9 Weeks Graduated!

Well there's Little H. I got to visit with him/her yesterday at my CCRM graduation appointment. Those folks there are really fab and I especially love Ruby, the new lab technician. Emily has been a sweet ultrasound tech, doing nearly every one of my appointments, and Dr. M herself gave me a lot of confidence in the two appointments we had with her. My new nurse, Lana, as darling as she is, was really only the harbinger of my exciting change of status - I've hardly seen her at all since she was assigned to me only for our pregnancy cycle. But, when all is said and done, I don't want to see any of them ever again!! If you've had to work with a fertility clinic, you know what I mean. If you've been diagnosed as "unexplained infertile," you get it. I'll spend the next 18-24 months praying that the next time I want to be pregnant, I'll be able to do it the good ol' fashioned way. I mean, who knows?! Stranger things have certainly happened.

So I was very unceremoniously graduated from the clinic yesterday, praise god. The u/s tech and my nurse were extremely pleased with how the little bugger was measuring and moving. My, oh, my, this little one has places to be! We got a look at him at approximately 2:30 in the afternoon and he looked like he was getting set to sprint across some imaginary finish line! Hands were waving, feets were shuffling, it was really incredible. And I could see her little heart muscle pump-pump-pumping. Emily was especially enamored with her feet flying around. The head is laying near my right side and the feet extend sideways to my left. Seems like an odd position but what do I know...

At 9w4d I am feeling remarkably unpregnant. Virtually no nausea and my exhaustion could easily be chalked up to the crazy move we did about 10 days ago and my daily 5:20am alarm setting. Not feeling crazy emotional either, peeing seems to be a rather normal schedule. Some days I feel nervous about the lack of typical symptoms, but Nurse Erin said to roll with it and love every minute. So that is what I shall do :) I do have pretty tender boobs though. And a funny moment today: one of my colleagues is in her 2nd trimester and I was in a meeting with her this morning that wrapped up close to 12. She was commenting that we really needed to finish soon cause she just had to eat and I agreed saying, "Yeah I'm ravenous. I don't know why I'm so hungry!" Her response to me? Amusingly: "Hey, maybe you're pregnant." Haha. yeah, maybe I am ;)

Thus far, I think I've been subconsciously very guarded about this little one. While I've been very outwardly excited with anyone who knows, deeper in my heart I keep feeling concern and I think I've been staying a bit disconnected. In a way that's an easy default setting for me because of how difficult the last year+ has been. And I'm sure most first-tri mommies go through that when there aren't many (or any) physical signs of what's happening. But now, after such a strong showing at her 9 week appointment, I think I'm ready to really go all-in, emotionally. I also took a hospital tour over the weekend and that helped push me forward a bit. Our chances of having a healthy, full-term birth are no better or worse than anyone else's - I need to just believe in this, 100%, no questions asked. So I'm going for it.

Emily printed several extra copies of our best u/s images and I promptly cut them out and placed them in the engraved silver frames that are currently on a flight to my dad in NY and my grandmother in FL. The news is seriously on its way and we plan to tell the family friends we're spending Christmas with. 

Surprise! 

Baby H

Arriving July 2015

5 weeks, 4 days

So here we are, still pregs. I've been reading a crapload of fertility blogs since the summer and it's always been interesting for me to see which women continue to post after a positive test and which feel like it's time to move on. It seems that for many who decide not to continue, there's a concern of making other infertile sisters who are still going through the ringer feel bad by posting all the fun pregnancy updates. And you know, I totally respect that decision and understand those feelings. I think I'm in a different boat at this point... Here are some thoughts.

1. This blog got started with the purpose of sorting out my feelings because, since our move to CO from the east coast, I have few friends that I feel comfortable sharing all of this information with. And J, being the stoic that he is, can only handle so much of my chatter. The other purpose was to have a holding place to document and summarize everything I was doing on this journey. And my feeling is that this journey continues, just with a new chapter.
2. Let's be real - not many people read this! I only have one friend who I shared this link with and since we don't get to catch up nearly as much as we'd like, I'm thinking she's open to reading all my blather whenever she gets time on the train ;)
3. I've been totally freaked since yesterday evening that there is cause for concern and I'll be calling my nurse in about 20 minutes when the office opens. I was lightheaded or dizzy very frequently over the weekend and that was accompanied by a fabulous stabbing pain in my lower right side last night. These are two things she cautioned me about with the words: Call Me. My frenemy, Google, explains that these can be symptoms of an ectopic. Jesus, that's all I need. It makes me sad to think that I'd step away from this blogy thing because I got good news and then as soon as something bad happens, I come running back. Isn't it better to have happy things to write about, too?? :)

