Stepping up the Game

     I know it has been awhile since I updated and that is mostly because we took last cycle off of treatments and I decided to give myself a mental vacation from the infertility world. Well, as much as I could. Since, the last go around was unsuccessful we met with a new doctor. We are super excited about this change as we feel this clinic actually sees us as people and most importantly listens to us. It helps that insurance covers some of the procedures there too. After looking at all of our records, the doctor could tell we had been doing all that we could but he was not really sure that the pervious clinic was holding up their end of the deal. I completely agreed. He was very direct and to the point and because all previous attempts were unsuccessful we all agreed it was time to step up the game. In infertility treatment that means IUI, intrauterine insemination.

    IUI is exactly what it sounds like, artificial insemination that takes place inside of the uterus. Good thing is it does not mean a lot of changes from previous treatment. I’ll still do all the ultrasounds, blood draws, and shots but at the end we will go to the clinic for insemination instead of doing things the “natural way.” This is what we assumed would be the next step so we were not surprise, but it is a little disappointing that it has come to this. It is kind of like the finally straw that says, this really is not going to happen naturally for us at all. Insemination makes it sound like a sure thing, which is far from true. Given my situation and current treatment I have around a 20% chance of becoming pregnant during a cycle, IUI will increase our odds to about 25%. I know it does not seem like much but at this point even a half a percent is a big deal. We are hopeful that the next few months will be our time because the step after IUI is a large one. IVF (in vitro fertilization) would hold much higher success rates for a couple our age, but is a lot more demanding in all aspects. It is a multi month journey, with the usual procedures plus egg retrievals and fertilizations. It also comes with a very large price tag and ethical concerns. IVF is still a forbidden land for some, especially specific Christian communities. To be honest it was one of those arguable topics that I did not take a real stand on until it became personal. When I realized that it is a possibility that IVF could be the only way I could carry my own biological child, it did not seem like such a bad thing. We do that often; don’t care until it directly affects us. I can clearly see both the arguments for and against IVF, and know that if our time requires IVF it will present new challenges.  I really hope that is not where we are headed but I cannot ignore that is likely. In the next couple weeks I am going to use this space to look at the ethical, emotional, and mental concerns of both IUI and IVF. 

Can I get a frequent patient card?

         Wow. That describes the past week pretty well, not at all where I expect things to be going. The second week of the cycle is the most drug, ultrasound, and lab intensive. Overall I ended up with 17 ampules of hMG, 4 ultrasounds (3 within 5 days), two blood draws, and one trigger shot. The ultrasounds and blood draws are so frequent now that the obgyn’s office knows me by name and the pathology lab knows exactly where my order is coming from by just looking at me. Things that use to make my blood pressure and anxiety rise are now just another part of my day. That is a place I never thought I would be, where labs and scans filling the calendar is the norm.  

         That was not however the most stressful part of the treatment, that would be working with the doctor’s office. To preserve the integrity of the staff and myself I will not divulge details, but I will say communication is important in any relationship. The result of miscommunication among other actions has resulted and everyone being disgruntle, and ultimately our departure from our currently clinic. It had been an idea we had been discussing for a while and after this week we knew it was necessary. Our insurance covers much more at the other clinic, which will hopefully prevent some of problems we experience with misunderstanding in the past. I think fertility clinic staff would be much more understanding and considerate if they were aware of how much their patients are actually paying for services. And I must say after that was explained to the current clinic they were much more willing to accommodate us and we are very grateful.

       The results of treatment are hard to know because I was unable to have my usual ultrasound tech this go around and the pervious mentioned miscommunication. What I do know is that we had a few good follicles on the left and lots of small ones on the right, however the estradiol were not as high as we would like. Saturday after all the issues came to a climax and an ultrasound was performed by a doctor we were given the okay to go ahead with a trigger shot. We were also given the disclaimer that there is an “increased risk” of multiples. I laughed a little because who am I to be picky at this point? Do I desire high number multiples? No, but I think I would learn to make do.   

