An Adventure in the Woods

Thursday I decided I needed a change of scenery and talked to the hubby about a weekend of camping/backpacking in the Adirondack Mountains. On short notice we decided to go. We got all of our supplies packed and headed out as early as possible on Friday afternoon. I wanted to return to the first place we ever went camping called Siamese ponds. During the next two days I repeatedly asked myself how good of shape I was in when we first went 6 years ago. 

Although we left early on Friday, we didn't have quite enough time. The hike in to the lean-to and camping area was 4 miles. Going in it wasn't bad, lots of downhill with some up along a river and tricky terrain. We left our car with all of our stuff and two dogs at 6:45 (WAY too late!) We ended up doing the last 30-45 minutes with flashlights, not fun at all. I was seriously just in charge mode and we didn't rest at all during the hike in. 

We didn't see anyone until we arrived at the lean-to. The dogs starting barking like crazy and a guy was there. He was by himself, upper 50's, and immediately asked us if we were the cops (any missing criminal you know of that fits that description?) After that I kinda feared he was going to kill us out in the woods, but we ended up OK. He did help us to find a great campsite and we set up our tent and got our dinner cooking on the camp stove. In addition, I had gotten us camping wine glasses so we were able to enjoy some wine with our dinner. Pretty fantastic! W was not thrilled about carrying the wine in, but it was totally worth it in my opinion.

On Saturday we got up, had some eggs and hung around for a little bit. We then decided to do a day-hike to the Siamese ponds. To get there was 2.3 miles and there was so much uphill hiking to get there. The view was completely worth it and the dogs had a great time. While we were sitting next to the pond we heard a loon calling to another one. It was so relaxing and perfect. 

The funny thing is, 6 years ago when we hiked to that pond we decided there was a perfect rock for some lovin'. I understand now why we didn't think we would see anyone. Well, we were wrong that time. A guy out in his canoe whistled to get our attention and it is one of the most embarrassing things that has ever happened to me. This time we didn't see anyone, but we also didn't give that rock any extra attention.

We hiked back to our campsite and took a little nap. The creepy guy had a radio with him and came to tell us that the hurricane was likely to bring lots of rain and wind which in not safe for being in a tent. So, we made the call to head back that afternoon. 

We hiked out the remaining 4 miles again with our packs and it was pretty rough on the way out. All that down on the way in... yeah, meant lots of up on the way back. We were able to rest more and made it back to the car a little short of 24 hours later. So, in total we hiked 12.6 miles in 24 hours, 8 of which we had our packs for. It was a little much and we spent yesterday lounging around complaining about how sore we were. 

It was really nice to get away. Although I wasn't able to completely avoid talking about IF, it was at a minimum. It was a great distraction, but unfortunately it never lasts. Here are some photos of our little trip.

Good morning dogs!

Enjoying my coffee by the river

Mmm... eggs!

Pepper by the lean-to

View from the suspension bridge

Me and Togie on the bridge

Dogs begging for a snack during a hiking break. Togie had her own pack and carried all the dog food. 

Siamese pond

Me on "the rock" and Pepper

W relaxing by the pond

The river on the hike out

Hiking out

W on a cool bridge along the hike

Me on the bridge

Becoming a more patient person

My doc called today while I was in the middle of a therapy session. As soon as my phone rang I excused myself. I felt bad just getting up and leaving for 15 minutes, but there was no way I was missing another call from him. He apologized for not calling back sooner as he was out sick Monday and Tuesday. 

Dr. S talked about the results of the biopsy. He first talked about the proliferative endometrium and said that although it was concerning, but there was nothing we were going to do about it at this time. When I told him I had only been on the progesterone one day he said that it may not have been enough time. I asked about how my progesterone levels got so high during the IVF cycle and he said that is in the blood and that my endometrium may be different. Without doing a biopsy the only thing you can do is measure the blood levels of progesterone and go by what you see on ultrasound. 

