My Horizon's

Warning: This is a super TMI pg post, so if you’re not in a good place, yamight wanna skip this one and I promise I’ll still love you anyway.

Lots of new developments in the last week or so. None of them extraordinary, but a few of them have taken me by surprise. I’m not going to sugar coat this first one folks, but holy crap my jugs are getting HUGE. You might remember that I usually refer to them as “the girls”, but dude, that reference is no longer applicable. They. Are. Jugs. Gozanga’s even.  A few weeks ago I noticed that I was starting to outgrow my regular bra’s so I was like, “Okay, cool, this is normal…” and I switched over to my “fat bras”. Read: Bras I had kept from before I lost 36+ lbs last year. Saved myself a little quiche right there, I did. However, not three weeks later, I am already muffin-topping out of them! Gah. My jugs are so full and heavy, and my veins read like a Metro Map. I could create an app based on my chest that would probably rival g.oogle maps. It’s out of control, really. 

THEN, the other day, I was walking through the house scratching my stomach when my finger found its way into my belly button, and cheese and crackers folks, it’s… it’s getting shallow. I used to be able to fit an entire fingertip in there, now it only goes about halfway. FREAKY. But cool. 

Oh, good news! I got my last NK Assay and TH1/TH2 follow up test. They came back: NORMAL. My favorite nurse called to tell me personally that everything looked great and I am officially released to my OB. RELEASED TO MY OB. She told me how happy she was for us, and asked that we keep them posted. I told her how very much we enjoyed working with her, and how grateful we were for all of her help. I was actually in the middle of shopping at Trad.er.Jo.es for my lunch when she called. I had a hard time staying composed in the frozen section while taking in exactly what our conversation actually meant… This is all really happening. And it’s going by so, so fast.

We’ve started looking at baby stuff. CRAZY. Brian is going to build the crib and changing table, so we went to a couple of fancy-shmancy boutiques to pilfer designs.  I know you might be picturing Brian with a glue gun surrounded by a pile of kindling, but this isn’t like a DIY project that I would get great “I told you so” satisfaction from. He is quite capable I assure you, and I can’t wait to show you how amazing his woodworking skills are…  And we’re going to choose a design that will convert to a head and foot board, so it’s something we can keep for a long time. Which makes me smile. It’s nice to feel excited and not quite as scared. I’m slowly letting my guard down, and this new world is just amazing. If you haven’t seen it yet, I hope you join me very, VERY soon. 

Holy Crap, She's A Lazy Whore

Oh wait, I’m talking about me.  Sorry it’s been like, a millennia since I updated. While rereading through my last couple of posts I realized I’ve left quite a few things open ended. So here are a few bullet points to ease your back into your seats.

• Progesterone – I was finally able to stop my suppositories. 13w6d as my last round. I had my P4 checked four days later and my level was 19, up from 17. So no more weekly blood tests!
• Immunology – I had another NK Assay follow up, they checked my TH1 and TH2 as well. Bad news on this front, all of my levels spiked even higher after my last infusion, so I had to go back for two more weekly infusions. This kid is definitely going to Junior College. And wearing mine or Brian’s hand me downs.
• NT Scan -  I decided not to go in for the test after all. I just really didn’t like the idea of a Ratio Diagnosis. Or that fact that a false diagnosis would lead to (potentially unnecessary) invasive testing. No judgment for those who go, it just wasn’t for me.
• Commenting – I signed up for Goog.le Ch.rome, and for the most part it’s working. Although randomly now Safari is giving me trouble. WTF blogger?

As for my overall well being I am, despite the crappy NK news, feeling much more confident and comfortable with myself and this pregnancy. I think making myself talk more about the pregnancy and acknowledging here just how much I was really struggling with it all has helped me feel less like I was an impostor. Or that talking about it will make something bad happen to the baby – having had the Doppler handy hasn’t hurt things either. One other really cool thing? I’ve started feeling movement – so bananas. Last Sunday afternoon (15w1d) I was waking up from a nap *(see post title above) when I felt what I can only describe as a cross between a tapping and bubbles popping, distinctly on my right side… It happened again a few minutes later. It was a very unique feeling, but it still took me about a day before I acknowledged it, or even mentioned it to anyone. I did some reading on it, checked in with some ladies on forum (cause that’s what IF bloggers do) and sure enough, they confirmed what I’d thought (knew) I’d felt. It’s not terribly consistent, which is kind of a bummer. And it's so subtle that half the time I don’t even realize it’s happening until it’s over. 


