Follistim, Party of One

CD19, folks! It’s been a bit since I updated, and a lot has happened the last 19 days! Let me break it down for you.

 

1. Provera was hateful to me and Letrozole was kind. Had a baseline ultrasound done on CD3. My Cycle Coordinator, H, has been wonderful in working with me and having some labs and other stuff done here locally so I don’t have to take off work as much. I got to go to Dr. L’s office for the baseline ultrasound and the girls there were ecstatic to see me. The ultrasound tech even used me as a teaching device that day, since my ovaries have a perfect string of pearls. I’m pretty much textbook, folks.

2. I began my very first cycle of Follistim. We started out with 75 units on CD’s 8-10. On CD11 Hubby and I made the 2 hour drive to have my midcycle ultrasound and labs done. It was uneventful. No mature follicles to be seen. So I was instructed to continue the Follistim 75units a day for the next 5 days. Then on CD16 we would return for another ultrasound to check things out.

3. I’ve become a pro at jabbing myself with a needle! Hooray! At first it was a little tough. I mean, it didn’t hurt, and I knew it wouldn’t hurt. But it’s like my brain wouldn’t tell my hand to give myself the shot! Crazy. But eventually I got the hang of it and I’ve been shooting myself up like a mad man.

4. Back to the clinic 2 hours away for our 2nd ultrasound on CD16. We got some good news. Actually, great news! There it was, on the screen. The most beautiful big black blob I’d ever seen. One mature follicle measuring 19mm. Bigger than Dallas right there on the screen. When she told me I closed my eyes and asked which ovary it was on. Luckily, it was on the RIGHT ovary! The left had a few little ones that weren’t mature yet. And the right only had that one. But oh my gosh, it was amazing. And it only takes one, right? I was pretty much giddy the whole way home. It’s just an amazing feeling to finally get some good news! After the last several cycles of my follies only growing to 12mm and then stopping, this is fantastic. I love Follistim. LOVE IT.

5. So we triggered that night at 8:00. Sexy time like crazy the last 2 nights {and probably tonight, just to be sure!}. Yesterday I was having bad period-like cramps most of the day, with some twinging of my ovary. I’m not sure if that’s a good sign or a bad sign.

 

So there you have it. Starting out the TWW with pretty high spirits. I’m always very careful not to get my hopes up, but it’s just so hard this time around. I don’t want to jinx it…but I’ve just got this feeling…. Fingers crossed!!!

 

 

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On Our Way

Well, friends, we are well on our way to Cycle #1 of TTC with the RE! I’m 5 days in with my old pal, Provera {grrr…} and hopefully within the next week I’ll have a little visitor and we can get this party started.

My Patient Education Class went well on Tuesday. I like Nurse M so far. She’s a little bit lacking in the personality department, but she’s very nice and helpful. We had to sign all sorts of legal mumbo-jumbo telling us of all the side effects that these meds {that I’ve already taken} can have. We went over the financial part of everything, and even though I’ve been approved by my insurance for fertility treatment, this first cycle is going to hurt a little bit until my $1500 deductible is met {ouch!}. We went over how to use my Follistim pen I’ll be getting {via mail, with all my other meds}, and Hubby got to take a trip to the Collection Room for a sperm analysis {results on Monday, I hope!}. All in all it was a good visit. Here’s the low down on the meds I’ll be taking:

Metformin ER 500mg X Twice a Day
Provera 10mg X 10days {currently}
Letrozole 2.5mg X CD3-7
Follistim 75units {dsg and days depending on ultrasound}
Trigger Shot {not sure which my insurance is covering yet}

In other exciting news, I cleared my kitchen cabinets of any and all junk food on January 2nd. Since then I have been trying to eat healthier and stay pretty close to a 1200 calorie diet. I haven’t had any sweet tea in over a week and a half, and I’ve only had a couple of diet sodas here and there when I really needed the caffiene fix. Exercise is coming along slowly. On nice days after work I’ve been taking my fur baby, Jenny, for a walk up and down our road. And I bought an elliptical, which was delivered on my doorstep Friday and I can’t wait for Hubby to put it together when he gets home from work today!

The best part? As of this morning…

I’ve lost 7 pounds!

I’ve still got a long way to go, but 7 pounds is a great start! The crazy thing is, it hasn’t even been that difficult. Its amazing what happens when you put yourself into a whole different mindset. Healthy Diet = Baby. That’s the equation I’m banking on.

Here’s hoping that Provera doesn’t make me a cranky bitch this week!

My life on progesterone.

My life on progesterone.

Once More, With Feeling!

fertilizedeggsplease

 

I’ve been a little MIA from the blogging world lately.  It’s just that with the holidays and work and doctor’s appointments, I tend to spend my free time doing absolutely nothing.  So here we go with an update.

