Sunday, December 25, 2011

Happy Holidays!

Just wanted to say Merry Christmas / Happy Holidays to everyone out there.

I was looking back at photos from Christmas last year and I had my husband take a picture of my waist because I was convinced that it was the last month we were going to see it.  Well it wasn't quite the last month, but we made it 6 months later.

May all your dreams come true in 2012.

Wednesday, December 21, 2011

100 days left! (hopefully)

I am officially 100 days from my due date.

I am feeling pretty proud of myself and pretty optimistic.  Contractions are more manageable (although I have my good and bad days).  Work is more sane manageable because with the holidays nobody wants surgery this week and several of my patients decided they don't want to come to clinic.  (Who wants a pap 4 days before christmas?  If it was me and I still had shopping to do I would skip the appointment too!)  And I have a whole 4 days coming up over the next 2 weeks to sit around and enjoy the company of others.

This christmas is going to be a little sparse.  I couldn't stand up to bake too much so everyone gets a couple cookies instead of a plate.  Almost all holiday shopping was conducted with my feet up from amazon.com. I never finished putting up my decorations. Wrapping - does an amazon.com cardboard box count?  I guess I could put a bow on it.  But I will say its going to be a very merry christmas anyway.

Its our last christmas as a couple - although really this little one pound peanut is the complete center of our lives already.  So 100 days to the fully cooked date - I'm becoming a better baker/incubator and I think my uterus appreciates the reduced activity.  I can sooo do this for 100 more days.

Tuesday, December 20, 2011

Christmas presents

My family keeps asking me what I want for christmas.

The answer - not much.

Seriously I just want kiddo to be healthy and keep cookin'.  Material things just really don't matter to me right now.  I have no interest in clothes, electronics, vacations or jewelry.  I asked from some nursing tanks because that will probably be helpful but otherwise I cant think of anything I want or need.  The material things that I wanted before  - I've moved on.  There has been an amazing priority shift in life and I just feel content.

I am a lucky girl and I wish all of you out there the gifts of family and health in the upcoming year.  They are the best presents anyone could get.

Monday, December 12, 2011

Hello Viability!

Well . . . I can officially start calling her a baby.  She is officially in survivability age and is still where she should be.  My cervix, is still hanging on at its slightly stumpy measurement, and my contractions - well they are still there too but many less of the take-your-breath-away type.

I have been a good girl too.  When you are in training for any type of surgical speciality its all about how many hours you can go without peeing/eating/or doing anything but concentrating on your task at hand.  Residency is not only a training for the speciality - it is a training of the body and mind that can make you focus so hard on something that 6 hours can pass without noticing.  This is the first time I am breaking that - I get up 30 minutes early to hydrate before I get out of bed.  I get to work early so I can walk slowly to my clinic so I wont contract.  I snack and hydrate and pee between patients, and I keep my feet up secretly under the desk.  Overall this seems to keep my uterus and my "baby" (still sounds weird to me) happy.

I am on a vacation day right now baking some cookies and relaxing.  I was supposed to join my best friend in a trip to disney with her 2 and 5 year old girls, but I thought better of it.  I can really think of nothing more fun than going with them, but fortunately when I backed out from contractions, my friend was the most understanding person.  She herself had very similar contractions - very bad when she was working but without cervical change - and she ppromed at 34 wk.  Its nice to have her to talk to about it, and nice that there is someone who is reassuring but at the same time doesn't try to tell me that everything is going to be perfect which is the response that I get from everyone in my specialty.

And can I just say thank goodness for online christmas shopping.  Holy cow the internet is saving me.  I went to the grocery store last night because I ran out of flour and carrying 5 lb of flour in 2 bags back to the car was really pushing it.  I cant imagine going to a mall at this point - let alone lugging gifts.

So things are great here so far.  Despite the issues and the worry, I am really loving this and really excited that I can admit that I am going to actually have a baby.

Thursday, December 8, 2011

the duggars

Just was looking on yahoo and the top story is that Michelle Duggar had a miscarriage - and a second trimester miscarriage at that.

I got really teary when I read that.  While it is partially my hormones going, I feel that it is so sad for her and her family. No matter how many kids you have it is still a big loss and to have to go through it so publicly must be torture.

I feel a little guilty because I was the one who ranted when I found out she was pregnant again - but my wishes really were for her to have a healthy pregnancy and a healthy child.  Any miscarriage is a tragedy - and despite all my infertility issues - it is one that I have so far been spared.  I am very thankful for that but very sympathetic to pregnancy loss.  I wish her and her family the best.

Friday, December 2, 2011

23 weeks

This is going to be a hard week for me - actually a hard month.

First of all . .. uterus decided it was going to cooperate and relax more today.  A little bit rough initially with lots of contractions this morning when rounding but then I got to clinic - saw patients with my feet up (thank god for gracious patients) and tonight dare I say - I am moving about the house (albeit minimally) with only the non-painful variety.

But 23 weeks is hard.  Its so hard because it is on the cusp of really being a possibility, but also on the border of having very bad outcomes.

Until this time, as much as I am irrevocably in love with this little thing, I have refused to call her a baby.  She is still my little fetus.  Non-viable, full of potential, but not old enough to be on her own.   I have refused to let many thoughts go through my head about what her life will be like or assume that she will even be there for sure.  I know I can loose her at any minute and it terrifies me to know all the possible ways that could happen.

This is going to be a hard week to get through - I need to make it several to feel good, but this is like the last week of near-guaranteed loss if something goes wrong.  Next week (and to a lesser extent the few weeks after) may be even worse because its going to be the week of likely permanent disabilities if she is born early.  There will be nothing but major guilt if I do anything to provoke that.

So I think this could be the most important month in determining the rest of my life and hers.  Whenever I have had those important months in life/career I have busted my butt to do whatever I needed to do to make it work. Now what I have to do is a whole lot of nothing.  I need to keep my feet up, I need to be on the couch hydrating and eating well, and I need to relax.

Hard to tell that to my brain and even harder to demand it from a my defiant womb.  So for now I will just keep crossing my fingers . . . and my legs.

Thursday, December 1, 2011

All or Nothing

Its amazing that when you are pregnant and not doing as fabulously as you hoped that there are really very few options.

Its been a rough week - the contractions came back with a vengeance.  Fortunately my cervix is still holding stable.  I wouldn't exactly call it fort knox - it is a little stumpy - but not technically to the point where I am considered real preterm labor.

What I find a little weird is that we as obgyns see it a little as all or nothing.  Either the cervix is changing and its really really bad . . ..  or the cervix is stable and everything is fine.  I can't really tell where I fall into this picture because I am not sure that I am either one of these.  I was to the point yesterday that not only could I not stand through work without huffing and puffing through contractions, but I couldn't sit and stop contracting either.

So I took a trip to my 2nd home on labor and delivery, only this time I was the recipient of care as opposed to the giver.  All things checked out okay and after they made me lay down for a while - of course I did better and stopped contracting. (I am not complaining here because every day she stays in is a day I am thankful for).  Problem with work is I can't just stop everything in the middle of a day and lay down for a while to make myself feel better.

The question is what to do with my life though.  I don't meet technical requirements to stop working and go on bedrest (and believe me thats not what I want and its really never been proven to help), but at the same time I have cut everything else already and the hours I am working are obviously not working for me.

There is no way to say - okay I am ready to work 20-30 hours a week now instead of my 40+.  There are just too many patients to see and too much work to be done - and technically I am not being diagnosed with preterm labor so I don't even have a justifiable medical reason.  The ironic thing is I could probably work longer if I could take it a little easier.  The weekends are going really well because they are mostly spent on the couch - but then I get hit when I go back to work each monday.

There is nothing more important to me than keeping this little one in - if someone knew in their crystal ball and told me that quitting my job would be the only way to have a healthy baby, I would throw out my umpteen years of training in a heartbeat.  But nobody can tell me which way this is going to go.  I myself have seen people contract like this their entire pregnancies and then need to be induced for post-dates.  I have also seen absolute disasters and now that I am almost to the viable stage I am terrified she could be born so premature.

I am thankful for my husband for waiting on me every night after I assume the position on the couch.  I am thankful for my little fetus who doesn't seem to be at all bothered by this.  I will be very thankful if I am still pregnant in a few weeks.

So for now, I just keep going along like everything is normal.  Time will tell.

Sunday, November 20, 2011

juno

Well - I cant sleep.  My schedule is a bit screwed up right now.  Since I have dropped some work (and a good chunk of my regular income) in favor of sitting around more . . .  lets just say I am no where near as tired as I normally am.  This is good for the cleanliness of my house and the progress of the afghan I am knitting.  It is however bad for the online shopping for baby stuff that I am doing.  (mattress here, swing there).  It is all worth it however to my uterus which has quieted down nicely.

So anyway, juno is on and its just one of those movies that makes me smile.  Of course I identify with the jennifer garner character's situation, but I really love the interactions between Juno and her parents.  I have this thing for stories of teenagers and supportive parents - possibly because if I have ever ended up in any kind of trouble I am pretty sure that my parents would not have been supportive at all.  (It was the end of the world once when I got a B - I can't imagine how they would have reacted if I ever had a real problem).

