Friday, October 31, 2008

Happy Halloween!

Today, I give myself permission to eat candy to my heart's content. I'll be the one dressed up like a pimp in the corner of the room with a dozen lollipops hanging out of her mouth. Seeing as how I'm living like a nun in all other respects (no caffeine, no alcohol, no excessive amounts of chocolate), I think the candy thing is a fair indulgence, especially as I'll be tonight's designated driver. Ya know, I was lamenting this whole DD thing for awhile, but then I became so thankful that my closest friends are still childless and our Halloweens consist of solely 'adult activities'. This day is nevertheless a reminder of all that has not yet taken place in my life and also, stands as the gateway to the holiday season, the hardest time of the year for all of us. Still, I wish you a Happy Halloween and hope you're able to find a little joy in the holiday. :)

Wednesday, October 29, 2008

The 2 WW Mulder/Scully Conundrum

It's setting in. Not just that ever elusive hope, but those expectations that I *try* to keep down because reality is so much easier to digest in that state. But the events of today cracked those plans wide open, leaving me terrified that if there is no BFP at the end of these two weeks, I might just lose it.

But I know better. There will be no BFP. It doesn't work that way. Not for me, at least.

I've been here a million times over (approximately 50, actually, as this is the number of months that have passed since we've been sans BCP). Yet still, delusions are so easy for me to grasp at. Despite my two lonesome little follies, everything else seemed to fall neatly into place, convincing me that this just might work. My cervical mucus is AWESOME. So awesome, in fact, that the NP couldn't even get the slippery speculum into place (ok, who ever thought I would blog about cervical mucus? and describe it as awesome at that? And in caps?). Then, my lining came past the finish line at a thick and fluffy 10. Yeah! Can I get a w00t? But best of all? Wait for it...

Mr. S's baby batter was almost in the normal range for both count and motility!

Hell to the yeah!

I know this doesn't seem very monumental, but let's look at this in relative terms. The type A half of my Gemini twin self has a spread sheet detailing the stats of every semen analysis and IUI sample Mr. S. has ever given. All 5,000 of them. Poor guy has had more dates with RE office porn than he'd care to admit. I will admit my cataloging of this seems a bit overzealous, but the fact that I can't find the title to my house makes up for that anal retention. Priorities, people. Anyhow, the best of the samples was given over 2 1/2 years ago at 21 mil and 20% motility, pre-wash. Since then, the numbers have taken a steep nosedive. The worst? 5 mil and 30% motility, and that was when we got pregnant in April (clearly and completely against the odds). When I opened the paper outside of the RE's office detailing this month's stats, I couldn't believe my eyes. It was... (drum roll, please):

45 mil count and 50 something motility (can't remember specifically), pre wash. Morphology was normal, as it always has been.

Holy shit. Are you sure this is my husband's sample?

Yes. Apparently it was.

You're probably wondering how this happened and there is only one explanation:



Now normally Mr. S. and I are textbook skeptics. Total Scullys. You show me solid proof and I may or may not believe. But after 3 different REs recommended this, I thought it was at least worth a look into. When I did, I saw that they've actually done studies to show improvements in count and motility. Real studies (at least, what looks to be from my limited scientific background). After some convincing, Mr. S. began diligently popping them nightly right after our miscarriage, despite the fact that they tear up his stomach. And now, I'm wondering how I can buy the suckers in bulk. Call me a believer. A total consumer whore. I'm sold.

While I might not have a BFP at the end of this, it increases the chances of it ever happening. Hey, in the very least, we may be able to avoid ICSI, which will save us a ton. In the mean time, I'm trying to stay grounded and not believe that just because of this, it'll work this time, but the Mulder in me is fighting his way through. I guess I'll accept that for now and do clean up later. And so, the 2 WW begins...

