There's a cycle of hope and despair for probably every infertile where they have lost hope. Where the idea of moving forward is unbearably hard, where there's no end in sight, and you just don't know how long you can go on like this.
The Prometrium could be a big part of it. I feel at my lowest emotionally before my period every month - part of that is because I know to expect yet another period, and the other is the progesterone surge in my system that is standard for a luteal phase of a woman's cycle. And now I'm taking supplemental progesterone from right after ovulation, so that despair has set in early. And I'm afraid it will stick around for the next two weeks until my period comes again.
Because I have no hope of my period NOT coming. I know it's silly, as by all accounts, I have at least a 10% chance this month, but I just don't feel it. We've had sex at ideal times for conception for over 18 months now - the only thing different this month is that I have two eggs instead of one. Sure, I'm also taking progesterone, but it seems I have good enough progesterone on my own. So in my head, it means two eggs is the same changes as two cycles - and it hasn't worked for last 18 cycles, so why would it work now, even with two eggs?
I feel like this just isn't ever going to happen for us. I know, logically, that we've got a good chance with medication, and especially once we move on to IUIs, and even if it doesn't happen then, we've got a really good chance with IVF. We've got a really, really good chance of a biological child, which I keep trying to remind myself.
But it doesn't feel like that. Emotionally, I don't think I believe it will ever happen for us. Sure, I know that we've got a really good chance with the doctor's help - probably more than a cumulative 80% if we do multiple IUIs and IVF - but we've already fallen into the 5% of couples our age who haven't gotten pregnant within 18 months of trying, what's to say we won't fall into the bottom percentile again?
This is stealing all the joy from my life. I can't plan anything - I don't know if I will need to go for a monitoring appointment, or if I will need injections (and thus have to bring my medication, needles, and Sharps box wherever I go). I don't know if I'll be pregnant, or if we'll need more money to pay for IVF.
We used to make do just fine - infertility didn't really impact our marriage. I'd have my period, and then it would end and we'd have sex for fun as we wanted for a week, and then I'd tell my husband, "Target zone is Tuesday through Friday" and we'd try to hit at least every other day during that time. And after that, we'd go back to our regularly scheduled program as we wanted for two weeks until my period came again.
We'd take baths together, we'd go wine tasting together, we'd to the bar and have a few beers together.
Now that I'm being medicated, it has taken over our life together. This month, it's controlled everything. CD 1-6 was my period, and I took meds from CD 3 onward. The doctor told us to have sex on CD 7 or 8 and come back on CD 9 for an ultrasound, so we did. And then after the ultrasound, they told me to have sex again the following day, do more drugs, and come back on CD11. So we did. And on CD 11, they told me to trigger that night, and have sex on CD 12 and 13, and then "as we want." Except on CD 14, he was tuckered out from dictated sex on CD 12 & 13, understandably. And in the evening of CD 14, I started taking Prometrium suppositories to supplement progesterone. Which meant we couldn't have sex between when I took them at bedtime until at least morning, and even still, there's a cottage cheese like substance left from the supplement, which is gross and messy.
Last night, my husband tried to have sex in the middle of the night, and I had to push him off and remind him that I'm on the Prometrium.
So this month so far, we've had unscheduled sex exactly zero times.
We no longer go wine tasting or to the bar, because I've mostly cut out alcohol (with the rare exception of a glass of wine or a small beer, like once every other week). And now we're looking at avoiding baths because they could impact my husband's semen quality.
Do I get nothing left of my life except the routine of an infertile? Do I just get belly bruises and swollen ovaries from fertility drugs shot into my stomach? Do I have to give up all the fun in my marriage? I can't job hunt because I can't get a job that would prevent me from my unpredictable visits to the doctor over 2 hours away, and with their earliest appointment at 7am, I couldn't guarantee to be back in time for work until 10am on a regular basis.
I've tried to find alternative ways to keep busy and fill the gaps - I have "mock-tails" and tea instead of coffee and alcohol. We watch TV shows like Dexter or House of Cards instead of going wine tasting or have some beer. But there's no supplement for fun sex with my husband - we managed so well for so long in keeping sex fun, but it's now at the whim of my doctor.
I cry at the drop of a hat. I feel sad and desperate and depressed. I honestly don't know how long I can keep moving forward like this, but I don't see any alternative that I'm willing to consider at the moment. I just have to survive. I'm emotionally drained and raw. I feel like an absolute failure and just about everything, and with nothing fun left in my life right now.
Friday, February 28, 2014
Tuesday, February 25, 2014
The Wait Begins Again
We triggered at midnight on Sunday, which means I'll probably ovulate within an hour or two (36 hours after trigger). We had sex last night and this morning, and will try again tonight. We've done everything we could for the best possible shot this month, and now we just wait.
Trying to keep busy during the dreaded "two week wait" is hard. Time passes like watching grass grow. There's not much to do except wait, and in the meantime my brain has too much time to think.
What are our chances this month? Better than they've been on our own, but still less than your average couple just starting to try to conceive. That's exciting, and sobering.
There's this double edged blade of hope. On one hand, I am so excited that I could be pregnant soon (I need to remind myself that I can't hang all my hopes on this cycle - if this cycle doesn't work, it doesn't mean the next one or the one after won't work). On the other hand, I'm trying to remind myself that we still don't have the chances of a couple just starting out, and it can take a healthy couple up to 6 months (or more) to conceive with those chances.
And as I waffle back and forth between optimism and pessimism, I'm running myself over the blade in between. It hurts to hope and lose, but it also hurts to feel hopeless.
I try to spend my two week wait focusing on what I can do to improve my chances, or to prepare my body for a pregnancy if this is our month. I don't take hot baths, I eat pineapple core, I avoid alcohol and caffeine, and I get really careful with my exercise regime - just walking or hand weights or gentle yoga.
But really, even with all those things, it doesn't help the brain to slow down. I used to have trouble falling asleep as a kid (who am I kidding, I still do) because I can't get the thoughts to slow, and my mind is racing. I feel like it's two weeks full of that - my mind is on hyperdrive. Am I pregnant? Am I not pregnant? If I am, what stage am I at now? If I'm not, what could have gone wrong that it didn't work this month? What will we do next month to try again? What day would I be due if I am pregnant? Is that twinge implantation cramping, or endometriosis?
Add into this month the medication effects - I'm going to start taking progesterone suppositories tomorrow night, which will likely make my standard progesterone symptoms during the two week wait much worse, and thus play even worse games with my head. Also, I took the trigger shot, which will make a pregnancy test show a false positive until my body processes it out, which means if I take a test too early without knowing the trigger isn't still in my system, I could have a false positive on a pregnancy test and get my hopes up. Which means I'm going to start peeing on sticks tomorrow to make sure the trigger is out of my body. I will likely go through 12 pregnancy tests this cycle.
Is that sensitivity to smell because I'm pregnant, or because I took the progesterone pill? Is that light positive on the pregnancy test still the trigger, or is it possibly an early BFP for real?
I'm excited for and dreading the next two weeks. Either way, let's hope it goes by quickly!
Trying to keep busy during the dreaded "two week wait" is hard. Time passes like watching grass grow. There's not much to do except wait, and in the meantime my brain has too much time to think.
What are our chances this month? Better than they've been on our own, but still less than your average couple just starting to try to conceive. That's exciting, and sobering.
There's this double edged blade of hope. On one hand, I am so excited that I could be pregnant soon (I need to remind myself that I can't hang all my hopes on this cycle - if this cycle doesn't work, it doesn't mean the next one or the one after won't work). On the other hand, I'm trying to remind myself that we still don't have the chances of a couple just starting out, and it can take a healthy couple up to 6 months (or more) to conceive with those chances.
And as I waffle back and forth between optimism and pessimism, I'm running myself over the blade in between. It hurts to hope and lose, but it also hurts to feel hopeless.
I try to spend my two week wait focusing on what I can do to improve my chances, or to prepare my body for a pregnancy if this is our month. I don't take hot baths, I eat pineapple core, I avoid alcohol and caffeine, and I get really careful with my exercise regime - just walking or hand weights or gentle yoga.
But really, even with all those things, it doesn't help the brain to slow down. I used to have trouble falling asleep as a kid (who am I kidding, I still do) because I can't get the thoughts to slow, and my mind is racing. I feel like it's two weeks full of that - my mind is on hyperdrive. Am I pregnant? Am I not pregnant? If I am, what stage am I at now? If I'm not, what could have gone wrong that it didn't work this month? What will we do next month to try again? What day would I be due if I am pregnant? Is that twinge implantation cramping, or endometriosis?
Add into this month the medication effects - I'm going to start taking progesterone suppositories tomorrow night, which will likely make my standard progesterone symptoms during the two week wait much worse, and thus play even worse games with my head. Also, I took the trigger shot, which will make a pregnancy test show a false positive until my body processes it out, which means if I take a test too early without knowing the trigger isn't still in my system, I could have a false positive on a pregnancy test and get my hopes up. Which means I'm going to start peeing on sticks tomorrow to make sure the trigger is out of my body. I will likely go through 12 pregnancy tests this cycle.
Is that sensitivity to smell because I'm pregnant, or because I took the progesterone pill? Is that light positive on the pregnancy test still the trigger, or is it possibly an early BFP for real?
I'm excited for and dreading the next two weeks. Either way, let's hope it goes by quickly!
Monday, February 24, 2014
Back to Your Regularly Scheduled Program...
I just got off the phone with my nurse. She's been out of office for the past several weeks on vacation, so I've been spending my first unmedicated IUI and my medicated cycle thus far being juggled by the rest of the nurses on staff - all very nice and helpful, but not familiar with my case, including the very nice (and apparently new) nurse who called yesterday and got my hopes up with talk of an IUI this cycle.
My nurse confirmed that it's timed intercourse this cycle. So staying up until midnight last night was not required, I could have taken the trigger several hours earlier since the exact timing of an IUI is not required. Oh well, a small price to pay!
So we'll have sex tonight and tomorrow, and then as much as possible. Starting Wednesday, I will start taking Prometrium (a suppository that I use around bedtime to supplement my natural progesterone to support a potential - hopeful - pregnancy).
The nurse told me I could take a pregnancy test on March 13th. I laughed and told her that I would likely (a polite way of saying "definitely") be testing out my trigger so that I could test sooner. She chuckled and said that she would likely do the same thing in my situation, which felt good. Sometimes it feels like this is all routine for the nurses; it is routine, to an extent, because it's their job - they do this every day. But for a nurse to recognize that impatience is part of the process for me felt good. This isn't my routine - this is my life, and it's exciting and scary.
So here goes nothing! Let's hope this timed intercourse cycle works. My hopes are significantly lower than they would be if we were doing an IUI, but they're still pretty high. And I'm back to burning my bonfire of hope low-and-slow to keep it burning for several cycles if needed, rather than pouring gasoline onto that fire. I can't afford to burn out.
My nurse confirmed that it's timed intercourse this cycle. So staying up until midnight last night was not required, I could have taken the trigger several hours earlier since the exact timing of an IUI is not required. Oh well, a small price to pay!
So we'll have sex tonight and tomorrow, and then as much as possible. Starting Wednesday, I will start taking Prometrium (a suppository that I use around bedtime to supplement my natural progesterone to support a potential - hopeful - pregnancy).
The nurse told me I could take a pregnancy test on March 13th. I laughed and told her that I would likely (a polite way of saying "definitely") be testing out my trigger so that I could test sooner. She chuckled and said that she would likely do the same thing in my situation, which felt good. Sometimes it feels like this is all routine for the nurses; it is routine, to an extent, because it's their job - they do this every day. But for a nurse to recognize that impatience is part of the process for me felt good. This isn't my routine - this is my life, and it's exciting and scary.
So here goes nothing! Let's hope this timed intercourse cycle works. My hopes are significantly lower than they would be if we were doing an IUI, but they're still pretty high. And I'm back to burning my bonfire of hope low-and-slow to keep it burning for several cycles if needed, rather than pouring gasoline onto that fire. I can't afford to burn out.
Sunday, February 23, 2014
Too Much Hope
I just got the call from my nurse - my doctor requested that I take the trigger tonight at midnight (guess I'm not going to sleep at 10pm like most nights). She then said that he wants my husband back on Tuesday for his sample, and I should show up a hour later for the IUI.
One problem - we had planned a timed intercourse cycle due to insurance reasons. They'll cover the cost of medication for a timed intercourse cycle, but not an IUI cycle. And they have generously covered the medications that have worked so beautifully. I've got a 20 mm follicle on my left ovary, and an 18 mm follicle on my right ovary, and my E2 levels indicate I've got two beautifully mature eggs in there, and my uterine lining is at 7.5 on CD11. It all looks "textbook perfect," in the words of the nurse.