I'd hate to think that my course of reasoning sounds selfish or cold. I hope that it makes sense. There are plenty of wonderful, beautiful, and, at times, heart wrenching stories being shared out there in the blogosphere. And if you stumble across mine and it doesn't resonate... Well it's totally cool to move on until you find something that's the right fit. I know I've certainly done my share of blog surfing, passing on the stories that I just know I won't be able to stick with for one reason or another.

And in the meantime I'm going to continue to silently lose my sh!t here at my desk until my nurse calls me with useful information.

No Beta Dramas Here

My dear nurse Lana took her sweet time calling with my blood test results today. I mean, I still love the girl and I know she has a serious job, of which phone calls are only a small part, and always done in the late afternoon. But daaaaaaamn I thought I'd hear back before 4pm! I was totally zen til maybe 2pm when I started falling asleep at my desk and feeling anxious to just call it a day.

I waited and waited for hours and hours. I checked my phone and email over and over again in case there was any message that came in during the 3 seconds that I wasn't paying attention. When Lana finally called, when I had completely given up on hearing today, I was in the car blasting music and completely missed the call. Doh! But, being the fab nurse she is, she left me a perfect message full of detail!

hCG Level: 2673 mIU/ml (CCRM wants to see it over 50) 

Progesterone Level: 73.8 nmol/L (should be between 32.6 and 140)

Bottom line? At 19dpiui, I'm pretty gosh darn pregs and Dr. M sees no reason to do a follow up beta test. Woo! I'm supposed to call back tomorrow to schedule my first ultrasound. squeeeeeee!

I thought I'd done a good job of staying chill all day while I waited around, but as I listened to her message and began tearing up (let's be straight, I was on the verge of hyperventilating), I finally realized how much anxiety I'd been holding. Would the number indicate a chemical pregnancy? What about ectopic? Would it just be low enough to cause general concern about the viability? When I listened to her recount the numbers in the message, my jaw literally dropped. It was so much higher than I expected! 

The news makes me feel a little more confident about telling my family over Thanksgiving. Even though it's traditionally "too soon," I can't imagine not sharing this news face to face and, sadly, I have no idea when I'll get to see them all again. We still will wait to tell J's family until they visit us at the end of December. At that point, we'll be closer to the second trimester. Not sure when I'll actually get to have the ultrasound since I'll only be in town until next Monday. That will mark 5 weeks and I'm sure that will be too early. Waiting over a week until I'm back in Denver is going to build up some crazy anticipation!

The month of November is carrying an unreal amount of gratitude for me this year. Thank you, thank you, thank you, Universe! <3

Here We Go

This fertility journey sure is insane. You're always on a roller coaster, though some days you find that you've gotten off one ride just to board another one. There's the Hope Coaster, the Depression Coaster, the Anger Coaster. And maybe if you're doing a lot of yoga, meditation and acupuncture, you get a few spins on that lovely, relaxing Ferris Wheel with great views. 

I've been hanging out on the Ferris Wheel for a bit now, I'm glad to say. It's a ride I always enjoy at any kind of amusement park. I just love the feeling of looking out and seeing everything spread out below me. There's so much to see and imagine, so much that is happening below you that you aren't even aware of. If I were getting philosophical I'd try to wrap that into some metaphor for living a beautiful life. But I'm busy at work (yep! I got myself a job about a week and a half ago. Go me!) and don't have a lot of space in my brain for flowery metaphors. 

Turns out it's time for me to board a new ride. I've been so scared that I was going to have to get in line for the scariest ride in the park - one that's sure to shake you about, turn your stomach, make you question what you've done wrong in life, and whether you'll actually come out in one piece - the IVF Coaster. Now, I love the thrill of a good, adrenaline-boosting ride, but I've found that as I get older, these rides aren't really agreeing with me. Last summer I blacked out on a roller coaster in Wisconsin! I've never blacked out in my life. Well... 'cept that night in college... Totally different. But I was so scared by the prospect of that ride that I didn't fully appreciate how it would feel if it turned out that I didn't need to get on that ride. That maybe, just maybe, all the stars would align and I'd be getting on the I-Just-Got-My-First-Ever-Positive-HPT Ride. 

