27 March 2007

Clomid is horrid

I can't sleep. It is pure torture to lay in bed at night and watch each hour tick by. It started on Saturday night, coinciding with my first dose of Clomid for this month. My doc increased the dosage to 100mg, doubled from the 50 mg I took last month. I haven't slept since and I am tired and pissed off. Guess what? Insomnia is a side effect of Clomid. Along with mood swings, hot flashes (having those too), sore boobs, major ovulation pain (check!), crying, depression, psychoses, you name it. I have a lot going on in my life right now already, so no sleep and mood swings add up to me being pretty much a nonproductive mess at work.

I wasn't even sure we were going to do the IUI this cycle. I went to have my ultrasound on Friday morning and lo and behold I have a cyst on my right ovary. It is a leftover follicle that is still filled with blood. If it is too big, they cancel the cycle. I was on the border, so the nurse had to speak with the doctor to get the go or no go. He said go, THANK GOD! I was going to really be a complete mess if they canceled IUI#2. One thing is for sure, getting pregnant takes 3 times as long as you think it will, it is just painfully slow to get through all the steps. Lots of waiting and waiting and waiting.

So, here I am happy as can be that I doing the IUI this month, leaving Orbitz for a fresh, spanking new fun project at LeapFrog. I could use the distraction of a fun new project in San Francisco!! I get to be a real consultant and travel and work on a cool, fun website. NOT. Orbitz decided they just can't let me go. I must stay and be tortured. I cried when I found out I was leaving Orbitz, now I am crying because I have to stay. I am just so completely bored here. Bored out of my freaking mind. Oh well, now I don't have to travel and give myself injections, let's look at the bright side!

That's all for now, IUI will take place in a little over a week or so and then I'll be in the 2 week wait, wait and wait period. Oh what fun.

15 March 2007

Obsession with the question

with the question
Am I pregnant?
Could this be it?
I’m not nauseous, just cautious
Of every little blip, pain or twinge
And there’s the syringe
Very pointy
Filled to 1cc
With something oily
To go into me
Is this a rap?
Or just crap
I’m spewing to get my mind off
The ugly truth

With the question
What’s my level of E2, P4 & HCG?
Why me?
You couldn’t possibly understand
This brand
It’s out there, left of left
Full of snow white tests and
Message boards of anonymous friends
Broken insides
With no explanation
Only emotions
That need ablation

With the question
Where’s our baby?
Give her to me
This feeling of alone
Can’t be shown
It’s difficult to comprehend
But in the end
The ultimate failure
No bed baby in the future
Instead a sterile injection
From the la-z-boy to the catheter
please let it work this time
i'm out of rhyme

12 March 2007

Needles, shots, injections, oh my

I had to start receiving a progesterone shot daily last Friday. The progesterone suppositories were irritating my va-jay-jay, so they recommended I switch to injections. Rudy was very brave and volunteered to learn to give me the injections (like he had a choice in the matter!!) I watched warily as the nurse made us watch a lovely video, then get out all the long, very pointy needles and vials of oily progesterone. Yuck. I was getting woozier by the minute just watching all the prep.

I first had to receive another 5,000 units of HCG, a "booster" shot to keep everything on track. She gave it to me sub-cutaneously in my stomach. Didn't really hurt, no biggie. Then it was Rudy's turn to give me the first progesterone shot. It is an intra-muscular (IM) shot. I dropped my drawers and bent over the nearest table and put my faith in him to not poke me too hard. My heart was pounding so hard, I was very worked up and nervous even though I had had a shot just like it a week before. It was a piece of cake, just a tiny little prick and then it was over. I jumped about six inches when it went in though, it was a more of a jolt than a painful prick. When it came out I started to feel faint and had to immediately sit down. I was sweaty and clammy - basically got myself worked up over nothing. But come on, the needle is 1 and half inches long! I sipped a little Sprite and was fine.

Rudy has given me two more shots since then and it really isn't a big deal. I get less and less worked up each time. I just can't watch him do all the prep or I will get freaked out and dizzy. He is such a good, supportive and loving hubbin. I love him so much!! I like that he takes good care of me and has a special job to do for our baby every day.

