Stop me if you heard this one....

It is a story about a 41 year old woman who has been trying to get pregnant for almost 4 years. She has had two surgeries, dozens of tests and blood work, 3 IUIs, 4 IVF cycles resulting in 2 pregnancies with heartbeats and one chemical pregnancy, all without the success of bringing home an actual child. Then after lots of soul searching and financial planning, decides that she is ready to move on to DE, following an FET. She is waiting for her period to start so she can start BCP and begin the process of FET. She goes on vacation, her period should be starting the day she leaves, although it never comes. She spends the next 8 days on vacation obsessing every time she goes to the bathroom...where the hell is AF? When she gets home from vacation she takes a pregnancy test...positive. Has a beta drawn the next day: 10,300. Has an ultrasound the day after that: baby measuring right on target with an adequate heartbeat. Twelve days later (7w4d) has another ultrasound that is spot on perfect with a great heartbeat.

Yes, I have become an anecdote. Now, let me clarify that we did not "relax" or "just forget about it for awhile". We did OPKs during that cycle and had very timed se.x. It was still stressful, the big difference is that I had no hope that it would work - why would I? I spent the first few days of vacation taking all sorts of cold and flu medication and stuff to help me sleep.

I am freaking out. Part of me wants to just be thrilled, but the infertile part of me is waiting for the other shoe to drop.

Better

Thank you, thank you, thank you. You all give me strength!!

The D&C went pretty well...as well as a D&C can get I suppose. One of my friends just started working in same day surgery, so she was the nurse that took care of me (she is also an infertile with beautiful twin girls via IVF). It was such a relief not to have to put on a brave face or tell my story. There were only two glitches today. One was when I was in the waiting room before the D&C and a woman parked her double stroller with her two kids under the age of 2 right in front of me....I promptly told C I needed to move and we went to the opposite side of the waiting room. And the second was the nurse anesthetist arguing with me on whether or not I really had aspiration pneumonia from an exploratory lap back in 2007. He was challenging me saying things like "well how do you know for sure that it was aspiration pneumonia?" Well, idiot, it is because that is what the doctor told me it was...I'm sorry that I didn't bring the medical records from that particular surgery to prove it to you. Then he says "well it sounds like the doctor was grasping at straws for a reason for the pneumonia". My DH, my rock, speaks up and says "you know what, my wife is having an emotionally difficult procedure this morning, could you please be sensitive?" What a guy!

I feel pretty run down, but physically mostly okay. I'm planning on taking an ambien tonight as I slept most of today and don't want to be up all night. As long as I continue to feel alright, I'll probably be using some of my time off from work to visit my parents on Cape Cod...as well as drink a fair amount of wine.

Good night all!

Out of limbo and into a new kind of hell

Today's ultrasound was traumatic. The news was as bad as we thought it might be...no heartbeat. But unfortunately that wasn't the worst of it. Let's just say that I will be communicating my experience with someone of authority.

I was crying..bawling actually, after the news of no heartbeat, ultrasound wand still in place. The RE was patting my leg, and saying over and over "I'm so sorry". Being sensitive to how I was dealing with the news and yet still being in stirups with a wand up my chickie, the RE asked the tech if she was finished with the imaging.

She says "just a couple more measurements".

I'm not sure what kind of measurements the tech needed that the RE couldn't have cared less about but, apparently she wanted to be very thorough about these apparently unnecessary images of my ovaries. The more she probed, the more I cried. And then I panicked, I felt violated, yet I wanted to be the good patient for "just a couple of more measurements". I finally wrapped my brain around the idea that I was going to have to be the one to stop this, but how? I was afraid that if it went on for another moment I was going to quite literally freak out. I was finally able form the words "I just can't"...and the torture came to an end.

I'm surprised that my RE let it go on as long as it did, but she told me afterward that she was getting ready to put and end to it right as I spoke up. I have no doubt that the tech will be spoken to...at least I hope so.

All of that said, I am relieved that there is a definitive answer in today's ultrasound. I'm having a D&C early tomorrow morning. I'll be taking some time off from work. As the nurse practitioner said today...this whole process has drained my cup and I need to take time for myself so I can fill it back up again.