Yeah, it's true. That's my new roller coaster. Here's the proof:

I'm not sure what to make of it still. As I start to think about what may lay ahead in the next 9 months I actually feel like an imposter. Like I'm on stage acting out a part from a script. It's someone else's life. I'm just standing in and pretending to be the girl who needs to figure out when to tell family, when to tell friends, what hospital to deliver at, when maternity clothes will be necessary, how long before someone at work notices. There are some emotional scars that remain, for sure. PTSD? Eh, that's probably overkill.

What's going to make it real? When will I feel safe from the infertility monster? I guess my blood work tomorrow will be a first step. Those hcg numbers will surely tell a tale. But after that? I probably won't feel settled in for the long haul until January. Maybe when CCRM graduates me to my regular OB. The truth is, full-term pregnancy is an honest-to-god miracle. There are so many things that can go wrong. Whether or not you're aware of it, you probably know someone who has had a miscarriage or a pre-term birth. It happens more frequently than most people are willing to recognize in polite company. Because it's goshdarn terrifying and no one wants to talk about it.

Other than feeling like kind of a fraud when J and I talk out loud about The Positive, I'm freaking elated. I took a test at 5:30am on Saturday morning and totally silent-cried in the bathroom as I watched the second pink line slowly darken as the seconds ticked by. I couldn't fall back asleep so I took pups for a walk and then we hung out on the couch watching tv til J woke up. I still wasn't ready to tell him. I was afraid it wasn't real. I'd hidden the test strip under my side of the vanity and kept going back to look at it, as if the line would have disappeared or that I dreamed the whole thing. 

The inspection on our new house was at 9:00am and, being a total novice, I thought it might take 1-2 hours. WRONG! We finished up at 1:30, at which point we took a lunch break. Knowing that the results of the inspection were pretty positive with only a handful of minor fixes, we were ready to appliance shop. But I couldn't keep it back much longer. It felt so anticlimactic to just spit it out and, frankly, the words "I'm pregnant" sounded far too risky in my head. So I asked J to drop me in front of Target after lunch so I could grab something. Truthfully, I needed nail polish remover but I also wanted something to hand over. A concrete object that would tell J: this is happening. We are going to start crib shopping whilst we search for a dining room table. 

I looked for a cute onesie but was far from impressed by the selection. Nothing called out to me as the "right thing." No precious little shoes either. And then I passed a section of monogram mugs. There was a green and white chevron one with a big letter D. And I immediately thought: Daddy. Into the basket for check out. 

As we pulled into a spot for Crate & Barrel, I said to J, "I hope you don't mind but I got you something in Target." He seemed intrigued as I fumbled to grasp the mug in the plastic bag. I handed it to him and said, "This," grandly, "is your new favorite mug."

"OK, but what's the D for?"

"It's for Daddy."

"Well," with kind of a sad and confused laugh, "don't I actually need to BE a daddy first...?"

"Yeah," nodding. "Well, you're going to be."

Poor guy. He didn't know what was going on for a good 10 seconds. And then it hit him like a city bus. His face turned bright red, I'm sure I spotted a little dampness in those eyes, and he grabbed me into him over the console of the car. And then after he released me, he grabbed me back again. For such a stoic and unemotional fellow, that was a much greater reaction than I ever expected!

The rest of the day was full of high fives, hugs, and washer/dryer shopping. We're both still wrapping our heads around this.  My guess is that I'm a little more guarded than he is after all the reading and research I've done this last year+ but I'm still incredibly thankful to have this first step forward. 

And to KRQ: whenever you read this, you're likely the 1st person to find out! So, shhh...That's what you get for following this story ;) Miss you!

Double Down on the Emotions Part Deux

Oh, Sunshine & Rainbows!

What a turn the day made. Number 1: we got our shipment of wine from the little family vineyard we visited in Napa last month, Bremer. They make the most fabulous wines, oh yesyesyes!

