On My Mind

I've had a few ideas for posts sitting in my drafts folder for more than a week, and I couldn't for the life of me get enough motivation to finish them (probably because most of them don't deserve to be their own post), so instead, I'm just going to smash the short version into one listy post.

• It's been a full month since I became a full time housewife, and overall I think it's going pretty well.  Money is pretty tight, but we've been working on adjusting our budget by shopping grocery sales, cutting cable, and selling some stuff on eBay, and we're getting by with what we have.  I still have phases of "oh f*ck, we're so broke and it's all my fault," but B is the best hubster ever, and he always assures me that we'll be fine and he's okay with me being a housewife as long as I actually get some cleaning done (which I have been.  Every day has a different room or task assigned to it, so it's mostly just maintaining the clean).  He's a keeper.  I'm still in the process of looking for (at least) part time work, but I haven't had any luck so far.
• It turns out I actually like Twitter.  I had an account a looooong time ago because B said it was the next big thing in social media, but then I barely used it and ended up deleting it when I was going through my "gotta decrease my digital footprint" phase.  I recently created a new Twitter account because I found out that a ton of awesome people who are going through the shit-fest of infertility have created an incredibly supportive community, which was something I was very interested in, considering my real life support group is pretty small.  I recently had to update my "Blogs I Enjoy" list because I have come across so many more amazing blogs via the Twitter, and then those blogs led to more, and now I have a lot of reading to do (not a bad problem to have).
• In preparation for our next cycle, I've decided to try something that's a bit unconventional (my mom would say "hippie dippie") - guided meditation.  I have the Circle + Bloom programs for PCOS and IVF/IUI, and I've started listening to tracks that aren't specific to any cycle days when I'm having a hard time falling asleep because B is snoring too loudly.  They've been successful in getting me into a more restful and relaxed state, and I'm interested to see how things go when I follow them daily.
• I'm getting really antsy for our next cycle.  Obviously I'm not looking forward to moving on to more expensive and aggressive treatments, but I'm tired of just waiting.  Hopefully AF will come naturally again.  I gave in and looked up the potential due date if AF comes when expected and our first IUI is successful, which was probably a mistake.  The due date generator guesses that we would probably be having a baby on our 4th anniversary.  Now I really want things to work out, and I'm not looking forward to the disappointment if it isn't successful.
• I've been an a major music kick lately - all I really want to do when I'm home alone (so, all day) is listen to Pandora.  The downside of this music kick is that I've been listening to some kinda emo music, and the lyrics of the songs make me think about B or about infertility and how much it sucks or about life in general and then I end up crying the entire time because I'm a hormonal freak.  I'm a sucker for punishment, so I've started making a playlist of songs that I'd like to use as lullabyes for future babies (and then I realize that we don't know when or if that will happen and I start crying again.  Ugh).
• Our front porch reno is coming along quite nicely.  Today, I helped B's dad stain all the trim, then B helped his dad install the rest of the drywall and the doorbell.  Next weekend the plan is to install the trim (except for in the closet) and put the final touches on the drywall so I can paint.  Then we just have to finish off the trim and it's done (hopefully)!  Just in time to host our expected 12 (?  I think?) guests for Thanksgiving.  
• B bought the Lego Marvel game for the Wii-U yesterday, and I'm addicted.  My favorite character to be is Hulk because all he does is smash the crap out of stuff.  The game is stupid difficult though (or maybe we're the stupid ones).

So that's pretty much all that's going on right now.

Whoopsie!

I totally didn't mean to take a bloggy break - almost a month since my last post, yikes!  I've been really stressed because the last few weeks have been a little out of control thanks to my split shift starting at work again and other random life-y things happening.  Plus I seem to have misplaced my motivation (again).  I wish I could take a week off just to get caught up on my free time.  Ha!

