babylust

the waiting game

I know that I’m only 2 days past ovulation at this point, and it’s way too early to be coming to any conclusions, but I’m just not feeling like we were successful this cycle. This may sound strange, but with my last two pregnancies, I just knew. Almost immediately after ovulation, I just had a feeling. But this time, it just isn’t the case. Perhaps I simply don’t want to get my hopes up. Maybe I’m so jaded with this whole pregnancy process that optimism just isn’t something I’m feeling up to. Or, it could be that I’ve gotten pregnant every time I’ve tried (and even once when I wasn’t trying), so I figure that the odds are that at some point, I’ll go through a cycle of TTC without being successful. Don’t they say that the odds of becoming pregnant during a cycle are only 25%?

While with previous pregnancies, I’ve noticed subtle changes in my body during the two-week wait that added to my suspicion of pregnancy, my hormones have been so wacky over the past few months that I don’t even know what normal is anymore. Add in some fertility drugs and some extra hormones, and who knows how I’ll be feeling.

I suppose the only thing to do is to wait and see.

...

Yesterday, John and I returned from a weekend in West Virginia, and headed to his mom’s house for lunch and an egg hunt for the family kids. In West VA, we stayed with some close friends of ours, Tom and Judy, who have a lovely cabin just outside of Franklin. The weather was a bit dreary, but not so bad as to keep us indoors for the entire weekend.

Shortly after we arrived, we were trying to figure out the last time we had been to the cabin; we were guessing that it was sometime last summer or early fall. Later in the evening, I remembered that it had been in October 2005, shortly after I had my second miscarriage. We had planned to go to the cabin with another couple, but they had to cancel at the last minute because of the stomach flu. It turned out to be a very restorative weekend for me. I spent the days journaling, crying, and reading Jon Cohen’s Coming to Term. It’s a little hard to believe that I had been pregnant and miscarried a third time since our last visit. This weekend, I was in much better spirits. There’s something about the brightness of new green leaves emerging on the mountainside trees that makes me feel hopeful.

Since my third miscarriage in December, I haven’t been reading all that much, and what I have read has been either fairly short books (The Year of Magical Thinking and The Full Cupboard of Life) or magazine articles. I just haven’t really been able to sit still long enough to lose myself in a book. This has been quite the departure from my normal reading habits, but I suppose it’s not really all that surprising.

This weekend, however, I managed to get through an entire book, and not exactly a short one. On Saturday, I finished The Distant Land of My Father, a novel about an American millionaire in 1930’s Shanghai, told from the perspective of his daughter, Anna. The story describes the father’s life—the choices he makes to be with and then away from his family, his ordeal during the Japanese invasion of China, and finally, his reconciliation with his daughter later in life. In the book, Anna’s father leaves her a series of journals, which she reads after his death. These insights allow her to gain some sort of understanding of her father’s decisions, as well as his regrets. I was sobbing while the last pages of the book. Mostly, it reminded me of the relationship, or lack of one, that I have with my own father. I was saddened by thoughts that my own father will probably never seek out a relationship with me. He didn’t even remember my birthday. I know that my father has his own story, his own issues, his own fears; I’m just afraid that I’ll never know what they are.

I believe that I am ovulating today, but, just to be sure, I’ll take another ovulation kit this afternoon. That means that I’m entering the two-week wait. I’ll start the progesterone in 3 days, and since extra progesterone can cause pregnancy symptoms (or really bad PMS) even when there is no pregnancy, I’ll try not to obsess over every twinge or sensation. Keep your fingers crossed for two pink lines on an HPT in 14 days or so.

the clomid report

It’s been a busy week, so I haven’t had much time to post. This past weekend, John and I spend Saturday volunteering for the ElderHomes project, a non-profit working to improve the living conditions of low-income, elderly and disabled persons in Richmond and the surrounding localities. There were around 10 of us who showed up, and we worked mostly on yard clean-up for a 99-year-old woman. On Sunday, we took advantage of the lovely weather to plot and plant the beginnings of our spring garden. We added beets, carrots, edamame, and bush beans to the chard and mixed lettuces that we put in last week. Hopefully, some tatsoi will be in the ground soon. I’ll try to post some garden & yard pics later.

I have started and finished both the doxycycline and clomid. I haven’t experience too many side effects from either, which has been a relief. I’ve had some moderate skin eruptions, and I’m guessing that I can thank the clomid for that. I’d say I have been a bit more moody and emotional than usual, and I had a few headaches here and there, but overall, I’ve felt pretty good. The biggest side effect has been some persistent and increasing lower back pain, which is mostly concentrated on my right side. I spoke with a nurse about it yesterday, and she believes it is because my ovaries are “stimming” and that I’m probably getting ready to ovulate.

Did anyone else who has used clomid have back pain?

