Tuesday, September 27, 2011

Yes?...No...Maybe?...No...Maybe!

This cycle has been... unpredictable. I wasn't expecting much in the beginning. After all, I had ovulated from my right side last cycle so, chances were, I would probably ovulate from my left side this time.
I went in for my day 3 baseline BW/US and my E2 was the lowest its ever been- 34.
Went back on day 13 after taking Femara days 3-7 and there was nothing. My E2 was 69 and both ovaries were totally quiet.
Three days later, on Monday... nothing. E2 up to 104.
Wednesday... 3 small follicles on my right!!! E2= 101. Down some... ???
Friday... one 12.7 mm on right.  E2 down to 96
Monday... 15mm on right. E2= 153 YAY!! Getting there!
Wednesday... 18mm on right, trigger time! E2 down to 99.7 WTF?!
Well, when I first saw those three follicles on my right ovary is was really excited. Then, when only one went on to grow I was a little disappointed but one is better than none! I figured the slight dip in my E2 level was from two follicles shrinking, even though I couldn't explain the decrease from Monday when I had no follicles to Wednesday when I had three. Oh well... the doctor wasn't concerned so it was probably no big deal, right?
I really hoped that I would be ready to trigger on Monday. Patrick had sinus surgery scheduled for Wednesday and I knew there would be no sexy-time for a few days after surgery. He is, after all, a whiny man when sick (or as he says... siiiiiiiiiiick!)
So of course, in line with my baby-making luck, I wasn't ready on Monday and had to go back Wednesday... but at least my E2 was up.
Now I was hoping I WOULDN'T be ready yet so Patrick would have a couple days to recover before I made demands of his body. ;) Again, no such luck. I took Patrick in for his surgery, waited until they took him back, then booked it over to the clinic for my BW/US. But there it was... a beautiful 18mm follicle, ready to be triggered. The nurse said that I might be able to wait until the next night before my trigger, giving Patrick another night to recover. I hoped I'd be able to wait.
They called me later and said that the doctor wanted me to trigger that night and have intercourse the next two days. As I looked at my husband's bandaged, bloody nose, slightly bruised eyes, and pasty complexion, I knew that was not going to happen. The nurse didn't mention my E2, but when I checked my online lab results I was shocked to see that my level was down to 99.7! How?! Why?!
Of course I panicked. What if the follicle wasn't mature? What if there was no egg in it? What if it was abnormal? It wasn't until some searching on the internet (thank you forums!) that I found out that Femara will cause low E2 levels even with mature follicles. Now, I knew that Femara lowers estrogen levels, but I thought it was only in the beginning of the cycle, especially as the medicine is suppose to be out of the system in about 9 days. Oh well, lesson learned.
Anyways... I didn't trigger that night. I refused to waste the Ovidrel on a missed cycle. This way I could have it for my injectable cycle that was looking more and more like it was definitely going to happen. Patrick was MISERABLE after his surgery. Every night he fell asleep on the couch, propped up against the pillows to keep his head elevated, I would go to bed alone, anticipating a thermal shift in the morning. My cycle that I had thought futile had turned in my favor, only to have circumstance stand in my way.
But my shift didn't come Friday or Saturday like I was expecting. In fact, by Sunday morning my temperature had gone down a bit. Sunday night I tried to initiate some baby-making but my poor hubby was still in too much pain. Monday morning I was afraid to look at the thermometer, only to be shocked that my BBT had gone down some more. And what do you know, Patrick felt better that night!
I got my thermal shift this morning. Looks like we might actually have a shot at getting that positive this month! :D

Sunday, September 25, 2011

Don't Count Your Chickens Before They Hatch

July- August 2011 (and a bit of September)
I was so excited about this cycle. I just had a feeling that this would be IT. My day 3 BW/US was great, took the Femara with little side-effects (it only gives me headaches), and if the "ovaries take turns" theory held, it was my right ovary's turn to ovulate.