So while I can certainly see the viewpoint of the type A woman who so desperately wants to be a mother, the mother I admire is the the step mother cutting out the magazine pictures of dogs and the one to yell at the ultrasonographer that makes an inappropriate comment to my daughter.  The parent that is there to take care of her and help her.

I hope I'm good at this.

Friday, November 11, 2011

Happy 11-11-11, Happy Veteran's Day and a Happy Me

I am 20 weeks!!!  I have actually made it halfway . ..  and better yet  . . . My cervix is closed!!!  Sure its not super long - but its not short enough for bed rest and its not changing yet!  The amount of relief is HUGE.

I went to my groups OB M&M yesterday.  In medicine there is the practice of reviewing patient cases where the outcomes are bad as a way to keep educating the staff and to look into if anything could have been done better.  I think every type of medicine does it - Ours are really educational.   We have the neonatologist team and the perinatology team come too and we talk about all aspects of care.  The topics though are usually a little depressing - and nerve racking when you are sitting though it thinking what could go wrong with your own life.

Anyway I was sitting next to my OB and she leaned over and whispered "I think I am going to ban you from these conferences until you are 30 weeks".  Its not a bad idea.  Exposure to complicated cases is not what my head really needs right now.  I already know everything that can go wrong - the reminder is not good.  I need to try to forget what I have learned and remember what I know - the majority of pregnancies have no problems at all. (must keep repeating the mantra)


On a separate note - I ran into my old infertility doctor at my prenatal visit while I was waiting for the restroom.  He is quite possibly one of the nicest and most brilliant physicians but he does not do IVF - but he oversaw some of my clomid /injectable cycles and was the one who was so disappointed it wasn't working.  He smiled at the belly - asked me how many cycles it took.  "Only one" I responded.

He dropped his head, smiled this huge smile and looked up.  "Isn't that just amazing"

yes it is.


Happy 11-11-11 and Happy Veteran's day!  I have lots of happiness today and a lot to be thankful for!

Wednesday, November 9, 2011

20 kids and counting . . . really?

I find the Duggars personally offensive.

They are probably very nice people with very nice children, but I find their number of children obscene and their attitude about it naive.  Is there a twinge of jealousy for the fertility that she has - yes, absolutely.  How wonderful it must be to be able to have the family of your dreams.  But really . . .  20?  

They just keep re-iterating that it is up to god with really irritates me because if it was up to god I would never be able to have a family at all.  Is that because they are so wonderful and god loving and I am such a terrible person that I am not worthy of a child?  It just accentuates the unfairness of it all.  The further problem that I have with it is that they seem to keep saying is that god will tell them when to stop - but things didn't go so well last time with the very preterm birth of their youngest daughter due to preeclampsia.  If it were not for good medical care - there would have been no mom and baby at the end of it.  Perhaps that was the message.

I am really hoping for the sake of their unborn child that everything goes well for them and that it is born healthy and mom does well, but if I was her OB I would have advised her against another pregnancy with her possible complications and multiple previous sections.  I understand that some people don't believe in birth control, but I am pretty sure that abstinence is an option endorsed by the big guy. (At least thats what they taught me in religion class growing up.)

Sure these are my personal values and they have theirs and there is no right or wrong answer here.  This is just how it makes me feel coming from the totally opposite perspective.  I wish them well, but I am rooting for the little couple more.

Tuesday, November 8, 2011

Still preggo!

On the bad side - I am still contracting.

On the good side - I am still pregnant with no more bleeding.

So whatever these contractions are I am hoping that they are not doing too much.  I am taking it easy - sitting down lots, walking slowly.  Keeping my feet up when I chart.  My but has been planted on the couch more in the past week than ever before.

Have my cervix scheduled for a check in days . . . crossing fingers.

On another note - I keep talking to her - telling her that she should be happy to be warm and swimming and that my uterus should be the best place for her.  It sounds totally silly - but I figure it can't hurt.

So kid . . . stay in there.  Mom's orders.

Thursday, November 3, 2011

hmmm

Something tells me that work may be short lived.

I worked sunday night, a 10 hour day monday, got called in the middle of the night monday, worked a 10 hour day tuesday and my uterus had enough.  I guess it was my signal that I need to limit things a bit.

While I appreciate the advance notification that I pushed things a little too far, I would like to tell my uterus that it can stop now.  Message received - loud and clear.  I had been cramping on and off since before the beta, but not like this.

Weird how a muscle can have such a mind of its own.  Now I am contracting every time I do pretty much anything.  Stand up - contract.  Lay down - contract. Change positions - you betcha, Restroom - check.  Seriously uterus?  I am only 18 weeks.  I got a long time to go here and you need to simmer down now.

While I am still technically okay - my cervix is definitely shorter than it was before.  I get it rechecked in 2 weeks and the B word was mentioned as a possibility.  I am taking the day as a vacation day, but I return to work tomorrow.

Everyone asks me how long I am going to work - all I am saying is "as long as I can" but that may not be as long as I thought.

Wednesday, November 2, 2011

I saw red

I had my first little freaky experience last night - started bleeding.

Not much, but enough to freak me out.  Had just gotten home from work and was getting ready to get on a flight for a much anticipated business trip and low and behold . . . there it was.  Bright red.  Definitely coming from the place I did not want it to be coming from.  And then . . . contractions.  She hadn't been moving much yesterday and I couldn't feel her on my way to the hospital.

S**T

The good news is I have friends in high places and I basically facilitated my own workup and had an exam and ultrasound very quickly - all of which revealed no clear reason and that kiddo was completely unaffected.  So while I was internally freaking out, I didn't have to freak out for very long.

The bad news is that I know EVERYTHING that can go wrong so despite the reassuring physical findings, I know that while it is likely NOTHING, it could be a harbinger for badness.

Anyway, my butt is glued to the couch today as I work remotely.  Business trip is cancelled but she is way more important to me.  I contract every time I get up but at least they have slowed down and no more blood.

I try very hard to not have anxiety about this pregnancy.  Hard not to after all the infertility.  Even my colleague commented that I seemed abnormally calm about all this - I reassured her that I was in fact an internal mess.  Can one really ever expect a normal pregnancy after IVF?  My job-brain says yes, but my personal brain says no.  I just don't know how to reassure myself.  After all that infertility that is the one skill I missed out on and something tells me I am not going to gain it now.

It is funny though . . . every time I start to get upset she thumps me.  Little Miss Reassuring.  She must already know its the only thing that works.

Wednesday, October 26, 2011

coming out

so I am starting to tell people . . . but I admit it is weird

I am getting questions I haven't really been ready for

"how long are you going to work for?"  hadn't really thought about that.  I mean ideally I would like to feel great and work up to my due date.  But lets face it, this may not be a straightforward pregnancy and I have a physically demanding job. (I don't really sit down for more than 5-10 minutes at a time and there are some very long OR days and call nites.)

Heres another thing I wan't prepped for:  My work will not grant me paid maternity leave.

wasn't expecting that one.  I have been told that I can use my vacation time and my sick leave, but after that . . . I'm on my own.  I think this is supposed to motivate me to come back faster.  Thanks but no thanks.  I am taking the longest amount of time that I can.  I have been waiting too long for this.  If I have to eat top ramen to stay home with my baby, so be it.

What it does mean is that I need to work as long as I can, and I should probably pick up extra shifts if I can.  Not easy because physical activity makes me contract, and contracting makes me paranoid.

There is definitely a balance to reach here and I haven't figured out what that is yet. I guess time will tell.

Until then I wonder if I can make a living blogging?

just kidding :)

Tuesday, October 25, 2011

Normal Chromosomes!!!

Shes a little 46 XX Baby!!!!!  A good number when it comes to genetic material.

Its funny - after the ultrasound I realized I was already pretty bonded.

There was something about seeing a structurally normal heart that meant to me that she wouldn't have to have repeated surgeries in her first year that to me was the turning point.  If she had downs after that point, sure I would be scared of all the challenges and the chances of stillbirth, but I wouldn't let her go.  I made peace with it before I got the results.

I still had the need-to-know aspect of my brain and I am glad I did the amnio anyway (still crossing fingers for no delayed complications) because I can't tell you how good I feel right now.

Its finally becoming real.  I am going to have a baby.

(happy tears!)

Thursday, October 13, 2011

wow

Its a girl!

She looks normal.

Amnio done but I'm no longer worried.

All I am is thrilled.

the really good news and the kind of frustrating news

I got a message yesterday "Hi... this is so-and-so from the genetics center here at the big old university hospital . . . can you please give me a call because we may need to cancel your amnio tomorrow."

huh?

So I called back.  I had dropped off my 2nd trimester sample for the screening program a week ago.  Apparently my hormones are more normal now which dropped the downs risk to 1/340.  This is the most awesome news I could have hoped for.  (I happen to refer a decent amount of patients there myself and I know the genetic counselor from many patient interactions.  We had a very frank discussion after my nuchal that this does not happen often to have a risk drop so much on further analysis.)

