Thursday, February 28, 2013

the three-letter word

Do you ever feel guilty for spending money when you know you have a big expense coming up? Like you should be saving every penny, but you're stressed so you want to go away for the weekend or go shopping?

I'm there. I took today and tomorrow off a while ago when we planned to travel to North Carolina to visit our friends. But then, I had to start my cycle on just the wrong right day, and now I have a doctor appointment Sunday morning that I can't miss. It's my CD12 follicle scan, hopefully with good news and lots of follicles.

Besides the fact that I'm not pregnant and still don't know what we're doing this weekend (I'm still determined to do something, even if we stay at home, and relax for a couple of days with Eric), I have had a great week. I got some really exciting news!

Nowadays, I tell my husband that we're just paying for our kid before they're even conceived... because we're getting ready for... the big three-letter word... IVF!!!

(I know In Vitro Fertilization is more than three letters, but you get the point :)

On Tuesday we were approved for a IVF multi-cycle discount  program through Attain Fertility. What that means is basically, you meet certain medical criteria, and they approve you for one of two discount programs. We chose the multi-cycle program which includes two fresh and two frozen cycles for a set fee, which is about 35% less than if you did them individually. The only thing the program cost doesn't include is medications, which my doctor says will cost about $3,000 more. Statistics show that most women do need more than one IVF cycle to get pregnant, and by planning ahead for two cycles you save yourself the stress of deciding what to do if the first try doesn't work (not to mention much less money).

I'm sooooo so so excited! I feel like this is the light at the end of a (very long) tunnel. It's been a long road. Just last year I was very opposed to IVF and swore I'd never do it. I wasn't opposed to it for any ethical reasons or whatever (I think that is just ridiculous), but rather I didn't want to put my body through the stress and risk spending THOUSANDS with possibly nothing to show for it.

But recently, in the past few months, I've befriended some girls on Instagram and through my blog who are going through IVF and who have either gotten pregnant or are in the midst of treatment right now. I was able to ask them questions, to see the process first-hand, and to really understand what it's all about. I realized that while it is serious and definitely can be difficult, it is also exciting and it almost always works. While I'm still jealous of those who live in the 15 states whose insurance covers IVF treatment (I wish), I am happy to say we have a plan to pay for it and it is FINALLY a REALITY. In addition to that, I've felt like we've just been spinning our wheels and not getting anywhere with our current treatment plan. While it has the potential to work and certainly does for some, it hasn't worked for us in over two years, so I'm moving on. Let's do this!

The plan is to have it paid for (plus arranging financing for a small part of it) in about two months, at which time we have to sign the contract with Attain. We will hopefully start injections in May or June! I'm really hoping the timing works out for us to start at the end of May when we get back from our cruise, and not have to wait until June. But either way, it is just a few short months away, and ... my god... we could be pregnant by my birthday in July! I tell ya what... that would hands-down be the best.birthday.present.ever!!

So right now we're in the middle of another Letrozole/FSH/Dexamethasone/Ovidrel cycle because that was the plan. The doctor increased my FHS from 75mg to 100mg so I'm hoping I get more than one follicle this time. :-) The only thing we haven't decided yet is if we're going to keep doing this for the next month before we get ready for IVF or take a break until then. I think we should take a break before IVF (could save $500) but I think we're going to play it by ear. Wait and see.

I covet prayers and positive thoughts as we prepare for this adventure. I'm really excited, and really nervous. Taking it one day at a time and not getting caugh up in "what if"sceniaros... keeps me sane.

I'm off to lunch with my girlfriend and then yoga class... another sanity saver!

Tuesday, February 12, 2013

The wait.

I don't normally blog during the "waiting" period, but I felt inspired today. One week down, one to go. I test on Monday the 18th. Lest any of you think this is easy ... IT'S NOT! :-) I've been here many, many times before, but this time is a bit different.

