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Doctor Appointment

Well, it was not a fun weekend. I spent it crampy, cranky, and crying over everything. But I allowed myself to nurse my wounds with a few indulgences which I rarely get to enjoy — soda, coffee, doughnuts, bagels, chocolate, old episodes of Dawson’s Creek, and some retail therapy — and that did help as much as it could.

Today, I met with my OB. We’ll call him Dr. Smiles since that’s always the first thing I see when he walks into the room. A smile. I had scheduled this appointment before I ever got my period so that I could renew my Clomid prescription, but the opportunity allowed me to ask a LOT of questions. Thanks to everyone for the suggestions, guidance, tips, and encouragement that enabled me to ask what I needed to.

Here’s what we discussed today:

  • Clomid: We’ll be sticking with 100mg for now as it worked well last month. Dr. S reminded me that I can’t expect to get pregnant on the first ovulation every time. He doesn’t do any sort of monitoring and advised, if that is something I am attached to (I’m not), then I’d need to see an RE.
  • Femara: My doc has no experience with this and thinks it’s wise to stick with Clomid for now as we know that has worked in the past. However, if Clomid fails or causes problems in the future, he’d be willing to look into this to see if it might be an option for me.
  • Supplemental Progesterone: Dr. Smiles does not prescribe vaginal progesterone suppositories to be used after ovulation. If this is something I want, I’ll have to see an RE. However, once I get a positive pregnancy test, I can then request them and he will gladly write me a prescription. This is perhaps the answer I was most disappointed in, simply because I’m concerned about my rather short cycle this month and would like to have one less thing to worry about. My doc doesn’t think my short cycle is cause for concern as it’s only happened once that we know of and, in the past, my luteal phase has been long enough to allow for implantation of two pregnancies. I will, however, follow everyone’s advice by adding B and D vitamins to the mix and cross my fingers that will be enough to get me through to a BFP.
  • Ovarian cyst: This was a new development over the weekend, something that caused me a fair amount of discomfort on Saturday and Sunday. I’ve had them before while using Clomid (including during the cycle that gave me my last pregnancy), so I knew what it was. It has since gotten better and the doc doesn’t see any reason to worry, unless it swells up again. It should not prevent me from getting pregnant this cycle (which I do believe, because of my last cyst and the ovulation and pregnancy that still resulted three weeks later).
  • My short period: I was concerned because my period only lasted 3-4 days this cycle (normal for me is 5-7), though one day was very heavy. Dr. S thinks this isn’t a problem and is no indication of the thickness of my endometrial lining.
  • More lab tests: While Dr. Smiles does not think I need a “re-do,” he agreed anyways to order my lab tests to be redone so that we can really know if I fall into the PCOS category, at least hormonally. Past tests have been completely normal but were taken on the wrong day of my cycle. I want a definitive answer for peace of mind, so that I can give it all a rest. With that being said, today I had my blood drawn to check for the following levels: LH, FSH, prolactin, testosterone, DHEAS, estrogen, iron, and TSH. Results should be in by the end of the week. He also ordered a P4 test to check my progesterone level after my next ovulation.
  • When to see an RE: This really deserves a post of its own, because I already have my own opinion and plan for when this will occur if it comes to that. But Dr. Smiles’ rec is to give Clomid another three to four months as that’s working for us right now. In fact, he said he has every confidence that it will happen for us again. I know that he really cannot make such a guarantee, but it’s nice to hear that we are not the only ones with hope.

So while it was not a perfectly satisfying appointment that gave me everything I wanted (ahem, a prescription for those vaginal suppositories), it did give me a few other things — answers, new hope, reassurance, and peace of mind — and I guess that is enough for one day.

And now, having met with my doctor, I think I am ready to move on. To let go of the  disappointment of a cycle that held so much promise, and to start again. I’m still feeling fairly melancholy on a day-to-day basis, but as Tami recently suggested in one of her comments, it helps to start looking forward, instead of dwelling on what could have been. I’m already on my second day of Clomid. I’m adding extra vitamin D and B vitamins to my long regimen. And I’m still praying. Hard. But also trying to release any expectations. I don’t know what this cycle will hold. I don’t know if I’ll ovulate, or if I’ll conceive if I do. But I do know that if I don’t, there is always next month. I still have plenty of options. My next chance could be right around the corner.

Metformin: a Decision

Well, I finally did it. I took my first dose of Metformin last night with dinner.

I actually made the decision to try it while we were away in Idaho. When I heard my sister’s news, there was a sort of flame of desperation that was fanned inside me. I just knew that I was willing to do whatever it takes to conceive and carry our next baby to term. Metformin offers no guarantees, but it is an easy next step and I’m willing to give it a shot. At least for now. And if I hate it? If it makes me miserable? Well, there’s no one saying that I can’t stop it whenever I want.

