Which Way to Baby?

The Story Behind The Gender Reveal

2012-01-23T20:52:00.000-07:00

Now that I've had a couple days to process, I thought I'd share the story of Friday's reveal...

I had ordered the cake earlier in the week, and we picked it up after our appointment on Friday afternoon. We wanted it to be a moment with just the two of us when we found out, and since my mom lives with us, that ruled out cutting into it at home. So from the bakery, we drove to a neighborhood park not too far from our house and walked to a ramada overlooking a small lake. (Well, technically to most of you it would probably wouldn't even qualify as a small pond, but we don't have much water where we live, so our perception of the size of a body of water tends to be a bit skewed.)

Anyway, it was a pretty setting. I had put R in charge of gathering the necessary supplies, and he had grabbed the cake-cutting knife and server we had used for our wedding, along with paper plates, etc. We cut it like we cut our wedding cake - both of our hands on the knife. I stared at the ceiling of the ramada as we sliced into it, but he had the camera in his other hand, so he was taking pictures.

When we pulled the knife out, I was expecting to see crumbs. There were no crumbs, but there was some of the filling on the knife.

My reaction was, "It's pink??!?"

I won't post the first picture he took of my face, but let's just say it's quite the expression. It's not that I was unhappy, it's just that we've known for 8 years (since our first adoption certification) that it would be more likely we'd wind up adopting a boy. We were/are open to either gender and any race, and the adoption professionals all told us that because of that, we'd most likely be matched with a boy. And the first two of our three matches were boys. (In the third one, which we were only matched for a few days, the gender wasn't known until the baby was born, and she was a girl.)

Because of those matches, we bought boy stuff when we were preparing. And the friend who gave us most of the baby furniture we have had two boys, so it's boy-themed. And of our normal embryos, 9 of them tested male and 6 tested female. And Kiddo has very long feet.

And so, because of all of that, my brain has been completely in boy mode for most of a decade.

So seeing pink was quite the surprise. I kept looking at the cake and saying "It's still pink!" Finally, after about the fifth time repeating that phrase, R said, "Yeah, I don't think it's the kind of thing that really changes over time...or with exposure to air."

He was great, as usual - he was able to wrap his head around the fact that it was pink right away.

Then we packed up, headed home, and invited his parents over for dinner. We had told them and my mom about the cake plan a while back but hadn't reminded them lately.

After we ate, I mentioned that we had dessert. They were kind of surprised, given that I'm supposed to be limiting my sugar intake. We had them close their eyes, and then R brought out the cake, which we had left in our car.

Their reactions were pretty funny. I video taped it, and we may think about sending it in to America's Funniest Home Videos someday.

R's mom's first reaction was puzzled: "Why is there a piece missing??" When I told them to look at the color, she said, "Piiink?" slowly and looked at us questioningly.

Then it dawned on my mom, who literally started screaming (no exaggeration) "It's a girl, it's a girl!" and pounding the table. Then she reached for the phone and began calling people, saying, "Oh my God, (friend's name), it's a girl, it's a girl! I've gotta go, gotta call more people! Bye!" There are some people on the East Coast who were probably awoken from a sound sleep (it was 11 p.m. there) and thought it was a prank call, because she bypassed the traditional niceties, such as mentioning who, exactly, was calling... :-)

For me, the surprise has worn off and now I'm just excited. But I do still think of things every once in a while that make me nervous.

For example, R was a Boy Scout, and his dad was a troop leader. Since I envisoned us with a boy, I also envisioned R being the troop leader. On Saturday, the thought occurred to me - can dads accompany Girl Scouts on camping trips? Apparently not.

"So you mean I'm going to have to learn how to pitch a tent and start a fire by rubbing two sticks together??" I asked him. "You know I'm not good with fire! I can't even light a basic match without burning myself!"

On the other hand, I have some serious skills when it comes to sniffing out a good deal on a hotel. Can't I just teach them how to make reservations instead?

Kiddo's Gender Revealed

2012-01-21T20:35:00.000-07:00

We reached 30 weeks yesterday, and we stuck with our plan of finding out the gender.

Doing so has made all of this so much more real, and I am still processing all of it, so for now, I will just leave you with the picture:

Also, I've tried to comment on a bunch of Blo.gsp.ot blogs lately, but when I click on the comment link, I get a completely blank page. I thought it was something Google was doing as part of its SOPA protest since it started happening around that time, but it's still occurring as of today.

I've seen a couple other bloggers mention a similar issue, so apparently it's not technology being cranky with just me. There are one or two blogs I've been able to comment on, but for the vast majority of them, I've had no such luck. So please don't think I'm ignoring you - I'm reading, it's just that's all I can do at this point. Hopefully Google will fix it soon...

R Discovers the World of Diapers

2012-01-16T23:21:00.000-07:00

I'm behind on the post I promised, although on the bright side it's in large part because I had a productive weekend nesting, i.e. cleaning up some of the messes I've let pile up in the house, and starting to research Kiddo stuff like car seats and strollers.

So, to fill in the gap until that post, I'll leave you with a bit of humor from R's online browsing session this evening...

Apparently, he caught the Kiddo-related research bug from all the info I shared with him over the weekend, because he's sitting here next to me exploring di.ape.rs.com.

All of a sudden, I hear:

(in an incredulous tone) "186 results??!?"

Followed a moment later by "19 different brands of diapers!" (still half incredulous, but now I can tell from a slight shift in tone that the enormity of all the different baby stuff that you need to wade through is starting to sink in.)

There's a big sigh.

Then, "Even better, here are diaper types..." And he proceeds to list off about 20 different ones. (Most of them, I can tell he has no idea what they are. But heck, neither do I, so there's no judgment from me on his lack of knowledge.)

That's followed by "17 different sizes??" and another big sigh.

And then, finally:

"So I think I'll leave diaper ordering up to you..."

Third Trimester! And Quick Updates

2012-01-09T22:32:00.000-07:00

Yikes, I can't believe it's been two weeks since I last posted! I have lots of posts I want to write but haven't gotten to them yet. Hopefully I will have a little more time this week and next.

For now, some quick updates, and I will come back and do a proper post within the next day or so:

* I finally, finally, finally finished the last of the 3 papers I had to do for my fall class at about 2:30 a.m. today. That's part of the reason for my lack of posts - I made a rule for myself that I would not do anything else online until I got that done. It was due sometime around Oct. 23, which was about 10 weeks ago. I have no good excuse, just that I hit a writer's block with this particular assignment and couldn't figure out how to get through it. The professor was very kind to grant me an incomplete and allow so much extra time to finish it, and he was very generous to give me a B in the class overall. I would have been grateful for a C. I had toyed with taking a class or two this semester, but you'll be happy to hear that I have come to my senses and decided not to do that.

* I have gestational diabetes. The downside is that I have to stick my finger four times a day to test. The upside is that as a result, I am back to weekly appointments. Thank God! These last 2 weeks between appoitnments were some of the longest of my life, and that was the only time I had gone more than 11 days between appointments. They are going to start doing cord blood flow checks and biophysical profiles on Kiddo with this next appointment, and they're starting my twice-a-week non-stress tests and biophysical profiles a week early, during the 31st week instead of the 32nd.

* Kiddo was up to 2 lb. and 14 oz. on Friday, which measured in the 67th percentile. I was just hoping for more than 2 pounds, so I was thrilled we were so close to 3 pounds. It was the best appointment we've had so far, one of the happiest days of this pregnancy, even with the gestational diabetes diagnosis factored in.

* The doctor was a bit shocked that I was actually willing to have a conversation about delivery methods and a due date. Apparently the hospital only schedules four C-sections a day, so she said if that is a route we are considering, we need to get on the calendar now. We can always cancel if we decide to try for a vaginal birth, because apparently it's easier to schedule those closer to the day of. So we opted for March 23 or March 21. Hopefully we'll find out on Friday if she was able to get one of those dates.

And, for a bit of humor, I will leave you with a real conversation my mom and I had this morning:

In true Borderline Personality Disorder style, everything has to be about her, so she has taken on the gestational diabetes diet with a vengance and decided to do it with me. She has called at least half a dozen of her friends to tell them about the diagnosis and that this is how she has to eat for the next few months. (I haven't told R he has to change his diet one bit, so why she feels compelled to do this I'm not sure, other than because of her BPD.)

So this morning, she was looking over the list of portion sizes for each food. She has a huge sweet tooth (which I inherited), so she was very excited to see that cake was listed on there.

I pointed out to her that the serving size is 2 inches by 2 inches, and I held my fingers apart to show her just how big - or, rather, how small - that is. Her face fell, because really it's not more than two bites' worth of cake.

Then she thought for a moment, looked down at the list again, and said, "Yeah, but it doesn't say there's a limit on how high you can pile the frosting!"

Only my mother... :-)

Small Steps, and Questions Answered

2011-12-26T17:17:00.000-07:00

We reached 26 weeks on Dec. 23. We are at least 2/3s of the way there. I am still very nervous, very scared about how this will turn out. I still make no assumptions that are are definitely heading toward a happy ending, although I know the odds of that are good at this point.

But you will be happy to know I have started to make small, small steps toward preparation.

I have researched pediatricians and picked three to meet with. I have not called their offices yet to schedule appointments, but assuming we make it to 28 weeks (the day of our next appointment, Jan. 6), I will.

I have started to put together a list of things we need to do. It is still very short at this point, but I will continue to work on it.

We will be hanging out at R's parents' house on New Year's Day, so I told R that we should inventory our baby stuff while we are there that day.

And I have ordered a book, The Expe,ctant Pare.nts' Compa.nion, that promises to tell you what you do and don't really need for baby. I've read through a lot of it. At this point, all I can say is carriages, cradles, bassinets (I still don't get the difference between those last two), playpens, strollers vs. travel systems, ect. - I feel completely overwhelmed. If you have any thoughts or suggestions, please feel free to chime in.* * * * *About the doppler...Thank you to those who encouraged me to get it. It has been a sanity-saver. I did some searching online and found wav files with the sound of a baby's heartbeat on doppler vs. the cord vs. the placenta, so now I can identify all three. What would we do without the internet?

I try not to use it every day, but if I get nervous, I bring it out.

I've been feeling more movement, so that helps. The other night, while I was icing for the Lo.venox injection, I noticed that a spot on my belly moved. I kept watching, and it happened again. I texted R to come quick, but then there were 4 or 5 jabs in a row and it was really funny to see my belly looking like there was popcorn popping inside of it trying to get out, so I started laughing, and that was the end of any movement.

So R still hasn't seen it yet, but hopefully he will soon. I think I'm starting to feel some rolling types of movements now instead of just individual jabs here and there.* * * * *Picking a date, inductions, and such...The doctor didn't push us to set a date at our appointment on Dec. 23. Unlike the nurse practitioner, she said as long as we pick one by 30 or 32 weeks, it's fine.

The reason they like to pick dates so early is because it's exclusively a high-risk practice, a lot of their patients wind up being induced. They only deliver at one hospital, and it's a popular hospital for deliveries, so they like to get on the schedule early.

I don't yet know for sure if the plan in our case is induction, because I keep telling the peri that that's a conversation for another trimester. But since we're coming up on the end of the second trimester (the peri's office counts 28 weeks as the start of the third trimester), I won't be able to say that for much longer. :-)

But my guess is that it probably will be an induction, because my understanding is that I'll need to stop the Lov.enox a couple days before delivery to reduce the risk of hemorrhage. So we'll need to know when the delivery will be in order to time the stoppage.

Which brings us to the whole C-section versus vaginal delivery question.

I'm a little bit torn about this one. I'd been thinking C-section, because I want the doctor to be able to get Kiddo out as quickly as possible in case of an emergency. Since Kiddo has a 50/50 chance of inheriting R's Brug.ada Syndrome and since the irregular heart rhythm it causes (ventricular fibrillation) is fatal 90 percent of the time if the person isn't able to be shocked back into a normal rhythm within two minutes, I wouldn't want to wind up in a situation where Kiddo gets stuck in the birth canal, goes into v-fib, and they have to scramble to get him/her out (or worse, can't get him/her out) in time.

So, in all likelihood, that's probably the route we'll go. However, I have read online in the past week about how when a baby is born via C-section, its lungs aren't squeezed as tightly and therefore don't expel as much fluid, which can cause complications. And I hadn't even thought of the challenge of not being able to drive for at least a few weeks afterward while recovering.

Because of those things, we will have a conversation with the peri during one of the next couple of appointments about which approach she thinks is the best one in our particular case. If she thinks it's a vaginal delivery, then that's what we'll try for - I just want to do whatever will be best for Kiddo given our particular circumstances.

* * * * *MC - I'm so sorry your beta dropped after your BFP. I know how devastating it is to have hope rise (even if it's just a little bit) and then come crashing back down again, and it's especially hard this time of year. But it sounds like you're regrouping, and I hope your next attempt results in a much happier outcome.

Merry Christmas and Happy Holidays!

2011-12-26T16:40:00.000-07:00

Just a quick note to say all is well here. Christmas always comes too quickly, mostly because I get very over-ambitious about all the stuff I want to bake. So much baking to do, so little time... :-)

But the day was lovely. I will post some pictures as soon as I figure out how to download them from my new digital camera, which was a gift from R.

Also, thank you to all of you for your comments on my last post. There were several comments/questions about choosing a date/induction/ are we having a C-section/how is the doppler working, so I will write more about that soon too. Our next appointment is on Jan. 6.

In the meantime:

Merry Christmas! (albeit a day late)

Happy Holidays!

Happy New Year!

You Want Me to Pick a Date For What??

2011-12-14T23:39:00.000-07:00

Our 24-week appointment was on Monday, and it was a bit surreal.

Kiddo still looks good. This was the second growth scan, and s/he measured 1 lb 9 oz, in the 56th percentile. Never have I been so thrilled about an "average" number as I am about average numbers like that...

After the scan, we had our usual appointment. The peri's office is a very personalized practice, and they all know our story, so they all know how detatched we're trying to stay from hope.

So at each appointment lately, the nurse or nurse practitioner asks a few questions to gauge how we're doing on that front. (And probably to check the state of my sanity.) Have we opened the envelope? What are we doing to prepare? Have we met with any pediatricians? Have we thought about signing up for classes at the hospital?

No; absolutely nothing because it's still entirely too early; no; and if anything, I will contact a nurse educator to do a private class for us.

I explained to the nurse that I had told myself that if we made it to 20 weeks, I would create a list of things we would need to do, and if we made it to 30 weeks, I'd consider starting to do the things on the list. Then 20 weeks arrived, and I told myself that 6 weeks was still plenty of time to create a list, so I moved the 20-week plan out to 24 weeks. Then when last Friday arrived, I told myself I'd wait and see how Monday's appointment went before making the list.

She looked at me, took my hand, and said, "Hun, it's time. Make the list."

I still haven't done it.

Then the nurse practitioner came in. At one point, she mentioned that during our next appointment (12/23) or the one after that (1/6), we'll pick a date with the doctor.

I looked at her and, in total sincerity, asked, "A date for what?"

Yes, she was referring to a delivery date.

It honestly did not even occur to me. Picking out a delivery date is what people do who assume they're going to take a living, breathing baby home from the hospital. Apparently the people at the peri's office think we will be one of those couples.

In my head, from a totally logical point of view, I know everything looks very good and there's no reason to think we won't be one of those couples. But all these years of heartache have made it a lot harder for my heart to get on board with that idea.

I'm not sure I can pick a date.

I've avoided knowing due dates as much as possible, and while I know the due date for this pregnancy, I also know we're not going to go that far. The last thing I need is yet another date on which to pin my hopes and dreams. I told R we may have to give the peri a list of dates we don't want, tell her to schedule a date that's not on that list, and then if we make it that far, just let us know a day or so in advance what day and time we need to show up at the hospital.

He was not fond of that idea, but it may be the best I can do.

Am I Doing This Correctly? (And, 24 Weeks!)

2011-12-11T20:30:00.001-07:00

The doppler arrived a few days ago, but I'm not sure I'm really finding Kiddo's heartbeat.

I've used it 4 or 5 times so far, and every single time, the sound that I think is Kiddo's heartbeat has been in the exact same place - right above my hairline, just to the left of center. The rate has been in the 130s-140s, but should it always be in the same place?

I do think it's been Kiddo at least once or twice, though. The first time we used it, there was a lot of static as I was moving the probe around and figuring out how to use it. Kiddo was not happy - I got kicked a couple of times. :-)

The next time, I found the heartbeat pretty quickly, but then I think Kiddo tried to hide by burrowing deeper toward my back, because the sound got more faint after a few seconds. I'm sure s/he must be thinking "Oh, great, here we go again..." every time I turn the doppler on... :-)

On a related note, we reached 24 weeks on Friday. I still can't believe it. I have now started a new countdown to 28 weeks, which the peri's office has repeatedly mentioned as the point at which there's not just a chance of viability but 90 percent odds of viability with a good outcome.

So, 3 weeks and 5 days to go 'til 28 weeks...

I'm Having a Moment

2011-12-08T21:27:00.001-07:00

Please forgive me, but I'm having a pity party moment.

I know I have a lot to be thankful for, and believe me, I am. I'm very grateful to be pregnant, to be less than 24 hours away from the 24 week mark, to be able to feel Kiddo moving around.

I'm still an infertile though - 100 percent. I've read a lot of women who have gotten pregnant after infertility say at some point that they feel like they've "crossed over", and others who feel kind of in between, not like a completely "normal" pregnant woman, but also not totally in the IF world any more, either.

Neither of those are me.

Some people live the nightmare for a year or two and then go on to find success in treatments without any miscarriages or other setbacks. They have all the kids they planned to have, and while infertility touches their lives and leaves its painful mark, their lives seem to eventually evolve into "normal": it winds up being pretty much exactly what they had envisioned, even if it took longer to get there than planned, and the mark eventually fades or disappears altogether.

Then there are those of us who have lived the nightmare for a much longer period of time. There's not just going to be a temporary scar; instead, for a lot of us, infertility has literally altered who we are. It hasn't just taken us on a brief, inconvenient detour - instead, it's changed our lives in irrevocable ways.

And it turns out that even being pregnant, even feeling Kiddo's movements, doesn't make it all better.

What has brought on this statement of the obvious, you ask?

Really, I have no one but myself to blame, because I brought it on myself. 'Tis the season. I opened a Christmas letter from one of my college roommates. She has two kids and generally leads a great life - great husband, great job, great house, annoyingly slender (I say this with affection, really), etc.

There have been some years that I have just not even opened her letters because I knew I couldn't handle it. But this year, I did.

I try really, really hard not to count anniversaries. And don't ask me how, but for the most part I manage to be pretty successful at it. But she was due with her second within just a couple of days of the due date of my very first pregnancy. And her daughter will be 8 in a few weeks.

Eight. R and I should have an almost-8-year-old second-grader now.

And - valid or not, I'm choosing to blame this on the pregnancy hormones - somehow all I can do is sit here and cry for all of the losses that represents. All of the milestones, all of the little moments, all of the big celebrations.

And yes, hopefully we'll get to experience those soon with Kiddo. But one child does not make up for the loss of another. Or, in our case, 7 others. I knew that intellectually, but I guess I'm just now recognizing it emotionally.

You would think I would be smart enough to stop there. But no...

Then I go on to read about her younger sister, who is probably about 34 and had a child several years ago and has severe endo. And got married a couple months ago. And is now apparently 3 months pregnant. You know, the way "normal" people do that. And has already picked out a name for the baby, because she's Just. That. Sure. that she'll be bringing a living, breathing, healthy kid home from the hospital in about 6 months.

I don't think I can blame the pregnancy hormones for my feelings about that news. Good old fashioned bitterness and jealousy get the credit there.

Like I said, pity party. And still an infertile, 100 percent of the way.

I Caved

2011-12-04T23:18:00.001-07:00

No, not on finding out the gender. The envelope is still hidden. :-)

Instead, I gave in and ordered a home doppler this afternoon.

I've been hesitant to do that because I've read that sometimes you can pick up the sound of blood flow of the placenta or umbilical cord instead of the baby's heartbeat and therefore wind up with a false sense of security. Or, on the other hand, have a hard time finding the heartbeat when it really is there, and therefore become panicked about it.

But a couple of you suggested it after my last post, and between those comments and realizing that this is not likely to get much easier in the coming weeks, I went ahead and bought one on eB.ay. Please feel free to share any suggestions or tips on how to use the thing.

On the bright side, I should mention that on some days the movements are now strong enough that R can feel them. The first time he felt them was on Wednesday night. It was a very brief but amazing moment to share with him, a moment I wasn't sure we'd ever get to experience. Friday night was another active night for Kiddo, so he got to feel it again a few times then.

One other thing I'm looking for thoughts on: short-term disability. Work has been unexpectedly even more stressful than usual for the past month, and my blood pressure is starting to creep up a little bit when I monitor it during the day (typically in the high 130s over the high 80s). And mid-December through February is our busiest time of the year, so the stress isn't likely to ease up much between now and March.

I mentioned this to the nurse practitioner on Friday. My bp was something like 138/87 at that appointment. She said there aren't many things that they/we can control, but stress is one of them, so she asked if I'd be open to short-term disability until delivery.

For the most part, the answer is yes, but I have a concern. From what I've read online, it seems like short-term disability applications for pregnancy get denied a lot, and you don't know what the outcome of your application will be until you're already out of the office. If the application is approved, I would still receive 60 percent of my salary, but if it's denied, I wouldn't. And while it wouldn't absolutely make or break us, it would put a major drain on our emergency fund.

I didn't think to ask the nurse about it, but I will bring it up at my next appointment. For now, we agreed to just monitor things for the next couple of weeks and see how it goes.

If any of you have experience with applying for short-term disability for pregnancy-related reasons, I'd love to hear them.* * * * *MC: Since you don't have a blog I can post on - thank you very much for your kind words. I'm glad our story has somehow helped you and your partner. Congratulations on her finishing bed rest, and I hope you receive BFP news very soon!

Movement Is Not Making This Easier

2011-11-29T22:24:00.001-07:00

I do not do well with Kiddo moving only intermittently. I have a feeling I'm going to be an obsessive kick-counter.

Last Tuesday, I noticed I wasn't feeling movement as often, and it wasn't as strong. I began to worry. I called the peri's office. The nurse reassured me that this is normal, that it's too soon to feel consistent movement.

That helped. For about 12 hours.

On Wednesday, the movements were even less, even lighter. By early afternoon, I was in tears and couldn't take it any more - I knew I was going to be a basket case all weekend if I didn't have some reassurance. So I called and asked them to fit me in, and they did.

And of course Kiddo was moving around a ton, which wasn't surprising given the amount of sugar I'd consumed in the 18 or so hours leading up to the scan in an attempt to get him/her to give me a definitive kick.

It turns out s/he was head down, kicking into the biggest part of my uterus, which was why it was so hard to feel.

Thankfully, by the weekend, I started to feel movement more regularly again. And yesterday, it was even strong enough that I could feel it externally when I put my hand on my abdomen. Just barely, but I could feel it. Unfortunately, R had already gone to bed and he was in the guest room because we both have minor colds right now, so he didn't get to experience it yet.

But I still get stressed about it. For instance, I feel movement the most between 8-11 p.m., and now here it is 10:30 p.m. and I'm realizing I'm not sure if I've felt it tonight. So now I'm nervous again, although there was definitely movement earlier today.

In other news, I managed to finish one of my papers but not the other. I requested an incomplete, so I have a month to finish it, although my goal is by Monday. The incomplete means a 10% penalty to my overall grade, but right now my goal is just to get the classes done. As long as it's a passing grade, the grade is not my highest priority at the moment...

And since we went for a scan last Wednesday, we moved yesterday's appointment to Friday.

Ten (almost down to 9) days to the edge of viability...

19 Days to the Edge of Viability

2011-11-21T20:00:00.001-07:00

A quick post...

Everything still looked good during Friday afternoon's ultrasound. The Kiddo looks like s/he is starting to add a little bit of fat/chub - very adorable.

I've been feeling movement more regularly throughout the day for the past few days, which helps me to worry a (tiny) little bit less. I am still so thrilled every single time I feel something. I've had R put his hand on my abdomen to see if he can feel it, but invariably the Kiddo stops moving then. I know it's probably still way too early for that, but he's been right beside me through every bit of these last 9 1/2 years, so I want him to be able to get to experience this (happy) part of it, too.

I have two major papers to write for school between now and Thursday. I don't know why I keep doing this to myself. I like school, I really do. Yet I procrastinate, which is why this will be a short (for me, anyway) post.