5 to 10%...

.....that's what the chances are that this pregnancy is viable. Thursday's ultrasound was dismal. Both the ultrasound tech and the RE welcomed me with hugs and smiles...yay! Then dildo cam went to work. I saw a sac and it appeared to be empty. "F**k." I said quietly and C reached for my hand (yes he did go with me). Apparently the RE's face was an open book, although I was too busy staring at the screen directly in front of me mounted to the wall. C was watching the RE and he told me later that her face clearly showed that she was not happy with what she was seeing. Then the craziest thing happened. I hear "there's the heartbeat". WTF? Sure enough there is an embryo (measuring at least a week behind) with a heartbeat of 100bpm. What is the cutoff for a heart rate at this age you ask? The answer is 100 bpm. They took a few more measurements and then we met the RE in the conference room across the hall.

I must say that I have the most compassionate RE EVER. I was slumped over the table with my head in my hands when she walked in. She walked over to me, gave me a kiss on the forehead and wrapped both arms around me while I cried into her lab jacket. We sat and talked for almost 30 minutes about what this could mean, the likelihood that this pregnancy will end, possible blood testing for next time around, and of course what to do about my antidepressant. Coming off the Paxil abruptly was necessary due to the risk of heart defects, but the "discontinuation syndrome" has sucked eggs. I am dizzy, nauseous, profoundly irritable, and having some GI issues that I won't go into now. She gave me a note to be out of work for 1-2 weeks...I think based primarily on where I work. The thought of going to work the next day and dealing with babies and pregnant women made me feel ill. The RE reiterated her feeling that this failure is nothing more that old eggs. I left the office after several more hugs and encouraging words.

Anyway, I digress. My next ultrasound is on Wednesday. I have a feeling that will be the nail in the coffin so to speak. There are other possibilities, it could have been a late implanter and is just behind. C is holding out hope that things will be okay. I can't say that I feel the same way. I know I shouldn't be thinking about next cycle yet, besides not knowing what is going to happen with this one, I'm in no state of mind to be thinking about the possibility of another cycle.

Never in a million years did I think I would be here. Pregnant 3 times from 4 IVFs and still no baby....and no diagnosis other than my age. I remember starting this blog and thinking there is no way that I will still be doing this in a year (that was over 2 years ago). I also remember being so gitty from our 1st positive beta and thinking "how lucky am I that it worked on the first try!" I looked on the "Veterans Only" page of IVF Connections today and thought "this is the message board for me". No more Pollyanna optimism of an initial beta, or even a good first ultrasound...no those rose colored glasses have been ripped off.

In the meantime, every moment with my daughter I want to hug her so tightly. I want to bring back the memories of kicks in utero, breastfeeding, and baby belly laughs. I know that I am so lucky to have had these in the first place, and I'm also so stupid to have not cherished those memories ENOUGH, as I never occurred to me that I would not have another child.

Am I wrong?

Yesterday was Z's birthday. She was a bit confused as we had a birthday party for her over the weekend. When she woke up I said "Guess what? Today is your birthday!" Z says "How old am I?" Me: "5". Z: "Still?" I guess five years old is quite boring and and 3 days of it was all she could stand. The original plans for the actual birthday included a family (including grandparents, aunt and niece) trip to the circus. Somewhere along the road it ended up being just me and Z. Apparently the rest of the family was just as bored with Z turning 5 (again) as she was. Silly me didn't reserve the tickets and it was sold out, so we didn't end up going anyway. There was a small "celebration" last night with a few more presents and a (that's right "a" as in a singular) cupcake. I was a little irritated with the way the whole day was turning out. Now here is the kicker. Toward the end of the "celebration" DH says to me "So are you expecting me to go with you to the ultrasound tomorrow?"


WHAT?

Here is what is going through my head: You mean the appointment that I talked to about, not only when I made it, but confirmed it earlier today? You mean the ultrasound that I have such anxiety about that I swore I was having a miscarriage the other morning? You mean the ultrasound where I might find out that there is no heartbeat and that this pregnancy is over and I will be such a mess that I will not be able to drive myself home because I will be such a puddle of mush?

