Taking The Long Way

Hey kids, sorry for all the drama on my last post. I sort of forgot what it was like to have no control over my life whatsoever. Ahhh infertility, you haphazard bastard- I kind of missed you.

Okay, not really...

So my appointment wasn't all bad. Except for the part after I'd gotten home and realized that I had shaved one leg twice, and the other not at all. That must have given Dr.3 a great impression. ("She'll probably Follistim her eye out", I'm picturing him telling the nurse) And I know I did one leg twice, because I switched razor blades on the second round... In case the first explanation didn't quantify my incompetence enough for you.

I digress.

The ultrasound. Right. So I made Brian go with me. To a baseline ultrasound. At first I wasn't going to ask him to come, but then I realized that this was the first appointment meeting our new RE (whom I've named Dr.3) and I really wanted him there. And truthfully having him with me gives me a sense of calm. It's like having someone to sit with on the first day of school, ya know? Anyway, the ultrasound was pretty standard, he pointed out my uterus and the lining, my femoral (right?) artery pulsing, then went on to each ovary and the follicle counts. It was at this point that he casually mentioned the OPCOS, in the same demeanor I'd imagine he'd have if he was telling me I had green eyes. I realize that this is common place for him, and essentially good news, but all I could think about is how TWO other RE's who'd seen my charts and gave me ultrasounds had never seen this, but Dr.3 nailed it over the phone. Meanwhile the vein in my forehead began pulsing and I could barely construct a sentence. He finished up, and told me about the Metformin, while I nodded likely with my mouth open, and he sent us on our way.



I will say that I have not thus far, noticed any side effects from the Metformin. I've heard from two IRL friends that it can be pretty nasty so I was a bit apprehensive about starting it, but I'm grateful to say it's been fine. Except that I can't really drink alcohol with it. Not that I was a big drinker before, but Dr. Google says the use of alcohol with this medication can disrupt the normal functions of my kidney and liver... Not quite the same as putting up with the runs.


Having now had a few days to cool down, I am a little more grateful for the diagnosis and the fact that it's potentially a good thing. Dr. 3 wants to put me on a Long Lupron Protocol, though I'm very familiar with most aspects of IVF, the medication protocol is my weak spot. Have any of you done the Long Lupron protocol? So far I've read it's typically very successful for first timers but of course I've come across a few horror stories about over suppression. What say you veterans?

Sensory Overload

WHERE TO BEGIN? I guess I'll start with when we first arrived. They had appetizers. I love this Doctor already. Turkey and Roast beef wraps (like pinwheels) with bell peppers and cream cheese. And an open bar. Okay not really, but I could have used a beer to take the edge off my nerves fo' sho'. With food in my tummy and a steno pad in my purse, I was more than ready to get started.

When we walked up to the desk to give our names the nurse coordinator greeted me with a huge smile and a cheerful "Oh, hi Melissa!". My first reaction was a little disconcerted, while I returned her smile I wondered why her demeanor was more like checking people in at a high school reunion and less like a symposium for a group of people who are (potentially) experiencing the biggest challenge of their lives. But as I listened from the inside of Conference Room A to her greeting other people, I had to laugh at my own jadedness. This wasn't a Rosary. We shouldn't feel sad or ashamed. And as the doctor began speaking I knew instantly that I was thinking like an asshole. This event should bring everyone attending hope and excitement. This man could FINALLY get us knocked up for Fucks sake - put a damn smile on your face!

But it was obvious that I wasn't the only one with trepidations, I quickly noticed that I was the only one laughing at the doctors attempts at jokes. Like when he said his head Embryologist was "Anal and scrupulous; not the kind of man you want to be married to, but definitely the man you want watching over your gametes".

The rest of the seminar was great. I don't mean to sound like a douche, but I was significantly well versed in most of the topics he covered. (But I'll chalk that up to the obscene amount of time I've spent reading so many of your well documented blogs.) The exception being the structure and operational elements of his lab and his philosophies on various topics.