The peri's office is closed on Friday, so for the first time we are going 10 whole days (gulp!) between appointments. If not for the regular movement, I don't know that I'd be able to survive until next Monday without another peek.

I am behind in commenting, so please forgive me. I will catch up after the papers are done.

Meanwhile, I wish everyone a Happy Thanksgiving!

20 Weeks, and Emotional Progress

2011-11-12T09:20:00.001-07:00

There have been small steps in emotional progress this week, but steps none the less.

We've been hanging out at R's parents in preparation for having a garage sale at their house. Most of the stuff we're going to be selling is down in their basement, which is also where all of the baby stuff resides from our failed adoptions. (After we sold our previous house and moved, I refused to let any of that stuff cross the threshold into our new house.)

So there we were on Wednesday night, and curiosity got the better of me. I had R pull out one of the suitcases of stuff. It had somewhat less emotional stuff in it - a baby carrier, the thingamajig you put into a carseat to make it smaller so that an infant is snug in it, some plastic-backed swatches of rather stiff fabric that I'm thinking are maybe mattress protectors that go under the mattress sheet.

I think it would have been harder if I had opened the suitcase to find all the onsies, receiving blankets, towels, etc. we had bought. But what was there was okay - I could handle it.

We have more stuff in boxes down there, but R's brother had piled a bunch of clothes on the boxes, so we couldn't easily get to them for now. That was okay, too. But R also showed a little bit of emotional progress/forward thinking/hoping: he asked his brother to begin removing some of his stuff over the next several weeks so that we could eventually get to it.

And I also got a pleasant surprise - we have more baby furniture than I remembered.

I knew we had two cribs, given to us by two different friends, a very cute dresser R had refinished, and an armoire from my mom. But I had forgotten that the friend who gave us one of the cribs also gave us a tall chest of drawers and shorter chest of drawers that match the crib. So I'm thinking (imagine me, allowing myself to consider the possibility of a happy ending in the near future!) that we could put one of the cribs and the small chest of drawers downstairs so that we would have supplies more easily at hand without having to always run up and down the stairs.

Then, in a sign of even more progress, when we went to our appointment yesterday, I forgot to stare at the ceiling until the heartbeat was announced. It took a couple of seconds of staring at the ultrasound screen before I realized what I was doing. Then, just as it occurred to me and I quickly glanced away, the tech announced the heartbeat.

But there are still backwards steps sometimes, too. I was at work on Thursday when I began to have a lot of anxiety about not having felt the sensations I think are movement in a while. I texted one of my friends to say that I was tempted to leave my desk and drive around in my car with the radio on to see if I could elicit some movement from Kiddo. I didn't, but I was still super stressed about it until I finally felt some movement again late Thursday night.

So, like I said, small steps, but steps none the less.

Almost Half Way to Goal

2011-11-04T21:12:00.000-07:00

At 19 weeks, you'd think I could walk into an ultrasound room feeling a little more confident that we'll see a heartbeat on the screen. Yet there's still a twinge of anxiety and nervousness every time.

I wasn't planning to ask the peri about what she's thinking in terms of the timing of delivery; it feels way too soon to even be thinking about it. But when she commented that I was almost half way there, I told her I was hoping that today was half way, that she wouldn't make me go any farther than 38 weeks.

She said studies have shown that 39 weeks has the most optimal outcome rates, so her goal is for me to go to 39, but she won't make me go any farther than that. But she said she'd also be happy with term (at least 37 weeks) if that's the way it turns out, and okay with late pre-term (35-36 weeks), but that if there were signs that the best thing would be for the baby to come out earlier, that's what we'll do.

I told a few more people this week.

I hadn't shared the news with my VP yet, but I had decided I would tell him if the big scan went well, because he and my boss are starting to plan 2012 and they need to factor in my absence. He was very supportive and also understood why I'm still not ready to let the rest of the team know for another several weeks.

Last night, I got together with a group of friends. All of us used to work together, and one of us was visiting from out of town for the first time in several years, so we went out to dinner together. I almost chickened out - I still look pudgy rather than pregnant so I could've gotten away with hiding it - but I took a deep breath and shared the news. They know what we've been through so they were very excited. But I still can't talk about it like a normal pregnant person.

Five weeks to the edge of viability...

Movement?? And Other Craziness...

2011-11-01T23:10:00.002-07:00

First, about the movement. I can't say with 100 percent confidence, but I think I might have felt it for the first time last night. Either that, or I have been hoping for it so hard that my mind has resorted to manufacturing the feeling.

It wasn't really a fluttering, more like a foot or hand (I'm guessing) very softly bumping up against the wall of my uterus repeatedly. It's kind of hard to describe. I wouldn't call it a tapping feeling, either. It happened when we were laying in bed before turning the lights off, so after I finish this post I'll go upstairs and see if it happens again tonight. (I know it doesn't always happen every day in the beginning.)

The other craziness...

Remember when I was feeling restless while on bedrest and decided to set up an exercise program for R? Yeah, well, that didn't go so well. He did it sporadically a few times, and then that was it.

So, after hearing a couple of my friends rave about an exercise program called crossfit that's gaining popularity, I got the bright idea that he should try it.

I found a crossfit gym that is literally two blocks from his office. I called to inquire about price and whether it's something someone who is not in shape can do. Yes, absolutely, each participant works at their own level, I was told. They offer to let people come in and try out one session for free to see if it's something they want to commit to.

I prodded R into attending, which he did reluctantly on Saturday morning.

About the time the class was ending, I got a phone call. He sounded tired and annoyed more than anything, so I knew he was ultimately okay, but the words "doctor" and "fracture" and "wrist" came up. Thankfully, he didn't actually break his wrist - after spending several hours at urgent care, it was determined to be a sprain, and he's now wearing a splint.

Since he called me at the end of class, I figured he'd hurt it around then. But it turns out he actually injured it during the first drill, which involved running forward 25 meters, running backward 25 meters for a total of 250 meters. During his second backward run, he leaned his body too far back and fell. He twisted around to try to catch himself, which is when he landed on his wrist. Still, he continued to press on through the rest of the session.

To add insult to injury, he was the oldest participant there, and it was the day before his birthday.

Apparently my attempts to get him into better shape are actually dangerous to his health. Maybe someday I'll also tell you about the time I set him up on a man-date with another tennis player and he came home with bloody feet as a result.

And yet more craziness...

Work has not been a super happy place since layoffs were done several months ago. Due to the manager I wound up reporting to, I've been spared most of the pain, but 20-25% of the folks in my department who were not laid off have since left, and I know another 15% or so are actively looking. Meanwhile, more and more work continues to be added, and it's not like we were light on work to begin with.

So with all of these people leaving or looking around, it's kind of become contagious. I searched online, and I found a position that sounds like it would be a great fit. The scope of work is narrower (i.e. more reasonable) that what I'm trying to juggle now, and it would be a significant salary boost. I meet all of the qualifications.

Except that FMLA only applies if you've been with a company for 12 months or more, and obviously Kiddo's going to come out before then.

Still, I think I'm going to apply for it and just see what happens. (Don't worry, I happened to have a therapy appointment this week, so I talked it through with her before deciding this.)

Maybe I won't even be called for an interview. But if I do happen to make it to the point of a job offer and they can't give me a written guarantee that they would keep the job for me while I'm out, or if any complications arise with the pregnancy between now and then, I can always politely decline.

The Big Scan

2011-10-28T22:35:00.000-07:00

These past few weeks, I've been pretty calm, not too nervous before our appointments. But for some reason - maybe because today was the big scan - I was much more nervous.

Last night when I measured my belly, it had shrunk a little. (I know, I know, stop doing that!) My chest has been sore and having shooting pains all week (which I read was normal, so I didn't freak out about those), but when I got up to go to the bathroom in the middle of the night last night, I realized they weren't very sore. So the boob-poking, which I hadn't done in weeks, recommenced. Thankfully a few hours later, the soreness returned.

And, thankfully again, there was a heartbeat on the screen this afternoon. As well as:

a brain that was symmetrical

a four-chamber heart

a three-vessel umbilical cord

two kidneys

Kiddo is now exactly 1/2 a pound, about 7 inches stretched out, and measuring in the 60-65% range for all measurements but one. That one (I think it was a skinfold measurement on the head) was at 27%, but the ultrasound tech said it's tough to get an accurate measure of that and it was still within the normal range, so we're not worrying about it. Today is 18w0d, and everything except that measurement was in the 18w1d to 18w3d range.

The only thing that concerned the tech was that my placenta appeared to be "marginal" - not covering the opening to the cervix, but right next to it. So she wound up doing a transvag ultrasound at the end, which thankfully showed it wasn't quite as close as she originally thought. It was more than 2 inches away (apparently within 2 inches is considered marginal), so she said it's low-lying. They'll recheck it again at some point.

And that lady already knows me well. I asked her how long my cervix was and that I was worried about an incompetent cervix. She said she would only tell me it was more than 3 inches long and that she wouldn't give me an exact number because I'd obsess about it during every appointment. This was during the transvag ultrasound, and she also pushed hard on the lower end of my uterus to put pressure on my cervix. It didn't change, and she said the fact that it didn't soften or open a little bit was a good sign. Maybe doing that was just BS and wouldn't cause a change even in an incompetent cervix, but it worked, because it did reassure me a little bit.

Two more weeks to the half-way mark. Six weeks to the edge of viability. Here's hoping those weeks pass really quickly. And, more importantly, uneventfully...

About What You Said...

2011-10-22T22:10:00.001-07:00

I love blogs, but one thing they don't seem to accommodate so well is a back-and-forth kind of conversation. There are a lot of times I want to respond to comments, but I figure if I do so in the comments section, most of the time you won't see them. Or if I respond via a comment on your blog, you may have to find your comment on my blog to figure out what the heck I'm talking about.

So, if you have any suggestions on a better way to do this, by all means, please share. In the meantime, since this is the best idea I have, this post is going to be a random collection of responses to recent comments...

* * * * * Enjoying this pregnancy - Based on a few comments some of you have made, clearly I'm not doing a good job of making it obvious how much I'm enjoying this pregnancy. I am, I promise. Truly, really, honestly.

There's an underlying concern about whether it will end well, and I'm realistic enough to know that concern isn't going to go away. Sometimes the concern overshadows the joy, and I realize that's when I tend to post, so you're reading that part of it more than the rest. But the joy is definitely there, and in the day-to-day, it's usually much more prominent than the concern/worry/fear that something may go wrong. I'm even starting to relax a tiny little bit if you can believe that.

* * * * * My weight and the brownies - I didn't mean to imply that I was going to try to gain 6.5 pounds in 3.5 weeks, only that that's where I should be if I was exactly spot-on with the peri's recommendation. But I know being a few pounds off from that is okay, and ultimately as long as Kiddo is growing appropriately, it's alright to be on the low side of weight gain. The brownies weren't an attempt to try to gain all of that weight, I promise!

Speaking of the brownies, I definitely enjoyed them. It's very rare that I encounter a form of chocolate that I don't enjoy. :-)

* * * * * Increased blood pressure / pre-eclampsia - Thank you for the reminders that a sudden increase in weight gain is something to pay attention to. I'm definitely concerned about blood pressure / pre-e issues, so I'm monitoring my bp at home a couple times a day. I took the monitor in to the peri's office a couple weeks ago to see how accurate it was compared to their readings, and it was very close.

I'm also keeping an eye out for swelling, but so far I've only seen a little bit of it at the end of the workday, and once I come home and put my feet up, it's usually gone by bedtime. When I'm not pregnant, it's not too unusual for me to gain a few pounds over a couple days depending on what I've been eating, so I took the wait-and-see approach to this week's weight gain since I wasn't noticing any swelling, and I'm back down about a pound and a half.

* * * * * Gender - A couple of you mentioned that you thought it was a boy for various reasons. I hope you're right!

Someone (I think IRL, though I can't remember for sure) told me they knew of a couple who found out by giving a baker an envelope with the gender in it and instructions to tint the cake pink or blue on the inside so that they would find out when they cut into it. Given my fondness for baking, that sounded like a pretty neat idea, so I think that's what R and I might do. Although still not unless we make it to 30 weeks. For some reason, that's the milestone that's sticking with us as the point at which we might be comfortable finding out.

* * * * * On a related note, attachment - We're definitely already very much attached to the baby, even without feeling the kicks/movement yet. We have been since seeing the heartbeat for the very first time. I know there's no point in pretending otherwise.

But somehow in our minds, we've made distinctions between 1) the baby we see on screen each week, and 2) the idea of actually taking a living, breathing, baby home from the hospital, and 3) that living, breathing baby progressing to the point of us being able to do things like dress her up in a tutu for ballet class or R taking him to fly model airplanes with R's best friend and his son.

We know without a doubt that it would hurt like hell if something were to go horribly wrong. I guess what we're trying to do is limit the loss to that point. If we don't think about taking a baby home from the hospital and all those other fantasies that follow that stage, maybe we wouldn't feel those losses as much.

* * * * * Planning - This one kind of goes along with the last one. As much as we're trying hard not to assume too much and plan for any of it right now, I did (albiet very cautiously) discuss picking a pediatrician and pre-registering at the hospital when the nurse practitioner brought it up during our appointment on Thursday. She was very proud that I was willing to engage in any sort of conversation about it at all. :-)

* * * * * Maternity clothes - Since I still have all of my clothes from my pre-thyroidectomy days, so far I haven't needed to shop for anything other than larger underwear and bra extensions. But I was in Ta.rget the other day to buy a gift for someone, and I decided to be brave and wander through the maternity section.

I don't think I'll be doing much shopping there, though. First of all, it was a tiny section - all of about two rows of racks. Secondly, half of the stuff in those racks was XS! (And the racks were full, so I don't think it was just that they were all out of the rest of the sizes and this was all they had left.)

I get it that if you're petite to begin with, you're still going to need sizes that are on the smaller side even in maternitywear. But most of this stuff looked like clothing that would be tight on a thin 10-year-old, much less an expectant mom. I had to wonder, just where exactly are all of these super-skinny 30-weeks-along pregnant women that the store's buyers are obviously buying for?

Thank you to those of you who have suggested mail-order shopping to start with. I hadn't even thought of salespeople descending on me in the store. That's definitely something I want to avoid.

* * * * *This post is getting ridiculously long, so I'll wrap it up. Next up: The details of our one-hour scan this coming Friday (18 weeks), unless I think of something brilliant to post before then.

More Happy Progesterone News

2011-10-19T23:22:00.000-07:00

It seems my body has gotten on board with its progesterone-producing responsibilities.

During the previous test, it was 29 on one suppository a day. Monday's test showed a level of 39 after having been on one suppository every other day. So now I'm off the suppositories and will have another recheck next week to make sure the level is still okay.

Also, about that weight gain thing - apparently all I needed to do was blog about it, because somehow I am now up 4 pounds in 5 days. I'm not quite sure how. I know I baked that pan of brownies, but there is still about 1/4 of the pan left, and R and my mom have eaten their fair share...

An Unexpected Challenge

2011-10-16T23:09:00.000-07:00

Since I've struggled with keeping my weight in a reasonable, healthy range for pretty much all of my life, I worried that I'd gain 40 or 50 or even more pounds if I ever made it to the end of a full-term pregnancy. I can honestly admit that back before we even started TTC, while we were still just in the thinking-about-it stage, it was more of a vanity concern than anything else.

Now, I could care less about the vanity aspect of it, but I know that additional weight increases the risk of a lot of complications that I'm already at risk for. There are some risk factors I can't do anything about (age, IVF, PCOS), but I'd like to at least minimize the ones that are under my control.

So imagine my surprise that here I am at 16 weeks, and I'm only up 3.5 pounds.

This, despite 6 weeks of bedrest and minimial exercise since then. (Although I am trying to get into a regular, albiet very low-exertion, routine.)

I don't need to gain a lot of weight during this pregnancy. The materials the peri gave me match what I've read online, which is that someone in a healthy BMI range (19-24) should gain 25-35 pounds for a singleton, a BMI of 25-29 should gain 15-25, and a BMI of 30 or above should be around 15 pounds. Since I was at a BMI of about 29 at the start of this pregnancy, I figure I should aim for an amount closer to the 15-pound end of that range.

I think the peri is thinking something slightly higher, because I asked her in general about my weight gain a few weeks ago, and she said to aim for about 10 pounds by 20 weeks. Which means I've got about 3.5 weeks to gain 6.5 pounds.

Normally that wouldn't be a problem for me. But I guess my body is burning a lot more calories than I realized in this process, and apparently I'm not eating enough for that. Although I certainly am eating!

It's not like I'm dieting or skipping meals or anything at all like that. In fact, I baked a pan of brownies yesterday. (Accidentally used 1 1/4 cups of water instead of just 1/4 cup, but it turns out that if you turn the oven temperature down to 250 instead of 350 and bake them for an hour instead of 30 minutes, they turn out just fine.)

I hope I don't sound like I'm complaining about this at all. I just don't want it to have a negative impact on the baby, although Kiddo seems to be growing fine at this point as far as all the ultrasounds show. At 18 weeks, we'll have the big scan where all the bones and organs get measured, so hopefully at that point we'll find out the percentile range the baby is in for size.

With regard to the progesterone, I was supposed to get it re-checked on Thursday, but the order wasn't faxed over until Friday, so I just continued with the every-other-day suppository routine. I'll go get it checked tomorrow.

As you've probably guessed, Friday's ultrasound went fine. This time, we could see the ribs. It still amazes me how we see something new during almost every scan.

Gender! It's...

2011-10-08T23:02:00.001-07:00

...still a mystery to us.

The answer is somewhere in our house, an ultrasound photo with a note on it, slipped inside a folded piece of the perinatologist's letterhead, stuffed in an envelope. I say "somewhere" because I told R to hide it, lest I become tempted to peek.

During our weekly ultrasound yesterday (15w0d), Kiddo still wasn't cooperating on revealing the gender. Then suddenly the ultrasound tech told us to look away if we didn't want to know. She said she's 99% sure, because she was able to see both from the bottom and the side.

At first, that made me think boy, because what would you see from the side if it was a girl? But then it occurred to me that not seeing anything from the side would also be a confirmation if she was thinking it was a girl. So who knows? Well, I guess the ultrasound tech does. But not us.

I'm not sure yet when we're going to open it. Probably not unless we make it to 30 weeks. Maybe not unless we're on the way to the hospital for delivery.

Or maybe we'll just let it be a surprise and then open it after the suprise has already been revealed.

If we were "normal", if we hadn't been through the hell of the last 9 1/2 years, we would have found out yesterday. But R wants to stay as detatched as possible. We're afraid to start forming fantasies in our heads, and that's easier to do if we know "girl" or "boy", so for now we'll just hold off on finding out.

And hope that when the time does come to open the envelope, R will remember where he hid it...

P.S. I know I still need to post about progesterone. I underestimated the time it would take me to do schoolwork last weekend, which spilled over into last week. The short of it: three weeks ago, while on 1 suppository a day and 1/2 cc of PIO every other day, my level was at 19.7. And on Thursday, being on just 1 suppository a day and no PIO in more than two weeks, it was up to 29.something, so I'm feeling a bit better about it and hoping it's a sign that my placenta is kicking in. I'm now on 1 suppository every other day, with another recheck this coming Thursday.

Second Trimester!

2011-09-30T23:41:00.000-07:00

Those are two words I wasn't sure I'd ever be writing in regard to myself. Yet, here we are.

I know some people count 12 weeks as the 2nd trimester, and others count 13. The peri counts it at 14, and for some reason I felt compelled to follow that - maybe because I wanted to be able to say it without any doubt about whether we really had reached the milestone.

To celebrate, R and I went out to dinner at my favorite Mexican restaurant.

The ultrasound was pretty uneventful. The techs aren't measuring the length every time anymore, just doing a really quick check of the heart rate. It was in the 150s today, which is where it's been for the last few weeks, so nothing new there. This time, Kiddo was facing in a way that was difficult to see much, so the tech couldn't get a shot that she felt was worthy of printing.

She casually mentioned that normally at this time, with most of their patients, they might not do another ultrasound for a month. I just laughed. Then she suggested that maybe I could try to stretch it out to two weeks.

I told her I could be okay with that as long as we could hear the heartbeat with a doppler at the appointment during the weeks that didn't include an ultrasound. She said we're just at the cusp of being able to hear the heartbeat that way and that she knew I'd freak out if they had problems finding it. So ultrasounds it is, at least for a few more weeks.

Given our rather tense conversation on Saturday, I thought it might be a kind of uncomfortable appointment with the peri, but she was actually very nice. She is trying hard to do anything she can think of to ease my fears (other than monitoring my progesterone levels). She mentioned the AFP (alpha fetal protein? - I haven't looked it up yet) test, which is a blood test that checks for spinal issues in the baby. It's supposed to be done between weeks 15-18, and she said "Why don't we just go ahead and do all of your tests at the beginning of the testing windows? The sooner you have results showing everything is okay, the better you'll feel." So we'll also be doing the big 18- to 20-week scan at 18 weeks.

She also said she has another patient (further along than me) who is from the same RE and has had a very similar history to me. She said she thought it might be helpful for me to talk with someone else who is now progressing after so many losses, so she offered to ask that patient if she'd be willing to call me. I said that was fine and gave her my cell number to pass along.

I also reminded her that it was another friend of mine who is also the RE's patient who referred me to her, and she said "Yeah, but that's not the same. Her history is different than yours, so for her, the pregnancy experience wasn't the same as it is for someone with your history." I'm glad she gets that, and understands that someone with as many losses as we've had is going to be so much more nervous than even the typical high-risk patient.

About the progesterone...I'll write more on that in the next couple of days. It's late, and I'm finding myself yawning and struggling to keep my eyes open as I type this post, so it would probably be a rather incoherent update. For now, suffice it to say that I'm still taking the suppositories...

I'm Making Progess, But Not That Much Progress

2011-09-29T23:17:00.001-07:00

Unrelated to the topic of this particular post, I've noticed people writing on other blogs that they're also having the same problem commenting on blogs that I am experiencing. Today I was able to post comments on two Blogger blogs, so I thought everything was resolved, but then the next ones that I tried to comment on, no such luck. So if I haven't commented on your blog lately, please know that's why.

* * * * *On to the post...

An envelope arrived in the mail the other day. It was bright pink, and addressed to me in handwriting I didn't recognize, from an address I didn't recognize. I had no clue what was inside.

It's the baby shower invitation for one of my former co-workers, who also struggled with infertility but didn't pursue any treatments and had resigned herself to living childfree. She confided her pregnancy to me this summer, right before we left town to do our transfer.

I honestly can't remember the last time I received a baby shower invite. Some of our friends are single, some are older and finished the child-bearing phase of their lives a while back. Of those who have had kids in recent years, I think a lot of them just decided it was best not to send an invitation, especially our IF friends.

Opening the envelope and seeing that pink and brown bottle wasn't nearly as difficult as it would have been if I was not also pregnant.

I still don't think I'm going to go, though.

If I do, I will cry. I don't think I will be able to hold it together. I will stand there and look at all of that baby stuff and see the cute baby cake and (heaven forbid) have to play the guess-the-flavor-of-this-baby-food game, and the whole time I will be thinking "Will I really get to have this kind of a day someday soon, or is this going to end in disaster and heartbreak, too?" Like I said, tears. And that would be bad form for a party guest.

So I will have another co-worker help me shop - I still need moral support and hand-holding to walk into a store like that - and then I will make a plan to meet up with her and give her the gift before the shower.* * * * *In other pregnancy-related news, it seems morning sickness is kicking into gear more in the second trimester than the first. For the most part, it's been more low-grade. Then again, I'm wearing the acupuncture wrist bands I had R buy last month pretty much constantly, so I don't notice it too much unless I take them off for an extended period of time.

Last week, I did have my first-ever experience with tossing my cookies during pregnancy, but I'm not sure it was morning sickness so much as it was that I had gone too long without eating. It's been years since I've gotten sick in that way, and the next day, my upper abdominal muscles were sore from all the heaving involved, which just goes to show how truly out of shape I am.

And speaking of shape, I'm beginning to notice changes in mine. I think my tilted uterus may finally be all the way in the correct position, because things seem to be pushing up a bit - I now have a natural muffin top even when I'm not wearing anything. I've only gained a 3 or 4 pounds so far, so I don't think that's what's causing it.

But whatever the reason is, I'm fine with it. Excited about it, actually, because it means maybe things are still on track.

What To Do?

2011-09-27T23:26:00.000-07:00

First of all - Libby, please know I'm thinking of you and hoping the transfer results in a positive outcome. I've tried to post a comment on your blog about a dozen times, but it just clears the comment without posting it after I submit it. Not sure what's wrong, because I've been able to comment on other blogs. For those of you who don't know Libby, please go wish her success with her recent transfer.