What I said: Of course I do.

He said something else, but my head was spinning so that I didn't quite catch it. All I could manage to say was "You really don't want to have this conversation with me right now" After all we still had family over.

Later, I tried so hard to control my anger and yet express my feelings about what he had said and how it affected me. In return for my efforts to spare his feelings I received a blank stare and a timid "I'm sorry". He then left to go downstairs, I went to bed. No kiss goodnight.

Did I mention that I had to come off my antidepressant cold turkey and on top of dealing with the anxiety of waiting between ultrasounds, I am now going through withdrawal? What fun!

Ultrasound is today at 2:45. I'm almost tempted to go by myself......

Mixed emotions

Following the ultrasound I should have been thrilled. I should have run right home and posted my news. What did I do instead? I cried for about 15 minutes, then slept for the hour ride home. The scenario reminds me of a conversation I had with a fellow nurse. We had taken care of a woman who, following over a decade of infertility, finally gave birth to beautiful twin girls. The new mother was obsessed with every little twinge during her recovery (she had had a c-section), and did not seem to be fawning over the girls "enough" in my friend's opinion. I told her that after dealing with infertility for SO long, she was probably still waiting for the other shoe to drop. That with us IFers, there never seems to be a finish line, that there is always another hurtle to jump. Even in good news, there is a shadow of "what if?"



Anyway, so here's the scoop. Ultrasound was fine. There was a nice round gestational sac, a yolk sac, and a flicker of a heartbeat that they just couldn't quite capture yet. They saw everything that they were hoping to see...but it didn't seem like it was enough. I was greedy and wanted a strong, unquestionable heartbeat. I have relived the details of what was said and how, trying to ascertain whether the RE and the nurse (and the us tech) were really thrilled...as they flat out said they were, or if they are just trying to keep me in a positive state of mind until the next scan. They gave us a picture of our little nugget. They have never done that before, I've always gone into my own online medical record and downloaded it myself. So both DH and I are saying "this must be good, if they gave us the picture". So next scan is this Thursday at 7w2d. I was going to put it off a few days so that there would be more to see, but this is the only time that works.



In the meantime, I'm desperately trying to keep myself busy. We finally had two days of beautiful weather. (It has been lousy with rain and thunderstorms for WEEKS up here in the northeast). The sun came out for my daughter's 5th birthday party this weekend. It was an awesome party, just the right mix of some family and some friends...not too many of each. I dove head first into making my daughter's cake. A relatively new "hobby" that is usually fun and challenging and occasionally stressful.




It seems crazy to me that I feel like a Debbie Downer...and things are looking good! I have nothing but good news, but I remind myself that I have been here before and it all went to shit. I'm hoping that if we can get past eight weeks, I will loosen up a bit and actually say the words "I'm PG" (see...can't even write it).

Thanks to all who have continued to comment...although I have been such a bad blogger and commenter! Betas have been going well. Not doubling always, but certainly making the appropriate 66% jump in 48 hours. Here are the betas to date:

12dpo 18
14dpo 36
16dpo 87
20dpo 277
22dpo 511
24dpo 1437

It is hard not to compare previous cycles, which had higher numbers...but ultimately unsuccessful. I am now in a holding pattern until my ultrasound on Thursday. In the past they did a 5w6d us, this time it will be 6w2d. They are hoping to see a heartbeat at that time...and needless to say I do too. In the meantime, I'm very cautiously optimistic. It is difficult to enjoy any of the success so far, when I have come this far and been devastated. I have not proclaimed I'm pregnant...I usually say something like "well, there's something in there, I just don't know what yet". Don't get me wrong, I'm so thankful to have even gotten this point, especially since I thought this whole cycle was going to be a bust.

2nd beta

Beta #2 was 36. Still low for my taste, but it did double. Next one is tomorrow. Not much time to post now, had a quick get away for 24 hours, which was awesome for keeping my brain out of beta worry mode.

