When Continuing Hurts More Than Stopping

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...

...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...

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

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?)

A New Post

There's a new post below. Thanks to Mrs. LC's comment on it, I realized that I had forgotten Blogger's quirky habit of using the date you start the draft as the posting date, even if you don't publish the post until a later date. So Mrs. LC, you didn't miss it at all - I just published the post last night.

Phoebe, totally agree with your comments about acu. I wasn't surprised in general that acu would be recommended - our first IVF RE recommended it - I was just caught off guard that current RE recommended it, because he doesn't seem to be the type that supports that kind of thing. (He's referred to some other alternative treatments as "vodoo" - his exact word - in the past.)

I've done acu immediately pre- and post-transfer for all of my transfers, and I've also done it for several weeks leading up to one of the transfers in the past, although not the most recent one. I was comfortable with that acupuncturist, but I have two friends who recommend another one, so I may try her this time around. Your point about getting established in advance is a good one.

Decisions (Sort Of)

I'm starting to calm down a little bit. (I think, anyway.)

We've made our first decision - we're going to give my uterus another try, probably in September or October. To that end, I've scheduled an appointment next week to talk with another RE about intralipids, and I'm probably also going to consult with an RI. Regardless of which one we go with, it means yet another out of state doctor, so if we do the full gamut of treatments (including the IV antibiotics), this will be a pregnancy that involves four separate states. Ugh!

I've also scheduled another appointment with RE. Last time, I was able to get in the next day, but this time the first available appointment was a full month out, so it won't be until the very end of the month. When we had our WTF appointment, all we knew at that point was that my numbers were low and looked like they had stalled. I want to know how likely he thinks it is that this most recent pregnancy was an ectopic and just bad luck.

I also received a somewhat surprising e-mail from RE's nurse. RE wants my most recent thyroid tests (taken in mid-May while I was still pregnant - they were normal), and wants me to get my thyroid levels retested 10 days before starting the estrogen patches. I asked her if he was thinking maybe that contributed to the loss, and she said he's routinely keeping a closer eye on patients with thyroid conditions.

The other surprising thing was that he also wants me to do acupuncture twice a week for the four weeks before transfer. I didn't think he was into any alternative treatments at all, so this was a bit unexpected.

Nurse said it was because my uterine blood flow during one of the one-day workups was low. I think that happened because I forgot the no caffeine rule and had caffeine both the night before and morning of the ODW. I was super careful to avoid it in the weeks leading up to the transfer, though, so I don't think that was really the issue. But I truly appreciate that he is trying to think of anything he can that might make a difference this time around.

I also met with ob/gyn last week. Surprisingly, he didn't think a laparoscopy is necessary in my case. He said even if I do have endo, cleaning it out won't really help with staying pregnant, it's more of an impediment to getting pregnant. But I've seen plenty of women mention being on dep.ot lupr.on for a couple of months before an FET to treat endo, so I'll mention it to RE and see what he thinks.

With regard to all of the surrogacy and adoption stuff, I'm still vascillating. I keep researching it all, and one day I think one option sounds great, and then the next day I see something about that same option that completely freaks me out. (Like a couple who got all the way to their court date in Ethiopia, and then the judge denied their adoption because the adoptive mom had taken anti-depressants for post-partum depression for a couple months half a decade before, even though Ethiopia is supposedly okay with anti-depressant usage from a couple of agencies I spoke with.)

The idea of just not mentioning our issues is tempting, but then I worry that if we do that, God will strike us down for our lie of omission by allowing R's heart to fall into an abnormal rhythm that triggers his ICD while we're in Ethiopia, most likely at the exact moment we would be standing in front of a judge. Because we have luck like that.

So for now, I've decided not to make any other concrete decisions about next steps. I will just continue to obsessively research while hoping that maybe maybe maybe the next transfer will be the one. Perhaps I should consider putting back 4 or 5 - you'd think out of that many, at least one would stick for the long haul.

(Yes, I am just kidding. Kind of.)

In the Wrong Club

I got a phone call this morning. I didn't recognize the number, but against my better judgment, I answered it.

It turned out to be a nurse from our health insurance company, calling to tell me that they had enrolled me in a special program. I assumed she was talking about a diabetes program, because I get calls like that from time to time. (I take metf.ormin for PCOS, and they mistakenly assume I'm diabetic.)

But this time, it wasn't about diabetes.

Oh, no. Instead, it was "I wanted to congratulate you and let you know we've enrolled you in the Healthy Baby Club program we offer..."

HA. HA HA HA HA HA.

I was tempted to say, "You know, I'm more of a Recurrent Pregnancy Loss Club kinda gal", but I behaved myself. I know it wasn't her fault - she just gets a list of people and is told to call them.

Apparently when they're generating these lists, they don't write algorithms to detect "fertility treatment codes followed by 10 hcg tests within a 5 week span, an ER visit and a very very early ob/gyn visit" and spit out a result that reads "WARNING: POTENTIAL PROBLEM. Call patient at your own risk."

Family Ties - A Pleasant Surprise

Occasionally, the horrible, painful, nightmarish situations in life can also cause something good to happen that otherwise wouldn’t have happened. I was reminded of that this week when I received an unexpected phone call.

Before I share more about the call, it would help to explain a bit about my family history.

I grew up with a very, very small immediate family. I was an only child, my mom was an only child, and although my dad has several siblings, most of them didn’t live nearby and I only saw each of them maybe once or twice that I remember while I was growing up.

To put it another way, when R and I got married, the picture of us with my family includes a total of 6 people – the two of us, my parents, a cousin (second cousin or twice removed, something like that since my mom didn’t have siblings) who was about 30 years older than me who I’d only ever met once, and the cousin’s husband. On the other hand, our picture with R’s family includes about 30 people, about 20 who traveled from out of state during the holidays to be there for us.

So you get the gist – I don’t really have a lot of close family connections.

When I was young, I begged my parents for siblings, but no such luck. Then one day when I was about 8 years old, my parents sat me down to tell me something: while I was an only child (my mom’s), I was also the youngest of 4 – my dad had 3 children from a previous marriage. That little bombshell caused some trust issues no small kid should ever have to have with their parents, but that’s a story for another post.

Anyway, it turned out that my siblings were in the tween and teen stages, and their mom had called my dad to say she was putting them on a bus and sending them to him for the summer, so my parents were kind of put on the spot and had to tell me. (There was a lot of acrimony between my dad and his ex-wife, who lived in another state, and he wasn’t able to see them much.)

So I got to spend the summer with them. That was 28 years ago. Other than that, we haven’t had much contact. There was some resentment on their part – as if I had taken their dad away. I understand it, and it doesn’t seem to be there as much anymore (my brother still brings it up occasionally), but it was uncomfortable to bear the brunt of that resentment as a child.

Since that summer, I’ve seen my oldest sister twice (once about 26 years ago and then in December, when dad was in the hospital), my brother twice (ditto), and I haven’t seen my other sister again. We've only talked on the phone a couple times more than that.

It’s always felt weird to know that I have siblings out there, but being raised as an only child, I didn’t have the opportunity to form the normal sibling bonds. As an adult, still living in a different state from them and not having a lot in common, it hasn’t gotten any easier.

So while we were in touch more while dad was in the hospital, I didn’t really share much about the infertility stuff we’ve been dealing with.

And so – back to the phone call – you can imagine my surprise when my oldest sister called me earlier this week and said that her daughter, who’s in her early 20s and has a toddler, would be willing to be a gestational carrier for us.

(Don't get all excited yet.)

Dad’s wife had asked a couple of weeks ago what our next steps are, and I told her that our doctor’s recommendation is to use a gestational surrogate. Then apparently dad called my sister and suggested that maybe she could be the surrogate, not realizing she had had a hysterectomy. So my sister asked my niece and then called me.

I don’t know that it will be a viable option for a variety of reasons, and even if it is, I don’t know that it’s an option we will chose to pursue anytime in the immediate future.

But I was really touched by the call and the offer. I spoke to my niece (who I met for the very first time in December), and asked her if she was sure she wanted to do this and why she was willing to do this for us when we haven’t really been in each other’s lives.

She sounded kind of surprised that she had to explain it to me – she said “That’s what family is for” in a very matter-of-fact, isn’t-this-what-every-famly-does kind of way.

It turns out my family is bigger than I thought. It’s still kind of a hard concept to grasp.

Finally

Beta #10 is negative. I can't believe I did a little happy dance over a negative beta, but I did.

The phlebotomist this morning said, "You, again?? Another stat hcg?" I think he's going to miss seeing me all the time.

Bouncing Around Like a Ping Pong Ball

Me without a plan is not a pretty sight.

I have been (figuratively, at least) all over the map this past week in trying to decide what to do next. Last Tuesday, about 2 minutes after R walked in the door, I announced that I didn't think we'd qualify for my first choice country for international adoption. He didn't even know I was thinking about international adoption.

On Wednesday night, he finished a work-related call and then walked into the room to find me e-mailing potential gestational surrogates. By Thursday I was on the phone with one of them. (I don't think that particular situation is going to work out.)

