Friday, September 30, 2011

Putting the "Hell" Back Into the Cycle From Hell

Today I received my fertilization report and needless to say, it wasn't what I expected. I always have a couple of eggs that are either immature or over-mature, and then from the remaining about 90%+ fertilize with the help of ICSI. I received the call just after 10:30 and I could tell in the nurses voice that she wasn't about to deliver good news. Out of the 10 retrieved yesterday, 6 were no good...to the point where they couldn't even attempt to fertilize them. Of the remaining 4, all of them fertilized. The nurse told me the my RE does not want me to wait until Monday for transfer, and since they are not open on Sundays, we are doing a Day 2 transfer tomorrow. Knowing that I had chromosomally perfect embryos, as indicated by CGH, arrest between Days 3 and 4 on my second IVF cycle, my RE would rather get them in me. The whole theory that "good looking embryos that survive to Day 5 are strong competent embryos and those that arrest are chromosomally abnormal" is a crock of shit. If you remember correctly my three best looking embryos on Day 5, one of which was a hatching blast, were severely abnormal having multiple trisomies and monosomies. So for those of you out there that get told that you need to hold out to Day 5 by your doctors so you can "choose the best embryos," your docs are full of shit or just plain stupid. The only thing they care about is reducing the chance of multiples so they don't look bad. It's scary to think how many "good" embryos didn't make it to Day 5 because the doc wanted to wait. Perfectly good embryos do arrest. Just some food for thought!

I am going in tomorrow morning at 9:30 for a massage (instead of acupuncture), having my transfer at 11, and then following the transfer with acupuncture. Since I have invested a ton of money in acupuncture and have nothing to show for it, I have decided to switch it up a bit. I was told that doing acupuncture post-transfer is best and that I could do a massage prior to relax me, so that is what I am doing. Normally I would be upset and freaked out that at this point, but I am seriously okay. I am at peace. I have 4 great embryos that we are transferring tomorrow and that is that. It is what it is and I need to be grateful for what I do have. I have encountered a few of the typical annoying comments on the forums I go on such as "it only takes one" and they are your typical IVF patient that got pregnant off of their first IVF so they are very disillusioned that it doesn't work that way for everyone. Let's see, I transferred 4 for my first IVF, 1 CGH perfect for my second IVF, and 8 on my third so obviously it doesn't take just one for me as I have already transferred 13! I know that they mean well but there seriously needs to be a separate club for those that this doesn't happen for because man those comments are annoying!

So I am going into this tomorrow at peace with whatever happens.I don't know if IVF will ever work for me, and sometimes I feel like it won't, but I am not ready to give up.

Thursday, September 29, 2011

Quick Update

This morning I had my ER and there was this weird kind of calm that surrounded me. My anesthesiologist was the best so far as he didn't give me any crap about my asthma or my requests for certain medications, my nurse was cheery and upbeat, and for the first time they got my IV on the first try (I'm a VERY hard stick!) I was relaxed when I was waiting in the OR and even found myself laughing and having nice conversation. My RE came in to see if I had any questions ( I always do) and then he pointed out that he was wearing the "lucky socks" that I bought for him like 3 months ago. Talk about one awesome doc! I mean really, what doc do you know that would look at the schedule in advance just to plan what socks he is going to wear?? Love it!!

As usual I had a hard time waking up from the anesthesia and yet again I required a few extra doses of pain meds once awake. I felt as if I was passing a kidney stone! They sent me home with a Vicodin script and I have been sleeping all day. Well, we ended up getting 10 eggs which means we only had a few empty follicles this time. They will be calling me by 10am tomorrow to let me know how many fertilized. If our fertilization rate is low we will do a Day 2 transfer on Saturday. I am, however, hoping that enough make it as I would really like to do a Day 4 transfer on Monday. My fingers are crossed!

Wednesday, September 28, 2011

Tuesday, September 27, 2011

Trigger Time. And No, I Am Not Referring To Roy Rogers' Horse.



Today I went for yet another monitoring appointment and I was very happy to learn that I am done with all of these stupid stim meds. All of my follicles were between 18mm and 22mm so I was told to trigger tonight. My ER is scheduled for Thursday at 9am. I am not sure when my ET will be and I will make that decision on Friday when they call me with my fertilization report. If we don't have many embryos I will probably do a Day 2 transfer on Saturday. If we have a sufficient amount I would like to push the transfer off until Monday which would be Day 4. What I like about pushing it off until Monday is that it is something different. I have done a Day 2, a Day 3, and a Day 5 transfer in the past and we all know how those ended. Actually, everything this cycle has been different. I was on different meds, the cycle from hell turned into an awesome cycle, I have never triggered on a Tuesday before, I have never had a ER on a Thursday before...everything is new for me and I like it. By having everything so different, I have been able to let go of everything from my past cycles. I do, however, feel a tiny bit of anxiety trying to creep in once in a while but I am trying to keep it under control.