* * * * *I'm still unsure with regard to what to do about the progesterone situation.

The score: 4 doctors think my level is fine and doesn't require additional support, 1 suggests additional support for a week, and 1 potentially suggests additional support until 20 weeks. You would think that having 2/3rds of them solidly on one page would put my mind at ease, but no.

The 4 who think things are fine: Both of the perinatologists in the practice I go to, my RE, my RI.

The peri who isn't the one I see was the first to respond to my call over the weekend. She doesn't think I need additional progesterone support but said it would be fine for me to take 2 suppositories a day until Friday if it would make me feel better. My peri called about 5 minutes later. It was clear she was annoyed that I was calling her about something we've already discussed and was very blunt in saying she absolutely would not order progesterone for me nor would she order any tests to monitor my levels. (To her credit, she also did her very best to try to reassure me that everything looks perfect and that she doesn't see any reason for me to worry.)

I haven't had a chance to ask the nurse why my RE is fine with my level being below 20, because it came in a voicemail.

And really surprisingly, the RI's office says anything above 10 is fine at the end of the first trimester/start of the second, even though their website says immune patients should continue progesterone support until 16 weeks. 10? Seriously??

The 1 suggesting additional support for a week: The RE who was on-call for the clinic this weekend.

The surprise of this one is that the nurse had told me on Friday that there was no point in asking him what his recommendation was, because that particular RE requires all his patients to be off all progesterone support by 12 weeks, regardless of their levels, no exceptions. But then she decided to go ahead and ask him anyway on Saturday since my RE hadn't responded yet. And the one who never recommends supplementation past 12 weeks told her to have me continue taking a suppository until this Friday, which will be 14 weeks.

The 1 potentially suggesting additional support until 20 weeks: Another RI who I had consulted with last fall but decided not to work with because the additional treatment he recommends for some tough RPL cases is a drug I won't take. One of the risks of it is an increase in the likelihood of developing leukemia, and with my dad's and grandfather's history, I'm not going there.

But he has a forum on his website where you can post questions. And while he didn't directly answer my question about what he likes the level to be at the end of the first trimester or directly comment on my particular level, he did say that for women who have had low progesterone levels and a history of losses, he keeps them on supplementation until half way through.

If I was already his patient and he was already involved in managing some aspect of this pregnancy, I'd just go with his recommendation. But I'm not actually his patient (we only did a brief consult about a year ago), and I think it could potentially create an uncomfortable relationship with the peri if I bring in another doctor who will do what I want because she won't.

If she was an average ob at a typical practice, I would shrug off that concern and find another ob if need be. But this is a fantastic practice in every other respect - they get what we've been through, they let me come in as often as I need to put my mind at ease, and I know I will get really careful and frequent monitoring. (Most likely weekly until 32 or 36 weeks, then twice a week at that point.) My friend who recommended this peri can't say enough great things about her c-section experience.

I'm supposed to get my levels re-checked again on Friday, and I see the peri that day as well. I guess we'll see how it goes.

This Is Why I Don't Trust My Body

2011-09-24T00:37:00.000-07:00

The ultrasound went well today. Test results, not so much.

Kiddo is still measuring on track - 6.7cm (about 2.5 inches) at 13w0d. I was thinking that measuring on track is a good indication of the health of the pregnancy, but the ultrasound tech dispelled that notion today. Apparently, because the size is so small at this point, the chance of being off on the measurement is too high to be a good indicator of the pregnancy's health.

She said they don't start to use measurements for that until about halfway through. Still, we've had consistent growth, and I'm hoping that's at least a good sign.

But test results are proving to be the bane of my existence.

We got the official results of the NK scan today. Risk of Down's is 1 in 6,600, and risk of Trisomy 13/18 is 1 in 6,800, so both of those are very good. We saw the nurse practitioner today, and she went over that table of results with us.

I didn't look at the results of the 3 individual tests that make up the results until we were in the car. The NT itself was 1.3, which we already knew was normal, and it was in the 50th percentile for results. PAPP-A was 0.90 mlU/ml and was in the 60th percentile.

Then there was the free beta HCG, which was 20.88 ng/ml, in the 5th percentile.

I know beta levels drop as the second trimester approaches, and free beta is much lower than the quant beta measured at the beginning of pregnancy. The one reference I was able to find for the difference between the two said that the free beta is generally about 1/2 of 1% of the quant beta, which would put my quant somewhere around 4,000.

The 4,000 is pretty low for this point, but I've been focusing more on the free beta results. From what I have found online (I know, shame on me for Googling), free beta results that are in the 5th percentile or lower on the NT screening have 2-3 times the risk for delivery before 37 weeks and the baby being in less than the 10th percentile for growth, and about 5 times the risk of fetal loss before 24 weeks.

So, I don't see myself relaxing much before 30 weeks.

Then after that, I got this morning's progesterone results. I'd been off of everything for 2 days. It was 17.45.

It was the optimistic nurse who called, and even she seemed rather concerned. I asked her if this happens often, and she said pretty much everyone is off of everything by 12 weeks and has a level above 20 at that point. I'm a week further along, and still not there.

She is checking with RE to see what he recommends. I may not hear back until Monday, but she explained that either way, it would just be a recommendation. Since I'm at 13 weeks, they won't continue my care, so the peri would have to be the one to prescribe it if he recommends I stay on it. She also wouldn't tell me what I should do over the weekend, but she asked me what I thought I might do, and I told her I was going to immediately restart the suppositories.

I was going to wait until Monday to call the peri, but my friend who referred me to her said to just call the peri now rather than stress all weekend, so I'm going to call her tomorrow morning. I'm going to insist on continuing the progesterone and regularly checking the levels for the duration of the pregnancy. We've approached our whole infertility experience - and this cycle in particular - with a "no regrets" attitude. I realize progesterone won't stop something bad from happening if there's something else that is a problem, but if something does go wrong and I'm not on it/don't have good levels, I know with 100% certainty that I would always have regrets about that. If she isn't willing to prescribe it, I think the RI would, so I'll go that route if need be.

From everything I've read and been told, there's no risk or adverse outcome associated with being on it in the 2nd and 3rd trimesters, Given that, it doesn' t make sense to me to not treat it and have me worry about it the whole way through. And let's face it, I would worry, big time.

No Ultrasound Today

2011-09-20T20:50:00.003-07:00

I decided to be brave and canceled today's appointment.

So far, I haven't been too freaked out. I felt lots of round ligament pains yesterday, which always makes me feel better. I told R that Kiddo must be going through a growth spurt. I've had hardly any today, but they seem to occur a lot one day, then ease up for the next few days, so I'm not panicked about it.

Also, I'm still having the fatigue. I slept 9-10 hours both days over the weekend, and I still needed two naps on Saturday and one on Sunday. I know the fatigue is supposed to ease up around this time, but I'll be fine with it if it sticks around.

The last PIO shot was on Sunday. My backside is rejoicing. Tomorrow is the next blood test to check the levels - hopefully it will be good news. My chest seems less sore, but it's grown about an inch during the last three or four days according to the tape measure, so hopefully that's another good sign.

66 hours to go until the next ultrasound. Not that I'm counting or anything...

More on the NT Scan

2011-09-18T21:07:00.002-07:00

Of all the things I've been freaked out about so far with this pregnancy, ironically the NT scan wasn't one of them. I think it's probably because we had already done chromosomal testing on the embryos, so we know the chances of Kiddo being normal (in that respect, anyway) are 90%.

Both of the things that the tech looks for during the scan - the nasal bone and the nuchal fold thickness - looked good. The bone was visible, which is a good sign. And the fold measured 1.3 at 12 weeks; anything below 2.18 is normal at that point based on what I could find online. Both the tech and the peri said everything is looking exactly as they would expect it to look at this point.

Blood was drawn for the other part of the screening, and we should get those results back in a couple of weeks.

The rest of the appointment went fine, too. Not surprisingly, the peri isn't concerned about my progesterone level - she never measures it in her patients, so she said to just do whatever RE recommends. The current plan is for tonight to be the last PIO injection, continue the endometrin once a day, and recheck levels again on Wednesday.

I told R that I will see how I feel tomorrow, and if I think I can make it until Friday's appointment, I will cancel the Tuesday appointment. I know at some point I have to stop going twice a week...

On an unrelated note, to answer Libby's question on my last post: we downloaded I.Q.. It's a romantic comedy from the early 1990s, starring Meg Ryan and Tim Robbins. I'm very basic when it comes to movies - I like romantic comedies, or, occasionally, a regular comedy, and it better not have a sad ending. (I don't care if the ending is predictable, I just want to be entertained for a couple of hours, and I certainly don't want to wind up depressed at the end of it...)

We hadn't seen this particular movie before, and it was cute, at least the part of it that I saw. Meg Ryan was her perky romantic-comedy self, so however you felt about her in You've Got Mail, you'd probably feel the same in this movie. I fell asleep halfway through, not because it was boring, but because the fatigue that eased up for a few weeks has returned again. But R watched the whole thing, and he said it was my kind of movie. That's about as much of an endorsement that can be expected from a guy forced to sit through a chick flick...

12 Weeks: NT Scan

2011-09-16T21:27:00.000-07:00

More to come tomorrow, because I've promised R that I will watch a movie with him and not spend the evening on the computer, but just a quick note to say there's still a heartbeat, and the scan went well.

Kiddo was sleeping, so it took a really long time to get the correct positioning for the scan, but we certainly didn't mind all the time we got to spend watching him/her.

And my progesterone went up ever so slightly, to 21.6. Who knows, it could just be a time-of-day fluctuation and still virtually identical to Wednesday's levels. But for the moment, I'm enjoying the fact that the scan went well and not freaking out about the progesterone.

Weaning: Progesterone Dropped Like a Rock

2011-09-14T18:23:00.002-07:00

My next post was going to be about how I am enjoying this pregnancy (a lot, honestly, I promise!) despite my worries. But then I got the call from RE's office about the latest P4/E2 results, so enjoyment is once again taking a back seat to concern.

The weaning had been going well. For some reason, I haven't ever been nervous about the E2, only the P4. They've been weaning me very slowly. I was on 3 progesterone suppositories per day and 1cc of PIO per day. We started by going to 2 suppositories a day, still doing the 1cc every day. Tested a few days later, P4 was at 35. Then went to 2 supps and 1/2 cc every day. After a few days, P4 was at 39. I was excited - I thought this meant my placenta was taking over.

Then we dropped down to 1 supp a day and 1/2 cc every day. P4 went back to 35, but the nurse assured me that it fluctuates, so I still didn't worry about it. (That was Friday.) Then we went to 1 supp a day and 1/2 cc every other day.

Today's test result showed P4 at 19.7.

The nurse said RE wants to see it above 20, but from what I'm reading online, the typical P4 level at 12 weeks (today is 11w5d) is around 33. And my P4 would be even lower than 19.7 if I wasn't on the supp and 1/2 cc.

For some reason, I've just always been nervous about my body's ability to produce an adequate amount of progesterone without supplementation, so I asked the peri about it during our first appointment. I've read a lot of information online about supplementation during the 2nd and 3rd trimesters being necessary for some women and that it's totally safe. However, it also sounds like there are a lot of OBs/peri's who don't believe in it.

I think my peri falls into the second camp - she basically said she doesn't use it after the first trimester and that if the placenta isn't producing an adequate amount, that's a sign of a bigger problem with the placenta that would likely jeopardize the pregnancy. But it seems like there are a lot of women out there who had second trimester losses, and then when they were on progesterone in subsequent pregnancies (including during the second and third trimester), they went on to have healthy babies. So obviously their placenta didn't completely fail them...

The plan is to continue with the 1 supp and 1/2 cc every other day for now, and then re-test P4 on Friday to see if it's increasing. If not, I'm going to insist on going back up to a higher dosage. I asked the nurse what happens if it stays low, and she said she'd have to talk with RE.

On the other hand, it seems my E2 is perfectly fine. I'm down to 2 patches every other day and no estrace at all, and my level was just under 1,200 today. The nurse said that level was totally normal, and it's up slightly from just under 1,100 when I first started weaning. I couldn't find much info online regarding what normal E2 levels should be at this point, but the couple of charts I did see seemed to indicate it should be closer to 2,000 at 12 weeks. So not sure what to think on that one either.

To top it all off, yesterday on and off and for most of today, I've had a resting heart rate of 100-120 bpm (tachycardia). It finally seems to be easing up this evening. I'm not sure it's pregnancy-related, though. That used to happen a lot when I was in a hyperthyroid state before my thyroidectomy, so I have assumed it was thyroid-related, especially because it didn't happen for quite a while after the surgery.

But then it started happening again last summer and really started to become annoying last fall, so I assumed my thyroid meds were too high and asked my family doc to lower my dosages. If you recall some of my posts from spring, that didn't work out well - I wound up in acute kidney failure (resolved by increasing my dosages back to what they were), and the tachycardia went away on its own.

Peri just checked my thyroid levels last week and free T3 and T4 were a little lower than mine normally are (but still within the normal range) and T4 was up to 4.45 (it had been 1.something a couple weeks before transfer), so she's increasing my Syn.throid from 125 to 138, but I haven't started the 138 yet.

It looks like we'll have lots to discuss during my appointment on Friday...

Trying to Reason With Worry

2011-09-13T20:52:00.000-07:00

Once again, I was totally nervous about today's ultrasound. And once again, everything was fine. Kiddo is still in there, heart is still beating, body is still growing. Or at least, it looks like it to me - since these are just reassurance ultrasounds, the tech didn't measure length the last couple of times.

I had no real reason to think things wouldn't be fine. I'd had low-grade nausea for a couple days, and I still felt the round ligament pains, although not as much the last couple of days.

And still, I get really stressed beforehand each time.

R tried to reassure me. In the past, when he's said "It will be fine", I've told him not to say that for fear of jinxing it. This time, I didn't scold him, I just let it go. I guess that's progress, at least.

But I still can't let go of the tissue box. When we had the first ultrasound last month, when I climbed up onto the table, I had R hand me the tissue box that was sitting on the counter. I wanted easy access to it in case it was bad news, plus it gave me something to hold and focus on. I still make him give it to me every single time.

I tried reasoning with myself this afternoon, after the appointment. Realistically, I'm doing everything I can do to encourage this pregnancy to continue. If something's going to happen despite that, then it's going to happen. If I spend all this time worrying and everything turns out fine in the end, I will have tarnished an incredible experience with worry. And if I spend all this time worrying and it ends badly, all that worrying wouldn't reduce the grief. So I'm trying to let the worry go. Not necessarily very successfully, but I'm hoping I'll get better at it with practice.

Whatever will be, will be. Maybe I should tattoo that on my forehead.

Pictures

2011-09-11T16:30:00.000-07:00

Here they are, pictures as promised.

The first one is the most clear one from Friday's ultrasound. The head is on the right side, and the white triangle is the nose. I think the ultrasound tech said the straight right line below that is the upper mandible, and the white area below that is the jaw. The left foot is on the far left side of the image, and the right foot is the light white blob above the short bright white line. I'm not sure what that white line is or what the bright white line running along the bottom is - maybe the spine?

This next photo is not the most attractive, so I can't quite believe I'm sharing it with you. But it is what it is. At least I don't have to show my face... :-)

And let me just say, not all of that bump is baby, not by a long shot. Even when I weigh 40 pounds less than I do now, with a BMI that is in the "Healthy" range (i.e. below 25), if I were to wear something form-fitting, I'd still have the kind of stomach that makes people look and think "Hmm, is she or isn't she?" About 90% of my body fat tends to congregate in my belly, something that no amount of sit-ups or cardio seems to be able to change.

From yesterday (11w1d):

Nose!

2011-09-09T23:29:00.000-07:00

There's a nose! I'm almost as excited about the nose as I was the toes.

It's late, so I'll leave it at that for now and post more this weekend, maybe even an ultrasound pic and the first belly shot, if I get myself organized enough to scan in the first and take the second.

I should have posted sooner, so I'm sorry if I worried anyone. Our appointment was toward the end of the day, and when we got home I took a long nap and then did something I haven't done in a couple months - cooked dinner.

My Body Is...Functioning??

2011-09-06T20:36:00.001-07:00

RE's office began weaning me off the meds last week, and we made the second change to the dosages over the weekend. I had blood drawn on Friday and again today. And even though we cut the PIO down to 1/2 a cc per day from 1 per day, my progesterone level rose a few points.

I've been worried that my placenta wouldn't kick in, but apparently, my body is functioning. Correctly.

I honestly don't know how to wrap my head around that. I've had, literally, 8 1/2 years of bad news about how my body doesn't function like it's supposed to, many of the malfunctions being fertility-related, others not. So this is new.

I think the best way to explain how I feel is to say "Hopeful, but not yet trusting." The analogy that keeps coming to mind is having a relative who has an addiction and decides to check himself into rehab. You're hopeful, because he's taking a positive step in the right direction, but that doesn't mean that the day he walks out of there, you're going to be 100% trusting that he'll stay on the wagon permanently without the wheels falling off at some point. Building trust takes time.

On the bright side, the ultrasound tech said that today I looked more calm than I have in the past. Apparently I've had a pretty wide-eyed, freaked out look up to this point. (Big surprise, I know!)

And I was feeling pretty calm, until we were on the way over there and I realized it's 10w4d, and the only other ultrasound we've had during the 10th week was the one at 10w2d when we found out that Baby #5's heart had stopped.

I had a few moments of panic where I thought maybe we should just skip the mid-week ultrasound this week - somehow 11w0d (Friday) sounded safer to me. (I didn't say logical, just safer...) But I kept those thoughts to myself and let R drive on.

This time, the tech was able to see Kiddo well enough through an abdominal ultrasound that she didn't need to follow it up with the transvag approach. Heart still beating, still in the 160's, legs and arms had grown and were waving around a lot.

Kiddo is measuring 2 days ahead of schedule. I just wish I could call my dad and tell him that. Today is the 4-month anniversary of his passing.

Venturing Out

2011-09-05T19:57:00.001-07:00

We didn't wind up going to the movies this weekend, mostly because the two movies I was most interested in are no longer in the theaters. But I did have R take me out to run a few errands.

I think I overdid it a little bit, but everything still seems to be fine. I got out of breath walking from a parking lot to the back of a store, and then when we got to the grocery store, I had to sit at a table by the coffee kiosk, because I knew there was no way I was going to be able to make it around the store.

I'm glad we're doing the twice-a-week appointments, because I seem to hit a point of concern around mid-day on Mondays. Today, I was concerned because I hadn't been feeling any stretchy/pulling feelings, which I've had pretty much every day. But thankfully, they're back again this evening.

They've been feeling a little different the last couple of days - somewhat higher up than the groin area, and more sharp/pinchy than achey. So of course that makes me nervous, too. :-) But I've been telling myself that it's probably because my uterus is moving into a different position and it's (hopefully) starting to rise up a bit. Plus, this is a couple weeks further than it's ever stretched before, so the change to sharp/pinchy makes sense.

I'm curious what all of you think about renting a doppler? I would have expected myself to already have ordered one, but I haven't. I think I'm worried about how I would react if I couldn't find the heartbeat. R thinks it will just cause me extra worry and stress.

And one last question. I just switched over to the new Blogger interface before the last post, and even though I'm still entering two returns after the end of each paragraph, now I'm having to put in line break tags to prevent the posts from being one giant paragraph. I never had to do that with the old interface. Am I doing something wrong, or are any of you having the same issue?

Double Digits

2011-09-02T23:06:00.000-07:00

I'm beginning to feel like a broken record, but in a good way.

There's still a heartbeat. It was down to 167 or 168 today (from 182 a week ago), but I know it usually peaks at about 9 weeks and then starts to slow back down again, so I'm trying not to worry. Both the u/s tech and the peri said it was fine.

We are finally into the double digits! Kiddo measured at 10w1d today, so 1 day ahead of schedule and almost exactly 1.5 inches in length. My retroverted uterus has also started to move into the correct position, although the tech guessed it'll probably take another couple weeks to get completely straightened out.

Today, Kiddo was on his/her stomach, the head slightly lower than the body. We could see an arm waving and the body moving a lot, but we couldn't really see the legs/feet today. No toe viewings. :- (

Since I haven't had any bleeding in 15 days, the peri said I can start to do light activity around the house. No exericsing, no heavy housework (ha! Even when I'm not pregnant, heavy housework is not likely to happen), no returning to work yet. She said we can discuss returning to the office during next Friday's appointment, depending on how the week goes. I did get permission to go to a movie, though, so I'm looking forward to an out-of-the-house adventure that does not involve lab work or an ultrasound wand...

The Tuesday ultrasound really helped with the stress factor - I was more calm going into this ultrasound than any of the prior ones. Of course, the fact that I had to go to the bathroom about 15 times yesterday (literally) and felt nauseous this morning also helped, too.

But I'm still only scheduling appointments one week at a time. I'm happy, I'm thankful, but I'm still taking this in very small increments.

Toes!

2011-08-30T21:37:00.000-07:00

It's amazing what a difference four days can make.

I did okay through the weekend, but then yesterday I started to really freak out again about my lack of symptoms. I was in tears. (Perhaps I should count being overly emotional as a symptom?)

So after talking with a friend who encouraged me to just go in and get scanned again for the peace of mind, I finally gave in, called the peri's office and told them I need to come in twice a week for a while. They were great, as usual, so I'll be doing Tuesday ultrasounds and Friday ultrasounds and appointments.

I was so incredibly nervous this morning. I haven't been tired or nauseous or had headaches since Friday, and the need to go to the bathroom isn't quite as strong anymore either, so I was really trying to prepare for bad news. But thankfully the heartbeat was immediately visible.

Kiddo is measuring on track - four days of growth since Friday. And instead of arm and leg stubs, there are now longer arms and legs, and even feet and toes! We could see where the bones are starting to form/harden in the head and in the toes.

Technically the toes looked more like a dog or cat paw at this point, and we could only see three or four of them on each foot, but hopefully they will all be there when they're supposed to be. :-)

I couldn't believe how much more human-like Kiddo looked today even compared with just a few days ago.

On Friday, I know I blogged that I was more terrified than happy after the ultrasound. But this time, there was just huge relief and the same kind of happiness I felt after the first few ultrasounds. Hopefully this will carry me through to Friday's appointment without too much of the crazy reappearing before then.

R is laughing at me - I just keep saying "Toes! There are toes!"

In New Territory

2011-08-26T17:37:00.002-07:00

Heart rate 182 (up from 167), Kiddo measuring 8w6d, which the peri said is fine even though today is actually 9w0d.

So, this is a new milestone - the furthest we've ever gotten with a heartbeat before is 8w1d.

With the first three ultrasounds, I felt a huge relief as soon as we saw the heartbeat, and I was so incredibly happy for a few days after. (Well, 12 hours in the case of the first ultrasound, since I started bleeding a lot again the day after that one.)

The odd thing is, I don't feel that way this time.

Of course, there was relief as soon as the tech said there was a heartbeat. (I still refuse to look at the screen until the heartbeat is announced.) But now, I just feel mostly...terrified.

I don't know what to do in this place. I don't know what to expect from here, what it's supposed to feel like, how it's supposed to go.

With all of our other pregnancies that got to the point of ultrasound, there was always just an oddly shaped gestational sac, or in the case of pregnancy number four, something that looked like a large white grain of rice, with kind of a large end (the head) on the 8w1d u/s. The ob's office just had a regular-resolution ultrasound machine.

I've been thrilled that the peri's office has such a high-resolution machine that makes it easier to see things. And it is pretty cool.

But.

But - this week there was very clearly a head. There are little leg buds and little arm buds. And a torso. He/she wiggled.

Kiddo is not just a large white grain of rice anymore. This time, the ultrasound tech typed "Baby" on the screen where Kiddo is for the pictures she printed out for us. Up until this point, it's always been "Embryo".

I've been attached to and grieved every one of the seven babies we've lost. I've felt the loss, even of the second one, which I realized on a Sunday I was pregnant, we got the faintest of faint lines on Monday morning, the beta that morning turned out to be 5, and I was bleeding by 2 p.m., so I barely even had a chance to realize I was pregnant before it was over.

But this, this would be a whole other kind of loss, a whole other kind of grieving if it were to end badly. And each week, it becomes more so.

So, like I said, terrified.