• Day 3 vs Day 5: He almost always does Day 5 unless by Day 3 there is only a small amount of embryo's, or some other significant factor. He likes to see the embryo's as close to the hatching point as possible before transferring.


• How many embryo's to transfer: His decisions are mostly based upon age. Under 35, no more than two - barring special circumstances. Over 35, no more than four. (A post on this specific topic is in the works.)


• Vitrification: They use the vitrification process for freezing. Which freezes the embryo to -196 degree's Celsius in milliseconds, leading to zero crystallization. Which means lower attrition, and better thaw rates

Overall it was a really great experience. And I'll bet the folks who are newer to the process gained a lot from this meeting. It was very thorough, and included video's of ICSI, egg retrievals, embryo transfers. Things I had seen, but I knew Brian hadn't. We ended the evening with questions from the attendees, the only questions I had were pretty specific to our situation and I prefer to ask them during our consultation this Saturday. After our consultation, we'll get started on testing again, since it's been about two years since our last round. CD3 could be as early as Monday or Tuesday for me, and we'll be doing an updated SA for Brian - I CAN'T WAIT to see if the tic tacs worked!

I guess this means our break is over, huh?

FUCK YEAH IT IS.

It's Seminar Day!

Holy Crap it's the end of September already! We're attending the seminar given by our more-than-likely new RE tonight. I'm so fricken excited that I'm not even a little bit mad that I won't have time to eat dinner in between leaving work and racing off to the seminar. Hopefully I'll find the time to inhale an apple or something because MELISSA DOESN'T SKIP MEALS.

Low Blood Sugar + Melissa = Rage

Just ask Brian.

Poor bastard.

Wow, am I still talking about food? Hell yes, because Melissa hasn't eaten breakfast yet. And being hungry compels me to make statements in the third person.

So the seminar, VERY EXCITED. And Saturday we have our phone consult with the good doctor. SUPER DUPER EXCITED.

More to come!

No News Is .... Because I'm Boring

So, yeah... I've been a little MIA... Sorry bout that. Iyah... Don't have a whole lot to say I guess - But how are you? What's new?

Okay Seriously. I'm sorry I've been a little out of touch. It's funny because I always wondered about the people who let their blogs go for weeks without an update. How could they not feel compelled to overshare with general public?! I love writing here, I love that years from now I'll be able to look back at April 9th, 2008 and see where I was in my life... I've tried though! I have several unpublished posts that I started and just felt like they weren't really going anywhere, and I didn't want to drag you along with me. Then I happened to look at my calendar and realized that Sunday will be August 1st. (Holy Crap - AUGUST?!) And I can't let the entire month of July go by without a single update, now can I?

So in an effort to keep my future self posted as to where I'm at in my life on this very day, and so you all don't think I've run off to abduct Jason Sudeikis. I give you updates via bullet point, ala: I'm not dead, I swear.

Da Heyouse - I've wrapped myself up in all kinds of household projects. Painting, organizing, purging - all LONG overdue.

Fund Raising - Remember my 34 year old, non-smoking friend with Stage IV Lung Cancer? Well I joined a 5K Fund raiser for the organization he is involved with and I've spent a bit of time emailing and calling folks about it. I've even gone back on to Facebook (gulp) to shamelessly plug it. (Speaking of shameless plugging, if you'd like to donate to a REALLY fantastic and worthy cause, you can email me at bloggyme027 at gmail dot com)

IF Related -I signed us up for a Seminar that a local RE is doing the last week of September. And I set up a phone consultation for a few days after to discuss our future IVF cycle. Exciting! (It's either a phone consultation or a $500 face to face - free shit is better)

The RE's office sent me a package the very next day after my phone call with tons of paperwork, a dvd about them, and pricing. I also found out we might qualify for a 10-25% financial assistance discount that will be based on our income. I'm pretty sure we'll qualify for one of the two - sweetness!

