Dr. Uterus, Sweetie and I Walk into a Bar…

So Sweetie and I met with Dr. Uterus today and shared our concerns about all of the roiding of the ovaries, our frustrations with not moving forward and whether we should consider IVF. As usual, Dr. Uterus was extremely helpful in answering our questions and letting us know our options.

First, we decided to have another HSG because Sweetie was concerned that it was possible that my tubes had been blocked again since that was our original main problem. At the time, they were blocked by debris, not by scarring, so the thought is if it could happen once, could it happen again? Dr. Uterus put the chances of a bilateral occlusion (both tubes blocked) at 10%. The worst that can happen is I have an uncomfortable HSG (which I’ve already had) and we get more information. We decided that if the tubes are blocked, we would move straight to IVF rather than continue with IUI (what would be the point?). If only one is blocked then we’ll continue to IUI but just try to make sure that the ovary corresponding to the open tube is producing enough eggs to make it worthwhile.

Second, we’ll do another IUI next month, assuming my ovaries have calmed down. If the IUI doesn’t work, then we’ll move on to IVF. For the longest time, the idea of moving on to IVF was very difficult for me in part because it seemed to imply further failure (and we all know how I feel about failure). But, now, talking with him about it it seems doable. He said we were very good candidates for it and that we could have a good 55% success rate per cycle. It’s hard not to glob onto numbers and feel as if they are really indicative of your chances, but it is so encouraging to know that it is a good option for us. He also agreed that our plan to do one more IUI was a good one and then do IVF in the new year.

It was the first visit in a long time that I actually felt better after going to his office.

Welcome to the Comfort Uterus Inn!

Thank you for choosing the Comfort Uterus Inn!  We here at the CUI are determined to make your stay as pleasant and as long as possible.  I see that we were expecting to welcome four of you, but in the end it is just two.  No problem! CUI can accommodate both of you with out any problems.  You will find that we have prepared everything with meticulous care for your burrowing pleasure and will continue to keep things at optimal levels so that you have no excuse whatsoever to want to leave. 

Please note that check out time is in nine months, give or take a few days. And, there is a penalty for early withdrawal.

So, get comfy – but not in the hallways! – and gestate away!

image: givepeasachance

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As you can see, everything went fine this morning.  I was loving the Valium, which I took on a mostly empty stomach since I was so nervous up until then that it went straight to the top of my head and I was not the least bit fazed by the process.  There was still some cramping, but it wasn’t as bad as last time. Mr. X was also there with me in the Smurf suit they made him wear last time and I just held his hand and pretended we were snuggling in bed rather than sitting in a procedure room with the goods on display.   Dr. Uterus pronounced it a super smooth transfer.

Of the six totscicles that we had on ice, only two made it out of the thaw, but those two were apparently “beautiful” according to Dr. Uterus.  I’ll take two beauties over four crap embryos any day.

I’m now on couch potato duty (twist my arm) until next week. 

As for the dreaded beta, I’m keeping my options open.  See, I never did the POAS thing after any of my 6 IUIs or my IVF.  This was mostly because each time I used an HCG trigger and a false positive would be worse than a false.  So, I just didn’t do it and waited for the blood results.  The problem with that plan, though, is I have come to DREAD the phone call.  I have tried any different number of ways to make it more pleasant – have Nurse to a T leave a message and I get it when I’m ready, answer the phone directly so I can know that moment, etc.  None of it has really worked. 

This time, I’m flirting with the idea of POAS the day before my scheduled beta so that a) I can grieve/celebrate before anything is official and b) I can decide if I want to do the blood test at all.  We’ll see how I feel closer to beta time. 

Until then, I am sending telepathic messages to the two totscicles bouncing around in my uterus to burrow in for a nine month hibernation.

Would You Like to Talk to My Uterus?

This is the conversation I had with Sweetie this morning:

Mrs. X: I had more of that brownish-red spotting again this morning. I was expecting it, though, because I had those cramps again last night.

Sweetie: I wish I knew what was going on.