12dpo

I had my first beta today ....18. Not sure what to think of it as it is pretty low. My other two betas (which of course ended unsuccessfully, so I'm not sure it is worth comparing) were 27 and 29. I did tell a few people that knew I was having my blood work done today that I am not NOT pregnant. There is a very small piece of me that wants to be excited, but mostly I am emotionless about it. Next beta will be on Tuesday so that should give me some direction. Of course I am pleased that I get to continue to ride this roller coaster, it's just that I've had two miserable outcomes with higher initial betas. I suppose I this emotionless state is a way to insulate my heart...even if it only works temporarily.

(So, have I been enough of a Debbie Downer with this post?...after all it IS good news. Note to self: be Zen and remember that I am PUPO).

Any success stories with low initial betas would be welcomed!!!!

2dp3dt

I'm a bad infertile. After reading some other blogs, I can't believe that I was complaining about my number of eggs and fertilization rate. There are so many out there that have their cycles cancelled at the last minute, or never make it retrieval, I should be appreciative of what I have had to work with over the last year.

I am now 2dp3dt. I called out from work today as I have been having some moderate cramping with pretty much any activity. Yesterday if I walked up the stairs, I would almost immediately start to cramp. I called the IF nurse on call and she said that even though the clinic does not officially have a bed rest policy following transfer, the cramping could be a sign that I am overdoing it and I need to take it easy. She also said that I shouldn't do anything that, if the cycle did not go well, I would regret doing. After talking with some co-workers today, they encouraged me to call out for tomorrow as well. I don't know why it is such a difficult decision for me....work can be physically grueling. Some days lunch consists of shoveling a sandwich down my gullet while standing next to the nurses' station, often times I don't have time to stay hydrated...let alone go to the bathroom. Then there are other days that requires busy work in the morning, then the afternoon is filled with chatting with co-workers. The problem is I never know how busy it will be (can't really predict when laboring women will be coming in). So my dilemma is that I feel pretty good, as long as I don't do anything...and when I don't do anything, I feel guilty. Anyone want to weigh in on whether or not I should call out for tomorrow? I've heard mixed opinions about bed rest and being inert...any insight would be appreciated.

Transfer

Just a quick note to update. We transferred 3 today. An 8 cell A-, a 7 cell A- and a 2 cell C. It was kind of a Hail Mary, looking back I'm not sure why we threw the 2 cell one in there, but I figured "what the hell".

I've watched way too much TV, and even asked the cat if she thought this would take -so I believe I've hit a new low. Beta will be on the 14th, until then I will try my best to live in the moment and not analyze every little twinge.

3

Yep, just three fertilized. I'm terrified that by Friday there will be none....barely got off the couch today. Hard to believe I was the beacon of hope and "relaxation" just a week ago.

ER

Just a quick note before I am off to bed. They retrieved 8 eggs today, quite a pleasant surprise as we were expecting 5 at the most. I'll have the fert report tomorrow, then a 3dt on Friday. Until then I plan on enjoying some rest and pain medication.

Shadows

Do I dare creep out of the shadows? I needed a break from the blogging and this morning a switch went on and apparently I am ready to put myself out there again. So here's the update from the ectopic saga....it was NOT ectopic. My beta went up after the methotrexate. My doctor wanted to see me"urgently" when the rising beta results came back, I totally panicked. The nurse asked if there was someone that could take me home after our meeting. My head was spinning and I thought that I was headed for emergency surgery. It turns out that my RE did not believe it was ectopic...she was out of town when all the hubbub happened the week before. She has a double specialty in RE and radiology so I really trust her interpretation of the ultrasound pictures. She recommended that I do a D&C, sent the tissue to pathology and if there was positive for chorionic villi, then it was a uterine pregnancy, then continue to check my beta just to make sure there was not a second one in the tube. Indeed the tissue was positive for chorionic villi, and my beta dropped to 1 within about a week and a half. I said that I would NEVER do another D&C in the office, but I wanted all of this to be over and again scheduling was an issue, so it was an office D&C....all alone as my husband could not get there in time. But it wasn't too bad, didn't hurt nearly as bad as the first time.

