317 - Outlet

With everything going on in my life lately I feel like I need an outlet. I'm supposed to do things that relax me, things I used to do but don't anymore. Turn the tv off. Listen to classical music. Play the piano. Turn the water fountain on and light some candles. Read more.

Write.

I got out of the habit of writing this blog because I was busy, but now that I have oodles and scads of time to myself I think I need to get back into it. Plus I need to let off some steam (once you see how long this entry is you will probably run away, and you're probably smart to do so). Hopefully it all makes sense... I'm so tired I can't see straight.

In the little posting that I've done, I mentioned that Bob and I got married. And I let you know that we were trying to start a family. I think I also may have told you that I was going to ditch the fertility clinic and find another one. I have to eat crow on that one. After a few more visits, and a peek at my doctor's (impressive) credentials I have changed my tune. I was frustrated at the time, and my doctor doesn't have much of a sense of humor so I find it a little hard to relate to him, but we've gotten past that. They did do testing to confirm everything, I guess he's just seen this enough that he has a good idea what the diagnosis is going to be, whereas I am a newbie. The staff at the clinic is top notch from the receptionist to the nurse to the surgical staff.

So here's where we are now...

I have high FSH levels. Normal is between six and ten, I've found some internet articles that expand that to twelve, mine is 17.4. I kind of let that get to me at first, but later found out that FSH levels vary from month to month, so I don't know if that's high or low for me. I also have low ovarian reserve, which means the quality and quantity of my eggs is on the decline. Early on Bob tried to cheer me up by telling me I could eat rocks, and his chicken reference totally went over my head... he suffered badly for that... my sense of humor about this comes and goes and I know it hasn't been easy for anyone to deal with, but Bob gets the brunt of it. He's a get to point A from point B kind of guy, very logical and wants to fix everything. I'm an examine all the angles and figure out my next move in all scenarios kind of girl. Doom and gloom at first, then I make a plan. Don't always want people to solve my problems, sometimes they just need to listen - one of my friends is really bad about giving advice and it drives me nuts. Ironically when I was talking to my doctor about what I can and can't take once the meds become a part of my regimen, he said I could eat rocks for all he cares. Lookee there, he's developing a sense of humor! (and Bob was on the right track)

So basically, there is a chance that I could get pregnant the old fashioned way, although that obviously couldn't happen until Bob gets back, but the most direct path to motherhood is IVF, and my doctor has told me that if we want to get aggressive about it - now is the time, in a few months my hormone levels can change. How much does that suck? It took some careful, though rushed, consideration. When we first started this discussion I wasn't too keen on it... at this point I look back and think I had the right idea, but I really want children, and I know that as much as I want them, Bob (possibly) wants them more (you should see the look he gets when there is a baby around). He has assured me that if this doesn't work, we'll be okay, that he's happy with the way things are and won't love me any less. That helped a lot because I was dealing with my own demons about what might happen to us if I couldn't have kids, in addition to dealing with my own feelings about the situation I find myself in.

I told Bob that it makes me feel a little like a breast cancer survivor. Many women who lose their breasts feel like their womanhood has been taken from them. To find out that I probably can't have children without help was hard to come to grips with. I've gone my whole life trying not to get pregnant because I've always assumed if I didn't take strict precautions it would happen at the drop of a hat. For most of my life I didn't want children, and now that I do it's a slap in the face that it's such an ordeal. And ordeal it is.

First there are the tests. Blood tests to find out if you ovulated. Blood tests to find out if your have infectious diseases. Blood tests to find out if you've been exposed to the chickenpox. Blood tests to find out how your eggs are doing. Blood tests to get other hormone levels. After that there are the procedures. Hysteroscopy to see what condition your uterus is in (mine was fine except for a small fibroid, which they removed). Tubal cannulization to run dye through your fallopian tubes and determine if they're open. Thank god they put me under for that. Next I will have a saline ultrasound which sounds super duper extra fun... I get the speculum, and then they put a catheter through my cervix to fill my uterine cavity with a saline solution before they put the friggin' wand in. This shows them what the lining looks like and how my body has healed since the fibroid was removed (it was 30% in the uterine wall and 70% in the uterine cavity so there could be a scar, which we don't want). It also shows them if I have any cysts on my ovaries. From what I've read, as long as the cysts don't produce estrogen it shouldn't hold anything up, and since they have me taking birth control pills, that lowers the liklihood that I should have cysts anyway. But I have had at least one in the past. I don't get to go under for this procedure... I just take some over the counter Motrin and an antibiotic to prevent infection. They claim it's not that uncomfortable... I don't quite believe them... and I wonder where the saline solution goes when they're done. If that's fine then I start the drugs.

