December 28, 2011 – The Clomid Ride

Starting Clomid made for an interesting month.  I say interesting because saying hellish or nightmarish is likely to scare people.  It was not fun.  Not really even a little.  In fact, we are still debating whether or not we will take it again if we were unable to conceive this month.  Here is a run down of how Clomid changed my month…

The first 7 days of my cycle were okay.  There was the embarrassing crying, but really not much else worthy of discussion.  It was very manageable.  Then from day 8 until day 18 was where the real torture began.  Every day, all day, I was nauseous.  Not a little bit, but a lot.  I don’t vomit.  People have a hard time believing this, but I don’t unless I am pregnant.  I think if I had been a normal person, I would have vomited daily for these 10 days.  I was dizzy for no reason and just felt awful every day, all day.  There were also other fun side effects like spots in my vision.  At one point I actually caught myself swatting at what I thought were gnats swarming me… they were just black spots filling my vision.  It was as if someone had taken a picture with a flash that was way too bright.  It is difficult to read, watch TV, do chores, or drive when you have black spots filling up your vision.  Not to mention that constant vision disturbances lead to migraines. 

Fertility days (or the days when we are supposed to be having sex every other day) are from day 11 until day 18.  I told Doc that this was the first time since our early college days that I had sex while nauseous and dizzy.  It was like 2am bar closing sex, only I didn’t get to be drunk or have heard a good band before hand.  Not really as much fun at 33 as it was at 21… The final side effect was the worst, and most difficult to tolerate.  Ovulation.  This was not normal ovulation with a little pinch and done.  No.  This was the Incredible Hulk of ovulations.  It included intense (meaning would normally have driven me to the hospital) abdominal cramping.  The nausea also took this opportunity to increase.  The pain was so intense that my lower back, hips, and abdomen hurt.  It hurt way worse than the worse bladder infection I have ever had.  Imagine having the worst cramps of your life along with the worse bladder infection you can imagine and you are maybe ¾ the way there.  It was impossible to find a position to relieve the pain.  Sitting hurt, laying hurt, standing hurt, moving exponentially increased the pain, using the restroom was painful, sleeping was impossible, and sex was just awful.  I cried and Doc said he didn’t want me to take Clomid again.  That is how awful it was.  Poor Doc had to give me multiple back massages to try and relieve the pain.  It was just awful. 

Here is the sunny side, because you know I have to say it all… by day 19 all symptoms were halved.  By day 20 the side effects were gone and I actually felt amazing.  I don’t know if it was just because it was such a relief to have the side effects gone or if the hormonal changes included this good day, but I felt great.  Of course that was also the day Doc ended up with the stomach flu and I spent the day taking care of him.  J

Yesterday was day 21 and I can’t tell you whether or not the side effects were gone because I caught Doc’s stomach flu, so who knows which problem is causing today’s nausea.  I think it is the stomach flu and that I would be feeling fine without it.  I managed to make it to the doctor’s office for my blood work and am still waiting to hear the results.  I hate the waiting game.  My next appointment is next week and that is when we will find out whether or not we were successful this month.  

We are still debating whether or not we will use Clomid again.  It may partially depend on what the doctor thinks.  I will say that this is not a drug you should take and assume that your life will continue on as normal.  It will not.  You will have side effects and they will limit your daily activities and you will not have total control over your emotions or body.  If you have vacation time to use, I suggest you take off for days 8-18.  Give yourself permission to take those days off and take care of yourself.  I will let you guys know when we decide whether or not it is worth another try.  Thank you to all the people that provided me with support during these awful days.  Friends are a wonderful distraction from troubles!  J

December 19, 2011 – The side effects go on and on…

It turns out that although I only had to take Comid for 5 days, the side effects can last a bit longer.  Side effects can include any number of things, but for me they seem to center around these: nausea, dizziness, and spots in vision, physical symptoms of anxiety, and a few mood swings. 

Needless to say, there have been a few extra prayers going up this month as I hang out on the bathroom floor, “Please don’t make me have to take this drug again.”  I now know why Doc’s colleague refers to Clomid as an evil little drug.  It is evil and I am pretty sure it hates me. 

The side effects can be a bit overwhelming and once again I find myself thankful I am not working.  (I have to wonder if that wasn’t someone’s plan all along.)  I am also so thankful to have Doc as my partner through this.  He responds to me with concern and compassion, and very frequently humor which helps me manage everything better.  I couldn’t ask for anything more.  He really makes an effort to be with me on every step of this journey.  I think a part of him is probably happy that he isn’t the one on the bathroom floor, or lying in bed for an hour after sex, or seeing spots, or having panic symptoms, but at the same time I think he would shoulder this burden if he could.  He does such a good job of acknowledging that it is hard and tries to do his best to make everything he can easier on me in the mean time.  I am a very lucky woman to have his love and support. 