At least this is what I’m telling myself as I consider popping some Tums for the GI discomfort that I think I’m already feeling. But maybe it’s all in my head at this point. It is still so early.

So for the next ten days, I will be taking just one dose of 500mg with my evening meal. After that, we will add another dose to have with breakfast. Hopefully, this stair-step approach will help to keep the side effects at a minimum. My OB says he can even add one more dose to have with lunch, but he wants to see how my body responds to just 1000mg/day first. He also prescribed me the Extended-Release version, which can further help reduce side effects, so I’m hopeful that it won’t make me feel too crummy. I still have limited expectations in regards to it actually helping my reproductive parts do their job, but miracles happen I suppose.

And at this point, I really need a miracle. I think we all do.

Some Thoughts on Hurting, Home, and the Things in Between

Today, I hurt.

I hurt today because yesterday I came to the conclusion that my sister is pregnant. She has not confirmed this, but I know. I know that she and her new husband started trying during my short-lived pregnancy in April. I know that she has always had regular periods and will probably have no problems conceiving.  I know that she has dropped hints such as being the designated driver at a bachelorette party, feeling so tired all the time, and in an e-mail yesterday she mentioned that she hasn’t been feeling well for a few weeks but said nothing more. And I know that she is probably afraid to tell me her good news.

I know she is pregnant, and I think I have for a while, though I have tried to convince myself otherwise. Either way, I sent her an e-mail last night to ask if my suspicions are true. Was this out of line? I hope not. I don’t want to make her uncomfortable. But if she is expecting, I want to know so I can accept it and move on. So we don’t have a pink elephant hanging around every time we talk on the phone or send an e-mail.

Sigh.

This, in the aftermath of my loss, is one of the things I have been fearing the most.

As you may remember from a previous post, my sister is no ordinary sister. She is a half-sister whom I learned about just this year. At this point, we are bonded only by blood and quite a few common interests and personality traits. We don’t have a history. Not really. And the history we do have is short and shadowed by the fact that I feel as if she did not support me through my miscarriage as I had expected. This has left me with a bad taste in my mouth and a lot of resentment. I’m trying to forgive, to believe her intentions were always good, to fake it until I make it. I think I have done a good job at that, but it doesn’t mean I want to celebrate her pregnancy with her.

I am happy for her but sad for myself, torn between wanting to hear every detail about every second of this pregnancy and this baby (my niece! my nephew! my very flesh and blood!), but also afraid to experience all of that. Afraid of the jealousy and contempt and pain it will cause me. There have been times that I wished she would have to deal with my same infertility issues (that somehow it was genetic) and, in the last 24 hours, there have been times when I wished that this pregnancy didn’t exist. Not that I would wish her and her unborn child any harm or tragedy. Just that this had not happened for her quite so quickly and not yet, not until there is another life growing inside me too. Maybe then it would hurt a little less.

I just want to stop hurting.

Someone please tell me I’m not a horrible person, or a bad sister. Because I’m new to this sister thing and I don’t know if these feelings and thoughts I have make me the very worst sister-friend to ever exist.

But on to other things…

It’s cycle day 3! Officially. Not long after my last post, the flow started to pick up and blazed throughout yesterday and into this morning. I don’t think I’ve ever been so glad to see that much blood! (TMI?) So of course, I was worried for no reason. Like always. It’s still not as wicked as it has been at times in the past and I’m not nearly as crampy either, but maybe that’s a good sign? I’ve heard extraordinarily heavy and painful periods are not healthy either. And now I’m at a point where I’m hoping for a little mercy and for the flow to slow waaaaaay down by the end of the day. And I took my first 100mg of Clomid with breakfast this morning. It’s always exciting to me, because it gives me new hope, even if that hope wavers. Often.

(And btw…thank you so much to everyone who offered their advice about cycle days, spotting, and Metformin. I needed to hear all of it and, with each new comment, I breathed a sigh of relief.)

As for the Metformin, I am still on the fence. I go back and forth about a hundred times a day. I did fill the prescription and pick it up from the pharmacy, but I’m going to leave it sitting on our bathroom counter for a few days. I want to ponder it and give my decision time. On one hand, I find it deliciously tempting not to take it and not to have one more obligation and worry in TTC-land. Especially when there is no proof that I actually need it. But on the other hand, I want to do everything I can to up my odds and help my body to ovulate and hopefully ovulate earlier than is standard for me. But at any rate, I won’t be taking it until next week (after my birthday and road trip) and I will definitely be taking it if this round of Clomid doesn’t work at all. I think.

