Trust me, I'm a Professional

Some of my most brilliant moments happen on the toilet. I have had great ideas while sitting on the can and from what I hear, this isn't uncommon. I'm trying to come up with an example for you, but on the spot, nothing immediately comes to mind. Hmmm, maybe I should go have a seat in the 'oval office' and think about it for a moment.

I was in a bathroom stall at work the other day and I noticed that the toilet paper holder was made by Kimberly-Clark and it was part of their "Professional" series. This really made me think... What does it take to be a "professional" in the bathroom? Am I really qualified to use this toilet paper? I mean, I've been going to the bathroom all of my life and potty trained for most of it, so I'm probably qualified, but really how do I know for sure? Is there an application process that the building owner must go through to have professional TP holders installed?

This got me thinking about all of the other products that I buy or have bought in the past which I was probably grossly under qualified to use. Off the top of my head, I have professional series food processor, blender, toaster, hairdryer, hairspray, gel and hairbrush. I promise when I bought these things, I wasn't trying to impersonate a chef or a hairstylist, I bought them without thinking. Now I feel like a fraud who is completely under qualified to operate the machines in her own home to make hummus and toast or even dry her hair.

:Sigh:

I'm sorry I haven't been updating much. I hate to admit it, but I am in a real funk right now.

I hate break cycles. I really didn't want to take a cycle off and I am having a very hard time sitting out this month. I will start prometrium tomorrow in hopes that AF will show around Thanksgiving and we can finally move on.

I temped this cycle just in case we got lucky and I ovulated on my own, but it didn't happen. Honestly, I don't know which is worse, a failed cycle or knowing that we had no chance at all this cycle. There will be no Thanksgiving BFP or Christmas PG announcement for us again this year.

:sigh:

Flipping the Odometer

Wow...I just read my little profile blurb and realised that I have our ages wrong. I'm not 31 anymore and Tim's not 32 anymore. Damn...when did that happen? It's time to fix that. I think I'll leave it for a few more days though, and just pretend that we aren't yet another year into this journey.

It's crazy to think that we are almost at the 2 year mark. This time last year I was trying to convince Tim that we needed to get a puppy, but he was still flying and I was working long hours so he talked me out of it. The compromise was that if I still wasn't pregnant by Christmas 2010 we would get a puppy. I'm pretty sure he didn't think there was any way another year would go by sans pregnancy/baby. Sadly, it looks like I need to make a trip to the local dog shelter. It's nice to have something to look forward to though! :)

Timing FAIL

Well, September was a bust and I am super bummed. :(
I was really depressed on Friday after yet another BFN and then I started spotting on Saturday which killed any bit of hope I had left for the cycle. I had a wonderful martini on Saturday night and a margarita yesterday as consolation prizes, but ya know, they don't quite cut the pain of a failed cycle. (they were tasty though...)
As for this cycle, we have to sit it out which is absolutely the worst. I will be in Baltimore at a meeting for work from CD14-CD18 so my RE said it wasn't worth doing any meds this cycle. It's so incredibly frustrating to sit out, particularly when we really don't want to.

In the mean time, I'll try and come up with some fun/funny things to post about to help the time go by, but today, I'm still sulking.

The Women Who Stare at Pregnancy Tests

I have become a member of a very elite group of women. We are the women who stare at pregnancy tests a la The Men Who Stare at Goats. I don’t know how it happened, one day I was taking a pregnancy test, as I so often do, and it was negative, as…well…it ALWAYS is, and I proceeded to stare at it for an inordinately long period of time. I don’t know what prompted this behavior, but it has now become a part of my routine when I POAS. {Technically, I pee in a cup (PIAC), but the acronym doesn’t roll of the keyboard as nicely so I type POAS instead.} So anyway…I POAS, I use the “internet cheapies”, and I wait maybe 10 seconds for the control line to show up. Then, I pick up the stick and proceed to stare at it for at least 5 minutes WILLING it to be positive. I haven’t quite gotten one to turn yet, but I think I've almost got it. Until then, I will keep practicing. For anyone else who is interested in becoming a member of this elite club, here are some step-by-step instructions. You too, can be one of the women who stare at pregnancy tests.

Waiting

Waiting is what women with IF do. We don't always do it well, but we don't really get much of a choice. We wait for AF, we wait to ovulate, then there's the 2ww which feels more like a 2 month wait sometimes.
I'm in an odd in-between kind of wait right now. I had an IUI on Friday which was not pleasant, but no one was seriously injured in the process so I guess it was a success.
The hard part is that I don't even know if I ovulated this month. I had several follie scans, the last one being Monday, and they showed multiple follicles, but none of them were overwhelming in size. Tim gave me a trigger shot on Wednesday hoping that the follies would be big enough to ovulate by Friday when we did the IUI.
I've been temping to try and keep track of things in hopes that I would be able to confirm ovulation, but my temp shift has been kind of pekid so far. So now I have to wait until Friday to get bloodwork to check my progesterone level. If the level is at least 10, then I ovulated. Over 15 and the RE will be pretty happy with the strength of the ovulation.
Another odd, in-between...I am testing out my trigger shot. See, the trigger is an injection of HCG which is the same chemical that HPTs detect in urine during pregnancy which means as long as the HCG from the shot is in my system, I will get false positives on HPTs. So, I took a test yesterday and it was positive and I will keep testing every day until I get a negative. That way, if I get another positive test after that, I'll know it's the real-deal.
The crazy thing is, I stared at that false positive for at least 5 minutes. Almost willing it to be real and true. We have been trying to have a baby now for 21 months and that is the first positive test I have seen. I hope I get to see a true positive someday.

