Best Laid Plans

So for anyone who doesn't follow me on Twitter (and why aren't you following me on Twitter!?!), a brief recap of the "revisions" to the Plan for this cycle:

Plan went overboard with much mad flailing in the waters. Acupuncturist threw out a life vest, and RE rescue boat pulled it out of the water.

So the Plan WAS Clomid with monitoring on CD12 to set Hcg trigger time followed by IUI, with acupuncture before ovulation (CD11) and again after IUI for good measure. I was really nervous about the Hcg trigger shot, in spite of the many reassurances of my fabulous tweeps. But I am a Big Girl, and I will do what needs to be done (or at least let the Professor do it to me).

Now, I know that I tend to get a positive OPK a little earlier than might be expected (CD12) given that the CrazyPills should push ovulation out a bit. So I have gotten in the habit of starting the OPKs on CD10. This cycle, I wasn't going to use the OPK since we were going to use the trigger shot, but SOMETHING made me grab a stick on my way out the door to work on CD11. I told myself that I had two OPKs in the cabinet, and with houseguests impending, I needed to get rid of them.

Good thing, too. It was positive. Well that explains the achy ovaries...

Crap.

Suddenly, the entire Plan was in disarray. Frantic call to RE to see what they wanted to do, and we scheduled in for an IUI Friday morning. All I could think was "I didn't test yesterday, what if it would have shown the surge YESTERDAY? It's too early, why is it so early? What if we've missed it?" All of this followed by a recurring string of profanity, from which I will preserve your delicate eyes/ears.

I left work early to go to my CD11 "pre-ovulation" acupuncture session in quite a state of anxiety.  The only ray of hope I could see was that the Professor and I seem to have seriously superior instincts about these things, and we had indulged those instincts the day before. Right on time. My acupuncturist felt like all of this was no big deal, we had done what needed to be done and she adjusted the treatment to be a post-insemination treatment. The IUI would just be back-up. She must have added something else in to the mix, because I slept through almost the whole hour and a half treatment and woke up feeling calm and reasonable again.

Friday morning IUI went smoothly, administered by our favorite nurse, Nurse FunnyBone. I had her once before and really love her sense of humor, sensitivity and down-to-earth confidence. She had them add in E2 and LH blood work to verify that the OPK positive was accurate. I don't know how they did it so fast, but they called with the results two hours later. Ovulation confirmed.

At least I've already got the progesterone supp's in the fridge!

Here we go...

Professor:1 - Crazy:0

What prompted my post earlier this week about the fabulous man I married?

Rewind back to CD7. Everything had been going so smoothly, I had been feeling so unusually positive about the cycle and life in general. About four hours after I took the third Clomid pill, the crazy caught up with me. I was suddenly so angry I was shaking and my heart was pounding. And why was I angry, you ask? Because the Professor forgot to take his vitamins.

Yeah... I told you it was crazy.

After I had a go at him for this grievous transgression, I broke down in tears and just let all the crazy flow right out. He was so good about it all, didn't even get defensive. He held me and talked me down till eventually, he could crack a joke and make me laugh. Crazy all gone.

I'm so lucky.

The Man I Love

The Professor. He basically rocks.

He is so damn smart. Well-educated and well-read, but also just innately clever. He masters concepts and subject matters that make my eyes cross. He teaches me something new every single day, and yet he never makes me feel stupid.

He is funny (hello - Confuterus?). He is a master of the pun, and the double entendre. He has the most delicious sense of the absurd and a refreshing willingness to be silly. Even at my lowest moments, he can always coax a giggle from me. Laughter is so important in our house, and he is a fabulous source of it.

He is hot! I mean smokin'... There isn't a single part of him that I would change. He has a certain natural charisma that draws people to him with no real effort on his part. He gets hit on more often than he likes to admit (always has). I love it that he now has a wedding band to wave around when this happens.

He is kind. To me, to strangers, to children and small animals... he doesn't even kill spiders! All I have to do is call out and he will come trap a bug and escort it outside for release (Except centipedes - they get no quarter around here).

He is my safe place. Wherever he is, there I feel secure. He is protective of me, he takes care of me. He is strong and confident when I am not. It feels like he can solve any problem, but in the rare instance that he cannot, he makes any discomfort or uncertainty bearable.

