Whew, What a Month!

Making it to Sunday with my sanity intact will be an accomplishment. It's been an unexpectedly crazy month!

Dad has been in the hospital three times this month, for a total of more days in the hospital than out of it. His blood levels dropped, then he got a fever, then it looked like he might have pneumonia but it turned out to be lesions on his esophagus caused by the chemo. But he's been home for the past 10 days or so, and we went to visit him. More on that in a moment.

As I mentioned in my last post, I contacted the clinic regarding planning an FET for early next year. Forgot we had to repeat the one-day workup. Went through the same stupid issues we did last time, with them turning my unpredictable cycles into an obstacle rather than working with me to address them. Wound up snapping at the receptionist who was being unhelpful in trying to get me scheduled and put it on said receptionist to solve my ovulation issues. (She loved that, as you can imagine.) Got a phone call back from a nurse pretty quickly after that.

Went back East with the in-laws to see fall colors. Left my textbook on the plane, with an assignment due three days later and a mid-term due a week after that (still not done). Wasn't expecting white to be a fall color, but it started snowing an hour after we arrived. Spent a day wandering around a Civil War battlefield envisioning brave soldiers meeting a tragic, traumatic fate. No disrespect at all to them or what they endured - our country would be very different if not for their heroic service - but a spa-and-chocolates type of vacation was more on order than an envisioning-blood-and-guts one. Note to self: Do not join in-laws when they go back to spend two or three more days there. Either that, or find a place to park self at a spa during those days.

Got back, crazy few days at work, hopped on a plane four days later to go visit big, bad clinic. Forgot and had caffiene the morning of the ultrasound. Blood flow was restricted, but uterus otherwise looked good. RE was optimistic, which made me tear up (fear of failure, not joy - I've now reached the point where doctors' optimisim about our chances makes me cry). A bit of pressure was taken off when he said he'd allow us to try a second FET if I miscarry on the first one.

Less than 24 hours after arriving, hopped back on another plane to visit my dad for a few days. He looked better than expected and had more energy, even was up to going to church which was great. Learned from his wife how to can homemade jelly and fry taco shells. Saw my oldest half-sister, who I hadn't seen in 23 years and who, it turns out, is on a first-name basis with the police in her town due to her children.

Drove 1.5 hours to take R back to the airport on Sunday night, then 1.5 hours back to my dad's for one more day, then back home myself. Did I mention he lives in the woods, where bears wander across the road and a shotgun is required after dark to ward off the mountain lions and ensure you make it safely from the carport to the front door? Yep, I come from true hillbilly roots. (Dad's word, not mine.)

Back home, more work craziness, still trying to get the mid-term finished (but clearly taking a blogging break at the moment). Trying to resign myself to getting a B in the class.

Metabolism has seriously slowed down. Instead of dropping 1-2 pounds per week, now gaining about 2 pounds per week. Have to exercise (walking/running) 1.5 hours per day in order to have any sort of weight loss, gain all of it right back if I miss a day. Up 6 pounds in 3 weeks.

FREAKING. OUT.

Endo is no help - she's treating the piece of paper the lab results are on as if that's the patient instead of me. Despite the ridiculous weight gain (in the face of strict healthy eating, I might add) and the fatigue, she says the T4 levels aren't low enough to warrant raising my dosage. Considering firing her and having the PCP (who will take symptoms into consideration when adjusting dosage) manage my levels.

Oh, and it is R's birthday tomorrow. I have not shopped, I have not arranged for a cake, we have not finalized plans to celebrate. And I will likely spend most of the weekend trying to finish the mid-term, do the assignment due this week, and get caught up on work.

So, how's October been for you?

Dipping My Toe Back In

Today I took a tentative step back into the waters of treatment and e-mailed our cycle RN to let her know that we're possibly thinking of doing an FET in the second half of February. It was probably a bit premature (pardon the pun), since it might take a few months to get my thyroid meds adjusted and since February is five months away.

And honestly, I'm glad it's still that far off. Obviously, at some point we have to give it another try, seeing as how we have all those frozen embryos. But right now I'm okay with that try not being tomorrow.

That's so different than when we first started this process - whenever a cycle failed, I immediately wanted to jump into the next one. We've been at it for so long, though, that apparently I needed a year off. And while childlessness is never fun and the painful reminders can come from anywhere (i.e. dinner with R's cousin from the same generation last night, who has an 18-month-old grandchild when we don't even have a child yet), it's actually been kind of nice in some ways to have this time.

I also had my annual pap today. My ob mentioned that he has a patient who's had more than a dozen msicarriages. However, she also had success after the first three, then success again after the next several. And, she knows what's causing all of her losses - she has a balanced translocation.

I know he was trying to be comforting and encouraging, but it's just not the same thing. For one, she knows what the issue is. Secondly, her issue is a crapshoot - if she keeps trying, occasionally she'll have an embryo that isn't affected by the translocation. (Or so he made it seem; I don't know anything about translocations, so I'm only going off of what he said.) Third, she doesn't seem to have to spend $20k a pop to try to get pregnant - that just happens the natural way. And, last but definitely not least - she. has. a. kid. Two, in fact.

Still, I couldn't help but wonder, will that be me someday? A woman whose heartbreak numbers in the double digits? Will I know when to stop? Heck, will I even know how to stop?

Trust Issues

It seems infertility has made me something of a paranoid freak.

I'm having a hard time remembering what life used to be like - you know, before 90% of my waking thoughts were consumed with infertility, thyroid issues, and R's rare heart condition. And an even harder time having faith that there will again be a time when life isn't so much about all of that stuff.

I think a large part of it is because I don't have a lot of trust anymore - not in our health care system (I won't get started on all of its problems), not in doctors (hello, missed diagnosis for at least 7 years), and sadly, not even in our own bodies (all the miscarriages, R's Brugada syndrome). I keep waiting for more loss, for the next horrible diagnosis, to be right around the corner.