But on the bright side, the peri really understands. She said if I need to come in more than once a week for reassurance, that's totally fine. She's had some patients who came in every day for ultrasounds for a while, until they got to a point where they started to feel more comfortable. R's head shot up when she said that - I think he was trying to figure out how on earth he'd shuffle work meetings every day if I decided to go that route. :-)

I think I'm going to try to stick with once a week appointments, because if there's bad news, I'd just rather get it at the end of the week than the beginning. But if I start to stress, I may take them up on extra ultrasounds.

I need to go get progesterone/estrogen drawn for RE, and his nurse mentioned that I'll probably start weaning based on those results. I'm going to ask her to let me wean a little slower than usual, because I can only imagine how freaked out that will make me.

I'm trying to be hopeful that my body can work correctly without the extra meds. The peri asked if I'd started getting headaches this week, and I have. She said that's usually a sign of the placenta's hormone production kicking in.

So add headaches to the list of things I hope to keep having, in addition to nausea and stretchy feelings...

Chant With Me

2011-08-24T21:04:00.003-07:00

Thou shall not get thy hopes up too high.

Thou shall not get thy hopes up too high.

Thou shall not get thy hopes up too high.

A couple days ago, it was a constant repetition of "Please, please, please let there still be a heartbeat." I swing back and forth like that. Right now I've been feeling nauseous for several hours, so I'm back to "Thou shall not...", trying to keep hope in check.

If there is a heartbeat on Friday (9w0d), it will be a new milestone for us. The furthest along we've ever been when seeing a heartbeat was 8w1d, four years ago this month.

I did well for about 3 1/2 days after the last ultrasound. I didn't have a lot of symptoms on Sunday, but after being a constant shade of green on Friday and Saturday, I was kind of okay with that. But only for a day.

So when there were still no symptoms on Monday, I started to get nervous again. Then it occurred to me that during the pregnancy four years ago, the ob thought the baby likely died within a few days after that 8w1d ultrasound. I realized that I was at 8w3d - a few days after 8w1d - and the nervousness escalated to anxiety.

On top of that, I noticed vaginal discharge that was different than anything else I've experienced so far (I'll spare you the details) after all the fiber I'd been eating finally took effect.

I caved and called the peri's office.

I love that place. They are all so nice and understanding. The nurse called me back and reassured me that everything sounded perfectly normal.

Still not very many symptoms yesterday, still very nervous. Then this morning I started feeling nauseous about 15 minutes before a major phone presentation I was giving (from bed, involving about a dozen people from our largest client, with my mom huddled in her bedroom with the dogs, me praying they would stay quiet and not give away the fact that I'm at home). I figured it was just nerves about the call, though, especially since it went away after the call was over.

But then it came back again late this afternoon, and it's stuck with me. Which makes me slightly green again, but happy nonetheless.

And trying desperately to keep hope reigned in.

P.S. Thank you all for the comments and ideas on fighting the morning sickness on my last post. And a special thank you here (since I don't think you have a blog) to A for delurking. :-)

About That Lack of Symptoms...

2011-08-20T16:45:00.004-07:00

Not so much a problem any more.

I woke up yesterday with a major case of morning sickness that lasted until falling asleep last night, and within an hour or so of getting up this morning, it was back again. There have been several times I thought I might actually throw up, but so far I haven't. I've had morning sickness with other pregnancies, but it's been more mild - never to the point of almost throwing up.

Don't get me wrong - I'm not complaining. I'll deal with it if it means all of this turns out okay.

I'm open to suggestions on what's worked to help minimize it. R is at the store shopping for ginger ale, gingersnaps, chicken noodle soup, pretzels, and an acupressure wrist band.

Right now I'm munching on saltines and 7 Up. I feel okay as long as I'm eating, but a few minutes after I stop, the nausea sets in again. And I figure eating my way through it for 16 hours straight is probably not going to be the best approach, at least not from a weight gain perspective...

There were also a lot of strechy/pulling feelings yesterday. Normally I feel them but they don't bother me per se, but yesterday it was enough that I was contemplating taking some tylenol. I think my pain threshold was just unusually low because I was already feeling not great from the nausea.

Overall, I'm thankful for the symptoms. I just keep trying to remind myself that having symptoms now does not necessarily equal the outcome we hope for down the road. It's still waaaaayy too soon to get our hopes up...

Emotionally Spent but Still Incubating

2011-08-18T21:00:00.002-07:00

We wound up going in unexpectedly this afternoon. Heart rate is 167 (up from 130 last week), and Kiddo is measuring exactly on target - 7w6d.

I had been totally braced for bad news.

We weren't going to move up the appointment. But then this afternoon, there was bright red blood once again. I hadn't expected it - after 8 days of no bleeding or spotting, I thought we were over that. I was hoping that tomorrow I'd get permission to get up and start moving around. Instead, I am still on bed rest until further notice.

If the bleeding had been the only thing concerning me, I would have just crawled back in bed to see if it would slow down (there wasn't as much as some of the other times, and it is slowing down now) and waited until tomorrow.

But because of feeling normal, noticing that the stretching/pulling feelings had slowed down to pretty much non-existent by yesterday, and realizing at 5 a.m. today that I'd screwed up my estrace pill dosing for the last 4 days (more on that in a minute), I couldn't wait.

I called and texted R, but he wasn't responding. It comes in handy sometimes that he and his dad work in the same company, about 20 feet from each other, because I called his dad and asked him to track R down.

The only thing that kept me semi-calm was that I wasn't feeling much pain, and no cramping. Still, I was trying to prepare myself for bad news. Instead, the tech said "Everything couldn't look more perfect." She looked thoroughly to see what might be causing the bleeding, but still couldn't find anything.

One thing I was worried about was my estrogen level, but the peri doesn't think that would have been enough to cause a problem.

I woke up as usual in the middle of the night last night, but this time I realized I wasn't having the night sweats that I get every night. Then it dawned on me that I had forgotten to take the evening dose of my estrace.

And that led me to realize that I'd also been forgetting my morning dose for the last 4 days. I had filled my pill boxes for the week on Saturday, but I kept the estrace bottle on my nightstand to remind me of my evening dose, and I forgot to grab it when I was filling the boxes. Between two thyroid meds, Vitamin D, the extra folic acid pills, the aspirin, the dexamethasone, and the anti-depressant and probably a couple of others I'm forgetting, it's a pretty full, colorful box of pills, and I just didn't notice.

I am still doing four patches every other day, though, and I was only missing one dose of the pills a day, so I imagine my level dropped a little bit but hopefully not enough to really cause a problem.

RE's nurse wouldn't commit to saying "no" when I asked outright "This won't hurt the pregnancy, will it?" But the peri doesn't seem to think it would.

The next ultrasound is in 8 days (next Friday), although the peri said they will absolutely fit us in earlier if the need arises.

Can someone make it be spring already? Please? Anyone?

The Weekly Pre-Appointment Freakout Commences

2011-08-17T07:27:00.002-07:00

I was doing so well. After last Friday's appointment, I had 4 days of being relatively calm and normal. I even started a draft post about how I am enjoying this pregnancy, really, even though it's also been stressful.

But zen only lasts so long.

I woke up in the middle of the night Monday night as usual when the dog wanted to be let out. Usually I'll lay there for a moment, trying to determine if she's really up and wanting to go out or if she's just readjusting her sleeping position and will go back to bed, and try to close my eyes and go back to sleep. But it's generally useless, because at that point my bladder has made itself known and there's no ignoring it.

Except when I woke up in the middle of Monday night, I felt like I could go back to sleep. I rolled over, closed my eyes again, then realized my bladder wasn't calling out to me and went pretty much straight into a full-blown anxiety attack.

I'm afraid my uterus is shrinking and not pressing on my bladder as much. I'm also not as bloated - I just feel more normal in general.

Also, the stretchy, pulling feelings I'd been having (I assume round ligament pains) had been occuring kind of all over, including on the sides of my pelvis. But now I'm only feeling them down low, so for some reason now I'm thinking that those feelings are really the reverse of stretching - that they're further signs of my uterus shrinking back down.

Plus, I'm getting a kind of mild burning feeling in my cervix that I get right before my period is about to start. And I had been crashing for a nap every day around 5 p.m., but last night I was fine - didn't need a nap at all.

This morning, I think my chest is shrinking back down as well. There was a tape measure involved, but I forgot to write down yesterday's measurement, so I can't be positive, but I'm about 99% sure I was bigger yesterday.

There's no bleeding. The last bright pink/red I saw was a week ago today. The only stuff I've seen this week seems to be a little bit of vaginal/cervical irritation since I restarted the aspirin/Lovenox on Saturday.

I know all of this sounds crazy. But during the other pregnancy where we saw a heart beat, we saw it at 8w1d, and around 9w1d I told R that I wasn't growing any more. My stomach wasn't getting any bigger (I popped really early that time) and my chest also stopped growing, but even more than those signs, I just had a feeling that something was wrong, and I started to physically feel normal (non-pregnant normal).

At the ultrasound the week after that, we learned that the baby had died a few days after the previous ultrasound. I had a D&C a few days later (about 2 weeks after the approximate day of death), and I never had any spotting or bleeding during those 2 weeks, so not having any bleeding now isn't reassuring me all that much. (Although obviously I'd rather have no bleeding than bleeding.)

I have work meetings for the next two days that I need to attend. I'm afraid to call and see if I can move up our next ultrasound appointment in case it's bad news, so I'm going to wait at least until tomorrow afternoon to call, but I'll probably try to make it all the way to Friday's appointment (54 hours at this point) if possible.

This calls for some heavy-duty self-soothing. Ice cream may be involved in breakfast. If I put it in a blender, I can call it a smoothie instead of a sundae, right?

Cabin Fever

2011-08-15T20:06:00.002-07:00

Today is the 24th day of bed rest, and the scenery is starting to look a little monotonous. I can't really complain too much, though, because it's R who is getting the shortest end of the stick.

The poor guy is doing all the laundry, grocery shopping, and cooking by himself, not to mention running up and down the stairs to bring me food and take dirty dishes away.

Meanwhile, I lay here looking at the exercise room that is attached to our bedroom. Which, mind you, I never seem to be able to find the time to use under normal circumstances.

But sitting here with a treadmill, elliptical machine, stationary bike, and a large collection of weights within my peripheral vision, I wind up thinking about my fitness. Or rather, lack of it.

Which leads me to think about R's lack of fitness. And his super stressful job that just got more stressful a few weeks ago when his boss retired and he was given a lot of those responsibilities to take over (with no promotion/raise). And the fact that we're not 25 any more. And all the horror stories you hear about seemingly healthy if somewhat out of shape men in their early 40s with high levels of stress who keel over unexpectedly.

So I decided it was time for action. I wielded the primary tool available to me at the moment - my laptop.

R now has a shiny new schedule of cardio, strength training, and flexibility exercises to do. It works out to an average of about 35 minutes a day.

Did I mention he hates to exercise?

He's wondering how the heck we've landed in this alternate universe where he's climbing hills on the treadmill while I cheer him on from bed. I tell him it reduces my stress level to know that he's going to be taking better care of himself, and the lower my stress, the better for the Kiddo. No, I'm not above guilting him into it...

I'm not sure he's entirely buying it, but he's exercising. So far, anyway.

Today's Sign Said...

2011-08-11T20:00:00.002-07:00

Continue to see where this path takes us.

The embryo measured 7w0d (today is 6w6d), and the heart rate increased from 102 last week to 130. The ultrasound tech, who was the same one as last week, said she could also see the beginning of something (I have no idea what, I was too busy trying to soak in the fact that there's still a heartbeat) that is the next thing that's supposed to develop, so that's a good sign.

She still couldn't see any sign of what might be causing the bleeding, but she said subchorionic hematomas can be difficult to spot, especially if they're small, and if I bled it out, it wouldn't be visible.

We met with the perinatologist for the first time. I liked her. She talked through each of my issues, and the entire appointment from start to finish took more than 2 hours.

She doesn't think the Lovenox and aspirin are necessarily related to the bleeding, so I need to talk with the RI's office about those. She does not appear to be a fan of IVIg, but she did say it was our choice whether to continue doing it. (We will.) I'm supposed to stay on bedrest for the forseeable future.

The medical assistant who went over the paperwork I filled out before the nurse came in mentioned that I'll have to get registered at the hospital at some point. I think she said 20 weeks. That's so far from my mind, I wasn't really paying attention.

As soon as she said it, I had a total reaction and kind of caught her off guard. I told her not to jinx things and that if I get to 30 weeks - if!! - then maybe we can discuss that kind of stuff. Apparently I would have to do it before then (again, if we make it that far, still not wanting to jinx it by thinking so far ahead) because they need me to be registered there in case something happens and I have to go in early. But seriously, did we need to talk about that now, when I'm still one day shy of 7 weeks??

And due dates. Okay, seriously people, they keep insisting on talking about this. Last week the ultrasound tech told us. (I refuse to say what it is, so just look at July 13 as 2w5d and count forward from there if you really want to know.) Today when the doctor finished examining me, she said it, but she posed it as a question for me to confirm.

I think my face blanched.

I explained that we made the mistake of calculating the due date on the very first pregnancy, and it just became a painful day, so we don't like to know anymore. I suppose it's no surprise, then, that later on in the conversation she asked if I have a therapist...

And then we got to the checkout desk and had to make appointments. Plural. The peri had told us to go ahead and book weekly appointments for the next month or so.

I couldn't do it. It just seems too audacious to assume I'm going to need that many appointments.

R finally talked me into making two appointments and suggested that starting next week, each week we'll just make one more appointment, so we'll always have two booked, we'll just be able to book them one at a time from this point on. He doesn't try to fight the crazy anymore - he knows it's just better to work with it. :-)

It seemed like a semi-decent compromise, so I took a deep breath, tried to relax, and told the lady working at the desk that we wanted to make appointments for the next two Fridays.

Her response (with a cheery smile): "Sure, no problem. What's your due date?"

Does anyone know how to selectively erase something (a date) from one's brain?

I Don't Have a Good Feeling About This

2011-08-10T21:44:00.002-07:00

Everything has been very uneventful. No spotting since Sunday, nausea that started Sunday night and lasted (in a mild state) through Tuesday morning, which I was thrilled about.

I'd started to let myself relax a bit again. Even went crazy and discussed whether we would find out the gender if we got to that point, had a discussion with a friend who is due with twins next week about vaginal birth vs. c-section as if I will face that choice someday soon.

And then, there it is again. I was feeling a little bit of cramping, but nothing major. I just figured it was a good sign that things are happening in there. I didn't even take a deep breath before peeking at the tp - I just assumed it would be pink-free.

It was not.

I put in a suppository at 5 p.m. There was not a speck of blood on the tp or the inserter. At 8:45, there was pink bleeding. So of course I had to check, and it looks like bright red is on the way again.

The ultrasound is at 2:30 p.m. PT tomorrow. We'll see what happens through the night and in the morning.

This time, I can't think of any good explanation for it. The first time, I chalked it up to low progesterone. The second time, I chalked it up to being out and about for bloodwork and the Rhogham injection. The third time, I chalked it up to restarting the Lovenox.

But this time, my progesterone level is great, I haven't been out and about since Saturday, and I haven't restarted the Lovenox. And there wasn't any sign of an SCH during the ultrasound. And the nausea eased up yesterday and did not return at all today. I realize it can come and go, but right now I'd much rather be having it than not.

So I don't have any good explanation. Just a nervous, uneasy feeling.

Hanging In There

2011-08-07T12:17:00.002-07:00

I think the Kiddo is still in place. My sanity is still relatively intact.

Apparently, I'm becoming more used to living with uncertainty and unpredictability. Either that, or R is secretly spiking my food with valium. (Just kidding, although I wouldn't necessarily mind that at this point.)

Once I got home and back into bed yesterday, the bleeding slowed. I was hoping it would completely stop overnight. Unfortunately there was still a little bit of red at that point, but it was darkish red rather than bright red, and by late morning today I think I'm pretty much back to the brown spotting point.

The next ultrasound is in about 98 hours - not that I'm counting or anything - so we'll see what that shows if something doesn't go very obviously wrong before then.

I'm on Lovenox 40 ml twice a day and a low-dose aspirin once a day for hetero Factor V Leiden and hetero MTHFR. I haven't taken any more of my doses since the bleeding started again yesterday.

I left a message for the reproductive immunologist who prescribed it, letting them know I had started bleeding again, was stopping the meds again and telling them to call me if I needed to do anything else. I haven't heard back yet, so I'm assuming there's nothing else for me to do from their perspective and they'll call me tomorrow. If I don't hear from them by late morning, I'll call them again. Based on Silver's comment on my last post (thank you, Silver!), I want to ask them about whether they think it might be best to hold off for now and restart if I make it to the second trimester.

In the meantime, I'm trying to resist the urge to ask R to bake me chocolate chip cookies. Do you think my life revolves way too much around food?? :-)

Here We Go, Yet Again

2011-08-06T15:34:00.002-07:00

Have I mentioned that I am not a fan of 6w1d?

Pregnancy #1 ended that day. In pregnancy #3, we lost the first twin on that day. For pregnancy #4, I woke up that day and all my symptoms were gone. That one turned out to be okay, because we got to see the heartbeat for the first time that day.

I was hoping since we saw the heartbeat yesterday and since I hadn't had even any spotting since Wednesday, that maybe we could get through today uneventfully.

No such luck.

R and I had just sat down at a restaurant for lunch, and I decided to go to the bathroom. Since things have been okay the last few days, I totally wasn't expecting the bright red bleeding.

And yet, there it was. On the pad, in the toilet, when I wiped. It didn't soak a pad within an hour, but it's definitely a lot more than I've seen so far.

We had just ordered, so we asked the server to pack up our food, and we headed home. I'm back in bed.

I hate this. I'm trying to be calm. Part of what's helping is that I'm not feeling aching or cramping, just bleeding. And there was no clotting - this bleeding (like last week and earlier this week) is still different at this point from the bleeding I've had in any other pregnancy.

The ultrasound tech couldn't see any sign of a subchorionic hematoma yesterday, but then again she also didn't look for it very long at all. The other thing is, I restarted twice-a-day Lovenox last night per the immunologist's orders since it had been 3 days since any bright red bleeding, so maybe that triggered it. But if I need the Lovenox, what effect will there be from not being on it?

If this is not going to end well, I'd rather it end now than later...

We Celebrated Reason #...

2011-08-05T19:52:00.002-07:00

1!

There's one "perfectly shaped" (as the ultrasound tech described it) gestational sac, and about half a second after she got the wand in place, we heard one of the best phrases ever: "There's a flicker!"

She started by doing an abdominal ultrasound. She pointed out the sac at that point, but she said my uterus was retroverted, so it was hard to see anything very well. From that angle, the sac looked like a weird, non-round shape to me.

And since we've heard "abnormally shaped gestational sac, this doesn't look viable" at the first ultrasound for several of the past pregnancies, the weird shape made me nervous. She switched pretty quickly to the transvaginal approach, and I couldn't bring myself to look - I just stared at the ceiling until she mentioned the flicker, at which point I popped up like a jack-in-the-box. (There was a screen mounted on the wall in front of me.)

The embryo measured 6w0d, which is exactly what today is. She said they want the heartbeat to be at least 100 bpm at this point, and it was 102 bpm. I would have rather it be a little higher, but I know it speeds up each week for the next several weeks, so we'll just wait and see what Thursday's appointment brings.

We're relieved to be over this hurdle. And I'm grateful that we get to experience seeing a flicker again. But at the same time, we're still being very, very cautious. One day at a time, though each day seems to feel like a week right now...

Anyway, thank you for encouraging me to get the ultrasound early and cheering us on. It's a great way to start a weekend.

I Took Your Advice

2011-08-04T21:51:00.003-07:00

I called this morning and scheduled the early ultrasound. 4:30 p.m. tomorrow (Friday). I was so relieved when she named a time that was at the end of the day.

I was stressed about it all day, but I'm starting to relax a little. Of course, there's a very high probability that will change again by mid-day tomorrow. :-) I will post at some point tomorrow night, but we're 3 hours behind the East Coast, so don't worry if you don't see something from me before bedtime...

There hasn't been any bright red in a little more than 2 days, and no spotting of any sort for more than 24 hours. This afternoon, I started to feel some stretching feelings, so hopefully that is a good sign. That's part of what's making me feel a little more hopeful. Still terrified, but a little more hopeful.

I'm trying to approach this by saying we're going to go celebrate afterward. Either we'll be celebrating that it went well, or we'll be celebrating that we're starting the adoption search, or (if things are still inconclusive) we'll simply celebrate that R was actually able to get me out of the car, into the office, and onto that table for the appointment.

There's a Whi.te Cho.colate Grill down the street from the peri's office. Gotta love a place that starts by listing dessert at the top of the menu.

Do you think they'd look at me askance if I order one of each?

More Ups, More Downs, and Trying to Surrender

2011-08-02T22:00:00.003-07:00

I know I can be melodramatic sometimes. Apparently, posting at 4 a.m. after looking at toilet paper covered in a color I don't want to see exacerbates that tendancy.

This pregnancy is continuing to be a total rollercoaster. I'm trying really hard to just surrender to it and accept that other than bedrest, injections, pills, suppositories, and patches, there's nothing more I can do - it's out of my control.

Of course, there are some times it's easier to accept that than others.

I honestly did not expect the bright red bleeding to stop. However, I decided I wouldn't stop any meds until told to do so. There was still bright red when I was going to put in this morning's suppository. I figured since my levels are low, putting in two couldn't hurt anything, so I did.

And the bleeding slowed way down and turned brown. And I stuck in another (basically, my whole day's dosage by 11 a.m.) since I wouldn't be able to get the PIO for another few hours.

And then even the brown almost completely stopped. And then R picked up the PIO and helped me with the first injection.

And then a couple hours later there was bright red again, although less than there was at 4 a.m. And now I'm back to brown.

Clearly I have no idea what the heck is going on. And, obviously, neither does my body.

I spoke to the RI's office this morning and explained that since I'm on suppositories, RE says anything above 5 is fine. They were very emphatic that they didn't agree with that, that I should have been put on PIO a week ago, and that they think the progesterone level may cost us an otherwise possibly viable pregnancy.

However, I'm not sure what to think. I know the three suppositories a day is the standard protocol RE uses, and clearly he has a lot of patients (including several of you, I realize) who are very successful with that.

I also know that all the PIO in the world won't save a pregnancy that is going to end for reasons other than low progesterone - I've lost pregnancies completely while still on full dosages of PIO and E2 injections.

RE's nurse still says she doesn't think this is out of the ordinary, and she isn't "overly concerned." Nevertheless, she still sent over orders to have progesterone and estrogen retested on Friday. I need to ask to have another beta added to that. She also sent over the ultrasound order (at my request), but I'm not sure I'm going to do it. I know it's too early to see a heartbeat, and I think I want to see what direction the HCG is going first.

Mostly, though, I'm just chicken, afraid to face that ultrasound screen.

I can't believe I'm only 5w4d today (Tuesday) and that we're still 9 days away from the first scheduled ultrasound. (Well, technically we should be 6 days away at this point since I could do it as early as next Monday if I wanted.) It feels like we've been dealing with this up-and-down pattern for a month already. At the same time, it feels like Aug. 11 is still an eternity away.

Assuming there are no bad-news betas between now and then.

More Bleeding

2011-08-02T03:20:00.002-07:00

I don' t think this is going to work.

I think this is the beginning of the end.

I think I' m going to be sick. And not because of morning sickness.

There was a perfect lining, two perfect blasts.

Why won't my body work right?

How do I learn to live with not knowing the answer to that question?

A Mixed Bag of Results

2011-08-01T18:54:00.004-07:00

Here's how I feel right about now:

I got today's results in a voice mail:

Progesterone: 5.8 (down from 11 on Tuesday and 7.5 on Friday)
Hcg: 3,672 (up from 2,091 on Friday, a doubling time of about 88 hours)

The reproductive immunologist's take: It's bad that the beta didn't double, it's bad that the progesterone is low, get an ultrasound now to see if it's ectopic or a missed miscarriage. (I don't think he realizes that the clinic's threshold for progesterone is 5 since they're suppositories, so maybe he'll feel differently when I have a chance to talk with the office tomorrow.)

The on-call nurse at RE's take: The progesterone is still technically in the normal range, they have to supplement sometimes, put in an extra suppository tonight and pick up PIO tomorrow morning. The HCG is rising, and at some point it's hard to tell whether it's a good indicator or not. E-mail my regular nurse tomorrow morning to see if I should get an early ultrasound. She said she isn't "overly concerned", but then again I also didn't go into my history of 6 prior 1st trimester losses with her, either. If I had shared all of that, she might have sung a very different tune.

