Words and Poppycock - August 8, 2013

As we have struggled with infertility I have noticed that people are really not very careful about what they say to couples struggling with infertility.  Words convey beliefs and attitudes that if the individual really stopped to examine, would probably not be what they chose to express to someone suffering such a terrible, personal, and constant loss.  I think I have mentioned before one of my favorites, “Children are such a blessing” which implies that the inability to have children is a curse (which implies the infertile couple is deserving of this horrendous punishment).  It seems to me that God allows all kinds of inappropriate parents into the world.  I know this because I used to spend my time helping to restore the mental health of the children they damaged.  God lets murders, child molesters, kidnappers, the unfaithful, the unsupportive, the abusive and all sorts of other monsters reproduce… But yeah, I am sure I have done something much worse and I deserve this curse.  I am glad you think so highly of me!

There are also those people that attempt to be ‘helpful’ with advice.  Things like, “we had a really hard time getting pregnant too.  It took us 2-6 months and here is what worked for us…” I just want to respond with over the top sympathy, “you poor dear!  2-6 whole months!?  You must have gone out of your mind trying to figure out what you did to deserve that horrible curse!”  Because as we roll into our 3^rd year of trying I don’t really have anything that I want to say about your horrible 2-6 months of trying with no drugs or medical interventions as you hold your perfect child.  If you haven’t really struggled with infertility say nothing or stick to a simple “I’m sorry you are struggling with that”.  I understand the desire to connect, but really your ‘help’ is like trying to tell an amputee how you understand their pain because you stubbed your toe once and it really hurt. Try giving them a hug, pat on the shoulder/back, or hold their hand.  And if you are not close enough to make these intimate gestures then why on Earth are you asking about their reproductive cycles?!

I can handle most of these situations when they come up and usually find a way to laugh about them, because humor can see me through just about anything.  The absolute worst though, comes from those people I have let in to share our struggle.  Those people that I thought understood the pain we have suffered and had been there with us.  When they speak up and reveal they too thought all along we must be doing something wrong (morally, physically, behaviorally) that we are not able to get pregnant or that maybe we just don’t want it badly enough, that is when my heart really takes a beating and I have a hard time finding my sense of humor.  I have had this happen to me a few times recently.  Several people have flat out asked if I really want to have children.  It feels like a slap in the face when I get asked that.  Apparently I haven’t grieved enough publicly.  Should I wear black every day until I get pregnant?  Should I weep openly every day and shame myself so that everyone can see the pain etched across my soul?  What exactly does wanting a child enough look like?  Once again I think about all the people in the world who didn't really want to get pregnant or have children, and yet they did.  These comments are really just another take on the “blessings” issue.  It implies that God knows my intentions are not strong enough and that is why children are being withheld from my life.  How exactly should I respond to questions like this?  So far I have managed to not burst into open tears at the utter sense of betrayal, but it gets more difficult each time I am asked.  Each time there is a dig about why I am not a mother.  People who don’t know our struggle will say things like, “that is why you don’t have children” as if it was a choice we made because, although we both work with children, we really hate children.  We dedicated our knowledge and our lives to helping improve the world for children, but we hate children.  It is absolute poppycock!  Thoughtless and empty words… which happen to be so incredibly painful. 

Back to my main point; words have a great deal of power and meaning and they convey our beliefs and attitudes.  It is impossible for any person to fully understand another person’s internal processes and motivations.  Even as a therapist, or spouse, or lover, or best friend, or parent.  The only experience you can ever really know is your own.  The only life and character you are able to clearly judge is your own.  You can’t ever know (even if you ask) what is really in another person’s heart and soul.  You can’t ever hear how many silent prayers they sent up just to make it through the day.  You don’t know how many times they excuse themselves so they can cry in the bathroom only to return to the table with a smile and a joke.  You don’t know how often they stomach your thoughtless and hurtful comments without replying.  But you can choose to be more thoughtful about what you say to people.  You can choose to fill your voice with love instead of jealousy, rage, or judgment.  You can acknowledge that you have been lucky and that means others have been unlucky.  You are not blessed, they are not cursed.  There are things in my life that make me feel incredibly lucky or fortunate and there are things that I know I worked hard to have.  I have a truly wonderful and supportive marriage with a man who gets my brand of crazy 100% and still manages to love me.  I was lucky to find him, but we worked hard to make sure our marriage was what we wanted it to be.  Notice how these statements don't demean my friends/family who have suffered the heartbreak of divorce?  They were unlucky or unfortunate and their hard work was put into an unlucky situation.  They are not cursed for having married the wrong person any more than I am blessed to have found the right person, I was just lucky.  I was fortunate to be able to go to school, but I earned the 3 degrees by hard work.  I have been very fortune that I could afford treatment for infertility, but I have been very unlucky in the outcome.  I realize that people are uncomfortable with the idea that they were lucky rather than blessed, I think this is because they are hoping to give God credit for their good fortune.  But again I ask you to be thoughtful with your words and intentions.  If you intend to give God credit you really don’t need to say something is a blessing.  You could still say it was luck, you just add “Thank God”.  “Thank God I was lucky enough to meet such an amazing man.” That way you thank God for his contribution to your life without demeaning anyone else’s struggle.  I doubt that your intent when you say you are “blessed” is to imply others are “cursed” but that is exactly what you are doing because the opposite of blessed is cursed.  Please be thoughtful with your words and when you find yourself saying something thoughtlessly, you will be amazed how far an apology goes.  "I am so sorry, that was a thoughtless statement.  I meant to say..."