What's put me in this mood is that I've scheduled my first baseline mammogram.

Though there's no history of breast cancer on either side of my family that I'm aware of, and though I do BSE regularly and have only discovered one suspicious thing that turned out to be nothing, a part of me still can't help but think "What if they call me with bad news, and we can't do a transfer in February because I have to do chemo instead?"

I know the fear of cancer is common - it's not like I'm the only one who's ever had that thought. But I think I've reached a point where I'm a little more of - like I said, a paranoid freak - than most people are.

I plan to have a discussion soon with my family physician about regular screenings for ovarian cancer, even though there aren't really any great options, because I'm at higher risk since I have PCOS and haven't had any kids. I make R check for testicular cancer. (We have a friend who had it; he survived, thankfully.) I'm constantly checking him for signs of skin cancer, even on his scalp, since he's very fair skinned and burns in the blink of an eye.

And since I don't reside in his body and therefore can't notice any abnormal symptoms he may be feeling, I ask him every couple of weeks if he feels okay, because I'm afraid he's just going to blow off some random symptom that results in fatal consequences. (You can imagine how thrilled he is with all the questioning and skin examinations.)

Not that my paranoia in that area is entirely unjustified. He told me he wanted to be in charge of his doctor's appointments for his defibrillator, and I agreed. He was supposed to have appointments every 3 months for the past year, alternating between over the phone and in person, then it's supposed to be every 6 months, again alternating, forever.

I hadn't heard about an appointment in a while, so the other day I asked him about it. When was his last appointment? He doesn't remember. When is his next appointment? He's not sure he's scheduled one, but if he has, he doesn't remember what date (or even what month) it's for. When was the last time he actually went in for an appointment? He's unsure, but his best guess is December. (If the first-year plan had been followed appropriately, it should have been May...)

I guess it's no wonder the paranoid one is in charge of all the medical stuff.

Sometimes it's the Small Things

There's unlikely to be anything momentous on the infertility front for several more months, while I work on getting the thyroid replacement meds regulated. So, in the meantime, I'm focusing on the small stuff.

Such as, standing on the scale this morning and having it tell me I weigh 30.6 pounds less than I did back in March. Yea! Happy, happy day. I still have a ways to go - ideally, I'd like to lose another 50 pounds before doing a transfer.

That may not be totally realistic, but I'm hoping that in a couple of weeks I'll feel up to exercising, which I haven't been doing in any sort of strenuous form because of the heart issues my thyroid had been causing.

I'm also hoping that having my thyroid removed (effectively becoming hypothyroid) also won't cause the weight to pile back on. But I think given how little I usually eat (1,300-1,400 calories per day), now that my body isn't requiring 3,000 anymore, I should still be able to keep on track.

So, for now, here's to the small stuff.

Home After Surgery

Thanks for all the well wishes for the surgery. There were no major complications, and I was able to go home after 24 hours.

Because I've been having high blood pressure (thought to be caused by the hyperthyroidism), the anestheologist took some extra precautions during the surgery. Ironically, my blood pressure was fine, but I wound up having a few heart rate issues. Apparently my heart rate sped up a couple of times and then dropped significantly just as the surgery ended, but they were able to deal with all of that.

This was my first time staying in the hospital overnight. I can't believe the lack of sleep you get when sleep and rest is probably the thing your body needs the most! There has to be a better way.

I had an interesting roommate. She was nice enough, but there were constant visitors trapising in and out, and they were loud. I think they thought they were at a party instead of in a hospital. At one point, I heard her ask one of the visitors what she had planned for last night (Friday night), and the visitor said, "We're waiting for Jose to be released from prison today, then we're going to the bar tonight", as if it was a common, everyday occurance to be waiting for someone to get sprung from the joint. I was just hoping Jose didn't come to visit...

My calcium levels dropped a little bit, to 8.0 and then 7.9. (They're supposed to be at or above 8.5.) So I'm taking calcium supplements four times a day for now. My fingers seem to be a bit tingly, which they said is a sign of low calcium, so I'm trying to decide if I should call the doctor or not. If it continues, I probably will.

I was hoping to wake up yesterday morning and magically have all my symptoms be gone. Perhaps that was a bit overoptimistic (ya think?) as I still have the tremors, but my heart rate and the overall jumpiness seems to be less noticable. The surgeon said that thyroid hormones have a long half life, so he said it would probably take a week or so before the hyperthyroid symptoms really start to abate.

The pain hasn't been all that bad. My throat is a bit scratchy, and my neck is sore, but I took the pain pill last night more to help me sleep than to reduce the pain. Interestingly enough, one thing that I've found to be much easier since the surgery is swallowing pills! I used to struggle just to get one small pill down at a time, but since the surgery even large pills just slide right down without effort. I guess it's because there's more room in my throat now.

The next step is going to be getting my thyroid hormone levels regulated with medication. That's a challenge for some people, so I'm a little nervous about it, but hopefully I won't have issues. Once that's stablized, we can look forward to a transfer. I'm thinking maybe February...

Here Goes Nothing (I Hope!)

At this point tomorrow, if all goes as planned, I will be thyroidless. So far, I haven't been too terribly nervous about it. When I had minimally invasive knee surgery 16 years ago, I spent the evening before telling R that I had changed my mind and trying to convince myself that I could just live in pain (and on crutches) for the rest of my life.

And that just involved them poking a few tiny holes in my knee! This time, someone is slicing my neck open. (My mom finds it funny to make the slitting throat motion with her hand at least once every few days...But I suppose she has some grounds to be amused by it, since she went through it 50 years ago.)

