Wednesday, March 30, 2011

doctors day

Today is doctors day.  Nurses, respiratory techs, emergency medical workers all get weeks to celebrate their work and the hospital throws a little shindig with food and awards - we get a day and an email from the CEO.  Social workers actually get the entire month of March and pharmacists get October.  Once the hospital gave us a plastic mug - but those were better economic times.  I did get an email from one of the administrators that works in our billing department wishing me a good day.  (must remember secretaries day this year . . . hey I guess they get a day too).  I looked it up.  Doctors day isn't even listed on holiday websites that celebrate this thing . . . nope today is national "take a walk in the park" day.

Anyway, I skipped out on work this afternoon.  I wish I could say it was to celebrate doctors day or to do something fun, but it was actually because I felt too terrible to go after dragging myself to my morning clinic.   (took me 5hr to go to sleep last night with the throbbing pain of a stimulated mass - I should have said the words "I'll wait a cycle" but now I feel committed).  It was administrative/educational time anyway, but I always hate missing our conferences and I hate falling behind on admin work.  And I am still in pain and grumpy so I am pretty sure nobody would have wanted to deal with me anyway.

I sometimes wish I had one of those jobs where someone could just fill in for me.  The same way our young fun labor and delivery nurses call in sick the next day because of a few too many the night before - I wish I could just call in sometimes and say I'm not coming and just go shopping instead.  Problem is that there is nobody else to do my work.  Sure someone could find another gynecologist but I am the one to make the phone calls to my patients as follow up and if I cancel a clinic thats someone who just had to rearrange their life.  (Actually some administrative help at work would be nice, but there are hiring freezes and such so I spend hours every week doing things someone with their GED could probably do.)

So as frustrating as work has been lately I am coping and the afternoon helped me catch up on health so I am glad I had the opportunity to rest so I can do it all again tomorrow.  Happy doctors day to all you doctors out there, and happy "take a walk in the park day" to everyone else.  And if any of you can take a day off tomorrow for no reason please do so and celebrate for me.

Tuesday, March 29, 2011


So I have a hemorrhagic corpus luteum from the last cycle.  Of course they are always a little hemorrhagic but this one is pretty decent sized and also pretty painful (and easily palpable).  I had the choice to wait a cycle or power though . . .I think you can all guess what the type A writing this decided to do.

Risks were described to me as more pain from the cycle and possibly a slightly higher failure rate with the cycle.  My response - I already have a high failure rate by history and physical pain may be a good distracting substitution for the other omni-present pain type.

So here we go again . . this time with more pain and more failure.  Well at least I am allowed to be pessimistic from the get-go this time.

Saturday, March 26, 2011

looking for the answers to life in books

So I am taking this weekend off of work.  My shifts are usually predetermined about 2-6 months in advance, so in a way I was just lucky that the stars converged to not have me working extra on a weekend that I really needed some personal and husband time AND that my husband had off too.

So we spent the morning going to the Gym, out to breakfast and then to the library - because if there is any place a nerd like me feels like everything is right with the world, it is when I have had my coffee and am around a bunch of books.

I don't know if this stems from the fact that as a kid the library was the only place I could hide at lunch from the vicious teasing sessions, or that it was a place where my mom would take us if we were "good" (kind of like going out for ice cream).  Or maybe it stems from the fact that in a library lies all the information, all there waiting to be sucked up off the page by inquiring eyes.   You can learn to write a better resume in one aisle, make wooden furniture in another, read about the history of food or get lost in a sordid love story.

I love books.  Always have . . . always will.  (I wear glasses because I have spent too much time reading in life.  Forced myself to be nearsighted - but according to my opthomologist, this will always preserve my ability to read.)

