September 30, 2007

Weighing In

Um, about that whole weight loss thing...It isn't going quite as planned.

It started off well enough, with a 5-pound loss in about 2 weeks. I was pretty pleased. Then I spent 11 days out of town undergoing the antibiotic therapy. I thought I would have lost weight, because I did a lot more walking than usual. But apparently I also did a lot more eating than usual, because I gained the 5 pounds back, plus a couple of extra ounces to boot.

So I decided that I needed some extra motivation. There's an annual marathon/half-marathon race in our town each year in January, so I considered entering the half marathon. (Mind you, at this point I can't even run a half mile, much less a half marathon.)

But then I contemplated it more and realized that 1) I'm probably overreaching just a tad bit to think I could go from 0 to 13.1 in 3 months; and 2) even if I could run 13.1 miles, I have Absolutely. No. Desire. to do so.

I opted to set my sights at a more realistic level, so now my goal is to run in a 5K race on New Year's Day. And preferably to not finish in last place. Although honestly, to finish at all will be an accomplishment.

I found a 5K training program online. It's 8 weeks long. I finished the first week of it this week. Basically, it involves running incrementally longer distances on Tuesdays, Thursdays and Saturdays, walking on Sundays and resting on Mondays, Wednesdays and Fridays.

Because I have cranky knees, and because I'm not in shape at all, I've opted to spend Tuesdays and Thursdays doing the distances on an elliptical machine we have at home. On Saturdays, the plan is to go to the local high school, which has a soft, cushy track, and run there.

This Saturday was my first actual run. And I've discovered yet another joy of infertility: After all of those PIO shots, my ass now hurts when I run. More precisely, it stings. For about the first two laps, anyway. Then it turns into more of a dull, mostly numb ache. Or maybe it's just by that point I'm so focused on the feeling that my lungs are about to explode that I don't notice the pain in my ass as much.

I mentioned it to R. He said, "Well, what do you expect? We've poked you so many times, your mucles are now full of holes."

Great. Now my brain is stuck on the image of two pieces of Swiss cheese where my glutes are supposed to be...

The Things We Do For Kids . . .

This week it was R's turn to suffer for the cause.

Actually, the poor guy spent about 10 days suffering. It began with an itchy rash (an allergic reaction) and ended with getting his arm hair ripped off in an experience I imagine is rather akin to a woman having her leg waxed.

I imagine you're wondering how, exactly, does all of this relate to having kids?

As I mentioned in the Next Steps post, our next move was to undergo high-dose antibiotic therapy with a doctor we met in May. Part of that involved 10 days of IV antibiotics. I did fine and didn't have any issues with it, but R wasn't so lucky.

About 16 hours after he got his IV, he began having an allergic reaction to the medication. The poor guy was covered in a rash, and he began to swell a little bit too. (Fortunately, his reaction wasn't severe enough to make his throat swell and close or anything like that.) He had to go on prednisone and switch medications in the IV. It took a couple days, but the itching calmed down and the rash faded.

Then came the worst part of all - getting the IV out. Actually, it wasn't removing the IV itself that was the issue. Instead, it was removing all of the bandages that were holding the IV and the IV tube in place.

The thing is, R is blond and very fair skinned, so his arm hair isn't particularly visible. The morning he was having the IV put in, the medical assistant forgot to shave his arm. She didn't realize it until his arm was swabbed with generous amounts of iodine, at which point the arm hair became more obvious. But at that point, it was also too late.

When the IV was inserted, she covered his arms with clear, very sticky bandages from about 5 inches above his elbow (which is where the IV went in) to about 7 inches below his elbow, then wrapped the whole thing in an Ace bandage.

My IV was in the top of my hand, because I have no good arm veins left after 5 years of blood draws. So I was fortunate in that 1) there isn't a lot of hair on the top of my hand and 2) there wasn't nearly so much bandaging involved. But still, when my IV was taken out, ripping the bandages off of the few hairs there were definitely was the most painful part.

Being the kind, supportive, smart wife that I am, I opted to stay far, far away when R had his IV taken out. (Meaning, I stayed home.) The nurses used alcohol and a couple of other sprays and liquids in an attempt to loosen the adhesive, but no such luck. Then they decided to cut the IV tube so they could get the IV out and then concentrate on the rest of the bandages.

