Tuesday, May 31, 2011

Thank you

I just wanted to say a little thank you for all the support  After almost 6 months of ranting, today my blog turned over ten thousand pageviews with 60 followers.  I never thought anyone would be interested.  Its nice to think I am helping others out there deal with this because its the toughest thing I've ever had to fail over and over again.  But its also nice that there have been such wonderful comments and loving support from friends I didn't know I had before all this.

So thanks :)

Monday, May 30, 2011

IF vacation is nice

10 reasons why I am enjoying my infertility vacation:

10.  I haven't broken into spontaneous crying in weeks  (husband sure appreciates this one)

9.  No peeing on sticks

8.  Haven't thrown any money in the gutter lately

7. No probing

6.  I can ride rollercoasters

5.  My calendar looks a lot less busy - no circled cycle day numbers, early morning appointments or scheduled inseminations

4.  I look about 5 years younger (thank you haircut and retin-A)

3.  I dont have to stress to about how my stress is affecting my conception or lack thereof.

2.  I have told my in-laws that we have temporarily stopped trying and that its not just gonna happen on its own.  Hopefully this will cut down the inquires

And the number one reason I am happy to be taking a break. . . .

When asked the question "so are you pregnant yet?"  I can respond that we are taking some time off.  Maybe that will keep them quiet and stop the inquiries for a while.

Sunday, May 29, 2011

Always the bridesmaid

SO I am planning another baby shower.

If you haven't read my previous postings I will just say in short that about 6 months ago I threw a double baby shower.  This was a wonderful event for my two friends and their 2 fetuses, but this was a lesson in self torture.  While most of us in medicine are used to delayed gratification - most of us in OB are a little masochistic.  Well . . . this was an exercise in that.

I swore I wouldn't go to another baby shower until after I had a baby - or was at least pregnant.  And here I am throwing one which is so much more involved.  But, alas there is one friend who I am obligated to throw a party for - and she's preggo and in town for 1 weekend in July.

Dont get me wrong - I am super happy she is pregnant, and thrilled to be throwing her a shower, but from a completely selfish perspective - I just wish the timing was a little better for me.  Its hard every time someone gets pregnant and I don't no matter how happy I am for them because no matter who it is now - I have always been trying longer and had to suffer through more disappointment than they will ever understand.

But its hard to come home to the decorations I bought yesterday because its a daily reminder.  And when I talk to the other people who are excited for the pregnancy and her - well . . .  I just really wish there was something else to talk about.

So I will be a good sport because that is what is expected of me, but I will be tortured the entire time.  This stinks.

Friday, May 27, 2011


When this is all over I fully plan to take off all my clothing and run down the halls of the hospital naked.

Why you ask?

Well because seemingly everyone has already seen everything I have.

Today was the boobie MRI . . . and the radiologist reading the film  . . . friend from med school.  Yea!  Another person to see my private parts.

Let me ask - WHY do I have to take my clothes off and have my boobs hanging down uncovered for a machine that can see through my clothing anyway?

My privates are no longer private.  I feel like I need to start covering up a part of my body that wont need any looking into - just so I can keep something to myself.  Lets see - my ears? The ears would be funny - I could just start walking around in the summer with earmuffs and when people ask I could say that I am just trying to be more modest.

This may however attract the attention of the psychiatrists . . .  although so would streaking down the halls of the hospital.

Tuesday, May 24, 2011

Oh Flo . . .

If someone had told me that I would be a regular blogger a few years ago I think my initial response would have been "whats a blogger?".  If someone told me at the same time that I would even be keeping a diary, I would have laughed because all my life I hated to write.

And if someone told me that I would be sharing period stories with the collective infertile universe I would have told them they were out of their mind.  I will say at the end of the day that it is really good to talk about something that unnecessarily rules my life.  If its not the bleeding, its the hormones that come in between.

Besides - I literally listen to people day after day talk about their periods . . . so why am I any different.

I can't say mine are actually too terrible . . . believe me that I have seen worse.  But they are on the border of bad and are disruptive to my life.    So I guess that counts for something.

So anyway . . . I was just doing laundry and folding my underwear (yes I am a little neurotic), and I generally pile them into their categories; cute ones, sexy ones I pull out mid-cycle, comfortable ones that I take 30 hour call in, anti-wedgie workout ones and the dreaded hole-laden period uggos).  This made me wonder . . . does everyone have period underwear?

