Out of Sight…Out of Mind

Since the beginning of September, I’ve made three visits to the fertility clinic.  The first visit was my pre-op appointment, the second visit was my post-op appointment with the nurse, and my third and most recent appointment was my post-op with my RE.  I did not realize just how much the roller coaster ride was affecting me until I was forced to get off.  The break has been great for my mental and emotional health!  IF can never be completely out of my mind (especially with all the babies and pregnant people in my life), but I have felt more like myself in the past three months than I have felt in a while.  In fact, I’ve enjoyed being away from treatments so much that I have very mixed feelings about starting treatments again.

When we met with the RE, he walked me through the surgery photos.  It was so cool to see it from his perspective, but I was completely grossed out by some of the images of my insides.  There was A LOT of scar tissue.  I had already goo.gled images to have an idea of what he saw, but there was a lot more tissue in my pictures than what I found through goo.gle.  My ovaries were literally attached to my abdominal wall, and you could not see the left tube.  He had to laser through scar tissue to even locate it.  He also found a good bit of endo on my ovaries and uterus.

The RE prefers that we proceed with IVF.  He is concerned about the condition of my tubes and ovaries.  Both tubes filled and spilled just fine, but he’s concerned that the tubes or the fimbriae may have been damaged by the endo and/or scar tissue.  However, he is “willing to allow us to try” a couple more IUIs.  He wants to increase my medication and see if I will respond any better.  Mr. B and I have been on the fence about our next step.  On the one hand, we would hate to spend the money on more IUIs and end up needing it for IVF.  At the same time, I’m curious to know if the surgery will make a difference.

Rather conveniently, our decision might just be made for us.  I have insurance through Mr. B’s company because it offers more coverage and options.  It also tends to be cheaper.  We are currently in open enrollment and are trying to determine which plan we want.  Our current plan is no longer being offered, but I think it may be a blessing in disguise.  I was pleasantly surprised to find that both of the 2010 plans offer coverage for IUI.  Both plans will pay a percentage for the medication and procedures.  And because of my diagnosis, monitoring with u/s and b/w will continue to be covered.  In light of this fact, how can I not try more IUIs?

Unfortunately, neither of the plans will cover IVF.  I spoke with the clinic this morning, and they think the insurance company would cover the u/s and b/w for IVF and a percentage of the meds for IVF since some of the meds are the same for IUI, but they will not cover any of the procedures.  Even so, the coverage for the meds and monitoring would be a huge help.

In the meantime, I have at least another month to decide where we go from here.  The RE wanted me to have one cycle without treatment to allow my body more time to heal.  When I met with the RE, I was on cd 50.  Surprisingly, I started on my own the very next day.  Since I am not on meds, I can expect at least another 40-50 day cycle.  That gives me another month to enjoy being off the roller coaster ride.

This is where the mixed feelings come in.  If I start my next cycle when I think I will, it puts me having the next IUI in the middle of December.  That means we would get the results right before Christmas.  If the results were positive, it would be an incredible Christmas.  However, if the results are negative, I don’t think I could handle it during the holidays.  The conundrum is that I like not going through treatments, but without treatments, I feel as though I have no chance of getting pregnant.  I suppose I’ll just play it by ear and make a decision when I finally start the next cycle.

Survived Again

Just a little over a year ago, while I was recuperating from laparoscopy and ovar.ian drilling, I remember wondering why anyone would ever do that twice.  After surviving a second laparoscopy, I now know that we IFers will endure more than we ever imagined for the sake of conceiving.

Surgery was last Thursday.  I’m told that everything went well.  I’m here to write about it, so I suppose it’s obvious that everything went well.  The procedure took longer than expected because the RE found lots of scar tissue when he got in there.  In fact, Mr. B got to see the pictures, and he said that it looked as though nothing was where it should be.  The RE told him that when he first got inside, he couldn’t even find one of my tubes.  It turns out that it was adhered to the top of my uterus.  He told Mr. B that both of my ovaries were adhered to my abdominal wall.  He also said that my endo was back.  The hysteroscopy was fine.  What he thought was a polyp was actually something else.  The RE isn’t sure exactly what it was, but he removed it and sent it off to be biopsied.  He told Mr. B that he wasn’t concerned about it.  He just wanted to be on the safe side.

I’m relieved it’s over.  When I talked to my nurse last Friday, she said that the RE seems to think the scar tissue is what was preventing me from responding well to the injections.  She thinks we should continue treatments as soon as I feel up to it.  My post-op is tomorrow.  They gave me the option of not going, but I really want to make sure everything is healing well.  I also have some questions for the nurse.  I won’t get to talk with the RE about everything until Oct. 7, when I have my post-op consult with him.