So I journey over to the section on pregnancy and conception and paroose the books.  This is not an attempt to make myself feel bad as sometimes I do . . . I am feeling well this morning and truthfully looking for information.  I realize I probably know more about the subject than do many of the authors, but I am looking for a title that may give me some new ideas.  So I spent some time looking through them  and found that each book however is flawed in one of the following ways:

1.  They are written by someone who does not know much about science
2.  They speak in a tone that is clearly condescending to the medical establishment.  No I don't think that doctors have the answers to it all, but I do usually want to help my patients and myself achieve fertility goals.
3.  They are aimed at people who have no problem with conception and they site too many success stories after 1 month of using some special method.
5.  Even when they are written by people with actual health degrees they are all about the natural and holistic practices.  (Thank you, I have been trying that already)

So I pose a question to you all  . . . are there ANY good, helpful books out there that infertiles can read that don't make me out to be the bad guy?

Thanks for your help!

Thursday, March 24, 2011


How much to I have to pretend that everything is all right.

Ran into my RE at work and smiled, but didn't really feel like chit chat.

Threw my mother in law a birthday dinner - I tried to be happy - it was easier after a glass of wine.

People are uncomfortable around me when I am not "my usual self" - they just don't know how to respond.  Frankly I am the same way when I am around someone as low as myself.  I'm sorry I can't be happy and cheer everyone up and keep people laughing. I kind of just stop talking.  Silence always makes people uncomfortable.

I am trying to bury myself in work - I think my productivity in the past week has been impressive.  My sleep has not.  I look like hell, I feel like hell, but my research is surging . . .  um yay?  I guess its either that or eat - which is counterproductive.

I just keep re-iterating in a dori voice "just keep swimming . . . just keep swimming"

I feel bad and yes I am wallowing in my own vat of self pity.   But this is not some chemically induced down-ness that can be solved with a little pill.  This is situational suckage that could be instantly repaired with one thing - okay maybe it could be solved temporarily instead with a puppy.

Monday, March 21, 2011

Thank god for best friends

My best friend is the opposite of me - she is too fertile.  The type of woman who has 2 beautiful daughters who began as a whoops.  Her marriage and life almost fell apart as a result, but she persevered and took care of her family before she considered herself.  You would think that she would be the last one able to relate to all this, but instead she is the most understanding of any non-blogger I have talked to.

She has had a lot of struggles in her own life, but when she calls and asks "how are you" she sincerely wants to know, and she listens to the real answer.  I don't have to put on a happy face, she justifies my feelings and offers condolence and support.  A good friend is hard to find right now, and while she will never experience this problem, she takes on the burden of some of my pain.

I am lucky.  She made me smile for the first time in days.  The bounce backs get harder each time, but its nice to know I have help from an unlikely source.

Thank you for all your support in the blogosphere.  I will feel better soon - I'm climbing out of the valley.

Sunday, March 20, 2011

lost love

I've only been in love twice in my life.  Sure I have had some wonderfully nice boyfriends along the way, but there was only real love twice.  The 2nd is my husband whom I love more than anything,  the first was when I was 14.

Admittedly, I was very young, but it was the most amazing, confusing time.  It was all consuming, but more than infatuation, I really cared and loved the boy I was with.  The feelings were so strong that anybody I was with after just paled in comparison to  that experience, and nothing met or surpassed that until I met my husband.

When he came to my gym after school to break it off, for the stupid reasons that 14 year olds break up,  I was devastated.  I remember the moment and being frozen standing on a blue carpeted floor height balance beam as the tears began to flow, and the inability to make a decision to stay on or get off.  But what I remember most was the large empty hole in my chest.  The grief that he was not going to be part of my life and the realization immediately of how empty that made me feel.  At the time of course I didn't think that anyone would ever be able to fill that void . . . but in my defense it did take quite a while.

Today this feeling returned just the same as it has been after every major loss in my life.   Empty.  Exposed.  A vortex centered under my sternum sucking every molecule of positive emotion into the black hole where it will seemingly never return from.  There is no escape from that amount of gravity.

I am without purpose, standing alone on a balance beam once again.  Don't know where to go from here, but I am paralyzed to go on with practicing the routine.

Saturday, March 19, 2011

not sure how to title this rant

As a patient I realize how absolutely frustrating it can be to have an emergency and not be able to get in touch with a physician that can help you.  For this reason, as a doctor I give out my phone number to any patients I operate on or see in the emergency room.

