And Then the Other Shoe Dropped

As I can imagine my few loyal followers have probably figured out due to my delay in posting, we lost our 7th baby. This time at 6w4d, and just two days before our first ultrasound.

I have wanted to come out here and blurt out my feelings a few times, but haven't been able to make myself post until now. Our hearts are absolutely shattered...we're still picking up tiny pieces every day. I break down occasionally at the most inconvenient times, and other times I feel strong when I feel like I shouldn't be strong. Grief is a funny thing that way. I can turn away from it, pretend it's not there, go on with life as if nothing has happened. But suddenly, out of nowhere, it slams into you like a Mack truck. Crushing you over and over, and then reversing and running you over yet again. Sometimes it is accompanied by floods of tears, sometimes silent screams of torture. At times I yearn for the numbness where I can't feel anything...where I am impervious to pain. The worst part of all is struggling in virtual silence, alone. My (amazing) husband can commiserate, be compassionate, attentive and 100% willing to do anything for me. But even he doesn't know what it ALL truly feels like. The physical, the mental, the overall feeling of having your heart ripped from your body. He knows too much of the pain, but even he can't feel all of it.

Other mothers who have suffered loss do know this feeling, and some handle it differently than others. Just as everyone handles grief in their own way. Sometimes I envy those who appear strong on the outside, until I remind myself that things aren't always what they appear. Just as I suffer, they suffer too. Most of us suffer in silence. We suffer in silence because you never know how someone will react. People have all sorts of ideas of when they think a baby becomes a baby. I won't risk the chance of someone telling me these babies who have started to grow inside of me weren't "real". Because my view is not shared equally with everyone, it becomes a taboo subject. People feel awkward. They don't know what to say or how to react. So, for the most part we continue to suffer quietly, not willing to risk bringing up the subject in fear of being hurt (mostly unintentionally).

Unfortunately, there are people in the world who believe "everything happens for a reason" "it'll happen when the time is right" "God wasn't ready for you to be a mother yet" are words of comfort and compassion.  I have heard all of these things, and more. While they are meant to be comforting, they don't realize those words can sting just as badly as saying nothing at all. By this point, I've learned to steel myself against those words, and expect them. I whoosh them right out of my brain as soon as I see or hear them. It does me no good to reflect on them or be angry about them. They usually aren't meant to be hurtful. But let this be a lesson to those of you who might use those words to someone in a similar position. They are not generally helpful, even if we nod in agreement.

Being raised Catholic, having believed in God, a higher power, that something out there must exist for most of my life...my faith has been shaken by these experiences. This loss has further solidified my position as a non-believer. I certainly have not been perfect in my life or always done the right thing, but I have done nothing awful enough which would be worthy of this punishment. No one should be reduced to screaming in their living room in pain because they are losing their baby. No one should have to watch the sadness and desperation in their husband's eyes as they hold you helplessly, unable to comfort, unable to stop bad things from happening, unable to fix what's wrong. I did nothing to deserve this kind of heartbreak and pain and I cannot stand to believe that someone "up there" is MAKING this happen because I'm learning some life lesson or the time isn't right or it just wasn't meant to be. No being could be that cruel. I can't take comfort in the thought that someone has given me this path or that it's supposed to shape me to be a better being or that it's for some cause or reason. That thought has become unacceptable to me.

For now, we're at a standstill. We talk about things often. We go back and forth between wanting to try right away again because we might be on the right track and being so weary and hurt...we're not sure if we're willing to take the chance of having to repeat this pain. It hurts to be unable to be excited about a positive test, or making it further than we have before. To have to stifle your excitement and be realistic about your expectations. Heck, to not be ABLE to have any expectations. It's a nearly impossible thing to do. I went about this last baby as if everything was on track and perfect. And it was. Until it wasn't.  There is something very unfair about that.

I thank you all for your kind thoughts (even if they're not seen or heard, because I know you're still sending them my way) and compassion. I hope some day to be able to bring some truly good news to this blog instead of seemingly constant disappointment.

5w6d - 6 days to go

Tomorrow, I will "officially" hit 6 weeks. As "official" as we can calculate before our first ultrasound, that is. But, the daily countdown to the ultrasound is underway and we have just 6 days to go until we get to see the first photo of our little Peanut. I can't beleive I am typing that right now.

I am overjoyed, over the moon and not overly anxious. I have to trust that things are progressing as they should, as everything seems to be. I have no complaints, I have been sleeping well, still able to eat (despite being occasionally frustrated or unsure of what exactly it is that I want and very occasionally queasy) and feel good physically. I am trying to be happy, to enjoy the present and leave those worries of the future out there for a bit longer. Yes, there are a lot of things to worry about, but there is no sense in thinking about them right now. I just need to make it 6 more days before we can truly relax a bit and start our planning.  6 days. 144 hours.

Desiderata
Go placidly amid the noise and haste, and remember what peace there may be in silence.
As far as possible without surrender be on good terms with all persons.
Speak your truth quietly and clearly; and listen to others, even the dull and ignorant; they too have their story.
Avoid loud and aggressive persons, they are vexations to the spirit.
If you compare yourself with others, you may become vain and bitter;
for always there will be greater and lesser persons than yourself.
Enjoy your achievements as well as your plans.
Keep interested in your career, however humble; it is a real possession in the changing fortunes of time.
Exercise caution in your business affairs; for the world is full of trickery.
But let this not blind you to what virtue there is; many persons strive for high ideals;
and everywhere life is full of heroism.
Be yourself.
Especially, do not feign affection.
Neither be critical about love; for in the face of all aridity and disenchantment it is as perennial as the grass.
Take kindly the counsel of the years, gracefully surrendering the things of youth.
Nurture strength of spirit to shield you in sudden misfortune. But do not distress yourself with imaginings.
Many fears are born of fatigue and loneliness. Beyond a wholesome discipline, be gentle with yourself.
You are a child of the universe, no less than the trees and the stars;
you have a right to be here.
And whether or not it is clear to you, no doubt the universe is unfolding as it should.
Therefore be at peace with God, whatever you conceive Him to be,
and whatever your labors and aspirations, in the noisy confusion of life keep peace with your soul.
With all its sham, drudgery and broken dreams, it is still a beautiful world. Be careful. Strive to be happy.