Tuesday, October 28, 2008

True Colors

I have been a pitiful reciprocal blogger lately. Sure I come spill to my heart's content, but my 'participation' in ICLW this month was lackluster at best. With 50 entries still waiting in my reader (mind you, I am signed up to follow at least as many blogs) I have some catching up to do. But if I'm not commenting, I am reading and keeping up with so many lives that along with the 27 kids on my counseling caseload, my head is starting to spin a bit! Of course, I am forever interested in others, so this is definitely not the worst thing in the world. And as always, I feel less alone with each visit.

I go for IUI #5 tomorrow morning. With the baby batter tucked safely away in my bra, I will cross the many different freeways the East San Francisco Bay has to offer and pray that the little guys in the tube I'm cradling will somehow find their way to my plump follies. I had a third that was right behind the other two in growth, but he/she doesn't look to be a taker. My expectations are low, but against my ever-loving will, my hope is high. I expect nothing less from the end of these next two weeks than a crushing defeat.

For someone who lives inside the IF closet, I do actually have quite a few people who know about our IF. But it's not the fact that we're infertile that I hide as much as how it effects me. This is my M.O.: the girl with a smile plastered on her face, even while standing in the middle of a snow storm. It was funny. The most empathetic thing I've heard in a long time came from my new boss yesterday. I hardly know this woman. I told her about our treatments and how I would be sure to make up the time here and there and her response was, "I'm not worried about that. I'm just worried that that must be so hard to deal with." Simple stuff, huh? Just a little acknowledgment of what I must be going through.

I don't often show my 'true colors' and am very good at standing an arm's length away and appearing unshakable. I wonder what I am missing out on because of this-the relationships and the support. Perhaps, in the near future, I'll get the courage to explain it all to someone outside of the IF world.

Friday, October 24, 2008

Move Two Spaces Back

Damn. Only two mature follies after the friggin' expense and discomfort of injectables. Great. It already feels like this cycle is a complete bust and waste of my time, one that I'll be scrambling to rearrange my work schedule for next week no less. Disappointment is a way of life in the great big IF, but this familiarity never makes it easier.

Being that this is my first time on injectables, they put me on the lowest dose of Menopur possible to avoid too many follies. Well, you got your wish on that last part, NP. I was doing just fine on the Clomid, popping 3 follies, but I just had to go and 'mix things up' a bit, didn't I? I guess there's some truth in, 'don't fix what's not broken'. Of course, I myself am broken, but the protocol we had going was not. However, I got greedy, thinking, "I want 4 follies! Maybe then Mr. S's struggling few soldiers will find their way to the battlegrounds!" Poor sluggish, wandering souls have no chance when there's only two needles in the haystack. But we must do what we must do to convince ourselves (and mostly Mr. S.) that everything possible has been attempted before getting out the big guns, so at least I can check IUI #5 off the list.

Today I felt much the same way as I have in the past after a BFN. I was easily irritated, wandering around with a vice on my heart, frowning at passer-bys. After seeing this in myself (which is unusual, as I'm generally cheerful), it always gives me a new perspective on people who walk through their day looking sour. It makes me realize that there is so much in the backstory that I am not privy to. Perhaps they have just lost a child? Perhaps they have just had their house foreclosed upon? Perhaps their friend just passed away? Perhaps, like me, they are watching day-by-day, year-by-year, their dream slip through their fingers? I am not so quick to judge now-to come to the simple conclusion after being met with a scowl that I'm just standing face-to-face with an asshole. My grief has allowed me a new empathy for and understanding of other's dimensions.

Once in a great while I get a stupid email from C.lassmates.com and today was no exception. That stupid email was something about being able to post one's 'personal time-line of life's big moments' for all to see. You know, so you can compare who's a loser and who isn't. So people can show, "look at me! I'm living the American dream! College, marriage, 2.5 perfect little private-school bound kids and a promotion to senior vice-president!" First of all, f&$k you C.lassmates.com for perpetuating this juvenile competition past high school and into adult years. This is why so many people avoid class reunions to begin with. Secondly, thanks for reminding me that I am not even close to where I once dreamed I would be. I'm sure this is true for many subscribers in multiple respects, but for me, my life's big accomplishment markers were many years ago-marriage, college. Yes, I'm happy with all of that and overall, I am proud of where I am, and also, I am by no means pursuing motherhood to add another notch to my accomplishment belt, but exercises in detailing your 'life's big events', whether online or in a conversation with an old classmate are yet another reminder that the dream that I spoke of previously is still waiting in the queue and worst of all, may never be fulfilled.

