Here We Go Again

Yet again, I'm going to try to get back to this blogging thing. It's time. I haven't posted much because things have been so good, but things have been stressing me out a bit lately. Travis is 10 months old now. Here are a few pictures.

 Here, Travis was about 7-8 months old, I think. I had my mom take pics of us in the bluebonnets.

 This is Brad, Travis, and me at the family reunion last weekend. We had a good time.

 This was also taken at the family reunion. Travis is a camera hound, and a ham.

I have been staying at home with Travis, and I am enjoying it. It feels strange to not be working, but I do like taking care of Travis. It has been kind of hard on us financially, but we'll get through. We recently went through the process to get licensed for foster care and adoption. We want to take kids ages 0-12. We are finished with the process, and just waiting for kids.

A few weeks ago, I had to have surgery to remove my gallbladder, but that went well, and I am recovered from that. The only lingering effect is about $2000 worth of medical bills. In addition, we got a nice letter from the IRS saying that we owe them $500 from 2008. And since I haven't been working, I have been paying for COBRA so that I have health insurance. So we are doing our best to stay afloat right now.

But if that wasn't enough, since the COBRA only lasts for 18 months, and I have already used up 7 months of it, if I want to have another baby while I've got it, I need to get knocked up within the next two months. And my deductible resets at the end of August, so I need to take advantage of what limited fertility coverage I have with the COBRA. So today I called the fertility clinic, and got set up to start treatments as soon as my cycle starts. They ordered the meds, and I'm supposed to call them on CD1. We're going to skip the clomid nonsense this time and go straight to what worked for us last time. The protocol should be about the same as last time, with follistim and IUI. While I have a sense of deja vu about all of this, I am able to approach it with a little more calm, since I already have a real, live baby here at home with me. Part of me feels very selfish to be trying fertility treatments when I've already got my gorgeous baby boy, but the other, bigger part of me insists that I have as much right to the family of my dreams as anybody else.

So, here we go again. Dear God, please let things go smoothly, and help me to keep the number of self-injections and strangers looking at my lady-business to a minimum. Also, I pray that the hormones don't make me too murder-y. Amen.

24 Weeks

Today I am 24 weeks along in my pregnancy. That means I have 16 weeks left to go. I had my regular OB checkup yesterday, and everything looks good. Blood pressure was fine, he seemed pleased with everything else. Aside from the back troubles, everything is progressing smoothly thus far. We have narrowed down our name choices for our baby boy to two - either Austin James Woodruff or Travis James Woodruff. We keep going back and forth between those two, and may not make a final decision until we meet him. We still have not purchased any baby stuff, and we are trying to hold off until after the baby shower, which will be on June 20, at my mother's house. I hate having to stand in line for customer service, so I am trying to avoid needing to return anything. The urge to nest is starting to get a little stronger, though. Especially since it is starting to look more and more like I am going to get a take-home baby out of the deal. According to some sources, a baby born in the 24th week has a 60% chance of survival, depending on sex, race, and NICU quality. As someone who has dealt with infertility, statistics like that definitely cross my mind. It certainly is helping make it seem more real, knowing that even if I suddenly went into labor today, I could still get a live baby to take home with me in the end (after NICU, of course). Not that I want that to happen, of course, but if it did, there is a decent chance that it could turn out okay. I know it's probably kind of morbid to think like that, but I can't help it. Each week that passes will make it seem more real.

Ultrasound Pics & Update

Okay, here's the pic from Ultrasound #2 (I don't have a copy for #1). The date was 12/24/2008, and I was 6w3d pregnant. The heart rate was 126 bpm, and the baby measured 5.9mm. The doctor neglected to mention that it was 5 days behind in size, but I'm kinda glad that we didn't find that out until the next appointment because it would have just stressed me out more. The big round thing in the middle of the sac is the yolk, and the little c-shaped thing off to the side of that is the baby.

Now here's the pic from Ultrasound #3. The date for that one was 1/2/2009, and I was 8w1d pregnant. The heart rate had gone up to 176 bpm, and the baby had grown to 15.2 mm. This time the baby's size was only off by 2 days, so it is catching up. The somewhat-c-shaped blur is the baby (no yolk is visible in these pics).