Don't Forget to Relax!

I had another monitoring appointment today. My follicles are being stubborn and haven't gotten much bigger. It looks like we'll be triggering Wednesday night and doing IUI Friday morning. I think Tim is more nervous than I am about the injection. I'm sure he'll do fine though.

Anyone who has been through IF has heard the phrase "just relax" or "don't stress" or "maybe you're just tyring too hard". Let me just say. These phrases do nothing but make me more tense and irritated. I don't know how or why someone thinks that relaxation is the key to pregnancy and that I am somehow "trying too hard" to get pregnant. Unless you see me standing on the docks waiting for a group of random sailors on shore leave, I'm not trying too hard.

Let's take a moment and think about stress. Think about animals which are under a lot of stress all of the time. What comes to mind? I'm going to venture a guess that the animals are not those at the top of the food chain, but rather prey animals like mice and rabbits and even deer. Hmmm...something tells me that their stress levels haven't had a major impact on their ability to procreate.

One of the funniest examples of the stress --> no baby stories I have is from this past spring. I was having lunch with a couple of my coworkers, one of whom was pregnant and the other has a young daughter. They both know that we have been struggling to conceive and frequently ask the "any news?" question when I see them.

On this particular day, the one with the young daughter was asking me what treatment we were currently undergoing. I told her, femara. She said "oh, that's the one that will give you like 5 kids at once, right?" Um, no. She then starts asking me about my stress level and how the treatments must be really hard on me and dealing with work and everything on top of it must be really stressful. I know exactly where this is going and I decide that I will hit her with a dead end in the conversation, but alas, she outwits me.
Here's how it played out.
Her: Wow, with all of this stuff going on in your life, it must be really stressful for you...

Me: Not really, actually. I have a wonderful husband, supportive parents and work is going pretty well.

Her: Really, you don't feel stressed?

Me: Nope, not at all. I'm all good.

Her: Hmmmmm. Well maybe you should try and get MORE stressed. I've heard that stress can have an effect on getting pregnant so if you aren't stressed, maybe you should be more stressed.

Me: Blank f-ing stare. I kid you not.

I mean really, what do you say to that? I think I said ok, maybe I'll do that, I'm not sure though because so much of my focus was directed at not letting my head implode. After that conversation, the geek in me wrote out what I believe to be the mathamatical equation for what she said. Here it is:

ΔStress α P(KU)

For those who aren't mathmatically inclined. That means a change in stress is directly proportinal to the probability of getting knocked up. Now go forth and change your stress!

Bare assed and waiting

I am so sorry that I haven't been updating my blog. There hasn't been much exciting going on and I didn't want to bore you all with every detail.
As it stands, I am halfway through another Femara cycle with hopes to do IUI this month.
I went in today for my first follicle scan.

For those who haven't had the pleasure of a follicle scan, let me give you a play-by-play of my appointment today:
10:00 am- Arrive, on time for my scan and shell out $$ to the "front receptionist" before being sent to "the back"
10:02 am- Take a seat in the "back"--I'm not sure why there are 2 waiting rooms, but this one is more cozy and there were 5 other people sitting around trying not to make eye contact.
10:09 am- Nurse puts me in a room and tells me to remove my clothes below the waist assuring me that the doctor will be in shortly.
10:10am-10:18 am- Strip down and sit on the exam table making small talk with my hubby, feeling excited and nervous about what the ultrasound may show
10:19am-10:25 am- Ran out of small talk, still sitting bare assed, getting annoyed...
10:25am-10:31 am- Still bare assed and bitching about being bare assed when the doctor walks in, oops.
10:31am-10:39 am- Doc takes a phallic ultrasound a shoves it up my vag. This is followed by some discussion about little follies and a tumor on my right ovary, then rooting around for my left ovary which is apparently "shy"
10:40 am - Sent back to "the back"
10:42 am - Met with nurse to schedule another magical follie scan on Monday with much discussion about our need to have lots of sex in the mean time - blush -

So in case you skipped that, there's not much to report. I had 4 or 5 little follies on the right along with my new friend, teratoma...it wasn't any bigger than last time, I don't think, but it's still freaky to know that I have a tumor on my ovary.

I really don't understand why I have to drop trou' before the doctor comes into the exam room. Maybe it's supposed to save them time, but really why should I sit there bare assed and waiting for upwards of 20 minutes? They don't even have real blankets, just these little paper squares that barely cover anything. Oh, and can I also add...The longer I sit there naked from the waist down, the more likely I am to get the urge to pee. That makes for a very uncomfortable dildo cam date. :0)

Then they do...

It’s been a hard day today. Not for any obvious reasons, although they are there, just like every day. It’s the little things that get me down more than anything lately.

I was driving into work this morning and a song came on the radio “Then they do” by Trace Adkins. http://www.youtube.com/watch?v=G-SAP8BFNkQ It’s a sweet song about children growing up too fast. I never paid much attention to that song before, but it hit me hard today. I was overcome by the realization that for every month we don’t get pregnant, it’s a month lost with my child on the other end of my life. I am 32 now, my mom died when she was 45 and I was 20, still a junior in college. She never saw me graduate, never saw me buy my first house, never saw me become a veterinarian, never saw me get married and she never got to meet her grandbabies (my brother is expecting the birth of his son any day now) Every month that I spent with her was precious, particularly at the end when I knew her life was ending.

