Step Away from Dr. Google. That’s an Order!

Dr. Google and I go way back.  He’s seen me through some pretty tough times – when I found out my tubes were blocked, when I wondered if it was normal for G to hump other Golden – and whenever I have a question that is either too pressing or too embarrassing to ask a real human being (or both), I turn to him. 

01135546100When I got my Day 4 FSH and estradiol results today, I of course plugged them in.  Big mistake.

First, I should say that my FSH was 7.1 and my estradiol was 81. The FSH is fine, it’s the estradiol that started me on a panic.  I unwisely clicked on … actual studies involving Day 3 estradiol levels that are over 75.  There were dark discussions of low egg yield for retrieval and no pregnancies.  Not what I needed to read. Mind you, one study is 12 years old.

And, never mind that in my one IVF, I had 12 eggs retrieved, 9 of which fertilized and developed.  Oh, no. All I could focus on was that damn number.  By 3pm, I was in quite a lather.

I turned to Dr. Silber’s book for some well-written guidance on whether or not I should truly freak out.  He didn’t disappoint – not only should I not worry, but I should be more focused on having an antral follicle scan!  I then consoled myself remebering that when I went in for my Day 4 ultrasound, there were lots of little pearls on the girls, so chances are I have a pretty good reserve.

But, I still cannot shake what I read in those damn articles.  I will definitely bring those up with Dr. Salsa when I meet with him in two weeks (!) and will content myself with the knowledge that if it was truly awful, they would have called me before I went in. 

So I am faced with a choice: I can either obsess and panic over this for a long time, likely without reason, or I can let it go and enjoy the fact that I have some beautiful little follies thanks to Clomid and Mr. X and I are taking every opportunity to bombard those beauties with lots of troops. 

Which do you think I’ll choose?

13w: Scanning & Scurrying

The NT scan we had with Rex featured the word “surreal” many times. Surprisingly, it was no different this time around.  It never ceases to amaze me how the tadpole blob of 6 weeks transforms into something closely resembling a baby as early as 12w4d.  We saw the profile, including the distinctive X family chin, the beginning of the nose, legs, arms, hands and little fingers.  It was too early to tell gender.

Unlike the MFM we saw with Rex, we were given genetic counseling about the most common chromosomal abnormalities and the various tests now available.  We told our sordid conception history, including the parts involving the man down the hall, aka Dr. Uterus.  We told of the conception success we had up the street with his rival.  And, we all marveled that this time we ended up where we were all by ourselves.

The NT measurement varied between 1.8 and 2.4, which we both found alarming but didn’t seem to phase the tech or the doctor.  Baby was measuring ahead at 13w3d.  She said that everything looked “great” and was unconcerned with the measurements.

As for the blood test, we opted for the Materni21 blood test.  It finds and isolates free floating DNA from the baby and evaluates it for Trisomy 13, 18, and 21.  The results come back as a “yes” or “no” rather than odds. It’s being billed as the no risk amnio. I prefer to think of it as the yes/no test.  We get the results in about 10 days.

As surreal as the scan was, being back in the waiting room at Dr. Uterus’s office was downright bizarre.   The staff remembered me and seemed glad to see me as a patient of the MFM rather than Dr. Uterus.  I couldn’t identify any fertility patients waiting, but I could definitely pick them out from the departing patients.  The lack of a big belly was a clue, but the dead giveaway was the consistent half-run they all made to get the hell out of that waiting room.  They all looked straight ahead while making a beeline for the door.  I was so sad for them because I knew so well what they were going through. I wanted to give them a hug and a referral card to the far more compassionate Dr. Salsa who doesn’t make them run the gauntlet of bellies.  I also wanted to punch Dr. Uterus for still making his patients put up with a waiting room of disgruntled, pee-prone pregnant ladies.  He obviously has learned nothing.

So, all in all, a positive experience.

Revisited

Almost three and a half years ago, I encountered a neighbor on my walk who was in full pregnancy mode and looking particularly smug about it. I blogged about it here. I expended more energy than I’d care to admit disliking her, her husband and their perfect life.  I scoffed to Mr. X at the name that they chose for their child. I hated that they had what I wanted.

This evening, around the same time of the evening that I had first run into her, I ran into her again. Her three year old son ran toward me, Rex and G to say hi.  We stopped to talk to her.  I complimented (genuinely) how sweet her child was. She asked after Rex and how old he was.  I asked her advice on when she transitioned him to a toddler bed from a crib.  We talked about potty training and day care.  We talked … as moms.  As much as Rex healed a lot of my wounds, this conversation today helped me forgive myself for how awfully I felt towards her all those years ago.

