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Archive for June, 2009

Last Call

On the advice of someone whose opinion I trust implicitly, I went to see a therapist this week – the first of many such encounters, I’m sure. Though the whole IVF thing is not the driving force for sending me into therapy, I felt it was relevant to tell her that we’re actively undergoing fertility treatment and that, in fact, the very week that therapy had been suggested to me, was the same week I had learned that IVF#2, Take 3 had not been successful.

There was a piece of me that really didn’t want to tell her about the IVF thing at all. Because people make a thing out of it. People ascribe emotional significance and stress to IVF or any infertility treatment that may or may not really be there – without really considering that every individual responds to these sorts of things differently. For me – returning to fertility treatment was returning to my “normal” – returning to my comfort zone in a weird and strange way.

But, still, I knew that it was something that needed to be mentioned, both because this particular therapist is a psychiatrist, so if the question of medication came up she’d know that right now may not be the optimal time to try that route, and because although I may not consider IVF to be a primary stressor in my life, and certainly not the driving force sending me into therapy, it definitely is a contributing factor.

And all that background brings me to the point of this post. While I was talking to Doc P. about the whole IVF thing, I told her that we would likely be attempting IVF #3 in August, but that I don’t know specifics, because I have my consult with SuperDoc on July 6th to figure all that out. And I told her that our August attempt would likely be our last IVF attempt. “And I’m okay with that,” I quickly added.

I hadn’t really thought about those words before they came out of my mouth, and I’m not really certain where they came from. Why was I saying them? What was my thought process? Did I even have a thought process?

While it’s true that technically once I run out of covered attempts with my insurance, we can switch me back to my husband’s insurance and I can do two IVFs at the clinic at his hospital – the fact is, it’s unrealistic to consider that. It’s very expensive to go that route (the coverage isn’t nearly as good), and the logistics are nearly impossible … the clinic is an hour in the wrong direction, they batch their IVFs, leaving very little flexibility on schedule, they do ALL monitoring appointments between 8 and 9am during the week, which means that I would never make it in to work before 10 or 10:30 on monitoring days during a cycle, which is impossible. So realistically speaking, it is unlikely that we’ll ever be able to go that route.

So the first part of my statement to the shrinkiedink was likely true – this next attempt is likely our last, unless one of us changes jobs again and finds ourselves with kickass coverage again.

But – am I really okay with that being it if it fails, as I expect it to?

I’m not so sure I’m really there yet. I know I said it in large part to keep the therapist from going down a long road of exploring “how I feel” about this particular thing. I don’t want to go there. I don’t want to focus on this issue. I’m not ready to discuss it. I’m not willing to share that part of me.

I was always so sure that IVF#1 would just be a breeze and we’d just be done and voila! our family would expand and that would be the end of it! Worst case scenario was that IVF#1 didn’t work, but an FET would – it had never occurred to me that there wouldn’t be anything frozen for an FET. But here I am, looking down the barrell of our last IVF and wondering whether anything will come of it.

I’m petrified of what will come of my meeting with SuperDoc July 6. A large piece of me thinkst that SuperDoc is just going to say that he wouldn’t change a thing and this is all just bad luck and we’re just going to have to hold our breath and hope for the best – but … while I know that’s probably all true, I guess it would ease my mind to hear that a different approach would yield a better result.

Mostly? I just want to move on.

And I’m quite certain that I won’t ever be okay with having my options cut off before I was really done.

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Seth went to give platelets early this morning. While he was gone, I got J's daily medication taken care of, got the babies out of their cribs, changed them, and made everybody pancakes. All four kids were eating their pancakes when Seth called to say he was on his way home. Our conversation went something like this:

Seth: Good news! I'm on my way home.
Me: Great! Happy Father's Day! I've got pancakes waiting for you – J! Do not drink off the chair! Turn around, sit properly, and drink appropriately! Sorry, honey. So, um, I'll see you soon?
Seth: Yeah, I'm leaving [city] now, so I'll be home shortly. Anything you need me to do on the way home?
Me: No, there are some things we need to pick – Sam! Don't throw your plate on the floor! Ugh. Of course, right after he threw his plate on the floor, he did his little mumbly-giggly thing and proceded to eat the pancake he still had in his hands. Um, right. So there are some things we need to pick up for the nanny for the week, but we can get them later.
Seth: Okay, I'll just come home then.
Me: That would be good. This hasn't been a great morning, what with whiny boy and all. He got mad at me for giving him strawberries with his pancakes. Ellie, SIT DOWN! Sorry honey. How'd things go this morning?
Seth: Fine. It was pretty uneventful actually –
Me: Get the strawberry out of your nose!
Seth: [laughing]
Me: Sam! No pancakes in your hair! I am not washing your hair today!
Seth: [still laughing]
Me: Yes, very funny.
Seth: It is!
Me: I am so blogging this.
Seth: You should!
Me: Yes, Ellie, that's Ellie's nose. Good job, Abby, that's Abby's nose! What's your ETA?
Seth: About 15-20 minutes. I'll be home soon. Did you remember to change J's weekly patch?
Me: No, I didn't have any whole ones upstairs, but I'll do it when I go downstairs again. Abby, do you need a new diaper? Yuck! Hasn't mommy changed enough diapers today?
Seth: Sorry, sweetie.
Me: It's okay. I'll see you soon. Wanna say hi to Abby?

And on and on…

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I know I said I wasn’t going to post for a while, but this particular thing has been eating at me, so I need to get this one out. This particular phrase, “it only takes one.” It hits me in my gut every time I hear it and I took a long time to figure out why exactly it hurt me so much. After all, it’s never meant to be hurtful when it’s said – it’s always said in an optimistic context.

Part of it, I think is simply because it is just a platitude that is meaningless until something comes of it. Worse, if I did get pregnant, the person who said it can say “I told you so,” and I’m not sure there ARE three more annoying words in the universe. Also it seems to invalidate whatever frustration I happen to be having at that particular moment in time – it says, “Yes, all your other embryos were crap, but your feelings about that are invalid, because all that matters is that one.” Certainly no one intends to send this message, though. So why does it bother me so much?

Finally, my beloved Barren put her finger on it in two ways. First, she said to me – yes, we all know it’s true – it’s only going to take one in the end, but platitudes don’t implant and make babies, so they don’t help. But later she said that really I should consider the math and think about it – and I would realize that, actually? It takes a heck of a lot more than one! And she’s right. Observe:

5 Clomid cycles, unmonitored, so I don’t know how many eggs, I ovulated, but we’ll assume at least one, because we do know I ovulated, so…5 cycles = 5 eggs, 0 pregnancies = 0 babies

5 IUI w/ Follistim Cycles = 11 eggs, 1 singleton pregnancy, 1 miscarriage = 0 babies

1 IUI w/ Follistim cycle = 30 follicles (not all mature, probably 5 mature), 1 triplet pregnancy = 3 babies

4 IVF cycle starts, 2 cancelled, 2 retrievals, 24 eggs retrieved, 17 fertilized, 2 transferred (1 at a time), 0 made it to freeze, 0 pregnancies = 0 babies.

So that’s … call it 45 eggs … 3 babies. So it actually takes about 15 to make a baby by my math.

Obviously it doesn’t work out to quite that math, but my point is that it’s taken a helluva a lot more than “one” to make a baby (or three, in my case). And in my 4 IVF attempts, I’ve made it to 2 retrievals and retrieved 24 eggs and gotten… zero babies. Clearly, it’s going to take more than one. Now, obviously, we haven’t found the “right” one – but there’s also no guarantee we ever will. And maybe the right one was already there, but we didn’t pick it.

I know that if I never get pregnant again, I’ve still been more blessed than I deserve to be. I know that many of you think that I have no right to even continue trying, let alone complain about our failures at this point. But this battle between primary and secondary infertility is ridiculous. These arbitrary decisions about the correct family sizes are equally ridiculous. We know our family isn’t complete, just as we know that we are blessed with the family we have. We are not blind to the blessings we have, nor to the suffering that people who haven’t made it to the other side are going through.

And the pain I feel in this loss is every bit as real as the pain I felt with each and every loss I felt the first time around.

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Official

Not that I needed the final word, but the beta’s back and I’m definitely not pregnant. George, Jr. is not to be. I take solace in the fact that I don’t have to put my tail between my legs and thank Dr. Hate.

