October 30, 2006
Everyone is annoyed with my ovaries!
We had our appt with Dr Wonderful today and I was once again reminded why we continue to see him. He began by saying "I’m really annoyed with your ovaries!" That threw me off and made J and I laugh, and we agreed. We had expected a 10-15 minute consultation of what we’d do next, but we talked with him for about 45 minutes. He never makes us feel rushed, and J said that one of the things he most appreciates is that Dr Wonderful doesn’t try to push us into anything–he lays out the choices and gives us his opinions, and then we can make our own decisions.
He told us that he doesn’t see a whole lot of benefit to doing any more pills and IUI–it’s a case of been there, done that, and we’re facing diminishing rates of success at this point. He said we could do a lap and see if there’s endo but it wouldn’t really change anything. If I have mild endo a lap isn’t going to help or change the treatment plans. He doesn’t think that I have really severe endo and I tend to agree–I just don’t have that much pain during sex or at my period (I get really bad cramps but they only last for a few hours). So we’ve all agreed that’s not something we’ll do.
I went in expecting to hear that injectibles + IUI was the logical next step. Dr Wonderful said that it’s definitely an option but his big concern is the risk of multiples, especially with a healthy 29-year-old (by then) woman with a partner who has a great sperm sample. He said that he’s a radical in some IF circles because he truly believes that the goal of all IF treatments should be a single baby at a time. We really appreciate that about him. He said that if we do decide to do injectibles + IUI, he wants us to talk specifically about selective reduction with an IF counselor before we do anything. Regardless, he’ll be really conservative with my meds because it’s young and healthy women with PCOS who tend to overstimulate the most. I wonder why that is?
We also talked about the size of my uterus being a concern with multiples. P was a full-term baby but born a little early, at 37w5d. I worry that my uterus said "6 lb 11 oz is my max–time to get the kid out!" My big concern is, should we get pregnant with twins (let alone higher-order multiples), my uterus would either kick out the babies when the combined weight was under 7 lb or rupture. Dr Wonderful agreed that is definitely a concern, which is another reason he’d recommend being conservative with me.
The major focus of the conversation was on IVF, and how he thinks that would be our best bet. He said that it takes away the concern that it could be a tubal problem* and, since I’ve already carried a pregnancy to term, we can be fairly confident that isn’t an issue. We talked about it for a very long time because, even though it’s not something we’re ready to do in the near future, we might look more at it in a couple of years. I’ll be a few years older but he said that 32 isn’t really different than 29 when we think my eggs are of fine quality right now. He also pointed out that it would let them get a look at the eggs directly to see if there is some sort of unknown issue there. If we decide to do IVF, he would recommend no more than a 2 embryo transfer and would prefer 1, though he understands why we might prefer to do 2. He thinks I’d probably have a greater than 50% chance of getting pregnant using IVF.
We now have all the IVF info to add to our File O’ Fertility at home. Dr Wonderful asked that we keep him updated no matter what we choose. He certainly lives up to his name! (Thanks for coining it, Courtney!)
J and I went to lunch after our meeting and talked a lot. We’re definitely taking the rest of this year off of treatments, and perhaps several months into next year (depending on how his business looks). We’re thinking that we might do a single cycle of injectibles + IUI. If we do and we ended up with triplets or more, we’d reduce down to one. If we got pregnant with twins, we’d take the chance of carrying a twin pregnancy. Either way, we’re going to go and talk to the psychologist about it. We think just one cycle because if I produce 6 or 7 eggs and still don’t get pregnant, we think it seems kind of pointless to continue that route as well.
So here’s our current plan: hold off on talking about treatment options until January, then perhaps (likely) holding off on treatments themselves for several more months beyond that. Do one cycle of injectibles + IUI and, if that’s not successful, start exploring the idea of doing IVF in more detail. While we’re on our treatment break, we’re going to talk to adoption agencies. We need to ask about what happens if we continue treatments while also pursuing adoption. We’re very clear that adoption is in our family’s future, so getting pregnant wouldn’t mean that we would want to stop the adoption. Especially since we’re planning on adding a toddler to our family–it would preserve the birth order of our children nicely! I know that some agencies have a problem with this but I have a friend who was 6 months pregnant with an IVF baby boy when they brought their oldest son (who was a toddler) home, so I know that not all will do that. In any event, we have lots of things to ask and lots of options to explore.