Unfortunately, they didn't think that plan all the way through. When you cut an IV tube and it is no longer hooked up to a pump and IV bag, it starts to backflow. And R does not do well with the sight of anyone's blood, much less his own. So at that point, they had to lay him down on the exam table and then just rip the bandages off so that they could get the IV tube out and stop the bleeding.

He's usually pretty staid and goes right back to work after medical procedures, but he decided he'd had enough trauma for the day and headed home from there. His skin is still peeling.

All I can say is, when we finally get them - regardless of how we get them - these better be some darn perfect kids!

September 19, 2007

An answer

We got the results of the D&C testing this evening. It showed a gender chromosomal abnormality - the baby was XO instead of XX or XY.

My ob said that about 98 percent of first trimester losses have that particular abnormality. He also said that is encouraging news for us to try again, because it appears it was just bad luck with the embryo and wasn't a problem with the uterine environment or something else.

It still doesn't necessarily explain the other four, but at least we know that no matter what we did, the outcome of this one was beyond our control.

I'm still processing this news. I think I feel mostly relief, because now it's easier to think that maybe it really wasn't my fault after all. It was hard not to think "Did I lay around too much? Maybe I should have been more active?" or "Did we stop the progesterone too soon?" or "Was my blood pressure the cause of it?" or even "Did the fact that I was soooo emotionally reserved about this make the baby feel unwanted and fail to thrive?"

But a little part of me also feels heartbroken over the fact that there was no way this could have ended the way we wanted it to. It's hard to think that beautiful flickering heartbeat and that normally shaped (from what we could see at the early stages, anyway) baby wasn't this perfect little being we thought it to be.

The fact that the chromosomal abnormality was gender-related is a bit ironic. I told my ob up front that I didn't want to know the baby's gender, because for me it would be easier just to always think in terms of "the baby" rather than know if it was a boy or girl. And now I can go on thinking that way without having to know that the answer is sitting in my chart somewhere.

September 02, 2007

Next Steps

Some of you already know from previous posts that I am a planner. I have to have my next steps in place, a Plan B, and even a Plan C and Plan D sometimes, so that I can keep moving forward.

Never mind the fact that so far none of the plans have actually gone according to plan; I still have to have them, for the comfort factor alone. So it should be of no surprise that R and I were already talking about what to do next on our way home from the ultrasound that showed the lack of heartbeat.

Some aspects of the plan are easier to write about than others, so I’ll start with the easy stuff.

The Plan, Part 1

This part of the plan is simple to explain: LOSE WEIGHT. Lots and lots of weight.

Now if only it was as simple to execute. Like most of us, weight loss has never been one of my fortes. But I am determined to make it happen.

I’ve gained 40 pounds since beginning the fresh IVF cycle last summer. I didn’t need to gain any weight to begin with, but I now top the scales above 200, and even at 5’7”, that’s not good. Since I’m prone to pregnancy complications anyway because of the PCOS and blood clotting issues, I was pretty stressed about what additional complications the extra weight would cause. One was pretty apparent up front – my blood pressure at all of my ob appointments was high, up to 150/100 during one appointment.

So I’ve created a progress chart that is posted on a wall in our bedroom, and R and I are dieting. I’m not doing any particular diet, just trying to 1) eat less, 2) eat healthier and 3) actually attempt to cook at home from time to time. I also started exercising again two days after the D&C.

In two weeks, I’ve gone from 206 pounds to 202.4. My goal is to lose 2.5 pounds per week, which I know is pretty aggressive, but even if I can be in the 1.5-2 pounds per week range I’ll be pleased. R started out strong, and I was afraid that soon he was going to weigh less than me, which would be wrong on sooo many levels. But the scale was less kind to him during our last weigh in, so I still weigh less than him, at least for now.

My first goal is to get below 200. Then I’m going to concentrate on 170, then 160, and then we’ll see after that. It’s hard to imagine that I used to look at myself in the mirror when I weighed 105 pounds and thought that I was fat, but I did! (Many years ago in college, while I was struggling with eating disorders.)

Ok, so that’s it for The Plan, Part 1. I may post my progress (or lack thereof) from time to time as extra motivation for me to be good.

The Plan, Part 2

I’ve found this to be more difficult to blog about, which is probably part of why I’ve put off blogging about next steps.

