IUI #2 CD 1 (a new plan)

This morning when my period still hadn't arrived I started to get nervous (since I made an appointment with my RE to talk about our next cycle) and a little excited. I got out my HPT and went for it. When I wiped, there was a little bit of blood on the toilet paper. My response? Someone is laughing and it's not me! Oh well, I knew this cycle didn't work so I was ready to get AF and move on to the next cycle. I was just bummed I wasted the test because I didn't even have to look at the result to know it was negative. 

We had our appointment this afternoon and I left feeling so much better about things. It seems like when  I ask I tend to get what I want. I never complain about getting what I want, that's for sure (just ask my hubby). We talked about the next cycle and my RE gave me a few options and leaned a certain way with his opinion. He said that we could up the dose of Clomid and try that again (although he didn't think it was that great of an idea to try it again), we could do injectables and another IUI, or we could do IVF. We talked the most about doing another IUI using injectables this time. He said it would include more monitoring (blood work and more ultrasounds) and I felt most comfortable trying another IUI given different circumstances. 

 So, we will start Gonal-F on Sunday (CD 3) at 75 IU's/day. I will go in on Tuesday for a baseline ultrasound and to check my hormone levels. I am really happy with our new plan and hoping for some good follies this time. I'm pretty sure if we aren't successful this cycle we will move on to IVF. IUI's are completely covered by my insurance, but IVF isn't at all. I had been thinking I just wanted to move on to IVF, but I felt more comfortable making the decision to do the IUI again given the new plan. 

We also discussed progesterone and Metformin. I asked about the progesterone and he agreed for this cycle I will start a few days after the trigger. He also agreed that it was a good idea to up my dosage of Metformin to 1000 mg/day from 500. I will see how that goes. 

So we have a new plan and I am feeling much more optimistic and excited this month. The only thing is, I didn't find out what time I am supposed to take the Gonal-F. Any ideas?

Mind over matter

My hubby and I have been talking a lot the past few days about my mood and attitude towards this cycle. This week I was feeling SO down and couldn't figure out why. It was worse than after the miscarriage; I was feeling so depressed. I know it sucks to have follicles on the wrong side, but really Liz? I was tired all the time, struggling to make it through each work day, feeling somewhat anxious and unable to focus on anything, and crying a lot. Each day as the week went on all I wanted to do was come home and curl up on the couch or in bed and cry. It was bad. Well, last night we were talking and it all started to come together. I started feeling my mood change as soon as I started the Clomid. My hubby agreed that I haven't been myself since starting it (the past 2 or so weeks). It started as moodiness and feeling short tempered and evolved into depression. It is hard to think that something so small could affect you so much, but I'm pretty sure that is the culprit. I'm not prone to getting depressed and have dealt pretty well with all of this infertility crap. I try to keep a positive mind frame and not dwell on the things I cannot control. This was definitely the worst I have felt during the past 9 months in dealing with everything. I was starting to wonder whether it had all built up to this point, but now I'm starting to doubt that. I blame it on the Clomid. 

Having said that I am able to feel much better. I consulted Google last night and found SO MANY entries on forums and boards where people said that Clomid made them depressed. My mind and body were telling me not to repeat the IUI and give up because I was subconsciously aware that it was the Clomid and I didn't want to repeat the process. I found faults with every avenue of my treatment this cycle and was ready to switch RE's. I have had great experiences with my clinic up until this month where my judgment was clouded, and therefore, so were my feelings about everything. 

Having said all of that I plan to make a call to my RE and raise some questions and concerns about this cycle and future ones. I'm not sure what his opinion will be about repeating Clomid, especially given the fact that it made me super depressed. In all fairness, my ovaries responded well, just not my brain. I would love to try something that will give me more than one dominant follicle, even if that means risking more than one baby. 

I am feeling SO MUCH better after realizing that my mood has been affected by Clomid. I was starting to wonder what was wrong with me and why I was feeling so terrible about everything. Starting last night I adopted the attitude of mind over matter and I know that I can control my mood and be more positive. 

My hubby smiled at me this morning and said it was good to have me back. 

Discouraged

Well, I finally talked to the nurse at my clinic after playing phone tag for the past two days. Let me tell you, waiting 2 days to get ultrasound results sucks. I haven't been able to focus at work and have been feeling down. I had an idea about what the news would be, but it was confirmed today. 