My colleagues have warned me against this - they certainly don't do it - they don't want to be called in their off time.  Plus there is always someone who thinks its okay to call at 11:30 pm because thats what time they go to bed.   But overall most people are respectful and I have usually found my patients to be very appreciative of this.

So today, after I peed on another one line stick, I am having a private moment of cathartic crying, and of course because it is inopportune, my pager goes off.  I call back the number trying to stifle back tears, but of course there is a message that "this subscriber does not allow blocked numbers."  Can't even leave a message without exposing my cellphone to the world, and if there is something that I feel is a violation of my privacy its when people call me on my cell.  (my phone is for my friends to call - not like I have that many, but still.)

So anyway, I get in touch with the patient and CVS wont fill a prescription without a number that they can clearly look up.  So in the middle of a very personal moment where I am trying to work out some deep seeded issues, I have to put on the professional face and make 10 minutes of phone calls to be put on hold 3 times before CVS will take down the number.

There is something about a good cry that afterward you at least feel a little better.  But with this kind of interruption - I am pretty much going to be depressed all day.  (or week or month)

So thank you fate for helping me to fail yet again.  Thank you CVS and phone carriers for interrupting the only time I could give myself to deal with this.  Thank you progesterone for making me an emotional basket case.  Thank you diet for not allowing me to go and feed the feelings with calories.  Thank you pain, for being the one constant I can depend on now.

I am thankful to all these things for ensuring that the first day off I have had in a while will be miserable.

This blows.

Thursday, March 17, 2011


I am not sure how to balance optimism.  People tell you to just be optimistic - like the lack of optimism in your attitude is the source of the infertility.  Its kind of like people telling you to "just relax" -- um . . . tried that . . . thanks for the advice.  But how do you maintain optimism without getting your hopes up?

I am a huge pessimist when it comes to my life.  I think that comes from watching my mothers brutal battle with cancer for so long.  Everything that happened . . . none of it was good.  One bad thing after another after another.  Got to the point where you just expect the news to be bad.  As I have now incorporated that expectation pattern into my own life.  Don't get me wrong. . . . I lead a charmed life.  I have enough to eat, I have a job, I love my husband. . . life is good.  But when it comes to medical things in my own health, I have a hard time figuring out how not to expect the worst.

I'm generally however a positive person when it comes to others.  I am an encourager, a reassure-er and a cheerleader for others.  I try to use some of this optimism on myself, but every time I do I end up getting let down even harder.   And the over and over disappointment does not exactly reinforce good mental happy thoughts.

At first my DH was just telling me I needed to be more positive and he was super encouraging.   Now after 9 months of failed infertility treatments, he is starting to see my reasoning.  Instead of keeping his positivity, he is putting on a protective shell.  I don't want him to turn into me.  If I ever do get pregnant, I don't think it will be a very optimistic road knowing everything that can go wrong.  I probably won't feel completely comfortable until the kid leaves for college.  But I don't want the DH to feel this way too.  I need him as my rock and to continue to put me into place when I am being a little insane.

I don't think there is a happy medium to this issue.  The only way I am balancing it right now is through ignoring it and distracting myself.  So with the next pregnancy test around the corner I am going to continue to focus on other things.  I will ride the wave of fate and accept what comes.  And all the while I will keep working on the IVF bank account.

Tuesday, March 15, 2011

one good side to progesterone

My obsession with food when filled with progesterone is obviously a problem for both my pcos and my waistline.  I will say though that everything that I taste is just about the best thing I have ever tasted.  Case in point - eating swiss cheese right now.  Just about the best cheese I have ever tasted.

Had a diet shake for breakfast - not the best breakfast, I know . . . usually tastes like I am eating the tin can its in.  But today - tasted like a chocolate milkshake.

Had a salad for lunch.  Dressed it with balsamic.  Almost licked the bowl.

Dug out a stash of godiva chocolate truffles that I have been consuming slowly since christmas and boy was it to die for.

for dinner . . . who knows.  Maybe subway.  I don't really care for it usually but something tells me its going to be a really good sandwich.