Every month that we don’t get pregnant is another month that my child will have to live without his or her mommy and daddy. So many times when I think of the time pressure to have a child, I focus on my age and the risks that may come with waiting too long to have a baby. This is the first time that I thought about the other side of it. What if we have a baby when I’m 33, and I die at 45 like my mom? That child will only be 12 years old. Who will teach her about being a woman? Who will teach him how to dance?

I know it’s senseless to think of these things. I can’t change my age and hell I may live to be 100, but I can’t shake this funk. I feel hopeless. There is a weight of sadness that I can’t shake today. I think it’s been worse since we took a month (almost two) off. I need to feel like I’m doing something to try and get pregnant. I hate this feeling of stagnation and it makes me want to cry to think of that time lost. The precious time with a baby that is somewhere waiting for us.

I should have asked my Spirit Guide

The good news: I'm done with the written portion of my candidacy exam. I don't think I completely bombed it and I will hopefully have a chance to redeem myself at the oral exam in two weeks.

The bad news: I'm pretty sure I didn't ovulate this month. I kept taking my temps because, well, I'm anal retentive and I have to know what's going on with my body.

The really bad news: I called my RE to try and get an appointment for next week to start the next round of treatments, but I couldn't get in for 2 weeks.

The worst news: I am feeling a lot of PMS stuff going on and I strongly suspect AF will be here in the next day or two. Since most of my treatments need to be started by CD3, I may miss my window and have to wait ANOTHER cycle before starting treatment again.

If only I had consulted my spirit guide a little sooner, maybe all of this angst could have been prevented. After all, isn't it better to know when things are shit rather than just guessing and wondering? I think so.

Me: Oh spirit guide, will Aunt Flo be visiting me this weekend and ruining my plans???

Spirit guide: Of course she will! You are going to be traveling and visiting with family and her arrival would be at the most inconvenient time. Why do you even need to ask?

Me: Gee, thanks. I can't wait for what promises to be a most inconvenient period.

And the studying continues...

I've been locked away studying for my candidacy exam and I'm going stir-crazy!
Piles of journal articles and books are scattered throughout my office and have now migrated into our family room. I will be so happy when this test is over.
It looks like the written portion will be a bit longer than originally planned. I was supposed to be done on Friday, but now it looks like it will be going into the following Monday, Boo!!
I hope to post more once the written exam is done. I still need to call the RE and set up an appointment for the week after next. I'm hoping to have a more concrete plan then.

The Evolution of Thoughts

When I was 10 years younger, I often said things like "I would never get fertility treatments. If I can't get pregnant naturally, than having my own child isn't meant to be" or "it's Darwinism, we shouldn't screw with nature". These thoughts are one of the main reasons why I never talked about wanting children.
When Tim and I were dating and getting serious about marriage, I told him that I would most likely not be able to have children. Since I was diagnosed with PCOS when I was pretty young I knew pregnancy would be difficult.
Tim was ok with not having children and I felt strongly that I shouldn't get hung up on wanting something that I couldn't have. The problem was that I already wanted it, I just never said it out loud.
As I got older, I became more comfortable with the idea of trying to have a child and seeing where our attempt would take us. I hadn't made any decisions about treatment, but I was at least willing to say that I wanted children.

The path of infertility treatment isn't direct, it's step-wise for most couples. You start of trying on your own, then move onto the soft stuff like clomid. Clomid leads to trigger shots and IUI and then, if that isn't successful, the hard stuff comes; full-on injectable cycles and IVF.
Just as the treatments are step-wise, my opinions about how far I am willing to go to get pregnant change in small increments over time. I now feel comfortable with taking clomid, doing trigger shots and IUI and I have no qualms about moving to IVF if these treatments don't work. I don't think that my willingness to pursue treatments to achieve pregnancy is an act of desperation, but rather an increased understanding of some basic life truths.

First, Darwinism doesn't exist in modern humanity. "Fitness" as described by Darwin relates to physical characteristics; if you can't outrun the lion, you will be eaten. "Fitness" as described by the people of child and family service is more related to ability to care for a child. A "fit" parent is emotionally and financially stable and will raise their child to be productive members of society. If physical limitations to pregnancy can be overcome with treatment, than why not pursue those treatments?

Second, there is no "meant to be". I don't know where this phrase came from, but I wish it would go away. If someone cannot get pregnant naturally, hearing the phrase "it wasn't meant to be" is like dumping a salt into a gaping wound. If "meant to be" really existed, than there would be no children to adopt or abortions. If "meant to be" really existed, no child would suffer at the hands of an abusive parent. If "meant to be" really existed, than Tim and I would have a baby by now.

Finally, wanting to have a biological child is selfish, but that doesn't make it wrong. I get so irritated with people who say that women with IF should stop being so selfish and just adopt. Couples dealing with infertility are no more selfish than anyone else out there trying to conceive. We only want what everyone else has, no more, no less. We want a chance to have a child with daddy's eyes and mommy's nose. We want to see the people we love in our child and yes, that is selfish, but it's human nature and it's not wrong and I will not apologize for wanting it.