The news sucks. On the left I had a dominant follicle that measured 18x17. On the right I had two bigger ones measuring 14x10, 12x8 and a tiny one at 10x8. The nurse reiterated we were planning to trigger on Wednesday until I asked her/reminded her about not having a tube on the left side. Well, she forgot, as did my RE. Come on guy, you removed the tube a little over a month ago!!! She then paused and said she would have to talk with him tomorrow and call me back then. 

I asked whether it was possible to ovulate on my own before the trigger and she said it could happen. I then asked if I should use OPK's and she said no. I asked if there was any chance the ones on the right would catch up, and she said they were counting on the one on the left being the best, if not the only one. It is unlikely they will catch up. 

Needless to say, it sucks to be out for this cycle before it ever really started. I am so disappointed that the dominant follicle is on the left and that I have no tube there. The reality of only having one tube is starting to hit hard. So is the reality of dealing with side effects for essentially nothing.  I'm also disappoited with my clinic. I can't belive they didn't remember that I am missing my left tube. It seems like everyone forgets this but me. This is the first time I have been disappointed by my clinic, but it seems like something you would remember. I have been feeling like they don't really care about doing IUI's and that I haven't really been on the radar. 

My hubby and I went for a walk after receiving the news and talked about our next cycle. It's not that we won't try this cycle, and it hasn't been confirmed the IUI will be cancelled, but I don't want to waste it if it isn't likely to work. There's always that theory of transmigration, but I'm sure as hell not betting on it. 

W previously said that doing an IUI was like rolling a dice, and that eventually your number comes up. What happens if you don't even get the roll the dice? I don't like the odds of IUI to begin with (20-25% success), but not even getting to the IUI puts those odds even lower. 

 My RE said that on average you ovulate 50/50 from each ovary over the course of a year. That doesn't mean that each month you alternate, it just means that over time they both average half of the year. Next month the exact same thing could happen again. 

I want to try something that will give me more than one dominant follicle. I'm not sure what my RE's response will be, but I feel like they will say call on us CD1 and we will prescribe more Clomid.  

I am so disappointed that this cycle was over before it even started : (

Can I get some Provera? ....... JK

Pass the wand

I had my appointment this morning at 8:30. I arrived a few minutes early and was out of there by 8:35. As I suspected the ultrasound tech didn't reveal much verbally. This was my first ever follicle check so I wasn't exactly sure what to look for/at.

 When she walked me down the hall she introduced me to a resident student and asked if it was OK if she observed. I was fine with it and I even recognized the resident from my last surgery. I go to a University clinic so both of my surgeries has been accompanied by a resident. This was the first time I had seen one in the actual office.

The ultrasound tech started doing her thing and first measured my lining. She said something to the resident about how it is tough to see the outside edges of mine, and therefore how hard it is to get an accurate measure. Unfortunately I didn't pay attention to what it measured. Well she first got my left ovary in view and there was a large follicle there. I have no idea how they tell the difference between a cyst and a follicle because I had the huge cyst before and it looked exactly the same. She measured it and I think it was something like 1.7. Then she went on to the right. On the right hand side she measured three smaller ones (2 at 1.2 and 1 at 1.07).

Here comes the good part. She then asked the resident if she wanted a turn. The resident came over and the tech looks at her and says "got it?" It was like an baton handoff in track and field. The resident took a quick look at both ovaries and then handed ole' wandy back to the tech. She then removed it. Well, the handoff was interesting, especially with the verbal confirmation. I guess the resident wasn't just observing like I thought. The tech then told me I could get dressed and would hear from the nurse later in the day.

I brought my phone into all of my sessions and warned parents I was expecting a phone call. Well, I didn't get one during the work day. I finally called the clinic a little before 4 and left a message. When I was searching crap on the phone around 5:15 I accidently exited out of a call from the clinic. The nurse left a message and said I wasn't triggering tonight and that I would likely trigger Wednesday. She wanted to talk with me tomorrow and said she would call.

How does this all work? Are they going to trigger the one on the left and the smaller ones will likely not release? Is there any way to let the left one go and then trigger the ones on the right? I guess I just don't feel like I got the answers I was looking for since I didn't talk to anyone about the ultrasound.