My follow up appointment with Dr. P was on the 31st.  Dr. P was looking much healthier this go around and seemed to be excited to get going with our treatment plan now that we had my lab results back.  Hubby’s karyoptype came back normal, as did mine.  Most of my other results were normal, too, expcept for increased testosterone and things like that that we had expected.  Then the bad not so good news.  My insulin resistance test came back positive.  So it’s official.  I’m insulin resistant.  All of my blood sugar numbers were great…perfect, he said.  But, my body is resistant to the insulin that keeps those sugars great, so it’s making an abundance of it.  The excess insulin is triggering my ovaries to make more testosterone, which interferes with the growth of my follicles.  Which essentially makes me a sad/angry/infertile woman at the end of every cycle.

Now, none of this was news to me.  I had expected that I had a hint of IR, just because I’m pretty textbook for it.  But Dr. L had tried to put me on Metformin before, and the side effects were terrible.  {TMI time} I couldn’t control my bowel movements, people.   And in my line of work where I am running around and with patients all day long, you can’t just scadaddle off to the restroom at the drop of a hat.  Not to mention, in an office of 35 women, we have exactly TWO bathrooms.  Seriously.  And I swear to God people just camp out in there sometimes.  You can never go when you need to go.

So what is our gameplan according to Dr. P?  Back on Metformin.  He told me it was not an option.  You want to have a baby?  Take the Metformin.  Period.  Well, ok, doc.  So he put me on 500mg twice a day, starting off the first week just taking it with my evening meal until my stomach can adjust.  He prescribed the Extended Release {ER} which seems to help a LOT with the stomach issues…I actually haven’t had any except I seem to be gassy all the time now.  Which could have something to do with the 2nd part of my IR treatment…

Diet.

Ugh.

We {hubby included, because I’ll be damned if I have to do this and he doesn’t!} were informed to start following a 1200 calorie diet and cut way back on sugar intake.  Sure.  Sounds fine.  Except for the fact that I can drink a gallon of sweet tea a day all by myself.  Seriously.  I’m addicted to the stuff.  Take away sodas.  Take away sweets.  I’ll be just fine.  But my sweet tea??  Oh, God, this is gonna be bad.

It’s not a bad thing.  We’re both overweight.  We’re both out of shape.  This is something we’ve needed to do for a long time.  I’ve known I needed to get myself healthier for a long time.  I could just never get myself motivated to do so.  Until the Fertility Specialist says if you want to have a baby, this is what you have to do.  That’s my motivation.  Why I didn’t look at it this way before?  I have no idea.  But that’s how I’m looking at it now.  I’m just doing what I have to do.  I was talking to a friend this week about my future fertility treatments, and she said to me, “I don’t think I could ever give myself a shot.”  Without any hesitation, I looked at her and said, “When you want something bad enough, you’ll do whatever you have to do.” 

So far its not going too bad.  We went through the cabinets and got rid of any and all food not on my approved list.  A brand new unopened package of Oreos thrown out. {Actually, I gave them away because I can’t bear the thought of throwing away perfectly good food}  My “snack” foods have been replaced with sugar free pudding, popcicles, and cool whip and fresh fruit.  The dinners I cook are pretty much the same, with a few changes like buying things with whole grains, etc.  I’m packing my lunch for work instead of going out to eat all the time and that saves calories and money.  I’m watching my portions and tracking my calories and so far I’ve done ok and lost 2.4lbs since the start of this week {which I’m attributing to cutting out the sweet tea lol!}.  I haven’t had anything to drink but water {except for 1 can of Diet Dr. Pepper} and with the help of Sweet Tea flavored Mio, it hasn’t been too bad at all.   It’s not easy, but easier than I thought it would be. {Making myself eat breakfast has been my biggest challenge, because I am NOT a breakfast eater at all!}  And I’m not there yet, but I’m eating world’s better than I was a week ago, so that’s something.

Next step: Incorporating exercise into my daily routine.  But, one step at a time.

Ok, where were we?  After explaining the diet/Metformin plan to me, Dr. P says he’d like to give me a month or two to get the IR under control before going on with any treatment.  Um, excuse me??  Did I hear you correctly, doc??  You want me to wait two months to start ANY kind of meds?  Nope.  Sorry.  Not gonna happen.  Two months, in the grand scheme of things, is not that long.  But two months for someone who has been TTC for two years is an eternitiy.  I haven’t had a period since November 8th and I’m going out of my frickin’ mind about it.  I’m gonna take your Metformin and I’m gonna cut my ties with my beloved sweet tea, so the least you can do is give me some mothertrucking Letrozole, guy.

The story, according to my husband, is that I whined and threw a fit and got my way.  But really, all I said was I didn’t want to wait that long to get started.  I’ve waited long enough, Dr. P, and you’ll soon realize that I’m going to be a pretty impatient patient.

So he gets out his prescription pad and writes me one more script….for Provera.  Ah, old friend, we meet again.  It’s gonna be a fun ten days.

He tells me to wait to start the Provera until I set up my Patient Education Class with Nurse M.  His plan for us right now is to do Letrozole with FSH injectables and timed intercourse {UGH}.  If it doesn’t work after a couple cycles we will move on to the IUI process.  I think this is just his way of tiding me over, since he wanted to wait until I was on the Metformin a couple of months before we did IUI anyway, but whatever, I’ll take it.  I can’t stand the thought of doing NOTHING.