I spoke with the RE about my questions regarding progesterone supplementation, and I’ll also be starting with suppositories at 3 days past ovulation. I feel much more confident moving forward with extra precautions in place.

The only other excitement in my life is yesterday’s trip to the ER, which looking back, was completely unnecessary. My nose started bleeding a little before 3 pm, and when it was still gushing an hour later, I called my primary care doc, who advised that I head to the ER to have them take a look. Let’s just say that I was far from a pretty sight with blood streaked on my cheeks and glasses, caked under my nails, and splattered on my favorite pants. Thankfully, the bleeding stopped just as we were parking. At least I know the baby aspirin is working!

Let's hope the clomid does the trick...

take 5 pills and call me when you're pregnant

I finally spoke with the RE yesterday evening. I was pretty irritated that I didn't get a return phone call on Monday, and I was moving towards being downright pissed off when I hadn't heard from him by 4:15 pm yesterday afternoon. Please tell me I'm not the only one who has frantically called their doctor's office three times in one day trying to get reassurance that the doctor will in fact return my call. I was starting to feel like a terrible nag, but I didn't know what else to do. I was really worried about starting the clomid and antibiotics, not to mention my anticardiolipin levels.

The RE said that one of my antiphospholipid levels was elevated. Specifically, my anticardiolipin IgM level was at 13. Normal is <9. From 10 to 19 is an "indeterminant" level, and a positive result is at 20 or above. The RE said that he didn't feel like this was something we should worry about at this point, even though this level has gone up slightly since it was tested in October. He advised me to continue taking one baby aspirin per day. Whew!

At 7 dpo, when progesterone levels typically peak, my P4 level was only 10. The RE said he was "very unhappy" with this, and that he would have liked to see them above 20. He advised that I take the clomid this cycle to strengthen my follicular development. He was worried that my follicles were not developing well enough to produce a healthy egg. I asked if I should also use progesterone after ovulation this cycle, and he said no. He advised me to call either when I get a positive pregnancy test or when my period arrives. When I get my first positive test, I'll go in right away so they can start monitoirng my levels.

So, I'll add clomid and doxycycline to the list of pills I'm currently popping (which includes children's aspirin, prenatals, B6, B12, fatty acids, and beneficial bacteria). So, that's 17 pills per day, plus clomid once per day for 5 days and doxycycline twice per day for 7 days.

I'm a little apprehensive about not using progesterone after I ovulate, but I'm trusting him on this one. But I am wondering...does anyone know about using clomid, and whether it is typical to also use progesterone during a clomid cycle?

a weekend of waiting

...waiting for my husband to get home...waiting to speak with the RE...

John left for Beruit on Wednesday morning. On Wednesday night, I checked his flight status, and the airline's website said the flight was "not operational." As you might guess, I had a bit of an uneasy night (okay, okay, I was pretty much freaking out). Thank goodness that the status had changed to "in flight" when I checked early on Thursday morning. This is the first time that we've been separated by an ocean and the first time that we haven't been able to say goodnight (even if it was just by telephone). I've spoken to him twice, which has really helped to ease my anxiety. He seems to be having a grand time and enjoying his visit with our friend Matt. Only three more nights apart.

I'm nearing the end of this cycle, and I was super-excited that I hadn't had any spotting...until yesterday (10 dpo). I feel that this is a good sign that my cycle was pretty strong, even though I suspect that my luteal phase will still end up being a little shorter than I would like. I'm not really sure what that means for us for next month. I'll speak with the doctor on Monday to try to determine if we should use clomid next cycle. My fear is that my cycles are pretty irregular...without going into too much detail, I'll just say that I can pretty much tell by my "fertility signs" and by my level of PMS how strong my cycle has been...and that just because this cycle was "strong," the next may be a totally different story.

And...

I got my lab results back today. Everything looked good except for an elevated anticardiolipin antibody level. The nurse only left a message, so I didn't get too many details. This is the same test that was elevated after my second m/c in October. That level was only slightly elevated, so I'm wondering if this may be a similar situation. So, I'm not sure what this will mean for our next pregnancy. Usually, the treatment for an elevated anticardiolipin antibody level is Heparin (a blood thinner self-administered daily by injection). From what I understand, Heparin is used because it is suspected that this condition can cause blood clots in the placenta, cutting off blood flow to the fetus and causing lots of other issues for mom and baby. I'm still learning about all of this, so I hope that my information is correct!

The nurse also said that my progesterone level showed that I had ovulated, but I'm not sure of the specific number for that either. My spotting makes me wonder if it's as high as it should be.