Food is still a bit of a battle. Still can’t do the spicy stuff, though I am able to do desserts again. Not sure that’s really a good thing. Meat. A little over a week ago, meat all of a sudden became an issue. Particularly when I had to prepare it. It didn’t make me yak or anything, I just suddenly found it profoundly vile. But then last night I was shopping at Costco and picked up a Rotisserie Chicken on a whim. Thirty minutes later I found myself talking dirty to it and eating it out of the pan on my kitchen counter… That said, I’ve eaten nothing but fruits, veggies, and carbs today. 


I’m getting closer to not being able to wear any of my regular clothes. Shopping at Maternity stores has certainly made me branch out with my style choices. More patterns and colors than I used to wear, as well as having bought a few skirts. I’m a fan of black, and earth tones, but evidently maternity stores think jewel tones and floral patterns are more appropriate. I suppose that has to do with it being summer and what not as well. 


So that’s it for now, I should try to at least make it look like I don’t agree with my title and get some house work done. I’ll check back in soon, folks!

12 Weeks, But Don't Get Too Comfy

I’m twelve weeks and four days, deep breath now, yes? Well, “BWAHAHA!!!” says the universe. Not so fast Melissa, here’s a little curve ball just in case you were getting a little too comfortable shopping for maternity clothes and thinking about colors for the potential nursery. Oh and don’t pick out any names just yet either!


I got a phone call today. My Natural Killer Cells are elevated again. Not to an exceedingly dangerous level mind you, but elevated nonetheless. And yes, aside from them being normal last time I had a blood draw, I was very aware that this could be an issue. But my friend Denial and I had made up our minds that this problem would just go away, and we were quite content with that. Let me just say, that I’ve planned to do, and will do everything within my power to keep this baby safe, but sweet Jesus am I so overwhelmed with the constant stream of having things to fear in regards to this pregnancy. Please know that I’m so grateful to have gotten this far, and for the fact that I have access to such specialized care. But oh my gawd I am just exhausted from all of this –  all the ups and downs, and feeling pushed and pulled by being so aware that having gone through four years of infertility has changed me, mostly for the good. And I’ll never be the same, I’m not a regular pregnant person - and for so many reasons,  I am proud of that. But now, in this regard, I want so badly to be a regular pregnant person.  I’ve read so many blog posts about the women who hate graduating from the their clinics (save the fact that it usually means they are pregnant)  because they are sad to leave the safety net of their RE’s monitoring and guidance. Which makes plenty of sense. But for me, I am just so fucking over the constant monitoring. I can’t wait to wrap things up over there. Don’t get me wrong. I love Dr.3 and the fact that he made our biggest dream come true (so far). But DAMMAT am I ready to be done with them. I don’t want to see another alcohol pad, or syringe of any type, or a fucking cotton ball covered by paper tape on my arm... I’m tired of weekly blood draws and hoping I get my favorite phlebotomist – I DON’T WANT TO HAVE  A FAVORITE FUCKING PHLEMBOTOMIST! It’s been six months now of regular monitoring and I’m starting to feel more like an inmate that a fucking patient. 


But back to the NK issue. All I have to do is have another Intralipid infusion. Piece of cake, right? Sure, except that my clinic and the satellite office for the Beers Center totally screw you on the cost. My clinic charges $700.00 per infusion, it takes about 90 minutes and they are 7 miles away from my office. The Beers Office charges $550.00, takes about 3.5 hours (including travel time) and is 30 miles away from my office. The kicker? A bag of the Intralipid mixture, cost roughly $50.00 US dollars. Which basically means I'm taking it in the tuckus to pay for their overhead, because they basically have me and everyone else, over a barrel. They might as well say “Take this, or your baby will die. Cash, Check or Charge? ” 


I just want to scream ENOUGH ALREADY!!! 


After I caught my breath a bit I sent an email to Dr. 3 with a few questions. 