Maybe everybody else has periods that are a little more predictable and give a bit of warning, but being off birth control with PCOS and therefore out of control of any predicted start days has done some bad things for my unmentionables - but I will not mention more than that out of trying not to gross any of you out.

So I was looking at the tattered and torn pile of these little sorry misfits of my closet and thinking that I should really get rid of them . . . but what would I have to wear when the time comes.

That's when I concluded I must put a 10 month stop to these periods.  I must get pregnant if for no other reason than I am just done with this process and cant bear to wear these anymore.  In the meantime, I figure if I can spend the cost of a car on a month worth of IVF . . . I can probably buy some new target undies.  Hopefully they will stay pretty and my belly will just outgrow them instead.

Monday, May 23, 2011

The time bombs on my chest

My mother was 42 when she was diagnosed with breast cancer.  Being that most cases of breast cancer are sporadic it is unlikely that I have any genetic predisposition, but that doesn't make me any less paranoid.

I have an irrational fear of breast cancer.  I will take all sorts of the other illnesses I have seen but I just don't want to have to go through what she did.  Maybe it is because she was dying at a time from her breast while mine were developing, but I just don't have a feminine emotional attachment to the lumps of fat that sit on my chest.

So I have been referred in for genetic counseling and possible genetic testing and thus I ask myself - do I really want to know right now?  Now before I go through more crazy hormones and then 9 months of even crazier hormones?  Do I want to be paranoid about breast cancer in pregnancy?  If I do have some gene am I going to have preimplantation genetic diagnosis to possibly save my children from this paranoid delusional behavior?

Ignorance is bliss - and I know too much already.  Since I'm in my vacation from fertility treatments I am trying to catch up on all those things that I should have been doing in the past year - I cant say this is all more important to me - but it does have some pretty big implications.

Friday, May 20, 2011

my body is wierd

Heres an interesting thing - I don't think I ovulated.

SOOOO many follicles and I don't think I even put out one - Heres why I think this:

1) hyperstim got better really fast - maybe it was just big honking ovary discomfort because it got better within days
2) Aunt flows twin sister came to visit - within a week of cycle cancellation.  Physiologically - this is not really possible  . ..  but leave it to my body to figure out a way to bleed when it is not supposed to.  Either I have the worst leuteal phase defect in the world or I just never got any progesterone out.
3) I'm not eating everything in sight.
4) I just saw a Hallmark commercial and did not shed a tear

Not that it matters from a fertility perspective with my planned time off, but since I have lovely endometrial shedding without a progesterone withdrawal actual period I cant say that I am really going to be at any baseline.  When do I start these birth control pills?  What kind of lining is going to be left?  Can't my body just follow the same darn hormonal rules as everyone elses?

Amazing that this cycle is over and it still continues to frustrate me.

Wednesday, May 18, 2011

conversational anxiety

I had a moment today when I was walking to/from meetings with several colleges and I realized
1) they were ALL carrying their breast pumps
2) the topic of conversation was baby acne and how you can't pick it even though you want to

When I developed into my full nerd-dom in college I developed a hint of social anxiety.  I was doing nothing but pulling all-nighters in the computer lab for my programming class I realized that I had nothing interesting to talk about at parties.  Going to a frat party - not only was I the sober sister, but also the one who kept from doing much socializing . ..  unless I could talk about the most recent assignment with another fellow nerd.

Well today was the entirety in reverse.  Now I am thought of as the "cool kid" because I can talk about adult topics . . . but I still don't at all fit in.  Again I have nothing to say.  I cannot comment about my favorite brand of diapers or complain about how much I am paying for child care.  I don't know what it is like to want to pick my baby's face or how much I miss them when I am at work.  If I try to talk about normal things the conversations always return to talk about their babies.

I realized there is no anxiety in it anymore - just boredom.  I will care about all these things one day - but right now I am just uninterested in the conversation.  Infertility can be isolating but I wonder how much of it is self chosen.

Tuesday, May 17, 2011


Hyperstim is getting better - I am pretty sure I have ovulated by this point and my only conclusion is that the drop off of the FSH caused all of the little buggers to regress.  My belly is only a little big and hurts a bit - but all other bodily functions resuming normal mode.