I have a bit of a negative streak to me today, as you may be able to hear in my words. I'm not sure whether it's a lack of sleep, the Menopur, the disappointment, or the combination of all three that are fueling it, but I see it disappearing by the weekend. I'm meeting up with some support group IF buddies for dinner and then heading to a 49ers games with a buddy on Sunday, so I'll be back, refreshed and more willing to face this cycle next week. I'm not in the best place, but being that I can still be excited about little things, I'm certainly not in the worst place, either. Hey, that's something.

Tuesday, October 21, 2008

Forward Momentum

Ladies and gentleman, we have lift off. As of last night, Mr. S. has been shoving needles in my gut to get my ovaries a' poppin'. Who knew mutilation would signal progress for me?

The good: I actually got more than 5 minutes of my nurse practitioner's time yesterday. In that time, I was able to get karyotype, thyroid panel, and some immunology blood work ordered, at a measly $10 co-pay for all of them. Booyah! That is assertiveness at work, a skill I sorely lack on my most days, but have been able to sprout all in the name of baby. The NP was awesome enough to order them under 'multiple pregnancy loss', despite the fact that there haven't been multiple. But she totally got my feelings about prevention and went ahead. I almost started to cry because the last time I saw her, she was standing in front of an ultrasound machine which was flickering with a heartbeat and telling me I had 'graduated' to a real OB. I think that helped my request along. Also at my request, we started an injectables protocol (menopur). Although I have responded fairly well to clomid, I wanted to mix things up and get at least one more follie than last time. I go in Friday for my check-up and if all looks well, our IUI is planned for Halloween or the day before...yeah! Despite Af taking her sweet time, I'm right on schedule because as I understand it, injectables speed things up. Love it. I spent over half an hour with a nurse showing me injectables and talking about the cycle, so I was feeling pretty cozy with my HMO path. That is, until I got to the Pharmacy to get my meds.

The bad: It was FAR more expensive than I originally anticipated. In fact, previously my HMO was covering my meds, but this time, I was forced to cough up hundreds. I'm not sure why the discrepancy and I'll have to look into it. Lucky for the raping and pillaging pharmaceutical companies, I want a baby so bad I'll go so far as to walk to work and live in squalor, so I handed over that debit card, as heart wrenching as it was. While it was worth it, financial 'surprises' are never fun.

Also, while I love my NP, she kind of poo-pooed my Luteal Phase/Progesterone talk saying that she's only had one patient who has needed progesterone shots in all of her time in practice. I was too polite to ask, "and how does this apply to me?" So when I go in on Friday, I will take that discussion further and suggest shots. It can't hurt, so if there's even a question about progesterone as the villain, why not?

Overall, I feel that I was more informed and more of an advocate in my appointment yesterday, thanks in large part to all of my online support. I've also been getting so much from my 'real-life' support group buddies, which I will talk about later as it deserves an entire entry. Thank you all, ladies! It is more appreciated than you'll ever know!

Friday, October 17, 2008

AF MIA

The plan, it was grand. The plan was so well-formulated that I had my cd3 baseline ultrasound appointment already lined up for Wednesday morning (my day off-perfect!), with the IUI to fall sometime around Halloween. At least that's what I had lined up in my head. Reality and what my body manages to do is a different story altogether. Because as I type this, it is Friday and I have been spotting for almost 5 days. FIVE. Not normal. Where was that perfect 28 day cycle I had last month, back when it was completely irrelevant? Well, I'm not sure, but I'm staring cd32 straight in the face and she doesn't seem to be giving it up either. Maybe I need to take a few long jogs around the block or have marathon sex (don't tell Mr. S. or he'll hold me to it) to coax her out. I've read this has been going around, this AF MIA epidemic. Damn contagious if you ask me.