I went in on day 13 to check my progress, my lining was perfect, and as the tech scanned over to my right side, there it was... a perfect, 18mm follicle, ready to be triggered!! I just knew it was meant to be. She said they would call me that afternoon with my BW results and that I would probably trigger the next day.
They called later, and said everything was perfect. My E2 was 265 which is GREAT for a Femara cycle. Patrick and I were intimate for the next three nights, until I ovulated. I couldn't believe how easy this cycle was.
At 6 DPO my temperature dropped below the coverline. Implantation dip? I wanted to take a pregnancy test... I went out and bought some, the first I had bought in nearly a year... but I made myself wait, knowing early testing just leads to early disappointment. At 10 DPO I couldn't wait any more. I was 13 days past my trigger shot so the HCG was likely out of my system, and if it was an implantation dip I was likely 4 days past implantation.
I peed on the stick, put it on the counter, and tried not to watch the lines form.
The pink dye spread across the stick, and as it passed the spot where the test line should be, some stayed! Nothing had ever stayed in the test line. I watched, frozen on the toilet, as two pink lines formed on test.
My heart stopped, my chest squeezed, my breath caught.
The test was positive... I was pregnant.
I nearly cried I was so happy.
The test line was faint, but... *all together now* A LINE IS A LINE IS A LINE!
I couldn't wait for Patrick to get home to tell him! But wait... I needed to wait until my blood test to be sure. But I really wanted to tell him. But I would hate to disappoint him if it was wrong. But it couldn't be wrong. But it was still so early. But I was so excited, I wouldn't be able to keep the secret. But something could happen. But I have been through so much already... surely nothing would happen.
I was back and forth all day. I still walked around with a smile the entire day, I can't remember ever being so happy. I put my positive result into Fertility Friend. My due date was April 30, 2012. I had dreamed of having an April baby... silly, I know, but it seemed like the perfect time to have a baby.
The night, when Patrick walked in the door, I was in the best mood of my life. He was not. He had had a tough day at work and traffic had been a nightmare on the way home. He had wanted to cook that night, and as he stood in the kitchen, angrily chopping an onion, I decided that I wanted him to share in my happiness. I went and dug out the baby bib I had bought three years before for when I was going to tell him I was pregnant, held it to my stomach, and walked back to the kitchen.
He looked at it for a moment and froze. His eyes popped wide and he asked, "Are you pregnant?"
I could only nod as the happy tears started flowing. As my news sunk in, he set the knife down and a huge grin spread across his face. "Really?"
Again, more nodding. He came around the island and picked me up in a bear hug. We laughed, and hugged, and kissed, and shared the most joyous moment in our marriage... learning we were going to be parents.
The next day the test was negative. I took three more, and they were negative too. I scoured the Internet and found instances of negative tests after a positive that still resulted in pregnancy. There wasn't many, but I held on that hope. I wasn't ready to admit to myself that I had probably had a very early miscarriage that I wouldn't even have known about had I just waited to test. The blood test the next day confirmed that this was the case, though.
I had known better than to test early. I had known better than to tell Patrick until I was certain. I had known better than to get so emotionally involved in a cycle. But I had done all those things and now I was living with the consequences. I was DEVASTATED. I cried for days. I don't think even Patrick knows how hard I took that cycle. He was upset, true, but he stayed positive. He reminded me that at least now we knew we could get pregnant. I agreed and put on a tough facade, but on the inside I was crushed. I had built up so much hope, now that it was gone, I felt ruined.
I started my next cycle, but my hope was dashed. At this point I was just going through the motions. At the start of the cycle Dr. Griffith told me he thought it would be best if we moved on to injectables
Patrick talked to his HR rep in charge of their insurance plan at work about adding an infertility rider to their plan during open enrollment in November. The rep said they would definitely look into it and add it if the cost is reasonable. *Fingers, toes, and eyes crossed*
A few days into my cycle Patrick told me his sister is pregnant. My first thought, though I hate to admit it and hate even more that I thought it, was that should have been ME! He told me they had found out two weeks before. That was when I had gotten my positive... we probably would have been due at the same time.