Last Thursday was CD4, which meant I got to visit the Fertility Services Clinic for the first time.  The appointment itself was pretty uneventful - I had 2 vials of blood drawn to update my hormone levels, and I had a baseline ultrasound to check for any larger than normal cysts, and none were found.  So far, so good, right?  Wrong.  Before I had any blood drawn or vag cam visits, I had to pre-pay for the appointment - makes sense, no problem ... except there was a problem.  Some miscommunication between the insurance company and the financial coordinator led to us being charged $300 for the first appointment rather than the $20 copay we were expecting to pay.  It took a few days, lots of phone calls, and husband intervention to sort everything out.  The good news is we'll be getting a refund from the clinic.  The not so good news is we're still not doing a medicated cycle.  We won't be able to resume treatment until B goes in to update his tests and we have a follow-up treatment options appointment, but due to work scheduling conflicts, that won't be happening until the 2nd week of October, so we won't be back to medicated cycles until November.  I really wasn't expecting to take a 3 month break from treatment, but that's about where we're at now, and we can't do anything to change that, so I just have to get over it - easier said than done.  I think the most difficult part for me is having my updated test results available, but not gettting any information about what the numbers mean until we finally have our what's next appointment in a few weeks.  Obviously I've turned to Dr. Google, specifically in regards to my AMH level, but apparently there are different ways to measure AMH, and my results page on my chart doesn't tell me which they've used - it's either really good, or borderline just okay.  Awesome.

Aside from not taking drugs to help make a baby, I've been working my butt off trying to make our house look cuter.  I don't want to go into too much detail - I have a post in my drafts folder all about it - but I think it's safe to say my mission is pretty successful so far.  We still have a long way to go, but progress is always a win in my book.

So yeah, that's pretty much all of the important stuff that's been going on in the past few weeks.  Hopefully all of the less important stuff (like making lesson plans and printing busy work for two 3 hour shifts of daycare or dealing with drama from daycare parents - ugh) will ease up now that we're pretty set in a routine, leaving me more time to work on fun stuff like these boring posts :).

Post-Appointment Update Extravaganza

I promised I'd come back to update about our consult with the head RE, and look at me - I'm following through!  It may have taken longer than I planned, but it's the thought that counts, right?

I thought our consult went pretty well overall.  It's a good thing B was there to join me in the meeting, because a lot of it revolved around updating our health histories and getting to know what testing and treatments we had done so far.  The nurse who we met with first was an interesting character.  She was very energetic and quirky ... she kind of reminded me of a Kristen Wiig-esque character from Saturday Night Live - obviously I thought she was great.  After going over my extensive list of treatments, the focus turned to B's testing, and we actually heard something new.  B saw a specialist last summer because my clinic had issues with his SA results, but the specialist said the results he saw didn't concern him, and that was it.  But at this latest appointment, both the nurse and the RE mentioned a notation about a varicocele.  We had no idea what they were talking about because it had been a year since he saw the specialist, but he didn't remember the doctor saying anything about varicocele.  I'm not sure when we'll get further clarification, so mostly the new information just confused us (mosty me) a little more.

Aside from that little surprise, we didn't really get a lot of information from the RE, but considering all she had to go off of was our past treatment information, that was expected.  We won't know our plan of action moving forward until we have some re-tests done, but the RE did mention some possibilities.  She was surprised that we didn't exhuast our options with the Letrozole (I only tried the lowest dose before I was moved to the Clomid/Follistim combo deal), so that's something that we'll probably revisit in hopes of getting better results.  She would rather have us exhaust all of our other options before moving on to the more aggressive treatments (which we - and our bank account and my tummy - really appreciate, because injectables are hella expensive, guys.  And stabbing a needle into your own tummy fat is no picnic).  Also, she was surprised that we even did a Clomid/Follistim combination - the "mother clinic" (that's what the nurse and RE call it - like the mothership of aliens) doesn't combine other medications with the injectables, they just start the injectables earlier in the cycle to hopefully boost egg growth.  It was pretty interesting to hear about what the main RE would do differently, and I'm looking forward to working with her.  One of my favorite things that they told us was that they like to change things up if they notice that they aren't working, rather than spinning our wheels and trying the same thing over and over, wasting time.  I'm hoping that this will keep us from feeling so stuck.