Number 2 requires a quick backstory. Last weekend we needed to go to the Lone Tree branch of CCRM for me to do my cyst check and bloodwork and we had the sweetest most enthusiastic nurse meet with us. I actually told J after we left that if we move to that area some time soon, I would request her as our nurse. Our current nurse is, well, clinical, and not very personable but I thought it would be a karmic no-no to request another nurse. She gets the job done just fine, being the conduit between Dr. M and us.

So I was in the midst of a nice, relaxing yoga session when my phone rang. I don't get many calls these days so I picked it up and SO glad I did! It was our CCRM nurse calling to let me know she'd taken a new position at the university and so our case would be transferred to another nurse. Well, wouldn't ya know, we're being transferred to the awesome nurse from last weekend! I'll call her Lana. She's awesome and I'm so pumped. Turns out, Lone Tree was just her weekend assignment.

Just the good news I needed. It feels like such a good omen. This cycle has to be a good one.

The Lengths We'll Go To

I'm eating out of the ocean.

Seriously, I've needed to become accustomed to breathing only through my mouth when eating and drinking several things these days. Making my salad tonight was a real... learning... experience.

Last week I bought a new cookbook, Cooking for Fertility, focused on fertility foods because I felt I needed more direction than just, "Oh yeah, that's a whole food. I'll eat it." I wanted better guidance on recipes rather than just eating salads and lentils. One of the first items I decided to try out was this Kale, Cucumber & Seaweed salad. Figuring that sushi works for me and I've tried a little seaweed salad from those sushi places before, it seemed doable.

Welp. Lemme tell ya. Woof.

For about a month I've been using a greens powder (Garden of Life Perfect Food) that has enough spirulina and chlorella to make you think you walked into the fish market. I religiously chug the mixture in two breaths, being sure not to breathe through my nose after each chug. Yuuuuuck! Additionally, the cookbook I bought made a suggestion to drink kombucha. It is a fermented tea and therefore smells a little like a brewery. It's funny, you'd think that would be easy to take, but just knowing that it isn't really a beer somehow makes it a beverage that I gulp down without breathing through my nose. Yawn.

You'd think I'd be used to this... But a seaweed salad is a new level! Most of what's in it is pretty good! Base of kale, chopped cucumber and red onion, shredded apple, black sesame seeds. The dressing is apple cider vinegar, pineapple juice, sesame oil, garlic. Of course there's also soaked Wakame and toasted Nori. Weeeeeird! The wakame seaweed comes in a zip bag all dried out. I put it in a measuring cup with some water and walked away. WOWZERS! I came back maybe 10 minutes later and it had blossomed out of the cup! Kind of a neat trick. But I'm a texture person and man is it slimy. Eeeeep :(

I'm trying to choke it down here remembering that I'm nourishing my body. A big piece of frosted chocolate cake may be easier to gobble up and have seconds tolerate but it sure isn't helping heal the imbalances in my body. So, seaweed it is... Man, when this baby gets here one day, he or she is gonna have a lot of stories to sit through!

LH Surge? Whaaa?!

I wanted to check, just to be sure. Just because I'm so damn curious. I took out the cup and dipped the OPK strip in it, truly not expecting anything. There was a faint little line which, to me, was too inconclusive. So I waited another 12 hours and did it again.

My Lord.

Dark double line. My luteinizing hormone is surging. Wowzers. Apparently this "lost cycle" may not be so lost! Oh, the optimism!

I'm attributing this good news to the major lifestyle overhaul of the last 2 weeks. Acupuncture, yoga, meditation and deep breathing, TCM style diet, no alcohol, (almost) no sugar. They were pretty certain at CCRM that I had nearly no shot at ovulation this month due to the cyst. But either way, this is good news :) My body feels healthy and in control of herself. Happy times!

Field Trip to the East!

Well I guess I'm 100% in the TCM game! I went for my second acupuncture sesh yesterday afternoon and, while I was spending time as a human porcupine, decided to pull the trigger and sign on for the special Chinese herbs. I'm taking something called Xiang Fu, twice a day, as a tea preparation. Obviously, I googled it as soon as I left the office and you'll never believe what I found. Although, I guess I shouldn't be surprised. One of the first results from the search was TCM Wiki! There is a wikipedia for Traditional Chinese Medicine! Ha!

http://www.tcmwiki.com/wiki/xiang-fu <---- There it is in black and white.

