Saturday, January 28, 2012

G.T.T.

Gym.  Tan.  Try to get KTFU.

In the interest of full disclosure, yes, I did just make a lame Jersey Shore joke and, no, I physically cannot tan.  At all.  Ever.

But the point is that even though I am not actively in treatment right now due to a forced break, my current fertility-improvement-strategy, if you will, has been weight loss.  I have never had any real successful weight loss in my whole life and I have never shown this much dedication for this long, so I am actually kind of proud of myself. 

So far, in about a month, I have lost about six pounds.  What really impresses me, however, is my total dedication to what used to be my vision of a personal hell - exercise.  I have been going to the gym five days per week and Zumba twice a week.  If I can't make it to Zumba, I make up for it with gym time or treadmill time at home.  One day, when I was feeling particularly shitty about what I had eaten, I even went to the gym earlier in the afternoon, then went to Zumba!  Who am I and what have I done with MB?!

Aside from this bizarre new person taking over my body who packs a gym bag every morning and kills it at the gym even if her buddies can't go, I have also been tracking every calorie in a new smart phone app called MyFitnessPal.  Several friends and family members are on it, so we really keep each other motivated.  I have been making healthier food choices because I have to record everything I eat into the app.  I have even been packing my own breakfasts for work, including healthy snacks like granola bars and natural applesauce. 

OK, enough with me congratulating myself...  Let's talk treatment.  Frankly, I have forgotten what day of my cycle it is because I have really tried to mentally detach during this break.  When a new cycle begins, however, the study coordinator wants me to come in on CD2 for my last-ditch-effort IUI #9, the last in the research study.  She is hoping that they will get a better read on my hormone levels and hopefully avoid cancelling by catching me early. 

I don't really see how this is helpful, but I'll give it a shot.  If the point of cancelling a cycle with elevated estradiol is safety, risk, et cetera, why fudge the numbers by testing me on CD2 just so that I am more likely to pass?  Also, there is very little chance, knowing my body chemistry, that I would have had elevated levels on CD3 anyway because that has never happened before.  In the past, we have never had a forced break last for more than a month.  Any time when we went longer than a month, it was for personal reasons, not hormonal. 

Nevertheless, I will go in on CD2 this time hoping that the RE and study coordinator's "hunch" will be worthwhile.  If not, I am trying to keep positive and hope for a summer IVF...

Monday, January 16, 2012

Canceled (Again...)

It really took me a while to post this for many reasons, but IUI #9 was canceled last Monday.  After all the trauma of the blood draw, the results came back early evening on Monday that my hormone levels were slightly elevated. 

For reasons that I didn't fully understand (and that I will discuss with the research coordinator in more detail later in person), she would like for my baseline ultrasound and bloodwork to be on CD2 next time.  It was my understanding that my hormone levels were elevated as a result of the many cycles of Clomid and Femara and the cysts that often accompany treatment.  I don't see how monitoring a day earlier will help, but at least I know that the research coordinator is making my specific protocol a priority and she really seems genuinely upset with each BFN.

Initially, when IUI #8 was canceled the first time, I was bummed that the study was dragging on even longer and that we were prolonging the inevitable IVF.  It seems, however, as we draw closer and closer to having to plan for IVF, that we probably won't be in a position to start for several months anyway, so there really is no need to rush the IUIs.

As much as it is my right to do so if I want to, I can't see us starting IVF during the school year.  Four of the six members of my grade-level team and need some guidance.  Two of them are already expecting and are due in March and May.  Another has also had to take some time off to have surgery for Crohn's disease, so I can't see my work receiving it well if I need to take some time off while we have substitutes all over the school. 

I also would prefer not to worry and take any protocol changes or bedrest in stride, so it is probably best to begin IVF over the summer.  That way, I can focus on it 100%.  Unless my last IUI is canceled for four more consecutive months, it can't interfere with us starting IVF.  I am also still in the saving and researching phase, so I am not going to worry about it now and I am just going to focus on our happiness, our marriage and my weight loss.