I'm supposed to call the RE first thing on Monday morning to discuss the levels and to make a decision about the clomid. I'm going to try not to obsess, freak out, or do too much investigation on my own until I speak with the RE on Monday. I'm sure that will be easier said than done.

heaviness

Well, there's not too much to report. I went in for my blood draw this morning--just three vials and a bit of a prick. Usually, I have some bruising from my uncooperative veins, but not today. The results should be in on Friday. The nurse said that the tests for clotting disorders take a few days longer than regular labs. More waiting.

I went straight from the RE's to my therapist's office. We had a very, very heavy session that I can't even begin to go into right now. Let's just say that there were many tears shed. And that she ran out of tissues. It's fascinating (and a bit frightening) how so many "issues" are hiding within into this fertility business. I'm doing okay now; mainly, I'm just feeling really, really tired.

John leaves for Beruit on Wednesday morning, which means I'll have some serious alone time coming up. I plan on getting together with a few people, but mostly, I want to create plenty of quiet space for myself. I feel like I really need to mentally prepare myself for next month. I've been feeling so hopeful lately, and I have a new sense of confidence since we began seeing the new RE. I know that I can't avoid the anxiety that comes along with trying and waiting and obsessing, and quite possibly, with disappointment. I can't avoid it, but I'm hoping to be better prepared to deal with it.

we missed it

By the time my appointment for the ultrasound rolled around, ovulation had already occurred. I'm guessing that we missed it by about 3 hours. The dr confirmed my suspicion that I had released the egg from my right side (there was a dark patch where the dominant follicle had been), but we have no real information on how healthy the follicle looked or approximately how big it was.

I was and am pretty disappointed, but I'm trying to look on the bright side. I now know that I ovulate pretty quickly after my LH surge (meaning John and I need to get right down to it when I get a positive OPK), I got about a dozen questions answered (and he didn't even give me a strange look when I pulled out a notebook with an entire page of questions), and I finally know why it is so darn uncomfortable to get a vaginal ultrasound (my uterus is tipped backwards, so the wand has to be pressed downwards to get a good view). So, not a completely wasted visit.

The next step is for me to go in next Monday for a round of bloodwork (progesterone, prolactin, a number of tests for clotting disorders) and then wait to see what my hormone levels show. Next Wednesday, he should have my results and hopefully a recommendation on whether (or not) we should use clomid next cycle. I think I would like to skip the clomid, unless he has a strong inclination that we should use it. And, he advised that we skip the progesterone suppositories this month to try to get a clear reading on my levels without additional progesterone. After reading about Ornery's delightful experience with the suppositories, I'm glad to put them off for another month.

All in all, I'm feeling okay. There's a big part of me that is really, really impatient. I'm trying to continue taking deep breaths and keeping myself in the moment. It will be 30 days (at least) until I ovulate again, and that just seems like forever. I know that it's really not so far away, but it really feels like it will never get here. My rational side knows that waiting is for the best: we're getting tons of tests done that will ease our minds when we do find ourselves pregnant again. My irrational side actually considered taking clomid just because it will make me ovulate sooner. Probably 6 days sooner. You'll be happy to know that I've talked myself out of that nonsense.

Last night, my sleeplessness returned. I'm feeling thoroughly exhausted, so hopefully it won't be an issue again tonight.

it's all in the timing

The past week has been a whirl, and, as you can see, I've had hardly any time to post. Mostly, I was busy with work--we put on our annual three-day training last week. As I grow older, I'm becoming more and more of an introvert, and this makes three days of being surrounded by nearly 300 people a bit exhausting. Perhaps a bit of exhaustion was just what I needed--I am happy to report that for three of the past four nights, I have fallen asleep all on my own.

John and I had planned to sneak away to Philadelphia this weekend. We were to leave early Saturday morning and return late tonight. When I met with the RE last Monday, he advised me to start using ovulation kits and to call when I got a positive test, or when my body was telling me ovulation was approaching--he wanted to do an ultrasound to check on my follicle development (to see if we would need to use clomid next month when we TTC again). We told him we were going to be out of town this weekend, so he advised to come in on Friday. On Thursday afternoon, my OPK was still negative, but I called to see if I could schedule an ultrasound for Friday afternoon. The only availability they had was for Friday morning, right in the middle of a workshop I was facilitating. The timing couldn't have been worse. I choked back tears as I told them that I couldn't come in at that time. That's when I lost it. I felt so frustrated and overwhelmed, wanting more than anything to be pregnant, but feeling so angry that everything in my life revolves around my cycle. Needless to say, I was in a pretty foul mood for the rest of the day. When I arrived home, John and I talked it over and decided to postpone our trip to Philly--that staying in town and being here to get the ultrasound at the right time was the best choice. Now I'm glad we canceled the trip. I got a positive OPK yesterday afternoon, and I'm on my way for the ultrasound in just a little while.