I felt like I was living my loss all over again. I cried all over again. I am SO happy for them, don't get me wrong, but I hurt.
It took me a while to get over it all again. I was angry... not at anybody or anything, just angry. I couldn't understand why this was so HARD. Why I couldn't just have something I so badly wanted. I didn't blame God, I know He has a plan for me and that I will get pregnant when the time is right, I just wanted the time to be right NOW. I felt alone with my pain. Patrick looks at our journey as having started in February, after the surgery, since nothing could have happened before then, but I have been emotionally involved in this for nearly four years! My mom told me it just wasn't a good time for me to get pregnant. That was the last thing I wanted to hear, especially from my mom. I felt like she wouldn't be happy for me if I was pregnant. How does she know whether or not its a good time?! I know she was trying to make me feel better (she doesn't know about my positive test last cycle she only knows I'm getting upset with the whole TTC thing) but she is suppose to support me. She was suppose to hug me and tell me she was sorry that this was happening. She tried for five years before she got pregnant with me, she is suppose to understand how I feel!
The lady that rents the suite next to mine came over to chat with me on a particularly hard day... maybe my hormones were off-kilter, I don't know, I was just emotional. She knew immediately that something was wrong. We were talking and she just said, "Oh, honey, there is something that's just eating you up inside."
I broke down. I told her everything. She hugged me and told me she was sorry that this was happening to me. She told me to trust in God's plan. Told me that I needed to do something that made me happy and get my mind off the things that didn't. She said that I had no control over this, and that I needed to give it over to God and concentrate on things I did have control over. She told me everything I needed to hear.
I was ready to quit. I was ready to throw my hands up and scream, ENOUGH!!! I told myself, and Patrick, that if this cycle didn't work, I was done. We would go on a break from TTC until our insurance covered infertility or until we could afford the treatments without cringing as we handed over the debit card.
Instead, I prayed. I asked for guidance, instead of a baby. Strength, instead of a BFP. And I got it.
Patrick got a big bonus at work and, after talking it over, we decided to do one cycle of injectables if this cycle doesn't work. Then we'll take a break.
My hope has returned, and I have a positive outlook on the next leg of our journey.

New Beginnings vs Same Old S***

With the new year came new determination. I decided it was time to know what was happening in my body. I called an RE's office and made an appointment. I filled out mine and Patrick's history before the appointment and waited anxiously for January 25 to come. I had started charting again with my new cycle which had started Jan 7.
Even though we were still trying to eat healthy, we had gotten off track over the holidays and getting fully committed to the healthy living was hard. I was not following as closely I needed to be so my cycles had returned to normal... ie. NOT normal.
January 25, 2011
I was the youngest one in the waiting room at our new Dr's office, Houston Fertility Institute. I felt out of place, but I just KNEW I would finally get the answers and attention I so badly wanted.
I liked our doctor from the moment we met him. Dr. Griffith is soft spoken, calm, knowledgeable, with a sense of humor, and a knack for reassuring and making you feel at ease. I'm using his name because I have nothing but good things to say about him, or the rest of his staff, and definitely recommend them if you are in the Houston area and looking for a clinic.
Dr. Griffith went over our histories, asked us a few more questions, and immediately told me he knew there was a problem and that I was likely going to need surgery. His exact words to me were, "Pain is never a good thing. It is always an indication of something going on."
He said we could do an HSG- a procedure where they inject dye into the uterus and fallopian tubes and take an X-ray to look for blockages or other problems- but he was so sure that they would find something he said he felt comfortable skipping that step and moving straight to a laparoscopy... provided Patrick's semen analysis came back normal. At this, Patrick goes stiff.
Patrick- "Semen analysis?"
Dr- "Yes. There is no use in cutting on your wife until we know there's not an issue with you."
Patrick- "O-Okay. What does that include?"
Dr- "We would get a semen sample from you and analyze it under a microscope to make sure there are no problems."
Patrick- "What if there is a problem?"