So we signed up for the next available Patient Education Class with Nurse M on January 8th, this Tuesday.  I’m not exactly sure what she’s going to teach me in this class that I don’t already know, besides maybe how to give myself a shot.  But they won’t let me start my meds until its done, so we’ll be there Tuesday morning, bright and early.

So there we have it.  I feel like I’m starting over, almost.  Like the last two years are being disregarded and I’m being treated as if all of this is new to me.  I’m sure that’s how they treat all new patients, but its a little frustrating, to say the least.  I’m ready.  For the big stuff.  If I had it my way we’d skip all this preliminary stuff and drop 20 grand on IVF tomorrow {might have to rob a bank or something first, but I can improvise}.

I’ll update soon about my first exam with Dr. P….it was interesting to say the least!

Hope everyone is having a happy new year!

 

Our First Consultation

This past Monday was our first consultation with the RE!  So exciting/scary/promising!  It’s been a crazy week with the holidays coming up, so I’m little behind on updating on how everything went.  But here we go…

First of all, everyone at the clinic {so far} has been so incredibly nice.  I get it, it’s their job and they work in a very delicate specialty.  But when you feel like you’re carrying around as much baggage as I do, it’s nice for people to not make you feel like you’re a burden.  Even if it is their job.

Hubby and I woke up way too early and left our house at 5:30am to make the 2 hour drive to the clinic.  $3.00 in toll fees and 2 detours later, we arrived at the clinic at around 7:50.  They don’t open until 8:00, and our appointment wasn’t until 8:30.  So we took a little joyride and found a place to take a bathroom break.  By the time we got back they were just opening the doors.  Hubs opened the truck door and asked if I was ready.  I wasn’t.  And I was.  All at the same time.

We were met with chaotic smiles behind the front desk.  There was clearly a new person being trained, quite possibly her very first day, and then they explained to us that the credit card machine wouldn’t settle, so they were on the phone trying to sort that out, and Dr. P {who happened to be the doctor I was seeing} was terribly ill this morning.  The girl assured me that things weren’t usually like this as she handed me and the hubs some papers to fill out {and thanked me a million times for filling out our medical history on the patient portal…which by the way is pretty awesome}.  I work in a medical office.  I can totally understand walking into a crazy Monday that you didn’t expect.

After handing in our papers we waited less than 10 minutes before being called back.  The girl who called us back {whose name I didn’t catch…I’ll have to pay more attention next time!} was all smiles as she asked me to step up on the scale.  I’m glad she was smiling because I was not!  Then Smiley took us into an exam room and asked the basic questions.  I had already filled everything out on the Patient Portal ahead of time, so she was basically just verifying the information.  She took my blood pressure then Smiley asked me to smile as she snapped my photo with a digital camera.  Then Hubs had to smile at Smiley for his photo.  At my office we just scan your driver’s license, but hey, whatever works.

Smiley then began to explain that Dr. P was very sick today, but since we were new patients and came from out of state, he was going to go ahead and see us before he went home.  Then she lead the way into his office.  Right off the bat I liked Dr. P.  He’s very personable, straight forward, and has just the right amount of a sense of humor.  The poor guy looked about half dead, though!  When they said he was sick they weren’t kidding!  I felt horrible for him, but so grateful that he chose to stay and see us.

First things first, we went over my history, discussed all the avenues we’ve already taken.  We came to the conclusion that I’ve got a lot of things working against me and that I’m pretty textbook for PCOS, but he wanted to do a few tests to rule out anything that could be disguising itself as PCOS.  Dr. P said we were going to be very aggressive with the meds to get me ovulating, probably keeping with the letrozole for now and adding FSH injectables.  Getting me ovualting wasn’t his biggest concern though.

Recently I had some blood work done.  A lot of bloodwork.  Bloodwork that required so much blood that I passed out in the lab.  Dr. P was studying my results and then informed me that I am a carrier of a single copy of both Factor V Leiden mutation and the C677T MTHFR mutation.  If you’re unfamiliar with this, I suggest you consult The Google, because it will explain it much better than me.  The basics of it is, I have a clotting disorder.  And the fact that I carry both mutations and not just one is just icing on the cake.  After explaining this to me, Dr. P then began to ask me questions about my miscarriage.

How far along were you?  8 weeks.

Did you hear a heartbeat?  Yes.

Yes?  Yes.

Hmm.

I had been told that we were so early that there was really no way to tell what caused the miscarriage.  These things just happen sometimes.  1 in 4.  It was hard, but I had accepted it.  Dr. P informed me that he didn’t think this was the case at all.

In his professional opinion, he said that once you hear a good healthy heartbeat, there is usually a reason behind the miscarriage.  In my case, the clotting problem.  It decreases and cuts off the bloodflow to my uterus and to the placenta, effectively cutting off the blood flow to the baby.  There’s no way to know for sure, but Dr. P believes this is what happened to me at 8 weeks and 1 day.