It got me to thinking about my periods, a subject Mr. S. tells me I am way too open in discussing at length nowadays. I've always had at least 2-3 days of spotting before full flow. Worst case scenario is what I'm facing now. I looked it up and the consensus is that this is likely due to low progesterone. I have a history of low progesterone, right from the very beginning of our IF treatment, so this makes sense. But to be honest, except for my first blood work with an RE and my pregnancy, there hasn't been any monitoring of this. I've also had suspiciously short luteal phases (even on clomid they manage to be around 10 days). For a long while I've been at the conclusion that I likely have a luteal phase defect. (this is based on my ever-handy self-diagnosis tool, much to many doctor's chagrin)

When I was pregnant, we watched my progesterone along with my betas. While my betas doubled beautifully in the beginning, my progesterone stayed quite low, even with suppositories. It was low enough to where I was told to be on 'miscarriage watch' as it appeared that it might not be viable. It finally picked up and jumped into low-normal ranges, but in reading studies on this, it has been found that progesterone at the beginning of a pregnancy is somewhat correlated to pregnancy outcome in that women who had higher levels were more likely to carry to term. And yeah, if I were a participant in that study, I would've further proven the hypothesis. Low progesterone=no baby. Not that this is definitely a singular cause, but I'm wondering out loud now. Did a possible LPD cause my miscarriage? The literature is varied, but it could be likely.

As I understand it, there's some controversy with the use of progesterone suppositories. A little chicken/egg conundrum, if you will. Some docs think that the progesterone is low because the pregnancy was not viable to begin with and therefore treatment only prolongs the inevitable. Then some docs believe that low progesterone is a result of a possible LPD and that it is quite treatable, but if left unattended, could cause a miscarriage. I think I might vote for the possibility of both, depending on individual cases. Not sure where I lie on that one.

Treatment is as follows: Suppositories. Check. Clomid or injectables. Check. You could also do some over-the-counter things, but the former is the gold standard. I did all that and still no baby. I think it's important to note that this Mother ship likely has faulty wiring here. Did Baby #1 go away because my body could not support him/her? I know that it's not useful to drive myself nuts with these questions, because all that could have been done was done. But every time I see AF stave off for several days, it will remind me. My body is dysfunctional. My body was unable to keep my baby. Will it ever be fixed enough to hold baby #2 all the way, if they should ever make it into the picture? Only time will tell. I just need AF to get here to help answer these questions, and more.

Follow-up: The ship has landed! Within hours of posting this, AF came to town in all her glory. I had no idea I had the power to summon her via blog!

Thursday, October 16, 2008

They're Everywhere!

Tell me, why is it that people drop out of your life for months, even years on end, only to reemerge just to tell you they're either knocked up or just had a kid? Where were you all before that? Do people cease to exist until we are with child?

Take for instance this couple we met on a cruise last summer to Hawaii who are several years younger than Mr. S. and I. Naturally, they were on their honeymoon. We, in turn, were celebrating our seventh anniversary like the old, barren couple we are, with drinks in hand :). I haven't heard a peep from them since, so imagine my surprise (or complete lack thereof) when the husband messages me on Facebook to tell me that, guess what?! They just had a kid!

Of course you did. And "oh, by the way," I say, "I totally forgot that I need to get somewhere so, yeah, congrats and bye." A little cold, but all in the name of self-preservation, folks.

Just when you think you've wrapped yourself up in a solid cocoon of isolation, the fertiles get out their heat-seeking missile and lay their target on you, no matter where you hide. Another example: today I was left to do some work for the school counselor because she had to go home as she is, and I quote, "completely pregnant and hormonal". She's really sweet, actually, but I have little tolerance for this given my current empty-wombed state. After her 'confession', I do not stick around for the obligatory gushing over the pregnancy and her out-of-control hormones. I get the work done and I flee the fertility battlegrounds. But then I step on a land mine on my way out.

After I get home, I discover that even checking the mail is no longer safe. They can hide in there, too. So there it was, lying in wait: Mr. S's cousin's birth announcement, coming on the heels of their first anniversary. Did I open the envelope? Hell to the no. Self preservation. I'm really coming to embrace it.

