Rinse, Repeat

Crazy

I wish I could imbed the Official video...

Truthfully, I don't think I've ever had PMS, or it was so long ago that I don't remember what it is like. This is logical considering I don't menstruate and my progesterone levels have proven to be low. However, this doesn't get me off the hook. This means is that I can't blame any of my bitchiness on PMS. No scapegoat for me. Yep. I can be a bitch. For no reason at all (I'm sure I feel like there is a good reason at the time, but there usually isn't).

I'm sorry.
I'm sorry about doubting the power of hormones and subsequently PMS. Whoa! I've been humbled during the infertility process and I am in awe at how intricate and amazing the human body is and what a delicate system it is. One deficient chemical and the whole baby making process fails. I am in awe yet again.

Lemme splain.

After the IUI, Dr. K. put me on 200mg Prometrium twice a day to keep my lining thick for implantation. Progesterone is an enigma...or maybe snake oil. Take your pick. I've read that it causes cancer, prevents cancer, treats menopause, initiates menses, prevents miscarriage, controls PCOS, clears skin, treats migraines as well as PMS. Some people have a wonderful time on progesterone. It increases their sex drive, helps them sleep, improves their mood, etc. However, progesterone has a dark side for some people... irritability, bloating, depression, dizziness, shortness of breath, headaches, anxiety, and on and on and on....

I've reached a whole new level of crazy with Prometrium. The dose may be higher than what an average woman produces, but nonetheless I feel like I have some serious roid rage of the Incredible Hulk variety. Throwing the fridge off the balcony kind of crazy.

Thankfully I am aware of it and don't act on theses urges, but it is incredibly frustrating to be so angry for no apparent reason. Poor Ryan. I've found I start to feel better when I talk it out, but I'm sure my rants are not fun for the listener. I try to keep myself in check and if I feel the hot rage bubbling up I try to keep my mouth shut and seek some solitude. Sometimes I think the self isolation makes the frustration even worse, but I don't know which is better.

If it turns out I am pregnant (test is this Sunday) I am supposed to keep taking progesterone for 8 more weeks! I don't know if I can handle 8 more weeks of crazy, so I called Dr. K. If I am pregnant we will reevaluate my natural progesterone levels and hopefully reduce the dose...if we can.

You might want to include Ryan's survival in your prayers for us.

Do you think Ryan would get me a Great Sword for Valentines Day?

Beautiful Sunday

Hey, hey, hey it's a beautiful day...

The ultrasounds this morning looked promising with one follicle at 20mm, two at 16mm, and another at 15mm (we want them bigger than 14mm). My blood test showed that I'm not "surging" which means I'm not ovulating on my own. My estrogen levels are good, but for what ever reason my progesterone and LH are still low. This is probably why we have fertility problems. Maybe I'm able to create follicles, but I don't surge. My lining is 12-14mm (we want at least 7mm). It's nice and luxurious...perfect for a little blastocyst to snuggle down into. :)



Instead of my daily injections, tonight at 10:30pm I inject HCG to make me surge. Our IUI is scheduled for 9:30am Sunday morning!

Keep crossing your fingers, sending energy, and saying prayers!

If at First You Don't Succeed...

We are trying again.

Since my previous round of Clomid and IUI didn't succeed and I had significant visual side effects, I can't continue to take Clomid. Following an ultrasound which showed a lot of small follicles and a blood draw for my estrogen levels, Dr. K prescribed Follistim. Things looked pretty good so Dr. K gave me to "go ahead" to start daily Follistim injections at a low dose of 75 IU. The injections really aren't bad. The sticker shock of $600 for two vials was MUCH worse.

After 3 days I went back in for another blood draw to check my estrogen levels. Too high, too high! Dr. K explained that women with PCOS have a very narrow therapeutic range with FSH injections and even a small amount can over stimulate the ovaries. If they are over stimulated the chances of becoming another octomom go up and so does the risk for Ovarian Hyperstimulation Syndrome (OHSS)...which can be, but is rarely deadly. Yikes. We toned it down a notch and he had me reduce my injection amount to 37.5 IU each day for the next two days.

Today I went back for another ultrasound and estrogen level check. What we want to see are a few big follicles instead of a lot of little follicles. Yay! I have 2 follicles that are right where we want them and 2 more that are nearly there. That means I possibly have 4 follicles...or eggs (if they all release) that could fertilize and implant. Exciting! Although I DON'T want quadruplets or even triplets, it is exciting to know that my ovaries are doing what they are supposed to be doing! I have hope for this round. Honestly, with the last round I wasn't too hopeful since my lining was so thin, but this time I have 4 follicles AND my lining is thicker!

For the next 2 days I continue with the 37.5 IU injections and go back in for another blood draw and/or ultrasound on Friday. If things still look good then I will inject HCG to create a LH surge and do the IUI on Sunday! Looks like I might have enough Follistim for another round at this low dose. I wonder what the shelf life is if this round works. Hmmm....

Keep your fingers, toes, and eyes crossed! Say your prayers and send your energy!

Please and THANK YOU!

Don't Stop Belizing!

Yeah, yeah, yeah. I know this is a little late coming, but I guess I wanted to brag a little bit about our Thanksgiving vacation to Belize.

We put fertility treatments on hold and took a precious two week vacation that was long overdue. I have been bugging Ryan for the last year to travel or go backpacking but apartment managing makes it tough (nearly impossible) to go anywhere.

We met up with my sister Erin, her husband Dave, and my mom and step-dad Richard in San Pedro on Ambergris Caye. San Pedro is small...very small...verging on tiny. So it was a little funny when we got off the boat to find taxis lined up offering to drive us 2 blocks to the airport, hotel, or store. I'm not so lazy that I can't walk a little. At first it was annoying, but then I started to feel sorry for them...awful actually. I don't know if any of you suffer from this, but I have this unnatural sense of guilt when I feel others are struggling. I could probably go broke from panhandlers, tipping waiters, etc. We spent the next few days scuba diving, hitting the karoke bar and stuffing our faces with lobster quesadillas, tortillas and coconut shakes.

Sunrise

Catching a few more z's before hopping on the dive boat

I love Ricky's hat

Sharks, RN!

The Blue Hole

Notice all the coconut shakes?

I forgot the name of this game, but essentially if the chicken poops on your number you win!
If you shake the chicken and blow on it's bum helps make it poop...so they say.

Our next stop was San Ignacio to visit the ATM cave where ancient Mayan offered food and human sacrifices. Then it started to rain. And rain. According to the locals it was a mild rain, but to this Utah native it was a downpour! All of the rain made it too dangerous to go into the cave since it is a "wet" cave where you have to swim in many spots. Boo! We hedged our bets hoping that the rain would stop within the next few days so we could venture into the cave. While the rest of my family took a bus across the border to Tikal (Guatemala), Ryan and I visited a near-ish dry cave with Mayan artifacts. We were hoping to do some cave tubing, but those caves were flooded too. Instead we headed to a cenote for a swim (Ryan) in the roiling brown water.

Mmmm! Termites taste like carrots!

The rain didn't stop, so we all pitched in and rented a car which cost about the same as all of us paying for bus fare and would give us more freedom. We drove nearly all the way back to Belize City to go zip-lining. It was so much fun flying through the trees. I wish L.A. offered zip-lining as a form of alternate transportation.

Rio Frio Cave

Rio on Pools

The rain lightened, but it didn't stop. We took the car for another day and drove to some waterfalls, swam at Rio on Pools (my favorite), and hiked through Rio on Frio cave. The rain had pretty much stopped, but my family was scheduled to leave the next day and it looked like we wouldn't be able to see the caves. Boo! As luck would have it one of the tour operators did a special 6am tour into the caves just for us! The water was still high so we had to do a lot of swimming. The cave was better than I remembered.

The Crystal Maiden

We made it out of the caves with time to spare to have lunch before saying our good-byes. Ryan and I headed back to San Ignacio and visited the Iguana zoo. Some locals have a taste for iguana eggs and meat and the population has suffered. This zoo breads them and introduces them into the wild.



The following day we took the bus to Placencia, a small beach town on a peninsula in the south. We did a couple more dives and spent Thanksgiving and the rest of our trip lounging around on the beach, eating loads of tortillas, gellato and lobster. Our dive master took us lobster fishing and cooked us up tasty curry lobster quesadillas. Mmmm...

This is me

FAIL

Intrigued by the infertility process? Want to better understand what we are going through? I found a blog written by a woman going through the same process. She does a fantastic job explaining all of the details and how technical it can be. Check it out here.

Wars Waged and Battles Fought

I've been thinking about this post for a long time, and how I was going start. I'm having a hard time putting my emotions into words, and perhaps it is because it is something close to my heart.

I want a baby. I'm not talking about your usual want, like when you want a doughnut or a new pair of shoes. Sometimes I think I even NEED those things, because I CRAVE them. No, this want is deeper, a more visceral want. It's something that I ache for, my heart aches for.

My nephew Jonas Hughes

We "trying" to get pregnant, but before you start congratulating us and wishing us the best (I still need your well wishes though), this is not the usual trying. It's not the kind where you toss out your birth control and start paying attention to ovulation calendars, basal temperatures etc. Oh how I wish it were that easy!! We are "trying" with medical interventions.

Back Story:
I remember walking with my friend Sarah H. when we were 9-ish discussing what our future husbands would look like, what qualities they would have, what type of profession they would have, how old we wanted to be when we got married, how many children we wanted and the ratio of girls and boys. I told her that I wouldn't be able to have children. She looked at me and said, "How do you know?" I replied, "I just have a feeling." I wanted 6 (3 or 4 is plenty), I think she wanted 4. I really did have that feeling and it worried me. It still worries me. Was it pessimism, self fulfilling prophecy or premonition? Could I really have been that in tune at that age?

I was relieved when I finally came of age and "became a woman" at nearly 16 (16 or later, as a rule of thumb indicates abnormalities). All of my friends had come of age years earlier. I was a late bloomer by medical standards. Even after I had my first menses, things didn't go smoothly. No monthly visits for me. They were all over the place. Every so often I would have sharp pains in my abdomen. Although I didn't know what it was at the time, I could tell it had something to do with my ovaries. It felt like they were in a vice and someone was jabbing them with a large sharp needle. The pain never lasted too long so I didn't worry much about it. At 18, my general physician suggested I start birth control in hopes to kick start my body onto a regular cycle. I stayed on it for a few years and at 21 decided to see if my body had finally gotten a clue on how to do it properly.

A year went by...nothing. Not a drop.

Friends tell me that I am lucky. No cramps, bloating, I'm saving money, etc., but for me it meant I wasn't normal. I want to be normal...at least in this area.

I went to see a recommended OB/GYN. He drew some blood, did an exam and said, "Well, I think you have Polycystic Ovary Syndrome, but I can't be certain because your hormone levels are within normal limits and you don't fit the typical profile of a woman with PCOS." Nervously I asked him if I was infertile. He said, "We won't be able to tell that until you start trying to get pregnant, but I can tell you that you are going to need help. The pain you are having is probably ovarian cysts that have ruptured. In the meantime, you need to keep your uterus healthy by shedding your lining every month with birth control. It will also help prevent additional cysts from growing." A trip to the ER (to rule out appendicitis) confirmed PCOS.

Currently:

Since we've been married we haven't been preventing, and more recently we have been actively "trying". In March I saw an Endocrinologist who put me on 500mg Metformin (diabetic medication that can also stimulate ovualtion in women PCOS) every day in hopes that it would stimulate my body to start ovulating. To my excitement, I started to have breast tenderness. Was Metformin the answer? After 3 months, still no period and the tenderness went away and hasn't been back. In May, she bumped it up to 1,000mg. In June, she bumped the dose to 1,500mg and she gave me a referral for a Fertility Specialist. In July, I was taking 2,000mg Metformin but even that wasn't working. It was time to take it to the next level. In August my Fertility Specialist added 50mg Clomid every day to the mix hoping to stimulate an egg follicle to grow. For a review on how complex ovulation really is click here. After 8 days and the start of intense hot flashes we did an ultrasound to see if anything was happening...nothing. My doctor increased my dose to 100mg every day plus the Metformin. 8 more days later and another ultrasound...follicles!!! They weren't /mature or big enough yet though. They needed to double in size. We came back 3 days later for another ultrasound...no growth. He increased the dose to 150mg Clomid and 2,000mg Metformin. 8 days later and after experiencing blurred vision and tracers in addition to the horrible hot flashes, the ultrasound showed 2 follicles that had "taken the lead" and were the appropriate size and ready to ovulate. SUCCESS!!!

Hold you're horses.

That is just the beginning. Now I had the follicles, but I still needed to release the egg, have it fertilized, and hope that it it implants. To ensure that the follicles launch the eggs (I might have released 2) I had to give myself a shot. We wanted to increase our chances of success, so 36 hours later Ryan gave a sperm sample *cough* that was washed, spun down and concentrated. An hour after the sample as given, I was artificially inseminated. We had homework too. For the next 3 days we needed to "get busy".

Now we wait.

Well, I do more than just wait. I still have to take the Metformin and Progesterone in addition to prenatal vitamins. Unfortunately, higher the doses of Clomid mean the thinner your uterine lining becomes. Eggs want thick luxurious lining to nestle down into. Progesterone helps build this lining. I was on near max dose of Clomid and because of my visual side effects, I won't be able to try it again. Vision is too closely connected to the brain and they don't want to take any chances. Good thing those 2 follicles were ready to go, otherwise we'd be back to square one.

After 2 weeks of waiting I take a pregnancy test to see if it actually worked.

I'm scared. What if it doesn't work? I've tried to keep myself emotionally distant so if it doesn't work I won't be completely heartbroken. I've always planned on adopting , so I have a back up plan, but in my heart of hearts I REALLY want this to happen. I want to feel my belly grow, and feel a little person moving inside. The process is so tedious and technically structured when you can't conceive naturally. Because of this, I've realized how special and miraculous having a baby truly is! There are SO many things that need to happen just to get pregnant let alone produce a healthy child (those are a whole new set of fears). If it doesn't work, I can't promise I won't cry.

There is so much frustration with not being able to conceive. I know pregnancy can be difficult, uncomfortable, and probably down right miserable, but sometimes it's hard to listen to friends and co-workers complain about their hardships when I would give anything for the same opportunity. Sometimes I want to take them by the shoulders and shake them and say, "Be grateful damn it!" I hate to think that in my life time I've only had a handful of opportunities to conceive naturally, opportunities that I may never have again without intervention. Most women have the opportunity every month and often feel that it is a curse. I hope my lady friends pause and give thanks for the ability you have been given to be able to create life. I have to fight for that gift.

The entire process is very expensive. My insurance covers some, but not all of it. We haven't received any bills yet, and I'm a little nervous to see how much this endeavor will cost us. If it works, it was well worth it. If it doesn't we are looking at even more expensive options.

Sometimes it feels like I'm wishing for this:

When I've been given this:

I'd be happy to settle for something like this:

So today is the day. It's been 2 weeks.

I could use a prayer, positive energy, luck or a combination of all three.