Despite the side effects we have maintained our busy schedule of dinners and appointments.  Last night as we prepared for yet another recruiting dinner, I was feeling a bit irritable and out of sorts.  Doc found this a little funny and also a little scary, because we really did need to entertain people soon.  He kindly asked if I wanted to skip the dinner, which of course was met with hormonal rage.  I was already dressed and still fussing in the mirror; obviously I was planning on going!  I knew by Doc’s expression that he knew this was hormonal, and he also knew that I knew it is hormonal, so what happened next was perfect… Doc looked at me, very seriously, adjusts my sweater and while completely ignoring whatever argument I was starting says, “Your boobs look really good tonight.”  It completely took the wind out of my sails.  How do you pick a fight with that?!?  I say, “thank you” because I couldn’t really think of anything else to say, he totally knocked me off balance with that one. I then watch Doc look down, slowly step to the side and back away from me with the smallest self-satisfied grin on his face.  He knew he just expertly maneuvered a hormonal mind field and he was very pleased with himself.  I started laughing and continued to laugh for the rest of the evening. 

Busy schedule aside, we are managing this situation to the best of our ability.  We are staying on schedule and even having fun again. J Apparently all we needed was the doctor to order us to have fun when we make love.  When side effects rear their ugly heads during dinners or with friends and family we just apologize and explain.  Once again I have found that the benefit of being open and honest about this struggle is that people really are pretty understanding when you give them the chance to be.  J

December 14, 2011 – Clomid Crying: Getting by with a little help from my friends

The 5 days I was on Clomid were some of our busier days.  Doc had holiday parties and recruiting dinners and he really needed me to be at my best.  He was working overnight, coming home to sleep for a couple of hours, and then we would be off to the next event.  There was very little sleep had by all.  To make matters worse, we both have a cold or flu bug.  Under normal conditions, this schedule and situation would have made me a little tense.  On Clomid… I had many episodes of what I call “inappropriate crying”.  It wasn’t that I was sad; if I had been sad it would have been easier to explain.  Instead it was just that any emotion and I mean any emotion, resulted in a session of bawling that lasted approximately 10 minutes.  I watched Our Idiot Brother… cried.  I looked at one of my dogs and thought, “He is a really good dog.”… cried.  Watched Doc shave and he made me laugh… cried.  Watched a video of a baby scaring itself with a fart… laughed so hard I ended up bawling.  Inappropriate crying!

By the time we were leaving for the party, Doc and I had managed to make light of the inappropriate crying and he was even excited to tell people about it.  I am not a public crier, but I quickly realized that feeling embarrassed by the crying only made it worse.  So, I pulled on my big-girl panties and accepted that I was going to cry, I would have no control over how/when it occurred or how long it lasted.  All I could do was accept that it was a part of my current situation and that I could only control how I reacted to it, not how others thought/felt about it.  Everyone at the party was a physician or hospital employee that already knows us and most of them knew we were having fertility issues, so we opted to just be honest about our situation.   

The party went well and I only had 2 episodes of inappropriate crying, that thankfully were very brief and little more than tearing up.  One of the doctors that had also been on Clomid before shared that she had the same side effect.  She said she would walk into a patient’s room to give good news and end up crying.  She refers to Clomid as “an evil little drug”. 

Overall, it wasn’t a terrible side effect and it was over by the next day.  I am thankful that although we were busy, I didn’t have to try and work while I was feeling so off balance.  I am thankful that I had the time to think about the situation, fully process it, and gain some perspective with Doc before I had to face the world crying.  Being open and honest about it was definitely the way to go!  I felt like our friends were supporting us and when I started crying we all just started making jokes about how our table had the most interesting people (the crier, the wino… you know the cool kids).  J

And I found that once again, I can get by with a little help from my friends J

December 9, 2011 – The Clomid Shuffle

My morning started off with a little more stress than I would have liked.  I got a call from my doctor’s office saying that the sonogram tech had called in sick and they would need to reschedule the appointment.  L I have waited nearly a full month for this appointment, my doctor said I needed to get the sonogram within the first 3 days of my cycle starting… today was day 3.  I called and let the scheduler know that this appointment was time sensitive and I would need to be seen today, if not at their clinic, then somewhere else.  No one likes to loose business… they had the nurse call me back within a couple of hours and they squeezed me in with a different tech.  I thanked her profusely.  I love nurses; they are generally a helpful group of people as long as you explain the situation.  It helps that my mom is a nurse, so I am always very nice to nurses. 