I feel very, very positive about our plan. The idea of taking some time off treatments doesn’t bother me today. It feels workable. When Dr Wonderful was talking about doing IVF and J was saying that we’d already agreed it wasn’t something that we were ready to do now, my emotional response was to say that I had reconsidered, I’d do it now! But I held it in and by the time we went to lunch, I’d gotten back to the practical part of me that knows I’m not ready for it yet. Financially, it isn’t so much of a concern. J’s parents have offered to pay for it and J reassured me that if we said we needed help, they’d do it in a second. But emotionally, I’m not ready to handle a failure. I just saw what happened when a Femara/Clomid + IUI cycle failed and IVF would be much worse. So I’m glad that I can be practical when it counts!
Today is a good day for me. I feel really good about things.
*I worry about a tubal problem because I had abdominal (bladder-kidney) surgery when I was 12, and Dr Wonderful pointed out at our very first meeting that since the bladder, kidney, and uterus are so close, they could easily have damaged my tubes and we’d never know. We know they’re open but we don’t know that they’re functional. I almost always ovulate on my right side; however, I ovulated the egg-that-became-P from my left ovary, which happens less than 10% of the time for me. If my right tube’s not functional and yet my right ovary produces most of the eggs, my odds are even lower than we know.
October 28, 2006
“I love you, Sweet Pea Mama”
P apparently picked up on the fact that I was pretty down the other day. I’ve been calling him Sweet Pea since minutes after he was born; I don’t think they’d even weighed him yet before I started calling him that. When I say "I love you, Sweet Pea", he normally just replies "I love you, Mama".
It makes my heart melt. I could hear it a million times a day and never tire of it.
Friday, I woke him up to get him ready for his day. As I was nuzzling his sleepy and soft cheek, I said, "I love you, Sweet Pea." He replied, "I love you, Sweet Pea Mama." Then he giggled, clearly impressed with his own cleverness.
I’ve been floating on Cloud 9 since then.
October 26, 2006
A post in which I use too many italics and links
Today is my blogiversary. A year ago, I was fairly new to Bloglandia. I’d dropped out of a message board that had been a very good source of support but wasn’t exactly a conducive atmosphere to someone experiencing secondary IF–everyone on there who’d experienced primary IF got pregnant without any trouble the second time around, while I was just sitting and twiddling my thumbs. I gained a lot from reading other blogs but missed having a place to write about my own thoughts and experiences. So I started this blog with this post: http://pcosbaby.typepad.com/my_weblog/2005/10/getting_started.html
It rambles, as I am wont to do. My major reason for starting a blog was to chronicle not only infertility but also to have as a pregnancy journal. I remember writing that post and thinking that I’d be getting pregnant soon and it would be nice to have a place to write about my pregnancy. I was starting it as an IF blog but surely I’d be pregnant quickly. I’d only been back on Metformin for 6 months, though we’d been TTC#2 for a year…in my naivete, I was convinced that I was one of those women whose PCOS would get better during pregnancy.
Wasn’t I as sweetly innocent as a new puppy?
I’d gone back on Metformin at my annual gyn appt in April or May, since maybe I needed a little more help. But surely I would then get pregnant quickly–I already knew I had PCOS! It only took the Metformin the first time around, so that’s all it would take this time. I was spotting much earlier than I’d ever been spotting before I had P. Maybe it was because I was still nursing, even though P was down to once or twice a day. I stopped since I just knew that I’d get to do it again with another baby, so what did it matter that I was terribly sad about stopping?
I had another appt with my OB/GYN in October to ask about the spotting. He set up a progesterone test, gave me a prescription for Clomid for the next cycle, and that was it. Not one to sit around, I also made an appt with my RE for before Christmas, during my Clomid cycle. We set up a plan. I would surely get pregnant very quickly with Clomid, right? My cousin with PCOS (who doesn’t even take Metformin) was, at that time, pregnant with twins from Clomid alone.
And besides, I didn’t, and still don’t, want P to remember IF. Clearly our timeline have changed since then, because I’d be pregnant before that became an issue. Back then, I figured that we’d do a few cycles on Clomid alone, try IUI + Clomid a few times, maybe IUI + Femara if Clomid didn’t work, and still have a cycle or two for IUI + injectibles–all by December!
Instead, this year has held 4 cycles of 100mg Clomid alone, one of them with an IUI. 2 cycles of 2.5mg Femara, one with 100mg Clomid and an IUI. 2 hCG trigger shots. An HSG. A saline sonohysterogram. Several "breaks" for financial and emotional reasons. Countless transvaginal ultrasounds. Countless blood tests. A staggering number of test sticks for my monitor. Much IF-related pain, both physically and emotionally. Astonishing numbers of babies born to friends. Abandonment of us by many of those same friends after those babies were born. Family annoyances and family support.