Hello Dr.3, 


I was wondering if you would be able to explain a little bit about what the recent increase in my NK cells could mean. I understand that the level is fairly low, does that still mean the Intralipid infusion absolutely necessary? Also, how likely is this to be an ongoing issue during the rest of my pregnancy? 
Thank you in advance for your time 


Sincerely, ProbablynotgoingtobeabletorelaxuntilI’mwritingacheckforthiskidswedding


His response:


Hi Melissa, 


90% of the patients who require immunology treatment are done by twelve weeks. You fall into the 10% where your NK is still a little elevated and the reason to treat is because of the possibility that the Natural Killer Cells could attack the developing placenta. 


As the placenta gets bigger it is better able to defend itself and that is why most people are usually done by twelve weeks. In patients with severe elevations, it is sometimes necessary to treat them up to 20 weeks, but not beyond. I think it is very likely that your levels will be normal after one more treatment, but the body is not a machine, so one cannot say with certainty until we test again. 


Warm regards, 
Dr. 3 


And my progesterone levels are still stupid – in my opinion. This week came in at 15. I have another 11 days of the suppositories that melt and drip out shortly after I go to bed, mostly because I’m up peeing every two hours. So I have to wonder if I am even getting the benefit of them. Sorry for the rant. And sorry if this sounded like my complaining is unreasonable. Deep down I am grateful to have problems like these, because I am all too aware of the alternative. Thanks for listening. 


Reading. 


Whatever.

I Love You, Man.

Holy Crow, where do I even begin? You guys. Well, you Just. Fucking. Rock. I can’t tell you how amazing it’s been to read all of your incredibly thoughtful and supportive comments. And hearing the personal experiences has been a big, BIG relief. Thank you, thank you for the bottom of my progesterone saturated heart.

I’ve been doing my best not to freak out about the Beta results. I realize that the number was by no means a harbinger of the worst possible case scenario, but for a minute, that’s what it felt like. I think the hardest part about this is the fact that I’ve seen too much. I know what possibly can go wrong, and I’ve seen it happen to way too many really great people – so why should I be any different? Please, please understand how grateful I am to be here. And I’m happy. And excited.  But this part of being pregnant is really scary. And I did not see it coming.

I felt a little better Wednesday because I had read, and reread all of your fabulous comments three or four times. Also I was consistently mildly crampy the entire day. Then yesterday I felt SO bloated and tired – exactly the same way I felt during the worst day of stims, which I am praying meant that my Hcg, E2 and P4 were all blowing up. But today – I feel nothing. No different. I know, I’ve heard symptoms come and go. But well, that just sounds like a cop out. I’m so hopped up on PIO shots, and Progesterone and Estrogen Suppositories; I should at the very least being seeing spots by now… I don’t get it.  This is hard. Not harder than being infertile – but hell, at least I know how to do that…

So here’s where I am treatment wise. I had my Intralipid infusion Wednesday. Even though my follow up NK Assay came back a 0 out of 5 (normal), Dr. 3 prefers to follow up with at least one infusion right after a positive pregnancy test.  All of the nurses who were there for our retrieval and transfer were in the area where they do the Infusion. It was nice to see them all again, but weird because they kept giving me hugs and offering congratulations… Which was cool, but very surreal. Our first ultrasound (gulp) is scheduled for April 30^th, I’ll be 6w6d. Seriously – so weird to say that.

I just want you all to know how insanely grateful I am for all of your support through this – and especially from those of you who’ve delurked.

I'm really just so, so thankful for each and every one of you.

Counting the minutes till Tuesday.

We Have Embryo's...

I woke up this morning feeling only slightly better than yesterday. Which isn't saying much. My retrieval was scheduled at 11am, but Dr. 3 was running behind. They had arranged my procedure to be the last of the morning because I had the most follicles of their patients also scheduled for the day. 17-18 that they could see. They wheeled me back to the  - what is that? an OR? - Whatever the name, it was a little surreal, let's just say that. I proceeded to lay on the table in the padded stirrups for what felt like an eternity while the nurse babbled on about my husbands chosen profession. In reality it was only about 25 minutes, and I was long gone within about a minute and a half of Dr. 3 gracing us with his presence. Afterward they managed to wake me up just before transferring me from the table to a gurney and I could hear the doctor telling me it had taken less than 20 minutes and that I'd done very well. I remember asking how many eggs they got, but he said he wasn't sure yet. Still, I persisted "lots?"... "Did you get lots of eggs?" And I'm pretty sure I remember them laughing at me.