Maybe I am just so sick of this path of treatment, or maybe I was distracted by outside factors, but it should be apparent at this point that I took the cancellation in stride. This week, I have felt slightly liberated not to be worrying about another cycle. I have been busting my ass working out every day either at the gym or at Zumba and my success (both in dedication and weight loss) have been far more fulfilling than another cycle. Since joining the gym, I have really impressed myself and everyone else with my dedication. I have tried not to weigh in too frequently, but I was pleased to see that I have lost four pounds. I still feel really motivated about going to the gym, and I have been using the app MyFitnessPal religiously to record my calories.

Overall, I am just taking some time to come to terms with needing IVF and all the emotional, financial and physical stress that it entails.  I think I am in a healthier place than I was even a few weeks ago, and I am actually enjoying the dreaded break.

Sunday, January 8, 2012

A Perfect Storm

This morning's baseline ultrasound was a perfect storm of unfortunate events to make me into a basketcase for the rest of the day. 

On Friday, which I counted as CD1, I called and made an appointment for today's CD3 baseline ultrasound at 9am.  On the way to the office this morning, I was already feeling teary and uneasy given that this is the last cycle covered by the study and we do not really have set plans for the future.

Upon arrival, I had to wait nearly a half hour just to check in, which is far from unusual at my RE's office, then another half hour to have blood drawn.  When the phlebotomist called me into the room, the study coordinator weighed me to find that I have actually gained weight.  I have been going to the gym and Zumba religiously everyday and I have been tracking every calorie in MyFitnessPal on my phone.  I didn't exactly expect to have a big loss, but a gain was rather shocking. 

When I sat in the phlebotomist's chair, she attempted a blood draw from the same big vein that they always use on the left arm.  She stuck me three times, but was unable to get any blood.  She told me that I was probably dehydrated and that she would have one of the nurses talk to me.  Back out to the waiting room.

One of the nurses approached me a few minutes later and was actually quite rude about the whole situation.  I explained to her that this was my ninth IUI and I have had well over 50 blood draws in the past year and this has never happened.  I did the same thing I always do - drank a good amount of liquids the night before, then came in fasting.  In the past, I have even been told by the nurses that there wasn't much point to drinking water that morning as it would take well over an hour to actually go into my bloodstream.  Well, this nurse was having none of it.

She said that I needed to guzzle a lot of water, but that they couldn't give me water.  I would have to walk to the Wawa four blocks away and get some.  Now, at my RE's office, a 9am appointment is actually quite late on a weekend, and the phlebotomists leave around 10 or 11.  I didn't really feel that I had time to go for a stroll.  I told her that I was still waiting for an ultrasound, so she begrudgingly got me water in a coffee cup from the cooler in the employee room.  She said that I should drink six of these, filling it up each time in the sink.

I sat in the waiting room guzzling warm tap water, then I was finally called in for my ultrasound.  It went normally, then I had to sit back out in the waiting room, drinking more water.  I drank more warm water to the point of nausea and at this point, there was no one else left at the office.  Finally, the nurse called me back and tried her hand at sticking me two more times.  She couldn't get any blood.  A doctor came in, felt around and said that he couldn't find anything either. 

She even tried looking on my forearms, wrists and the tops of my hands.  I am already a little uncomfortable with needles, but I do just fine during a normal blood draw.  The thought of needles in my hands and wrists, however, makes me want to vomit.  I can't help it - it absolutely disgusts me.  I was already on the verge of vomiting with an empty stomach filled with warm Schuylkill Punch, and this was just more than I could take.  I put on a brave face, but on the inside, my body was having an inner debate about whether to faint, vomit or burst into tears. 

Finally, another doctor came in and tried her hand at sticking me two more times.  No blood.  At this point, it is after noon.  My mom and C are calling me wondering where I am and my head is spinning here, the last patient and five medical professionals whirling around and sticking me.

After nearly a half hour of tying and untying tourniquets, poking, stabbing, flicking and rubbing, they called the study coordinator to see what we could do.  The parameters of the study are so strict, I was afraid we would have to cancel the cycle altogether.  Luckily, Jean agreed to let me try another blood draw tomorrow morning at the lab in Radnor, then they will let me know tomorrow afternoon whether my levels are OK to begin taking the pills.  Technically, I am supposed to start taking them tonight, but I can't without the OK on my hormone levels.