In the past few days I have returned to my artsy fartsy projects.  I didn't realize that I had backburnered this but I was spending my extra time at the doctors office.   (about 2 hours a day when you take into account driving, parking, paying etc).  Its kind of nice to have a little time again - its also nice to sleep past 5 in the morning.

So overall- I'm doing okay.  Holding my own.  Trying not to think about the three letters on the horizon.  What am I going to do for the next month of my life?  What am I going to think about?  Write about? Obscess over?

I'm sure I'll find something :)

Sunday, May 15, 2011


There have been many times during this process that the process itself has made doing the wifely duties (ahem ahem) a little difficult.  I'm not one of those people who fakes a headache - unless I am super tired and need to get up early . . . well  . . .I'm usually game.

But then came the infertility - took a bit of the fun out of it.  At first it was just the hassle of "come on honey . . .we're mid cycle!"  that chipped some of the romance away.  Then came the treatments with the migraines, the hemorrhaging, the vaginal progesterone, the discomfort of ovarian enlargement.  All of these things infringed on the majority of each month making it much less enjoyable.

Then came the IUIs.  No longer needing sex for the purpose of procreation, at first this was very freeing.  Back to recreational activity!  But then there was the waiting 2 days before the insemination and then the gotta go every night after  . .. just in case it helps.  Then would follow all of the other lovelies as mentioned above.

But at no point during this process have I not been able to have it for more than a day, and further more the reason I can't because I may in fact get pregnant.  Interesting conundrum.  I know logically it all makes sense and there is such a thing as too pregnant, but I feel like I am back in high school - terrified that if I go for it on prom night I could get knocked up.

I'm looking forward to a few weeks from now when I take my little infertility hiatus when I start birth control pills and remember what it is like to feel normal again.  I simply hope the year of infertility treatments hasn't altered my sex life forever.

Saturday, May 14, 2011

at least I look pregnant

the belly is slowly expanding.  I was able to get in a little breakfast.  Weight is stable but I think that is secondary to losses ala numero dos.

Feeling like I have to pee (darn UTI) but cant because there is not much there.  They always teach you in med school that when it comes out looking like tea - thats a bad thing.  I'm literally following my urine output and watching it drop.  Still maintaing my own at about 20 cc an hour but not sure how long that will last.

A year ago when I was much more optimistic and naive I bought a few dresses with an empire waist - I'm definitely wearing one today.

It has begun.

Friday, May 13, 2011

go big or go home - I'm home now

Well . . . I have failed.  Failed before I even tried this time  Instantaneous failure this time with the promise to suffer for the failure in the upcoming days.

So this is how it turned out yesterday morning after we had STOPPED the fsh on wednesday.

Open Tube side: 17, 15, 12, 11, 11 -apparently there was a whole other half an ovary hanging out on the other side of the scar tissue that we didn't see until it was huge.  Hmmmphf.

closed tube side: 15, 15, 15, 14, 14, 14, 13, 13, 13, 13 and too many 12's and 11's to count


The good part is that at least it was obvious that we had to cancel.  There was no beating around the bush with this.  No reason to go for it and hope - all this is a recipe for disaster.

But I will say that when I thought I may overstim - I NEVER thought I would be looking at over 20 enlarged follicles.  I think my right ovary is about 8 cm now - so now I am at risk of torsion.  Fabulous.

I dont really like the way I feel - my pelvis is so full and uncomfortable and I cant tell if the UTI is worsening or if my ovaries are just sitting on my bladder because I cant stop running to the bathroom.  What I am really fearful of is the upcoming hyperstim.  This could be really bad - really really bad.  I'm just crossing my fingers that most will regress without the fsh before I ovulate.

And so now I stay on pelvic rest, and no exercise and I watch my weight and swelling and I just wait.  Wait for my ovaries to rule my life once more.  Wait for it all to be over.  Wait for my period so I can have sex again.  The only thing I am not waiting for is the double pink line - this time because I didn't even get to try.

last post didn't post

Darnit - I posted the other night  . . . but apparently I didn't hit the post button.

I hate lost data.  Arrgh . . . oh well - thats pretty demonstrative of my week - totally frustrating and counterproductive.