Man, I really wish I hadn't exited out of the call. I am so disappointed that I waited all day for the call and then screwed it up. I will be calling first thing in the morning tomorrow.

On pins and needles

Tomorrow I have an ultrasound at 8:30. I have no idea if my body has even responded to the Clomid (other than by being a hormonal crazy lady.) I am nervous to find out whether I have any follicles and which side they/it are on. I am really hoping righty can pull off something fantastic, especially since I have been giving her periodic pep-talks all week. Not having a tube on the left makes me not care a whole lot about what lefty has going on. She can let righty steal the show and lay low. If we need to pursue IVF in the future, I will be counting on her then to work collaboratively with righty.

Worst case scenario is that there are no follicles or one on the left side. If that is the case I don't want to do the IUI because it is likely to not work. Best case scenario is that I have 1 or 2 follicles on the right that are dying to be fertilized.

I decided I don't need W to be there tomorrow since the ultrasound tech never reveals much info. My best bet is that she will do the scan and I will have to wait from my RE later in the day to find out. My clinic is part of the University so the doctor is only there certain days and times. I know he will not be there in the AM so I will probably be expecting a call from him in the afternoon. Let's hope for good news tomorrow.

Battle of the wills

Well, I think the Clomid started to really kick in today. Of course I said something yesterday and pay the price today. It was the same with the Provera, I didn't really feel any side effects until day 3. Well, I am MOODY today. I can feel my hormones going crazy like with PMS, but a bit worse. I keep reminding my hubby not to mess with me because I'm on Clomid!

Last night W set the alarm yet I woke up on my own this morning. Monday's are my earliest and longest days all week and it turned out he set the alarm for PM, not AM. Well, I had about 45 minutes to get ready total (compared to a usual hour 15). I was doing well when W popped his head in the bathroom to apologize. I really just didn't say much. I lost it when I went downstairs and I had to do things I don't normally do. I know I have it good and that W helps me SO MUCH in the mornings, but on the mornings that I have no time it really sucks to have to do things I don't normally do. I was pretty pissed, and when he came downstairs and started talking, I kinda went off on him. I just voiced how frustrated I was and bitched a little bit. No big deal, I still left and we were fine. He even sent me a text a little later to apologize again. I told him when I got home this afternoon that I was sorry for getting upset, but MY HORMONES ARE GOING CRAZY!!

The second kid of the day that I saw decided to give me a hard time. He was being a squirmy wormy and by the age of 3 1/2 I expect a child to be able to sit and focus for at least 20 minutes. He wasn't being cooperative and was having a difficult time listening. Well, it got worse rather than better and the session ended with him crying and giving me the stare down. Both of us were feeling stubborn and didn't want to back down. He has a very permissive Mom and gets away with a lot and when I am feeling moody I tend to butt heads with him a bit. When I was pregnant before, I had a difficult time with him. He doesn't do anything he doesn't want to do since Mom never makes him.  Usually though, he loves me and we have great sessions. In fact, just last week he insisted on showing me his superhero underwear (just got potty trained a few weeks ago). The underwear were on backwards so the images were on the front and he kept pointing to the guys and telling me about them. I couldn't help but laugh really hard. Needless to say though, Will wasn't happy with me today. I just realized I titled this entry "battle of the wills" and I had a battle with Will today. Very appropriate : )

The last kid of the day also decided to be difficult. He didn't want to play a game by the rules and became focused on turning all of the cards over when it wasn't his turn. I became pretty frustrated but wasn't feeling stubborn by this point in the day. Instead, we cleaned up the game (he didn't want to help but ended up helping) and I spent a little extra time talking with the grandma rather than pushing him. 

I guess I am feeling like I have a really bad case of PMS and can tell it's all hormonal. Oh well, two more nights of Clomid and I am done! I am still having a hard time giving up caffeine and don't know how I am going to do it. I really regretted not giving it up when I miscarried, but it's SO HARD. I was able to give up coffee before but found a new love for it after when I was able to have it again. Tea just doesn't do the trick. 

Any ideas?