At the end of the appointment, I was given a shiny new Clinic Fertility Services folder packed full of information about their pricing for different procedures and testing (yep, that's right, this clinic actually wants us to know what the approximate costs of everything will be.  Amazing right??), general information about IF, a list of grants available for IVF (which appears to be outdated.  I checked out all of the websites, and a few of them have been inactive for a couple years) and copies of our insurance coverage and tests ordered.  I'm planning on starting a new folder o' stuff to keep everything together, and I'll close out my folder from my last clinic (that I didn't do a very good job of keeping updated).

The biggest drawback to this switch is that all of the appointments will take place at the mother clinic, which is located within the hospital, and of course the hospital is located about an hour away.  Getting to our frequent appointments was difficult enough, and now with the clinic being farther away and crazy work schedules coming our way (I'm back to the split shift soon, and B has a few work trips coming up) things are really going to get difficult.  It's looking like we'll continue our break through September, then hopefully get back to treatments and appointments by October.  More bumps in the road, but hopefully this new RE and clinic will get us closer to the light at the end of the  tunnel.

Good News, Bad News

I've been meaning to update for a while, but life has been so busy lately (isn't that always the case?  I need a vacation).  I figured the best way to do this update was a Good News/Bad News list, because that's how things have been going lately.

Good News - it appears as though insurance has covered more of my HSG than we had originally expected.  After what felt like a million phone calls (and several customer service representatives), I was told by a financial coordinator through the clinic and an insurance representative that the procedure itself would cost $1,501 and we would be responsible to cover the rest of my deductible and then 20% of the remaining cost, for a grand total of $700+.  Ouch.  But on July 24th, I got an excited text and email from B with our insurance explanation of benefits attached - it appears as though we are only going to be charged the $20 copay that accompanies office visits at our clinic.  That's a major savings, which our bank account greatly appreciates.  It's not going to last long of course, but we'll take what we can get!

Bad News - AF arrived early at 5dpo, almost 2 weeks ago.  Yeah ... that sucked.  I noticed some spotting and just knew.  Wednesday morning (July 24) - the day I was supposed to get my progesterone level tested - AF was here in full force.  My progesterone results came back really low, indicating I didn't ovulate (which I totally don't understand - I had a 19mm follicle and I gave myself a trigger shot ... how did I not ovulate?), and general suck ensued (500 points if you just did the How I Met Your Mother salute to General Suck).  I had to have my CD3 ultrasound with a different doctor, and it was soooo awkward.  First of all, it was a dude, which is not my favorite.  Second, I felt like he wasn't really listening to me (we actually had a debate about what cycle day I was on, as if I didn't know how many days I had been bleeding!).  And he raised the exam table way into the air rather than sitting down at a lower level for the exam, so when he was done, I couldn't sit up and regain a teensy bit of modesty until he lowered the stupid table down.  Nothing like waiting for the table to slowly lower back to the ground with my legs spread and my hooha hanging out.  Not my favorite experience.  I really hope that I never have to see him again.

Good News - I have an appointment with the head RE at my clinic tomorrow, which will hopefully get us more answers.  The physician I usually see suggested I make an appointment with this RE, although I'm not entirely sure what the purpose of the appointment is, to be honest.  All I know is that the consult is supposed to be about an hour long, and I'll probably bring B back with me.  I want to have a second set of ears so that we can be sure to take in all the information we can get.  I'm guessing we'll discuss the last year's worth of treatments and maybe talk about a plan moving forward, but I don't really know.  I guess I'll find out tomorrow :).

Mixed Message News - When we realized that last cycle didn't work out, I was told that we had 2 options - go ahead with an increased dose of injections and try again, or take a break for a cycle, chat with the head RE, and then decide where to go from there.  After we talked about it and mapped out important dates, we figured the timing probably wouldn't work out.  Even though I hate the idea of losing another month, I know it was our best choice, and it hasn't been too bad - it's nice to have a break from giving injections, taking pills, visiting my pal the vag cam, and peeing on sticks.