Up until last night I have been doing great with this cycle. No bloating, pressure or pain, and I also haven't been all that emotional. Last night I started to feel quite full in my pelvic region and when I woke up this morning it felt like someone had taken a 2x4 and whacked me across the lower back. After seeing the size of my follicles and how many there were, I wasn't surprised in the least bit that I was having this pain. I was actually quite relieved that it wasn't any worse. My emotions kicked in a little today as well, but again, not bad considering. When the nurse manager was done doing my ultrasound and left the room to get all of my instructions, I was just sitting alone in that room and my mind started to wander. I suddenly realized that I was in the room where we found out that the heart had stopped in my 2nd pregnancy, a time when I was oblivious to the realities of miscarriage and to how many I would actually go on to have. I then started thinking about this cycle and how something could be wrong because we were unable to get a good look at my lining today (even though she was not at all concerned by this.) It was like I needed something to be worried about. By the time she walked back into the room I was crying. I told her that I wasn't sure if we were doing the right thing by moving forward and that I was having second thoughts. She asked me why and I told her that I was nervous about my lining. She immediately said that she would do another ultrasound to show me that everything was fine but I didn't want to give in to my old habits. If she says that everything is fine, I need to trust her! She didn't spend a lot of time on my lining because it "looked" great. It looked nice and fluffy. She told me that if I was that concerned that I could freeze everything but said that I should just move forward with this cycle and go through with the ET as everything about this cycle is going so well. I have a good number of follicles and my lining is the thickest it has ever been. Again, I think that I was just looking for something negative so I could have something to dwell on and feel "normal" as every cycle has had something about it that wasn't right, and the fact that this one has turned out to be so good makes me a bit uneasy as I don't know how to feel or what to expect.

I feel much better about things now and I am ready for Thursday to hurry up and get here. I keep reminding myself that I have no indication that anything is "wrong" or "off" and that everything actually looks pretty darn good. Even if something wasn't right, it is what it is and there is nothing that I can do to change it. 

Monday, September 26, 2011

Better Than Expected

This morning I went in for another monitoring appointment. Everything is looking great! My lining is the thickest it has EVER been at 7.6 and is still trilaminar. Even when I started this journey ages ago the thickest my lining has ever been was a 7.28 and that was on day of trigger. My follicles are ranging in size from 15mm to 18mm and I have one at 20mm. Since only one is at 20 and the rest are a bit smaller, I have to go back in tomorrow morning for one last check. The plan is to trigger tomorrow night as long as they grow sufficiently between today and tomorrow. The other exciting news is that this cycle has officially been converted from an IUI to an IVF cycle! I have at least 12 great looking follicles, and since my lining is the best it has ever been, they don't want me to waste this cycle on a procedure that only offers a 15-20% success rate. I will know for sure tomorrow, but it looks like my ER will be on Thursday. Hoping for more great news tomorrow!

Sunday, September 25, 2011

Ch-Ch-Ch-Ch-Changes

It is officially one week since I started my "transformation" and let me just say that I have never felt better. I have continued to nurture my new found relationship with food. This is in no way a diet, I just have adapted a healthier lifestyle. I continue to drink my organic smoothies with wheatgrass and flax seed in the morning. I have completely cut out all "white" carbs and will only eat whole grain carbs (brown rice, 100% whole grain bread) and even those are limited. I no longer drink ANY soda or indulge in anything that contains the words "diet," "low-fat," or "fat free." Those things are poison to your body. Don't believe me, start doing some research! I have invested in quite a few books about natural eating and I wish I would have learned these things a long time ago. A year ago I would have laughed at this concept but now that I am in my 7th injectable cycle and have nothing to show for it, I am no longer laughing. I have realized that eating organic is much more expensive but at this point I don't care. I feel like a completely different person. I have energy, I am happy and even though I still have a long way to go, I am feeling better about the way I look. I have only lost 4 1/2 pounds since starting this a week ago, but I think the fact that I know that I am doing something about it is enough to boost my self esteem. I also want to make it clear that my motivation for doing this is not to lose weight, it is to live a healthier life. After dealing with these ups and downs with my blood sugars I realized that my body was controlling me. I also found out last week, after having my blood drawn the week prior, that my cholesterol is 221. Not good! I also figure that if modern medicine can't get me pregnant that I need to take matters into my own hands. I am not stopping fertility treatments, but I now know that I need to do my part, and that is to take care of myself. I put on 35 pounds since starting this journey over 2 years ago and that is disgusting!

