Holiday Wrap-Up

Christmas was not as bad as I feared. I'm sure some of that is from my happy pills (been on them 2.5 weeks now, and while I'm not skipping around shitting rainbows, I do feel like the world is a place where I can actually live instead of needing to hide in my house as much as possible). Part of it, though, was sheer determination. I am so sick of not being the aunt I want to be. I went for my niece first and often throughout all our gatherings. I cried once on Christmas Eve and once on Christmas, but they were brief bouts. I was able to stay the entire time for all gatherings (which is no small feat--Christmas Day goes from 10 am to 6pm). I attended every party, dinner, gift exchange. I am proud of myself.

I am so ready to be done with it all. To slam the door on 2010 and move on.

My RE, Dr. B, did not agree with my other RE, Dr. H. He thinks the cyst on my right ovary might interfere with my cycle. Since it is his batch, he calls the shots. He wants me to come in for a 2nd ultrasound, either this Friday or on Monday. I can't do Friday, and can't really do Monday either (especially since I'll be coming in late on Thursday, from my baseline...), but I will. I am prepared to demand that he aspirate the cyst if it is present. I am prepared to argue my way into some treatment or another. I have been attempting to suppress my lovely ovaries since September now. I am fed up with it. I refuse to accept "next time" any longer.

It's been a rough, long, ugly December, 2 of my friends lost their mothers, and one lost her father as well. I try to be thankful for what I have. It doesn't always work.

Blood Makes Noise

Ok so, it was dark, cold, miserable when I woke up. Our water takes forever to warm up, and I'd had a hard time dragging myself out of bed, so I was already running behind. Took my shower, washed my hair, my body, shaved, all that jazz in as little time as possible. Got out, dried off, began dressing...

and noticed I had TONS and TONS of blood on my thighs. It was dripping on the floor even! I yelled for my husband, absolutely devastate and terrified, convinced I'd somehow gotten some sort of whacky period from my new birth control (I'm on CD 9 or 10 or something), or possibly god forbid some sort of miscarriage, because WTF?

Sat down on the toilet, crying, bleeding. After about 3 minutes, I noticed that the blood was like...really, really red, and not at all thick or period-y. Grabbed a handmirror and sure as shit, I'd nicked the hell out of my labia while shaving.

I don't know how I didn't notice--maybe the cold water? But I bled through 2 pantyliners after I figured it out.

I am such an idiot.

Welcome to ICLW!

Not much is going on for me fertility-wise. I'm hanging out on the birth control Pill, waiting to start IVF. I take my last Pill Jan 5th.

The holidays are proving to be easier than I'd anticipated, thanks in part I'm sure to the antidepressants. Also, my baby niece had a horrible stomach virus and she (and her mom) missed our 2 holiday/birthday parties last weekend. I feel guilty for feeling relieved, but it does mean that I'll have all my internal reserves intact for Christmas Eve and day.

I'm just trying to make it through--not much into the holiday spirit. That makes me a bit sad--even decorating our house didn't bring out my joy. But I'm coming to believe that I do the best I can at any given moment. If I can not ruin anyone else's Christmas, I've done what I need to do this year.

A Dash of Salt

...but mainly good news!!

First, non-IF related, was that my husband's job position is being eliminated mid-Feb. We've known for a month now, and it's been nerve-wracking, in large part because he is our insurance carrier. (I work for a small business that does not offer insurance of any sort.) He applied for a different position at the same company--and on Wed. we found out he got it!! I'm so proud of him. It was a very competitive position, and they interviewed at least 10 people. I sure picked a goodie.

Second, the monster cyst on my left ovary is gone!!! So I get to cycle, with a baseline on Jan 6th. Yay!!! Also, apparently billing said it would be illegal to bill the insurance and then comp it if that didn't work out. So they just comped it. I love my clinic!

And now for the salt...