At dinner on Sunday, I announced that I thought we should consider a different country. Then that night I received an e-mail from an old Resolve friend who highly recommends a local domestic adoption agency that R wants us to consider working with. Over the past several years, there have been several people who have mentioned that particular agency to me, and every one of them has had good things to say. I've searched online for opinions about them, and I honestly have not been able to find one negative thing.

Poor R's head is spinning. And he's wondering what country (or other crazy option) he's going to come home to tomorrow. :-)

All of those may be future options, but for now, I think our next step is Option #1 - trying again with me.

It pretty much comes down to something Mo said in a comment that Blogspot seems to have somehow eaten, but thankfully not before it landed in my inbox: "If you don't know that you've lost pregnancies to nonchromosomal issues while being treated for the thyroid/factor V, then I still think carrying on your own might be your best shot."

Technically, this miscarriage would be the first one we've lost while I was treated for Factor V and thyroid, and the embryo was presumably normal given the CGH results. But given that this one also looks like it was probably ectopic, it could be that this one was just bad luck. So I think it may reasonable to give it at least one more shot.

There's one thing I want to look into first, though - the possibility of endometriosis. When I saw ob last month for my RhoGham shot, it was a very hastily arranged appointment, and his office didn't have a chance to get my chart from the office where I usually see him to the office he was at that day.

In trying to remember my history, he asked about endometriosis. When I told him I haven't had any of the symptoms of it, he said that many women don't have symptoms. Then he proceeded to tell me about a friend of his who asked him to go to the ER with her because she thought she was having appendicitis. It turned out that instead of appendicitis, it was the worst case of endo that ob had ever seen. He said he couldn't understand how she hadn't had pain before then, but she hadn't.

Here's the thing: I've been to the ER twice in the last four years with symptoms of appendicitis. The second time, the ER doc was so sure it was my appendix based on his exam that he had the nurse call down to the OR and tell the on-call surgery team (which had been called in for another case) to stay put because he was going to be sending down an appendectomy. But both times, CT scans showed that my appendix was just fine. So they sent me home, saying "We don't know what it is, but we know it's not an emergency."

And - this will sound incredibly stupid - when I poke around to the right of my belly button, there is pain. I first noticed it a few months before the first "appendicitis" attack. I was gearing up for IVF #1, and I was poking around on my stomach trying to figure out where I was going to do all the shots. I noticed it hurt when I pressed (not particularly hard) in some areas. But then I got sick the next week with a lot of GI symptoms and eventually wound up with a diagnosis of IBS, so I always assumed it was that. Even now, I avoid giving myself shots in the area where I most commonly feel the pain. It tends to sting like crazy when I do them there, so I generally choose my left side for the shots.

So, the really stupid part - it's honestly never occurred to me to mention this to an RE. And all of their questions about endo have been along the lines of "Does it hurt when you have sex?" (no), not "Do you ever feel like you're having appendicitis?", so the subject has just never come up.

I have an appointment in two weeks to discuss this with ob. I've also sent a note to RE's nurse explaining the appointment and asking if RE would want to weigh in on this if ob recommends a laparoscopy, but I haven't heard back yet because nurse was on vacation last week.

I'm not quite sure if this is truly a legitimate concern/possibility, or if I'm just a crazy person grasping at straws.

Coming Full Circle

Beta #9 was yesterday, and it was 11 - the same as the first beta in this cycle.

So, yea that it's going down, but boo that it wasn't 4 or less. Beta #10 (hopefully the last one this time around!) will be next Friday.

I've seen the phlebotomists at the lab so often lately that they feel practically like family at this point...

More to come about the post before this one, but first I'm going to try to tackle two papers for school and clean up the house a bit - wish me luck!

The Options

I keep going 'round and 'round in my mind, trying to figure out what to do next. Trying to figure out what the heck will get us to the point we actually want to be at - parenthood. But I think I'd have better luck trying to see through walls at this point.

There are a few different options we're mulling, a couple of them with some variations we need to sort through. I tried (but didn't really succeed) being brief in outlining them. Feedback is more than welcome, so feel free to chime in with your thoughts. Things couldn't possibly get more muddled. (I don't think, anyway.)

Option #1 - Another FET with me (i.e. the not particularly hopeful option in my last post)
Pros: We have embryos to work with. I tend to get BFPs with FETs. Insurance will cover the transfer. I have leftover meds from this time around. We're very familiar with the drill. This most recent loss looks like it was ectopic, so maybe it was just bad luck and this could still work.
Cons: The obvious - 6 pregnancies, 0 babies that made it to the 2nd trimester, much less birth. So the odds of success are not in our favor.

Aside from that, there are still costs involved, and the actual FET may be the least of the costs. I want to do intralipids for the next FET, which will involve finding a new doctor, most likely a reproductive immunologist. That requires time, energy, and probably at least $2,000, since RI's don't tend to take insurance. And I think I probably want to do IV antibiotics too - might as well throw the kitchen sink at this if it's our last attempt. Insurance paid for some of it in the past, but there's still travel costs. On top of all that, I have an appointment with ob/gyn at the end of the month to talk about whether I may possibly have endometriosis. More on that in another post.

Option #2 - Gestational surrogacy (i.e. the not particularly realistic option in my last post)
Pros: We have embryos to work with. RE thinks our chances with this approach are "absolutely excellent."
Cons: The cost. We're not independently wealthy. There is no money tree growing in the back yard. If we were, or if there was, we would have turned to this option a couple of years ago.

We've started tentatively talking about this with some of our friends, but no one has come forward to volunteer to carry for us. (A lot of our friends have either had infertility issues themselves or difficult pregnancies with complications that make surrogacy not a viable option for them.) None of our family members are particularly good options, either.

I've done some research into the costs. We're looking at $10k for the testing/transfer, $7k to $10k for legal fees (we would probably have to go independent through an attorney, because an agency would be too expensive), $3k to $5k for travel and miscellaneous expenses like maternity clothing, $20k to $30k for the GC's fee and $20k to $30k for medical insurance for the GC if she doesn't have it.

So we're talking $40k at an absolute minimum (assuming she has insurance) to $85k at the top end. And I would already be out there working a second job and trying to figure out any other way we can come up with the money to do it, except for one thing:

It's a $40k to $85k gamble.

There's no guarantee at the end of it. We would pay the $10k testing/transfer fees up front, as well as at least $5k to $7k of the legal fees, and part of the medical insurance fees if applicable. Then, if there is a BFP, there are small payments made at that point and at the first ultrasound that shows a heartbeat, then the rest of it is paid in monthly installments as the pregnancy continues.

And if something goes wrong at the end and the baby is stillborn or there are complications and the baby dies, we will have paid out all of the money, and have only a dead baby to show for it.

I know that stillbirths are not common, that the odds of us getting to the end of a pregnancy and having complications and having a dead baby are low. But they're not non-existant, and we've been on the wrong side of the odds so many times.

And I think we're at a higher risk than average for those things, because there's a 50/50 chance for each of our embryos to have Bru.gada's Syndrome. There's research that seems to be showing that at least half of all SIDS deaths may really be because of Bru.gada's, so it seems reasonable to think there's also a greater risk of a fatal irregular heart rhythm (which is what Bru.gada's is) in utero, when nothing can be done about it.

R and I are not gamblers to begin with. I really don't think I could lose yet another baby, lose $85k, and still somehow manage to pull myself together again after that. Not to be dramatic, but in total seriousness, that could be just the thing that makes me shatter irrepairably, and I don't think I can risk that.

So unless Ed McMahon shows up on our doorstep with a giant check (is he even still alive?), this option just doesn't seem very realistic.

Option #3 - Adoption (i.e. the not particularly appealing option in my last post)
Pros: Sometimes this works, for some people. If my understanding of recent adoption tax credit changes is correct, we may be eligible to take the credit again, which means this could potentially be the least expensive of all the options.
Cons: We've been badly, badly (did I mention badly?) burned by this option in the past. Badly.

When I say it's "not particularly appealing", I don't mean that I dislike the concept of adoption. In fact, for those of you who haven't been following this blog for the entire time, R and I turned to domestic adoption before we turned to IVF.

And we were lied to (about a birthmom's intention to place), lied to again (about a birthfather situation), and lied to yet again (about drug use). Those were all birthmoms who truly had babies - that doesn't even count all of the scams we encountered but thankfully didn't fall for by women who weren't even pregnant. We spent $30k on those efforts, and we couldn't keep putting ourselves through the heartbreak and feeling being taken advantage of, so we let our homestudy expire and faced the reality of needles and egg retrievals, etc.

So I'm very, very wary about this option. (Okay, yes, "bitter" may be a more accurate word.)

We chose domestic adoption at the time because we wanted to start with a newborn. Now we're more willing to let go of that ideal, and we would be willing to pursue international adoption.

Except, I don't think we're eligible.

R and I both take thyroid meds and anti-depressants, and R has a defibrillator. Granted, he's never had any sort of irregular heart rhythm except the ones induced by medication while he was undergoing an EP study in the cath lab. It's just a kind of insurance policy, in case he was to go into v-fib.