He then talked about the traces of the polyp that were found. He was surprised since he had done a sonohysterogram (SHG) in Dec and didn't see anything then. He said that they don't often pop up in a short amount of time and that there is no real reason why this would happen. He said if I had been on estrogen the entire time without exposure to progesterone, that could cause a polyp, but it isn't the case with me. The only thing that could explain why we didn't see anything with the first SHG was because it wasn't done on the high resolution ultrasound machine at their office. He wants to do another SHG on the high resolution machine and see whether we see something. He said it is rare to miss polyps on a SHG because they light right up. If we do find a polyp we will likely do a hysteroscopy. He didn't want to go there immediately because it means surgery and he doesn't want to subject me to unnecessary surgery.  

Doing another SHG means having to schedule with the ultrasound technician and my RE. He said he would try to do it before going out of town next week, but he wasn't sure about scheduling. 

The receptionist called me a few hours later to tell me they won't be able to get me in before Dr. S goes out of town next week. They will have the nurse call me next week to schedule. I was disappointed at first, but at least now we have a plan in place. I am hoping we will be able to schedule it for the Monday when he is back. Until then, I guess I just continue taking BCP's and crossing off the days on the calendar. 

We are looking at the week of the 12th for the HSG. If they find something, who knows when they would do the hysteroscopy. Looks like September is likely out for the FET. The hardest part about that is that my EDD for the miscarriage is September 30th. I really thought I was going to be pregnant again by the time that rolled around. 

Things haven't been easy the past couple of months. W said the other night that he wants a list of all the potential problems we could encounter and once we cross them all off then we know we will get pregnant. It really seems like one roadblock after another and that is something can go wrong it will. I'm starting to become more patient and understanding with this. There is really nothing I can do about it, and feeling badly about it all the time doesn't help. I'm tying to distract myself and focus on other things, but it is hard. 

I made a realization about friends lately as well. If we find a nice couple to hang out with (usually they are married), they are either pregnant or they already have a baby. As much as I like them, it is hard to spend tons of time gushing about their babies. There is no "safe" couple to spend time with these days. That means I am hanging out with younger people who are more at the partying stage of their lives. This isn't a great influence on being healthy and making good decisions. I feel like I just can't relate to any friends right now. 

A few months ago I made an appointment with the other RE in the area. I am happy with the care I receive with Dr. S. I am happy he knows who I am and takes the time to call me personally and talk for 45 minutes if needed. I am happy with the treatment as well as decisions made to this point, but at times I do feel like Dr. S is overly conservative about things. I'm not really displeased in any major way, but the price is a huge consideration. The other RE (Dr.K) has package deals, and they have one package deal I am considering. I have an appointment scheduled with him coming up in September. I never thought it would get here so quickly and I had previously hoped I wouldn't need it when I made it in June. Now I am faced with canceling the appointment and sticking with Dr. S for now until we at least complete an IVF cycle, or seeing the other doc and finding out what he has to say. I feel like my case has been so complicated it will be hard for the new doc to follow it all. Also, I have to get my file to the new doc and that means notifying my current office and making them think I'm not happy with the care I receive. Is there really any point in seeing another doc if we can't even get out of the starting blocks with my current doc?

Any advice? 

Biopsy Results

I have a new idea for any doctors. Never call your patients on Friday afternoon and leave a message.

On Friday I missed a call from my RE and he left a message. Really?? A message on at 4:50 on a Friday afternoon with no hope of any conversation until Monday. 

And then? He was out sick on Monday.

On the message he said he had the pathology results of the endometrial biopsy. The biopsy revealed a small fragment of benign polyp and a proliferative endometrium (no progesterone effect). He said we will have to address the polyp as it could interfere with implantation. He was also surprised that he was seeing no progesterone affect as he thought I had been on it at least 2 days. I had actually only done one shot and it was fewer than 24 prior to the biopsy. He said that I could be progesterone resistant as some women with PCOS are. He is not sure, but this is something he will have to look at. He ended the call by saying we would have a further discussion Monday over the phone about it. 