Sunday, March 13, 2011

Maybe I'm just tired, but this is getting hard

When you are in medical school there are ways to tell what you are really interested in.

If you love the OR and prefer your patients to be asleep when you are dealing with them - Surgery is for you.

If you love to think about details and the billion things this potassium value could be - well then, Internal medicine is key.

Never want to touch anyone?  Psychiatry, my friend.

(can you tell I am an OB . . . .  I am very glad there are lots of different doctors out there doing great jobs, but we all poke a little fun of each others specialty.  Believe me that most physicians rule out OBGYN before they even enter medical school - not everyone can handle what we do and I certainly couldn't mentally handle the medicine or psych.)

There are many of us however that fall in love with both OB and Pediatrics.  When we see these students come through, loving both of their rotations, really torn as to what to do with their lives.  We tell them that you can tell where you belong when you deliver a baby.  If you want to hand off the baby and stay with the mom - OB is your choice.  If you could care less about what comes after baby and just want to follow the kid . . . its pediatrics for you.  If you are torn and want to do it all . . . think Family Medicine.

Peds was by far my favorite rotation way back when I was in their shoes, and while I could have had a lot of fun at work dealing with kids everyday, I always wanted to stay with the mom after a delivery.   The occasional times where there is an outright emergency - I wanted to be the one in control, not the one waiting to be handed the baby.

This is just a personal choice because I am probably a control freak -- I certainly can't knock pediatricians.  My husband saves more lives than I do while dealing with bigger complexities than I could handle.  But there is a certain Zen that comes over me when the figurative excrement hits a rotating blade during a labor or delivery, and I can manage the chaos calmly and effectively.

Problem is, lately during the routine aspects of my job, I can't stop gazing at the babies.  I'm not sure I was ever really seeing them before.  Sure I used to look at them and comment on how cute they are or how hairy or how much they looked like dad, but they were just an object at the time.  Something that I had to get out of the uterus, or try to keep in.  An afterthought, when things were said and done with mom, I would just look at the kiddos and congratulate the happy parents.  Sure, I always cared about what happened to them, but my focus is always on mom after delivery.

But now, when I ultrasound them, pull them out or catch them, its just too hard to not see them.  My biological clock went off a long time ago, so its not really that.  Its the overwhelming sadness that I have because I do SEE them now.  I see the baby, the mom, the family, the love, the joy and I can't ignore that I am still far from getting there in my life with many more hurdles to get through.  And when things don't go well despite the best that medicine can offer, I feel the pain.  Deep deep pain.  I hurt so bad for these women and I can't stop thinking about them, and its all getting a bit overwhelming.

I really do love my job.  I have such a special opportunity to take care of women, but it is taking a toll on me.  There may be a time limitation on my happiness or an empathy limitation on how much I can haul.  But for now it is a sad and lonely place to be and any strength I had is leaving me.

Friday, March 11, 2011

10 infertility-related things I am thankful for this week

One egg, successfully out.

I am taking back to back calls tomorrow, and the second one is extra pay!  (IVF fund is growing)

My Walgreens pharmacists.  I'm seriously not kidding about this . . . there are about 4 of them that work at my local Walgreens and they are the nicest people ever.  I swear they have spent as much time on the phone with my insurance company as I have and by now they know me when I call.  One of the pharmacists today leaned over the counter and in a hushed voice and said: "do you mind if I ask how its going?"  So nice.  He didn't say "are you pregnant yet?" like everyone else, but rather a check in if a) I minded and b) how I was really doing.  One of the other pharmacists there has a 6 month old through IVF, and he always cheers me on when he sees me.  After all the crappy systems/insurance/clinic problems I have had, this is the one part that has always worked in my favor.

My gas-efficient vehicle.  Gas prices are terrible and I am doing way too much driving with all the trips to clinic that is way too far away from my job.

My boss (a.k.a. best boss ever).  He asked me to assist on his surgery Tuesday morning - this was of course before I had "plans".  There is nothing more offensive to surgeons than showing up late for the operating room - it is just the absolute 'no no' in our field.  The night before I emailed  him telling him that I would be late because of the IUI.  His response:  "Don't worry about it . . . take your time".  A little thing that is such a relief.

