December 28, 2005

Another Bump in the Road

I had another conversation with the cycle coordinator at the clinic today. She pointed out that my records indicate my blood type is Rh negative, and that none of R’s records show his blood type.

She says that when the beta comes back positive (she’s ever the optimist) I'll have to get "another" RhoGAM shot, because we’ll need to assume that R is Rh positive. The shot would prevent my blood from developing antibodies.

This is important, because once you have the antibodies, you can’t get rid of them. And when you have them, it can cause very, very bad things if you become pregnant with an Rh positive baby. Things like anemia in the baby, which can lead to brain swelling, liver enlargement and a whole host of other horrible and possibly life-ending problems for the baby.

The good news is, all of this is easily preventable with the shot.

The bad news is, if I get pregnant with this cycle, I won’t be getting “another” RhoGAM shot, because I never had one when I was pregnant.

I’m dumbfounded. The clinic we were going to when I got pregnant KNEW about my blood type before I ever crossed their doorstep for the first time. They KNEW about my pregnancy when it happened six months later. They did two ob ultrasounds on me. They confirmed the miscarriage via bloodwork they did in their office.

Since at least 90 percent of the population is RH positive, they should have assumed DH was positive. They should have insisted I have the shot, because it can't hurt to have the shot even if DH did happen to be Rh negative. But at no time did any of the nurses (at least three) or REs (two, including mine) I saw or spoke to mention ANYTHING about needing this shot.

Yet everything I've read on the internet says that even if you don't get the shot as soon as pregnancy is detected, you absolutely should get it if you miscarry, regardless of how far along you are. But I did not. Nobody ever even mentioned that the shot existed, much less told me I needed it. I'm still trying to wrap my brain around that.

We checked with MIL, and it turns out DH is Rh positive.

Chances are, the pregnancy ended too early for it to be an issue. And maybe that is why no one at the clinic mentioned it. But still, why take the chance? Why? Especially when the whole point of my being there at the clinic is To. Get. PREGNANT.

I go back in next week for more blood work - this time to check for Rh antibodies. Stay tuned.

December 27, 2005

The Great Race

Even though we have the results back, we’re still going to delay the cycle. I’m going to use the time to challenge R to a weight loss race in the hopes that if I take off a little bit of the extra pudge it will reduce the risk of the aforementioned potential complications.

My goal is 20 pounds in 9 weeks.

I got off to a great start this morning. Skim milk, an apple and a small amount of peanut butter for protein.

Then I unexpectedly wound up meeting a co-worker for lunch at a Mexican food restaurant. There were chips, there was salsa, there was ooey, gooey cheese. Lots of it.

After work, I came home. There was a big bag of Christmas candy sitting on the kitchen counter. I had meant to take it to work this morning and drop off in another department to get rid of the temptation.

Instead, I had Rolos for dinner.

At least I don’t have to step on the scale again until Friday morning.

The Results Are In

The good news is, the NK cells test is back (much quicker than the two weeks I was told to expect), and it’s normal. Yea! So we don’t have to figure out how to pay for IvIG. I’m very relieved, but not entirely surprised since thankfully all of the immune tests I’ve done have come back normal.

I can’t exactly say the same thing for the thrombophilia tests, though. Apparently I’m heterozygous for the Factor V Leiden and MTHFR gene mutations, meaning my blood tends to clot too easily. The RE is recommending baby aspirin, mega doses of folic acid and heparin injections throughout the cycle and the (hopefully resulting) pregnancy.

I’m a bit freaked out now. Seeing as how I haven’t even begun the cycle yet, much less received any sort of beta results, I realize I’m starting to worry and obsess just a wee bit early. What can I say? I worry more easily than most people breathe.

The thing is, PCOS raises the risk of gestational diabetes and pre-eclampsia. The Factor V and MTHFR raise the risk of blood clotting and, again, pre-eclampsia. From what I’ve read, the heparin will reduce the risk of clotting and pre-eclampsia. However, I’ve also read that you have to stop taking the heparin before delivery so that you don’t bleed too much, and stopping it then raises the risk of blood clots and pulmonary embolism. Neither scenario sounds particularly comforting.