I did more labwork on 12/31/08, and my progesterone had gone up to 37.4. That was enough that at my appointment on 1/2/09, the doctor felt it was safe to take me off the progesterone supplements. Also, since the baby has been growing well, she was willing to release me to my regular OB/Gyn. So my next appointment is with my oh-so-fine OB on Monday 1/12/09, and I should have another ultrasound then. I'm glad to be done with the fertility clinic for a while. They did a great job, and did what they were supposed to do, but I'm glad to move on. Brad and I are pretty excited, and relieved that things seem to be picking up speed. Brad has been telling pretty much everybody he knows - even the bank teller! It's kinda cute. He's pretty much a typical male when it comes to (not) sharing his emotions, but I can tell he is excited about being a Dad (again). After all, it's been nearly twenty years since the last time he had an expecting wife. Anyway, I'm glad to be getting this show on the road finally.

Goodbye 2008, Hello 2009!

So today is the start of a new year, and I am glad for it. So far, it is shaping up to be a better year than the last. Granted, I did get married last year, and that was awesome, but a good portion of the year sucked. I also managed to get pregnant toward the end, but the initial stages of that have been fraught with worry and fear of miscarriage. Only on Christmas Eve did I finally get some relief, in the form of a strong heartbeat on the ultrasound. The bulk of the year was spent doing infertility treatments that just made me sad and miserable. So to 2008: I'm glad to see you go.

2009 looks like it may be much better. If everything goes as planned, I should give birth to a healthy baby in August, which has the potential to make the whole year. I shouldn't have to do any fertility treatments this year, and that sounds really good, too. And, to top it off, I will get to be off work for two months before the baby is due, because of the way the school schedule works. Yay! for summer break. If I can just get through this next semester, it will all be okay. Before too long, I should be able to start buying baby stuff. 2009, I'm glad you're here.

Two Lines!

I'm scheduled to go for bloodwork tomorrow, and I swore I was not going to cheat and pee on a stick. However, at work today, the waiting was making me crazy, and the girls at work were like, "Why don't you just go pee on a stick?" So I folded. I have no self control. I went to Wal-Mart on my lunch break and bought pee sticks. I did one in the bathroom at work. There are two lines, people! I'm knocked up! Holy shit, Batman! I'm so excited! Of course, now everybody knows. I do realize that something could still go wrong, and that a positive pregnancy test does not necessarily equal a take-home baby, but this is the furthest we have ever gotten. It is a step in the right direction. So I will go for bloodwork tomorrow, and probably again on Thursday, then probably an ultrasound sometime in the next few weeks to check for the heartbeat(s).

New Tortures...

...Because the old tortures just weren't good enough. Yesterday, I was in the shower getting cleaned up for the IUI, when the doctor's office calls to ask me if I can come in for the IUI 15 minutes early. Now anybody who knows me understands that for me to get anywhere even *on time* takes an act of God. But I say OK, and make it there 15 minutes ahead of schedule, as requested. I walk in, sign in, use the restroom, and then sit down in the waiting room... for 30 minutes. After 30 minutes of waiting, my phone rings, and it is my nurse calling to ask if I am coming in for my IUI. I explain to her that I have been sitting in the waiting room for half an hour, and yes, I do still want an IUI. Apparently, the front desk girl forgot to let anybody know that I was there. Ughh!

So then I go back, and she does an ultrasound first, and says that it looks like I probably ovulated 3-5 eggs. All the while she is very sweet to me, probably because of the fact that the waiting room incident pissed me off so bad that I looked like I was going to eat her for lunch. Then she does the IUI, and explains about the newest form of torture they have devised for me. I thought that the next two weeks I would get off scot-free. I was actually looking forward to the 2ww. But no, it can't be that easy. Since I started my period early last cycle, starting on Friday I get to do progesterone suppositories every night when I go to bed. Yuck. That grosses me out worse than the Follistim shots every day. But I really didn't wan't to do the progesterone-in-oil shots either, so I didn't argue. But it won't keep me from whining about the ickyness of vaginal suppositories, either. Blech! I go for a pregnancy test on December 2. Maybe we'll get lucky this time. But hopefully not too lucky. One or two would really make me happy. But I will take what I can get, and go from there.