The next thing I knew I woke up crying in recovery and asking the nurse for Brian. She gave me a heating pad for my abdomen and shot of a pain killer in my IV.  I remember several people asking me why I was crying, and to tell you the truth I'm not sure I could narrow it down to one specific thing. I felt relieved that this part was over. I felt grateful to see my husband standing over me with concern. But I also felt violated by the fact that I even had to go to these lengths to achieve such a common human experience. Parenthood. And suddenly none of what I was doing there made any sense.  How do blood draws, and stabbing myself in the stomach repeatedly with fine gauge needles, and procedures that require general anesthetic, and lab technicians, and petrie dishes... how does all this lead to motherhood? It felt so unnatural. Unfair.


But maybe that was just the pain talking. Because my mood quickly elevated from there. They gave me a box of apple juice, and propped me up so that I could feel a little more normal. Shortly after that I felt decent enough to change back in to non-assless clothes, and before we knew it Dr. 3 came in to sit down with us. First he reviewed the follow up "NK Assay" blood panel they had taken earlier in the week. Great news: The Humira and Dexamethasone had done their jobs and all of my levels were normal. This meant that I wouldn't be required to do the ($700 per session) Intralipid infusion until after a positive pregnancy test. The plan they initially set for me required one at the retrieval, one after the transfer and then every few weeks after positive betas. Whew, deep breath. Then he told us they got 19 eggs. Nineteen... We were  thrilled. 


I spent the rest of the day in bed with my new best friend Mr. Heating Pad. Seriously, if you have a retrieval pending be sure to pick one of these bad boys up. Brian took great care of me, getting up and down, going back and forth with my every whim. Dr. 3 told us that we'd likely get a call by "lunch-time" today with our fertilization report, but they tortured us until a little after 1pm. Out of the 19 retrieved, 11 were mature, and 9 fertilized normally. That's an 82% fertilization rate. Which is pretty good. Which is why I feel like a total asshole for being a bit disappointed that we didn't have more mature eggs. But such is the life of a PCOS gal. We can produce quantity, but not always quality. Intellectually I know that nine embryo's is good.  And I will keep telling myself that. NINE IS GOOD. But my poor little infertile heart wanted more. More mature, more to choose from, more to freeze. I know we're lucky to have this many and to have even gotten this far, so I'm going to end it on that. Nine is good, and we're lucky.


I won't hear anymore about the status of our embies until Thursday, when we go in for our transfer.  Please keep our little ones in your thoughts until then. Thanks again for all of your support.

November ICLW!

Each time I participate in ICLW I try to come up with some new-fangled concept for and intro. And today is no different! With that, I give you: Contributing factors in an Infertility Bloggers Life; via Bullet Point. Autobiographical.

1. An outlet of some sort became necessary approximately six months after we officially started trying, and my lovely husband couldn't understand why I cried alone in the bathroom every 31 days.
2. At that point I was still fairly certain that I'd see a positive pee stick in the very near future and shortly thereafter commence writing a wildly self-indulgent, and more than likely whiny pregnant-lady-type-blog.
3. Lingering only slightly in denial, we didn't have any testing done until after 14 months of trying.
4. A week before Christmas, 2008 we found out we had Severe Male Factor, and were instructed to go directly to a Reproductive Endocrinologist.
5. Before even seeing an RE, we promptly decided not to have children at all.
6. That resolution only lasted about two weeks.
7. Fast forward to now, and we are gearing up for our very first IVF cycle in January/February, though I'll likely be starting BCP's towards the end of December.
8. In an effort to circumvent my crying over MUCH spilled milk, you can read about my sordid past here. It gets down to the nitty gritty of exactly what happened from the time we were diagnosed, to the beginning of what would be a break in TTC, and ART for pretty much all of 2010.
9. The new RE we're seeing (referred to here as Dr.3) ran an obscenely comprehensive blood panel on me and it came back positive for MTHFR (two mutations of the A1298C gene, with a borderline homosteine level), Elevated TH1, TH2 and Natural Killer Cells. Awesomeness. Oh, and also Ovulatory PCOS - different than Classic PCOS - cause ya know - I'm an over achiever... Okay, not really.
10. None of the aforementioned diagnoses were ever found by my previous RE(s) because they don't believe in Immunological Disorders. Or paying close attention to Antra Follicle counts evidently, because the OPCOS is as clear as day on a baseline u/s, and should have been determined easily based on the knowledge of my 30+ day cycle.
11. I'm over the misdiagnosis - CLEARLY.
12. I know you have 742 other blogs to read and comment on, so I'll keep it brief and end it here; welcome you to my blog and thank you in advance for your comment, then tell you I look forward to reading all of your blogs as well. Oh, and if you're going to be cycling with IVF close to when I am, be sure to say so in your comment - I'd love to stalk you and compare Lupron induced rants notes!