Xiang Fu seems to be a relatively straightforward herb used to treat a lot of different things. It seems to be combined with many other herbs to specify its treatment possibilities. But on its own, it is indicated for liver depression and qi stagnation. And based on the last "period" I had, something is definitely stagnating in me. Also, it is the essential herb for regulating qi and menorrhea, and alleviating pain in gynecology for it can regulate qi and blood circulation, soothe stagnant liver qi. These all sound like things my little bod needs some help with.

What is "Qi"? Yeah... It's a tiny word with a lot of meaning. At its base, it refers simply to energy. Here are a few more specifics about it:

• Qi manifests itself in various meridians that run through the body. These meridians, or channels of energy, are the areas that are targeted by acupuncture.
• Qi energy is converted in the body into 4 substances and 2 fluids: Qi, Yin, Yang, Blood & Essence and Moisture. These substances and fluids convert our air, water and food into waste and help the waste leave our bodies.
• Qi forms all of our organs.

My takeaway? Qi is basically the essence of life. Better be nice to it!

AJ really gave me the full needle treatment. There were 3 needles in my head, one in each ear, about 4 in my abdomen, a couple in my knees, a couple in my feet and, to top it all off, one in each of my hands. In that soft spot between your index finger and thumb. It felt really weird! But once she positioned the heat lamp over my belly, I was as good as passed out! This acupuncture thing is awfully relaxing. For now, I'm choosing to buy in, body, mind and soul. That Clomid didn't do me any favors so for now I'm choosing the nature path.

Experimenting with TCM

Yay! More acronyms! TCM has floated around in various blogs I've meandered through and some fertility books and websites. The acronym doesn't usually "stick" for me and I need to go look it up, but I think it's here to stay. Traditional Chinese Medicine.

When we first met with Dr. Minjarez at CCRM, she did mention that I may want to consider acupuncture, as several of her patients had seen some success in pairing the western medicine ART techniques in which CCRM specializes and traditional eastern methods with which many of us in the US are unfamiliar. My takeaway by the time of our regroup in June was that our numbers were so strong, an IUI was sure to be a success - I'd consider the additional spend on acupuncture only if the IUI didn't work.

So it was only one unsuccessful round for the IUI. I haven't totally lost hope or anything. But I just figure, if a little needle poking and some of the dietary wisdom from the ancient Chinese can only assist my attempts at 'assisted reproduction,' why not go for it? I anticipate starting the Clomid again tomorrow and having another transfer two Thursdays from now. In the meantime, as part of my TCM experiment, I've had my first acupuncture session, I ordered a recommended book (The Infertility Cure), set up two more acu appointments related to my IUI schedule, and started up 3 additional supplements - Vitamin D 4000 mcg, methylated folate and a spirulina based greens powder. Dr. Jane has also prescribed me yoga at least 1-3x a week and aerobic exercise 3-5x, as well as a particular kind of meditative deep breathing.

When I read things like bananas encouraging "dampness," and are therefore something I should avoid, I admit I feel some skepticism. But it's also the same practice that discourages refined sugars, processed foods and stress. That all makes good sense to me! If I need to avoid bananas in favor of plenty of other veggies, fruits and good grains, I guess I can make it work. Like I said, it is a bit of an experiment, but it is also something I'm trying to approach with an open mind and some enthusiasm. Cause hey, you never know!

Shoot 'Em Up

... Ovidrel style!

So I managed to "administer" my injection last night. Don't you just love the euphemistic medical language? I poked myself with a needle. Yowzers. My entire life I have been terrified of needles. I would practically hyperventilate when going in for routine bloodwork. Probably until I was, say, 26 when I strangely was compelled to start donating blood. Racing heart, sweaty palms... I can't say I was a strong candidate for self-administering an injection. On the other hand, all of this fertility nonsense has me pretty accustomed to needles now. Surely I do not enjoy a needle to the arm (or belly, or anywhere at all), but if I look away I can handle myself at least.

Of course, the Ovidrel injection required that I look directly at that little pinch of belly fat while I stabbed it with a "quick dart motion."