Oddly enough, the thing that has me most stressed about the surgery is that I am supposed to not eat or drink anything after midnight, yet my surgery isn't scheduled until 1 p.m. By the time it's done, if all goes well, that would be 15 hours without water! And I don't think I'll feel much like swallowing immediately after surgery.

So I called the nurse today and asked her if it was really necessary to observe the midnight rule given all that. She wasn't happy about it, but she extended the deadline to 4 a.m. Which means I will be getting up at 3:45 a.m. to chug down a couple bottles of water...

Wish me luck!

Surgery is Scheduled

So it's official: on Sept. 10, my thyroid and I will part ways. I'm hoping this is the thing that's the key to me being able to stay pregnant, but I am very clear that there's no guarantee of that in any way. To start with, though, I'll just be grateful if it means I don't constantly shake anymore and my heart stops doing cartwheels in my chest.

People keep asking me if I'm nervous about it. And I'm sure I will be, starting a few days beforehand. But right now, I'm just looking forward to getting a step closer to being able to do a transfer again.

This is completely random and off the cuff, and I don't usually share much about R that's personal. But I think he's having a good day, and he hasn't had a lot of those lately, so it makes me happy and I'm sharing it.

He spent this afternoon at his best friend's house. There have been times during the past several years when that has been tough, because his BFF has a 6-year-old son. Even though they struggled with IF too, they're one of those couples who seems to have completely forgotten what all those emotions were like as soon as their son was born. BFF has even gone so far as to try to reason us out of the sadness and pain we feel, so at some points, we've had to distance ourselves.

But today sounds like a good day. When I talked to him a little while ago, he said he'd played computer games with the 6-year-old, and the two of them were in R's truck driving to their next activity, with BFF and some others in a different car.

It was just good to hear R having a happy day in the presence of a child.

Feeling Alone and Left Behind

I'm trying not to feel sorry for myself, but I'm failing miserably.

I've been in a good place for the past few months. I've needed a break from infertility, and I've had it. It's been good to not have every day, every decision we make, revolve around fertility treatments and my cycle day and needles.

Then last week happened. It was actually a pretty good week. I realized on Thursday that I hadn't even noticed what Aug. 17 represented - the 2-year anniversary of the D&C for the only pregnancy we've had that progressed to the point of a heartbeat. I thought it was a sign of healing. It's not that I don't think about the baby, because I do every day, but this time I didn't relive it in the days leading up to it.

About an hour later, I got an e-mail. An acquaintence, who is a former infertile who used donor egg to have her first child about a year and a half ago, is 27 weeks pregnant again. Apparently this time, she just naturally got pregnant a few months after she stopped breastfeeding. By accident. After deciding that she didn't want a second baby because the birthing process of the first was so horrible and the realities of motherhood didn't quite live up to the fantasies of it that she had.

It's not that I begrudge her this pregnancy. Or a mutual friend we have, who also had her first babies (twins) through IVF and also got pregnant naturally without trying the second time, less than 2 years after the twins were born. (She just had her third last month.)

It's just that I feel so totally left behind, and almost completely alone. I say "almost" because I know there are others out there in the same boat. But it feels like even those who are out here in the deep waters with me will also eventually find a path to success, and at some point I will be the only one left out here, floating aimlessly and Completely. Totally. Alone.

Then I made the mistake of logging on to FB, and seeing all the first day of school pics from this past week. Friends from the local resolve group who were down there in the trenches with me are sending their children off to school! For us, the prospect of a child going to school is still so far off that those kids will likely be in high school before we're showing up at the door of a kindergarten classroom.

Saturday, I bounced back. It was a happy day. A pair of capris that I bought 14 months ago, thinking "these will be perfect if I can just lose 5 pounds", finally fit for the first time! (25 pounds later...) There is almost nothing that can kill the high that comes with fitting into a piece of clothing that was once too tight.

Except showing up for an appointment with your 23-year-old, size 2 hair stylist and finding a cute little ultrasound pic. She wasn't even trying to get pregnant.

Thank God for Dairy Que.en's Girl Sc.out Cookie Thin Mi.nt Blizzard. Even if I don't fit into those capris anymore as a result...

Newsflash

I saw this headline on CNN.com yesterday: "Octuplets' mom says, 'I screwed up my life' "

Ya think? Really??

For the record, I have no problem with someone choosing to have 14 children if that's what they want to do - as long as they are able to support the children, rather than rely on the children to support them.

(CNN has since taken the video down, so I couldn't link to it.)

Thyroid Diagnosis: Hashitoxicosis

Finally, a firm thyroid diagnosis and a plan: Hashitoxicosis and (hopefully) surgery to remove my thyroid.

Hashitoxicosis is a relatively rare thyroid condition, but R and I tend to fall on the rare side of the odds when it comes to health issues, so that doesn't really surprise me.

It's just such a relief to finally have a name for it. I've been reading about hashitoxicosis today, and it's so weird to read stories of others who have it and think "That's me! That's me!" as I'm reading what they're describing. Basically, it's an autoimmune disease in which antibodies will attack the thyroid intermittently, causing it to spill excess thyroid hormone, which creates a hyperthyroid state. However, since it's intermittent, it's also possible to have times the thyroid is normal and even times that it's underactive.

My endo made the diagnosis based on how my thyroid-related hormone levels have repeatedly fluctuated significantly in relatively short periods of time (one month or less), and a thyroid uptake scan done this week that showed my thyroid was definitely taking up iodine at too quick of a rate.