Disturbing The Peace

Oh gawd, she's back. The whiny, and seemingly indecisive side of me that Infertility has capitalized on. And I'd love nothing more than to punch her square in the jaw.

I'm okay. But I think it's fair to say that last week was rough. I know that the three crappy diagnoses I've gotten in the last two weeks are not the end of the world. The hardest part for me was really that we've gone so long thinking that MFI was the only hurdle we had to jump. So hearing now that there are three significantly crappy issues on my side that could hold us back was pretty much the infertile equivalent of walking in on your parents. You turn away, alarmed, disillusioned, and in overall shock.

One more thing that sucks is that treatments could end up costing close to another 5k - worst case scenario. Which is pretty much infertility's way of pissing on the ashes that once was my retirement plan.

Now I need to clear a few things up. I'm sticking with Dr.3. I like Dr.3 (I'd say love, but we're still basically courting since I've only seen him in person once - and well, he hasn't gotten me pregnant yet - Hmm if you didn't know I was talking about IVF that statement could be misleading). AnyWAY, I believe in Dr.3. But I think it's my responsibility as a patient to question different and inconclusively proven treatments. While I'm not 100% sold on the immunological theories, my gut is telling me to go with it. Or maybe it's my uterus, since it's got a better view as to why SIX iui's failed...

Man, after taking two thirds of this year off, and away from treatments I've forgotten how truly overwhelming and consuming it is. It's like this whole other component in my marriage - it's like a second fucking job, even. Gah, I'm sort of tired of it already.

Cheese and Crackers, folks - NINE posts in one month. Are you guys sick of me yet, or what?

Well, If They Don't Know...

I'd like to thank you all for your incredibly thoughtful and supportive comments on my last post particularly. I'm still digesting the information but I can see clearly enough now to know four things.

1. The ALI community is AH.MAZ.ING.

2. I'm grateful that these issues have been diagnosed now, and not after an IVF failure or miscarriage.

3. A big part of me feels like we had to go through the failures at our other clinic to get us to where we are now.

4. I'm perplexed. I really, really don't understand how certain controversial medical, and scientific theories are not actively proven either way. I understand the contentions behind the Big Bang theory, but in my uneducated opinion: that shit happened a long ass time ago, and there ain't much any of us can do about it until Doc Browns visions come to fruition in real life. But how is it that with all the technological advancements we have at our finger tips and with the issues in front of us now, that there is still room to argue about things like global warming, possible causes for autism, and immunology's impact on reproduction? I realize that it simply takes time to run proper experiments and compile evidence, and that it's not remotely as cut and dry as I'm thinking it should be. I know I probably sounds like a moron, but I guess my point is that I'm frustrated that there aren't any irrefutable answers. Yet.

Friday I had been emailing with a good friend and fellow blogger, Sarang about how frustrating it is that some doctors practice the immunological studies and some don't. (As was also pointed out by a comment in my last post, thanks LC). There are two MAJOR Universities near me that don't test for immunological disorders. During the second opinion we got at one of the universities, the distinguished RE we saw diplomatically told me that it was 'nonsense' when I brought it up. But just a few hours before that, the OBGYN who works closely with the RE I'm seeing now, told me that his miscarriage rate had dropped by almost 20% since he started following the preventative care methods based on the immunological disorders. i.e. the IVig, and intralipid infusions, and blood thinners for MTHFR - clotting issues, etc. Still, I can't overlook the fact that there are the big guns like CCRM who don't practice this...

What does that say? Is my RE a trailblazing pioneer or a bohemian maverick?

The One Where the Universe is on a Roll

I got the call regarding the last bit of my immunology testing.

It's not good.

My TH1 and TH2 and Natural Killer Cell levels are elevated.

I know this isn't the end of the world, but sure feels pretty close to it at the moment.

And I know it can be treated, but right now, I really don't know if I want to.

Fucking. Fantastic.