I made J count down from 5 for me after the alcohol had dried over the injection site. Elizabeth was right, I hardly felt a thing. The anticipation of sticking myself, along with the sight of a syringe sticking out of my abdomen, were positively the worst parts of the whole experience.

I hope with all of my heart I never have to do it again. Not because it was that awful, I could absolutely do it again, with my eyes shut I bet! We just want this to be over. We want this to be it. No more cycles, no more drugs, no more OPK strips, no more weekly envelopes in the mail from Cigna. Just a big, fat positive on my next test.

Pre-IUI Ultrasound

Today was my first check up since starting the Clomid. The ultrasound showed some impressive results!

8:30am - Monday, July 7
The first part of my appointment was the actual ultrasound with Jessica. It was pretty straightforward and I watched on the screen while she measured various follicles. Not much was going on with my left side... as per usual, at this point... but there was some activity going on in the right ovary that she was checking out. The process didn't take long, maybe 10 minutes total. Afterwards, I dressed and headed back to the waiting room and gorged myself on back issues of US Weekly. Amazing how many freaking celebrity babies are in that mag. Including a special spread on North West's first birthday party! Oy...

9:00am - Monday, July 7
My nurse called me in to review the results and do a backdated IUI consult. (Normally this is done prior to starting your Clomid course. I couldn't do the consult at the proper time since we were traveling, but Dr. M went over a bunch of important dos and don'ts at the June 20 appointment.) Other than the superficial side effects from Clomid, like mood swings and hot flashes, there can also be internal side effects. It frequently dries up whatever cervical mucous there is (impeding the production of eggwhite mucous which is problematic for couples using Clomid with intercourse), and can hinder the growth of a nice, fluffy uterine lining which can complicate implantation.
My ultrasound showed really positive results! My lining measured a healthy 8.9mm, which is right where it should be, even in a 100% natural cycle. As the ultrasound tech had suggested, nothing was really happening on my left side. There were three follicles, all measuring less than 10mm and not nearly large enough to mature and rupture as eggs. On my right side, however, there are three good looking follicles. My measurements are 22, 19 and 15mm. Our nurse gave me two insights that I thought were particularly interesting: First, if there are more than 3 viable follicles, they will cancel the IUI cycle due to the chance of multiple fertilizations. Second, as you can probably deduce from that statement, it is more common for the Clomid to stimulate only two viable follicles rather than three and so we've just upped our chances of a multiple fertilization. I had to sign an informed consent form to go forward with the cycle as scheduled.

***

Let's just pause for a moment. People can get real fired up when they hear any of the following: "multiples," "twins," triplets," and "Clomid" even. For people labelled as "Unexplained Infertile" like ourselves, it's important to remember the law of small numbers you're dealing with, as well as the risks associated with multiple embryos. For starters, our chances of getting pregs this cycle are only 8-12%, which I believe is only about half the likelihood of a normal couple conceiving in a given cycle. If we are lucky enough to end up with fertilization and implantation and a BFP (yep, "big fat positive" test), the stats on having two of those eggs become fertilized and give us twins? Only 10%. I'm no mathematician, but 10% of an 8-12% window seem like awfully miniscule odds! And one step further, the chances of triplets - all THREE of my eggs being fertilized - would be under 1%.
In the years that Clomid has become a popular prescription for fertility issues, doctors have come under fire for the resultant multiple births and associated risks. Due to that, many REs (reproductive endocrinologists) are extremely sensitive to multiples and therefore do what they can to control the math.
Women have twins. It happens, naturally. What's the big deal?? That's what I had thought, too. The most common risks in a multiple gestation probably don't seem all that scary to someone who hasn't had a baby because we hear about happy-ending stories all the time: poor vision, pre-term labor, low birth weight. Modern medicine makes these things seem commonplace, but as an expectant mother, you don't want to see your infant up against any of these things. There are also very serious complications that range from miscarriage, stillbirth, diminished brain development (i.e. cerebral palsy) to problems for mom like elevated blood pressure, diabetes, and greater incidence of nausea/vomiting. So... no thanks.