Doc is working nights again this weekend, so he was able to come to the appointment.  I am going to be a little gross for a moment as I describe this, so if you turn away from medical shows on TV, feel free to skip this section.  In case anyone doesn’t remember from health class back in the day; day 1 of a woman’s cycle is the day that her period starts.  This appointment takes place on day 3...  The appointment started with the sonogram, an internal sonogram.  For those of you that haven’t had the pleasure, this is a sonogram done from the inside using a magic wand.  I look over at this magic wand and all I can think is that it looks like a very thin dildo.  Doc is in the room for this so of course we begin joking about the magic dildo.  It is larger than a tampon, smaller than a penis, I really don’t know how else to describe it.  It doesn’t really hurt unless they are poking at an already sore spot (such as my left ovary).  So, this lovely young lady comes in and violates me with a magic wand.  I’m given a minute to get dressed (and clean up) before a nurse comes and tells me to come with her… There is nothing more terrifying than a nurse that rushes you from one room to another and says NOTHING!!!  She has my sonogram in her hand and puts me in a regular exam room.  She then tells me to get undressed (again) and wait for the doctor.  Thank God Doc was with me, or I would have been in tears waiting for my doctor.  Instead of worrying and crying, Doc begins telling jokes about the number of pelvics I have had in the last month and trying to calculate the amount of money the doctor makes each time I visit.  We end up laughing about the fact that the equipment to look in ears has dust on it and that every medical problem can apparently be diagnosed with a pelvic.  This is just one of many reasons I love my husband.  He keeps me sane when my imagination could run away with me.  J

My doctor finally comes in and informs us he will not need to do an exam and I can get dressed. J I get dressed and my doctor comes back in to discuss my results.  Everything looked good on the sonogram.  He said small adhesions won’t show on it, but no structural issues were present that would keep us from getting pregnant. J A big sigh of relief!!  He then asks if we had decided we wanted to start the Clomid, because he remembers us being a bit cautious about it.  I explain that after we read more about it we had decided to start it.  And that was that, he gave me a ton of information, a new schedule to live my life by and told me I needed my first dose today.  And that was it!

Our new schedule is a bit rigorous.  I take meds from day 3 until day 7 of my cycle.  We are supposed to have sex from day 11 until day 18 every other day or more (the doctor’s note even says we should try to have fun J).  I am now required to lay on my back for an hour after sex!!!  I'm not sure there is enough Angry Birds for that much time laying around.  I may need to buy a book or two.  On day 21, I come back for blood work to make sure I ovulated and all that jazz.  Then on day 28, I come back for another pelvic, because all of the world’s problems can be solved with a pelvic!  Actually, it is too make sure my ovaries didn’t become overactive and enlarged, which is a real side-effect of the med.  Then we start the dance all over again!  Here is hoping we have good news in the future! J

December 5, 2011 – Routine Maintenance

I have found myself in a waiting period, yet again!  This time I am waiting for my cycle to start so that I can have my sonograms and begin Clomid.  I swear the lesson that is being taught through this is “patience”, but wow do I suck at waiting! 

Doc and I have been asking around to see who has tried Clomid and what kind of side effects we can expect.  Doc found a physician he works with that had taken it to have her first child; she said it made her a “raging bitch”…. That should be interesting!  I’m surprised that they can’t make a fertility drug that has the side effects of super horny and super happy… wouldn’t that be more productive than a fertility drug that makes you super cranky?  Pretty sure that bad moods are not conducive to frequent intimacies. 

While Doc was asking around about Clomid he did get to hear a few stories about people trying.  Apparently we are not the only people with days on the calendar that mark when we should have sex, and we are not the only people who groan on those days.  When we first started trying to have a baby it was exciting and new.  A few months in it became like a second job… six months in and we are figuring out the fastest way to get done so that we can get back to our lives.  This is the sad truth of really trying to get pregnant.  Sadly, the exciting, magnificent, and mind-blowing sex that is present at the beginning of the journey is hard to maintain for the duration.  I mean, if you had your favorite desert every other day for 6 months, would it still be your favorite? 

Life is busy and it is hard to find the time to woo, but it is necessary to maintain our relationship while we are trying.  If we neglect our relationship during this process we will regret it later, when we have children and are supposed to be working as a team again.  We’ve been scheduling regular dates, which seem to help.  Decreasing the amount of time on the computer and smart phones seems to be helping the connection too.  It takes effort to maintain our relationship during this, but it is worth it.  J

November 30, 2011 – The Awesome Doctor

It turns out that my sonogram appointment for tomorrow was lost by the office staff at my doc’s office.  Of course I was upset, because anything that delays us is upsetting, but in the end it worked out.  I called to ask a question about the appointment only to find out they no longer had record of it.  The woman I talked to was rude, and very unhelpful.  Eventually she said she would have someone call me back… 24 hours passed and no one had called me.  I called back and spoke to the office manager regarding everything.  She took care of it very quickly.  I explained that it was concerning that an appointment just disappeared, and she seemed to agree that the whole situation was unacceptable.  I received a call back from the sonogram tech and my question was answered: “yes, it is okay to combine my appointments.”  I was pleased and it was done.