I have three kinds of stimulation drugs. I have to mix two of them from powdered form and inject them. Since Bob isn't here I get to do that myself. When I say he isn't here it's just a statement of fact, nothing more, it just makes it harder on me in many, many ways. I have to be more dedicated than most. No one to remind me, no one to help me, no hugs, but he is there every day to encourage me and he does everything he can. The third drug comes in later, and is in a pre-filled syringe that I can squirt into this other mixture so I can take them all in one injection. If I understand the process (and I so don't...) all of those drugs tell my body to create follicles, which is step one in the egg creating process. Then there is the shot I have to refrigerate, I think I take it 36 hours before the egg retrieval and it is the shot that tells my body to actually produce the eggs. I also have pills that I let dissolve under my tongue, muscle relaxers for after the embryo transfer, antibiotics for various reasons, steroids to prevent inflammation, and pain relievers (for obvious reasons). All the meds, plus the syringes, needles, alcohol wipes and a sharps container were delivered this afternoon. That in itself was an odyssey that I will spare you.

Between all that I've had to deal with the pharmacy, my insurance company, try to figure out who is going to drive me to three different appointments that I can't drive myself to, and try to schedule a flight for my cousin who is going to stay with me when I have to spend three days lying in bed (not sitting up... lying down... they were very specific - I am only to get out of bed to go to the restroom). Plus I have to deal with my emotions about everything. Bob being gone is hard to deal with, trying to stay positive about all of this is difficult. There are so many ways it could go wrong and I try not to focus on them, but I know they exist. Since my FSH levels are already high, my body may not respond to the stim drugs, they're basically FSH and are trying to spike my levels so I'll produce follicles. If I don't produce follicles, we're done. If I do produce follicles and they turn into eggs, they will do an egg retrieval. Then they put the eggs in a petri dish with Bob's sperm and hopefully embryos form. If the eggs aren't viable there are no embryos and we're done. If embryos do grow, they choose the healthiest ones and transfer them into my body via cathether. If they don't attach to my uterine wall, we're done. I will be on a regimen of progesterone to support the pregnancy and hopefully we have two beautiful babies at the end of this.

I've started thinking about the success rates of IVF and I wonder how much of it has to do with the patient. If I don't mix my drugs correctly, if I don't take them at the right time, if I inject them in the wrong place, if they were stored at the wrong temperature, if I take something that adversely interacts with the drugs (grapefruit juice???)... all of those factors affect the outcome. What the doctors do is certainly a large part of the equation, but they are professionals, they do this day in and day out. So I wonder how much of the first round IVF failure rate has to do with user error, the drug learning curve. I have to go to a teaching appointment so the RN can show me how to inject myself... It's overwhelming... I freaked out when I first saw the instructions on how to mix the medications I have to inject. And then there was a nineteen page document about IVF. I flipped. I was sobbing and typing an email to Bob... it's stressful. Every aspect of it from the diagnosis, to the procedure, to the finances, to the outcome.

To deal with the stress of it all I started going to acupuncture. The clinic I go to actually recommends it and I have read several articles that claim acupuncture does improve fertility in women undergoing IVF (specifically IVF). It either has to do with stress reduction, or bloodflow to the reproductive organs, or maybe it's just a placebo effect or all of the above, but whatever it is, it supposedly improves your chances by up to 50%. They claim it can also reduce FSH levels, which is golden. I've only been to two sessions so far, but I like it. I still tense up when Marie puts the needles in, some sting, some don't, but it's my body's expectation that it will sting that makes me tense... She spent about an hour at the first session going over my medical history, my eating habits, my sleeping habits, my stress level. She put me on a b-complex vitamin and a couple of enzymes. I'm sold on the enzymes, I'm not bloated for the first time in months. As for the acupuncture itself I think it's more of an internal change than one I can feel at the moment. Today she added electricity to the mix, a small electric current via alligator clip on some of the needles in my abdomen, it tingled is all. And before she sent me home she stuck two tiny needles in my ear, they're covered by a bandaid so you barely notice them. It sort of itches, but is otherwise unnoticable. Have to remember it's there when I scratch though... otherwise I am reminded... The longer they stay in, the better, but if they fall out it is okay. I have two, one is for relaxation, the other is for my uterus. Fun! Did you know that acupuncture is a four year degree? I had no idea.