***

The original plan Dr. M devised for me meant that I would monitor my cycle for ovulation with OPK strips and then call the office when I had a positive. Given my great response to the medication and the size of the three follicles, our nurse determined it was best to trigger my ovulation with Ovidrel (an injection of hCG, human chorionic gonadotropin). Waiting too long could either allow the follicle to grow too large, or allow ovulation to occur naturally at a time that wasn't ideal for the IUI transfer in the office. I was given a pre-filled syringe of Ovidrel with strict instructions to get it home to the fridge and then administer it PRECISELY 36 hours before my transfer. So, 9pm tonight. Yipes!

I'm excited. I'm optimistic. I'm hopeful. I'm also a little nervous. Excuse the pun, but I'm afraid of putting all my eggs in one basket - meaning, the mathematical odds of this working on the first try aren't terribly high. So I'm trying to toe the line between optimism and realism. Not an easy line to draw. The current strategy: put all of my faith behind this procedure - we are very strong candidates for success - and if it doesn't work out, know that we've still got plenty of resources to lean on for more attempts.

HERE WE GO!

Cycle Day 7: BOGO Sale

Buy one, get one... Two posts for the price of one. Here's the update of what I didn't know when I wrote the previous post. 

1) I believe I have a new symptom to record: hot flashes. It's summer time and NJ has been having some wretchedly hot 90+ degree days with insane humidity, so I could be off-base here. However, the fact that I'd sit around the air conditioned house during the day and actually feel chilly enough for a blanket and then totally sweat my tush off when going to sleep kind of makes me think... maybe that's what a hot flash feels like! I was literally dripping sweat and had to throw off the sheet and turn the AC down a touch. I hold out hope that I'll never have need for clomid again (!!!!) but in case I do, remember the hot flashes...

2) No in-laws this holiday weekend, after all. Bummer. I've been sitting in the airport all evening waiting for my 5:15 pm flight to depart while they've been at the Philly airport also waiting. Unfortunately their flight was finally cancelled (it's now 11pm). As for me, I did get on the plane for about two hours. But a brilliant airport employee left the jetbridge unsecured and the storm that came through before we pushed off from the gate smashed the equipment into our wing. WOMP womp :( So we all deplaned and have been waiting ever since for a new aircraft to come in from another place in the country with no storms (not a lot of those tonight. hurricanes and storm cells abound!) Hoping for a plane in the next 30 minutes or so... which will get me into Denver just before 2:30am. Poor J needs to come pick me up then. Ouch. 

The Irony:

I really had stopped worrying about wacky mood swings with the in laws. All I'm feeling is a touch over-emotional, but I've been keeping good control of that when I realize it is a chemically induced over-reaction.

The Good News:
None of this effects our ultrasound or IUI schedule! Deep breath in, deep breath out..... Very excited about our dates next week. 

Rx: Clomid

So we had our regroup appointment with Dr. M on Friday the 20th. As I mentioned, I was kind of freaking out about it, expecting a bunch of news that I wasn't excited about. Stuff that would just extend our timeline.

Well! Wasn't I surprised!

VARICELLA
My number one freak out was about the varicella (chicken pox) vaccine. I felt devastated when our nurse told me that it was highly recommended that I start the series. It is a live virus vaccine taken in two doses separated by 30 days. After the second dose, you must wait an additional 30 days for the live virus to dissipate and not put a potential pregnancy at risk. Looking at my current cycle on the calendar, that was putting us at a three month delay which just felt like an absolutely crushing blow.

When I discussed my chicken pox history with Dr. M on Friday, however, she gave me a pass! Her opinion was that after having the vaccine only 2 years ago and having such decreased immunity to it, I am most likely in the small minority of people who are never fully immune. No continual vaccinations will change that. I just need to be careful, of course, about who I am around and the level of travel I plan over the next several months. No problem!

ENDOMETRIOSIS
After my fun trip to the ER on Day 1 of my last cycle, I had a hunch that Dr. M may suggest a laparoscopy to look for endometrial tissue outside of my uterus. She certainly was concerned after hearing my account, and the procedure was suggested. However. Dr. M also cited recent studies showing that removal of the tissue is really only effective for pain management, not fertility. Since my pattern seems to be a entire year without much pain at all, it seemed like overkill to have a surgical procedure to A) look for something that may not even be there and B), if found and removed, would likely not affect fertility. There are risks with even the simplest surgeries. If you were desperate to have a baby and someone was telling you that your entire reproductive area would be at risk for infection or worse... how likely would you be to sign up? I'm a total ninny about pain, but this pain only jumps out and grabs me once a year. It's just not worth the risk.