My feet.  They appear a bit sunburned, but no blisters, the skin is still on and I wore shoes today.

My iphone.  Just got it last week and loving it.  I have officially uploaded all my cycle info and now have it at the touch of a button!  Next up - scanning infertility receipts with the camera.

As always, the husband.  This week for providing his genetic material at 5 am working 30 hr straight without sleep and then providing again.  Sorry, that may be TMI but its actually a remarkable amount of stamina.

My progesterone craving this week is salad.  So much easier to watch the calories when all you want to eat is leaves.

and finally . . .

Regardless of outcome, I don't have to bet probed or injected for about 2 weeks.

Thursday, March 10, 2011

infertility is hazardous to your heath

So I'm sitting there getting my chi fixed with needles today and every week they put a heat lamp to keep my feet warm.  According to my Eastern Medicine Practitioner, keeping the feet warm is important to keeping the uterus as good environment.  The heat lamp usually feels very nice and the treatment is quite relaxing.  So relaxing however that today I happened to fall asleep.

Yup - burned both feet.   Big bright red half circle on each one.

Hope that sends a message to my chi that I am in fact serious about this cycle.  I'm so serious I will be walking around in slippers.

Tuesday, March 8, 2011

How babies are made

One day I will have a child and when I answer the questions how babies are made, I imagine it may look something like this:

Well . . . when a mommy and daddy really love each other and want to have a baby they do lots of things to make that baby.  Mommy takes lots of shots for an awful long time to get ready for a baby and that makes mommy kind of crazy.  One day, when mommy and daddy really have to work that day, they get up at 5 am together, eat breakfast and then mommy gives daddy a cup.  Daddy takes the cup into the bathroom for a while and comes back with the cup that now has magical seeds in them.

Then mommy puts the cup with the seeds into her shirt so the seeds will stay warm, kisses daddy goodbye and runs out the door forgetting half of the things she needed that day.  She then drives to the doctors office being very careful not to get pulled over because getting pulled over that day would be really bad.  Once she gets to the doctors office, there she hands the seeds to a nice man who washes them for a whole 45 minutes and counts them one by one until he counts into the millions.  The doctor then puts the seeds in mommy and she lays there and plays word warp on her i phone for 20 minutes.  Then mommy stands up and most of the seeds fall out and keep falling out all day but she hopes that one will stay where it was put.

And then mommy and daddy wait for weeks to see if a seed decided to sprout while mommy eats lots and lots of food.  Mommy then pees on little sticks that make her cry, and usually mommy ends up crying for many many days when she has to wear a diaper because she has lots of problems keeping her pants clean.  But one day one of the seeds finally decided to plant itself and it grows for nine and a half months and turns into a baby!

AND THATS HOW BABIES ARE MADE. (or hopefully how my babies will be made)

On a personal note - IUI was today.  The little follicle was rarin' to go so we did it.  (and by "do it" I mean in the completely clinical sense as above).  I guess whats done is almost done - GOOOO SWIMMERS!

Saturday, March 5, 2011

My week by the numbers

Hours worked: 48 (low for me!)
miles driven between work, appointments and meetings: 312 (high for me)
Number of doctors appointments: 3
Number of consecutive days with a migraine: 7
Number of loads of laundry: 3 (plus the 4 more I have waiting for me today)
Number of pounds gained: 3
Number of hours on the treadmill: 1 (I know, I know, must do more)
Number of hours spent on the phone with insurance, clinics, pharmacies and billing departments: 4.5
Number of people I talked to on the phone that were actually really helpful: 1
Amount of money spent on medications, appointments and ultrasounds $266 (way low for me)

Number of follicles discovered: 1 on the open tube side - and worth all the numbers above!

I'm really excited for this one!

Thursday, March 3, 2011

aaaaaarrrrggghh! (the sound frustration makes)

Good news - I have a single 11 mm follicle on the open side :)  This is really good news except for the bad news. . .