So... she said we should just go ahead with the IUI! Oh my goodness! I just finished writing the whole post about keeping hope in check - stoking the fire slowly to keep it burning through several cycles if needed - and this was like throwing gasoline right on the fire.
I'm going to call tomorrow with my nurse and make sure it won't somehow mean I have to pay full cost for all the medication that I've already used for this cycle retroactively. If that's the case, we'll keep with timed intercourse as the plan. Otherwise, I think we're going to grasp this opportunity and do the IUI on Tuesday!
The fact that it's even a consideration is rather infuriating to me. The insurance company won't have to pay for my IUI, they won't pay for the sperm preparation. They won't pay a penny more than they would pay for a TI cycle. So why exactly won't the insurance cover the same medication for an IUI cycle than a TI cycle? When it's like an IUI is what will make the difference between hope and no hope, why does the insurance company draw that line in the sand?
The only answer I can come up with is religion. Certain religions oppose ART (Artificial Reproductive Therapy), or specifically any form of conception that is not through sex. I understand it, I can respect it - if you don't want to use medical techniques to overcome physical obstacles to conception, that's completely your choice. That's fine! But by deciding that the insurance company will only cover medicine if the method of conception is sex is unfair. That can help plenty of people, sure. But what about those it can't help? I understand also not covering the IUI procedure - I do! That's fine. I don't like it, but it's acceptable. But by removing otherwise covered benefits simply because I am choosing to add a procedure that will more than double my chances of success is cruel and unfair.
That's my political rant of the day. I wish all infertility treatments were covered as needed. Not only is it a cruel medical condition, there would be fewer twin and higher order multiple pregnancies if insurance carriers covered treatment because people would take fewer risks. It would be easier to decide to cancel a cycle where you over responded and risk higher order multiple pregnancies if you knew you wouldn't be losing thousands of dollars on the cycle.
You'd think, "Well, the insurance company doesn't want to pay for that either!" Understandable! But what isn't considered is the additional costs to the insurance company from those higher order multiple pregnancies that occur as the result of women taking higher risks because they couldn't afford multiple cycles. Women who went ahead with IUIs with 4 mature follicles, women who implanted 2-3 embryos during IVF because they couldn't afford another cycle. Those women end up pregnant with twins or triplets or even quads (or, very rarely, even more). Sometimes they then have to make the incredibly difficult choice of selective reduction (where you have to choose whether or not to eliminate one or more of the fetuses to increase the chance of survival for the rest of them and lower the risks to the health of the mother).
Stay with me - you're still wondering why the insurance company should consider paying for such expensive elective treatments. They're a company who wants to make money - what is their motivation in covering that at all?
We'll start with their financial benefits (and hit on the misnomer of "elective" later) from covering these procedures.
How much does a typical IUI procedure cost out of pocket? Usually under $3000, sometimes as low as $1000 depending on the medication. If they don't cover the IUI itself and just the medication, under $2500 usually. If it's simply a Clomid or Femara IUI with trigger, and they aren't paying for the IUI, perhaps only $400-500.
How much does a typical IVF cycle count? Probably around $15,000. Perhaps as much as $20,000 with medications.
What are the most common risks from twins and especially higher order multiples? Miscarriage, pregnancy complications, early labor, premature delivery. One day in the hospital for even one of those issues would easily cost more than the cost of one cycle of IUI, and likely IVF. If even one baby ends up spending time in the NICU, it is not unusual to rack up an insurance bill of over $100,000.
So what is the insurance company's motivation to cover fertility treatments? So women will take LESS risks because of the high costs of each cycle. Less risks will likely mean less risky pregnancies, which will result in exponentially fewer costs of care for the Mom and baby (or babies).
Okay, I'll stop ranting... all that to say, I think we might get to do an IUI this cycle! We'll pay the $650 for it if we do, but I will gladly pay that to double our chances. I'm just going to make sure we don't have to pay retroactively for the medication we were already prescribed (and already took) for this cycle, because the Follistim would put us back easily the cost of another cycle (or two!) so it wouldn't be worth it.
Keep your fingers crossed for me. I'm in uncharted territory, and not sure how this will all work out. Either way, I'm hoping beyond hope that this is our cycle, that it's finally our turn!
One problem - we had planned a timed intercourse cycle due to insurance reasons. They'll cover the cost of medication for a timed intercourse cycle, but not an IUI cycle. And they have generously covered the medications that have worked so beautifully. I've got a 20 mm follicle on my left ovary, and an 18 mm follicle on my right ovary, and my E2 levels indicate I've got two beautifully mature eggs in there, and my uterine lining is at 7.5 on CD11. It all looks "textbook perfect," in the words of the nurse.
So... she said we should just go ahead with the IUI! Oh my goodness! I just finished writing the whole post about keeping hope in check - stoking the fire slowly to keep it burning through several cycles if needed - and this was like throwing gasoline right on the fire.
I'm going to call tomorrow with my nurse and make sure it won't somehow mean I have to pay full cost for all the medication that I've already used for this cycle retroactively. If that's the case, we'll keep with timed intercourse as the plan. Otherwise, I think we're going to grasp this opportunity and do the IUI on Tuesday!
The fact that it's even a consideration is rather infuriating to me. The insurance company won't have to pay for my IUI, they won't pay for the sperm preparation. They won't pay a penny more than they would pay for a TI cycle. So why exactly won't the insurance cover the same medication for an IUI cycle than a TI cycle? When it's like an IUI is what will make the difference between hope and no hope, why does the insurance company draw that line in the sand?
The only answer I can come up with is religion. Certain religions oppose ART (Artificial Reproductive Therapy), or specifically any form of conception that is not through sex. I understand it, I can respect it - if you don't want to use medical techniques to overcome physical obstacles to conception, that's completely your choice. That's fine! But by deciding that the insurance company will only cover medicine if the method of conception is sex is unfair. That can help plenty of people, sure. But what about those it can't help? I understand also not covering the IUI procedure - I do! That's fine. I don't like it, but it's acceptable. But by removing otherwise covered benefits simply because I am choosing to add a procedure that will more than double my chances of success is cruel and unfair.
That's my political rant of the day. I wish all infertility treatments were covered as needed. Not only is it a cruel medical condition, there would be fewer twin and higher order multiple pregnancies if insurance carriers covered treatment because people would take fewer risks. It would be easier to decide to cancel a cycle where you over responded and risk higher order multiple pregnancies if you knew you wouldn't be losing thousands of dollars on the cycle.
You'd think, "Well, the insurance company doesn't want to pay for that either!" Understandable! But what isn't considered is the additional costs to the insurance company from those higher order multiple pregnancies that occur as the result of women taking higher risks because they couldn't afford multiple cycles. Women who went ahead with IUIs with 4 mature follicles, women who implanted 2-3 embryos during IVF because they couldn't afford another cycle. Those women end up pregnant with twins or triplets or even quads (or, very rarely, even more). Sometimes they then have to make the incredibly difficult choice of selective reduction (where you have to choose whether or not to eliminate one or more of the fetuses to increase the chance of survival for the rest of them and lower the risks to the health of the mother).
Stay with me - you're still wondering why the insurance company should consider paying for such expensive elective treatments. They're a company who wants to make money - what is their motivation in covering that at all?
We'll start with their financial benefits (and hit on the misnomer of "elective" later) from covering these procedures.
How much does a typical IUI procedure cost out of pocket? Usually under $3000, sometimes as low as $1000 depending on the medication. If they don't cover the IUI itself and just the medication, under $2500 usually. If it's simply a Clomid or Femara IUI with trigger, and they aren't paying for the IUI, perhaps only $400-500.
How much does a typical IVF cycle count? Probably around $15,000. Perhaps as much as $20,000 with medications.
What are the most common risks from twins and especially higher order multiples? Miscarriage, pregnancy complications, early labor, premature delivery. One day in the hospital for even one of those issues would easily cost more than the cost of one cycle of IUI, and likely IVF. If even one baby ends up spending time in the NICU, it is not unusual to rack up an insurance bill of over $100,000.
So what is the insurance company's motivation to cover fertility treatments? So women will take LESS risks because of the high costs of each cycle. Less risks will likely mean less risky pregnancies, which will result in exponentially fewer costs of care for the Mom and baby (or babies).
Okay, I'll stop ranting... all that to say, I think we might get to do an IUI this cycle! We'll pay the $650 for it if we do, but I will gladly pay that to double our chances. I'm just going to make sure we don't have to pay retroactively for the medication we were already prescribed (and already took) for this cycle, because the Follistim would put us back easily the cost of another cycle (or two!) so it wouldn't be worth it.
Keep your fingers crossed for me. I'm in uncharted territory, and not sure how this will all work out. Either way, I'm hoping beyond hope that this is our cycle, that it's finally our turn!
Saturday, February 22, 2014
Allowed to Hope
I'm feeling hopeful. Not so much for this cycle, but for cycles in general. The medications are working as they're supposed to - I didn't overrespond, I didn't underrespond - I feel like Goldilocks! The meds did their job JUST RIGHT! I have two follicles that will likely be perfect size for trigger tomorrow. My lining is thickening as it should.
I still have my suspicions that we've got a cervical problem, or that my husband's morphology are partially responsible for our lack of success. Either way, a timed intercourse cycle won't likely help us (though having two eggs instead of one, and perfect timing, makes me feel a LITTLE more hopeful for this cycle!). But with future cycles, when we do IUI in combination with medication, I have hope. Oh, so much hope!
It's been awhile since I felt hopeful. When we first started trying, I was full of hope. I designed a little logo that said "Mini-(Last Name)" with a teddy bear and balloons - appropriately gender neutral - and bought a package of newborn onesies with the idea that I would iron on the logo to a onesie to give to my husband when I got a positive pregnancy test. That was 17 months ago, and I have moved that package of onesies three times since then. No, not moved them from one drawer to another - we have moved houses three times since then (ah, the wonders of military family life). That's just depressing. I'm not going to dwell on that, because it just bums me out.
We went to see a reproductive endocrinologist long before we knew we were having trouble. I have a family history of Fragile X, so I wanted to confirm that it wasn't a concern. During our appointment, the doctor started talking about how we shouldn't worry yet, that we should try on our own for a few more months - I remember being really confused, and feeling like she was rushing things by even having that conversation. Of course it would happen for us, we had only been trying 4 months or so! Why would she even say such things?
That original hope started to dwindle after about 6 months of trying. I started having a hard time right before and immediately after my period came, but by the time ovulation occurred, I always spent the two week wait in blissful hope. I worried, for sure, but it would ebb and flow with the various stages of my cycle. Early disappointment and nervousness, followed by superstition that I had figured out the "secret" that would change my fortune that month - eating pineapple core after ovulation, evening primrose oil before ovulation, doing a handstand after sex, having sex two days before ovulation and one day after, followed by optimism and hope.
Around 7 DPO, I would start peeing on sticks (I never claimed to be a patient woman). I would hope for an early positive, and when I got negative after negative, that hope would dwindle. I would calculate exactly what chances I had of still getting a positive test. If 30% of pregnant women got a positive test on 8 DPO, and 70% didn't see a positive test until later dates, then I knew to be 30% disappointed and 70% hopeful. With those declining numbers, my hope would dwindle in the same proportions.
Originally, I would not "call it" until my period arrived. In months since, I've started becoming increasingly resigned after 10 DPO and completely resigned after 12 DPO.
There were months I tested 2-3 times per day, and months I tested only once before my period arrived.
At 8 months, I sobbed when I got a negative test around 12 DPO. I sat on the stairs of our home, fists clenching my husband's shirt where he stood in front of me, with my head pressed into his stomach while gasping for breath between choked sobs.
"What's wrong with me?" I implored of him, as if he held the answer.
The poor, sweet man held me and told me confidently it would happen. I think he really believed that.
After 10 cycles, I convinced my husband it was worth doing some testing, especially as I had been off birth control for 6 months before we started officially trying. During our 11th month, we had our initial appointment with a reproductive endocrinologist and did initial testing. My husband's numbers came back mediocre - his count was good at around 55 million, his volume was good, his motility wasn't good at 25% (the doctor said they wanted to see 50%), and his morphology was on the bottom end of what is considered an acceptable range at 4%.
After sobbing when I first heard the news, I felt oddly hopeful. If that was our only issue, we would try vitamins! We would just try longer. It would happen.
I read every study on the subject. I bought tons of vitamins (if you've read my early posts, you can see exactly what I gave my husband to take). We timed everything perfectly, and "tried to relax" (man, I hate that phrase). I had such hope!