So, I'm wondering, am I more aware of all things/people fertile because I am not, or are they just especially loud about reproducing? Or both? My feeble attempts to protect my heart have been insufficient lately, leading me to believe that I might as well fully join the universe. They'll** find me any way you slice it.

**They, as in fertiles, most of whom in my life I love, so don't peg me for a fertile hater! :)

Wednesday, October 15, 2008

Goodbye Letter

(written June 19th, 3 days after my D&C)-posted to remember for National Infant and Pregnancy Loss Awareness Day: Oct. 15th.

Our baby,

Last Friday, I began to say goodbye to you, and to a dream years in the making but only briefly realized. I never got the chance to meet you, to hold you, but I did get the chance to imagine what life would be like with you. You would have been due January 6th, a baby so deeply hoped for, for so long, that when I learned about you, I felt a combination of disbelief and elation. Four years of waiting, pills, shots, doctor's offices, and much to our surprise, you defied the odds and found a way into existence, even if for a short time. My little fighter. I heard your heartbeat, so I know you were real. Dreams of what your eyelashes would look like fluttering in sleep, what your tiny toes would taste like in kisses, what your pink skin would smell like are still locked in my heart and will be for some time. I now must find a way to cast those off into the Bay at my feet. I'm not sure that'll ever happen.

I wondered who you would become, what talents you would have, how you would change the world. In some ways, you already have, for me. You couldn't have been more loved, even before entering this world. You would've had a Mother and Father who deeply and completely love each other and who had already begun to share that love with you and two sets of Grandparents eagerly anticipating your arrival.

It was fate that you would never come home with us, a fate I try not to curse, but at times, I can't help it. You're not here. You see, deep in my heart, I knew you were never meant to join us. I chalked this up to years of disappointment in waiting for you, but something told me that it was more than this. The worst moment of my life was the day this was confirmed, the day I had learned that I was right-I had lost you. Wherever you are, know that you will always be missed. Always. Goodbye my darling baby.

Sunday, October 12, 2008

Onward

For a girl who had to previously restrain herself from gratuitous multiple daily posts, I have been uncharacteristically absent from the blogosphere. My job is great, but really demanding of my time, emotion and energy, I've been sick, and have honed an amazing ability to feel supremely sorry for myself lately. I wrote an entirely depressing entry last night and have decided not to post it as it did what it was meant to do: I feel better. I do feel the grief of infertility and loss more strongly right now, but I'm finding my way back to a more settled place. I think I'll be finding my way back to this place for a long time. I've been better, but I've been much worse, so it's time to move forward.

Moving forward should start next week when I either begin clomid or injectables, depending on what the NP suggests. I'm just waiting for Ms. AF, who has been happily on time in the past few months, so I hope she follows suit. I can't tell you how relieved I am to finally, after so many months, start something constructive. Even with BFNs, at least I'll feel that I'm doing something and not just waiting, the only activity I can claim since June. The plan remains the same: 2 more IUIs and then on to the IVF big guns. I face it all with a mixture of terror and expectancy. Because I plan on pursuing it all with no breaks, one cycle after the next, the questions that I live with everyday might be realized in the next 6 months. Will we have a biological child or not? By this time next year, I will have been at this journey for 5 full years. By then, I hope to at least have more answers and at most, a baby. Only time will tell.

As far as the response to the article, I've received nothing back. I think she's a bit cowardly or classless not to at least send a simple, "Thank you for your response. I appreciate your position." But I honestly wasn't expecting that kind of tact from her. Speaking of cowards, I think I won't be posting about the pregnancy and infant loss awareness day on my real blog after all. I would like to in the future, but I just don't think I'm in the right place to put up with people's responses, whether supportive or not. I'm not looking for inane comments or sympathy, and I have a feeling this is what I'll get. I really believe in not making miscarriage a secret and for that matter, infertility, but I'm just not ready to handle it...yet. I will be, one day.