Beta Base comparison: The Beta Base site has been down at least through Friday. (It was up when I had the test last Tuesday, so not sure what happened.) However, through the magic of Google, I found a thread someone had posted on a forum with average singleton numbers for 24dpo, which is what I am today. The most common range was 3,667-5,506, so we're right there at the bottom of the most common range. The thread was posted in 2008 so the numbers might have changed a bit since then, but that's all I've got to work with at this point.

The bleeding/spotting: Had pretty much stopped, but today I went out for labwork, came home, went back upstairs, took a shower, came down to go out for the RhoGham injection, and now there is bright red again. Not a lot, and I think it's already tapering off a little since I have my feet up again, but it's still very stressful any time I see it. Per RI's instructions, I'll be stopping the Lovenox and aspirin until it stops.

My take: The beta is still hopeful, particularly if I did lose a twin on Friday night. I think something in there is still growing since then, or the numbers wouldn't have gone up that much. The progesterone dropping from 11 to 5.8 in 6 days is more concerning to me at this point.

I'm honestly not sure what to make of the bleeding. It's most like pregnancy #1 - I spotted for the first time (bright red) on a Thursday at 4w6d, it continued on and off. Went for an ultrasound at 6w0d, and there was a lot of blood when I went to the bathroom right before the ultrasound started. At that point, it didn't stop. I lost the pregnancy the next day, and continued to bleed what looked like a full period for the next 4 or 5 days.

In the other ones, there wasn't this spotting in advance, and once the bleeding started, it just kept getting stronger until it was over.

So I guess we'll go in for an ultrasound and see if there's a sack. Other than the one pregnancy where we saw a heartbeat, in the other three that got to the point of an ultrasound, it was an abnormally shaped sac each time, and they couldn't necessarily see a definitive yolk sac or fetal pole.

I'm so tired. Of course, part of that is that I barely slept last night because I was stressing about today's tests, and I took Benadryl this afternoon for the IVIg. (The nurse had to try 3 different locations before she could get one this time. I almost passed out after the second one and had to put my head between my knees for a while before we could try again.)

Mostly, I'm just tired of the uncertainty of this process. I did tell R that if this doesn't work, I might want to try one more time in the far distant future (hopefully after a successful adoption), using the IV antibiotics again, since that's what's gotten us the farthest. (We didn't do it this time because we wanted to see what the IVIg would do, and because of the expense involved, and because apparently the IV antibiotics can cause an NK flare in some people, so we didn't want to conflict with the IVIg.)

But if this rollercoaster ends by going off the tracks, I think I'm ready to walk away from it for now. This has reached the point where it has become too hard. I'd like to think I've had a fair amount of fortitude for the past 9 years, but I have officially reached my limit.

Beta #5 Coming Up

2011-07-31T18:55:00.002-07:00

I'm trying to stay hopeful, but for no reason in particular, I haven't been feeling very optimistic today.

Actually, that's not true. I think the reasons I'm feeling discouraged are because I've spent entirely too much time with Dr. Google today. Pretty much everything I found when I searched for "pink* gray* tissue miscarriage" pointed to being fetal tissue, so I'm pretty sure we lost at least one. And my cervix feels a lot wider and softer whenever I put the suppositories in, which also does not seem to be a good sign.

Also, the achiness is still coming and going, I don't have any morning sickness, and I'm not feeling any of the other stretchy, weird, one-side-or-the-other kinds of feelings I was feeling up until a few days ago, which I assume were implantation and/or my uterus stretching.

On top of all that, I also saw plenty of stories where women saw heartbeats at 8, 9, 10 weeks or made it to 15 or 20 or 25 or 35 weeks and still went on to lose their baby/babies for one reason or another. And that's already happened to us once. So that just underscored the reality that even if everything looks good during the first ultrasound, every day of this is still a new, uncertain day.

On the bright side, I'm only spotting now, and it's mostly brown or very light pink.

I had called and left a message with the reproductive immunologist's office yesterday to see if I should stop the aspirin/Lovenox. A nurse called me back today and said to stay on those since the spotting is brown at this point, but stop them if it turns red again.

She also said they want another beta, even though RE's office said they'd rather not. So I have another stat order for an HCG and progesterone tomorrow. We'll see what happens.

And Sue, weren't you the one who told me to back away from the HPTs? :-) But to answer your question, I stopped on the way home from Friday's beta and bought another box of 2. The one I took when I got home looked very similar to the one before that - the test line was much darker and wider than the control line.

I have one more left, but I figure my levels would have to be down somewhere near 300 before I'd be able to tell the difference, and even if my levels are dropping, they probably haven't dropped that fast. So I'll try to hold off on the last one, at least for now.

I have to go get a RhoGham shot tomorrow morning. My best bet is to go to the ob/gyn I've seen in the past, but I had decided to switch to a different doctor this time around - a perinatologist one of my friends recommended. My first appointment isn't scheduled until 8/11, but I think I'm going to call them in the morning to explain the situation and see if they'll help me out. I'd just really rather not go back to the other doctor's office if I can avoid it.

And even though I'd really prefer to do the ultrasound as close to the end of next week as possible so that we have the weekend to cope if it's not good news, I think I'm going to see if I can get it moved up to 8/8, assuming that it appears we still have a reason to go to the appointment at that point.

Have I Mentioned I'm Not a Big Fan of Rollercoasters?

2011-07-30T13:20:00.003-07:00

And yet, here we are.

I've never been one to define strapping myself into a cart, racing around a metal (or, scarier yet, wooden) track, and praying we don't derail as "fun". But at least that's over in the span of about 4 minutes.

Clearly, this "what the heck is happening inside my uterus??" rollercoaster is promising to be a much longer ride.

As bedtime approached last night, the achiness and kind-of-but-not-really-cramping feelings started to get quite a bit stronger, and the bleeding increased a little, although it still wasn't anywhere near full flow. The last time I went to the bathroom before bed (warning: TMI ahead), there was still the bright pink/red bleeding, but also a small, almost teardrop-shaped, smooth, grayish/pinkish blob of some sort.

It was only about half an inch long, and I didn't poke at it. I don't think it was a clot, because those are usually dark red/purple and sponge-like, and this was neither of those things. Maybe it was a gestational sac? Although it didn't look transluscent, which is how I've seen gestational sacs described. Maybe it was part of the placenta?

Whatever it was, as soon as it passed, the achiness really started to ease up, and by morning it was completely gone. The bleeding seems to be slowing as well, and now it's a light pink/brown combination rather than bright pink/red. It hasn't quite slowed to the point that I would call it spotting, but I'm hoping it will get there soon.

In the meantime, I'm still laying here in bed, and poor R is running up and down the stairs bringing me food, doing laundry, etc.

All we can do is wait. And see what the next bend in the track brings.

Beta #4

2011-07-29T20:32:00.002-07:00

Well. 2,091 - a doubling time of 44 hours. P4 and E2 in normal range, though I really would have preferred the P4 to be higher than 7.5.

So we wait. And I lay in bed. Or is it lie? I could never keep the rules around that one straight. The nurse said she'd rather i stay in bed than get up to get another beta, so another one isn' t on the schedule at this point. If the bleeding changes significantly, then a repeat beta may be ordered.

Today's beta means I'm still nursing a thread of hope. The continuing bleeding means it is a very frayed thread. Let's hope this is just an initial, isolated bump in the road and isn't indicative of what the next 8 months are going to be like...

Bleeding

2011-07-29T12:57:00.003-07:00

There's bleeding.

Not full flow, but certainly more than spotting. Bright pink at first with no tissue, now bright pink mixed with brown and a little bit of tissue.

I had blood drawn this morning for P4 and E2, and it started a couple hours after that. I called the clinic and spoke with a nurse, so she called the lab to see if they could add an HCG. I'm assuming they could, since she hasn't called me back to tell me to go in and get drawn again.

I'm now officially on full bed rest, only supposed to get up if I have to go to the bathroom. And when you're constantly thinking about going to the bathroom, and what you're going to see when you do, it feels like you have to go every 20 minutes or so. (No, I'm not actually getting up that often.)

I know what everyone says about SCH, and the nurse said it's a possibility, but I'm not hanging my hat on that. My symptoms were less on Thursday (nausea, having to go to the bathroom frequently), and today they're non-existent except for the thinking-about-having-to-pee situation.

I just want to know, one way or another. I suppose if the beta is significantly below 664, we'll know. But the nurse also warned that the number might not tell us a lot - if it's higher than 664, we won't necessarily know if it's on its way up or down. She also mentioned the possibility of both of them starting to take and one not continuing on. So I may have to get blood drawn for a 5th time on Sunday.

And, since that isn't enough fun, I also have to arrange for a RhoGham shot within the next 72 hours.

Calmer...(For Now, Anyway)

2011-07-27T20:34:00.003-07:00

You guys are awesome! I've been checking in on the comments all day, and they really do help make me feel better. I couldn't ask for better virtual hand-holders than all of you. :-)

The last time I saw any sort of spotting was that 4 a.m. trip to the restroom. There was a tiny little bit of staining around noon, but that looked like what I've been seeing for the past week, so I chalked it up to cervical/vaginal irritation.

I still haven't been quite as bloated today, and I haven't had some of the uterine sensations I've been having, but I keep trying to remind myself that I won't have every single symptom to the same degree every single day.

And, I think the morning sickness kicked in this morning. I felt a little bit of nausea yesterday morning, but I wasn't sure if it was the real thing or just nerves over beta #3. This morning, even though there was the spotting, I knew it wasn't nerves.

It was great - it lasted most of the day. Never have I been so thrilled to feel not well... :-) So I'm hoping for more of the same tomorrow morning.

I also keep trying to remind myself that in most of the other pregnancies where the end began with bleeding, the bleeding didn't stop once it started. There was only one other one (my first pregnancy) where I spotted on and off for about 5 days before it was clear that it wasn't just normal pregnancy spotting. So if the intermittent spotting continues, hopefully I'll become a little less uptight about it at some point.

On the other hand, I spoke last night with an IRL friend who has struggled with infertilty for longer than average and is now going to be delivering twins in a couple weeks. I'm changed things up this time and scheduled the appointment with her ob, who is a peri. (Apparently I'm hoping some of her luck rubs off...)

My friend told me that when it came time to get in the car and go to the first ultrasound, she told her husband she just couldn't do it - she was too afraid and anxious. He was able to coax her into the car, and then she said she stood there in the parking lot and couldn't bring herself to walk into the building. She eventually went inside, and then when she got on the u/s table, she cried and cried and cried - too hard for them to do the scan until she was able to calm down.

I said, "Oh, good, they've seen that before. So they won't be surprised if I do the exact same thing!"

The u/s is scheduled for Thursday, Aug. 11 - two weeks from tomorrow.

I made the appointment, I still have the appointment, but that is as far as I have allowed myself to come. The receptionist told me she would e-mail me a new patient packet that I need to fill out and that I also need to arrange to have records from RE and former OB sent over. I haven't received the e-mail, and I haven't called her to tell her that or called RE/former OB to get records sent over.

I'll get to the first part of next week and then see if I'm ready to take those steps. Just scheduling the appointment felt like a risk - I'm not yet up to anything more than that.

I could make it easier by going to the local RE who handles my monitoring. I'm already an established patient there, and I wouldn't have to get any records transferred. But somehow, I just don't want to.

When we walked out of the clinic after the transfer, I told myself that whichever way this goes, I am no longer an infertility patient for the foreseeable future. I won't totally rule out me doing another transfer at some point down the road, but not as our next step. So I guess I just don't want to hop back into the stirrups as an infertility patient with someone who was actually my very first RE in this whole process and has known me throughout the journey.

Apparently, I'd rather spread around to strangers the fun of dealing with the completely hysterical mess that tends to be me on ultrasound day...

Uh-Oh

2011-07-27T04:41:00.003-07:00

Typing from Nook at 4 a.m., so this will be short.

Had dinner, fell asleep for a couple hours, came upstairs to go to bed. Felt a couple sharp pains right before bed. Didn't like them but decided not to worry.

Didn' t have to get up to go to the bathroom for 4.5 hours. Told myself not to worry (should have been only 3 hours) even though I had a lot to drink last night.

Got up to let the dogs out, went to the bathroom.

There is spotting again. But this time, it doesn't look like the staining type of spotting I've been seeing, it looks like the bad kind. And now there's a pain on the left side of my ute area that I don't like.

I got cocky yesterday and scheduled the first u/s after getting the beta results. Ha!

Now I'm worried.

Which Path Will It Be? (aka Beta #3)

2011-07-26T12:43:00.001-07:00

664. A doubling time of 38.06 hours.

Huge sigh of relief.

So for now, we are still on this path and will see where it takes us.

I will post more later, but wanted to put up the result and say thank you again to all of you for your support. I will continue to need virtual hand-holding, I'm sure. :-)

Slowly Losing My Sanity

2011-07-25T20:48:00.003-07:00

So, since it appears the HPT line has gotten as dark as it's going to get, do you think it's an unreasonable approach to start timing how quickly it gets dark as a measure of whether the beta is still rising or not?

I'm only half kidding.

I just did yet another HPT. (I believe this is #9.) Now I'm checking to make sure the line doesn't start to get more faint.

Once again, thank you for all of your supportive comments. You're what's keeping me still a semblance of sane right now.

Here's how the last 24 hours have gone:

I did some more research yesterday (surprise, I know!) and found a lot of places that said 48-72 hours is a normal doubling rate. I read, and re-read, and re-read all of your comments.

I start to feel better.

I get an email from my regular nurse this morning: "Congratulations!! So far, I think it looks fine..."

I feel better still.

I can't leave well enough alone.

I e-mail her back: "So you don't think it's a problem that it didn't double?" She responds: "Yes, if it had doubled it would be a better sign..." She went on to say it was still a "normal increase" and that the first beta was "very good".

I fixate on "if it had doubled, it would be a better sign".

Hope fades.

The day progresses. I don't have any spotting.

Hope starts to rise again.

Then I start to worry that perhaps the lack of spotting is a bad sign. (Only in my completely screwed up brain, I know...)

Hope fades.

I realize that I am having to go to the bathroom more than usual today. This is usually a good sign for me.

I start to feel more encouraged.

Reading an article online, I come across a reference to a book called 50 Ways to Soothe Yourself Without Food. It's written to help emotional eaters. I'm doing pretty well at not doing a lot of emotional eating, I lie to myself (as I'm eating a bowl of cookies n cream frozen yogurt). I check out the book on Amazon to see what kinds of reviews it gets.

Some achey, not quite crampy, feelings begin. I start to get the physical feelings I get when I'm about to start my period. I remind myself that I had those same feelings at the beginning of the last week, too.

I hope that this is a good sign. I worry that it's not.

I decide to check to see if there is any bleeding and do another HPT. (The last one I have in the house.)

There is no bleeding, no spotting.

The line comes up on the HPT faster than it ever has - a lot faster than the control line. (This is when the stopwatch test idea enters my mind.)

I look at the line. Ok, it's dark, but it's not quite as dark as the last one I did. I can't remember exactly when I did the last one. Maybe Saturday morning.

I think maybe not enough time has passed. After all, it's only been about 20 seconds.

I write this post.

I go back to check on the test. It turns out, the line can get even darker. But the control line on this one is a lot fainter than the control line on the last one. This one and the last one are out of the same box, shouldn't the control line be similar between the two?

Still, I can't help it - hope rises a little bit that maybe this darkest yet line means that everything is still on track.

Beta #3 (and a repeat progesterone, at my insistence, even though the last one was fine) will be tomorrow morning. (Silver - the first two draws were at 8:30 a.m. This one is scheduled for 8:15. But I appreciated the idea you had... :-) ) I will ask them not to call until the end of the day, because I have meetings all day.

I need to buy the 50 Ways book - I have to figure out a way to keep my sanity in check.

I hope R hasn't eaten the last of the fro yo.

Beta #2

2011-07-24T10:51:00.002-07:00

Once again, there are tears. Lots and lots of tears. And they're not happy tears.

It's not horrible, but it's not great either. It only rose to 277, so it didn't double.

The nurse who called is one I've never spoken with before. She said it only rose by 53%, they were concerned, and I'd have to get a repeat beta on Tuesday. When I pointed out that 149 doubled equals 298, so 277 couldn't bethat far off, she argued with me at first but then finally relented and went to ask someone else.

It's actually a rise of 86%, a doubling time of 53.66 hours. And when I look in the Beta Base calculator, the average for a singleton at 16dpo is 206 overall, 202 for the 33-37 age range.

So why am I so darn upset? I don't know, but I am. R has put a tissue box on one side of me, and an adorable, fluffy cat on the other. Normally she's a grump, but she rises to the occasion when I have moments like this.

I have a 14-page paper due in 9 hours. I've barely started. I can write fast, but even so, I don't think it's going to happen...at least, not by the deadline.

Beta #1...

2011-07-22T14:50:00.002-07:00

...is finally here.

149.

So, much, much better than the 11 we had last year. It's higher than average for a singleton on the Betabase chart (102 is average overall, 99 for my age range), but below average for twins (206, 209 for my age range). So who knows? But for now, at least one has started to take, so I'm going to just enjoy that.

I mentioned the bleeding to both the RI's nurse and the nurse who called with my beta, and both seemed to think it's the suppositories that are causing the bleeding. I've stayed in bed as much as possible today, and there hasn't been much bleeding, so I'm still calm.

The conversation with my boss went well; she was very understanding, so I'm just going to work from home next week.

Hopefully Sunday's number will double. For now I'm trying to decide if I should test again tonight or make myself wait all the way until tomorrow morning. :-) This morning's test looked pretty much the same as last night's, but then again there was only about 9 hours between the two.

I figure that at some point, the line just can't get any darker. But I may wind up with a countertop covered in tests while I check out that theory...

More Testing, More Spotting

2011-07-21T21:41:00.002-07:00

Thank you for all of the encouragement and support. I didn't post again last night because I wound up waiting until this morning to retest. The line was significantly darker.

Hope rose.

Then before I left work this evening, I went to the bathroom. And there was a fair amount of reddish orange blood covering some of the surface of the pantyliner, and more when I wiped. (Sorry, I know, TMI.) And I'd been achy again.

I had an acupuncture appointment right after that, and as soon as I laid down, the achiness eased up.

I stopped on the way home and bought 4 more tests. Tonight's test is darker than this morning's, just barely lighter than the control line. (I haven't taken photos yet, but I will.)

I will be testing again tomorrow morning. :-) Beta draw is at 8:30 PT.

On the advice of an IRL IF friend, I'm going to get into bed and stay there as much as possible for the foreseeable future. I wasn't going to say anything to my boss (we're not in the same state, so we don't see each other, just communicate via e-mail and phone), but I think tomorrow I'm going to tell her what's going on and tell her I'm going to work from home indefinitely. (My phone number on caller ID and dogs barking in the background give away my location, so I can't just pretend I'm in the office and not tell her...) She doesn't know anything about our IF/adoption history. Let's hope that goes well.

Pictures, and Spotting

2011-07-20T21:15:00.003-07:00

Here's the first picture from last night. It was difficult to get the line to show up in the photo. I don't know if you'll be able to see it or not, but it's definitely darker than it appears in this picture.

I did the EPT last night right before bed, and for the first time ever on an EPT, it said:

So, yea hurray. Last year, I still got a "not pregnant" on an EPT from the same box when my beta was at 45, so I'm assuming this means the hcg level was at least 50 last night.

Today was fine, but then on the way home from work I started feeling some achy pains. I wouldn't say they would qualify as crampy, but still, I think I'd prefer to feel nothing at all at this point.

When I got home, I put in another suppository, and there was a fair amount of light pink. I would like to think it's just because the suppositories (they're tablets, not the waxy kind of suppositories) are irritating my vaginal lining. However, it had been 10 hours since I'd put in the last one, so I don't think the bright pink could have been from that. And I'd be surprised if that much bleeding happened that quickly from the suppository I had just put in.

I laid down for a while after that, and the aching stopped. But then when I got up and went downstairs for dinner, it started back up again. It's still going on.

I had promised myself I wouldn't POAS again until tomorrow night, but now I think I'm going to be chugging some water and doing an "is it darker, is it not?" line comparison tonight.

I want some indication of which way this is going, but I'm not freaking out. I'm just resigned at this point - either it's going to work or it's not, and if it doesn't, it doesn't, and we move on.

Or at least, that's what I keep telling myself.

So, I Tested

2011-07-19T22:33:00.002-07:00

During last year's FET, I tested at this point. It was a Monday night, and the first offical beta was on Thursday morning. There was no line on Monday night. Not even a hint of one. And it wasn't until Wednesday night - 12 hours before beta - that if I held that night's test literally right next to a lightbulb and squinted really, really hard, that I could barely see what had to be the faintest line ever.

Here we are again at that same point - Tuesday night, with the first beta scheduled for Friday. I was really, really tempted to test last night, but R talked me out of it.

Tonight, I decided to just rip the band-aid off. I told myself that I would stop looking at the test as "positive" or "negative" because, well, "negative" just has such a negative connotation to it, and making it so black-or-white was just adding to the stress.

So I told R I would look at it differently - the result will just be a road sign giving us an indication of our path, nothing more. Nothing super final. One line = the road sign is pointing toward adoption, two lines = the road sign is pointing toward seeing where my uterus takes us in this process.

I tested. I set it on the floor in the water closet. I opened the door to check on it twice within the first 30 seconds.

I didn't see a second line.

I decided to forget patience and just picked the thing up and stuck it on the sink counter. And then I looked again. A full minute hadn't even passed yet.

And there is a second line.

And I don't have to hold it directly next to a light bulb to see it. I don't even have to squint. It's there.

It was a FRED. I have a couple of EPTs, which have never, ever been kind to me. They always show up with "not" before "pregnant", even when I had a beta of 45.

So tonight (if my bladder is full enough) or tomorrow morning, I'm going to try an EPT and see what it says. And if the darn thing finally leaves off the word "not", I will take a picture and post it.

I took a picture of tonight's test with my cell phone, but it didn't turn out well enough. I'm going to go grab the regular digital camera; maybe that will work better. Because I think for once it's a line that might actually show up in a photo.

We're not overly excited. At all. In fact, we looked at the test, said "Okay," and then left to go grocery shopping.

But I am going to enjoy this (apparently in a very unexcited way) for every moment, regardless of how many (or how few) moments it lasts. And be a little, little bit happy that at least in one tiny part of the process, it seems I can actually count on my body to work correctly, at least for a little while - this is the 5th treatment cycle in a row where we've gotten a positive. Now if only we can get it to stick for another 8 months this time...

'You're Up and You're Down'

2011-07-17T20:29:00.002-07:00

My mood - and degree of hope - is a bit like a Katy Perry song at this point. But thank you all for your words of encouragement and support. You're helping keep me sane. Well, I suppose that word is relative at this point, but you know what I mean... :-)

I've managed to make it this far without testing. I was tempted this morning, but I talked myself out of it.

Friday night, we were laying in bed watching TV, and I began to feel something kind of like a kitten very gently kneading inside my uterus. I refused to get up for fear of disturbing anything that might be happening, so I took off my contacts in bed and made R take them into the bathroom to clean them. (The things that man has done for me these last 9 years!)

There haven't been any other consistent sensations, just an occasional twinge here or there. When I feel one, hope surges. When the twinge doesn't continue, hope fades.

This afternoon, I was feeling really sleepy. I know the progesterone supps cause that, but still...like I said, up and down, up and down...

I need to stop at the store and stock up on some FREDs, so I'll probably do that on the way home from work tomorrow. My guess is that's about as long as my willpower will hold out.

Feeling...Nothing

2011-07-15T12:38:00.003-07:00

Two days post-transfer, and there's no implantation spotting (the one time I want to see a little bit of bright pink on tp, and where the heck is it?!), no pinchy implantation cramping, nothing.

For the two FETs I did that made it to at least 6 weeks, I had a tiny bit of implantation spotting within 24 hours of transfer. For the 1 FET that was negative and for last year's FET that was pretty much over as soon as it began, there was no spotting.

I always have implantation pinching/cramping, always. Last year, it was less than I would have liked, which is probably related to the fact that it ended so early.

So I am bummed.

And then I had a dream last night - R and I were in a room somewhere (blank white walls, nothing to distinguish it), and then we got the call from the nurse: BFN. After that, I walked out into a hallway, and there was Kerry Vi.ncent (of the Food Network's "Challenge" show) saying in her signature disdainful tone, "I don't know what you were thinking..." and shaking her head at me. (As in, "I don't know what you were thinking by hoping this would work.")

But then again, we've done everything different this cycle - different supression protocol, different acupuncturist, different immune treatments, staying at a different hotel, different RE did the transfer (Sur. - he was very nice), different number of embryos, etc. And if this works, I'm going to use a different ob/gyn this time, too.