On IF blogs, we seem to strike an unusual combination of the public, the private, and the vague. Meaning that our blogs are open for the world to read, we put out there details about cycles, thoughts, feelings etc. that many of us may never share with people IRL, and yet most of us choose to maintain a degree of anonymity by not putting forth identifying information about what clinic we go to, which doctor we see or even (in some cases, like me) specifics about where we live.

But on the treatment front, our next steps are pretty specific. Those of you who are familiar with the theory and approach I’m about to explain are going to know exactly who I’m talking about and exactly where I’m going.

I’m okay with that, because if I wasn’t I wouldn’t blog about it, but on the other hand it feels kind of weird. I think part of it is that I don’t want to come across as an advertisement. Although really, how can I be an advertisement when we haven’t gone through treatment yet, much less had success with it? The other part is some of you may think I’m crazy. But then again, at this point that’s probably not too far off from the truth!

So here goes. There’s a doctor I read about from an online IF forum who believes bacterial infections can cause infertility and miscarriages. I had heard about him a year ago and filed the idea away in the back of my brain. After we lost the twins in January, I thought of it again but was too emotionally tired to pursue it. I finally got around to calling and setting up a consult in the end of April, and then that following week we found out our clinic was requiring us to do our last FET.

We went ahead and did the testing with this new doctor before beginning the FET cycle, just because I wanted to be ready to move forward if we got a BFN. This doctor handles testing in a different way, growing specimens in the lab for about three weeks rather than just a few days, so many patients who test negative through the labs they usually use wind up testing positive through his lab.

The day before our transfer, we found out I tested positive for three infections, and R was positive for four. (None were STDs.) We were a bit surprised that we had that many infections, because we are asymptomatic, but apparently they can be low-grade and still cause problems.

The infections were in my cervix and uterine lining, and it’s likely that they’re also in my ovaries. The doctor believes that introducing an embryo to the uterus can cause the infections to flare, thus raising NK cell levels and resulting in the embryo being attacked by those cells. He says our embryos were likely infected within themselves as well, because R’s infections were found in his seminal fluid, which means that his sperm is marinating in infections as they’re growing and developing. Just like it’s impossible to detect sperm with high DNA fragmentation by looking at them through a microscope, it’s also impossible to detect infected sperm that way.

His belief is that infections damage the DNA, which causes chromosomal issues. And my ob thinks it was likely a chromosomal problem that caused this loss. That could also explain the other losses we’ve had.

So, our next step is to go through high-dose antibiotic therapy to get rid of the infections. Some STD infections tend to be stubborn and can’t be completely eliminated but only tamed down. But since we didn’t have any STDs, the doctor thinks ours can be completely eliminated.

We have to go through a few months of therapy and then wait one more month after that, so we can start trying again around the end of the year. The timing actually works out well, because that will give me a few months to lose some of the weight and develop healthier habits. Also, I need some time to focus on other things in my life, so I’ll have the opportunity to do that.

Once we reach the end of the year, assuming R still has normal sperm counts and I’m ovulating, we’re going to try naturally. I realize that sounds like we’re going backwards, which is a bit insane. (Okay, maybe more than a bit…) But the whole point of IVF was to create better quality embryos that would then last. Clearly, that approach hasn’t worked. And I’m tired of putting my body through all the stress it has to go through when we cycle.

We’ve gotten pregnant naturally twice before, so we know it’s possible. My ob is on board with prescribing the Lovenox, and I’m sure I can get progesterone suppositories from him, too. He doesn’t think they’re necessary, but he knows that given our history, there’s no point in saying no to me because they won’t hurt.

So we’re going to see what happens in 2008. I won’t completely rule out going back to IVF at some point, but definitely not in the immediate future. And if I don’t get (and stay) pregnant naturally in 2008, as much as we dread hate absolutely abhor the idea of adoption hell, we will reluctantly reconsider that option again.

This time it would have to be on our terms, though, meaning the adoption attorney we want to work with would have to agree to take our profile and not call us until there is a baby to be picked up at the hospital. She knows what we’re open to (either gender, any race, no major drug or alcohol use), so she shouldn’t need to call us to see if we want our profile to be shown for a particular situation. And we definitely refuse to go through months of being matched again – twice was waaayyyy more than enough, thankyouverymuch.

So, there it is – The Plan. Now we’ll see how long it takes before it goes drastically and unexpectedly off course…