Good News - MTV did something pretty awesome - huge shock right?  Their program True Life finally focused on something important with the episode "True Life:  I'm Desperate to Have a Baby."  (Yes, I know they've covered topics like addiction, which is also important, but one of their newest episodes is called "True Life:  I'm Too Beautiful."  Give me a break.)  It followed 2 couples who were struggling with infertility and documented their efforts to get pregnant via IVF.  It is definitely worth a watch.

Get More: True Life, Full Episodes

So that's the most recent update.  I'm hoping to be back tomorrow with all of the details from our meeting with the RE, and I have a couple of drafts that are burning a hole in my brain that will hopefully be published soon.

Upbeat

Monday was my second follicle check of this cycle (on CD14), and I left my clinic feeling awesome - that almost never happens.  Everything has come back so much stronger than the same point of precious cycles, and that, my friends, is finally some forward progress.  I give credit to my new BFF.

I ended up surviving the Follistim injections, and it really was not as bad as I had imagined it would be - I really didn't even feel the needle, and after the first couple, it didn't even phase me anymore.  Anyway, all of those injections paid off, and the prize so far ... was another injection.  But I'm getting ahead of myself.

Last Thursday was follicle check number 1 (CD10).  I had a leftover 23mm monster cyst (it was 13mm on CD1), but otherwise things looked decent.  The first thing I noticed when I walked into the ultrasound exam room was that they had a new exam chair, which was beyond exciting for me - definitely a sign that I spend too much time there.  I visited the vampires in the lab so they could test my estradiol (the stupid hormone that always fucks everything up), and my RE called with the results that night - 210, the highest I've ever shown.  Booyah!

Saturday, I had another trip to the lab to have my estradiol tested.  Unfortunately, the lab didn't get my results entered as quickly as they were supposed to, so I got a call Saturday night letting me know that I would get the results on Sunday, and I was told to take another dose of Follistim that night.  I didn't do that though, because we didn't get home until late - we were celebrating the first birthday of my friend's adorable baby girl and enjoying a mini college reunion.  It was so nice to catch up with my friends - much needed.

Sunday morning, the results phone call wasn't as great as I had hoped - my estradiol was only up to 216, so I had to keep my appointment that was set for Monday afternoon, and wait to trigger until I was given the okay.  I also ended up giving myself that last Follistim shot.

On Monday, I was supposed to start in the lab to get my estradiol tested again, but I wasn't able to get there early enough and the lab was a zoo, so I decided I'd just finish up there instead.  Like I mentioned in the opening, my second follicle check was really good - triple layer utey lining, the monster cyst was gone, and I had 2 follicles, 19mm and 15mm.  My RE's outlook was very positive, and she said that we would determine when I should trigger after my estradiol results came back the next day.

Finally, on Tuesday morning, I was just finishing up our "morning meeting" at work when I felt my phone ring (yes, I answered my personal phone at work, which is totally against policy.  And I don't care, because it was an important phone call).  My estradiol came back at 264, so I was told to give myself the trigger injection (my prize!) later on Tuesday, have some scheduled intimate time with my hubster (scheduled sex is such a turn on ... not), and then go in next Wednesday for a progesterone test.  After that, it's the long wait until we find out if we caught the egg.

So that gets us updated to today ... I'm feeling cautiously hopeful - I don't want to get my hopes up, but it's hard not to when things seem to be going so well.  I guess we'll find out in a couple of weeks if all of this worked out.

Tried It

I can officially cross two more items off the "tried it" list.  Two things that don't appear to be on the fun little list below ...

Earlier today, I had my HSG.  Holy eff, it was "uncomfortable" (if uncomfortable means ohshit this frakkin' hurts!!).  Before the procedure, I asked the radiology nurse if there would be a physical picture printed so I could get a copy for my scrapbook - unfortunately, there was not.  The procedure itself was pretty quick, and I've been crampy and uncomfortable all night, but I'm surviving.  Oh, and they saw the "fill and spill" of everything being clear and my ute is the correct shape, so things are good.