Putting a laparoscopy on the shelf also takes away a month (cycle) of surgery/recovery time. Deciding not to go forward was a major win for our timeline and also fully supported by Dr. M. We're feeling good about the choice. She also prescribed me vicodin as a "just in case" measure so I can stay out of the ER if there is a next time.

DRUGS/ASSISTED INSEMINATION
My next freak out was a bit of a catch 22. I'd started feeling really weird about the concept of someone else impregnating me in a lab. So impersonal, the very definition of clinical, it made me feel sad to think that J wouldn't even be in the room when I got injected with the magic juice. The catch 22 here is that I also realize that we are basically out of options now. There's no point in continuing to try unassisted.

Dr. M's assessment: I will start Clomid starting on Day 3 and we will try for an IUI cycle. Clomid goes for 5 days. Around Day 10 or 11 I am scheduled for an ultrasound to measure my follicles. At that time I'll also be doing OPK testing and then they schedule J to come in to provide his sample. The lab takes 2 hours to "wash" the sperm and then I will come in to have the washed sample inserted into my uterus. No, it's not romantic. But maybe it'll finally be the solution we need.

This should feel similar to having a pap smear. After the procedure, I get about 10 minutes to rest and then just go about my day. Go about my day? Seriously? No sure how I'll be able to do that. An IUI cycle is far less expensive than IVF and so we can go a few tries in terms of affordability. One caveat of a Clomid-assisted cycle is that you should only go for three cycles on this medication. I suppose because of the effect that it has on your hormones and the overstimulation of your ovaries, it starts to get risky to use it for more than 3 cycles without a break.

So we're starting right away. None of the delays that I was so worried about in the last couple of weeks. This pretty much puts us exactly where I hoped we would be on the calendar when we first started talking to CCRM. A week ago I was thinking that we had to wait for three months. Now, in one thirty minute appointment, I'm carrying this hope that in the next three months we may have some good news! What a relief. On the one hand, I almost want to celebrate. But that feels a touch premature right now. For the time being, we're happy to just feel a sense of relief and be able to finally make forward steps.

Setbacks Continue

One of the reasons I was so excited and relieved to get on board with CCRM was the feeling that we were finally entering a pattern of moving forward. And I need to keep the perspective that just by being a patient there we are already better off than going cycle after cycle on our own. But, for today at least, there's no moving forward. We're stuck in a waiting period. Again! Still!

I just heard from our nurse to go over my most recent set of tests. Prolactin=normal. Testosterone=basically normal. Rubella=immune. Thyroid=normal. Thyroid antibodies=normal. Blood chemistry=normal. Vitamin D=good. DHEA= normal. Blood counts=mostly normal, low white bloods cells due to my sniffly nose that day. Antibody screen=negative (that's good). So what was wrong? Varicella. Ugh. 

Bottom line is that I don't have enough antibodies against chicken pox. Despite the fact that I was immunized as an infant, had the virus, and then re-immunized two years ago. The impact of re-immunizing again feels pretty steep right now: 60 days from the date of the first shot (it is a series of two). The earliest possible date we can try for conception again is 3 months away. September. Just thinking about how far away that is makes me tear up. I'm so damn frustrated. 

It would be possible to move forward without the vaccination series. We would need to sign a waiver for CCRM. The chances I end up catching chicken pox in these next summer months seem completely ludicrous. But there is still a chance and if we sign that waiver, move forward with a conception plan, and I get this ridiculous virus while pregs, I'm at risk for pneumonia and the baby at risk for all sorts of nasty. birth defects. Seems like one hell of a gamble. Sure, the odds that everything goes according to plan with no virus in the picture are good. But it takes about .3 seconds to realize the risks outweigh those good odds all day long. So yes, we could sign the waiver. But we don't really have a choice, do we...

Our regroup with Dr. M is this Friday. That's when we'll discuss what our best options are going forward. I'd been looking forward so much to this meeting. Now I just feel like it will be frustrating to talk about things that I can't touch for 3 months. I'm just so sad right now.