The most common treatment for it is a high dose of radioactive iodine to destroy the thyroid. That usually creates a hypothyroid state, which is much easier to control than a rapidly fluctuating overactive thyroid. However, I had some major concerns about that:

- you have to wait at least a year after the RAI before getting pregnant
- it takes 3 to 6 months to determine if it was enough RAI to do the job, so if it wasn't, you have to take another dose, which means it could be even longer than 1 year before trying to get pregnant
- there is very inconsistent information out there about how long you have to stay away from other people after receiving the RAI (the radiologist who reviewed my uptake scans said 3 days, endo said 5 days, I've read anywhere from 2 to 11 days on the Web)
- I've read lots of stories from thyroid patients who have taken RAI who have had other issues crop up afterward that they attribute to the RAI
- my family doc, and more importantly RE, recommend against RAI
- RE says his patients who have taken RAI have only had success rates that are about 50% compared to his thyroid patients who didn't take RAI

I brought up the one-year wait issue, and endo asked how I would feel about waiting that long or longer before doing a transfer. I pointed out that we've already been waiting 7 years, and I'm in the latter half of my 30s and would like to try to have two kids before 40 (the original goal was two before 30!), so she was very sympathetic and agreed that surgery would be a reasonable approach in my case given all of that. The question is whether the surgeon will also agree to that. Since a surgeon's whole job is to operate, I'm hoping he will.

I'm so happy to have a diagnosis, but on the other hand a bit of me is angry, too. Hashitoxicosis patients are often misdiagnosed as having emotional issues or told that they're being hypochondriacs. There are so many times I went to my former family physician with issues that he couldn't explain, and he just told me I had anxiety and don't handle stress well. I mentioned some of those to the radiologist and to the endo, and they both said they suspect it was my thyroid causing the symptoms (onset of major tremors, racing heartbeat, etc. that developed out of nowhere over the course of a week). Part of that anger is directed toward myself, though, because I knew my complaints were being dismissed, and I didn't stand up for myself.

But mostly, I'm just hopeful that getting the thyroid issue resolved will help me to be much healthier. It won't guarantee a successful, healthy pregnancy, but it will give us a better shot at it.

A Good Week

There's definitely some truth to the idea that sometimes the anticipation of something is worse than it actually happening. The first week of being 35 has actually been a pretty good week.

Nothing particularly exciting happened; I've just been in a good mood for some reason. On Monday, a co-worker who is trying to get pregnant brought in a book to show me - Dr. Robert Green's Perfect Hormone Balance for Fertility. And while I've been content to think of a transfer as something far off in the future, the energy to deal with infertility is actually slowly returning.

I ordered the book, because I have his Perfect Balance: Look Younger, Stay Sexy, and Feel Great, and when R and I followed the book's 2-week sample menu for a couple months, the results were amazing. We lost weight, my skin was the clearest it's been since about the 1st grade, R's incredibly sensitive stomach was sensitive no more, and his nails went from being brittle and cracked to totally normal. So I'm interested to see what the fertility book will bring. It didn't look like it has a menu, but my co-worker said it's the best book she's read on fertility so far.

I've also lost just over 20 pounds as of this past week, so I'm happy about that too. Ideally I'd still like to lose another 80 pounds (dream weight), or at least another 60 pounds (very healthy weight), but realistically I'll be lucky if I lose another 40 pounds (still technically "overweight" according to all the charts) between now and whenever we do a transfer. But at least "overweight" is better for a pregnancy than "obese" is, which is still the category I fall into at this point.

My thyroid is still freaking out. Last month's test showed my TSH was 0.005, which is very low. I'm actually quite glad, because at least I'm not going crazy imagining symptoms, they really are happening. I'm supposed to have a thyroid uptake scan this week or next to determine if it really is thyroiditis or if it's regular hyperthyroidism.

My dad is doing ok. I'm probably going to see him again in a few weeks, possibly to accompany him to his next doctor's appointment. His first round of chemo pills last month reduced the cancer cells to 6% of his blood (down from 25%).

However, because he didn't go completely into remission, he's been kicked out of the study he was in. His doctor has given him a couple different options. It sounds like the preferred route is another round of chemo pills, but this time for 17 days instead of 7. Since he's no longer in the study, the pills aren't free, so he's trying to find out if his insurance will cover them. If not, it's about $10,000 for the 17 days, and it's not guaranteed that he won't need additional pills.

The other option is a more aggressive form of chemo taken as a hospital in-patient, but I don't think it's been determined whether insurance will cover that, either, and it's more risky because it could damage his kidneys and start to shut down his organs.

Overall, though, he's handling it with amazingly good spirits, which makes it easier for me to handle, too.

Here's hoping for another happy week this week.

Turning 35, Feeling Fragile

In less than 12 hours, I will officially reach the age that makes REs hyperventilate.

I've actually been doing pretty good about it - mostly just ignoring it. Non-IF pregnant women in their ignorant state of bliss haven't annoyed me any more than usual this week. I had lunch with a friend today, and she told me about a former co-worker whose wife had their first baby a couple weeks ago. They got married less than two years ago. Yea, hooray, whatever. Not a single tear of self-pity welled up.

Then R's dad called tonight. We celebrate my birthday and R's brother's birthday together, because his birthday is the day after mine. I picked the restaurant, so it's R's brother's call for the movie.

The (32-year-old, single, childless) man wanted to see "Up". I'm sorry, but I'm going to be downer than "Down" if I have to spend 2 hours of my 35th birthday sitting in a theater surrounded by children, thinking about how I'm now 7 years older, 50 pounds heavier and $100,000 poorer than when we started TTC. I don't care if it's the best movie of the year, the most fantastic example of animation ever created - I can't do it.

We're going to see "The Hangover" instead. And although I've never been drunk before (I don't like the taste of alcohol, so can't drink it fast enough), I may just decide to end the day with a hangover myself.

P.S. I appreciate all of your thoughts and prayers for my dad, and I'll update more about him soon. A quick synopsis: He had another bone marrow biopsy this week, and he's supposed to get the results next Thursday, so we'll have a better sense of what's going on then. The pills his doctor gave him last month did, in fact, turn out to be chemotherapy. He tolerated it very well, and he is very proud that he still has his hair. I'll be going out to see him again soon, but I don't know exactly when yet. (KayJay, thanks for asking. And, congrats on beta #1!)

