Annual Panic

Last week I went in for my annual exam. The midwife I used for Leah's delivery is on sabatical, so I went back to my old OB's office. Yes, the OB I left due to personality conflict. The main reason is because his office works with Dr. 3's office, and when we do our FET (at some point) we'll need to go through them for testing. Annnnd I don't actually have to see my OB, I can work with the Head Nurse Practitioner, whom I adore. She really held our hands through the first few weeks of my pregnancy after Dr. 3 released us. Doppler checks and peace of mind/elective ultrasounds. She kept us sane. And also, she got pregnant after I referred her to my Acupuncturist. (PCOS/MTHFR/MFI) So I feel a kinship of sorts with her... So you can see why I was oddly looking forward to my annual exam and PAP.

I was greeted with a squee and a hug, just as I presumed. We chatted about our babies, motherhood, and how other people are idiots. My three favorite topics. As my exam went on, I mentioned this odd shooting pain I'd noticed recently in my right breast. It's not terribly painful, it's just a little peculiar, and it gets my attention. I have been doing regular self-exams, but my milk ducts are still quite prevalent so I'm having some difficultly discerning... differences. She could feel my ducts as well, but wasn't sure she could find anything of concern. Still since Breast Cancer runs in my family and we've done an IVF cycle, she opted to send me in for a Mammogram and an u/s. 

My first Mammogram.

I have several reasons to believe that it is nothing. One, the timing of this peculiar pain correlates with a new exercise regimen. The shooting sensation may be an area with distressed tissue due to that fact. Two, all of the research I've done regarding "lumps" is not consistent with the textures I have felt. Though I have suspicion they may be cysts or fibroids (pleaseGodplease). Also, Leah uses my girls a lot for leverage and I wonder if there has been a specific trauma that I forgot about. 

But there is a small part of me that is absolutely, positively terrified. I've yet to do any research on what to expect for mammograms, anyone interested in sharing their experiences?

(I haven't got an appointment yet. We got so busy chatting that she forgot to give me the paperwork and instead it's being mailed to my house. #Whythefuckdon'tmoreregulardoctorsuseemail??? )

E2=MG Stalled (Help Needed)

I went in this morning for my E2 (Estrodial) and CBC (platelet count). In order to get the clearance to start FSH and hMG (Follistim & Menopur), your E2 level needs to be lower than 70. When I went in last week to get instructions for administering Lupron, the nurse reviewed our calendar and explained how things would proceed step by step from here on out.

On January 20th, I would take my last active BCP and wait for my period to show. My next appointment would be January 25th, today, for the E2 & CBC. She then explained that if my period hadn’t shown by today, my E2 levels would likely not be low enough to get cleared to start stims. I tried not to panic this weekend as my spotting noticeably cleared up (just in time right?), and then fortunately yesterday morning she made her appearance. And let me just say her presence is much more substantial than normal. So naturally I was pretty pumped. I knew that her presence by yesterday would mean that my levels would be dropping considerably. This morning Brian and I happily showed up at 8:30 for my blood draw and for the rest of the instructions on how to work the Follistim Pen and how to mix Menopur. The nurse was sweet and told me she’d call herself when she got the results back. And so she did. And as soon as the phone rang I had a funny feeling the news would not be good…


My E2 level? 346.


Fuck.


So. I was told as of now, not to start stims Thursday night. But I will need to go in Thursday morning for another E2 check, and an ultrasound to rule out any cysts. Fuck.


I have of course consulted Dr. Google only to find horrible information that makes me think IVF will never work for us. Basically one site indicated that elevated levels can point to a problem with ovarian reserve. Which can significantly lower IVF success rates. The only thing that kept me from hurtling myself on to the train tracks, was that I pulled up my records from my Full Blood panel on CD3 in October, and my E2 was 34. So the other possible scenarios, which I discussed with my nurse are:


A) It could be due to a Cyst. I have never had or been diagnosed with a cyst before, but I am technically poly cystic – so maybe now is just the time. Fanfuckingtastic.

B) My nurse said she has seen cases where Lupron actually causes stimulation instead of suppression, which in that case would cause a higher E2.


Now comes the part where I get to stew and over analyze things without having factual information to back it up. In the last few weeks I have, off and on, felt a strange pinching twinge on my right side near where my ovary would be. My right side is my dominant side, if that means anything at all. No pain, just a weird pinch while sitting up in bed, sporadically. It could have been gas, who knows.


Here are my concerns: I’m only on 10 units of Lupron per day. Which seems low compared to other bloggers – I know, I know, you’re not supposed to compare cycles since everyone is different. But really it seems low.


I could really use some more information about this, whether from experience or a reputable website.


HALP!

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.