No Idea What to Title This...

...oh, I guess I could go with "More Disappointment and Stuff."

We weren't going to try again until March, but I got my period semi-naturally (explaining semi-naturally will take too much time and it's not interesting), so we decided to go with "the flow."

And "the flow" is what we've ended up with (ba dum dum).

Anyway, it was kind of a hell month. My meds had to be jacked way up -- which, in turn, jacked up the cost of my meds. That, in combination with the fact that I got the news that about one billion more of my friends and family are pregnant.

Really, shitty month.

In my mind, I'm really happy for my friends and family. But emotionally...jealous, hateful, more hateful.

So, my nurse just called me to tell me that I'm not pregnant. Now I have to drive back into my doctor's office (second time today) so I can arrange my next treatment...but really, I don't really want to go into my doctor's office today...and considering there is no urgency...I just called my doctor's office and cancelled.

Unless my body goes crazy and tries to be all semi-natural again, we're not trying for a while. I need a break. Man, I'm going to have a big caffeinated drink -- with possibly some rum -- for dinner...and goat cheese and brie. Maybe a crack rock.

In the meantime, could someone please send a memo to all the assholes who keep asking if and when we're going to be/try to get pregnant? Please ask them to stop bugging me. I'm really open with the fact that I'm a fertility patient. It's insensitive and rude to ask me.

I should have used the "well I had a baby, but it died last week" retort when I could. Christ...I really hate people.

On Hiatus

Last night we made the decision to wait a while before we try again.

Medical proof that my body isn't ready made it easier to admit that I'm not mentally ready to continue trying. That last round wiped me out. I've been going through the motions this time and I knew something was wrong when I can't get over the fact that I just don't want to go to doctor anymore.

It goes against every fiber of my being to stop something before I've obtained what I want, but I've decided that is what's best in this situation.

We will try again after my birthday.

~$700 Down the Drain

My test results today show that my estrogen levels are falling -- and they should be rising. Basically, my body isn't ready to try this month, so our cycle has been cancelled.

We'll try again in December -- which I'm fine with. I'm mentally not ready this month.

Un-Effing-Believable

So, I had more bloodwork done today (as my heroine addict arms can attest to) and my body now believes it is not pregnant. In fact, my tests came back so clear, that we are now a go to try this cycle.

I have no idea how so much could have changed between 11:30 AM this morning and 2:45 PM this afternoon, but whatever.

Up and down. Up and down.

Also, this week I've had three different people ask me if we're going to try to have more kids.

Why this week?

I'm in such an up-and-down bitchy mood, it's all I can do to not say, "Well, we had one earlier this week, but since I was only five weeks along, the baby died. Thanks for asking."

Which Crappy Option?

Well, despite my tests looking good yesterday, we will not be able to try again for at least four weeks. Even though I'm technically not with child anymore, my body thinks it is and it's not backing down.

We have two options...

CRAPPY OPTION #1 (CO1):
Start taking birth control today. Should have period in four weeks. At that time my body should be "restarted" and we can try again. Ahh...more drugs in my system. Great.

CO1 Time table...
Expected period = Nov 19.
Target insemination = Dec 8 or 9.

CRAPPY OPTION #2 (CO2):
Wait six weeks. If no period (which, there won't be...because I don't ovulate), take Prometrium to cause period.

CO2 Time table...
Expected period = Dec 10.
Target insemination = Dec 28 or 29.

Currently having trouble deciding on which option.

CO1 hits before a long trip to California (D & V are coming with me). It's a sooner timeline, but we will be running around a lot that week, which is bad. CO1 also involves more drugs.

CO2 is a longer timeline, but the potential insemination date is during a perfect restful time.

I think I've talked myself into CO2. Almost.

This Month

I just got a call from my nurse. Despite the fact that my body still thinks it is pregnant, my hormone levels are coming down exceptionally fast (which my nurse said, may result in severe mood swings this week -- oh, no shit).

So...we may be able to try again this month! I just spent another $1700 on drugs today.

I'll get confirmation tomorrow -- I have to go in for more blood work and another ultrasound.

I'm developing track marks. Seriously. The chick who takes my blood said we will definitely have to start using my other arm after the next test.

Too Pregnant to Try

My nurse just called to tell me that while my miscarriage has officially started, my body still thinks it is pregnant. I have to go in for comprehensive blood work tomorrow to determine if additional corrective courses (I have no idea what this would entail) are necessary.

We will most likely not be able to try again for at least one cycle.