But still, I've made some inquiries, and it seems that other countries frown on the idea of allowing someone to adopt when they have a medical device implanted in their body on the off chance that their heart suddenly goes into a wacky rhythm. And even if he didn't have that, anti-depressant use is highly frowned upon (even if it's past use and not presently being taken), and even common thyroid meds are apparently enough to knock you out of the running.

I've thought about lying - I mentioned these restrictions to our family physician, who said it was ridiculous and has no concerns about us being parents given our health situations, so might be willing to give us a medical clearance - but I tend to be a horrible liar, even when it's a lie of omission. And R, whose character is one of the things I love most about him, vetoed the idea.

So, now that we're at the point we're willing to consider international adoption, it appears to no longer be an option for us. And that one seemed like the closest you can come to a "sure thing", so it's been a bit disheartening.

So yes, we have options. But of the ones that are practical, they don't feel particularly likely to get us to where we want to be - out of this maze, with a baby in our arms.

An Attempt at Being Positive

I realize all of my recent posts have been downers. Honestly, IRL I don't walk around with a 10-foot field of negativity radiating from me - apparently it all just comes out online.

So, I decided to post a couple of happy things. On the bright side:

I've lost another 5 pounds in all of this. No good reason for it, it just seems that my body is now at a stage where it plateaus for 4-5 weeks then suddenly drops 5-7 pounds with no warning, then plateaus again, drops again, etc. etc. So at least the scale is saying nice things (relatively speaking) to me.

I called my insurance company to find out how much of my $10k infertility benefit is left, because we need to know that in weighing what to do next. I was kind of afraid to do it, because I thought maybe it would make them re-evaluate my claims and find some infertility ones that they overlooked. But I figured we have to be pretty close to the $10k at this point, so really what did I have to lose?

Imagine my shock when they called a few days later to tell me I've used less than $3,800 of it! And then they even sent me a follow up letter stating that fact, and a printout of the spreadsheet that shows which claims counted toward that amount. So I have good news from an insurance company, in writing. If the earth feels like it's a little bit off of its axis lately, that's probably why.

The $3,800 is for one fresh retrieval and one FET. Apparently most of what is billed falls under diagnosis codes other than infertility ones. Last month's FET counted for $840 toward that amount. So technically we have enough of a benefit left to do about 8 more FETs. Not that I see that happening - I don't think RE will allow us to use my uterus much longer.

And speaking of using my uterus again, yes, that is one of the options we're debating. It's not that we don't have options, it's just that none of them (for various reasons) seem particularly hopeful/realistic/appealing to us at this point. But this is supposed to be a happy post, so I'll save the rest of that for later.

Oh, and one other happy thought. I'm taking next Monday and Tuesday off work so that I can have a long weekend. I figure after this past month, it's the least I can do for myself. :-)

The Never-Ending Miscarriage

Beta #8: 96. So it's still going down, but slowly. Beta #9 will be next Friday - I think I'm going to set a new record for the most betas ever during one cycle.

In the meantime, I'm trying to figure out what the heck our next step will be.

For once, I'm a woman without a plan. For someone who usually has a backup plan for the backup plan, this is a new feeling.

And it's one I'm not sure I like.

It's Almost Over, Really (I Think)

Out of all the miscarriages I've had, this has definitely been the most unusual one. Typically, my numbers go up, my numbers come back down, the end.

Not this time. Beta #5 (last Monday, 8 days ago) was 188. The bleeding that had started 5 days before that (and seemed like a full period) was pretty much winding down by that point. Beta #6 was Friday, and there had been no bleeding at all for a couple of days by then. It was 187.

The nurse wanted to talk about a D&C or methotrexate, but I wasn't ready yet. They were concerned about the possibility of an ectopic, but I wanted to push it out a bit to see if we could get confirmation that that's really what was going on. (My logic being that if it's truly an ectopic, then I can hold out hope that this cycle was just bad luck. In all my other miscarriages, my beta was back down below 5 by time time I stopped bleeding, so it seems strange to me (and the nurse agreed) that my beta would still be that high even after I stopped bleeding.) She made me promise to call if I started having any pain or other symptoms.

We didn't wind up with official confirmation, but I'm about 95% sure that's what it was. On Saturday, I woke up to pain on the lower left side of my pelvic area. It wasn't super sharp, but it wasn't dull either. It was pretty constant, but I didn't want to call RE's office, because I knew they'd tell me to go to the ER. Then when I went to the bathroom that afternoon, there was bright red blood again. Not a lot, but it struck me as strange seeing as how I'd just ended a week's worth of bleeding a few days before.

So I called. And they told me to go to the ER. And I had blood drawn twice, because the doctor decided to order one more test after the nurse had already drawn blood. And the nurses kept marveling that I wasn't a sobbing, hysterical mess. And I was treated to the lovely experience of a bladder catheter. And the ultrasound tech wanted to do the trans vag portion of the ultrasound with the bladder catheter still in place! (A word to the wise - never, ever. Ever. let someone try to do that to you.)

And after 7 hours in the ER, we were told mostly what we already knew - that my numbers were too low to show anything on ultrasound, so they couldn't be certain it was ectopic. But the one new thing we learned was that my hcg level was down in the 120s. So it seems to be moving in the right direction at a pretty significant pace.

The pain went away by Sunday morning, although the bleeding is still continuing, at that same small rate as it was on Saturday. Beta #8, to confirm that the number has gone back down below 5, is scheduled for Friday.

This is the first time I've ever wanted a pregnancy to be over.

It's Not Over, After All

Not yet, anyway. But it's not good, either.

Beta #5 was drawn yesterday to make sure that my levels were going down. Last Wednesday, beta #4 was 45. Yesterday it was 188. That's a doubling time of 58 hours - not great, but definitely within the 48-72 hour doubling window.

I freaked out when RE's nurse told me, and I asked if it was possible that we stopped the meds too early on what could still be a potentially viable pregnancy. She said no, RE still thinks it's a non-viable pregnancy and that it may be ectopic.

My last pregnancy implanted in my uterus right next to one of my tubes; at first, the obstetric radiologist thought it was in the part of the tube closest to the uterus. So I went for an ultrasound this afternoon to see if it was possible to get any sense of where the pregnancy might be.

The ultrasound didn't show anything; given my levels, it's probably too soon for anything to be visible. But the doctor reviewing the ultrasound kind of confirmed what I was concerned about - when he came in to tell me what he thought of the images, he said "It's too early to tell whether this is a viable pregnancy or not."

I said, "Well, at this point I hope it's not, because I was told to stop my meds 5 days ago." At which he started backpedaling and saying "Well, it's very likely this isn't viable, I'm sure they know what they're doing."

But now, if this isn't definitively determined to be ectopic, I will always wonder if I should have kept going with the meds.

Beta #6 will be on Friday, unless I bust a tube before then...

It's Officially Over

Today's beta was 45, so it was only up 2 from Monday. No big surprise there.

The nurse didn't say much, other than that she had thought this cycle would work for us. Yeah, well, REs, nurses, and financial coordinators have been thinking that for seven years.

I scheduled a follow up with RE for tomorrow afternoon, and I also asked the nurse to have the surrogacy coordinator call me. We will probably try one more time with me if we can, but I have a feeling it's time to start looking for a uterus to borrow.

Thank you all for the support and kind words.

Oh, and I thought of Upside #11 while I was in the shower this morning - no more having to scrub my skin raw to get the sticky estrogen patch residue off.

Oh, and one more thing. My mother is not speaking to me. Instead of just simply saying "I'm so sorry, I wish there was something I could do", she started a conversation with me this morning that began with "Aside from you and R, I'm the one most impacted by all this. This is really upsetting to me, and I'm really hurting because of this, too..." (This, after last Friday she implied that perhaps we're not having any luck because we're not praying enough or not praying correctly.)

After she said that this morning, I told her I didn't want to talk about it, but she kept pushing. Finally I just had to walk away while she was still talking to me, so now she says she's just not going to talk to me any more. Ever again.

Fine by me. She's been diagnosed by a psychologist (who she saw) as having narcissistic personality disorder, and another one (mine, who hasn't seen her but has heard the stories) also suggested it was NPD without me mentioning she'd already been diagnosed as such. So I know that part of it is just who she is, but frankly, I don't have the energy to even care.

There is Blood

Perhaps I shouldn't have said in my last post that there hasn't been "even a speck of spotting"...

I got up at 1:30 this morning to go to the bathroom. I wiped. I totally did not expect blood. I gasped, because there it was - and not just a speck, either. It looks like the beginning of CD1, and there was even a little bit in the toilet, along with a tiny little clot.

Please don't say lots of women spot or bleed during early pregnancy. I know, because I'm one of them. And every single time, it has marked the beginning of the end.

I'm sitting on the floor of my closet typing this, so that I don't disturb R. I want to throw myself on the ground and cry, wail, have a tantrum, but the emotion won't come. I'm numb inside - there have been a few tears, but no sobbing.