I have a cyst on my right ovary, about 2cm. They can't tell if it's coming or going. (I sure hope it's going, now that I'm off that damn Lupron.) But because my monster cyst vanished "so quickly", they think that...well, we'll do one of 2 things: either just cycle around any existing cysts, or else aspirate them and figure they won't grow back. I kinda hate my ovaries. But at least I won't be cancelled...hopefully.

And then D, the nurse I really liked for Dr B, quit to spend more time with her family. So there's a new nurse...

And either she didn't know, or she just isn't as hooked up as everyone else. Because my clinic had said they would try to get me the antagonist for free (from the med company or else from donations), but she said no, I'd have to order it. Same with the extra Bravelle I need. I'm trying not to be bummed about this--my clinic has been overly nice to me. And JimDear does still have a job, so our straights aren't entirely dire. But still, I was sort of counting on that. Oh well, I guess that's what credit cards are for.

Holding My Breath

I called my nurse yesterday to (a) inform her that I'd gone hunting for drugs from a different supplier, and (b) tell her I think I started my period. Now, I am 31. I do indeed know what a period is. But like...I spotted for 2 days, but it was bright red? But not enough to fill the tampons I used (hate panty liners, hate pads!). And then yesterday morning I awoke to what I was pretty sure was it...but the flow was still really light, and I'm back to spotting today. Whatever, body. Lupron and BCP and a 35 day cycle...they can all just suck it.

Anyway, my nurse, when she called me back, said how happy she and Dr H were that I'd gotten some happy pills (and I think they're working already, though I was told 2 weeks. I have more energy today than I have in months!). We also had the scheduling talk. It went something like this.

Me: So am I supposed to go on birth control now?
Her: Well, when would you like to cycle?
Me: As soon as possible. Today?
Her: *laugh* (thinking, not actually funny) Well, the next batch is Dr B's batch.
Me: (thinking, then I wouldn't have you for a nurse, and I really like you. But on the other hand, Dr B's nurse, D, I totally love her and was so sad to leave her. I'm evensteven on doctors, don't much care, but the nurses...well, I guess you all know me anyway, it's not like I don't talk to D each time I enter your Office of Bad News, so I'm sure I'll see you...)Ok, when is it?
Her: January 9th.
Me: Oh nice! Yes, sign me up!!! (pause) Do you think the cyst will be gone by then? Because I really don't know if I could take getting all excited about cycling and then being crushed again.
Her: Well, I really can't say.
Me: So like, with the antagonist cycle, I go straight from the Pill to baseline, right?
Her: Yes.
Me: So that would be my first ultrasound, but I wouldn't have started injecting, so I could just pretend it was a regular checkup, kinda?
Her: Would you like a cyst checkup?
Me: Umm...
Her: We could just do a blood draw, if money is your concern. It would be a lot cheaper, but a lot less accurate.
Me: Well, how much would that be?
Her: You know, let me check with Dr H and billing and see if we can work something out. We should be able to code this as a cyst check, not infertility. Your insurance might cover it.
Me: I love you! Thank you!!!!!
Her: I'll call you back.
Me: (gets prepared to wait for a day. It was already like 6, after hours. So, imagine my surprise when she called me back, not more than 15 minutes later) That was quick!
Her: Dr H says we'll try to bill your insurance, and if it doesn't go through, we'll just write it off.
Me: Oh my god, thank you sooooo much!
Her: So we'll do an ultrasound.
Me: Really??? Thank you!!!
Her: No problem. We want to do it on cycle day 2-4. So...how's Wednesday?
Me: Perfect!!!

So, tomorrow morning, I might get some answers. Nothing from this office has been good news yet, but somehow I am still very hopeful.

The secret part is, if we do cycle with this batch, our transfer might very well be on my husband's birthday. Which means nothing, except, well, that would be the most pregnant I have ever been.

Desperate Times

...call for desperate measures. And desperate sisters call the doctor in the family.