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We spent this past weekend putting in a walkway from our driveway to the gate where we access our yard/backdoor. It was a LOT of digging and W kicked some serious ass with the axe. There were so many roots and we called many of them a "yule log" once they were removed. The dog had a blast playing with all of the roots as we would throw them into the yard for her. I will post pictures once I take some of the completed product. I have to say, it was super nice to not have to walk through the mud this morning to my car, especially since it was raining. 

This afternoon we did a first coat of paint in our previously purple guest room. I can't believe anyone would ever pick the color that was there and it's been a project we have been looking to do for a while. It feels nice to do some projects with the house, especially since we are planning a big housewarming/grad party for the second weekend in June. You are all invited!! 

When work breaks your heart

Many of the families I work with I get to know well. I mean, I go into their house twice a week, play with their kids, and give them advice and ideas to enhance speech and language. Topics other than their children often come up.

Family #1: Mom just turned 21 and has two boys (4 and 2). I work with the 2 year-old (Ronnie) who isn't really talking. He uses a few words with lots of prompting, but doesn't talk much spontaneously. The boy who is 4 is profoundly deaf and goes to a special education school. He has no functional speech and has lots of behavioral issues. I started talking with Mom the other day about the father of the 4 year old. We had talked previously about how he was much older and charges were pressed against him. Well, I asked about how court went and she went into further detail about the guy. Apparently, he is her step-father and raped her from ages 6-12. He controlled much of her life and she found out she was pregnant 3 days before her 16th birthday. The guy recently got 2 years of probation and the decision fell partly on her as to whether she wanted him to have to register as a sex offender. I left the house in shock and feeling so badly for her. She tries her best, but her abilities are limited at 21 with 2 children. She owns her trailer and recently got back together with the father of her youngest and is always receptive to strategies and ideas I give her. I think she has done incredibly well considering her background.

Family #2: One of the worst houses I have gone into. I no longer see the little girl (Jasmine) as she went to a preschool where they provide services there. Mom is VERY overweight and often doesn't wear pants (that's a story for another day). I try my best to help families I know have limited resources by passing on clothes or toys from different families. If a family I work with has clothes they are going to donate to Goodwill, I tend to take them instead and pass them on to a family I know needs them and will use them. Well, although I don't work with Jasmine anymore a family gave me some clothes to give to her. I dropped them off on Friday. Jasmine was pretty severely delayed. From the way she walked, I called her a "drunken toddler" by the way she walked (she also received physical therapy and a special education teacher). The physical therapist had referred her to a neurologist and I hadn't gotten the update since I no longer see her. Well, Mom found out she has Trisomy 16 and is probably having seizures. The doctor's aren't sure she will ever be "normal".

I hate to say it, but seeing in person a child with a chromosomal disorder and knowing her abilities makes me know that my miscarriage happened for a reason. I can't imagine raising a child with needs like her. 

My job isn't always easy, but knowing I can help others to the best of my abilities makes me feel better. Sometime though, you can only do so much.

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Tonight I will take my third dose of Clomid. I haven't experienced many side effects, but I said the same about the Provera and then it hit me that day. 

I spoke with the nurse at my clinic on Friday and was SO happy she was back from having surgery. I told her how difficult it was to get questions answered and how bad the office was, and she said she had heard the same from many others. She was able to answer any and all questions I had and told me I will go in on April 11th for an ultrasound. If my follicles are mature that day, I will trigger that night and come in the next two days for inseminations. If not, I will return the next day or two days later for another ultrasound. Unfortunately the ultrasound is the same day that I have to give an inservice for work, but I'm sure it will all work out. 

I am amazed by how quickly this is all happening. The scenario I had in my head was that AF would come about 5 days after stopping Provera (Tuesday), but instead it started before I even finished the Provera. I don't think I really needed it and I don't think I gave my body the credit it deserved. I've never had to take anything to get my period before, I was just eager to get the show on the road. 

I just hope this week goes by quickly. 

  

Clomid Dust

I am beginning to think I see my RE too often. When I enter the city Syracuse in my GPS, it automatically knows where I am going (I use the GPS to get an ETA). Speaking of ETA's when I use my GPS, I get such a sense of accomplishment when I am able to take time off from the projected time. It leads to more speeding, but makes me feel like I accomplished something while driving. I am so sick of rushing my Friday's to get to appointments on time. I don't want to cancel therapy since each session = more money, but it's starting to get to me. I am looking forward to not going there any more (someday). 