We've failed. At the place that is supposed to be the holy grail. At the place that is supposed to be our last (and best) shot.

I was going to get up early, go to a lab near my office, then go in to work for most of the day. Instead, I will be showing up at a lab near my house, without even showering first, and attempt not to cry during the draw. (I didn't even tell you guys about how I completely lost it during Saturday's draw when the phlebotomy tech started complaining about how she was tired of being pregnant and is annoyed that she still has five more months to go. I will be going to a different location today.)

Then I will come back home, get on an 8 a.m. call for a big, very visible project that I was assigned yesterday, and then cancel the rest of my meetings for the day and await the call with the number, probably while downing copious amounts of sugary desserts alternating with fried foods.

But, because hope is a **tch this way, this time I will not take off the patches or skip any doses until I'm told to. Because, you know, maybe just maybe the number will still be good. Ha.

Less Than 24 Hours 'til Beta #4 Results Are In

Tomorrow (Wednesday) morning is beta #4. We'll see how it goes. I'm trying to be hopeful, but I've gotten so good at building a wall of defenses against the pain that I've actually seriously kind of forgotten how to be hopeful.

But I haven't had even a speck of spotting, and I've continued to have a lot of aching types of feelings that I hope means the placenta has kicked into gear and is growing at a rate that will translate into a strong rise in hcg.

I'm going to leave the office to work from home tomorrow afternoon as soon as I can, so hopefully I will be home when the call comes and I won't have to wait until the day ends. I'll post as soon as I can.

Officially in Beta Hell

After Saturday's freakout, I managed to find a very Zen place yesterday. Today, I was even hopeful and somewhat optimistic, which is rather impressive for me.

But today's number was only 43 - it didn't double this time, it only increased by 67%. Which I know is technically still within the "normal" range for rate of increase, but I think it's worrisome that I went from a 133% increase all the way down to 67%.

I'm supposed to get another beta on Wednesday, and progesterone retested in about a week (assuming I make it that far).

I'm not feeling good about this. (Shocking, I know.) Particularly since I found this study that says "Patients with slow rising beta-hCG levels should not be given an optimistic prognosis even if viability is demonstrated at eight weeks."

So apparently, we could go along for another couple of months and still not have a good outcome. But then again, I already knew that, because it's happened before. It's just that if this is not going to end well, I'd at least rather it end now instead of two months from now...

Um, I Spoke Too Soon

Crap crap crap crap crap.

I hadn't gotten a call by 4:45 p.m. Denver time, so I called the clinic. They hadn't received any results from the lab. I explained that I was there before the doors were opened and was among the first 10 people to be drawn. So the nurse called the lab to track down my results.

25.7.

Yea, hurray, it more than doubled. Except that I had taken off the estrogen patches and hadn't done any of my morning meds.

I was too scared and mortified to confess this, so I didn't ask her what I should do. R and I were out with some friends, so I made up an excuse to have him take me home right way. Then I took all the pills and slapped some more patches on. Tonight is the night I would have had to swap them out anyway, so hopefully the vast majority of the estrogen from those patches was already in my system.

And then I panicked over the progesterone. The insert that came with it said if you miss a dose, just take it as soon as you remember, but don't take more than you normally would in one day. It didn't say anything about if it's close to your next dose, just skip it and resume your normal dosing schedule. So I took two - the one I missed this morning, and the one that I would normally be taking mid-day.

Then I laid down in bed and started frantically Go.ogling "forgot progesterone IVF", and about half of what I read said don't double up on the dose.

So then I panicked in the opposite direction and tried to, ahem, remove one of them. It turns out that once you stick those little suckers in there, it's pretty much impossible to get them back out. Especially if some time (the 15 minutes I spent searching online) has passed and they've started to dissolve.

So now I am just completely freaked out all the way around. And if this fails now, I will feel like this is why and it's all my fault. And hope has risen again. In fact, when the nurse called me to tell me she was waiting for the lab to call her back, she said, "I looked up your results, and you were at 11. A lot of times FETs have lower numbers, so I don't think this is over yet by any means." She was definitely a lot more optimistic than the nurse on Thursday. She said they will want me to keep getting draws every other day until the number is at least above 100.

So, lesson learned: No matter how faint the second line is, hell, even if there is no second line, and even if all your bloating goes away and you wake up feeling like you're not pregnant, and you've been around this mountain 5 times already, don't stop taking your meds until you get the official word.

It's (Unofficially) Over

I took another test this morning. The line was even more faint than the one I made my mom look at Wed. night. The only surprise in that was I didn't think it was possible to be even more faint and yet still visible, but it was.

My best guess is it will be a 4. Anyone else want to take bets on the number? Sadly, I have no good prize to offer - only bags full of needles, meds, and other shot-related supplies. And lots of hard earned, painful wisdom to share.

Speaking of wisdom (or in this case, the lack thereof), after I saw that pathetic line, I took off the estrogen patches, didn't bother to cram in another suppository, and skipped the es.tra.ce and folic acid pills. I even got a caramel mocha Fra.ppu.cino on the way to the lab. Who cares about the caffeine at this point?

On the off chance there is anyone here who is still relatively new to this process (unlikely - my story probably scares all those types off as soon as they read my profile and realize this hell can last for the better part of a decade or more): don't do what I've done. Wait until you get the official results first.

But once you've gone through five losses, you pretty much know the trip around the mountain by heart, so at that point you can be stupid and stop your meds early and not worry about whether you've just screwed up your chances, because you know you haven't.

Hell, if I was the type who drank, I'd probably have looked for a place I could stop and pound a few back on the way to the lab. (Though come to think of it, if I did that, that's probably the time fate would stick its tongue out at me and give me a tripling beta...)

Instead, as I type this, I'm sitting in a beach chair (i.e. my butt 2 inches off the ground) in an asphalt parking lot with the sun beating down on me (the line begins to form an hour before the lab opens), waiting for someone to jab me so that a complete stranger can call me in a few hours to tell me what I already know...it's over.

Looking on the Bright Side

You'd think by now I'd be prepared for this kind of news. I spent a few minutes freaking out one of our dogs by holding onto her and sobbing into her fur coat. The poor thing usually sticks right by me, but by the time that was over, she fled with a rather confused and wildly panicked look in her eyes.

And then, since I figure there will be plenty of time for a wailing, whiny, self-pitying post soon enough if the situation doesn't improve, I decided to focus on the bright side for now.

So here's my Top 10 List of the Upsides to This Ending in Miscarriage. (Keeping in mind that the difference between "bright side" and "dark humor" is a very fine - or should I say faint? - line at this point...)

Without further ado:

10. I can pick things up without first having to contemplate whether they weigh less than 10 pounds.

9. The ugly yellow-purple telltale Lo.venox blotches on my stomach should disappear in, oh, two or three months.

8. I can be kind of weird about numbers, in a slightly OCD way. This would be m/c number 6 - a nice, even number. An even half dozen.

7. I can blow my nose without R worrying about me using stomach muscles.

6. I can focus on losing more weight, to reduce my risk of pre-eclampsia and hopefully be able to stay under 200 pounds even at full term. Funny the things I worry about when I can't even manage to stay pregnant for 5 minutes, much less 5 months...

5. I can take a second class this summer, because if I'm not incubating, it doesn't matter so much if I spend 12 weeks doing nothing but working, sleeping, and studying. Though I don't know if I could also cram any sort of meaningful weight loss in, so that may merit additional consideration.

4. The dry spell is over. (Even if I wasn't all messy with suppository goo, there's no way we risk sex while I'm incubating.)

3. Caffeine, here I come. Frappucinos, Pepsi, Cherry Coke, and chocolate. Lots and lots of chocolate. Actually, I got a head start on this one - there is a pan of brownies cooling on the counter as I type.

2. I will be able to fit into all those clothes I just bought for longer than the next two months. (Well, I suppose this depends on how much chocolate from Upside #3 is involved...)

1. It's an excuse to get dressed up and go out somewhere where I can wear the sexy, strappy shoes I will rarely have an occasion to wear. Because nothing says celebration like yet another miscarriage.

(Mo, perhaps there's a postcard somewhere in that last sentiment?)

Beta #1 is in

And it's a whopping 11. Should be at least 50. Progesterone is 6.8, should be a minimum of 6.0, so at the low end of normal. So clearly not good.

The nurse did say that they have had a few cases of numbers this low progressing, but she wasn't overly encouraging either - they expect my numbers to be lower by Saturday. I'm to stay on the meds and retest then.

So the wait continues. And if this doesn't work, we are one step away from being asked to do gestational surrogacy. Anyone know where I can find a money tree?

No News Yet, But a Thank You

Just wanted to say a quick thank you to all of you for holding my hand and keeping me company during these last few days. The 2ww is always a challenging time, but you're making me laugh and smile. In no particular order:

Silver, you're cracking me up. Thank you for leaving nothing uncrossed!

