Tuesday, November 30, 2004

IVF #1 - Canceled

My IVF Cycle was canceled today. I’m still in shock. I can’t believe it. It wasn’t as if I hadn’t thought that it could happen. I did think about it, but ruled it out. It was too unlikely of a scenario to even spend time contemplating. I feel like things just go from bad to worse the longer I am on this ttc journey. I knew the news wasn’t going to be good once Dr. N read out the size of the lead follicle - 24. Way too big for cd9. I had 5 follicle’s total all on my left ovary. My right one decided not to play this time around I guess. I knew the news would be worse the longer he looked around for something on the right. I had zero, nada, not one on the right. I really think I hate my right ovary, but I think it may be the one that has the good eggs. The only cycle my right ovary decided to show was for my second one, the one I got pregnant with and miscarried.

Let’s follow the history here…

Cycle 1, Protocol = 100 mg Clomid cd 3 - 7/LH Surge; U/S Results: cd10, R 8/L 9, 7; cd13, R 12/L13, 13, 9; cd 15, R 17/L 18, 16, 7; cd 17, R 19/L 18, 15, 9; cd 18, R 10/L23, 20 Result: Either BFN or Unconfirmed preg/early m/c

Cycle 2, Protocol = 100 mg Clomid cd 3 – 7/HCG Trigger; U/S Results: cd 9, R12/L10, 8; cd13, R18/L14/12 Result: Confirmed preg/early m/c

Cycle 3, Protocol 2 amps Repronex cd 3 – 10/HCG Trigger, U/S Results: cd9, R 13, 11/L 16, 10, 9; cd11, R15/L23, 18; cd 13, R zero/L23, 18 Result: BFN

Cycle 4, Protocol L5, U/S Results: cd9 R zero/L 24, 16, 13, 12, 10 Result: Canceled

I was given the following options:

1) Cancel and hope for better response for next time with a higher dosage protocol
2) Drain the lead follicle, stim longer and hope the others caught up before the 16 was ready
3) Continue and hope the 24 didn’t ovulate and/or affect the other follicles

Truly, I didn’t like any of these options. The most I would get were 1 – 3 eggs, maybe, if I was lucky. Not bloody likely. IVF is too expensive with those kinds of lousy odds. I asked about converting to IUI. It’s a long shot, but with $2K of meds invested I hate to not at least try. You can’t win if you don’t play the game. So, I am going to sink good money after bad and hope for a miracle baby. I am triggering tonight/tomorrow at 4 am and insemination will be Thursday at 4 if I haven’t ovulated before then and/or still have any follicles left. The only way this could work is if the 24 doesn’t ovulate and/or suck up the rest of the drugs and the 16 matures to like 20 by then. The 24 is a bust. It will be over mature. My only hope is that 16 follicle catching up and being the perfect maturity when I need it. The odds are so low it is not even funny, but better than zero.

I am so glad that I told so few people about even trying this. Making the few calls that I had to make were hard enough. I have some really great friends who are terrifically supportive. I will be taking them up on that support in the days to come. Tonight, I had to wallow in self pity.

I can’t even think about next steps right now. This process is so hard. I seriously thought a few times tonight that I am not sure that I can do this again. I know that is an emotional response to the huge disappointment. I am not ready to give up. I am not ready to quit. But, maybe I should. Maybe this is a sign that it just is not meant to be. Maybe I am not listening or open to the message. Now, is not a time for decision making. I can’t imagine never being a mom. I just can’t. If that’s the message I am NOT ready to hear it.

My left ovary is so sore that I can’t imagine I will not ovulate before Thursday. I was talking to a friend the other day about feeling bloated and sore when I realized I was feeling less so, especially on the right. I said that wasn’t a good thing and passed it off as being my imagination. Now, I know it wasn’t and my body is just a traitor. I really hate it right now, especially that right ovary. She is getting the majority of the blame in this. In case I haven’t said it. This process really sucks!!

Monday, November 29, 2004

No, I have NOT just delivered a baby or returned from maternity leave

I’m back at work today and spent the morning catching up from being out last week and in meetings. I need to make a bunch of phone calls, but to folks on the east coast so I guess it will wait until tomorrow at this point.

I have gotten some funny comments lately that I don’t know what to make of. In one of my meetings today (we are a very virtual company and all of our meeting are conference calls), when I announced I had joined, the meeting organizer/facilitator (who I have never met or even been in another meeting with that I can remember) said, “Great, glad you could make it, I thought you were still out on maternity leave?” What? Is he kidding? I wasn’t quite sure how to respond so I said, “I’m not even pregnant”. Then, I think he said something like “Oh, well there is still time to work on it” or something about working on it. I just didn’t know what to say. Other people joined and I just let it go. What the heck? Probably, he just has me confused with someone else. My boss and her administrative assistant do know what is going on, but that is not something they would share. I have a meeting scheduled with her for tomorrow. If I get a chance, I am going to ask her about it. Unfortunately, she didn’t join the call until after this little exchange. It’s probably just nothing. But, it was strange and made me very uncomfortable.

I got a manicure/pedicure the other day. My acupuncturist (who I just love) recommends this during stims. There was a young guy (mid 20’s?) doing the pedicure and the shop owner doing the manicure. The owner said the young guy hadn’t been in America very long and she was telling him about the Thanksgiving holiday and the tradition of it. When I put my feet in the water, the owner asked if it was too warm and I said no. Then she said, it would be good for me right now and my circulation to get the blood flowing. I said nothing, but thought “Yes, exactly what my acupuncturist said”. Then, later, the young guy made a comment to her in another language (he doesn’t speak English) and she made some comment to me about me just delivering a baby. Again, what the heck? I just said, no I hadn’t and am not pregnant and left it at that. She translated that back to him.

Am I giving out some king of weird hormonal signals here with all of these meds being pumped into my body. How does this happen twice in four days? Even if my stomach is looking a bit bloated and puffy these days, the guy on the phone couldn’t see that?

Let me tell you, these types of comments are NOT good for the ego and not something someone who is TRYING to get pregnant wants to hear.

Sunday, November 28, 2004

Deer Sightings

I saw two deer this morning while hiking with the dogs. I never fail to feel awe and marvel when I have the chance to see them. It is truly precious to me. It was just a quick glimpse before they ran into the brush. If I hadn’t been looking up right at that moment, I would have missed them. The funny thing is that I was just thinking at that exact moment that I hadn’t seen any deer for this cycle. I live in Southern California and deer sightings are fairly rare. In fact, before ttc I think I had only seen them once or twice max in the 7 years or so that I have been hiking. Coyote sightings are all too common and they get more aggressive and bold each year. I have seen a mountain lion twice and the reason I now make sure that I always have my cell phone with me when I hike. Deer sightings, they are enough to make me stop in my track and contemplate the beauty in life and thank God for what I have.

I have copied below part of a post I made on IVF Connections in September when I was starting IUI#3 that talks about my deer sightings.
IVFC Post on 09-06-2004 10:28 AM …
However, the best thing that happened lately is that I saw 2 deer this morning. It was so cool. I can't even really tell you or explain, but I will try. As I have mentioned, I hike a lot (okay, almost every day). Coyotes sightings are common, but deer sightings are very rare. In all the years I have been hiking, I think I have only seen deer 5 or 6 times total...and, 4 times since I have been ttc. Right before my first cycle (have I told this story?), I was hiking and reflecting and "talking" to god. No sooner than I had asked God if I was on the "right" path and dong the "right" thing and I saw a deer. I couldn't believe it and thought "is this a sign?" The next day when I was hiking, I was asking god if the deer yesterday was a sign and telling him that if he was I needed another sign... to be hit in the head with it (so to speak). As soon as I had the thought, I saw another deer. I was in awe. I said, okay, it was a sign and the deer is a symbol that I AM on the right track. On my first cycle, I really felt (and still do) that I did get preg., but lost it before it could be confirmed. We later found out that I had low progesterone.

I also had a deer sighting on my 2nd cycle. I am not exactly sure of the timing (I need to call my cousin who was with me for this one, but don't want to yet because my mom is still here and she will likely overhear the conversation and I am not telling her or any of my local family that I am trying again this month). Anyway, I think the timing was after I was preg., but before I m/c, (either that or it was just after I m/c). We saw a deer grazing on a hill and it was being stalked by 2 coyotes. The deer either caught our scent or the coyotes and took off, the coyotes went after it and they all ran off until they were out of sight. I remember my cousin and I talking about the symbolism.

Back to today. Got AF today. I was hiking. I wasn't actually talking to god, but I was thinking about today being cd1 and that I was still nervous, but getting excited. As you know, I really struggled with what type of cycle to do next and decided on the Inj. IUI late last week. Even though I still had some concerns, I really wanted to do it anyway. I was thinking about this and pondering if it really was the right decision. And, as soon as I thought the thoughts, I saw not one, but two deer. I couldn't believe it. Tears came to my eyes and I thought, this IS a sign. I didn't even have to ask this time and god is telling me that I am on the right path. I am not sure if seeing 2 deer is 1) a sign that it will be me and an actually baby this time or 2) twins (which was never my first choice and something that really concerned me with going to the inj.), but if it does turn out that way, I will know that it was my path. I am now at peace with it 3) just coincidence and/or B.S. I guess time will tell. I do know that I just had joy and peace at seeing them. I am finally comfortable and at peace with my decision. A weight has been lifted off of my shoulders. Again, time will tell if I am reading way to much into this or if it really was a sign, but...it has brought me the peace I needed going into this cycle. I just had to share.....