I've been trying to relax as much as I can. It seems like every day there is a new curveball being thrown at me to prevent that from being completely successful, but I still try. Bob does his best to talk me down, and it really does help. I know he feels helpless being so far away and probably doesn't realize how much his emails do help. We both made the choice for him to take this job, so I can hate the situation, but I'm not at all mad at him for it. In a way, he has it worse than I do... I can take action, he can't and I know that has to frustrate him even more than he lets on. I also have a very good group of friends who are going above and beyond to help me out and be supportive and who put up with my wishy-washiness. I had to ask them a difficult favor by letting them know what's going on, but asking them let me initiate the conversations about it. At some point I realized that while things are going great and I'm excited I probably won't shut up about it... but if things go the other way, the last thing I need is people constantly bringing it up. And I know that's not fair. Plus, in my case it's even more important that I get past the first trimester before I tell people I'm pregnant. Again... I try not to think about all the negative stuff, but I have my aha moments.

One of the more difficult challenges is that I'm not telling my parents any of this. They would stress out over the surgeries, the medication, they would hover. But also, I don't want to get their hopes up. If it doesn't work, I think that's the kindest thing I can do, because I know mom has always wanted grandchildren. Me and Bob being disappointed will be plenty without anyone else having to go through it too. His family knows, some of them anyway. They handle it differently than my parents would, they don't worry as much. I'm trying not to involve them in the actual process though, partly because if I do and then my parents find out... it starts a shit storm that isn't fair to Mike's family. Also, I'm just getting to know them and this is a farily intimate thing I'm doing. To share it with people I've known for decades is hard enough, to have to ask them for help is even more difficult. I don't mean talking about it, I mean having people there when I'm at the doctor's office and things of that nature. If I get in a pinch I will ask, but otherwise I think it's best if I don't.

So that's pretty much my life at the moment. I try to keep myself occupied with other things as much as possible, but as I said, I have more time on my hands than I did a short while ago. And I'm not a very social creature, so going out every night doesn't work for me like it would most of my friends. Plus most of the socializing I do seems to center around drinking at some point, and I'm trying to avoid that at the moment. Trying to eat healthier and act as if I'm already pregnant so that it's not such a shock when I have to give certain things up... I'm going to miss bleu cheese... And I need to learn to sleep... but that's another subject altogether and this post is long enough.

I was telling Bob earlier that a lot of my friends have told me I'm taking on a lot all at once, but it doesn't always feel that way. When I set my mind to do something, I just do it. Bob is the same. We did decide to keep the house and not move. I'm not trading Scout in just yet. Things are slowing down bit by bit and it has helped immensely. I adjust a little more every day to Bob being going, but I do miss him. Sometimes I smile when I think of him, sometimes I cry. I feel a little obsessive sometimes because I'm constantly checking my emails to see if he's written anything... it's a little pathetic - I sleep with my phone in case he IMs at odd hours because I don't want to miss an opportunity to talk. We do write back and forth a lot, and we IM, occassionally we talk on the phone. We talked today and even though it was short, it was good to hear his voice. Now if we could just figure out how to send hugs over the internet...

And now if my fucking neighbor would turn the music down I would go to bed because I'm exhausted... You know... I have parties, but I can't remember a single one where people were screaming all the time, hooting and hollering for hours, and I don't play my music outside where the neighbors have to be bothered by it - even during the day. I guess if I wasn't running on empty right now it might not piss me off so much, but in my imaginary world I just lobbed a grenade over the fence at them. In my imaginary world... this problem is solved... In reality I keep hoping that someone will call the cops or MAYBE they will suddenly become considerate of the people who live around them... no... surely that's too much to ask...