I left a message yesterday both at the clinic (the nurse is out this week) and on his "academic" line that is a direct line to his personal voicemail. I guess I will have to keep my phone glued to me today.

Upon consulting Dr. Google, it seems that removal of polyps usually entails a hysteroscopy and D&C. Any personal experiences from anyone out there with polyps?

I really just want to have a plan in place and hopefully be able to execute the plan prior to my RE leaving for 10 days on Sep 1st. In a sense I like to think that dealing with this issue will make the fluid no longer be an issue. I know it will mean more time before we are able to do the transfer. Why does it feel like I am the only one standing still on this journey lately?

Hopefully I will talk to Dr. S today and have some answers and a plan in place. I will update when I do. 

Happy ICLW August

August... really? Wow, this summer flew by! Happy ICLW to new and old readers. My name is Liz and I just turned 28 a few weeks ago. We have been TTC for 15 months but seeing a RE just about the whole time. Our journey started with a diagnosis of PCOS and a huge cyst on my left fallopian tube that I ended up getting 2 laparopscopic surgeries for. The first time we drained it but then it returned a few months later and I ended up losing my left tube with the second surgery.

 In January I became pregnant but that pregnancy ended in a miscarriage at 8 weeks (only measured 6 weeks). After that we tried 2 IUI's but were unsuccessful so moved on to IVF. I did my first IVF cycle in July and wasn't able to transfer the embryos due to fluid in my uterus the day of transfer. We froze the 5 embryos on day 3 and tried a FET in August. A few days before the scheduled transfer we again saw fluid. Most recently I had an endometrial biopsy to try to determine the cause of the fluid. I haven't gotten the complete results yet but it appears like it will involve more complications and delays.  

Outside of IF treatments I work with young children and love my job. My hubby graduated in May and we recently became a DINK family (dual income, no kids). We have 3 fantastic fur babies that keep us occupied and entertained.

I like to ask readers questions for ICLW and also answer them, so here goes:

When you have 30 minutes of free-time, how do you pass the time? 

On my phone or computer cruising the internet.

What did you do growing up that got you into a lot of trouble? 

Everything and anything. The biggest ones? Sneaking out of the house and being a smart ass.

Have you ever had something happen to you that you thought was bad but turned out to be for the best? This didn't happen to me personally but my hubby tore his ACL skiing. He loved physical therapy so much he chose it as a career path. You never know when a big mistake will turn out to be a blessing in disguise.

What is your first memory of being really excited? 

I remember getting a new bike for Christmas when I was about 5 and then riding it into the lake we lived on.

Also, if you are visiting and leave a comment, please leave me your blog address so I can come visit.

The Two-Minus-One Pregnancy

So someone else shared this story on their blog and I just read the entire story tonight. It is long, but well worth the read. 

The Two-Minus-One Pregnancy

I guess I am the IVF'er who would prefer twins. I can't imagine working so hard and spending so much to get pregnant and then reducing from twins. My opinion is if you can't handle the thought of twins, then do a single embryo transfer. 

What are your thoughts?

Roadblock

I'm glad I went for another ultrasound before doing the transfer. Yesterday afternoon I had another ultrasound followed by an appointment with Dr. S. The ultrasound revealed the same amount of fluid plus traces of additional fluid next to it. 

I then met with Dr. S. He pointed out the trace fluid and gave me three options. 1) Go ahead with the transfer despite there being more fluid 2) Cancel the transfer and do an endometrial biopsy, 3) Cancel the transfer and do nothing. 

We talked for a while and I asked for his best recommendation. He said none of those situations are ideal, but since we know a FET is less successful than a fresh transfer, it would be best to eliminate any other variables that may reduce the chances of implantation. He also said he would hate for it to not work and look back and say we should have waited. He looked at the ultrasound and my trial transfer and tried to determine if he could avoid the fluid. It was possible, but not the ideal placement for them. He was planning to place the embryos where the new fluid appeared. He doesn't know why the fluid keeps reappearing since I don't have a hydrosalpinx and there is no possible reason at this time. He recently rechecked my testosterone levels and they were normal (thanks Metformin!)  He's not sure we will be able to avoid this happening in the future, but it is probably best to wait and see what happens in subsequent cycles. It's not a problem I had doing IUI's or on anything ultrasound until last month. 