Last night around 9:30 my doctor called, just to check in and make sure my question was answered.  I appreciate that he would do that.  I know he keeps a packed schedule, and taking the time to call me just to make sure my silly little question was answered was very nice.  While I had him on the phone I asked him about those at home ovulation tests and my frustration that my LH surge seemed to be hit or miss on them.   He laughed and said, “those tests seem to cause women the most frustration and drive women crazy.”  YES!!!  They do!  That is why I took the whole month of October away from them!  So ladies, here is what my doctor said.  Have sex every other day if possible during your fertile period.  Don’t worry about those tests.  If you are concerned that you are not getting a “nice ovulation” then ask your doc to run a progesterone check on day 21 of your cycle.  You will only produce progesterone if you ovulated.  He also said that the Clomid would help make sure I had “strong ovulations”.  So, I kind of love my doctor because he made me feel better and less stressed with a 5 minute phone call.  J We’ve got a plan to have me tested on day 21 of my December cycle, so I am not going to worry about those silly, expensive, and stress inducing home ovulation tests any more!

November 17, 2011 – And we are off!

We met with the specialist this evening.  Doc is working nights, so he was able to make the 4pm appointment before his shift.  I’m glad he was there; it was just nice to have the support.  The doctor has me scheduled for an ultrasound in early Dec to make sure there are not visible adhesions from the endometriosis.  If there are adhesions we will need to have surgery to remove them.  If there are no adhesions we will be having another ultrasound on the first day of my next period.  The second ultrasound will check the size of my ovaries.  If all is well, I will then begin a fertility drug called Clomid (Clomiphene).  Clomid will help increase ovulation, which will hopefully help us get pregnant.  The doctor warned us that taking this med will increase our chances of having twins or even triplets.  That is a terrifying thought!! 

The doctor also reminded us that because of the endometriosis we should be aware that we may need to consider IVF, and that it could cost as much as $15,000.  Another terrifying thought!  Overall, it was a quick but productive visit.  I still haven’t fully processed the emotional part of starting fertility treatments.  The doctor warned that the side effects of the med may be a little intense.  Of course today I feel like I can handle anything, but I may feel differently after I start the med.  

Thankfully, Doc was able to attend today and will be able to attend the next ultrasound.  It has just worked out that way.  He may not be able to attend the second ultrasound, just because we won’t be able to plan it, but it is nice that he can at least come to some of the appointments.  The hand-holding is such an important part of feeling ready to deal with this.  Just knowing that we both heard the same information and we are on the same page is nice.  The process just feels a lot less lonely when he is there.  J

November 7, 2011 – Girl Time

As you all know, my goal for last month was to relax.  As a part of that effort I made a date for a girl’s weekend with one of my girlfriends.  The unusual part of my girl’s weekend?  My girlfriend happens to be a gifted psychiatrist.  Now, when you have a psychiatrist and a psychologist in the same place for a weekend, what do you think happens?  Basically, it is a big cathartic time for all.  Our profession demands that we listen to others… all day, and do our best to not reveal pieces of ourselves so that we don’t interfere with their process.  We are trained at keeping ourselves hidden and helping clients find their own personal truths.  Our focus is always on others.  So, when we get together it is a filter-free, all cards on the table time.  We can freely talk about our shortcomings as human beings, and our struggles to find our place in this world.  And although it can leave you a bit raw, especially when it is crammed into a quick trip, it can also leave you feeling stronger, more capable, and ready to take on the next challenge life has for you. 

That is how I feel today.  Ready to go!  My friend pointed out that although I left my career behind, I hadn’t left the care-taking role behind and that I was in a way still hiding myself in it.  That I needed to take the time to take care of myself and really process the things happening in my life.  She confirmed that these are not small things, to face infertility and the numerous life changes we are going through.  Suddenly, I’m not afraid to make my appointment with the specialist.  I’m ready to face the next challenge and ready to see what happens next.  The wonder and joy of life (my own) coming back to me.  How is that for girl time?  J

November 2, 2011 – Pointe shoes off!

I think taking a little break from worrying about baby (or lack there of) has been a wonderfully reparative thing.  Not that we stopped trying, it was just nice to have a few decisions made and to let Doc take the lead.  I will be making my appointment with the specialist after a “girls weekend” I have planned this week.  Doc and the puppies will just have to fend for themselves! J

One of the ways I know that taking a break was the right thing to do is just that I don’t feel so emotionally spent.  I was recently asked about infertility during a dinner and I didn’t get mad or cry.  I was able to have a frank and open discussion without all the emotional burdens that had been coming up around the topic.  I didn’t feel attacked or belittled by the conversation, it was just a chat.  It of course helped that the individual was very kind and well mannered, but I also didn’t feel like I expected people to walk on eggshells in order to avoid hurting my feelings.  I even laughed. 