I am now the proud owner of my very own prescription for antidepressants, and have one down the hatch already.

I Want Candy

And by "candy" I mean Prozac. Or some other antidepressant.

But I can't get them. My RE (and the nurse) were quite sympathetic to my plight. He is willing to write a prescription that is (as-far-as-they-know) safe to take during IVF and pregnancy. If. If my therapist is willing to consult with them, to tell them my diagnosis and to recommend which drug she thinks is best for me. They want me to know I'm not alone, that "most" of their patients who do IVF are on (or get on) an antidepressant. Especially, my nurse was careful to add, in situations like mine, where things do not go smoothly. But mental health isn't their area of expertise (you'd think doing 200+ IVF cycles a year would make it have to be, wouldn't you?), so they want outside input.

My therapist...is a social worker. I began seeing her for reasons unrelated to infertility, but when it hit and hit hard, I kept up. I also joined a "women's group". (There are no infertility support groups that I can afford. There is one that charges $50 per week, but come on.) We meet for 2 hours every Wednesday and talk about life and stuff. I'm the only infertile, but these are nice, loving, lifesaving women.

And yet, 3 hours of mental help a week and I am still batshit insane. I cry every single day. Oftentimes more than once. I cried for at least half an hour the other night because a bunch of children (and a handful of parents) were Christmas carolling and stopped at our door. I listened to their two songs, wished them all a merry Christmas, closed the door and about died. Tonight I was supposed to go to a Jazz game with my husband and my brother, and I begged off "sick". I am not sick. I am fucking depressed. I cannot bear the thought of going out in public. I haven't studied as much as I need to. I've skipped classes. I called in sick to work last Friday because I couldn't get out of bed. I've gained a ridiculous amount of weight. I haven't gotten much further on my application, which is now due in a month, than I had in October. For christ's sake, I am barely functional. If it weren't for JimDear, I don't know that I would function at all.

And yet my therapist says she doesn't know how much of this is me and how much is just the hormones. (I've been off Lupron for a week or so now, and no better.) Does it even fucking matter at this point? She says she does believe in physiological causes for depression but isn't sure about me. (She knows that depression and anxiety run in my family. Very, very strongly. At last count, all 3 of my biological siblings were on antidepressants and/or anti-anxiety meds, as is my mother. My father committed suicide when I was 16. His whole family is crazy.) I would think the fact that even I, as sluggish and unhappy as I am, recognize that something needs to change is a sign that, you know, I can't do this anymore.

I am so angry at these people--my doctor, my nurse, my therapist. I have bared my soul (and my vagina) to them and they sit in judgement of me and declare me unworthy of help. I am so angry at myself for getting to this point.

And the worst part is, a little voice tells me that, you know, this is why I'm not a mom. Because I'm such a complete fucking basketcase that I can't take care of myself, let alone a child.

It's Just That I Don't Like the Answers

The REI fellow answered my email. She apologized for taking so long (3 days??!) to get back to me, saying she had house guests and had been very busy. It's not at all productive to compare her to Kate, so I'm trying not to go there.

Anyway, she said that there really is no difference between how the recombinants (Follistim, Gonal-F) act on your ovaries, but that many REs will prefer them to Bravelle because the actual FSH concentration in Bravelle can vary from batch to batch. (I guess those menopausal nuns can't urinate exact concentrations on command.) Because I as yet have no indication that I will be a poor responder and need those exact IUs to the nose, I'll continue with my significantly cheaper Bravelle.

She also said there is no, none at all, difference between Cetrotide and Ganirelix. (She did not add "aside from the various pharmaceutical give-away calenders and other assorted kickbacks", but then again, she is only halfway through her fellowship, so she's not quite an expert on all things.)