Cycle Update

Sorry I haven't updated in a while. Things have been kind of hectic, what with doctors visits every three days. So here is the condensed version of the latest visits. On Monday, 11/10, I went back for another follicle check, and I was still showing 18 follicles: Right - 12,10,8,7,7,7,6,6,5,5,5mm Left - 9,9,8,7,6,5,5mm Endo - 12.6. When the E2 came back from the lab however, it had fallen from 68 to 48, so she raised my Follistim dosage for the next three days up to 150, 100, 100 units.

When I went back on Thursday, 11/13, she just measured the three largest follicles on each side. It kind of pissed me off, because she rushed in and out like she had somewhere else to be, and I didn't get to ask the questions that I had. So the measurements for that day: R - 14,10,7mm L - 13,9,9mm Endo 11.1. My Estradiol had risen to 262, so that was good, and my dosage for the next three days was 150,150,150.

Today, I went back for another check. On the right ovary she measured follicles at 21,14,14,10,9mm. On the left, she measured follicles at 18.5,14,11,10,10,9mm. Endo was at 11.6. Not sure about E2. They'll probably call with that tomorrow. She had me trigger with ovidrel at 5:30 this evening. The IUI will be on Tuesday morning. She said that anything at or over 14mm can release a mature egg, so we're probably looking at 4-5 eggs released... hopefully. Yet again, when I tried to ask questions, she was a little snippy with me, and acted like I was an idiot for questioning her. Sorry, but IMO, anybody who *doesn't* ask questions of their doctor is an idiot. Next time, if she's short with me, we'll have a come-to-Jesus-meeting and I'll let her know exactly what I think. Maybe she just has PMS. She hasn't been like this before this week, but if it continues, I *will* come unglued on her. Oh well. I guess I will wait and see.

Let's Party Anyway

On Friday 11/7, I got up at the butt crack of dawn and drove to Austin for bloodwork and an ultrasound. I had the labs drawn at about 7:00am and the ultrasound at about 7:45. It was CD7. My endometrium was at 11.0. My left ovary had 6 follicles that measured 8,7,7,6,5,5mm. And it was the underperformer. My right ovary was being the overachiever again, and had 12 follicles that measured 7,7,7,6,6,6,6,6,6,5,5,5mm. That's a total of 18 follicles that she measured! And I think there may have been a few hiding, as well. And this was with me on a very low dosage of follistim (75, 75, & 50 for the first three days). Can you imagine if she had put me on a standard dosage? Later on, they called with the lab results, and said that my E2 was at 68. I don't know if that is high or low or what, but I am going to verify that number when I talk to them again. I was in a class full of yelling kids when they called, so I could have heard wrong. The dosages they gave me for Fri - Sun were 75,75,50 again. I go in again tomorrow morning for more labs and an ultrasound. I wonder what things will look like then. I have gotten pretty good at this whole injecting myself thing. I did it in the truck in the parking lot of the Golden Wok restaurant last night right before dinner. Easy as pie.

Yesterday Brad and I went to a wedding for a mutual friend of ours. We had a lot of friends there, and it was nice getting to visit with them all. And Brad looks really sexy when he's all dressed up. So I had an ulterior motive for wanting to go. But it was nice. Then we went to JC Penneys and returned most of the clothes I had bought the other day. I have decided that I will stay at my job with the school for the time being. Mostly because the insurance is paying for more than I thought it would, and the leave policy is more generous than most places offer. The pay still sucks, and I am still miserable, but I will put up with it for now. If I stick with it, I will have the summer off, and if I get pregnant this cycle, the baby(ies) would be due in August sometime. That would give me the last couple months of a pregnancy off, which would be really nice, especially if there are any complications. But, usually, planning just screws shit up, so I'd better just stop now while I'm ahead. So that's all for now. I will update more tomorrow after I the doctor's appt and lab work. Now I'm off to eat left-over dim sum. Yum.