Problem is - I dropped below the screening cutoff for an amnio to be paid for by the program.  So now they don't think there will be enough time for them to get authorization from my insurance company for the amnio.  And technically since I will be the age 34.97 at the time of delivery (due date is a couple days before my birthday), I do not qualify for an amnio automatically.

uuuuughhhh (frustration)

Interestingly this is not a screening results I would have gotten an amnio for before. But now after 4 weeks of stressing out over this - I kind of feel like it may be the only way to get some comfort and reassurance.

"well . . . you could wait another week for the authorization to come through"

seriously?  I am already laughably hiding this and 16 wk tomorrow.  If I have to wait another week I will be almost 17 and then about 19 by the time results come back. (which is kind of late to make any decisions) Now at this point, after making it this far,  I am not sure I would change anything even if it did come back abnormal.  But at this point I mentally need the information so I can prepare myself for whatever.

They offered the suggestion that I could pay for it myself, but 2K seems a little steep.  even though its a lot less than the IVF, it still isn't pocket change if the funding may come through at a later time.

So I guess we will see if I get my amnio or not - I get to show up and wait for them to get authorization.

Overall I am still happy, just not really reassured yet.

Sunday, October 9, 2011

frame of reference

Its funny - I can't yet refer to it as a baby.  Its like I cant get my hopes too up right now and think that its something I actually have.

Sure medically I can call it a fetus, but with my husband we just refer to it as fruit.  Theres a little app I downloaded that tells you how bit it is per week and we just call it that.

A couple weeks ago there were such sayings as "don't squish the peach in those pants", last week "the lemon is making my stomach upset" and this week "the navel orange is jumping".  White its fun and cute and like a little inside joke between the hubbie and I - its like our little defense mechanism against falling in love with this little thing too early.

Something tells me I'm going to have attachment issues, although after the infertility, I think thats a given.

Wednesday, October 5, 2011

showing


It is still hard for me to fathom that I am in the double digits of weeks let alone the 2nd trimester.  With all the disappointments along the way, I had set myself up mentally to be able to handle a first trimester loss.  Not that I expected it, but I did recognize that it was a possibility.

But here I am still pregnant, although not really out of the woods.  There is no mental setup for what could be.  I just have to ignore possibilities for now and ride this one out.

So even though I am still trying to hide it - I am VERY visibly pregnant.  Enough that people are commenting.  I look about 24 wk instead of 14.  I have not seen many people pooch out like I have - and I have seen my fair share of pregnant bellies. 

I think I am huge for a few reasons:
1) ovary on top of the uterus.  Its like having a counterproductive twin.  The good side is that my uterus is now larger than my ovary (not that I think my big ol' gagnormo gonad is shrinking but at least it has stopped the rapid conquest for pelvic real estate).
2) I was so big from the IVF ovarian masses at 5 wk that I think it stretched things out a bit.  (Its like my belly was primed and ready to go)
3) I lost a decent amount of weight 2 yr ago and kept it off for all the fertility treatment.  I had a tiny waist after the diet - not anymore!
4) I am lovin' the carbs - my perfect meal is a salad with balsamic and a half a baguette.  (although I have really only put on about 5 lb - the fat pad on the top of my belly has claimed all of it)

It all still feels like a bit of pretend to me.  Like I am dressing up as a princess (because there is still a component of feeling like it is not real).   I hate to admit it but I can't tell you how many times I tried to push out my belly and look in the mirror and pretend I was pregnant - and now here I am - and its really happening.

It was fun being out of town and wearing whatever I wanted to - I didn't have to hide it.  I could just hang out looking like a pregnant person at the pool in my bikini (or at least a woman with a very odd body shape).   I just wish I could be more proud of it, but right now I have to keep it covered.   Emotionally because I don't really want people knowing before I have more info, but physically its getting difficult because it is a decent amount to hide.

Despite the big sweaters and the strategically placed sweatshirts, I am loosing the battle.  Two days ago one of my nurses called me out on it, although she made me feel better because she knew I was trying.  Today though - I was talking to a colleague and I felt like I was a waitress at hooters.  I wanted to say "my eyes are up here" because I knew what she was staring at.

Crap.  Really what I want to do is run to the top of the mountain and yell to the world "I AM FINALLY PREGNANT!' but I just can't yet.  And I really wish people could mind their own business a little more just to give me a little more time.  

I hope one day though I will just look back at this and laugh.

Tuesday, October 4, 2011

October

Today is the 14 year anniversary of my mother's passing.  You would think after 14 years it would be easier, but here I am, up since 3 am thinking about it.  Last year I actually remember thinking to myself that things were getting better, and compared to the early years - well, at least I am not crying anymore.  But this year is a little hard again.

In a large religious extended non-birth-controlled family there is the mini-unit of my immediate family with only 2 well spaced children.  In the context of knowing she had endometriosis and finding a letter in my baby book that mentioned her infertility, I have my theories about the whole thing.  My father refuses to talk about any of it.  Would have been nice over the past few years to have her talk me through it.  Would have been nicer to have her now to talk me through this.

Aw crap.  Tears.  Darn hormones.

She did teach me a good lesson.  I remember clearly her pregnancy with my sister, and being a 5 year old - Well I remember being very verbal about how much I wanted a girl and not a brother.  Every time I said it she would just tell me that I should just pray for it to be healthy.

Several people have asked me along the way what gender I am hoping for, and I respond the way that I did when I was taught when I was 5. When I was 5 though, it was just a programmed response.  The depth to its meaning now is way beyond.  Its a weird connection when you realize that your mother went through the turmoil you are currently in and you have to somehow figure out how she felt without being able to ask.



Nothing good has ever happened in october.  In different years, it was the month she was diagnosed, it was the month her cancer came out of remission, and it is the month she died.  We have no happy memories in october - no family birthdays, anniversaries or celebrations as a distraction.  With the advent of breast cancer awareness month it is this amazing daily reminder of how much this disease has taken from me.  The pink ribbons on everything, the grocery store asking for donations, the walks, the commercials.  All just a little pick axe chipping away at me.

Don't get me wrong - anything that reminds women to go out and get their mammograms makes me happy.  (Its not a pure coincidence I changed my career or went into Women's health.) This campaign saves many lives on a yearly basis and it is completely worth it, and if I had more personal strength I would be out there with a pink-ribbon sign too.  The constant reminders in October are just a little poor timing on a personal level and are sometimes a bit tough.



So I need this to be an October with some good news.  Through these weeks of mental torture I need some courage and belief that I can have a healthy baby.

But right now, I just need my mom.

Monday, September 26, 2011

in the category of mothers think they are special

This story could also be filed under the "women who are (insert not very nice adjective) at baseline"

First of all - I am feeling much better about life.  Still in a weird limbo, but at least now emotionally stable.  But this story is not about me.  This story is about the most heinous person I have ever sat next to on a plane.

A little background to start - The hubbie and I have been wanting to go to Hawaii for years but with the whole cost of the treatments it was on indefinite hold.  We started thinking about going again after the bfp, but then when we got the first trimester screening news - well lets just say that we could spend the money on  Hawaii or a psychiatrist.  So here I am - under some palm trees with my coffee and a laptop - feeling like everything is going to be just fine.

Since the trip was a bit short on the planning stage there was a glitch in the airline reservation and we did not get assigned seats.  My husband spent lots of time on the phone followed by lots of time in the airport to try to get us seats on the plane together.  After an even bigger total screw up on the part of the airlines with our reservation and the need for change in the type of planes at the last minute - everyone needed to be re-assigned their seats and we didn't have any.

Needless to say, after a 5 hr layover and with all the hormones - I got a little teary.  I don't know if it was that they were the last two spots on the plane or that the guy took pity on me after my sob story with the sobs - but we got upgraded to business class.

(I have never had the money to just fly to hawaii on short notice let alone sit in business class - but let me tell you - it was a little slice of awesomeness.)

So anyway - we are close to the last people to get on the plane and there in my seat  (which is a 2-across middle row) is a sleeping infant nestled in the seat surrounded by the airline blanket and pillows.  (my husband took one for the team and took the other last seat next to some very infectious looking person who was hacking nonstop)

"excuse me . . . is this seat 9G? . . . I think I got assigned to sit here"

"well the airline said I could have this seat for my baby"

"well I'm really sorry but this is where I have been assigned"

"honey. . . come here and watch the baby"  she then proceeded to leave the infant in my seat and have her husband come guard the area. (and she goes off to chew someone out)

Meanwhile I have nowhere to sit - nowhere to put my luggage and she refuses to move the kid and there are people pushing past me to get to the regular seating area.  At this point I am so done with the day that I got up to the flight attendant and just start crying.  I felt terrible - I didn't want her to have to move her baby out of the seat that she felt she was promised, but it was not my job to be the bad guy.  The flight attendant then had to escort me to ask the woman to remove the child and reiterate that this was not my fault.  I apologized (choking back tears and just shaking because I feel bad), and she moved the 4 month old - but boy was I the recipient of a really dirty look.