When I was much younger, I used to pride myself on emotional self-sufficiency. When the Professor first came into my life, I was constantly doing need-checks on our relationship... consciously evaluating how it would affect me if he suddenly vanished from my life, and trying to keep the need-level to a minimum. It's very scary thing to truly open yourself up to incorporating another person into your life on the whole.

Somewhere along the way, I grew up. And now... I cannot imagine a life without him. I still occasionally need-check (old habits die hard) and I know that if he vanished from my life forever, I would never fully recover. And that is freaking terrifying.

Would I trade the relationship I have with him now for emotional protection against the prospect of losing him? Not a chance in hell.

To My Friends in the Computer...

I started this blog one month ago today.

I just wanted to say "Thank You" to all of you wonderful women who have reached out to me since I joined the crowd on twitter and started this blog. It has been such a comfort to have so many strangers extend such warmth and good will to someone they've never met, and probably never will.

Thank you for listening.

Thank you for caring.

Thank you for talking back.

Thank you for getting it.

Just... Thank You.

So-Called Clean Slate, or WHY? (without answers)

Why was I so much more optimistic about this process last week when I first started spotting and realized that the last cycle failed, than I am today?

Why am I feeling so defeated NOW, when just yesterday my baseline appointment gave me the all clear to start a new cycle?

Why am I riding an emotional roller coaster, moody as hell, when I haven't even taken the first Clomid yet for this cycle?

Why am I having trouble focusing long enough to string two sentences together, when I'm nowhere near the two week wait onset of Hampster Brain?

Why do my damn eyes keep leaking (not crying, nuh-uh I AM NOT) for no reason?

Why can't I feel the sunshine anymore?

Cycle Number... Hell, I'm Losing Count

CD3 baseline appointment went well. Confuterus is still in there, slightly less confused at the moment. Rightie was hanging out, a cyst free grey shadow on the monitor. There was a brief moment of terror when she aimed the magic wand at my left ovary and I saw three distinct dark circles along one side. But she just said, "Looks good" and went on clicking out measurements. So I asked what the dark spots were and she went back to them.

"Three follicles at the starting gate - you are ready to go!"

No cysts (thank God) and the blood work came back clear as well. I'll start back on the Clomid this Friday, go back for monitoring the next Friday and get my trigger time. IUI should be over that weekend. Will also call my acupuncturist to see when she prefers me to come in, before ovulation or after IUI.

My Mom comes to visit that next Monday (and is staying for 10 days), so she will be an unwitting distraction during my 2WW.

Back in Limbo (UPDATED)

So I knew where I was. I thought... well, I thought wrong. Where I am is in limbo.

My beta was scheduled for Saturday (two days ago), but since we were leaving town Friday, I used an HPT that morning. Negative, followed by heavy spotting. Ah well. That's what I was expecting... nothing to see here folks... move along!

I called my RE's nurse line and talked to them about this situation, explained about our travel plans and asked for guidance. The nurse told me to continue to take the progesterone until I saw full flow, which was a bummer since we were going to be staying with family and they don't know we are dealing with infertility. What's that in the cooler case you just stuck in our fridge? Errr... ummmm... nothing to see here folks! Move along! With the spotting came a killer headache, so I assumed my period would appear any moment and took a prescription painkiller. Sweet relief!

I decided that I would indulge myself a bit on our little vacation (see my last post about resentment), so Saturday morning I drank a cup of coffee. Spotting continued, but still no full flow and Saturday evening I had a glass of wine after dinner. I will admit that I was a little surprised to still be spotting, but... *shrug*. Come the end of Sunday, the spotting had all but stopped with never a drop of red blood, but the headache was back. Still no change this morning, and I'm debating calling my RE but I KNOW what they'll say. Go for the beta. But I'm still out of town. POAS? But I'm not comfortable doing that in this house. So I won't call. If I still don't have my period when we get home, I'll go for the beta Wednesday morning. But I don't really think this is a good thing. I have no symptoms, other than headaches, light spotting and period-like cramping.

I was sitting here with a frown on my face and sighing, while contemplating the What If elephant in the room. The Professor asked me if I was sad, and I said, "Not really, my uterus is just clearly confused". His reply?

It's a confuterus?

Oh, how I love him.

UPDATED: A mere matter of hours later, and I've got full flow. I'll call the RE in the morning and schedule the baseline.