Besides the fact that my husband's incredibly busy and rigid schedule would not have allowed for any treatment cycles, and we were moving twice in the coming months, I sincerely hoped it would happen. Of course it would! I gave us 6 months before we'd go back to a reproductive endocrinologist, which just happened to be the same amount of time it would be until we were finally settled in a place where we would stay for awhile.
During those 6 months (September through January), my hope took an odd path. At first, my hope was relatively low as I had just seen my husband's sperm analysis, and knew our chances were not great with those numbers. But I felt positive and patient - we were doing the right things, it would happen. After 3 months, I started getting very hopeful as any vitamin regimin for my husband would take approximately that long to start having an effect.
As each month started passing, I got more and more discouraged. I felt hope for fewer and fewer days, and felt despondent and hopeless for more and more of each cycle. As you can see by my post from my birthday in December, I hit rock bottom around then. My following cycle, the last one before starting medical intervention, I felt such a split between desperate hope that it would happen before we needed medical help (because isn't it always that way in the stories?) and absolute lack of hope that this would ever, ever happen.
When we finally went to see the doctor, I felt hopeful that it would happen with their help. When we re-did some of our tests and my husband's numbers came up surprisingly good (70-something million count, great volume, and over 80% motility - no idea what the morphology was, but my guess is that it still isn't great simply because morphology usually is the hardest to improve), I oddly felt less hope. If my husband's numbers were so much better, why would an IUI work? If they can't find anything wrong, how can they fix it?
Hope hasn't been steady since then. It wasn't like early on, where I felt hopeful all the time. And it wasn't like later in the process, where I felt hopeful and despondent based on which part of my cycle I was dealing with at the moment. Now it it feels ephemeral - hope shows up like a flash of lightening in the night sky, lighting up the room and disappearing as soon as you notice it. Or it's like a bonfire - it's warming and soothing and you can hang around its glow for a little while, but eventually it burns out and you're left in the cold dark again, desperately trying to reignite the embers so you can feel its comforting warmth again.
Today I'm standing by that bonfire. It feels good, and I'm trying to just enjoy the ride while it lasts. I'm trying to stoke the fire - finding ways to add logs to the fire to build the hope and sustain it just a little longer.
I'm also trying to plan ahead to maintain that hope - if I put too much stock into this cycle, it will knock me down when my next cycle starts and it will be harder to start the fire up again. Like building up the fire with lots of logs and then pouring ice water all over it, with no logs left to rebuild. I'm trying to stoke the fire slowly, making the logs last long enough, with the plan to try to keep it burning low-and-slow until this long night of infertility is over and dawn arrives. Because if I build that pyre of hope too high, I run the risk of being left in the cold dark without any hope and without a baby.
I'm trying to space out that hope so that I have enough for three cycles - I'm not putting all my logs on the fire for this cycle, I'm saving some for my first and second medicated IUI as well. If I get to that point and we still aren't pregnant, I might need some serious help in rebuilding my bonfire of hope. But for now, I feel hopeful. Not overly hopeful for this cycle, but a little hopeful. I am feeling hopeful that this plan will work, and that within the next few months, we'll be pregnant.
That hope burns warm inside me. It feels so good! I did something yesterday that I haven't done since over a year ago - I went through the baby aisle of Walmart while shopping and imagined what it would feel like to buy little items. How it would feel like to walk through those aisles in a few weeks or a few months and actually be pregnant and looking at those items for my future child.
I also used this hope to think more about the next stage - I realize that I have been so focused for over a year now on getting pregnant, that I have learned so much about how the conception process should work and how the infertility treatment process works, but I know very little about what to expect after this is over. And I have spent my bad hopeless days researching what happens if we reach the end of this fertility treatment journey without a baby - we know that we want to be parents, and will move onto adoption if necessary - but I haven't spent any time since those early months researching pregnancy, labor & delivery.
I actually started looking online today to start thinking about what kind of maternity care I want, what to expect from pregnancy, what kind of labor and delivery I want, what pain management options I might consider during labor, which facility I want to give birth at.
Early on in my hopeful days, I created a secret Amazon registry of baby items I thought we might need. I've added to that and changed things around several times in my hopeful days. It's been a very long time since I looked at that registry, but it might be something I revisit during my newly found hope.
I also might start doing some research on early childhood development, what to expect as a new mother, vaccine research, and so forth. Because at some point, all this research that I've done on infertility and how to become pregnant will become moot. At some point, I will have to move forward. At some point, I will need to research something else and think about other things.
At the moment, it feels good to hope. It feels good to think about what could be awaiting me, what I would need to know after all of this research pays off and we finally get what we have worked so hard for. It feels really good to think about researching something new for a change, something hopeful.
I'm going to burn this fire of hope for as long as it burns, and hope that the dawn arrives before I run out of wood to stoke this fire.
I still have my suspicions that we've got a cervical problem, or that my husband's morphology are partially responsible for our lack of success. Either way, a timed intercourse cycle won't likely help us (though having two eggs instead of one, and perfect timing, makes me feel a LITTLE more hopeful for this cycle!). But with future cycles, when we do IUI in combination with medication, I have hope. Oh, so much hope!
It's been awhile since I felt hopeful. When we first started trying, I was full of hope. I designed a little logo that said "Mini-(Last Name)" with a teddy bear and balloons - appropriately gender neutral - and bought a package of newborn onesies with the idea that I would iron on the logo to a onesie to give to my husband when I got a positive pregnancy test. That was 17 months ago, and I have moved that package of onesies three times since then. No, not moved them from one drawer to another - we have moved houses three times since then (ah, the wonders of military family life). That's just depressing. I'm not going to dwell on that, because it just bums me out.
We went to see a reproductive endocrinologist long before we knew we were having trouble. I have a family history of Fragile X, so I wanted to confirm that it wasn't a concern. During our appointment, the doctor started talking about how we shouldn't worry yet, that we should try on our own for a few more months - I remember being really confused, and feeling like she was rushing things by even having that conversation. Of course it would happen for us, we had only been trying 4 months or so! Why would she even say such things?
That original hope started to dwindle after about 6 months of trying. I started having a hard time right before and immediately after my period came, but by the time ovulation occurred, I always spent the two week wait in blissful hope. I worried, for sure, but it would ebb and flow with the various stages of my cycle. Early disappointment and nervousness, followed by superstition that I had figured out the "secret" that would change my fortune that month - eating pineapple core after ovulation, evening primrose oil before ovulation, doing a handstand after sex, having sex two days before ovulation and one day after, followed by optimism and hope.
Around 7 DPO, I would start peeing on sticks (I never claimed to be a patient woman). I would hope for an early positive, and when I got negative after negative, that hope would dwindle. I would calculate exactly what chances I had of still getting a positive test. If 30% of pregnant women got a positive test on 8 DPO, and 70% didn't see a positive test until later dates, then I knew to be 30% disappointed and 70% hopeful. With those declining numbers, my hope would dwindle in the same proportions.
Originally, I would not "call it" until my period arrived. In months since, I've started becoming increasingly resigned after 10 DPO and completely resigned after 12 DPO.
There were months I tested 2-3 times per day, and months I tested only once before my period arrived.
At 8 months, I sobbed when I got a negative test around 12 DPO. I sat on the stairs of our home, fists clenching my husband's shirt where he stood in front of me, with my head pressed into his stomach while gasping for breath between choked sobs.
"What's wrong with me?" I implored of him, as if he held the answer.
The poor, sweet man held me and told me confidently it would happen. I think he really believed that.
After 10 cycles, I convinced my husband it was worth doing some testing, especially as I had been off birth control for 6 months before we started officially trying. During our 11th month, we had our initial appointment with a reproductive endocrinologist and did initial testing. My husband's numbers came back mediocre - his count was good at around 55 million, his volume was good, his motility wasn't good at 25% (the doctor said they wanted to see 50%), and his morphology was on the bottom end of what is considered an acceptable range at 4%.
After sobbing when I first heard the news, I felt oddly hopeful. If that was our only issue, we would try vitamins! We would just try longer. It would happen.
I read every study on the subject. I bought tons of vitamins (if you've read my early posts, you can see exactly what I gave my husband to take). We timed everything perfectly, and "tried to relax" (man, I hate that phrase). I had such hope!
Besides the fact that my husband's incredibly busy and rigid schedule would not have allowed for any treatment cycles, and we were moving twice in the coming months, I sincerely hoped it would happen. Of course it would! I gave us 6 months before we'd go back to a reproductive endocrinologist, which just happened to be the same amount of time it would be until we were finally settled in a place where we would stay for awhile.
During those 6 months (September through January), my hope took an odd path. At first, my hope was relatively low as I had just seen my husband's sperm analysis, and knew our chances were not great with those numbers. But I felt positive and patient - we were doing the right things, it would happen. After 3 months, I started getting very hopeful as any vitamin regimin for my husband would take approximately that long to start having an effect.
As each month started passing, I got more and more discouraged. I felt hope for fewer and fewer days, and felt despondent and hopeless for more and more of each cycle. As you can see by my post from my birthday in December, I hit rock bottom around then. My following cycle, the last one before starting medical intervention, I felt such a split between desperate hope that it would happen before we needed medical help (because isn't it always that way in the stories?) and absolute lack of hope that this would ever, ever happen.
When we finally went to see the doctor, I felt hopeful that it would happen with their help. When we re-did some of our tests and my husband's numbers came up surprisingly good (70-something million count, great volume, and over 80% motility - no idea what the morphology was, but my guess is that it still isn't great simply because morphology usually is the hardest to improve), I oddly felt less hope. If my husband's numbers were so much better, why would an IUI work? If they can't find anything wrong, how can they fix it?
Hope hasn't been steady since then. It wasn't like early on, where I felt hopeful all the time. And it wasn't like later in the process, where I felt hopeful and despondent based on which part of my cycle I was dealing with at the moment. Now it it feels ephemeral - hope shows up like a flash of lightening in the night sky, lighting up the room and disappearing as soon as you notice it. Or it's like a bonfire - it's warming and soothing and you can hang around its glow for a little while, but eventually it burns out and you're left in the cold dark again, desperately trying to reignite the embers so you can feel its comforting warmth again.
Today I'm standing by that bonfire. It feels good, and I'm trying to just enjoy the ride while it lasts. I'm trying to stoke the fire - finding ways to add logs to the fire to build the hope and sustain it just a little longer.
I'm also trying to plan ahead to maintain that hope - if I put too much stock into this cycle, it will knock me down when my next cycle starts and it will be harder to start the fire up again. Like building up the fire with lots of logs and then pouring ice water all over it, with no logs left to rebuild. I'm trying to stoke the fire slowly, making the logs last long enough, with the plan to try to keep it burning low-and-slow until this long night of infertility is over and dawn arrives. Because if I build that pyre of hope too high, I run the risk of being left in the cold dark without any hope and without a baby.
I'm trying to space out that hope so that I have enough for three cycles - I'm not putting all my logs on the fire for this cycle, I'm saving some for my first and second medicated IUI as well. If I get to that point and we still aren't pregnant, I might need some serious help in rebuilding my bonfire of hope. But for now, I feel hopeful. Not overly hopeful for this cycle, but a little hopeful. I am feeling hopeful that this plan will work, and that within the next few months, we'll be pregnant.
That hope burns warm inside me. It feels so good! I did something yesterday that I haven't done since over a year ago - I went through the baby aisle of Walmart while shopping and imagined what it would feel like to buy little items. How it would feel like to walk through those aisles in a few weeks or a few months and actually be pregnant and looking at those items for my future child.
I also used this hope to think more about the next stage - I realize that I have been so focused for over a year now on getting pregnant, that I have learned so much about how the conception process should work and how the infertility treatment process works, but I know very little about what to expect after this is over. And I have spent my bad hopeless days researching what happens if we reach the end of this fertility treatment journey without a baby - we know that we want to be parents, and will move onto adoption if necessary - but I haven't spent any time since those early months researching pregnancy, labor & delivery.
I actually started looking online today to start thinking about what kind of maternity care I want, what to expect from pregnancy, what kind of labor and delivery I want, what pain management options I might consider during labor, which facility I want to give birth at.
Early on in my hopeful days, I created a secret Amazon registry of baby items I thought we might need. I've added to that and changed things around several times in my hopeful days. It's been a very long time since I looked at that registry, but it might be something I revisit during my newly found hope.
I also might start doing some research on early childhood development, what to expect as a new mother, vaccine research, and so forth. Because at some point, all this research that I've done on infertility and how to become pregnant will become moot. At some point, I will have to move forward. At some point, I will need to research something else and think about other things.