I look at moms and families on planes and I always have a certain amount of sympathy and respect.  With all the gear and the soothing and the attention that the kids need to stay calm - it looks exhausting.
Turns out she was p/o'ed because her family and nanny were forced into business class instead of first class (which I think other than electronic reclining to the seats looked the same to me).  This was also the LAST seat on the plane and she but had NOT bought a ticket for the baby.

For the remainder of the flight she proceeded to hog the entire space and pretty much disrupt everything.
The floor space and baggage space under the seats was covered with no less than 4 separate carryons of hers which she didn't offer to move when I sat down, blankets that she kept kicking to my side, and she used the armrest for herself and her food.  Instead of standing up in the aisle to rock her baby - or in front of her 2 other kids, nanny or husband in the other business class aisles, she proceeded to stand next to me moving back and forth for a good portion of the flight. (even climbing over my feet once)

At the end I was really tempted to say something about her behavior but I refrained.  (trying to hold onto as much good karma as possible.)  Obviously if you can afford to fly your whole family and nanny first class you can cough up the dough for an extra seat for your infant if you want it.  If anything I should have been the one shooting the dirty looks.  All I wanted after working all night the night before was a good 5.5 hr nap. Interestingly the baby was fine for the flight - slept most of the time and when awake didn't complain too much.  Problem was the woman sitting next to me had such ADHD in getting up every few minutes and playing with her IPad that I didn't really get much relaxation out of the flight.

I don't know what bothered me more - the fact that she thought she was special because she was obviously wealthy or the fact that she thought she was special because she had an infant. Maybe it was a manifestation of my new anxiety around babies or a hint of jealousy for all that she had, but obviously took for granted.

Or maybe she really was just a heinous person.

Saturday, September 17, 2011

An update

I officially made it to 12 weeks yesterday but this has been much harder than I ever expected.

I have told multiple people when they ask how I am doing that everything has been great and that I am super happy to be nauseated - which don't get me wrong is still kind of true.  At some point though I just started to feel so bad that I officially pronounced that the old infertile me would be disappointed in the new pregnant me for not being able to suck it up.  I also had a difficult time posting because no matter what, I am kind of bragging to be pregnant - and it just felt like if I bragged that fate would get me.

So I didn't post and I didn't brag -but fate through me a fast ball that hit me upside the head anyway.

On Thursday I went in for my nuchal and saw this cute little thing that looks just like my husband.  Big head and a thick neck.  Problem is that thick little neck and some very low papp-a blood test results combined to give this little fetus a calculated 1 in 11 chance of down's syndrome.  Now, I am 34 years old and no spring chicken, but I was expecting a little more like 1/200 so to get hit with such a high number has been potentially devastating.

I say potentially devastating because this could all work out perfectly well, but its the mind screw that is going to be the problem.  When you get bad news like this, even though likely this will turn out to be nothing, its just too much to fathom.  You stop thinking about the next several months of the pregnancy and start to think about the rest of your life and how one little chromosome can change everything.

One could say I know a little to much - which is true.  My mind is on a high-speed rail train going through the years instead of focusing on just the next step.  But the truth is we are going to have to wait a signficiant amount of time to really figure this out - which is a lot of time to spend freaking out about it.

We were offered a cvs next week vs an amnio at about 15 weeks.  The whole idea behind first trimester screening is to give a couple an earlier answer so they don't have to wait so long to find out, but with the published rates of a 1/100 loss after cvs, I just can't take that chance.  If we lost the pregnancy I would NEVER forgive myself.  So we are waiting for about 15-16 wk for the amnio where the loss rate at my institution is more like 1/400.  Problem is that combine the waiting time for the amnio with the waiting time for the results we are looking at 5-6 weeks before we know anything more.

The other not-so-great thing is that I now have a 6 cm solid mass on one of my ovaries.  Gone are the huge cystic egg sacs that they were and here is this thing that actually freaked out my perinatologist more than my downs risk.  The funny thing is that the ovary with the mass is good old stumpy that really was but a small little half-an ovary after my surgery.  I guess I can't call him stumpy anymore.  Maybe lumpy - especially since he is adhered to my abdominal wall and getting pushed out by my uterus.  I already look about 18 weeks and am having trouble not looking very pregnant - but its really all ovary.


So please forgive the lack of positivity in this post.  I am feeling pretty beat up - both physically and emotionally.  Every time I think about the possibility that that perfect little embryo we implanted could have had a little extra chromosome in each of its 8 cells I physically can't even breathe.  Its like I have to remind myself to just take a breath because if I don't the gravity of it all will just crush my chest.

Through it all though I just keep telling myself the following two things:

1)  I still have a 91% chance of having a totally normal kid in there.  When you look at where I have come from between the 10% chance of conception per cycle to the thirty-something percent chance of a single embryo transfer IVF cycle taking to the 50% chance of miscarriage in the first few weeks -->  I'm still doing way better than before and this is the first time the odds are really in my favor.

2)  breathe

Thursday, August 11, 2011

one way to get back at a pregnant person

I have discovered something from the other side that I wish I knew a year ago.  Silent but awesome way to quietly torture a smug preggo . . . .

wear a lot of bad perfume.

I have seriously always hated perfume.  I think there is nothing more offensive than someone who wears too much.  I would rather sit next to a dude with the worst BO than to sit next to a woman that think she smells good.

I ask - If its socially unacceptable to go around having your music audible to everyone, why do I have to smell you?

Now with my very keen sense of smell - perfume is driving me batty.  I went to the doctors for my ultrasound and there was a 60 ish woman in the elevator that stunk up the whole place.  If she was a little younger or I was less happy I would have asked her to take the stairs.  I literally plugged my nose and made my husband laugh.

SO anyway - if you ever want to be a little subtle and make your smug pregnant acquaintance slightly uncomfortable - theres your answer.

Tuesday, August 9, 2011

flicker

Today I saw the tiniest little heartbeat.

Today we looked at each other and stared in amazement at our future family member.  Most people contribute a sperm and an egg initially and invest their energy later into the pregnancy to bond with their child.  But we started long ago and put so much of ourselves into the process of creating this little fetus.  In addition there have been countless others that have put part of themselves in too.

And from today on - my heart will never be the same.  As much as there was love between us that grew for each other in the absence of success, our hearts now swell with love for this microscopic little being.  And its not just us - its everyone who put in a little love for what they do who made this possible.

I can't wait for that little heart to grow and to fuel the life of a baby . . . our baby.  And I hope that baby grows to be a person with a big generous heart.  Goodness knows it is starting off with a ton of love from a lot of people - that should be more than enough to get it started and keep it going.

Monday, August 8, 2011

infertility screws with your head

This has been a weirdly emotional journey the past few weeks.  Sorry for the lack of posts in the past week but its actually been a bit of a head trip and I have been trying to distract myself.

Physically I am doing great.  No bleeding, no nausea, my ovaries have actually decreased in size to the point where they are both back in my pelvis.  (I can tell because my belly is way less bloated and I have to pee all the time again because of the pressure).

Mentally I am having a little trouble with it.   There is happiness and hope primarily, but also a new anxiety I have never had to deal with.  I am grateful that this has been perfectly normal so far, but I have realized that it NEVER crossed my mind that my pregnancy would be normal.  All along I have expected the worst.  I have expected first trimester bleeding and hyperemesis and ectopics and all manner of bad things.  Its like I keep waiting to have something bad happen because the thought in my head is that I am going to have to struggle through the next 9 months the same way I have struggled through the past couple years.

I had my first miscarriage dream the other night.  Terribly vivid.  Terribly upsetting.  Woke up in tears because it felt real.  I went to the bathroom and fully expected to see red but nothing there.  And nothing there the next day, or the next.  And so today I am still okay, and still pregnant.  Actually after all the crazy things I have done to my body with hormones combined with terrible periods - this may be the first time I have felt well for more than a week in over a year.

Tomorrow another scan to look for a heartbeat.  I think I may relax a bit when I see it, but hopefully at some point I will change my way of thinking and relinquish the doom gloom and failure of infertility that I have gotten so used to dealing with.

There is no medical reason this pregnancy can't go well.  My ex-boyfriend once told me I had good "child-birthing hips" so hell, I may have been born for this.  Hopefully, the hardest thing about this pregnancy will be the conception - that is if I can get my head under control.

Crossing-fingers . . .

Tuesday, August 2, 2011

I've got a sac!!!

Its still there and I can see it! - a little small for what it should be but within the range of acceptable.  I walked into that appointment completely thinking it was all over - like I couldn't possibly have made it this far.  Like I wasn't deserving of really being pregnant.

The head trip that I put myself through.  Not sure why I torture myself.  Maybe its self defense or maybe I think to much.  Probably a lot of all of it.