Thyroid Levels

I've been promising to post my thyroid test results for about 8 months now. Clearly I've been lazy about it, but for those of you who are into this sort of thing, here they are, finally. I'm including the test names exactly as they are written on the lab results, with the normal ranges in parentheses and abnormal results bolded:

Sept. 2001 (family physician, part of bloodwork for a routine physical) - T3 uptake 35.8% (23.4-42.7); Thyroxine (T4) 7.9 (4.5-12.5); T7 Index 2.8 (1.2-4.3); TSH 0.19 low (0.40-5.20)

Sept. 2002 (family physician, part of bloodwork for a routine physical) - TSH High Sensitivity 1.10 (0.40-5.20); Free T4, Non Dialysis 1.0 (0.8-1.9)

March 2003 (ob/gyn, for irregular cycles after starting TTC, got diagnosis of PCOS at this time) - TSH High Sensitivity 0.51 (0.40-5.20)

April 2005 (endocrinologist, regarding PCOS while on a break from TTC) - TSH High Sensitivity 1.18 (0.45-4.50); T4 Free, Non-Dialysis 1.5 (0.8-1.9)

October 2005 (family physician, part of bloodwork for a routine physical) - TSH High Sensitivity 0.41 low (0.45-4.50); T4 Free Non-Dialysis 1.6 (0.8-1.9)

July 2008 (RE, one-day workup) - TSH 3rd Generation 2.29 (0.40-4.50); T4 Free 1.1 (0.8-1.8)

Sept. 2008 (different familiy physician, part of bloodwork because she thought something was up with my thyroid) - TSH 0.092 low (0.45-4.50); Thyroxine T4 8.3 (4.5-12); Thyroxine T4 Free Direct S 1.30 (0.61-1.76); Triiodothyronine T3 188 (85-205); Triiodothyronine Free Serum 3.3 (2.3-4.2)

Oct. 2008 (endocrinologist) - TSH 3.19 high (0.30 - 3.00); Free T3 3.8 (1.5-4.1); Free T4 1.28 (0.80-2.00); Total T3 76.8 (65.0-185.0); T3 Uptake 32.3% (25.0-40.0); Total T4 6.3 (4.5-12.5); FTI 2.03 (1.13-5.00); Anti-TG Abs 69.2 high (0.0-40.0); Anti-TPO Abs <10.0 (0.0-35.0); TRab <1.0 (0.0-40.0)

Nov. 2008 (endocrinologist) - TSH 4.95 high (0.30 - 3.00); Free T3 5.7 high (1.5-4.1); Total T3 225 high (65.0-185.0); T3 Uptake 23.7% low (25.0-40.0); Total T4 10.5 (4.5-12.5); FTI 2.49 (1.13-5.00)

I'm no longer seeing the endocrinologist who did those last two rounds of bloodwork, because my company went with a new health insurance plan this year, and he isn't on it. I had an appointment about a month ago with a new endocrinologist, and I'm hopeful that she will be a good doctor to work with.

She was very patient and listened to my whole story. She was also encouraging about the baby thing, saying that "when" I get pregnant again, she wants to see me immediately and then will continue to monitor me every 6 weeks or so throughout the pregnancy. She and her husband tried for four years before they were able to conceive, and she just had her baby this year, so she really relates to us wanting to get (and stay!) pregnant.

She said she thinks I have a rare form of thyroiditis called Hashi-something-something-thyroiditis. (Not Hashimoto's.) She said a virus or other triggers may be causing my immune system to attack my thyroid occasionally, which leads my thyroid to dump all the hormone it's holding, initially causing my TSH to drop and then rise slightly abnormally high before settling down again. That kind of makes sense, because when I had the really low TSH level in September, the blood for that test was drawn about two weeks after I had a really bad cold.

My next step is to go back to her in August. I'll get the results of the bloodwork I did last month at that time; I'm guessing it was normal based on how I was feeling. She also wants me to repeat the bloodwork in the meantime if I think I'm feeling significantly hyper or hypo, but so far that hasn't been the case.

From there, she'll continue to monitor me every 6 weeks to 2 months until my bloodwork shows three consecutive normal levels. At that point, we'll look at doing a transfer, depending on how things are going with my dad and how I'm feeling about my weight and overall general health.

'Couple's Lov.emaking Session Sets House Ablaze'

Note to self: Buy a proper candle snuffer, so that the local media isn't forced to print a photo of us next to a headline like that.

Because we infertiles rarely have enough laughter in our lives, I will share the story of our near humiliation with you. (Just don't tell R, because he will not be happy with me for sharing, even in this relatively anonymous forum... :-) )

As you know, one of the silver linings of infertility (albiet one that we would of course trade in a heartbeat) is being able to sleep in during a weekend morning because there is no pitter-patter of little feet wandering around the house. Well, yesterday morning after sleeping in, we were in an amorous mood. So, even though it was daylight out, R set the scene by lighting a bunch of candles in our room.

Afterward, I got up and was in the bathroom when I heard the sound of running feet. I looked in the mirror, and there was R, dashing toward the bathroom, one of his hands held high in the air and orange flames leaping from the top of it.

When we extinguish candles, we use an unbent paperclip to extinguish the flame by pushing the wick into the melted wax, because it doesn't create smoke in the process, like a candle snuffer does. When R was lighting the candles, he noticed that the paperclip had been left in one of them last time, and the wax had hardened around it. (He swears it was me who left it there.) When he saw that, he decided to just leave it, figuring that once the wax melted, he'd just be able to use the paperclip as usual.

What he didn't count on was the fact that a paperclip, being metal, absorbs heat.