At the moment, it feels good to hope. It feels good to think about what could be awaiting me, what I would need to know after all of this research pays off and we finally get what we have worked so hard for. It feels really good to think about researching something new for a change, something hopeful.
I'm going to burn this fire of hope for as long as it burns, and hope that the dawn arrives before I run out of wood to stoke this fire.
Friday, February 21, 2014
Cycle Update
This is my first medicated cycle, and I've spent hours reading others' blogs to see what to expect from this experience, so I figured I'd update and share what's going on with me.
Today is CD 8. My period ended on CD 6, with some slight brown spotting on CD 7.
My period started on Thursday February 13th at around 3pm, so we counted that was CD1. I went in on Friday February 14th (Happy Valentines! At least we don't celebrate that holiday, so it wasn't a big deal) for a baseline ultrasound. It showed 9 antral follicles on one side, 10 on the other. No cysts. Lining looked appropriate for CD 2 - I forget specific numbers. All looked good!
I took 2.5 mg of Letrozole (generic for Femara) every morning at 8am for 5 days - from CD3 (Saturday) until CD7 (Wednesday). On Wednesday evening, I had 33.3 iu of Follistim injected into my left lower belly at 6pm, and another 33.3 iu of Follistim onThursday evening at the same time.
So, to put it more clearly, here was my schedule:
CD3 - 2.5 mg Letrozole (8am)
CD4 - 2.5 mg Letrozole (8am)
CD5 - 2.5 mg Letrozole (8am)
CD6 - 2.5 mg Letrozole (8am)
CD7 - 2.5 mg Letrozole (8am) & 33.3 iu Follistim (6pm)
CD8 - 33.3 iu Follistim (6pm)
CD9 - Ultrasound
My husband was a champ with the injections! He really liked being a part of the process, so I highly recommend to other women going through this to have their husbands do the shot for them if they're comfortable. I wasn't at all afraid of the injections, and probably would have preferred to do the shot myself, but after seeing how happy my husband was at being involved, I'm so glad I asked him to do it.
Today is CD9. I drove up to my doctor's office today. It's just under 2 hours door-to-door, so it was just about 4 hours in the car for a 10 minute appointment. But it was worth it - it tells me whether or not we're using the right amount of medication to maximize our chances while minimizing our risks (like multiple pregnancies, ovarian hyperstimulation syndrome, cysts, etc.)
The nurse was so happy and cheerful, and she was nice and gentle with the ultrasound (compared to the nurse last week, it was much appreciated!). I've got one 12 mm follicle on my right ovary, and one 15 mm follicle on my left ovary. That means I'm definitely responding, and well! My lining is 5 mm, which isn't ideal - it should be at least 8 mm before ovulation, but we've got time, and even at ovulation, we have a bit of time before implantation would occur. I had a blood test to check my LH levels to confirm I'm not ovulating on my own already (not likely, but possible since the 15 mm follicle is considered mature). They'll call me later today with the results and the plan from here.
Assuming I'm not ovulating on my own already, the nurse said to expect the doctor to tell me to do another night or two of Follistim and then come back in on Sunday for another ultrasound. Meanwhile, I'll do ovulation tests 2-3 times per day to make sure my body doesn't start ovulating on its own.
Since we're doing timed intercourse this cycle, the nurse will tell me when she calls exactly when we're supposed to have sex over the next few days.
We already were told to have sex Tuesday or Wednesday this week. Since I still had my period on Tuesday, we decided to wait until Wednesday. And then on Wednesday, we took a bath together with some epsom salts that I mixed with peppermint extract and lavender extract. I used a bit too much peppermint extract, and it felt like a Ben-Gay bath - all minty fresh and made our skin tingle! It was a nice bath, but to risk being TMI, I didn't want that tingly sensation in other parts of my body! So we skipped sex, with plans to do it on Thursday.
It's really hard to do it in the mornings during the week (and we are usually morning people, if you know what I mean) since my husband leaves so early for work, so on Thursday evening, we planned to do it right away when he got home. He definitely was feeling the pressure, which is something we've tried hard to avoid in the 18 months that we've been actively trying to get pregnant. I felt bad that he felt pressured, but there wasn't much I could do that wouldn't feel forced and fake to help him get in the mood. As he described after, it's like going to play mini-golf as a work outing. Sure, mini-golf is fun, but the fact that you HAVE to do it makes it infinitely less fun.
I'm not looking forward to telling him several more days/times that we have to have sex in the next week. It's so specific, it's hard to keep it vague and low-pressure, with no mention of fun or sexy.
I'm pretty excited, to be honest! Two follicles! I know it's not quite double our chances from a normal cycle, but it feels like it. Especially since we'll likely have two large & beefed up eggs, great timing, supplemented lining with progesterone suppositories (Endometrium) that I will start after ovulation - I'm hopeful!
Even if this cycle doesn't work, I'm hopeful for the next couple of months. Once we add IUI next cycle, we'll have a really good chance each month if this cycle is indicative of future responses. Also, I normally ovulate on CD 15-18, but today is CD 9 with nearly mature follicles, so I'm likely to trigger on CD 11 with a CD 13 ovulation. Which means cycles will go a bit quicker (assuming progesterone supplementation doesn't make my normal 14 day luteal phase into something significantly longer) which means I get better chances quicker. At this rate, I could start my luteal phase almost a whole week sooner, which means finding out sooner, which means starting my next cycle sooner (since, despite the hope I have for this cycle, I'm still very prepared - at least intellectually if not emotionally - for another failed cycle as chance still aren't great for success).
I'm happy! I'm excited! I'm so relieved I didn't end up over responding. I'm so excited that I seem to be responding just as we would hope at this dose. I'm grateful that my insurance has covered so much of our treatment expenses so far.
I'm in a good place emotionally today, so that's good. I'll take the sunshine in the middle of this rain storm where I can find it.
Edit: Well, it's been less than a hour since I wrote this post, but I just got the phone call from the fertility clinic. They said if my LH level from my bloodwork this morning was over 15, they would have assumed I was about to ovulate on my own. Thankfully (though no surprisingly) my LH is 3.8. So the doctor wants me to do two more doses of Follistim tonight and tomorrow and come back on Sunday for another ultrasound and bloodwork. In the meantime, I'll do ovulation tests to make sure my body doesn't change its mind and start ovulation before hand. Since there's no such thing as privacy in this process, I told the nurse that we had sex last night (Thursday, CD8) and she suggested we have sex again tomorrow (Saturday, CD10) and then wait for the results on Sunday to hear from the doctor when we should proceed after that.
Today is CD 8. My period ended on CD 6, with some slight brown spotting on CD 7.
My period started on Thursday February 13th at around 3pm, so we counted that was CD1. I went in on Friday February 14th (Happy Valentines! At least we don't celebrate that holiday, so it wasn't a big deal) for a baseline ultrasound. It showed 9 antral follicles on one side, 10 on the other. No cysts. Lining looked appropriate for CD 2 - I forget specific numbers. All looked good!
I took 2.5 mg of Letrozole (generic for Femara) every morning at 8am for 5 days - from CD3 (Saturday) until CD7 (Wednesday). On Wednesday evening, I had 33.3 iu of Follistim injected into my left lower belly at 6pm, and another 33.3 iu of Follistim onThursday evening at the same time.
So, to put it more clearly, here was my schedule:
CD3 - 2.5 mg Letrozole (8am)
CD4 - 2.5 mg Letrozole (8am)
CD5 - 2.5 mg Letrozole (8am)
CD6 - 2.5 mg Letrozole (8am)
CD7 - 2.5 mg Letrozole (8am) & 33.3 iu Follistim (6pm)
CD8 - 33.3 iu Follistim (6pm)
CD9 - Ultrasound
My husband was a champ with the injections! He really liked being a part of the process, so I highly recommend to other women going through this to have their husbands do the shot for them if they're comfortable. I wasn't at all afraid of the injections, and probably would have preferred to do the shot myself, but after seeing how happy my husband was at being involved, I'm so glad I asked him to do it.
Today is CD9. I drove up to my doctor's office today. It's just under 2 hours door-to-door, so it was just about 4 hours in the car for a 10 minute appointment. But it was worth it - it tells me whether or not we're using the right amount of medication to maximize our chances while minimizing our risks (like multiple pregnancies, ovarian hyperstimulation syndrome, cysts, etc.)
The nurse was so happy and cheerful, and she was nice and gentle with the ultrasound (compared to the nurse last week, it was much appreciated!). I've got one 12 mm follicle on my right ovary, and one 15 mm follicle on my left ovary. That means I'm definitely responding, and well! My lining is 5 mm, which isn't ideal - it should be at least 8 mm before ovulation, but we've got time, and even at ovulation, we have a bit of time before implantation would occur. I had a blood test to check my LH levels to confirm I'm not ovulating on my own already (not likely, but possible since the 15 mm follicle is considered mature). They'll call me later today with the results and the plan from here.
Assuming I'm not ovulating on my own already, the nurse said to expect the doctor to tell me to do another night or two of Follistim and then come back in on Sunday for another ultrasound. Meanwhile, I'll do ovulation tests 2-3 times per day to make sure my body doesn't start ovulating on its own.
Since we're doing timed intercourse this cycle, the nurse will tell me when she calls exactly when we're supposed to have sex over the next few days.
We already were told to have sex Tuesday or Wednesday this week. Since I still had my period on Tuesday, we decided to wait until Wednesday. And then on Wednesday, we took a bath together with some epsom salts that I mixed with peppermint extract and lavender extract. I used a bit too much peppermint extract, and it felt like a Ben-Gay bath - all minty fresh and made our skin tingle! It was a nice bath, but to risk being TMI, I didn't want that tingly sensation in other parts of my body! So we skipped sex, with plans to do it on Thursday.
It's really hard to do it in the mornings during the week (and we are usually morning people, if you know what I mean) since my husband leaves so early for work, so on Thursday evening, we planned to do it right away when he got home. He definitely was feeling the pressure, which is something we've tried hard to avoid in the 18 months that we've been actively trying to get pregnant. I felt bad that he felt pressured, but there wasn't much I could do that wouldn't feel forced and fake to help him get in the mood. As he described after, it's like going to play mini-golf as a work outing. Sure, mini-golf is fun, but the fact that you HAVE to do it makes it infinitely less fun.
I'm not looking forward to telling him several more days/times that we have to have sex in the next week. It's so specific, it's hard to keep it vague and low-pressure, with no mention of fun or sexy.
I'm pretty excited, to be honest! Two follicles! I know it's not quite double our chances from a normal cycle, but it feels like it. Especially since we'll likely have two large & beefed up eggs, great timing, supplemented lining with progesterone suppositories (Endometrium) that I will start after ovulation - I'm hopeful!
Even if this cycle doesn't work, I'm hopeful for the next couple of months. Once we add IUI next cycle, we'll have a really good chance each month if this cycle is indicative of future responses. Also, I normally ovulate on CD 15-18, but today is CD 9 with nearly mature follicles, so I'm likely to trigger on CD 11 with a CD 13 ovulation. Which means cycles will go a bit quicker (assuming progesterone supplementation doesn't make my normal 14 day luteal phase into something significantly longer) which means I get better chances quicker. At this rate, I could start my luteal phase almost a whole week sooner, which means finding out sooner, which means starting my next cycle sooner (since, despite the hope I have for this cycle, I'm still very prepared - at least intellectually if not emotionally - for another failed cycle as chance still aren't great for success).
I'm happy! I'm excited! I'm so relieved I didn't end up over responding. I'm so excited that I seem to be responding just as we would hope at this dose. I'm grateful that my insurance has covered so much of our treatment expenses so far.
I'm in a good place emotionally today, so that's good. I'll take the sunshine in the middle of this rain storm where I can find it.
Edit: Well, it's been less than a hour since I wrote this post, but I just got the phone call from the fertility clinic. They said if my LH level from my bloodwork this morning was over 15, they would have assumed I was about to ovulate on my own. Thankfully (though no surprisingly) my LH is 3.8. So the doctor wants me to do two more doses of Follistim tonight and tomorrow and come back on Sunday for another ultrasound and bloodwork. In the meantime, I'll do ovulation tests to make sure my body doesn't change its mind and start ovulation before hand. Since there's no such thing as privacy in this process, I told the nurse that we had sex last night (Thursday, CD8) and she suggested we have sex again tomorrow (Saturday, CD10) and then wait for the results on Sunday to hear from the doctor when we should proceed after that.
Thursday, February 20, 2014
Letter to My Future Child
My precious child,
"One... two... three... four... five.........six!" and he pulled it out. It came out at a bit of an angle, so it scratched my skin slightly.
"Really?" he asked enthusiastically. "It's doing magic!"