Its interview season in the world of residency programs and that means discussing health care packages and of course children once again.  This is going to be a part of my life.  Doc loves being a part of the educational process, so I should get used to these things.  The break helped a lot.  It also helped that I am done rationalizing and blaming and well into the acceptance that this isn’t going to be an easy process.  I have very little control over the situation, so I need to be ready to ride whatever road comes along.  You know what they say, “if you want to make God laugh, tell him your plans.”  He knows my plans… time I figure out his. 

I really couldn’t do any of this without my friends and family.  I can’t tell you how much it means that several of my girlfriends have offered to come and help if Doc has to miss my surgery.  I’m trying to schedule things so that Doc can be there, but it is so nice to know I am not alone.  Sometimes it is the emotional handholding that means the most!  So, thank you all for being so awesome! J I love you!

October 25, 2011 - Give me a break

I think it is time to give myself a little break from worrying about infertility. I decided that this month I need to let go of some of the constant worry and reminders.  Doc and I discussed it and he is going to take over some of it.  For this month he’s going to be counting days and I’m just going to follow his lead.  I’m not going to be taking any ovulation or fertility tests.  I’m just going to try and enjoy my favorite month of the year.  I need to break. 

As for our other looming decisions, we’ve discussed those as well.  We’ve decided that I will see the specialist next month, by myself.  Doc will be working his inpatient month in November, which means I will only see him when he needs to sleep or be home so he doesn’t have a duty-hour violation.  By getting all the pre-work done by myself I am hoping that we can push the surgery back to a month when Doc is more available.  I think the hospital will give him time off for the surgery if it isn’t during an inpatient month.  They can’t afford to be short a doctor during those months.  The hospital is short a few doctors right now and until those positions are filled all of the current doctors need to be working steady.  While I hate putting things off, I hate the idea of doing it completely on my own more.  I can’t ask the hospital to sacrifice a doctor when I can so easily move the dates I need my husband. 

So, we are continuing on this path until we hear otherwise.  This month started out rough, but now that I’ve decided to give myself a little break things are looking a lot better.  I realize that not everything is in my control and I am doing everything I can to improve our odds.  The rest is in someone else’s hands.  J

October 18, 2011 – Doctor, Doctor

It has been a rough couple of weeks.  Last week we had another failed pregnancy.  I became very ill last Monday.  I tied to ignore it and tried to go on with my daily life, but by the time Doc got home I had been unable to eat anything and was not keeping things down.  The nausea continued for two days, along with shaking, sweating, and just general ickiness.  There was no fever, so I knew it wasn’t a virus.  I already had my doctor appointment scheduled for Monday, so I waited to talk to her then.  Even though in the moment it felt very urgent, I knew there was nothing that could be done to stop it. 

Yesterday I saw my doctor.  I love my doctor.  I explained everything that happened and she ordered some additional tests.  I’ve been having a pain in my left side since Monday.  It hasn’t been bad, but I know better than to ignore pain.  For once the news that we were not pregnant was good news.  If I had still had elevated levels of HcG it would have pointed towards an ectopic pregnancy, which would have made yesterday suck a lot more than it did.  Unfortunately, it did lead to a doctor’s order to see a specialist, “sooner rather than later.” 

For those of you that don’t know about endometriosis; it is a disorder where the lining of the uterus grows in places where it should not.  When it grows in these incorrect places (like the abdomen) it is still functioning, so when the rest of the lining is shed, this incorrectly placed lining attempts to shed.  Only when it sheds into the abdominal cavity it causes internal bleeding.  Pain is just one fun side effect.  The real trouble begins when the body attempts to stop this internal bleeding.  As a part of the “healing” process it creates scar tissue in places where it should not be and can cause problems when it attaches normally free floating organs to one another.  I once had a doctor describe it as trying to pull apart tissue paper that has been glued together.  Not a nice picture when you consider this is my abdomen.  It causes the individual pain when they move.  The solution for this problem?  Surgery!  L

One of the side effects of all this healthy living I have been doing (increasing my iron, adjusting my hormones) is that the lining has been shedding more.  Simply put, there has been a lot more internal bleeding going on.  So a new pain, which has developed in only a few months, is not a good sign.  The internal bleeding is one of the many reasons that patients with endometriosis have trouble conceiving.  When the uterus attempts to grow, existing scar tissue prevents expansion, which isn’t good for baby. 

So, I have orders to see the specialist.  I know we will need to schedule surgery, but one of the problems is finding a good time to do that.  Doc doesn’t exactly get a lot of days off and he needs me to take care of things around here, like walking our crazy dogs and grocery shopping.  I had a similar surgery done when I was 20 and while the surgery itself isn’t bad, the recovery days sucked. Doc is scheduled to be in his inpatient rotation next month, which means he is working pretty much non-stop for that month.  He won’t be able to hold my hand for the surgery, much less take care of me afterwards.  Not to mention my extreme dislike of surgery.  Irony of all ironies; I am actually afraid of doctors.  J  I will figure it out; I am just finding all kinds of reasons to avoid thinking about it today. 