When he went to extinguish the candles while I was in the bathroom, the paperclip was hot. So he decided to grab a Kleenex, fold it up and use that to grasp the paperclip.

It was an approach that worked well...until he reached the last candle. As he lowered the paperclip to the wick, the flame caught a corner of the Kleenex, setting it on fire while R was holding it. Not wanting to burn the furniture, and having no bucket of water immediately handy, R decided to race across the carpeted room to the bathroom. He was about four feet shy of the bathroom when the charred Kleenex bits began to fall to the floor, catching it on fire.

Flames, it turns out, really can dance. And apparently, so can R, when the floor is on fire.

I stood there with my mouth gaping open, trying to comprehend the scene in front of me, particularly the facts that our house had just been literally set on fire and that the flames were moving rather rapidly across the carpet. By the time I came to my senses and whirled around to fill a glass with water, R had stomped most of the fire out with his (bare) feet. Then he was dancing around because his feet hurt, although thankfully he didn't get any significant burns.

Our light beige carpet had some black spots, but somehow between using carpet cleaner, a scrub brush, and the vacuum, R managed to return the spots where the burnt Kleenex melted into it to a nearly normal color. Thanks to the ceiling fans in our bedroom and bathroom, as well as some frantic fanning of the air, we also managed to prevent the smoke detectors from going off.

We were particularly grateful for that, because how would you explain that to a mother who lives with you (like mine does)? "Um, well, we were in the mood, and I guess things just really heated up..."

In Need of a Miracle

Once again, I'm reminded of what an incredible group of women the infertility blogosphere is comprised of. Thank you all for your support and words of encouragement.

Unfortunately, I don't think modern medicine is going to be enough for my dad; I think he's going to need some divine intervention to beat the leukemia.

In response to Ashley's question about the medical center where he was taken, he's in California, and his local doctor arranged for him to be taken to Stanford. That doctor told him he would likely be there for two to three months, but he got there late on Saturday night, and they were planning to release him today without any significant treatment at this point. (Not a good thing.)

He wasn't in great health before his diagnosis. He's had a couple of heart attacks and a stroke in the past five years, and he also has diabetes, high blood pressure, and high cholesterol, and because of all that stuff, he's already in partial kidney failure. The Stanford docs told him that aggressive treatment (i.e. high-dose chemotherapy) would likely kill him in 4 to 6 weeks.

The doctors presented him with six different options, and he chose to go home, wait for the bone marrow biopsy results and take pills of some sort.

I know, I know - I should have more information than "pills of some sort." But when he tries to talk, he has hacking coughing fits, and his wife is not the type of person who enjoys spending much time on the phone. I will probably call his doctor at some point, but I want to ask their permission first. Hopefully I will talk with them again tomorrow.

Ironically enough, I had an appointment with my therapist about two hours after I found out about the diagnosis on Friday. She asked how I would feel if my dad doesn't get to meet our children. I told her that wouldn't bother me as much as if my mom doesn't get that opportunity, because I'm my mom's only child, i.e., only chance for grandkids.

My dad has three other children from a previous marriage, and all three of them have kids; he's been a granddad since I was in high school. He lives near two of my three siblings, although I don't think he really spends much time at all with them or their children; out of all his relationships with his children, he and I are by far the closest, in large part because they grew up living with their mom in a different state than him.

I also figured that because we're in different states, even though he would love our kids, he probably wouldn't see them more than once every couple of years anyway. So I rationalized that it wouldn't bother me as much, and in some ways I do very much believe that. But listening to him tell me that Stanford is sending him home and that he's not a candidate for aggressive treatment, the tears finally came, and they were around this issue as much as anything else. Damn infertility if it has stolen the opportunity for my dad to meet my kids on top of everything else it's taken from us.

I was on the phone with R, relaying everything I'd found out, when I started to choke up. He was very sweet and quick to reassure me by saying, "Honey, he may not get to meet our kids here on Earth, but he will definitely get to meet them one day."

If anyone's medical issue was to be reversed by a miracle, it wouldn't surprise me at all if it was my dad's. He has a tremendous amount of faith and believes very strongly in "laying hands on people." But as we all know, God doesn't necessarily grant miracles in the way that we hope for them.

I'm heading out to visit him on Saturday morning. On top of that and work, my next semester of classes started yesterday. This time I'm taking two classes, and they're kicking my butt already - they involve much more reading and many more weekly assignments than last semster's class, so I may wind up having to drop one in light of everything else that is going on. I want to catch up with each of you individually, but please forgive me if it takes me a while to do so.

Turns Out Infertility Is Good For Something After All...

The first time I received an infertility diagnosis (PCOS), it was a painful thing to hear. A few months later, when my OB called to tell me about R's practically non-existent sperm count, it felt like the world was crashing in around me.

Almost exactly a year later, when we experienced miscarriage #1, it was absolutely impossible to even fathom how it would be possible to wake up one day and not have my first thought be of the baby we lost, impossible to think that we would ever be able to even laugh again.

But the thing about infertility - when cycle after cycle fails, diagnosis after diagnosis hits, baby after baby dies - is that eventually you deal with so much devastating news that handling it actually starts to come automatically.

My dad was diagnosed with leukemia on Thursday.

When I heard the news, of course it was like a punch in the gut. His symptoms came on quickly; I talked with him a week or so ago, and he was fine at that point. (Or at least if anything was bothering him, he didn't mention it and he sounded totally normal.)

Six years ago, this news would have leveled me. Instead, I haven't even cried, haven't even teared up. It's not that I don't care or that I'm not concerned, because I absolutely am. It's just that this is how far infertility has brought me - instead of falling apart, I automatically went to "What type of leukemia is it? What are the doctors doing for him immediately? What is the longer-term treatment plan?" etc.