And that using microdose hCG along with FSH, which my clinic does, unique from any other protocol I've stumbled across on the various infertility message boards I frequent, as opposed to Menopur, makes no difference aside from the number of injections. She's incorrect in assuming that Menopur means fewer injections though--I am a master (mistress?) at mixing, and using my low-tech means, I only give one injection per day, counting Lupron, Bravelle, and hCG. No fancy pens for me, though I do have to admit to some curiosity.

But, alas, she said there is absolutely no evidence that any dietary restrictions, vitamins, Wiccan chants, etc. can "shrink" cysts, that I just have to wait (patiently, she did not add, perhaps she knows a bit about me?) for it to resolve on its own.

And also that she agrees that starting me on a long Lupron protocol made the most sense, but if I'm ready to move on, I should talk to my RE. She seemed to favor the antagonist over the flare protocol for me, but she didn't really go into it. Probably because she's not my doctor and is a bit wary about dispensing medical advice, sight-unseen, over the internet. (Which, really. She should frequent some of these boards I mentioned. Women guzzle grapefruit juice, cough syrup, soy, whatever, all because someone said it works. But then again, I suppose no one could slap FertilityFriend with a malpractice suit.)

So I continue to wait, and do nothing. (Well, not quite nothing. I put in a call to my nurse asking about maybe getting some antidepressants. I see a therapist, but I honestly some days think I'd rather just die than deal with Christmas. That can't be right.)

Lupron, OPKs, Sisters, and Books

So last night was my last Lupron injection. Hopefully forever. (The nurse said I don't have to buy more, that the idea was just to keep my ovaries quiet, that I start the Pill after I get my period, which...well, today is CD28 and there are no signs, so we'll see.) I had a tad more than the 20IUs I needed, but I just drew it all back and stabbed it in. After disposing of the needle, I hid the red bio hazard container. That's the 2nd one I've gone through, with not so much as an egg to show for it. But I realized...I spent all of November on Lupron. Every single day of it. God I hate that drug.

And another thing about November: I didn't pee on a single stick. I realized this when cleaning out the 2nd bathroom. I found half a box of OPKs under the sink. I guess I'd stashed them there so I wouldn't accidentally pee on one of them instead of a pregnancy strip? I don't know. But I stared at them for a very long time, and felt very sad. I had such hope when I bought my first OPKs. And in fact, OPKs have never once failed me. I ovulate in a timely manner every month (except, you know, the Lupron or BCP months...). I've never once missed my fertile window. I started out with just temping, and got a nice happy rise, but quickly backed that up with OPKs. I was such a different person then. Seeing that box made me kind of sad.

What made me even more sad was to realize I hadn't even taken an HPT in November. I did the whole BCP+Lupron thing, and got my period right on time. No need to even pee on a stick to urge it along (which yes, I did when I came off Provera after my last cancelled IVF). November was a month of dismay, of no hope. I hate November. This December is not proving much better, but at least it's not worse.

I read So Close yesterday. Seriously, that's what I did yesterday. I'd originally bought the memoir thinking I would read it and then pass it on to my friends and family, so they would understand. The concept behind the book is that, with each IVF, she gets closer and closer to a take-home baby. It was a very good book, and it made me cry. But I won't be passing it on to friends and family, because it is a very different journey from my own. The author...well, she gets pregnant. Lots. I do feel bad for her for having so many pregnancy losses, but well over half the book is spent with her being pregnant. She even muses at one point that May is the only month of the year in which she has not been pregnant (and then goes and gets pregnant). Her situation was heartbreaking, but for someone who has never seen a positive HPT, even from a trigger shot...well, it's just different. I don't want to give the book to people who I wish understood me (except perhaps the wonderful email she wrote to her pregnant sister), because my baseline ultrasounds have brought me nothing but heartache. She was never stopped at that point (although she was once stopped prior to egg retrieval). It just made me a bit sad that almost all of her "so close" journey is steps and steps further than my own. But it was a wonderful book and I honestly could not put it down, so I do recommend it to anyone who is actually infertile themselves, or who has dealt with RPL.