I have an appointment on Monday, March 19th for my first blood pregnancy test. They measure the levels of HCG in your blood. They are doing it 10 days after my last HCG shot to ensure it is out of my system. If the levels in my blood are above 5, I am considered pregnant, but they would prefer to see 20 or 25, I forget. Then, I get tested two days later and if the HCG levels have gone up, I am pregnant! By the way, my progesterone levels were tested last Friday and were 80.5 - they want to see 15 or up, so I am well above the minimum.

The bad news is that if I am pregnant, I still need to continue the progesterone shots daily until I am 12 weeks pregnant! That is 8 more weeks of shots, or 56 more shots. My bum is going to be a sore pincushion! Although it is worse if I am not pregnant as I will have to start this whole cycle over again and do Clomid, then start the shots again. At least I can take a couple of weeks off from the shots though. However, Dr. Miller may change the protocol and put me on some other kind of shots.

Basically, I am not going to get away from the needle until I am 12 weeks pregnant. COME ON BABY!!! I really really really really pray and hope that I am pregnant right now. Please please please?

05 March 2007

Two week wait

The 2ww (two week wait) has officially begun. I am hoping we find out if we are pregnant around St. Patrick's day in honor of my Papa's birthday. (According to the nurse I just spoke to, it will probably be on the 19th). It may be after that though. It sucks! I can't take a home pregnancy test because I am getting hcg shots and that is the hormone that the tests detect. So, I would get a false positive. The only way the doc can tell is by doing two consecutive tests I think - if the hcg levels go up, then you are pregnant. But, you have to wait 3 weeks for the hcg to be out of your system completely or something.

So, now would be a good time to introduce you to some of the terminology of the infertility set. This is a whole subculture that you probably never knew existed! This is terminology used by people ttc (trying to conceive) everywhere, but as you struggle with infertility you become more obsessed and use these abbreviations and terms more and more. If you ever visit any message boards (tcoyf.com is one) regarding fertility, you will see these all over the place. Here are a few to get you started.
  • TTC - Trying to conceive - as you saw above, it is used alot! Pretty self explanatory
  • CM - cervical mucus - one of the indicators of your fertile days - it must be clear and stretchy, like egg whites. I know what you are thinking, ewwww gross!!
  • DH - dear husband. This is your partner in babymaking, duhhh!
  • HPT - home pregnancy test. I don't get to take these because of the hcg shots, whaaa!
  • IUI - intra-uterine insemination. I had this on Sat. AKA AI: artificial insemination.
  • IVF - in-vitro fertilization. This is where they harvest eggs, mix with sperm in a petri dish, then put them back in. This is our next step if IUI fails after 4-8 months of trying that.
  • LP - Luteal Phase - The second half of your cycle from ovulation to the day before your period starts.
  • LPD - Luteal Phase Defect. This is when your LP is too short for implantation to happen. I think this is part of our problem. My LP is sometimes 10 days which is borderline too short. This can be corrected by taking clomid (i am), hcg and progesterone (I am , I am).
  • O - Ovulation. This is when the egg is released from the ovary and is available for the next 12 - 24 hours to be fertilized. You better get some sperm in there during this time!
  • OPT - Ovulation Predictor Test. Use this to predict when ovulation is going to occur. Not a very reliable test for me unfortunately.
  • PG - Pregnant! I hope I get to use this one very very soon!
  • RE - Reproductive Endocrinologist. This is the fancy name for your fertility doc.
  • SA - Sperm Analysis. All the ones Rudy has had are normal to above average. Way to go dh!!
That is enough for now!! God I feel nauseous this morning, ugh. Too bad I can't attribute it to pregnancy because of all the fertility drugs and hormones I am taking. So, I will be in the dark if this worked or not until the 19th - 2 weeks from today!! Hence, the 2ww.

03 March 2007

Our very first IUI - intra-uterine insemination

I ovulated last night! We arrived at the doctor's office this morning at 7:45am and immediately had another fabulous ultrasound. There were two enlarged follicles, one at 14 mm (too small), the other had already released the egg. Yay! Wait, no! Usually they try to catch it before ovulation occurs - did I call as soon as I had a color change? What? What does "color change" mean? The instructions for using the ovulation test were confusing. I clarified with Dr. Miller that I should call when the lines were the same color - that is the definition of a color change. The nurse said a color change is when a line appears at all. Well, a line was appearing from the first day I started taking the test (day 9), so this makes no sense to me. They will be speaking with the doc to decide what to do next month. He may decide to change my meds or put me on injections to be able to better pinpoint my ovulation.