The Anger

My hormones are raging and so is my temper. I'm ready for this to be over.

I haven't been able to sleep well for more than two weeks now. Being angry all the time isn't helping.

This morning I told Dave that he might want to lock me away until this passes.

Pragmatic Reaction, I Guess

I can't believe that after two weeks of having to wait to find out if I'm pregnant, I now have to sit her and wait to have a miscarriage. That's a bitch.

I cannot even imagine what it's like for women who make it further (or even full term) in pregnancy and then have to wait for a still-born baby, etc.

That said, I guess I consider myself lucky. Kind of hard to feel lucky right now, but I guess I do.

My lower back is really starting to hurt, so I'm guessing that things will start to happen sooner rather than later.

I can tell you what I'm not happy about. I'm not happy that tomorrow I have to go out with friends and family (non-cancellable) and put on a happy face while I'm miscarrying a baby.

Sucks.

Probably Not

In a worst case scenario, we still don't know, but it's very unlikely that I am viably pregnant.

Right now, I am technically pregnant. I'm technically pregnant, but my pregnancy hormone levels are exceptionally low. When I was pregnant with V, my hormone levels were at a 134 at this point. As of today, they're at 20.

This most likely means that I will miscarry within the next couple of days.

I go into the doctor on Monday to have my bloodwork done again.

I never thought I would be this upset about it.

Oh Come On...

Tonight I took another pregnancy test. It stayed negative for like 30 minutes...then we saw a super faint pink line. Like, so faint, I had to say, "Dave, is this just wishful thinking or do you see something too." After a minute of concentration and staring, he saw something too...but it took 30 minutes to pop up there...so that's pretty inconclusive.

Even more frustrating is the fact that I know that a false positive is a very rare thing -- so it's pretty much impossible to not get my hopes up now.

WWWWWHHHHHHHHHHYYYYYYYYYY?

I have had horrible cramps, but I'm vaguely remembering having bad cramps when I was PG with V. I haven't actually started my period.

I know I'll spend another $10 on a test tomorrow.

I hate this damn up and down. I can't wait for Friday's blood test. I'll have a decisive answer either way. I'm OK with either answer, obviously we're hoping for "yes," but "no" is OK too.

I just want to know, damn it.

Not Looking Good

Test this AM, negative.

Bad cramps, also negative...meaning, I have them and that makes me feel pretty negative.

I'm totally OK thought. I remain hopeful, but not expectant. We'll get the final word on Friday and then we'll start the next round.

On to the next!

Tests # 1 & #2

In my brain, I know that rationally, I should not receive a positive pregnancy test (if I were prego) until at least Wed of this week...

...that doesn't mean I haven't taken two tests (one Friday, one today). Both of which were negative.

I'm a glutton for punishment.

I'll try again on Wed, when I should receive an accurate (and hopefully positive) result.

Pregnancy Brain

Reason #2 I had better be pregnant.

Today I opened the back hatch on my car. Blew off the reason I opened the hatch. Got in the car. Backed up and busted the rear window wiper on the top of our car port, because I forgot to close the hatch.

Idiot.

(Non) Puke-o-rama

I am about to stick my fingers down my throat in an effort to get rid of anything that might be causing nausea. Puking is bad, but at least you kind of feel better when you're done. The never-ending nausea. Holy hell.

If I'm not pregnant, I am going to be super pissed.

Don't Get Too Excited

This is what I keep telling myself, as I endure the long two-week wait.

I'm telling myself to not get too excited, or to build myself up for disappointment. I'm telling myself this because I'm nauseous as a mo fo.

I can hardly keep food down...and I was at the grocery store yesterday and I swear I could smell perfume on every other person in there. I am so, so nauseous.

Really though, don't get too excited. Extreme nausea is a side effect of the progesterone supplements.

I am Bitchy -- Leave Me Alone

In the hopes of being prego, I'm cutting down on my caffeine...and Violet is sick...and I'm working round-the-clock...and I don't feel well...and I'm dealing with a jackhole who just asked me if I'm "a little annoyed these days?"

Umm...wrong question. Can I say YES? Yes. At many things, but mostly that annoying question.

I'm going to start spitting fire out of my mouth. With all of the drugs I'm taking, I'm sure it's a side effect to one of them.

Rarrrrrrrrrrrrrrr!

Progesterone Suppositories

Standard operating procedure for fertility treatments is that you take some sort of progesterone supplement after your treatment. If your body doesn't make enough progesterone, it is one of the easiest ways to miscarriage.