My RE had some fantastic quotes from this meeting:

1. "Your chart is starting to take on a life of it's own."

2. "I'm starting to think all I have to do is sprinkle Clomid dust in the room and you will get pregnant."

Well I wish getting pregnant was that easy! Really the appointment was just to talk about the plan for Clomid and IUI and my RE wrote a script for Provera and Clomid. When I took the script to the pharmacy they got a sketchy and then told me you can't write more than one prescription per page. He wrote both on the one page. Not sure if this was a mistake or something that is legal in other states (he moved from Atlanta this past summer). I am constantly amazed by how fantastic my insurance is. The meds were $13.00. 

We will not be adding a gonadotropin this cycle since my RE wants to see how I respond to Clomid. Now, each night I take 500 mg Metformin, a prenatal horse pill, 5000 IU's of Vitamin D, and Provera (tiny little sucker!). My RE did do a pregnancy test and it was negativo. Here's hoping last month was my left ovary's time to shine (if I even ovulated) and this upcoming cycle will get righty psyched to kick some follicle-growing ass. Reminder-no left tube. 

I did get to see my friend the dildo cam (#8) and ultrasound tech. Everything looked fine (according to her) and my file got a little thicker with those images. Does anyone else ever wonder where to put their hands while in those stirrups with a wand inside of them? Gets me every time. 

Vacation

So we are home and it's Sunday night which means I have to go back to work tomorrow. Don't get me wrong, I love my job, but the end of vacation is always a bummer.

We had a great trip full of lots of sunning, swimming, reading, drinking, eating, relaxing, and enjoying each other. Our room was great and the weather was fantastic. The food and drinks were both consistently great and I had my first bahama mamma (it was absolutely delicious!)

The resort was about an hour and a half away from the airport in Santo Domingo and we had a shuttle arranged. It was interesting to see more of the country and it didn't seem overwhelmingly poor. Unlike Costa Rica there wasn't much wealth either. The biggest thing I noticed was that the street and sides of the streets were covered in garbage. One of the coolest things was that the red lights had a timer to let you know how much time you had left. It seemed like red lights were optional and the driver of our van was very "horny" in that he tapped the horn quite often.

The resort was pretty far back from the road and was very nicely manicured. The beach area was a bit small, but had chairs to sit in. There were a lot of topless women on the beach (not me), and my hubby and I would give out our own award to the best set seen. The waiters even came to the beach to get drink orders and I drank a good amount of frozen alcoholic beverages.

The last day I called MSED (maximum sun exposure day) and am peeling as a result. I got a little burned here and there, but nothing too bad by the last day.

Here are some pictures from the trip:

In other news I started my Metformin last night. I haven't had any extreme side effects, just minor disturbances. I am hoping it stays this way. I had a pretty bad headache all day but so did W, so I'm thinking it was more out of withdrawal from beverages.

Of course I couldn't complete ignore the issue of our trying to start a family on the trip. We had some conversations (less than usual) and I brought ovulation prediction tests with me (of course). I wasn't counting on ovulating this month, but was given the green light to try if I did. I am so confused and frustrated by the test strips since it looks like I got a positive, but in reality I don't think it was. The test strip is darker, but only a portion of the line. When I looked online it said it had to be 50% or more of the line to be positive, so I don't think it counts. What do you think? I'm pretty sure it doesn't count as a positive.

The thing is, even when this test appeared positive, I didn't feel like I was ovulating. I did have some increase in CM the week before but hadn't bought the OPK by then. I really don't think I stood much of a chance ovulating this month, but I may ask my RE to run progesterone levels in order to see since I have to get blood work anyway. 

I am supposed to call me RE this Thursday to tell him whether or not I have gotten my period. It's not that I don't think I would get it if I just waited, but I'm not feeling particularly patient these days. If I haven't gotten it by Thursday (4 weeks post D&C) then he will prescribe Provera to induce it. I don't feel like my period is close as all, but if I did ovulate then I would want to know for sure whether I was pregnant or not before taking it. I'm not feeling like this is very likely, but you never know, right?

 Any experiences with Provera? I've never taken it before. I will probably schedule an appointment for this week to talk about Clomid and I still have to go back for more blood work to check HCG levels and testosterone levels. Ahh, back to reality!