My Money's Worth

I didn't receive any new news or shocking revelations yesterday at the appointment with the doctor. He still holds true to wanting me to pursue a gestational carrier and do IVF. He's wanted me to do this since day one.

He pulled out the scary statistics once again (thankfully, he has them secured in my chart so he can conveniently flip to them should I get too hopeful and he feel the need to reign me in) -- a 30% live birth rate from some study in 2005 and then some seven-year-old, outdated study from Finland where they studied a whopping 8 people and only got a 5% live birth rate. To his defense, he didn't put much stock in the Finnish study -- something about low pregnancy rates and them drinking a lot of vodka over there anyway. But I digress.

When we first walked in, we sat down and I pulled out my notebook full of questions and after some small talk, I fired away. One after another after another. Let's just say I got my money's worth. My husband was mortified after about 45 minutes of it, but I was paying him for every minute he sat there, and after everything I've been through, what happened with my last cycle and the money I've spent at that place, I deserved to have every question answered. And I didn't feel one bit bad about it.

My first question? What happened with my last cycle. "You have a hair-trigger ovary. They were slow to respond at first because of the PCOS, so we kept the dosage higher, but then they took off and we couldn't reign them back in. You'll make a lot of eggs for IVF and your ovaries are good, it's the PCOS that makes ovulation induction hard." At that explanation, I was good to move on. It's in the past now.

We talked about the UU at length again. I asked him about why he thought the tube was bad. He said there's no way to tell, but that because the uterus forms from the fallopian tubes and the fact that my uterus is malformed and is a birth defect makes them suspect something is also wrong with the tube.

I decided to go on glucophage to help me ovulate, so we talked about that and then after a while he stopped me and brought me back to the IVF and GC as to what he believed should be my main focus. I thanked him and he gave me a BBT chart and told me how to use it to track ovulation while on glucophage. Yeah, I think I know how to use one of those by now considering I AM AT A FERTILITY CLINIC NOW AND ALL, but thanks. I used those back when TTC was fun.

Aside from all of this, the RE is such a darn nice guy. I must say I appreciate him not wanting me to have a loss and seeming to look out for our best interests. I just don't want to hear it. I admit it. "You're not here for a pregnancy. You are here because you want a baby to hold in your arms at the end of it." I know. But I want both.

After promising to fax my charts to him and come in for an ultrasound with my next period to check on cysts, I gave my nurse a hug and we left.

Immediately after, we went to eat at a very well-known fast food restaurant here in the South and as we were sitting there, I just had the strangest feeling that he was going to walk in there. Guess what? Yeah, he did. He came over and we talked about his addiction to said place's chicken sandwiches. Can you say, awkward? We went from talking about my "birth defect" uterus to chicken sandwiches in under an hour flat.

Good stuff.

Well, that's it. We aren't sure what we are going to do next and don't feel the need to know right now, but taking a break, living life and letting God be God sounds pretty good to me right now. I must admit, I am so relieved.

A Respite

Well, tomorrow is our final appointment with the clinic for a while. It's such a strange feeling. I am excited to be through with going there all the time and being poked and prodded. I'm glad I won't be on the constant emotional roller coaster you stay on when in the midst of treatment -- wondering how many follicles I will have or won't have, stressing about them growing or not growing, hoping they are on my "good" side, stressing whether my husband will be in town for the IUI, etc. I'm also looking forward to people not asking all the time about what's going on and knowing the details of my private life. I am looking forward, in that sense, to fading into oblivion again -- just like everyone else. Oh, for one day for someone not to ask about my infertility. Believe it or not, there is more to me than that. Infertility is NOT my identity.

While I'm glad for a respite from all of this for a while, I'm also sad. I have to admit I like knowing what side I'm going to ovulate from and when. I like that my cycle has been monitored so that I know what is going on at any given time. And I love how my cycles have become increasing shorter (21 days this past time) because fertility treatment tends to speed them up for me. Even though I've had all "no's" during treatment, time seemed to go by faster because I always felt that I was doing something. By the time you get your period, it's almost time for cd 3 ultrasound, and then you are taking drugs. By that time you're done with that, it's another ultrasound, then an IUI shortly after and a week after that, a progesterone check. Because you stay busy, it goes by faster. So, I'm sure after all this, one cycle on my own will seem like an eternity, especially because of the PCOS.

I have a ton of questions for the doctor tomorrow. I can't believe I'm walking out of there with no pregnancy after all this. When I started with them back in March, tomorrow was the day that I feared -- a conversation and meeting because it didn't work.