The second thing I can check off the list is giving myself a Follistim injection.  I put it off for a while, then B helped pump me up to do the damn thing.  I got everything ready, I cried for a minute, then said fuck it, stabbed the needle in, pressed the button, and it was done.  I have 3 more doses in the pen, 2 of which I am definitely expecting to take.  Hopefully I won't have to refill any time soon, because it's so expensive, and we're super broke.  I'll maybe have an idea tomorrow during my ultrasound appointment, but I wouldn't be surprised if I had to make another follicle check appointment for Saturday.

Crossing fingers and toes for good news ...

Overwhelmed

I apologize in advance if this post makes no sense - my brain is all kinds of jumbled right now.  Also, be warned that this post is pretty much all about AF, so if you want to avoid a TMI-fest, move on now.

Last weekend, I noticed that I had started spotting, which was absolutely amazing to me - it's been so long since I've started AF without the help of Provera.  On Monday night, the spotting was a little heavier, and by mid-day Tuesday, I was certain that AF had finally arrived - it definitely seemed like a full flow.  I called the clinic, and because of a long workday on Wednesday and the holiday on Thursday (which would be CD3, when I typically have the baseline), it was decided that I would come in for the last appointment on Tuesday (on CD1) for my baseline ultrasound.  My ultrasound came back normal, I talked with a nurse about setting up an appointment for my HSG, and my RE gave me a lot of information about injectables, because I'm starting those this cycle (holy shit).  It was a lot of information to take in, and I'm surprised I didn't completely break down when we got to the car.  Instead of turning into a sobbing mess, I turned to my BFF the Internet for support from my friends who have gone through or are currently going through infertility treatments, and to research the least expensive supplier of injectables.  (Spoiler Alert:  injectables are expensive everywhere.  The best choice I found was Walgreen's Specialty - after enrolling in the Design Rx program, the cost will come to $254.  My second choice was Freedom Fertility, at $256.)

On Wednesday, I got a call from one of the nurses letting me know when my HSG had been scheduled (next Wednesday at 10:45), and I used that opportunity to ask about my cycle being wonky.  I explained that I was only spotting again, that I only briefly had full flow, and that I was confused about what was happening.  She told me that sometimes it's normal for AF to start, then stop, then start again, so I should just wait it out, and if there was no increase by Friday, give them a call again to figure out what's next.

Because I am clearly cursed, there was no change over the last couple of days.  Still just spotting, and barely that.  I called this morning to talk to a nurse, and she said just go ahead with things as planned (although now the medications will all be pushed back a day).  So that was the plan ... until I got a phone call from my clinic this afternoon.  She said that my RE has requested a blood pregnancy test to make sure that all of our bases are covered (even though the odds of that being the cause of this stupid, semi-non-existent AF are slim to none).  Unless I hitchhike, that's going to have to wait until tomorrow.

When we started with treatments over a year ago, I knew that things weren't going to be easy.  What I didn't expect was that things would become so damn complicated.  I'm ready for everything to fall into place ... any day now would be perfect.

Three Calls, That's All

Infertility sucks big time, but it has been helpful in improving my life skills, so I guess that's a bonus (not really).  I have become a phone call ninja - I used to panic when I had to call the doctor's office to make appointments or ask questions, but now I'm kind of a pro.  #humblebrag

When I left off last week, I was waiting for more information from my doctor's office regarding the cost of the HSG.  My doctor's office was amazing at getting back to me about my request - an hour or so after I sent the message, I got one in return that provided the customer service number to call to get an estimate and the CPT code to help get more information.  And this is where the fun started (if you call confusion and multiple phone calls fun) ...