And finally (yes, the "f" word, but I mean "the last thing I will talk about today"), my sister, the gyno. After writing my post about her last Saturday, I did indeed send her an email simply saying "the email address you gave me for the REI fellow doesn't work. Hope you made it home safely". I didn't hear anything from her. A week later, last Saturday, I asked my mother if she'd heard anything from (oh, let's just call her) Kate. My mom said she had. I said I hadn't. My mom said Kate was probably very busy, what with being a doctor and all. Indeed. Then the next day, I did get an email from Kate, with a different email address for the fellow. I sent the fellow the same email I'd written before, but I don't know whether she'll answer or not. I'm not her sister, after all, just some infertile stranger. I've decided to just let it all go. To never bring up my infertility to Kate again, even in passing. If she broaches the subject, I think I'll just tell her I'm opting to keep everything to myself for now. Maybe in a few more months I'll be able to tell her how much her non-responses have hurt me, but not right now. Maybe if I ever get pregnant, I'll be able to let go of it entirely.

You Can't Make an Omelette Without Breaking a Few Eggs

...inside my cervix.

Which is to say, I've been having eggwhite cervical mucus since, oh, about November 15th. I think it's safe to say that my cyst is just a tad functional. Oh, and that the Lupron, of course, isn't doing its damn job.

I've got maybe 2 days left of Lupron. I was supposed to stay on it until I got my period (at my current dose of 20IUs), but I really don't want to shell out another $131.70 for yet another vial of that evil substance. So, pretty sure I won't. I put a call into the nurses (they love me, yes indeedy) saying, and I paraphrase, "so if I stop shooting this fucking substance into my gut, nothing bad will happen, right? See you in January."

I don't understand why they haven't returned my call.

Infertile People in Real Life

(For the record, I'm getting sick of referring to people by initials, so I'll start giving the important ones nicknames. My husband, who is not named Jim, from here on out is JimDear, like in Lady and the Tramp. Not just because I'm hoping for a puppy for Christmas, since there's no baby, but because I think I'd make a damn fine Darling.)

I keep stumbling across statistics suggesting that 10-15% of couples are infertile. (I assume they're not counting homosexual couples in those figures, by the way.) If that's true, I kind of have to wonder, where the fuck are they?? If our numbers are so mighty, why on earth is "Do you have children?" an acceptable ice-breaker? I understand that infertility is a private topic--I've personally only told about 50 people, and JimDear has probably told about zero. But still, really? Maybe those stats count those who are "a little bit infertile"? Or are there really this many women walking around feeling the way I do?

I'm trying to think of all the infertile people I might know in real life. Here's a list:
(1) My grandmother. Of course, now that she's 82, that's kind of a given. But, after 7 children and 3 miscarriages, she had to have a hysterectomy. She wanted more children, and was unable to have them. So I guess she kind of counts, although I have a hard time working up sympathy for her when my mother (2nd oldest) did most of the child rearing in that family. My grandmother was a big old Mormon though, so the more kids she had, the closer to heaven she got. (This is not actual doctrine, just perceived. Nonetheless, having children is considered a woman's "divine nature". I am not, alas, divine.)

(2) My first cousin once removed. She is my grandmother's sister's oldest daughter, my mother's cousin, my "aunt" for shorthand. She has the same first name as my grandmother, by the way, so no way is that name going anywhere near a daughter of mine. Unlike my grandmother, she is/was a kickass mom. She too had an emergency hysterectomy, after the birth of her 4th. She would have liked more kids. I do feel bad for her, but she's a wonderful mom, aunt, and grandmother.

(3) A coworker/friend of mine. She's only "borderline", but might be what they're talking about when they say 15%. Of course, she might have actual problems, but with her husband being deployed left and right, it's hard to say for sure. They've been trying for a year now, and when he comes back in a few months, they'll seek help. She is my favorite person to talk to about infertility. Even though we're at different places in our journey, she totally gets why I wanted to quit my job when my boss joked about me "needing to call in sick in the mornings anytime now, right?"