July 09, 2013 – Check Up

After I wrote my last entry I contracted strep throat from Doc (one of the joys of being married to a pediatrician).  Doc had been working in the ER and saw a lot of strep throat last month and he had been sick, so it really wasn’t a big surprise.  With pain meds on board and sleeping only on my back I hadn’t really noticed the sore throat.  What I did notice, on the evening of my last post, was that I had a rash all over my stomach.  When I showed Doc he knew instantly what it was; a rash caused by strep.  Thankfully my doctor was able to call in a prescription for me so that I could start antibiotics Sunday morning.  I love my doctor.  I am extremely grateful that she was able to do that for me because by Sunday morning I started really feeling sick and by Monday I was miserable even after starting the antibiotics.  I can’t imagine if I had waited until Monday to see my doctor, which is what I would have done because I wasn’t sure it was serious enough for an ER visit and Doc was leaving for summer camp, so I was home alone.  After that I had to see my OB/GYN again because he wanted to make sure it wasn’t an allergic reaction to something in the operating room (it wasn’t).  It took an extra week to heal from the strep infection and it really took it out of me.  I am on my final day of antibiotics and the rash is finally starting to go away.  My stomach is mostly clear, but my arms still have it.  Doc thinks I may have also picked up a virus to go with it because I still have some sore throat and congestion, but the fever has been gone for several days now and I can go for a walk without feeling like I am about to pass out.  J

We saw the OB/GYN today for our post op follow up.  The incisions are healing well.  He made fun of me for always being the patient with weird stuff happening and we all laughed.  He asked where we wanted to go from here and we told him we are just going to not worry about it for a bit.  I am continuing to take the prenatal vitamins and all the other vitamins they asked me to while we were trying.  We will continue to have unprotected sex, but we just aren’t going to stress about cycles and counting or ovulation tests for a while.  My doctor thought that was the perfect plan, so we were all in agreement.  This was the best decision for us right now and we are happy with it.  The last 2 years haven’t been easy, they have actually been pretty stressful, and Doc and I are ready for a break.  We realized that we are able to enjoy our time together a lot more without this constant worry hanging over our heads.  J

June 29, 2013 – Post-Op

I am now 5 days post-op and doing well.  The surgery went very well.  In fact the doctor was unable to find any endometriosis!  We had pictures from my last laparoscopy so my doctor could see where the endometriosis was and then he printed us new pictures to show us it is nowhere to be found now!  I haven’t had a chance to talk to my doctor about this little miracle.  I was under the impression that once they found it you would always have it.  This is excellent news in the land of infertility where endometriosis can cause big problems.  However, this leaves us all a bit more stumped as to why we are having so much trouble getting pregnant!  I didn't get a chance to talk to my doctor post-op as he had to hurry back to see his clinic patients and I was very busy sleeping.  However, he did talk to Doc.  His basic assessment was that all things being equal we should be pregnant.  Doc’s sperm count and morphology are good.  I appear to be healthy.  We should be pregnant.  But we aren't.  So now what?

The doctor did say that stress (even the stress of trying to have a baby) can cause difficulty getting pregnant.  So once again I am being given the order to chill out.  He also pointed out that we aren’t exactly living the stress free life style with Doc in residency and all the scary things that have happened during our efforts to start a family.  Despite what the general population thinks doctors work long, hard hours, and they are not rewarded with a magic pot of gold for doing so.  I stay home because we live on a very tight budget not because we are rolling in dough.  So, the doctor ordered us to take a vacation, have some fun, and not worry about the baby making thing for a bit.  This sounds good in theory, but we haven’t had a real vacation in years.  Doc doesn’t exactly have loads of free time and we don’t have tons (or any) disposable income.  So, it will have to wait.  And honestly, Doc and I are enjoying the non-scheduled time we have together.  Ritualized, forced sex just isn’t as intimate as we would like it to be and we believe that sex should be an enjoyable activity in a marriage.  So for the time being we are taking a break from worrying, counting, stressing, micro-managing our fertility desires.  For the time being we are just going to enjoy each other.  We are blessed to be married to our best friend.  We are blessed to get to spend the time we do together and really enjoy each other’s company.  So, for the time being that is what we will focus on.  Maybe in a couple of months we will take it more seriously again, but for now we are good with a break. 

We are currently managing to get our regular baby fix by being an Auntie and Uncle to my dear friend’s baby girl.  She brings so much joy into our lives and we are so thankful to get to spend so much time with her.  She is at that age where she can express that she is excited to see us (although not in words) and we just love singing and playing with her.  She reminds us that our lives with always include children, because it is just a part of who we are. 

In other words, once again I find myself counting our blessings, which doesn’t leave me much time to mope about what we don’t have.  Do we still want children?  Absolutely!  But this is the life we have and we can choose to enjoy it for what it is or be miserable because of what it isn’t.  I choose to be happy for all the amazing blessings in our life and to let go of the things that are out of my control.  Life is short and God only gives us the one to live.  We should always focus on being grateful for the things we do have, instead of being sour about the things we don’t.  It takes the same amount of energy but has vastly different results.  J

June 23, 2013 – Pre-Op

I go in for my exploratory laparoscopy tomorrow.  I am surrounded by doctors who know that this procedure is so routine and easy that there is nothing to worry about.  But since I am going to be the one giving up my control and laying naked and unconscious on a table while a very talent and smart man roams around in my abdomen; I have decided it is okay to be nervous.  Because although I too know it is a routine and easy procedure, I also have the unfortunate knowledge that crazy and unexpected things can happen during routine procedures.  So, I am nervous and trying very hard to just not worry about it.  Distraction is a wonderful thing!  My sweet doctor noticed my nerves during our pre-op appointment while we were going over the ‘here are all the horrible things that could happen’ consent.  He stopped in the middle to say, “You know, if the hospital blows up we will both probably die.”  It made me laugh and remember that there are so many things out of my control that there really isn’t much sense in me worrying about the what-ifs.  I love my doctor. 

Thankfully Doc will be able to be there for the procedure.  Despite the hospital’s best attempts to get him to work instead; he has informed them that he will not be working and will be staying with me.  We scheduled the surgery for one of Doc’s rare days off.  He had Monday and Tuesday off for this week and we decided that Monday would be best so he could spend an extra day with me post-op (we don’t know what news we will have to think over and discuss).  My doctor scheduled me on his non-surgical day to accommodate Doc’s schedule, which means he is literally running over from his office during his lunch hour to perform surgery for me.  Then last week Doc gets an email informing him the schedule for intern orientation (welcoming the new docs to residency) has been moved from Wednesday to Monday.  Well, this year’s intern class will just have to wait to be greeted by this year’s chief resident, because I called dib’s and I was here first!  I did let Doc know I was okay with him going to work before or after the surgery if he really needed to, but he just told them he needed to be home.  I am really glad he will be home with me, because I always feel better when he is around! 