I want you to know how hard I am working so that we can have you in our arms rather than our dreams. We love you, even before you exist.
Today, your father nervously asked for instructions on how exactly he should jab me with a needle. That needle contained medication that will hopefully help my eggs grow. We both hope every day that you're in one of those eggs, and that we'll time everything right so that the egg that will someday become you has the best possible chance to become the baby we've hoped for and dreamed of for so long.
Your father was so brave! He did not want to hurt me, so he asked several times how to do it correctly. He first practiced with a normal pen the motion of jabbing me in the belly as I pinched the spot where he was aiming, to the lower left of my belly button.
I had already set the vial of medication into the pen that is used for injections, attached a needle, and removed the cover and handed it to your father. Then I swiped the area with alcohol and pinched the spot where he'd be aiming. He didn't hesitate, though he was clearly nervous. He jabbed the spot and held, like I had told him. Then he depressed the button so the magic medicine slid into the right spot as he held the needle still.
"Okay, now we count to 5," I told him.
"Okay, now we count to 5," I told him.
"One... two... three... four... five.........six!" and he pulled it out. It came out at a bit of an angle, so it scratched my skin slightly.
He felt so bad that he had scratched me! I tried to wipe it away with the alcohol wipe, but it bled just a little bit more. Not a big deal, but I didn't want to stain my clothes, so he ran to get a bandage.
"Did that hurt?" he asked nervously as he kissed my forehead. "I'm so sorry I scratched you! I'll do better tomorrow."
He was so proud that he had done it, and I must tell you that it made him happy to feel like he's part of this process. We're both working so hard so that we can have you. He loves me so much that he didn't want to hurt me - but he also loves you, even though we haven't met you yet, and that is why he gives me the shots.
We're both so hopeful! We have hoped and wished for you for 18 long months now, but now we have doctors and medicine to help us get a little bit more likely to meet you sooner rather than later.
"I feel a warm sensation down near my ovaries," I told him as we sat down for dinner after taking the shot an hour earlier.
"Really?" he asked enthusiastically. "It's doing magic!"
We're hoping for magic. We're hoping for you every day. You are so very much wanted and wished for and loved.
We've loved you since before you existed. We just need a little magic to create you!
Love,
Your Mom
Tuesday, February 18, 2014
Feeling the Pain
"Ouch!"
That's my ovaries talking. They're sore. It feels like someone is beating up on the poor little guys.
"I'll take your mind off your ovary pain."
That's my head responding to my ovaries. This headache is pretty distracting.
Drugs are something that teenagers and Hollywood stars do for fun. They pay big money and risk big consequences by intentionally buying and consuming (through whatever form - pill, needle, smoke, or in a certain tweenybopper star's adorably juvenile drug habit, styrofoam cup mixed with soda). Supposedly it's fun? Otherwise, why do they do it?
I don't like drugs. I don't like taking anything. I'd rather suffer through a headache than take pain killers. After having my wisdom teeth removed, I refused the narcotics in favor of Tylenol. When I had shingles, I declined Vicodin in favor of Tylenol 3 (acetaminophen with a little codine) to just take the edge off my discomfort. I went off birth control 6 full months before our wedding because I simply didn't like taking drugs - we chose to take the risk of a pregnancy before it was desired rather than take the medicine (it was a calculated risk - we were emotionally and financially ready if it happened, it just wasn't the best time for us).
I don't like drugs. I tried to fix our problem with vitamins, which I still preferred not to use. Neither my husband nor I took vitamins before we found out we were having trouble (well, I have taken a prenatal since when I went off birth control).
This month, I'm taking 2.5 mg of Letrozole (often sold under the brand name Femara, but I'm on the generic) from the 3rd day of my cycle every day at 8am for 5 days. I took my 4th dose this morning, and tomorrow will be my last Letrozole pill this month. Tomorrow night, I will take out my fancy Follistim pen and pull out one of the beautiful and expensive Follistim vials. I will dial that pen to 33.3 ml, pinch the fat in my belly below my belly button and wipe it with an alcohol wipe (because clearly what every woman wants is to grab a big old hunk of her belly fat) and jab a needle in it, press the button down so that all the liquid gold (at $1 per ml, that stuff is VERY expensive!) gets into my subcutaneous area. I'll likely put a warm compress against the spot for a bit, as I've heard it can help the spot keep from stinging too badly, and help the medication spread out and be absorbed (cold is apparently NOT suggested as it can prevent the medication from being absorbed properly).
So here I am, pumped full of drugs. Every day that I've taken the pill, my head has started to ache a few hours after I swallow the drug. Each day it has gotten a little bit worse, and today is pretty bad. It's still not awful, but it definitely hurts. Supposedly the injects don't have side effects, besides injection site soreness, so I'm sort of looking forward to those.
But I'm also afraid to take the injections, because my other side effect has been soreness in the general area of my ovaries. They ache, and sometimes they pinch like a bad period cramp but just on one side. I know something is happening down there, and so I'm hopeful for 2-3 mature follicles when I go in for my monitoring appointment. But of course, my imagination goes to over responding - I'm afraid of 4+ follicles. This cycle, that wouldn't be a huge deal as we are doing timed intercourse which lowers our chances. Future cycles, I'd be worried about anything over 2 follicles because I really don't want twins and am absolutely petrified of anything greater than that.
I don't like drugs. I don't like what drugs do to my body. But I'm so hopeful the drugs will bring me what we've sought after for so long, and then it will all be worth every penny, every ache, every pain.
That's my ovaries talking. They're sore. It feels like someone is beating up on the poor little guys.
"I'll take your mind off your ovary pain."
That's my head responding to my ovaries. This headache is pretty distracting.
Drugs are something that teenagers and Hollywood stars do for fun. They pay big money and risk big consequences by intentionally buying and consuming (through whatever form - pill, needle, smoke, or in a certain tweenybopper star's adorably juvenile drug habit, styrofoam cup mixed with soda). Supposedly it's fun? Otherwise, why do they do it?
I don't like drugs. I don't like taking anything. I'd rather suffer through a headache than take pain killers. After having my wisdom teeth removed, I refused the narcotics in favor of Tylenol. When I had shingles, I declined Vicodin in favor of Tylenol 3 (acetaminophen with a little codine) to just take the edge off my discomfort. I went off birth control 6 full months before our wedding because I simply didn't like taking drugs - we chose to take the risk of a pregnancy before it was desired rather than take the medicine (it was a calculated risk - we were emotionally and financially ready if it happened, it just wasn't the best time for us).
I don't like drugs. I tried to fix our problem with vitamins, which I still preferred not to use. Neither my husband nor I took vitamins before we found out we were having trouble (well, I have taken a prenatal since when I went off birth control).
This month, I'm taking 2.5 mg of Letrozole (often sold under the brand name Femara, but I'm on the generic) from the 3rd day of my cycle every day at 8am for 5 days. I took my 4th dose this morning, and tomorrow will be my last Letrozole pill this month. Tomorrow night, I will take out my fancy Follistim pen and pull out one of the beautiful and expensive Follistim vials. I will dial that pen to 33.3 ml, pinch the fat in my belly below my belly button and wipe it with an alcohol wipe (because clearly what every woman wants is to grab a big old hunk of her belly fat) and jab a needle in it, press the button down so that all the liquid gold (at $1 per ml, that stuff is VERY expensive!) gets into my subcutaneous area. I'll likely put a warm compress against the spot for a bit, as I've heard it can help the spot keep from stinging too badly, and help the medication spread out and be absorbed (cold is apparently NOT suggested as it can prevent the medication from being absorbed properly).
So here I am, pumped full of drugs. Every day that I've taken the pill, my head has started to ache a few hours after I swallow the drug. Each day it has gotten a little bit worse, and today is pretty bad. It's still not awful, but it definitely hurts. Supposedly the injects don't have side effects, besides injection site soreness, so I'm sort of looking forward to those.
But I'm also afraid to take the injections, because my other side effect has been soreness in the general area of my ovaries. They ache, and sometimes they pinch like a bad period cramp but just on one side. I know something is happening down there, and so I'm hopeful for 2-3 mature follicles when I go in for my monitoring appointment. But of course, my imagination goes to over responding - I'm afraid of 4+ follicles. This cycle, that wouldn't be a huge deal as we are doing timed intercourse which lowers our chances. Future cycles, I'd be worried about anything over 2 follicles because I really don't want twins and am absolutely petrified of anything greater than that.
I don't like drugs. I don't like what drugs do to my body. But I'm so hopeful the drugs will bring me what we've sought after for so long, and then it will all be worth every penny, every ache, every pain.
Sunday, February 16, 2014
Living in an Infertile Body
Every twinge, every cramp, every mood swing, every headache, every bout of diarrhea or constipation. Every time a smell makes me gag, every time my sinuses are blocked, every time I wake up to pee, every time I can't sleep, every time I feel like going to sleep early or taking a nap.
Every moment, I am wondering what my body is doing. Whether it's related to my fertility. Whether it's a symptom of pregnancy, or a symptom of infertility. Whether it's a sign my body doing things normally, or whether it's a sign something is going wrong.
Every twinge. Every day.
I live in this body, and this body has failed me. It has not been able to do an essential bodily function - reproduction. And so every sensation, I am hyper-vigilant of what it could mean.
I will myself to let it go and not pay attention, but the very next twinge, my imagination starts running again.
I remember when it was fun and exciting. Back when we first started trying, I remember excitedly reciting every potential symptom to my husband. I remember we walked into a spice store a few days before my period was due, and I gagged and had to leave. We were both so excited at the idea that it could have been an early symptom.
Now I know that early pregnancy symptoms are usually nothing more than progesterone symptoms. If you can't turn a pregnancy test positive, then there isn't enough hCG in your system to cause any symptoms. You can have progesterone symptoms whether you're pregnant or not, but it doesn't stop a woman from hoping.
It's amazing how much I've learned about how my body works. It's like a mini-biology crash course. I know more now about how my cycle works, what my body's likely doing on any given day of the cycle, what is necessary to occur for fertilization and implantation to happen. I've used that information to pay close attention to every detail to try to figure out what's going on, to see if there's some lesson that will indicate the problem or a solution.
Is that cramp endometriosis? My uterus tipping towards the bladder can be seen on the ultrasounds - is that a sign of endometriosis? Would my experience with HPV several years ago affect my cervix? Scarring or pH level preventing sperm from getting through my cervix? Or is my cervical mucus the right consistency, or is it somehow hostile to my husband's sperm?
I've spent over a year now more aware of which cycle day I'm on than what day of the week it is. It doesn't help that I haven't been working much because we've moved 4 times in the 18 months we've been trying thus far. I am so in tuned with which day of my cycle it is, it's hard to turn off.
Sometimes I wonder what's going to happen when (I can't bear to say "if" but that's often how I think of it) I get pregnant. How will my life change? Will I still over-analyze every twinge in my body? I'm sure I likely will, as it will then be motherly protective instinct over the baby I will have inside me. Will I think of my life in terms of weeks of gestation, rather than cycles and cycle days? Probably.
And once I have a baby, will I count life in terms of weeks and months of the child's growth? Until I try to conceive a second child (assuming we're lucky enough to have a singleton pregnancy with our first conception... otherwise, we might be done after one pregnancy) I have feeling that my life will revolve around that long-sought after child's growth.
When I have two children, do I simultaneously count time passing with both their ages (assuming they aren't twins)?
I'm starting to wonder if I've gotten lost in this process. Where am I inside this body of an infertile? When do I get to have control of my life again?
I'm trying to refocus on other goals that have nothing to do with reproduction. I'm trying to focus on writing a book I've been wanting to write for a very long time. I had taken a job to try to help bring in some extra money, but that job did not work out (and I am not remotely disappointed as I was pretty dismal at the idea of going every day). So now that the job is gone, I need to focus on my own health and well being. That involves exercising and writing. However, it seems easier to write about infertility than the novel that I've been tooling with for about a year now. But I need to focus on tangible dreams and goals that don't involve living inside my own head, living inside my body.
Every moment, I am wondering what my body is doing. Whether it's related to my fertility. Whether it's a symptom of pregnancy, or a symptom of infertility. Whether it's a sign my body doing things normally, or whether it's a sign something is going wrong.
Every twinge. Every day.
I live in this body, and this body has failed me. It has not been able to do an essential bodily function - reproduction. And so every sensation, I am hyper-vigilant of what it could mean.
I will myself to let it go and not pay attention, but the very next twinge, my imagination starts running again.
I remember when it was fun and exciting. Back when we first started trying, I remember excitedly reciting every potential symptom to my husband. I remember we walked into a spice store a few days before my period was due, and I gagged and had to leave. We were both so excited at the idea that it could have been an early symptom.