And speaking of our road trip…

We leave today!  Going back to Idaho. Back home…or at least to the only home I had ever known until the place that we now call home became our home. (Hey…that was a lot of fun to say!) I’m so excited for this return to our “roots.” There was a time when I hoped I would be returning with a growing belly and, for a short while during my Teddy Graham pregnancy, I really believed I would. In the weeks after my miscarriage, I lamented that this picture I had of myself in a cute sundress attending the wedding of a family friend in Idaho would never come to be. I cried for days over that silly image. But I’m stronger now, and looking forward to going back to a place that is so familiar to us. It will be good to get away for a short while and, when we return, I will already have made it through the first week of this cycle…with only one (but probably two) more weeks until the anticipated ovulation date. I will welcome anything that can make time go faster right now.

And with that being said, I will probably be off the grid for a few days. If there’s time (perhaps in the evening while watching the Olympics!), I will stay caught up on my blog-reading, but I don’t anticipate that I’ll do any of my own posting. Unless, perhaps, I hear back from my sis about her suspected pregnancy. In that case, I might have no choice but to come here to whine and cry over the unfairness of it all.

Just a warning, friends.

Thanks & Stuff

First, I want to say a couple big thank yous…

To those of you who responded to my post on faith…thanks for the stories you shared, the support you offered, and the prayers you have said. I do so need and appreciate them.

And to those of you who responded to my post about my many overwhelming worries…thanks as well!!! You guys offered some great advice and gave me a lot to think about.

And with that being said, I present to you my plan going forward (though, being a woman, I have the prerogative to change my mind at any time):

My next cycle (#2) will proceed as planned. I finished the progesterone yesterday and am now waiting for the flow to begin. I will then take “just” 100mg of Clomid and annoy God with my constant prayer (i.e. begging and bargaining), while also crossing my fingers and hoping for the best. Part of why I’m choosing this route (no monitoring, RE, trigger, etc.) is for the simplicity of it (less stress, I imagine, though certainly not stressless) and also for practical reasons as it will be a busy month and I’ll be out of town for a few days next week. Not to mention, I have always taken this route and it has always worked. So far.

If this cycle ends with a glorious BFP, I will then request for a beta draw every other day until I see a heartbeat, at which point I will ask for a quick u/s every other week until the end of my first trimester (when I may just buy a doppler, so I can find a new way to obsess). I guess then I will not only be annoying God (please God don’t let this baby die too, please let there be a HB, please protect my embryo, please have mercy, please please please pleeeease), but I will also be irritating my OB with my paranoia. I’ve warned him already…but I don’t know if he really understands what he’s in for. And that is, of course, only if I build up the courage to demand what I want and need. I’m a bit like a timid twelve-year-old girl in that way — not very good at standing up for myself or being assertive. Work in progress, remember?

If this upcoming cycle ends with the stupidest-of-stupids BFN, I plan to have all my blood work redone so PCOS can be ruled out once and for all, maybe also have a baseline u/s done on my ovaries (to verify there are no cysts), and perhaps request to be monitored for my third cycle.  I may also try to charm my doctor into letting me try dexamethasone or Metformin…and/or increase my Clomid dosage.

And if I don’t ovulate at all? Well, the plan will probably compare to the BFN plan, except I will most definitely be begging the doc to increase my Clomid or try Femara and give me a trigger shot…anything that will just get my body to release a damn egg.

As for going to see an RE, I’m still hesitant, mostly because of money matters. Our health insurance does not cover infertility. Like, at all. And so I’m scared that once I go see a fertility specialist, all coverage will stop. So far, we’ve been lucky enough to have every ultrasound and all lab work covered 100%. Not to mention, seeing my OB only costs us a $30 copay. I like having money. I like having no doctor bills. I like being able to, instead, save for baby items and a stay at the Labor & Delivery unit sometime in the future. I don’t want to spare every penny possible in order to expand our family. I will, if necessary…but I’m not ready yet, and I’m still hopeful it won’t come to that. After all, I’ve been pregnant twice and have not needed an RE thus far. After two cycles of Clomid at 100mg and two at 150mg, though, I think it will be time. Sigh. I know all of you RE-veterans will laugh to hear this, but the thought of it sort of makes me want to barf.

Also, one other note…as arminta suggested, I took a pregnancy test. A good suggestion, but futile in my case. It was a BFN. In fact, that single control line was so dark and bold and in-your-face with “You’re NOT pregnant,” I found it sort of rude and obnoxious. So no worries, guys…I’m not pregnant. Go figure. I mean, really? A surprise, unexpected pregnancy? That only happens to OTHER people.

Which means I was getting a close-to-positive OPK for one of two reasons: 1) My LH was just wonky for a few days for whatever lame reason. Or 2) I actually ovulated. I’m pretty sure #1 is the winner, but either way, the tests have gone back to being completely, undoubtedly negative and that has helped me to breathe a sigh of relief. And so now I just wait for my period. And in honor of the Olympics, all I have to say about that is this:

Let the Games begin!

(Okay, I know that was cheesy and hardly even accurate, as all of this is more akin to torture than a game, but it was the only closing to this post that came to mind. Please forgive my lameness.)