Countdown - We're 35 days away from Pumpkin Spice Latte's.

Which means we're on the downhill side of the countdown to IVF in early 2011. Hoo-fuckin-rah

Weight Loss - I'm down 21.5lbs total, and I've hit a bit of a plateau. In the last two weeks I've bounced up and down about a half a pound. Which is pretty annoying. Guess it's time to mix up my exercise routine again. 14.5 more to go!

So there you have it. Nothing terribly exciting to post about, but I just wanted you all to know I'm still here. Brian has commented on more than one occasion about how nice it is to "have me back". While I feel like I've been in a good place for at least the last four months, I kind of know what he saying. I'm living my life again, and it doesn't have much to do with TTC or our failure to do so. (though I still demand sex when I'm ovulating). And I think the main reason it's been so easy to let go of is only because there is a silent simultaneous countdown ticking away in my head to when we will finally get to move forward again. So while my world is no where near revolving around it, it is still very much present in my everyday life. And now, if you'd like to discuss Politics, I can contradict myself further.

Melissa G - OUT.

Radio Silence

I've had plenty to write about lately, but just not the urge to write. Which feels strange to me. There have been many moments over the last two plus years where I found myself suddenly overwhelmed by the urge to come here and lay it all out. Every thought. Every feeling. Leaving no detail unwritten. But lately I find that I'm less and less inclined to share. Not because I think the details of my goings on these days are any less important, but because my feelings aren't bubbling over the top anymore. This break from trying - it's starting to become more than a getaway and more like an extended leave. Don't get me wrong it's not like all the baby thoughts have magically disappeared- All the normal stuff that bothers us infertile's still stings, but the voices that echo the pain back and forth have begun to grow still, and I can hear myself think again.

It's kinda nice.

So as much as I hate to admit it our old RE was sort of right about seeing a urologist. He was a really cool Doctor, and aside from being extremely knowledgeable about IF, he was just really funny and warm, and didn't BS us. And in the middle of the appointment he stopped what he was doing and told us he hopes it happens for us soon because we're going to be great parents. It was just so sweet of him to say, he sounded so genuine it kind of caught me off guard. And then he asked Brian to turn his head and cough.

So other than concluding the appointment with information we already knew, we did at least get some reassurance about Brian's Testosterone levels, which our most recent RE told us to look into. Brian's results were on the higher side of being boarder line, but it turns out that his test was done at 1pm, when testosterone levels should be checked at 8am... So this doctor said they would more than likely be normal if we were to test again at the correct time. Which makes sense cause Brian usually has a five o'clock shadow by noon. So next we'll probably do the DNA fragmentation test with our current RE because they give a discount to those who have no IF insurance coverage.

In other news we're going to interview one more RE. He's very well established, and closer to home than our current RE, so if we like him and the cost won't be much different then it'd be nice to be so close to his office. And while I feel it's necessary to finish up some testing and check one more doctor off our list, I also think it's important that I tell you all how far away our next treatment will probably be. We haven't set a date for when we're jumping back on the ttc train, and we're not going to. Partially because of finances and partially because I am REALLY not ready. I still can't believe I feel that way, and I remember shaking my head when reading a statement like that on other blogs. I couldn't identify with not wanting to pursue treatments. But right now, I need to focus on me and Brian. I've been doing that a lot more lately and it feels SO GOOD. The clouds are slowly lifting, and I'm head over heels for my new found freedom from heartache. Yes, I still think about babies, and everything we've gone through. I still haven't gone back on Fac.ebook to avoid a pregnancy related status update. But the wait/weight is gone. I'm not going to let anxiety and frustration rule my life anymore. Until I start cycling again anyway.