IUI#3 was ultimately a failure, but I did have 2 perfectly good size follicles and going through that helped me be okay with twins/multiples if that is what happens. I was very worried about multiples in the beginning. Now, I just want it to work. Having twins as a single mom will be extremely difficult, but if that is what happens, it is and I will be happy with it. I would rather get pregnant with twins than to not get pregnant at all. I did ultimately confirm with my cousin that the deer sighting on IUI #2 was after I had the cramping and bleeding when my beta rose from 110.54 to 155.23 before dropping to 61.43.

Getting the BFN (big fat negative) with IUI#3 was probably the lowest point of this whole process for me. I think even more so than the m/c a few months earlier which was completely devastating. For the first time, I thought that maybe this whole thing wouldn’t work and I would NEVER be a mom. I couldn’t listen to the radio or watch tv or read books for awhile because almost all of the songs or the shows or the commercials or books had babies and families and pregnant women. They all had things that I wanted and couldn’t/didn’t have. I really didn’t like myself very much at the time and this was very hard on me since I am usually very comfortable in my own skin. I felt like God had forsaken me. I was really sad that my deer sightings were not prophetic. How egotistical of me to even contemplate God giving me a sign? Who did I think I was that I should be so fortunate and so blessed? I was mad at the world and wanted everyone to leave me alone. As sad as I was that this try didn’t work and as angry as I was that I would be moving to IVF, I was equally upset that my deer sightings were just random, coincidental sightings that I has stupidly read to much into.

I realized when hiking this morning that the last time I had done this trail was in early September at the beginning of my injectable IUI cycle and the last time I had seen deer. I was reflecting on the fact that I hadn’t seen any deer for this cycle and no longer was even asking God if I was on the right path or not and as soon as I thought the thoughts I looked up and saw two deer. What does this mean? Was this just another random coincidental event or a sign? At what point does it stop being a coincident? It really is quite bizarre when you think about it. How many times does it have to happen for me to really believe? I am too afraid at this point for it to mean anything. Maybe this was God’s way of saying, like the footprints poem, it is then that I carry you.

After I miscarried, I read a book called When Bad Things Happen to Good People which was written by a Jewish Rabbi after he lost his son to a rapid aging disease. It talks about laws of nature vs. laws of God. It is an excellent book for anyone (regardless of faith or religious belief) to try to understand how/why bad things happen when you are a good person and that it is not "God's will".

Maybe the deer sightings are not a prophesy at all? Maybe the deer are not a sign of the outcome, but of what could be if not for laws of nature? Maybe it is just God’s way of saying; keep the faith you really are on the right path and it was my interpretation that was wrong?

I have a good friend who is an ordained minister and one of the pastors of her church. We have talked a lot about faith and God’s plan for each of us over the last year or so. We have talked about the need to be open to hearing God’s word even when it tells you what you don’t want to hear. It took a lot for me to decide to become a single mom by choice. I debated over it for years because I really believe a child deserves the benefit of having two parents whenever possible. I knew I would be a great mom, but wasn’t sure if that gave me the right to move forward with this on my own. I finally decided to move forward with ttc after realizing that if I didn’t try it would be the biggest regret of my life. Most of the time, I have felt very sure that I was on the right path doing what I needed to be doing when I needed to do it. There have been a few times when I have stumbled and had self doubt, but by in large I feel like I am on the right path.

Maybe the deer sighting was God’s way of saying, don’t forget about me. Don’t give up faith and hope. I haven’t forsaken you. I am with you and you ARE on the right path.

IUI #1

Yes, woke up at 4 am like clockwork this morning. Sigh. As I was laying there trying to decide how badly I needed to go the bathroom, I heard a door squeak open. One of my dogs and I both heard it and were up in an instant with an adrenalin rush. When you live by yourself and it is 4 am, this is not a good thing. Turns out my back door (which is a French door going out into the backyard) must have just been closed, but not latched. We are currently having a wind storm and the wind was strong enough to blow open the door. Glad it wasn’t an intruder. As I lay back in bed attempting to go back to sleep for an hour or two, I started thinking about my first IUI. Boy, I was such an ignorant newbie at the time. I am sure that this is the worst kind of newbie. I was so full of excitement and hope and optimism. How could this not work? I had spent 6 months getting everything checked out and ready. I had no known problems and had never tried to get pregnant before. In fact, like many others, I spent considerable effort making sure that didn’t happen.

My college degree is in Information Management from the School of Business. I started out with a general business major, but moved to the Information Management degree after a year of general education. As the saying goes, it was like a duck to water. It was my niche. I love information and have a strong need to know. I also have a strong project management background. I do and have done a lot of project and program management for work, but it really is part of my personality. I am a planner. I really have to have a plan. The plan can change and be updated, but it must be present.

My baseline (original) ttc plan had me delivering a child in February 2005. I figured starting in October should give me plenty of lead time. Of course the more I learned, the more I learned and I realized this could not be as easy as I planned. I was truly shocked when I heard that my chances of conceiving in any giving month with an unmedicated cycle was only 5% and went up to about 10% with clomid and 20% with injectables and this was only if no problems were encountered. With these odds, I was already behind schedule and I hadn’t even started yet. However, in my heart of hearts, I never believed I would be where I am today moving to IVF and having used up all of my insurance benefits. It was just inconceivable to me at the time.

Work was extremely, extremely busy and stressful at the time. I had taken on a new job (a promotion of sorts) in January 2004, but couldn’t give up my old job until May 2004 so I was doing both jobs (my old one and my new one) for the first few months of the year. This was compounded by the fact that each of these jobs were combined in the west, but separated in all of the other regions (east, central, and Canada). Meaning, I was basically doing 4 jobs -- Performance and Process (PPI) and Project Office (PO) Leader for both our SF/Bay Area Solution Centre and the entire Western Region. It sucked, but I really just couldn’t give up my old job yet. I had been leading an effort for the SF/Bay Area SC (BASC) to improve our process maturity to a CMMI L2 for over 2 ½ years and we were in the final preparations for the assessment (process audit) to confirm that we had achieved our goals. I just had to see it to the end even if it meant working nights and weekends to keep my head afloat in the meantime.

I started my first IUI cycle in late April. I had to be out of town for work for a few days so we did my cycle day 9 (cd9) check on cd10 after I had returned. This was just weeks after successfully passing our CMMI assessment. I guess reflecting back now it is much easier for me to understand how I could be so ignorant going into the process because I literally had no extra time for personal research just then. I had been trying to chart my basal body temperatures (BBT’s) since I went off the pill in Nov. 2003, but it was erratic. I did take my temperature every day (or almost), but my sleep patterns were irregular and I never did get a solid pattern. I now know that this was because I was not ovulating on my own and what looked like a nice regular cycle was masking anovulatory cycles and a luteal phase defect.

When I went in for my cd3 baseline u/s, I had an ovarian cyst. I couldn’t believe it. It seemed like every time I turned around there was another hurdle or roadblock. My dr. said I could either wait the cycle out or have the cyst aspirated. I just couldn’t decide right then and there while I was in the stirrup’s so I asked for a few hours to think about it. I got home and called the sperm bank to find out if I waited would I have a better chance of getting one of my top 2 donors. I think I had gotten my 4th choice. Turns out my #1 donor had just come available and I could get him either way if I waited a month or if I proceeded this month. They would swap out since it hadn’t yet been shipped. Perfect, if I hadn’t had the cyst, I would never had called and never known this. I went back and counted the days and went through all of the options on shortest cycle and longest cycle. It was almost certain that if I waited a month, I would be waiting two months because I would be out of town for work the week I would be ovulating next month. I went back to the office several hours later to have the cyst aspirated and left with my clomid prescription in hand. I was so excited to be doing this. I was finally on my way!

I had never used an ovulation predictor kit (OPK) before my first IUI cycle. It actually never occurred to me at the time to try to do a trial run to make sure that it worked and I knew how to do it. I had another u/s on cd14 (Sunday, May 2nd) and was told to start testing and to come back tomorrow for another u/s. Cd15 showed neg. on the OPK. While I was supposed to test once a day, I decided more monitoring was needed. On cd16, I tested 3 times at 6 am it took 6 min. for the surge line to appear, at 1 pm it took 4 min., and at 7 pm it took 7 min. I was told to come in on cd17 for my IUI. I was a bit freaked because I was showing neg. again on the OPK’s. At the time I didn’t realize that it was called LH Surge for a good reason and that I wouldn’t be testing positive for the duration. I had my first IUI on cd17 (Wednesday, May 5th) and my second IUI on cd18. The u/s on both days confirmed that I had not yet ovulated. I was truly freaked out at this point because I had only bought 2 vials of sperm which reportedly only last for less than 24 hours. They did an LH blood test to test those levels on cd18 (since I STILL had not ovulated) and I went back in on the cd19 for another u/s. I was in a panic calling the sperm bank to see if I could get another vial or two of sperm, just in case. Could it be emergency shipped? Not only was my donor not available, I realized that they just can’t react to such short term requests/emergencies no matter how much money you are willing to pay. I am sure they thought I was crazy and truth be told, I was. How could I possibly ovulate so late? If I hadn’t ovulated, the cycle was a bust. My u/s on cd19 (Friday, May 7th) showed that I had finally ovulated. Yes, there was still a chance!

