/ The RE's Muse: October 2004

The RE's Muse

After 4 years of infertility, 2 surgeries, 1 miscarriage, and 19 months of high risk pregnancies, hubby and I now have two little women in our lives--one a toddler, the other not far behind. Buckle your seatbelts, it's gonna be a wild ride.

Saturday, October 30, 2004

326

As you can see from the above number, I am able to continue breathing for the rest of the day. Beta #2 has more than doubled and I am, for the time being, somewhat relieved. I'll probably coast through today with that knowledge comfortable in my head and then my stress levels will amp up starting again tonight, building up to beta #3 Monday morning at 8 a.m.

I really don't know what to say other than I am shocked by this turn of events. It hasn't really sunk in and I'm also not really letting it sink in. Questions I answer from A about this pregnancy are started with "If we have a baby..." not "When...." I'm still in self-preservation mode and intend on staying there for a good long time.

One thing that I do know what to say is--again--thank you. I don't know how I could make it through each day (past, current, and future) without such thoughtful and wonderful responses from each of you. You are my touchstone, and I'm grateful for the day I came upon this group of strong women via Getupgrrl. So thank you again, friends. I'm glad we have one another to lean on in good and bad times. You get it...you really do, and for that I'm so grateful.

Thursday, October 28, 2004

117!

Sweet jesus gay...Dr. Rub's office just called and beta #1 is looking very nice indeed, this at approximately 14dpo. And my progesterone is at 10.2 from 7.34 exactly a week ago. While the nurse said they like to see it above 10, in the interest of doing whatever we all can to keep this pg going, Dr. Rub would like me to start riding the magic progesterone train tonight.

Holy crap...in the past few hours I had convinced myself that the FREDs (3 of 'em thus far) were giving me false-positives. What the hell do I know? Apparently nothing. My celebration of this promising news is somewhat subdued owing to A) my previous experience and B) recent events in the lives of our beloved gals Cecily and Beaver Girl (I'd link to them but am pressed for time right now).

Thank you--each of you--for your kind comments, feedback, and congrats. Send all the sticky vibes you can, ladies, both I and emby need them. As we all know all too well, there are no guarantees; cautious optimism abounds though.

Beta #2 is Saturday morning at 8 a.m. I'll keep you posted--here's hope for a good doubling!

Wednesday, October 27, 2004

FRED said...

um, yeah, it looks like FRED thinks I might be pregnant. I'm not quite sure I believe him, especially when you view the three Kilimanjaro-sized zits on my face that have me convinced that AF is due within the next day or two, as scheduled. I think today I am either 13 or 14dpo depending on exactly when I ovulated (the ClearBlue monitor showed 10/14 and 10/15 as peak days).

To rehash this morning's inaugural whiz, I did my business and went to brush my teeth. When I was done, I checked FRED and there the second line was, faint but visible. This was around the 2 minute mark so I dillidallied for a few minutes and checked again. Yep, still there and definitely more visible. It's nowhere near as dark as the control line but it's visible enough that I don't need to hold it up to the light, angle it a thousand different ways, break out the magnifying glass, or disassemble FRED.

I went and showered and came back 10 minutes later. Yep, still there. But I am thinking the whole time that my eyes are deceiving me. So convinced am I that I don't really see anything and that I simply WANT to see a second line, I wake A up and ask him to come into the bathroom and let me know if he sees anything. He asked if I meant the darker line (control) or the other one. I ask him if he's positive he sees the other one; yes, he says, there's definitely a line there. Are you sure? "Yes." I don't say anything more and off he goes back to bed.

My beta was back down to zero on October 6th so I don't really think it could be residual. But I'm not quite sure I believe I'm pregnant. I just don't know. I don't have any symptoms like I did last time, nothing outside of my boobs still being slightly tender (but I chalked that off to PMS). The only other thing that stands out in my mind is how I got that raging sinus infection at exactly the same time I got pg in July--and about two days ago, my nose began to run (even though I felt/feel completely fine) and now I've had some thick gross post-nasal drip since yesterday. Obscure symptom--if it is one, but if AF doesn't show up around these parts today, I'll go in for a beta tomorrow morning.