I’m not gonna lie, that’s a tough pill to swallow.  To know that I had a perfectly healthy baby growing inside of me, and my body betrayed me, betrayed my baby.  To know that I could have a 7 month old son or daughter right now if I had just been taking a frickin’ baby aspirin?!  It’s hard to wrap my head around.

So, game plan.  Dr. P proposes that the day I get a positive pregnancy test I will immediately begin heparin or lovenox injections every day.  I started a baby aspirin everyday when I had this bloodwork done and I will continue to do this.  {I will likely be on an aspirin regimen for the rest of my life.}  He seems pretty confident that I will be able to carry a healthy pregnancy this way.  Now, about the getting pregnant part..

Like I said, we’ll most likely stick to the letrozole for now and add FSH injectables.  But all of this depends on the results of the bloodwork I’ve had done this week.  Dr. P said depending on what the results show will depend on how he treats me.  I also had to be checked for insulin resistance, since it usually goes hand in hand with PCOS.  We discussed the fact that I was put on Metformin before but it did nothing but make me race to the bathroom every 5 minutes, so he’s not sure if its actually an issue with me or not.  At least if it was it would help explain all the weight gain!

He said he usually likes to start out doing 3-5 cycles of IUI before he moves on to IVF.  Depending on how I respond to the meds will determine how many cycles we try.  I’m ok with that.

After we talked and the poor man finally got to go home to bed, we were sent to the lab to get some blood drawn.  They use a separate lab company, which is convenient because they have a lab a couple towns over from where we live, which happens to be in the same town that we both work in.  We went straight from the clinic to the lab in Tulsa {which was in a kind of shady location behind a grocery store} and since they wanted a karyotype test from both of us, the Hubs had to get stuck with a needle this time, too!  I enjoyed it a little too much, haha!  Then later this week I went to the local lab here to have my insulin resistance test.

We go back to see Dr. P on December 31st to discuss what the results were and how he plans to go about treating me.  He also talked about probably getting an ultrasound of my ovaries this visit or shortly after, as well.  Dr. L’s office sent a short novel to him, so he’s already got a lot of the info that he needs to start off with.

So far, thats all she wrote!  I’m excited for the 31st to get here and see what we’re going to do.  I’m anxious to get started.  I still haven’t started my period since my last cycle {November 8th} and I don’t like not being in a cycle.  After counting cycle days for 2 years its like a way of life!  Although, I can’t say that I’m excited to meet up with my old friend, Provera.  Ugh.

Merry Christmas, everyone!

What The Hell Is Going On In There?

Ugh.

Haven’t posted in a while, so here’s a little update.  I went in on Friday the 28th for my bloodwork.  Nurse D called me on Monday and said my progesterone level was 0.7.  0.7!  That doesn’t just mean I didn’t ovulate, that means Hell no I didn’t ovulate.  Geez.  We discussed it and decided that since my next cycle I should {in theory} ovulate on my left ovary anyway, it would be a good time to do another month of birth control to “quiet” everything down and help me respond to the Letrozole better on the following cycle.  So I am to call her if I start my period, which, if I didn’t ovulate I probably won’t, and if I haven’t started by CD35 I’m to test and then call her to get another script for my favorite med: Provera.  Nurse D said to just wait it out because the numbers don’t necessarily mean anything, especially in my case since my body always seems to do the exact opposite of what the numbers say.  And why shouldn’t this time be any different?

So Saturday {October 6th} rolls around and I wake up to AF giving me a big fat Good Morning!  Um, what?  I didn’t ovulate, so therefore AF shouldn’t be showing her snotty little face, right?  And if she is showing up, does that mean I actually did ovulate?  And if I did ovulate, WHY didn’t all that sexy time me and the hubs had work???  Basically what I want to know is…What the Hell is going on inside my body?!

I just called Nurse D and am anxiously awaiting her phone call back so I can tell her about AF’s little surprise visit.  The hubs and I have talked a little, and since Dr. L has mentioned IVF the last two times I’ve seen him, we will probably be going to an RE after the first of the year if we haven’t gotten pregnant by then.  This month marks 2 years that we’ve been trying.  It’s time.  The first of the year seems like as good a time as any.  That will allow us to get past the holiday season and have both of our vacation times start over at work.  Since the ony two fertility clinics close to us are both around 2 hours away, we’ll need the time to take off work.

In other news, its October, and October is my favorite month of the year.  So let’s be happy about that.  🙂

Weird Cycles & Crappy Insurance

In an earlier post I said that I should be getting AF on or about September 6th.  Imagine my surprise when that little devil actually showed up on September 6th!  That’s pretty much unheard of, for me anyway.  I haven’t been able to predict my period in….ever.  But sure enough, there she was, right on time.  But here’s the thing…

The last two cycles I’ve been on Letrozole.  My last two periods {this one included} have been….strange.  Started out very light and spotty, and instead of getting heavier, have stayed very light and spotty.  This is day 3, and the only thing I’ve had to wear is a tiny little panty liner.  Before the letrozole, when AF showed up, she showed up guns-a-blazin’.  Flood gates opened and it was on.  Granted, most of the time I had to take Provera to start my period…even while I was on Clomid, because at least half the time I wasn’t ovulating on it {hence the Letrozole}.  I’m just confused and almost feel like I’m cheating since its a barely-there period.  Anyone else had this happen while on Letrozole {Femara}??