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I had a date this morning with an old friend, the Dildocam.  This was not the panic-inducing wand of Dr. Salsa’s office – it was the one at the OB/GYN’s office.  I had gone to see the Lady Doctor last week because I had two annovulatory cycles in a row and was getting concerned that something was going on.  She ordered bloodwork and, not surprisingly, wanted to get a peek on the screen of the lady bits.

It was as uneventful as it could be and the ultrasound tech and I had a few good chuckles.  She didn’t see anything amiss and I agreed since, I’m so good at looking at scans of my lady parts. Still, part of me was almost wistful for the days of searching for a little sac in the uterus.  There was always that possibility of hope, that this would be the time it would work, that was just so addictive.

There Is No Try

I saw the Lady Parts Doctor in October for my annual exam.  I passed  (I studied hard) but not before she quizzed me on important topics such as how much I drink, whether I smoke and of course, my birth control habits.

She didn’t ask whether I was using any birth control.  She asked what form I was using.  I just had to roll my eyes a little at silly Lady Parts Doctor.   She just assumed that I was on birth control because otherwise, I would be poppin’ out those babies like a rabbit.  She assumed that I was normal,  bless her heart.

I was honest.  I told her I wasn’t using any birth control*. I stopped filling the birth control prescription in August.  “So, you’re trying,” she stated, not questioned.  “Not exactly,” I said.  “If something happens, great, if it doesn’t great.”

“In my book, if you aren’t preventing, you’re trying,” she countered.  Touche, Lady Parts Doctor! You got me there! Ha, ha, not really.  I’m still not trying, no matter what magical powers you think Mr. X’s sperm have or how many stories you may have heard of infertile ladies getting knocked up the old fashioned way after Baby No. 1.  (Yes, I know some of these ladies, and no, I do not think I will be one of them. And that is just fine with me.)

We’re not “trying”, Lady Parts Doctor, because for us, trying to have a baby means we go see Dr. Salsa.  We’re not seeing Dr. Salsa, adorable as his Spanish accent might have been and no matter how darned effective he was at getting me knocked up.  Just having unprotected sex with my almost 36-year old eggs and a guy with a low sperm count does not count as trying in my book.   It counts as just having fun and seeing where the chips (or babies?) fall.

So, Lady Parts Doctor, no need to give me that knowing smile when you say you’ll see me in the new year.  I’ll be seeing you in the new year… for my next annual.  Maybe then we can talk about how I define trying.

*Does male factor infertility count?

Rex’s Dollars and $ense

It’s rare that I mention or speak about how much money we spent to have Rex, either here or with people outside of the computer.  Part of it is because we didn’t really have financial issues in trying to have him, hence no drama.  But the other part is that I think it’s a little tacky to talk about the gargantuan wad of cash that we spent over the course of our five year epic saga to have a real live baby when so many couples in similar situations don’t have the means to take their journey as fas as ours went.

I will break that silence today, though, because those nifty ladies Lori and babysmiling asked me (and everyone else) to answer some tough questions about finances and infertility.  What is the effect of finances on the path that we chose to take in building our family?  What will I tell Rex when he’s older about how much money we spent to have him?

For us, finances were a consideration, but not a deciding factor in terms of how far we would go to have a baby.  This was partly because my tubal surgery, 6 IUIs and 1 IVF (including meds for most of those) were covered by insurance.   Between the write offs that my insurance company was able to negotiate with Dr. Uterus and our generous lifetime benefit, we didn’t feel the full financial heat until IVFs number 2 and 3 with Dr. Salsa.  Even then, though, Dr. Salsa had very competitive rates for IVF.  I even got him to give me a discount for IVF number 3 that resulted in Rex.  So, money was an object, but it wasn’t the only object.

With each additional cycle, and disappointment – either with a negative or worse a miscarriage – the question that we would ask ourselves was did we have the emotional resources to continue on, not the financial ones.  We had about hit the wall when we decided to do IVF #3.  We both knew that if it didn’t work that we were probably done.

Of course, since it was IVF # 3 that produced Rex, are we going to tell him how much he cost?  No more than we are going to give him a bill when he turns 18 for all of the food and expenses he’s cost growing up.  It’s part of doing business.  The reality was that we were not in that fortunate group of people who got pregnant for free.  I won’t lie and say that this didn’t bother me greatly because it did.