I have spent this weekend preparing to be unavailable this week; cleaning and cooking and making sure all the bills are paid.  The nurse said post-op I will not be allowed to pick up anything over 10 pounds for a least a few days, possibly longer depending on what they find.  That means I had to give up my 2 days watching my dear friend’s baby this week L.  The baby that was born in February has become my sweet companion a couple of times a week while her parents work.  She is a joy to have, even on her worst days, and always brings a smile to my face.  So having to give up those days is a very sad thing for me.  But I am sure I will still see her this week as her mother and I rarely go very long without spending some time together.  We will be back to our regular schedule after this week.  J I am still not quite sure what I will do with myself having a few days “off” with orders to be chill and recover.  For a “stay at home” spouse I am rarely home and my schedule is rarely empty, so I may go a little nuts with even a few days of nothing.  

June 3rd, 2013 - New Horizons

Doc and I have had a lot to think about and a lot of decisions to make.  We took some time to make sure that we gave the decisions the time and energy that they deserve.  We still haven’t come up with all the answers.  It is amazing how much energy trying has taken and how much better we both feel being away from that cycle.  That being said, we still know we would like to have a family. 

The first decision we made was that we will not be going back to the fertility clinic we had been using.  We both hate them.  The doctor had no bedside manner, something I find to be incredibly important in a doctor.  Basically he was a douche bag.  He never examined me, never attended any procedures to make sure things were done properly and didn’t order any follow up blood work or examinations to ensure the meds were working without doing harm.  I am not even sure he ever really read my chart.  He was not a good doctor, I don’t care how close to the top of his class he graduated he sucked.  By the way we know a lot of doctors who were top of their class; they all suffer from the same lack of social skills/douche baggery.  Then there were the nurses.  I am pretty sure that I could charge at least one of them with rape.  Not something I would joke about.  She was a rapist nurse.  She did awesome things like removed a speculum without collapsing it, and of course it was the biggest speculum she could find!  She also repeatedly injured my cervix which caused some serious pain and spotting that would last a day or more.  When the procedure is done well on me there is no spotting and no pain.  I have a perfectly centered cervix that is soft and malleable.  People could teach on my cervix and yet every time I had her it was torture.   Regardless, they won’t be making any more money off of us and I won’t have to be tortured by them anymore.  Yay!!!  And no, I wouldn’t recommend them. 

As excited as I was about this decision it did leave us with another dilemma; where will we go if we don’t go there?  The answer wasn’t as simple.  My OB/GYN was stumped on this one too.  The best doctor he knew for infertility had retired and it has left us with a hole that the above jerks have happily filled.  So, I hit the web looking for the best clinics in the country.  Then within a 24 hour period I had 2 different friends, who have never met, recommend a clinic in Colorado to me.  The recommendation came attached to success stories for doctors at our hospital that had used them!  So of course I checked them out.  They have the highest success rates in the country!  You can check out success rates at http://www.sart.org/find_frm.html  all fertility clinics are required to submit them.  Their success rate is nearly double that of the clinic we had been to.  The only problem is the price tag for treatment is nearly double what we were paying and requires us to be able to travel to them a few days a month.  Obviously, we can’t afford that and Doc has almost no say in his schedule to plan for last minute trips.  So, we will have to put that idea on hold.  Regardless, we will not be going back to the clinic here.  They were awful! 

In the meantime we decided to go ahead with an exploratory laparoscopy.  Basically, we are going to let my OB/GYN go roaming around my lower abdomen to see if everything looks healthy.  I had one when I was 20 and had some endometriosis burned off, but apparently times have changed.  My doctor will remove any endometriosis that he finds rather than burn it.  I am hopeful that the surgery might give us some answers, but I am also terrified that I won’t like those answers.  I am having the procedure done at the end of the month.  My doctor scheduled me over his noon hour which was very sweet of him.  He fit me in on his non surgery day so that Doc could be there.  He really understands our position.  I really appreciate him doing so much for us.  When I called to talk over our options with him he was very understanding of why we didn’t like the fertility clinic we were going to.  He also said he would be willing to manage our care should we decide to use a clinic that was out of state.  I love my doctors here.  My dream is that together we all figure out what is going on and Doc and I are able to get pregnant without further intervention.  Maybe the surgery will give us that, maybe it will steer us in a new direction, maybe it will just leave us all scratching our heads even more.  The truth is the only way to know for sure is to go through with it.  So, I scheduled my dreaded surgery on one of Doc’s rare days off.  Wish us luck!

April 20, 2013 – Dollars and Sense

I know it has been a while since I last updated everyone and I am sorry for that.  Doc and I have had a lot to think about, talk about, and process.  We completed our 4^th cycle and were unsuccessful again.  We met with the fertility doctor and he laid out our options for us.  He explained that the 5^th and 6^th IUI cycles are generally used to collect data to make for more successful IVF.  They don’t expect us to be successful during our 5^th or 6^th IUI.  They really just hope to stimulate my ovaries enough to produce eggs for cryo-storage. 

He laid out the options very clearly.  For the 5^th cycle they double my Femara, which we agreed to, and try another IUI.  Should that fail they suggest I have another endometriosis surgery to remove any adhesions, because according to him even one small speck of tissue in the wrong place can create an environment unsuitable for egg fertilization.  I’m not sure why he didn’t mention that before I did 4 sessions of IUI and spent thousands of dollars, but it is what it is.  For the 6^th session of IUI they want me to take injectable hormones.  Apparently they have maxed out my body’s ability to produce the hormones and they are just going to shoot me up with hormones to replace them.  The shots cost around a $1,000.  They also require much more intense monitoring which can cost up to $2,000 more.  That is $3,000 on top of the cost of the surgery to try another month of IUI.  Obviously we can’t afford that. 

He really kept pointing us to the fact that we are most likely going to need to do IVF if we wish to have a family.  A single round of IVF is around $12,500 here.  If we can’t afford the 6^th round of IUI we obviously can’t afford the IVF.  In short, we are done.  We cannot afford to continue on this journey.  It may be that in a few years we will be able to consider it, but for now it is an absolute no.  The doctor did say that he thought we would be able to consider IVF if we do it before I turn 37.  After that he said the quality of my eggs would be much too poor to produce viable candidates for implantation.  So we have 2 years to save the money.  That doesn’t feel like a very long time to save that much money, but we will give it our best shot. 

