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Archive for February, 2009

Seriously, people!

Will 9:30 tomorrow never come? And why, oh why, did I not make the 6:45 appointment instead? What was I thinking?? (Oh, wait, that’s right, my husband has to be at work at 0630, so I couldn’t go in at 6:45 regardless… it’s HIS fault!) Yes, I totally get that tomorrow’s vampire draw isn’t going to change anything. But at least it’s something to do.

Bah.

In other news, I need a new blog layout. Seriously. And I’m not creative enough to make one. And I’ve searched for free blogger skins that I could modify and I can’t find any that I love. So I need help.

Help?

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Do you know the definition of insanity? Doing the same action over and over again, expecting a different result.

Why, then, do I continue to POAS? Is it insanity? Or, as Jody suggests, simply ritual?

Truthfully, though I don’t deny that I’m crazy, I don’t expect a different result, so I imagine there’s simply some comfort in the morning ritual, just as there is in the evening ritual of drawing up the PIO injection. At least I’m doing something.

It certainly won’t change tomorrow’s beta, that’s for sure. But after tomorrow, there won’t be anything to do for at least a few weeks. That time is interminable to me. I remember after my miscarriage in 2006 I had to wait a couple of months for my hCG to zero out, and then they still made me wait another month before starting a cycle.* That was absolutely the worst three months of TTC for me, ever.

I suppose I’ll use my break this time to make random drop ins at YOFC to check and see if that mobile has been hung yet. AHEM. What do you think, J – has it been hung yet?? Don’t think I’ve forgotten about it! I’ll cut off the cookie supply if it doesn’t get hung!

Just kidding. I’d never cut off the cookie supply. I’m too nice. Snickerdoodles tomorrow. They’re already made.

*Note, there are no scientific studies (that I can find) that support a need for a month off after the beta bottoms out (my OB/GYN supported my theory on this) – most doctors admit that this is purely because they believe it will help a patient emotionally. However, I believe that the 2 months it took my beta to bottom out was a sufficient break. Furthermore, my completely unscientific survey with a sample size of, oh, 6 or so, showed that being forced to take an additional month break without being consulted as to whether this month was emotionally necessary was, in fact, perceived as patronizing and was more emotionally harmful than helpful.

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Infertile Enough?

Because Infertile Myrtles aren’t neurotic enough, we like to find ridiculous things to obsess over. In my first go-round with fertility treatment, I often thought about the fact that I really just didn’t have it all that hard. I have a relatively simple issue to correct – anovulatory PCOS – which does seem correctable with the right combination of gonadotropins and hCG trigger.

My original (evil) OB/GYN ridiculed me – telling me if I just lost weight and took Clomid, I’d ovulate and get pregnant in a jiffy. I should just exercise more and eat less and I’d be pregnant in no time, she told me. I tried that, and I took her five prescribed cycles of Clomid, unmonitored, I might add, which I now believe to have been a dangerous course of treatment, but no pregnancy. I listened to her lectures. I took her berating stares, believing that this was really all my own fault. I discarded the facts of the case, I ignored the truth, which was that I had gained much of this weight not through my own fault but quite suddenly – sixty pounds in five weeks, due to a metabolic shift in my body that was out of my control, and the rest due to years on migraine-controlling medications such as Depakote (known as Depabloat, for a reason). I took upon my shoulders, instead, the guilt and the shame that she placed there, knowing that my simple problem was my own. If only I hadn’t done this to myself, I’d be pregnant.

Eventually, though, I realized that I needed more than stern lectures, and exercise pep talks, and cute little white pills for five days a month, and I self-referred to Ye Olde Fertility Clinic, where I met with a wonderful doctor who told me that this wasn’t so much my fault, that I had, at least on the surface, a common issue, that would likely be relatively simple to fix, but that Clomid was not my answer any longer. My OB/GYN at the time was pretty pissed at me for self-referring. She, herself, would have had me take one more round of Clomid before referring me over to YOFC. “But no worry! This is such a straightforward case that just the teeniest little dose of the heavy duty drugs and you’re going to be pregnant in no time!”

Nearly a year later, a couple dozen vials of blood, an HSG, many ultrasounds, and four IUIs later, I was, indeed pregnant, and in need of an OB. No way was I returning to that doctor. No. Way. So I got a referral from my RE to an OB who was actually even more convenient to me and (as it turned out) someone who a bunch of my friends see, and I was off. Three months later, I miscarried that baby, and I became thoroughly convinced that I had made the absolute right choice in doctors – he handled the situation with care and empathy and concern for my welfare. And back to YOFC I was, only to find my RE on maternity leave – and when she returned to work, she didn’t return to the office convenient to my home and work … but to an office far out of the way for me. So I switched to SuperDoc.

Even then, a piece of me felt that I just wasn’t that interesting or complicated a patient. I have this theoretically simple issue. I don’t ovulate. I have PCOS. Give the girl some drugs, give her an hCG trigger, a quick intimate moment in a doctor’s office in stirrups with an IUI, and bada bing bada boom – pregnancy (theoretically). Not a complicated case. I knew then, and I know now, that I don’t suffer many of the indignities of infertility that a lot of my fellow infertiles suffer. I don’t have thrombophilia. Er, not exactly anyway (I am borderline on one test… but not quite enough to make anyone worry). I don’t have recurrent miscarriages (yet, and I hope never to be able to say that I do). I don’t have natural killer cells. I don’t have fibroids or stage IV endometriosis (though it’s been suggested that I might have very mild endometriosis which does not in any way interfere with my fertility). I have never had uterine, cervical or ovarian cancer. At the time I had a completely unremarkable HSG with patent fallopian tubes. I do not have premature ovarian failure. I was able to do something that many of my fellow stirrup queens had never been able to accomplish – I had been able to get pregnant. And with only the “low tech” IUI, at that! I knew, really, that I had nothing to complain about.

I’ve written about it before, but for the sake of completeness of history, I’ll tell you the story again… I remember sitting in SuperDoc’s office at my second consult with him after another 2 IUIs and saying that I knew that compared to most women with infertility, I have it pretty easy. I have carried his answer with me ever since: He looked at me earnestly, paused, and said, “Let’s just say you’ve handled your burden with extraordinary grace.”

I shrugged it off at the time, as I am prone to doing. I wasn’t, after all, one of the “real” infertiles. I wasn’t hard-core yet. I’d never done IVF. I hadn’t suffered multiple losses. I’d only been at this baby-making business for about four years. I’d only had six IUIs at that point, for a total of 11 medicated cycles. After all – there were so many out there who had been through so much more.

Two weeks later I found out I was pregnant. And two weeks after that, I found out I had HOMs a-brewin‘. I felt exposed and vulnerable. And once again, like I wasn’t a “real infertile.” Why, I was so fertile, I’d gotten knocked up with more than I’d bargained for. WAY more than I’d bargained for.

But it DID start changing my perspective on infertility, quite accidentally. Because being pregnant with HOMs makes you the poster-child for infertility. Suddenly everyone assumes you’re an infertile. (Oh I feel so sorry for anyone who is pregnant with spontaneous HOMs – for they must forever be explaining that “No, these were a total surprise!” like it’s anyone’s business) I began to realize that at any stage of infertility, whether it’s someone who’s been trying to get pregnant for just one month without success, or someone who has given up trying after months or years of treatment (or anyone in between) – they have a story to tell, and their own burden to bear. People would come to me and say, “I know I haven’t been through as much as you, but we’ve been trying to get pregnant for six months, and…” And I tell these women that they should never believe that they’re not “infertile enough” to be legitimate in the infertile world. Each stage of infertility has its own burdens, trials, and tribulations. Each stage has its own challenges. And each set of challenges must be met with its own level of grace and humility. But we have a right to rage against each stage – to express our hurt, our anger, our outrage. We have a right to wonder, “Why me? Why now?”

And now? Now that I’ve been through IVF and probably failed a cycle, do I feel any more “legitimate” in the world of infertility? No. I still know that I have this pretty simple problem. This problem that should be pretty simple to solve. (Oh, except I do now have that blocked tube on the left side that may be real or may have just been a spasm, so who knows?) I have this problem that should be a simple case of “injections, IUI, bada bing, bada boom, BFP.” But nothing is that simple, is it? Most people do IVF because IUI doesn’t work for them. I’m doing IVF because IUI worked too well and I can’t take that risk again.

I don’t regret my infertility as many do. I know there are days that I am on medication when I am not the sweetest, kindest person I could be – and I regret those individual days. But by and large, I have reaped the benefits of infertility far more than I have suffered from it. I have met amazing women, experienced great joy, been introduced to a wealth of knowledge, learned about a plethora of intriguing scientific, ethical and moral issues that many people never even think about. I have become a stronger, healthier and ultimately happier person overall. I have become more sensitive to the needs of others, and recognized that you never know what is going on beneath the surface of another person, and I try to live my life accordingly. I know that the reason I’m going through this again is because I recognize the true gift and blessing of my children – and I know that (for me) I cherish them at least a little bit more for having had the wait (note, I don’t mean to imply that fertile myrtles don’t cherish their children, I only mean that I, personally, know that I view my children differently because of my experience)

I also know, now, that infertility is never about fault. I know now that infertility is a disease of the reproductive system. And I’ll never again let a doctor tell me again that a legitimate disease is my own fault.