I will tell him, though, how fortunate we were to be able to afford all of the treatments because (insert Hallmark Channel music here) they resulted in him.  The baby I wanted for so long and who turned out to be even more fantastic and amazing and every other superlative adjective in the English language.   We wouldn’t have had HIM – not a baby, but HIM – if it hadn’t been for all that we did and to me, that’s priceless.

This doesn’t mean that we won’t joke to him every once in a while that we spent his inheritance trying to have him.  It will be just like the time when I was in college and received a post card from my parents in Europe that simply said: “Study harder. Inheritance fading fast.”

All Linked Out

I’m a somewhat half-hearted member of Linkedin.  I say half-hearted because I have literally a dozen connections, two of which are with co-workers.  I haven’t used it to its full potential by any means.

Nan Palmero via Creative Commons

I recently got an invitation that I’m pretty certain will not help me realize LinkedIn’s full potential either.

It was from none other than Dr. Salsa.  My RE. The man whose face I gleefully peed in, who harvested my eggs twice, wanded me more than a TSA agent, and finally impregnated me.  That Dr. Salsa.

My first inclination was ah, no. No, not even with a cherry on top.  The man has seen my private parts way too many times for me to be able to accept his invitation without blushing.  He saw me at my most vulnerable, on multiple occasions.  He literally has a map of my uterus.  How can I possibly be publicly linked to him?

It took me a few days to realize that a) it’s very unlikely that anyone who sees that we are linked would assume that the only reason was because he was my doctor; but b) even if these facts weren’t advertised on Linkedin, I would know. I would know everytime that I saw that we were in the same network that the only reason I know him was because he helped me to get pregnant.  I’m not embarrassed by this – I tell people all the time that we had trouble conceiving Rex.  I just want to be able to have that conversation – or NOT – at my choosing, not because a prospective client sees that I am linked to an RE.   Would they necessarily assume that’s the only connection? No. There are several other legitimate reasons why I might be networked to Dr. Salsa, but there would always be that question in their minds.

I’m all for being friends and sharing, but as Nancy Regan taught me, I think I will just say no this time.

 

Once and Again

Five weeks before Mr. X and I got married in 2003, our venue was closed by our city’s fire marshal as a reaction to the huge fire at the nightclub in Rhode Island.  We didn’t live anywhere near Rhode Island, but we were going to get married on the second floor of a restaurant that unfortunately had only one emergency exit … through the kitchen.  Where are fires most likely to start in a restaurant? Yep, the kitchen.  So, the fire marshal put the kabosh on all functions at the location through an unknown date in the future (which was likely going to be well after our wedding date).

I found out on a Friday at work and I admit it, I cried. At my desk.  I called my mother and left a tearful voice mail.  And, then, I pulled it together and found five venues for us to tour the next day as replacements.  We found our new venue (right down the street) and had a lovely wedding. In fact, I secretly think that it was probably a better wedding, even with the extra hassle.

I thought about this today when I learned that my OB has left the practice where we saw her and is in limbo waiting to fully extract herself before moving on to another position.  My first thought was, what the hell am I going to do now? I loved my OB and now I can’t see her anymore.  What’s worse is that we are in the third trimester with a due date that is only two and a half months away.  Not the best time to switch horses.

My overall feeling right now, though, is just plain annoyance.  I have to either find another doctor at the practice who I like and who is delivering babies or I have to find another practice altogether.  Unfortunately, there is no information on whether and when my old OB will find a new practice, so for now we’re operating on the assumption that someone else will be our OB. The good news is that we have choices. The even better news is that I contacted Dr. Salsa and he came through with recommendations for a new OB.

We’ll find our new venue, and thankfully, this time we don’t have to send out revised invitations.  Still, what a pain in the ass.

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This Must Be the Place

Not only is this the title to one my of all-time favorite ever songs, this should be my new mantra in getting used to the idea that I am now a patient in an obstetrics office.  Not an infertility doctor.  Not even the gyno.  A doctor for pregnant ladies.  Whoa, momma.