Crossroads

I totally meant update sooner, but I spent the entire weekend in bed with a NASTY cold. What started as a slightly stuffy nose on Friday (I have allergies, so a stuffy nose is fairly common for me), turned into a full blown head cold by Saturday. It fucking sucks. Anyway, Friday was a very long day but I will try to do my best to break down each appointment despite the fog of my head cold.

A Little Secret
I began the appointment for my pap smear by arriving 10 minutes late. I'm typically the type to get there 20 minutes early, but the recent onslaught of storms has massacred the morning commute in the bay area. Fortunately I think my tardiness only resulted in less time that I'd spend in a paper gown. When my doctor came in we chatted briefly, but before she got started on my examination she noted on my chart that I wasn't using any contraceptives. When I explained to her that I'd been trying to get pregnant for two and a half years and just wrapped up six failed dIUI's, she shook her head, and looked down at the floor as she began to tell me about the four IVF cycles she had completed several years ago. She explained that she was older when she started trying so she knew it wouldn't be easy. Her first IVF cycle resulted in a chemical pregnancy which required a D&C. Just two days after her D&C she had to go back to work and delivered four babies over the course of two days. She said she bawled after every single delivery that weekend. Her next IVF resulted in her son. The one after that was a BFN. And the one after that resulted in twins, thanks to donor eggs.

I was astonished that she was so willing share her journey with a patient, maybe she just took pity on a fallen comrade. Whatever her reason I was, and am grateful for her honesty. Anyway, the appointment ended with both of us in tears although not necessarily sad tears.

Dr. Do Little
The second appointment was with the OBGYN, and Brian joined me. I'm still not sure what to say about this guy. I left the appointment kind of shaking my head. His only saving grace is that he works somewhat closely with the honorable Dr. Zouves, and even referred to him as his "mentor". Basically he thinks my issues may be immunological, and wants to run a boatload of blood tests to prove it. Fortunately he took pity on us and our crappy insurance situation and offered to file the blood tests under "Infectious Diseases", instead of "Infertility" so that our insurance would cover it.

He never really even got in to what our plan of action would be, he just did a lot of babbling about Natural Killer Cells. Which I'm not blowing off. I just don't much about it. I was impressed when he said that since implementing the immunology practices, his miscarriage rate has gone down from 33% to 20%. I still don't know about this guy though ...

Dr. Deja Vu
Despite being 20 minutes late this doctor was pretty awesome. He went over all of our test results and explained what everything meant. He also did an u/s "off the books" since our appointment was being paid for out of pocket. We were grateful for that. He wanted to take a look at my lining and check my antra-follicle count. Just like my test results, and just like we heard before - "Everything looks great" and "There doesn't appear to be any issues"... He did however suggest that Brian go to see a urologist. If not for fertility sake, just to make sure there are no other issues. He also said this doctor could confirm/define any chromosomal issues. Which is a whole other post in and of itself.

He wrapped up the appointment by telling us our options: Injectable dIUI's with a 20% success rate at $2,500. Orrrrrrrr. IVF with Brian's sperm, with a 40% success rate at $15,000. And this is where it gets complicated.

SERIOUSLY?!
This is literally, the exact same situation we were in last January. We need to make the decision between a moderately affordable dIUI that we could do as soon as we're ready (emotionally). Or we wait for an undefinable amount of time,(possibly a year) while we save up for IVF, but we should be able to use Brian's sperm.

The main reasons we decided in dIUI before were because:

A. IVF would be very difficult on us financially (Still is)
B. We were concerned about genetic issues that could be passed on to our children. Brian may have Marfan Syndrome, (we're going to get that officially diagnosed this week) He also has two very close relatives that are mentally handicapped. *This is something we were fully aware of when we started TTC, and just decided we'd be happy to have any child we were blessed with. But when Brian's SA's came back abnormal, our concerns about what could be passed on became greater.
C.Because IVF would be so difficult financially, we were having a difficult time justifying the 40-50% success rate over the financial risk. And it would mean we'd have to wait that much longer to get this show on the road.