Almost every thing else looked good during my visit.  I’ve got low blood pressure, which considering my family history of heart problems and high blood pressure is good news.  Almost all of my blood levels were within the range of health.  The only problem with my blood work was that my iron is still low!!  I have made so much effort on this one variable!  I eat red meat, I eat leaf greens, I eat beans, and I take prenatal vitamins plus an additional supplement of iron!  Now I find out I have to double the supplements I take!  I don’t understand how I can still be low!  For those who have never take iron supplements before, they suck.  They cause all kinds of trouble.  I love the way my doctor gave the order though, “if you can tolerate it, double your supplement.”  Sadly, we all know I will tolerate it.  I went through a month of stomach aches when I started it all in the pursuit of baby-making!  I’m not stopping now!

October 3, 2011 - Welcome to October!

Welcome to October, my favorite month of the year!  Of course right now we just know it as month 4 of trying to get pregnant.  I have to say that even though our doctor told us we were going to have trouble getting pregnant, and even though in 10 years of marriage we have only gotten pregnant once, there was a part of me that thought I would be pregnant by now.  Sadly, we are not.  I’m really disappointed and feeling pretty down today, so forgive me if this isn’t as hopeful as usual.  I wanted to be honest and share all sides this struggle, and some days just suck more than others.  The dark secret of the moment is that I cry at the mere mention of family, or sight of a big baby bump, and at pampers commercials.  Yep, the thought of dirty diapers makes me cry, and not in the way you might think!  I realize what we are missing out on, which makes me sad.  L

Doc and I have had a lot of thinking to do about how we will continue this journey.  We are very fortunate that Doc’s job provides us with excellent insurance, which doesn’t require a waiting period for pregnancy.  We are also blessed with access to some of the best healthcare available.  See, Doc is a resident at one hospital, but that hospital is part of a large organization of hospitals, clinics, and private practices.  Fortunately, any physician in that network is considered “in network” for our insurance, so we can pretty much see any physician in our area and if we incur expenses at the hospital, the program will cover a portion of the bill.  It’s like being part of the mob, if the mob were a huge group of fantastic doctors whose goal it was to make the world a better place by providing top-notch healthcare.  The downside (doesn’t there always have to be a downside?) is that fertility treatments are not covered at all by our insurance and while the hospital can write off things like supplies, the doctor performing the tasks still has to be paid.  So, while we have access to the best healthcare, it doesn’t matter because we can’t afford the treatments.  Which is today’s second suckfest, I know.  L

So, what have Doc and I talked about?  We have been trying to figure out how much money we should spend on trying to get pregnant and whether we should consider adoption instead.  Med-school was very expensive, and more than a fourth of our income will go towards student loan payments for the next 10 years (at least), and residents don’t make that much money (McDonald’s money) and despite common opinion, doctors really don’t make as much as people might think (at least pediatricians don’t), so we have to consider the financial ramifications of our choices.  For the moment we have decided to continue on with trying to get pregnant, with a better understanding that we may have some tough choices ahead.  There are a lot of tests and procedures that have to happen before fertility treatments can begin, so we need to talk to our doctor about spreading those tests out so that we can make the process more affordable.  Hopefully this won’t add too much time to the process, because as we all know I’m old and the clock is ticking on my fertile years.

Keeping in touch with our doctors has become second nature now that we understand how much more smoothly things go when our doctors are informed.  We’ve signed releases so that the OB and GP can communicate, which also makes it possible for our GP to order and run tests that might cost more if done at the OB.  It helps that our GP was a resident in this network and she understands how to get things covered either by insurance or the hospital.  In a couple of weeks I have my next scheduled appointment and we will discuss options for spreading out testing.  I will also check to see if she has any helpful money saving tips or if she knows which tests will get us the most info for the money.  We need to be proactive in our situation, which means we need to be doing our own research and we need to walk into appointments informed.  Hopefully our doctor appointment goes smoothly and she has some good ideas for improving our odds.  I’ll let you all know what we figure out! J

September 27, 2011 - Timing is Everything

When Doc & I first met we were young and pretty much your typical college students.  We functioned on minimal sleep, ate way too much junk food, and regularly closed bars that had live bands.  To top it all off, we couldn’t keep our hands off of each other.  It didn’t seem to matter that we had less than 3 hours of sleep.  Sometimes we even skipped sleep so that we could have of some quality time together. 