Could it be? I mean there's always a margin of error with these things. It could be a defective test.... I know it's not expired, I just bought it in August. But FRED's are one of the better ones...or so I thought. Am I wrong? Is there another brand I should try? This was the only pee stick in the house and I'm now toying with the idea of going out and buying a cartload more, peeing on them every time I have to go. I'm already nuts....

(In other news, my furbaby Norm is scheduled for surgery to remove his tumor this coming Tuesday morning, 11/2. We decided not to wait until 11/11 when our vet's schedule was open; instead, we'll take him to my SIL's vet down in Broward county.)

As you can tell, I'm trying to pretend this is just another normal day. But I don't think it is...I don't think I'll be able to function today, not really. I'm counting the hours until tomorrow morning, for now. (And no, I can't go in for a beta today, I've got a lot to do at work--but tomorrow I'm going into work late so I'll stop by Dr. Rub's on the way in.) Holy shit...do I dare to hope--is FRED onto something here?

Monday, October 25, 2004

Which bitch do I choose?

I'm back from Hot-lanta and have to say we had a great time. How I needed that down time! Though I will say it can get a little trying when hanging out with one of the other couples that joined us--they had a miscarriage 11 years ago but to this day have only ever had his SA done (with "enough healthy sperm to get all women in the state pg"), no tests on her--and instead just fly by on the thought that this month will be their month. It gets a little tiring to hear her say to me yet again, 'just wait 'til we get pregnant at the same time....' Bless her heart that she can remain so optimistic month after month, all 132 of 'em and counting. I just wanted to get away from IF for the weekend, not hear about when we both (magically) get pg together. Where is this utopia she speaks of and how do I find it?

On the IF front, I'm now either 10 or 11dpo and have resisted the urge to POAS. The then-ongoing twingy cramps I spoke of in a post last week have quieted down but still rear their heads from time to time. My boobs are slightly tender but I'm of the mindset that this is PMS starting up (AF should start later this week). I went back and looked at my BFP cycle to see what the symptoms were (like I've asked before, 'did it really happen?'--'cause I can't remember a thing about the details it seems). **Warning: pg symptoms mentioned below--please skip this post if you're not up to my babble about what I experienced, hell sometimes I'm not up for my babble about this**

What I'm dealing with now, I don't know if you can call them symptoms. Last time, I had cramps starting 8dpiui but everything else was quiet. By 11dpiui, my boobs were slightly tender; by 13dpiui, my boobs were agonizing to touch; at 14dpiui I had a positive beta and the peeing a lot, excess salivation, and aversion to sweets (sacrilege!) began shortly thereafter.

This cycle? Since 4 or 5dpo, twingy cramping off and on--largely in the same spot. Nothing else to really note unless you want to count the slightly tender boobs I'm sporting today. But...in my mind, I would imagine that any subsequent pg symptoms I have likely wouldn't vary from what I experienced previously. Which is why I expect that this is not my cycle for good news. Plus, crap in various forms keeps raining down on a lot of gals in the IF blogosphere lately, myself included.

I've got one FRED in the house but don't know if I'll actually bust it out this week (okay, first I need to find it 'cause--yes, I really did this--I packed it away in the hurricane supplies to take with us when we left for Jeanne and now am not sure where I've put it). Since AF is due this Thursday or Friday, I guess I could theoretically take the test tomorrow but don't know if I'm emotionally ready yet for the sight of one line.

I'm wondering if Wednesday or Thursday would be better since I'll be 12 or 13dpo and last time my boobs amped up a notch at 13dpiui, a sure sign for me that there was some 'action' going on in the cooter. Or should I just fight all urges to whiz on FRED and save myself a few bucks while I wait for the telltale coming of the bloody bitch? Hope is waving her arm frantically in the air, asking me to pick her, while AF leans smugly against the doorway, smiling knowingly my way.

Thursday, October 21, 2004

The system works (for now)

It seems the old uterus and hormones cooperated this month--whoohoo! I had a progesterone draw today to see if I ovulated on my own and sho'nuff, I did. The progesterone was a (whopping) 7.34 but that's good enough to indicate my follie ruptured out an egg. Let's hope A's sperm were able to find the coy vixen.