Ok.  On to my crappy insurance rant.

My stupid workplace has been trying to switch our insurance for a while now to something that is cheaper for them.  They pay 100% of my insurance.  To clear that up, I pay NOTHING for health insurance.  Nothing gets taken out of my check every two weeks.  Whereas most companies pay 80% for employees, and the rest is deducted from their paycheck every pay period, my employer pays 100% for us for medical and dental {does not imclude spouse/family, only employee coverage}.  Which is fantastic.  I appreciate it, I really do, because I know the workplaces that do this are few and far between. Which is why I feel a tiny bit of guilt bitching about my insurance, since its free and all….but here we go.

Like I said, my employer has been trying to switch insurances for the last couple years, but they haven’t been able to because they’ve had some “high risk” employees {people with ridiculous medical conditions that went to the doctor/had surgeries all the damn time} on the payroll and no other insurance company would touch us.  For a little while there I thought I might be one of the “high risk” employees, since I’m in my OB/GYN’s office almost as much as I’m in my own!

Well, lo and behold, within the last year we’ve had two employees quit and about a week and half ago we were signing up for our new insurance.  Absolutely no warning whatsoever.  They just started pulling us into the conference room one day to fill out paperwork and said effective September 1st, you’re covered by the new crappy insurance!  Initially, I was swept up by panic, because I have no idea if Dr. L is covered under the new insurance, and there is no WAY I can change doctors after two years of treatment with this man.  Then, the thought of IVF hit me…because we aren’t there YET, but my old insurance did cover it {80% up to $15000} so I knew if it came to that we could at least try once without going COMPLETELY broke.  I was pretty pissed off, because this new change was A.) Unexpected, and B.) Screwing everything up for me {yes, me me me me me! I’m back to my selfish phase}.

Luckily, Dr. L is in network and IVF is covered, but with very strict stipulations that I luckily{?} qualify for {though the overall coverage of this new insurance blows}.  So yesterday I go to Walgreens to pick up my Letrozole, since I started AF on Thursday and will start the Letrozole on Monday.  I give the lady at Walgreens my new insurance info {which is typed out on official stationary from my employer since we haven’t even gotten our cards yet} and she promptly tell me that my new crappy insurance requires a prior authorization for the medication.  Fuck. Me. {sorry for the four letter word, but SERIOUSLY.}

She starts to explain to me what the prior authorization means, and I stop her and tell her I work in a doctor’s office, I know exactly what it means.  It means that I am going to end up paying $80 for FIVE pills.  Because it’s Friday and its after 5, and my doctor’s office isn’t going to get the prior authorization form to fill out until Monday, and they probably won’t get around to filling it out and faxing it in until later that afternoon {because I work in a busy doctor’s office and I know that’s how it goes}, and if by some SLIM chance of a miracle by the Powers That Be decide that this medication will be covered by the new crappy insurance, it will already be too late because I HAVE to start taking it on Monday.

I did what any desperate self respecting girl would do and I called in a favor.  I happen to work with and be pretty good friends with Nurse D’s {Dr. L’s nurse} daughter.  Since it was just a few minutes past 5 I tried calling Dr. L’s office but they already had the phones shut off.  So I called my friend A and explained the sitch to her asked if she knew if her mom was still at work or not.  I know she stays late sometimes because she’s called me well past 6 o’clock before from the office.  A said she’d call her cell and see and have her call me if she was.  I figured if she could at least get the prior authorization form faxed in now instead of waiting til Monday, it might speed things up a little.  Unfortunately Nurse D had already left work.  But I figured it was worth a shot.

Oh, well.  I don’t expect that it will be covered anyway.  Especially since I’m using it for infertility reasons instead of it’s actual use {breast cancer} but my old awesome insurance hadn’t caught on to that yet.  It just sucks because I paid $10 last month for the same 5 pills I’m gonna have to pay $80 for this month.  I can’t wait to see what other surpises this new insurance has in store for me!

Ok. End rant.

Everyone have a great weekend!

If At First You Don’t Succeed…

Here I am, back on CD20.  Doesn’t it seem like we were just here?

My ultrasound on the 17th showed some good and bad news.  Good news is, I am ovulating. Yay! Bad news is, its on the wrong ovary. Boo!  Having a missing fallopian tube can really be a bummer.  So I’m basically sitting this month out, which is a little depressing and frustrating when I know there are perfectly good follicles just waiting to make a baby on that left ovary with absolutely nowhere to go.

On the bright side, the letrozole is working, much better than the clomid ever did.  And chances are I’ll be ovulating on the right ovary next cycle {fingers crossed}.  If my cycle resembles any sort of normalcy {which lets be honest, it never has} then AF should show up around September 6th, and we can get on with it.  Who knew I’d ever be looking forward to that happening??