Fast forward 13 years and you have a different story.  Not that we have less love for each other (I’d argue the opposite) and it isn’t that we don’t enjoy each others company (he’s still my best friend & I’m his).  It is just that now we have a ton of responsibilities and pesky lives to live.  We don’t close any bars (or go to them at all), we don’t go to live shows, junk food gives us tummy aches, and we don’t skip sleep unless we absolutely have to.  When we do skip sleep we are supper cranky and really not functioning well.  So, imagine how difficult it is to conceive with only a 24 hour window of opportunity.  It wouldn’t be that hard if we actually had a full 24 hours, but the reality is that we end up with a much smaller window.  Doc worked 16 hour shifts this weekend, so that knocked us down to 8 hours of actual time together.  By the time he came home, he was understandably exhausted, so he was pretty much in an eat/sleep mood.  Not exactly baby-making heaven, but we of coursed worked it out J

The thing I find myself becoming more and more frustrated with is Doc’s job.  Not that I’m complaining about my husband running off to save babies ever day.  What I get frustrated with is that we have absolutely no control over when he works.  We don’t get a say.  He works long, hard hours, getting paid the same as your average McDonald’s employee and our lives get put on hold in the process.  This is frustrating because we put our lives on hold to get here, so that he could go to med-school.  We moved because medicine demanded it.  I lost my career in that move.  We will most likely be facing another move in 2.5 years again because medicine will again demand it.  It just leaves me wondering “when will this be our life again?”  I refuse to put off starting our family any longer, so medicine can kind of suck on that.  And it isn’t that the hospital is asking us to, it is just the reality of his job that makes it difficult.  When you only have 24 hours to try and make a baby, timing is everything. 

September 23, 2001 – The Sweet Week

Each month is packed full of stuff to remind me that we are struggling with fertility.  All of the monitoring, testing, & trying (J) serves as a daily reminder.  But for one week each month there is relief.  For that one week I can be hopeful and anxious and wonder if we have finally managed to start our family. 

Of course, so far, that one week has had a very sad ending.  It has been followed by a day that is personally devastating and full of self-doubt.  And on the worst months, I wonder if we aren’t being punished for some great error and that is why we are having trouble conceiving.  If we are somehow living our lives incorrectly and the punishment is the withholding of this one pleasure. 

Then the realist in me kicks back in, and I know that this isn’t punishment, it is biology.  I was diagnosed with endometriosis when I was 20 years old and it was going to make getting pregnant very difficult.  I also believe that we all have lessons to learn and things to accomplish and things happen exactly as God intends.  So, while I am ready today, God has additional plans for us.  We will get pregnant in his time, and he has a purpose for this struggle. 

September 20, 2001 – If only this were an Olympic sport!

I feel like I am in training.  It started around April with prenatal vitamins and baby books.  Of course, if you are taking prenatal vitamins you should also take DHA, so 2 pills already.  All of this was, of course, doctor recommended for a woman of my age (apparently the Friends stars lied, 33 is old in reproductive years) to start vitamins before we started trying.  Done. 

Then came blood work… lots of blood work.  After that we added a thyroid med and additional iron.  I’m the only person I know taking 400% the daily recommended amount of iron just to have a “normal” blood level.  Yes I eat red meat (now) & love leafy greens; I just have abnormally low iron.  Anyone who has ever taken prenatal vitamins or additional iron can tell you they tear your stomach up!  I spent 2 full months with daily stomach aches.  Awesome, but if it helps with the baby-making I’m all over it.  Of course the increase in iron meant we needed to increase fiber too.  Oh joy! 

I also gradually increased my daily activities.  While I loved being a therapist, it didn’t encourage a lot of activity.  I sat in a chair or on the floor working with kids all day.  While we had excellent facilities to engage the children in more active play (basketball court & track), it turns out depressed kids just aren’t that into physical activity.  Now that I’m home I can take the dogs running, go for long walks, clean, and do all of the other things I was neglecting before. 

All of these are good things to do, especially when trying to conceive.  And so we happily tried.  It was very casual at first, a bit romantic even.  The thrill of doing something new.  Then a month went by… no baby.  We decided to get a little more serious with our efforts & plotted everything on the calendar.  I had a good idea of when our trying would be most successful, then we took an every other day approach.  Most people don’t realize that an ovum is only viable for between 24-32 hours, but sperm can remain in the uterus for up to 5 days.  So, trying every other day was a pretty safe bet… no baby. 

I realize the doctor told me this wouldn’t be easy, but I’m hopeful by nature, so my hopes were being crushed monthly.  As time passed, we continued to get more and more serious about our efforts.  We are currently up to daily efforts along with lots and lots of tests.  Home pregnancy tests, followed by fertility tests, rounded out with daily ovulation tests. All this so that we can one day see 2 pink lines!  