So, I called a perinatology practice this morning to schedule a pre-pregnancy consult. I figure they deal with this stuff for the majority of the pregnancy, so they may be better able to address my freakout than the RE can. Especially since I won’t be seeing the RE for follow up since we’re traveling out of state to cycle.

I remember when my co-worker was pregnant, she had headaches from time to time but opted to suffer through them because she was too terrified of what taking a Tylenol might do to her baby.

If this cycle works (trying to think positive here), I’ll be taking baby aspirin, metformin, heparin injections and who knows what else. Tylenol sounds like candy at this point.

December 24, 2005

The Lab From Hell

Ok, about that lab thing. As I mentioned in a previous post, I had bloodwork done at a lab at the beginning of last week to check for some blood clotting and immune issues. They stuck me three times, took 10 vials, then called me back to say oops, we need one more vial. Two more sticks later, and the 11th vial was produced.

Unfortunately, the bloodletting is not over.

My REs office received faxes last week with all of the test results. Except, of course, for the NK cells test that required me to go back in and produce vial number 11. Instead of receiving a fax for that one, they received a letter - via snail mail - that said I had failed to come back in to have my blood drawn for a third. time. Say what?

When they did the first blood draw, the lab where I went sent all of the blood to their main lab to be tested. One of those 10 vials needed to be coupled with the 11th vial in order for the final test to be run. So, the main lab set that vial aside. Then, when the 11th vial arrived two days later, somehow there was confusion and they didn’t realize the two vials went together.

So the vials sat there, and expired. Which means I needed to go back in to have yet more blood drawn. Except that no one bothered to call and tell me this. Instead, they simply sent the letter to my RE.

By the time we figured out what the heck was going on, it was Thursday night, after the lab had closed. I went in Friday morning and had the 12th and 13th vials drawn, and they swear to me that it will be the last time I will have to come in for this test.

However, the test takes two weeks to complete. And because of the holidays, that now means I won’t get the results until after my IVF cycle starts. I could start the cycle and, assuming the test results come back normal, just continue it. But if for any reason it doesn’t come back normal, that could throw a curve ball into the cycle. And that just feels like an awful lot of stress.

So, we’re postponing the cycle. Since the clinic does batch cycling, I won’t be able to cycle until the end of February.

But I’ve decided this is probably a good thing, because at least it will give my body time to build my blood levels back up. After all of the blood that’s been drained from me these past two weeks, I’m not sure there’s enough left to keep me going, much less a (hopefully) growing embryo!

December 23, 2005

Congratulations, you’re infertile!

Since we’re coming up on the end of the year, it seems an appropriate time to recap the stupid, idiotic amusing things people have said this year in relation to infertility. Please feel free to add your own in the comments section…

The first one that comes to mind is from a co-worker of mine who was trying to get pregnant at the time. (She’s just had her baby, by the way.)

Her first child was a “surprise” since they weren’t even trying, so having to actually make an attempt to get pregnant was a bit of an adjustment for her. She started trying last December. One day in March, we were having a conversation about how unfair it is that some people are able to have baby after baby without even trying, and others do everything they can and still have no luck. It’s at this point that she says, “Yeah, they just have no idea what it’s like for those of us who have to try so hard!”

HELLO??? “Try so hard”??? You’ve had a lot of sex for four months. I’ve spent (at that point) 25 months jamming dozens of needles into my body, having at least 18 dates with the wand, taking pills that bring hot flashes and mood swings that make R consider temporarily moving back in with his parents, R has had vericocele surgery, we’ve lost a baby through miscarriage and are still childless. There is no “us.” We are not in the same category, not even close. Of course, she got pregnant the next month…

Then there was the comment by my best friend. I have to issue a disclaimer and say that with the exception of this comment and the timing of her letter right before Valentine's Day to let us know she was pregnant, she has been phenomenal through all of this. But her comment comes close to erasing all of the phenomenal-ness.

We were out of state, waiting to hear whether our birth mother was going to take her baby home from the hospital. We were 1,500 miles from all our family, in an unfamiliar town, in an unfamiliar apartment, scared out of our minds that huge heartbreak was headed our way. She had just gotten home from the hospital two weeks before with her daughter, conceived the month after she got married and without intending to try.