Friday, October 3, 2008

October 15th: National Pregnancy and Infant Loss Awareness Day

On October 15th, my candle will be lit. When I light my little pomegranate candle with the Chinese inscription for 'family' on it, I'll be thinking of the little bean I said goodbye to at just past ten weeks this June. I'll also be thinking of all the little angels my friends in the blogosphere have had to say goodbye to as well. Now that I know what it feels like to experience this type of loss, how truly earth shattering it is, I am fully prepared to help in this cause. In fact, rather than letting this be an issue that remains hushed, I'm seriously considering posting this on my 'real' blog as well. Coming out of the closet, if you will. I think I preceded this in good timing with my post about preventative and genetic testing. I believe that more can be done with regards to miscarriage and infant loss and yet, our medical industry is better equipped to react rather than prevent. That's why we must stand together in this effort:


October 15th is National Pregnancy and Infant Loss Awareness Day during which I hope you'll join me in lighting a candle. If everyone lights a candle at 7 PM, and lets it burn for an hour, there will be a continuous wave of light across the world, a light that will remind us what we must do to make sure this issue is heard.

So, how can you help?

Visit http://www.october15th.com/ for more information. Also, visit Antigone Lost who has spearheaded this movement in the IF community to see more specific actions you can take. We are blessed enough to live in a nation that is home to the most innovative medical advancements in the world. There is absolutely no excuse why more research and funding cannot be devoted towards this issue.



Wednesday, October 1, 2008

Response to the Author

Rachel,

I am writing in response to your article posted yesterday on MSN.com, "Designing the $100,000 baby." On the tails of this, it is important to note that October 19-25, 2008 marks The National Infertility Awareness Week during which those who are affected will disseminate valuable information to their communities about infertility. This includes dispelling myths and sensationalized portrayals of the very treatments those who suffer from infertility must endure in order to bring a child home. In reading your recent article, I believe that you have done a huge disservice to this effort and to the infertility community as a whole. In fact, speaking as someone who suffers from infertility, I would go so far as to say that your effort at journalism on this piece was completely irresponsible.

Firstly, your portrayal of infertility treatments is incredibly limited, representing a minuscule percentage of cases. Given that we have so few spokespeople who have the visibility to make a real impact, this is the information the public is given. It is sensationalized, painting a picture of the misuse of medicine for the purposes of greediness and vanity. You fail to even mention the very real heartbreak that people who face years of loss and disappointment because of infertility must endure. In case you were unable to research it in its entirety, I can assure you that 99.999% of us did not choose this path. We were forced into it. Whether or not our child has blue eyes or goes to Yale is completely irrelevant. The real question is whether or not there will even be a child and if so, will he/she survive? IVF and PGD, the procedures you portrayed as very slippery ethical slopes, are the miracles of modern medicine that grant us this ability to answer that question. And in failing to paint a full portrait of infertility by not including any of its real cast members, you have just made this unwanted path that much rockier for all of us.

I am disappointed. Your article also managed to make light of one of the biggest life crises a person can face: living with infertility, the stress of which has been proven in research to equal that of patients with cancer. In likening donor egg selection to ‘online dating’, you have ignored the reality that by the time they reach that point, the woman making the selection has likely been through immense disappointment, including financial and emotional loss, and has recently had the door for a biological child slammed shut in her face. I’d hardly compare that with a perusal through match.com.

Infertility is not just a crisis in adding to one’s family, but it is also a daily social struggle. We are met with hurtful comments time and time again, the product of information such as that seen within your article. This needs to stop. This is the purpose of National Infertility Awareness Week, making your article strangely well timed. I invite you to read about the real stories behind infertility and moreover, I invite you to write about them. One of six couples in the U.S. experience some form of infertility, so that coverage of this epidemic would speak to millions rather than the small, elite group you chose to represent. I look forward to seeing more realistic portrayals of what we go through in the years to come and I'm hoping you can join us in this effort. Thank you for your time.

Sincerely,

Disgruntled in SF
(actually, I put my real name, in case you're wondering!)

PS. This lady is actually a contributing author to Conceive magazine!