But its there - the rest doesn't matter.  Yes I have ovaries up to my belly button with so many cysts she couldn't even count them - but I guess that the only real sign of pregnancy I have - the fact that they keep responding and growing to the HCG.  My RE was shocked by the scan and apologized after she looked at my abdomen for how I must feel.  I just looked back at her and told her as long as I saw that little sac it didn't matter how uncomfortable I feel.

I will take it - take it all.  I want it that bad.  And maybe thats the biggest reason of why I am so worried, because I know how much it all means.

Monday, August 1, 2011

well at least my ovary is growing

My ghagnormous ovaries have been a problem throughout this entire process.  They were pretty huge at the time of the retrieval and the transfer.  That along with all of the other issues/meds at that time - well I was pretty bloated.

But now its getting a little out of control.  My left ovary is stuck to my anterior abdominal wall because of my previous surgery and lets just say that when I lie down I have been able to see/feel the little bulge.  Well over the past week its been continuing to get bigger and bigger.

I have no idea if this little pregnancy has continued to exist give my complete disappearance of symptoms, but I am sure that my ovary is there and thriving.

Its at the point where I look easily 20 weeks pregnant because its almost to my navel- and I don't think this is just bloating anymore.  I think this is all one ovary - Its taking up my entire pelvis and I can't really hide it.  People are going to start asking if I am pregnant - I may have to come up with some creative stories because I hope the answer is still yes.

Needless to say I moved up my ultrasound appointment to tomorrow.   I can't take the waiting anymore and I feel that I have a good excuse.  All this is not really a complaint - if there is a little sac tomorrow I don't care at all what it feels like, how I look or anything else.  Im just a little worried medically about how big this ovary is getting and what it could do in a pregnancy or how long it could take to get rid of if I have FET #1 in my future.  The honest truth is that I am a lot worried that there is not going to be anything inside the uterus - because thats all I really care about at this point.

crossing fingers.

Sunday, July 31, 2011

are you still there?

So my clinic does not repeat betas.  Literally they checked the one and said come back when you are almost 6 weeks and we will do an ultrasound.  That's it.  Its another 2 week wait except pee sticks won't help me cheat on this one.

I am in total limbo.  I have had no pregnancy symptoms at all for 2 days - and trust me I have been poking my own boob to see if it hurts.  Nothing.

Obviously the disappearance of any symptoms I was having is making me crazy wondering if it is still there.  I thought about calling into clinic and asking them to draw one - just so I could know.  Its not that doing betas would change much for me - it doesn't make it stick any easier, but I do think it may soften the blow.  (Or just make me worry more - who knows).  I cant look for the normal signs like bleeding because I am full of progesterone anyway.  If it was low however it could help me move on with my life sooner - I'm not sure what solace that has.

Just frustrating and hard to worry this much.  I just keep telling myself I will feel better after I see the heartbeat, but something tells me I am never going to trust the future until my kids grow up and move out of the house.  I am not normally an anxious person, but this process has provoked a level of obsessiveness and insanity that is unlike me.

And so I wait again.  Wait for the reassurance or the crushing blow of the ultrasound.  Wait for anything to make me feel queasy in the meantime so I can relax a bit.  Wait for the fate that I have zero control over.  Wait for the positive feelings to come back.

Thursday, July 28, 2011

addicted to nausea?

So I have said that by the time I got pregnant I would actually be happy to be nauseated.  And by golly - every time I feel queezy I smile this big goofy smile.

I take this as a reassuring time that things are continuing to go forward and pump out the nausea hormones, but at a point I have started to realize that I'm getting a little addicted to it - to the point where I start to worry if I feel normal.

I really do love this feeling and yes it kind of sucks feeling like I am going to puke, but its the symbolism of it all and the reassurance of what it may represent that makes me just eat it up.  I'm pretty sure when the actual puking start and when its gone on for weeks I will no longer be so enamored with it, but for now I will take my odd enjoyment of the moment and love the nausea.

Wednesday, July 27, 2011

the odd spot

I am kind of in an odd place right now.  My whole world has changed in the past week and my head is spinning a bit and I'm not really sure what is going on.  Don't get me wrong - I am overjoyed, but there is also the feeling that it is surreal and maybe I am just dreaming.  (or maybe that this might get taken away as fast as I got it.)

I have spent lots of time, an amazing amount of energy and a decent sum of money dedicating my life and body into getting pregnant. I tried diets, exercise, LH kits, acupuncture, herbal remedies progesterone withdrawals, timed intercourse, clomid, sleeping with my legs up, ultrasounds, "just relaxing", follistim, inseminations - you name it I probably did it.  Now after our first IVF, after 22 months I have finally turned from a G0 to a G1 and if all goes well I may get a child out of this and I can move forward towards the life I have envisioned.  Its really kind of weird.

Maybe I should have just cut to the chase and went to IVF when I figured out that I couldn't get anything out of my ovaries.  I would have avoided a lot of pain and suffering along the way.  But without that process I can't say that I would be the same person or have as much appreciation for the chance I have now.

The shower went well on sunday.  Armed with the knowledge of my beta, it was much more bearable, but I have to say that it was still kind of hard.  Then, after spending the last 3 days listening to nothing but talk of this little 22 wk boy I realized I couldn't take it anymore.  I thought as soon as I was pregnant I would be on the same page as other excited preggos.  But nope.  I was not.  I was instead still just as  annoyed by it.

It kind of put some things into perspective and made me realize that this infertility will be a part of me forever.  Its not like its cured and I can just get pregnant on my own in the future - this will always be my diagnosis.  But in addition I have become a stronger person who fully values the opportunity that I am being given.

Now I just wait until next week for the ultrasound to see if it keeps going.  But I know now I am strong enough to handle whatever comes.

Monday, July 25, 2011

um . . .

                                                               11dp5dr Beta = 184 !!!


I'm trying not to get too excited, I'm trying to remember given my PCOS and my age and my autoimmune conditions that I need to treat this with a certain amount of respect because happiness could seriously vanish into a pad at a moments notice.

But holy shit.

It worked so far and it may keep going.

I am lost for words but filled with joy.

Saturday, July 23, 2011

I think this may have worked

Sorry for no posts for a couple days - worked a 36 hr followed by date night with the hubbie (its the only night together this week).  Plus I have had MAJOR baby shower crap to get ready.

So today I was planning on testing - I liked everyones advice. But I changed my mind.  The reason I didn't was that I think I know.

I do have a weird positive vibe about me.  As a functioning pessimist, this is an odd feeling.

 In addition . . .

Reasons why I think it worked:
1) I feel like a bloodhound.  For some reason I can smell really well.  I have heard about this happening in pregnancy but certainly not this early.  I actually had a little trouble at work yesterday.
2) I am cramping like a banshee.  I have been for a week.  Again, really not what is supposed to have happened this early, but since I'm not bleeding maybe its okay.
3) throwing a baby shower should be good karma

Reasons why I think I am not pregnant:
1) I am crazy and usually can convince myself of anything
2)  I keep poking myself in the nipple to see if it hurts.  Nope.  Not at all.
3)  Odds are in fact against me
4) Only thing making me nauseated is thinking about the shower.

SO tomorrow is the big day.  Lab draw in the morning.  But no matter what happens - I think I am ready to know and to move forward with my life.   If thats forward to motherhood or a slow motion forward to a FET and then on to motherhood, the end result is the same.  I will get there.  (Theres that positivity again . . .odd!)

If I haven't gotten the call by the time the shower starts tomorrow I'm going to turn off my phone and listen to it later with the hubbie.  For some reason I feel mentally stronger to handle anything right now.

Maybe thats the best reason yet.

Wednesday, July 20, 2011

decisions decisions

Its amazing how little decisions and turns of fate can make your life turn into what it is.

so I'm working on some charting from home tonight, husband is working and I have the TV on in the background so I tune in to Big Brother.  Figured I would watch an episode and see what it is all about - all I have to say is this is the dumbest show ever.

Here's the irony -  I was a semi-finalalist for their first season :)  This was back when I was very young, super cute and the whole reality TV thing was just taking off.  At the time my mother had just died, my grades were not so good, and I didn't really know what I wanted to do with my life.  I had seen Survivor and I know myself enough to know that I wasn't going to be eating bugs - so I applied for the show where you sit on your butt in an LA house.  Sounded like a pretty good vacation with cute boys.

Thank god they never took me.  Instead I got a job, figured out my goals, started the premed classes I needed and got my life on track.  If I hadn't missed out on the "opportunity" to be on a reality TV show, I would have probably never gotten into medical school, I wouldn't have met my husband and my life would be completely different.

So fate- maybe you do know a little - and maybe there is a reason why I am not getting the initial opportunity to get pregnant easily.  Maybe its all part of master plan to keep me on a certain path or to do something important in the meantime.  At least thats what I tell myself sometimes.

BTW . . .The producers called me back the next season and asked me to re-apply.  I declined.  That was the point where I realized that I can in fact help fate with some good decisions along the way.

Tuesday, July 19, 2011

to test or not to test part deux

My husband does not understand the jumping the gun mentality of the home pregnancy test.  Although I am not sure if I should partake in the self mind torturing ritual - especially since it has never really panned out before.