(4) This one breaks my heart. A high school friend of my doctor-sister. I don't know her well, and my sister and she have more or less fallen out of touch. But it was my sister's 10-year high school reunion shortly around the time I found out we'd have to do IVF, and so I identified overly much with her story. This woman has miscarried something like 8 times. She's adopted 3 children, and keeps trying and miscarrying. My sister doesn't know all the details (and really wanted to ask her, but felt like the setting was inappropriate), but my god, I feel for her. I have never had a pregnancy to lose, but I can't help but imagine that it is...oh, about 1,000xs worse than getting another negative. But then again, if she's now a mom three times over, surely it can't hit her like that, right? Surely a mom can't afford to spend about 3 days huddled sobbing in the bathroom per month? When I think about her situation, my heart just breaks and I'm not jealous at all, even though she has children. I haven't even seen her in 10-11 years, so I just keeping seeing her as she was: a superskinny carefree, somewhat awkward teenager. To think of her grief is unbearable. I sometimes think about reaching out to her, but I don't know what I would say. "Hi, my sister told me about your recurrent pregnancy loss. I'm infertile. Have you ever tried IVF with PGD? What made you adopt? Do you cry all the time? I'm glad I'm not you but you're probably glad you're not me too, since you do, after all, have kids. Are you still Mormon or would you like to do coffee sometime?" I think it's probably better that I don't.

(5) and this one. Listen, I do believe in the sisterhood of infertility, but not if I have to be sisters with this one. She is a horrible person, through and through. Thank god she lives in another state now. People on message boards often say they wouldn't wish infertility on their worst enemy. I suppose I wouldn't either, but...I have a hard time imagining this woman in my situation. I don't want to go into all of the horrible things she did (and tried to do) to me and JimDear before we moved and cut her out of our lives as best we could. But around the time she was being all evil, she was undergoing IUIs. I still hear about her through the grapevine, because her husband is friends with friends of friends of my husband. They've tried at least 3 IUIs and are doing their 4th IVF right now, or around now, before Christmas they should know. JimDear and I hadn't even started trying when we last spoke, and I haven't, and will not, made any attempts to reach out to them, to commiserate (or try to hit them up for leftover drugs), to say "you are not alone". I don't think infertility makes you a better person, and I do hope she's changed, but...yeah. I feel guilty for not feeling at all bad about her situation. I think she'd make a terrible mother and her marriage is (and always has been, though it's lasted about 5 years now, I guess) extremely unstable. But life is never fair, not even for the evil people.

(6) My mother-in-law. She has Turners. She knew she'd never have biological children, and my father-in-law must have known too. They adopted 2 children. My husband has asked that we not share our own struggles with them, because he feels like his mom would interpret our attempts at IVF as a rejection of adoption. I can respect that. Our situations are so different that I don't know how much we would have in common to discuss anyway. She always knew, the technology we're using wasn't even around then, etc. They live in a different state, so it's not hard to keep this from them. But still, it makes me somewhat sad that we do.

But that's really it. I only know 6 couples who have dealt with infertility over the course of their lives. Surely I know more...right? But where and who are they? It's possible one of my aunts, who is childfree, might be infertile. She has never once said anything, and she's rather eccentric and raises showdogs, but she's married and has been since I was very young. I don't know that she and her husband wanted children, but I don't know that they did not. (He has 2 children from a previous marriage.) But those are seriously all the people I can think of, and I know way more than 100 people, so there must be others. It's possible that some of my married-with-children friends used ART. After all, that's not something many people put on Facebook. But...I don't know. And when I have a list of 6 people, 3 of whom are now post-menopausal (well, I don't know if Turners women do menopause, but whatever), and one of whom I hate, and one of whom I don't actually know...it's not hard to see why I feel so alone, 10-15% be damned.

Thank god for the internet.