Obviously this has been a hard time for us.  Doc is encouraged that we have 2 years, I feel beaten down from the efforts of the last 2 years.  However, we won’t let it take away the everyday joys we feel in our lives.  We have a lot of wonderful things to be thankful for and we won’t waste our time being depressed about something we cannot change.  So, here is to the next 2 years.  We are looking forward to what is in store for us, even if it isn’t exactly what we wanted. 

**Before my inbox gets flooded by well-meaning but still insulting comments about adoption and all the unloved and unwanted children we could be taking care of, let me just address this point here.  Adoption isn’t free.  Even if you find someone who wants to give you a baby you still have to pay the state and court fees.   You still have to pay for contracts to be drawn up and to make sure your adoption is legal.  The cheap side of adoption is about $34,000.  We personally know someone who had 4 adoptions fall through before they were able to get a child.  They paid all the fees 4 times ($136,000) before they had a child in their arms and even then they had to fear the child would be taken away for almost 2 years before the process was completed.  It isn’t cheap and it isn’t easy and we simply aren’t there yet.  We are open to adopting children when our finances permit it, however we would first like the opportunity to have children if possible.  It is a personal and painful decision and I ask that you respect that this is our decision to make. 

March 11, 2013 – Let it Be

I am sorry for the long delay between posts.  The reality is we are stuck in the IUI loop and nothing really new has happened for me to talk about.  It is also March, which in our world means Match and with Doc being chief next year we actually have a lot to do to welcome the new doctors to our program.  My dear friend who delivered the most gorgeous baby girl in February has also been so generous to me and allowed me to be very involved in their lives.  God bless her for that.  I am thankful for all of these things because they keep me too busy to wallow.  Besides, it is impossible for me to feel sorry for myself when I am holding a beautiful baby and she is snuggling into me.  J

As we move further along in the IUI loop Doc and I have had to face the reality that children may not be a possibility for us.  After 4 sessions (April) we will meet back with our doctor to discuss what our next course of action should be.  He had told us that two thirds of all patients are pregnant by 4 sessions.  We are in the middle of 3, so we may very well be in that other third.  That is not an easy thought to grasp.  I don’t really know what the future holds for us starting a family.  So I have decided to just let it be.  I am taking the pause button off of my life.  I will complete the final cycle of IUI but I am not going to spend every day counting down the days and I am not going to spend every moment being careful.  Instead I am taking my life back, enjoying the beautiful and wonderful things all around me and just letting go of the worry.  I will write when something new happens, but it may be the end of April before we hear anything new. 

 

Until then, I will leave you all with the immortal words of John Lennon & Paul McCartney, “There will be an answer. Let it be.”

February 20, 2013 – Another No

We are not pregnant again this month.  I want off this unmerry-go-round.  I seriously am starting to feel like my life is set on repeat.  Take pills, manage side effects, feel old and exhausted, have sex, get IUI, have sex, sore breasts, nauseated, crazy dreams, negative test, period, broken heart, rinse and repeat.  There are 4 more months of this before we can move on.  I didn’t think I would make it through 6 months of Clomid, but I did.  So I am assuming I will get through this too.  Just keep swimming.  The count down to my 35^th birthday and my impending infertility is also on.  The odds are just not in our favor.  I should probably accept that, but I am just too stubborn. 

So, instead I am trying to focus on the positives.  Here is what I came up this morning when I was done crying because I got my period:

1. Femara induced a good ovulation.  More eggs = better chances
2. Femara kept me much closer to my regular cycle.

That was all I could come up with right now.  This morning I had 3, but I can’t remember the third.  I will keep working on it.  I still have many things to be grateful for, I am just feeling a bit sorry for myself today.  This self pity is not cool, so I will be making cupcakes for the residents, stopping by to see my dear friend and her cuter than cute little baby girl, signing up for volunteer hours at the hospital, and cleaning my fridge.  If I am still having a pity party after all of that then I guess I just need a little time to feel sorry for myself and I will try again tomorrow. 

February 12, 2013 – Miracles

I had the most amazing day today.  At about 9:30 this morning my dear friend called and let me know she had been having contractions since about 3:30.  They were irregular and tolerable, but while on the phone I could tell they were getting more intense.  This is the same dear friend who has held my hand through uncomfortable procedures and has been there for both Doc and I as we faced the last 2 years.  When I found out her husband had gone into work that day and would be in surgery for the morning I asked her if I could come sit with her.  What followed was simply the most healing and amazing day of my life. 

By the time I got to her house she already had a call in to the doctor.  We were just sitting down to watch a movie when the doctor called and asked if we could make it into the office to get her checked.  We were fine with that as it put us in the hospital where the baby would be born and where her husband was working.  From that moment on I spent the day holding my dear friend’s hand and comforting her through her contractions, waiting excitedly with her for this new arrival.  It turns out that those 22 days of contractions last spring taught me a lot about being a woman in labor.  It was all that knowledge that I used to help support and comfort my friend.  To be able to take something that was so difficult for me and turn it into something so amazing and positive was the ultimate healing action for me. 

My friend had become pregnant 4 months after Doc and I had which means we found out her good news when we were still lost in our deepest grief.  In the moment that she shared her news with me I vowed to try and keep the two events separate in my mind so that I could be as happy for her as she deserved and be as excited about her baby as a friend should be.  There were times when it was hard.  Times when it felt like my grief would overwhelm me, but I refused to pull back or give up.  I could tend to my needs in private.  My dear friend deserved to have her friends be excited with her and support her.  I wanted to do everything for her that I would have liked done for me had we been expecting our first baby.  And during the last 9 months our friendship has grown in ways that I didn’t know were possible.  I don’t even really have the right words to describe it. 

After a day of intense bonding she delivered a healthy baby girl.  Doc and I were standing in the hall when we heard her first cry.  I was crying and praying, Doc was reviewing care of new born infants and trying to figure out where to get a gown just in case anything went wrong.  He took 2 steps towards the door looking very serious, but then the little girl gave out a good hearty cry and he retreated.  You can’t take the doctor out of the man, and I love him for caring so much about our friends and their new baby.  We gave the new family some time before we visited.   My friend was the most beautiful I have ever seen her, which is amazing considering how busy her day had been.  As we all gazed lovingly at this new addition my sweet friend looked up at me as if she had just remembered something very important and said, “When do we find out your next test or start your next cycle?”  I laughed and it took me a minute to even remember when we test next or will start a new cycle.  I gave her the update and then Doc asked to check the baby.  We all agreed to switch places in about a year or so and laughed about the amazing and miraculous day we had. 