Mrs. X: Do you want to talk to my uterus when you get home?

Sweetie: Yea. I’d like that.

He’s going to have to do it through my stomach since the other entrance is strictly off-limits (per Dr. Uterus’ orders). I hope this “talk” gives us some answers, although, so far my uterus has been awfully deceptive. Bad uterus!

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21w0d: Mover and Shaker

As a general matter, I do not recommend moving households with a toddler.  I especially don’t recommend it when the moving truck gets delayed because the driver is not authorized to come into the new state you’re moving to, and you are without your household goods for four days.  Add into the mix two cats, one elderly Golden Retriever and gestating another human being and it is freaking hard work. Thank goodness for my mom, good friends and meticulous planning.

Before we moved, I had the anatomy scan with the MFM who shares office space with Dr. Uterus.   I was pretty certain going in that we were having a girl.  Mr. X was pretty certain we were having a boy.  In the X family, there has not been a girl born since 1932.  Yes, there has not been a girl born in the family in 80 years.  The girl in question, however, is still kicking at 80 despite a regrettable smoking habit.

So who won?

 

 

 

 

 

 

Me. Of course. We’re having a baby girl.  My mother-in-law was beyond herself.  After three grandsons, she’s getting a granddaughter.  I for one am not looking forward to onslaught of pink frills that will inevitably invade my home. For her part, baby is a mover and shaker.  I’ve been feeling her move since 13 weeks.

The scan did show a marginal placenta previa, but hopefully that will resolve itself by 28 weeks.  No restrictions other than no sexy time.  Which, considering all of the crap we’re going through, that is the last thing on the agenda.

 

 

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.

10w4d: Live to see another day

Quick update to report that baby is still there, measuring 10w3d with a heartbeat of 180. 

Moments of the absurd:

– Sono tech banging on my belly to wake up the baby and it responding with outraged wiggling.
– I’m being referred to the MFM who shared (and still shares) office space with Dr. Uterus for my sequential screening. AWKWARD.

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.”

We Came, We Saw, We Heard

I have a really bad habit when something big is about to happen. I think, “oh, in x number of hours, we’ll know” or “in another hour, it will all be over.”  Of course, this is only used for events that are anxiety inducing – they are not pleasant thoughts and only serve to cause more anxiety about the impending event.

This was what I was thinking as we drove the five minutes to the clinic in 6:50am cool air.  I’ve driven this route so many times now, seen the same people walking the same dogs, it’s amost comforting. Almost. Because today, was no ordinary day.

Today was the 8 week scan. The scan where the stakes were raised to threat level heartbeat.  Luckily, Dr. Salsa didn’t waste much time getting down to business.

And, poof, there was the little p.  I could tell right away that there was significant growth since our last scan two weeks ago.  And, with the movement of the wand just a milimeter, I saw the tell-tale flashing.  The tiniest heart amongst us.

You will probably shocked to hear this, but I never actually saw the heart flash before on either my two previous pregnancies.  Dr. Uterus’ scanning equipment was fine, but there was one monitor and it was rather hard to crane my neck to see the important stuff. Dr. Salsa of course, provides you with your own monitor on the ceiling which I am appreciating more and more each time. 

He turned on the sound and there it was – wocka, wocka, wocka – like Fozzie bear.  The rate measured at 167 bpm which is nice and solid. He took some measurements and everything was on track.

I also tallked with him about the big D.  He gave me the name of a psychiatrist who can, if need be, proscribe me something.  I also see my regular therapist on Monday and will definitely raise the issue with her as well.  Between the two, we’ll see what we can do.  The uncertainty level has gone down a little with today’s appointment.  But, it will come back up again.  We are in charted, but still dangerous waters and know that the boat can capsize still.  We’re just taking it day by day.

Thank you all for your lovely comments and support. May this karma rebound to you in droves!