Now I know that early pregnancy symptoms are usually nothing more than progesterone symptoms. If you can't turn a pregnancy test positive, then there isn't enough hCG in your system to cause any symptoms. You can have progesterone symptoms whether you're pregnant or not, but it doesn't stop a woman from hoping.
It's amazing how much I've learned about how my body works. It's like a mini-biology crash course. I know more now about how my cycle works, what my body's likely doing on any given day of the cycle, what is necessary to occur for fertilization and implantation to happen. I've used that information to pay close attention to every detail to try to figure out what's going on, to see if there's some lesson that will indicate the problem or a solution.
Is that cramp endometriosis? My uterus tipping towards the bladder can be seen on the ultrasounds - is that a sign of endometriosis? Would my experience with HPV several years ago affect my cervix? Scarring or pH level preventing sperm from getting through my cervix? Or is my cervical mucus the right consistency, or is it somehow hostile to my husband's sperm?
I've spent over a year now more aware of which cycle day I'm on than what day of the week it is. It doesn't help that I haven't been working much because we've moved 4 times in the 18 months we've been trying thus far. I am so in tuned with which day of my cycle it is, it's hard to turn off.
Sometimes I wonder what's going to happen when (I can't bear to say "if" but that's often how I think of it) I get pregnant. How will my life change? Will I still over-analyze every twinge in my body? I'm sure I likely will, as it will then be motherly protective instinct over the baby I will have inside me. Will I think of my life in terms of weeks of gestation, rather than cycles and cycle days? Probably.
And once I have a baby, will I count life in terms of weeks and months of the child's growth? Until I try to conceive a second child (assuming we're lucky enough to have a singleton pregnancy with our first conception... otherwise, we might be done after one pregnancy) I have feeling that my life will revolve around that long-sought after child's growth.
When I have two children, do I simultaneously count time passing with both their ages (assuming they aren't twins)?
I'm starting to wonder if I've gotten lost in this process. Where am I inside this body of an infertile? When do I get to have control of my life again?
I'm trying to refocus on other goals that have nothing to do with reproduction. I'm trying to focus on writing a book I've been wanting to write for a very long time. I had taken a job to try to help bring in some extra money, but that job did not work out (and I am not remotely disappointed as I was pretty dismal at the idea of going every day). So now that the job is gone, I need to focus on my own health and well being. That involves exercising and writing. However, it seems easier to write about infertility than the novel that I've been tooling with for about a year now. But I need to focus on tangible dreams and goals that don't involve living inside my own head, living inside my body.
Friday, February 14, 2014
Raw and Ready
I'm feeling like someone scraped my soul with sandpaper. I'm just sore and worn out emotionally. Every time someone asks, "How are you?" I wonder if they can handle the truth, and how much of it I should be honest about and what I should hold back for fear of oversharing. People don't want to know the truth. Even those who care don't want to know that I'm feeling empty and hollow and raw and tired and hopeless, because their next question is how to help, and they just can't make it better right now.
I had my baseline appointment today for my first medicated cycle. My period came with a vengence last night, as expected, and though we had hoped to drive up to our clinic together on Saturday for this appointment, they told me that they only do monitoring appointments on weekdays typically. Which is news to me, but whatever. My new job had told me that I didn't have to work today, so I could drive up by myself, which I did.
I wasn't nervous, and I wasn't expecting it to be emotional. I had the transvaginal ultrasound (as we infertiles occasionally affectionately call it, the dildo cam) first. A nurse practitioner came in and introduced herself and said she was learning the equipment. Man, she thought that thing was a stick shift! DO NOT PUT ME IN THIRD GEAR, PLEASE! It freaking HURT! I involuntarily said "Ouch!" three or four times and stiffled it another few. I don't mean to exaggerate, but it honestly felt violating. It was worse than my HSG, which I was very scared of at the time (unnecessarily, it turned out).
I thankfully have 10 antral follicles on one side and 9 on the other, which was deemed to be "excellent" and then I was sent to pee in a cup to confirm what I already knew (especially - TMI warning - since the "pee" was red instead of yellow) that I was not actually pregnant (but go ahead and rub salt in that wound).
Then I spoke with the nurse, who is not my typical contact as my nurse is out of the office this week. She explained how to use the medications I'm about to have to take, when to take them, and went over my calendar. We practiced the injectible medications to make sure I get it right. She was very nice, and very helpful. She asked about my experience with the pharmacy, which I confirmed was less than quality customer service, and she apologized and explained that others had complained and they were switching pharmacies going forward. So I'm glad I wasn't just being a difficult customer!
I explained that I was worried about twins, and asked about how many mature follicles is too many. She confirmed that it's a real possibility, that they have lots of twins from their procedures, but not so many triplets and not any more than that. But really, I don't care how many triplets they have or don't have - I don't want twins. I started getting choked up at the idea of having a 20-30% chance of twins, if I can even get pregnant at all.
As I checked out, the receptionist tried to charge me the full amount before I suggested that my insurance is supposed to cover 80% of timed intercourse cycles, which she then confirmed and I only had to pay around $25, so I'm VERY appreciative of my insurance right now!
I cried in my car for awhile. Ugly sobs. And I went on Facebook to try to distract myself so I could collect my thoughts enough to be okay driving home, and sure enough, there's a friend's pregnancy announcement on top of my news feed. I lost it. I ended up calling my Mom to try to talk me off my hysterical fit, and she did, but not before a good long hysterical temper tantrum fit.
Really, I don't get why simply because I'm infertile, I should embrace without reservations the idea of a) twins, b) sperm donors, c) ovaries the size of grapefruits, d) IUIs, e) IVF, f) adopting.
As if it's just like buying one brand of milk instead of another. If I want milk, and everyone's getting milk, and I can't get milk - I can only get almond milk or goats milk, or I can try to find and milk a cow for my own milk, why can't I be pissed about it?
Why am I expected to go, "Oh well, if I can't have milk like everyone else, I've got no problems with drinking almond milk!"
Almond milk is perfectly nice, but why can't I say, "You know what, damnit, I want milk! Everyone else gets it whenever they want it. I don't really want almond milk or goats milk right now, I want cow's milk! If I can't have cow's milk, I'll learn to accept almond milk or goats milk and it will be just fine in the long run, but right now I want cow's milk, damnit. And I don't want to risk getting kicked by the damned cow to get that milk. I want it to come in a carton at the grocery store like everyone else, and it is NOT FAIR that I can't do that!"
I just want a baby. ONE baby at time! A biological baby that shares genes with both my husband and me, preferably. I don't feel like I'm being selfish for feeling the urge to want to see if our child has my husband's or my features, grows tall like my husband or stays short like me. Everyone else takes it for granted, but why am I made to feel like I'm being unreasonable for really wanting that?
So... there's that. I'm raw about that. I'm hopeful, and scared, and resigned, and sad, and angry. It's a whole bundle of emotions to carry around every day, and it weighs me down sometimes. I'm so exhausted from it all, I just don't have the strength to feel anything right now. I poured it all out of my face in tears this morning in the parking lot of my doctor's office.
I took a picture of my tear stained face as "The Face of Infertility" but it was too depressing so I deleted it. That level of misery does not need to be documented - it needs to be survived and put behind me.
And to add to it, I started a new job on Monday. I didn't love the job, I had a pretty nasty co-worker. I was going to give it another week to see if it got any better. Today my new boss called me and told me nasty co-worker had filled her in on why I wasn't "a good fit" and that she thought it best we go our separate ways. Which is fine, I was going to quit anyway. But as my husband so aptly summarized, it's like a bad date - you don't want to keep dating, but you get pretty pissed if they're the one to break up with you first. What's wrong with you? They're the one with issues! Of course you were cold and disinterested - they were so terrible! They don't get to break up with you first! It's their fault! But really, in the end, it doesn't matter. It's over, and it didn't work.
I'm feeling pretty raw about that, too. Not disappointed, as I disliked the job and was upset that I would have to struggle to fit in monitoring appointments, and not be able to meet with my new psychologist who I really need. I just feel embarrassed that I got let go. What's wrong with me?! Why didn't they like me? I could overanalyze it all, and feel like a pretty terrible person, but I am going to try my darndest not to add this to my overwhelming heap of stress. I'm going to try to just move past it.
Prior to me losing my job, we had discussed the need to take a vacation in April/May. It might mean a treatment break, which is just fine, but we really, really need some relaxation. My favorite trips are adventure trips - 3 cities in 10 days, long flights to far flung places, budget hotels and overnight trains. I love it! But it's not relaxing - it's hard work. Exciting and fun and thrilling, but not relaxing. And really... I need to relax.
I'm sick of everyone else telling me to relax, especially as they make it seem like relaxing will solve my infertility. But really, I'd be the first one to admit I'm high strung at the moment. I'm struggling with depression and anxiety. It's amazing how two words summarize a vast canyon of pain and suffering - depression and anxiety. There's so much I'm wearing around my neck at the moment, pulling me down, but it's all wrapped up in those two simple words.
So I'm just... raw. Too tired to be sad, scared, angry, embarrassed, frustrated, frightened, overwhelmed, mad, envious, irritated, tired.
I'm too tired to be tired. Let's just do this already. Whatever may come, or not come, let's just freaking get this party started already. I'm ready. Well, no, I'm not. But I'm raw, and that's nearly as good as ready.
I had my baseline appointment today for my first medicated cycle. My period came with a vengence last night, as expected, and though we had hoped to drive up to our clinic together on Saturday for this appointment, they told me that they only do monitoring appointments on weekdays typically. Which is news to me, but whatever. My new job had told me that I didn't have to work today, so I could drive up by myself, which I did.
I wasn't nervous, and I wasn't expecting it to be emotional. I had the transvaginal ultrasound (as we infertiles occasionally affectionately call it, the dildo cam) first. A nurse practitioner came in and introduced herself and said she was learning the equipment. Man, she thought that thing was a stick shift! DO NOT PUT ME IN THIRD GEAR, PLEASE! It freaking HURT! I involuntarily said "Ouch!" three or four times and stiffled it another few. I don't mean to exaggerate, but it honestly felt violating. It was worse than my HSG, which I was very scared of at the time (unnecessarily, it turned out).
I thankfully have 10 antral follicles on one side and 9 on the other, which was deemed to be "excellent" and then I was sent to pee in a cup to confirm what I already knew (especially - TMI warning - since the "pee" was red instead of yellow) that I was not actually pregnant (but go ahead and rub salt in that wound).
Then I spoke with the nurse, who is not my typical contact as my nurse is out of the office this week. She explained how to use the medications I'm about to have to take, when to take them, and went over my calendar. We practiced the injectible medications to make sure I get it right. She was very nice, and very helpful. She asked about my experience with the pharmacy, which I confirmed was less than quality customer service, and she apologized and explained that others had complained and they were switching pharmacies going forward. So I'm glad I wasn't just being a difficult customer!
I explained that I was worried about twins, and asked about how many mature follicles is too many. She confirmed that it's a real possibility, that they have lots of twins from their procedures, but not so many triplets and not any more than that. But really, I don't care how many triplets they have or don't have - I don't want twins. I started getting choked up at the idea of having a 20-30% chance of twins, if I can even get pregnant at all.
As I checked out, the receptionist tried to charge me the full amount before I suggested that my insurance is supposed to cover 80% of timed intercourse cycles, which she then confirmed and I only had to pay around $25, so I'm VERY appreciative of my insurance right now!
I cried in my car for awhile. Ugly sobs. And I went on Facebook to try to distract myself so I could collect my thoughts enough to be okay driving home, and sure enough, there's a friend's pregnancy announcement on top of my news feed. I lost it. I ended up calling my Mom to try to talk me off my hysterical fit, and she did, but not before a good long hysterical temper tantrum fit.
Really, I don't get why simply because I'm infertile, I should embrace without reservations the idea of a) twins, b) sperm donors, c) ovaries the size of grapefruits, d) IUIs, e) IVF, f) adopting.
As if it's just like buying one brand of milk instead of another. If I want milk, and everyone's getting milk, and I can't get milk - I can only get almond milk or goats milk, or I can try to find and milk a cow for my own milk, why can't I be pissed about it?
Why am I expected to go, "Oh well, if I can't have milk like everyone else, I've got no problems with drinking almond milk!"
Almond milk is perfectly nice, but why can't I say, "You know what, damnit, I want milk! Everyone else gets it whenever they want it. I don't really want almond milk or goats milk right now, I want cow's milk! If I can't have cow's milk, I'll learn to accept almond milk or goats milk and it will be just fine in the long run, but right now I want cow's milk, damnit. And I don't want to risk getting kicked by the damned cow to get that milk. I want it to come in a carton at the grocery store like everyone else, and it is NOT FAIR that I can't do that!"