The nurse said they like to see the progesterone over 10 but anything over 3-5 indicates ovulation has occurred. I'm a little concerned about my number but they weren't concerned at all. The reason for my concern is that in June (non-stim cycle with BFN) it was 7; in July (stimmed cycle followed by BFP) it was 14.6. Hmmm...could be nothing or it could be something, what do you think/what has been your experience with this? Do I need to see if Dr. Rub thinks progesterone greased flippyflaps (all credit to Akeeyu) are in my future?

Anyway, I will not think about the fact that since 5dpo I have been having slight uterine cramps off and on (they're on as I type this) in the same spot. Hmm...implantation? I had 'em with the BFP starting around 7 or 8dpo. Today is CD21 so I'm about 7-8dpo and AF should make her appearance--if she dares--around the 28th or 29th. Dr. Rub's office said to come in for a beta if I don't get her by the end of next week. Here's hoping...that I don't poke my boobs off in the coming days as I gage whether or not they're sore, never mind that they will be after all that prodding at 'em.

So, A and I are flying to Atlanta tomorrow for a long weekend. Going camping with some great friends and just hanging out in general. Even though we only lived there for 3 years, A and I sometimes miss it. It's just a cool place to live and work (though not commute in as traffic blows). It was also where we bought our first home and really worked to make it ours. With such pleasant memories of that time, how could I not love Atlanta? Plus the friends we made are so wonderful--kind of a like personalized souvenirs from our time there. I can't wait to catch up--and get my mind off the rest of the 2ww. Only 6-7 days left--when can I start POAS?

Monday, October 18, 2004

But wait...there's more

Just when you start to think you've crossed the hump, turned the corner, are on the up-and-up, along comes something else to knock you down a notch.

I got just such a thumping this fine south Florida evening.

Tonight A and I took our two furboys to the vet for their annual exams. Furboy #1 is the younger of the duo at an immature 5, and according the vet, "one healthy guy!" (exclamation point hers). Furboy #2 is my senior guy at a mature 9, and tonight we were told that he has cancer--specifically, he has a mast cell tumor (or mastocytoma) on his left hip. It is a grape-sized lump that we pointed out to the vet. Being 9, furboy #2 has long had lypomas (or fatty tumors) here and there on his body. Always biopsied, always benign. Until now.

The vet thinks it's only (ONLY!) stage I but we won't know for sure until the surgery to remove it, presently scheduled for Nov. 11th. If it's worse than that (Stages II or III, the worst), we may be talking chemo and/or radiation.

I ask you universe, just how much more shit can I take? You've been dishing it out lately and I've taken it--begrudgingly--but I've dealt. This shit is getting old quick but I will not give you the satisfaction of breaking me, no.sir.ree. I won't give you the fucking pleasure. Instead I give you the big two-fisted fuck you to whoever is in charge, sick twisted bastard.

And I ask you wonderful women to please please please keep my Norm in your thoughts (and prayers if you're the religious type). He's my oldest baby and I don't know what my life would be like without him in it. I don't want anymore loss--not this year, hell not for many years...Norm deserves at least that much. Please don't let this be the start of the final chapter...I'm not ready.

Friday, October 15, 2004

A normal Friday

Whoo-hoo! Karyotyping on A (yep, I have just somewhat 'outed' the hubby) came back normal. We're two for two on that front.

The magic 8 ball ClearBlue Fertility Monitor revealed today to also be a peak day so lots of "bow-chick-a-bow-now" going on in the Dee house through tomorrow. (Bow (as in 'take a bow')-chick-a-bow-now being the typical music 'soundtrack'--and I use that term loosely here--of bad porno movies.) Don't wanna toot our own horns but toot toot, 5x in 48 hours never hurt anyone (well, okay, it did hurt me back in July when I got that inflamed Bartholin's gland with all that post-IUI back-up sex but hey, sometimes you gotta take the bad with the good).