I started officially reporting to my new boss on May 3rd. The first week I reported to her I was out of the office 4 out of the 5 days for my first IUI. We were off to a great start. Her administrative assistant who knew that I needed blood tests (my cd3 FSH/LH levels) while on my last trip to Texas because I needed her help in finding a lab thought I was dying at this point. I really wasn’t prepared to disclose what I was going through, but I couldn’t let them think I was terminally ill. My new boss and her admin. are located in Texas. I suppose I could have just not told them I was out of the office for all of these appointments, but I just couldn’t do that even if they would never know. When you work remote from your boss like I have done for years, I feel it is very important for them to know when you are not working during business hours. I never want to be in a position where my boss can’t get me if they need me in an emergency and not having disclosed I was out. The trust is too fragile. Thankfully, both my boss and her admin. have been very supportive. It has made it easier on me with them knowing what I was going through. It didn’t hurt that my boss has several personal friends that have gone through infertile treatments and had a working knowledge of what I was/am going through.

I am not sure that anyone can prepare you for your first 2ww. I know that I was completely unprepared. It didn’t help that my mom and my sisters kept asking me “do you feel pregnant”. Yeah right. I was at wits end. I had completely turned over my BASC job and was just doing my new job, but there were strong rumors that we would be re-organizing within the next month or two. As such, things had really slowed down. No point in heading too far in one direction at this point when it was all going to change. It would just be a waste of time and resources. I became an internet junkie soaking up everything I could learn more about the process now that I had a little bit of time. I became an avid reader of my clinics discussion board and was reading religiously through the archives when I came across a reference to IVF Connections where other women who were using my clinic supported each other. As I have previously posted, this was just what I needed at the time. From there, another single women pointed me to SMC and I got hooked into that network. I have made a lot of contacts and several really great friends as a result.

I really feel like I conceived on my 1st IUI, but that it didn’t stick. I really think I felt the egg implant. I have often thought back to whether this was all in my mind or not since I have never felt like that again. Granted, I have been on progesterone supplements ever since as well which would mask the symptoms. I can remember it vividly. It was a Thursday and I was working away. I just got a rush and a feeling of intense joy. It was very weird. I just re-read an email I sent to my dr. after that titled “Getting Excited, Should I be?” Even though I find it very embarrassing (even now), I want to be honest on this blog and that is where I was at the time. So, here is the email exchange…..

My email:
Dr. N - In my own humble opinion, I have been doing a great job of not worrying and staying occupied with work, family, and friends during this waiting game… although this has been one of the longest/slowest week that I can remember even with keeping busy. I swore to myself that I wasn’t going to be obsessive over this and do an early pregnancy test at all…or at least until next Tuesday or Wednesday if I just couldn’t stand it. Next Wednesday would be day 30 of my cycle (which is the longest cycle I ever have had) and I am very regular. However, is it possible to actually feel the egg implant? We did the second IUI last Thursday and I think you said that it would take 7 – 10 days to implant so the timing would be right. How soon can I/should I test? I think you may have told me last week when to come back, but I honestly don’t remember. This morning I had mild cramping which was not at all like normal cycle cramping and then a “rush”. I don’t really know how to explain it. Plus, I think my breasts have swollen a size or two this afternoon and are tender. I am just feeling very happy and optimistic. Could all of this just be in my mind? Other than not sleeping very well (although much better than last week), I am feeling GREAT and not at all like I am going to get my period. Logic tells me that at this point I either am or am not pregnant and that only time will tell so what does it matter if I know tomorrow or next week. However, from an emotional perspective, I want confirmation before I get too excited. What do you think? Debbie

His response:
The symptoms you describe are symptoms of very early pregnancy. However, the only way to know for sure is to do a blood pregnancy. The first time this test is positive is roughly 14-15 days after the insemination. Commercially available urine pregnancy tests usually are not positive for a another week after that. You should have had an appointment to come back and see us after the insemination. If you didn’t give our office a call and make one. Good Luck!
Dr. N

Friday night, May 14th (cd26), I started spotting and having minor cramping. By Saturday, I was having major cramping and heavy spotting. I could only lie around and be a couch potato. I even took a several hour nap, which is just unheard of by me. By Sunday, I knew that if I had conceived it was no longer viable. God, I was so sad.

My dr. endeared himself even more to me by not laughing off or discrediting the fact that I had thought I conceived when there was no hard evidence to confirm it. He had me come in for an u/s and beta just to be sure. Turns out that I had another cyst, but I wasn’t cycling this month anyway. Not only would I be out of town while ovulating, I need to take a break and regroup from the roller coaster ride of my first IUI. I had expected the process to take an emotional toll. I could never have imagined the reality. Knowing it and living it are two entirely different things.

Now that I had found the internet school of medicine, I researched to death all of the possible causes of early m/c and my dr. and I decided that we would test my NKA (natural killer test) before my next cycle and we would test my progesterone level 7 dpo of my next cycle. My NKA’s came back normal, but my progesterone levels on my next cycle came back as too low to sustain a pregnancy. If I had conceived with my first IUI in all likelihood I would not have sustained it based on these levels.

Did I conceive on this try? We will never really know. I feel like I did. It could have all just been my imagination and I have never felt the same since. Even if my progesterone was higher, I had ovulated so late that there was a good chance the egg was overmature anyway. Who knows? I was on to IUI#2 much more educated and much less of a newbie.

Saturday, November 27, 2004

Quick CD6 Update

Things are going well. I had a nice relaxing day and another trip to the acupuncturist. I am doing 2 treatments per week at this point for the duration of my cycle. Can’t hurt and can only help. It keeps me nice and relaxed. I had a somewhat lazy day. I was putzing around last night and didn’t get to sleep until after 11 pm. When I woke at 3 am, I was hoping I would drift back off. No such luck. At 3:30, I counted the hours and figured, what the heck, tomorrow is Saturday and I really need more sleep than I am getting. So, I took some Tylenol PM. Around 4, I drifted back to sleep until 7:15ish. This was the start of a very slow, unproductive day. By the time I got dressed, brushed my teeth, did my Lupron shot, it was after 8 before I even left for my morning hike. While this may be early for some, it is very, very late for me. It was a cool, damp, overcast day here which actually turned to light rain this afternoon/evening. I had a very enjoyable relaxing walk with the dogs while catching up with my cousin on the cell phone.

I came home fixed the outside xmas lights which had blown a fuse causing a need to split the power source. Ate the rest of my Thanksgiving left overs, and got ready for my apt.

One of the things that I have noticed over the last few days is that I seem to be constantly hungry. I am trying not to eat too much and make good food choices, but it has been hard. There is defiantly activity going on in the ovary region. I’m just a little sore/tender and feel very bloated. I really notice it when I am hiking and walking with the dogs. Those ovaries must be starting to take away space previously used by my bladder because I have needed “to go” more frequently than usual. Loose clothing is much more comfortable at this point. I can only imagine how this is going to increase since I still have at least 4 – 5 more days of stims left.

When I was laying on the acu table today thinking random thoughts and relaxing (or at least trying to), I thought….a week from today, I could be having ER. Wahoo. If things go the way I think they will, I will have my cd9 apt on Tuesday and my dr. will have me come back for another check on Thursday. I will trigger Thursday night for a Saturday retrieval and a Tuesday (12/7) transfer. We will see.

I was happy that last nights Gonal F shot was without incident. On Thursday night when I did my stims shot, I had quite a bit of bleeding associated with it which has never happened before. This was my first night mixing the Pergonal and Gonal F and I was out of practice breaking the top off the Pergonal vial and managed to get a very small chard of glass in my finger. It bled quite a bit and didn’t really stop after a minute or two of pressure so I went and put a Band-Aid on it and the bleeding flowed through the Band-Aid before stopping. The amount of bleeding was more in line with slicing your finger with a knife, not a small itsy bitsy puncture wound. While I thought it was odd, I didn’t really think anything off it so was not prepared when I did my IM shot for bleeding as well. When I took the needle out, I had a gush of blood that ran down my leg and left a trail on my floor in the few seconds for me to grab the washcloth. It was quite a mess, but did stop after a minute or so of pressure. I had pulled back on the needle so I’m almost positive that I did not put the meds into a vein, but I must have gone through one getting there. I’ve since wondered if it could have been because I had a small glass of Champagne earlier in the day while helping fix Thanksgiving dinner and a glass of wine with dinner. I haven’t had a drop of alcohol since the summer. Even though it had been over 8 hours before, maybe it still caused it? Anyway, it was odd and I am glad it didn’t happen again.