Four times yesterday I had people ask me if I was okay.  I honestly didn’t understand the question.  I was doing great; I was much more worried about my friend and her baby than about anything going on in my life.  My joy for her had overwhelmed any and all remaining grief for myself.  I was grateful that I was able to provide her support and comfort.  That meant that I had to be grateful for how I obtained the knowledge to do so.  No, that doesn’t mean I am grateful for the miscarriage.  I am sure I could have just as easily had that knowledge from delivering a healthy baby in October, but maybe not.  Maybe I needed 22 days to make it stick so clearly in my mind so that I could have the most amazing bonding experience with my friend.  Maybe it took that to open me up to being so vulnerable with my friend.  Maybe it took that to make me comfortable and calm enough to make it okay for my friend to do the same.  I really don’t know.  All I know is I wouldn’t have traded yesterday for anything.  It was an amazing, wonderful, and miraculously healing day.  It was also a really cool way to welcome another girl into the world. J

Note: I am sorry for the vagueness of details, but I am trying to tell my side of the story without betraying my friend’s story.  That story is hers to tell. 

February 11, 2013 – Positive Change

We have made it to Day 21 on Femara.  For the most part it is a much easier drug to take than Clomid.  I had a few side effects, most notably joint pain which made me feel like I could barely use my hands.  This was very upsetting considering I use my hands all the time!  I couldn’t sew or clean because my hands hurt terribly to grip things for extended periods.  I would end up sitting with my hands very still to be pain free.  Even then I would get the occasional pain in my hands/wrists.  It was like aging 40 years over night.  Thankfully that side effect didn’t last the whole month like many of the Clomid side effects did.  Femara has a much shorter half-life, so there is relief from the side effects towards the end of each month.  With Clomid it just continued to build up in my system and then became ineffective. 

Clomid had also lengthened my cycles to 34 days.  That is a long time when you are used to 29 days.  On Femara I am back to my normal schedule.  That is really nice. 

Finally, we have to compare effectiveness.  Towards the end of my time on Clomid my progesterone levels were in the single digits.  I was getting maybe 1 egg each month, so it wasn’t really increasing my chances of having a good egg available for fertilization each month.  This is my first month on Femara and my progesterone was 23 today, so obviously Femara is working better for me than Clomid was.  Now we just have to keep our fingers crossed that our timing was good and a healthy sperm met a healthy egg and we are currently making a healthy baby.  We should know in about 9 days. 

February 05, 2013 – Positive Surge

I woke up this morning fully ready to go in for a Day 15 sonogram but was surprised to get a positive LH surge test this morning!  That means that on Femara my cycles more closely match my natural cycle.  YAY!!!  Maybe this means my body will get back into a more normal groove. 

The positive surge means I will have my IUI tomorrow morning.  Doc is working and, unfortunately, so is everyone else.  My dear friend who went last time offered to go again, but her baby is due to arrive this month and she needs to work 15 days or she would have to repeat a month of residency.  So, I am going to woman up and go all by myself.  I asked Doc to check and see if he could get off, but I am not expecting that to actually happen.  He isn’t happy about having to miss it again, but I understand he has to work.  He is on a rotation where he is the only pediatrician, so I know they really need him there.  I am going to try and focus my thoughts on how proud I am of him instead of thinking about being by myself.  I can do this.  It isn’t ideal, but that is okay.  In a couple of weeks it really won’t matter that I had to go to this appointment alone.  J

Keep your fingers crossed!  You know we will!

January 30, 2013 – Femara

So far Femara has been a lot better than Clomid.  The only real side effect I had was exhaustion.  I would take it at 10 and by 1 it was hard to talk my brain would be so shut down.  On the first day I laid down for a nap and Doc woke me up several hours later asking if I wanted dinner.  Not safe to drive on pill days, for sure. 

Femara is labeled as a drug to treat women with breast cancer (which is really sensitive to estrogen production).  Fertility treatments are an ‘off label’ use for it.  Lots of drugs have off label uses.  For example, Benadryl can also treat nausea. Regardless, we are hopeful that Femara will be more successful than the Clomid was.  We will know in aproximately 22 days.    

  

At the moment we are staying with the clinic here in town, but we have started to look for another place to do the IUI.  I am just not impressed with our current clinic.  This month when I called to ask for the Femara prescription the nurse argued with me that I was already on it and just needed to call the pharmacy for a refill.  I had a hard time convincing her that I have never taken Femara and didn’t have a prescription available for it.  I finally convinced her by asking her which pharmacy they sent the prescription to, for which she didn’t have an answer because they had never sent one in for me before.  I prefer my health care professionals competent or at least capable of reading a chart.  I also have to go back in for the Day 15 sonogram this month if I haven’t had my LH surge because it is a new drug.  I plan on not listening to the tech this time when she tries to convince me to get the IUI early.  Overall, I just feel angry when I have to deal with these people.  I don’t feel like they care and they are really in it for the money, which doesn’t make me feel good at all.  Unfortunately the other clinic is an hour and half away and out of network for our insurance, so it is really hard for me to switch.  Although we may do that if we aren’t pregnant in a couple of months. 

I really miss my regular doctors.  I always knew they were taking excellent care of me, but this experience has reminded me how special it is to find people you really trust to take care of you.  I don’t question their directives because I know they care about the outcome.  With this clinic I feel like I need to do my own research and manage my own care.  Very stressful!  Sadly, they are the only fertility specialists around here.  I know some amazing doctors, but this is just not their specialty.  Hopefully we will only have to work with them for a short time before we go back to the loving care of my amazing doctors. 

January 18, 2013 – On the road again

I will show my age and reference Johnny Carson here.  “The answer to your question is no.” Or I could be a magic eight ball, “Outlook not good.”  Regardless of how I say it, it doesn’t look like we were successful this month.  So, it was another month on the crazy hormone roller coaster and we still have nothing to show for it. 