We went on with the regularly scheduled programming anyway as the egg can live for up to 24 hours, so the insemination may still work. They drew some blood from me, then sent Rudy to "the special room". I then received a giant shot of Hcg - the shot didn't hurt, but my backside was pretty sore afterwards. But, it was not as bad as the pain I was having last night where my ovary is - it was ovulation pain! Duhhh!!!

Oh - more about the ultrasound. The nurse said my right ovary is tucked under my uterus, so it has less wiggle room. So, when it swells up, it is like being stuck in a vice, thus the extra sensitivity. My other ovary is not touching my uterus, it has more room, however there were no mature follicles on that side. I wonder if that is normal? I will have to see next month if my other ovary produces any eggs. Hmmmm...

Rudy came out of "the room" and we waited on the couch for a while for the specimen to be prepared. About 20-30 minutes later we were called back into the stirrup room (named for the stirrups I have to put my feet in every time I enter that room). The nurse brought the specimen in and gave us the sperm analysis - 25 million sperm! Wow! She said anything above 5 million is good, so a very good specimen. The little guys had been spun around til dizzy to remove all the non-swimmers. They were also mixed with a medium to eliminate the sperm anti-bodies. It was pink for some reason - I read somewhere that they put pink dye in it.

I put my feet in the stirrups, and the nurse put in the speculum. She then proceeded to clean out my cervix and said this may be uncomfortable since I have just ovulated and my cervix would be sensitive. It wasn't so bad - like a pap smear. Then, she did her thing. I guess they put in a thin tube up into the uterus, I didn't watch. Then, inject the sperm. Not a very romantic moment in my life, but Rudy did sit next to me and hold my arm. I felt a little crampy - especially at the end when she finished, OUCH!!

I laid on the table for 12 minutes, then got dressed. All done! Tomorrow I start prometrium (progesterone), then go back next Friday for another hcg shot. I will go in for a pregnancy test in two weeks.

I am feeling pretty crampy - it hurts when I cough and pee. I laid in bed for a few hours and am now lounging on the couch. I am supposed to take it easy for a few days, so I am! Emotionally, I am feeling ok. I am definitely stressed, we have a lot of stress in our lives right now on top of dealing with infertility.

I really, really hope we get pregnant so our infertility journey is over. Something good has to happen to us soon, we have had too much bad stuff happen and it is time for a turnaround.

02 March 2007

We're making a baby

I am starting this blog a little ways into the process, but feel it is time to start putting this down so we remember the tough journey. We are having IUI (intra-uterine insemination) tomorrow at 7:45am. Whoopee!

Some background. This may be more than you wanted to know, or you may already know it all. My dear wonderful hubbin (that's gibberish for husband, more about that some other time) had a vaso-vasotomy (vasectomy reversal) on July 12, 2005. Thirty days later we got the green light to make a baby! I thought for sure it would happen right away. Or, even within 6 months. The doc said it would take 6 months to a year to be back to normal in terms of sperm quality. We kept tryin' and tryin', but nothing happened. By early 2006, I started tracking my ovulation using a method in a book called "Taking Charge of Your Fertility" by Toni Weschler. I started taking my temperature every morning and checking my cervical fluid and cervix position and softness to determine when I ovulated (I said this would be TMI!!). You see, everyone is different and you don't necessarily ovulate on day 14 like the medical doc's say. At the time, I was very regular and seemed like ovulation was happening on day 14 or 15. Several months later it started to slide towards day 17-18, although I think I had it wrong all along. At least that was the excuse I used to explain whey we weren't pregnant yet. I also started to notice I was spotting several days before my period is supposed to start. Around this time Rudy had a sperm analysis. It came back totally normal! Above average, in fact! We thought we would try for a few more months because maybe it just became normal and we hadn't tried on our own long enough.

By September 2006 - one year of trying under our belts we'd had enough of the fun. I called the fertility doctor and made an appt. Surrrrre, you can have an appointment. In. two. months! ARGH! This is one piece of advice I would give people - don't wait too long to see the doc, it takes awhile to get in as they are very busy.

November 12, 2006 we went to see the fertility doc. He asked some questions, said maybe I have endometriosis and made out a treatment plan. First, bloodwork to test some hormone levels and make sure I don't have any infections. He also wanted to schedule some tests to poke around and have a look see. All of the tests were normal except for Rudy has anti-sperm antibodies. This is pretty common and could be treated by washing the sperm before doing insemination.