More to come tonight . . .

Wednesday, May 11, 2011

this is not going well

Sorry for the lack of posts - life has been really really really not great this week.

So this is the go big or go home cycle . . .

heres the good news:  On my open tube side I have a nice juicy 14 mm follicle

heres the bad: on my closed tube side I have the following: 13, 12.5, 12.5, 11, 11, 11, 10 - the whole ovary is 7 cm.


Oh and in addition, I feel terrible - bilateral low abdominal pain and now a UTI on top (my fault which you can conclude the cause of from the previous post).  I am not eating because I am too nauseated, I am trying to drink water to flush it all out and all for a cycle I probably have to cancel this cycle anyway.

I have just come to the conclusion that if it takes this much stimulation to get my stumpy ovary to produce 1 follicle - I'm never going to get anywhere with ovulation induction.  If you make the assumption the tube is closed and there is no crossover - I am golden  . . . . but what if the tube is actually open all along - I cant be an octomom.  Let me re-phrase . . . I WONT be an octomom - which is why we are probably going to cancel the cycle unless the first one pulls way ahead tonight.

This has been during a really bad time at work.  I have no support staff and I am overwhelmed because there just aren't even enough hours in the day to call back all my patients - and there are not enough appointments in a month to even see them.

Oh . . . and I am being sued.

I feel really helpless, very stressed and pretty miserable right now.  I think I am ready for this whole episode of my life to be over.  A month of birth control pills may be just what I need - and maybe a personal assistant.

Thursday, May 5, 2011

hormones on the brain

okay seriously, my brain has reverted to the thought process of a 15 yr old boy.

This follistim cycle, with its little increased dosage sure has increased the testosterone in my life.  I couldn't stop thinking about my husband all day - and these were not innocent little thoughts.  Fortunately, he is understanding, and after 2 wk of progestrone grodieness followed by the visit from aunty flow - well  . . .  he was willing to help me out.

(Not only do I think like a teenager, but my acne is about as bad as it was when I was in high school.  Problem is - no retin-a to help me now.  I look terrible - I am wearing high neck shirts in beautiful spring weather. )

its just amazing to me how much the brain is responsive to hormones.  There is no way that male and female brains work the same if my head feels this different with a small boost in my testosterone.  I feel so much smarter when my estrogen levels are up and so much more grumpy and short with people when I am in progesterone land.

I miss the stability of my birth control pills where I could think the same every day, but maybe if I ever do get pregnant - maybe the high level of hormones will make me super smart - or super grumpy or both.  Hmmm... grumpy and brilliant - could be a recipe for disaster.

Wednesday, May 4, 2011

opening the blocked tube

So the question arose if they have considered opening the blocked tube and I'm afraid I have not yet explained it (despite my myriad of previous ramblings).  Especially since I scoured the internet for any good opinions on this subject when I found out about it and found virtually nothing scientific - I feel I should explain my assumptions and conclusions.

Here I wil make it clear that I am not talking as a doctor - There is no science to this part of my story - this is just a confused patient talking about what I came up with that sounded rational after overanalyzing the situation.

So the answer is yes and no

First of all - they were not actually convinced that it was blocked.  I couldn't take any anti-inflammatories for the hsg and seemed to have a pretty bad pain at the time.  (I'm someone who took no narcotics for 24 hr after an ex lap yet the HSG was way worse than a huge incision.)  They found a proximal occlusion on the side opposite my previous surgery.  As I had never had any infections or surgeries before that they actually did not initially think that it was closed -- they thought it was just a spasm.

Plus - one only needs one open tube to go forward with ovulation induction.  (goodness knows that lots of pregnancies can even get picked up by the opposite tube).  They offered me a repeat on the hsg with a possible cannulation - but given how much it hurt in the first place and the fact that they didn't believe it was closed . . .  I passed on the opportunity.

Before I go on . . . I always had the choice to go straight to IVF but I thought that was a bit of overkill to treat anoulvatory infertility.

So on we went.  Problem was, with the 20/20 vision of hindsight helping me tell this story,  my open side only has a stump of an ovary so my chances of ovulating out of it are greatly reduced.  Now after 5 failed cycles with only 2 of them producing a follicle on the open tube side the thought is - well maybe it is closed after all.  Why else would I have failed so many cycles (especially since in those cycles I put out 7-8 closed side eggs)?