Miracles Do Happen

After my last appointment with Dr. G., he said at my next positive test to give them a call and get in for bloodwork and a start on my Lovenox injections. I fully expected I'd be waiting quite some time for that to happen, but apparently my body had a different idea in mind.  Apparently my change in diet along with my Metformin gave me an early kick start. I had done zero tracking or planning of any kind, and really had no idea where I was in my cycle.

On October 15th, I felt that now too-familiar naggy little headache. I took a cheap Dollar Tree test and thought I saw a line. It was what I call a "squinter" because it's barely there. The next morning I stopped and picked up a Walmart cheap $0.88 test and a pack of First Response tests. When I tested on the First Response test, there was a shadow of a line there. I have analyzed the hell out of tests over the years and I know a positive from a negative and I got excited but I just wasn't 100% sure I wasn't seeing things or trying to convince myself of a line.  My husband was no help. "I think maybe" was about the best I got out of him.  The doctor had told me that starting my injections wasn't an immediate need as long as I was on my baby aspirin, but that worried me because I knew things went from good to very bad VERY quickly in the past. 

My October 17th test was convincing enough for me. I called the doctor.  They immediately called in bloodwork for me. It was 6:30pm by the time the lab got me in, so I'd have to wait overnight for my results.  When the call came in, I was so happy. My HCG levels were a 10!  Under normal circumstances a 10 is very low, at the very end of what the even consider positive and viable, but hey! I was a 10!!

So, they called in my prescription for Lovenox. After momentary panic over the cost of those injections ($900/month) I decided I was more thankful than ever for our insurance, which covered all but $5.00 of those outrageously expensive blood thinners.  They wanted to show me how to inject myself, so after picking up my boxes from the pharmacy, I headed in for injection training.

My nurse was great. She said she thought I'd do just fine, that I certainly seemed motivated enough. When she showed me what to do, I stuck the needle in my belly and felt nothing. I also felt nothing as I injected the syringe. Wow, that was easy!  Much easier than the panic I had started to feel after hearing that it caused some pain. They made a follow up blood test for Friday to do a re-check of my levels.

When Friday rolls around and I go back in, I anxiously await the results. When it gets to be 4:45, I still haven't gotten a phone call. My mind instantly goes to bad news. Last time they made me wait through the weekend it was because my level had dropped to a 2. I started to panic.  At 4:55, the results are in. The nurse on the other side says "Well, hmm...let's see. Looks like you doubled, you are at a 20." If I could have sang from the rooftop in that moment, I would have. I had a double!  She tried to be rational with me right away and say "It just means it's very early" I said "That's ok! I have never had an actual double before!" she laughed and said "Well then I guess congratulations is in order!".  She said the doctor was gone for the day but she'd put the note in his mailbox and they'd let me know my next step on Monday. 

I fully expected he'd want more lab work on Monday, but no. He was confident with my level rise, and instead we're just going to schedule an ultrasound for November 8th.  At the time, it was a long 17 days away. Now, we're down to 15 days. It's flying by already. :) 

I still worry. I still have moments of panic. I have alarms set on my phone for my injections, vitamins and meds because I'm so freaked out I'll miss a dose of something.  But so far, things are good. My symptoms are good. And yes, I'm still testing and those tests just keep getting darker.  I hope at some point (maybe after the ultrasound) I can relax. But people, it looks like we're having a baby!!!!!!!!  After all this time, it's still very surreal.

An Answer

When I met last time with my brand new OB (Dr G), he was great. He listened patiently, and was proactive. He had some actual theories for what was going on with me.  When I was there, he pulled out a piece of paper and started two columns. I instantly had flashbacks to Dr Asshat and his "list", but tried not to panic.

Instead, I found him to be intelligent and knowledgeable. He was not concerned a bit about our fertility. Fertility is not the issue. He was willing to explore what was really going on with me.  One of the things on his list was a clotting disorder. He said it doesn't happen often, but can be a cause for early losses. He said I could go down to the lab after the appointment and get checked. I did. 7 vials later, I waited with anticipation because he said it could take up to a week for results to come back. 

My followup phone call with the results of that test brought instant tears. But not tears of sadness, at all. Tears of joy and relief. One test, one week, and we had an answer. An answer, people!! A real honest-to-goodness answer.
He found that I have something fairly rare called Antiphospholipid Syndrome, or APS.  The bottom line is that I have sludge for blood. It is prone to clotting and could cause some serious health issues down the line like a heart attack or stroke, along with miscarriages.  I have known for quite some time that getting blood from me is not easy. In all of the vials of blood I've had taken over the years, it's a struggle for them and frequently the flow will just stop. Then they poke me again. Sometimes they've just given up completely.  They have always blamed it on crappy veins or that I didn't drink enough water. I lived with that and always warned whoever was taking my blood that they might have a difficult time.

So while absorbing that news and making a follow up appointment for our plan, I was trying very hard not to be bitter...thinking about the things that could have been. Instead, I decided to move forward focusing on the fact that we had someone helping us and knowing we have a diagnosis.

My next appointment was scheduled a few days later. I was nervous and excited. He told me I'd need to start blood thinners as soon as I got another positive test, and to stay on my daily baby aspirin (which I had been less than consistent with taking over the months). The blood thinners would be an injection I'd have to give myself every day called Lovenox. Combined with my Metformin, Progesterone 2/day, Baby Aspirin, and prenatals, I had quite a cocktail of things I needed to remember every day.

Then, the name of the game became "Waiting".  But for once, it was a happy wait. An "I have an answer" wait.  And little did I know, I sure wouldn't have to wait very long. 