Mrs. LC, nope, no pictures. It's matter of getting your nose right down to it (to the point of smelling the pee) before you can see it. I'd need a $3,000 camera with a super macro lens to have even a remote chance of capturing the faintness of those lines, so I didn't even try. Although if I found a pink Sha.rpie and drew it in there a bit darker, maybe I'd feel better about it? :-)

Mrs. Spock and Sue, thank you for the encouraging stories.

Nic, thank you for continuing to check in on me after all this time. For those of you who don't know Nic, she and I began this horrible journey around the same time several years ago. She was one of my very first blogger friends, and although she has now had success twice over, she still continues to keep tabs on me. I've been meaning to post a comment on your blog to thank you for that, but I realized it's password protected. I'll check my e-mail in box to see if I have the password.

Mara, I'm sorry this wasn't the month. Pee sticks are evil, but yet somehow it's impossible to stay away from them, isn't it?

Mo, Polly, and Anna, thank you for thinking of me.

Hopefully there will be some real news to follow soon. So far, I am getting very little actual work accomplished today...

Testing, Round 3

The alternate title to this post is "Pregnant, Not Pregnant, Pregnant, Not Pregnant..." (Think plucking petals off a daisy.)

Our bathroom countertop looks like a science experiment gone mad at the moment. There are four test sticks there at this point. The first is the one I posted about last night (it was a brand name Fi.rst Res.ponse).

The second is one of the E..P .T.'s digitals that R brought home yesterday. I did it right before bed and was then too lazy to tromp all the way downstairs to log on and post about it. (I've tried posting from my Bla.ckbe.rry but apparently my particular version isn't supported.) Anyway, it was very mean and said "Not pregnant".

This morning I did one of each again before heading off for the blood draw. The FR once again had a very faint second line, although it was slighly less faint than last night's line. So at least it seems to be moving in the right direction. And the other one still said "Not pregnant".

So my guess is that my beta is somewhere above 15 and below 50, because the FR is supposed to be sensitive in the 15-25 range, and the other one's sensitivity starts at 50.

The wait for the call begins...

Testing, Round 2

Sorry for the quietness yesterday. I was too afraid to test for fear of getting the same results, so I decided to wait at least until today. And then when I got home last night, I was so tired I wound up taking a nap for a couple hours, got up for dinner, and then went back to bed fairly soon after that.

I started having period-like aching and minor cramping that began yesterday afternoon and happened again this afternoon. And I started having a very, very tiny amount of light brown spotting today as well.

So, I decided I might as well face the inevitable when I got home from work tonight. I did the test, spent a couple minutes crying, and then began the obsessive watch for the second line.

And it was barely there. I mean, barely barely. At first I wasn't really sure, but then it got ever so slightly darker as a couple more minutes passed. Finally I was confident enough to call R and tell him to buy a different brand on the way home. (Preferably one that says "pregnant" or "not pregnant" so that we don't have to interpret.)

Then I couldn't wait any longer - I had to have someone else verify that I wasn't just imagining things. So I took the stick downstairs and made my 75-year-old mother sit right next to a lamp. At first she kept saying she didn't see a second line, but then she held it up under the lampshade, right next to the bulb, and as she kept turning her wrist to different angles, finally she saw it.

By this time, more than 10 minutes had passed, so I was afraid that maybe we were seeing a false positive. So I went into the garage to dig Monday's tests out of the bottom of the garbage can. (I didn't tell anyone but you guys that I took those - especially not R.) We examined both of those, and even after 2 days neither of them had a second line.

So I think it really is a second line.

However, now I'm concerned (I wouldn't be me if I wasn't concerned about something) that the line isn't dark enough to result in a beta of 50 by tomorrow. And I'm concerned about the period-like aching, cramping, and spotting.

But really, there's nothing I can do except wait and see what happens. And pray. Although I have to admit, for the last few years, it's been painful to pray. So any prayers you care to offer up on my behalf would be more than welcome, because I am seriously out of practice.

I will post again later if I do a second test tonight. (I didn't think ahead to collect anything in a cup, so after I called R and asked him to pick up more tests on his way home, it occurred to me that I will have to wait until my bladder fills again.)

I'm working from home tomorrow because I didn't want to be at the office when the call comes, so I will be able to log on and post once I get the call.

I Caved

And it wasn't pretty. Saved some FMU from this morning and tested it when I got home tonight. BFN.

Thought maybe it was just that saving it (in the fridge) affected it somehow, so decided to test fresh. BFN again.

I know it's not totally over, there's still a chance that it could turn up BFP later this week. But if it's supposed to be at 50 on Thursday, that means it's supposed to be at 25 by tomorrow morning, which means it should be at least around 20 at this point.

And that, I would think, should definitely show up on a test. It was a FRED, not a dollar store one, and I've gotten a faint line on a FRED before and had a beta drawn a couple hours later that turned out to be 5...

Slowly Going Crazy

We're at the half way point of the 2ww. So far, it's gone like this:

First 24 hours after transfer (Tues. night to Wed. afternoon) - Doubting it worked because there wasn't any implantation spotting in the first 24 hours like there was in my other two FETs that ended with BFPs.

Later Wednesday afternoon - Started to feel some very slight pinching sensations, hope started to rise a little bit.

Thursday morning - Nauseous, hope in full bloom.

Thursday afternoon/night - Nausea went away (to be expected, even if it was m/s it's usually only a few hours per day for me), but no more pinching sensations or other symptoms. Also don't seem to be particularly bloated. Hope fades.

Friday - No symptoms at all (other than the sore boobs I've had since starting the estrogen, so those don't count because that symptom existed pre-transfer). Really feeling like it didn't work.

Friday night - Totally nauseous again, but not sure if it was just that dinner didn't agree with me (though it seemed fine when I was eating) or if it was something more.

Saturday morning - Still very nauseous, probably just an issue with dinner, but a little hope still crept in.

Saturday late morning to early evening - More pinching feelings that are a little stronger, as well as some slight tugging feelings. Hope blooms anew. And then I think I've detected a bit of bloating. Yea!

This morning - Got a Mother's Day eCard from someone who knows I don't have kids and knows that we've struggled to have them - WTF?? (She doesn't know we're currently cycling.) Oh well, it's not someone I see regularly, so I'm just going to delete it from my inbox and ignore it. I'd probably be a lot more upset if I wasn't in a hopeful place. Had more pinching feelings during the night, and bloating still seems to be there. Yea again!

And speaking of hopeful places, I'm debating when to POAS. I'd be tempted to do it tomorrow morning (6dp5dt), but I have a meeting first thing in the morning and it includes some people I don't normally work with, so I don't want to go into that meeting in tears if there isn't a second line. Ditto for Tuesday, because I have an even earlier meeting (7 a.m.) that day.

So I may be forced by circumstances to wait until the day before beta to test. I always test - I'm one of those people who doesn't want to have the news broken to me by a nurse. I think part of it's a control thing; there's so little in this process we get to control that darn it, I'm not going to let someone else control when I get to find out if it worked or not. Plus, it just seems like such a personal thing to hear from someone who doesn't know me that well. And, when I've gotten bad news test results in the past, I generally tear up and can barely whisper, much less talk, and then it's just awkward and uncomfortable all the way around.

So there. Those are my excuses for POAS, and I'm sticking to them (no pun intended, really). :-)

Positively Hopeless or Hopelessly Positive?

It is the beginning of May, and R and I are sitting in the middle of a winter wonderland.

I think I mentioned previously that we were going to spend the latter part of our Denver trip in a condo in ski country. We got here early this evening. The condo is comfortable and cozy, with a fireplace and picture windows that look out onto the ski slopes and a forest of pine trees that are dusted in snow. Tiny snowflakes are drifting ever-so-gently to the ground.

This is just what I need to try to maintain some semblance of sanity until next week’s beta.

I spent the first 24 hours convinced the cycle didn’t work because I haven’t seen any implantation spotting. However, I did start to feel a little bit of minor pinchy type of pains yesterday, so then I began to think that maybe implantation is starting to happen after all. So far, the pains have continued off and on. More off than on, and I wish they were sharper like the implantation pains I’ve had with past pregnancies, but still, I’ll take ’em.

Then, this morning, I woke up feeling nauseous, almost to the point of throwing up, and it lasted for a few hours. I know it sounds ridiculously early to be morning sickness, but then I spent the morning Googling to see if anyone else has ever had morning sickness that early, and some women swear that they have. And I’m not one to have a lot of nausea in general unless it’s morning sickness or food poisoning.

I have had morning sickness pretty early in some of my past pregnancies (sometimes between 7 and 14 dpo), so I’m hoping it’s not totally out of the question. And it’s following the pattern of the other rounds of morning sickness I’ve had – it strikes in the morning, then goes away after a few hours. We’ll see what happens tomorrow morning.

R has been on my case because I tend to be very cautious in how I speak about this attempt – I say things like “Assuming we get to the second trimester…” or “We’ll see what next week’s beta shows”, and he thinks I should speak more confidently.

So then this morning after the nausea, I got all excited and told him, “Hopefully this is a good sign!” To which he responded, “I said ‘Be positive’, not ‘Have hope’!”