Go Wild and Have a Party

Today I went to the doctor for a baseline ultrasound and an injection lesson. For the ultrasound, they had one of the junior doctors do it, with the guidance of my regular doctor. Her technique was kind of weird, and so it was hard to see what was going on. My regular doctor is very predictable, and does it the same every time, so it's always easy to tell what you're looking at. My left ovary had a bunch of antral follicles, but because of the jumbo one on my right last time, there wasn't much going on on the right side this time. The right ovary really looked more like a gray pile of mush to me. So the left will likely be the star performer this time, but who knows, since I haven't started stims yet. I start stims tonight. I'll be using the Follistim Pen. I will do 75IU for two days, then 50IU for one day, then on Friday I will go in for E2 levels, and another ultrasound so they can tell what dosage to give me for Friday and the weekend. I knew that because of the PCOS, the doctor would want to be careful on the dosing, but this morning the exact words that came out of her mouth were, "We're going to take this slow, and go with a low dosage, because you're 25, and your ovaries are scary. We don't want them to go wild and have a party." She has often remarked that I have enough antral follicles to supply the entire office.

After the ultrasound I got an injection lesson, where I practiced injecting a lump of fat-like material. It was easy, but pretty gross. On the first try, I forgot to quit pinching the "fat" before I pulled the needle out, and the fake meds squirted out of the "fat" all the way across the room, out the door, and across the hall. The nurse and I laughed until we cried. It was so hilarious. The Follistim Pen seems fairly easy to use. I don't forsee any problems. The pharmacy that the meds came from was the Apothecary Shop in Phoenix, AZ. The meds were packaged well, and arrived exactly when they said they would, and there was no charge for the overnight shipping, sharps container, or alcohol pads. The only charges were my insurance copays for the actual drugs. They were fast and friendly when I talked to them on the phone, and I would highly recommend them to anyone else.

Well, I'm off to watch election coverage. I voted last week, and I am anxious for all of this election crap to be done with. If you haven't voted, do so. There's still a little time, depending on your location.

Or Just False Hope

So later on Saturday afternoon, I realized that the possible progress was really just false hope. After the initial bit of spotting, I started my period Saturday evening, a full 5-7 days early. Blech. How's that for ruining my weekend? So much for that cycle. Today is CD3. Tomorrow I go in for an ultrasound and an injection lesson. This round, we are moving on to the big guns, since I found out insurance will cover the injectables. The RE's office got the prior authorization from the insurance, faxed the order to the pharmacy, and the drugs should be on my doorstep tomorrow, to the tune of $115 for the cycle. Not too bad, considering it's only $65 more than last month. Hopefully I can get knocked up this time, but not wind up with a litter. And hopefully, I don't wind up with so many follicles that they cancel the cycle. We'll see

Possible Progress

Since there was some ambiguity as to whether the black hole on my right ovary was actually a follicle or a cyst, my RE wanted me to go in for bloodwork 7DPO to check my progesterone levels, to confirm that I did truly ovulate. That way I would know whether I had thrown away $400 on an IUI the week before. So on Thursday, 10/30/08, I had the labs drawn. They didn't call with the results until the next day, which really pissed me off. But I got the results, and they said I did ovulate last week. So that was good. Now, for TMI. Yesterday evening, when I went to the restroom, I noticed just a little bit of red spotting. Late last night, it was just a very little brown, old blood. This morning, nothing. At 8DPO, that could be implantation, right? A little spotting at the right time is the furthest we've ever gotten. It could be possible progress. I know I'm just getting my hopes up, but it's really hard not to, when so far to date, we've got nothing. It just makes the waiting harder.

Here's a pretty picture of an Austin sunrise- I'll admit, I stole it, but here's the link to the owner's flickr page. I couldn't resist.

Get In, Get Out, Quit F*&%ing About

I had my IUI this morning. It was probably the quickest appointment ever. Wham, bam, thank you ma'am indeed. Hopefully it will produce the desired results (a baybee, in case you hadn't been listening).

I also called my insurance company and found out that they will cover injectable fertility drugs (if the current cycle doesn't pan out). It just requires prior authorization, and that I not be using them in preparation for or in conjunction with an IUI or IVF. Basically, the dumbass insurance company wants to pay for these drugs that will make you ovulate eight eggs, and then they want you to go home and make nookie with your husband so you wind up with a litter. God forbid that they cough up the money to do an IUI to increase the probability of the expensive-ass drugs working on the first round. Or even better, that they ante up the money to do IVF so that you can have a healthy singleton or twin pregnancy, rather than a God-awful expensive set of sickly sextuplets. It's all about the profit NOW, not what's best in the long run. But, if they will pay for the meds, then I will have the doctor fail to mention that I will be having an IUI, since I pay for those out of pocket anyway, and I will go ahead and get them. I'm not saying this cycle won't work; I'm just planning ahead. 