Speaking of tomorrow, A and I are starting the day off with his and hers blood draws at the lab and then going to an international adoption seminar down in Ft. Lauderdale. Just to kind of feel things out and learn more, particularly about the south American programs (A's heritage). I--like most of you--am a planner in all this--it's the only bit of possible control over something that's completely uncontrollable; gotta have a plan B, C, and D. We're currently on B, know what C will be (IVF), and are now investigating a potential D. Hope the seminar is helpful or else that'll be half a day of my life I can't ever get back...and a Saturday too, that should mean it counts double in the grand scheme of things.

Thursday, October 14, 2004

A good stretch

So, it's been a good stretch of days this past week (despite the verbal warning I got at work for being a slacker--yep, my work ethic has gone right down the shitter since the mc but I'm trying to get it back together now, I really am). Today I found out my karyotyping came back completely normal--whew. We now have medical proof that I am, indeed, a female. (My husband's results, however, have not yet come back--apparently the lab had the wrong fax # so I gave them the right one earlier and they were going to send it right over. And now...we wait.)

Since this is a cycle where the RE is not directly involved, I figured I would try using a Clear Blue Easy Fertility Monitor and maybe, just maybe, see if those fuckers work (my ovaries, not the monitors). So I bought one on eBay and started it back on CD5 and--holy crap--this morning it showed today as a peak day! So maybe that follie Dr. Rub's tech saw yesterday is breaking through as we speak. Last night I was slightly crampy on the R but don't know if that was just coincidence since I know that's where it is.

Just to be on the safe side, and because Dr. Rub told me/us to 'practice' this month, I made sure we got our groove on last night and again this morning. I will again tempt the fates, I mean my husband, later after work and at bedtime. Can't say I'm not giving it the ole' college try. TMI but if cervical mucus is a factor, can't say I've seen that bitch since CD12--two days ago. No sign of it since. Is it hiding deep in my cervical recesses/does such a place even exist? I don't know. But with the last IUI we did, I didn't have any CM, yet the nurse said there was lots of it at the cervix when she did the deed on me (how odd does that sound?). I guess it just never felt inspired to come down south and pay a visit to my panties.

When Dr. Rub told me to go home and practice, I said to him "But what if it works and then I won't need you next month?" "What do you mean?" he calmly asked, "I'll still have to see you for the pregnancy test..." (and as my IF friend reminded me, for care up 'til the end of the first trimester). That is why this doctor keeps me inspired. Man, is he confident and hopeful. I have to remind myself to be the same way. I just keep thinking that there ain't a snowball's chance in hell we can do this on our own...years of hope and disappointment do that to you. But I'm more hopeful than not, especially now that we pretty much know what our issue is and what can be done to work with/around it. So here's hoping the next 2 weeks go by quickly and perhaps with good news at its end. One can always hope, can't she?

Wednesday, October 13, 2004

All hail the mighty donut

Hopped up on 1100 mg of naproxen sodium, I drove 60 miles to Dr. Rub's main office this morning for my 7:30 saline infusion sonogram (SIS). Mind you, this is not my normal office. I go to a small satellite location by me. I came bearing two dozen fresh donuts for the good folks in the office (it's a large practice). They were very appreciative I tell you...plus, I think it's harder for them to forget you if you stand out from the crowd somehow. For me, this means bringing treats. Ah, who the hell am I kidding? I just want them to like me....

So, the SIS was completely painless--and I don't think it had anything to do with the naproxen, really. The SIS at my practice does not involve the dreaded balloon catheter which, Dr. Rub pointed out, typically causes the cervix to dilate immediately--hence the extreme discomfort for many patients having it done with that 'old school' catheter. That must be precisely why my previous one with Atlanta's Dr. Insulin (who turns out to be a good friend of Dr. Rub's) was excruciating.

Speaking of Dr. Rub's good friends, I'd like to see our REs in action in their 'real' life interactions with each other. Like at national conferences and stuff. After a day of sitting in sessions or presenting, do they hit the bars, go out carousing, try to pick up, get drunk, talk shit about the ones who aren't there? I mean, they all seem to know one another and the gossip about who's doing what where. Today Dr. Rub told me that my previous RE in Birmingham was now head of that program and the former head (who he said could be "difficult to work with") had left to open his own private practice. He then went on to tell me that the practice he refers people to in Birmingham was this other one run by Drs. X and Y. Turns out he did his residency with Dr. X, blah blah blah. Very small world those REs live in it seems. I wonder if they're all up in each other's business 'cause it sure sounded like they are based on today's conversation with Dr. Rub. Kind of cute to see him all in his element, talking smack (but good smack, not catty smack).