I could probably choose to go on with ovulation induction for a bit longer hoping to someday get the good side to work, but I probably won't for the following reasons:
1) I feel like crap 3 wk out of 4
2) this is way too time consuming and interfering with life and work
3) this is costing less than IVF but with only about a 10% chance of working each time - the cumulative costs are adding up
4) repeated hyperovulation is not good for my ovaries (increased epithelial damage that requires repair thus theoretically raising a risk of ovarian ca if you do too much)
5) this is not good for my brain - I just don't feel like getting depressed again.

I am reaching the point where mentally and physically I just need it to work.  I am fearful that there may be another reason for the infertility - maybe the closed tube, undiagnosed endometriosis or even just bad luck.  Sure I could go back and have it re-cannulated at this point, but I am not really ready to go back to square one and spend another 6 months doing this.

No mater when I get pregnant, I still need to get through the chance that I will miscarry, and even if everything goes perfectly I am always 10 months away from a term baby.  I have friends who started trying after me who have very cute babies at this point that are about to turn 1 - I am still behind.

May marks the 1 year anniversary of seeking infertility treatment.  I thought I would be further along at this point, but I am still on the starting block.  Maybe I would be decorating a nursery at this point and complaining about kankles if I had decided to open it - or maybe I would have some other procedural complication.  A whole lotta maybes - but it is what it is.

Tuesday, May 3, 2011

Hail Mary (the football pass, not the prayer)

One of my REI's is a doc I truly admire.  There are 3 people that I have worked with over the years that I will NEVER call by their first names because there is just too much respect there. - He is one of them.

I see one of his very wonderful underlings (who is fantastic in her own right) and she reviews my case from time to time with him.  Apparently he just bows his head, shakes it back and forth and just mutters the words "we have to get her pregnant".  So anyway - this time, not only was their head shaking, but he brought my case up for review with all my REI colleagues.

There are times where my privacy has been completely screwed by this process.  The run-ins with other physicians as I am am being roomed as a patient, the fact that that I was mis-scheduled with one of my department heads (he didn't know but was very confused as to why I was on his schedule), my name popping up as the first appointment of each day so that is ANYONE I work with opens the main clinic schedule - there I am.  Plus, there are simply more people I work with have seen my vagina than I care to admit.  

This however was no invasion of privacy at all.  Even though I feel like an absolute failure, I am really happy they discussed my case- it feels good to have so many brilliant opinions in my care.  Its nice to know that its not that I am just being impatient but that they actually believe that a) I can actually get pregnant and that b) they are a little surprised that I haven't done so already.  

So anyway what they came up with was that this cycle we are pushing the system a bit harder to try to get me a good follicle on the correct side this time.  Go big or go home I guess.  Unfortunately we may have to cancel if we get to many - because I certainly don't want higher order multiples (and I think everyone in the department would be pretty peeved if our REIs gave me anything that would put me on bedrest - nobody likes covering my clinics) .  

So my REI calls this cycle the "hail mary" (and I always appreciate a good football reference).  Figuratively I am the wide receiver running towards the endzone and my team is down by 5 with about 11 seconds on the clock.  If the throw is good and I make the catch I can win the game without IVF.  But all the hope is into this single play and the fans are all holding their breath.  Theres only one chance left before the twenty thousand dollar petrie dish.

So here we go - come on underdog!!  Only a small chance I'm going to win this game but if so its going to be a thrilling finish.

Sunday, May 1, 2011

I'm Back

So I'm back - I had an absolutely excellent vacation and thoroughly enjoyed the company of my husband for an entire week.   Life has been so busy we have not had enough time to be together so this was really therapeutic for me.

On another note - on to follistim cycle #6 pending a clears sono tomorrow.  Even though cycle 5 went down in flames it was not nearly as upsetting as the previous one.  I'm not sure if I just expected it to fail because the follicles were on the closed tube side or if I just expect this whole ovulation induction experience to be in vain.  Maybe it was just that I was enjoying vacation with my husband and didn't want it to be ruined by disappointment.  Either way - I am okay this time.

There will be some longer posts later - I am chalk full of things to say from the vacation but right now I need to seek the comfort of my heating pad.