I’m not exactly sure how one is supposed to be positive without hope. Apparently, neither is he, because he couldn’t give me a good answer to that...

Incubating

The transfer went well yesterday. We transferred one blast that was 100% reexpanded and starting to hatch.

The transfer itself was surprisingly fast (to us, anyway). Our former RE tended to take a lot more time and also showed us where they were in my uterus on the monitor.

But the upside to yesterday was that my leg cramps, which always happen during transfer, weren't very bad. (During one of our previous transfers at our first IVF clinic, they were so bad that after the embryos were in, I had to have that RE hold one leg straight up and R hold the other one. Talk about embarrassing...)

So now I'm hanging out in bed, and R is obsessively monitoring every move I make. Last night he told me not to blow my nose because it involves using stomach muscles.

Speaking of being obsessive, R isn't the only one. I'm trying not to, but failing miserably at obsessing over implantation spotting. Or more precisely, the lack of it.

I know, I know, it doesn't always happen. It didn't happen in my first two pgs, but then again I wasn't on Lo.venox then either. But out of the four transfers we've done in the past, it did happen both times on the two that resulted in BFPs. The first time, it happened the morning after transfer. The second time, it was around midnight the night of transfer. Just a tiny little bit of light pink, just once each cycle, when I went to the bathroom.

But this time, nada so far. And I'm on 80ml of Lov instead of 40, so I'm bleeding a bit more in general.

It's going to be a long 8 days until beta. We're heading to a condo in the mountains tomorrow, so at least we will have pretty scenery to distract us until Sunday night when we head home. And then, knowing me, I will break out the sticks on Tuesday morning. Or Monday if I'm really impatient... :-)

Transfer Time

We're heading to the clinic for the transfer in about 45 minutes. We decided to transfer 1, unless the first one doesn't look good upon thaw, in which case they'll thaw another one and then we will transfer both.

I had been strongly leaning toward 1 anyway, and then when a nurse called on Sunday with my instructions, I told her that we wanted to do 1 but I wanted to confirm with RE that he didn't feel strongly about transferring 2. She said given my age and the high percentage of normals we had, their standard is now to transfer 1 in those kinds of cases. (Apparently this is a change that took place a couple of months ago; before that, the standard was 2.)

So that gave me the final bit of peace I needed to go forward with one. A ridiculous amount of shopping over the weekend - mostly for clothes I hopefully won't fit into in 2 months and sexy, strappy black high heel shoes I never have an occasion to wear - helped relax me, too... :-)

Aaack!

Today did not go quite as expected. This is thanks in part to the estrogen (I think) and in part to the fact that my ovaries seem to like to stick their tongues out at me in defiance at the most inopportune times.

It started out well enough. I had my lining check, and it was 9mm. Yea! And there was a triple stripe. Yea! And it looked like my ovaries were quiet, according to the monitoring RE. Yea yet again! (I need them to be quiet, because we didn't use Lupron or BCPs on this cycle.)

Then I got to the office. And realized that while I'm usually the most dressy one there, all the rest of the women had decided to wear suits today and even some of the men were more dressed up. I knew two of our VPs and two of our directors were coming in for their annual visit today, but I didn't remember everyone being that dressy last year. So I had chosen to wear an outfit (dress pants, button down shirt) that isn't really anything out of the ordinary for me.

Thank God for my one co-worker, who was in white jeans and a muscle shirt; at least there was one person there more casually dressed than me. And honestly, the VPs and directors weren't in suits or even in ties, so I'm sure no one else but me even gave it a second thought.

But still, being all hormonal, this did not bode well.

On top of that, one of my co-workers had suggested that we should all bring our families to the team dinner tonight. That meant 3 kids under the age of 2. I knew R couldn't handle that, so I planned to go solo. I knew at least one other co-worker's fiance couldn't make it, so I took some comfort in the fact that at least there would be two of us sans significant other.

Except that she told me her significant other was able to change his plans. At which point I began to cry. Sitting right there in my cubicle, with mascara running down my face. Thinking that I was going to be the only underdressed, solo one at the table.

She knows about the cycle, and about my unfortunate start with the extra patches. So she leaned over and quietly said, "Hun, how many of those patches are you up to now?" I held up four fingers. She shook her head in sympathy and handed me a Kleenex.

I knew I had to get out of there for a few minutes, but there is no place for privacy in our office space or in the bathroom. So I wound up sitting in my car (needed someplace with a/c) in the parking lot, wailing into the phone to one of my BFFs about being underdressed, solo for dinner and something else that I can't even remember now. Yes, I know it's ridiculous. After a few minutes, it sounded ridiculous even to my own ears, and I started to laugh about it and pulled myself back together.

What can I say? Me on hormones isn't a pretty thing.

Then just as I was packing up to go to said dinner (most of them were already there), I got a call from RE's nurse. Lining check looked great, but progesterone was at 1.5 and LH was at 23.

Meaning I am starting to ovulate. Even though I usually don't ovulate. Even though I have Never. Ever. had a d21 progesterone level above 1.0 without medication support. The one time I don't want my ovaries to cough up an egg, they decide to get with the program and function (sorta) like they should.

Since the progesterone is only at 1.5, it means I haven't ovulated yet, so fortunately the cycle can still go forward - one day early. And, I needed to start the progesterone suppositories today instead of tomorrow and rush to the pharmacy to pick up some oral estrogen, because that level isn't quite as high as it should be.

So I had to back out of dinner at the last moment in order to race home to start shoving pills up you-know-where. I've got nothing left in me today except what feels like the need for a very good cry, so I left it to Kleenex co-worker to make an excuse for me...

Just to Clarify

From some of your comments recently, I realize that I've left a bit of a wrong impression.

It's not that I don't have hope for this upcoming cycle - I do. Actually, that's kind of the crazy thing about it: I have more hope than I probably should, and that's freaking me out a bit. So what's coming across as a less-than-hopeful attitude is actually fear.

You see, I consider:

1) We're at the Big Guns Clinic
2) Our RE is the founder of said clinic
3) We have a ridiculous number of embryos that tested chromosomally normal
4) They're from a protocol that's different than our first 2 cycles, so maybe that will make the difference
5) My thyroid levels are finally stable
6) I'm on 80 ml of Lov.enox this time - I found a study that showed women who have a history of RPL and 2 clotting factors have much greater success on 80 ml as compared with 40 ml. I've only been on 40 ml in the past.

So I think about all of that, and a large part of me thinks "How could this NOT work?" I have to admit, having had 5 pregnancies in the past (so actually getting pg doesn't seem to be our issue as much as staying that way is), I even catch myself tending to think "when we get the positive beta..." instead of "if".

But the reality is, even with all those things in our favor, it could not work. So I think I keep reminding myself of that to keep the hope in check. I've even spent a fair amount of time (far more than I should) visiting blogs of fellow IFers who have had to endure the unthinkable - losses of babies in the second or third trimester. I know I've had a lot of losses, but they've all been first trimester. Somehow I tend to think that losses after that point are even worse, because you start to let your guard down and think "This could really work", and you feel movements and see your belly grow, etc.

So, yes, I've been reading about preeclampsia stories and cord accident stories and incompetent cervix stories and placental abruption stories. Bracing myself for what may be to come. Reminding myself that if it does happen, others have endured and survived. I guess somehow that helps me to think that I would be able to, too.

Because that's just how IF screws with your head. With mine, at least. But in my own weird sort of way, I do have hope. Really. I promise.

Yin and Yang

One of the things I've been most grateful for these past 7 years is that R and I have always been on the same page or able to quickly get to that point. The other thing that ranks up there at the top of the list is our ability to switch from yin to yang roles when need be.

You see, it's mainly R who has been the optimist in this process. Especially when we were first starting out, he was so confident that everything would work out, that we would get the results we hoped for. And I needed that, because by my nature I tend to be a bit more of a glass-half-empty kind of gal.

His optimism lasted a good long while, even through the canceled cycles, the failed cycles, the failed adoptions. Then when we hit miscarriage #4, after seeing that promising heartbeat for three appointments in a row, the optimism faded. He struggled more than he ever had in the past, and he didn't bounce back like he had with all the other disappointments and rounds of bad news.

Suddenly it was up to me to be the optimistic one, because one of us has to be, or what's the point of continuing to try? So we swapped places, and for the last year and a half I've played the role of cheerleader (hard to believe, I know, given the tone of most of my posts) while he struggled to believe.

And now that this cycle started and I began to hyperventilate a bit, at the moment I needed him to assume the role of optimist, there it was - his trademark confidence that this will all work out. It's wonderful to see that in him again; I didn't realize how much I'd missed it.

You Were Right

Turns out, quadruple overdosing yourself on estrogen isn't that big of a deal, at least not on the very first day of an FET cycle.

The nurse e-mailed me this morning to say no problem, just stick with the schedule from here on out. A lining check ultrasound has been scheduled for 4/29, and the transfer date couldn't be changed, so it's still set for 5/5. I've decided to just go with it and try not to freak out about the date too much.