I opted for choice number 2. He did the biopsy right then and it was not fun. I wasn't able to take anything prior so there was a lot of cramping, but nothing horrible. It felt similar to an IUI but with much more cramping. I saw the tissue he removed and it was a decent amount. 

After the biopsy I went back into his office to get my prescription and paperwork to bring to the receptionist. At first he wrote me a prescription for oral progesterone and told me to take it for a week and then would start the protocol for the FET once I get my period. He then informed me that he is going to be out of town from Sep 1-11. We looked at a calendar and determined that if I took the progesterone and we started another cycle, the next time we would do the transfer would fall during that time he was away. He offered that the other RE in the office could do it, but I've never even met the guy. So, after some discussing with the nurse he decided to put me on birth control pills and keep me on them until he is back. That way he will be there to make any decisions and not have to communicate over the phone with the office during my cycle. 

In a sense I feel relief. I know this is the best decision and gives me the best chances for the future. I'm not sure why this fluid started appearing and has now become a chronic problem. I'm hoping giving my body a break for a month will help and the fluid won't reoccur in the future. 

I had the cyst and surgery and wasn't able to start trying until January. Once January hit we did the IVF that got cancelled because I got pregnant, a miscarriage in Feb followed by a D&C and laparopscopy #2. March was spent waiting for my cycle to start again after the miscarriage, I tried Clomid + IUI in April, injectables + IUI in May, Lupron started for IVF in June, IVF cycle in July was cancelled at the time of the transfer due to fluid, and a cancelled FET cycle in August. I need to step away and take a month off, forced or not. 

At the same time I am disappointed. Disappointed that this has been so difficult, disappointed that my body won't cooperate, and disappointed that I will be in limbo for another month. I need to step back from infertility and distract myself. I need to live life outside of trying to get pregnant and just be. This is going to be hard, but it is something I know I have to do. At this point I don't know how to not focus on TTC. We shall see how the next month pans out. As I left the office my RE apologized that we had to cancel the transfer again. My response, "I'm learning how to be patient." 

"I'm working for you."

Although this is true of every doctor, I think it is rare for them to actually say this.

 I called and left a message for Dr. S yesterday morning and heard back that afternoon. We talked for about 45 minutes and I got off the phone feeling much better about the situation. I knew if I talked to him I would understand his logic more about continuing with the cycle. When I first saw the fluid I thought for sure the cycle would be cancelled. When I heard the transfer was still on, I lost confidence in the cycle working. I needed to talk to him, voice my concerns, and hear his rationale.

Basically he said it is my choice and if I don't feel comfortable putting the embryos back in we won't. He said the amount of fluid was very, very small compared to last time and located at the very top of my uterus. In case you were wondering, the very top of your uterus is called the fundus. Add that to your vocabulary!

He said as soon as he saw the ultrasound he knew I was freaking out. He said some patients don't even watch during an ultrasound, but that he knew I saw the fluid. I guess he knows me by now : )

I voiced my fears about having more fluid the day of the transfer and having no choice but to put the embryos back. He understood that and offered me another ultrasound before that time to be sure the fluid doesn't change. He feels confident putting them back if the fluid is the same. If there is more than we will cancel and do an endometrial biopsy. 

Apparently there isn't any way to remove the fluid without traumatizing my lining, so just draining it isn't an option. Also, sending the fluid for testing doesn't make much sense either because he said he didn't know what to test it for. If we tested anything it would be the endometrial tissue and that is unlikely to show anything. 

I feel confident in his decision to continue this cycle. I am thankful that he has taken so much time to talk to me and explain things clearly. 

I have another ultrasound followed by an appointment with him tomorrow afternoon. I am hoping the fluid is gone, but no change would also be OK. 