Tomorrow I have a conference to go to at the Texas School for the Blind for work. At least I don't have to do any real work tomorrow. And it will be Friday. And I just realized that even though when I get out of the conference it will be five o'clock somewhere, for the next two weeks, and maybe longer, I will be pregnant until proven otherwise. Arrrrgggghhhh.

The Black Hole

I went to the RE today. I had 53mm black hole in my right ovary. It could be one of two things: either a very large follicle or a very large cyst. I have been having mild pain on my right side for about a week, so I wasn't surprised about it's presence, just it's size. The doctor feels fairly confident that it is a large follicle, rather than a cyst, as my uterine lining was at 14mm, which she seemed happy with. So she wrote me a prescription for Ovidrel, and as soon as I am done typing this, I will go pinch a roll of my plentiful abdominal fat and inject myself. I had to go to People's Pharmacy near 38th & Lamar to get it, as they are the only place in the Austin area that keeps it in stock. It is a little bitty place, but they were fast and friendly, and holy shit! my insurance covered the shot! I paid a $25 copay. I was astonished. I wonder if I can get them to cover other injectables. I'm scheduled for an IUI on Thursday morning at 9:30.

I also had a job interview today, out at a vet clinic on Bee Cave Rd., and I think it went well, but even if they call me back, I don't think I will take it. It's just too damn far to drive, the traffic is terrible, and the schedule they are wanting is a little crazy. I'm going to keep looking for something slightly closer to home. So, I missed most of work today, I will be miss all day Thursday, and then I am supposed to go to a conference for work in Austin on Friday. Easy work week, but hell on gas. Oh well. Nice change of pace, I guess. I'm just hoping everything goes right and this 2ww is a successful one.

And The Forecast Called For Galoshes

 

Well, I didn't need an ark for the flood after all. After the cats poked holes in the inflatable life raft, I had to go with the galoshes, and it turned out okay. It wasn't a miserable period like I expected, and my husband survived it as well. I also finished up my new, higher dose of Clomid, and I am trying to maintain my composure in this state of hormonal flux. I am scheduled for an appointment next Tuesday 10/21, to check on Lucy and Ethel, to see if they are behaving like good little ovaries. Knowing my luck, the ultrasound screen will look more like a re-run of the Candy Factory episode. But we can hope that they will behave.

My job hunting continues in earnest. I am so tired of all the nonsense at my current job. Hopefully I will find something soon. Oh well. At least tomorrow is Friday.

Waiting for the Flood

I finished the 10 day course of Provera last night. Now I am just waiting for the flood, and wondering if I should build an ark. Seems like it might be a prudent course of action. Or at least invest in an inflatable life raft. I think we will see how this round of Clomid w/ IUI goes, and if it doesn't go well, I'm going to ask my RE how much it would increase our chances to try injectibles. If it would be a substantial increase in probability, then I will start investigating costs. I don't wan't to do Clomid over and over again if I can help it. I'm supposed to call on CD1, and go in for a scan on CD12. We'll see how things look then.

In other news, I am job hunting. I am still currently employed by the school, but I am also seeking employment elsewhere. I like the *job* but the pay sucks, and the level of BS is amazing. I need one of these. It might get used on people too frequently though.

I have an interview coming up on Thursday. I'm excited.

We Have a Consensus

So far, the logical order for our infertility journey, based on how far we're willing to take things, has looked like this:
1. Clomid
2. Clomid w/ IUI
3. Injectibles w/ IUI
4. IVF
5. Adoption
Currently, we are in phase two of the treatment plan. Unfortunately, #4 is not really an option due to our financial / insurance situation. It is just too damned expensive. Also, to me, donor eggs or sperm seem a little pointless - if genetic material isn't the point, then why not just adopt? Skipping directly from #2 to #5 seems a little premature, but until last night, I have had my reservations regarding #3. This is due mostly to the fact that there is a high risk for high order multiples with option 3.

Wait, let me go back. I am very pro-choice. I feel like all mentally capable people should have the right to make their own decisions when it comes to reproduction. If I have the right to pursue treatment for infertility, any other woman should have the right to pursue treatment for unwanted fertility.