I just finished the book "Inconceivable: A Women's Triumph Over Despair and Statistics" by Julia Indichova and this is what opened my eyes to all of this. She was a women of "advanced maternal age" who had a FSH of 42. She went from doctor to doctor in NYC and was told by every single one of them that there was no hope. She ended up walking away from that route and took matters into her own hands. She became a vegan, ate nothing but organic and even participated in guided imagery and yoga. Needless to say she conceived naturally and that month her FSH was 30.4. I also read about 6 other women who also had similar stories. Two of them consulted with the same RE I did in NYC who told me that he would never do IVF on me because of my linings. He said that my only chance of ever having a baby would be through surrogacy. They left his practice, one after radical treatment and testing (the kind my current RE talked me out of) and the other after failed treatments. They too were given no hope. After leaving his practice they adapted a healthy lifestyle, taking part in relaxation techniques such a meditation, guided imagery, and yoga. All of these women also attended their local RESOLVE support group. All of them conceived.

I do realize that not every women gets pregnant and this isn't a "fix all" for everyone. I am a believer though. The clinic I work with is big into Eastern Medicine combined with fertility treatments. The head RE advocates for things like acupuncture, meditation, and Maya abdominal massage. He is a huge advocate for positive thinking. He is very "metaphysical" so to speak. When I first started with them I never got into this and sometimes I would laugh at it. Well, not anymore. I truly believe that perception is everything. I have gone though 7 injectable cycles, 5 loses (one being heterotopic), 3 D&Cs, 4 rounds of Methotrexate, a septum removal, a HSG, 3 hysteroscopies, an endometrial biopsy, emergency bladder surgery with 6 weeks of dealing with a catheter, endless testing with no answers, and numerous failed cycles, and if I can find a way to stay positive and hopeful after all of that, it can be done! I don't know what the future holds for me but I do know that I am at peace. I have taken all of my energy that I would put into being depressed, sad, anxious and defeated, and I have channeled it into something better...a healthy and happy me!

Friday, September 23, 2011

More Good News

This morning I went back in for my monitoring appointment. I was unusually relaxed. As I sat there waiting for the nurse manager to come in to do my ultrasound, I was trying to figure out what cycle day I was on. Like I said in a previous post, if this was any other cycle I would know without any hesitation as every ounce of my being would be dedicated to my cycle, in other words, I would be obsessed. This cycle is completely different though. I finally figured out the today is CD20. I should have had my procedure by now and should be in my TWW, but I'm not and I am okay with that. This cycle is not controlling my life. No more! The nurse manager finally came in and started my ultrasound. Since this has been what I have coined "the cycle from hell" my expectations are really low and I am just kinda going with the flow. She always starts with my lining as that is  my our biggest source of frustration. She was hovering over it and I could tell right away that it looked different. It still had that glowing triple stripe but it looked different. I watched as she measured it...6.62mm! I know that this doesn't seem like much but for my previous IVF cycles my lining never made it above 6.5 on day of trigger and now I am already over that! Even with my IUIs my lining maxed out at 7.2. Am I going to make it to a 7 this time? God, that would be great! She then continues on and measures each ovary. As she is doing this I can see all of the follicles. There are a bunch of them. She started measuring each individual follicle and stopped measuring at 12. I have at least 12 follicles ranging from 12mm to 14.5mm. My E2 also more than tripled from 176 to 543. I go back Monday morning to check things again. I am continuing with 600 of Follistim and 250 of Ganirelix until then. I couldn't be happier!
 

Wednesday, September 21, 2011

The Cycle From Hell...Maybe Not

I am trying not to get excited but it looks like the cycle from hell is taking at turn, a turn for the better. I was rather scared when I went in for my monitoring this morning as I knew that this would be the day that I found out if my cycle was canceled. I was actually sick to my stomach a bit as I couldn't fathom having to stop all of this after 18 days of medication and determination. Yes, this is CD18! Technically I should have already triggered, but nope, I am still shooting up with FSH! As the nurse manager started my ultrasound, she immediately focused on my lining. My lining is still thin in comparison to "the norm" at 5.91, but for me this is not bad considering where my E2 and follicle development is. On the screen was this glowing triple stripe. I typically have the "triple stripe" but it never looked this good. The other thing that stood out is that the thin part of my endometrium that looks like a sperm tail is starting to thicken. In the two years that I have been doing this, that section has never thickened. She then moved to my ovaries. She is measuring one and I look at the screen and see all these beautiful follicles. Since my right ovary is always the retarded one and never produces much of anything, I assumed she was looking at my left. I commented how my left ovary is always my good one and she corrected me and said "no, that is your right ovary." She then went over to my left ovary and I couldn't believe how many there were. We didn't count them today but there were at least 8 or so on my left. They are still relatively small and are all measuring between 10mm and 12mm, but they have grown quite a bit since Monday. My E2 rose from 62 to 176 which is a decent rise. I am continuing on the 600 of Follistim and possibly starting Ganirelix tomorrow evening (waiting to hear from the nurse.) I go back on Friday for another monitoring appointment where I am hoping I will get more good news. The way things look right now, I am figuring that I will be triggering on either Monday or Wednesday. I am leaning more towards Wednesday though.