Back at the Starting Line

So here we are again, at the start of another round. Last time I updated we were in the middle of a cycle and had just finished the second ultrasound. After a third ultrasound and more blood work, things still were not progressing as desired. Instead of giving up completely the hMG dosage was increased to two injections a day, but it might not have been enough, bringing us back to the starting line once again.
            I know I have complained about endometriosis a lot but part of the reason I do is that I want you to understand that it is a very real disease. I kept silent for years because I believed the lies that I was just weak and everyone had “bad periods”. Not true. When a woman has endometriosis it can take over her life, she’ll miss school/work, avoid social situations, and suffer physical and emotional pain. For a few months after my surgery I got to experience what I would call an endometriosis free life, it was refreshing and exciting but short lived. Now about a year and half later I am almost back to my pre-surgery state. It is a little hard to take especially when it starts affecting others. My husband and I spent the weekend at the lake and I was not a lot of fun because I did not feel well but I sucked it up and put on a good show, I learned to master that a long time ago. The façade could only last so long as my body got the best of me. After multiple trips to the bathroom, which I use to think was caused by IBS – but is more than likely endometrial lesions on my intestines, I lied in bed crying from the pain. When I could not take it anymore I woke up my friend at four in the morning in hope that some fresh air would help. I felt so bad for waking her up and even though I know I would try to do the same for her, I cannot repay her for all she has done along this journey for me. My husband I ended up sleeping curled up in the back of our SUV because I felt better outside. And I am saddened by the fact that things should not be this way, endo is not something we talk about because we are afraid to offend someone by talking about “woman problems”. For that reason research and treatment is underfunded and slow, we have no problem talking about breast but talk about menstrual cycles and people do not want to hear it.  I have had people tell me that my blog is TMI (too much information) but that is part of my point. I did not choose to have endometriosis and I should not suffer because the problems it causes make others uncomfortable, it makes me uncomfortable too. This puts it in perspective, “‎If 7 million men suffered unbearable pain with sex and exercise and were offered pregnancy, castration or hormones as treatment, Endo would be a national emergency to which we would transfer the defense budget to find a cure.”-Nancy Petersen, RN, ERC Advisor, Internationally recognized advocate.
         Now that I am sure you have had enough of my ranting, a little on our current state. I had an ultrasound today which a required a lot of phone calls and waiting, but it got done. I’ll start the injections tomorrow at 1.5 ampules and then get another ultrasound in a week. Praying that this is our time.    

More meds

       Very short update on what is going on. Monday was ultrasound number two for this cycle and it show a little bit of growth on the right side follicles. Since the ultrasound did not show the preferred development we increased my hMG dosage to one and half. Then, Tuesday was a blood draw to check my estradiol levels. It looks like things still aren’t exactly where we would like them to be so that means more shots. We are going to keep up with the larger dose until Friday and check again with an ultrasound and blood draw.

       I have really felt like my life revolves around infertility this week. Waiting day to day for results is nerve racking, I feel like I have to be connected to my phone all day for a three minute call that dictates my treatment. The actual shots don’t bother me much anymore, although I am not sure I will ever get use to the burning sensation of the meds. My thighs do have large matching bruises, a small price to pay if this actually works. 

Waiting for the Other Shoe to Drop

     Well, the past few days have been stressful. At times I feel like it has been weeks rather than days. Last cycle was unsuccessful so we started our eight round of treatment, and we started right away. After much miscommunication with the RE’s office and the amazing compassion of the ob/gyn’s office we got things squared away (between Monday and Tuesday I spent about 2 hours on the phone). This time we are taking a “more aggressive” approach. The ultrasounds started at the beginning of the cycle, with one on Tuesday and another one this Monday. The idea is with multiple ultrasounds throughout the cycle we can watch how my body is reacting to the medication. We start with the injections immediately and I’ll also be getting an estradiol test with the next ultrasound. Estradiol is a hormone that aids in follicle growth among other things. The results from Monday will indicate what the next step in treatment will be, it is rather nerve racking when we don’t know what is coming next.