Maybe I'm Shallow, But... (UPDATED)

I don't really mind all the bottles of prenatal vitamins taken. My body benefited I'm sure. I can live with all the OPKs & HPTs used and discarded. They gave me information when I needed it. And I'm OK with the amount of money spent at the clinic in pursuit of parenthood. Kids are expensive. Mine would just be a little more so. And the painful and uncomfortable procedures are nothing I'm sure to the pain of childbirth or the bliss of seeing that child for the first time.

No. What I resent is the months and years of curtailing my lifestyle in order to try (so far, unsuccessfully) to boost my fertility. No coffee, no wine or whiskey, no hot tubs, and no painkillers. Hoarding vacation days with the hope of using them to extend a maternity leave instead of taking a long weekend whenever I felt like I needed one. Maybe that's just my only-childish mentality... I've very rarely had to make personal sacrifices for anyone else before. I want to have my cake and eat it too. I mean really, why shouldn't I?

I also resent all of those girls and women who deny themselves nothing, only to find themselves unexpectedly expecting and then fail to appreciate the gift they have been given.

If I come to the end of my IF journey with a baby, I will happily swallow that resentment. But if after all our options are exhausted, we are still just the two of us... I'll be grieving more than the loss of a child. I'll be grieving the loss of years worth of fruitlessly denied personal comfort. And you bet your ass that I then will wallow in self-indulgence to the full extent of my abilities.

UPDATE: I wrote this post on my phone yesterday at work after I started spotting. Last night, the Professor and I had a long talk about cycles so far and the plan going forward. So you know where I'm coming from - the Professor was in pre-med when we met and now works in public health. Without going into too much detail (he's touchy about privacy), suffice it to say I have the utmost faith in his ability to analyze this particular situation and form an objective opinion.

I have been worrying a lot lately... about the amount of trust I have to place in our medical team and about the fact that we continue to use the same basic protocol. I finally voiced this concern to the Professor, and he was surprised and very reassuring. He has clearly considered the subject, and he is in full agreement with the RE. The main factor in determining the continuation of the Clomid+IUI protocol is the fact that the first time we used it, I got pregnant. IT WORKED. He reminded me of the statistics, that in any given cycle, a fertile couple have a 20% chance of fertilization (not even viable pregnancy, just fertilization). So, four Clomid cycles with one fertilization that ended in miscarriage is right in line with that statistic.

I have to say, his calm and rational analysis of the situation did more for my state of mind than anything else could. I feel like this will happen. It's going to be OK.

Needle in a Haystack (or foot or knee or wrist)

Recently, I have seen a lot of people on twitter asking about acupuncture, so I thought I'd put my two cents in.

The first time I went for acupuncture was actually for treating my TMJ. I'm a tooth clencher/grinder, and even with a night guard, I sometimes have issues. I had reached the point where my lips were numb, and my dentist suggested I add acupuncture to the treatment plan. I had a friend who was apprenticing at a local clinic, and he recommended one of the practitioners there (who was on my insurance plan, as luck would have it). I wasn't entirely sure what I thought about it, but I was certainly willing to give it a shot.

The first visit, she asked me about a million and three questions before she stuck me full of needles. Can I just say how bizarre it was to lie there with a face full of needles? But after laying completely motionless and on the edge of sleep for about an hour, needles out and I felt so refreshed and peaceful. She asked me if there was anything else, and I remembered something I had forgotten to tell her about in the beginning.

A few months earlier, I had cut myself quite badly on a trash bin, necessitating a tetanus shot. Well, it turned out, I was still carrying sufficient immunity and had a bad reaction to the shot. I lost about 50% mobility in that arm for a couple of weeks. Three months later, I was still only at about 75% of my full range of motion in that arm. I explained all of this, and she said, "Oh! I can fix that!" She had me put that arm behind my back, palm out, and show her how far up my back I could move it. She then stuck a needle in one of my legs, and asked me to move my arm higher. After a few more minutes with the needle in my leg, I had equal range of motion in both arms for the first time in months. And I was officially converted.

After that, any time my TMJ, migraines or sciatica got out of control, I headed back for more acupuncture. And when infertility began to loom as a larger part of my reality, I began to see references to acupuncture as complementary treatment. I started noticing articles about studies showing it to be beneficial to fertility. I knew what acupuncture had done for me in the past, and once again, I was willing to give it a shot.

I had been having weekly treatments for just over a month when I first met with the RE and got the Luteal Phase Deficiency diagnosis, and in that time, she had already corrected my early/extended spotting issues. Another month of weekly treatments, and I got my first and only positive HPT. Coincidence? Maybe. But in the ensuing aftermath of miscarriage and subsequent cycles, I just didn't have time to go back for more acupuncture, and neither have I had another positive.