I have to admit, during past 2WW (two-week-wait) times I didn't really do anything different. I'd go running a lot, workout like normal, drink wine, and try not to think about it. About halfway through, I'd start doubting the process and get discouraged. I mean, yes, I never did get a positive test. Reading back over my old blog posts is sort of discouraging, because there have been so many tries and no wins. I wonder every day when it is going to be the "right" time for us. Sometimes, though, that was sort of my fault, because I wasn't mentally in the game. I was more... uh, along for the ride, maybe.

This time, though, things are different. I'm acting like I actually might be pregnant. *gasp* I'm changing up a few things, just in case. I think I've had like 2 glasses of wine total. I'd like to be able to say I had NONE, but a girl has needs. LOL. I'm doing acupuncture, and man, I feel so much more balanced. I am thinking about being pregnant, dreaming about being pregnant (I definitely had a dream last week where I was getting an ultrasound and found out I was pregnant, and started bawling - in my dream ;), eating better, and trying to take it easy in other areas. Mostly of all, I'm striving for emotional balance and mental health - eliminating negative thoughts and inviting positive thoughts. And prayer.

I've said this before, but during the 2WW I start to try and interpret every little feeling, craving, and mood-swing. Does it indicate more towards + or -? And, how should I know because I've never had a +??? I'm craving sweets, so that could mean something... or it could mean the other thing. To me, the symptoms are so similar. So this time, I've tried to NOT do the symptom-analyzing as much, because it's never worked in the past and it just causes stress!

I will say, taking this progesterone supplement turned me into a super b*tch for a few days. I didn't understand where my terrible mood came from, but finally figured it out. I feel like my body is adjusting now, which is a relief!

Either way, whatever the outcome is on Monday, I feel prepared. I am still hopeful. I feel that ever since the husband and I agreed to start IVF in May/June if we are not pregnant by then, I finally have a "wow, this actually will happen eventually" instead of a "this is never going to happen" attitude. Of course, I'm crossing my fingers that we won't have to do IVF (due to the cost and physical toll) BUT it gives me hope to have that option. I am so excited for this year.

I will keep you posted. :)

Monday, February 4, 2013

Thirteen millimeters

We are well underway our first attempt of the year! Things have been quite the roller coaster already, so I'm here to give you a little status report. :)

My husband and I met with our RE on January 18th (my parents were in town so my mom got to sit in and listen too!). It was a good meeting, he ultimately supports whatever we want to do, which I sort of what I figured. We talked about IVF, the mandatory class we have to attend that tells you all the bad things about it, my desire to not do any IUIs, and a flexible time frame on how much longer I'd wait until we start IVF.

We decided to do several months of medication + acupuncture only and see how it goes. My tentative deadline for this approach is the May/June cycle, at which time if we aren't pregnant, we will hopefully begin IVF.

So - for January/February cycle, my medication cocktail entailed:
   - Metformin, 2000 mg daily
   - Dethamexasone, .05 mg every night before bed
   - Letrozole, days 3-7
   - FSH (Gonadotropin) shots, days 6, 8, 10, 12
   - hCG (Ovidrel) trigger shot, TBD (turns out it was day 13)
   - Progesterone, beginning on day 16
   - Acupuncture once a week


In addition to this, I had an ultrasound on days 11 and 13.

I went in for my day-11 scheduled ultrasound on Friday to measure my follicles and do my E2 bloodwork. That was a hard day. After all that work and money, the biggest follicle I had was 11mm.

And there was only one.

Mature follicles are at least 18mm. Most doctors like them bigger than that, up to 24mm. Finally, the nurse called back after the doctor reviewed the scan to confirm I had been taking the right dose of medication - like he was surprised I didn't respond like I should have. I started to have that sinking feeling. She then said that since I wasn't responding well, I needed to do my last FSH shot (day 12) on Saturday night, and come back for another ultrasound Sunday morning. If, at that point, it still wasn't the right size, we would have two options - to purchase another round of FSH (approximately $300) or cancel this cycle and wait for next month. She told me to come in Sunday prepared to give them an answer of what my decision would be.