Last week also brought my birthday, which has been a bit sad for the past few years. It was just a few days before the big day in 2002 when I had my very first miscarriage. This week, I've been thinking about the kind of mother I would have been at 24. I know I would have made out just fine, but it's quite amazing to see how much I've grown in the past few years. I am thankful for how my life has unfolded. I know I would feel great happiness at being a mother, but I also know that if that pregnancy had worked out, I would not have met John. I would have given birth a month before John and I met on Christmas night in 2002.

Lately, I've been having an old debate in my head. Do things happen for a reason? Or do we find reasons to comfort us, so that our wounds can heal, so that our scars aren't for nothing?

On your mark, get set...

Has it really been 10 days since I last posted? That means nearly two weeks of sleepless nights spotted with b*nadryl-induced shut-eye and lots of groggy mornings. Some days I feel that I can barely form sentences, much less compose an entire coherent post. Last night I tried to break free of my new "habit" by attempting unassisted slumber. I quickly realized that it was poor judgement to attempt such a tremendous feat the night before the big appointment.

Yes, that's right. The Appointment. John and I had our first visit with our new RE this morning. I knew we were off to a good start when he actually shook my hand and greeted me (you may recall that the last RE we saw only felt comfortable talking to John and the papers he constantly shuffled from one hand to the other). I absolutely love our new doctor. I had heard so many wonderful things about him, and I was starting to worry that my expectations were too high and my hopes too big. But he was everything I had heard he would be.

We went over all of the particulars and came away with a pretty solid plan. It's good that I've so many of the preliminary tests; we can get right down to business. Based on my spotting, short luteal phase, and plateauing HCG levels, his suspicion is that my progesterone levels are low, causing my miscarriages. We also discussed that my late ovlulation may be causing the eggs I am releasing to be of poor quality.

Since I can feel the sleepy pills kicking in, I'll try to sum up our plan:

• Take one baby asprin per day
• Starting this month, use ovulation kits. When I get a positive OPK, I'll call to schedule an ultrasound to check on follicle development. If the follicle development isn't to his liking, we'll try clomid in the next cycle. If all looks well, we'll try the next cycle, letting my body do its thing unassisted.
• At 2-3 dpo, I'll start progesterone suppositories. At 7 dpo, I'll have my progesterone level checked, as well as a few other blood tests. Hopefully, the progesterone will help with the spotting and will increase my luteal phase.
• When my period starts, John and I will both start a round of antibiotics (to kill any bacteria that may be causing miscarriages, but not necessarily making John or me sick).
• I'm hoping to get knocked up in April during my next cycle. I can hardly wait!

Oh, and I will also be weaning myself off of sleep-inducing substances. Hopefully, sleep will return to me very soon.

More later, when I can keep my eyes open...

warning! entering hormonal hell

I know, I know--it's been a long time. Here's the update...

I haven't had much time to write. Mostly, I've been dog tired, due to some pretty horrible insomnia that not even my prescription sleeping pills have been able to tame. I'm pretty sure that it's hormonal, but who knows. I swear, I've been having hot flashes at night. My daily temps have been very, very high this cycle (around 99 before ovulation). If that keeps up, I'm going to have the doc check my thyroid levels again. Hmm...did I just volunteer myself for more tests?

All in all, this has been one of the worst cycles for me on record. I didn't think it would happen, but my body did manage to ovulate. Even my very detailed charts aren't helping me to determine exactly when that happened, although I believe it was somewhere around CD30. I started spotting on CD34, and AF arrived after a 37 day cycle. Whew. The bad news is that I'm looking at a very short LP, which seems to be getting shorter with each cycle. Although I'm not certain, this pattern is leading me to believe that my progesterone level may really be the cause of my miscarriages. I see the new RE on the 13th, and I can hardly wait.

Recently, I've started to feel somewhat hopeful about becoming pregnant again. I'm certainly not ready to jump on the baby-makin' bandwagon just yet, but I think I will be soon. I'm not sure if my feelings have changed simply because time is allowing me to heal, or if it is because there is a possibility that we may have some answers soon. In addition, having low progesterone levels seems to be a fairly fixable issue, which adds to my optimism. I'm not sure that I would feel this way if I didn't have any indication as to what may be going on. One day at a time.

We received a summary of the cost for John's portion of the chromosomal analysis, which, of course, is not covered by insurance. The bill for my part hasn't even arrived. I had NO idea that it would be so costly. However, as a friend of mine said yesterday, there's no price you can place on peace of mind. She's right--at least the test gave us a little more clarity on our situation.

There's a part of me that wants to tally up how much we've spent on this so far--everything from vitamins to bloodwork, ultrasounds to fancy genetic tests. Acupuncture, therapy...the list goes on. On second thought, that's probably a really bad idea. One does not need to take additional measures to freak herself out when she is pretty good at working herself into a frenzy as it is.