I am not at my best today.  I am finding it hard to be positive or perky and really finding it hard to want to keep doing this to myself.  I keep trying to tell myself that we are done with Clomid and the doctor said the new med would be better, but I just don’t know that I believe it. 

It doesn’t help that the day after our insemination I slipped on a patch of ice and injured myself.  I couldn’t seek treatment because I didn’t want to get imaging done of my pelvis while trying to get pregnant.  I fractured my hip in the 4^th grade and the pain I feel is reminiscent of that.  So dealing with 2 weeks of pain only to find out it wouldn’t have mattered if I had gotten it looked at right away isn’t helping my mood.  After my period starts and it is official that we are not expecting I will get my pelvis looked at.  Monday will start a new cycle and hopefully it will be better than this one. 

January 08, 2013 – Timing Is Everything

I survived my Day 17 insemination!  It really wasn’t bad.  I had a friend who was willing to come and hold my hand during the procedure, so I wasn’t alone.  Being alone for it seemed really depressing to me, so I was very thankful that I had a friend who was willing to hold my hand and support me when Doc was stuck at work.  I absolutely have the best friends a girl could ever ask for.  I don’t know what I would do without them!  This is the second time a friend has held my hand when Doc was stuck at work.  I can’t express how much it means to me.  One of the greatest blessings to come from starting this blog and sharing this journey was that it opened me up to the support of my friends. 

I finally met my doctor’s partner, and have decided I would rather switch to his care.  He was much more personable and I just felt like he provided more compassionate care than what I had been getting.  I will ask to see him next time I have to come to the office.  The procedure took all of 5 minutes.  It wasn’t any worse than a pap smear for me, but I have heard that if the timing is off or if they have to stabilize your cervix it is a much more uncomfortable procedure.  Then I just had to lay with my pelvis tilted for 15 minutes before we could leave.  There was some mild cramping for the rest of the day and part of the next.  The doctor told me to follow up with intercourse the next day and that was all.  That was probably the most uncomfortable thing, because my cervix was a little sore the next day. 

My LH surge came on Day 18.  The LH surge comes 24-36 hours before ovulation occurs; which means I ovulated no later than the morning of Day 20.  All that means is that our timing was good.  We have ovum in the same place as sperm.  With a little luck the ovum was healthy and perfect and was met with a healthy and perfect sperm.  We should know in a couple of weeks if luck was on our side. J

January 4, 2013 – Day 15

Day 15 came and according to my new instruction sheet I was to call the office for directions.  I did and they scheduled me for an ultrasound.  No idea what for, just agreed to come in for it.  The woman I met with still didn’t explain to me what they were doing.  When I asked (while she was already looking) she said it was to look at my ovaries.  I kind of figured that out because my favorite magic wand was back! 

She showed me that on my right ovary I have 1 decent looking egg that I will ovulate this month.  I have another smaller egg that may also ovulate this month.  On my left ovary I had roughly 4 that were not going to amount to much even if they did ovulate this month (which she said they may not).  All this fun with Clomid and I have 1 egg.  I am learning a lot about acceptance this week. 

She then told me they could go ahead a schedule me for insemination the following day (Friday/Day 16).  I asked if perhaps it would be a bit early since we are only on Day 15 and my surge doesn’t usually occur until Day 18 and ovulation occurs after the surge.  She became obviously annoyed with me.  It was the “how dare you question me” scowl.  I didn’t care; what she was saying didn’t make sense to me and she didn’t seem to have an answer except to tell me if I wait I could miss it.  She kept saying my egg was 17.  I still have no clue what that means.  I told her I had to discuss it with my husband before I could schedule anything. 

As I got dressed I kept thinking about how this new office made me feel.  I feel like a piece stuck on a conveyor belt.  There is no thought to how people are different, we are all treated exactly the same.  They have a recipe that seems to work well for them, or well enough that they keep using it, but what happens if someone doesn’t fit that mold?  It really feels very impersonal and like they are in it for the money.  “Shut up and hand us your money.” 

Doc was working, so we couldn’t talk until the evening, which would make it too late to schedule for Friday anyway.  I called him and left a message explaining what had happened.  He sent me a text that he didn’t really know what to do either.  I then spent the day worrying about whether I was going to miss my time if I didn’t schedule for Friday.  In the end I decided to call the fertility doctor and ask, after all I am already paying him for his opinion.  He called me back after the office closed, which was fine because I know most clinic doctors finish patients and notes before returning messages. 

He agreed that Friday seemed a little early given that I usually ovulate on Day 18, but did tell me that numerous studies have shown no difference in pregnancy rates for insemination that happens a few days before or after the surge.  He said Saturday would work or if it made me feel more comfortable I could wait until the surge.  I still wasn’t left with the warm and fuzzies.  After Doc made it home and we had a chat we decided Saturday (Day 17) might work out best for us. 

I called this morning to schedule the procedure and Doc’s drop off of sperm.  Turns out they only take sperm in the morning on weekends and Doc would still be working at the hospital at that time.  When I let her know we wouldn’t be scheduling anything she offered to have the sperm frozen if we could get it there by 10:30 today.  Doc is switching to nights, so I called him to see if that would work.  We managed to get the sample there just before 10:30!  They waived the $50 freezing and storage fee because they are just keeping it one night, which was the nicest thing they have done so far.  Next month we will pay $50 to have sperm stored in advance just to avoid dealing with Doc’s schedule.  At 9:30 tomorrow morning I am off to see a doctor I have never met (mine’s partner) who will hopefully knock me up.  I am struggling with this decision a lot.  I dislike this process, I distrust the people I am supposed to rely on, and I just haven’t had time to sort things out for myself yet.  I understand we have maxed out the options for getting pregnant on our own, I am just unhappy about our options. 

I realize being unhappy about them won’t change the situation.  For right now I have decided to continue and go to the insemination.  I plan to continue to be polite to the people I come in contact with and give them a chance to warm up.  I will pray about each encounter and ask for guidance in my own actions.  I will be positive about my 1 egg because it only takes 1 egg and 1 sperm to make a baby.  I have to remain focused on our goal. 