Letting go of control

So I didn't hear from my RE or the nurse yesterday. We went for a long walk with the dogs and I kept waiting for the phone to ring. Actually, my phone doesn't ring anymore. The ringer died a few months ago and now it only vibrates. I am waiting to upgrade to the new iPhone when it finally comes out. The anxiety of having my phone so close and waiting for a call isn't fun. I'm still yet to miss a call though, so I guess my phone is doing the job.

Since I didn't hear last night I changed my estrogen patches (Vivelle) and upped the dose to 4. My belly is now covered in patches. Today I had a dull headache most of the day, but this tends to accompany an increase in dosage.

Again today I waited for the call. I can't say I had my phone on me all day, but I checked it multiple times. Around 3:00 I left a message for the nurse. She called me back around 4:00. I just asked her what was going on. She said we are still on for the transfer on Monday. I am supposed to start progesterone PIO's on Thursday and the Dexamathasone on Friday. I asked about the fluid and she said my RE acknowledged it but wasn't concerned. It was a much smaller pocket of fluid so he is still planning the transfer. She said he would be able to avoid the fluid when placing the embryos, but I'm not sure how I feel about that. I asked if the fluid could increase and she said most likely it will decrease or go away. She also said the fluid may just be something I have mid-cycle and something we may not be able to avoid.

I felt a need to call my RE and discuss this with him. As much as I want to do the transfer, I want the best chances.

I went to my fertility yoga class tonight. There were 3 new people there and myself. The instructor didn't show up so they ended up canceling the class. I sat in the waiting room area and chatted with the other women for a little bit. The receptionist gave me 2 free passes for future classes and then offered up acupuncture for free to all of us. Ummm... yes please! It was the same guy as the one who did my session prior to the transfer last month. He asked for the update and talked to me for a bit. He did a relaxation session and within 3 minutes of getting the needles in, I felt amazing. I love acupuncture, especially when it is free. He made me more relaxed about the fluid and said they would cancel it if needed so that if they are planning to do the transfer, I should have confidence in the decisions made. He told me to stay relaxed and warm until the transfer and I scheduled appointments for before and after my transfer on Monday. He reset all of my feelings and brought me back down to where I was last month. I really needed a reminder of how I can only control so much and have to leave the important decisions up to others.

The transfer is scheduled for Monday at 2:30. I need to find a way to stay relaxed and calm about everything. I'm not sure if I will call my RE to talk about the fluid or not.

Now I just need to make it through this week. I will be PUPO next week! I am really starting to get excited. I need to remind myself that I can only control so much. I will do my best to make good and healthy decisions and control my body and state of mind to the best of my ability. The rest is out of my hands.

Not sure

I wrote last night that I wasn't nervous about my appointment. I woke up this morning feeling completely different and so anxious. My stomach was in knots, my head hurt a bit, and I had zero appetite. I guess once you have something bad happen at an appointment you forever fear it happening again. This morning I was so scared of them finding fluid again. 

Guess what? 

My fears were confirmed. My lining was triple striped and great at 12, but there was a small pocket of fluid again. The most frustrating part of this is that it wasn't there 10 days ago when I went in for my baseline ultrasound. This means I had fluid last month, it went away, and now more/different fluid is back. 

I have been getting ultrasounds for a year now consistently. Before last month I never had any issues with fluid in my uterus. Now it seems to be a problem I can't avoid. 

I haven't heard from my RE or the nurse yet, but I am expecting the call will be from Dr. S. I am going to ask him if we can drain it to see what the hell is going on and then monitor and possibly still do the transfer. I don't think he will be down for this, but I guess you never know. 

I'm starting to wonder whether this is ever going to happen for us. I'm really starting to think we should pursue adoption or take a break from treatments. I am so frustrated right now!

Birthday Festivities

My birthday was Wednesday, but the celebrations lasted almost all week. On Wednesday (my birthday) my hubby and I went out for a great Italian dinner. We had delicious food and he got me a great present. A huge bouquet of beautiful flowers and a blue-ray player that can stream off of the internet with surround sound. We have really been enjoying that! 