I don't know the answers to most of those questions yet, other than that it's AML, which is the kind that has a less favorable survival rate. It's tough, because I'm used to being in the center of all the medical stuff and pushing to get answers, but this time I have to take a step back and respect that as his wife's role. She's not as pushy as I am. :-)

My dad lives in a very small town, and he started out in that town's hospital. However, he was supposed to be taken by ambulance last night to one of the best medical complexes in the country, which is three hours away from where he lives. I'm thankful he's going there, because that's one of the very best places he could be. But it's probably also a sign that the situation is pretty grave.

I expect we won't have much more information until toward the end of the week, because I'm sure it will take at least a few days to do the initial tests that his new hospital is going to want. I'm trying to figure out when to go see him.

What to Say?

I've decided it's time to kick the last post's title off everyone's blogroll, but I haven't been able to figure out exactly what to say. I've started several posts and saved them as drafts, but they all feel very convoluted and scattered to me.

I know I've been relatively quiet since the great micro array results from a couple of months ago. The reason is, a few weeks after the results came in, I had a follow up consult with RE that kind of threw me for a loop.

I figured given that we have 19 embryos to work with, we'd give me a shot with at least 6 to 8 of them before contemplating surrogacy. However, RE says if I have one more miscarriage, he'll recommend surrogacy at that point. That was a bit of a shock - I just wasn't expecting to be facing a "one more strike and you're out" kind of scenario with so many embryos on deck.

So, I decided to take the ostrich approach while I processed that. I didn't do anything infertility (or thyroid) related in April. I just chose to ignore the whole darn thing.

Of course, ignoring it can only last for so long, so last week I finally did get around to making an appointment with a new endocrinologist. That will be in the first week of June. A co-worker who also has thyroid issues recommended her. She's a young doctor (finished residency in 2007) and had a baby a few months ago. Co-worker said, "Maybe that will make her more sympathetic to your situation." I hope so.

Generally I prefer doctors who have had at least 10 years of private practice experience, but at this point I figured, why not give her a try? She can't be any worse than the endo who told me he wouldn't do anything to treat me until I start to show signs of congestive heart failure. Yes, that's right - he wants me to develop an irreversable heart condition before he'll take action to treat my thyroid condition. Infertility or not, he's out of his mind if he thinks I'm going to wait until that point before getting my thyroid addressed.

On a happier front, now that I understand what's going on with my thyroid, I think I've gotten the hang of managing my eating in a way that is helping me lose weight. I'm significantly upping my food intake when I feel the hyper signs, then as soon as I feel myself swinging to the hypo side, I start popping Synthroid for a few days and switch to eating salads for the last two meals of the day.

So far, I've lost 16 pounds in the last three months. There's still a looong way (weigh? - sorry, couldn't resist) to go, but at least I'm moving in the right direction.

Other than that, R and I are thankful we're both still employed, which is definitely never a sure thing in this economy, and we've embarked on a new (hopefully tear-free and heartbreak-free) adventure: we're buying our first investment property. It's amazingly nice to have a goal that doesn't involve needles and wand dates.

Once I manage to edit my other ramblings into semi-coherent thoughts, I'll post those too. But I'm starting the next semester of school next week (two classes this time - what was I thinking??), so I probably still won't be a super frequent poster. Looking at the syllabuses (syllabi?) for each class, I think I have about 200-250 pages of reading each week. Yikes!

Dead Baby Week

This is the week of the year that I dread the most, by far.

Tomorrow is the 5-year anniversary of Miscarriage #1. It's incredible to think that half a decade has passed, that I've made it through to such a different place than I was 5 years ago. Heck, some days, the fact that I've made it through at all feels like a miracle.

It's sad to think that we should have a child who is almost 4 1/2 at this point. And even though it's Cinco de Mayo and I live in a place where that's celebrated with almost as much fervor as New Orleans celebrates Mardi Gras, it's just not possible for it to be a day of celebration for us anymore.

Friday is the 3-year anniversary of Miscarriage #2. That pregnancy came and went so quickly - the day we found out for sure that I was pregnant is also the day we found out I wasn't going to stay that way - that it didn't feel quite as devastating as the first one. But it still counts, and I still hate that it had to happen this week, of all weeks. Some years, it falls on Mother's Day itself. Double ouch.

The other pregnancies didn't end during Mother's Day week, but for two of the three, that weekend still marked some sort of significance. For the twin pregnancy (pg #3, m/c's #3 and 4), I would have been entering my third trimester during Mother's Day weekend. Instead, we didn't even make it out of the first trimester. And last year, Mother's Day marked the 1-month anniversary of m/c #6, which was also D&C #2.

I just want to go to bed tonight and sleep through until next Monday morning. Hopefully at some point in the future, there will come a time when I don't hate this week so much.

Micro-Array Results are In

It's good news. News with significant ramifications, though, which I'm still trying to process.

Out of the 21 embryos that were biopsied, 15 tested normal. So just under a 75% normal rate. We're in shock.

However, those 15 embryos combined with the 4 "no results" from last cycle, means that we have 19 embryos to deal with. And since it was never our goal to have 19 children - or 57, if you consider that each one of them theoretically has the potential to divide into identical triplets – that also comes with the aforementioned significant ramifications.

I'm just trying to let this news sink in, and let all the different emotions that are swirling around in my brain, settle down. They include, in no particular order:

Disbelief, as in are these results really true? What if the lab made a mistake? If they didn't, why did this cycle turn out so well, when last cycle we didn't have any confirmed normals? I think the only way to determine that for sure would be to thaw all of them, rebiopsy them, and then send the "no results" batch to the micro-array lab and the "normals" batch to the CGH lab, and see if they come back with similar or different results. But I'm not keen on thawing and refreezing them, so I doubt we'll do that.

Hope, which out of self-preservation my mind and heart have tried to squash (although never succeeding completely) over the course of this nightmare, especially the last couple of years. Now it's back, as much as my inner self will allow it to be. It's not a jumping-for-joy, shouting-from-the-rooftops kind of hope, more of just a small, quiet thing that is being allowed to sit tentatively in the corner of my heart for now, acknowledged but not a guarantee of anything.

Fear, because as much as everyone will think "wow, they've got it made now!" and as much as the staff at the clinic are shrieking in excitement, we've been on the wrong side of tiny, tiny odds too many times to count. It could happen again, folks. When you've lost six babies, the core of your soul eventually comes to accept that which most people are blissfully ignorant of their entire lives – nothing, NOTHING, in this world is ever guaranteed. Not even when there are 15 supposedly chromosomally normal embryos with your name on them.

Sad, because odds are that at least a couple of the babies we've lost were chromosomally normal. In May, it will be five years since we lost the first one. Half a decade. I wonder what they would have been like, think about the milestones they would have been reaching. I still ache for each one of them, every day.

Guilt, because odds are that at least a couple of the babies we've lost were chromosomally normal, which means it's my body's fault that we lost them. When I see another IFer post something like that, my instinctive reaction is "No, it's not your fault, there are just some things beyond anyone's control." And I believe that 100 percent. Yet the guilt is still there, underneath it all.

Fear, because what if we put one back and it works, and then a couple years later we put one back and it works, and then we have 13 remaining chromosomally normal embryos, and four other "no results"? I might, might be able to talk R into one more at that point (and who knows if I'd even want to?), but I definitely couldn't talk him into 17 more. Not that I would want 17 myself! And then would come the painful process of letting go of them and finding other families for them. And after you've worked so hard, endured so much, for so long, how do you live knowing that pieces of you, the two of you together, are out there walking around, without you to take care of them?

Overwhelmed, because if we transfer 4 or 5 or 8 of them to me and none of them work, we're going to have to attempt the gestational surrogacy process. And that's a whole new, huge, overwhelming task that I can't even begin to contemplate tackling. Not to mention, it will involve R or me (or both of us) having to get a new job that has surrogacy coverage, because we definitely don't have the financial resources available for that on our own.

Fear, because if we have to use all 15 embryos to reach our goal of two or three children, that means there's a whole lot of heartbreak, be it negative HPTs or miscarriages, that will have occurred along the way.

Fatigue, because this means there are now 15 chromosomally normal embryos between us and the end of the treatment road. I realize that's a great dilemma to have, and don't get me wrong - I'm incredibly grateful to have this dilemma rather than the alternative. But still, it's been a long 6 years, we don't know how many more we're facing, and right now I'm a heck of a lot older, fatter and more tired than I was when we began this process.

In a lot of ways, this 75% normal rate is the best outcome we could hope for, and I know that. But regardless of what the end of this road turns out to look like, this outcome is also a guarantee that there will continue to be tremendous pain along the journey to that end.

Freezing But Having Fun

I know I've been quiet lately. Everything is fine, I'm just trying to get into a rhythm. And now we're on vacation, so I don't have much Internet access.

So far, I'm not terribly great at juggling school and work. (I started working on my master's degree online two days before I headed to Colorado for our January cycle.) And I decided to ease into it by starting with just one class for this first semester, so I can't imagine what all the rest of the semesters will be like with two classes each! I keep saying I'm going to get ahead, but right now I'm still turning in all my assignments the day before or the day they're due...

Nothing new on the IF front at this point. This Wednesday, it will be three weeks since the embryo cells were sent off for micro-array, so I imagine it will be at least a few more weeks before we get the results. But between school, work and vacation, the time is flying by.

On a much more fun note, R and I decided after the November cycle that we needed a vacation. 2008 was a tough year, with R's company kicking off the year with a major layoff, miscarriage #6, all his dad's heart problems, R winding up needing a defibrillator, and it taking six friggin' months and a couple of false starts for us to get to the point of being able to do the November cycle.

We started our vacation by flying out late on Friday night. On Saturday, we met up with my best friend and went to a place called Jillian's (I imagine it's like a Dave & Buster's, although I've never been to D&B.) Jillian's has an arcade, pool tables, a bowling alley and food. We played air hockey, skeet ball, basketball hoops and some other games. I also spotted a Chocolate Cafe nearby, which is totally my kind of place, so I dragged my friend and R there and bought $26 worth of chocolate. (Not all for me, I swear!)

Then we said goodbye to BFF and drove a couple of hours to see another close friend of ours. Her oldest daughter, now 17, was the flower girl in our wedding, and I consider her and her younger sister to be my nieces.

They had gift cards to an even more yummy chocolate place, and my friend (without knowing about the chocolate I'd bought earlier in the day - even I'm not that much of a chocolate whore!) suggested going there and stocking up. We wound up going there before dinner, just to make sure we got there before they closed. We spent $57 on chocolate - yikes! But it was for 6 people, so I suppose it's not quite so bad if you look at it that way.

We went to dinner, went back to her house and dug into some of the chocolate, and then I stayed up until about 1 a.m. helping my older niece paint her bedroom royal purple on three walls and black zebra stripes on the fourth, white wall. It sounds extreme, but it worked, especially once she started putting the room back together. It was great to see all of them.

Then we drove a few more hours to meet some other friends of ours, and tomorrow the four of us are getting up and driving five hours to the Traverse City, Michigan area, where it's supposed to be about 20 degrees. (Keep in mind, back home it was 85 degrees this weekend!) This is cold unlike any we've ever experienced! :-)

But we've rented a great place that has a fireplace and a 6-person hot tub, so we'll find ways to keep warm. We're going to go snowmobiling, play board games, just relax and have fun. Something we don't do nearly enough!