On another note, I think I may be losing my mind.  I’ve been doing this for two years now.  Provera, Clomid, Provera, Clomid, Provera, Letrozole, etc, etc, etc.  It’s true that most of the time I’m an emotional wreck.  I cry at ridiculous moments. I snap at people I love for no reason.  I cry some more at some even more ridiculous moments.  But here lately, it seems to be getting the best of me.  I feel more on edge, more anxious, and more stressed about little stuff {mostly at work} that never bothered me before.  More than once in the last few weeks I’m broke down in tears at work because I’ve just felt so overwhelmed.  I feel like maybe all the hormones are finally catching up to me?  I spoke with an older friend at work {who is an RN} privately about this, and she suggested that I tell Dr. L whats going on and see if maybe he can prescribe a low dose something or other to help take the edge off.  She told me that there was no shame in taking something as needed short term, especially since I legitimately seem to need it.

I’ve never taken any sort of antidepressant/anxiety medicine.  I’m very reluctant about it even now.  But I’m getting to the point where functioning normally at my job at a daily basis is getting more and more difficult.  I don’t want to be that girl.  You know… “Oh, don’t worry about her. She’s just having another emotional breakdown. *whispers* She’s on fertility meds.”  Yeah. That girl.  But I am. I am that girl.  People make excuses for me because of all the hormones I’m on.  Hell, I make excuses for myself!  And I hate it.

So, here I am.  I can’t even bring myself to make the phone call.  I almost feel like if I make that call and ask for help, it means I’m weak and I can’t handle this.  And I can handle this.  I’ve been through too much to not be able to handle this now.  But I don’t know if I can keep going the way I’ve been going.  I’m a few breakdowns shy from everyone {including myself} thinking I’ve completely gone off my rocker.  And quitting this process is not an option.  I’m probably way overdue for taking a break from TTC.   I wish I had enough sense to do that, but I want this too bad.  I will not stop until we’ve made a baby.  We will have to exhaust every single option there is out there, and even then I think my uterus will have to fall out before I finally give up.

So maybe I’ll call on Monday.  Maybe.

Provera & Clomid & Letrozole…Oh My!

When my husband and I got married in March 2010, we knew we wanted to start trying to get pregnant pretty soon after.  I already knew that there was a big chance we would have problems conceiving, and the fact that I hadn’t had a period in almost a year and half was not a good sign either.  I saw Dr. L a month before my wedding and told him I didn’t want to be put on the pill again because we were planning on TTC within the year.  So he gave me an Rx for Provera {medroxyprogesterone} with 3 refills to make myself have a period until we came back to see him again.

In October 2010 my husband and I went in for our first {of many} consultations together with Dr. L.  He explained to Hubby what was going on in my body and what we going to have to do to get pregnant.

First, I would take a 10 day dose of Provera to make me start my period.  Sounds easy enough, right? Sure. Except for the fact that Provera makes me an absolute CRAZY person.  And by crazy, I mean short tempered, hateful, and angry.  Think of the worst PMS you’ve ever had and times that by 10.  Yep.  That’s it.  Luckily, my first cycle of the meds didn’t really bother me too much.  The crazy ended up coming a little later on.  But I digress… So I took Provera for 10 days. Within another 5 days after my last dose, I started my period {cycle day 1}.  The day I started I began numbering the days on my calendar, days 1 through 35.  On days 5-9 of my cycle, I took 50mg of Clomid a day.  Clomid is an entirely different beast.  This medicine is supposed to stimulate my ovaries and produce ovulation.  It also makes me a blubbering whiny mess who cries all the time. ALL THE TIME.  After my last dose of Clomid, the Hubs and I were instructed to do it like rabbits at the very least every other day on cycle days 12-20 {possible ovulation days}.  Then on cycle day 22 I went back to the doctor to have labs drawn, for what Dr. L’s nurse calls my quant.  Basically, they are checking progesterone levels to see if I ovulated or not.

Ok, got all that?

So our first cycle on the meds we didn’t really have any big expectations.  Dr. L said he was starting me out on the lowest dose of Clomid to see if my body would respond to it or not and then we would go from there.  My day 22 quant levels came back very low at 2.7.  Nurse D told me that anything above 5 they consider that you ovulated but they like to see numbers at 10 or higher {since we’ve been doing this my quant levels have never been higher than 7}.  She told me I most likely did not ovulate this cycle.  So I probably wouldn’t start my period on my own, and if I hadn’t by cycle day 35 to take an HPT just to be sure and then we would start another cycle and up my dosage of Clomid up to 100mg.

Well, low and behold, right around Thanksgiving the HPT came back POSITIVE.  Positive! The hubs and I were estatic, but cautious, and maybe even a little scared.  We weren’t expecting to get pregnant so quickly.  Dr. L had me come in that day for a blood test.  My HCG level showed I was indeed pregnant, although it was so low that he wasn’t even sure how it showed up positive on a HPT {HCG levels usually have to be 25 or higher to get a positive urine test. Mine was around 20.}   For the next 2 weeks he had me coming in nearly every other weekday to have blood drawn.  In a normal pregnancy, the HCG levels will double every 48 hours.  Mine were going up, but they were not as high as they should be.  It was way too early to tell if anything was wrong, and we wouldn’t be able to see anything on an ultrasound until we were at least 6 weeks along.  When we finally tried an ultrasound, they still couldn’t see anything.   Dr. L told me that it may still be too early to see, but to prepare myself for the possibility of a miscarriage or an ectopic pregnancy since my HCG levels were not anywhere near what they should be.

He had me come back a week later for another ultrasound.  It was now the week of Christmas. This time they were able to see that it was an ectopic pregnancy {a pregnancy that happens outside of the uterus, in my case the fallopian tube}.  Since we caught it so quickly, Dr. L wanted to try treating it with medication before doing surgery.  I left work that day {December 21} to go to outpatient at the hospital where I was given two injections, one in each hip, of a drug so strong that I had to have my liver function checked before they gave it to me.  These injections were actually a form of chemo treatment, used to shrink tumors.  The idea is that they will shrink the pregnancy and it will expel itself.  This was the ideal way to go, because if it worked I would avoid surgery and possible trauma to my fallopian tube, which could cause another tubal pregnancy in the future.

Everything seemed to go fine with the injections.  The hubs and I were sad, but we had known from the very beginning that something was wrong, so we didn’t let ourselves get too emotionally attached to the pregnancy.  We had tried to act like I wasn’t even pregnant at all.  Don’t get me wrong, it was difficult and emotionally taxing.  But it helped to know from the get-go that something was wrong.  And to be honest, we were just happy to know that we actually COULD get pregnant.

My first day back to work after the New Year was January 4th.  It was a Tuesday, and a surgery day in the clinic that I work.  I felt fine that morning.  Everything was going well.  And then it hit me.  Literally, I was good one second and the next I was hunched over in the fetal position in incredible pain in the operating room floor.  Pain that I had never felt before.  Pain that felt like something was going to explode in my abdomen.  Within minutes I had tears streaming down my face because it hurt so bad.  I knew something was wrong.

Nurse D called me back immediately and instructed me to come in right then and there for an ultrasound.  Turns out the injections didn’t work and the pregnancy in my fallopian tube had continued to grow and was very much in danger of rupturing my fallopian tube {which could be fatal}.   Dr. L told me we could do surgery that evening or first thing the next morning.  I of course bursted into tears {again} when he told me I had to have surgery.  I opted for the morning.

That next morning in pre-op Dr. L visited with me and the hubs and told us he would do everything he could to save the tube.  The very first thing I asked after waking up was whether or not he took my tube.  Turns out, he did.  When he got in, it had already started to rupture and bleed on the underneath side {thats where all the pain and pressure was coming from}.  There was so much damage and trauma that he felt like it would do me more harm than good to leave it, because it would most definitely end up in another tubal pregnancy in the future.

So now, on top of the PCOS and ovulation problems, my chances of getting pregnant are automatically cut in half because I now only have one fallopian tube.

I had to wait 6 weeks after my surgery before we could start trying again.  It was almost March when I started my next Provera/Clomid cycle.  We ended up doing 4 cycles without any luck at all.  On the 5th cycle after my surgery, Dr. L told me if it didn’t work this time then he wanted me and the hubs to come in for another consultation on what we should try next.  My quant level was only 2.5 so we weren’t getting our hopes up.  But, by the first part of August we had another positive pregnacy test.

We were excited, but cautious.  Dr. L kept a close eye on me because of my history.  We did bloodwork 2-3 times a week for the first several weeks {I had more track marks than a heroine addict!}.  Thankfully, everything was looking great.  My HCG levels were doubling like crazy, I was tired and fatigued, I didn’t have an appetite at all and couldn’t stand the smell of chicken, and my boobs were incredibly sore.  All of these things made Dr. L very happy.  At around 5 weeks we were able to do our first ultrasound, and so far everything looked good.  I continued to do bloodwork once a week  until the next ultrasound at 7  1/2 weeks on Monday, September 19, where we got to hear our baby’s heartbeat.  It was incredible.  And healthy.  And it finally looked like things were going to happen for us.  Dr. L saw us that day and said everything looked perfect, he had no reason to worry and decided to only see me once a month from here on out instead of nearly once a week like we had been doing.  He did warn us that we were still in the very early stages, and most miscarriages happen within the first 12 weeks.  But again, everything looked great, so at that point there was no reason to worry.

That Friday, September 23, I started bleeding at work at around 3:45pm.  It was light bleeding, but definitely more than spotting.  I called Dr. L’s office and Nurse D called me back quickly, telling me to go ahead and come in for another ultrasound just to be safe.  I left work that day with barely a word to anyone and went straight to the doctor, which thankfully is  just across the street from the office I work.  It was Friday and well after 4 o’clock, and the office was empty except for the girl behind the desk, the ultrasound tech, Nurse D, and me.

I knew that something was wrong by the look on the ultrasound tech’s face.  She was trying hard to void her face of any emotion, but I saw it.  She told me sweetly that I could get dressed and she would be right back.  Nurse D was the one who returned and asked me to follow her to an exam room.  The office was literally deserted and most of the hallways were dark.  I felt bad for keeping them here so late.   When we got to the room she broke the news to me.  There was no heartbeat.  I was miscarrying.  It looked like it had just happened.  I had feared this was what was happening as soon as I started bleeding, but as soon as she said the words I broke down.

Nurse D told me Dr. L had left the office at 2 that day, and there was another doctor on call who could come in and talk to me.  I told her that was fine.  But Nurse D said she was going to call Dr. L first because she felt like he would really want to know.  I didn’t want to bother him at home, but she insisted and stepped out to call him.  Within a few minutes she came back in and told me not to go anywhere, he was on his way.

Dr. L showed up 15 minutes later in jeans and an old t-shirt.  He had been working outside in his yard he told me.  Dr. L had taken a special interest in me, and when he heard what had happened he wanted to be the one to come in and see me.  I can’t even begin to describe how much that meant to me.

I was 8 weeks and 1 day along when my baby’s heart stopped beating.  He basically told me that when miscarriages happen this early, its hard to find a reason why.  Usually there is some defect in either the egg or the sperm that causes the baby to stop developing at some point.  He insisted there was nothing we could’ve done to prevent or cause it.  If it was going to happen, it was going to happen.

Dr. L gave me the choice of doing a D&C or letting it happen naturally at home.  I wanted to avoid another surgery at all cost {not only because I didn’t want to be put under again, but because of my past experience working in surgery, I know exactly what happens during a D&C. no, thank you.}, so I chose to let it happen at home.  He told me that if I could handle it, that was the way to go.  Especially since we wanted to start trying again as soon as we could, and the D&C causes a lot of trauma to the uterus.

I couldn’t get through to the hubs at work so I had to break the news when he got home.  He punched walls.  I cried.

The next week was probably the hardest of my life.  Physically and emotionally.  I had no idea the kind of pain I would experience.  I was almost in shock about it.  Nurse D told me I was essentially having contractions.  So I spent most of the week in bed with my heating pad and a bottle of Lortab.  In the few moments I was spared of pain, all I did was cry.  I can’t even really describe what I was going through mentally.  Its not something that you can really understand unless you’ve been through it yourself.  The most horrible thing was that I still felt pregnant, even though I knew the baby was gone.

For the next few months I cried, if only a little bit, every single day.  Every. Single. Day.  Its coming up on a year now and I still often cry about it.  I don’t think its something that I will ever completely get over.

In December we got to start trying again.  We started back on our old regimen of Provera and Clomid.  Dr. L wanted to give it a few more shots since we had successfully gotten pregnant on it before.  He bumped my dosage up to 150mg and for 4 cycles it was hit and miss.  I either didn’t ovulate at all or I did and didn’t get pregnant {which is possibly because I was ovulating from my left ovary, the side that doesn’t have a fallopian tube}.  In May we were surprised again with another positive HPT.  Then, the next day I started my period.  It ended up being what is called a chemical pregnancy.  The egg was fertilized, but it just didn’t implant, so I had my period like normal.  There was enough HCG in my blood to get a positive pregnancy test, and since I take 20 HPT’s a cycle, of course it showed up.  A normal woman probably wouldn’t have even known because she would’ve just had her period like normal.

After this, Dr. L brought us in and decided we were going to try something new.  He put me on birth control for 1 month to “quiet” my ovaries down so we could essentially start from scratch.  When I started my next cycle, instead of Clomid I was to take 2.5mg of a new medication called Letrozole {Femara}.  This is actually a breast cancer medication but is apparently being used to stimulate ovulation as well.  Its been known to work well in women who don’t respond to Clomid.

So on cycle days 5-9 this month, I took Letrozole instead of Clomid {it also made me cry unconrtollably}.  On day twelve of my cycle Dr. L had me come in for an ultrasound to check and see if I had any follicles on my ovaries.  We got good news: there were good follicles on my right ovary and they were the perfect size he said.  He wanted me get what he called a trigger shot {Pregnyl to trigger ovulation} on Thursday and then come in Friday morning to do IUI {Intrauterine Insemination}.  Dr. L felt that since our chances are pretty much cut in half from the get go, IUI would increase our chance of getting pregnant, because we would be making sure the sperm got to the egg.

So yesterday {Friday, July 20} I went in for my IUI.  I took the rest of the day off work because I was feeling a little crampy for most of the day afterwards.  It was actually pretty easy and everything went well.  I only felt a little discomfort during the IUI, and honestly that was nothing compared to what I’ve been through thus far.

Now its time for the big TWW {two week wait}.  Yes, I still won’t know for another two weeks if the IUI worked or not — same as if I got knocked up the old fashioned way.  I’ve very nervous and excited and just so hopeful that it works.

I feel like I’m due for some good luck.