We were on the phone, and I’m telling her about our birth mom’s baby being born, how the social worker is trying to reach the birth mom but the birth mom is shutting everyone out and we don’t know what’s going to happen. Best friend’s baby is wailing in the background, and she says, “Are you really sure you want one of these after all?”

WTF! You have GOT to be kidding me. I didn’t hang up on her, but I did cut the conversation off and end the call. Granted, I know her body was still going through major hormone fluctuations and she was sleep deprived, but still. If she had been anyone else, that would have been a friendship-ender.

The last comment that comes to mind for now – and the one that prompted this post – was one made by the phlebotomist at the lab today. (More to come later on why I’m back at the lab for the THIRD. TIME. in two weeks.)

She’s trying to pick out a vein, and she’s chatting with me. I’m a very familiar face by this point since I’ve been there so much recently, and she knows this will be my 12th and 13th vial drawn, so I guess she feels comfortable getting a little personal.

“You don’t look sick,” she says. I probably should have just smiled and not responded, but I tend to be pretty open about our infertility. And, I have to admit, sometimes when people who don’t know me pry a little bit, I like to have a little fun by being blunt and watching their response. So I said very honestly, “I have infertility.”

Her response (I’m not kidding): “Oh, how exciting! Congratulations!”

Huh?? This time, I was the one caught off guard, instead of the other way around. She knew I wasn’t there for a pregnancy test.

It turns out her brother and sister-in-law struggled with infertility and went through IVF around this same time last year. They had their baby during the end of the summer. So I guess in her mind, the phlebotomist automatically equates infertility tests with success and a baby at the end of the process.

Naive, but cute.

December 21, 2005

Good News and More Good News

Lest you think all I do is whine, complain and wallow in the pit of dispair, I’ll share happy news from today. And some of it is about infertility insurance, no less.

First, good news on the health front for R. When he had his annual physical last month, his doctor recommended he go see a dermatologist because of his acne and a couple spots on his back. I had a half dozen questions about it, but R, being a typical male patient, hadn’t actually uttered more than two syllables during his appointment, much less asked anything that could remotely be construed as a question.

So I tried to be calm and wait for the derm appointment. The derm removed two spots, and we got the biopsy report back today: Neither was malignant. Thank you, God!

Riding high on that wonderful news, I decided to call our insurance company and see how much money we have left on our infertility benefit.

The benefit is not large to begin with – certainly not enough to cover an IVF cycle – but hey, anything is better than nothing. I was afraid we had used all of it, or worse yet, that the insurance company would realize they had overpaid on our benefit and tell us that we owed them money.

Instead, we still have enough left to cover the anesthesia for our upcoming IVF cycle and most, if not all, of my drugs. Happy day!

December 16, 2005

The Bloodletting

Well, this week was fun. Some bloodwork needed to be done before the IVF cycle begins. I went to the lab on Monday. They needed TEN. VIALS. TEN!!

The tech started by going for a vein in my left arm that is cooperative 99 percent of the time. Monday fell into that 1 percent category.

She finally gave up and went for the top of my right hand. Now, I don’t like needles and blood draws to begin with, but the top of my hand? Yooouuuuccchhhh! She managed to get six vials, and then the vein took its bow and closed the curtain on the blood flow.

She switched to the top of my left hand. At some point, the room was starting to spin, but she managed to get the last four vials, and I was out of the chair and out the door before she even got the needle in the sharps container.

Then the lab called that afternoon.

“Um, we miscalculated. We actually needed 11 vials. Can you come back in?” someone from the lab said in the message on our machine.

The next day, I couldn’t bring myself to go back quite yet. That was ok: Infertility Hell had another fun little surprise waiting for me on Tuesday, anyway.

My mom goes home each day for lunch. She got a Christmas card in the mail from R’s aunt and uncle. It turns out R’s cousin is pregnant. With her third child. At age 40. The natural way.

My mom races back to her office and frantically e-mails me, a breathless little “Guess who’s pregnant? Guess who’s pregnant? I bet you don’t know!!” message. No, sensitivity and tact are not her strong points.