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Just in case you were thinking that just *maybe* 14dpo might *just* be a little too early still and there *might* just still be a miracle waiting… let’s just assume that 15 and 16dpo is quite definitive, shall we?

I’m still bringing J and Co. Snickerdoodles on Wednesday (beta day). It’s not their fault my body sucks, right?

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Get it? Reading between the lines? Like, if I had two lines and you had to rea… oh forget it, they always say that it’s not funny if you have to explain the joke. Onward and upward…

ANYWHOZIT: The point, for those still reading (and I wouldn’t blame you if you’d stopped bothering after that lame-assed joke), is that I recognize that I’ve obscured the facts somewhat in the last few posts. So let me clear it up for those who have emailed me (though, to be fair, most of you HAD seemed to understand where I was going with it all)…

Yes, I have POAS’d. No, there were not two lines. Well, I mean, if you took TWO of the tests and put them together, you’d get two lines, but I doubt that’s what any of you meant. Yes, this was a direct violation of my doctor’s orders. But it’s not like it was going to change the end result. Wednesday’s beta will still be whatever Wednesday’s beta is going to be. Plus, SuperNurse said I could pee on anything I wanted, so long as I was going to be sane about it (e.g. not call her every five minutes with the latest test results freaking out).

I’m very uncomfortable, both because of the giant lumps on my, ahem, posterior, and because I am extraordinarily crampy. I have little question in my mind that if it weren’t for the blasted PIO, I’d be on CD-something right now based on how I’m feeling. Yes, I’ve tried a heating pad for both pains. No, it’s not helping. Thanks for the suggestion. The warm heating pad sure is snuggly, even if it doesn’t help. And the cats like it, too (bonus).

And now I get to hang out until Wednesday when I have my beta and can ask what my next steps are. I might call on Monday to schedule an appointment for a consult with SuperDoc, preemptively. I know it’ll take a while to get an appointment with him, so I may as well get it on the books. I could always cancel it if (hah!) today’s test results were somehow mistaken.

To answer Lori’s comments….

I know my clinic did not allow back-to-back cycles. Your body needs a little downtime after all that.

Different clinics have different protocols. And some are satisfied that the month on BCPs = sufficient downtime before starting over. That isn’t the same as going straight into another stim cycle, which is what back-to-back IVFs would actually be. A month of BCPs IS actually time off between cycles. I just don’t know if that’s sufficient for my clinic because in my efforts to be more “go-with-the-flow” than I naturally want to be, I just forgot to ask.

If your beta is negative do you have a consult before the next cycle? My clinic did. You should SO push for a cycle without Lupron.

They don’t require a consult between cycles – that’s really my call. I don’t currently have a consult scheduled, but I might schedule one. I haven’t really decided what to do. As for pushing for a cycle without Lupron… to be honest, I’m tired of pushing. I pushed and pushed through my first round of infertility treatment, and I’m really done with that. I have full faith and confidence in my doctor and his expertise. I don’t have the emotional energy or the mental capacity left to play back-seat-patient. Certainly, I will ask what he thinks of doing an antagonist protocol instead, but I will not push for it. If he has a reason he doesn’t think that’s the answer, I’m not going to rock the boat. The headaches from Lupron suck mightily. There’s NO question. I would love to be without them. But the fact of the matter is that if the protocol ultimately works and I get to hold a baby in my arms sometime in the next year or two… I won’t give two hoots about the headaches (though I reserve the right to complain about them here, while I’m going through the process).

Finally, I know it ain’t over ’til it’s over, and the fat lady hasn’t sung yet (wait, I *did* sing bedtime songs to my kids tonight…), but I know that the reality is that this isn’t going anywhere. Many of you have emailed me directly to express your sympathy for this (and boy, will *I* feel stupid if I end up with a positive beta on Wednesday! Hah!), and I do appreciate it. I’m okay, though. I’m sad about the lost time and the lost chance and the fact that only 2 opportunities remain without some seriously creative financing, but I’m really okay with giving this another go. I’m eager, in fact, to keep moving. And like I’ve said all along – the good news is I love SuperDoc, SuperNurse, M (sonographer extraordinaire), J (Marketing Supervisor Extraordinaire)*, and everyone at my clinic. So is it really so bad to have to spend some more time with them?

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*Er, not that J has anything to do with my treatment cycles or anything, because of course he does NOT. But at least I get to barge into his office now and again and drop random boxes of cookies on his desk and harass him. That part is fun for me. 🙂

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I will now postulate that at 8dp6dt, aka 14dpo, it is now too late to say it’s too early to tell anything.