Yet it hasn’t held one single positive HPT for J and I. It hasn’t held the promise of a sibling for P, who keeps asking for a baby brother or sister.
My period started today. We hit two years of TTC#2 next Wednesday. P will be 3 in less than 6 weeks. We have an appt with Dr Wonderful for Monday morning to discuss the next step. When we’ll next be able to afford to do treatments, I haven’t the slightest clue. It won’t be before 2007. I feel about as far from emotionally ready to give up on trying to get pregnant and start the adoption process (let alone the financial aspects) as I ever have felt. I can’t get my mind around the idea of never giving birth again. The idea of giving it all up fills me with despair.
One of my Bradley classes, my very special one from this past spring, gave me a gift certificate for an hour-long massage that I hadn’t yet used (they loved classes as much as I loved having them–I’ve never had a class give me a gift before but, like I said, they were special). I called the other day when I started spotting and set up an appt.
I have it scheduled for today. If ever I needed a massage, today is the day. At least the cramps and backache aren’t too terrible. Being on the verge of tears at all times, which is what I have been today, is terrible.
Happy Blogiversary to me.
October 24, 2006
And that’s the ballgame
Car being totalled, check.
Mild backache, check.
Vague cramps, check.
Disappearing pregnancy "symptoms", check.
Stock of feminine supplies to see me through the coming week, check.
Oh, and spotting.
Check.
October 23, 2006
SpotWatch, day 2
Thanks to all who posted about our accident. So far, they haven’t found (or even looked for, as far as I know) the person who hit us. This could be a big problem for several reasons:
1. We owe the $500 deductible if we have to pay it ourselves. An extra $500 going into the holiday season.
2. The insurance adjuster who came yesterday all but guaranteed that they’re going to total out our Explorer. It’s 9 years old and in mechanically perfect shape but it’s got 9 years of normal wear-and-tear and just isn’t worth much. Apparently we got hit in one of the most expensive-to-repair places.
3. We cannot afford to buy another car now. No way in the world. We just bought the Jaguar a month ago. We had no car payments for 2 years before that. There’s no way we can go from no payments to 2 in the space of several months. We had no intention of replacing the Explorer before it fell apart, which, given how fantastic it’s been (seriously, we’ve barely spent $1000 on it in the 5 years that we’ve owned it and that included new tires and brakes on all 4 tires), we didn’t expect to be for a good, long time.
4. We cannot afford to pay the extra beyond what they’ll give us as an insurance payout to fix the car so that we don’t have to get rid of it. I don’t even know if that’s an option–won’t they refuse to insure a car they’ve already totalled? And clearly, we can’t go without insurance.
5. We need to replace P’s carseat (thanks for the reminder, Amy). He was in the $300 Britax carseat. I don’t yet know if our insurance will cover it.
If they can find the other driver, we can get his insurance company to pay for the repairs to fix the car even if they’re more than the total value of the car. (Being married to a lawyer who has done this a million times for his clients can be a good thing.) If not, we’re screwed. Needless to say, that would completely eliminate our ability to continue fertility treatments, and probably delay our ability to start the adoption process by at least 6 months.
I go cold just typing that. It feels so hopeless. A car accident that wasn’t even our fault could ruin our chances of having a child join our family before mid-2008. If then.
Today we’re on SpotWatch day 2. It’s 10dpIUI and no spotting yet. I can account for that since releasing two eggs would cause my post-ovulatory progesterone levels to be higher than normal (I think? Correct me if I’m wrong). Any pregnancy "symptoms" could have the same cause. I get nervous that I’ll be spotting every time I go to the bathroom, because I truly am still hopeful for this cycle. Two eggs. Excellent sperm sample. Please, please, please.
Because if not, this is probably the end of the road for quite a while. Damn it all.
October 22, 2006
Hit-and-run
Literally. We were on our way back from a trip to the pumpkin patch and dinner last night when we were hit by another car. We were stopped in a turn lane, waiting to make a left, and this other car apparently decided to make a U-turn, not realizing that we were completely stopped and waiting for the signal. It smacked right into the rear door on the driver’s side.
That happens to be where P sits. It was a low-impact collision but in the time between being hit and turning around to make sure he was OK, my heart stopped. I shook for 20 minutes afterwards, I was so scared that P could have been badly hurt.