I started my progesterone supplement today. The supplements that I have used in the past have varied, but most are suppositories and most are "icky."

I've even used suppositories that were progesterone mixed with cocoa butter -- my thighs have never been so well moisturized. Those bad boys were the nastiest.

This time the nurse says, "Start progesterone on day three. Are you used to suppositories? OK then, well these may be a little dry. They're like pills. Just run them under water if you want them to be a little slimier."

OK...in the past, slimy was never an issue. I should have been curious when she said "they're like pills."

Sure enough, they're like pills. More specifically, they look like gigantic Tylenol caplets. Weird. They are, literally, pills for your vagina.

Cracked me up when I opened that package tonight.

I'm pretty sure a spoon full of sugar would not be "the most delightful way," as it would probably cause a yeast infection or a UTI in this case.

The IUI (#1)

On Friday we had our first IUI for this round. There weren't any complications, so things went as well as could be expected -- we'll find out in two weeks if we're pregnant.

What's an IUI?
IUI = Intrauterine insemination. People also refer to this as the "turkey baster" method. As someone who has basted a turkey and experienced this procedure, I can tell you that it is much closer in resemblance to a "flavor injector."

What Happens?

• Male gives semen "sample."


• Sperm in semen is analyzed and "washed" in an andrology lab.


• Sperm must be removed from semen, because semen cannot go into the uterus. The female uterus is allergic to semen -- trust me. The first IUI I had, the sperm weren't clean enough and I had severe cramping and fever.


• During intercourse, sperm is separated from the semen via cervical mucus.


• It takes about 45 minutes to analyze and clean the sperm. Enough time for a nice breakfast at the clinic's cafe.


• Once the sperm is cleaned, the sample is taken to the fertility clinic (ours is in the same building).


• The procedure is very quick, like five minutes total.


• Strip. Get into stirrups. At that point, the nurse uses a speculum to get to your cervix. Once there, a catheter is inserted into your uterus.


• For me, there's not any pain at this point. It's not comfy (by any means), but it doesn't hurt. It does feel weird when they insert the catheter, because you can feel something wiggling around inside you -- and it doesn't feel natural like, say, a baby.


• When the catheter is in place, the sample is inserted via a syringe (a la flavor injector). Dave pushes the syringe in, that way he's involved in the actual conception (if it works).


• After that, they ask you to lie on your back for 15 minutes and then you go on your merry way.

And then the wait begins...

Dude, Ovulating Hurts

Since I don't typically ovulate, I need to give it up to the ladies who do. Ovulating hurts.

Yes, a side effect of fertility meds is that you can hyper ovulate, which causes more pain. I'm also dealing with equipment that doesn't typically work...there's the breakin factor.

Anyway, my lower back kills. It feels like someone is stabbing me and I've decided that I do not enjoy being stabbed (it's a double entendre cause of the shots, get it? heh...).

Shots at the Spa

Last night two of my associates took me to the spa. It was nice, except for the fact that I had to conceal my arsenal of injection paraphernalia -- on the one night of the month that I have to give myself two shots.

Surprisingly, the timing on my spa treatments worked out perfectly for the two separate shots. The first shot is the one that's typically painless. For some reason, it hurt like hell last night and it drew blood. I think I contaminated my remaining meds (not everything in the tube is injected -- I use one tube for multiple injections). Awesome.

The second shot is the shot I dread all month. The BIG one. It's one shot that is 10 x's the amount of the shot I give myself on a daily basis. The needle is also thicker. This shot is the ovulation trigger. I was critical that I give myself the shot at exactly 9 PM CT. I did (well, 7 PM PT).

The second shot...holy hell it hurt. I'm in the bathroom at the spa, which is a stall within the main locker room. One of those bathrooms that isn't really private, because everyone within earshot can hear exactly what's going down.

The BIG one comes it it's own hermetically sealed package. I opened the world's loudest packaging (echo, echo, echo) and tried to give myself the shot. It usually only takes a try or two, but I lost count. I could not push that big needle in.

Finally, I sucked in my breath and "darted." It went in. Then I had to inject myself. How much medicine do they need to put in an injection? It seemed to take forever. I could feel my "shot location" AKA front fat roll, filling up with liquid. So gross.

It got worse.

When I pulled the needle out, a "skin-like substance" came with it. Foul.

So here I am, sitting in the non-private bathroom where outsiders can hear everything and I'm trying to not scream.