For those of you who made it through this loooong post, you deserve a cookie :)

This is Lisa, stepping off her soapbox. Thanks for reading!

Thirty Three...

Thirty three is the number of my friends on Facebook that have their kids in their profile picture. That's 33 out of 185, roughly 20%, of my friends on facebook identify themselves first and foremost as parents. It's funny, because I am always commenting about how everyone I know is pregnant, but the reality is, many of my friends aren't pregnant, they are parents already. This isn't any sort of great revelation or surprise, of course. I'm 31, most of my friends got married shortly after graduating from veterinary school which was 4 years ago, a baby boom should be expected. It's just one more confirmation that what we are trying to achieve by having a baby, isn't a crazy request. We're not asking for the moon and stars, we just want what so many others are able to have with very little effort.

Second Thoughts

So, I know that I'm the one who said we needed to take a break, but the not-trying may actually be worse than the trying-but-failing that I have become so familiar with. I'm thinking we may need to go back to the RE next week to talk about what we can do moving forward. We have started to talk very seriously about IVF, but I am honestly not educated enough about the process. We need some guidance about what is best for our situation before we make a decision.

On another note, I have been studying for my candidacy (generals) exam at school. For those who haven't had the pleasure of enduring this test, it is one of many hoops that I must jump through to get my PhD. The exam is 2 parts, written and oral. The written exam, which I get to take in 2 weeks, is a 4 day-long essay exam which is designed to test specific knowledge in my area of research as well as my analytical ability. The oral exam is 2 weeks after the written and generally involves grilling the candidate on anything they didn't answer well on the written. It also involves questions which are not even remotely related to my area of research, I've heard of people being asked things like "how old is the universe" and "what is the milky way". This portion of the exam is designed to "take the candidate down a peg" and show them that they don't know quite as much as they think they do. I am scared shitless to take this exam, but at the same time, I am so excited to have it done (assuming I pass).

Hello, Depression.

Well, I moved through the stages pretty quickly this month. I'm in the depression stage. I tested this morning and got (another) BFN followed several hours later, by cramps and spotting. I think it's safe to say that this cycle was a bust. I am heartbroken, yet again.
Tim and I will be taking a break for awhile in hopes of rejuvenating our spirits. I don't know how long the break will last, but I'm guessing 2 months or so. After that, we will meet with the RE and talk about doing one or 2 more medicated cycles with IUI and then moving onto IVF.
I just need to think about the timing and what would be best in relation to my graduation and board exams.
Hoping acceptance comes soon,
Lisa

The Stages of Grief

I think that one of the hardest things about IF is the hope-loss cycle that occurs every month. With each new cycle, comes new hope that the treatment will work and I will finally get pregnant. I take my medications, go to my appointments endure the tests and procedures all with hope for a successful cycle. The 2ww also starts off with so much hope, even if everything didn't go perfectly, as long as I ovulated, I am hopeful that I could be pregnant that cycle.
I continue charting my temps and looking for clues that I'm pregnant. If things look good, I will generally start testing around 11DPO which is a bit early, but not impossible to detect a pregnancy. From 11DPO and my first BFN (which was today, by the way), I start working my way through the stages of grief at the loss of a pregnancy that never even happened. I begin, as most do, with denial. I keep testing and hoping and with every BFN I get one step closer to realizing that it didn't happen, yet again.
I then make the abrupt transition to anger. I can't stand to look at pregnant women, I yell at the TV when I hear stories of women neglecting their children and teens dumping their unplanned babies in the nearest garbage can. I can't understand why they get to have a baby and we can't. It seems so unfair and I get angry at the world for this injustice.
After anger comes bargaining. I don't consciously make bargains, but I do change some things at the point right before AF shows her ugly face. I stop drinking (not that I drink much anyway), I focus on my eating, I clean the house and basically act like a pregnant person. Maybe this is my way of bargaining. -Hey, if I prove to the world that I am a good person, worthy of a baby, it will happen, despite the multiple negative tests.
Well, bargaining has failed for 18 cycles now and when it does, and AF shows, the next step settles in, depression. I cry, I mope, I sleep more and I just plain hate the thought of trying again. This is the worst I think, for me and for Tim. I know he hates seeing me like this and he really hates hearing me say that I want to give up. It's always the depression talking, because I want a baby more than anything, but in the depression days, the thought of going through the loss again is more than I can bear.
All of my treatments have started on CD3, so the final stage generally comes at some point that day. Acceptance. I have to move on, I have to keep trying and to do that, I have to let go of past failures.
And then the cycle begins again...

Ovulation?

After my RE told me that the cycle was a bust and I could start taking prometrium any time to trigger my period, I was beyond bummed. I decided not to start the prometruim right away because we were going to be traveling and going to a fundraiser event and I didn't want to be tired, which is one side effect of the drug. I kept taking my temps and tracking them just to see how things went. Surprisingly, on Friday last week, my temp jumped up. I continued taking my temps through the week and wouldn't ya know, it looks like I ovulated afterall. I went in this morning for a blood progesterone level not only to confirm, but to be sure that my RE knows that I did eventually ovulate.
Without the IUI, our chances are still pretty darn low, but low chances are better than no chance at all so I'll take it! Since my LP is so long, I've got about 7 to 10 more days of waiting before I can find out if we are pregnant. Fingers crossed!