I was devastated. I didn't want to think about spending even more money this month and creating a hardship on our budget, but also didn't want to "waste" everything we'd already done. Luckily, I was in the car driving home with my husband, so I just started crying. He was so sweet and, after a few minutes, asked what I was thinking.

I managed to stammer out, "I... just... hate... my body."

That described everything I was feeling in that moment. How unfair this is. Why do we have to go through this? Helpless that my body seemingly is working against me. There is nothing I can do. Why, why, WHY?

He lovingly reminded me that this shouldn't be a step backwards for us, for me, in my thinking. I need to just continue on the positive path that we have been and keep making progress. This isn't the end. It is just a (potential) setback. We talked about the options, but I honestly didn't know what I wanted to do. Neither option #1 or #2 were very encouraging.

However, there was also the third option. On Sunday this damn follicle could actually turn out to be the right size, by any miracle. That was my secret hope. I was afraid to even voice it, for fear of setting ourselves up for disappointment.

In an effort to distract myself I started googling "follicle size" on my phone to see what I could expect over the next two days. I found that 18mm is the smallest it could be to be considered "mature", but 20-24mm is even better. I also read that follicles grow only 1 to 2mm per day, and I did the math. If I had an 11mm follicle Friday, when I went back on Sunday the biggest it "should" be is 15mm if it grew at the maximum each day.

I just decided to wait and see. And pray.

Saturday night I started to feel super nauseous. I took some Nexium because I thought it was my stomach, as well as my final FSH shot. I felt a little better during a dinner out with friends, but on the way home I started feeling sick again. I went to bed as soon as we got home. I woke up early Sunday morning to head to the doctor, and still felt sick. I was super worried that something was wrong. With all the talk about the risk of ovarian hyperstimulation syndrome and all these other potential complications, I didn't know what to expect.

I got to the doctor expecting bad news. There was only one nurse doing ultrasounds so I had to wait for a while. That pit in my stomach combined with feeling nauseous was super fun, let me tell you.

Finally, I was on the table during the ultrasound. The poor nurse said to me that everything had been going wrong that morning, so she really hoped I would be her first "normal" patient.

..."I hope so too", was all I could manage to say.

Moments before she had the ultrasound going, I told her I had been feeling super nauseous. I expected a concerned look or comment, but instead she excitedly said, "Oh really?!? Well maybe there is a big fat follicle growing in there!"

Wait, what?

Apparently, (and I wish someone would have told me this!) nausea is a good thing. Very good. The first ovary she looked at she exclaimed, "WOW!" and proceeded to measure a 24mm follicle, along with a smaller, 14mm follicle next to it. There were only tiny ones in my other ovary, so she only measured the biggest one, which was way too small to count.

But seriously. My miracle had happened. My little, struggling follicle had grown THIRTEEN MILLIMETERS in two days. That's more than it had grown in the past two weeks.

I don't know why, I don't know how. But I don't really care. It happened - to me - and I am grateful. My faltering faith and hope was revived. I am grateful for science. Grateful for miracles.

The nurse was so excited, and kept thanking me for giving her good news and being her first easy patient. I don't think she understood or appreciated just how or why, but in reality, SHE had just given me the best news of the month. I was beside myself.

This is where I can't seem to find the words to describe how I feel about this little miracle. Silence and awe seem the only appropriate response. No, this isn't a positive pregnancy test, but it was close. I needed that miracle, that small dose of hope and optimism to keep me going. It really just made me stop and think ... God does care. He cares all the time, I know. But this was so special, so personal.

Now we enter the two week wait. I am aware that we may not get pregnant this month, even with all of this good news. Of course I hope we do, but I'm also ok with the alternative. Because I want what God wants... I want to follow that plan. I trust the doctors, I am determined to keep a positive attitude (acupuncture is helping!) and most of all, I believe this is exactly where we are supposed to be.

Because He is good.

He heard my prayers.

He cares about the millimeters.