So, in 20 days, I will officially be incubating. The first beta is one week from yesterday. It falls on a Friday, and there are no labs open on Sunday, so I assume I will have to wait until that following Monday to get the official results. Though I always give in and start POAS a couple days before the first beta anyway.

I shouldn't be surprised by how fast all this happens, but somehow I am.

I just realized today that it's been nearly 3 years (FET in June 2007) since the last time we made a formal effort to get pregnant. I can't believe it's been that long! I guess I forgot a bit about how much shorter FET cycles are compared to fresh cycles.

A Cycle-Cancelling Screwup?

No luck on getting the FET date changed with the lab, but I'm wondering if the cycle will still happen at all next month:

Does anyone know what happens if you put on four estrogen patches when you're only supposed to put on one?? Seriously? (Aside from turning into a royal *itch overnight, I mean.)

When the nurse called me yesterday, she said to start the patches as soon as I could get them. I swear I heard "patches", plural. I know there definitely weren't specific instructions to just use one and then work my way up from there.

And when I got the patches, the directions on the prescription information taped to the boxes said "Apply 4 patches every other day."

So I stuck 4 on my hip last night. Then this evening, she faxed over my calendar. It says to use 1 patch on the first day, then 1 patch two days later, 1 patch two days after that, then 2, then 3, etc. So I'm not supposed to use 4 patches for almost two weeks!!

I pulled off 3 of them as soon as I read that, but I'm wondering if this has already royally screwed up the cycle? I will call tomorrow to find out. My nurse is probably already tired of me, so I'm sure she'll be thrilled to hear about this...

Hope, and Fear, and Hyperventilation

Our FET is approaching at a rapid pace. I thought I was ready. A few weeks ago, I was in a very Zen place.

Now, I'm an example of just how much infertility can screw with your head and make you seem like a crazy person to friends and strangers alike.

It started with a visit to the hematologist last week. RE doesn't want to manage the Lovenox, so a local hema doc is doing it. I was hoping I could just call and get another script, but since the last time I saw him was 18 months ago (before the retrievals), I had to go in again. With the retrievals, I was only on Lovenox for a few weeks, so there weren't any follow ups.

With the transfer, if the beta turns up positive, apparently there will be follow ups. Early. Ridiculously early. As in 4 weeks pg early.

He told me this, and I started to have a mini-meltdown. Because, you see, when he said "I want to see you around 4-6 weeks, closer to 4 weeks, to make sure you're not bruising or bleeding excessively", my infertility-addled brain thought, "By going in there at 4 weeks, you're signaling that you're arrogant enough to think you're going to be taking those shots for a while to come. Which means that you're just opening yourself up to fate reaching out and smacking you back down once again to prove you wrong. Which means that going to see the hematologist at 4 weeks = way to guarantee yet another miscarriage."

I stuttered, I stammered, I teared up. I pointed out that rarely do I make it beyond 6 weeks. He acquiesced and said I could just come in whenever I feel ready. Probably figured it was just easier to give in than to risk seeing what full-blown hysteria looked like.

Then CD 1 showed up on Sunday. The fact that it arrived wasn't much of a surprise since I had to do progesterone suppositories for a week to bring it on, but Sunday was a few days earlier than I had expected it to start.

I was supposed to start the patches and Lovenox last night, but there was a mixup because the clinic thought I had the patches when I didn't. So I got those today and slapped four of the clear little suckers on. As long as it doesn't generate some sort of weird rash, I'm all for patches instead of injections. And I've got plenty of real estate (i.e. flab) on which to stick them. Finally my hips come in handy for something.

The nurse called me today to talk about the cycle schedule and some of my paperwork. Transfer is tentatively planned for May 5th. Three weeks from tomorrow. Aaack - so soon! Another mini-meltdown ensued with me hyperventilating and calling one of my best friends to say I couldn't possibly be ready to face the reality of this in three weeks.

She had just managed to calm me down when another thought struck: May 5th is the 6th anniversary of our first miscarriage. Perhaps doing a transfer on that day isn't such a great idea. But the nurse is trying to find out if the transfer date can be pushed to the 6th or 7th anyway so that I don't have to take quite as much time off work. So rather than call her back in a panic and completely erase any doubt about my sanity or lack thereof, I decided to wait and see if she is able to get the date changed.

On the bright side, a transfer that week means we'll stay in Colorado and hide out during Mother's Day weekend. (We're celebrating two weeks early with our mothers for other reasons.) And I have decided that once the first 24 hours after transfer pass, we need to go stay at a place in the mountains where I can just relax and take cues from nature about how to get life to grow.

So at least there's one upside to that infertility-addled brain - it also makes the leap from "vacation" to "treatment-enhancing medicinal rest" without a second thought. Now if only we could claim it as such on our taxes...

So Very Thankful

We didn't have much luck tracking down the fill-in oncologist that my dad saw earlier this month, but on Friday a friend of mine who has connections in the medical world was able to help find another oncologist for my dad. (I don't know why I didn't think to ask her for help sooner.)

The new oncologist is about 1.5 hours away from where my dad lives. He had an opening for an appointment this afternoon, so my dad's wife spent Friday scrambling to get copies of all of my dad's medical records. (Another good argument for always getting a copy of your most recent records every time you go to the doctor, a lesson I've learned through these many years of IF.)

So they drove down to see the new onc today, and the appointment went well. Really, really well. I'm so incredibly thankful.

First, there's some amazing news that I didn't really go into during my last post. And the details of it are still a little fuzzy, since I didn't actually get to speak with the doctor myself. But, basically, the fill-in oncologist Dad saw earlier this month and the oncologist today think that he doesn't currently have leukemia!

Last spring when Dad was first diagnosed, a bone marrow biopsy showed 51% of his blood cells were "blasts", which are immature cells, i.e. leukemia cells. He had another BMB after his one round of chemo at the fancy schmancy medical center 4 hours from his house, and that showed 6% blasts. I don't think he's had another BMB until this month, and this month's showed 5% blasts. Basically, 20% or more is considered leukemia, 5% or less is considered normal, and I guess 6-19% is a gray area that is considered to be progressing to leukemia.

On the other hand, it's not that the doctors have said "Congratulations, you're 100% normal and healthy now!" The fill-in onc, at his one appointment with my dad and without the benefit of the results of all the tests he ordered, thought Dad might have a very rare blood disease called parox.ysmal noctu.rnal hemogl.obinuria. Today's onc, having the benefit of those test results in front of him, thinks that Dad has my.elodysplast.ic syndrome. Both of those have a 30% chance of progressing to the type of leukemia Dad was diagnosed with, and M.DS is still considered to be a form of blood cancer from what I gather in the quick research I've done online tonight. But both of those diseases can be managed, people can live for years with them, and a lot of people who have them don't die from them. So, again, very, very thankful.

The other great news is that today's onc got right on dad's transfusion issue. The iron chelator drug has already been ordered and should arrive by Thursday, and a blood transfusion has been arranged for Wednesday. Ideally he could have used it now given where his blood levels were at today, but I'm guessing perhaps the onc wanted to wait until it's closer to the time the chelator will arrive in order to try to minimize the amount of organ damage from excess iron, since Dad's now at the point where that is a concern.

I think there are also possibly some other drugs he can be given to try to address the M.DS more directly, but he and his wife didn't discuss the details of that when I talked to them tonight. I think we're all just taking a day or so to be grateful about the fact that this doctor didn't tell him to just go home and die; I'll ask them for details about the M.DS drugs sometime during the next few days.

Thank you for all of your thoughts and prayers.

Ups and Downs

Ups:
The antibiotic treatment in NY is done. My uterus should now be squeaky clean and bacteria-free.

I did not gain an obnoxious amount of weight during the trip, despite eating an obnoxious amount of junk - lots and lots of chocolate, a fair amount of other dessert, pizza at least 4 times, fish and chips, mac n cheese, etc. (Clearly one of my favorite things about NY is the food.) Must be all the walking and climbing up and down stairs to the subway and the apartment we rented that kept the pounds from piling on.

Our flight home landed an hour ahead of time. The pilot must've really been stepping on the gas pedal! But I'm not complaining - happy to be home, and got an extra hour of sleep as a result that night.

We have a tentative FET plan. There will be no Lup.ron, no BCPs. It looks like the transfer will be either the week before or the week after Mother's Day, which means no test results during that holiday timeframe (yea!).

It only took one phone call this time for the nurse and I to get beyond the issue of my unpredictable cycles. I don't ovulate with any sort of consistency. I've never, NEVER had a Day 21 progesterone draw that was above 1 during a non-medicated cycle. They are a fertility clinic. We've already been through this issue 3 times before - for the first one-day workup, the first retrieval, and last fall's one-day workup. So why the heck is it so hard to understand that when I say "I don't know when my next CD1 will be", the appropriate response is NOT "Okay, so do you think you'll get CD1 next week?" as if I had just spoken the words into thin air. But as I mentioned, we got through it (and landed on the "no Lu.pron, no BCPs" approach.)