Just Ducky :(

Well, yesterday was our 2 year wedding anniversary and it was a crappy day.
We spent the weekend in Hocking Hills which was nice. We brought the dogs and stayed in a little secluded cabin. We hiked and went canoeing and Tim took lots of pictures of the beautiful sites, including a nest full of 5 baby birds on the patio just outside our door.
I had a follicle scan (transvaginal ultrasound) on Thursday that showed 2 follicles on my left ovary and 1 on my right all between 11 and 13 mm. In order to get my trigger shot and do IUI, I needed to have at least one 20 mm follicle so I was scheduled for a recheck yesterday with high hopes of sufficient growth.
Not so much...
All 3 follicles were the same size or smaller than they were on Thursday and to add insult to injury, the doctor found a calcified nodule on my right ovary that may or may not be something to worry about. Happy anniversary...
So, after all of the crappy side effects, clomid was a bust.
My doctor gave me a few choices for the next round. We could up the dosage of clomid, keep the dosage the same and add metformin, do injectables or try femara again.
Right now, Tim and I have decided to take a break for a month or 2. I need to study for my candidacy exam and more than anything, I just need some time off. We have been trying to get pregnant for 18 months now. With temping and pills and TI and OPKs and 2WWs and month after month of disappointment, we need to focus on us for a little while.
I'll still post, but it will be more about what we are doing and things not TTC related.

The Clomid Monster

Well, last cycle was a bust, again. My RE doesn't want me on Femara so I'm doing clomid this cycle and hopefully IUI. One of the reasons that I chose Femara (when I had a choice) was the side effects were reported to be less severe. On Femara, I had a few headaches, hot flashes and night sweats with crazy dreams, but my moods were manageable and once I finished the 5 day course of meds, the s/e eased off.
I am currently on my 3rd day of Clomid and I am already fighting with myself not to injure someone. Things that ordinarily irk me, send me into an angry tailspin and the more I try to pull myself out of it, the angrier I get. I've also had hot flashes that could melt the polar ice cap. I've heard that these s/e won't go away for several weeks after finishing the meds (just in time to start again), but I am hopeful that I will be able to manage them better over time.
Tim is working on a bunker in the basement that he can hide out in until the rage wears off. I'm wondering if it would be safer for everyone if I go live downstairs for the next few weeks. Ugh!

The waiting game

It has been a crazy cycle! I took Femara this month starting on cycle day (CD) 3 through CD7 which was actually back at the end of April. Generally, I ovulate around CD15 or 16, but this month it looks like I didn't ovulate until CD24 which was on 5/20. So here I am 11 days past ovulation (DPO) and my temps are still up, but then, that's not unusual for me. It will probably be another week before I know anything.
TTC is all about waiting, though so you'd think I would be good at it by now. I wait for my ultrasounds, wait to ovulate and then, there's the 2 week wait (well, 3 week wait for me) to find out if our efforts paid off. It's a repetitive process that, after even a few months, gets pretty old.

Nope, life's not fair.

So, I've been meaning to add this, but haven't had time yet this week so now you get a double blog day.
Tim and I went to brunch an then the zoo on Sunday for a friends birthday. As I'm sure you can imagine, the zoo on a beautiful Sunday was well, a zoo. The day was filled with watching children and their parents interact, something I try and avoid if I can. Seeing how some parents treat their children is a reminder that life isn't fair. People who either don't deserve to have children, or don't appreciate the children they have never cease to amaze me.
I witnessed small children, maybe 2 or 3 years old, getting hit for minor things and called names like "moron" or "idiot" for making mistakes that little ones make all of the time. It made me really sad, and angry at the parents for not appreciating their children.
I am all for consistency and discipline, but when things are said or done in anger or frustration, they are almost always excessive and unnecessary. I guess a lot of it goes back to how I was raised. My parents spanked my brother and I, but I never felt abused, because they took time to calm down before doing it. I never felt like I was hit out of anger or frustration and I don't believe they spanked us until we were old enough to understand what a spanking meant. I was never called mean names, ever. I can't think of any scenario that would make it OK to call your child a name.
I try and imagine that the parents doing these things likely had this done to them as well. It's no excuse for someone to treat their child that way, but it helps me to deal with my own anger at those parents.
I feel so blessed to have had such wonderful parents growing up and I really believe that Tim and I will be good parents too. I hope that we get the chance to find out someday.

From if to when to if

Before Tim and I got married and even a little after, we weren't entirely sure that we wanted to have kids. We both like children and we were emotionally and financially stable enough that getting pregnant would be a blessing, but we didn't know how we would handle it. With Tim flying all of the time and me spending my time split between research and my residency, we weren't sure how we would make it work. So, when our conversations turned to having children, we always said if.
As time went on, we both began to feel a strong urge to add a baby to our family and once we decided that it was what we wanted, we changed our if to when. When we have a baby we will... I think that phrase was uttered 500 times in the first 6 months of TTC. We talked about names, we talked about discipline, we talked about traveling and family and all of the things that change when you have a baby, which is pretty much everything.
After we reached the 1 year mark, and I had to officially accept that we were dealing with infertility (IF), I changed my phrases back to if. If we have a baby... If we get pregnant... I can't seem to make myself switch back. The uncertainty that we had at the start of our marriage about having children is back and I hate it. IF has made me if the possibility of children.
One of my good friends noticed this recently and said Could you try saying when? and I just looked at her and said No, I can't. She told me that every time I say if, she is going to insert a mental when because she has faith that it will happen for us somehow, someday. I really hope that she is right. I want my when back.