I’ve been back at work since Monday, and I still feel like I’ve been hit by a truck.  I have no energy and no appetite.  I suppose it’s just the process of healing, but I’m ready to feel up to 100% again.  For a couple of days I could barely move, so each day has been better than the day before.  It really makes me wonder what they do to you when you’re out.  On Saturday, when every muscle in my body ached, I told Mr. B that I thought everyone in the OR took turns beating me.  I’m sure that’s not the case, but seriously, I could barely move my legs without excruciating pain.

I’m really curious to hear what the RE recommends for our next step.  Mr. B and I think we would like to do one more IUI (two if necessary).  After hearing about the scar tissue and the tube issue, I don’t feel like the three previous IUIs even had a fair chance of working.  For the sake of our wallets and our schedules, it would be great if IUI would work for us.  However, if the RE thinks we should move forward with IVF, I suppose that’s the route we’ll take.  In the meantime, we’re just waiting for whatever comes next.

Results are in

“Your eggs are fine,” said the nurse.  CD10 and clo.mid challenge test complete.  FSH is 8.3.  We were hoping it would be a little lower, but I’ll take it.  My nurse said that they considered anything under 10 to be good.  Surgery is scheduled.  I asked what the results meant for future treatments.  She said that they would do the lap/hystero.scopy and remove the polyp, endo, and anything else that might be getting in the way.  Depending on the surgery results, we’ll hope to start treatments again in October.  I’m breathing a huge sigh of relief.  It’s nice when the dr. is actually wrong about some things.

Finding the Way Back

I never thought I would say it, but taking a break has been wonderful.  In the two months that we’ve been away from ttc, we’ve taken a couple of trips and have spent time with family and friends.  Through all of it, I managed to avoid letting IF consume me.  Most of July, Mr. B and I got to be a fun, married couple who came and went as we pleased, and who spent our hard-earned money on things besides fertility meds and dr. appointments.  I ate and drank whatever I wanted and have the extra pounds to prove it!

We are finding our way back and slowly allowing IF back into our home and daily lives.  It’s proving quite difficult.  After 10 days of pro.vera, AF finally showed up, ending a 51 day cycle.  I’m on cd9 and my last day of clo.mid.  My FSH test is tomorrow morning, so by the same time tomorrow, I hope to have a better idea about ovarian function.

As of this week, I’ve returned to my PCOS/IF diet of low-carb/whole grains.  I picked up six pounds during the three months we were cycling w/ injections.  I have a sneaking suspicion that it has more to do with the ice cream I’ve been consuming to get through these hot summer months than it does the meds, but I’m blaming it on the meds.  I had already gained four pounds in the winter months before starting treatments, so I’ve gained back a total of 10 pounds since January.  I had hoped to drop those 10 pounds before my surgery, but considering it’s two weeks from today, I’m not counting on it.  It’s not like I have to lose weight to have the surgery, but I know it will make me feel better.

I started therapy about a month ago.  When I was dealing with the third failed IUI and my sister’s pregnancy announcement, I decided that it might be time to talk to someone who could help me cope with all of my emotions.  I’m not sure what to expect from therapy, but I definitely feel better knowing that I have a safe place to share what I’m thinking and feeling.

I suppose everything I’ve been sharing in therapy has kept me quiet in this space.  I’ve been lurking, checking up on the blogs I stalk read regularly, but I haven’t really been commenting.  I needed time away from thinking about me.  I’ve enjoyed reading what’s happening with others, but I guess I didn’t want to think about what was happening with me (or what’s not happening with me).  I’m also finding my way back into this blog world.

I think I’ve written about it before, and I know many other IFers have written about it, but in this time away from ttc, I discovered how much IF has changed me.  As with many other life experiences, you cannot experience the IF journey without some type of change occurring.  I don’t know that I was even aware of how much I had changed until I was reintroduced to the me who is not ttc.  (All of you grammar girls can have fun with that last sentence, but somehow I think you’ll understand what I’m trying to say.)  I told my therapist that I realized I had missed myself while going through treatments.  I like to think that I’m a thoughtful, selfless, friendly, and generally happy person.  I don’t recognize the person who’s made it through four years of ttc.  She’s bitter, angry, sad, grumpy, and I don’t think she’s pleasant to be around.  It probably explains why I’ve stopped receiving regular phone calls from some of my friends. 