Learning to Live with Loss

It has been a long, long time since I've written. We took a break. We tried to stay busy. I put the thermometer away. I stopped tracking. We tried to just "live" for a while. I kept trying to pick up the phone to call a new OB but kept putting it back down. I wasn't ready. I still cry frequently when I think of Dr. Asshat and the things he said to me. I'm still traumatized by him, and the way Aurora Medical Center and Aurora Fertility Services handled things. On my really bad days, I filled out my hospital surveys for Dr. Asshat and sent them in. I left online reviews for him. Limited impact, but it made me feel better. My testing obsession subsided. I was tired of getting my hopes up to just have them crushed. Mostly, I just tried to get back to living.

My grandmother (my last living grandparent) also passed away. Little did I know that while I was going through the emotional turmoil of losing her and dealing with my crazy family, I was pregnant again.

I was determined I was just going to let things be that cycle. I didn't do any early testing. I made sure I didn't even have them in the house. I just kept trying to move forward until one day I felt a little naggy headache.  I know what those headaches mean. 

The next day, I went and bought a pack of First Response. I took one that night before bed and thought I saw a little second line. I had quite a bit of water that evening and thought it could just be a evap line, since I sometimes got those gray evap lines on FR tests. When I held it up to the light it looked like maybe it had some color but I wasn't sure if it was just wishful thinking, so I went to bed.  When I tested the next morning, there was a definite pink line. I picked up a pack of Answers, another FR and ClearBlue digital tests, and my obsession came back like it had never left. Test after test, double lines. I showed Tom and he was seeing them. Understandably, his reaction was not one of excitement or joy. Instead, his reaction was solely "Are you going to call a new doctor? Promise me you'll call in the morning?".
That night, I bit the bullet and took a digital test.  One word popped up. Pregnant. The one word I had been waiting for such a long time to see on one of those stupid digital tests. This was REAL to me. Not that it made any of our other positive tests less meaningful, but it meant it was stronger. It meant I was already beyond any point I'd been before. When you've been waiting to see one of those tests show only one word for so long, finally seeing it does something magical. It transports you to this euphoric place. I floated to the living room on cloud nine with that test in my hand. I was shaking. I was grinning like a fool. Tom was standing there sharing a piece of string cheese with the dogs when he gave me a funny look. I handed him the test. I couldn't even get the words out. Neither could he. We stood there hugging and bawling for so long. THIS was the moment we'd been waiting for. I wanted to celebrate. I wanted to let myself feel the joy of that little word. I didn't want to think of the what-ifs or the negatives. I wanted to be able to be happy. I have seen my husband emotional over the years, but he's still a "tough guy". Our hug and cry session was therapeutic. We had both needed to do that for a very long time.  Again, he asks if I'm going to call the doctor. I promised him I'd do it in the morning. I was cautiously optimistic. He was holding his cards pretty tight to his chest.

When I called the new doctor, his receptionist told me they had a protocol on seeing patients, and that he didn't see anyone before the 9-10 week mark. She made an appointment for a 45 minute "orientation" meeting with a nurse, and another for October 18th for my actual first appointment. When I expressed some concern over waiting that long because of my history, she was nice enough to transfer me to a nurse. When I explained my story to the nurse, she was immediately concerned and said she would check with the doctor and call me back. An agonizing 2 hours later, she said they wanted me in for blood work, and that they had already called in a prescription for Progesterone and that he wanted me on baby aspirin immediately. I was so encouraged by that step. A step I had yet to be able to get a doctor to take for me. This was exactly what I thought I needed. 

I had to put my realist hat back on. I had stopped on my way to work to pick up more tests. I even grabbed a First Response gold digital Yes or No test. When I took it, it said NO. I blinked and looked at it again. Still No. I looked at the non digital I had taken with the same urine and it was clearly still positive. I tried to search for the sensitivity of FR digitals online and found encouraging news that they sucked. I chalked it up to just detecting really high levels, and it was maybe still early for me. But any remaining joy I had crashed after seeing that No.

I found myself getting incredibly stressed. I screamed at Tom on the way to the hospital because he was late picking me up. I was out of control. I was a walking combination of fear and hormones. Blood test was at noon. I waited impatiently for the results. When the call came in a couple hours later that afternoon, the nurse was gentle and quiet. She asked if I knew when I had ovulated and I said I couldn't be sure. She said "Ok, your hcg came back at a 7. That's pretty low, but it could still be early."

After I hung up, my heart sunk. In my heart, I just knew 7 was not good. How would a digital test pick up a 7? Heck, how would my regular FR pick up 7, when they never had before?  I tried deluding myself into thinking that it was maybe just really early or that on some off-chance, the blood work was wrong and that things would be ok. I kept up on my progesterone and my aspirin and rode the hormonal storm. I continued to pee on sticks. I continued to try to convince myself those lines weren't getting lighter.

When I went for my recheck, I already knew. I still had no spotting or bleeding, but had some cramping the night before. I knew better. I went in again at noon for blood and waited for that phone call. And waited. And waited.  I hoped that a no news was good news type situation. But I knew better.

The next morning, my lines were lighter. But I was sure working hard to convince myself otherwise. Now, when I look back at the photos of those tests initially, there is a HUGE difference. Granted, all of those damn tests are finicky and inconsistent from one pack to another. (See me justifying it even now?)

The call came in around 9 or 9:30. The rest of that day is a blur right now. All I heard was "2" and I shut down. Broke down. Fell down. She said he wanted to see me though. Whenever I wanted. I picked Thursday Sept 27th, thinking at the very least I'd be over things by then and in a better place.

For the next few days, I waited. Impatiently. No spotting, no cramping, nothing. I had stopped my progesterone the night before that phone call because I already knew, so I didn't bother to take my morning dose. I just wanted it over with. I couldn't face it, couldn't make it real until I saw it was over. I was a mess.

I feel like I have suffered an incredible amount of loss, more than a person ever should. I feel like I've been in some stage of grief or mourning for such a long time that I'm not sure what "normal" is anymore. Maybe this IS my normal. That I can function at all after what I've been through...dang, in my eyes it deserves a gold medal.