So for some reason my clinic does not test a beta until 11 days post 5 day transfer.  Thats a long time.  Far longer than it would take to get a beta of 20 which is the cutoff for most pee sticks.

What to do . . . what to do.

So my 11dp5dt is this sunday and I have an appointment at 8am.  This happens to be the day that I am throwing a baby shower.  I imagine this is how it will go down.

At 2 pm I will be calling baby bingo at which time my phone will ring - do I answer or let the clinic leave a message?  I can let it go to message and just check it after the shower, but how much self control do I really have?  When it comes to waiting for answers - well lets just say I know myself enough to not be able to ignore it.  I am obsessive when it comes to finding things out.  I am the type of doctor that calls the lab 15 times if a lab was sent stat and they haven't resulted it yet within the usual time parameter.

So what I will do is probably sneak away to the bathroom to check my message - but then what?  I still have to play happy hostess and center the world around the mom-to-be.  It would be an absolute disaster if I started crying and I would never be forgiven if I stole any attention for myself.

So then I start thinking about cheating the system and just checking a little early.  I certainly can and I think everyone else does.  But should I?  And if so  . . . when?

Or should I just let it go - come what may?  The answer doesn't change because I know any earlier.  Its either there or its not.  It doesn't make me any less upset once it happens - but it might make it easier to get through the day.

To test or not to test - I still don't have an answer.

Monday, July 18, 2011

Spoke too soon

Seriously the personal mind games I play with myself.  I think I spoke too soon with my previous email.

So today at work I started cramping.  Good old uterine irritation - no bleeding, just the familiar cramp. So then I analyzed and realized that with everything I know about gynecology - I have no idea what is going on inside that uterus of mine.

My first thought was - must get off my feet - this is bad.  Although if the pregnancy is not taking - there's nothing I can do about it, and if I'm cramping because nothing implanted - well then its not there anyway.

Second thought was maybe the little embie is just digging itself in and growing which would be recruiting all sorts of blood vessels to the area.  Then I thought that maybe that should have already happened.

Third thought was that I have officially moved into crazytown.  This was my smartest thought of the night.  There is certain level of obsessiveness that his disease imparts and I have certainly reached the threshold.  Goodness knows what an anxious pregnant woman I will be - that seems to be the only thing I am certain of at this point.

feeling better is supposed to be good right?

With every follistim cycle before I would usually not feel well for about 10 days after ovulation.  And then it would happen that a few days before I was ready for that pregnancy test I would feel absolutely normal.  No more discomfort, no more breast tenderness, no more mild nausea.  After a few cycles I picked up on the body cues and this is how I would know I wasn't pregnant even before I tested.  It was like I felt the hormones were going away even though I was supplementing progesterone.

At first I was really encouraged this weekend that I was feeling better and the ovaries were not so prominent, but then I woke up this morning and felt. . . . completely normal.  Then I realized I am 10 days post retrieval.  Logically I know that my progesterone levels are good because my clinic checked it yesterday (and I have the bruises to prove it). But other than some mild belly pooching it is weird that everything else has pretty much normalized.

uuuuughhh

I hope I am wrong about this.
I hope IVF is different.
I hope in 2 weeks I am huddled over the toilet with nausea.

I hope I can handle the results when they do come.

Sunday, July 17, 2011

proud of my mouth and my ovary

today I reached a mini-milestone - I can no longer see my left ovary bulging through my skin :)

I'm kind of proud right now. It confirms what I know to be true which is that it is completely adhesed to my anterior abdominal wall, but at least I don't have a huge lump anymore which means that my ovaries are shrinking!  (and I do feel a LOT betrer)

Hoorray for small victories.

Also  - in response to my last post.  Yes she was there again today and yes I kept my big mouth shut.  Also a little proud of myself for that too.

Saturday, July 16, 2011

i wanted to scream "none of your business"

I got a good lecturing today.  One of the few nurses who I have known for years whom I never particularly cared for personally decided she was going to really get into why I don't have kids yet.  Fortunately for her I was in a good mood.  Also fortunately I do respect her as a nurse.  She however is quite abrasive, terribly nosey and really annoying.

Yes I am the last person in my group practice to not have children.  Yes there have been 3 maternity leaves within the past year in a half and none of them have been mine.  Fully aware thanks.

nurse: "Doesn't being around all these babies just make you want to have your own".

me: "actually I've been pretty busy working lately" (avoiding)

nurse: "But don't you want a family of your own?"

me: "sure at some point" (deferring)

nurse: "you know, you either have your fun now or you have your fun later - if you don't have your kids soon you'll be too old to enjoy life when the kids finally move out of the house."

Me : starting to get annoyed, trying to focus on my charting, not responding (ignoring)

nurse being persistent:  "You shouldn't wait too long - you know how these women have difficulty if you get too old."

Me:  "Yep  I know" with a fake-o smile and then I proceeded to escape into a patients room. (leaving)


It was like every terrible intrusive stupid question I've ever heard was all in the same darn conversation.

So I ask this question:  AT WHAT POINT ARE YOU ALLOWED TO BE RUDE TO PEOPLE WHO ARE BEING RUDE BEYOND BELIEF?

I know she's socially inept.  I have known this for a long time.  But is it ever okay for me to look at her square in the face and tell her the truth and just try to make her feel as bad as she has made me feel?  Some people are ignorant and have never known of anybody that was infertile.  But this is a high-risk nurse who takes care of pregnant patients every day - there is no excuse.  Don't get me wrong - this is nothing that I haven't heard before.  And at this point its a little like water off a ducks back.  It doesn't bother me nearly as much as it used to.  But am I justified to tell her to go fly a kite?

Seriously I just spent thousands upon thousands of dollars to get fairly ill so I could have a 38% chance at conceiving this cycle and I am so freaking thrilled about that because that is such a better chance than I have EVER had before.  I have never been so hopeful in the process and she just had to re-hash everything all at once.  Its just a little bit of a downer.

I just hope she't not working tomorrow because I am still so annoyed there may be a few things that inadvertently fly out of my mouth if I am not careful.

Friday, July 15, 2011

and now we wait

Infertility treatments are a very funny thing.  You spend several weeks in a row working really hard to make it to appointments, give yourself shots, take pills, get ultrasounds and blood draws.  There is all sorts of anticipation and excitement regarding the time of conception - and then . . . . you wait . . . and you hope . . .  and you dream.

IVF post-transfer bedrest is even a funnier thing.  (I didn't post yesterday because it was too difficult to type on my back.)  Its not like standing up would cause the embryo to just fall out.  But was I going to take that chance?  Nope.  So I was a good girl and was compliant with all recommendations.  Took a day and a half off work (unheard of for me) and took it really light today.  I paid someone to take my call tonight and I'm only working mornings this weekend.    I've done nothing but think about this infertility process for the past several weeks but now I am supposed to just try to forget about it for a while and return to my previous life.

Its kind of hard to forget about though.  Its such in the forefront of my head - and in the forefront of my gut.

On a physical note, I'm actually pretty uncomfortable.  I'm safe to admit that to myself now where I didn't before because I wanted so badly to go through with the transfer.  I fortunately didn't get any ascites, but my ovaries are soooo enlarged that during the transfer instead of filling my bladder and using that to look at my uterus, we just looked through my huge cystic left ovary.  Lets just say that it hurt.  Quite a bit.  But I was on valium and I really wanted it to be a perfect picture of the little one going in so I certainly wasn't going to complain.  But I have been excessively sore since.  I cant even go over bumps in the car.  Eating has been a challenge and when I went back to work today there were quite a few independent comments about how much weight I have lost. (obviously not trying to do so but not much food is fitting in.)

Logically and medically I should have probably just froze them all and waited for my abdominal  cantaloupe and grapefruit to shrink down, but my heart would have hurt with the "what-if's" more than my belly if I didn't go through with it.  I'm thinking of this as a win-win situation.  Given the 62% chance in 2 weeks that I am not pregnant my body will have a bit of time to recover and the first FET will go more smoothly.  On the other hand (in the real win category) there is a 38% chance that this will work and all the pain will be worth every moment.

And so I hope  . . . . and I dream.

Wednesday, July 13, 2011

Dear little embryo

To my little embryo-

You today were chosen because you were the most beautiful embryo we had ever seen.  Don't worry - we aren't expecting you to be perfect the rest of your life, but we do appreciate that you were the little star performer that started hatching before everyone else.

I hope you like your new home and find it comfortable.  I have been working hard to furnish it with nice fluffy pillows so you can just nestle in.  If your little space squeezes on you a little bit - please just hold on tight.  I will try not to move too much or jostle you around.  I really want you to like it inside me just as much as you liked it in that little petrie dish, because I am happy to have you and would like you to stay as an extended houseguest.

I am sorry to take you away from your siblings but I promise that if you do your job you will reunite with at least one of them in the future.  I know that usually you little embryos are transferred in pairs, but I didn't want you to get crowed out later.  So please stay put and I will send you lots of nutrition and love.  I make no guarantees but I think you will be happy with us - at least I know we are already thrilled with you.