Oh, yeah, right, the SIS.... Dr. Rub went very slowly and gently so I think that helped too--he periodically asked how I was doing, if I was uncomfortable, etc. Hell, even the dildocam wasn't bad; all in all, a pretty good start to the day, all things considered. Once all was said and done, he went over the images with me.

Basically, everything looks great, no polyps/fibroids/cysts...nada. Instead, I have what Dr. Rub called a "gorgeous" uterus with a nice thick lining (today is, after all, CD13). And—whaddya know--I have a big ripe follie on my R ovary, 23 x 20, just waiting to pop any day now. If your scorecard is current, you know that I'm not doing stims/IUI this cycle. In fact, I am doing nothing this cycle except taking the glucophage--but, says Dr. Rub, "It's doing what it's supposed to," i.e., helping me ovulate on my own. So he suggested I go home and 'practice' this month. I told him I'd go home tonight and have a party (Deespeak for get my freak on) to which he countered, "I don't know about a party but just have sex with your husband." Ahchachacha--he must have been paying me back for my retort to his "I can do you with your husband in the room" comment ("well, okay, if that's what you're in to") at my last visit.

But here is the kicker: today Dr. Rub told me he's pretty sure I have adult-onset congenital adrenal hyperplasia (CAH). This is why my androgen levels are so high and why I take 2.5 mg of prednisone every night--and why, he tells me, I'll have to take it for the rest of my life. Of all the obscure things to have, leave it to me to get a doozy. Since my 17 hydroxyprogesterone tests are normal, my version of CAH involves a deficiency that only 5% of cases exhibit (11-hydroxylase as opposed to the very common 21-hydroxylase version). Yep, seems I'm a real freak. In case you're wondering exactly what CAH is, here is what I've learned from Dr. Google:

This condition is caused by an inherited defect in one of the enzymes in the adrenal glands. The adrenal glands manufacture the hormone cortisol and aldosterone from cholesterol. The process of making cortisol or aldosterone from cholesterol requires five steps each controlled by at least one activating protein (an enzyme). CAH is caused by a fault in one of these enzymes which literally runs slow. The effect is that the patient may not make enough cortisol or aldosterone or both. The low levels of cortisol reaching the brain makes the main hormone controlling gland (the pituitary) release a signal, called ACTH, to the adrenal glands to speed up the manufacturing of cortisol by switching on all the enzymes along the five steps of production. However, the CAH patient has one faulty enzyme so a backlog of partly processed hormone builds up. The adrenal gland then has to channel away this build up or the adrenal would silt up. The adrenal has one other route - which it opens up -allowing the partly processed hormones to be manufactured into male hormone called androgen. This androgen builds up in the blood and causes many problems especially in females. These are:

Extra hairs over the face, neck, breasts and body, especially up the front of the abdomen. (no--thank you sweet jesus--but you should see my penis!)
The voice may become deeper (nope)
Greasy skin and hair, acne (check)
Period may never develop, be very irregular or stop (nope--regular as they come for some odd reason)
Infertility (check)

Lucky me, huh?

For the record, I don't really have a penis--swear. It's just a joke hubby and I have. Because of my elevated androgen level, he claims he married a dude. Nice...I know.

Oh--and the donuts were such a hit, the cashier said she wasn't going to charge me for my co-pay. Either that or she liked me. Must be the donuts...you can ply just about anyone with food. Remind me to up the ante to bagels if we need to move on to IVF with this practice--there's no telling what that could do for us.

Thursday, October 07, 2004

Back to zero

So yesterday I had a beta. Nope, not 'cause I thought I was preggers. Simply to make sure that my body knew I was no longer preggers--and you know what? It did. Hooray me!

Of course, I did have to tell the nurse doing the blood draw that if some behind-the-scenes lab monkey called me with the results and prefaced it with "I'm so sorry, you're not pg" I was going to laugh maniacly/scream/cry/curl up in the fetal position (how appropos) because, um, yeah...no shit sherlock. She made careful note of the fact that the beta was a post-D&C so that said lab monkey would not be on the receiving end of my potential breakdown. Bless her heart. Happy to report that the message got through, loud and clear. Houston, your beta is negative.