You've Come a Long Way, Baby

I started this process a year ago. While I had been thinking of it for ages, I consider October 2003 as my official start with a trip to my primary care physician (PCP), for my annual well women exam. My OBGYN had retired suddenly a few years ago with heart trouble and I never found a new one. I really like that guy. I still miss him. He was an old crusty one that had been around forever and was slowly retiring before heart trouble caused him to close his practice. When I called my PCP to get a referral, I was told me PCP could do the exam. I took the lazy route and just saw her instead of finding a new one. When I was in for my October 2002 visit, I broached the subject of single motherhood to her. She was not shocked or outraged or even fazed by the topic. I wasn’t ready to make a final decision or commit yet in 2002, but my 2003 appointment got the ball rolling with a blood work up, a trans vaginal u/s to look at my fibroids, and a trip to the OBGYN I was referred to. The OBGYN was a bit surprised and even went as far as to ask me if I had considered adoption. She said she had done inseminations, but only with fresh sperm and was unfamiliar with the process/procedure for working with frozen donor sperm. After talking and hearing my reasons for wanting to proceed, she said that she wouldn’t have any problem assisting me as she felt that I had really thought things out. She wanted to get a baseline u/s of my kidneys because I was born without the tube between my bladder and kidney and had a kidney infection for the first 10 years or so of my life. So, back for more tests.

At the same time, I had started the search for a sperm bank and a sperm donor. I had decided that I would really like to have a donor who was willing to be ID Released when the child turned 18. While personally, I could care less, I have heard in a lot of adoption cases where the child wishes that they could contact their biological parents and for some this was a real issue. If my child cares, I want them to have the opportunity or at least to know that I did what I could to ensure that happened. Who knows, the guy could not stay in contact with the sperm bank or die, but at least I have done what I could from my end. I found a bank that I really liked and had my initial consultation and narrowed my search. By this time, I had decided to have the nurse practitioner (NP) at the sperm bank do the inter uterine inseminations (IUI) figuring that she would have way more practice than my OBGYN. I came to the consult with the results from my previous tests including the film of the fibroids from the u/s. The NP said she was happy to help, but really felt that I should have my fibroids looked at by an RE to ensure that they were not in a place that could impede pregnancy and gave me a referral to the clinic and dr. I have been using.

I had a consult with my RE and just knew that this was “right”. I really felt comfortable with his skills and knowledge and that he could help me reach my dream of motherhood. After reviewing everything with him, it turns out that the blood workup from my PCP was worthless because 1) It was not done on day 2/3 of my cycle and 2) I was still taking BCP’s at the time. I just have to laugh about how ignorant I was about the whole process back then and how fortunate that I ultimately ended up in good hands.

My blood work was re-done, but that presented challenges in and of itself because I had taken a new job at work and was doing quite a bit of traveling at the time. My cd3 blood work was actually done in a lab outside of Dallas early morning before meetings. Let me tell you what a joy that was to arrange and organize. On 3/23/2004 at 8:20 CT, my blood was drawn indicating that my FSH was 6.5, my Estradiol was 31, and that I don’t have HIV, Hepatitis, and the various other things they test for. I have learned since that these are decent numbers for my age group.

I was also scheduled for a fluid u/s so that my new RE could check on the placement of the fibroids to determine if they would be a problem. At that time it was determined that the size, placement, and position would not be a problem and that what I thought was one fibroid was actually 2. However, the dr. did see a polyp which needed to be removed prior to proceeding. I was scheduled for minor outpatient surgery to remove it.

Finally, after 6 months of prep work and planning, I am ready and set to go for IUI #1.

This years well women exam was actually done by the nurse practitioner at my PCP’s office. I was really hoping to get into see the new OBGYN recommended to me by my RE and that I has switched medical groups to be able to see within the HMO portion of my POS (point of service) insurance coverage, but couldn’t get an appointment with him until December. Since I needed this done along with a few other tests for my RE for my November IVF cycle, this just wouldn’t do. And, since I couldn’t get into see my PCP until the middle of November, I ended up seeing the nurse practitioner at my PCP’s office. I suppose I could have had my RE do it all, but when I see him I am under the PPO portion of my POS benefits which means that I pay 20% of the contracted rate for all service. By going to my PCP’s office, I had a $15 co-pay. Much more economical.

It was amazing to me when talking to the NP about how much more knowledgeable I was than she on the whole reproductive endocrinology and assisted reproductive therapy. As I went through the lab slips from my RE, I was explaining everything to her and why it was needed. She was really very nice and accommodating and included in everything I needed with the normal yearly well women labs that they do. As I lay in the stirrup’s in a position that has become all to familiar to me by now, I REALLY had to fight the urge to break into uncontrollable laughter as she guided me through the process. “I am going to touch you now. I am going to open you up now. I am inserting the speculum. I am going to get the culture now.” As I lay there getting the play by play trying not to laugh, I thought…”You’ve come a long way, baby”. The NP was very concerned that blood was present and kept asking if I was sure that I was not on my period or expecting it. She was so concerned that she actually showed me the blood on the collection swab. She also said that I had a zit or pimple like thing on my cervix (which my RE later told me was probably a benign cyst called a nabothian cyst) and that she was going to do an additional test as a result. A year ago, I would have been freaked out or worried by this. This year, I couldn’t even muster the energy to be truly concerned. I knew more at this point than the NP in the PCP’s office. What’s a little blood or a zit on the cervix? Shoot, with all of the extra hormones I have been on, I have had zits in all kinds of strange and interesting places. Why not the cervix too?

Yes, I’ve come a long way baby.

Friday, November 26, 2004

My Family

I suppose my family is as normal and/or as dysfunctional as most. I thought I would give the lay of the land so to speak on whose who:

My mom is 62 (born 4/42). She and my dad have been divorced since I graduated from high school. My mom lives about 40 miles away from me and I typically see her several times a week. I have a great picture of my mom and I that my cousin took when we weren't looking a few year ago. I wish I had an electronic copy. In many ways as the saying goes, I am my mother's daughter. I don't know how we got into the routine, but my mom usually comes on Wednesday night and we go out to eat and she comes on Sunday during the day and I make Sunday dinner. Recently, I have needed less structure and had several Sunday commitments and I haven't been seeing my mom on Sunday's. When my sister Kris (the baby) complained that I had "two" days and she didn't have any, my mom said, fine...you can have Monday's. This just makes me laugh! So, now they have dinner every Monday. They used to live with each other (long story) and now they don't. I guess it bothered Kris not having a day after that. I think it bothers Julie that mom comes to visit me so often and they do get together on occasion, but don't have a designated day. Every few months she will go out with us on a Wednesday night or stop by on a Sunday afternoon to visit. Probably, I am the closest to my mom and/or she feels the most comfortable hanging out with me at my house.

Mom, her brother Tom, her sister Barb at Beth's wedding in Nov 2000

My dad is 63 (born 9/41). He lives outside of Atlanta, GA. My father remarried about 10 years ago and they have a son together who is eight or nine. I have only met him a few times. My father’s wife had two sons by a previous marriage and they are both grown. She is also very insecure and psychotic who does everything in her power to keep him from his previous children. On the rare occasions where we are allowed to see him, it is only if she is present. I could tell some stories to illustrate, but I won’t.

Julie is my older sister. She is 13 months older than I am (born 1/65). She has two daughters who are both in college this year. They are currently 19 and 18 (although the 19 year old will be turning 20 next month). She lives less than a mile from my house. We are currently in two very different places in our lives where she is trying to deal with empty nest and I am trying to have a child. When she first found out that I was going to ttc, I received a several hour lecture on how selfish I am and how I should spend my time and energy finding a husband. It got a bit ugly when I finally asked her why it was so wrong for me to try to have a child by myself when I am older and financially secure and it was okay for her to have 2 young children by chance in her youth. “It just is” was her response. She did end up marrying the father, but divorced a few years later because he was a loser druggy. She remarried about 11 years ago to a wonderful/supportive man. She tried to be (or pretended to be) supportive of my ttc efforts once she knew I was moving forward against her advise/best judgment, but things have been fairly strained since we got into an argument this summer after my m/c. She told tons of people when I got preg. when I asked her not to, but didn’t go back and tell all of them when I m/c. This made things very difficult for me in a few cases. Funny enough, our argument was not about that, but something stupid. I do truly think she was happy and excited for me when I did get preg. She just can't imagine having a small child now or understand why I would want one. I have told her that she already has her children and they have brought her such joy (and pain and sorrow and everything else that goes with being a mom). I really just don't think she gets the need. We have continually made very different choices in life. We haven’t seen much of each other lately. While I wish it were different, I have needed the break while dealing with the m/c, my fibroid surgery, and my last failed cycle.

Summer 2003 in my backyard
Carolyn (Terri's youngest), Julie, Kris, Elizabeth (Terri's oldest), James (Terri's middle)

Cindy is my younger sister. She is 36 (born 12/68) turning 37 in a few weeks. She is the sister I am closest with. She lives outside of Atlanta, GA (about 45 min. from my dad) with her husband and 3 children who are 6, 4, and 3. We talk almost daily and see each other a few times a year. She is supposed to be coming out for a week the day after Christmas. I can’t wait. I saw them for a week this summer when they came out for a visit. Last year, my mom and I went to Atlanta to be with them for Christmas. She is “in the know” about my current cycle plans and progress.

Christmas 2003 at Cindy's in Atlanta
Cindy, Marcel, Mom, Sophie, Julian, Emilie

Kris is my youngest sister. She is 34 (born 6/70). What can I say? She is the baby of the family. She lives about 40 miles away in the same town that my mom lives in. We are just very different people. She is not supportive or unsupportive of my ttc efforts. She would also like to start a family, but I don’t think she would ever do so on her own. I could be wrong.

Hiking with the dogs
Debbie (many years ago when I was briefly skinny), Elizabeth, Terry, James, Kris, Lucky, Shadow

Terri is my cousin and one of my closest friends. She is 38 (born 11/66) this month. My mom and her mom are sisters. Terri and I spent summers together growing up. Every summer she would come out for several weeks/month to visit. We drifted apart during college, but my first job happened to be in Michigan where she lives so we were able to renew our friendship. She has 3 children (14, 13, and 7). I lived there when her two older children were born and it was difficult on both of us when I moved to Boston for work in 1991. She has come out to visit every summer for 3 – 5 weeks since her 7 y.o. was 6 months old. We just get along so well. As strange as it probably sounds, all I need is to find a man like her and I could be happily married. I also get along very well with her husband Jim. He is a great guy! She is also very supportive of my ttc efforts and is “in the know” about my current cycle plans and progress. She was here visiting while I had my m/c. I think this really helped me not go into a major depression afterwards. She also delayed her trip home by a few weeks so she could be here for my fibroid surgery. She was so awesome and took great care of me and my dogs while I recovered. One of these years soon, she is not going to make it out for the summer visit as the kids get older it gets harder and harder. I hope I have a child/children of my own by then because it will break my heart. Summer is meant for children and it feels so much more like summer with her and the kids here.

Summer 2002 in my backyard
James, Jim, Debbie, Carolyn, Terri, Elizabeth

As a side note, my sister Cindy and Terri’s sister Anna, who are the same age are very close friends as well. In fact, my sister Cindy moved to Michigan and lived with my aunt and uncle for her last few years of high school. At the time, my parents were getting divorced and Cindy was mature enough to know that she needed more guidance and structure in her life. Cindy and Anna and their families see each other every Thanksgiving trading off who hosts.

Anna and Cindy

One of the things I am most proud of in my life is going/graduating from college. Not only because of the opportunities that it opened for me, but also because both of my younger sisters have told me that my going motivated them to go. They both went through on sports scholarships (Cindy – Gymnastics; Kris – Soccer). They said if I could do it paying my way through and struggling, they knew they could do it too. My father wanted me to stay home, go to a junior college, and help take care of my sisters. It was a difficult time for the family as my parents when through their divorce and my mom was in the hospital for awhile. I knew that I had to go away for me and I stuck to my guns. I think I helped my sisters much more by going than I would have had I stayed home.

Anyway, that is my family. We fuss and fight and disagree, but deep down I know that we all love each other. I would love to have my own children. I want two. I want my children to have a sibling to play and fight with. Some how, some way, I am determined and destined to be a mom. I hope this cycle works and I am on my road to motherhood by the end of the year. That would be the best Christmas present ever!

Mom's 60th Birthday Party

Back Row: Debbie, Elizabeth (Terri's oldest), Cindy, Brittany (Julie's youngest), Terri, Carolyn (Terri's youngest), Nicole (Julie's oldest) Front Row: Julie, Mom, Aunt Barb

The cousins at Beth's Wedding in Nov 2000
Back Row: Kris, Cindy, Steve, Julie, Terri Front Row: Beth, Ana, Debbie (wish I looked like that now!)

Thursday, November 25, 2004

Happy Thanksgiving and other random thoughts

Happy Turkey Day. I woke up this morning thankful for what I do have. I’m glad. The past few days I couldn’t think of what I was thankful for without also thinking about what I don’t have in my life. What I want, but is not there. I wasn’t feeling negative or sad, just…..just…hmm. I don’t know exactly.

My cycle calm was challenged yesterday.

I had a lovely hike with the dogs. Except for the part where it was really wet and damp out and the fact that I only wore my tennis shoes, not my hiking boots and the grass was tall. My feet got wet. I hate that. Walking around in wet shoes/socks. However, I ignored that and we went on an extra long hike because I could.

I haven’t hiked in that area much (only twice) since this summer. They made it a “paid” parking area so they can raise funds to make it a bird sanctuary. So, I can park there for $3 each time or get an $80 year pass. I was so angry and bitter about this change that I couldn’t do it. I couldn’t pay to park there. I am getting over it and was just resigned yesterday. I used to hike that trail about 3 times a month. Now, I have only been doing it about every 6 weeks. Oh well. Anyway, I did an extra long walk so that the dogs and I could get our moneys worth.

I get home from hiking after stopping by Target and spending more money than I should have or planned. I bought the new Harry Potter DVD and the complete first 2 seasons of Sex in the City to watch on my 3 days of bed rest. I don’t have HBO and really watch very little TV. I seem to always find other things to fill my time. I have never seen (not one) episode of Sex in the City. Can you believe that? I spent almost $100’s on DVD’s for a show that I have never seen and am not sure if I will like. Oh well, I will be having a marathon. As I was selecting the sets, I was wondering if one season was better than the other and if I should just “jump in” random. I decided to start at the beginning. I have to say, I am now looking forward (instead of dreading) the bed rest so I can watch these. Because of that, it was worth the purchase.

I also bought my dogs and my friend’s dogs Christmas presents. My dog Lucky and her dog Daphne love the little squeaky toys. I got them both a little duck that quacks. Everything was still sitting on the counter because I checked voicemail and there was a call from my clinic. This had me bit worried since I was not expecting it. Turns out they wanted me to do another test, for Rh – Antibodies. I try to understand why from the nurse. Why now? Why at the last minute? What happens if I do have them? Is that a good (I think not) or a bad thing? What would be do differently? Anything? Yes, I am Rh- and my donor is Rh + and I did have a m/c and did receive a Rhogam shot. If they need it as just a precaution, why did I not get this test with my last medicated IUI instead of now that I am going into the IVF? So many questions that I still do not have answers for. I am glad that my Dr. takes and responds to email. As soon as I get some time, I am going to email him.

Anyway, got sidetracked with the story. I’m on the phone with my clinic and had moved into the office to check which line I had hooked up to the fax machine and my dog comes in with her Christmas present in her mouth. She is so happy. She must have jumped up and taken it off the counter. I should have been pissed since she knows she should not take anything off the counter, but I couldn’t help but laugh. She was so cute and happy running around the house with it making it squeak. I let her play with it, thought about letting her just keep it and getting her another present, but picked it up when she wasn’t looking and hid it off. She will be just as happy to see it again in a few weeks. Yes, I know. I am a dork buying the dogs gift. However, my friend is as big a dork.

Blogging my random thoughts are more of a priority than composing an email to Dr. who wouldn’t get it until at least tomorrow at this point. I am a bit concerned, but not panicked at this point. I think it is just a precaution. More data to have if I do get (oh, I mean when) pregnant on this cycle.

The nurse tells me that no, the test doesn’t have to be done today and I can have it drawn locally, but it will take at least 4 – 5 days to get the results and they would really like to have them, if possible, by my cd9 u/s check next week. Fine. They fax me the lab slip. I quickly shower. And, off I go to the lab. I walk in and am thrilled to see only one other person waiting. Great! I can get in and out and on my way. HAHAHAHAHA! I wait for at least 10 – 15 min. before some even talks to me. I show them my lab slip that says “Pt is RH negative needs a *Titer blood Test.” The two lab technicians talk among themselves about what kind of a titer test as there are several. They call the dr. office and talk to the nurse. At this point, I think I was watching them too intently because they ask me to go wait in the second room on the left and they will be in. The technician comes in (after about 20 min.?) and says they are still trying to figure out exactly what test. They don’t want to do the wrong one you know, but they need the room so they are sorry, but can I come back to the lobby. I do. A new lab request is faxed indicating that I need the Anti D Titer. They look up IDC9’s. They call their head office. They have no idea what test this should be and more importantly what colored tube it must be in. At this point, they ask me to call the dr.’s office. I do. My dr. gets on the phone. I hand the phone to the technician who is very please to actually be talking to the dr. Apparently, he wanted to do this before but the nurses wouldn’t let him. The tech is pleased to hear that I needed a Type and Screen test (he has heard of this one, code 360) and dooly notes this on the lab sheet that Dr. N had authorized this at 11 am on 11/24. Yes, I did get a copy of this. My blood was FINALLY drawn. Who knows when Dr. N gets the results, if it will be from the test he thinks he orders. Time will tell at this point.

My plan for Wednesday morning was to bake pies. It is now 11:20 and I am woefully behind schedule. I am making/made Cherry and Pumpkin. Hmmm. The Cherry Pie recipe is my grandmothers and is tasty. I have been looking forward to it for weeks and weeks. Anyway, the filling needs to “set” for awhile so I got that prepared then made the pumpkin. I was a tad distracted because of the whole Rh- thing and a bit confused about why they had me heat the oven at 425 for 15 minutes, then turn it down to 350 and cook the pies for 50 – 60 minutes. I thought, odd, okay, I guess I just need to start with a hotter oven. When the pies had been cooking for 50 – 60 minutes, they were still undercooked. Shit! I go back and look at the instructions closer. Upon closer evaluation, I re-read and realize I was supposed to bake the pies for 15 min. at 425 not just pre-heat the oven. Oh well. I decided to let them cook longer and see what happens. In the down time waiting for the pies to finish baking I'm on the computer looking up Titer Bloood Test. RH -, Anit D Titer, etc. NO HITS! NOTHING! The pies still look undercooked, but I have to go to get to my acupuncture appointment. I just shut off the oven leaving the pies in there thinking “How does one ruin pumpkin pie? It is one of the easiest pies to make, ever. Yes, I royally screwed up an apple pie once (and have never attempted it again). But, pumpkin? I’m telling myself not to get worked up about it. T here is nothing I can do about it now. I will just stop by the store on the way home from my appointment, get more ingredients, and do over. The Cherry pie filling will just have to "set" for much, much longer.

I get on the freeway and hit a wall of traffic. This is LA baby and the freeways can resemble parking lots at times. This was one of them. I almost burst into tears (and I am not a cryer). I was never going to make my appointment time and I was late for my last appointment (a long story). I kept telling myself. Be calm. The Rh – test is a pre-caution, not a problem. You will get info. You can just remake the pies, not a big deal. There is nothing you can do about the traffic. Stay calm. Don’t let this rattle you. Stay calm. Don’t get worked up. Stay calm. You can do nothing to change any of this at this point. Stay calm. Yes, a lot of self talk. When hiking that morning, I was thinking about how calm about this whole cycle I have been and how prepared mentally and physically I feel for it. I was happy. I was thinking about what a challenge and what a feat it will be if I can make it through the whole thing this way, but know that it was going to get harder and harder as things progress and more hormones get put into my body. Experience tells me this. It is much easier (but still very, very hard) to be calm, cool, and collected at the beginning of a cycle. Much, much, harder with the hormones.

I am only 5 – 10 min. late, whew, and my acu (Denise) was in with another patient so I had time to calm down, breath deep, and try to relax. My acu works with her husband and there are other acu’s and chiropractors and such that share space. Her husband, A, finishes with a patient and comes and sits down to talk with the receptionist/office helper, J? It’s a small area and I can’t help but overhear. J is talking to A about a patient she is seeing outside of the clinic and how the patient is really crazy. A asks J if he is helping her. J says, well, I listen and try to support her, but I am not a therapist. Then, they start talking about Denise in that light. I burst out laughing at this point, drawing attention to myself, and tell them that yes, I have referred to Denise as my mini-therapist at times. We all have a good laugh. A says, yes, she likes it and so do her patients. Enter Denise. She’s ready for me. Do we jump right in and start treatment? No, we talk for about 10 – 15 min.(aka mini-therapy session). I tell her about my morning and the test and the pies and the traffic and my cycle progress. Then, treatment. I just love her! I left feeling much calmer. She saved the day. The major freak out was saved and calm was restored. I decided to take the coast home and saw the sun setting over the ocean. Nora Jones playing in the background. I had a nice drive through the mountains. Made a few phone calls. One of which to my house to see if my mom was here yet and to see if the pies had made it or I needed to stop. Good news! No need to stop by the store. The pies weren’t ruined after all. Yes, there was some traffic, but it wasn’t horrible. An hour later I am almost home, but feeling good. I call Denise to thank her.

It is going to be a challenge not to let the stress of life and the cycle get to me, but I am committed. Everything at this point is out of my control. I am following dr.’s orders. I will have whatever follicles I have, we will get what eggs we get, what will fertilize will fertilize. I am vowing NOT to stress over these things. They are unknown, but they will be what they will be. There is nothing I can do to change things at this point, but to follow my instructions.

When I get home, my mother had not taken my strong hints to put the Cherry Pie filling into the pre-made store bought crusts and get them in the oven. Deep breath. No big deal. I did it. Then, walked the dogs. I knew that I wasn’t going to feel like cooking or going out on Wed. night so I made dinner (baked chicken and brown rice and cucumber and mushroom’s with a special holiday dill dip) on Monday. Heat and serve baby. It was perfect.

My sister, Julie, came by to visit for an hour or so. She and my mom drank a bottle and a half of wine while she told stories that she has told either a million times or at least the other day when I saw her. I kept thinking, I wish I could go on the computer and research the Rh- stuff instead of listening to these drunken stories again, but I didn’t. I haven’t seen much of my sister since this summer after my m/c when we got into this fight (I’ll save that story for another day) and I have seen less of my mom than usual lately so I sat there politely visiting with them.

Thanksgiving is not at my house this year. I moved into this house Nov. 1, 1995. I can’t believe I have been here for 9 years. This is the first time since then that Thanksgiving is not at my house. This makes me so happy. My sister decided that she wanted to just have a small affair with her and “her family” since both of her daughters are off at school/college this year and will both be home at the same time. This left my mom, my sister Kris, and I on our own. I really think my sister did this to try to hurt us and make us feel excluded and it really annoys her that I am happy with it. When the topic first came up, my mom thought I should cook a small turkey breast for us. My sister Kris thought we should go to Marie Calendars. My friend Heather, who knows I am cycling, invited us all over. This is a win-win for both of us. This is her twins first Thanksgiving and her husband broke his collar bone a few weeks ago. He can’t help with the children. We decided it would be a lot more fun and less stressful to share the holiday. My sister Kris hated this idea and told my mom and I, fine, she would just go eat at Marie’s by herself. Can you say emotional blackmail? I said okay, if that’s what you want to do, but you are more than welcome to come with us. My mom waffled back and forth. She wanted to go to Heather's with me, but didn’t want Kris to be alone. Finally, she committed. It turns out Kris’s friends Liz and Kevin who were going to go camping decided to not and she is spending the day with them. So, it all worked out well. Julie was explaining to my mom and I that it is “good to shake things up” like she did. Again, I think she was just trying to stir the shit and make us feel bad. I again told her how happy I was that it worked out the way it did. I think she thinks I am just saying that, but really I am not. It has been so much less stressful not having to prepare everything and knowing that I don’t have to spend time with her while jacked out on hormones. It makes me a tad sad that I feel that way. I would like to have a better relationship with her since we live so close, but I have realized this last year while ttc it takes two and things work great when everything is about her. Enough about that for now….

I think there really is something wrong with me. I have been on vacation this week and the latest I have slept is 5 am. Every other night I have been up at 4. This is truly sick. I wish I could sleep better. I was doing really good and back to normal sleep patterns until I started the Lupron/Dex for this cycle. I made it worse last night by having a small piece of both Pumpkin and Cherry pie after dinner. Added to the 5 amps of Gonal F which hype me up anyway and I was up until 11:30 and awake at 4 am like clockwork. Oh well, I am going to enjoy the holiday and the lack of sleep will be worth it WHEN (not if) it works.

I’ve been feeling like I am going to get a cold/fighting off a cold. I was telling Denise about this when I was in so that she could maybe “treat” that as well. She reminded me that I felt that way on my inj. IUI cycle, but that I never did. She’s right. A sore thought, achy, either roasting hot or freezing cold with little middle ground, bad headache on and off that won’t quit, feel like a cold sore coming on. We had the same conversation and agreed that the stims just may affect me that way as my body starts working so hard to overproduce eggs. I’m sure it would help if I got a decent night sleep. However, now that I know that Tylenol PM is safe now and throughout pregnancy. I avail of that and get at least 4 – 5 hours.

I have ideas and thoughts for about 5 blog entries that I want to write, but haven’t had the time. Maybe I need to not be on vacation to slow down. HA HA. I am so glad I am on vacation this week. It was busy enough without having to worry about work as well.

The sun will be rising soon and time for my next shot..Lupron..soon. I am glad that I am done with the 5 amps a night down to 3. It is a lot of mixing and takes awhile. I am getting better and faster with each day of practice.

Man, my mom is like a hawk. I had that small bottle of Lupron in the fridge hidden behind the butter. She wasn't here for more than an hour and she's asking. What's this for? Who needs shots? You or the dogs? I couldn't believe it. I just didn't say anything for about 30 seconds. Then, I said, me. She said, well your brave. I couldn't do it. Thank God, she left it at that. Man, she's sees a lot more that she lets on half the times. Then, wammy, she hits you with it. I know that it hurts her that I am not confiding what is going on with my ttc plans, but I just can’t right now. As I lay awake in bed last night trying to relax from the sugar/Gonal F high, I thought about telling her and I just got a knot in my stomach about it. Even though I know she would keep it quiet now she would not be able to resist asking tons of questions or even if she did I know that she would be thinking them anyway and hoping and wondering. It is much better her not knowing at this point. I am sorry that this hurts her, but I need to do it for me. There is so little that I can control in this process. I just need to control the information about it. It will be bad enough that I will be disappointed again if this doesn’t work. I don’t’ want to do it to her to. I know she wants to support me, but I will feel like I let her down again. She so wants me to be pregnant and have a baby and to have another grandbaby that lives close to her. Maybe not rational my need to keep this quiet, but that’s how I feel. She will just have to wonder about why I am giving myself shots. It is better this way.

I still have a few more random thoughts rattling around, but I’ll save them for another day. I’m glad that I was able to get down what I did. Off to shoot up, hike the dogs, and hype out on sugar by having another piece of Cherry pie for breakfast. Hey, my mom made that rule/tradition years ago. You ALWAYS start Thanksgiving day with a nice healthy slice or two of pie. Her rules, not mine. I’m just going with the flow in my nice calm cycle state.

Happy Thanksgiving!

Thansgiving 2004 at Heather's with Martin, Heather, Charlie, Debbie, and Mom (Sanger taking picture and Hadley taking nap)

Thanksgiving 2004 with Hadley and Daphne

Tuesday, November 23, 2004

Green Light

I was like the energizer bunny yesterday. I just kept going and going and going. I hadn’t really planned to, but I ended up putting up ALL of my Christmas decorations and lights up. It is something that I wanted done this week while I was on vacation, but it just seems….wrong….to actually put it up before Thanksgiving. I did want to get my outside lights up and wanted to get my fall decorations put away. With all of the cycle related stuff and Thanksgiving, I needed to get some of it done today so I didn’t have to do it all next weekend after being on stims for a few days. It is important to note here that Ana, the lady that cleans my house every two weeks, came today. This means that I had a time factor and couldn’t leave anything undone or she would not be able to clean. As I had all the boxes out and the house a mess putting away the fall stuff, I thought, I may as well put up the Christmas decorations since the place was already a wreck. Then, I thought, do I really want to put the Christmas tree up next weekend trashing the house after it has just been cleaned? The answer was NO, NO, and NO. As I was giving my dog’s their evening walk, I was feeling really guilty and embarrassed with having my outside lights on, the tree up, etc. and people have Thanksgiving yard art up instead. I am clashing with the seasons. I was joking with my neighbor and one of his buddies about it who assured me that it was okay and that I had “real” Christmas lights (the multi-bulb ones, not the icicles) and he whole heartedly approved. I was feeling embarrass until my neighbors son (who is 3) got home and started yelling. “Daddy, Daddy, Look! Daddy, Christmas Tree Lights! Christmas Tree Lights!! And, Candy Canes. Look over there. She has Lights up”. He was so happy. He came over and told me how much he liked the lights and the Candy Canes as he walked around looking at them with big eyes. He was so happy that it made me happy. It made my day. I’m glad that I did it and it is done.

It was a bit harder than I thought it would be. Last year, I was sure that I would be pregnant this Christmas. In preparation, I re-wired the lights on the Christmas tree because it was a fire hazard. The tree came with the white lights and I had added colored lights and some of each were not working. When I took the tree down the year before it was melting the surge protector. Not good. When I took off all the old lights and put on new ones, I filled a large trash bag with the old lights. It was really quite frightening. I hadn't realized how many were actually on the tree. Anyway, I was a bit sad that I am not very pregnant right now (my original baseline plan had be delivering in February 2005). I’m glad that it is done. And, there is still a chance I could be pregnant by Christmas. I am feeling very calm and getting excited for this cycle.

I had my baseline u/s and E2 check today. All looks good and stims start tonight. E2 was 19. Lining was 4.8. Antral Follicle Count was 9 (5 on one side 4 or the other). Next check, a week from today.

Today was pretty busy as well. Mostly just running around getting ready for Thanksgiving, the u/s apt., moving the sperm to the clinic. I also went to a late lunch/early dinner with a friend and to the movies. Great way to kill time waiting for the E2 call and the green light. I feel like I am coming down with a cold. Hope I can avoid that.

Off to mix up the Gonal F and then to bed.

Monday, November 22, 2004

cd1 and the calendar

Today is officially cd1! To honor the event, I thought I would post my calendar.

10/10/04 Start BCP

11/13/04 cd - 8 BCP, 10 U Lupron, Dex .75, “Cycle Starts”

11/14/04 cd – 7 BCP, 10 U Lupron, Dex .75

11/15/04 cd - 6 BCP, 10 U Lupron, Dex .75

11/16/04 cd – 5 BCP, 10 U Lupron, Dex .75

11/17/04 cd - 4 BCP, 10 U Lupron, Dex .75, Last BCP

11/18/04 cd – 3 5 U Lupron, Dex . 75

11/19/04 cd – 2 5 U Lupron, Dex . 75, Expect Period

11/20/04 cd - 1 5 U Lupron, Dex . 75, Expect Period

11/21/04 cd 0 5 U Lupron, Dex . 75

11/22/04 cd1 5 U Lupron, Dex . 75**We are here**

11/23/04 cd 2 5 U Lupron, Dex . 75, 1 mg. Folic Acid, Baseline u/s and E2, 5 amps Gonal F

11/24/04 cd 3 5 U Lupron, Dex . 75, 1 mg. Folic Acid, 5 amps Gonal F

11/25/04 cd 4 5 U Lupron, Dex . 75, 1 mg. Folic Acid, 2 amps Gonal F/1 Pergonal

11/26/04 cd 5 5 U Lupron, Dex . 75, 1 mg. Folic Acid, 3 amps Gonal F

11/27/04 cd 6 5 U Lupron, Dex . 75, 1 mg. Folic Acid, 2 amps Gonal F/1 Pergonal

11/28/04 cd 7 5 U Lupron, Dex . 75, 1 mg. Folic Acid, 3 amps Gonal F

11/29/04 cd 8 5 U Lupron, Dex . 75, 1 mg. Folic Acid, 2 amps Gonal F/1 Pergonal

11/30/04 cd 9 5 U Lupron, u/s and E2, Expect further instructions

12/1/04 cd 10

12/2/04 cd 11 Probable HCG Trigger

12/3/04 cd 12 Probable HCG Trigger

12/4/04 cd 13 Probable Egg Retrieval

12/5/04 cd 14 Probable Egg Retrieval

12/6/04 cd 15

12/7/04 cd 16 Probable Embryo Transfer

12/8/04 cd 17 Probable Embryo Transfer

12/9/04 cd 18 Probable Embryo Transfer

12/10/04 cd 19

12/11/04 cd 20

It’s odd. I am actually looking forward to this process, everything except the 3 days bed rest/house arrest after the transfer. I think it is the controlled aspect ofit. Everything is monitored and controlled every step of the way. It is very appealing to me.

I have to say that I am starting to get excited!!

Is it the FSH, the Estrogen, or the LH?

I am on vacation this week. Yahoo! I am so happy about that. It was actually planned before I knew I was cycling this month, but it works out well since I have a lot of cycle related things (baseline u/s, sperm run, acupuncture) and it will nice to get it done without worrying about juggling work as well.

Since this is my first day of vacation, what I am I doing up at 4:44 am blogging? Yeah, well, not one to ever sleep in. Last night was actually a decent night sleep. A solid 6 hours with no sleep aid. In an ideal world, 7 hours is usually best for me so 6 isn’t too bad. Since I started the Dexamethasone and Lupron, I have had trouble sleeping. It was worse in the beginning and climaxed last Thursday my first full day with no BCP with only 2.5 hrs sleep. I am not sure if it is the FSH, Estrogen, or LH, but one of those hormones when increased causes me insomnia. I am sure the Dex doesn’t help, but it is not the primary cause…in my humble opinion.

When you first start taking Lupron, it causes your body to produce more FSH/LH causing a feedback loop to prevent further production of it by your body. Once this happens, you can lower the dosage to maintain the bodies freeze on the production of these hormones. Once it has been confirmed during the cd2/3 baseline u/s that the Lupron has done its job and your ovaries are quiet (indicating that the body is no longer producing these hormones), stims can be started to stimulate the ovaries, but the Lupron is continued so that your bodies natural hormones remain suppressed and don’t interfere with the ones being injected allowing for more predictable results.

Based on the above understanding of Lupron (which I confirmed with my dr.), going with my theory of FSH, Estrogen, or LH causing the insomnia that my sleep would be worse when first starting Lupron, but once it was suppressed it should get better. I don’t really understand how the BCP fits into it and why the insomnia peaked after stopping them. I read the package insert on the BCP’s last night, but that was useless because it only talked about how you should use the BCP’s not how they work. My Taking Charge of Your Fertility book just said that they affect your hormones by causing your body to already think it is pregnant. Obviously, more research is needed here.

Once I actually started my period, which has been lighter than normal, but more than spotting, my sleep improved. Before I started all the ttc, I did notice that a day or two prior to getting my period, I would have trouble sleeping. It is more pronounced while cycling.

It seems to be a fairly rare side affect, insomnia during stims. I have run into a few people out there in internet land that have this reaction, but most don’t. Again, clearly something that needs more research. I suspect that maybe it is the LH. It will be interesting to see how I respond on the Gonal F (pure FSH) stims with Repronex (FSH/LH) thrown in a few times as opposed to my Injectable IUI cycle with only the Repronex.

Why is this important? It’s not. Just interesting to me. I like to find the patterns. I like to understand the details and the whys.

Sunday, November 21, 2004

Why Blog?

Why Blog? I have been thinking about this on and off all week after talking to a friend about it last week. She mentioned that she wouldn’t want to put her story and the intimate details of her life (my words, not hers) out on the internet for all to read. It made me realize that I felt that way once as well and not so long ago. I have been pondering the idea of a blog since this summer when I miscarried. I was sure that if I stared one, I would want it private and password protected. How could these women tell their stories and all the pain and highs and lows for all? I found them very courageous, but as I tend to be more private, it was not something for me.

Going through this trying to conceive (ttc) process has really changed me. I’ll save the details of that for later, but sitting here today I realize that while this year has been difficult, I have really grown and I have met a lot of great people along the way.