Love,
mom

Tuesday, July 12, 2011

just sayin

I think tomorrow I will go get knocked up.

Yep . . . sounds like a plan.

Embies update

20 embies classified as "good" at cleavage stage - which I think is way better than good - I think this is just the best news ever.

Throughout this process it has been difficult to think about the far-off future - being infertile I have spent so much time focusing on the cycle at hand and then re-focusing to the next cycle when failure occurs.  I will indeed be lucky to have one healthy child if I am offered that opportunity and I hope that I can fully embrace that.

But I also realize that most families do get to the point where they want a second and have to do this all over again.  That to me has always been daunting.  How do you do it again when you are nothing but older?  Do you rush into it before you're ready because you want to avoid the poor quality and you know its going to take a ton of time and money, or do you wait and cross your fingers and hope for the best?

If we end up with several good ones to freeze then a lot of pressure comes off my future - just like that.  Less pressure to get pregnant each frozen cycle this time, less pressure to transfer multiple embryos, and less pressure to run into later if we still have some left.  After living through so much repetitive failure with infertility it is difficult to fathom that things may actually be going my way now.

We may get the family we dreamed about after all.  Its something that most fertiles don't appreciate or even think about, but it is the core of what will make my life complete.  Other than a long happy marriage to my husband, all I want is a healthy family.

Hope has returned - and this time it may be for good.

Monday, July 11, 2011

If you're easily grossed out - just skip this one

So I haven't used many blog abbreviations when I write because I tend to find them confusing.  Don't get me wrong, obgyns have the worst letter lingo ever.  One of my purely theoretical notes could read:

25 y/o G3P2 POD#2 s/p RLTCS/failed VBAC for NRFHT c/b PPH c EBL 2L s/p 2 U PRBC -- which would mean in real language that 2 days ago this poor woman was trying a vaginal birth after cesarean section and baby didn't tolerate the labor so had a repeat cesarean section with a low transverse incision on the uterus and bled out about two liters of blood and got transfused two units of packed red blood cells.

Just as a point you can see where the abbreviations come in handy.  Problem is not even everyone else in the hospital has a clue of what we are saying.  This is partially going away with electronic records but we are still culprits.  Therefore on this blog I tried not to incorporate the work ones or the blog ones for fear of getting them all confused. (I seriously wrote ttc in a patient chart one day and had to go back and correct it because while it makes sense to me it is not "approved" for charting.)

The one abbreviation that most people around the hospital appreciate is FOS.  Stands for full of . . . poop.  While we use this in common language when someone is not quite good at telling the truth - around the hospital the FOS is a little more literal.  I have even seen in on preliminary radiology reads of abdominal x-rays.  "Impression: FOS, Recommendation: bowel movement".

SO anyway today I developed quite a bit more distention and pain.  Question being is this OHSS vs. FOS??  I do not feel swollen elsewhere, my weight is stable and we are planning for a little sono on wednesday anyway to determine if we should transfer.

So I called my nurse because I never called in for OHSS with my first follistim cycle and I promised I would keep them updated this time.  Her advice - do whatever you need to do to get more comfortable otherwise we may not be able to go forward.

I told my husband this and asked if he could stop at the grocery store and pick up some milk of magnesia.  He did the math in his head and realized that transferring now will save us a few thousand dollars and a lot of time - so he came home with miralax, MOM, senna, and enemas.

Oh its going to be a fun night.

Sunday, July 10, 2011

The weird things you think with insomnia

Today I woke up (way to early again) and noticed something - my rear hurts more than my ovaries :)

This leads me to several conclusions:

1) Progesterone in oil - who dreamed up this one?  In all my medical training I have never seen an oil based injection and after this I never want to put sesame oil in my bum unless its going in with some chinese food through my gut first. (but for now as with everything I will do anything asked to make it work)

2) my ovaries are behaving themselves.  Weight is stable.  Belly still poochy but I am peeing which is something that kind of stopped 2 days after ovulation the first time I had OHSS. So far so good.

3) I am manic on prednisone (which is why I can't sleep).  I've been on it before and I remember this feeling of needing to run around and clean everything.  I am normally a certified messie and right now I am channeling my mother who was the biggest neat-nik I have ever seen. (My husband is partially happy because this is the cleanest our house has been in a long time, he is partially unhappy though because I am acting like my mother whom he never met but seeing what I could be like in 20 years)

4) I really want the OHSS to stay at bay so I can have my Day 5 transfer.  I know, I know, yesterday I was completely satisfied with this cycle just knowing we had a successful harvest and I still am.  But is it terrible to be greedy at this stage?  Is it acceptable to be impatient?  I will do whatever they tell me to do. I do trust my RE that she just wants what is best for me and my future children.

5) And on that note I was laying in bed thinking last night at 3 am what a pain in the rear it must be to take care of me.  Don't get me wrong - I am a nice person, compliant and punctual.  I say please and thank you and do what I am told.  But she must be under a decent amount of stress taking care of me.  Just as there has been little privacy throughout my infertility treatment, there will be virtually none when I am an obstetrical patient.  Everyone will see my chart, everyone will see my infertility history and everyone will know who was in charge making those decisions.  Our department is run by perinatologists (high-risk pregnancy docs) who when things go poorly have been known to verbally assault the RE's with "what were you thinking" questions.  (this mostly comes when discussing higher order multiples and how they happened, but when anything goes wrong in an IVF pregnancy from within the department there is scrutiny.)  So if I end up with a high risk pregnancy - I am sure the department chair may not be too pleased.

So I will listen, say please and thank you and do what I am told.  But I will be hoping that we can move forward for a day 5- because I am ready and hopefully one of those embryos will be too.

Saturday, July 9, 2011

JOY

25 embryos is our day 2 count!!!

This is how I have dreamed I would feel when I see a + pregnancy test.  I have imagined for so long how good that moment would feel and even thought I am not there yet - even thought it could be months before I get to the pregnancy part . . . well I am feeling that good now.

So far the result is just plain awesome and I am taking this moment in as a sign that we can get there.

We are blessed and I am ecstatic!

I am the Harvest Winner!!!!

Through all my infertility treatments not only has there been a constant theme of failure, but there has been the constant thought of "I hate my ovaries".  They got me into this mess first (sure I've got antibodies and scar tissue and one questionable tube), but the major factor has always been by inability to ovulate and my overwhelming sensitivity (or lack there of) to medications.  No response at all to clomid but they exploded to cantaloupe size with the most recent regimen (and then subsequently got starved which led to plummeting estrogen levels).

Needless to say I was really worried about the egg retrieval.  My RE had estimated that we were going to get 6-10 mature follicles.  Don't get me wrong - after years of doing initial infertility workups and diagnosing a lot of diminished ovarian reserve, I am fully aware of how lucky I am even to get that and how low reserve is just a terrible terrible thing to have to deal with.  I was so aware of age and difficulties with conception it I begged my husband to start trying way before we were married - - but thats a funny story and I will save it for another post.

So yes 6-10 would have been good, but I was hoping that if I had this much ovarian enlargement/discomfort/nausea/risk of complications that we could get a few more so I might never have to go through a stimulation cycle again.  A little greedy I know, but I can't say this has been too easy.

So please don't take this as bragging, but this is the best announcement since hearing that my husband has perfect sperm.  They sucked out 40 eggs yesterday and 18 were mature!!!!  I am flabbergasted that I put out this many - the nurse even patted me on the back and whispered that I did better than some of their donors.  I feel like I won the grand prize.  My husband and I keep looking at each other and smiling little goofball smiles.  I know its not an actual pregnancy and I don't know how many are going to fertilize, but it means that the process is at least going to get a bit easier at this point and I have never been so happy with my ovaries.  I know its not my "fault" but I feel like I finally did something right.  Its like a mixture of joy at my luck and pride that I stuck it through.

I will say however that it is not all good news.  We may have to cancel egg transfer for this cycle.  Kind of a bummer because it means that there will of course be more waiting, more money for frozen cycles, less chance of pregnancy if they are frozen.

As much as I am doing the happy dance around the house because of the number we got - I am fully aware that this was NOT how it was supposed to go and that the hyperstim from this could be pretty extreme.  I know this partially because the happy dance (and even walking) is pretty uncomfortable with my massive abdomen thats about to get worse, and that I have been up since 4am because I couldn't take the nausea anymore.  I also know the very early data about complications of pregnancies with OHSS - and while not the worst thing in the world - I have to keep reminding myself that the goal here is not just a baby, but the healthiest baby I can make.

So while I am not there yet - its a good first step.  We'll see later this morning how many embryos there are.  But for now I am uncomfortable but insanely happy.

Wednesday, July 6, 2011

too much of a good thing

I woke up this morning and felt really good.  No nausea, no headache - just a little discomfort.  "gee - I may be able to do this" was the thought of my mind.  Maybe the past few days weren't that bad.  Maybe I'm getting used to the estrogen levels.  So I went about my day pretty happy that my estrogen levels had come down just a tad from 4816 to 4125.  Nice little drop in the prior days and I got to take a little pinch of follistim.  I was thinking this may turn out all right.