So with that behind me, bright and early next Wednesday morning (CD13) Dr. Rub will graciously inject my ute full of saline to check it for any rocky outcroppings, a la Pike's Peak, while I ride the dildocam at the same time. Whoo-hoo--hold on tight, it's gonna be a fun ride! I had this done once before, with the previously unmentioned Dr. Insulin in Atlanta and--ack, my g-d, the pain, the grossness, the dribble/gush factor, the embarrassment (yeah, I know, need to get over that one), and the completely normal results. So now we do it again...to make sure there's nothing left in there (hello? anyone for some spelunking?) and that the ol' lining looks normal before starting stims again with my next AF. Bring it on, I say!

The nurse who scheduled the SIS (saline infusion sonogram in case you're not familiar with that one; I knew it previously as SHG, sonohysterogram) made me promise not to get pregnant before it's done. Hahahaha...whew boy, that was a good one. Had to pick myself up off the floor there before I told her that wasn't likely to happen without medical intervention. She said 'you'd be surprised..." Heehehe, there she goes again, cutting up, what a card. She really should consider taking her schtick on the road.

For the record, this will be the 5th time in 6 months (!) that Dr. Rub has his face in my cooter--and I mean, UP CLOSE AND PERSONAL, plying her with tools and gadgets galore. Seems like he's seeing it more than my husband is these days...and that is one sorry state of affairs.

Sunday, October 03, 2004

Take my breath away

Depressing post ahead...consider yourself duly warned :-)

Sometimes it hits me out of nowhere, leaves me momentarily stunned. You see, sometimes, when I least expect it, I'm reminded that I lost our baby. Friday I would have been 12 weeks along; instead Friday was the five-week 'anniversary' of my D&C, it was also the first day of AF. What can I say? My timing, apparently for once, was impeccable.

Sometimes I wonder if the pg was real or if I dreamed it; it seems so far away and as if it happened to someone else, someone not me--at least not the me that I am now. It all happened so quickly it seems, looking back on it. A surprisingly smooth cycle: only 1 follicle after 8 days of low dose Gonal-F, 2 unremarkable IUIs with 3 rounds of back-up sex at home, didn't let myself stress over it, went to Key West late in the 2WW, got drunk for the first time in years--no lie, implantation happened somewhere along the way, 3 superbly rising betas, 1 early u/s where all was good, 2nd u/s where hope got the shit beat out of her, as did my heart. Did it all really happen?

Sometimes I get angry. But I've also come to understand that, for me, it had to happen...that the baby would not have lived long had the pg progressed to term. But that doesn't make the pain go away, even when I haven't felt it for a while. Still it returns...pokes into my ribs with its sharp claws, makes my head swim and my eyes water, makes me question myself, my choices, my life, and why it has to be so damn hard.

Sometimes the pain is so fresh, so raw, it takes my breath away. I have to wonder if I can possibly go through it again and emerge intact. I'm not intact now, not in the least. An indelible scar has been left on my heart and in my soul. I feel broken at times and wonder what can be done to 'fix' me.

Sometimes I'm afraid to go to sleep at night. You see, in those early days following the miscarriage, I did everything I could to delay the inevitable coming of night--I watched TV 'til the wee hours, read, anything that meant I didn't have to close my eyes and try to sleep. The thought of sleeping and then getting up to face the coming day was overwhelming when I didn't know how I could find the strength to go on, to get up, to continue living. I was paralyzed, consumed by my fear; it was all-encompassing. Life was not the same, I was not the same, so how could I just return to my same 'normal' (read pre-miscarriage) routine? I struggled with that one. And now I again find myself struggling with it; it hits when I least expect it.

Sometimes I have to stop and remind myself to breathe, to carry on, to hold my head up high, to put one foot in front of the other. That I'm a survivor, that people have made it through much worse and still they persevere. What is their secret? How do they do it? How can I face each day when I sometimes can't face the night? How do I learn to breathe again?


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