December 29, 2012 – A New Chapter

I am sorry for the tardiness of my update.  The holidays were a whirlwind for us!  On the 24^th we met with the fertility doctor.  He was nice, really smart, and talked really fast.  I am hoping he was talking so quickly because he knew Doc could follow and that isn’t how he talks to everyone, because not everyone has had biochem and understands neurochemistry.  If it had been just me he would have had to go slower.  If your doctor ever says things you don’t understand feel free to interrupt and make them explain.  Doctors spend time with other doctors and they tend to forget that not everyone knows the Latin name for everything.  Doc is a big fan of the big words and I regularly make him explain things in simpler terms, because I am afraid he forgets when he speaks with patients. 

We did learn a ton.  For one thing: Clomid actually stays in the body for 35 days.  That is the reason it lengthens cycles.  Clomid initially tricks the brain into thinking you have too little estrogen, so it sends a signal to the ovaries telling them to ramp up production.  This increase causes hyper ovulation; which is why Clomid is a great fertility drug (although they initially thought it would be birth control.  Being part of that study must have sucked.)  However, when you use Clomid for several months your brain gets a little confused because you start taking more Clomid before the previous treatment has worn off.  Eventually it leaves you with excess estrogen building up.  This build up confuses your brain into thinking you have too many estrogen receptors and can actually cause depletion in the number of estrogen receptors available.  This is not a good thing to have happen when you are trying to get pregnant because you need estrogen receptors in order to get the signal to ovulate!  The doctor told me it was probably a good thing that I took myself off of it last month.  I am feeling very grateful that I listened to my body and gave myself a break when I most needed it. 

The doctor also said Clomid sucks.  It has horrible side effects and makes people feel terrible.  I really didn’t learn that, but it was nice to know I am not completely insane for struggling with the side effects. 

This cycle will be the last cycle where I take Clomid.  Ever!  J The only reason I am still on it this month is because I started it 2 days before seeing the new doctor.  Next month we will switch to Femara.  He said it will have fewer side effects but accomplish the same thing. 

He did recommend that we move to IUI (intrauterine insemination).  He explained that there are 2 challenges we humans face in getting pregnant.  The first is ovulating a viable egg and the second is getting a healthy sperm to that egg.  We increase the number of eggs I ovulate with the drugs in hopes of producing a healthy one.  The lab will wash Doc’s sperm so that we are left with the healthy fellas.  They then thread a catheter through the cervix and deposit the sperm at the back of the uterus during ovulation so that they have the best chance to reach the egg.  The shorter distance to the egg also means my body has less time to fight the swimmers off.  The doctor said that using this method 2/3rds of his patients become pregnant within 6 sessions.  The sessions aren’t cheap though, so we don’t know if we will be able to do 6.  Certainly not 6 in a row which would be more than $2,400!  Infertility isn’t cheap. 

We are starting this month. J I have to start taking a ClearBlue Easy fertility test every morning starting on Monday.  As soon as I have my LH surge I call the clinic and schedule an appointment for the following day.  Doc has to give his sample and then an hour later I have the IUI done.  It sounds pretty easy and hopefully it is.  J

Just a product note for those of you trying: I had previously been using First Response ovulation tests but the doctor recommended I switch to the ClearBlue Easy.  I have both this month because I already had the First Response kit at home, but the CBE kit is MUCH better.  First, it gives you a smiley face when you ovulate and a circle when you don’t which I find to be more rewarding than the daily NO I get from FR.  Second, if you don’t use all of your CBE tests (they come with 20) you can use them again next month.  FR’s version shuts itself off after you get a YES, so it can’t be used again which is very wasteful and since the kits are $35 a pop I will go with the one that I can use all of the sticks on!  Finally CBE packages the sticks separately so they can store for a month.  FR has them all in bag with warnings about exposure to moisture ruining them.  CBE wins hands down; I can see why he recommended it!  I like doctors that research products to recommend to patients.  Doc does that with formula brands and other baby items, so of course I think it is brilliant! 

December 04, 2012 – Another Opinion

We are at a fork in the road.  We can keep doing what we have been doing or we can try intrauterine insemination (IUI, AKA: artificial insemination).  Either way I am back on Clomid just before Christmas.  If we keep going the way we have been it means that Doc has to be available for intercourse every other day for about 2 weeks.  This wouldn’t be a problem if he had chosen any other profession.  It turns out working with sick and dying kids isn’t super great for the sex drive.  Not only does he work crazy long hours, but the things he is exposed to during that time isn’t exactly helping maintain a sex drive.  For example, right now he just admitted a set of twins into the NICU and was on call to admit another set.  That is 4 sick newly born babies he will work on just before coming home.  Not exactly a turn on.  Not to mention the stress of working on sick children every day. 

Our other option is IUI.  If we choose IUI Doc has to be available to give a sample 1 day, but we don’t get to choose the day.  When my hormones surge I call the clinic and they set up an appointment within 24 hours to do the insemination.  Doc would need to be able to go to the clinic and produce a sample.  It sounds like a no-brainer; 1 day vs. 14?  Trouble is that he has no control over his schedule and he can’t request time off to go masturbate.  Shocking, I know.  Regardless of our choice it adds stress to his life because I need him to be home and the hospital needs him to be there.  I also still have to take Clomid or possibly take injectable drugs (a terrifying thing for me) in order to continue.  Doing that without knowing whether or not Doc will actually be available to provide the sperm is not an easy thing. 

We will be discussing all of this with a new doctor.  We are not changing doctors; we are just adding a fertility expert to the team, because my doctor doesn’t perform IUI in his office.  On Christmas eve we have our first meeting with him at the fertility clinic.  We plan on talking about all of our options with him.  I will let everyone know how it goes. 

November 28, 2012 – The Results Are In

We finally have some answers!  My HSG was yesterday and went well.  It was painful, but very quick.  It wasn’t the worst pain ever, but I am not going to volunteer to do it again.  I was very thankful that my friend came with me.  It just made everything easier.  Everything looked good on the HSG.  My uterus is well formed and the tubes are still open.  All very good news. 

Doc’s test results took a little longer to get.  The doctor called this afternoon.  There is some concern about motility and they would like to repeat the test.  They have asked Doc to take 500mg of vitamin C every day for the next 3 weeks and then be tested again.  Should the results remain the same, they will move us to insemination. 