So maybe this is just one more thing that's different, and it'll lead us to a different outcome. Because as R pointed out: "You may have spotted, and you may have cramped, but look how that turned out in the end."

They're On Board

2011-07-13T19:11:00.002-07:00

I'm officially incubating. We transferred two Day 5 blasts: both survived the thaw, both were 100% re-expanded without losing any cells, and both had hatched. It was a different RE than our regular one who did the transfer. He was very nice and said blasts couldn't get any more perfect than that. Hopefully "perfect" = "they'll stick around."

I was too stressed about this to sleep much last night - I tossed and turned for all but about 2 hours. Finally around 6 a.m. I decided I might as well do something helpful and productive, so I got up and went to the hotel fitness center to walk/run (mostly walk) on the treadmill. That helped calm me down and made me feel stronger. Note to self: Must exercise more often.

I teared up a couple of times while we were at the clinic, but surprisingly I don't actually cry. I was quite proud of myself for that. :-)

Of course, the valium might have had something to do with it. I don't remember it having much of an effect on me last time, but this time it almost put me to sleep. I'm still feeling very zen - we'll see how long that lasts.

So, do you think tomorrow is too soon to start testing?

It's a Go!

2011-07-08T20:13:00.002-07:00

The repeat blood draw at the other lab came back at 0.2, so RE's office says the cycle is still on. I still had a small bit of doubt, because how do we know it's the first test and not the second that's wrong?

But then I called the place that ran the first test (it was a local RE's office), and they were great. They got someone on the phone with me right away, and she explained that their office uses a different assay than the other lab, so in their lab anything less than 6 is equivalent to 0.5. So she was also very confident that I hadn't ovulated and that it was fine to proceed.

Why their results sheet doesn't make that clear, I don't know. And she said that our RE's office should know the less-than-6 rule, because they do monitoring for a lot of our RE's patients. The nurse at RE's office said she had never heard of that, but as long as everyone is in agreement and there is a valid explanation, I'm not going to have any "what if's" lingering in my mind over this.

So that was great news. Then the IVIg infusion coordinator called and said "um, I just checked in with your insurance and there's been a change...call me back."

I was afraid she was going to say they reviewed the preauth again and denied it. If so, we'd be paying about $3,500 out of pocket.

Well, it's going to be $3,000, but for a different reason. When she originally got the authorization, it was in May. My company's benefit year runs from June 1-May 31, so this year's benefits took affect on June 1, which means a new, $3,000 out-of-pocket requirement before insurance will start covering anything.

Fortunately, last fall when we signed up for R's benefits (which run from Jan.-Dec.), we knew we'd be doing IVIg and figured it wouldn't be covered, so we did the maximum contribution to his FSA account. So while we'll have to pay out the $3,000 up front, we'll be able to get it back pretty quickly through that.

Now that we're sure we're going to the clinic, I've got to figure out a place for us to stay. We're both going to be working all week, so we were hoping to get a 1-bedroom suite for the separate spaces while we're both on calls.

However, something major must be going on in Denver next week, because we can't find even one hotel anywhere vaguely near the clinic that has anything other than a studio available. (Well, maybe we could if we were willing to spend $300-$400 a night, but that's just not in the budget.)

Wish me luck, in more ways than one. :-)

Possibly Canceled, and Another Surprise

2011-07-07T20:30:00.002-07:00

So, it seems that every time I move an inch closer to the finish line, it moves an inch farther out. Or, in this case, possibly a month.

My progesterone level is never, ever, ever above 0.5 during CD21 tests in a natural cycle. Except during last year's transfer, when it was slightly above 1 and caused the transfer to be moved up a day.

And this morning, when it was above 2. It would figure - the two times my body works like it's supposed to is when we're trying to do a transfer.

RE's office thinks maybe there was just a lab error, so I had to get redrawn this afternoon. We'll find out tomorrow. If it wasn't, the cycle has to be canceled, because it's too high to know for sure when it started to rise, so they wouldn't know with confidence which day to do the transfer.

I'm scheduled to have IVIg on Saturday, and our flight is scheduled for Sunday night.

I was on a bcp/lupron overlap protocol. Both of those things are supposed to prevent ovulation, aren't they (indirectly in lupron's case)? So that's what makes RE's office think it was a lab error.

Still, not great news.

But I had plans to have dinner with a former co-worker, and I was looking forward to that. She's a couple years older than me and also has no kids due to fertility, so she can relate. Except, it turns out, now she's 13 weeks pregnant.

I tried my best to put on a happy, excited face for her. But I'm afraid it probably wound up looking more like a "Seriously, universe?? How many more I-can't-get-pregnant-but-oh-look-now-I-am announcements are you going to send my way?" face.

On the bright side, at least I managed not to cry.

An Honor (and Trying Not to Hyperventilate)

2011-07-03T21:42:00.003-07:00

I was going to lead with a title like "We've Been Chosen", but given that you'd probably think it was related to adoption, I didn't want to be deceptive. Nor do I want to jinx us...

So, you're wondering, what is this honor? Well, we actually have been chosen (in a manner of speaking) by a couple who thinks we'd make good parents. R's best friend and his wife approached us a couple of months ago to ask us if we'd be willing to be legal guardians and take custody of their son if something (heaven forbid) should ever happen to both of them.

But they also mentioned that they were considering several other people as possible guardians, so when we didn't hear anything more about it, we assumed they'd chosen one of their other options. Then a few days ago they called to tell us that they'd made a decision, and it was us.

I have to admit, even though this is a situation where of course we hope we will never gain custody of the child involved, it still felt really nice that they chose us from among all of their options. We are truly honored.

We also have to figure out how to hang out with a 7-year-old. R hangs out with his best friend and their son frequently, so he's comfortable with R. We also spend time as a fivesome doing various things (including weekend trips), but his parents suggested that it would be good for the two of us to spend an afternoon with him (just the three of us) every once in a while. I have to admit, I had a fleeting moment of "What if he thinks we're boring/lame/hates us?" But he's a great kid, so I know it'll be fine.

That's actually not what's creating the hyperventilating. The transfer is in 10 days. Beta is in 19 days (or maybe 20, depending on how I feel about the 22nd at that time). In less than three weeks, we'll know the outcome of step 1. And then be plunged into the unknown of step 2, because either way, it's an unknown. Even if we get to step 2 of a pregnancy (meaning the day after beta), that doesn't guarantee the next day, or the day after that.

As I write this, it's just dawning on me what's causing the hyperventilating. I was thinking that coming face-to-face with the beta results - the answer to which path we'll be going down for step 2 - was what was causing it. But I think it's really the unknown of step 2, regardless of which path it is, that's bothering me.

Have I mentioned that I'm not a big fan of uncertainty and unknowns?

This Oughta Be Fun

2011-06-30T10:11:00.001-07:00

The results of my first E2 level check for this FET cycle came in yesterday. It was supposed to be at least 50, but it was only 8.

So instead of stepping up to 2 estrogen patches, then 3, then 4, I'm going straight from 1 estrogen patch to 4 patches, plus oral estrace twice a day. R is already bracing for the hormonal moodiness that is bound to ensue. :-)

The blood draw was on Monday. It was kind of complicated, because I had one order from RE for the E2, another order from the PCP for a thyroid panel, and then vials for the communicables that needed to be drawn and spun but then shipped to RE rather than run by the lab. Plus, R was with me to contribute his 2 vials for the communicables as well.

I have to admit, I couldn't help but think "I hope this is the last time I have to do a draw for something other than one simple, straightforward order." I'm afraid to find out how the cycle turns out, but at the same time I'm also ready to move on.

Speaking of which, I held out for as long as I could, but I finally gave in today and called the adoption professional we're planning to work with if the cycle doesn't go well. I'm working on updating our profile. You know me - always a backup plan. I think I'm on Plan T at at this point...

T Minus 28

2011-06-15T22:13:00.002-07:00

Assuming all goes well, I will be incubating four weeks from today. We booked our flights last night. Gulp.

I'm trying to be calm about this cycle, but it feels like there's so much riding on it. I looked at R last night and said, "You mean if this doesn't work, I'm just supposed to stop? Give up? Admit that I can't do this? That something 85% of the population has no problem doing (half of them without even trying or meaning to), I can't do it despite 9 years, 2 countries, half a dozen states, and who knows how many needles/cycles/procedures?"

Clearly I'm not good at accepting limitations.

R pointed out, though, that succeeding at incubating isn't the end goal and that we will still have other options to get to the end goal if that particular route doesn't work.

I saw my therapist today. Our next appointment will be exactly one week after transfer, assuming transfer occurs as scheduled. Even though that's a couple days before the first beta, I'm sure I will be peeing on a stick that morning, so I told her to be prepared.

She asked if I'd rather wait to see her until after the betas. Ha. I'm pretty much going to need to be camped out on her couch for about a week, so I scheduled another appointment for a couple days after the second beta.

I'm still not really letting myself process the grief about my dad yet. She pointed that out too, but surprisingly gave me a pass again this time.

But I can tell that it is slowly bubbling to the surface - after I left her office, I swung through a drive-thru to pick up dinner, and they were featuring a banana pudding milkshake. Banana pudding was my dad's favorite dessert (I made three huge pans of it - seriously underestimated how long it takes to cook 12 boxes of cook-and-serve pudding! - for the potluck reception after his services), so I ordered the shake. And then promptly burst into tears. But fortunately there were a couple of cars in front of me, so I managed to (mostly) pull myself together before I got to the cashier's window. Thank God for the trend of Jackie O-style sunglasses.

Stuff...and a New Cycle

2011-05-31T21:31:00.002-07:00

I've started several posts in my head during the past couple of weeks but haven't gotten one into the computer until now.

Going through the services for my dad was tough, of course, but there was good in that week at the same time. R and I got to spend some time with my oldest sister and her family (including my niece, who volunteered last summer to be a gestational surrogate for us). Although I'd only met my nephews once before, all of her family was very welcoming to us.

It was really unexpected to me, but in a good way, how much we just felt like family. It was just natural, just there. I don't know how to explain it very well. I generally think of my parents as being my only blood family, and I had no idea how much I had been missing that connection in my life until after the reception following my dad's services, when we were in the car and R told me that I should organize a family reunion. I said, "Seriously? With everything else going on in our world, you think I need to take on organizing a family reunion?" And he said, "Yeah, I know, but you're happy when you're with them." "Happy" isn't the word you expect someone to use to describe you literally a couple hours after you've buried a parent - and honestly, it's probably not a word he has used to describe me in a very long time - but I realized that he was right. So I'm grateful for that connection.

I haven't really started to deal with my dad's death yet. Certainly I shed some tears in the moments after he passed and during the services, but mostly I just force them back and haven't let myself have a good cry yet. I saw my therapist a couple days after we got back home. She said I was reciting the events as if I was describing a movie that I was watching. She pushed and probed a little and ultimately decided to let me live in my little world of denial for the moment, but I don't think she'll let me get away with that during my next appointment in a couple weeks. :-)

We got some surprising news the week after my dad's services - it looks like one of my health insurances (I'm on both my employer's insurance and R's insurance policy through his employer) will cover IVIg! The home health company that will do the infusion let me know, but I wanted to hear it for myself so I called the insurance company to verify it. They confirmed it as well, although I have to say I still don't believe it 100%.

The cost of IVIg had apparently been weighing on me more than I realized, because as soon as we found that out, I was like "Ok, let's get this show on the road!" And, as R and I so often do, he ying'd when I yang'd. He's been so supportive and strong in all of this, but as soon as I was ready to move forward, suddenly he was feeling "Whoa!" and not quite wanting to face the prospect of our last attempt (with my uterus). But now he's on board.

We still don't have quite all of the pieces together, so the transfer could get derailed, but as of right now it's planned for two days after my birthday in July. The reproductive immunologist can order the IVIg itself, but since I don't live in the state where he practices, I have to find a local doctor who is willing to order the actual infusion of the IVIg, or else I need to find another home health company within my insurance's network in his state to do the infusion, and travel there to have it done. I have an appointment on Friday to ask my PCP if she'll order it - fingers crossed.

Also, my TSH level is better but still not where it needs to be. It was 7+ a couple weeks ago, so that's about half of the 15+ it had been, but it still needs to get down into the normal range before transfer. My PCP increased my Syn.throi.d dosage again from 100 mcg to 125 (I was on 75 when I got the 15+ result), so I'll re-test again in the end of June.

Thankfully, though, it does seem that the improved TSH has reversed my kidney issues. My eGFR is now back in the normal range instead of Stage 3 kidney failure, and my creatinine is much improved (still not quite back to normal yet). Granted, the eGFR technically still at the low end of the normal range, but I'm hoping if the TSH gets back to the normal range that the eGFR will move toward the upper end of normal. It still amazes me how all of our body's systems are so interconnected.

And now, after all that good news, here's how I came off the holiday weekend and launched into the cycle (bcp's start tonight): The co-worker who I began carpooling with a couple months ago, who I clicked with right away and was so happy to find someone else my age who doesn't have kids, who I have made it a point to not discuss the kid issue with at all because I just didn't want to go there, asked me point blank on the way home tonight whether R and I have thought about having kids. I tried to just laugh it off with a "Yeah, maybe someday" kind of response.

It turns out she's 14 weeks pregnant. From her first IVF cycle. I am trying hard not to feel sorry for myself, but I'm not sure I'm succeeding.

Dad Passed On

2011-05-09T16:32:00.001-07:00

I was not looking forward to last week, but it turned out to be a much more painful week than even expected.

Wednesday was the 5th anniversary of miscarriage #2. Thursday was the 7th anniversary of miscarriage #1.

And then, on Friday morning, dad passed away with his wife and me by his side.

It was somewhat expected, although I don't think anyone - including the oncologist - thought it would be quite that soon.

Dad had seemed to be doing well (relatively speaking) when I spoke with him several times in April, but then test results the weekend after Easter showed that despite the transplant, leukemia cells had returned. So R and I drove out to be with him two days later, and then four days after that he was gone.

I'm thankful he's not suffering any more, and I'm glad his wife, who has literally been by his side pretty much every single moment of every single day since he was diagnosed two years ago this month, no longer has to be a full-time caregiver.

I don't know if it's relief that his ordeal is over or that I've dealt with so much loss that I'm an expert at coping or if I'm just flat-out avoiding dealing with it at all (ding ding ding, I think we have a winner, folks), but so far I haven't really cried. R keeps looking at me sideways, like he's trying to spot the warning signs of the big implosion he's anticipating.

I haven't been in the mood to talk much lately (obviously, since I haven't been posting or commenting). I think between all the infertility stuff and my dad's battle, I'm just tired of medical stuff in general.

We don't know yet when we're going to do our next transfer. A couple months back, tests showed my thyroid meds dosage was way too low (TSH was 15+) and that my kidneys were in stage 3 (the middle of 5 stages) of kidney failure.

My doctor increased my thyroid meds, and I think that has also improved my kidneys, but I need to get bloodwork done to confirm that before we can move forward with a cycle. I was going to get that drawn last week, but with everything going on, we won't be home until next week, so it will have to wait until then.

Fingers crossed that I manage to keep myself together through this week - services are at the end of the week.

Doggie Pictures

2011-03-23T23:58:00.003-07:00

To everyone who commented on my last post, thank you for your words of kindness and comfort. I can't believe it's been almost two weeks since we lost him.

There's a major deadline coming up at work next week that involves an out-of-state trip, so I haven't really allowed myself to think about it, much less grieve yet - I've just been stuffing it in. (Not a good idea, I know! It comes out eventually, and the longer it's in there, the less pretty it is when it finally does happen...)

Anyway, I think I mentioned last fall that we had some professional photos taken after Indy was diagnosed, so I thought I'd share a few of those. However, this blog is anonymous, and while the chances of someone I know happening across it and recognizing the photos is small, it's still not a risk I'm willing to take. Since Blogger does not allow individual posts to be made private, I created another blog and posted them there. If you want to see them, send me an e-mail at momto 3dogs@ yahoo (dott) com, minus all of the spaces, and I'll give you access to it.

Horrendous guilt

2011-03-13T09:00:00.002-07:00

Coming out of my cave to share some horrible news.

We had to say goodbye to our "baby boy" at 3:30 this morning. We were expecting that we would lose him to the rare nerve sheath tumor he was diagnosed with in the fall. Instead, we lost him to an intestinal obstruction.

I don't know what happened. I don't know what it was, what he possibly could have gotten in to. There aren't children's toys to get into around here (obviously), we don't leave clothes or other stuff on the floor, he wasn't a chewer or the type to get into things. All of his toys are present and accounted for.

I keep racking my brain trying to figure it out.

It's quite possible that it was something he got into while I was at work, when there's nothing I could have done to prevent it. It's even possible that it was another tumor that was compressing his intestines; the vet offered up that possibility, although it sounded like she thought it was less likely to be that and more likely to be a foreign object. Apparently right before we got there, she had just finished pulling a fully intact pair of boxer shorts out of another dog's intestines. She also mentioned something about having pulled batteries, magnets, bikini underwear and even a tampon out of other dogs.

We could have done surgery. And though it would have been $4,000-$8,000 and required a 3-5 day hospital stay, and though we knew we only had weeks to a few months left with him, I was tempted. I didn't want to let him go like that, for that reason. But then R pointed out that his legs would have been even weaker after all the time he would have to spend laying down during recovery, and I knew I'd only be doing the surgery for me, not for him.

The vet said it wasn't our fault, that dogs will be dogs. That her own dogs have gotten into things they shouldn't, and that I shouldn't blame myself. But I do. How could I not?

I was supposed to take care of him, not let him eat something that would kill him. Maybe this is why we don't have kids. If I can't even keep a dog alive, why on earth would God trust me with a kid?

I know that's extreme. And self-pitying. And on some level, ridiculous. But still, there it is. The thought that keeps playing again and again in my head.

<insert primal scream here>

2011-01-27T20:04:00.004-07:00

This was going to be an angry, shrieking, lots of words in capitals and inappropriate language kind of post. But then I ran/walked 2.5 miles, which made me tired, so you are getting the still not happy but much more calm version of me.

R was not so lucky. But more on that in a minute.

Everything is fine, and yet it's not.

My dad is doing pretty well. The transplant went well, and he was released from the hospital earlier than expected. He's still living near the hospital (1.5 hours from home) because he has daily doctor's appointments. He had a bone marrow biopsy this week, so we're waiting to hear the results of that. Hopefully it will show no abnormal leukemia cells.

The dog is also doing well, relatively speaking. Considering the vet gave him 2-3 months and it's now 3 months and he's still his normal, happy self (albiet playing a little less), I'm very grateful. His left hind leg seems to be getting a little weaker, and now his left front paw turns under sometimes, but he catches that before he puts any weight on it. We're just continuing to keep a close eye on him and keep him as comfortable as we can for as long as we can.

I've been lurking around the blogosphere for the past month, reading but rarely commenting, and obviously not posting.

There are so many things in my world to be grateful for - and truly, I am - but at the same time, I've been fighting not to slip down into a well of self-pity. There has been a major burst of baby announcements around me at the end of last year/beginning of this year, particularly IRL, and as much as I'm happy for others, I've been battling the "why not us?" blues.

This afternoon pushed me over the edge. I left work early, swung through a drive through to order a large chocolate shake (it turns out, chocolate does not fix everything), and slid down to the bottom of the pit.

It echoes down here, as I found out after losing that last thread of self-control I was so desperately clinging to and giving into the urge to let out 8 years of anger, frustration, disappointment, and loss in a series of primal screams.

The dogs fled, R froze, and my mother - for once! - decided it was best to give me space and stayed far, far, far away.

If there are any guys reading this, please know that when it's obvious your wife's hold on that tattered thread is very tenuous at best, "it's going to be okay" are not necessarily the wisest words to utter. R can attest to that.

So, what snapped the thread?

The adoption social worker called this afternoon. I rarely step out of a work meeting to take a personal call, but since I wasn't expecting her to call, I did.

I thought she was going to tell me "Surprise! Your home study certification has been granted already."

Ha. Ha ha ha ha ha. How far the hell up my ass did my head have to be for me to ever, EVER think that returning to the adoption process would be a good idea? (Okay, so apparently there is still a little bit of the foul-language, words-in-caps frustration down here with me...)

The court commissioner who used to handle adoption home study certifications apparently left the job recently. Then another commissioner was hired. Apparently she lasted only a couple of weeks, and during that time, she did not get around to the home studies that are waiting for approval.

Now she is gone, there is no new commissioner, there is no clear sense of when there will be a new commissioner, and so our home studies are sitting in the "in" box on a desk that currently belongs to no one.

In other words, we are out there in no man's land, with absolutely no idea of when our home study might be certified. Could be weeks, could be months.

I realize you are probably thinking "But weren't you doing LIT? Aren't you going to be doing an FET? Isn't the home study just a head start in case you wind up going down that path?"

Yes, yes, and yes.

But that's not the point, as I told (well, actually, screamed) at R when he told me "it'll be okay".

It's NOT OKAY. It will never be "OKAY". We could get another phone call tomorrow telling us that the court temporarily certified someone as a commissioner in order to get the home studies approved (we're not the only one - there are a few families affected), and it still will NOT. BE. OKAY.

Because it's not right that OUR "ability" to create OUR family hinges not just on SOMEONE ELSE who couldn't give a damn about whether or not we ever do go on to adopt (although that in itself isn't right), but right now it hinges on SOMEONE WHO DOESN'T EVEN EXIST. That is not "okay". There is no way to make that "okay", not even after the fact.

Am I over-reacting? Yes, I am. I know that I am. And I don't care.

After 8 years of hell, I get to over-react. I may not get a baby, I may not get all those happy moments that parents get to experience, but I damn well get to over-react about the fact that our ability to move forward in this process revolves around a freakin' empty chair. And that there could be many, many other empty-chair situations or other complications along the way.

It's not that I think our home study will be held up in court for the next decade. (Although I do think it's quite possible that it could be held up for months.) It's that the feeling of complete, utter powerlessness that I felt five years ago when we lived through Failed Adoption Hell came flooding back in, as if all of that just happened yesterday.

And I hate it.

It is not okay.

You Know You're an Infertility Patient When... (#4)

2010-12-22T13:49:00.002-07:00

...you take an HPT not because you expect it to show two lines (ha! ha ha ha!), but because you know that taking it is pretty much a surefire way to bring on CD1 within a matter of hours.

Except, unfortunately, in this case.

Took the stupid thing two days ago (yes, it was negative) because I'm on something like CD45. Our anniversary is at the end of next week, we have a romantic trip planned, and I don't want to be dealing with my cycle then.

But so far, all I've seen is a little bit of spotting. Grrr. If the test can't show two lines, can't it at least just do the other thing it's supposed to do and bring on CD1? Grrrr (again).

We're heading out to see my dad in a few hours. Please keep him in your prayers - the transplant should start in about 24 hours.

Also, please stop by and visit Gypsy and The Tramp to offer some friendly, comforting words and birthday wishes. This time of year is tough in general for us IFers, and she's dealing with a loss and some other challenges right now on top of everything else.

LIT, Round 1 is Complete

2010-12-13T22:33:00.003-07:00

And obviously, I lived to tell about it.

I was really stressed about crossing the border - I didn't sleep at all the night before. But it turned out that the whole thing was really no big deal.

The most annoying part was being badgered by a very persistent shop owner who wanted us to buy medicines from a pharmacy or get our pictures taken with a donkey while we were standing at a corner (with the clinic's receptionist) waiting for another clinic employee to pick us up and drive us to a restaurant for lunch.

The guy doing the badgering asked if we were there to see a dentist. I smiled and shook my head no. Then he asked "Why are you here?" I just shook my head no again, and he insisted rather rudely "Tell me why you're here!", then accused us of being terrorists when I wouldn't respond.

I wasn't in the mood to talk about it, but perhaps I should have gone into every personal detail - that would have made him think twice about asking the same questions of the next couple he sees waiting on that street corner! Now that I'm prepared to expect that, maybe I'll take that approach if we see him on our next trip.

After the injections, I was kind of bummed because I didn't feel or see much of a reaction. However, 48 hours in, I have red welts the size of a quarter at each injection site. (There are 8 - 4 on each arm.) The itchiness I've heard about has also developed, and I'm not allowed to scratch or take antihistamines. Thankfully the itching isn't so bad that I'm going crazy - if I'm focused on work or some other activity (Christmas baking) or sleeping, I'm usually distracted enough to not notice it too much. But still, I'll be glad when the itching goes away.