On Thursday we had dinner with my parents and brother. The family tradition is a lobster dinner for my birthday and it is always delicious. We had ice cream cake and it was nice to see them and spend some time at their house. We talked about an upcoming wedding (Sep 3rd) where we are going to Cape Cod. I am super excited to see all of my step-father's family and have a great time. Hopefully I won't be drinking at that wedding : )

Friday afternoon I went for a walk with co-worker C. She is the one who had baby Max a few months ago and is one of the few people completely in the loop about my fertility treatments. We were able to talk for a while and hang out with Max. He is really growing into his cheeks and was fun to hold. He is smiling and cooing and is super cute. Friday night we had my B friend over and we rented a movie through our new blue-ray player and drank some wine. We stayed up late talking and laughing. 

Last night my in-laws took us out for an AMAZING dinner. It was the best meal I've had in over a year and was so indulgent (as if every other dinner this week wasn't). After that we met up with B and her new guy interest at a bar and had some drinks. Her birthday is today so we were able to celebrate some after it hit midnight. I don't think W and I have been to a bar even a handful of times since we have been married. Definitely different for us, but still very fun. 

Today we went over to my in-laws house and went swimming. My in-laws have been great about asking what is new in the treatment area and my FIL was super excited that I had extra syringes he could use for house projects. 

Tomorrow is my appointment. I'm not nervous about it. It will be quick and I expect to hear from the nurse or my RE later in the day. I will know what my lining measures tomorrow and that is all that is important right now. I did find out from the nurse at my clinic that my estradiol levels were 23 on day 5 of my cycle. This means although there were cysts, that they weren't producing estrogen. I don't expect them to be gone since I have felt them from time-to-time, but I also don't think they are much of an issue. The estradiol patches have been going fine. When I changed from one patch every two days to two, I got pretty bad headaches. Tomorrow afternoon I change from 2 patches to 4 and am expecting some more headaches. I joke that the brand is Vivelle and that it sounds sexy. Not sure, don't ask. I have definitely been feeling more feisty and irritable this week, but W is great about it all. I am really hoping my transfer will be moved up to this week, but I should have a better idea tomorrow. Right now it is scheduled for a week from tomorrow. 

In terms of eating healthy and exercising, that part hasn't been going well. It doesn't even feel like I am doing a cycle since I haven't had many appointments. Yoga was cancelled last week and I didn't go the week before that. I haven't been to acupuncture at all. I said to W it felt very similar to the cycle we did Clomid and an IUI for. It was basically one ultrasound and an appointment. This cycle is a little more than that (likely 3 ultrasounds) and will hopefully be much more successful. I am mixed in my feelings about the FET. I know our embryos aren't the best quality, but I really want it to work.  I'm so sick of fighting for this, that I have days where I wonder if it's all worth it. I know it will be, but I just want to not have to fight any longer. I think there are times where I lose track of what exactly I am fighting for, I just know I haven't won yet and need to continue. 

Flowers Galore

Since I don't have much to post about fertility related, I thought I would share some photos of my flower garden. My favorite flowers are dahlias. My dad always grew them so I had them in my wedding bouquet and as centerpieces at my rehearsal dinner. I decided this year I was going to plant my own since we have flower gardens. Needless to say, I am obsessed and have to check on their progress daily. We did have a ton of japanese beetles who thought they were delicious so the first few ones that flowered got chomped. We since got a beetle trap and my dad told me a trick to keep them away. 

The dahlias are located on the end of our 50 foot flower garden. Here is the area before we started:

Tons of weeds

And here is the progress of the same area

Mostly planted, early sprouts

Things are getting bigger and starting to flower

beebalm transplanted from my Dad's garden

calla lilly

echinacea

Stargazer lillies

We also have hydrangea outside of the garden, but located close by. The white ones appear to have been there a while since they are so big and tall:

 The pink ones were a housewarming gift form our neighbors

And since I talked so much about the dahlias, here they are: