Tuesday, August 20, 2013

Pre Op Dx: Primary Infertility

The decision has been made. We are going ahead with Laparoscopic Ovarian Drilling!

I ended up getting my period Monday, August 19. After telling my doctor this, and after he was able to review all that my body has done (or more like has not done) while taking Clomid these past few months, we came to the decision that surgery is the best next step.

So a week from today I will be heading to the hospital where I work as a labor and delivery RN to have this procedure done. Talk about weird being on the other side and having to be a patient and not the nurse. I'm hoping the next time I'm ever a patient at Winnie it will be to have a baby!


In addition to the drilling, I'll also have an hysteroscopy (to look inside my uterus through the cervix and make sure there is nothing going on in there that may have been missed from the ultrasounds) as well as dye inserted through the cervix into the uterus and out the fallopian tubes. The doctor will be looking into my abdomen laparoscopically and should visualize the dye coming out, meaning my tubes are patent (open and not blocked).

I had a preop office visit today to discuss all the risks/benefits. While I cried a little in the room after seeing my weight written down, I was able to pull it together and it was a nice visit. All my questions as well as Phil's were throughly answered. Although I am a little nervous about the entire procedure, anesthesia, pain, recovery (oh and not eating all day as the surgery isn't until 3:30pm!!) etc. I am beyond excited that we are going after this infertility issue aggressively. I've said this before, but it's an understatement to say that I have a wonderful doctor! One who isn't wasting my time with pointless rounds of medications that haven't proven to be working. I couldn't ask for anyone better!


So next week, once the drugs wear off, I will be updating everyone how things went....and if my doctor sticks to the plan, I plan on having lots of great (yet possibly disturbing) pictures of my insides!!

















Sunday, August 18, 2013

Where do we go from here?

I am coming to the end of what has been one of the most challenging and emotionally draining months to date. It was filled with such highs and happy moments only to be followed by equally upsetting lows and heartache.


Here's a recap:

July 21 - Got my period! Sucks that 100mg of Clomid didn't work, but excited to get the 3rd round at 150mg started!



July 23 - Started taking 150mg Clomid, continued for 5 days!

July 30 - While using my Clear blue easy Advanced Ovulation predictor I got my first "blinking smiley", which means it detected a rise in my estrogen level. This happens a few days before the LH sure which signals OVULATION!


video
(Blinking Smiley!)




August 1 - Blinking smiley turned solid which means, LH SURGE! Also had CD12 blood work and ultrasound. Estradiol level 90.8 (up from 86.4 last month). Still much lower than we'd like mid cycle. As for the ultrasound, we were looking for one big, dominate follicle that would hopefully be the one to burst and ovulate. Unfortunately, it showed two very polycystic (lots of cysts) ovaries, with the largest follicle measuring 1.2mm.....we wanted at least 1.7-1.8mm. First big downer of this cycle. Yet I've still had the positive OPK, my basal body temperatures were also promising that I ovulated! Keeping optimistic this could be a successful cycle! (Insert bumpin' and grindin')

(Solid Smiley stays displayed for two days!!)

(Solid Smiley!)

(TVUS)

(Selene app on the iPhone to track Basal Body Temp)



August 10 - CD21 progesterone blood work. This again will tell us if I ovulated this month or not. >3 doc says I ovulate. However, we are hoping for >15-20. This cycle, my progesterone was 7.02. Yes, up from 5.99 last month, but still such a huge let down. Both me and Phil as well as my doctor were pretty bummed about this.


August 12 - One more ultrasound to look at my ovaries and uterine lining again a little later in my cycle. Looking for a corpus luteal cyst which is what would have been left behind if I ovulated. This time I could not see the usual looking polycystic ovaries with a bunch of tiny little cysts. This time each ovary looked like a big, black hole. It didn't help that the ultrasound tech wouldn't tell me much, but asked in a concerned manor when I was going to see my doctor again. In the end my doc says it's not concerning, just two large cysts on each side.



August 17 - CD28. The last four months on hormones, I've gotten my period on either CD27 or CD28. Woke up to no sign of a period so I cautiously took a pregnancy test. Negative. Bring on the tears and beer!


Now, August 18, CD29, still no period. The fact that I've been taking progesterone since August 3rd to help sustain a pregnancy if I were pregnant could be to blame for the delay. I'll stop taking that tonight and most likely retest tomorrow since my doctor advised waiting until CD30 to test if I hadn't gotten a period by then.



Phew, what an exhausting 29 days. I was so excited and happy the first half. But since getting the low progesterone level last weekend I've been so blue and down.  I've literally cried everyday.....actually crying as I type this. Cry for happy things, cry for sad things, I seem to cry every morning I get dressed. I'll be the first to admit it, I'm a hot mess. I don't know if the transient depression is from the progesterone (as it's known to cause changes in mood), from the daily changes in my body, from the fact that this third cycle is a bust or most likely from a combination of all of the above. I know couples struggle with trying to conceive for years. And while I can say we've only been truly trying to conceive with the help of medication for three months, we've honestly and truthfully been unable to conceive for over 4 years. Yet these last three months have taken such a toll on me both mentally and physically that I'm not sure how much I can endure. Of course I say this knowing that I will continue to do whatever it takes to have a baby. I knew it would take time and that it would be a long process, but at the same time I secretly thought we would be the lucky couple who got pregnant on the first round of Clomid, and if not the first month then most certainly by the third. I guess I wasn't prepared for it to be this difficult in all forms of the word.

One evening last week I got a very real reminder of why I'm putting myself through all this. We watched my three year old nephew Samson last weekend and had such a fun time with him. The night after he'd gone home I went to take dinner out of the oven, and grabbed the oven mitt. When I put my hand inside I felt something at the bottom. I looked in and took out two Teddy Graham cookies that Samson had hidden in the oven mitt. I immediately started bawling. THOSE are the little moments I so desperately want. While small and insignificant, I want a little person running around the house hiding Teddy Grahams in random places.



So where do I go from here? That question is still up in the air. Lucky for us we still have lots and lots of options. First things first, still waiting for a period. My doctor has been wanting to go through all my blood work and ultrasounds since we started all this to see how I've truly responded before making a decision on the route we take next. There is still a possibility he will say do another round of Clomid (dear God I hope this isn't the case). However, what I think we're both leaning towards is laparoscopic ovarian drilling. If he told me to be ready tomorrow I would be.  I just feel like my body is at a stand still when it comes to the Clomid. I will do whatever he thinks is best, but man I really do hope it's not another round of Clomid at this stage in the game.

I'm probably starting to sound like a broken record by now, but I would like to say that even though I've been pretty sad lately and not so much fun to be around, I still have so much love and support surrounding me. Of course Phil has been amazing, loving me no matter what, telling me I look wonderful, and letting me cry (and not questioning it too much, haha). He continues to make me laugh and help get me, get US through another day. My Mom who reminds me daily that I'm beautiful no matter what, and that this is all worth it. My nephews who give the best hugs in the world.  A doctor who actually listens to me, treats me with respect and works his ass off to get my ovaries working.  All the text messages, funny YouTube videos and emails I've received lately from friends telling me they're thinking of me and praying for us. A surprise package from an old friend, a random beer and good conversation with a new friend, and daily love from my two sweet dogs make things bearable. It can be hard to see the good in such a shitty situation, but when I look around I see so much love and support.....Of course it only makes me cry a little more. To each of you, I thank you and appreciate everything more than you'll ever know.



(Phil)

(Samson)

(Taj)

(Thanks Joan)

(Yum!)

(The best nonjudgemental listeners, shoulders to cry on and company to have around!)



Oh and once I figure out our next step I will be sure to let you know!

Lastly, here's another good song from you guessed it, Rascal Flatts! 













Tuesday, August 13, 2013

Infertility Etiquette

**FYI: An update on Cycle #3 will be coming in a week or so as well as the next steps**

Phil and I have now OFFICIALLY and actively been trying to conceive for three months (unofficially, aka without meds and without ever ovulating on my own, well ya know, a few years). These past few months we have taken the steps to induce ovulation and hope to get pregnant. So as exciting as this time can potentially be, these past three months have been some of the hardest ever in my life to endure.....emotionally, physically, mentally, etc. I always knew this whole process would be difficult, but there are no words that can even begin to prepare you for what it's really like. Such deep, deep sadness and heartache I didn't realize was possible to feel month after month that it doesn't work. Feelings of being a failure because my body can't do what a woman's body is made to do. Anger that "everyone around me is pregnant".  Frustration with the changes in my body that I deal with everyday I get dressed or catch a glimpse of myself in a mirror. Hope and optimism each new month and cycle brings that this could be the one! Reality that this whole trying to conceive process isn't going to be as easy as I'd hoped it would be.




Throughout it all, I am constantly reminded how much love and support we have. I've said it before, but random conversations, emails, comments and texts I get from so many people mean the world to me and truly make such a big difference in this whole process. At the same time, I've also experienced first hand some things that no woman trying to have a baby, whether there be issues or not, would like to hear. This has inspired me to make a little what to do or say/not to do or say to someone struggling to have a baby:




* Provide unbiased support. Sometime I just wanna cry, or vent, or talk about how upset I am. Please just let me have this release and I promise I'll feel better.

* Give genuine hugs. I can feel how much you care.

* Pray.

* Give me space. I'm obviously not shy about sharing our struggles, but there are few times where I'd rather just not talk about it.

* Let me drink a beer. If my doctor says it's ok, then don't judge me.

* Let me cry. Sometimes this is the only thing that makes things better at that very moment. Don't be embarrassed or uncomfortable.

* Randomly email, call, text. I can't begin to explain how important those little gestures mean to me.

* Allow for my emotional and hormonal roller coaster I call my day to day life. I'm sorry in advanced for any meltdowns, outbursts, hot flashes, or whatever else may come without warning.

* Listen.




* Offer unsolicited fertility advice. While I appreciate helpful advice, I also know what's wrong with me. I don't ovulate. Like, at all. So telling me that your second cousins step brothers best friends aunt tried 10 years to have a baby and then tried (insert specific diet, drug, workout, position) and now has 10 beautiful children isn't helpful.

* Start any sentence with "Have you tried. . ." Yes I probably have, and no it hasn't worked.

* Tell me it will happen when I stop trying. Honestly? We did that the last four or so years. No, actually it won't happen when we stop trying, because again, I do not ovulate on my own. That little detail is pretty important in making a baby.

* Tell me not to be so negative when I'm upset that something didn't work (Phil is the worst when it comes to this one, but I love him so much so it's ok). While I know this is well-intended, and for the most part I do try to stay positive, sometimes I just want to be bummed. I didn't get the results I wanted and it hurts and it sucks. Let me feel like this.

* Talk about my weight or body. Or even worse, tell me I look pregnant! For as long as I can remember I've had a special talent of looking about 20 weeks pregnant at any given moment (about 24 weeks after any meal or large drink). I am reminded daily that my clothes are too tight or just don't fit. I don't need an outside reminder of this. It also hurts when it comes in the form of a compliment ("Oh well you look great with a little weight on you, you were way too skinny before"). It's not hard to look at my body as broken or as the enemy in this process, and I don't need to be reminded that my outside reflects this fact.

* Talk about how crazy your kids are and how lucky we are to sleep in. Not cool.

* Tell me to relax or not stress about it. I am managing my stress pretty well if you ask me, and I don't need to be reminded that the unavoidable stress is bad for my situation.

* Judge my choices. You can't say what you would do until you're put in that situation.

* Ask me if I'm pregnant yet. Trust me, you will know when it happens and when I'm ready to share it!


(Am I an ugly crier, you betcha. . .but is this picture proof
that dogs offer the most unconditional and 
unwavering form of love and support, absolutely!)


Again, from day one we've had nothing but love and support. Anytime I've been hurt or frustrated with what people tell me, I know it's not ill-willed or malicious. However, that doesn't escape the fact that it still hurts, sometimes pretty bad. So whether it be someone you know struggling with infertility or any other difficult situation, remember to be considerate, compassionate, and when in doubt, a simple hug and a "I'm here for you" is usually all that's needed.


Ny nephew Samson gives the best hugs and cuddles when I need it most!