I am encouraged by the steps my new doctor is taking, however. He has put me back on my Metformin after being flabbergasted about Dr Asshat taking me off of it. He seemed encouraged himself that we've managed to achieve these pregnancies without intervention so far. For now, we are hoping the combination of Met, progesterone and baby aspirin just might be the magic we need. I sure hope so. 

Trauma

I have been a such blog slacker. I just realized I never published this post this when I originally typed it back in April until I just went to type a new post. So here it is, more than a few months late...

We've all heard it before. "If it's meant to be", "Everything happens for a reason", "It'll happen when it's the right time", "God has a plan".  Generally when I hear those statements uttered (which is quite frequently) I roll my eyes, nod my head or give a simple "yeah" response.  But I don't actually believe it.  My faith has been tested over the last year, many times. My spiritual faith, faith in myself, my body, and faith in my doctors have all been questioned and doubted. Who do I trust? What do I believe in? Can I keep doing this? 

I was hoping with Spring on the way, April would bring a fresh change in our lives. A restart. We were going to do everything in our power to try to make this happen on our own this year before taking the invasive treatment course of action the fertility specialist wants us to take.  We started a vitamin and supplement regimen, and got back to dieting.  When I started getting very light positive tests, I was ecstatic. I was feeling so good, a bit different than normal symptom-wise, I was not stressed and we were really happy and had faith this was going to be IT for us. Perhaps it was blind stupidity, but we didn't utter a single negative thought or give any "what if's" a chance to register. Our excitement started to build.

Conveniently, I had scheduled a follow up appointment with Dr. Laibly, my regular OB/GYN, because I wanted to discuss the possibility of trying a few cycles less-invasively. I had mapped out a plan for us and we needed minimal help, mostly in the realm of a prescription and some lab work. But now I was going to be able to able to walk in there with a positive test instead and didn't even have to worry about it.

My appointment was on Monday, but by late Sunday afternoon I had started spotting. I had hoped it was leftover implantation bleeding because it was "old" blood, very light and I had no cramps or pain.  I rested with my feet up, but unfortunately by the time the evening rolled around, I knew things were over. I was upset and discouraged, but took comfort in the idea that I had an appointment in the morning and we would be able to make a plan and get some answers and get things rolling in a better direction for us.

What happened that morning is something I'll never forgive or forget. I've been through some rough appointments, both mentally and physically before, but this...this was unbelievable.

His first words were "Your established with Severino (the RE/ fertility specialist).  Why are you here?" I told him about the tests and said that I had just started to miscarry. He looked at his notes and shook his head. No compassion, no "I'm so sorry", nothing.

He asked if they were treating me yet & I said "no, not yet. We did this one on our own". He said "So what do you want?" I said I actually ovulated later than normal this cycle so I was hoping he would run Cycle Day 3 labs (which measure 3 hormone levels and can be a good indication for ovulation issues), give me a prescription for Clomid or Femara & do some day 21 labs to keep an eye on my progesterone. He immediately got defensive "Why? Because you want to?" I was surprised by his reaction. I said yes, that after our appointments with the specialist, I wasn't sure we needed to be that invasive with treatment since my results all came back normal and we are able to get pregnant on our own, we just can't get things to stick.

He said "I looked at his notes, he said you need IUI with a trigger or IVF. You need to ovulate earlier. I practice science and evidence-based medicine. Look, your 34. You have challenged ovulation and sperm issues. Your case is beyond me".  At this point, I'm crying pretty hard and I said "Ok, I just feel like we're getting so close and that something must be missing. I just thought it could be the possibility of being a progesterone issue".  He shook his head. "You've been tested, you're hormones are fine. Severino wouldnt try selling...uh, pointing you in the wrong direction".  I told him he specialist specifically told us that he can't guarantee Tom's sperm morphology issues are the reason we aren't getting sticky babies. I said one of the RE's nurses had mentioned my late ovulation as a concern for why things aren't working...that my lining is breaking down as implantation is trying to happen. It's such a time-sensitive process that even a day or two could make a all the difference in the world. 

He said "Look, again, I'm a science guy. There's no proof progesterone supplementation even works. I'm not going to do that."

He turned around a piece of paper and started writing my options. 1. Nothing. "But your here so obviously that doesn't work". 2. Clomid days 5-9 "but I won't monitor it and Severino already said you need IUI with a trigger." Then he wrote 3 and 4, and started talking about IUI and IVF, and their cost, which he proceeded to quote incorrectly.  "Look its expensive to have a baby. If you guys had saved up for all the years you have been trying I'm sure you could find the disposable cash or your savings. He crossed out options one and two and circled 3 and 4. "You need the best bang for your buck. You need to go home and discuss it with your husband. You guys need to decide between IUI and IVF at this point".  Talk about a crushing blow. He was saying we had no other options. This was it for us. He said "I don't do IUI. I won't. Well, maybe when I'm old. I don't want to be stuck here on my weekends doing that stuff". 

The appointment was summed up him saying "Im putting follow up "As Needed". That means I don't want to hear from you again until your pregnant".

As I sat in the chair crying, he asked if I needed a few minutes. I said yes and he started to walk out. He turned around and smiled. "Hey, if there is anything else you need or that I can do for you, just give nurse Jen a call and let her know you want to talk to me and I'll call you back". 

If you cannot already see why I was upset over the way he treated me in those 15 minutes, let me recap...

1. He made me feel old by commenting on my age. At 34, I haven't even reached the "advanced maternal age" designation.  All sorts of women have babies at 34, and many even older than that.
2. He certainly wasn't willing to listen to my concerns, nor was he familiar enough with my chart to actually know what our issues are.  
3. He chose to say I had "challenged ovulation", even though on paper my tests have all come back perfectly fine and I do ovulate regularly. Our "sperm issues" are minimal and even the fertility specialist said plenty of men with known morphology issues go on to father perfectly normal healthy children.  So, why the resistance?
4. The whole science vs progesterone issue...progesterone doesn't hurt anything. You can't overdose on it, it's not a controlled substance and the fertility specialist (who belongs to the same hospital system and who my OB said he works closely with) regularly prescribes it to their patients.  Again, why the resistance? 
5. The rude and unnecessary comment regarding him being stuck on weekends doing IUI procedures was completely uncalled for.  I wasn't asking him to do an IUI on me. In fact, it was exactly what I was trying to avoid entirely.  
6. His follow-up comment about not wanting to see me until I'm pregnant?  Who says stuff like that to a woman who has had multiple miscarriages? 

It was truly awful. I only wished my husband had been along to witness his behavior.

So maybe, just maybe, this was meant to happen. Maybe somewhere along the way I would have found him to be intolerable or the wrong fit for us if I had ended up with a successful pregnancy and would have been "stuck" with him. Tom didn't like him from his first experience at my HSG with him, said he was a jerk. He absolutely traumatized me.

Who To Trust And Hospital Big Business

The doctor at my clinic is not only a fertility specialist, he's a Reproductive Endocrinologist (RE). An RE is trained to specifically evaluate and treat hormonal dysfunctions as it pertains to infertility. Typically a vital doctor to have on your side when dealing with PCOS.

We all know hospitals and fertility clinics are BIG business. This clinic specifically is a member of Society for Assisted Reproductive Technologies (SART). Being a SART member means the clinic reports everything, participates in specific protocols and is regulated by the FDA.  I didn't think much of it at first, but the longer I've had to process things, the more concerned I become. Why does there need to be governmental interference in this process?  What is the advantage to the patient by using a SART clinic?

If things on my end look so good and they can't guarantee that my husband's issues are causing our losses, then what's the deal?  Why the big rush to the most expensive option? At our first appointment before they had conducted any tests of their own, they handed us a 3" binder filled with IVF information. It was quite obvious where their focus was.

I have researched all of the results I had access to.  I also found many of my results were not even posted to my online portal, even though ALL test results are supposed to appear there. That's when I began to find that what they were calling "good", weren't necessarily big-picture good.  The Anti-Mullerian Hormone (AMH) test can be done at any point in your cycle and while it can't tell the quality of your eggs, it can measure quantity. Results between 5 and 15 are considered normal.  I am 34 and started my cycle early in age so I expected to have come back with a lower than typical number, but him saying my results at a 3.73 were "good" was misleading. In terms of a normal woman's fertility, those results are low.

When I found a document in the big binder giving what their acceptable range of results were, the light bulb went off.  I was at the very high end of acceptable in their book for nearly all of the results I've actually been able to see. Just because I fit in those IVF-able numbers, it means there is nothing wrong with me?  Of course it doesn't. To them, it only means I'm a candidate for IVF.  They don't actually care what my numbers look like in terms of my health or ability to have a child without intervention.  They don't care that I'm ovulating on my own. They don't care really what my body is doing naturally at all- they have meds for that.  I truly believe I'm only a statistic to them and their main concern is how I will contribute to their reporting. A cynical way to look at things? Perhaps. But, it makes complete sense to me.

I think it's a rare thing to find a doctor you truly like and trust.  You always need to have your eyes open and be sure of what they're telling you. Second opinions and research are vital. Right now, my biggest concern is staying pregnant. All of the injecting of good sperm in my eggs mean nothing if I can't stay pregnant. I would be totally monitored, which is great, but can't I just be monitored by doing this on our own? 

So, I've decided I'm going to take this all back to my OB. He originally referred us because of my husband's issues, but now I want him to take a look. And, if he won't, I'll find someone who will.

Changing Your Mindset

I love blogging. I don't do it often enough, but I enjoy going back to re-read my previous posts to see how I was feeling at a particular time.  After re-reading my last fertility related post, I realized I was angry and frustrated. It was valid anger and frustration, but I am that way so infrequently that reading it makes me smile a little. It shows me I'm still IN this, still fighting for it.  Sometimes it takes a while for the brain to process and emotions to follow.

My husband's second semen analysis using the more accurate protocol came back much the same as the first.  Out of 500 total sperm tested, in batches of 100 at a time, only 1 out of every 100 are considered normal. We're looking essentially at 1%, where a fertility specialist wants to see nothing under 4%.  When talking about abnormal, we found it doesn't necessarily mean his are freakish by any means. What we found was mildly encouraging. They aren't crazily misshapen, no double heads or tails, no missing tails, no coiled up or odd shapes. The nurse said "yours aren't too bad. We see some crazy sperm sometimes".  Most of what was considered his abnormal were wedge-shaped heads, or a little thickening of the area right under the head.


Unfortunately, there is not enough known about the process of what attracts sperm to an egg. "They" say the egg has almost a signaling beacon of sorts which only attracts perfect good sperm. "They" also say abnormal sperm are still able to penetrate an egg and make a perfectly healthy baby. My doctor actually said "I can't guarantee that his morphology issues are the reason you aren't staying pregnant". My confusion level skyrocketed. So, are his sperm our problem or not?

They came to my test results.  Shockingly, after a crazy number of vials of blood and testing, everything with me came back in their normal range. I'm still not sure how that is at all possible, but he literally said "there is nothing at all we would treat you for".  Even all of my testing for PCOS issues like testosterone and androgen hormones all came back normal. He said my ovarian reserve testing came back "good". I happened to see the number they had down for that AMH test, and it was a 3.73.  I didn't know what that meant at the time, but if they say it's good, it's good, right?

This doctor was quite specific with his recommendations. IVF is most highly recommended (about $15,000 for a 42.9% chance at a live birth), followed by a monitored cycle with Clomid (a ovulation inducing medication) followed by an insemination ($6,700 for a 20% chance). Last on the list, and not recommended, would be a monitored Clomid cycle without insemination, but with timed intercourse instead. The nurse said right away that it's not recommended because really it's no different than what we've been doing already.

After our appointment, we were both left feeling a bit frustrated and lost. It also led to a pretty big disagreement over what to do financially and whether or not to put a price tag on our future child(ren). After a lot of soul searching and discussion, we've come to the conclusion that barring any new information we may gain with a 2nd opinion, we'll wait out the rest of 2012, in hopes of doing this on our own. He's agreed to get healthier, diet with me, stop his caffeine and start his vitamins.  My hope is that now that we're at least established patients with the fertility clinic, they'll be really on top of monitoring me at the next positive test. Hopefully if there is some yet-undetected issue with me, they'll catch it early and we can make the next one stick. 