So I can stop the estrace and the PIO. Wait, I already stopped both, because, really? What’s the point?

Follow up and re-group with SuperDoc on July 6th to plan out IVF#3. We’d touch base sooner than that, but he’s halfway across the globe right now. How dare he?

And that, my friends, is the end of IVF#2 (Take 3). I suspect I won’t have much else to say here for a while. I’m not in a very good place right now and I’m not really sure I have anything left to say.

I’ll let you know what SuperDoc says in July.

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No more PIA or PIO

I talked with my nurse today. I’m going in tomorrow for my beta despite being sick. My doctor this morning said if the plague I have is the flu, I should be better by tomorrow, and if it’s not, it’s probably bacterial, and I’m now on antibiotics just in case, so I should be okay to breathe my germs on them by tomorrow.

That being said, my nurse gave me her blessing not to take my PIO tonight since my HPT is still snowy white. I told her she needn’t worry about how to make that uncomfortable phone call tomorrow with the negative beta and she said, “Oh thank heavens!” Apparently those phone calls aren’t easy to make, and occasionally get pretty dicey. She hopes to give me a pleasantly surprising phone call tomorrow, but meanwhile she said it was okay to skip the PIO tonight. Whahoo!

Meanwhile, there’s nothing much interesting going on here in perky-land.

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No Pressure!

My company is changing insurance plans as of January 2010. They are making the change in such a way that it will mean they get around the Maryland Mandate for fertility coverage.

Awesome.

This means that I must get IVF#3 done in 2009, which means I must get started by August, in case I have another debacle with a couple cancelled cycles before I can move forward again.

Stupid insurance.

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A Definition

I love my husband. And you know why? Because if you look in the dictionary under sweet, optimistic, or (most importantly) naive, you’ll find a picture of him. Allow me to illustrate with a conversation from yesterday:

Him: Did you take your morning estrace?
Me: Yeah, but really? What’s the point?
Him: I’m still hoping George will surprise you.
Me: Honey, George isn’t going to surprise me. Today’s 15 days post retrieval. Even the stupid internet cheap POS pregnancy tests would have shown something if I was pregnant today.
Him: Okay.
Me: You really think there’s going to be a surprise.
Him: I’m hoping George will surprise you.

It’s cute, no? So for his sake, I will continue to take the little blue pills and the damn PIO, despite my blubbering in a doctor’s office yesterday (see Chez Perky for that one), because, after all, I’d hate for him to say “I told you so” on something that critical, right? (but I still haven’t made an appointment to go in for my beta…)

(for the record? No surprises this morning, other than I still feel like crap. And not in a pregnant kind of way – in a “oh my god where are my lungs and all my energy?” kind of way)

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ick

Still sick. Still not pregnant (so Barren? You can stop holding out that tiny bit of hope, okay?).

I have yet to schedule my beta, which is supposed to be Friday. I wonder if they’ll notice if I don’t show up for it? I’m guessing they would notice. Back in 2006 when I was away on vacation (the only real vacation I’ve ever taken in my entire life) on a beta day (and had told them I wouldn’t be there on beta day), they freaked out when I didn’t show up for my beta. But then, having not been on PIO, I’d had solid proof that that IUI (#2) had failed miserably.

So … not showing up for my beta is probably not an option right?

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I Am Sick

I am sick.

And I am also not pregnant. I did cave and POAS. Today is 9dp5dt. Otherwise known as 14 days post retrieval. Though I suppose some of you will argue that it’s too early to tell, a lot of clinics do their betas at 14 dp retrieval. The fact that my clinic waits 18 days doesn’t change the fact that today is probably accurate.

I will dutifully keep taking my PIO until Friday, because I’m a “good” patient (though not good enough to follow my doctor’s directions not to POAS), but then I’ll just be waiting out the 2 weeks until I can see SuperDoc for a follow up consult to decide the following:

  1. WTF???
  2. What next?
  3. Is there anything I should change about my protocol?
  4. Is there any reason I should not start a cycle in August (the alternative is to wait until November, which is not my preference).
  5. What are we going to do to avoid another Dr. Hate situation in the future?
  6. No, seriously, WTF???

I can’t say I’m surprised, or shocked.

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