It took 3 calls to my clinic's customer service to finally get my information passed on to the estimate department (it was ridiculous - 2 out of the 3 representatives I talked to had no idea what they were doing), but once they had my information, the turn around was really quick.  I talked to the estimate department representative yesterday morning - all I can say is I'm not looking forward to the bill after the procedure.  Of course that's in addition to the injections that I'll be adding in to the process when the HSG comes back clear  ... BUT we can't even get to that step until AF finally shows up, which doesn't seem to be happening any time soon.  I still have a week and a half before I'm supposed to call to ask for the Provera, and then 10 days of pills, and then AF, and by the time it's all over, we'll have missed the entire month of July.

I feel like I say it all the time, but I've been trying to be less of a bitter Betty - not very successfully, unfortunately.  There are a lot of positive things that I could focus on, but the easier choice has been to be angry or depressed.  We spent last Saturday at the ballpark (snooze) with B's parents, and I had kind of a nice chat with my mother-in-law about all of the crap we're going through.  She went through fertility treatments when they were trying to have B, so she understands - to a degree - what it's like, which is really nice (especially considering that my own mom doesn't get it - at all.  And I don't have the patience or brain power to explain this never-ending nightmare to her again and again ... and there's the anger and bitterness creeping back).  We also have some really great friends, in real life and online, who are so supportive - we're really lucky to have so many amazing people on our side, and I need to work on being more grateful for them and focus on the positive, rather than focusing on the negative all the time.  I'm a work in progress.

Roller Coaster

I really would like to be done with this stupid emotional roller coaster now.

Thursday, I was having an awesome day until I got the phone call.  I spent Friday crying off and on all day, completely devastated.  Saturday's appointment had me hopeful again - follicles were more developed on CD14 than in previous cycles, and I had lovely triple layer lining.  And then ... I woke up this morning, and although I haven't gotten the official word from my doctor's office, I'm pretty sure this cycle is a bust.  My E2 came back at a whoppin' 19.  Nearly nothing.  For two 12mm follicles.  I'm crushed.  I'm expecting a call from the clinic tomorrow to make plans for what comes next.  Yesterday, the plan was to come in for another date with the vag cam if my E2 was decent, and if it was a little low, the appointment would be bumped to Tuesday.  With it coming back so low it's barely on the charts, I don't know what the plan will be, and it sucks.

I spent an hour this morning laying in bed consulting Dr. Google, which didn't help very much.  I was hoping maybe somewhere I would find someone with a similar experience saying they added in new meds mid-cycle that helped.  Or maybe that they started taking a supplement that improved their E2.  I didn't find those things, and now I have to wait until tomorrow morning to find out where my life is going this week.

B has been such a rock star husband through a lot of this, and I don't tell him that enough.  He's becoming really good at saying the right things at the right time (which never really was his forte before).  I'm also lucky enough to have an amazing friend who I can vent my frustrations to, knowing that she understands 100% and she's not going to say something stupid, like "just relax."  I'm soooo looking forward to our Skype date later this week - I need some perspective.

To finish this off, I'm sharing this video that I came across a while back.  I have heard pretty much every single one of these gems a million times in the last 2 years, and it never stops being annoying.


P.S.  I think I need to send this video and this link about IF etiquette to so many people I know (like my mom).  It's great information.

Quickie

I have a few more substantial drafts simmering on the back-burner, but I haven't had the time or motivation to actually finish and publish them yet.  Hopefully those will be ready soon, but in the meantime, I have a quick TTC update.

Wednesday afternoon, I had my baseline ultrasound (it was CD4) and I was given the all clear, allowing me to start the Letrozole right away.  On her way out of the exam room, my RE asked how I was doing on the Metformin, which really confused me - I've never been on Metformin.  After I explained that to her, she said that if this cycle doesn't work out, then next cycle we'll add Metformin to the cocktail, and that was the end of the appointment.  Tonight will be my last dose of the Letrozole, and so far I haven't noticed much - maybe a few twinges here and there ... I don't know.  I really hope that I have a decent reaction to the Letrozole - this is getting exhausting.  I just want things to work out for once.

Aside from that, it's been a sad week - a close friend of mine got some really devastating news at the beginning of the week, and my heart hurts for her.  If you could spend a minute to send prayers or vibes or whatever you're into, it would be very much appreciated.  <3