I was so moved by Sassy’s post about the face of infertility.  I read her post early in this ttc break, and I’ve been haunted by it.  It prompted me to pull out my photo albums from college and remember the days when I met Mr. B.  I looked at our wedding and honeymoon pictures and thought about the couple we were almost nine years ago—so happy, young, and carefree.  Then I looked at photos from the past couple of years.  In 90% of the recent pictures, I look so tired.  As I sit here typing, I realize that I.am.so.tired.

I’ve been considering “coming out” of the IF closet.  I’ve chosen to remain anonymous in this space so that I can share my thoughts, feelings, and frustrations with complete honesty and without worrying about hurting someone’s feelings (family or friends).  I haven’t made up my mind, but some days, I think life would be easier if my family and close friends could come to this space to learn more about what I’m feeling.  They might understand why I act a certain way or say certain things.  Then again, in some ways, it could make things worse.

In finding my way back, I’m taking one day at a time.  FSH tomorrow.  Surgery in two weeks.  Our path is unknown beyond my surgery, and I’m fine with that.  We’ll certainly have a better idea about the path after tomorrow, but we’ll know even more after my surgery.  Either way, I hope I get to see the other me again- and very soon.

A Dash of Salt to the Open Wound

First of all, thanks for all of the love from the blogosphere.  I really appreciate those of you who dropped by to offer your support and virtual hugs.  It reminded me that I must get better at keeping up with LFCA and offering my support to this community of incredibly strong women.

This week was actually going much better than last week.  I still haven’t spoken to my sister.  We’ve texted a couple of times, but I was waiting until my appointment with the RE.  I thought that I could handle a conversation with her if I knew what we would be doing next.  I was so wrong.  Let me hit the high points of our visit with the RE (in this case, I suppose they were actually the low points of the conversation):

- RE performed SHG which showed a polyp.  Thankfully, the 800 mg of ibu.profen made the SHG only slightly uncomfortable.

- RE is disappointed in my response to stims.  He is concerned that my inability to offer up more than one mature follicle per stim cycle may indicate poor ovarian reserve.

- Clo.mid challenge in August to test FSH and determine ovarian reserve.  Can’t wait.  200mg of Clo.mid in the hottest month of the year!

- Pending the clo.mid challenge results, possible lap/hystero.scopy in September to remove polyp, check endo.metriosis, and check ovaries/tubes for scar tissue resulting from July ‘08 ovarian drilling.

Those are our next steps.  I’m not quite sure because I sort of stopped listening when I heard him say “donor eggs”, but I think he said that if the results of the clo.mid challenge show diminished ovarian reserve, he will not do the surgery.  I can’t even think straight.  He did a random FSH test and the HSG in February.  After both of those, I thought we had jumped all the hurdles.  I thought we were cleared to move forward.  I had hope that we were well on our way to having our baby.  It just goes to show that you never know where the roller coaster ride of IF is going to take you.  The past week has been full of tears.  I’m tired of shedding tears over this.  I think I’ve earned a glass of wine, and I think it’s calling my name.

Insult to Injury

It’s been a rough week.  I’m finally at a place where I can write about this without having a meltdown.  My previous post was written Monday morning while I was in a really terrible mood.  If I had known how the day would end, I probably would have stayed in bed.

After spending the day fighting back tears, I retreated to my home where I could get comfy, stay cool, and enjoy hugs from Mr. B.  An hour after we got home from work, we were discussing our dinner options when we heard a knock at the door.  It was my sister and bil.  It’s not unusual for them to drop by, so I didn’t really think anything of it.  About 30 minutes into our conversation, I told my sister that I have an appointment with Dr. McDreamy next week.  (I was due for my annual exam in January, but I put it off when I was referred to the RE.  My RE’s nurse told me not to worry about it because the Dr. would do a pap at my first ob appointment.  Since it is now July, and I am still not pg, and since I can’t possibly stand to go an entire month without some sort of procedure taking place in and around my female parts, I decided to schedule my annual exam during our month away from treatments.)  My sister inquired as to which day I would be seeing Dr. McDreamy.  (It is important to note that we both go to the same ob/gyn.)  When I told her the day, she inquired about the date.  I confirmed the date, and she proceeded to tell me that it must be a popular day for Dr. McDreamy.  My stomach started to turn flips as I prepared myself for what I knew was coming next.

My sister is my only sibling, and she is older than me by a few years.  We are very close and talk to each other every day or two.  She and my bil got married last fall.  Because of her age, they decided not to use any birth control.  I don’t think they necessarily wanted to have a baby right away, but knowing my situation, they were afraid that it could take a while, so they decided not to prevent it.  Eight months into their marriage, and they are pregnant with their first child.