If I never hear any of these phrases again...

I will be a happy woman.

1. "Don't drink the water"...(this is so overused I can't express it), it also comes in the fun variety of "If you want to get pregnant, you should try the water where I work"
2. "As soon as you stop thinking about it, you'll get pregnant so just stop thinking about it" Um, yeah, that's like telling someone not to think about breathing. This phrase also comes in the form of "you're trying too hard", "you should stop trying" and "you should look into adoption, then you'll get pregnant for sure"
3. "Having a baby is overrated, you should just enjoy being married"
4. "Since you don't have kids, you wouldn't understand..." Yeah, thanks for reminding me. This one comes in several forms too like "you'll understand when you have children" or "you think that is bad, just wait until you have kids"
5. I could also do without the constant "So, any news?" or "Anything new and exciting with you??" This is generally accompanied by raised eyebrows, flared nostrils and an expectant grimace which quickly turns to a frown when I say, "nope, how about you?"
6. "Really, (you're so lucky) my husband just has to look at me and I get pregnant"

For good measure, I'd like to throw in these gems:
"ugh, morning sickness sucks, you have no idea"
"I can't wait until this baby gets out of me" Generally followed by my back hurts, I want a drink, my feet hurt, I'm bloated, I'm tired... Yeah, well, I'm infertile, so I don't want to hear about it.

If you have ever uttered any of these phrases (and yup, I'm guilty of it too), please take a moment to reflect on the effect that they likely had and never use them again.

Letters to my doctor

So, here is the full version of the letters I sent to my previous doctor. I am still so happy that I was finally heard. It feels unprecedented, which is actually kind of sad.

First, my original e-mail-

Dear Dr. -- and other doctors of --:

I expressed concern at my follicle scan this morning regarding the volume of Novarel which is given as a single intramuscular injection. Ten milliliters seemed like an unusually high and unnecessary volume to give IM. When I expressed my concerns, I was told that this medication is given as two, 5 cc injections. I continued to state that this seemed unnecessary, and was told that if I don’t like the dosage, I should take it up with the drug company.

I wanted to inform you that I have in fact contacted the drug company and was told that it is not necessary to give this medication in a 10 cc volume. As they show in the instructional video on their website, it can be reconstituted in as little as 1 cc. (http://www.ferringfertility.com/medications/trainingguide.asp)

Attached is a letter from a nurse at Ferring Pharmaceuticals explaining this as well.
Please, do not continue to give this medication to patients in 10 cc. It causes unnecessary harm.
I will also fax a copy of this letter to your office.


Thank you,
Lisa

E-mail from Ferring:

Thank you for contacting Ferring Pharmaceuticals Clinical Hotline in regards to Novarel. Please see the following in regards to guidelines for the reconstitution of Novarel.

It is recommended that the amount of diluent used to reconstitute NOVAREL is selected on the basis of the dose to be injected.

--For ovulation induction requiring doses of 5000 IU to 10,000 IU, the volumes of diluent usually used for reconstitution are a 1 to 2 mL
--For cryptorchidism or hypogonadotropic hypogonadism requiring doses of 500 IU to 1000 IU, the volumes of diluent usually used for reconstitution are 10 to 20 mL

Thank you

Amy

Then, my final e-mail to the owner of the practice-

Dear Dr. --,
I wanted to tell you that I received your voicemail last night and to let you know how much your call meant to me. As I am sure you know, women going through infertility experience a roller coaster of emotions, but the one feeling that takes hold and will not let go through the entire processes is helplessness.
Feeling like my voice was heard, even if I had to fight harder than I should have, meant more to me than you will ever know. I wish you and the other doctors luck in your practice; however I feel that it is best that I move on to a specialist for my infertility treatments.
I hope you understand.

And last, the reply from the doctor which I just received:

Thank you for your kind reply. One of our beliefs in the physicians need to keep listening and learn from whatever valid source they encounter. Thank you again for being that source. We wish you well with your efforts. You will obviously be a great Mom.

I am now ready to let this go...after I do my happy dance a couple more times.

Real vindication came today...

I got a phone call from the owner of the ob/gyn clinic today. Apparently he received my e-mail regarding the Novarel and he wanted to let me know that they stand corrected regarding the administration. I can't even begin to describe how amazing it felt to get this phone call. It is posted below for your listening pleasure. I cut out the first few seconds of the call to protect the name of the doctor and the practice. By making this phone call, he has helped me to let go of some of my anger. All the same, I will only return to that practice once more. To pick up my medical records.

A poem

Here's a poem that I found (I'm not really creative enough to write one of my own)
For those dealing with IF, it will surely hit home. For those who know someone who is dealing with IF, please take a moment to read it, the questions and statements made are so common and none of them are helpful. Don't say them...

