to help the fertilization process.

Detour on the road to the science fair: In some cases, the ovaries can become over stimulated causing a syndrome known as Ovarian Hyperstimulation Syndrom ("OHSS"). OHSS can cause fluid retention in the abdominal cavity, nausea, vomiting, and bloating among other unpleasant and possibly dangerous symptoms. The ovaries become abnormally enlarged and tender. One of my fellow infertility ("IF") pals described the feeling very eloquently as "walking around with tennis balls in your sides." If OHSS becomes an issue, the transfer is cancelled and all viable embryos are frozen for possible future use. In our case, our first "fresh" IVF cycle resulted in 27 follicles (yikes!), 20 of which matured and 18 of which fertilized with the help of ICSI. However, along with a great response to the medications came OHSS and an estradiol level of 10,000 (which is quite high, can be dangerous, and would have gotten higher with pregnancy) that landed me in the emergency room 3 days after our egg retrieval. The cycle was cancelled and all of our 18 embryos were frozen. This was back in mid-to-late September.

Science Experiment #4: Frozen Embryo Transfer ("FET"). For this procedure, I started with a pack of birth control pills (ironic, isn't it?) to regulate my cycle, added some more injections to suppress my ovaries, and began estrogen therapy to build up the lining of my uterus. If all were to have gone as planned, some of our embryos would have been thawed, monitored for growth and 1 or 2 transferred into my uterus. Success rates for FET's are not as high as those for fresh IVF cycles, but they are still worthwhile and the cycle is generally much easier to handle (at least physically). Unfortunately, my lining was not cooperative (it is so frustrating when your body does things out of your control and without your knowledge) and our transfer date was moved back twice (which meant more shots and more hormones). Just as we were approaching another possible transfer date, the most recent ultrasound showed an "irregularity" in my uterine lining. The RE is now recommending a procedure to clean out the lining before we can start over.

Detour from the detour: Dilation & Curettage ("D&C"). In this procedure, under general anesthesia, the cervix is dilated and the inside of the lining is carefully scraped to "clean out the cobwebs." The hope is that after the D&C, the lining will grow back normally and allow the embryo(s) to successfully implant upon transfer resulting in pregnancy.

I'm sure by now (if you're still reading), I have either put you to sleep, grossed you out, or given you nightmares and I apologize for that. Nothing about the disease of infertility is pretty or proper. That being said, I am usually willing to talk about this because I don't believe it is anything to be ashamed of or that we did anything to bring this on ourselves. We are lucky because we have an opportunity to benefit from medical science and because our family and friends are very supportive. And another positive thing that has come out of this process, I've overcome (mostly) my fear of needles and realized that I am brave and strong.

On that note, I'll sign off for the night (I think I'm finally starting to put myself to sleep with this long-winded post) and send some positive thoughts to our 18 frozen embies. May they someday (some of them) go from being freezer buns to buns in the oven.

Thursday, November 1, 2007

Wondering what the acronyms mean?

2WW = Two week wait (between transfer and pregnancy test)
AF = Aunt Flo (period)
ART = Assisted reproductive technology
BCP = BIrth control pills
BFN = Big fat negative
BFP = Big fat positive
CCRM = Colorado Center for Reproductive Medicine (our clinic)
CD = Cycle Day (CD 1 is 1st day of period)
D&C = Dilation & Curattage
ER = Embryo Retrieval
FET = Frozen embryo transfer
HPT = Home pregnancy test
ICSI = Intracytoplasmic sperm injection
IF = Infertility/infertile
IRL = In real life (as opposed to virtual life online)
IUI = Intrauterine insemination
IVF = In-Vitro fertilization
OHSS = Ovarian hyperstimulation syndrome
PIO = Progesterone in oil (injection)
POAS = Pee on a stick (i.e. home pregnancy test)
PUPO = Pregnant until proven otherwise
RE = Reproductive Endocrinologist
SA = Semen analysis
TMI = Too much information
TTC = Trying to conceive