I don’t know that I could have received the news on a worse day.  After not dealing with the disappointment of our third failed iui cycle, and after fighting back tears all day, I could not hold it back any longer.  I immediately lost it and cried continuously until Mr. B made me go to sleep.  In fact, I started crying when I woke up the next morning and didn’t stop crying until about 5:00 that evening.

I apologized profusely to my sister.  I felt horrible for my reaction.  It’s not exactly the response I would want from her if the situation were reversed.  She understands, and she and my bil dreaded telling us.  Unfortunately, knowing she understands doesn’t change my situation or make it any easier.

It’s not the same situation, but I got married before my sister.  Almost seven years before my sister even met her husband, she watched me get engaged, plan a wedding, and get married.  I was 22, and she was 25.  At the time, she wasn’t even dating anyone.  She had a hard time with it.  She distanced herself from me and avoided any situations where there would be talk of the wedding.  It’s not the same, but it’s what helps my sister understand the hurt in my heart.  While she was happy for me, it was painful for her to see her younger sister have something that she wanted so desperately herself.  Because she loves me, she bandaged her lonely wounds and stood by me on my wedding day.  She held my flowers and watched over my shoulder as I married the love of my life, all the while, never knowing if or when her day would come.

Over the past several months, she and I have had many conversations about this exact situation.  She knows how much I have struggled with close friends who got pregnant quickly.  She has seen me shut people out because being around them made me sad.  When we would discuss the scenario of her being pg before me, she would tell me that my feelings about her being pg should be different from my feelings towards my friends.  I did not consider it during those conversations, but she was so right.  It’s much worse when it’s your sister who you love deeply and need in your life.

I have not spoken to her since Monday.  I have already backed out of a family event because I can’t bear the thought of being around while everyone congratulates her.  I am so torn between wanting to talk to her about how she’s feeling and not being able to handle actually hearing about it.  It’s already killing me to know that she needs me, and I can’t be there for her.  She is scared.  She and my bil are still figuring out married life.  Before they even have a chance to get that figured out, they’ll have to figure out how to be parents.  But I’m still licking my wounds and feel like I owe myself the time to heal a little.

I know that the wounds will not fully heal over the course of the next eight months.  In fact, I’m certain they will reopen several times – perhaps a little salt will also be added from time to time.  However, I know that because I love her, I, too, will bandage my wounds and be there for her.  I will stand by and watch as she and the love of her life enjoy a future that I want so desperately for myself, all the while, never knowing if or when my day will come.

Hope Deferred

According to the wise King Solomon, hope deferred makes the heart sick.  As someone on an official break from ttc, I can attest to the fact that hope deferred makes the heart sick. 

I avoided posting results over the weekend.  It seemed that if I didn’t talk or post about the results, I could somehow make it change.  I didn’t sleep very well most of the past week, and I was really looking forward to sleeping late on Saturday.  Unfortunately, the same thoughts that woke me up at 5:00 a.m. throughout the week woke me up at 6:00 a.m. on Saturday.  I managed to climb out of the bed without stirring Mr. B.  As soon as the single line appeared, I decided to go back to bed.  It was actually the best way for it to happen.  Three hours later, I snuggled up to Mr. B and informed him that the test was negative.  I immediately launched into the list of things we needed to accomplish that day.  I didn’t allow any time for discussion, and I was grateful for a busy weekend. 

It’s Monday and AF showed up just in time to remind me that I am definitely not and have never been pregnant.  I’ve not allowed myself to shed any tears over this last cycle, and it’s made for an extremely difficult day.  Every random conversation at work has put me on the brink of tears.  I’ve retreated to my office multiple times and have finally decided to post about this terrible place where I find myself. 

We are definitely taking a break this cycle.  I know I need the break, but I’m a little frustrated that I really don’t have a choice about it.  We’re going on vacation in a couple of weeks, and cycling would probably interfere with our vacation schedule.  I really need the break, but I’ve developed a love/hate relationship with cycling.  I hate the injections, the constant appointments, the bloodwork, and the ultrasounds.  But I’ve also learned that without all of it, I cannot and will not ovulate on my own.  When I’m cycling I am hopeful, and I love being full of hope.  A break from cycling means that the hope is deferred.  And my heart is sick. 

I don’t know where to go from here.  I’ve called my nurse to make an appointment with my RE.  Are there more tests?  Should we increase the dosage and hope for more follicles?  Should I have another surgery?  Should I lose more weight?  Should we make plans to move on to IVF? 