No news. I don’t expect this to change come beta time. Still don’t know what the plan is – whether I have to take off a month before rolling in to BCPs or whether the month of BCPs IS my month off. Different clinics have different policies, and I don’t know what my clinic’s policy is. I do remember back in 2007 when I had my original IVF consult with SuperDoc he had said that I wouldn’t be able to do back-to-back IVF cycles, but that could still be that he was referring to the BCP month in between.

I don’t love not having a plan.

Frankly, I don’t even know how we’re going to pay for another set of coinsurances/copays again right now anyway – we just had a major huge crisis in our house which will likely involve digging up our entire yard to fix a broken water pipe to the tune of several thousand dollars, so it may be out of my hands for a while regardless, but I’m hoping not. We’ll just have to see.

Anywhozit, we’ll just see what happens. Wish I could just stop taking the PIO, but I’d probably get yelled at by SuperNurse on behalf of SuperDoc if I did that before beta day. So stick it out (pun intended), I shall.

I do not like not knowing the plan.

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No News

Absolutely nothing to report. Aren’t I interesting these days? I know, I’m a bundle of fun.

7dp6dt aka 13dpo.

Whahoo.

Beta Wednesday. I am not expecting good news.

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6dp6dt aka 12po

So I’m just saying, if I POAS’d, oh, I don’t know, say, today, what are the odds of it showing anything? Nada, right?

Yeah.

I mean, hypothetically speaking.

You know. IF I were to do so…

I’m just sayin’…

Not that I would EVER consider explicitly disregarding my doctor’s instructions not to POAS. Not me. No. Never. Nosirree. Uh uh.

Ahem.

Oh, and by the way, I absolutely saw the humor in both SuperNurse’s remark about the six embryos and even in SuperDoc’s remark about transferring eight. It doesn’t come across very well in writing, of course. But I had a big smirk on my face while writing about her smarty-pants remark to me. 😉

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Finally heard back from SuperNurse. She didn’t realize I hadn’t gotten a call over the weekend (and apparently hadn’t gotten to my email from yesterday). So all is forgiven and she has been re-established in my book of people who are allowed to have snickerdoodles next week. Maybe. You’ll see why she may have fallen back out of status later.

Anywhozit, there was nothing to freeze. Everything tanked. Shocker. I know this is not an indication of whether George is resilient enough to have parked his little butt in place for the long haul, but it does give one pause, no?

.
.

Right. Well, I think that was enough of a pause. Anyway, it doesn’t mean a darned thing. My clinic has some pretty strict standards for freezing, and I’m cool with that. A lot of clinics would have frozen right then and there when they transferred George.

My nurse wasn’t worried that there was nothing to freeze, “because the six they transferred were real beauties, so I’m sure you’re going to have a positive beta next week.”

*blink*

Yeah, you read that right. SO not funny. She may *think* she’s funny, but she’s not.

I told her I was just proud of myself for not having peed on any sticks yet. “NO! DON’T PEE ON ANY STICKS!” she shouted through the phone!
“Oh for crying out loud, SuperNurse! I just told you I haven’t! And I don’t understand why you people get all ridiculous about not letting us pee on sticks – it’s not going to change the result. Either I’m going to be pregnant on the 18th when I come in for my beta or I’m not – it’s not like peeing on a stick will change that.”
“Yeah, but then you get a stick that tells you you’re pregnant, and then we have to tell you you’re not, and then…”
“Well that doesn’t change anything for me! I don’t get all weird about it! Hello? I’M totally rational, you know me!”
“Well then by all means! Pee on all the sticks you want! Go buy a box of popsicle sticks if you want! Whatever makes you happy!”

If it weren’t for that remark about the six transferred – she’d TOTALLY be on my cookie list right now.

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5dp6dt aka 11dpo

No word from YOFC. If they’re not careful, I may revert to the pseudonym I used in my original blog, transparency be-damned.

11 dippos. Think it’s too early to POAS? Last time I got a 2nd line at 10dpos, but admittedly that was with at least 2 having implanted already, and possibly more. G-d willing, that is NOT the case this time.

Well, I don’t have any HPTs anyway. Not YET! but SOON! 🙂 Yeah! Of course, I could always run out and head over to CVS… I might even get the sassy cashier – the one who when seeing me buy a couple packages of sanitary napkins and a couple packages of twizzlers … both were on sale, so sue me, okay?… said, “Well, I see you’re prepared for any emergency, aren’t you!” But no. My internet cheapies should arrive tomorrow. I can hold out. Honest.

Maybe.

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