As of this morning, I'm officially ovulating (I have a stick with two pink lines to prove it)...so the clock is now ticking. By this time tomorrow, I'll have had my IUI.

Miracle Drug

I lost my voice, so I broke down and went to the doctor. When I got weighed, I found out that I've lost 20 pounds in the past two months. Hell yes!

This is all due to my Metformin. Metformin helps my blood process insulin more effectively. When my body processes insulin correctly, I can actually burn fat.

A w e s o m e.

If only it didn't level off once my body is regulated.

The IUI is Scheduled

I didn't post after Friday's scan, because there wasn't anything good to say. I had one follicle developing and it was at 10 -- which means that it will be "ripe" when I'm out of town Wed & Thurs.

After today's scan, I now have two additional follicles that were at 10 today -- which means that they will most likely be "ripe" on Friday...so we're scheduled for an IUI on Friday morning (10/3).

===============

Today when I was having my ultrasound two thoughts came to my mind.

1. I bet most people would find it weird how comfortable one gets with having invasive ultrasounds done on a bi-daily basis. I timed myself today. I can get my clothes off and into the stirrups within 18 seconds.

2. October is "medical ultrasound month." There's a flier in my doctor's office. Uh, does that mean I'll be getting a discount on one of the 10 - 15 ultrasounds I'll potentially have in October? Yeah, didn't think so.

===============

Tomorrow I'm going out of town. This will be my first trip (this time) with fertility meds. I keep forgetting that I need to pack a little cooler to go with me on my trip. Having needles is a good way to get through security fast. Seriously. If you're forthcoming with the info, the security people always wave you through quickly. I guess they assume that if you have to give yourself shots, you're not worth hassling.

True that.

Headache & Low Estrogen

In the hopes of becoming prego sometime in the near future, I've started to cut down on my caffeine intake. I remembered this sucking when I was trying to get prego with V. It seems worse this time. I need caffeine.

Less caffeine + hormones + fertility meds = super bitchy Bethany

People need to stop messing with me.

=================

My nurse called and my blood work showed that my estrogen level is not increasing as quickly as it needs to, so I get to bump up my injectable. I'm now at 150 cc's of Follistim each night.

Next ultrasound is Friday.

No Stimulation -- Yet

So far my meds haven't kicked my follicles into gear. Nothing to be alarmed about yet.

So, RD is the winner, with a guess of 21...because I'm still technically at 42.

Today I had an ultrasound and bloodwork. I'll have an injection this evening and I will wash the day down with seven of my closest friends (pills).

Taking Bets

I'd like to start a little contest. Whoever guesses closest without going over wins. No actual prize...well, maybe I'll name one of my follicles after you.

Last scan I had 42 follicles with the potential to grow. How many will I have after tomorrow's scan? It's not science -- at this point, it's a total crap shoot. The number will be between 0 - 42.

I am going with 17. Although, I'm hoping for 8.

G R U M P Y

The meds are making me super bitchy this time around -- bitchier than normal. They're also making me a bit frantic. This could also be related to last week's natural disaster.

Poor Dave/planet Earth.

I'm also crying. A lot. Human emotions stink.

Pinch - Dart - Push - Release - Pull Out

I started injections yesterday. It was far less traumatic than I expected it to be. Everything is still second nature.

Put the shot together. Stick shot in stomach. Pull shot out...or, as they teach you at the doctor's office: Pinch (your skin), Dart (the injection in -- I still cannot dart -- I'm all for the slow entry), Push (the meds in), Release (your skin), Pull Out (the needle).

Easy.

Round 1: Day Two (Baseline Scan, Blood Test)

We’re currently on day two of the cycle. Day two means that I go in for a base-line scan to make sure my uterine lining is shedding correctly and to count the number of follicles that have the potential to release eggs. On this day I typically also have blood work done. Because I had blood work done so recently (two weeks ago), I got to skip this goodness today. Awesome.

I have Polycystic Ovarian Syndrome (PCOS). PCOS patients typically either produce very low (or no) egg counts or very high egg counts – this is why they’re very strict on the amount of medication I take.

As of now, I have 42 follicles with the potential of growing to release eggs. To put this into perspective, on the cycle that worked with Violet, I had 38 follicles with potential.

Today I was also reminded of how dramatically fertility meds can effect my emotions. While driving to the doctor I saw a convoy of work vans from Phoenix. I started thinking about how nice it is that these people were willing to come to Houston to help our city get back on schedule post-Hurricane Ike. Then I started thinking about their families. Next thing I know, my face is a waterfall...