Then came Wednesday.

I finally sucked it up and went back to the lab. A different tech drew the short straw this time and wound up with the chore of coaxing another vial of blood from my oh-so-cooperative veins. She started to go for my left arm.

“I don’t think that’s going to work. The other tech tried that on Monday, but the vein disappeared,” I cautioned her.

“Oh, don’t worry. I can get it. It’s a nice, plump vein. This won’t be a problem at all,” she responded.

Yeah, well. After a couple minutes of digging around in my arm, she gave up. I got stuck in the left hand again, but at least that vein cooperated and produced the requisite vial they needed.

I headed in to the office. I noticed my fingers and toes were tingling. Apparently, having 11 vials of blood drained from your body does that to you.

Then the phone rang. It’s an adoption connection who has our profile on file.

“A baby was born yesterday. I’m going to the hospital to pick him up. Would you be willing to get on a plane today and come get him?” she asks.

Are you kidding?? “Yes, of course!”

R and I wait anxiously for the phone call telling us to book our flight. An hour passes, then two. Finally, six hours later, she calls us back. The birth mom’s mom showed up at the hospital and talked the birth mom into taking the baby home.

So much for becoming a mom before Christmas.

R and I had been procrastinating (just for a couple days) on RSVPing to a party we’ve been invited to. It’s a long story I won’t go into now, but we weren’t looking forward to attending. For family reasons, though, we felt obligated, so R called on Thursday to let the host know we’d be there.

It was supposed to be a wedding reception/Christmas party for someone we knew a while back from school.

When R got off the phone and walked into the room, I could tell by the look on his face that something wasn’t good.

“What, are they registered at Babies ‘R Us?” I joked. He shook his head.

“Pottery Barn Kids,” I said, still kidding.

“No. But they’re due in March,” he responded.

We won’t be attending the party after all.

December 09, 2005

Hope, for me

We had our annual office Christmas breakfast yesterday morning. One of my co-workers gave me a stocking with some candy in it and a star-shaped ornament that has the word “hope” on it.

I’m not sure if she got it just because she was grabbing whatever she could grab in a moment of last-minute gift-buying panic, or if the message was intentional.

R and I are gearing up to start our first IVF cycle, and I’ve been struggling with the idea of hope. More specifically, I’m afraid to allow myself to feel it. On a cerebral level, that seems silly, because why should we even bother doing the cycle if we don’t have at least some little shred of hope that it will work? But on an emotional level, it feels like hope has been mercilessly beaten out of us so many times, that I’m afraid to let myself go there again for fear of the emotional battering that seems to always follow.

I’ve chosen to believe that she gave me the ornament intentionally. I’m going to hang it on the wall somewhere (we don’t have any Christmas decorations up - I’m not in the mood this year), and look at it whenever I need a little reminder that it’s ok to allow myself to hope.

I have a feeling the wall and I are going to be spending a lot of time together.

December 06, 2005

Let’s Play Ask the Infertile

A co-worker of mine had her baby last week. She and I have worked together for a few years now, and we’ve become good friends. I’m happy for her, but being faced with her pregnancy day in and day out for most of this year has been painful for me, and she gets that.

Apparently the rest of my co-workers, not so much. It’s an office of mostly women, and I couldn’t keep the infertility stuff secret even if I tried, which I haven’t. I’ve chosen to be open about it, to be honest about it, in hopes that sharing the experience will help erase some of the stigma that comes along with the diagnosis.

So they know about all the painful test results, all the failed cycles. The miscarriage. The adoption that went bust a couple months ago when the birth mom changed her mind after the baby was born. They know that R and I have had to drag ourselves up off the ground after that latest blow, and that somehow this time it feels even worse than all the other heartbreaks we’ve had. That something inside us didn’t just crack when the adoption failed, that it broke. In a sharp, jagged way that will leave us never the same.

And yet, who do my co-workers call to ask all the specifics about the new baby in our office? Yep, you guessed it. Who else do they think would want to talk in great detail about how much the baby weighed, what time he was born, what his name is, how adorable it is and how wonderful that she’ll be at home with him for the next three months?

The resident office infertile, of course.