We plan to go back for round 2 in January, but that will depend in part on what's going on with my dad. He's been stable in remission for the past month, so he's supposed to go back into the hospital on Thursday, and his bone marrow transplant is scheduled for Dec. 23. Prayers are welcome.

Also...thanks to all of you who offered anniversary gift suggestions!

A Favor to Ask (I'm Desperate Here, Folks)

2010-12-09T23:52:00.004-07:00

I need help. In more ways than one, I suppose, but for the moment I'm fixated on one particular problem...

R and my 15th wedding anniversary is coming up in 3 weeks, and I have absolutely no idea what to get him. He bought me something, which we normally don't do for our anniversaries. He's actually become quite "the perfect gift" giver over the years (after I cured him of giving me things like ice scrapers, cookbooks and cooking utinsels during our first couple years of dating) so I'm sure he managed to find something that is meaningful and, well, perfect.

I, on the other hand, have never been one of those people who manages to find "the perfect gift" when gift-giving occasions arrive. My saving grace is that R's family are big believers in maintaining wish lists, so I work from those for birthdays and Christmas.

This fall, I've been even more sucky at it than usual. I managed to get R a card for his birthday and decided what to buy him (luggage, because his carry-on suitcase was falling apart) but didn't actually get around to making the purchase. Then a couple weeks after that, I realized I totally forgot my 16-year-old niece's birthday! And it's the same day as my dad's birthday, so how the heck did I manage that? Technically she's not a blood relative (her mom's one of my BFFs and is very laid back about those kinds of things), but still...Then R eventually wound up researching and buying his own birthday present because I still hadn't gotten to it - how lame is that?! It just arrived last week. (His birthday is in October.)

So I am in serious, desperate need of help. Ideas, in particular.

We always spend the day together (take the day off work if it's a weekday), but we don't usually buy gifts for each other. The last time we did was our 10th wedding anniversary. I got him an engraved frame and a photo album with a sterling silver cover that also had an engraved plaque on it. I didn't get around to actually putting pictures in them (mostly because I hate pretty much every picture taken of me during the past 10 years), so I took them back after I gave them to him with a promise to do that. Guess what I found a few weeks ago when I was cleaning up our office?

Finally getting pictures into the 10th anniversary photo frame/album might be a great 15th anniversary gift, but realistically it's not going to happen. So, I need ideas. Something other than conjuring up a baby out of thin air, since I haven't had any success in making that happen yet. And we're going on a short getaway for our anniversary, so travel probably won't count.

Ideas?? Thoughts? Suggestions?? Help!

Um, About What I Said...

2010-12-01T20:32:00.002-07:00

I know I've been whining lately about being tired of infertility treatments, of the tests, the shots, the disappointments. That I don't have much left in me and just want to be at the treatment finish line, one way or another.

Yet somehow, here I sit, filling out the 934th half-inch-thick patient information form I've been asked to complete in the last 8 years. For yet another doctor. About yet another treatment.

Clearly I've lost the last shred of sanity I was precariously clinging to.

I belong to a Y.ah.oo group for infertility immunology issues. I've been seeing something lately about a very new treatment called c-g.s.f. (Google it minus the periods if you're curious.) So I decided what the heck, I'll look into it.

Which is how I wound up with an 11-page form to fill out. Half way in, after asking extensive questions about pregnancy history, testing of any losses, gyn history, etc., there's a section that says "Please describe the nature of your problem."

Well, let's see. Where to begin? I have to pick just one? Off the top of my head (no pun intended)...my hair is thinning, neither my eyesight nor my memory is what it used to be, I have entirely too many things to do and not enough time in which to do them, my dad is sick, my dog is sick, I work entirely too many hours because I don't want to be the next one to be laid off, when I cook I only have about a 50/50 chance of the recipe coming out right...

Oh wait, that's right, you're a fertility doctor. Probably not the kind of problems you're referring to. Let me try that again.

I DON'T HAVE A KID. And I miscarry. A. LOT.

What do your other patients normally come to you for?? Were the first four pages not a clue? Particularly page 1, which required me to explain each pregnancy and its outcome in great detail??

But I contained the snarkiness. Probably best not to tick off the doctor before even speaking with him. Now I have to dig out the records of our last retrieval and all of our immune testing so that I can write down exactly how many vials of Gan.are.lix I shot myself up with two years ago and what my latest FSH was. (4.something, for all the good it does me...)

In other news...

This doesn't mean we've put a halt to the home study. Pool fence and home study visit are still scheduled for next week. (Hopefully the former before the latter, or else the latter will have to be rescheduled.)

We survived Thanksgiving with relatively little drama, all things considered. BIL, who was making the turkey this year, announced the day before that he wanted to eat much later than we normally do - about 6 p.m. instead of 1 or 2 p.m. - because eating earlier would have required him to get up before 1 p.m. (And no, he doesn't work the night shift - he doesn't have a job at all.) For my mom, eating at 2 p.m. is late, so I knew she wasn't going to like this.

Surprisingly, she seemed pretty gracious about it when we told her. That should have been a clue to me, but I was just so relieved she didn't throw a fit right there on the spot that I didn't get suspicious.

Then on Thanksgiving morning, when R and I came downstairs and started getting things ready in the kitchen, she came in and announced that she had called the neighbors to wish them Happy Thanksgiving and that they invited her to eat with them at 2 p.m., so she was going over there instead of having Thanksgiving at our house, where she lives.

I knew that if the neighbor had extended an invitation, it was only after a lot of obvious hinting and wrangling on my mom's part. The neighbor is lovely and sweet, but she was hosting Thanksgiving for 16 people, including her in-laws and a vegan, who she was fretting about what to serve. She was completely stressed out about it, so I knew she wouldn't have just jumped at the chance to add one more person to the chaos.

Still, I just smiled sweetly and told my mom to have a good time and tell the neighbors we said Happy Thanksgiving, and turned back to what I was doing. R's eyes had kind of bugged out at the announcement, but he didn't say a word.

At 1:30 p.m., she changed her clothes. At 2 p.m., she was still sitting in her chair in her living room. At 2:30 I offered her a drink I was making, and surprise, surprise, when we ate, guess who was sitting at the table with us??

Score one for refusing to let her get under my skin. I don't play head games. Maybe at some point she'll learn to accept that.

A Brutal Day

2010-11-18T22:23:00.002-07:00

This was the second day of layoff notifications. It hit closer to home and was even more brutal than yesterday.

The person in the cube adjacent to mine was let go. They're experiencing some personal challenges at the moment, so I feel for them even more than most. Two others I didn't work with as closely were also let go.

And, not only was my closest co-worker, who I work with on literally a daily basis and am also personal friends with, let go, but in her case, her last day is tomorrow. I understand why they did that, but it wasn't really necessary. It also means we have 8 hours to figure out all the stuff I might possibly need from her, and as of Monday, my workload doubles. I've been working 14-16 hour days and working on weekends for the last couple of months, so I'm honestly not quite sure how I'm going to fit more in.

I'm being told we're expected to "work harder".

I told R that we're going to spend time this weekend taking a very close look at our budget and "work harder" making cuts so we can boost our savings.

We have a decent savings account, and at the moment I don't plan to look elsewhere. My work is in an emerging niche, and I think there are still a lot of things I can learn in my job. With a few more years of experience, more opportunities may be open to me, and those opportunities may come with a nice salary boost.

So for now, I'm willing to stick it out. But R and I both have corporate jobs, and I don't want to be beholden to corporate America.

I want the option of being able to tell them where to shove it if they expect me to continue working ridiculous numbers of hours with no end in sight, then turn around, walk out the door, and not have to have a second's worth of stress about how we would survive indefinitely if need be.

On completely unrelated notes...

We ordered the pool fence yesterday. Assuming they're able to install it in the timeframe they say they are, our home study visit will be in 2.5 weeks.

I've scheduled our first LIT treatment for Dec. 11, but I'm still playing "should we, should we not?" with the idea of crossing the border.

I've been comfort eating for the past two days. Yesterday's dinner consisted of butter pecan ice cream with chocolate sauce. Today's dinner was garlic parmesan fries with a kicky paprika aioli, pepperoni pizza, and meatball pizza, topped off with more butter pecan ice cream, with an even more generous squeeze of the chocolate sauce bottle. Oh, and did I mention the bag of peanut M&M's I had while still at work?

Meanwhile, I've earned exactly $0 running dollars toward a massage so far.

Dodged a Bullet

2010-11-17T20:32:00.002-07:00

The department I work in is having layoffs today and tomorrow. Thankfully I found out that I survived, but not everyone was so fortunate, and there is still more news to come about others' positions tomorrow.

R has been through layoffs 8 or 9 times in his career (and thankfully survived all but the one in which the company closed its local offices and we declined to move to Brazil), so I thought I was prepared to deal with the stress. And I was, to a large degree, but your spouse going through it still isn't the same as walking into the room to hear your own fate.

We were a lean department as it was, so some people who are very great to work with were let go, and others were demoted to non-management positions. Several of my co-workers, including the one with whom I work the closest and have formed a friendship with in addition to a colleague relationship, don't find out their fates until tomorrow.

I have to say that I've been incredibly fortunate - our department is very professional and pleasant to work in, and there isn't anyone in the group who I wouldn't want to work with.

I really feel for those who are affected. There's never any good time to do this, but of course right now is an especially tough time. And it feels particularly unfair, because there are 5 layers of management above them that remained virtually untouched through this process.

I'm thankful to have survived, but at the moment I'm mostly just sad for my co-workers. And anyone else who has had to endure a similar situation, especially in this economy.

Testing, Round 2

2010-11-11T20:39:00.002-07:00

I scored a deal a couple nights ago on a box of 3 FREDs, on sale for $15. When I got up this morning, the boobs were still sore, so I figured what's another $5 test at this point? I opened a test, I peed, I wiped.

And I didn't even need to look at the test to know the result.

CD1 will be showing up tomorrow. Nothing like a couple of HPTs to bring her on.

On the bright side, dad is still doing well and still has his hair (one of his biggest concerns). He finds out tomorrow if a bone marrow biopsy he did yesterday shows that he's in remission again. The dog is still his limping but happy self.

And, we got the adoption home study agency's finger printing done today.

I was hoping to be able to say that the paper work is all done too. For some reason, though, the agency director only sent us half of it to do in advance. So when we got there today, he handed us a bunch more. I filled it out tonight - we'll either take it down there tomorrow or get it in the mail.

The carpet cleaner is coming Saturday morning, so the only big thing left on that front before the home study visit is getting the pool fence scheduled for installation.

We are planning to do the first round of LIT in December and the second round in January, but oddly enough R's Hep A total test came back positive. (The Hep A IgM was negative.) So we have to figure out what that means in the context of all of this.

I looked it up to get a better understanding of it before mentioning it to him. It's common, infection often comes from eating fruits, vegetables, shellfish or not washing your hands well enough, etc., it very rarely becomes chronic, even more rarely becomes fatal, and pretty much goes away on its own eventually - there's not really a treatment for it.

I tried to approach it very calmly, saying "One thing I need to mention...it's no big deal, millions of people get it, it goes away on its own without treatment, but you seem to have the very common mild form of hepatitis."

Still, understandably, his eyes got very wide and he said "what do you mean no big deal?? Hepatitis??!?"

Sigh...our world involves far too many strange, unexpected medical conversations...

I Tested

2010-11-09T08:19:00.002-07:00

And any sane, normal, rational person (i.e. R) will tell you that it is one very single, lonely line on a very solidly stark white background.

I, on the other hand, still ridiculously continue to cling to hope.

Because I swear there just may be something there. If there is, it's the faintest line in the history of faint HPT lines, even fainter than the time we were scratching our heads trying to determine if it was a line for pg #2, and the beta that morning turned out to be a 5. (I used a FRED then, and it was a FRED again this morning.)

But I swear I can see something if I turn it at just the right angle. I know a stark white background when I see one, the kind where you can't even tell where the line is supposed to be. And this time, I think I can see where the line is supposed to be.

But mostly I just smell pee. And clearly I'm not confident enough that I'm really seeing something to call RE's office and ask for a blood test to be ordered.

So instead, I'm rationalizing that if I ovulated late - which is entirely possible for me - maybe ovulation didn't occur until Halloween weekend, in which case I'm only 8 or 9 dpo. So maybe I just tested too early.

In other words, we're in for another round of this in a few days, unless CD1 shows up before then.

Meanwhile, the hourly boob checks (they're still sore - yea!) will have to be temporarily suspended when I go in to work this morning. There's a security camera right above my cube, and "Woman feels herself up at work while she thinks no one is watching" is not a video I want showing up someday on America's Funniest Home Videos...

I Chickened Out

2010-11-08T23:17:00.003-07:00

Got up this morning at 6 a.m. to take the dog out, boobs were still sore but decided I'd rather crawl back in bed than stay up for a few minutes to pee on a stick. (Last week, I asked to take today off - I needed a mental health day.)

So I crawled back into bed, and when I got up two hours later, boobs were noticably less sore.

I figured it was over, decided what was the point in wasting a $10 test and starting my day off on a negative note (way to think positive, I know), so I decided not to HPT.

Then, of course, the soreness returned and I spent the day feeling very aware of them every time I ran up and down the stairs. (R and I were working on cleaning up/better organizing/rearranging the upstairs.)

The cramping returned this afternoon and evening. It's not my normal PMS cramping, but then again, it wasn't my normal PMS cramping back in August, either, and I'm not sporting a bump. So who knows what's going on inside my body? Clearly not me.

I'm just going to bite the bullet and take the stupid test tomorrow morning.

I think.

Maybe.

A New Idea for Motivation to Exercise

2010-11-07T19:14:00.003-07:00

Today, I came up with a brilliant new motivation to get my lazy bottom up off the couch and exercise.

Well, at least, it seemed like a brilliant idea when it popped to mind, although given that said lazy bottom is currently camped on the couch, maybe it's not going to be as effective as I hope it will.

Anyway, here's the idea...for every mile that I run (without stopping, without any walking), I will credit myself $1 toward a massage.

I love to get massages, particularly from one specific massage therapist at a nearby day spa. But it's on the expensive side - $75-$80 not including tip - so I don't do it very often and feel a wee bit guilty whenever I do.

I'm hoping this will be a more effective approach than "if I lose 10 pounds, I'll schedule a massage" (or buy a fabulous new dress or make reservations at that new restaurant I want to try), because that approach hasn't brought much success in the past.

So I'm thinking $80 massage = 80 miles = I'd have to lose at least some weight after running 80 miles, wouldn't I?

Since I'm out of shape, I may start by 1 mile = $2 in order to get myself started, and then switch to 1 mile = $1 after I get a little more up to speed (pun intended).

On another note...guess who has mild cramping and unusually sore boobs, is on CD33, and has 3 HPTs in the bathroom cabinet taunting her?

Yep, you guessed it.

I keep vascillating between thinking I might as well wait another week because chances are it's just CD1 getting ready to make an appearance and thinking I'd better test now, because if it's positive, I'd need to start up the Lovenox, prenatals, folgard, etc., ASAP.

I'll probably test in the next couple of days. Apparently there's at least a tiny part of me that's still an eternal optimist.

Either that, or I just love to torture myself with false hope.

A Much-Needed Reminder

2010-11-01T22:21:00.002-07:00

On my way home from a vet appointment with our cancer-stricken dog late this afternoon, I called my dad to check in on him. He went into the hospital on Friday for a more hard core kind of chemo than he's received in the past, and today's his third day of it. I asked him how he's doing, and his response made me laugh out loud:

"I'm feeling great, baby! Plus, this new chemo makes me glow in the dark, so it's easier for wifey to find me at night when the lights are off..."

It was a definite reality check. There are certainly things in our world right now that are painful and not how we'd hoped they would be, but my dad's attitude serves as a reminder that no matter what the circumstances, a sense of humor and positive attitude are still possible. If we choose them. So I'm trying hard to choose them.

On that note, updates about the three D's that are dominating our world right now...

The Dad - As I mentioned, the hard core chemo is underway. He has four more days of it. The oncologist decided to take this approach because the other chemo he had been on was only helping for a week or so; it wasn't keeping him in remission long enough to get the transplant under way. It sounds like he'll be in the hospital at least 30 days, and possibly longer if the transplant happens. He'll be keeping the nurses on their toes with his sense of humor, that's for sure.

The Dog - We got a follow-up report from the radiologist late Friday afternoon, and I met with our regular vet today to talk about all of this. It was a sad appointment, but a decision has been made. As painful as it is, I'm also at peace with it because it's the right decision for our "baby boy". The only criteria we used is what we think is best for him. And unfortunately, we decided that is palliative care rather than surgery.

R, my mom, and I had talked about it over the weekend and decided that if surgery seemed like a viable option, we would do it.

However, I noticed during the past couple of days that the dog's hind left leg (it's his front left one that is affected by the cancer) is starting to show signs of weakness. It's shaking a little bit sometimes, and he's sometimes starting to lean his right hip against things - walls, the kitchen island - to gain additional support, which he hadn't been doing before. So I think the cancer has probably spread a bit further than the MRI images can detect at this point.

Our regular vet did an additional exam of him today and is concerned about the same thing. Also, he explained some things I didn't fully understand last week. Because the first sign of trouble was that the dog was holding his left foot off the ground, I assumed it had started in his foot. I thought that if we had just caught this a few months ago, they would have been able to just remove his leg and we would have had a chance for a much better outcome.

But the vet explained today that the tumor started deep in his armpit area, between two major muscles. He said that's pretty much the worst possible place it could start. So even if we had caught it earlier, it still would have been difficult to remove; even then, it wouldn't have been a simple leg amputation - they still would have had to go in and take out a significant amount of under-arm tissue to get to it.

The other thing he explained - and maybe the vet last week also explained it and I just wasn't hearing her since I was in shock - is that this particular kind of cancer isn't encapsulated. Instead, it's as if it's growing along tree branches, branching out into increasingly thinner branches along the nervous system. So not only does the main mass have to be removed, but all of those additional strands of the cancer that follow those branches would also have to be removed. And removing all of the cancer cells with clean margins without damaging the nerves in the process is a very challenging thing to do.

As if all of that wasn't enough, the radiologist's final report indicated that we would have to remove not only the leg and a signficant amount of muscle tissue, but also at least one rib and possibly additional ones.

And odds are that in all of that, somewhere, some place, at least a couple cancer cells would be left behind. Which means that it would grow back, the dog would have a missing front leg, at least one missing rib, and would still lose the use of his hind leg on that same side. Given what we've seen with his hind leg in the last few days, it's possible that he could lose the use of it before he's even finished recovering from the surgery.

So instead, we're going to keep him as comfortable as possible until he's no longer himself, and then we'll make the tough call. In the meantime, we're having a pet photographer come over tomorrow to take pictures of the entire zoo, while he's still feeling well enough that we can get images of him as his usual self.

In the meantime, we continue to welcome all prayers and kind thoughts that you care to offer up, because sometimes sanity can be a very tenuous thing. :-)

The Doctor - Somehow, I managed to hold myself together very, very well during my annual physical over the weekend, which included filling out the medical report for the adoption recertification.

I decided to take the approach of being honest without oversharing.

The nurse reviewed my meds. They know I've been on anti-depressants, it's in my chart, but somehow this time when she ran down the list to ask me if I was still taking each of them, she didn't mention that one. Nor did the form ask specifically if I've taken them. And when the doctor listed my meds on the form, she didn't mention the metformin or low-dose aspirin, only the thyroid meds.

The form did specifically ask about diagnosis of mental illness (no), anxiety (yes), depression (yes), and a couple other things I don't remember. I pointed out to her that my previous doctor had diagnosed (and prescribed medications for) anxiety, but none of the meds worked and the "anxiety" went away when my thyroid problem was addressed. So she noted very clearly in two places that the anxiety diagnosis was actually a misdiagnosis and that the issue was actually my thyroid.

The depression isn't a misdiagnosis, but she also put down that it was situational and caused by multiple miscarriages and by all of the hormones I've taken, which is entirely true. Before we started ttc, birth control pills caused the first round of depression I ever had, and when I stopped taking those so we could start ttc, it went away. (Well, briefly, until we started getting all of the IF diagnoses...) And Clomid and progesterone also trigger it.

On the form we have to fill out, it also asks about professional counseling, so I wrote that we've participated in "grief counseling" after our 4th miscarriage, which was of a baby with a heartbeat that died, and that we've continued to participate "as needed" while we've gone through additional treatments and miscarriages.

My hope is that "grief counseling" (which is a very accurate description) sounds better than "treatment for ongoing depression because my body can't seem to hold onto a kid", and that the social worker won't feel compelled to make a big deal about that in the home study. If she doesn't, international adoption might still be an option for us. Time will tell.

It's Doggie Cancer, and It's Bad

2010-10-27T19:57:00.004-07:00

I hate when medical people lead you off with what sounds like good news, and then lower the boom.

When I was a freshman in high school, an aunt of mine wound up in the hospital due to an accident, and while she was recovering we got a call asking us to get to the hospital ASAP. I remember standing in a stairwell of the hospital with my mother (apparently all the consult or "family" rooms were occupied) while a doctor rambled on and on and. on. about her various health problems.

It sounded bad, but like there was still hope. Finally, I couldn't stand the sound of his voice anymore, and I just cut in and said "So you mean she's still alive, right?" And then he said, "No, she's gone. She died about an hour ago."

Everything went black, and he reached out to catch me as I collapsed. To this day, I still don't understand why he kept rambling incessantly when she was already gone.

This afternoon was a little like that.

We got to the vet's office, and the front desk told us the doctor was preparing the instructions. One of the vet techs handed us a couple of bottles of pills. She sounded so perky and happy, not like she was telling someone horrible news.

One of the bottles was a steroid. The vet had said if it was the best case scenario, steroids would be what the dog needs.

There were instructions to give him the pills for 8 days and then call to let them know how he's doing. "If it was cancer, they wouldn't want a report on whether he's improving," I thought.

Hope crept in.

"For once, we're not landing on the rare side of the odds," I thought. "Thank God."

Ha. When the vet finally came into the room, she seemed perky for a few moments, too. Then she told us it's bad. Very bad.

He has a rare nerve sheath cancer. It's big, and it's spreading.

If it was just in his leg, she would recommend "taking off" (they use that term, as if it's just a piece of clothing) his leg without a doubt. She says it isn't the kind of cancer that recurs in multiple places, so that usually cures it. And he's a strong, mentally tough but very happy-go-lucky dog, so she thinks he wouldn't be fazed much by losing the leg. I agree with that assessment of him.

But. But.

The tumor has spread, and it's now involving a couple of roots along the spinal cord and it's touching the spinal cord (I think at the beginning of the cord).

If it was in the cord, they would recommend palliative care until progression to the point that it was time to say goodbye.

However, from what they can tell, it's touching the cord but not within it yet.

So there is another option, which is take off the leg and remove as much of the tumor as possible. But they're not sure they can get all of the tumor cells where it's touching the cord, and if they don't, it will grow back. In that case, it likely will continue to grow down the cord, and then he will start to lose function of his hind left leg. (It's the front left one they would need to amputate.)

Chemo doesn't address this kind of cancer, and she said that the amount of radiation that would be needed to kill all the remaining cancer cells after surgery would damage the spinal cord.

The vet thinks he has 2-3 months without surgery, and maybe 6 months with surgery if they don't get all of it. If they do get all of it, he could have a normal lifespan (he's a cattle dog, they often live to 12-13 or longer).

The surgery would probably be at least $5,000. Maybe 6 months. But how do you put a price on time with a being you love, even if it's an animal? He has such personality. He's such a sweet, loving, happy dog. He just wants to play all the time - you'd never think he was 8 years old. We have 4 dogs, and he doesn't care what place he's in in the pack. Even with the limp and the pain he's been enduring, there have only been a couple of days when he hasn't been his normal, happy self.

If we don't do the surgery, our choices are put him down now or wait until he progresses further. I wouldn't want to keep him alive just for us if he isn't having a good quality of life.

On the other hand, how do you put down a dog who, when he is just sitting there looking up at you, you would think is 100% healthy?

We've had to make the tough call before, and we knew when it was time. But in that case, the dog went from being fine and us not knowing anything was wrong to suddenly being very not fine. Watching a dog progress slowly into "not fine" is a whole other thing.

I don't know what to do.

$5,000 is a lot of money. We're going to have big bills coming up for our next transfer. But on the other hand (and I realize this is my 4th or 5th hand at this point), would I be able to live with myself if we didn't try? It would feel like we were saying he isn't worth it.

Is it fair to do that to the dog? Is he better off if we just do palliative care until the time becomes obvious? Or is it better if we say goodbye now?