O-Bla-Di, O-Bla-Da, O-My-God

alfarmanI had my blood draw this morning for my third and final beta and all I can say is thank God.  I actually find it more stressful to go to the clinic now than I did when we were just cycling.  Part of that is because those people insist on throwing out the p word at me and saying, “I’m so happy!”  And, they see my pained expression and say, “Oh, I know, I know, but I am going to be happy.”  I also cringe because it’s a fairly open office and I hated it when I was a patient and would overhear such protestations of joy.  I can’t bear the thought of someone else having to deal with that, too, in the one place where they are supposed to be able to get away from it.

And, with this last blood draw I thought with a certain amount of satisfaction that it was going to be a good while before they would have me back for an ultrasound.  I mean, at least not until the end of July, which would give me lots of time to mentally prepare, right?

Wrong.

Next week.  They want to see if there is a gestational sac.  This is a new one for me. With Dr. Uterus, they practically bar the door until at least 6 weeks because there isn’t much to see.  But, they also didn’t do third blood draws, so maybe comparisons aren’t as helpful here. 

I have a week.  A week to calm my self down and find that mellow spot of meditation where I can still function.  Because I have to be able to function.  Hibernation, while attractive, is not an option.  And, I need to develop a method for coping with my anxiety because this may not be the end of the road and I don’t think my body can handle the up and down stress for a long period of time.  I also don’t want to drive everyone around me batshit crazy (except Mr. X.  I’m certain that he accepted this in our marriage vows).   Any suggestions for how to achieve a zen like calm in this kind of situation would be greatly appreciated.

I could have really used them this afternoon when I had to wait until 4 to get today’s results.  They were worht it, though: 15dp5dt beta = 846.  Doubling time of 44.4 hours, which while not as overachievingly spectacular as my previous 36 hours is still damn respectable.  Progesterone = 306, and yet, I still have to shoot myself in the ass.  Sing with me, “While my butt gently weeps…”

image: alfarman

A Thousand Points of Light

One of the more important differences between Dr. Salsa’s methods and those of Dr. Uterus is that Dr. Salsa places a great deal of emphasis on the holistic and mind/body connection aspects of infertility treatment. He was the one who really recommended that I try acupuncture.  He asks how you are doing emotionally as well as physically.  He gets it and that’s been a welcome change.

flickrolfThere was a time, not that long ago, though, that I didn’t put a whole lot of stock in alternative medicines and theories.  It was a big step for me to start acupuncture.  Still, even after this long road, there are still some aspects of alternative and holistic medicine that I have trouble accepting.  I had one of those moments as I was being impregnated with my two embyros on Monday and Dr. Salsa instructed me to begin talking to them as they were heading down the catheter.  I cheerily agreed because the man had delicate implements in delicate places, but my inner cynic said no way.

It’s not that I didn’t want to do the absolute most to ensure that this works.  It’s that I didn’t want to start thinking about those two little blastocysts as people. Not yet. Because, if neither of them decides to stick (ha) around, then I will mourn them that much harder.  This is precisely why I didn’t want blastshots of the embryos from my previous cycles.  I knew that I would begin to project all manner of human characteristics on them so that should things go awry – and let’s face it, with me that always seems to be the case – it wouldn’t be as hard.

Luckily, I had an alternative that while recognizing the life potentially taking hold of me, didn’t elevate it to the status of personhood that would have required me to have a non-stop conversation with my uterus. 

jesse-gardnerDuring my pre-transfer acupuncture session, the acupuncturist gave me a pep talk of sorts to get through the two week wait.  She warned against the effects of worrying and offered alternatives to allowing myself to get mired in it.  One alternative involved a visualization technique but with a twist.  Should I feel that worry coming on, welling up inside, I should imagine those two little blasts as points of light that grow stronger and stronger with every deep breath and feeling of relaxation.  Kind of like little headlights in my uterus that instead of dimming, get stronger each time the engine turns over. 

So far, I haven’t had much worrying, other than if it is possible for my ass to begin to blend into the couch. But, I have been visualizing those two little points of light and mentally sending them invitations to stick around for a while.  For now, though, I’ll leave that talking thing to the professionals.

images: flickrolf (top right); Jesse Gardner (bottom left)