Thursday, December 29, 2011

What "They" Don't Tell You About Laparoscopy

1. It will hurt... for a week or two... not a little hurt, I'm tough and I'd call it a significant pain.
2. The pain will be worse around your belly button (primary incision).
3. There will likely be some bruising.
4. You will be bloated... a lot... for a few days from the gas.
5. You will be constipated, pain meds will make this worse. (They might tell you this one.)
6. Don't even try to wear jeans or button pants for at least a week (remember the belly button pain?).
7. Sitting fully upright will hurt because your belly squishes (even if you don't have extra there).
8. You will have bleeding. Not "spotting"... this was likely worse in my situation due to over dilation of my cervix as part of the repair.
9. You will feel "stinging" pain in the areas that scar tissue/implants are removed as the areas heal... (at least I did... but my bladder was involved.)
10. You will probably be glad you opted for the procedure even if everything came back "normal". Call it peace of mind.

I'm exactly one week post op today. Yes, I still have pain... mostly it's incision pain, mostly around the belly button. Even though I stopped taking pain meds on day 3, I'm still battling the constipation issues. I still can't wear jeans... I tried, the buttons made a big bruise under my belly button (and hurt REALLY badly). The bloat is mostly gone now... my belly has returned to it's normal jiggly size instead of inflated balloon size. :-) I can button those jeans... it just hurts to wear them (bending, sitting, etc... yuck!).

I had significant scar tissue and adhesions on my bladder, uterus, and bowel holding the three organs together. Because of this, I have had pretty significant bladder pain for YEARS. It was one of those things I thought I had to live with... the urologist and gynecologist never found any reason as to WHY... I frequently thought I had bladder infections when I did not. I am THRILLED for them to be gone and praying that the scarring does not return!!! My bladder is already feeling better... although not completely healed. I've had some stinging pain in the same areas I used to have the tugging pain... so I know that is the areas healing from removal of scar tissue. Already by bladder is happier... It doesn't hurt when distended and released... I don't have difficulty draining my bladder or retained urine. This has me doing the happy dance.

I also feel good knowing that the rest of my insides are looking good... no endo... no damage... no blockages. And that my cervix is returned to a properly functioning body part (although I don't know yet if CM will return). I've had bleeding/spotting every day so it's hard to tell what is cervical CM and what is uterine fluids, etc...

And... I ovulated on CD16 despite having the surgery. This is a good thing... I know the likelihood of conceiving this cycle is slim, but I'm glad that my body is still responding appropriately.

In other news... my PMS symptoms are worse this time than the last two cycles. I'm only 3 dpo, so I don't know yet if they will reach my previous normal... BUT my breasts are very sore... the last two cycles, I've had almost no breast tenderness (and great progesterone levels at 7dpo) and my emotional status has been more stable, not being pregnant was relatively easy for me to deal with. So... I'm wondering if that was due to acupuncture or medicated cycles (controlled ovulation)... I've not had acupuncture in two weeks because of holiday vacations and obviously, this wasn't a medicated cycle since I was having surgery... I wish I was having acupuncture still so that I could determine which was the cause. My next session will be on Jan. 4th.

In my mind... worse PMS symptoms without controlled ovulation mean that I still am having hormonal/ovulatory dysfunction... which I really want to correct so that in the future, even when I'm not actively trying to conceive, I can avoid hormones. NFP is really important to me... but when you are in dire straights physically and emotionally for two weeks every month it takes a toll on your marriage, parenting, and life in general! I'm praying that with continued acupuncture, dietary changes, and supplements... I will be able to get the PMS symptoms down to a manageable level (as they have been the last two cycles!).

Thursday, December 22, 2011

Post Laparoscopy

I went in this morning for the laparoscopy and cervical dilation. It went well. The good news is that I don't have endometriosis. Dr. A found severe adhesions/scar tissue holding my uterus and bladder together. He was able to remove all of it, so hopefully the bladder pain I've dealt with for years will go away now!

I'm staying on top of the pain... taking one percocet 5/325 every four hours for now. I don't like taking pain meds so this is a challenge for me. Dr. A informed me that I can take up to 4 pills every 4-6 hours and I can piggy back with ibuprofen if I need to. DD and I have had several laughs the last couple of days about Dr. A being a "pill pusher". I think it's that as an RE involved with IVF and all kinds of painful fertility treatments, he knows that we need pain relief. Some doctors (especially males) have a tendency to undermine the amount of pain... "you'll have a little discomfort". Dr. Awesome is not one of those guys.

I know every woman is different, but I thought that posting a summary of what I'm feeling/experiencing here may help someone else prepare for their procedures.

I checked in at the ASC (ambulatory surgery center) at 8:00. I changed into a weird looking disposbale gown that was made out of what felt like flannel paper, it was thick and soft and actually wrapped around the back to tie on the side for coverage. Once I was seated in a nice recliner, a hose was hooked up to my gown and it blew warm air into it. AWESOME. If you have to be there, the air gowns are a definite bonus. I've had surgery before but this is the first time I got warm air. :-) The IV took two attempts... bummer. But I'm used to that. My veins don't cooperate and I get more nervous because I know they don't cooperate so all in all it's a challenge for the nurses. Luckily, the second one worked, I'm not sure I could have held out for a third!