I just want a baby. ONE baby at time! A biological baby that shares genes with both my husband and me, preferably. I don't feel like I'm being selfish for feeling the urge to want to see if our child has my husband's or my features, grows tall like my husband or stays short like me. Everyone else takes it for granted, but why am I made to feel like I'm being unreasonable for really wanting that?
So... there's that. I'm raw about that. I'm hopeful, and scared, and resigned, and sad, and angry. It's a whole bundle of emotions to carry around every day, and it weighs me down sometimes. I'm so exhausted from it all, I just don't have the strength to feel anything right now. I poured it all out of my face in tears this morning in the parking lot of my doctor's office.
I took a picture of my tear stained face as "The Face of Infertility" but it was too depressing so I deleted it. That level of misery does not need to be documented - it needs to be survived and put behind me.
And to add to it, I started a new job on Monday. I didn't love the job, I had a pretty nasty co-worker. I was going to give it another week to see if it got any better. Today my new boss called me and told me nasty co-worker had filled her in on why I wasn't "a good fit" and that she thought it best we go our separate ways. Which is fine, I was going to quit anyway. But as my husband so aptly summarized, it's like a bad date - you don't want to keep dating, but you get pretty pissed if they're the one to break up with you first. What's wrong with you? They're the one with issues! Of course you were cold and disinterested - they were so terrible! They don't get to break up with you first! It's their fault! But really, in the end, it doesn't matter. It's over, and it didn't work.
I'm feeling pretty raw about that, too. Not disappointed, as I disliked the job and was upset that I would have to struggle to fit in monitoring appointments, and not be able to meet with my new psychologist who I really need. I just feel embarrassed that I got let go. What's wrong with me?! Why didn't they like me? I could overanalyze it all, and feel like a pretty terrible person, but I am going to try my darndest not to add this to my overwhelming heap of stress. I'm going to try to just move past it.
Prior to me losing my job, we had discussed the need to take a vacation in April/May. It might mean a treatment break, which is just fine, but we really, really need some relaxation. My favorite trips are adventure trips - 3 cities in 10 days, long flights to far flung places, budget hotels and overnight trains. I love it! But it's not relaxing - it's hard work. Exciting and fun and thrilling, but not relaxing. And really... I need to relax.
I'm sick of everyone else telling me to relax, especially as they make it seem like relaxing will solve my infertility. But really, I'd be the first one to admit I'm high strung at the moment. I'm struggling with depression and anxiety. It's amazing how two words summarize a vast canyon of pain and suffering - depression and anxiety. There's so much I'm wearing around my neck at the moment, pulling me down, but it's all wrapped up in those two simple words.
So I'm just... raw. Too tired to be sad, scared, angry, embarrassed, frustrated, frightened, overwhelmed, mad, envious, irritated, tired.
I'm too tired to be tired. Let's just do this already. Whatever may come, or not come, let's just freaking get this party started already. I'm ready. Well, no, I'm not. But I'm raw, and that's nearly as good as ready.
Tuesday, February 11, 2014
That would have been TOO easy!
As I'm staring at a negative pregnancy test 12 days since my IUI, I'm ready to call it. Not surprisingly, it didn't work.
We had a 10-15% chance. Why did that make me feel so hopeful? I believed we'd beat the odds. I gambled wrong. Bye bye, $650 we spent on that IUI. We bet and lost this round.
So... we're upping the stakes. Medications. This is such a double edged sword, because it gives us more hope at success, but the idea of twins petrifies me. I don't like the increased risk of multiples that comes from taking fertility medications. At all.
But at this point, it feels like our only option besides "wait and see" and seriously, after 18 months, waiting is killing me. I feel like my entire life is wrapped around the idea of waiting for the possibility of being pregnant one day. Maybe. Hopefully. Without medical help, unlikely.
I'm in the process of ordering our meds. I'm not a fan of my customer representative I've been assigned at our pharmacy - she does NOT return phone calls, and often has to be hunted down via page after I've already left two voicemails over the course of three days. I've given up on being patient - I call her directly and leave a message. If I don't hear back within 1 hour, I call and have her paged. I'm a customer, damnit, and they'll be making a lot of money off of me (hopefully more from my insurance company than out of my pocket, but either way).
I already have my progesterone (Prometrium) and my trigger (Ovidrel) and my Femara (generic brand Letrozole, 5 pills, 2.5 mg). I'm waiting on my Follistim, which we are in the process of going back and forth between my doctor's office and the pharmacy and my insurance company to get the override approvals for the dosage prescribed. Because it's such an expensive drug (think thousands of $$$) the insurance automatically caps it at 1 vial. We needed the pharmacy to call the insurance company to request override, which they did (only after I called the insurance company, who told me that, so I called the pharmacy and asked them to, of course. Twice.) They overrode the prescription from 1 vial to 3, but the doctor prescribed 4, so I have to call the doctor to ask them to call the pharmacy to override that last quantity limitation. I'm not sure if they will or not, or if we can ask the pharmacy to give me smaller vials so it fits in the quantity now allotted by insurance. I'll fight that battle this afternoon.
Either way, my period will likely be coming tomorrow or Thursday. I got my positive OPK on a Wednesday and went in for the IUI on Thursday, but I felt ovulation cramping late Wednesday night around midnight, so I wouldn't be surprised if my period comes tomorrow evening, even though I usually have a 14 day luteal phase and I'm counting the day of IUI as ovulation day even though it happened a few hours before, likely. I didn't get an ultrasound with my IUI (it was out of pocket) so I'm not sure, and never will be.
I'll be going in for my baseline appointment on Day 3. Which I'm grateful looks like it will be Saturday, since I just started a new job and don't relish the idea of asking for time off already. And it means my husband will probably be able to go with me, and I always enjoy having him with me rather than make the trip alone. Maybe we can check out an awesome barbecue joint nearby after the appointment? That would be fun!
Because, you know, the doctor's appointment won't be fun. We'll get instructions on how and when to take the medications, how to inject the shots (which, of course, I already looked up videos online so I'm prepared - I am not afraid of the needles, I'm afraid of the twins). This cycle will be timed intercourse, so I still only have about a 10% chance of success, same as last cycle, but now with the meds, we add in the fun bonus (NOT) of 20-25% chance of twins and (gulp) 2-3% chance of triplets.
It's not that they're not cute and adorable, because they are. And it's not that I don't think we can do it, because I know we could. The twins would lack for nothing that a single baby would have - love, affection, good food, clothing, attention. But it's selfish - I don't want the risks of carrying twins, the elevated risk of losing one or both in utero. Infertility has handed me enough of a burden to carry, I don't want to add miscarriage and loss to that list. I also don't want the risks of premature labor, the challenges that face premie babies, the developmental delays. I don't want the physical risks for me - the higher risk of gestational diabetes, pre-eclampsia, cervical failure. I don't want to have to go through a c-section, which the vast majority of twin pregnancies are. I don't want to have an induction because there's simply no room for twins to continue to grow. I don't want an induction, period.
Assuming the pregnancy and delivery go okay and we end up with both babies healthy at home (which is lucky, with twins, and often involves a NICU visit first), it doesn't get easier. I also don't want to have two crying babies and have to choose which one to comfort first. And at what point do you put down a still sobbing baby to pick up his or her sibling, who has been crying the whole time you've been carrying the first? I babysat for my friend's twins, and this was the most eye-opening part of it. When you're playing with two babies on the floor and the doorbell rings, what do you do? You can't carry them both with you. So you have to choose - pick one up and put him in the crib and take the other one with you? If there's no crib, you have to take the time to put the baby in a secure spot, like fastening the buckles on the rocker.
How do you put them to bed at night? My friends would put their twins on the floor and lay between them, and then pick one up and put them in the crib as they fell asleep. My dreams of walking around and soothing a crying baby would be difficult, as there would be another crying baby on the floor. Or in their crib. And how do you get two babies to go to sleep when one cry wakes up the other and causes a chain reaction? Getting twins to sleep on the same schedule is very difficult (i.e. impossible) for the first few months, so sleep for the parents is impossible. At least with one baby, you can catnap when they sleep during the day (which I'm quite good at!). With twins, there's no downtime their whole infancy. Breastfeeding is exponentially more difficult as you have twice the soreness and twice the milk demand and twice as time consuming. How do you make sure you're making enough milk for two babies? It's survival time for parents, you don't really get to enjoy it (if there's any parent of twins out there reading this who disagrees, I'd love to hear it! This is just what I've seen/heard).
And if one parent has to go away for a few days for work (as my husband often does) - that's pure panic. Sure, every new parent is apprehensive about the first time they have no back-up. But seriously, one person with two infant twins is pure panic-mode. What if there's a house fire and you can't physically pick both wiggly babies up at the same time and you drop one? What if you have to put them in the car? You can't carry the babies with you to put them in the car seats at the same time - you have to bring one out while leaving the other inside. My friends would bring the car seats inside, put both babies in car seats, and then bring both car seats outside at the same time and snap one in at a time. Have you ever tried to carry two car seats? It's HEAVY!
Selfishly, I feel like I would be sacrificing all my dreams of being a new Mom by having twins. I wouldn't get the sweet moments of napping on the couch with a baby, or "baby wearing" and going about my day. Every moment would be survival mode, full of poopy diapers, constant breastfeeding (as I'd still try to do that with twins as I believe in its biological advantage), baby-wrangling, crying. So much for cloth diapers - that would be next to impossible to keep up with everything else.
I don't want twins. I don't want twins. I don't want twins. That is not how I picture being a mother.
I REALLY don't want triplets. We won't even go there.
And I feel like I'm jinxing myself. At this crossroads, I either risk twins or I risk never being a mother. It's a horribly unfair decision that I have to make, and I'm very angry at the universe that this is a choice I'm forced to seriously consider.
This month I will be choosing to take the meds. And crossing all fingers and toes that I do NOT end up pregnant with twins.
I'm scared. I'm really scared. My dreams of getting pregnant without medical intervention have already been ruined. I don't want my dreams of enjoying motherhood to be destroyed, too. I'm feeling selfish and angry, and damnit, I just want ONE baby at a time, please! And yes, I know I could "just adopt" (as horribly inaccurate as "just" is as an adjective) but I strangely want a biological child - I want to see my husband's eyes and my nose in a child we created. Why is it that infertile people are made to feel selfish for wanting a biological child and not easily rolling into adoption as a quick "solution"? And I don't want to endure months upon months of needles and pills and suppositories that turn my ovaries into grapefruits and my body into a science experiment. I don't want to put my feet in stirrups several times a month - I thought the annual pap smear was bad enough. And I really, really, really don't want twins.
Why is this so difficult?!
I will have my first baseline appointment probably on Saturday. And then a few days later I'll start Femara pills, once a day. And then Follistim for a few days. And then back for more monitoring appointments, until we're ready to trigger. And then trigger, and then doctor-ordered sex. And then we wait, again, two long painful weeks of hope and anxiety and denial and anger and fear. Two weeks where every cringe or cramp makes my mind whirl. And then likely, we do it all over again. Or, if we do get that long awaited positive pregnancy test, my excitement is combined with waiting anxiously for our first ultrasound to see if we're expecting twins. I'm not sure how I'll feel if that day comes, where we see two embryonic sacs. I'm sure I'll be thrilled to see my children finally after so long, but the fear and sadness that they both came at once will be something I will have to face. If that day comes.
We had a 10-15% chance. Why did that make me feel so hopeful? I believed we'd beat the odds. I gambled wrong. Bye bye, $650 we spent on that IUI. We bet and lost this round.
So... we're upping the stakes. Medications. This is such a double edged sword, because it gives us more hope at success, but the idea of twins petrifies me. I don't like the increased risk of multiples that comes from taking fertility medications. At all.
But at this point, it feels like our only option besides "wait and see" and seriously, after 18 months, waiting is killing me. I feel like my entire life is wrapped around the idea of waiting for the possibility of being pregnant one day. Maybe. Hopefully. Without medical help, unlikely.
I'm in the process of ordering our meds. I'm not a fan of my customer representative I've been assigned at our pharmacy - she does NOT return phone calls, and often has to be hunted down via page after I've already left two voicemails over the course of three days. I've given up on being patient - I call her directly and leave a message. If I don't hear back within 1 hour, I call and have her paged. I'm a customer, damnit, and they'll be making a lot of money off of me (hopefully more from my insurance company than out of my pocket, but either way).