Overall these are not bad results because we can do something about them.  It means another month off Clomid, so a nice break for us.  Doc is not thrilled about having more tests or taking additional pills, but he is a good sport and willing to give it a try.  Besides, we all know he secretly loved the 12 step directions for masturbating.  J  He did recently look at my chart and saw that it has 281 results listed.  That is 281 times that I have had a test done and waited on the results.  It gave him a little more perspective about what the last 17 months have been like for me.  Perspective is always good!

P.S. Some people are having trouble leaving comments.  Please feel free to e-mail me if this happens to you!

November 21, 2012 – Grateful On a Day to Be Thankful

Doc and I are grateful for a month without Clomid and the fertility schedule.  Due to his crazy and hectic schedule this month we did, however, forget that Thanksgiving is this week.  I have written before about my theory of being grateful every day, so it seems a bit redundant to have a day to be thankful.  It is also hard to remember holidays because Doc is working, so they are just another day in our household.  We celebrate days off!  Yesterday was one of Doc’s few days off this month.  The day was packed full and included 4 hours of work related tasks, so it didn’t feel much like a day off.  It was the first time that we had been able to talk since my doctor suggested additional tests and a break from Clomid, so that was something to be grateful for. 

We needed the break from Clomid. The idea of additional tests is scary, but we would like some answers.  We should have a few of the answers on Monday.  Doc had the wonderful experience of turning in a sample to the fertility clinic yesterday.  I was downright gleeful that he finally had a slightly embarrassing test.  After 17 months of very embarrassing, painful, and terrible tests/side effects I think I deserve a break.  Doc agreed that it was his turn.  He said that he figured if I can endure everything I have had to so that we can have children then turning in a cup of sperm was the very least he could do.  I love that man.  He had to follow at 12 step set of directions for collecting his sample, which we both thought was hilarious.  He also said that 16 yr/old Doc would have been much happier about the idea of being ordered to masturbate than grown up Doc was.  Obviously, we handled the task with our usual sense of humor. 

My testing will be done on Tuesday afternoon.  Doc is going to be stuck at the hospital working in the PICU that day, so a friend has agreed to take me.  I am so grateful for the friends we have made here.  They are so supportive and wonderful.  It really does take a village, and we have found ourselves in one heck of a village.  God knew what he was doing when he put us here. 

I am nervous about the tests and have heard it described as everything from slightly uncomfortable to horrendous torture.  The reality of the situation is that because I have made the choice to go through with the test, I have no choice but to deal with whatever pain or discomfort the test brings.  So there really is no point in worrying about it.  At this point the answers we get from the tests are worth any temporary discomfort we may experience. 

Regardless of the answers we get, we are grateful for each other and the life we share.  I am so grateful to be married to this amazingly loving, kind, funny, and supportive man.  And as much as I like to complain about his job and the strain it places on us, I am so proud of him and how he chooses to spend his life.  I am grateful for living where we do, being surrounded by the amazing people here, and getting the chance to be a part of something much bigger than our petty struggles.  I am eternally grateful that I am still able to make a difference in the lives of children by helping those that are caring for them and helping to improve the environment of the hospital.  I am grateful for the people who allow me to use my skills and training to help them make informed decisions to help improve the hospital, program, and atmosphere of our world.  Regardless of the answers we receive, this is a wonderful life.  J

November 8, 2012 – We Interrupt Your Regular Program…

My progesterone results are finally in for this month; 5.4.  You read that correctly.  If you have been following my blog for a while you will realize that for someone on Clomid this number is not good.  My normal progesterone draw is around 28 on Clomid.  It is however, a normal number for someone not on fertility drugs.  I didn’t ovulate until Day 18 or 19 this month, so testing on Day 21 may not have been accurate.  I am pretty sure this is the problem because this was the worst ovulation I have ever had.  It felt like a cartoon bomb had gone off in my abdomen.  There is normally some pain and swelling following ovulation, which my doctor explained was blood from the extra ovulation.  This month my entire abdomen was so swollen that it looked like I was sticking my stomach out as far as I could.  Seriously, push your stomach out as far as you possibly can and that is what I have looked like for the last 3 days.  It was so painful I would cry when I tried to pee!  I was getting muscle cramps in my sides and back from having my abdomen extended for such a long period of time.  There was so much pain I just didn’t think I could do this again. So, obviously there was more than 1 egg released this month. 

However, the low test result did earn me a call from my doctor.  This poor man.  He called last night and he sounded like he was miserable with a cold.  He barely even sounded like himself.  I really appreciate him calling me when I know he would have rather been in bed.  Things like that make me really like him, and make it easy to forgive rude nurses and delayed results. 

As usual we were right on the same page.  It is time to take a break.  We have been going at this for a while and we haven’t been successful, so he feels like it is time to take a break and get some additional tests run.  It was obvious that our lack of success was just as frustrating for him as it has been for us, which is nice.  It reminds me that we are a team.  He wants to check Doc’s sperm count, just because it can decrease with age and with ovulation occurring so late in the cycle it is possible that the count is lower anyway.  He also wants me to go in for a study to check and make sure my fallopian tubes are still open. 

I am nervous about the tests and am not thrilled that we have to go through them, but I am also ready for a break.  I just feel worn out.  I don’t know when I will write again.  I am not sure when the tests will be.  They may wait until after this cycle is completed before running any tests, or they could want to do them right away.  I won’t really know until I hear from the nurse to schedule them.  I will keep you updated about the tests, but as of today I am counting myself as on vacation from fertility treatments and the side effects of them.  It is time for some much needed rest and relaxation. 

UPDATE: The nurse called shortly after I wrote my blog.  They will run my test, which is an HSG, during my next cycle between Days 4-16.  Doc tried to explain it to me but honestly it sounds like some form of Cold War torture so I stopped listening.  I picked up Doc’s “kit” and he will make his appointment for later this month.  We should have some answers next month.  On the way into the office to pick up the kit I did run into a lab tech, who asked me if I was visiting them today, and a secretary for my Internal Med doc who stopped to chat.  You spend too much time at your doctor’s office when everyone knows you!  It was sweet of them both to chat with me.  I really love my doctors’ offices.