I held it together until I got to the car, then I just fell apart.  I drove home through West Philly just sputtering and crying, hoping that no one in the other cars would see my mini-meltdown.  The combined knowledge of this being our last cycle and that it most likely will not work, coupled with my completely overwhelmed state of needles and nausea just brought me to my knees.

I also just found out early this morning that a good friend from work delivered her twins last night.  I am happy for her, but it came at a bad time and just added to the perfect storm.  When she and her husband got married, I was already in IF treatment.  Then, she confided in a few friends that she was worried because it was taking so long to conceive.  In her mind, "taking too long" was about six months.  As much as I like her and her husband, this was just too much this morning.

Wednesday, January 4, 2012

The Inevitable BFN

I had my beta draw yesterday early in the morning, but it took until almost 5:00 to hear back from the RE's office.  I hadn't taken an HPT, so technically I should have been on pins and needles all day in anticipation for the results.  As much as I kept checking my phone for the call, I was also repeating to myself, It's definitely negative.  Don't even start getting your hopes up.  There is just no way. 

There was no reason at all to suspect that it was negative, other than the fact that it is always negative.  Everything went perfectly and they still can find nothing wrong with me.  But it's pretty obvious that IUIs are not going to work for us, so I try to remind myself that I am just going through the motions to complete the study and that I shouldn't get hopeful.

Nevertheless, I was already thinking about how I would tell C if it were positive.  He is not as involved in IF treatment as many other husbands.  I mean, he does everything he is supposed to do and he is very supportive, but he doesn't know what cycle day it is or what my levels are, etc.  He knew that I had an appointment yesterday morning for a blood draw, but he didn't really know what for.  Try as I hardest to remain pessimistic and anticipate the disappointment, I started imagining what I would do and, sadly, I have known what I would do for a long time. 

I have always envisioned surprising him with a gift.  Back when we were married, I had custom Phillies jerseys made as a gift for him with our newly-shared last name.  He was so excited.  I wasn't 100% sure that I would change my name, but it was really important to him, so the jerseys were kind of a double gift - an awesome shirt and a name change.  For years I have imagined going out and buying a custom infant jersey with our last name and giving it to him as a gift.  I couldn't help but think about getting a BFP, confirming it with further blood draws, then getting him the shirt for his birthday, which is just two weeks away.

I was in the car on my way home from work when the call finally came in, and even though I had attempted to prepare myself for this for weeks, it was still like a punch in the throat.  I only had less than an hour to go home and collect my thoughts before Zumba and, as much as I didn't really want to go, I dragged my ass there and I am glad that I did.  Even though I might not have been in the best mood, it got my mind off the situation, at least for a while. 

Later that evening, I had made plans to meet up with some old friends at a bar and catch up.  I would have to rush home, get changed, then hurry over and I was quickly losing steam.  Again, I dragged my butt to the outing, though, and my friends couldn't have been better.  I had a great night and didn't end up getting home until almost midnight.  It was totally worth the sleepiness I felt today.

At work today, it was a little rough.  I have two co-workers who are about to pop, and two more teachers on my grade team who are due in the spring.  Not only will I have the joy of watching five babies arrive in the next few months (one of my co-workers is expecting twins), but I will be working my ass off during their maternity leaves to make up for their absence. I am the only woman in our immediate group that is not a mother, and the conversations at lunch are literally about nothing else.

All this, and I still haven't broken it to C.  I honestly think he is much more perceptive than appearances and he may already know.  Or at least he certainly suspects...

I am really working on staying positive and I have been busting my ass with workouts for the past few weeks.  Regardless of what the doctors say, there is a constant nagging voice in my head that says this whole IF business might be all fat-related.  They can find nothing else wrong with me.  Let's be real, obesity seems to affect everything, and I have seen research that it can affect fertility.  That makes me feel guilty, like this whole thing was in my hands all along.  Obviously, losing weight would benefit me majorly, so it's worth it no matter what.  But at least if I turn out to still be infertile, I can't blame myself anymore...