I'm currently on cycle day 19, and should be ovulating any day now. Bring it!

Make Me A Believer

Caution- long post ahead. My apologies in advance...

I'm a skeptic. A big one.  I'm always looking for the logic behind things because it keeps my world orderly. If it weren't for my questioning of things and my incessant research to find the answers to anything and everything, I'm sure I'd have a little more free time in my day. I recently had an experience which left me questioning, but also provided some insight and answers, if I choose to believe. 

During my short-lived college career, one of the things I learned was to read tarot cards (hey, I was learning something!).  It was fun for parties and people were always impressed by my skills.  But, it was just that...a skill.  I don't claim to be any sort of psychic and when learning tarot, I recognized there was a process involved. Anyone willing to get a tarot card reading is of a certain vulnerability. They want answers, they want their future told, they want to believe, all of which works to a reader's advantage. If you actually study the meaning of the cards, you'll find they're just generic enough that their meaning can be interpreted many ways. Basically, the magic comes with the reader's ability to sense and follow the direction of the person being read. Everything from facial expressions down to the jewelry they're wearing are all indicators for a reader to follow.  My sister was also involved on the back-end of production in television, so I know the stuff that goes on "behind the scenes" of the psychics you see on TV. It is the magic of television, afterall.  When you put all of that together, it can make it difficult for a skeptic to believe in these things. I do believe that sensitive people exist. I believe in spirits. I also believe that anyone who advertises themselves as such is probably a big fat fake.

When my best friend announced she was taking me to a psychic for my birthday I was a bit hesitant. I didn't want her to waste her hard-earned money for nothing.  I reluctantly agreed to go but I wanted to know the woman's name. I also wanted to make sure my friend didn't provide excessive information over the phone which would have allowed this "psychic" to research anything in advance. As it turns out, she only asked for my friend's first name, and didn't ask mine at all. Ok fine, score one for her.  

I went researching. After a quick Google search of this woman's name plus "psychic", I found no results. After searching the name of the city she was located in plus psychic, I found 10 results in the surrounding area, but no mention of her. After a Facebook search, I found her name, found her page but found NO mention of her abilities. She was a normal 40-ish woman who likes animals and Barnes and Noble. I found her address, which lined up with the address I was given. I even know how much her house is worth. It was nothing extravagant, which also served to make me a bit more comfortable that she's not out taking advantage of people while living it up in a mansion. Good. 

As the day approached, my friend was getting excited. I was encouraged by my earlier findings, but I still wasn't planning on putting much stock into what was said. I was just going to go with the flow. 

We pulled up in front of a cute little house.  When we walked in, she asked my first name. She had just a chair and couch, coffee and end tables and one tiny candle burning off to the side next to a bowl. No incense, or heavy drapery or crystal balls to be found. The room was painted a soothing light green and the furniture was big and overstuffed with lots of pillows. She was so "normal" you'd never pick her out in a crowd.  She asked us to have a seat on the couch.

We sat quietly for a moment while she started scribbling on a notebook. I saw her write 7 and boy. She looked right at me and asked if I had a 7 year old son. I shook my head no and she looked shocked. She said nephew? I said no. She looked confused. She said wow, he is definitely here. He got here before you walked in. He is very strong around you. She kept writing on her notebook.

I waited a bit, trying to figure out this 7 year old and just couldn't make a connection. I was trying to calculate what year that would have been but I didn’t want to miss anything she was going to say, so I just shook my head. She shook it off and said maybe we’d come back to it.  She asked if I was dating/married. I said yes, married.  She asked his name.  I said “Tom”.  She said “what is his full birth name?”  I told her and her eyes got big. She had circled the name Ray on her piece of paper.  Tom’s middle name is Ray, and his grandpa’s name was Ray.  She looked a little confused for a minute and shook her head again. She said she might have to come back to that.

She asked if I was in school. I said no. She said "hmm, I see you in school, do you teach? I see you surrounded by children". I just kept shaking my head but she said “young children... they love you, they are drawn to you. I don't know what you do, but teaching is very good for you”.

What she didn't know was that I originally started college with intentions of a major in elementary ed. I ended up on another path, but I think about it often. I also had been given the "assignment" of signing up for a class, any class, from my boss at my last review which I still haven't yet done.

She asked if I was self-employed.  I said no.  She said “you don’t run a business?”  I said I used to.  She said she feels I’m solitary, that I work for myself. Well, technically with the way things are set up here, since I’m a department of 1, I am solitary…a little island. And, I do freelance from time to time.  She said she sees me in business for myself.

She said I have a golden path, that I’m starting a new birth year, then she paused and said “when is your birthday?” and I said “tomorrow acutally”.  Her eyes got big again and she smiled…she said “you really are starting a new birth year right now then!”

She said she feels I have to do something this year, that whatever it is, to work for it but don’t worry about it, that the path is there for me to take.

Then she said she felt trauma around me and I needed to identify it. She asked if there was connection between kids and trauma.  I gave in at that point a little and mentioned my losses, but provided no details. She asked if I was afraid of something each time and of course I was...afraid of losing the baby. She pressed a bit. “But what are you actually afraid of? What has made you afraid?”  I said with the first one that I had just found out before getting on an airplane and that I was scared to death to get on that plane because of it.  She said “ok, but that’s where you were projecting your fear. The airplane wasn’t causing your trauma”.  I got it after that. It made sense. It wasn’t my fear of the airplane at all, but just the knowledge told to me that something was wrong with me and that any pregnancy would be difficult to attain. 

She believes the trauma was caused by my first doctor diagnosing my PCOS and telling me that if I didn’t have kids right away that I never would. She talked about the fight/flight/freeze in us and how if our energies are not being focused correctly and we hold trauma in physically, it can certainly have an effect on us physically.

She gave me the name of an author who has a book with skills for removing that stress and trauma. Peter Levine. One book specifically she mentioned has easy exercises to help, including one to identifying sensations and applying descriptions to them until they move or leave entirely. Interesting.   

She said my husband and I have a very bright path and that she sees a lot of happiness around you. She asked if I was creative. I smiled and said I was a graphic designer. She said that doesn't fulfill all your artistic needs though, does it? I said no. She said to make sure I have a lot of creative outlets for my art energy. She said there are creative people, mostly women since it’s a feminine attribute, but others are finger-printed as artists. She said creative people need an outlet, but true artists need many outlets. She described me as a glass of water or a water balloon. That if I don’t have enough places for my creative energy to go that it overflows or blows up and makes a mess.

So, after contemplating what she had to say to me, she made me a believer. Those were things no one could have known. Heck, they're things even some of the people closest to me don't know.  My friend had similar results. This woman was completely on target for her, though I had to laugh because what she told her was stuff I've been telling her for years.  So maybe I'm a little psychic after all?  ;)

Our entire session was well over 2 hours even though we were supposed to be there only 45 minutes each. This poor woman desperately needed a nap after she was done with us...she looked exhausted. All in all, she made me a believer...in HER, anyway. If nothing else, I ordered the book she mentioned. After doing a little excerpt reading, I realized that if there was even a slight chance that she was right, some coping skills to get rid of some of the traumatic events of my life would be good for me no matter what.  Perhaps if I can eliminate some of the baggage, I'll be healthier all the way around. 

A Man Named Murphy...And His Law

Those who know us know that somehow, if luck is to be had by either of us, it will be bad luck. Small odds? We got 'em! 

In the last two weeks, two additional freak incidents of low percentage odds were thrown our way.  At this point, if it weren't so darn heartbreaking, someone would probably find it amusing.

First, I had my HSG to ensure my uterus looked normal and my tubes were clear. They were, in fact, perfect.  As I'm not accustomed to hearing anything of mine being normal, much less perfect, so I was happy despite the terribly uncomfortable procedure.  My doctor did not give me antibiotics for the HSG (which involves icky things like a speculum, catheter and contrast dye) but I had heard from others who had not been prescribed them either and figured all was well.  After some research, I found only 2-3% of women who have this procedure done end up with an infection. Those are some small odds!  One day after the test and I knew something wasn't right. Yup, I'm one of the 2-3%.  Super. Because the test had to be done when it in my cycle, did the infection was really coming close to affecting our timing for the month. I was worried, anxious and unhappy.

But, we had our consult with the infertility doctor coming up in 2 days. I didn't have much time or energy to dedicate to being frustrated over the infection because it was STOMPED on by the anxiety I had for this appointment. I was worried. More than worried, actually.  I was straight-up freaking out. These people have the future of our potential children in their hands. I know what walking into a fertility clinic means to most people, and I also know the generalized push to shove every woman immediately into their big money-maker, IVF.  We had already discussed our position on IVF and knew we wanted to try everything possible before going down that road and were hopeful that they wouldn't immediately tell us we have no other viable option. 

When we arrived, we were quite happy with everyone. The nurses were great, doctor was great, even their finace lady was helpful and friendly.  They gave us a tour, went over everything we needed to get started and asked if we wanted to at least get our bloodwork going that day.  Since the clinic is a full hour's drive away, we figured we'd go ahead and get the ball rolling with the blood draws.  I am typically a terrible blood-giver.  My veins (if they can even find one) suck and I have never had good luck.  Well, even this nurse proved that getting blood from stone was possible when she got me on the first stick and there wasn't even a tiny pinch of pain. My arm did give up after the first 9 vials and she had to move to my hand for the rest, but that was still major progress.  She told us no news is good news, so we would only hear from them if there was something we needed to take care of. 

They did push IVF as I expected, but it wasn't a hard-core sales pitch at least.  Her words basically were that they wanted to give us the highest possible odds of walking out with a baby in our arms and technically with a 50% success rate, IVF makes the most sense in that regard. Even with that, we felt comfortable and really taken care of. They wanted to redo my husband's sperm analysis in hopes that the first test was incorrect and getting me the meds I need by running all of the correct tests (finally!) all at once. 

The next day, I saw the now-familiar phone number come up in my phone. It wasn't an immediate feeling of dread, nor did I really think about why they would be calling.  In a cheerful voice, the nurse says "Well, we got the first of your bloodwork results back...and..." was all I had to hear before my heart sunk.  I remembered the "no news is good news" comment and knew immediately this was not going to be a pleasant call. 

Apparently, the doses of the MMR (Measles, Mumps & Rubella) vaccine I was given when I was 1 & 5, has worn off.  One of the "important" tests the clinic is required to run is to ensure every woman has an up-to-date Rubella (German measles) vaccination.  They are not allowed to continue to treat a patient until they are properly immune.  Rubella can cause serious issues while pregnant, including miscarriage and severe birth defects.  While that is all fine and good, it's also ridiculous. There were 3 cases of Rubella in the entire United States in 2009. Three.  Small odds? I think so.  Also, what are the odds of a vaccine wearing off?  They can't be big.  Another win for me.  And, even more frustrating?  It pushes back our efforts even more. I cannot even attempt to conceive for 30 days after the vaccination since it's a live-virus vaccine.

To say I'm disappointed, irritated and angry doesn't even begin to describe it. Those brick walls just keep popping up out of nowhere.  And no offense, but if I hear another person say "everything happens for a reason" or "it'll happen when it's supposed to happen", they might be looking at a fist in the face. So, now I go on Wednesday to get a pointless vaccination for something I'd never likely even be exposed to.  Oh, wait...with my luck and odds, perhaps I would have come in contact with the 1 person in the US who might have it. 

Unfamiliar Territory

I expected to have fertility problems. I have crappy cystic ovaries, I'm overweight, and I haven't taken the best care of myself over the years. I expected it, prepared the best I could for it. While you might never truly make yourself "ok" with an infertility diagnosis, you deal with it the best you can and remain hopeful that you'll be blessed despite your body's faults. That your overwhelming drive and desire to be a parent will triumph over the hurdles you face.