Useful Advice
You're 37? Don't you think that maybe
It's time you settled down and had a baby?
No wine? Does this mean happy news? I knew it!
Hey, are you sure you two know how to do it?
All Dennis has to do is look at me--
Some things just aren't meant to be.
It's sad, but try to see this as God's will.
I've heard that sometimes when you take the Pill--
A friend of mine got pregnant when she stopped
Working so hard. Why don't you two adopt?
You'll have one of your own then, like my niece.
At work I heard about this herb from Greece--
My sister swears by dong quai. Want to try it?
Forget the high-tech stuff. Just change your diet.
It's true! Too much caffeine can make you sterile.
Yoga is good for that. My cousin Carol--
They have these ceremonies in Peru--
You mind my asking, is it him or you?
Have you tried acupuncture? Meditation?
It's in your head. Relax! Take a vacation
And have some fun. You think too much. Stop trying.
Did I say something wrong? Why are you crying?

Author of infertility poetry Catherine

Vindication

As a follow up to my earlier post:
I decided to contact the drug manufacturer and ask about the proper resuspension of Novarel. The nurse was appalled that the doctor would give a 10 mL injection (or even 2, 5 mL) injections. She told me that the drug could be reconstituted in 1-2 mL and given that way. She also sent me an e-mail which conveyed this information to pass on to my (former) OB/GYN.

I sent a letter to the OB and all of the doctors in the practice with this information and then made an appointment to see an RE. I am happy to report that I will be seeing this new doctor on Thursday. I have hope again, I feel powerful again and when struggling with infertility, these feelings are like gold. :)

Feeling Defeated

So, yesterday was Mother's day and I tried to sulk, but Tim wouldn't let me. We spent most of the day running errands which was a good distraction.

Today, I went in for a follicle scan to see if I am ready to trigger and do the IUI. The trigger, Novarel, is an HCG injection that has to be given IM. I had to pick up the medication yesterday at the pharmacy and bring it with me today in case they wanted to give it. When I got the Rx, I looked at the instructions and it said "inject 10 milliliters (mL) intramuscularly for 1 day". I freaked. No one gives that much volume as an IM injection. It's f-ing crazy. So I went online and tried to look up how people give the medication and I went on the bump and asked the ladies how they have gotten it. It turns out that generally, the medication is reconstituted in a smaller volume if it is all being given at once IM so I felt better. Until my appointment.

The follicle scan showed only one follicle with any potential, but it is still too small to trigger so I have to go back in a couple of days to see what happens. While I was there, I told the doctor that the instructions on the Novarel freaked me out, I couldn't believe that they would give an injection of 10 cc IM. He laughed and said "yup, but we actually give it as 2 shots" I just about broke down right there. He told me that if I didn't like it I should "take it up with the company".

I just want to cry right now. I feel so defeated and so unheard. I don't understand why my body won't just do what comes natural to the vast majority of women. Sometimes I just want to give up.

Infertility Creeps In

Last week, my best friend's father was tragically killed. He was here one day and gone the next. It has been such a hard time for her and her family and I wanted to be there to help her through it.
Tim and I drove up to see her for the wake and funeral this week. My heart goes out to her. I know what it's like to lose a parent and I know that there isn't anything I can say to make it better. I actually didn't say much. I tried to distract her and ask about other things, but I knew better than to tell her that it's going to be alright or that it will get better in time, because those sentiments didn't help me when I was grieving.
As I sat with her, I listened to the things that people said to her and her mom in an attempt to comfort them and one thing was said over an over again--"he will live on in his children and grandchildren". The statement is true and I do think that it offers comfort to the family, but for me, sitting there, it made me want to cry.
I know that the past few days weren't about me or my own struggles and I would never expect anyone to edit their comments to someone just because I am sitting there, but it was still like a knife twisting in my heart.
What if we never get to have that? What if we are a genetic dead-end? What if something happens to Tim or me? What will people say when they realize that they can't use those comforting words? Who will keep Tim occupied or help him with arrangements when I'm gone? How would he cope? How would I cope?
It is amazing to me that even in this time when there is already so much grief, infertility can creep in and somehow make it that much worse.

Moving Forward

Well, I have an appointment with my doctor tomorrow to discuss our options. I am expecting that we will do u/s monitoring, HCG trigger and hopefully IUI. To be honest, since I am not working with an RE (reproductive endocrinologist), I may not be able to get IUI, this month. If that's the case, I will ask my doc to refer me to an RE as soon as possible. I don't want to keep wasting cycles without doing everything possible.

More Disappointment

I tested this morning and it was negative. I'm 14 days post ovulation (dpo) so there is virtually no chance that I got pregnant this cycle. To top it off, Tim is visiting his family this weekend in Montana so I'm alone and he is hanging out with his 2 little nephews. He told me last night how cute the boys are and I could hear the hope in his voice. I hate myself for not being able to give him a child and I wonder if he will start to hate me for it too.

The Story of Us

So I figured it was time for a post about Tim and I, how we met and the wonderful things that have happened since he came into my life. (I also felt compelled to throw in some pictures for your amusement)

Tim and I met on match.com in October 2005. I honestly think that this is the only way a 4th year veterinary student and a commercial pilot could have met. Tim was a first officer at the time and I was in my clinical year at the college.

For our first date, we went to dinner and a movie (Max and Erma's and "Prime" for those who love the details). Also, in case you were wondering...yup, we kissed on the first date (scandalous!). I could tell that Tim was a kind man the moment I met him. He is sweet and caring to his core and even though he was really nervous on our first date, I was sure that once he loosened up, he would be fun and easygoing.

Tim and I lived together for about 6 months before we got engaged in December 2006 and we were married a 1 1/2 years later on June 21, 2008.

In 2 months, we'll be celebrating our 2nd anniversary. I feel so fortunate to have met Tim and I can't wait to spend the rest of my life with him.

Waiting on results

After several months of this, I thought I had it down, but apparently I don't. Every month at 7 dpo, I get my blood drawn to check my progesterone level. Thus far, I have never gotten a call with the results. I always have to call the office for them. In the past, the results have been available by 8:30 am so I generally wait until 10 or 11 am to call. Today I called and was told that they aren't back yet, which is fine. What I don't understand is why the lady on the phone has to be so snarky. I understand that I am making her do work, but isn't she at work? Isn't it her job to answer the phone and address patient questions? When did patients go from customers to nuisances? I just don't understand.
Oh well, the wait continues and you can bet I will call them again if I haven't heard something by this afternoon.

Mother's Day

How great would it be to find out that I am pregnant the week before Mother's day? I honestly thought I would have a baby by this Mother's day, but I'll take a BFP. After losing my mom to cancer when I was 20, Mother's day has always been a day to hide away for me. I love my step-mom, but it's still really hard to be without my mom. I'm tearing up thinking about it now.
I really do hope that I have something to celebrate this year and for all of the future Mother's days to come.
Tim is out of town this week and if my progesterone level comes back nice and high, it will be really hard for me to wait to test until he comes back. I will try though. I want him to be the first to know if we are pregnant.
Here's hoping for a reason to celebrate this Mother's Day!

Vampires

Over the past 6 months I have had blood drawn at least 10 times. Mainly for IF stuff but for other stuff too. Through the multiple pokings, I have learned that I only have one good, reliable vein. It's inside my right elbow, the "elbow pit" if you will. It runs in a weird direction, but it's big and it always flows if the vampire (phlebotomist) hits it right.
Today was a good blood draw day. I had to get my 7dpo progesterone level to find out if I ovulated and how strong the ovulation was. The vampire listened to me when I told her about my vein, felt my arm and stuck, no muss no fuss. If only they all went that well... Half the time, they don't listen to me and want to feel all over creation and even poke me multiple places before finally resigning to the fact that I know my body and I've been through this enough times that I know what works. Today was good. Now I just have to wait for the results.

Anyone have a crystal ball handy?

I hate trying to time my cycles. It is the most frustrating thing about TTC. I temp and chart and use OPKs all in an attempt to pinpoint ovulation BEFORE it happens. It is so frustrating. Temping doesn't tell you when you are about to ovulate, it only tells you that you did after it happened. More than half of the time, I don't get a positive on the OPKs even when the doctor confirms that I ovulated. We haven't done ultrasounds because Tim is out of town so much it would be even more frustrating to have the doctor tell me that we need to get busy when Tim isn't available.
Even still, we will start doing monitored cycles next month (assuming we don't get pregnant this cycle). I just can't take the guessing game any more.

HSG

So HSG stands for hysterosalpingogram, but it really could stand for "Holy Shit, God!" because it freaking hurts. OMG, when the doc injected the dye into my uterus, I wanted to DIE. It hurt. The pain only lasts about 20 seconds, but UGH.
I have to admit, while I was laying on the table I said several times (to myself and out loud) "childbirth hurts more and I want that pain more than anything in the world" I also said "it's worth it for a little one" over and over.
The results of the test: ALL CLEAR!!! No blockages. I am so freaking happy.
Tim had a semen analysis last month and that was all good and now we know that my tubes aren't blocked. So far, it looks like PCOS is our only issue. It's a crappy issue to have, but I am so hopeful now that we may be able to get pregnant.
After the test, Tim took me out for Chinese (my fave) for lunch. My fortune said "with every deed you are sowing a seed, though the harvest you may not see." His "You will be sharing great news with all the people you love"
His brought a tear to my eye. I really hope that we have news of a little one on the way soon.

Crying in the car

If you haven't heard the song "I would die for that" by Kellie Coffey, you need to listen to it.
Here's a link to it on youtube: http://www.youtube.com/watch?v=JqfGqOx2iDQ
For anyone struggling with IF or just having trouble trying to conceive (3TC), this song will really hit home.
I played it for Tim in the car on Friday while we were driving to get dinner. He reached down to hold my hand and I lost it. I've never wanted something so much and I just can't accept the fact that no matter how hard we try, it may not happen for us.

Intro and background

My name is Lisa, I'm 31 and I'm married to a wonderful man, Tim, who is 32. I've decided to start a blog to share our struggles with infertility caused by PCOS (polycystic ovarian syndrome).
Tim and I have been trying to have a baby since January 2009 (15 months, not that I'm counting!). We started of with the basic "hump and hope"-method just having sex when we felt like it and hoping that a little miracle would happen. After that, we moved onto "timed intercourse". I tried to "time" my cycles by using the OV watch and ovulation predictor kits (OPKs). After coming to the realization that my cycles are too crazy to just use OPKs, I started monitoring my temperatures. Basically, I would take my temp (orally) every morning when I woke up and record it on a chart looking for patterns of ovulation. This was an eye-opener! My temps were all over the place and I was clearly not ovulating. We have now moved on to medical intervention. I am taking metformin to help regulate my hormones and femara at the beginning of each cycle to help trigger ovulation. This will be my third cycle on femara and each month that I don't get pregnant, my heart breaks a little...