Went to my appointment today - not much change on the sono.  They told me that we'd probably play a little catch up tonight with fsh and get some of the medium follicles more mature and retrieve on saturday.

then the call.  Estrogen level now 1290.  yep - one friggin quarter of what it was yesterday.  you know what that sounds like to me?  A whole lotta dead follicles.  A whole lotta what coulda been.

So then comes the decision.  Do we "cancel" the cycle or push ahead quickly and try to retrieve what is mature now and get way less than we anticipated.  I'm not sure how one is supposed to make that decision.

From the financial angle:
On the cancel side - it would save THOUSANDS of dollars to stop here and do it right a second time.
on the go for it side - I've just spent THOUSANDS of dollars on meds, sonos and blood draws

From the I have doctor brain angle:
Cancel=> I know that the best IVF pregnancies are good quality single embryo transfer with no hyperstim and I am way more likely to get that from a different cycle
go for it=>there's no way to tell what quality these will be until we do it

From the emotional angle:
cancel => I will be really disappointed if this does not work out well and the eggs may not be great so I may be putzing along for several frozen cycles with crap
go for it => I am really ready for this to work and we should go for it now - after all - it only really takes one embryo... right?

So I just asked my doctor what she would do and she said she would go for it and hope for the best.  So there we are.

and here I am - waiting to see how this turns out.  I'm not sure if I should feel excited, nervous, hopeful or pissed.  Its hard to know that its less than ideal.  Hard to know that it is as much money as it is to start from scratch.  But I do also know that overstimulation is a bit of a blessing because its not the opposite.  There will be follicles there to aspirate, and if we are playing a raffle, well at least I bought a lot of tickets.

Now all I need is a little luck.

Tuesday, July 5, 2011

estrogenized

My estrogen level is 4500. (So much for not wanting to exceed 3000 - and thats after no meds for a couple days).  And the best part is my (previously) normal ovary is 8 cm.  Robusto!

Can I also just say . . . . Nauseating.  No literally I feel like puking.  I went to a BBQ yesterday and managed to eat a few chips and dip, 4 cherry tomatoes, 3 pieces of lettuce, a bite of steak and about 6 strawberries.  Oh and that was the most I've eaten in days.

Today I gave up the ghost - Zofran to the rescue - and boy do I feel better.  I feel like I can even go higher. So bring it on eggies.  My stomach may be weak but I have a helper now.  Please just don't stroke me out or torse my ovaries and I may be okay.

I CAN DO THIS!

Sunday, July 3, 2011

I've got huevos!!!

And I am overstimulated.  Great.  Perfect.

Stupid body.  I have so many darn follicles and none are dominant or big enough to grow on their own, and yet, my estrogen levels are too high to keep going.  They have literally stopped my meds.  Fantastic.

Well I guess we shall see if they keep growing or not.  I really am going to be peeved if this whole thing yeilds one good egg that doesn't even take.  With an antral follicle count of 58 and more eggs than they can count I am really hoping they can pull a lot out.  Is that really greedy?  Yes I admit it I want a lot of eggs harvested and I want a lot of embryos to fertilize.  I'm not asking for triplets or anything, but it makes this first run so much less crucial if I've got some more stored in the freezer for next month.

And ideally now that we've deemed it to improbable to do anything other than IVF, it would be nice to have a little freezer stock for down the road.  Yes I know I am feeling a little greedy here but I also feel that something has to go my way.  If nothing else I am younger than the average IVF patient and I should at least have time and eggs on my side.

Unfortunately I just have too many of them to even keep going with the usual treatment.

Saturday, July 2, 2011

analogy

My friend said something last night that was kind of perfect.   "It’s like you got run over by a car and you are still holding on to the bumper and getting dragged down the street.  Yes it sucks that you got hit by the truck but just let go of the bumper already".  She’s right.  The whole thing blows but it only gets worse if I sit here and be upset about it, it will keep dragging me down – so I am letting go now.  I may be injured lying in the middle of a street bleeding, but I just can’t let this stress me out right now.  I am in the middle of an important process and sanity is difficult to keep on my side.

Friday, July 1, 2011

science has deemed me not a good fit for my husband

Today I was dealt another crappy card in the game of life.  First and probably the worst news I have had in a long time - I have antisperm antibodies.   For those of you who don't know what they are - basically I have formed an immune response to my husbands sperm that recognizes and destroys them - usually before they ever get in.  Simplified - I am allergic to the best thing that ever happened to me.

F**K  - sorry there is no other word.

Infertility is a funny thing.  You pray for them to find a reason that you haven't gotten pregnant for so long, but when they do its devastating.  I cried when I was 24 and got diagnosed with the PCOS.   I cried when I had the ovarian cyst and then cried when I found out about the lack of the cyst and the destructive surgery.  I cried again when I found out I have one open tube because it was going to make the ovulation induction harder, and now I am crying some more because its not even that natural conception is unlikely for me - its pretty much never going to happen.  I am never going to be one of those people that has a little whoops baby.  I'm not even one of those people who will be likely to succeed without ICSI.

Sure I am already in the IVF pool ready to go and ICSI will in fact help make this a non-issue.  But I am just not sure why there are so many reasons nature is telling me not to have any kids.

Its like my body is fighting against this now.  Now I am up to multiple separate infertility diagnoses.  Don't get me wrong - through all this I have a good uterus and I am thankful for that, and I have a great husband and if I had to choose I would rather have him than a baby - but I am really upset over the implications of having antisperm antibodies.

I have a history of an autoimmune disease called ITP.  Basically a few years ago I started attacking my own platelets after a bout with mono.  I got over it with the help of some very high dose steroids, but I have always been worried that one autoimmune disease will be followed by others.  So here we are - more inappropriate antibodies.  Its not even these I care about - its the wonder of how many more there are.  Do I have undiagnosed antiphospholipid antibiodies that are just going to make me miscarry when I finally do get pregnant?  Am I going to have lupus nephritis/preeclampsia at 24 weeks?  Am I just freaking out right now? - well yes I am, because thats what I do - but I feel justified in my fear.

All I want to do is make a child with my husband.  I don't think I am asking too much from the world and almost everything in this process has been one low blow after another after another.  I'm not ready for more failure.

Sunday, June 26, 2011

Kate Spade

I just injected myself with Kate Spade strappy sandals.  Believe me they were difficult to powder up, reconstitute and get into the syringe - but I fit it all in in only 3 pokes.

I am not someone who owns many designer things.  All my purses and most of my shoes come from a little french store down the road named Target'.  My most expensive shoes are made by Dansko (medical clogs) and Saucony (best running shoes ever).  But when I got married there were this very cute pair of Kate Spades that I coveted.  Everyone said - go ahead and get them - you only get married once, but I just could not justify spending that much on shoes.  We were doing it all on a budget and I felt really good that I got my dress through a breast cancer charity, but I couldn't spend hundreds on one pair of shoes - no matter how cute they were.

So anyway - I added up today the meds I am injecting into myself and realized that they are the cost of the shoes.  Im not sure if this makes me sad that I don't have the shoes in my closet or happy I never bought them so I would have the money for the injections.  Either way I am going swimming today and I will wear a bikini and be proud of those little bruises because they are very fashionable.

I have had my eye on a coach bag for a while - I think I'll inject that over the next 2 days!

Saturday, June 25, 2011

Fire up them ovaries and drain out my bank account

Yesterday was kind of a big day.  Had the "lets get your cycle going / we want your money up front now" appointment.  I didn't think much of it before I went in.  I was just so relieved that my period actually showed up the night before so I didn't have to cancel.

made a few realizations;

1) Other than the down payment on my house, I have never dropped so much money in one place at one time.  It was so bad that within 1 hour I had gotten calls from my bank and my credit card companies fraud departments asking me to verify the purchases.

2)  My estrogen levels are undetectable and I'm having hot flashes.  (thank goodness because this is what we were going for).  Its been REALLY HOT with 90% humidity where I work.  Oh - and the air conditioner broke.  But I realized that no matter how hot I feel, I don't think its that bad.  Realization #2:  I may do okay when I get to menopause.

3) Realization 3: This may have been day#1 of my pregnancy - sure I know I am not pregnant yet but when we look back as OBs to calculate due dates we generally go from the first day of the last menstrual period.  It was at this point that I realized that the hope had returned to the process.  Everything I felt about this IVF cycle being expensive and may not work evaporated and I started thinking that this may be the first day of the rest of my life.  This may actually take.  I may get a baby from this process.  Its a feeling I haven't felt in a long time.  Even with the last few follistim cycles - this feeling wasn't really there.  Sure I was going though the motions with my fingers crossed, but logically and emotionally I knew it has a slim chance of panning out.

So all day yesterday I felt a little giddy, fairly positive and kind of happy. It was a nice feeling until I logged on to check my bank account for something and I saw a number much lower than it was before.  I may not spend a lot of money on myself - but for me this is literally the price of happiness.