Today I received a call with news that all of my pondering, all of my worry and concern over my own fertility wasn't prepared to handle. My husband is the one who is being referred to a fertility specialist. Not me... Him. How did that happen?

When you spend so much energy and focus on your own issues and you have to refocus on a new hurdle, it's overwhelming. Not to mention the emotional baggage which comes along with it. No man wants to be told they are less than perfect. It is a blow to the ego of even the least self-conscious guy.

So while my own fertility is still in question, we need to refocus. Spend some time and energy on him. I guess perhaps I'm a bit thankful in this instance for my own struggles, if it at all helps me provide emotional support to him.

So, onward we go. Uncharted territory for both of us.

Doctors Are Supposed To Make Patients Feel Better, Right?

To say I've had my fair share of doctor problems over the years is an understatement.  I have had everything from doctors who had terrible schedules, to a doctor who actually used to ask me what I thought was wrong with myself...you know, because I am really a doctor in hiding, of course! I've had doctors who blamed everything on my weight and treated me poorly. Doctors who were uncaring and ones with terrible bedside manner.

I don't believe I'm particularly more needy or demanding than any other patient, in fact, I don't enjoy being a "bother" and certainly don't want to become one of those patients who the doctor rolls their eyes at whenever they hear they called again about something.  So even when I'm ready to rip their hair out, I don't show it.  It's an area that I suffer silently (er, well...silent to them, anyway).

After having really high hopes for a great doctor, I thought I got so lucky with this guy. He had been amazing at my first appointment. It was productive, I had done everything he wanted me to do...got all of my paperwork released from my previous docs, I went in for my ultrasound, hubby went in for his semen analysis...all was well. I just had to wait for results.  We've discussed the impatient-factor I have before, but I WAS patient. Very patient. 11 days patient.  I waited out those results, praying every day something would be posted in my online portal. Wishing for a phone call. Making sure my phone was charged and right next to me at every moment, just in case.  During that time, I was also in the 2ww and obsessing about what I was hoping was going to be my BFP, so that I didn't have to wait and worry anymore anyway. 

I had high hopes this cycle, we had taken the route my new doctor prescribed...less frequency, better timing. Turns out we had perfect timing according to his schedule for us. I had an amazing looking chart. My temp kept going up, up, up! Best looking chart in over a YEAR! I started testing at 9 dpo, looking for any hint of a line so I could call and they could get me in for a level check.  Nothing. 10 dpo: Nothing. 11 dpo: HUGE temperature drop, and since I'm a glutton for punishment, I tested anyway and got another big fat NOTHING.  And, "Aunt Flo" (I really need another nickname for her...Aunt Flo sounds much too friendly) made her appearance that very day. 

My doctor had instructed me to make sure I called right away on the first day of my next cycle to get my HSG (AKA hysterosalpingogram, a test where they place a dye which runs through the uterus and fallopian tubes to ensure everything is clear and there are no abnormalities or blockages) scheduled. So, being the very obedient patient I am, I call.  And that's when everything starts to fall apart. 

The next several days consist of me being angry and impatient. First, I am told there is no order in the system and that they have to have an order before they can schedule the HSG. Ok, fine. But why is there no order? He specifically told me to call on CD1. The receptionist tells me she will have to talk to the nurse first. At the same time, I ask her if I can get the test results I've been waiting on for 11 days.  Oh sure! The nurse will call me back to talk to me about that. The rest of the day goes by...no call back. The weekend passes...no call. I pushed everything to the back of my mind and we tried to enjoy ourselves.  It's nagging in the back of my head still though, so I call again this morning and again am told I'll be called back by the nurse.  

After finally hearing back from the nurse late this morning, I'm even more frustrated than I was to begin with. Apparently she has to coordinate my schedule (which I told her was 100% open...certainly I am not the issue) with the radiologist's schedule with my OB's schedule. She tells me she will call me back with some options because Dr.'s schedule was "a little fuller than I'd like to see".  When she calls me back, she tells me that she has me tentatively scheduled for Jan 30th, at 1:00 (ha, so much for "options"), but that she needed to confirm my doctor would be able to do it that day. Otherwise I would have to wait for yet another cycle.  Uh, so I'm not really scheduled, now am I?

She asks if there is anything else she can do for me, so I ask again about the test results. "Oh yeah!" she says.  "Ok, it looks like you have a 1.5 x 1.7 cm cyst on your right ovary. We expected that but we want to monitor it with another ultrasound next month. It could be nothing." My response was "Ok, just one cyst?" I mentioned that my last U/S showed tons of cysts, so if I'm down to one, that's pretty good.  She says "Oh, well, I'm not sure because it looks like they couldn't get the left ovary at all".  Say WHA?!?!?!?  That U/S tech took a bazillion pics as she was clicking away at her computer but she didn't get ONE shot of my left ovary?? NOT ONE???????  What complete and utter nonsense. Obviously it's in there SOMEWHERE, keep looking!!!

At my original appointment, I had spoken to this nurse and she was very sweet and kind.  I really liked her a lot. She told me that she wouldn't be able to release hubby's results to me because of HIPAA. Ok, totally understandable. So, when we got to that point, I assumed she was going to tell me that she would have to talk to him about the results like she told me earlier. I was expecting it.  But, no. She just starts rattling it all off.  Not that I care (in fact, it was the only thing that got me a bit off the ledge), but so much for HIPAA standards, I guess.

Out of the 5 things she rattles off, hubby is normal in 4 out of the 5.  His morphology (normal shaped sperm) is a bit low, but she tossed out an odd number that I had never seen in my research. Typically you see a small percentage number, but she told me his was 24 and they want it higher than 29.  She tells me that might still be totally ok with the rest of his results, but that the doctor would review it in the morning. Ha.  Not holding my breath for that one. 

So, my frustrations continue. It's great that I LIKE the doctor, however if there is this much dysfunction involved with everything, I'm not sure liking a doctor is enough.  Not that I have much choice. *sigh*