I have always been open with my family and friends about wanting to have a child. When I actively started the process, I gave full discloser. Family and friends knew what was going on every step of the way. Mostly, everyone was supportive and I was so happy to finally be pursuing something I have always wanted…children.

In the middle of my first 2ww, I was feeling … I don’t know exactly….anxious, hopeful, and a strong need for “something else”. I was out reading the archives of the discussion board for my clinic and I found a reference to IVF Connections and that other women who were going to my clinic posted there for on-line support. I hightailed it over. Even though I was still doing IUI and it was an IVF board, I posted. I am not much of a lurker. Everyone was great and very supportive. I had mentioned that I was single and going this alone. Another single on the boards sent me to Single Mothers by Choice (SMC). Wow! Yes! I was not alone in this. It was so great to have these forums. They were exactly what I needed at the time. I felt so much less alone. As much as my family and friends love me and were supporting me, here were other women going through what I was. They “got it” in a way others that have not gone trough the process never could.

When I went into my last (3rd) IUI, I was in a very different place than where I was when I started this process. When I found out I was pregnant (from my 2nd IUI), I was so happy. I knew that miscarriage was a possibility, but the reality was something else all together. Those more experienced with the process cautioned about telling people so early. I told a lot of people anyway. When I did miscarry, it was really hard to tell everyone and to have to talk about it. Even though I had asked others not to share the news, they were so happy for me and did. Unfortunately, in a few cases, people were told I was pregnant, but not that I had miscarried. I got a couple of comments weeks/months after the m/c from people that I didn’t realize were told that I was preg., but hadn’t been told of the loss. This was incredibly painful for me. I did not want this situation to happen again. I wanted more control over the information about me “out” in the world among my family and friends. Mostly, I just didn’t want to talk about it anymore. Period. I felt like such a failure. Like my body was now a traitor. For the first time, I thought maybe this won’t work. Maybe I will never be a mother. The hurt was too real and too painful. It is just not something that I could have out there. I stopped talking to my friends and family about what I was going through. I told them that I was planning on keeping the details of what I was going through private. I tried to explain why, but I know that they don’t really understand. This really wasn’t/isn’t about them, but about me and where I was/am. I just couldn’t stand the questions because it felt like a dagger to the heart with each one because this hadn’t worked. I needed time to heal without people constantly bringing things up and asking how things were going (or not going). It was like picking the scab off the wound before it could properly heal.

The source of comfort and camaraderie that I was feeling with my on-line friends was weaning at this time as well. Several were successful in achieving pregnancy. Others were taking a break from it all. And, I was feeling left behind. I know that this wasn’t personal to me and that just like I needed to not talk to my family and friends about it, they were in a different space. The people that were successful moved on leaving only those that it didn’t work out for remaining. And, that number was less and less, re-enforcing the feeling of failure making me feel bad about myself instead. I was personalizing everyone’s pain and disappointment and adding it to my own. It got to be too much. While I still post occasionally on these forums, I no longer feel comfortable expressing as much detail and passion as I once did.

During this time, I also found the world of blogs. Unlike the IVFC and SMC groups, I almost without exception was/am a blog lurker. There are many, many courageous women out there who have gone through some incredible things to try to achieve a family. Every women has a different story and a different journey, but in so many ways the feelings and emotions and highs and lows are the same. I learned so much from reading them. I realized that my feeling after the m/c and the failed cycle were “normal” in ttc land. Once again, I felt less alone with the process.

Why blog? I think I need a place to process what I am going through and what is on my mind and I no longer feel comfortable doing that in the ways/places I had in the past. I could do a private journal instead (and have thought about that), but I feel like I would be more committed to a blog. I realized that I was already posting intimate details of my journey in other public forums and that by blogging, I would just be doing so in my own space instead.

Maybe, just maybe, someone will come across this and my story will help them like others stories have helped me. Mostly, I think it will be therapeutic and a way for me to record my story for me.

Tuesday, November 16, 2004

Lupie Lupron?

The early morning ramblings of someone who can't sleep. Read on at your own risk. Maybe it will make sense, but I'm offering no guarantee.

I've been thinking about a few posts that I’d like to write, but have been a bit sleep deprived these last few nights and work has been busy as I prepare to be out of the office for several weeks (okay 4 total) of vacation/holiday in Nov./Dec. Maybe I'll get to them while I am off work.

The way I understand it, Lupron causes your body to overproduce FSH/LH causing a feedback loop to your body to cut production in order to "quiet" your ovaries and temporarily put them in a state of menopause. Once this has been confirmed by cd2 u/s, stims are started.

I have found a re-occurring pattern that shows that when ever I am on stims (Clomid and Repronex/Pergonal) that causes more FSH/LH, my sleep seems to be reduced by the amount of the hormones produced. So, maybe I will have a brief period of time where the Lupron feedback loop has kicked in lowering FSH/LH and before stims where I will get a few nights of sleep. Otherwise, this month just got a lot longer. On the other hand, you can get so much more done in a day the less time you spend sleeping. I was expecting the insomnia once I started Gonal F/Pergonal in a few weeks. The Lupron insomnia caught me a bit by surprise. Of course, it could be the Dex, which is supposed to cause insomnia and nausea in some people as well, but I don't think so. The FSH/LH theory better fits the pattern.

I had a consult with my dr. a few weeks ago and got a lot of questions answered. I have a few more like why my protocol has me on Lupron throughout the cycle instead of switching to Antagon or Citratide once I start stims. I think it is because on my inj. IUI cycle I started with 5 follicles, that went to 3, that reduce to 2 at time of IUI. I think he wants to make sure that I don't oversupress. I've been pondering this for awhile. Since I am awake at 3:30 am PT and have nothing better to do, maybe I will kick him off an email. On the other hand, I have decided to trust that he knows what he is doing with all of this; maybe I don't really care enough since it not going to change anything. Hmmm.

I just love the fact that my dr. answers emails. When I first stared this process, I had pages and pages of questions. I really have cut back as time has gone on. My friend, M, pointed out that I have a terrible habit of asking him a question and then telling him what I think the answer is. She is right. I can't just ask a question without giving at least one (or more) probable explanations. I have tried. I wonder why that is.

Other than not being able to sleep and a low grade headache (also a side affect of Lupron), I think things are going well over here. Okay, other than that car accident that I almost got in because I wasn't paying attention (looking at directions) and didn't realize the light had changed and almost pulled out in front of someone. I have been much more cautious since.

Moving to a few items that may fall under the too much information (TMI) category around bodily functions...so don't read on if such topics disgust or annoy you...I have noticed that my urine has a really foul odor these days. I wonder if this is also the Lupron as well. When on stims (FSH/LH) enhancers in the past, it has been accompanied by frequent loose stools. The Lupron seems to be causing frequent formed stools. My dr's explanation in the past was that as the ovaries grew they pushed on the intestines causing this. However, since I am on BCP's and Lupron is supposed to suppress them further (at least for the time being), I wonder what would cause this. Reading the Lupron package insert constipation is one of the reported side affects (as well as insomnia) which would explain the "formed" part. But, what about the frequent? Why do I even wonder about this stuff?

On this high note, I think it is time to move on to other pastimes until daylight and the new day official begins.

Saturday, November 13, 2004

And, the cycle "officially" starts

At cd -8, my IVF has officially started. How do I know this? Because, my calendar says so.

BCP - a
10 U Lupron - a
Accupunture - a
Dexamethasone - pending

I got a twinge of excitment earlier today while hiking with my dogs. After all, it could happen this time. It is not likely, but it is possible. All in all, I think I am more ready and relaxed for this cycle than any of my previous ones.

Friday, November 12, 2004

how exciting! or not

I always thought that I would be a Kool Aid mom. You know, the house where all the kids want to go and hang out. The house with milk and cookies. I've always wanted a family/children.

Life doesn't always work the way you think it will.

I've been saying since my 20's that if I wasn't in a serious relationship by the time I turned 30, I was going to have a child..."so don't think it was an accident". Thirty has come and gone. I am currently 38. Still single. Still no children.

A little over a year ago, I started to actively try to conceive. It has been a roller coaster of a year. I have done 3 medicated IUI's (2 clomid, 1 inj.) in April, June, and September. I had a confirmed pregancy with my June cycle, but had an early miscarrage. It was devestating. My dr. recommened that I have my fibroids removed before trying again. I had them out in early August. I had such high hopes with my September injectable cycle. I was doubling my odds and had two perfectly sized follicles. Negative.

For a lot of reasons, I decided to move to IVF. I have been on BCP's since my September negative. I am one of the few women that react very well to being on birth control pills. I LIKE being on them. I have spent most of my adult life on them. I found it more than a little ironic that in October 2003 I went off BCP to get pregant and in October 2004 I went on them again for the same reason.

Anyway, my IVF cycle officially starts tomorrow with my first Lupron shot. Those that know that I am cycling this month keep asking me if I am excited. I'm not. I'm not, not excited. I just "am" for now. I wish I were, but I'm just not. I really hope this works, but the reality is that very few people get a postive on their first IVF. Maybe I will be one of them. If not, I already have a solid plan for my next cycle.

I just feel like I have been in a war this last year and that I am battle weary.