Over the last 6 months I’ve made numerous and sweeping changes in my life, all to improve our chances at successfully creating life.  It is hard to be the woman in this equation.  I’ve changed everything from the pills I take daily (I’ve given up any OTC med that my doctor hasn’t ordered me to take), the amount of sleep I have, my overall stress level, the amount of exercise I get, the water I drink, and the food I eat.  Doc has had to increase his water consumption and in the process of conception his orgasms are far more important than mine.  So, when it comes to the fertility Olympics, it kind of sucks to be a girl.  J

The Dreaded Question

The journey to residency was full of major changes for us.  It started in the last year of medical school.  During the fourth year of medical-school hopeful young doctors all over the country (and in a few others) go through the dreaded process of Match.  Match sucks.  It is essentially speed dating for doctors in which they hope to be matched with the perfect residency program.  Each doctor interviews at several residency programs, they rank each other, and if the residency wants the doctor & the doctor ranks the residency highest, then a match is made.  Match is announced in March and residency starts by July. 

For us this process was the bane of my existence last year.  Doc had a ton of interview offers.  We decided to cap the speed dating at 12 interviews.  The interviews include an informal dinner followed by a full day of interviews at the hospital.  The most shocking thing we discovered about the process of becoming a pediatrician is that your life is no longer your own, and it is no longer private.  Doctors have no filter, so when sitting at a table full of them I’ve come to expect what are normally deemed inappropriate questions to become common place. 

The most popular question is of course about how many kids we have.  Not “do you have any children?” but “how many children do you have?”  There is nothing more embarrassing than sitting at a table full of the worlds most fertile people (serious we know a pediatrician with 8 kids) and saying that we don’t have any children.  You can see the assumptions go around the table: “must be something wrong with the marriage” or “she must be frigid”.  The question is always followed by my husband or me trying to delicately explain, without going into detail, that we would love to have children but haven’t yet been successful. 

Eventually we used this question to inquire about healthcare and child care options provided by the program.  We would simply respond with, “we are looking forward to starting our family very soon.”  Most of the time this response satisfied people’s curiosity.  There is always the exceptional individual that doesn’t catch on though.  We actually had a doctor inform us that “no one trusts a pediatrician that doesn’t have kids. You need to have them so you can have street cred.”  WOW!  How does one respond to this?  I mean everyone is a child at least once in their lives, so that is some experience.  Childhood is a pretty well documented stage of life; med-school should have illuminated a good deal of process.  Not to mention the moral ambiguity present in having children simply so people will trust you!  Then I started thinking about gynecologists.  No one questions a male gynecologist, but he lacks the body parts and the personal experience of his expertise.  So, a pediatrician that doesn’t have children right out of med-school seems a lot less awkward when compared to a gynecologist that has NEVER had a uterus even after 30 years of practice, right? 

Needless to say, we didn’t rank that program very highly at all!

July 27, 2011 - The Epic Battle

My blood work came back and we now have the doctor’s approval to try and have a baby, which is good because we have already started trying.  I’ve been taking prenatal vitamins for more than a month and they started me on additional iron… basically my stomach hurts all the time now.

Something my doctor said in my visit keeps rolling around in my head.  Although the physical exam went well he told me that endometriosis can cause my body to produce an extra defense against sperm.  Basically, my uterus has extra sperm-killers.  All I can think of is the Family Guy episode where Stewie shrinks himself so that he can stop his parents from having another baby.  He is flying around in a little spaceship shooting lasers at sperm.  The thought of an epic battle occurring in my uterus is kind of funny to me.  Now we just have to figure out how to defeat Stewie!

July 26, 2011 - The New Doctor

Today we had our first appointment with the new OB/GYN.  It was the first time I’d seen a male OB/GYN in more than 13 years.  Before the move I had an amazing female doctor.  Seeing a male is just a different experience.  He was very busy, and the appointment felt rushed.  I didn’t get to know him as much as I would have liked. 

We reviewed my medical history (a brief version) and he ordered a titer for Rubella to make sure I have been vaccinated.  If I haven’t been vaccinated then it will be an additional 3 months before we can start trying again.  He also made sure I was aware of how difficult it was going to be to get pregnant because I was diagnosed with endometriosis when I was 20.  He created a plan, we would try for 6 months (until November) and then if we hadn’t conceived by then we would do a fertility work up.  It may require me to undergo another surgery.  I will do whatever it takes to get pregnant.  The hard part is thinking about the reality that none of it really means we will conceive, it just means we aren’t giving up. 

Being married to a physician has some benefits, but it also has some downfalls.  For example, Doc didn’t get to meet the new doctor today.  He had to round in the nursery, so he wasn’t there to help me explain everything in doctor terms.  Hopefully they will meet soon though.  It is always better to have Doc in the room; doctors listen to each other far better than they listen to patients. 

Overall, it was slightly depressing.  I was hopeful that we were already pregnant, so hearing that we aren’t kind of sucked.  We will march on though.  Next month may be our lucky month.