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.