Then, of course, I have questions that my RE can’t answer– the questions that may never be answered.  What is keeping one egg and plenty of sperm from forming a baby?  Why did I ever change my mind and decide I wanted to have children if it isn’t going to happen?  Why do people who don’t even want children get to have them?  Will I ever have a child?  Why can’t I get pregnant?  The perpetual “WHYs?” are the questions that are making me crazy.  I’m one of those people who believes everything happens for a reason, so I usually don’t dwell on the questions that may never be answered.  But I’ve found myself in a place where those questions plague me.  And my heart is sick.

Two Can be as Bad as One

At least, two can be as bad when you’re referring to the tww.  I’ve almost made it through one week of this tww, and it’s gone by surprisingly fast.  I’m experiencing serious crunch time at work.  While I don’t need the stress of crunch time, I’m thankful for the distraction.

IUI #3 was last Saturday.  Everything went well.  My RE was not on call last weekend, so I ended up with the other RE in the office.  It was my first time meeting him.  He was nice enough, but he got right down to business.  He didn’t even introduce himself when he first came into the room.  He glanced at me and Mr. B and proceeded to flip through my chart.  He finally asked if we had ever met before.  When I told him we had not, he introduced himself.  He performed the procedure, removed his gloves, washed his hands and quickly exited the room.  It made me appreciate my RE who always makes sure I’m comfortable and completely covered before he walks away from me.

I’ve been in a little bit of pain this week.  I’m not sure what’s causing the pain, but it’s in the lower abdominal area on my left side.  It started out as a major cramp around my left ovary.  By Monday, it felt like I had pulled a muscle between my ovary and hip.  By Wednesday, the pain felt more like it was in my hip joint.  I had a paratubal cyst on my left side at the beginning of this cycle, and I wondered if that could have been the source of the pain.  Like any reasonable IFer, I goo.gled information about pain following folli.stim injections/ iui / hcg injections.  I couldn’t really find any side effects to help me diagnose the pain, so I took Tyl.enol and dealt with it.  It’s better today than it has been all week and seems to be moving on.  I haven’t even taken Tyl.enol today.  I didn’t really experience any pain in the previous two cycles, so of course, the tww psycho in me is hopeful that it’s a good sign of something happening in there.  The realist in me told the tww psycho to keep her mouth shut for the next week.

One week down…one to go.  So glad it’s the weekend!

One is the Loneliest Number

After 11 days of folli.stim, my right ovary is “quiet” and my left ovary has one lonely follicle.  I was hoping for more than one follicle this cycle, but one is all that popped up.  As of this morning, the lonely follicle is measuring at 21.5mm.  I’ll trigger tonight and go in for the iui on Saturday.  I’m quite discouraged, but the nurses keep reminding me that people get pregnant every day with just one mature follicle.  I would probably be encouraged by that logic it weren’t for the past two failed cycles with one lonely follicle in each cycle.

I can tell it’s time for a break.  I’ve been really anxious during the tww of the past two cycles.  I’m more relieved about this tww than I am anxious, and that’s how I know it’s time for a break.  I’m looking forward to two weeks with no appointments, injections, ultrasounds, or bloodwork.  It’s a pleasant thought just knowing that I will not be starting another injection cycle in two weeks, regardless of this cycle’s outcome.  I’m two weeks away from an IF vacation and one month away from a work vacation.  That thought alone will carry me through the tww.

Third Time’s a Charm?

My nurse seems to think so.  During my baseline u/s on Monday, she explained that she got pregnant after her third iui.  We’re hoping there’s great truth to the expression.

We had planned on taking a break, but after some words of encouragement from my nurse, we decided to move forward with iui cycle #3. Actually, it wasn’t her words of encouragement that helped as much as the free month of meds she offered me with samples from the clinic.  They are switching me from go.nal f to folli.stim, and the clinic had enough samples to get me through my next cycle.  I will still have to pay for the ovi.drel and the iui, but I just couldn’t turn down free meds.

AF started on Saturday, and I started injections on Monday.  I go back Thursday for monitoring.  We’re hoping and praying that I’ll respond to the new meds better than the previous two cycles.

I’ve already declared that we will most certainly be taking a break if this cycle doesn’t work.  My best friend told me not to think about this cycle not working.  She thinks that’s part of my problem – lack of positive thinking.  Unfortunately, Mr. B and I have both reached a point where we go into a cycle not expecting it to work.  It’s much safer this way.  If it does work, we’re surprised and thrilled.  If it doesn’t work, it’s exactly what we expected.  I know there’s a lot to be said about the power of positive thinking, but I have learned that it can also come back to bite you in the rear.  And I’m so glad to know that my state of mind is the problem.  All this time and I thought it had something to do with my dysfunctional, polcystic ovaries.  I must remember to send positive thoughts to my ovaries and endocrine system.