Monday, September 19, 2011

The Saga Continues

The cycle from hell continues on. The nurse manager was pretty sure that she was going to be canceling my cycle today due to the bleeding that started over the weekend coupled with the lack of response to the meds. Much to her surprise, and mine, I had a tiny bit of growth in my follicles (still <10mm) and my estrogen skyrocketed from 24 to 62 (note the sarcasm.) The bleeding that I had over the weekend, which was similar to AF, has stopped as well. The fate of this cycle will be officially determined at my next appointment on Wednesday. They are keeping me on the 600 of Follisitm so I am hoping that I respond so we can at least have a chance this cycle.

Okay, now on to the complaining...
I have figured out that the horrible migraine type headaches that I have always attributed to the Lupron are actually being caused by the Follistim. I am about 5 seconds from blowing my head off, actually, I am about 5 seconds from taking a Percocet (no joke.) I thought for sure that the few hours I went without this headache this morning signified the end of them, but I could never expect to be so lucky as it came back with a vengeance. The other thing that I have been having a tough time with are my blood sugars. Thursday I unfortunately had an episode while driving. I was driving down the local Interstate when I suddenly became nauseous and started sweating profusely. I ended up pulling over off into a parking lot. I decided to check my sugar and it was 54. I called my PCP and he had me come in the following morning. Since I am not too keen on more injectable medications, he is sending me to an Endocrinologist to see if we can get this under control. He isn't exactly sure what is going on as my blood sugar fluctuations are not in any way related to my eating patterns. He said that something is going on with my pancreas but we shall see. In the meantime, I have completely overhauled my diet. I have thrown out every bit of processed food that we have in the house. All of my produce, dairy, and meat is now all organic. I have also replaced all of my condiments, cereals, and protein/fiber bars with organic substitutes. Every single morning I make myself a smoothie which consists of a half of banana, 1/4 cup organic frozen blueberries, 1/2 cup organic plain yogurt, 3/4 cup organic orange juice, 1 1/2 cups organic spinach, 1 heaping teaspoon of ground flax seed and a scoop of powdered wheatgrass. All of these things are what my RE recommends for a morning "fertility" smoothy. I thought that they would be gross, but I am finding that I actually enjoy them. The rest of the day I eat nothing but salad with grilled chicken, fresh sliced organic veggies with organic balsamic dressing, V8, organic fruit, and organic sliced pita chips with different organic seasonings. I am turning into a first class tree hugger!! In addition to making me healthier and ridding my body of all the toxins from the crap I used to eat, I am hoping that I will drop some serious weight. Not because I am trying to diet (because I am not) but because for the first time in my life I am eating well and taking care of myself. I am also determined to make this change permanent so when I do have a child I can teach them what proper nutrition and healthy eating is. I don't want them to go down the same road that I have!