The other car pulled into the lane next to us for a second and we motioned to them to pull into the gas station right there. They didn’t. They drove on and looked like they were going to turn around at the next light but then kept going. I was already on the phone with 911 at this point and J had the presence of mind to get their license plate number. We both agreed that the driver looked pretty glazed-over and weren’t surprised that they didn’t stop.
We’re OK. Today J and I are a little sore and P, who thought it was great fun to be stopped at a gas station and be able to climb all over the car last night, is moving a little slower but says he feels OK. The police officer who came was great with P, which gave us a chance to teach P that if he ever needs help, he can always ask a police officer because that’s what they do–never let it be said that we won’t make the best of a bad situation! Fortunately we were in the Explorer, which is better equipped for side impacts*. The door won’t open at all (they were in a minivan and hit the door and the panel behind it) but the car is driveable. I called the insurance company and they’re supposed to call this morning set up an appt to check out our car.
But we’re OK. That’s all that matters.
*Since that IS all that matters, it was kind of funny that J said he would have cried if we’d been in the Jaguar, though P sits on the other side in there and would have been further away. Then the insurance company person asked which car we were in and I told her, and her response was "That was lucky!" I thought she was referring to the fact that we were in the bigger, heavier car, but she was referring to the fact that we’ve only had the other car a month. I told her what J had said and she laughed.
October 20, 2006
A traitor to my own cause?
I sometimes feel like a completely wretched person. Why? Because I’m a biology teacher. As such, I teach my classes some basic points of evolution. And in talking about evolution, we always talk about Surviv@l of the Fittest, in which the animals that survive to pass on their genes are the best ones evolutionarily.
Inevitably when this comes up, someone brings up infertility. They ask, "What about people who are infertile? Does that mean that they’re evolutionarily less fit?" What do I say? I felt like I’d run into a brick wall when I was first asked that. How to answer them?
I don’t share my personal struggle with infertility with my classes, so I try to treat it in a purely scientific fashion. I tell them that since people who are infertile often can’t pass on their genes without medical treatment, then they fit the definition of evolutionarily less fit. That modern technology has allowed us to circumvent nature by allowing people who otherwise couldn’t get pregnant to bear biological children.
It makes me feel like absolute scum to say that, especially since I don’t believe it.
I don’t want people to feel like reproductive technologies are a horrible idea because they’re allowing us to circumvent nature (obviously). If you put it that way, so is chemotherapy. And so are antibiotics. And so are life-saving surgeries. And blood transfusions. Many of my students are young, but some are much older than I. Statistics say that approximately 15% of people are infertile. In a class of 25, I can assume that 3-4 of them will be or have been touched by infertility personally. Do I want to make them feel as badly as it makes me feel to hear things like that? What if they get a diagnosis of endo or PCOS or azoospermia one day, and that’s what they remember? That nature decided that they weren’t genetically fit to reproduce?
Did I thumb my nose at nature by having P with the help of Metformin? Am I trying to do it again with Metformin and Femara and Clomid and IUI? Probably. I probably would have died long before ever trying to have him if I hadn’t had a kidney problem corrected surgically when I was 12, or perhaps from one of the many kidney infections I had before that time that were treated with progressively-stronger antibiotics. If those hadn’t killed me, it’s highly unlikely that I would have conceived and borne a live child, given my PCOS.
How am I supposed to care about evolution? How am I supposed to be anything but intensely grateful that there were people who developed Metformin, who figured out what was wrong with me, who kept me on Met for 14 weeks of my pregnancy? WHO CARES IF IT WASN’T SUPPOSED TO HAPPEN? I have a child. A beautiful, brilliant, loving child with my eyes.
Sometimes I don’t give a rat’s ass about nature. P was meant to be in my life. Maybe that’s what I should tell them.
October 19, 2006
Meet my best friends–sweatpants
Right now I’m wearing a pair of plaid flannel pajama pants. Either they or some regular sweatpants are all I’ve been wearing at home for the last few days.
Wait–just to clarify, I am wearing a shirt and various undergarments and accessories. If I know you IRL, don’t feel like you have to avoid my house!
Of course, if I were really only wearing sweatpants, I wouldn’t blame you for it in the slightest.
Today the waistband on my regular sweatpants felt too tight, so I switched to these since they have a drawstring waist. I’m so uncomfortably bloated–I look like I’m 5 months pregnant (without all the kicks, though). I can’t really sit upright comfortably, so I recline quite a lot. Standing is OK, which is how I got through my long day of teaching yesterday. That, and an elastic-waistband skirt.