All of a sudden, out of nowhere my insurance has decided NOT to cover my ultrasounds.  I arrive this morning only to be handed a wavier that I had to sign saying I would be responsible for the charges.  When I asked if this was going to be the $125 out of pocket cash charge or the $500 they bill my insurance each time the response was . . . I don't know, but you cant get your ultrasound unless you sign.

I asked for the authorization coordinator to call me.  When I didn't hear back by 2 pm I called.   She was too busy to speak to me and could call me back, but not today.

SO, I have spent about 3 hours today on the phone asking questions of my insurance plan, asking questions of my clinic, my pharmacy, my hospital and I have gotten NOWHERE.  I still have no idea how much they are going to bill me or if my next one will be covered.  But I have to have them done.  I am now mid cycle with a good follicle so I am certainly not pulling out here. (bad contraceptive pun intended)

I am so frustrated I could scream.  I hate hate hate hate insurance companies.  I pay a lot of money monthly to get this insurance and the only reason I don't go through my husbands insurance is that we were keeping the infertility coverage.

Just sad that they had to make me so upset on a day I could actually be excited about something my body was doing.

Okay think positive . . . . think positive.  Gooooo follicle!  Grow big and ovulate out so I don't have to deal with stupid health insurance for infertility . . . actually, that is an exceptionally positive thought!

A little pregnancy may cure a lot of things!

Wednesday, March 2, 2011

doctors make terrible patients

How does a working professional do this?  I just cant keep going in for ultrasounds every other day - This takes up SOOOOOO much darn time.  People have noticed that I am frequently late to work, and if my infertility doc is late . . . well then so am I.  I am too type A to be satisfied with being late, and there is nothing else like dealing with irate patients when I run late myself. (although I swear I have the nicest patients ever.)

So today, I got held up by traffic by about 5 minutes.  Unfortunately that was late enough to put me 4th in line to be seen.  At 0740 (for a 7 am appointment) they finally pulled in patient 2 and 3 (and there are only 2 rooms) - so it was going to be a while.  Problem is, my first patient would be there at 8 am . . . and my clinic is 25 minutes away from the infertility clinic.

So I got up and left.  I felt terrible, I even cried to the parking guy on the way out because I wasn't validated even though I had copayed.  I am a bad bad bad patient, but hopefully it is offset by the fact that I was only 5 minutes late for my patient and maybe a good doctor.  No reason I need to perpetuate the frustration with my patient experience to my patients.  But still - it was stressful, frustrating and took about an hour an a half out of my day - and I got NOTHING out of it.  And while I will be going in tomorrow for redemption as a patient, its still going to carve another hour or two out of my day.  When you work about 10 hr a day - an extra two pretty much knocks out the ability to do anything outside of work and sonos.

I don't know how everyone does it, and seriously I feel so bad for everyone else in that waiting room because I know they are all going through it as well, but they probably don't feel empowered enough to just get up and walk out and reschedule.  (Of course I got a BIG freakout talking-to from my RE because she is worried I may be overstimming, but I do have the knowledge to at least defend myself a little).

Alls well that ends well . . . although we will see if it actually ends well tomorrow :)

Tuesday, March 1, 2011

more insult to injury

I work in a large group practice and every woman physician has children except 3 of us.  One has dogs and is vocal about not wanting any kids, the second is recently married (and none of my business for what her plans are) and then there is me.  Most of my partners are actually done with their childbearing as evidenced by their giving all their baby hand me downs to one of my work friends.

So anyway today I went to a staff meeting, one of the points brought up - the length of maternity leave and how it is unlikely that they will be able to support this much longer.  My job gives a very nice 3 month maternity leave.  6 wk as customary they have you work on a project at home for the next 6 weeks.  This has always been a great asset to my job, and one of their selling points.  (and something that I would enjoy immensely)

With this demographic however, I realize that I may be the only one affected by this, which I just find unfair.  Trust me that I tried to be pregnant already and if I had been as lucky as everyone else I would already have delivered and taken my 3 months.  But nope, not in the cards for me, and now apparently half of my maternity/adoption time is out now before I even got a chance to get pregnant.