I'll be completely honest and say that I am pretty lost at this point. The thought of Brian being the biological father makes my heart sing. But I'm still having a hard time justifying the financial risk and the time lapse. What if we take the next year off to save for IVF, and it doesn't work? Then not only we will we be extremely heartbroken and another year into this mess, but we'll be out 15k and have nothing to show for it... Part of me feels like if we're going to gamble on 15k we should just put it towards adoption - which has an exorbitantly higher rate of us coming home with an actual child. But I just don't know...

May I just say once again, just how fucking much infertility sucks.

Three Doctors and an Infertile Walk into a Bar...

First of all, if you had today off for MLK, I hate you. Where ever you are, I hate you. I'm so exhausted and there is a big storm heading into the Bay Area. Today should have been filled with movies from the 80's and Top Ramen, and I should still be in pajama's from the night before!!!

But it wasn't. And I had to work. Meh. The only consolation is that this is still a four day work week for me. I'm taking Friday off. Not to watch movies and eat ramen. But to shop for a new RE.

My first appointment and order of business is with my GP. Time for my annual pap Smear. Fun, Fun. I was technically supposed to go in October, but I was SO sure I would be newly pregnant by then that I kept blowing it off. Yes, I know you can get a pap smear while you're pregnant, not that I need to worry about that now. Oh and I'm looking forward to the conversation with my doctor as our last one was right before we were sent to an RE. So I'll get to rehash all the goings on from the crappiest year of my life thus far. Remind me to get a mocha before I head in there, the elevation in blood sugar should keep me happy enough to refrain from gauging out my own eye's while I sit freezing in my paper gown waiting for my doctor who's always at least 25 minutes late.

Appointment deux, is with a local OBGYN, who was recommended by a friend who had a successful IUI with him. She delivered a healthy baby boy last month. I know, I know what you're thinking: An OB? Not an RE?! Has she gone quietly mad?! I assure you that when I go, it will most definitely not be quietly, and you'll all be the first to know. So this OB does a lot of the standard practices for IUI's that my RE would have, only this guys waiting room is not overlooking Alcatraz and the Bay Bridge. He maintains a practice outside of the hospital, and has fantastic reviews from my friend who's a mom because of him, and from the local physician's websites I found. I called a few weeks ago to ask if they would be able to work with donor sperm, and got the head Nurse Practitioner on the phone. She must have spent a good 20-30 minutes on the phone discussing my history, and how tough infertility can be. And how she was sorry I had to go through all this.

When Brian suggested we go see this Doctor, I totally blew him off. I was like: "Why would we go waste our time and money with a regular ol' doctor? We should be seeing a specialist". But my chat with the NP completely disarmed me. She was eloquent, and very kind and extremely inquisitive about the variables of my cycle. She asked if they had done any other testing after my multiple failed cycles. Such as looking for a clotting disorder, or polyps. The testing she was asking me about makes me think that we have been doing everything wrong from the beginning and I'm starting to freak out about it.

Fuck I hate the testing phase, I know it's exciting to get answers, but I went through this before, and I'm terrified that something major could have been missed.

My third and final appointment is at a very prestigious hospital with a very reputable RE, that came highly recommended by two of my IF buddies. (Thank you Lau and Nikki) I feel very confident about this doctor, and also pretty intimidated.

I'm starting to seriously panic about these appointments. I'm afraid that these doctors are going to question everything we've done up to this point. That they'll tell us the IUI's were a waste of time, and that we never had to do donor. I've always felt very well informed on our situation but now I'm literally questioning everything. Ugh, Friday suddenly feels very far away.

Lastly I'd like to thank you all for your incredibly thoughtful and reassuring comments on my last post. I was really concerned about alienating anyone - especially people I care about. I'm grateful that so many of you shared that you had felt the same way at one point or another. And I'm grateful to be reminded yet again, that I am in no way alone in all this. Hugs.