Having IVF out there as a potential next step in the future has given me some hope. I plan to ask about it tomorrow.

My cycle started Wednesday, 3 days after stopping the progesterone, and only lasted 48 hours. I also had no PMS symptoms at all -- not even any cramping. The RE said to expect a heavy period, but instead I got the lightest period I've had in a long time despite the Follistim. Strange.

Until tomorrow...

Starting to Come Out of the Fog

"It is awfully hard to be b-b-brave, when you're only a Very Small Animal."

- Piglet

The last reminders of this past cycle are beginning to fade. I finished my progesterone last night and the lovely Follistim bloat is finally starting to go down. So, I got the side effects of Follistim and none of the potential benefits. The only thing left to officially finish out this cycle is the exclamation mark of a period.

I have been showered with love from so many over the past week or so. Both strangers and friends alike. I am blessed to know eight women off the top of my head who are either walking the infertility road with me right now, or have walked it in the past. I work with most of them, so on any given day, I can walk over to their cubicle and cry if I need to. The day before my cycle got cancelled, one of them offered to walk outside with me and just listened to me. Two of them go to the same doctor I do. I meet with three of them two Mondays a month to talk and pray together. My boss also went through infertility at the same clinic, so I've never had to stress about missing work, which has been one less thing to worry about. She gets it. The day I was going to get the verdict on the cycle (AKA The Doomed Friday), I got a text message from another one. I got cards in the mail. Another fertile friend teared up when I gave her the news. She had been praying for me all week. My sister lost sleep over me. I'm very blessed.

Today, I went over to an old co-worker's home for lunch. She didn't struggle with infertility, but she has walked this road with me and is the most compassionate person I've ever met. She just listened and let me cry. And she hugged me long and hard. It felt so good to be hugged like that and to not have to apologize for any of my tears.

I realized this week how incredibly blessed I am that I don't have to walk through this pain alone. If there is any silver lining to this trial, it's that I was reminded of how God graciously placed these people in my life. He didn't expect me to walk the road alone.

I told my husband last night that something just doesn't feel right about moving -- moving out of this house and moving on with life. And not in the sense that it's not wise financially or anything like that. It just doesn't feel right. I feel like I'm leaving my heart somewhere else and my body is moving on with life.

My husband said we are going to do better if we embrace this and surrender and move on. I agree with him. But while I embrace it, I'm also grieving it, all at the same time.

I know this is not the end. I'm not giving up. IVF is still on our radar possibly one day. I guess I'm just grieving this part of the journey -- that the treatments we've tried thus far didn't work. I have much to be thankful for with nothing else visibly wrong other than PCOS. As confused and upset as I get, I'll never give up hope.

Never.

I think it's the human condition.

Thanks to all those who have commented on my blog too. You guys have encouraged me more than you know.

Still Reeling

I spoke with the nurse yesterday morning. She called me first thing Monday after I left the message on Friday afternoon.

After asking me how it was going and I was silent for a second, she offered, "Are you devastated?" I explained to her that, yes, I was absolutely devastated. In a very polite, honest, real tone, as if talking to a friend, I just explained everything to her. I didn't hold back. I explained to her how this was our last cycle, how frustrated I was to have spent $2400 dollars and not to have even had a chance, how we drained the last of our savings to do it, and how ironic it was that the fertility doctor was telling me to stay away from my husband. I told her that I didn't understand what happened from Thursday to Friday for the doctor to have changed his mind. She explained that she didn't think he thought the smaller follicles were going to grow like they did. After reading him the sizes over the phone she said he was like, "Wait, how many?" and knew by the tone in his voice that he was going to cancel. She said she was thinking, "You're not even going to give her a choice?" and that she told him he was going to have to call me. She didn't want to do it. "I am so, so sorry," she said.

She is a great nurse and I hope I didn't go overboard -- I don't think I did. But I just needed to feel heard and for them to know that beyond that medical chart of numbers and levels and ultrasound pictures, there is a real person who was effected by the news and decisions made and will be reeling from it for a long time. I know they know this, but I wanted her to hear the heartbreak and be reminded of the casualties that they might have become callused to by seeing this and having to do this every day. There was just no way I could put on a happy face and pretend I wasn't effected by it, with a "you win some, you lose some" attitude and talk about the logistics of the progesterone script I needed her to call in. There was no way.

We made a follow-up appointment for a couple of weeks from now where I'm sure I will have 101 questions. The first being, you guessed it, "What the crap happened?"