My husband has a different view. He is morally opposed to abortion, and feels it is wrong. He's okay with it in cases of rape, incest, or risk to the mother, but that's it. He especially doesn't like it when it is used by women as a form of afterthought birth control. Although I seriously doubt he would vote to make abortion illegal, he is fairly rigid on the topic. His view differs from mine, but I respect it.

So, back on the topic of injectibles... I am okay with the risk of high order multiples, because I am okay with selective reduction. The risks associated with high order multiples are just too great to ignore. I would not be willing to try injectibles if selective reduction was not an option, which I was afraid that it might not be, because of Brad's views on abortion. I would not do anything that he wasn't okay with, because it's his child, too.

Anyway, last night I finally got up the nerve to ask him about his views on selective reduction, should the need arise. I was afraid to ask, because of what his response might be, but ask I did. We needed to discuss this anyway, just so we could know where we stand. Of course, as usual, my husband never ceases to amaze me. He said that he is okay with selective reduction, because the risks to me and to all of the babies is just too great. Why try to keep six, only to have them all die in NICU when they are born too premature to survive, when you could have made the hard choice early on, and wind up with two healthy babies in the end.

I underestimated him, and he surprised me as always. It just reminds me why I love him so much. Folks, we have a consensus, and along with it a better understanding. I'm a lucky woman.

Yep, This Cycle is Thoroughly Messed Up

Today I went back to the RE. They wanted me to come in to check if the two of the larger follicles had done anything. No such luck. The largest one just peetered out, and the next one in line only grew by about 1mm. My lining was still thick. So my doctor wrote me a prescription for Provera to bring on my period, and raised my Clomid dosage up to 150mg. She said to call on CD1, and come in for an ultrasound on CD12, to see how we're doing. Hopefully the higher dosage of Clomid will work.

Yet Another Effed Up Cycle

Yesterday I went to see the R.E. I typically have been ovulating around CD 16-17, so when I hadn't gotten a positive OPK by CD 16, they had me come in for an ultrasound, since I managed to miss the surge last month (the doctor thinks I did ovulate last month, since I went on to have a period at the right time, but we didn't do any bloodwork to confirm). They said, "We'll see what we find, and most likely write you a prescription for a trigger shot. You go home, trigger Thursday night, and we do the IUI on Saturday morning." Well we got to doing the ultrasound, and the biggest follicle we can find is only at 12mm and the next biggest is at 8mm. At least one has to be 20mm or more to trigger. In addition, my uterine lining was super thick. With one angle she measured it at 18mm, and with another angle she measured it at 23mm thick. That is way too thick for this point in the cycle, unless I already ovulated really early, before I started doing the OPKs. But the estrogen that is making the lining thick has to be coming from somewhere, and she said that it could be an indication of very early pregnancy. So I went in for labwork to test for hCG and Progesterone. The hCG was zero, like I knew it would be, and the progesterone was 0.6, which indicates that I did not ovulate early. So she said to keep doing the OPKs for another 5 days or so, just to be sure, but that I probably am not going to ovulate this month, especially with that weird super-thick lining. And what's really great is that whether I spontaneously start my period or not (which would mean Provera) the thick lining will likely make for a miserable awful period. If I have to do the Provera, of course it will be worse. It always is. And to top that off, they're going to increase my Clomid dosage next cycle. Toro! indeed.

Uncontrollable Rage

This is what the clomid makes me feel like. I am the bull. Also hot and cold flashes, and terrible headaches. It is like some crazy Mexican is constantly waving a red cape in my face and yelling, "Toro!"

Of Tunnels and Hope

I've spent the past couple evenings reading the blog of a fellow infertile Texan. I saw her blog listed on Cyclesista, so I stopped by, and her first few posts caught my interest. I like to have the story from the beginning, so I went back and read her archives from the start, and one of her posts really hit home with me. Her blog is the Happy Not-So-Newlywed, and the post I am referring to can be found here.

The following is the exact quotation that has stuck with me since I read it:

"I have to know that if we aren't successful this month, I can brush it off and say "that's ok, because I know what we're doing next month." If there is constantly light at the end of the tunnel then you are never in complete darkness."

To me, that is just beautiful, and it sums up exactly how I get through this whole infertility thing. I may not be able to control everything, but I can do it one step at a time, as long as I know where I'm going in the end.