I already have my progesterone (Prometrium) and my trigger (Ovidrel) and my Femara (generic brand Letrozole, 5 pills, 2.5 mg). I'm waiting on my Follistim, which we are in the process of going back and forth between my doctor's office and the pharmacy and my insurance company to get the override approvals for the dosage prescribed. Because it's such an expensive drug (think thousands of $$$) the insurance automatically caps it at 1 vial. We needed the pharmacy to call the insurance company to request override, which they did (only after I called the insurance company, who told me that, so I called the pharmacy and asked them to, of course. Twice.) They overrode the prescription from 1 vial to 3, but the doctor prescribed 4, so I have to call the doctor to ask them to call the pharmacy to override that last quantity limitation. I'm not sure if they will or not, or if we can ask the pharmacy to give me smaller vials so it fits in the quantity now allotted by insurance. I'll fight that battle this afternoon.
Either way, my period will likely be coming tomorrow or Thursday. I got my positive OPK on a Wednesday and went in for the IUI on Thursday, but I felt ovulation cramping late Wednesday night around midnight, so I wouldn't be surprised if my period comes tomorrow evening, even though I usually have a 14 day luteal phase and I'm counting the day of IUI as ovulation day even though it happened a few hours before, likely. I didn't get an ultrasound with my IUI (it was out of pocket) so I'm not sure, and never will be.
I'll be going in for my baseline appointment on Day 3. Which I'm grateful looks like it will be Saturday, since I just started a new job and don't relish the idea of asking for time off already. And it means my husband will probably be able to go with me, and I always enjoy having him with me rather than make the trip alone. Maybe we can check out an awesome barbecue joint nearby after the appointment? That would be fun!
Because, you know, the doctor's appointment won't be fun. We'll get instructions on how and when to take the medications, how to inject the shots (which, of course, I already looked up videos online so I'm prepared - I am not afraid of the needles, I'm afraid of the twins). This cycle will be timed intercourse, so I still only have about a 10% chance of success, same as last cycle, but now with the meds, we add in the fun bonus (NOT) of 20-25% chance of twins and (gulp) 2-3% chance of triplets.
It's not that they're not cute and adorable, because they are. And it's not that I don't think we can do it, because I know we could. The twins would lack for nothing that a single baby would have - love, affection, good food, clothing, attention. But it's selfish - I don't want the risks of carrying twins, the elevated risk of losing one or both in utero. Infertility has handed me enough of a burden to carry, I don't want to add miscarriage and loss to that list. I also don't want the risks of premature labor, the challenges that face premie babies, the developmental delays. I don't want the physical risks for me - the higher risk of gestational diabetes, pre-eclampsia, cervical failure. I don't want to have to go through a c-section, which the vast majority of twin pregnancies are. I don't want to have an induction because there's simply no room for twins to continue to grow. I don't want an induction, period.
Assuming the pregnancy and delivery go okay and we end up with both babies healthy at home (which is lucky, with twins, and often involves a NICU visit first), it doesn't get easier. I also don't want to have two crying babies and have to choose which one to comfort first. And at what point do you put down a still sobbing baby to pick up his or her sibling, who has been crying the whole time you've been carrying the first? I babysat for my friend's twins, and this was the most eye-opening part of it. When you're playing with two babies on the floor and the doorbell rings, what do you do? You can't carry them both with you. So you have to choose - pick one up and put him in the crib and take the other one with you? If there's no crib, you have to take the time to put the baby in a secure spot, like fastening the buckles on the rocker.
How do you put them to bed at night? My friends would put their twins on the floor and lay between them, and then pick one up and put them in the crib as they fell asleep. My dreams of walking around and soothing a crying baby would be difficult, as there would be another crying baby on the floor. Or in their crib. And how do you get two babies to go to sleep when one cry wakes up the other and causes a chain reaction? Getting twins to sleep on the same schedule is very difficult (i.e. impossible) for the first few months, so sleep for the parents is impossible. At least with one baby, you can catnap when they sleep during the day (which I'm quite good at!). With twins, there's no downtime their whole infancy. Breastfeeding is exponentially more difficult as you have twice the soreness and twice the milk demand and twice as time consuming. How do you make sure you're making enough milk for two babies? It's survival time for parents, you don't really get to enjoy it (if there's any parent of twins out there reading this who disagrees, I'd love to hear it! This is just what I've seen/heard).
And if one parent has to go away for a few days for work (as my husband often does) - that's pure panic. Sure, every new parent is apprehensive about the first time they have no back-up. But seriously, one person with two infant twins is pure panic-mode. What if there's a house fire and you can't physically pick both wiggly babies up at the same time and you drop one? What if you have to put them in the car? You can't carry the babies with you to put them in the car seats at the same time - you have to bring one out while leaving the other inside. My friends would bring the car seats inside, put both babies in car seats, and then bring both car seats outside at the same time and snap one in at a time. Have you ever tried to carry two car seats? It's HEAVY!
Selfishly, I feel like I would be sacrificing all my dreams of being a new Mom by having twins. I wouldn't get the sweet moments of napping on the couch with a baby, or "baby wearing" and going about my day. Every moment would be survival mode, full of poopy diapers, constant breastfeeding (as I'd still try to do that with twins as I believe in its biological advantage), baby-wrangling, crying. So much for cloth diapers - that would be next to impossible to keep up with everything else.
I don't want twins. I don't want twins. I don't want twins. That is not how I picture being a mother.
I REALLY don't want triplets. We won't even go there.
And I feel like I'm jinxing myself. At this crossroads, I either risk twins or I risk never being a mother. It's a horribly unfair decision that I have to make, and I'm very angry at the universe that this is a choice I'm forced to seriously consider.
This month I will be choosing to take the meds. And crossing all fingers and toes that I do NOT end up pregnant with twins.
I'm scared. I'm really scared. My dreams of getting pregnant without medical intervention have already been ruined. I don't want my dreams of enjoying motherhood to be destroyed, too. I'm feeling selfish and angry, and damnit, I just want ONE baby at a time, please! And yes, I know I could "just adopt" (as horribly inaccurate as "just" is as an adjective) but I strangely want a biological child - I want to see my husband's eyes and my nose in a child we created. Why is it that infertile people are made to feel selfish for wanting a biological child and not easily rolling into adoption as a quick "solution"? And I don't want to endure months upon months of needles and pills and suppositories that turn my ovaries into grapefruits and my body into a science experiment. I don't want to put my feet in stirrups several times a month - I thought the annual pap smear was bad enough. And I really, really, really don't want twins.
Why is this so difficult?!
I will have my first baseline appointment probably on Saturday. And then a few days later I'll start Femara pills, once a day. And then Follistim for a few days. And then back for more monitoring appointments, until we're ready to trigger. And then trigger, and then doctor-ordered sex. And then we wait, again, two long painful weeks of hope and anxiety and denial and anger and fear. Two weeks where every cringe or cramp makes my mind whirl. And then likely, we do it all over again. Or, if we do get that long awaited positive pregnancy test, my excitement is combined with waiting anxiously for our first ultrasound to see if we're expecting twins. I'm not sure how I'll feel if that day comes, where we see two embryonic sacs. I'm sure I'll be thrilled to see my children finally after so long, but the fear and sadness that they both came at once will be something I will have to face. If that day comes.
Saturday, February 1, 2014
The Industry of Infertility
For those of us who have been in this game for over a year, we've all spent some money on this process. From ovulation tests to pregnancy tests to vitamins to doctors' appointments, eventually it starts to feel like you're bleeding money.
And everyone has an answer - and usually it costs money. Acupuncture, massages, Chinese herbal medicine, yoga, meditation, SoftCups/DivaCup, baby aspirin, Vitamin D, CoQ10 (or its more expensive derivative - Ubiquinol), L-Arginine, L-Carnitine, acetyl-L-Carnitine, Omega 3, DHEA, folic acid, zinc, selenium, combo vitamins like Fertility Blend for Men (or for Women), green tea, red raspberry tea, Vitex, maca root, horny goat weed (yes, that's what it's called), and so many more!
I've tried (and thus paid for) probably 80% of the above. Let's see... out of the 25 things I listed, I count 3 I haven't tried (the last 3). So for anyone looking for a miracle cure, none of those are it!
That's not to say none of them have helped. My husband's sperm count went through the roof, and his motility jumped from 25% to over 80%! Yoga and meditation have helped me feel less anxious. Also add in therapy, which I didn't list as no one has ever told me it's a miracle cure (well, except my first therapist, who told me that she had a client who dealt with some childhood trauma that she had suppressed and then voila! Pregnant. Add it to my list of reasons I wanted to punch that therapist in the face).
However, the more I look into infertility and my constant search for a solution, the more I find opportunists who are looking to make money off poor men & women who can't seem to get pregnant as soon as they would like. I'm not talking about doctors - at least not most. I think doctors - or at least hope - believe in their Hippocratic oath, to do no harm. They're there to help us. That's not to say IUIs and IVF and consultations and medications don't come cheap - they certainly can be the most expensive part of the process for someone battling infertility! But I'm hoping they're not in it primarily for the money.
And I'm not saying acupuncturists and massage therapists or really, that any one person is in it for the money. I'm sure there are plenty of people whose intentions are to help those of us who are dealing with this monster. But man, there just seems to be tons of way to throw away a TON of money on this process!
So far, we've had 17 failed cycles. I estimate I've peed on 3 pregnancy sticks on average per cycle (don't judge me!), 4 ovulation tests, bought $30 of vitamins on average per cycle, and several hundred dollars on myriad other potential solutions. Altogether, I hate to estimate how much, but it's likely over $2000 already, even buying internet cheapies for the pregnancy and ovulation tests.
This month, we spent $650 on the IUI. It's the first BIG CHUNK I have seen go out the door in one payment. In addition, I spent probably $30 more on a yoga/meditation DVD and other meditation tapes. This month stings financially. A failed pregnancy test in a week (because you REALLY think I'm going to make it much further than 9 DPO before I test?) will make it sting a lot more.
I can't help but wonder how much money some people make off poor people like me who just want a baby. I can only hope that they have good intentions rather than seeing us as a cash cow.
And everyone has an answer - and usually it costs money. Acupuncture, massages, Chinese herbal medicine, yoga, meditation, SoftCups/DivaCup, baby aspirin, Vitamin D, CoQ10 (or its more expensive derivative - Ubiquinol), L-Arginine, L-Carnitine, acetyl-L-Carnitine, Omega 3, DHEA, folic acid, zinc, selenium, combo vitamins like Fertility Blend for Men (or for Women), green tea, red raspberry tea, Vitex, maca root, horny goat weed (yes, that's what it's called), and so many more!
I've tried (and thus paid for) probably 80% of the above. Let's see... out of the 25 things I listed, I count 3 I haven't tried (the last 3). So for anyone looking for a miracle cure, none of those are it!
That's not to say none of them have helped. My husband's sperm count went through the roof, and his motility jumped from 25% to over 80%! Yoga and meditation have helped me feel less anxious. Also add in therapy, which I didn't list as no one has ever told me it's a miracle cure (well, except my first therapist, who told me that she had a client who dealt with some childhood trauma that she had suppressed and then voila! Pregnant. Add it to my list of reasons I wanted to punch that therapist in the face).
However, the more I look into infertility and my constant search for a solution, the more I find opportunists who are looking to make money off poor men & women who can't seem to get pregnant as soon as they would like. I'm not talking about doctors - at least not most. I think doctors - or at least hope - believe in their Hippocratic oath, to do no harm. They're there to help us. That's not to say IUIs and IVF and consultations and medications don't come cheap - they certainly can be the most expensive part of the process for someone battling infertility! But I'm hoping they're not in it primarily for the money.
And I'm not saying acupuncturists and massage therapists or really, that any one person is in it for the money. I'm sure there are plenty of people whose intentions are to help those of us who are dealing with this monster. But man, there just seems to be tons of way to throw away a TON of money on this process!
So far, we've had 17 failed cycles. I estimate I've peed on 3 pregnancy sticks on average per cycle (don't judge me!), 4 ovulation tests, bought $30 of vitamins on average per cycle, and several hundred dollars on myriad other potential solutions. Altogether, I hate to estimate how much, but it's likely over $2000 already, even buying internet cheapies for the pregnancy and ovulation tests.
This month, we spent $650 on the IUI. It's the first BIG CHUNK I have seen go out the door in one payment. In addition, I spent probably $30 more on a yoga/meditation DVD and other meditation tapes. This month stings financially. A failed pregnancy test in a week (because you REALLY think I'm going to make it much further than 9 DPO before I test?) will make it sting a lot more.
I can't help but wonder how much money some people make off poor people like me who just want a baby. I can only hope that they have good intentions rather than seeing us as a cash cow.
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