Sunday, September 18, 2011

The Cycle From Hell

This is officially the cycle from hell! I am on CD15 and I am still stimming. As of Friday I was still at baseline as my E2 dropped from 26 down to 25 and my follicles didn't show any sign of growth. My Follistim was upped from 450 to 600. So what does this mean? Well, first off I am still at baseline (perfectly) so we are still moving forward with this cycle. The nurse manager told me that many PCOS patients (which I don't have) stim for 25-30 days as they need to stim very slowly to prevent OHSS. They get pregnant so obviously there is no effect on egg quality when you stim this long. The other thing that this implies is that my hopes for doing a low-stim IUI cycle have been crushed. This cycle proves that I no longer respond to low dose gonadotropins and that my ovaries need very high levels to even get started. My ovaries are shot! We are learning a lot from this cycle and this new found knowledge has by husband and I engaging in some serious discussions. Since we know that taking Femara and low dose Follisitim doesn't work, and the whole point in doing that was to limit the amount of meds my body had to process, that IUI may not be the way to go. If I have to take mega doses of hormones just to get my ovaries going, why put all that stress on my body only to have a 15-20% chance of success with IUI? Why not do IVF which, if everything goes well, gives you a 50-70% chance of success? Now just because the odds are higher doesn't necessarily mean that it is going to work. The endometrial lining needs to be nice and plump with a trilaminar appearance, the uterine cavity should be free of fluid, and the follicles must be exposed to optimum growing conditions. If, and only if, these conditions apply will we move forward with IVF. I will say, however, that my lining has always been an issue. From the first day of stims I have had a trilaminar endometrium but it is way to early to tell what my lining is going to be like. We know that I will never have a lining that is 9mm or more so we are not expecting that to happen. We are shooting for a lining 6.5mm or greater. Yes, this carries a reduced chance of pregnancy but this is all I have to work with...I have no choice. So here are our plans (and this is assuming that I start responding to the meds):
  1. Stick with original plan and do IUI if 1). there are not many follicles when it comes time to trigger, 2). lining is less than expected or 3). some other type of barrier gets in the way reducing my chances of success.
  2. Convert to IVF only if everything looks great, meaning that my lining looks healthy and that I have a good number of follicles.
  3. Convert to IVF but freeze all embryos on Day 1 and prepare for a FET. We would do this if I have a good number of follicles but my lining isn't good. 
Either of these options are fine with me. It is what it is and there is nothing I can do to change things. It took 7 injectable cycles for me to realize this! I am very thankful that this was the cycle that I learned that I had to "let go." With the way things are going, if this were any other previous cycle, I would absolutely be losing it right now. After 5 days of Femara and 5 days of low dose Follistim (150-450) I have had no response; my E2 levels have been dropping because of the lack of response; my lining shrunk because of the lack of estrogen production; and I have started bleeding after having AF end 8 days ago. That is enough to drive anyone crazy! I go in first thing tomorrow morning for another ultrasound and more blood work so I am hoping that there is some type of activity going on in my ovaries. Damn ovaries!!!

Wednesday, September 14, 2011

My Ovaries Suck!!

Today is CD11. I did the Femara from CD3-7, Follisitm 150 on CD8, Follistim 200 CD9-10 and now I am being bumped up to 450. Unfortunately I am not responding to the meds, but luckily for me I am still at baseline so my cycle to not effected by this. My estrogen actually dropped between Monday and today (36 to 23) but I am at a great point to have a decent response to meds now. Also, my lining is already a 5.57 and technically today is like "CD3" because we are starting from the beginning again, so my lining is already ahead of the game. Not sure how, but my lining is thickening at every appointment and it has that lovely triple stripe...already.

Normally I would be freaking out at this point obsessing over every little number and detail...but I'm not. I actually had to figure out what cycle day this was and I can honestly say that this is the first time I haven't kept track in 2 years. I am completely detached from this cycle. I am not avoiding it or ignoring it, I'm just not letting it run my life. I am in charge of my life, not my ovaries! I will say though, that it is a bit disappointing to see that I no longer respond to the meds. When I first started this process I responded to only 75 of Follistim! For my IVF cycles I only responded to 600 units total. My nurse manager said that this is because we suck the life out of my ovaries month after month, which makes total sense. My goal was to use less meds and try and be more natural, but apparently that is not possible. Despite this setback, I am thinking that this could be a blessing in disguise. Normally on CD3 my lining is only in the 3's. Since technically we are starting from scratch and my lining is already almost a 6, this could turn out to be just what I needed. The only explanation for my losses and for my embryos not sticking, is my sucky lining. I am praying that all of this is happening for a reason...

Saturday, September 10, 2011

You Can't Always Get What You Want...

...and if you try sometime you find, you get what you need.

Those words could not have been any more accurate than they were yesterday. Let me start out by saying something regarding my post on Wednesday. I wasn't going to mention this but Wednesday was our due date for our 4th loss and that has been contributing to the mood I have been in. I have never been one to obsess over those dates, but this time it bothered me. It wasn't the fact that I wasn't giving birth or that I wasn't holding a baby in arms, it was about how much I have lost and how much I am still struggling with this.

Over the past few days I have felt myself going downhill...fast. Yesterday though, I had a revelation, a spiritual awakening of sorts. With all of the flooding that we have had, my parent's basement apparently had a foot of water in it. They had asked me to come get all of my stuff out of their house as they were having a cleanup crew come. I really didn't think much about this until I got there. I walked down the basement stairs and my entire childhood was staring me in the face. I immediately became overwhelmed. Most of my things were in bins (thank you OCD) but some things didn't make it. I immediately looked down and there was a little stuffed dog lying on the floor all dirty and wet. I reached down and picked it up and then realized this was a dog that my Dziadziu had given me when I was a toddler. I then proceeded to start going through the bins. There were a million memories, both good and bad, just sitting in those bins. I found all of my books, mostly Dr. Suess and Golden Books, and luckily they were okay. I then moved that bin aside and discovered a bin of stuffed animals. I started digging through it until I came upon the one thing that ended the day for me. There was my little pink musical lamb. When wound up, it plays "Easter Parade." As I was standing there holding it, I quickly went through a series of flashbacks, some that I was happy to remember, others that I would rather forget. I know that this is just a stuffed pink musical lamb, but to me it represents so much more. It signifies survival. I was given this lamb by my mom right before she was diagnosed with Stage IV Uterine Cancer. She was the age that I am now when she was diagnosed, and I was only 7. As a scared child, not knowing if my mom was going to live, I always held this lamb like it was the last thing she was ever going to give me. It was everything to me. At this point I had to put the lamb back in the bin. I couldn't take anymore. I grabbed that one bin and I left. To make the day even more spectacular, I had to pick up the ashes of my dog. Great day!

By the time I got home I was overcome with emotion. I was pacing back and forth with no one to help me. My husband was three hours away. I kept thinking about that lamb, I kept thinking about everything that I have lost, and I kept thinking about the things that I may never have. I was literally going out of my mind. Something that I never do, I decided to reach out to someone. Even though I was worried about bothering her, I went against my usual instinct and I called the nurse manager from my clinic. Through my journey at this clinic, I have become close with her, and consider her a friend. I was so upset I just started talking. I didn't worry about the words that were coming out of my mouth or how ridiculous I may have seemed. This was how I felt and I couldn't deny it. After talking with her for quite sometime I realized a lot. I realized that I need to let go. Not give up, but let go. This journey through infertility was not a part of my life, it became my life. In my conversation with her we discussed every possibility...me being pregnant, adoption, surrogacy. She said something though that really struck a nerve. She said at the end of the day, when all is said and done, that I will be home with my husband holding our precious baby, and everything that I am going through now will not matter nor would how I got to have that baby. I couldn't believe how right she was, however, the one thing that hit me is what if my husband isn't there. What if he leaves me or something happens to him. I have spent these past two years focusing on starting a family that I have forgot about what I already have. I couldn't believe this.

My husband ended up getting home earlier than expected and I told him to get dressed as we were going for a ride. I did not tell him where we were going, but I had an evening planned. We drove for about 45 minutes, back to the little town where we began our lives together. We had dinner at the steak sandwich shop that we always used to go to, we saw a movie at the little one screen theater in town, and then finished the night off with a coffee at the local Dunkin Donuts where we always would frequent late at night. It wasn't until we were sitting having our coffee that I realized that I already have what I need. He is my entire life and without him, life just wouldn't be worth it. At that moment Israel Kamakowiwo's version of "Over the Rainbow" started to play. I was overcome with feelings of happiness and contentment, it was at that point that I knew that everything was going to be okay. That song has special meaning to both of us. It is the song that he sang to me at our wedding, the song that signified the beginning of our lives together and the end of a past filled with sadness and despair.

I learned the greatest lesson of all yesterday. Life isn't about what you don't have, it's about what you already do have. It's about the love and happiness that fills your soul and gives you life. You don't have to give up on your dreams, you just need to realize all of your dreams that have already come true. 

Wednesday, September 7, 2011

Bad Things Do Happen

Today the reality of things came crashing down. Even though I walk around acting like all of this is okay and I will do whatever I have to do, there are times, a lot of times, where I just want to give up. I still think that I have become a strong person because of all of this, but this by no means indicates that I don't have moments of weakness, because I do.

Over these past few weeks I have been doing a lot of self-psychology, or as I like to call it, reminding myself why I decided not to become a clinical psychologist. Through this self talk, I have discovered a lot about myself. I have talked before about how messed up my childhood was, but this does not account for the problems I have now. I am able to accept what happened in my childhood and I am able to disassociate from it in a healthy way, so my childhood can't possibly be, entirely anyway, the reason I am the way that I am in the present. Obviously something else, a catalyst of some type, has contributed to these feelings of anxiety, vulnerability, and also to my depression. I have been going over my life, as if it were a timeline, scrutinizing every aspect of it. This is currently a work in progress but there are a few things that pop out at me. The first thing, and I think the biggest, is my early career choice. Before deciding to become a psychologist, my plan was to go to medical school to become a ER physician, possibly specializing in trauma surgery. Since this was my dream, I became a Certified First Responder at the age of 16 and volunteered one evening a week, after school, for the local ambulance service. I absolutely loved it. I knew that I wanted to take things further so I contacted a local college that offered Paramedic and Advanced EMT classes, and asked if I could enroll. NY State law indicates that a person holding this type of a license must be 18 years of age. I actually ended up getting special permission from the State to take this class over the summer when I was 17 as the test date was 2 days after my 18th birthday. I ended up getting accepted. I continued to volunteer for a while but soon I was hired by a commercial ambulance service that covered three of our local cities. I went from working under another person, to working by myself. Even though I was very young, I was damn good at what I did as I took my responsibilities very seriously. During this time, I not only was working full time (nights and weekends) I was also going to school full time during the day in pursuit of my bachelor's degree. I had a mortgage I had to pay so I had no choice at this point. I would get off duty at 7am, go home and change, grab a coffee, and drive 30 minutes to get to my classes.

Okay, this is all fine and dandy, but what happened to me? Through working with this commercial agency, I witnessed a lot of things that I don't think I was ready for. I was still a teenager when I started this and I was not prepared for the reality of life. I always thought that my situation as a child was something that I could escape and that as soon as I did, life would be peachy and there was an entire world out there full of peace and happiness. Boy was I wrong! I witnessed a 15 year old being shot and killed, a child who was brutally abused by her father, a 18 year old that had his head smashed in by other teenagers with a baseball bat...I could go on forever. During this time I developed a skill that allowed me to detach myself from these situations, so they wouldn't bother me. If the calls were really bad, we would have a mandatory debriefing where support staff was brought in, but I would never attend. I figured that the sooner I could forget about it, the better off I would be. Wrong again! There was one call in particular that I believe sent me over the edge. I won't go into gory details but it was a car accident that came in 20 minutes before I was set to go off duty. It was at an intersection, not too far from my house, and it happened during the morning commute. Again without going into great detail, a small compact car was t-boned in the driver's side. Driving that car was a man who was on his way to work. Because he was trapped in the car, we had to wait for the fire department to extricate him. I ended up crawling in the backseat to assess him while they did this. During this time, we had a nice conversation about how his daughter was getting married in two weeks and how excited he was. I was trying like hell to get a blood pressure on him but I couldn't. Our medical helicopter was enroute to the scene as we didn't want to take any chances. I kept trying to get his BP but I wasn't getting it. At this point I knew something wasn't right. He started complaining of being nauseous and soon became confused. The fire department had finally freed him and we started to get him onto the backboard. The minute we laid him down his eyes rolled back and he went into cardiac arrest. Because of this we had to transport him to the local hospital. We tried like hell to get him back, but we just couldn't. When we got to the ER his family was already there as one of the cops on the scene went and picked them up. There was his wife, son and daughter just starring at his lifeless body as we brought him through the door. I was still doing CPR at this point but as soon as we got him into the trauma room, the ER doc called it. It was over. As I walked out of the room his wife collapsed and his daughter (the one that was getting married in two weeks) got sick. I have worked many cardiac arrests in the past, but they never bothered me like this.

It was on this particular day that I realized that we have no control over our lives, and anything can happen at anytime. Just like this man, you can wake up one morning to go to work and get killed on your way. When my husband leaves in the morning, that could be the last time I ever see him. You just never know. It was on this day that I became obsessed with trying to protect everything around me. If life wasn't going to protect these things, then I had to. I don't have much in my life so I make myself crazy trying to make sure what I do have stays with me. Throughout this fertility journey I have struggled to gain control, but I have failed at this, as realistically, it is impossible to do. The part that makes this tough, and has also contributed to the way that I am, is all of the losses and my inability to protect my babies. Every once in a while when I am laying in bed at night, images of the ultrasound with the little fluttering heartbeats fill my head and I can still hear the sound of those beautiful hearts beating. Realizing that all of this is gone, the fear kicks in that I will never have this again. Or what if I do, only to have it taken away time and time again? Everyday I read this quote by Walter Anderson to try and put things into perspective:

"I am responsible. Although I may not be able to prevent the worst from happening, I am responsible for my attitude toward the inevitable misfortunes that darken life. Bad things do happen; how I respond to them defines my character and the quality of my life. I can choose to sit in perpetual sadness, immobilized by the gravity of my loss, or I can choose to rise from the pain and treasure the more precious gift I have--life itself."

Tuesday, September 6, 2011

Ugh!