After the last BFN (which was accompanied by a recurrence of the early/extended spotting), the nurse said it was time to schedule another consultation with the RE, to revisit the plan going forward. It seemed like this current cycle might be the last shot with an IUI, so I wanted to throw every possible advantage at it. I decided it was time to bite the bullet (or the needle) and head back to the acupuncturist. At this point, I can definitively say that the spotting issue has been sorted out again. In a day or so, we'll know even more.

I don't know how or why it works. I don't necessarily drink the Kool-Aid, so to speak. My RE told me not to take the herbs, so I don't. But I will keep going back, because I have seen results. And I will encourage anyone who asks, try it for yourself. And check with your insurance company first. You might just be surprised.

By All the Saints

Disclaimer: I hope this doesn't totally alienate any of you believers out there. I wanted this to be a place where I can be totally honest about me, but I don't set out to be purposefully offensive.

I am not what most people would call a religious person, or even a particularly spiritual one at that. I was raised Protestant in the Bible Belt, but the Church failed me early on so I left. I decided that while I don't have a problem with God (or spirituality per se), I have very little patience for the people who take their religion as their identity. People are people, whether or not they go to church, and in any group of people there's gonna be nice folks and there's gonna be asshats.

That said, there is something about the rituals of High Church that fascinates me. I'm all for rituals - they elevate the mundane, they impart a sense of peace in their performance. I have sat in on a few Catholic masses and those folks have ritual down! It's like theatre to me, engaging all of the senses. Even without subscribing to the meaning behind it, there is a certain kind of release in letting the flow of sounds and scent just wash over you while you watch the officiant in their finery, repeating moves that are so familiar to them as to be instinctual.

Along with those rituals go a host of accessories (for lack of a better word), and herein lies the point of this post. Saints. I love reading the stories of the saints, their histories, their symbology, their special causes. I figured there had to be an official Patron Saint of Infertility, and I found a bunch! I thought (obviously erroneously) that there wouldn't be more than one saint for any given cause, but there's a whole army of them! So for those who feel like they need a few extra folks on their team, here are a few suggestions:

• Saint Agatha of Sicily - patron saint of the sterile and breast cancer, rape and torture victims and nurses (Agatha's story is gruesome, but interesting)
• St Anne - patron saint against sterility (among many other things), particularly in Taos and Canada (apparently)
• St Casilda of Toledo - patron saint against sterility
• St Felicity of Rome - patron saint against sterility and death of children
• St Gerard - patron saint of motherhood
• St Margaret of Antioch - patron saint of all kinds of reproductive issues
• St Philomena - (not much info on her)
• St Rita of Cascia - patron saint of hopeless causes (gee thanks)

I don't really know how the Catholics do it, but I think you just choose the saint that speaks to you. So after reading the stories of those above, I'm going with Agatha.

Also, if you are saint person or just into religious art, check out the artist who created the image above. His name is Arturo Olivas, and I totally dig his style.

Who is your Patron Saint?

BFF

PCOSChick wrote a very poignant post about BFFs (Best Fertile Friends), and it made me think about my BFFs. I am such a lucky girl that I have two, we'll call them BFF(H) and BFF(B). These two women are not just my Best Fertile Friends, they are my absolute Best Friends Forever (aside from the Professor of course).

BFF(H) is a friend from my wild-child college days. I first introduced her here. I've known her longer than I've known my husband. She was my Maid of Honor at my wedding. We've been through some truly horrible ordeals together and we've had a lot of fun together, and year after year, we appreciate each other more. She has always been the first one to jump to my defense when I feel hurt or slighted, always ready with an offer to fly across the country to kick somebody's ass for me (and she could do it, too, she's fit). When I told her about my infertility, she just said "Damn, that sucks", and when I explained to her that basically my ovaries and my uterus had communication issues, she came back with the suggestion that they should seek couples counseling because she'd heard it really worked wonders for that problem! Not a trace of pity, which would have crushed me. She just comes at life fists raised and cracking jokes. It just breaks my heart to know that, barring a miracle, we will never live in the same place again. She got married last year, and is now 5 months pregnant with her first child. And I so cannot wait to watch her be a Mom, because it's gonna be a riot!