I’m only 6dpIUI. Since I have, in the past, been known to start spotting at 9dpo, there’s only a few days to wait. Or there could be a week…occasionally my uterus decides to play tricks on me and let me get all the way to 12 or 13dpo before starting to spot. We’ll see. I spotted on 7dpo with Patrick, then started again at 14dpo and continued for the next three weeks or so, so spotting doesn’t really tell me anything (well, most often it tells me that yet again, I’m not pregnant). I’m still hopeful.
I’m so tired of waiting. Back when we oh-so-naively started TTC the baby who turned out to be Patrick, I sometimes read about people who’d been going through IF for years. I couldn’t fathom how they could stand it–2 years seemed an eternity, longer than that seemed interminable. We hit 2 years in 12 days. As it stands, I’ll either be just-barely pregnant or still be experiencing the joys of post-period spotting. Now I know how it happens…one day at a time (Krista’s entirely right). Now I know how you stand it…when there’s no choice, you just keep plodding along. Sometimes you scream and rage, and sometimes you cry and hug your spouse, and sometimes you refuse to give in to the pessimism and remain hopeful that the new treatment worked.
I’m going to keep it going. Thanks for helping me out.
October 17, 2006
Now I feel guilty confused
I’m glad to know that J isn’t the only common-senseless husband. To give him a lot of credit, though, he’s been great through this whole cold. He took P to the zoo on Saturday so that I could get some lectures written and take a nap, and did a lot of playing with P on Sunday because my energy levels were so low. His letting me get that extra rest is probably why I am feeling so much better now. I’ve had colds in the past where I haven’t had that extra resting time, and they last forever–I’m nearly over this one only 4 days later.
Well, D and Y have cancelled for Thursday, and J didn’t invite G and his girlfriend, so I have that night with nothing to do. But I feel guilty because I was dreading a pregnancy announcement. They cancelled because Y hurt her back moving furniture the other day and is in pretty bad pain. I’m sorry that she’s hurting and also sorry that she clearly wouldn’t have been moving furniture if she were pregnant.
I wouldn’t wish infertility on anyone (maybe my freshman roommate, but she’ll probably spawn instead of giving birth anyway), especially not D and Y. We really like them. D held P for P’s bris and Y is an absolute sweetheart. They’ll be fabulous parents. They’ve been "seriously" TTC for at least 6 months and were just "having fun" for several months before that. I know it’s got to be hurting them that this hasn’t happened yet.
At the same time, it makes me extra glad that I told them about our infertility when we had them over last time. They’ll know that we can understand what they’re going through, that we won’t just give them platitudes and assvice. If they need anyone to talk to, we’re here for them. It was really hard for me to admit that at the time but maybe that knowledge will help them in some little way.
On my own personal fertility front, I need reminders that feeling nauseated at 3 and 4dpIUI is far more likely to be a side effect of the Metformin on a mostly-empty stomach (the cold has me only wanting to eat soup, water, and juice) than an actual pregnancy symptom. I was trying not to get my own hopes too far up about the cycle. Then I realized that it’s going to hurt if I’m not pregnant regardless of whether I’m hopeful or not, so I might as well be hopeful. It’s kind of nice to ignore the pessimistic, cynical voice inside of me occasionally.
October 14, 2006
Do all husbands lack common sense?
Or did I luck out in getting the only one who does? My schedule this semester has been non-stop. Mondays and Wednesdays, I leave the house at 8 a.m. and get home between 10 and 10:30 p.m. Tuesdays, Thursdays, and Fridays, I get to leave work quite early but I’ve had two separate Bradley classes going on Tuesday and Thursday nights. So Friday is the only night of the work week that I don’t have anything scheduled. I would never have held two classes at the same time while working but when I scheduled the second one, I didn’t have a job yet and had to figure out a way to make money.
For weeks now, I’ve been dreaming of the day when my Thursday Bradley class would end so that I would have an extra night free. I’ve made no secret to J of how happy I would be to have that night off each week.
Their last class was this past Thursday, and I rejoiced that I would have Thursday nights free from now on. I also started coming down with a cold that day (J and P had just gotten over it, so I knew it was coming), so I was feeling pretty lousy on Friday. Friday was the day that J came home and said "Since the Thursday Bradley class is over, I invited D and Y over for next Thursday, and I was thinking of also inviting G and his girlfriend."
He’s lucky I was feeling too weak and sniffly to do more than glare at him.
And I swear, if D and Y announce their pregnancy that night, I’m going to cry.
PCOS Baby 