In some respects, it would have been easier if it had been the very worst case scenario, where the tumor was already growing down the spine and surgery wasn't an option.

This is a special kind of hell. I am so devastatingly sad.

Not to whine and fall into a pity party, but just how much more do we have to endure?

I understand that dogs die. They don't live as long as we do. I get that, I really do. But with the exception of one, it seems that ours don't even seem to have normal lifespans.

Need Doggie Prayers

2010-10-27T13:50:00.005-07:00

I think I've mentioned that one of our dogs has been limping. Mom and I took him to a veterinary neurologist this morning. He's undergoing an MRI.

He may have a very rare nerve sheath cancer.

It may be in his spine.

They may not be able to do anything about it.

We will find out in about 3 hours. He's the youngest of all of our dogs - he's 8. He's the only male pet I've ever had. I refer to him as our "baby boy". Out of the 3 dogs R and I have had together, one other one is still with us and the third one died several years ago of congestive heart failure when she was only 6.5 years old.

All I can keep thinking is "Are we destined to lose every creature we love like a child at an early stage? Does God really hate us that much?" 7 dead babies, 1 dead dog, possibly another.

I'm not coping well. And somehow, I have to pull myself together enough to attend a work meeting (thankfully over the phone rather than in person) in two minutes.

Gold Star Uterus

2010-10-23T21:01:00.002-07:00

Beta 3 integrin results are in: I tested positive, which is good. So between that and the other endometrial biopsy testing that also produced good results, I guess this means that my uterus isn't the issue.

Mo and Libby, in answer to your question about what the other biopsy testing was - they were checking for CD57+ cells, which they don't want to see, and FoxP3+ cells, which they do want to see.

I had none of the CD57+ and FoxP3+ cells that were "adequate in number, suggesting adequate stromal regulatory activity" according to the report.

So I guess it's looking like my immune system in general is the culprit.

We also got the results of the repeat bloodwork. While the NK cell levels in my uterus were good, they were still slightly off in my bloodstream. Not a surprise, as that was also the case during the transfers we did for IVF retrieval #1 a few years back. IVIg is still recommended, no surprise there.

My Leukocyte Antibody Detection levels (T cells and B cells) were also low, so LIT is recommended. And one of my Cytokine ratios was high, so Humira was recommended.

So, what's the plan?

I'm not doing the Humira. It has an increased risk of cancer, usually lymphoma, which is in the same family of cancer that my dad has (leukemia) and that his dad had (multiple myeloma). R and I decided pretty quickly that it's not worth the risk, and that view hasn't changed. If Humira is what's standing between me and a biological child, so be it.

I think we're going to do LIT. I'm still afraid of crossing the border, but we did go and get our passports yesterday and requested expedited processing. Two rounds are being recommended (3 weeks apart), so hopefully we can do the first trip in November and second trip in December.

We also plan to do the IVIg. And hopefully transfer in January.

At the same time, I'm ready to be done with this and move on to the next step. (Or so I say now - I realize I may sing a different tune if we wind up with one single line in January/February.)

To that end, I've contacted a local adoption agency to request a recertification application, and I've scheduled carpet cleaners to come out in mid-November. I'm not going to obsessively clean, but we have 4 dogs and 2 (indoor only) cats, and our carpet is just embarrassing.

I also need to work on getting a pool fence installed, and once we get the application completed and fence installation scheduled, I'll contact the social worker to do the home visit. If we can get that done by the end of November, we should have our certification around the time we get transfer results.

We haven't totally decided which way we would go on the adoption front. I'm still hesitant to do international for fear of being rejected. What I've decided to do with the home study is give the health forms to our family doc and mention that certain things would possibly disqualify us, but leave it up to her whether she thinks they are a possible impairment to our ability to parent and puts it on the form or not. (I haven't seen the form yet, so I don't know if it's a very specific questionnaire or if it just asks for a general statement.)

Then during the home study visit, if questions come up we'll answer them honestly, but we won't go out of our way to point out things that the social worker doesn't ask about. Once the certification is done, we'll request a copy of the home study and review what the report says and decide whether we think it would knock us out of the running internationally.

We'll see what happens.

Good News - Not Sure What To Do With This

2010-10-12T22:23:00.002-07:00

The results of the NK tests that were done on the biopsied tissue came in today. Apparently there are two types of cells they look for - one type is bad, so they don't want to see that in the endometrial lining, and the other is good, so they want to see lots of those.

It turns out I have none of the bad cells and lots of the good cells.

In other words, good news on one small front in the infertility fight.

It's been so long since we've gotten good news relating to infertility that I just sat there stupified for a minute. I don't think I trusted my brain to interpret what I was hearing, because I had to ask "You mean, my test results are good? Really??"

I'd like to think that this means my uterus isn't killing off the embryos, but I haven't heard the results of the other endometrial biopsy test (for the beta-3 integrin) yet, so I guess that thinking is still a bit premature at this point.

I sent an e-mail to ask the clinic when they think those test results might come in, so hopefully we'll also have that answer soon.

A Random Thought 'Dancing' Through My Head

2010-10-05T21:07:00.002-07:00

This is completely unrelated to anything about infertility, but...

I'm catching up on last night's TV, and can I just say - I hope I can move like Florence Henderson when I'm 76 years old!

I couldn't even dance half as well today, when I'm less than half her age. That lady is amazing!

Survived the Biopsy

2010-10-04T20:22:00.004-07:00

Apparently I should have researched the endometrial biopsy process a bit before undergoing it.

I was thinking that it involved literally snipping some of the uterine lining out, much like the sudden, sharp pain felt when a dermatologist uses that little tool to cut a chunk of skin out of your arm/leg/back/wherever to make sure it isn't skin cancer. At least, I assume it's a sudden, sharp pain, given the face R makes when it happens. Fortunately I haven't had occasion to undergo that particular form of torture.

Anyway, based on that assumption, I showed up to the appointment this afternoon more freaked out about a procedure than any other time I can remember in the last decade or so.

It wasn't fun, but fortunately it also wasn't as horrible as I imagined it to be.

Actually, for the first bit of tissue that local RE took, I just felt a little bit of mild cramping. Had the process stopped there, I would have classified it as "no big deal at all". But I'm having two tests done - the integrin-B (I think that's what it's called, too lazy to look it up at the moment), which RE is doing, and NK cell testing, which RI is doing.

Which meant that I had to have two bits of tissue removed, instead of just one. While the second bit was being removed, that was more like "lay in your bed moaning about really bad menstrual cramps" kind of pain. But I did a lot of deep breathing, and clearly I survived.

As soon as the second one was done, I took my feet out of the stirrups and sat up (probably subconsciously thinking that if I was in an upright position, he couldn't take any more tissue even if he wanted to).

Then he started to ask me about how many embryos we have, what protocol we used, what our next steps are. (Even though he's the RE I do all of my local monitoring with, so we've already covered this ground.)

But I tried to answer the questions anyway, and then I realized that my own voice was starting to sound a little bit distant and hazy and the room was starting to sway. Suddenly in the middle of a sentence about our protocol, I announced, "I think I'm going to pass out."

Fortunately I didn't, but they did have me lay back down and stay there for about 15 minutes. I don't usually get dizzy, and I've never fainted in my life, but I guess I had just stressed myself out about this so much that I got a little lightheaded with relief once it was over.

Oh, and after it was over, I found out that the tissue doesn't actually get cut out - some cells are sucked out with a pipette. If I would have realized that beforehand, I probably wouldn't have been so freaked out to begin with.

Big G.irl Pan.ti.es and a Biopsy Question

2010-09-28T22:35:00.004-07:00

After my meltdown a couple of weeks ago and the subsequent crankiness, I think I am finally getting myself back together.

A few years ago, at my previous job, one of my co-workers had a sign on her wall that said "Put on your big g.irl pan.ti.es and deal with it!" As silly as it sounds, that sign has stuck with me.

So, I have located said pan.ti.es** and am dealing with all the infertility crap.

We haven't made any solid decisions yet, but I am going forward with the biopsy next week. I figure for all the weight gain, bloating, acne, and mood swings these hormones have cost me, I might as well get a couple of test results out of it.

And speaking of test results, since half of the bloodwork I had done last time didn't produce results we could be confident in due to possible heat damage, I have decided not to risk shipping the blood again.

So, we are doing what we do best - medical tourism.

The lab is about 3.5 hours from my dad, and we haven't been to see him in about 6 months. So next week we're flying in to the airport closest to the lab after work on Wednesday, staying the night, getting blood drawn the next morning, taking the day off, driving a couple hours up the coast to San Fran, staying there for two nights (including working remotely the next day), catching up with one of my co-workers who lives there, going to the farmer's market at the Ferry Building (we're only to Saturday at this point, people), driving up to see my dad, staying the night there, and then driving the 3.5 hours back down to the airport and heading home.

How's that for a 96-hour itinerary?

I saw my therapist yesterday. She asked the last time R and I went somewhere on vacation - no medical stuff involved - just the two of us. And sadly, I had to reach back 5 years to our 10th wedding anniversary.

Surely we've gone on a vacation like that since then? But my hormone-addled brain can't remember.

Maybe we really haven't. And the 10th anniversary was not a full vacation, just a long weekend. And while we tried to avoid anything medical related on that trip, an adoption possibility came up in the middle of it and we wound up coming 'round a corner at one point during the weekend only to find foot-long giant sperm on the floor. (If you haven't been reading for that long - I can't even believe I've had a blog for that long! - you think I am making this up. I assure you I am not.)

I almost forgot...on to the question: What was your endometrial biopsy experience like? Did it hurt? Is the pain going to be so intense that I may be likely to reach up and smack the doctor? (Which I have been known to do in the past. But in my defense, I was 6 at the time.)

My uterus cringes each time I even think about it. And the thought "What the hell am I doing?" has crossed my mind more than once.

** I can only imagine what kind of visitors I'd get with that phrase if the periods weren't included!

The Perfect Symbol of My Mood

2010-09-22T21:59:00.002-07:00

The estrogen pills are making me cranky. They're making me gain weight at the rate of about half a pound a day, which really makes me cranky, but somehow I tend to think that I'd still be feeling cranky even without that highly annoying side effect.

Unless the pills made me lose weight at the rate of half a pound a day. Then I would love them.

But they aren't, and I don't.

And to top it all off, they make my skin break out horribly. Clearly my hormone levels are now even more imbalanced than usual - how can this possibly be helpful for achieving a pregnancy?

So here I am, highly annoyed by everything going on in my world (I hide that fact well, don't I?), including pretty much everything that poor R says or does. Me on estrogen is almost as unpleasant as me on Clomid. But at least on estrogen I haven't locked him out of the bedroom. Yet.

Tomorrow morning I have to get up earlier than usual, to fight traffic earlier than usual, in order to go have a lining check to see if I'm on track for the endometrial biopsy. I usually have RE's office e-mail me the order so that I can print it out and take it with me, rather than having them fax it to local RE and risk the fax getting lost or misplaced.

Being the model of efficiency, I printed out the order a few days ago. It's been sitting on the dining room table (aka the dumping grounds where my purse, piles of mail, etc. reside). So this morning I come downstairs and discover that the printed order is covered in cat hairball puke.

Pretty much sums up how I feel about the whole thing at the moment.

Lest you think I am completely without humor, I have thought of another addition to the "You Know You're an Infertility Patient When..." list: ...va.gi.nal discharge the color of a smurf is a completely expected occurance that doesn't phase you in the least.

Example A - Why I'm Too Tired For 'Big' (aka Post #250)

2010-09-18T00:00:00.003-07:00

I had the consult with the reproductive immunologist this morning. It did not go well. I don't think it went particularly badly, either, but then again, at this point my judgment on those sorts of things is probably a bit askew.

I did my homework. I Googled, I read a lot of info online. This guy is with one of the most prominent RI groups in the country. He had great reviews on Yelp. (Let's not think about what it says about me that I'm now basing medical decisions - at least in part - on a community review website.) So when they asked me if I had a preference of doctors, I decided why not, everyone seems to love him, ask for him. So I did.

And it's not that I hate him. Or that I need to love the doctor I'm working with - at this point, I'm far beyond that. But I think that's part of the problem - at this point, I'm far beyond pretty much everything, and apparently it is all annoying me.

Let's start with the fact that the first thing he tells me is that the tests run in his lab, which account for 15 of the 37 vials of blood drawn recently, produced really bizarre results, and he thinks the vials may have been damaged by the heat while in transit. So, he has no confidence in half of my test results, and I need to have another 15 vials drawn (along with another 5 from R).

Then as he runs down the list of other tests, which were run at a national lab chain, he proceeds to mention that those kinds of labs generally aren't as sensitive at detecting this as some of the more specialized labs are. (What was making him say this is that in the past, through a more specialized lab, I've tested positive for APAs, but this time I didn't.)

So if he has zero confidence in 99% of the test results, why are we even having the appointment at this point? Not a great beginning.

It didn't exactly get better from there. The appointment can basically be summarized like this:
- Based on the current (screwy) lab results, he recommends 1 round of LIT. Depending on what the re-test shows, I may not need LIT.
- Based on the current (screwy) lab results, it doesn't look like I need Humira. Depending on what the re-test shows, I may need Humira.
- Based on the current (screwy) lab results and past (more confidence-inspiring) lab results, I need IVIg. Regardless of what the re-test shows, I need IVIg. But those tests will be re-done anyway, because the current (screwy) lab results don't provide a baseline that he is confident in.
- I need Lovenox. It should be half the dose I've been taking, once a day, until positive pregnancy test, at which point the other half of the dose I'm taking should be added in via a second shot each day. Hematologists don't know what they're talking about when it comes to using Lovenox in pregnant patients. (RI's opinion, not mine. It was RE who told me to go to a hematologist in the first place; it's not like I wanted to add yet one more doctor to the mix.)
- I need dexamethasone, pre-transfer and through the first trimester. This will save me from having to remind RE that he very reluctantly agreed to prescribe it for me. So there's one small silver lining. I had to get out the magnifying glass to find it, but it's there.

Here's how I thought the appointment was going to go:
- You need IVIg. (Check)
- You need LIT. (Probable check)
- You might need Humira. (Check, as in it's still "might" at this point)
- You need Lovenox, baby aspirin, folgard. (Check, check, check)
- You need dexamethasone pre-transfer and through the first trimester. (Check)

So part of what annoys me is I feel like he's not telling me anything I don't already know. And isn't that what a doctor is for in the first place? But then again, that's not entirely fair - he did say something about also testing my seratonin levels, because seratonin plays a role in uterine lining development. (Or something like that - I admit, at that point I wasn't really paying attention to what it does, I was just thinking "okay, make that 16 more vials of blood that need to be redrawn...")

Then I made the stupid mistake of asking what he thought our chances were. (70%) He looks at my age and says "Well, you're dealing with 36-year-old eggs..." (which were actually 34-year-old eggs when they were retrieved, thankyouverymuch) "...have you thought about donor egg?"

Seriously. SERIOUSLY? That just floored me. Not because it's shocking that a 36-year-old would get the donor egg speech, but because it goes back to some of the themes from my previous post. We were 28 when we started this. Back then, every RE's office we sat in, they looked at us and said "What are you doing here? You're still just babies!" I kid you not, we heard the word "babies" - meaning the two of us, not the kid we were trying to produce - many, many times. (Part of it is because R has always looked very young for his age.) And now, we've been in this hell for so long that we've gone from "you're just babies yourselves!" to "you may need donor eggs".

I just made some sort of noncommital sound and moved on to another question. Because if I don't have the energy for something like LIT, there's no way I'm going to muster up the stamina for donor eggs.

When Continuing Hurts More Than Stopping

2010-09-14T20:59:00.002-07:00

When R and I first started undergoing treatments and I was new to the online IF world, I'd see women ask "How do you know when it's time to stop?" as they were trying to figure out the next steps in their paths. And the answer, invariably, always came: When it hurts more to continue than it does to stop.

As a relatively naive newbie back then, I couldn't exactly wrap my head around that.

I mean, really, how could it hurt less to stop trying (and possibly not have kids) than it could to sit in a chair and listen to your doctor rattle off all the (medical) things wrong with you and your husband and conclude by telling you that it just might never happen for you?

I planned to fight like hell until we got to the other side, regardless of what it took. I would just keep marching forward, doing whatever we needed to do, until we made it happen. As if determination is the only essential factor.

So we went through a lot, and still, stopping wasn't even a consideration. And then we lost baby #5 through miscarriage #4. And for the first time I started to understand, at least on a very vague level, how continuing could maybe hurt more.

But still, I wasn't ready to consider stopping.

So we continued to march: through a disasterous retrieval, a shockingly good retrival, thyroid surgery, and my dad almost dying.

And slowly, during all of that, I began to think about how much time we have spent. How much we have sacrificed, lost, to infertility. Financially, emotionally, time-wise, other dreams and plans. All in the pursuit of a dream that is still just as elusive now - if not even more so - than it was when we started in 2003. And how if we stopped, we could stop funneling all of our bank account to REs, we could travel without a medical purpose as impetus for the trip, we could buy a smaller house with a smaller mortgage and possibly work a smaller number of hours.

Then we had the most recent miscarriage in May. And we decided to pull out all the stops for one last attempt - antibiotic treatments, consulting with reproductive immunologists, even a biopsy to confirm that I have the beta-3 itegrin receptor (which is a good thing), even though RE is already pretty sure I have it.

No regrets. It's the motto with which I vowed to approach this entire process.

To that end, in the past month, I've had literally 37 vials of blood drawn. Ovulation could not be detected, so now I'm on estrogen, soon to be followed by progesterone, so a little piece of my endometrial lining can me snipped out of my uterus in a few weeks, sans general anesthesia. On top of all of that, it has been the most insane month of work in my entire life, and the next three or four will be just as crazy.

So I'm cranky. I'm freakin' tired. Exhausted, really. Bloated like a balloon and gaining weight at the rate of about a pound a day, thanks to the estrogen.

Then yesterday, all of the immune test results (accounting for 35 of the 37 vials) arrived. And I looked at the results. And I know with 99.9% certainty at least one of the things the RI is going to recommend is LIT.

And I Don't. Want. To. Do. It.

More accurately, I don't want to cross a dangerous border into Mexico to get it, and I don't want to drain our bank account to travel repeatedly to someplace like Europe for it. It's not the actual treatment I'm against, just what is involved in getting it.

So R and I talked about it last night. We didn't reach any decision yet. But we - or at least, I - did reach that moment. The moment where it finally hurts more to continue than it does to stop.

I don't know yet what we're going to do. R's feeling is go big (including LIT) or go home.

I don't know that I have "big" left in me.

You Know You're An Infertility Patient When...

2010-08-31T20:51:00.002-07:00

...the lab tech knows you by your veins rather than your name. "Oh, I remember you, you're the one I have to draw in the top of your hand instead of your arm."

...early morning his-and-hers lab appointments count as a "date". "But honey, it'll be romantic, really - we'll get to see the sunrise on our way to the lab." (It was a good effort, but he didn't buy it. Apparently his idea of fun at 6 a.m. involves sleep rather than a needle being jabbed into his arm. Imagine.)

More to come later (hopefully this weekend), but I just wanted to make a quick post since I've been quiet the last few weeks. Nothing majorly exciting going on, just beyond crazy busy at work. Since I was in a humorous mood for the moment, I figured I'd share...

As I Said...

2010-08-10T21:20:00.002-07:00

It's a week later. (Okay, 9 days, though I did actually test 2 days ago, so that part was exactly a week.) Anyway, as I said in my last post...still only 1 single line. And then CD1 showed up.

So, no big happy surprise.

I guess the cramping I was feeling just before we left for vacation must have been ovulation rather than implantation. I used to only have a few sharp pinches around ovulation time, but within the past year or so I've been noticing a bit of spotting around that time and cramping rather than pinching. I wonder if it means my ovaries are covered in scar tissue from all of the retrievals? They've each been poked with a needle more than 50 times, so I wouldn't be surprised.

Oh, and about the hot tub - thank you all for the advice. I decided to follow the prevailing vote and stay out of it. Oddly enough, no one else expressed interest in going in again all week, which was particularly surprising given the group we were with.

One thing I am happy about (in that odd way that only someone who's been dealing with IF for a ridiculously long time can be) is that at least my post-ovulation progesterone levels seemed to be higher than they usually are, given all the symptoms I had. So maybe my body is functioning in a semi-normal way in at least one respect.

And now, I need to cross my fingers that it continues to do so. I spoke with RI's office today. I'm still waiting for the test orders, but one of them will be an endometrial biopsy, which from what I understand has to take place at a certain point after ovulation. So I will be starting up with the OPK pee sticks in about 10 days. Given my ovaries' propensity to quiet down when I need them to work (and to work when I need them to be quiet), I could wind up going through quite a few sticks.

To that end - and since I kind of pigged out on vacation - I regrouped again yesterday to cut the refined sugar and caffeine out of my diet.

It's day 2. I'm hungry, I'm cranky, I'm sleepy, and I. Want. Sugar.

I've been eating fruit in an attempt to compensate - strawberries, raspberries. I cut up an entire watermelon last night. I eyed a banana as dessert. Of course, it would have been much better sliced up over a bowl of ice cream and chocolate sauce, but I figure I have to make it for at least 48 hours. :-) (Ideally, much longer.)

I know it gets better. It's just this initial withdrawl period that stinks.

I'm an Idiot

2010-08-01T20:54:00.002-07:00

In more ways than one. And I have the receipt to prove it.

Despite all evidence to the contrary, I still cling to the faint hope that I can be like a normal person who has sex, gets knocked up, and pops out a kid 9 months later.

R discourages hip-propping after the deed, figuring that I don't have much of a chance of producing a normal, healthy egg sans fertility meds. But last weekend I ignored him and did it anyway.

So then on Thursday, I started having really bad cramps. As in, I-can't-remember-the-last-time-I-had-cramps-this-bad cramps. I even went home early from work.

And I was ticked, because we were leaving for a week at the beach yesterday, and the last thing I wanted was to be dealing with AF. But I didn't start to spot or bleed.

Then last night it occurred to me that my chest is sore, which rarely happens outside of pregnancy. This morning, the back pain started, and I've been having AF-like aching and pains all day long. Which I thought were maybe round ligament pains.

So I made R take me to the store to buy a test (first way in which I am an idiot, as proven by the store receipt for the test). Of course it was negative, despite my hopes to the contrary (second way in which I'm an idiot). And then after taking the test, it occurred to me that given that we had sex last weekend, I could only be a week out from conception at the very most, so if anything these are implantation pains and it's still way too early to test (third way in which I'm an idiot).

But now I don't want to hang out in the hot tub with our friends, and there are two more pregnancy tests stashed in one of the dresser drawers, mocking me and tempting me. And chances are 99,999 to 1 that in a week I'm going to be coming back on here to post that 1) AF has shown up, or 2) Still no sign of AF, but the tests still show only one stupid line.

In other news...I had a phone consult with an RE who believes in immune issues. She recommended IVIg - no big surprise there. I finally got myself together enough to send off my records to an RI as well, so I'm waiting to hear what tests he wants to order.

My dad is doing well enough that his oncologist now thinks he is a candidate for a bone marrow transplant. (The level of cancerous cells in his blood is low, but on the other hand his marrow isn't producing much blood, so he's still needing transfusions all the time - hence the recommendation for the transplant.)

So his siblings are getting tested, and we're waiting for the results. Our next FET is on hold until we know more about what's going on with him and whether I'll need to be tested as a possible donor.

My mother is having memory issues, not to the degree that I think it's dementia but still to a degree that is unusual for her and something to keep an eye on. She doesn't believe this, so we had another big blowout in which she: 1) accused my husband of lying, 2) accused me of trying to make her think she has Alzheimer's, and 3) accused me of making her upset enough to have a stroke. (This, despite the fact that I never raised my voice to her, even when she was shouting at me.)

We are still living under the same roof as her, but now all of our communication with her takes place through e-mails, which are sent to her and then printed out, logged in a binder kept in the kitchen, and I even go so far as to make a copy of the log sheet every time I add to it, so that I have proof in case she ever tries to remove an e-mail and edit the log, because that is something she would do.

And she thinks the problem is us.

I've also been doing some preparations for Plan B. More on that to come in a later post, but for now I need your thoughts - do I spend the next week staying out of the hot tub on the very remote chance that this may be implantation that I'm feeling, or do I throw caution to the wind, climb in, and say "Whatever will be, will be"? If you were me, what would you do?

(Also, Peaches, you commented a few posts ago that you'd be willing to chat about surrogacy, but I'm not sure how to contact you as your name doesn't seem to link to a blog?)