    I also so herbalist again and it is amazing how she can understand my body. Hopeful the combination of supplements and medications will be the answer. I have not been coping well with the physical effects of this journey. As I have stated in the past my endometriosis is only getting worst and I’ve barely been able to operate this time around. I just keep hoping it is worth it. I hate that all the different mixes of hormones has made me look like a teenager with uncontrollable acne. I know it isn’t my fault and there is not much I can do about it since most acne treatments are not advised for those pregnant or may become pregnant. But as I told Jeremy, I cannot wear a sign that say “I have acne because I am infertile.” Then my weight fluctuates depending on where I am in the cycle. It is only a few pounds but with my small frame I am able to notice even if others don’t. Again, a small price to pay for fulfillment of a dream and some of the less talked about effects of infertility. It is probably obvious that I am not in the most positive of mood at the moment. I keep praying that we are doing the right thing and everything will have a purpose in the end. I’ll be sure to post a small update early next week with what the plan is from here.  

Some Old, Some New

      Yet again it has been awhile since my last update. I had finals to finish up for school and little energy left to do much else. This go around I did a double dose of Femara which I was smart enough to take at night so I didn’t pass out for hours during the middle of the day. That was the old part – taking some pills for 5 days. The new part – injections. I was rather anxious about this part. Even though my husband is a paramedic the office insisted I come in to learn how to give them to myself. It wasn’t anything that Jeremy had not already told me or I had not read and it was a ridiculous waste of money. Nothing I can do about that now. When it came time for the first shot Jeremy was not home and I was working on a paper due later that day which made me even more nervous. Jeremy walked me thorough it on the phone and I was so shaken up that I spilled the dissolvent, it felt like it took me forever to get the medication mixed. When it came time to actually inject, I hung up the phone and said a quick prayer. I worked myself up so much that when it was actually over I thought “That’s it?” Thankfully Jeremy was able to do the next couple so I was more comfortable with them by the time I had to fly solo. We had our normal ultrasound on Friday. I have to thank my doctor’s office again because they squeezed me in between patients because they know how important it is that it is done on specific days and early so the results can be faxed to my RE. I tried not to get myself too excited and at first I really thought it was not going to end well. There were less follicles than previously but there were larger so that was good, but the ones on the right ovary were not quite “ripe.” However, on the left we had one that was just the size we like to see 20 mm. That meant one more shot, the trigger shot. Now we wait yet again.

      On a related note I would like to draw attention to Family Act of 2011, a Senate bill create to aid families with infertility cost, specifically IVF. You can find more information here. I encourage you to contact you Senators and ask for their support of this bill, because 1 and 8 couples suffer from infertility and that means someone you know is living with this daily.

      Also a well know infertility advocate was feature on the Boston news, discussing the fact that infertility does not only affect older women. You can find the video here. I like to point out her correction; she still needs to save $18,000 for her IVF cycle with an egg donor not $1,800 as the segment says.       

Medic! Guest Post from My Husband

How many times have you heard that phrase? It’s in practically every military movie. Medics are called when people are injured, sick, and/or at the end of their rope. We are fixers, there aren’t many things we aren’t trained to handle. When Jenni and I discovered having baby wasn’t going to just happen the easy way, I wanted to cry MEDIC! There really isn’t anything to make the news come easy.
    It
Makes
You
Question

EVERYTHING.

Your mind becomes flooded with questions:
“How can this happen to us? What did we do to deserve this? How much is this going to cost? What are our options? How will this affect our relationship? Where is God in this? Does this mean never or will it get better? Where is the justice?”

I can’t even begin to comprehend what Jenni’s going through……

SO…

We began our journey in infertility. At first it didn’t seem real, almost like we were in a fog. Then the tests came and the fog lifted quickly.  Jenni became a pin cushion and blood was drawn, medications were injected, and she became an excel champion tracking all sorts of things.  I felt helpless, trying to offer moral support and empathy. I wanted to take her place seeing her heartbreak daily because of the unknown. I’ve learned listening isn’t enough, communication is the real cure. At first my words escaped me, Jenni wondered if I cared…which I did, but sometimes my off colored humor didn’t help. I still managed to get her to smile, that beautiful smile I fell in Love with. There are times though when all the pieces fall apart. I’ve learned that sometimes you have to let the pieces fall because there is nothing you can do to stop them from falling, but the greatest thing to do is to be there to help put the pieces back one piece at a time. One day we will be stronger because of this……
“God, who foresaw your tribulation, has specially armed you to go through it, not without pain but without stain” C.S. Lewis
“Experience: that most brutal of teachers. But you learn, my God do you learn.” C.S. Lewis