The treatment plan was as follows: do an ultrasound, then a hysterosalpingogram OR laparoscopy/hysteroscopy (which is surgery) to look in the abdominal cavity and inside the uterus to diagnose and treat endometriosis. These tests would also ensure the fallopian tubes were clear. A hysterosalpingogram is an x-ray of the uterus and tubes while pumping a dye through them - it gives a picture of the outline of the uterus and tubes to identify any problems. I didn't know what to do, but Rudy was adamant he didn't want me to immediately have surgery, so we decided to sleep on it. The rest of the plan involved doing IUI (artificial insemination) while taking Clomid for several cycles.

The next morning we went in to have the ultrasound - a fun vaginal one! After a few minutes of looking around Rudy said "it looks like a necktie!" The nurse said "actually, what we should see is a flat top on the uterus, but yours has a depression in it". This could be a septate uterus - one with a division in it, or it could be arcuate, just a little dent in the top that doesn't mean much. She would have to talk to the doctor to determine the next steps. I received a call the next day and the doc wanted to schedule a hysterosonogram - another vaginal ultrasound, but this time they would pump saline into the uterus to be able to better see the shape of the inside and outside of the uterus. I was transferred to the receptionist to schedule my appointment. She said "Oh, we can fit you in on December 10th". ONE MONTH AWAY, WHAT? I was freaked. I had to wait a whole month to find out if my uterus was deformed or not? Oh. My. God. In the mean time I had developed chronic cervicitis and was being treated with multiple antibiotics with no relief. Great. Luckily, the hysterosonogram went well and they found my uterus to be just fine, no septum that would need to be removed surgically. But, now a month later, I was back to where I was in November. Still no answers as to what our infertility problem was. The doc still wanted to do the surgery or the hysterosalpingogram, but it was my choice. The surgery would tell us everything and be able to fix any problems on the spot. I decided this was the way to go as I was in a hurry and we scheduled the surgery for January 10th, 2007. Big surprise, I had to wait another month for this next step.

January 10th after a bowel prep (awful) and no eating, we showed up at the hospital at 8:30am. By noon or so I was in recovery and felt awful. This was really the beginning of all the physical pain I was going to have to endure to achieve pregnancy. I know the worst is yet to come with child birth, but no one really realizes that infertility is a painful process to live through as well. I woke up nauseous and that was the first word I said to the nurse when they asked me how I felt. "Nauseous". I went to a recovery room where I finally got to see Rudy. He told me the surgery was a success, I didn't have endometriosis and they didn't have to remove anything. My tubes were clear, but they did a tubal lavage to wash them out and stretch them. I also had a pre-sacral neurectomy to cut the nerve that gives menstrual cramps. Awesome! I am still waiting to see if that worked as it takes 3+ months to heal. I scheduled my follow-up appt, couldn't get in for 7 weeks. Very frustrating. VERY very frustrating. I finally asked the nurse when I could start insemination and she said you just call on day 1 of your period, the doctor is not involved. But, we decided to take a month off after surgery because I needed the recovery time. The IUI would happen right around the time I went back to see the doctor.

A few words about the surgery recovery. Even though they didn't do much, it was painful. I couldn't get myself out of bed for a couple of days. Rudy had to lift me up to go to the bathroom or move around. They gave me vicoprofen and it hardly made a dent in the pain, and kept me up all night with a totally buzzed high. I was high, but still felt all the pain, it was not fun. I tried several other painkillers, but none of them were much better. Tramadol ended up being the most helpful with the Vicoprofen a close second. It took a good 3-4 weeks for all the pain to subside. It was a lot better after a week, but still had a lot of tenderness for while. It was not fun and I really felt that I had the surgery for nothing because nothing was wrong with me. However, at least I know now that nothing is wrong!

Which brings us up to date. Tomorrow morning we go in for our first round of IUI. I took 5 days of Clomid from day 3-9 (25 mg). I think that is a fairly low dose, but man, I have had a pain in my side for a week now and it is getting worse. I think I always get ovulation pain, but this is pretty exaggerated. More pain to endure. I have a rice bag that I warm in the microwave on my belly non-stop, I couldn't live without it. It hurts pretty good tonight, I hope it subsides after I ovulate.

Well, I hope you haven't been too bored, I will keep you posted on the progress of the IUI. For now, good night.