We had our first OB appointment today, and it went very well.  Our OB is just adorable and super nice (in fact, I think she might very well be known here as Dr. Sweet).  Dr. Salsa hooked me up.  She took our (sordid) history and I got the impression very quickly that she understood that we were not her typical patients and that she was more than up to the task of dealing with our unique challenges.  The practice itself seems like a pretty low-key.  There was just one other person in the waiting room when we arrived and during our whole visit, we weren’t hurried at all.  What was really amazing was that there was not a single poster showing a baby in the whole place. for which I am truly grateful.  Even now, those are a bit much for me.  I was weighed and then I had to give a urine sample – which for a moment I thought was so that they could confirm what we’ve known for the last 10 weeks – but was really so that they could look for proteins, etc.  Then it was essentially a well-woman visit complete with the breast exam! and pap smear!  But, she was super gentle and it was fine.

Then she whipped out the portable doppler.  I had been eying it ever since we got in the room with a mixture of curiosity and anxiety.  Then, I was slathered with gel and all we could hear was …. my heartbeat.  But, I did not allow myself to panic.  I got dressed and headed over to the sono room where I had my first belly ultrasound, with even more gel.  And, of course, there was the little bugger looking a little groggy but perking up once he knew he was on TV.  We even got a little wave.  Heartbeat was 167 and measurement was on target at 12w1d.

We are set up to schedule the nuchal translucency test next week.  This must be the place.

No Pomp, No Circumstance, No Problem

I have been in no less than three graduation ceremonies in my illustrious educative career.  And, through all three I never got tired of the ceremony, the playing of Pomp and Circumstance as we paraded solemnly down the aisles, subtley craning our necks to see our relatives.  Of course, with my maiden name, I was toward the end of the alphabet so I usually got the tail end of the song, but it still had the cache.  I loved the feeling that I had earned this pageant and I was finally participating in something that everyone got to do. 

wicckedToday, I had my fourth graduation: we have officially been released to the OB.  This time, there was no ceremony, no cap or gown, just a brief check that Little Bugger was still in there and doing his disco thing (he was with a heartbeat of 175).  It was surreal and ordinary at the same time. 

I have thought (and agonized) about this moment a lot in the past.  I tried to imagine the feeling of knowing that I had finally made it to the next step.  I envisioned the nice parting hug from the doctor and the nurses and then being carried out on a litter leaving the office without looking back and moving onto the next grade: Big Time Pregnancy.  Reality was a wee bit different than fantasy.  The appointment was lightening fast – I don’t think I am particularly interesting now since I am no longer a problem to be solved.  I was given the name of the OB that Dr. Salsa handpicked for me on a post-it note.  We paid our final fee and like that, we were gone.

I realize though, that an uneventful graduation was exactly what I wanted and needed.  I didn’t want to be fawned over or exalted (although, being carried out on a litter would have been pretty awesome).  I just wanted to be patted on the back and sent on my merry way.  And that’s exactly what happened.

We already have set up the appointment with the new OB.  Not only have I graduated to the next level of pregnancy monitoring, I have graduated to the infertile gal’s version of the ninth ring of hell – an OB waiting room with lots of beaming pregnant ladies.  That might take a lot more to get used to.

image: wiccked

That’s What Friends Are For

hopper_chop-sueyI have a very hard time asking for help from my friends.  It always starts a running tally in my mind, “ok, so and so had us over for dinner, so now we need to have them over for dinner” and I begin to feel very guilty if the perceived balance of favors gets out of my hand.  With the drama of last week, I think I have piled up so many favors to repay that I will be cooking from now until December. 

When I started bleeding last Monday, I knew that there was no way I was going to be able to walk the dog.  I intended to remain horizontal until told that it was safe to do otherwise.  When we saw Dr. Salsa the next day, I was told to take it easy, and that included not walking the dog.  Mr. X was able to pick up some of the slack, but only in the evenings.  My dear friend in the neighborhood graciously stepped in and squired G about the neighborhood three to four times during the week between the bleeding and when I was finally cleared. 

As if that wasn’t enough, she also took me to my latest monitoring appointment* with Dr. Salsa since Mr. X thoughtlessly scheduled business travel this week (I give him no credit for the fact that this was scheduled several weeks in adanvce).   She had such a great time that she even offered to come on our other appointments.  

How did I ever manage to find such a wonderful friend?

How did I ever manage to find such wonderful bloggy friends who left such lovely notes last time?

How can I possibly make all of this up to everyone?

*I was still anxious about this appointent because even though we are officially farther than we’ve ever gotten before, I cannot let myself begin to assume that everything will work out.  But, the minute the picture came up on the screen, Little Bugger was no kidding spinning around like a disco ball.  The arms were longer and the heartbeat was a nice 180.  It also measured 11w2d even though at my appointment I was 11 weeks at the appointment.  We’re still taking it one day at a time.