Dr. Awesome was running a few minutes late... he is a very busy man. He walked in at 9:08 which isn't bad at all. Chatted with me for a few minutes, signed the papers, listened to my heart and lungs... and said "see ya in the O.R. in a few minutes" as he jovially walked out the door.

I was able to walk into the O.R. which is great... it gives a little sense of control in a situation we really have no control over. I've been wheeled in on a gurney and allowed to walk in a couple times and I definitely prefer walking myself in. That's actually on my list of questions for the hospital once we are well pregnant and ready for a tour. I'll be a scheduled cesarean because of my L&D history. I want to walk into the O.R. ... I know that seems like a small, inconsequential thing but it really helps me cope.

Once in the O.R., I manipulated my I.V. line (we had to place on the right arm which isn't the best for the O.R.) and climbed onto the surgical table. The Dr.'s joked about how I could have done a triple dismount there. We started chatting about cheerleading and my almost 7 year old daughter's innate abilities. The anesthesiologist says "I'm giving you some medicine now to relax you". I can feel it in my body, makes me feel a little strange. We keep chatting about cheerleading and that's the last thing I remember. I don't even recall the part where he says "you'll be going to sleep now" or whatever it is they tell you as they put you under. Definitely no counting backward for me. I was out.

When I woke up in recovery, I couldn't open my eyes... it was like dreaming. I remembered conversations and thought I responded (or was I hearing people and only responding in my head?). Once I was able to open my eyes, I was able to have conversations better and woke up pretty quickly after that. Once my eyes were open and I could see the nurses, I asked if my husband was coming back in. One of them said something about him doing grading out there and she'd go check. It was nice to have him back in with me. Plus I knew he was really stressing about me having surgery so he needed to be back in with me... to see I was okay.

I had taken some gluten free crackers in with me to eat afterward, since I knew they would want me to keep some food down and saltines were out for me. When I was waking up, I did have pain in my abdomen... at first it was a deep pain, then as the nurse gave me meds in my IV it changed to just a superficial pain at the entry sites, she gave me more IV meds. Then I ate my crackers and she gave me an oral percocet because I didn't want an IM shot (ouch).

My throat hurt (and still does 12 hours later) from the breathing tube. My husband spoon fed me ice chips which helped a lot. Then I had sips of water with the crackers. Once I was awake and medicated, they had me moving out of there pretty quickly. I was up and dressed and discharged. I was allowed to walk outside to the car with the nurse holding my arm, another nice treat since wheelchairs make you feel like an invalid.

I do have quite a bit of bleeding. Dr. A said it would be more than from a laparoscopy because of the cervical dilation. I would call it medium flow vs. the normal spotting from manipulation of the uterus during the lap.

I pee'd blue for a good part of the day today. This was from the blue dye Dr. flushed through my tubes to make sure they were clear. Mixed with the blood, I had purple toilet water. This was kind of entertaining.

I've been able to eat normally. I've gotten up and walked quite a bit. I've done a little too much but it's really hard for me to be still, especially when there is a household to run. I'll try to rest a lot tomorrow because then Christmas and it's busyness will be upon us.

I'm bloated... a lot. My belly is hard. I know this is from the combination of fluid left in to keep my organs floating (which helps prevent new scar tissue from forming) and leftovers of the gas that was placed in my belly to inflate it for better viewing. I've had some minor referred pain in my shoulder also from the remainder of gas... nothing serious.

My incisions are still covered with band aids, but the belly button incision has done some bleeding, it is also the more painful incision. Dr. A only had to make two incisions since I wasn't an endometriosis mess like we feared. Even the band of my yoga pants is tight and uncomfortable on my abdomen.

Dr. A gave DD pictures of my insides before and after... I'm kind of a medical geek, so I like that. Some people are all "gross" and don't want to see it, but I love it. I also have pictures of my placentas and of my cut open belly during my cesarean.

And I think that's it... obviously, I'm coherent enough 12 hours post procedure to write. I was nervous (mostly about general anesthesia)... it's a relief to be done and have answers.

Monday, December 19, 2011

Surgery on the Horizon

My "procedures" are on Thursday... today is Monday. Three mornings from now, I will wake up... unable to feed my hungry body. I'll be nauseated from low blood sugar... and likely, dieing of thirst. Isn't that how it always goes when you can't have even a sip of water?

The surgery center called today to "pre-register" me for my "procedures". This consisted of a young woman telling me everything I'd already received in the packet. I guess they figure that by speaking with the patient they are assured I'll show up?

Since I'm gluten free, I'll be sure to pack a safe snack for after surgery... since they always want you to eat before letting you go home. I can't eat crackers or I'll be one sorry chicken. Tonight, I also purchased two more pair of yoga style pants (which I needed anyway) because my belly probably won't feel like wearing jeans for a week or so after (wondering how I'll manage two church services over the Holiday).

What are they going to do to me EXACTLY?

Well... I'm having a laparoscopic removal of endometriosis. This means, Dr. A will make 1-4 tiny (5mm ish) incisions in my abdomen. Through these incisions, he will insert a camera and other necessary tools. They will blow my belly up with gas to enlarge the cavity and allow better viewing pleasure. With any luck, Dr. A will locate every last bit of the nasty endo and adhesions and eradicate them (including the pesky things on my bladder causing me so much distress). Dr. A will also go in and fully dilate my cervix (think giving birth dilate). This will break up the scar tissue that is has sealed over the entrance to my womb (and thus far kept the swimmers out effectively). My big questions for my pre-op on Wednesday are--- conjugated estrogen cream on the cervix following surgery to help prevent formation of new scar tissue (I skipped this vital step the first time my cervix was punched open after my cautery)... AND will we be taking a look inside my uterus as well via hysteroscope to make sure my lining is a-okay (previous surgery may have burned out too much lining).

In all likelihood, I'll be MIA for the next couple weeks with surgery and Christmas upon us... (Not to mention all the littles are out of school).

Am I nervous about surgery? No... I'm actually looking forward to it. Why? Because it is my prayer that this procedure will allow us to conceive a baby or two. Without it, my chances are looking slim (unless we magically come up with 15k for IVF).

So, I'm relaxing... breathing deep since I don't have to be concerned with timing and POAS and watching CM... and waiting, worrying, hoping... I get a cycle off, to just relax. That's a good thing since my acupuncturist is on vacation for two weeks. :-)

Merry Christmas... I'll check back in after the New Year!

Tuesday, December 13, 2011

While We Wait

Since baby making is on hold for the next two months, I've decided to jump back on my clean eating bandwagon and shed a few (or 30 pounds). The last time I stuck to clean eating, I lost 40 pounds in just over 3 months... A year later the weight started creeping back on because I wasn't eating clean anymore, going out for dinner too often, and enjoying a few too many mocha's.

I know that weight isn't contributing to my infertility issues as my ovulation pattern has been more regular than ever AND I conceived three children previously with my body at the same weight... this is the place my body likes to be even though I don't like it here.

For the first two weeks (when I know there is ZERO chance of conception)... I am taking Alli as well as recording 100% of food (calories and fat). I'm eating clean... I'm eating every 2-3 hours... I'm drinking lots and lots of water. I'm food obsessed but it's only day 2... it will get easier. Today I took in 1681 calories & 58 grams of healthy fats. I know many people think of a weight loss diet as having a much lower calorie intake, but I tell you this... I would not survive. I've discovered the metabolism miracle of eating clean, frequent, and in the right combination actually allows me to consume more calories than I would on the Standard American Diet.

I'm not sure that I've mentioned... I'm Celiac but 100% gluten free... not sure if that is at all related to the infertility...

Here's what I ate today:
7am- 2 eggs (free range) scrambled, 1/2 cup GF oats, 1 tsp coconut palm sugar, 1 Tbs. cream
8:30am- Coffee w/ 4 Tbs creamer 140 calories/6 grams fat (and not clean, this is going soon)
10:30am- yogurt 190 calories/2 grams fat (better if homemade)
1PM 1 cup brown rice w/ 1 small zucchini & 1/2 cup mushrooms (saute), 1 oz grated cheddar cheese, Celtic sea salt & pepper. 376 calories/ 11.5 grams fat
3:15PM 1/2 Lg. banana w/ 1 Tbs chunky peanut butter 175 calories/8 grams fat
6:00 PM GF spaghetti w/ ground turkey, big organic salad, 1 Tbs Ranch 460 cals/17 grams fat.

I'm drinking lots of water and taking one Alli with each of the three meals.

Maybe the weight loss focus will help redirect my baby crazy brain... :-)

Sunday, December 11, 2011

Cycle 2- FAIL

Today officially marks the end to cycle 2... AF showed up.

I knew we were out of this cycle two days ago when my BBT dropped almost a full degree. I was surprised AF didn't show yesterday but what I've noticed with medicated cycles is that my progesterone is good (19.6 cycle 1, 23.4 cycle 2)... while I don't know what my progesterone was on non-medicated cycles, I'm assuming that my slightly longer LP is due to the progesterone taking a bit longer to get out of my system since it's a nice, high value at 7dpo.

My progesterone draw on CD22, confirmed my ovulation for CD15 (day of u/s scan) and we didn't IUI until CD16 because scan on CD15 showed one big follicle at 26mm and the LH surge showed on my OPK later that morning... we were assuming O was going to be the NEXT day. However, I woke up on CD16 to an elevated BBT indicating O had occurred already and our IUI wasn't scheduled until 10:30AM.

We went ahead with the IUI... I was praying that the combination of my cervix still being slightly open (IUI cath could PAINFULLY pass through without breaking scar tissue this time) and BD on CD13 PM, combined with IUI on CD16 that we still had a chance...

Amazingly, I've been much calmer this cycle (even calmer than the last cycle). A combination of acupuncture, a plan, and expecting it to NOT work... ? I didn't even really cry this time, although I had a few moments of self pity.

My surgery is scheduled for Dec. 22. Dr. A will go in an remove all the endometriosis implants (including any on my bladder and bowel), flush my tubes to make sure they are clear (and remove blockages if possible), and fully dilate my cervix to break up all the scar tissue keeping it closed.

I'm a bit apprehensive about surgery... but at the same time, I'm looking forward to it. Prayerfully, we will get an all clear afterward and be able to conceive (naturally, even?) OR we will at least have a name as to what is wrong with me. I'm pretty confident that if Dr. A comes back with a poor prognosis, we won't be able to even consider IVF (due to finances among other concerns)... so at that point, I will have to close the book on pregnancy and start exploring foster/adoption (which is likely in our future whether we conceive or not).

Monday, November 28, 2011

Cycle #2

Well... on CD15 I was ready to bag this cycle and call it a wash.

I had not even the faintest hint of a line on the OPK... I was having pain, but it was different than the ovulatory pain I experienced in the previous cycle. My CM was inconclusive... it's always kind of milky in color, but appeared to be thinner and more watery... since I have severe scarring of my cervix I know that CM isn't a reliable indicator for me. My cervix had moved higher and seemed to be softening...

So... I called Dr. Awesome's office. They suggested I either wait a few more days to see if a surge shows up -OR- go in for a scan and possible trigger. I opted for the scan.

Scan shows 1 follicle on my right ovary, 26mm. We do a progesterone draw to confirm that we haven't missed ovulation. Progesterone is .84 indicating I have not yet ovulated as of 10:30 am on CD15.

Once I return home, OPK's start showing a surge. By early afternoon it is fully positive. We are scheduled the following morning for IUI.

CD16, my temp is UP (WHAT?). 10:15 am, we are in the RE's office... sample is prepped and IUI goes off a bit smoother than last cycle, although still quite painful. My cervix remained open enough to get the catheter through... slowly and painfully. Thankfully, they didn't have to break through the scar tissue again.

Today, I'm 3dpo... concerned we actually missed our IUI window. Wondering what a better method will be for the next cycle (a few months away). Also, concerned that I had one cycle of great response to clomid and this one is piddly.

We did BD w/ Pre~Seed evening of CD13, hopefully with my cervix open and the extra fluids some of those swimmers made it to where they belong. So... BD CD13, O CD15, IUI CD16... the IUI could still be productive if my O was in the few hours before I woke up... if it was during the day on CD15 we are probably out of luck unless those swimmers made there way and hung out from our romp on CD13.

The next two cycles are breaks... well, technically, I'm having surgery on Dec. 22 for the endometriosis, cervical stenosis, & bladder pain. I'm so excited to start the Christmas break with surgery. Depending on the outcome of the surgery, we will try naturally in January and possibly start IUI again in February (clomid or injectables or combination?).

I'll head in on Friday for a progesterone draw... to confirm that ovulation occurred and was strong enough. If my progesterone is low, I will be prescribed suppositories to use until AF shows.

Friday, November 18, 2011

Natural Fertility Journey

We didn't jump right to ART... although I was pretty sure that our fertility issue was anatomical this time and might need some interference.

My bag of tricks has included:

BBT- Basal Body Temperature Charting w/ cervical signs and fluid
OPK's to confirm Ovulation (or lack of)

Food Based Prenatal Vitamins
Fish Oil/DHA
Vitamin D
Evening Primrose Oil

Self Fertility Massage DVD
Castor oil packs

Acupuncture (weekly)

I also tried guafenesin for cervical fluid and Metformin for PCOS for a very short time, it made me very ill.

The biggest impact on my cycles (becoming ovulatory) has been dietary changes. I gave up almost all sugar, only use healthy fats (real butter, EVOO, coconut oil), I eat gluten free and combine lean protein/complex carbs for my meals. I need to eat 5-6 times a day in order to regulate my blood sugars & boost my metabolism.

For the past 11 cycles, I have ranged from 26-37 days in length... for PCOS, this is remarkable. :-)

Calming the Baby Tide

I spent the last two years trying to regulate my cycle and return to an ovulatory pattern. I spent the first 3 months of the year charting, ensuring BD happened on the correct days, and assuming we'd be pregnant quickly... after all, I was ovulating which was my previous cause of infertility. We'd both spawned/birthed children previously despite some obstacles.

I spent the next 7 months fretting over why I wasn't pregnant yet... what else was wrong. Then the SA came back low... VERY low... so I blamed it on that. Two weeks later the SA came back normal (after a 60 hour abstinence). So, we decided maybe it was too frequent BD draining the supply.

While waiting three months to see the RE, we spaced out BD a bit, taking breaks during my fertile window while still getting enough action to ensure adequate swimmers. We used PreSeed (messy). Still nothing... not even a hint of a line on a stick...

Honestly, I knew deep in my mind that pregnancy won't be easy to achieve... now or ever. It wasn't a dozen years ago, why would it be now? I haven't conceived in 7.5 years, and there has been plenty of drama "down there" since that pregnancy and delivery. I just wanted it to be easy this time...

Strangely enough... now that we are on a plan, I feel better. I also think a part of me is just assuming it isn't going to work so my hopes aren't as high. I want it to work... and I will be an emotional wreck if it does (or doesn't), but I feel like that's one of those far reaching dreams that just may not be.

I've calmed down over the last 5 weeks... AF wasn't even emotional for me this past cycle (normally I'm a mess). I like having a plan. I like not having to stress about when we should (or shouldn't) BD. Now I have phases- 1. AF & baseline ultrasound 2. medication 3. POAS 4. IUI 5. progesterone draw 6. AF or BETA. This helps my OCD mind function. I'm sure after a few cycles of this, it will lose it's calming affect.

As things stand, this will be our last round before a couple month break. During that break, I will likely have my cervix dilated to remove the scar tissue and possibly have surgery to remove the endometriosis. After surgery, we are undecided about waiting for a few months and seeing if it happens on its own or continuing on with a couple more IUI's.

I want to say that I will do whatever it takes to have another child... to have a child with my amazing husband. But the reality is, I don't know how we could ever afford IVF... even if we managed to save the money for a round, how could we justify it with all the other expenses of raising our family (and trying to get out of debt).

For now, we are between medication and POAS phases. Sunday starts the OPK's (CD10). We will take BD breaks on CD12-until IUI (likely CD14). We will still use PreSeed on CD10 & 11 and following IUI. Last round, we had a 3 day BD break but the total swimmer count was lower than the previous 2 day break so I don't think it's going to change our numbers much. The counts were still good and motility was good.

Monday, November 14, 2011

Stress... AND Shingles?

I have shingles.

Related to TTC? Who knows. Generally, shingles can happen to anyone who has had chicken pox... the virus (varicella zoster) lays dormant in your body forever more and can be activated by STRESS.

It's incredibly painful... and I feel generally ill. I'm taking antivirals and using lidoderm pain patches over the rash. Putting the patches on is horrifically painful, but after about 10 minutes the pain improves. I can only leave the patches on for 12 hours so I've been going without at night. Funny, I'm not having difficulty sleeping... and I can lay on the side of the rash. It seems the steady pressure is bearable, but light friction is NOT. But, I do wake up VERY sore and don't want to move...

Evidently I can continue TTC... I'm right at the start of a new cycle and I'll be done with antivirals a week before ovulation. That said, the antivirals are considered safe during pregnancy (category B). I don't like to take even a Tylenol while I'm pregnant, so I'm glad the medicine will be done beforehand.

Yesterday I had my baseline ultrasound (CD3). I have a total of 16 anterior follicles. My uterus is clean and ready to go. I started clomid (150mg) yesterday, we are hoping 2-3 of those follies will mature and ovulate like they did last cycle. (It's great to know that my body starts with a good number of follicles, if we have to move onto IVF we know that injectables will mature all 16 of those follies.)

I'll begin using Clearblue OPK's on CD10, we are anticipating a CD14 ovulation again... which means IUI on Turkey Day! I'm still BBT charting, I like to confirm ovulation and watch for the length of my LP (and any variations). My temps are running a bit high due to the shingles virus AND clomid, so I may stop temping until CD8 (after clomid is done).

And that's about if for the next 10 days or so...

Tuesday, November 8, 2011

ART Fail...

I had myself convinced that we would be lucky... that one round at the fertility clinic and $1,000 would solve our baby making woes...

I even took it a step further... I had THREE beautiful, ripe follies so why not plan for triplets (or twins at least).

I'm just saying...

The reality is... no matter how many sticks I pee on... this round was a FAIL. And I hate that. I wanted this to be simple. I wanted it to be "oh, let's just get around this roadblock in your cervix and you'll be knocked up in no time".

I know, statistically speaking, this may work for us in the first 2-4 attempts. It took four ovulatory, well timed cycles to conceive baby girl number one and I was a dozen years younger (after many, many unsuccessful anovulatory cycles). So, why would I really think that the first go at this would work?

I've never been fertile. Yes, I have been blessed with birthing three beautiful daughters. I haven't conceived again in seven years... two of my three children required fertility assistance and I was in my early 20's. I've had surgeries and numerous gyn issues crop up in the last few years... so, why on earth would I think it'd be easy now?

Pulling myself together... moving on. Next cycle starts today...

Saturday, November 5, 2011

Most Severe Pain EVER... and bad news.

Yesterday, midday, I started experiencing what I thought at first was indigestion or intestinal distress. It started as a burning sensation in my abdomen. After a bit it seemed to improve so I loaded 12 kids into the van for an outing... about 15 minutes into our drive I began experiencing such severe pain that I couldn't drive. Devoted Daddy had to leave work (it's grading time and therefore a very busy time for him) to drive me home and help with the kids until their parents picked up. I lay on the couch, curled in a fetal position with a heating pad pressed to my belly.

Dr. Awesome thinks I have a cyst (which is more common when you take fertility meds like clomid)... advised that I take Percocet and rest, call if it worsens, and come into the office in the morning for an ultrasound.

I don't take pain meds... so it took several hours of pain and two calls to the Dr. before I took a pain pill... then I slept. When I woke at 4am, the pain meds had worn off and I was in excruciating pain so I took another one, waited for it to kick in and set my alarm for 7:15 to call the clinic once they were open (thankfully my fertility clinic is open 7 mornings a week).

The good news is that I don't have a cyst... everything looks beautifully normal inside. The bad news is we don't have any clue what is causing the pain... Dr. thinks its likely severe endometreosis given my history.

In other news... I had a beta blood test as part of my work up today... it was negative. At 10dpo it should have shown at least mildly positive if we were pregnant.

I'm really struggling... I had three eggs and perfectly timed IUI and nothing took... what does that mean? Is there a blockage in my fallopian tubes? Could my ovaries be bound with adhesion that are preventing the eggs to enter my tubes? Are we wasting $1000 each cycle trying with IUI... should I stop and have the laparoscopy to figure out what is causing this pain and how its relating to my infertility before proceeding with more rounds of treatment?

Wednesday, October 26, 2011

IUI Successful... On to the 2WW.

At 7PM yesterday I got a positive OPK and another one at 10PM, so we took the swimmers into the RE's office first thing this morning for washing and preparation. Devoted Daddy and I returned at 9am for an ultrasound and IUI.

The ultrasound showed that my endometrium was PERFECT! 11.6mm on CD14. YAY! It also revealed 3 BEAUTIFUL FOLLIES! The follicles measured 25, 26, & 29 mm with two on my right ovary and one on my left. Dr. Awesome said they should rupture within hours.

The IUI itself wasn't a walk in the park... these things are suppose to be easy but due to the scarring on my cervix (cervical stenosis) from previous surgeries, my cervix wasn't open and Dr. Awesome had to dilate and push through the scar tissue. Needless to say, that was a very painful experience. My biggest fear was that the scar tissue would be too significant and Dr. Awesome would say we had to move on to IVF... which I don't think we could ever afford.

We had 27 million MOTILE swimmers placed at the top of my uterus near the fallopian tubes to lie in weight for those eggs. Devoted Daddy says he's blaming me if we get triplets. :-)

I'm home now... with normal activity level, but I do have spotting and cramping. Dr. Awesome said I could expect to feel like AF was coming but that it won't.

On to phase 3... progesterone draw in 7 days. Dr. Awesome said that with three rupturing follicles I can expect a higher level of progesterone this month.

Then, 14 days from today I can POAS. If the test is a BFP, I'll go in for Beta Blood to assess HCG levels. If it's BFN, I'll wait for AF and go in for an ultrasound to make sure my ovaries have recovered enough to start clomid again. If it's BFN but AF doesn't show... we will do a blood test.

I have no clue what the chances of being pregnant this cycle are... but I'm praying for at least one sticky baby out of this! In the meantime, I'll keep charting and see how my temperature reacts to all that progesterone.

Monday, October 24, 2011

Having a Plan

I've felt better since we attended our Fertility Center appointment and met extensively with the wonderful staff there. I like having a plan... blame it on my OCD tendencies if you like.

I wasn't distraught when AF showed up after 37 days because I already knew I wasn't pregnant... I had a corpus luteum cyst that continued to produce progesterone (and some nasty symptoms). Since I was armed with knowledge, I was eager for AF so I could start on The PLAN.

I completed phase one of the plan on CD7 (Oct. 19th) with the completion of five days of 150mg clomid. I didn't experience any crazy side effects... just a few hot flashes (okay, more than a few) and I was a bit more fatigued (it was harder to get up in the mornings, but when isn't it?).

Today I am on CD12. I started using Clear Blue Easy OPK sticks on Saturday. No line to speak of yet but I am feeling more Pre-O like.

So now I'm testing and waiting... when I get the go (a test line that is almost as dark as the reference line but not quite positive), I'll call the clinic and get scheduled for first thing the following morning.

Other than the fact that I hate waiting (I'm an instant gratification person)... this is a good plan. It feels nice to have a plan.

Tuesday, October 11, 2011

Fertility Center Appointment and What's Next

This morning was our first appointment with the fertility center... I feel like things went well and instead of being sad (as I usually am when I discover I'm not pregnant), I feel empowered. Now, we finally have a plan of action (and I'm an action girl).

So... I am on day 36 of this cycle. That's 18dpo since I ovulated on CD18. By all signs, that should mean I am pregnant. But I'm not... I took FIVE HPT (3 different brands). At my appointment this morning, we did a blood draw for pregnancy as well (they are also checking for rubella immunity and progesterone levels). When the results come back this afternoon, we will know that's its okay to proceed with our "plan".

It looks like I have a fabulous corpus luteum cyst. That means I ovulated like I should have... the corpus luteum produced progesterone like it should have... but instead of going away after my LP, it hung around still producing progesterone. Awesome. The progesterone level will confirm this.

Now we will down regulate for two weeks (which will squash the cyst and get menses started), then start clomid on CD3-7. I will begin using OVUKIT (Clear Plan Easy) to detect the very beginning of my LH surge. When I see that first faint line, I will call the clinic and prepare to come in bright and early the next morning for IUI, swimmers in hand. :-)

In other news... when I got home from the RE, I noticed a tinsy bit of spotting has started... this could mean that AF will show up on her own, likely tomorrow. If that's the case we will shave two weeks off for the down-regulating.

Dr. agrees that a laparoscopy may be needed, given my past and increasing pain issues... BUT that those issues may not be affecting my ability to conceive. We know that I have a damaged cervix that is not producing happy cervical fluids which combined with slightly slow swimmers is our main issue. If we aren't pregnant after 3-4 medicated IUI cycles then we will dig a little deeper.

Sunday, September 25, 2011

Late Ovulation & Infertility Depression

As any infertile knows, we watch our cycles like the crazy, obsessed, women we are. I know exactly what day AF will show up. I know what signs signal impending ovulation. I know what EWCM is and what lack of it means. I know how to OPK and read the results with accuracy. I take my temperature every morning, before I do anything. I then record my temperature in a computer program which graphs my temperatures & symptoms and let's me know when I might be entering my fertile phase. Some days, I obsess over that chart... looking over it many times (as if it would change).

This cycle, I was well prepared for an early ovulation. I was expecting CD12-13. CD10 & 11 I had nearly +OPK and all the signs the ovulation was rapidly approaching. DH and I had backed off to our every other day schedule and began using Pre~Seed to help the swimmers quantity and motility. By end of day on CD11, I was in SEVERE pain. CD12 arrived with no sign of LH on the OPK and the pain reduced to moderate. My temps stayed down. I had another weird symptom this cycle, CD10-16 there was pink spotting. I've never had that, but hoped it was ovulation spotting. CD17 & 18, I felt my body ramp back up to try for ovulation again. By end of day on CD18, the pain was back. I woke to elevated temps on CD19 along with my post-O symptoms that arrive with progesterone.

By CD19 we were no longer in BD mode and had switched back to the "normal" frequency and had stopped using Pre~Seed. So, I know the chances of conception are pretty low as the swimmers probably had a low count from "overuse". :)

The good news... the late O has lined things up for me to be on CD3 when I see the RE on Oct. 11th so we will be able to sneak in a medicated IUI cycle if the RE thinks we are good to go.

The bad news... I am depressed. It's mostly an infertility issue... trouble is I can't take anything for it because I wouldn't want to get pregnant while on medication. I should find a therapist...

Oh the joys of not being able to make a baby.

Did I mention how angry it makes me to see these young girls, sleeping around, smoking, doing who knows what and neglecting their offspring?

Wednesday, September 21, 2011

Gynecologist FAIL

Today I had an appointment with my "regular" gynecologist (as in not a reproductive endocrinologist). I went in because there's some weird stuff going on right now. It wasn't about wanting to get pregnant, in fact, I told him that we were considering putting the "baby thing" on hold until we figure out what is wrong with me. I hurt... a lot... and some other stuff that I'm not going to put out there on the world wide web.

He basically said, "take some ibuprofen and stop whining". Um, yeah... no exam... no lab work... nothing.

Guess I'm finding a new gynecologist. It's really not my fault he was behind and had a waiting room full of pregnant and menopausal women... I'm still paying him a whopping $250 for my 15 minutes.

What I assumed would happen... he would examine me to make sure the pain in my ovaries and cervix wasn't something abnormal (like a hugely enlarged ovary). I also assumed he would consider ordering some lab work to see if there was anything amiss. In the past, my gynecologists have also ordered ultrasounds when I'm having this kind of pain to check on the status of my ovaries AND they have also been known to do a biopsy of my uterine lining and cervical tissue.

Granted maybe all of that wasn't necessary today... but sitting there and telling me to go home and take ibuprofen without even a base exam (well, the nurse did take my BP and pulse when I arrived)... Makes me want to refuse payment.

This was his summary of my situation, (not an exact quote) "you are probably having an anovulatory cycle, with a large cyst that didn't rupture that is causing pain, your body probably didn't produce enough LH to rupture the follicle, you had some withdrawal bleeding because your body didn't start getting progesterone to support your uterine lining, you probably won't have a period when you expect to, go home, take some ibuprofen, keep your appointment with the fertility center in 3 weeks, those are hard to come by".

Okay... here's the deal. I am on CD17 and it's too soon to assume this cycle will be anovulatory, late ovulation obviously... of course my period isn't going to show up on CD29 like normal because I didn't ovulate on CD14 like normal (duh). The "withdrawal" bleeding was on CD9-15, so my body would normally be just starting to get progesterone from the corpus luteum and therefore it makes NO sense that the spotting was from lack of progesterone mid cycle. I've been having almost positive OPKs for 8 days now... so obviously my body has been TRYING to ovulate but hasn't produced enough LH to make it happen. Thanks for telling me everything I already know (or know can't possibly be the case).

So yes, I'll go away and leave you alone. I won't be seeing you again... ever. I still want to know why I hurt like crazy (especially with certain activities) and why I had midcycle bleeding that I haven't had in years (since my old issues were resolved). Thanks for brushing me off so you can see more important patients, the ones without problems you don't know how to solve.

Tuesday, September 13, 2011

The Cost of Infertilty PRE-ART

Who said baby making was inexpensive? Since we follow NFP and therefore didn't purchase birth control, I'm not saving anything there. (Some of you may be saving $360+/yr, I save that every year anyway).

Our infertility related costs will be covered at 50% by our insurance company (including IUI and IVF) with a $5,000 lifetime cap. So, we might get one round of IVF paid for at 50% if we don't exhaust our lifetime cap with diagnostics testing and IUI before then. Some medications will be covered at 50-90%, we won't know which ones until our prescriptions are in hand.

Our fertility related expenses so far~

Pre~Seed $19.99 (monthly)
OPK's $20-$33 (monthly)
Prenatal Vitamins (food based, organic) $28.00 (every two months)
Other supplements for Manic Mama $75.00 (every two months)
Supplements and vitamins for Devoted Daddy $50.00 (monthly)
Pregnancy tests $20.00 (monthly because I'm pee stick obsessed)
Preventative yeast treatments (for end of AF) $15.00 (monthly)
Acupuncture for Manic Mama $65.00 (weekly)
Online fertility charting $50 (annual)

Pre-pregnancy dental exam/cleaning $85.00 (every one should have this, insurance pays 70%)
Regular gynecologist visits (3 so far totaling $167.00 out of pocket)
Lab work for Manic Mama $584.00 (funny, insurance doesn't like to cover infertility labwork)
Lab work for Devoted Daddy $112.00 (ditto above statement)
Infertility books $100.00

When our clinic appointment rolls around in October, we will pay $200 for the first visit (normal fee is $400). We are anticipating minimal/no testing in the beginning because our tests to date have already given a clear picture of what our issue is. We may opt for a hysteroscopy to make sure my uterine lining is not severely damaged from the previous surgeries. Our fear is conceiving and losing the baby (possibly late in the pregnancy) due to uterine damage. How this procedure will be covered by insurance we aren't sure... is my old insurance responsible since it's assessing damage from a previous surgery covered under them? Will my new insurance cover it as a medically necessary procedure (based on pain/cycle issues) or will it fall under infertility diagnostics?

I have researched standard pricing for many IF treatments, but the cost of our IUI will depend on a lot of factors including medications and monitoring.

Monday, September 12, 2011

Infertilty Recommened Reading

A Few Good Eggs
TCOYF (Recommend reading for all women)
How to Make Love to a Plastic Cup (For Dad to be, although I enjoyed it as well!)
Real Food For Mother and Baby

(The links will direct you to Amazon, I've included them purely for reference... I have nothing to gain by your use of them.)

First Fertility Clinic Appointment Coming Soon...

We are four weeks from our first appointment at the fertility clinic... this is the big guns, ART clinic. Manic Mama is ready to wet her pants with nervousness, apprehension, and excitement. Devoted Daddy is living in the world of "what appointment" which is pretty standard for men. :)

What we know... Devoted Daddy's swimmers are up to par when we take BD breaks of two days... Frequent BD was sapping the supply.

Manic Mama's cervix is scarred from previous surgery and doesn't make happy fertile fluid.

What we fear... the condition of Manic Mama's uterus. Did the former surgeries scar the uterus to the extent that we won't be able to conceive/carry???

Manic Mama is hoping that medicated IUI will do the trick for us... even with my religious objections to ART, IUI can be acceptable as long as we BD before and after the IUI. I'm still working things out in my head regarding my churches teaching on IVF and the reality that it may be the ONLY WAY for Devoted Daddy and I to have a child together...

What's a Half Full Quiver?

Devoted Daddy and I are not really part of the Quiver Full (at least not in the true context of the word)... what we are:

A mixed Christian faith household... Manic Mama is a Catholic Christian, Devoted Daddy is a Protestant Christian.

What we believe... Children are a gift from God, our arms (and hearts) are open to any and all children sent to us (we are pursuing foster parenting at this time).

Our family includes FIVE children related to at least one of us biologically (we are a combined household).

We desire more children.

As a Catholic Christian, Manic Mama believes in large families and Natural Family Planning (when spacing is needed). Devoted Daddy is in agreement, although has many moments of feeling overwhelmed by the demands of a large family.

Manic Mama believes that Natural Family Planning/Fertility Awareness EMPOWERS all women, strengthens marriages, and changes the mindset about families.

With a family of seven, our quiver is only half full... we have lots of room in our hearts, arms, & homes for the blessing of more children. BUT, we currently find ourselves battling infertility -- now called secondary since we both were part of primary infertility, but technically we are experiencing primary infertility since the two of us together have not procreated. :)

This is a place to journal our many struggles with parenting, infertility, and welcoming children into our lives however they arrive.

Psalm 127:3-5

Children are a heritage from the LORD,
offspring a reward from him.
Like arrows in the hands of a warrior
are children born in one’s youth.
Blessed is the man
whose quiver is full of them.
They will not be put to shame
when they contend with their opponents in court.