Downs:
My first day back in the office, drama arose. I haven't shared this blog with anyone at work, but just to be safe, I won't go into the details. Suffice it to say that the drama does not involve me at this time, but depending on how it plays out, I could wind up being pulled into another job that is an area in which I have little experience and even less interest.

The FET isn't going to happen before our communicables expire, so we'll be coughing up several hundred more bucks for that.

Really Down:
My dad saw a new oncologist a couple weeks ago, while he was filling in for the oncologist in my dad's small town while she was on vacation. The new doctor (new to my dad, he's actually been practicing for 40 years and is semi-retired, so not new to medicine in general) gave my dad hope and said he thought there was more that could be done to try to treat him. But now the other doc is back, and she refuses to try. She discharged my dad from her care around Thanksgiving because she feels there is nothing more to do, that blood transfusions are pointless (despite the fact that they've kept him alive for the past 4 months), and she thinks he should just go into hospice, stop trying, and accept death. I'm trying to find a way for my dad to get in touch with the oncologist who filled in.

I could understand her feeling that it was time to stop trying if he was like he was in the hospital - delirious, constantly restless, sores all over his body, requiring oxygen to keep his levels above 90%, a respiratory system that seemed to be in decline at various points, etc., but that's not the case. He has his full mental faculties, he's able to walk without assistance, feed himself, talk on the phone (he sounds pretty normal, other than sometimes he has mouth sores that cause him pain), go out to lunch, lead an hour-long church service, and play Yahtzee all day long. It still seems to me like a life worth fighting for.

In the middle of all of that, another challenge arose this week: My dad's iron levels are way too high - 5,100, when the normal is below 400. It's apparently a common problem in patients who get a lot of blood transfusions. Because of the iron level, he can't have any more transfusions. But the transfusions are what's been keeping him going, and he's been getting them every 10-14 days. So we don't have a lot of time to figure out a solution.

The options seem to be phlebotomy (taking a pint of blood at a time out of the body) or iron chelation medications. Dad's not a candidate for phlebotomy because some of the other levels in his blood are too low; that's why he's getting the transfusions in the first place. So it looks like iron chelation is his only option, but the oncologist won't consider doing any sort of treatment at all. I'm hoping we can get in contact with the other oncologist tomorrow.

Obviously, depending on what's going on with him, the FET may need to be postponed again.

Info About the Antibiotics

First of all, thank you to all of you who commented on my last post and gave your thoughts about the transferring one vs. two question. I appreciate all the input, and it's given R and me lots to think about.

A few of you also had questions about the antibiotics stuff and who we're seeing. I don't usually mention the doctors I'm seeing by name (although I realize that by mentioning the location of our clinic, that pretty much gives that one away). But since there isn't much info about there about this topic as compared with mainstream fertility treatments, if you Google "fertile vs. infer.tile" (without the second period), you'll find one of the books that the doc wrote.

He's not an RE, and he doesn't do IVF or IUIs - he pretty much sticks to his antibiotic therapy from what I understand. He's a gyn and pathologist. For those who asked why I'm doing this: we've had several miscarraiges, and it was something that annother IFer mentioned on a bulletin board I'd read a few years back that had helped her after recurrent pregnancy loss. There wasn't any particular test result of ours that made me think "we definitely need to go see him, he's the one who could address this particular test result", we were just looking for another potential solution to all the losses.

I won't go into all the specific details of his treatments here, because there's info in his books and on his site that explains it better than I could; there's also a Yaho.o group started by some of his patients that has a lot of info, and I blogged a bit about what we did back in 2007 when we first went to him, so you can look at Sept. 2007's archives if you're in the mood for more in-depth reading.

What I will say is one of the reasons I chose to go with his approach (aside from desperation :-) ) is because I liked the fact that he is trying to address a root cause of infertility. So much of what infertility treatment is about, at least in our case, has seemed like treatment that attempts to find a way around the problem rather than address it. Sometimes there is no way to address the problem other than to go around it, but in our particular case I think perhaps there are things that can be done to try to address the root cause, and so I wanted to attempt to do that.

I don't know if it will work. Like all doctors in the infertility world, some people love him and some don't, some have great success that they attribute to his treatment and some don't. We'll just have to see what happens in our particular case.

Um, about 'the plan'

Mrs. LC's comment on my previous post made me realize that while I've alluded to various bits and pieces of it, I hadn't actually posted "The Plan".

In short, The Plan was:
- Lose 20-25 pounds
- Go to NYC and get antibiotic uterine lavages in March
- Lose another 5-10 pounds
- Do an FET with 2 blasts in April

In reality, The Plan is looking more like:
- Lost 14 pounds
- Go to NYC (tomorrow!), may or may not get lavages depending on if I'm bleeding
- Lose another 1-6 pounds, depending on how long it takes CD 1 to show up
- Do an FET, number of blasts debatable, in April or May, again depending on CD 1

So, not perfect, but I'm long past obsessing about perfect. RE thinks the antibiotic stuff is "voodoo", but he didn't expressly forbid it. And we got further during the pregnancy when I had the IV antibiotic than we have with any other pregnancy, so we decided to give it another try. (That was the pregnancy with the Turner's syndrome baby, so it's not that the antibiotics didn't work. My body held onto the pregnancy very well that time; unfortunately there was just no hope of the baby making it to the second trimester because it was a complete Turner's. Some babies with partial Turner's do progress.)

Honestly, I would kind of feel better about another IV since that's what we did last time, but NYC doc thinks that's unnecessary this time around. And the lavages are cheaper, so it's not that his recommendation is motivated by getting more money out of us.

With regard to the number of blasts to transfer, a year ago RE was thinking two or three. But given the number of twins from CGH transfers, he told us in October that he'd recommend two, definitely not three.

That sounded fine with me, except that I've been lurking on the boards lately, and there seem to be a lot of twins coming up from CGH/MA transfers of two blasts. A lot. And while I would love to have two at once, I'm concerned about the wisdom of that. I'm already at risk for lots of complications, weigh more than I ideally would like to, and don't even know if my body can carry one baby for any length of time, much less two.

Then I came across some very scary stories about preeclampsia and almost bleeding out during emergency deliveries of twins. R wanted to start packing last night, but instead I forced him to sit and read said stories.

So now I'm thinking maybe it's best to transfer just one. But on the other hand, I have a feeling that if we transfer just one, none may stick. Thoughts? Suggestions? At least we've got a little bit of time on that one.

I plan, nature scoffs

Today is CD 8. We get on a plane in less than 48 hours, and my uterus is supposed to start getting bathed in antibiotics on Monday. I can't be bleeding during that time.

Today I poofed out (my term for bloating) and started spotting. Almost everything about me seems to be so much more normal and healthy since the thyroidectomy - why can't that include my cycles becoming normal, too? Ugh.

I told R he is going to just have to go with the flow (no pun intended when I said it to him.) We have plane tickets, we have an apartment reserved, his parents are coming with us - we're going. Either the bleeding is going to stop and the lavages will start as planned, the bleeding will continue but eventually stop and the lavages will get started a few days late, the bleeding will continue the whole time (I really hope not!) and I'll get IV antibiotics instead, or the bleeding will continue and it will be just a working vacation and nothing more.

Whatever will be, will be.

A (Small) Success

It's amazing what time can do for perspective. When I was in high school and college, if I stood on the scale and it said 130 pounds or more, I was devastated, and my day was ruined.

This morning, I stood on the scale, and the number (notice I'm not telling you exactly what it was) equated to a BMI of 29.9 - the highest possible number it could be without falling into the "Obese Class 1" category on the BMI chart. And I was thrilled!

That's because at least the number is going in the right direction. A year ago this month, at my highest weight ever, my BMI was 36.55 ("Obese Class 2"). I managed to lose 28 pounds - which I don't even feel like I should take credit for since I lost them by eating more and not exercising - before my thyroid surgery. Then I spent four months at pretty much a standstill while my meds got adjusted.

Now, since the beginning of the year, I've managed to drop another 14 pounds, mostly by cutting back a lot on sugar and just being careful in general about what I eat. But still, it mostly feels like it's just my body doing what a normal body with normal thyroid levels is supposed to do, so I still don't feel like I can take a ton of credit for it. Instead, I'll just be grateful for it, and do my best to make it continue.

I don't think I'm going to reach my goal of 30 pounds before our next transfer, but hopefully I can manage to drop at least another 6 to 8 pounds before then, for a total of 20-22 pounds.

Speaking of the next transfer, we are off to NYC in a few days to bathe my uterus in antibiotics, and then as soon as the next CD 1 shows up, we'll get started on the meds for transfer. Although since my last cycle was 48 days, I'm kind of nervous about whether we'll make it for transfer before our communicables expire.

If we don't, I'm not going to stress out about it too much though, because it's dawned on me that if we are able to do a transfer before they expire, we'll either be mourning a BFN or reaching 6 weeks right around Mother's Day. In my world, historically Mother's Day around 6 weeks = miscarriage, so perhaps the transfer being postponed for a week or two wouldn't be such a bad thing after all.