It was a long day. Me and my 42 follicles are going to sleep. Shots start tomorrow.

Power and Pharmaceuticals

A hurricane is headed our way. We should be concerned for our safety, but now that we have $1500 medications that require refrigeration in the picture...

My Dad has a cooler that is powered by your car. This is our current backup solution.

Oh and I've only been taking one of my Prometrium pills for the past two days. Last night I realized I should have been taking two. Crap! So many details!

Today's Medications 09/10/08

Here's what I'm ingesting today:

Medication	Purpose	Dosage	Delivery Method	Number
Metformin	Insulin regulation	2000mg	Pill	4
Valtrex	Subdue fever blisters	500mg	Pill	1
Duet DHA	Pre-natal vitamin	(1) vitamin (1) soft gel with DHA	Pill	2
Prometrium	Shed uterine lining	200mg	Pill	1

TOTAL PILLS FOR DAY: 8
TOTAL INJECTIONS FOR DAY: 0

Fingers Crossed

I've worked my travel, so that I should be in town for most of the rest of the month...but I have to be out of town on Oct 1 & 2...which, if my body goes slow enough, could be target insemination days. No way around it.

I'm just crossing my fingers and hoping for the best.

Health Care Failure

So, after multiple hours on the phone with multiple levels of different components of my health care provider, I found out that every month, we will have to pay $1500 for prescriptions.

So, my coverage was changed so that all fertility treatments are covered -- but none of the prescriptions to enable said treatments are covered.

Really fucking mad is the only statement that comes close to what I'm currently feeling.

As if the whole fertility business is not stressful enough, now I've got the fact that each month's meds are $1500 in my head.

I'm really glad that Viagra is covered by my policy. I hate men.

And So It Begins...

I'm writing this for my own personal sanity, to share with my closest compadres (the ones who had to stick it out with me the first time -- for your cheer leading that I'm eternally grateful for -- I could have never done it the first time without your support) and for future reference.

Today I visited my fertility doctor to begin a new cycle. Meaning, I've already seen my fertility doctor recently and I've taken care of the preliminary steps I (it's individualized) have to go through in order to begin fertility treatment.

Preliminary steps:

1. Take medicine to induce period. Check.


2. Get blood work on second or third day to verify crazy whacked out hormone levels that require aforementioned fertility treatment. Check.


3. Run through the financial check to make sure you're willing and able to fund treatment. Check.


4. Start taking prenatal vitamins. Check.


5. After initial blood test, integrate and sustain Metformin (to regulate high insulin levels).Check.

In today's visit, we discussed my pre-Metformin blood work results -- which were, as expected, crappy. My doctor gave me an awesome backhanded compliment, "Your insulin levels are remarkable." Hooray for me. Other negative: My blood sugar is pre-borderline diabetic.

There were some surprising positives though: My testosterone levels were normal (say what?), my cholesterol is really low (good cholesterol needs to be higher -- as always) and my triglycerides were low.

==================
PRESCRIPTIONS

1. Follistim AQ -- Ovary ripener. Makes one ovulate.


2. Follistim AQ Pen -- Less threatening way to say, "needle."


3. Endometrin -- Progesterone suppositories (for post insemination). As you may remember from round #1, this was formerly known as "cocoa butter." My thighs are sad that they will not be as well moisturized this time. I'm, however, not sad. Disgusting.


4. Prometrium -- Makes one shed their uterine lining. AKA Get period.


5. Pregnancy tests -- I was supposed to take one of these today before I started taking Prometrium, but GD Rebecca distracted me on the phone. I'm not really worried about it.


6. Ovidrel -- Shot that forces your ovarian follicles to release eggs. Given 24 - 48 hours prior to insemination.

COST OF TODAY'S PRESCRIPTIONS: $1500. I just about fainted when they gave me today's price tag. In the past, my prescriptions have cost about $250 per cycle.

When I got home from the doctor, I called the insurance and (thank GOD) it was a mistake (not the pharmacy's fault -- the insurance company's fault). Now I'm jumping through hoops to get our money back. The lady at the pharmacy is being so incredibly helpful. I'm writing a letter of commendation to Walgreens.

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DOCTOR'S ORDERS

1. Take Prometrium to get period.


2. On third day of period, get baseline scan.


3. I'll detail the additional items after I finish #1 and #2.

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TARGET INSEMINATION DATE: 9/29/08 (exactly two years and one day after we conceived V!)

TARGET PREGNANCY TEST DATE: 10/14/08