In other news, the pharmacy graciously agreed to take back my Ovidrel if I promised to keep it refrigerated over the weekend. As I was driving back to the pharmacy, I just cried. It wasn't fair that I was having to do this. It wasn't supposed to be like this. On top of it all, the pharmacy is right near the doctor's office, so all of the events of last week came flooding back over me. Just one week before, I was at this office complex, full of hope and excitement, and just like that, it was all over. Just 10 days prior, I had a phone conversation regarding starting this doomed cycle with the doctor in the parking lot of the same pharmacy as I was walking in to buy Follistim to start my cycle. And now, with returning my Ovidrel, I was officially ending this cycle in the same parking lot. I guess you could say it came full circle.

It's amazing to see what kind of drama you can literally buy yourself in just 10 short days.

I am back to work tomorrow after taking a couple of days off for my mental health and the always delightful sinus allergies.

I promise my posts won't always be this depressing. ;-)

Canceled Cycle, Canceled Dreams

William Parrish: It's hard to let go, isn't it?
Joe Black: Yes it is, Bill.
William Parrish: And that's life... what can I tell you.
(From Meet Joe Black)

I'm just angry today. I'm angry for what happened; I'm angry that I was given so much hope; I'm angry for the way the cancellation was handled and I'm angry that at a time when I've never been more fertile in my life, I can't even try.

I'm angry.

Call it going through the stages of grief or whatever you want, but I'm just ticked off.

Re: Being more fertile than I've ever been, and can't even try. Isn't this ironic? I paid this clinic to help me have a baby, and the fertility doctor tells us to "stay away from each other." Is there something not messed up about that statement? I really wonder how much good they really did for me. It's just ironic to me that the things they have done for me have actually inadvertently caused me to not even have a chance at pregnancy because its caused me to have to go on birth control and have cycles canceled thereby preventing pregnancy.

Another reason this has been so hard to take is that for us, it not only was a canceled cycle, it was the end of the fertility road for us. That phone call changed the direction of our life.

I live almost 40 miles from my job. I spend 3 hours a day in traffic. I wake up at 4:45 a.m. each morning to get a head start on the morning commute. I have done this for 2.5 years with the hope and plan that I was doing it for my baby -- for my children. I have always planned to be a stay-at-home mom once I had children. In order to do this, we needed to stay in this house. I've always been a responsible, type A, first-born planner. I've always done the "right" thing. So, I've stuck it out, praying that something would give and all this sacrifice would pay off. Instead, I just got more pain.

We decided that if this cycle didn't work, that we would have to move closer to my job. It was kind of like a fleece that we put out there. I just can't do it anymore, especially with no child in sight. I love what I do, and can't imagine working anywhere else, so it's the thing to do.

So, the little room in the front of my house that I dreamed I would decorate for my first baby -- the one that I've walked in for the last 2 years daydreaming of what color I'd paint the walls, won't be my nursery after all. And it just sucks.

That's why that quick phone call was so jarring. It was more than just a canceled cycle, an isolated event, to me. It signaled a shift in our life, and one that I don't want to embrace right now.

Because it means I didn't get my baby.

That's all folks

WARNING: Follistim; May cause heartache.

One side effect the manufacturers of Follistim failed to warn its consumers of in the fine print was potential heartache.

My cycle was canceled today. Canceled. Over $2000 dollars in since my period started 10 days ago, and arms and a stomach that resemble some sort of junkie, it's over.

My ovaries responded too well. I had at least 10 mature follicles and 17 on the board total and an estradiol level of over 4200 today. Yes, you read that number correctly.

The past 24 hours have been quite the roller coaster. At 3pm yesterday, I expected him to cancel, so when he made no mention of it and was telling me the risk was minimal and that things were looking great, I was walking on air. This morning, the nurses were so excited for me, "I think you should definitely do it," and on my way out said, "We think you are going to get pregnant this month!"I was so hopeful and had a smile on my face as I headed to the pharmacy for the Ovidrel trigger shot. Needless to say, when 3pm rolled around and I hadn't heard from the clinic on when to be there for the IUI and the final okay to trigger, I was a little concerned, but not exactly mentally prepared for what 3pm today would hold.

At 3pm, I was starting to get nervous and when the "unknown" caller came up on my cell phone, I knew it was the doctor and if it was the doctor, it only meant one thing.

In a very rushed, quick, CYA phone call, he said,"B? This is Dr. S. Well, girl, we're going to have to throw in the towel. It's just too risky. You've got 10 mature follicles and your estradiol is over 4200. You've fought the good fight, and it was valiant effort, but we just can't do it." Gulp. I honestly thought he was joking with me at first -- that he was going to tell me he was kidding and when to be at the clinic because of the quick, flippant manor he told me the news in, especially after he was so upbeat yesterday. I was blindsided.

Stunned, but still coherent, I asked him a few questions. It's all quite a blur and especially what with the two other phone calls he had in the midst of our quick conversation.

"Your ovaries work, we know that. If I were to do this again, I'd start you at a lower dosage..." I explained that we weren't doing THIS again -- that we were done unless we do IVF someday.

"I'll probably advise putting you on birth control through the holidays."

Great. You're a fertility clinic right? You help people get pregnant, right? Then how come most of the things you've done for me have caused me to have to go on birth control which prevents pregnancy or given me too high of dosages of drugs causing me to cancel cycles? I think I might have done better on my own. Thanks.

I told him I was heartbroken, but I understood and didn't want a tragedy, and he replied with some medical babble about it not being about being heartbroken, "but that with elective medicine, we have to be responsible," blah, blah, blah.

I know that, dude, but your quick check-it-off-my-list-I-cancel-cycles-everyday phone call just effectively ended my fertility journey and inadvertently broke my heart. When you get off the phone with me, you'll forget about me and my cycle -- another casualty in the field of infertility. I know it happens every day for you. But not for me. I had all my hopes and dreams wrapped up in this last cycle. I bet the farm, gave up my vacation, and drained my savings on it. You can't just call me and flippantly tell me this and expect me not to be heartbroken -- to just look at it medically.

After telling me to stay away from my husband for a week, and that he was going to have the nurse call me in progesterone to end the cycle and that I needed to start it by Saturday night, he got another call.

"I've got another call. I need to go." Okay.

I said goodbye and just sat stunned in some fixed gaze, reeling from what he had quickly just told me, trying to process it all.

To top it off, the nurse never called, nor did they answer the phone so I guess I won't be starting any progesterone this weekend. I feel so unsettled. I know they cancel cycles every day, but I don't have my cycle canceled everyday, and it hurts.

I have so many things rolling around in my head to write, but I'll save those posts for another day. Right now, I just want to go to bed and pretend this day never happened. I can't stop crying.

"Busy Becca"

Right ovary: a bunch
Left ovary: a bunch
E2: Soaring!

Yeah, let's just say the nurse called me "Busy Becca" when she came in this morning to give me my follicle report. I have a ton. Thank you, PCOS.

It has been a very tense couple of days. I knew this process would be intense, but not this intense. I have been in the fertility clinic every morning this week since Monday, and tomorrow will be no exception. When you're on this strong of fertility drugs and when you have PCOS like I do, you have to be monitored very, very closely.

Yesterday, more follicles came on the board and then today, even more. The good news is I have a couple of lead follicles, and the ones that are small and have recently come on board, probably won't mature and release. I was scared to death that we were going to have to cancel because of having so many follicles. I was almost in tears this morning. To have spent this much time, effort and money without being able to complete the cycle would be devastating.

This ovulation induction business is such a game. I go in each morning at 8am for an ultrasound and blood work. In the afternoon, the nurse calls me and tells me what the doctor wants to adjust my dosage to and what my E2 level is. I have done that each day. This morning, however, the nurse said Dr. S would want to talk to me at this point. I walked out of the ultrasound room absolutely thinking they were going to cancel the cycle.

I was catatonic most of the day, staring at my computer screen, trying to get some work done, and keep it together. I was sick to my stomach and emotionally drained, bracing for the worst.

The doctor called me at 3pm and said that he felt the risk was minimal of multiples (what we're afraid of), that things were looking pretty good and to dial the dosage down to 50 IU and come back in the morning for more blood work. The game I was talking of before is trying to get the bigger follicles to still grow and hoping the smaller ones don't catch up.

He told me I was a "very brave little lady" and that "he was proud of me for sticking it out so long." Again, a fabulous, compassionate doctor. I'm very lucky.

Physically, I just feel strange. I know exactly where my ovaries are -- I'll tell you that, and my emotions are all over the place (thank you, Follistim). My E2 level was high, but the doctor said that was the PCOS speaking. And, I think they've run out of places to draw blood from me.

I'll know more tomorrow.

CD 7

Right ovary: 1.2 cm, 1.0 cm
Left ovary: 1.1 cm, 1.0 cm
E2: 1222 (Yikes!)

I'm to keep dosage at 100 IU and return tomorrow. Nurse said not to worry about E2 yet.

I feel like a stuck pig. Nurse tried to stick me in left arm and that didn't work, so I got stuck again in the right arm. My arm is bruised and I'm running out of spots to get stuck. Between the shots in the stomach and the blood draws from my arms, I look like a flippin' junkie. I have marks everywhere.

Do people really get pregnant without getting ultrasounds everyday, giving themselves shots and spending thousands of dollars? And to think I used to think OPK's were expensive and inconvenient. Sheesh.

CD 6 of IUI #3

My ultrasound this morning revealed 4 follicles at .9 cm on my left and 1 follicle on my right at 1.o cm and another one at .9 cm. Everything else was small.

The nurse called me a little while ago with my E2 level. It is 766 which she said was a little high for cd 6, so I am to reduce my dosage to 100 iu and go back in the morning.

More tomorrow...

Dial it up, baby! (The Follistim that is)

The nurse called earlier and said my E2 levels were fine and that the cyst appeared to be on its way out. They see these all the time and it will be fine.

I spoke with the doctor this afternoon. I got him right before he leaves for vacation for 2 weeks. I was in the parking lot of the pharmacy when he called getting ready to drop the money for the very expensive Follistim.

I'll tell you, my RE is the nicest, friendliest doctor I have ever met. His bedside manner is second to none. When he called, he said, "Becca? Hi! This is your friendly neighborhood doctor!" We chatted about his upcoming vacation and he later asked me what I was doing this weekend. What a nice guy. The other thing I like about him is he is very honest.

I began the conversation explaining the cyst. Not having my chart in front of him, I figured with hundreds of patients, he would need me to review. But he didn't. The man has an unbelievable memory. I remember one of the nurses telling me one time it was like photographic. Not only did he remember the huge cyst, he remembered the exact size it shrunk down to and that he had put me on the pill last month for it.

He basically told me that he wasn't concerned about the cyst. He told me if the cycle didn't work, he wouldn't attribute it to the cyst -- he would attribute it to a tubal issue. He thinks that the reason nothing has worked so far could be because there is something functionally wrong with the one good tube I have. He's told me this before. Yes, the tube is open and looks good, but it must do more than just be open. It must "squirt stuff" and be able to move the egg down the way to the uterus. It's something that they can't test for, though. There's just no way to be sure. So, it's an educated guess.

He said it was so much money to do an all injections, and said he'd almost tell me to just do IVF and bypass the whole tube mystery. I explained it would be a while before we could do IVF, so he agreed that it was worth a try.

So, we're going to do it. Guns blazing, full force, give-it-everything-I've-got -- here I come. I am determined to have a positive attitude.

I started with Follistim 150iu and will continue through the weekend. Monitoring on Monday morning.

What To Do?

I started my period yesterday (finally!) and had my ultrasound today. Dear old cyst is still there, but dramatically smaller. It went from 5.3 cm to 1.4 cm. Not bad for a months time, I guess.

So, a nurse came in who isn't my normal nurse and took my blood. She couldn't find a good vein, so I offered the other arm. It hurt so badly -- not the initial prick, but as the blood was coming out. Then, she gave me a piece of paper with my cycle instructions on it, and I was like, huh? I told her that this cycle was all out of pocket and I was concerned about the cyst. She told me Dr. S would look at the ultrasound picture and blood work and absolutely give me his opinion on what I should do -- that he wouldn't tell me to do it unless he was really confident about it. She thought it would be fine because it was so small. So, I didn't get to see or talk to the doctor and I left frustrated because I had no answers on what to do.

The nurse called me back at 4:45 p.m. and said Dr. S looked at the ultrasound picture and said, "Boy, this looks a whole lot better than it did." She said he looked at it for a long time and said he absolutely thought I should go ahead and felt very confident that it would be fine. She told him I wanted a "perfect" cycle and he said unless the blood work comes back strange, we should move forward. SO, I was really happy that she called. I'm going to wait to hear on my blood work and then ask that the doctor call me so I can ask him a few questions and be assured of moving forward.

So, if all goes well, I'll start injections Friday. 13 follicles on the left ovary, 11 on the right.

Let the party begin.

Waiting

Well, I finished the birth control Friday and I am still waiting for my favorite friend to show up. Ugh! It's coming, very slowly. I mean very slowly. I'm really anxious to get started with the injections. It's funny how when you want your cycle to start, it stalls. What torture.

I have been taking the Omega Complex for about a month now, so that's good. Kate -- did you end up having good luck with it recently?