BFF(B) is a newer friend that I met at my previous job about six years ago, when we were both unmarried and childless. Now we're both married, and I'm still childless. I was there when she had her miscarriage, and she was there when I had mine. We had the exact same problem, but I had a different doctor and a lot more monitoring so I feel like I got off easy after what I saw her endure. When I told her about my infertility, she asked intelligent questions about the problem and the plan without getting soppy. And she just keeps telling me "You'll get there. You will." and it's hard not to believe her. She is the one who when I got my period after the last IUI, told me to come on over, put the kids to bed early and cracked open a bottle of red. I've watched her wrangle those three kids with calm and humor that I cannot fathom. She and her husband are possibly the most fertile people I know, and they are the people the Professor and I will look to for parenting tips should we be so lucky.

Take a minute to think about your BFF, then give them a call or send them a note and let them know how much they mean to you.

Once More, With Feeling

Present Day - Cycle #17

Which basically brings my story up to date. Once again, baseline ultrasound clear and non-pregnant status confirmed, we are rolling with the Clomid/IUI and home OPK testing. This time for good measure, they threw in a mid-cycle ultrasound with blood work and added progesterone suppositories to the treatment plan. I'm throwing acupuncture back into the mix as well.

I had been getting acupuncture for a couple of months before the pregnancy/miscarriage. It has been shown to be beneficial in complimenting fertility treatments and it certainly made me feel better. But with my boss out on maternity leave during our busy season, I couldn't justify the added time out of the office.

I still haven't told my coworkers about my infertility and treatments. Sometimes I want to, not just as a way to explain my many doctor appointments but also to explain my mood swings, exhaustion and the other physical symptoms the raging hormones inflict (headaches, nausea and mush-brain to name a few). But still I hesitate. We are a very small group, only five people including me. I know that one person would feel sorry me and one would question why I even wanted kids, my boss would be cool about it but I have no idea what our director's reaction would be. I THINK he'd be cool, but I don't KNOW. So I'm not telling.

The mid-cycle ultrasound showed five follicles on the left ovary, only two of which were mature, and one immature follicle on the right ovary. This was a bit of a revelation for me. I only ever feel ovulation on the right side, so I had developed a theory that Leftie was the slacker. What if, maybe, it's Rightie that has issues and that's why I only feel ovulation on that side. What if Leftie is just fine, thank you very much, and Rightie hurts because there's something wrong there? Just an interesting thought.

The blood work came back normal, estrogen just where it should be but no LH surge. I was told to use the home OPK and expect a surge any day. And next day, right on schedule, positive OPK. I called and scheduled the IUI for the following morning and the nurse called in the prescription for the progesterone. I never felt the ovulation (go Leftie!).

So now, here we sit, in the middle of the two week wait. Still hoping that we can make this work.

Lather. Rinse. Repeat.

Thirty days after the miscarriage, I got my period again. Baseline ultrasound completed, non-pregnancy status confirmed and Cycle #14 was under way. Clomid/IUI with home OPK testing. This time I bought the expensive OPKs and everything went according to plan (well, mostly).

OPK +
IUI completed +
2WW =
BFN

The BFN wasn't part of the plan. Neither was the cyst they saw on my left ovary at the CD2 baseline ultrasound for Cycle #15 "the Cycle of the Cyst", which was now off the books.

BUT WAIT! That's not ALL!! Don't you want to see else you've won!?! It's an all expenses covered breast exam/mammogram/sonogram for that horrible pain and scary lump in your left breast!

(cue audience cheering)

After what my poor mother went through only months earlier, I was not fucking around with this! I took yet another half day off work, got to my midwife for a breast exam which got me an immediate call to the breast imaging clinic downstairs from the midwife. It must have been a slow day (or my midwife must have been REALLY concerned about what she felt) because they told me to just come right on downstairs and they'd see me then.

The first time I ever had a mammogram (we're very lumpy in my family, so I started early), it really didn't hurt but it was definitely uncomfortable. This was a different story. When there's something in there that's already hurting, the mammogram SUCKS! I won't lie - I cried. In the end, once again, it was worth it.

Diagnosis: cyst. Probably related to the hormonal fluctuations from the Clomid. Ten days later, the cyst and accompanying pain were gone.

None of this stopped us from continuing our quest unaided by medical science. Not surprisingly, my period showed up again. Baseline ultrasound completed, non-pregnancy status confirmed and Cycle #16 was a go. Clomid/IUI with home OPK testing. We've been here before.

OPK +
IUI completed +
2WW =
BFN