Dr- "Depending on what it is, we would retest to make sure it wasn't just a fluke and if we got the same results we would refer you to a Urologist to see if it can be corrected or if we would need to work around it or move straight to IVF."
Patrick's eyes were huge and he sat there a moment, processing. Then he asked, "How do you get the sample?"
I held back a laugh and could tell the doctor was doing the same.
Dr- "You would come into the office, we have designated rooms, the staff will give you a cup, and you will masturbate to ejaculation."
Here, Patrick's eyes nearly bulged out of their sockets and he turned into a snickering 10-year-old boy.
Dr- "You can also do it at home and bring us the sample, but it has to be here within 45 minutes."
We then discussed the possibility of endometriosis, he confirmed my PCOS diagnosis and told me it was actually fairly common for women to present with cases similar to mine, and he promised that I would never have to take Clomid again. He said that we had age and time on our side and he felt confident that I would one day be a mommy.
He sent me to have blood work to see where I was in my cycle and told said that if I wasn't close to starting on my own, they would give me medicine to bring on a new cycle so we could get the diagnostic ball rolling.
February 2011
Patrick had his semen analysis done Feb. 11 and they called him the same day and told him everything looked good.
I had started Prometrium the day after our first appointment, but a mistake at the pharmacy had given me only half the dose needed and I didn't start until Feb. 16, 11 days after my last pill. It worked out, though, and with Patrick's normal results, Dr. Griffith said we should proceed with the laparoscopy. It all happened fast from there. A week later, on Feb. 23, I went in for surgery.
I don't remember much about what the doctor told us after I woke up in recovery. I remember him telling me I had a lot of scar tissue on my left ovary, and that it looked like I had been having cysts rupture (I had felt them, but thought them to be gas pains or constipation pains until he described what it would have felt like) and that the scar tissue had fused my left fallopian tube to my ovary and that he had to cut the tube because it "was sabotaging everything".
Even though I didn't understand most of the whats or whys... hell, I was so out of it from anesthesia I barely understood simple English, as the post-op video Patrick took of me showed... I understood that I still had one tube and that meant I still had a chance to get pregnant on my own.
Patrick on the other hand, took what the doctor said to mean that we now needed IVF to get pregnant. (Dr. Griffith had actually said that even though I only had minimal scar tissue on my right side and my right tube was open, the presence of scar tissue raises concerns of HOW open my right tube is, which raises concerns of the possibility of ectopic pregnancies, so they recommend IVF to lessen the likelihood of an ectopic)
Needless to say, Patrick was crushed until I spoke to the doctor the next day and cleared this up.
March 2011
A week later we met with Dr. Griffith for my post-op.
Turns out, I had a hydrosalpinx of my left fallopian tube. In response to injury, the body sends inflammatory cells to the area, and the inflammation and scar tissue results in a loss of fimbria (the frilly tissue at the end of the tube that sweeps up the egg when it's released from the ovary) and a closure of the tube. The tube then fills with inflammatory fluid and becomes distended. My tube had basically gotten caught up in the scar tissue from my ruptured cysts, had a inflammatory response of its own, causing more scar tissue, and filled with fluid. This was the cause of all my pain. As my cycle progressed and my left ovary tried to ovulate, it was causing more fluid to gather in my tube, with was now being pulled between my ovary and uterus.
Dr. Griffith also felt that we probably were getting pregnant, but the inflammatory fluid draining from my left tube was coating my uterine lining, preventing implantation and, in essence, sabotaging everything.
FINALLY!!! Answers!
Next, he said that, given my excellent ovarian reserve and the fact that Patrick's semen analysis made their Hall of Fame, he was certain that I would get pregnant.
I could practically see Patrick's head getting bigger at the mention of "Hall of Fame" and "his semen analysis" in the same sentence. Dr. Griffith joked and said that Patrick's results were so good they were hung up in the back room. I figured he was just trying to encourage Patrick and assure him everything would be okay, and I was grateful for it.
Dr. Griffith said that our next course of action would be to put me on injectables with timed intercourse and see what happened. He said that we would have a 15% chance of multiples on the injectables and usually he would lower that chance in patients with one tube, but given Patrick's little swimmers, he was going to keep them at 15%. I have always wanted twins so this was fine with me. We agreed to do the injectables.
After we talked a little while longer about options, chances, etc., he sent us out to talk to Brittany at the front desk to discuss insurance coverage and cost. We walked out of his office with high hopes.
It didn't last long.
Our insurance covers NOTHING.
Brittany told us that the monitoring for a cycle of injectables would cost $1500. I died a little inside. I would happily spend that and more if I knew it would work, but if I was to shell out that much money and not get pregnant, I would feel like I flushed it down the toilet. (And at that point I still had no idea how much the medicine was!) I asked her if we could do another cycle of *dumdumdum* CLOMID while we figured out our finances and decided if we could afford to continue. She said no problem and we left, discouraged.
Two weeks later, I was back in the office for Day 3 blood work and ultrasound, crossing my fingers that Clomid would be good to me now as there was no way that we could afford the injectables if we weren't sure they would work. After living with Patrick's inflated ego for two weeks, I also asked the receptionist for a copy of his semen analysis, certain they couldn't have been THAT good.
They were. So good, he insisted that we post them on the fridge.
His concentration was at 177.5 million/mL...impressive. Coupled with the fact that he produced a volume of 14mL, Patrick produced a total of 2.485 BILLION sperm. That's right, BILLION! Even with a slightly crumby 67.61% motility, it still left him with 1.68 billion motile sperm.
Hall of Fame is right. At least we don't have to worry about his swimmers! (Probably the only thing we don't have to worry about in this quest)
A week later, after taking the Clomid, as I checked in to my day 12 appointment to check on the progress of my cycle, I had my card ready to pay my $40 co-pay when Brittany says, "Okay, its going to be $800 today."
I nearly fainted.
After I stared at her dumbly, I managed to ask why so much. She told me that the monitoring for Clomid cycles was $800 and that, now that I had been diagnosed, my insurance wouldn't cover my monitoring any more. I told her I had not been told it would be so much and asked if I could put half on my credit card and have a few days to get the other half together. She agreed and I felt sick as I handed over my card. There went half of my injectable cycle on Clomid!
April 2011
I responded very slowly to the Clomid that time. I didn't trigger until day 18 and didn't ovulate until day 21. We timed it very well...knowing almost exactly when you're going to ovulate REALLY helps ;) ,
and we hoped that it was going to be $800 well spent. Let the TWW begin!
We went to mediation on the lawsuit for the house on April 11 and they settled!!! We were ecstatic to be done with that nightmare! We didn't get what we wanted but we got enough to fix the house as long as we do some of the work ourselves and budget wisely. Things were going our way.
My 14DPO pregnancy blood test came back negative. Time to reconsider out options.
May 2011
After our failed cycle, I explained to Dr. Griffith that we couldn't afford to move forward with treatment and we had decided to just try on our own for a few months as we saved up for the next step. A few weeks later he called me and said that he had a treatment option that he felt would be a good fit for us. He said that the reason I wasn't responding well to the Clomid was that my estrogen was high (790 at ovulation with only one mature follicle) and that he thought switching to Letrozole (Femara) would produce positive results. He then told me that, as they don't use Femara very often since its not approved as a fertility drug, they were willing to do my monitoring for free for a few cycles to see how I respond. I was thrilled!!!!
June 2011
When I went in for my day 3 BW/US, the US showed what the tech thought was a cyst on my left ovary, and my E2 came back at 101, so they wanted me to do two weeks of birth control and come back.
Turns out the "cyst" is just the way the fused tube sits on my ovary, because two weeks later it was still there and my E2 was down to 31.3, so they gave me the go-ahead to start the Femara.
I ovulated on the left side.

As I have now pretty much caught you up, I will cover July and August in my next post because it's kind of a long one and needs to stand alone.

A Year of Changes

We lost Rudy in early March 2010. Patrick took it VERY hard. I felt as though we had lost a child. The last month was horrible, watching him get weaker and weaker, his stomach visibly growing with masses. At the end, the vet we took him to to end his suffering said that he had cancer on every organ except for his spleen. In three months he had gone from nothing visible to looking like he was pregnant he was so infected. It was rough.
In April we got the twins. Two crazy, lovable, fluffy Australian Shepard puppies born on Valentines Day. We weren't planning on getting another dog so soon, much less two, but the moment we saw these two monsters there was no leaving without them. Patrick had been so depressed and the puppies helped heal a lot of the pain we were both feeling. They could never replace Rudy, but I truly felt he had led us to them.
Patrick had sold his business in March and had been working with a Marketing company since November, so in May I decided that it was time for me to make a career change of my own and leave the salon I had been working at for four years and rent my own suite so I could be my own boss. I had been unhappy where I was for a while but we hadn't had the stability for me to make a change. Now that I had the opportunity, I was going to jump in with both feet.
With everything being so hectic in the first half of the year, we had strayed from our TTC path. I stopped charting, testing, everything. I randomly tried a couple more rounds of Clomid (I just called in the refill to the pharmacy and the Dr's office would approve it without ever speaking to me or asking to see me) but I wasn't invested in the cycles and barely even tried to take it at the right time. People would tell me, "Oh, this is when you're going to get pregnant, now that you're not trying." I knew better. My cycle was all over the place. I would have had better luck predicting the Apocalypse than trying to figure out when my next period would come. Stressed played a big part, I know. Starting at the new salon was a great move for me, but stressful none the less. Having two rambunctious puppies was stressful, especially when they started becoming very fearful of strangers (they never had a negative experience with one, it just tends to be a breed quirk among herding breeds). Patrick and I were fighting a lot, each one worse than the last. I felt like our marriage was crumbling. I knew he was depressed after Rudy's death, but I didn't know what to do about it and, honestly, I was a step away from falling into the depression pit as well.
I became hyper-aware of all the hardships we had faced over the past two years. The lawsuit against the insurance company still hadn't gone anywhere, they were just ignoring our lawyer, I felt as though every time we tried to catch up financially, there was something else that needed more than we could afford to spend. Rudy's illness and death was just another weight added to our load of crap to deal with. With every fight, unexpected bill, and added hardship, I felt myself edging closer and closer to pit.
Then, one day just after my birthday in September, I decided I had had enough. I would take control of my life and work harder to bring positives to it. I called Patrick and told him there were going to be chances. No longer would I sleep until the last possible minute before I HAD to get up. No longer would I fill my body with junk, oblivious to what I was putting in my mouth. No longer would I let our marriage fail. I was going to get up early, take the dogs for a walk, do yoga, work out. I was going to buy fresh groceries once a week, learn to cook, eat healthy. And he was going to do all those things with me. We would reclaim our intimacy, strengthen our trust, and work together to better ourselves. These were things I had control over and I was going to take it. I bought the book Making Babies: A Proven Three Month Program for Maximum Fertility, using it as the basis for our healthy-living program.
I happened to start our new healthy lifestyle on the first day of my cycle. I followed everything to the tee. And one month later, I started my period. I had NEVER had a normal cycle without medication. Something had to be working! Everything the book said made perfect sense, and I had just seen that it actually did work. I HIGHLY recommend this book to anyone trying to conceive.
Everything was going great. Making those changes had changed my whole outlook. I actually had hope for positive things.
A week later, my positive momentum crashed and burned. Patrick and I got into a hellacious fight. I moved out, back to my parents. I wasn't ready to call it quits, but I needed to separate myself from the chaos that was my home-life before I went crazy. Patrick needed the wake-up call that things HAD to change, and I needed to see that he was taking this seriously.
A month of being at home, and Patrick was making dramatic changes. In December, we went on a vacation with friends that had been planned since June. It was the first time we had spent a lot of time together since I moved out. I was shocked at how far he had come and how determined he was to prove to me that things would be better. I moved back home as soon as we got back, more determined than ever to make 2011 OUR year.