Today I went in for baselines. As usual my uterine lining looks like crap. It was at a 3.48 but it is really odd looking. The fundus is where all the thickness is but as you move down towards my cervix, it looks like a little tale. So to help you visualize this, imagine a sperm. My uterine fundus is the head and everything else is the tail...definitely not normal. I also have a couple of cysts but since my E2 was at 53 they are assuming that they are non-functional cysts and that they will not interfere with this cycle. Another concern is my LH and FSH. My LH is low at 0.38 and my FSH is extremely low at 0.6. Last cycle my numbers were similar but we thought that they were like this due to the meds (Ganirelix and E2V) taken before baselines. This cycle now shows us that this is not the case. These types of numbers indicate that something is messed up with my pituitary gland and/or hypothalamus. If I wasn't going to do a medicated cycle, chances are that I would not ovulate on my own this month...my numbers are just too low.

Despite all of this we are moving forward with this cycle. As I stated before, I am done with IVF so this will be an IUI cycle. I will be taking 5mg of Femara CD3-7 (starting tonight) and then I will take 150 Follisitm CD8-12 (or trigger.) In addition to these I will take 250mcg Ganirelix, baby aspirin, 10mg Prednisone, and DHEA. The only change that we are doing is in regards to my IvIg. Normally I get 30g IvIg every 30 days but we are bumping it up to 60g. Since 30g takes 3 hours to infuse, it would take 60g 6 hours. Since they don't want to torture me I will have 30g on Monday and 30g on Tuesday. Since we are not sure what we are dealing with, it has also been decided that I will need to continue with this schedule until at least the 20th week of pregnancy...if I ever get pregnant again. Why can't this be easy?!?!

Sunday, September 4, 2011

Difficult Times

I have never been one of those people that refused to associate with pregnant women or carried around anger and hatred towards those that are pregnant...and I am still not. However, yesterday was a very difficult day for me...something that I wasn't prepared for. I had a shower to attend for my husband's family and was surrounded by many women who I did not know. Things were fine up until the point where I started to pay attention to my surroundings. I was surrounded by mothers and their young children....many of them. I couldn't help but to watch the interactions between them realizing that I should have had this a long time ago. If my first pregnancy would have worked out, my child would be almost 14 months old. I just tried to ignore it but soon I felt myself becoming overwhelmed. All I could think about is how there is a good chance that I may never have this. If my body has killed 5 pregnancies, what is going to prevent it from happening again? I never imagined that this type of a situation would bother me, but it did. I was not angry or hateful, I was jealous. Along with these feelings of jealousy and envy was complete hatred towards myself. The one thing that I was put on this earth to do, I am a failure at. Why does there have to be something wrong with me? I ended up leaving early and walked out with my husband's family as they had other commitments so they could not stay for the whole thing. I was so focused on not crying I honestly don't even remember saying good-bye to them. The minute I got into my vehicle and closed the door, the tears started to flow. I ended up crying the entire 45 minute drive home but was proud that I was able to hold off as long as I did.

My biggest fear right now, as I mentioned before, is that this is never going to work out for me. I can't help but think that my body is going to destroy every single pregnancy, never giving me the chance to experience motherhood. People tell me not to think like that (virtual middle-finger is currently erect) but when that is all I know, it is hard to think any other way. Since I don't know what the outcome of any of this will be, my husband and I have made a decision. We are officially pursuing adoption. We have our appointment on September 30th to start filling out the paperwork. The agency we have chosen is amazing and I will talk more about them in another post. Before we can even be on a placement list, we have to undergo a NY State Home Study which can take anywhere from 1-6 months. The Home Study and application fees are about $2000 and that is all we would be out if we weren't accepted (which I don't think would ever happen.) The agency fee (which is the largest fee) is approx $20k and this covers just about everything but my attorney fees and the attorney fees for the Birthmother (which I would be responsible for.) We also have to pay $5000 for advertisement and this includes a profile book  and an Internet profile which is shown to Birthmothers so that they can choose a family to work with (this is how they select us.) The nice thing about this agency is that if the adoption falls through, either pre or post placement, we are refunded the placement fee. Very few agencies do this and will actually keep your fee is the Birthmother changes her mind. The other really nice thing is that the placement fee includes medical expenses and housing for the Birthmother which is required by law. Other agencies will actually make you pay directly out of pocket and the fees are not refundable if the Birthmother decides against adoption once matched. There is a lot to this and I will dedicate an entire post to it later this week.

On another note, AF has finally arrived. I have an appointment to go in for baselines on Tuesday so I will know then whether or not this cycle is a go. The only thing at this point that will prevent me from doing a medicated cycle would be cysts. I am a bit nervous about this but I am hoping that since AF was a week late, that my body had enough time to rid itself of any cysts. If there are cysts, we will be doing a natural cycle...something we haven't done in over 2 years!