So then it was the decision of what to do next? Do I take a couple of months off? I feel like I am so pressed for time 41 is looming around the corner for me. We decided to soldier on. The antidepressant has been a small miracle. I feel like the person I was 5 years ago, and it is such a relief to be in a place that I can truly laugh, relax (yikes!) and most importantly feel like I have the capacity to rationally cope with stress.

So we are doing another cycle. Actually I triggered last night, retrieval is at 8am on Tuesday. I had high hopes for this cycle because I am such a different place than I ever have been before. I am calm, "relaxed" (though I HATE to use that word), and dealing much better. However, I am not stimming as well as I have before. In previous cycles they have retrieved 14, 11 and 10 eggs all with great fertilization (11, 9, and 10). This cycle it looks like we may get 5 mature eggs. As I am writing this, I wonder if the poor stimming has anything to do with the methotrexate?! I've gotta write that down and ask the doc about that one. My nurse said it was just a down cycle, that I shouldn't expect to stim the same every time because each cycle can be so different. I did the same protocol as before: BCP, Lupron 20, 10 then 5u, Follistim 75 and 2 Menopur in the AM and Follistim 150 and 1 Menopur in the PM.

I've had a pretty rough weekend at work, yesterday I had a melt down - combination of stress of the day and hormones. Feeling better today, but quite mellow. I have no idea what to expect from tomorrow. My primary thought for today is to stay hydrated so the IV will go smoothly tomorrow. I have my favorite anesthesiologist lined up for my retrieval so I know I will be in good hands. Unfortunately my RE is away on vacation. I'm excusing her for this because it is her 20th wedding anniversary, and she told me that she would be thinking about me while she was having a fruity drink....and honestly I think she will make a point to send some good energy my way. The RE that will be doing both retrieval and transfer is very good, just not the warm and fuzzy type.

Once I'm up and about, I'll send out the retrieval report.

Ectopic

So ultrasound today was interesting. I now have a new diagnosis of ectopic pregnancy...which had been whispered about early on with the way my betas went, but I certainly never really took it seriously (silly me) because I only have one tube. Although they did not see a heartbeat, and therefore cannot say with 100% certainty that is an embryo in the tube...even I could see the gestational and yolk sac. I thought this appointment was going to be a quick ultrasound then a prescription for the miso, it turned out to be much more involved. I was there for a total of about 3 1/2 hours. I had to have labs drawn and processed before they would even mix up the methotrexate. My beta went up (WTF?) since the last draw. I am now out from work until at least Monday, no folic acid or alcohol for me, and I cannot travel very far away from the hospital "just in case". Oh, and I asked for an antidepressant today.....

Betas betas everywhere

I don't think I mentioned what my beta was after my ultrasound. It was 1415 and that was pretty much the nail in the coffin...so to speak. I went out of town this weekend, mostly just to get my mind off of all the usual. We spent it with family, and although we did not talk directly about what was going on, it was very healing. Both my parents wrapped me up in a huge hug and simply said "we love you so much" and that was enough to lift up my soul. The only thing that was hard was that there was some chit chat about two of my cousins who have had twins via IVF in the last year and of course there was baby talk about them.

Unfortunately nothing has happened on the miscarriage front. I am at the point where I have mended (at least somewhat) on the emotional front and I just want to move on. My manager called this morning (not the same person that sent me the amazing email) and asked when I was coming back. Apparently there was a little miscommunication about my time off and they were expecting me there today. I was really hoping to go back by Thursday, but that doesn't look like that will happen. Since I have had no bleeding (only some very light and very small amount of spotting) they wanted me to repeat my beta today (it was 685) and follow up with an ultrasound tomorrow. Because of the slow rise of my betas they are concerned about a tubal pregnancy...what are the odds of the that, considering I only have one tube. Anyway, if they can rule out a tubal, and I still have not had a flow, then it looks like misoprostol for me.

I just want this chapter to be over. I have already started to calculate when I would likely cycle again...maybe fourth time will be a charm for me. Maybe we will switch things up a bit and do a 3dt. I'm sure they will also want to check an FSH with my next AF. In the meantime, I've got to get back on the exercise band wagon and focus on my diet...I have been doing nothing but emotional eating for the last few weeks...and it is starting to show.

The Silver Lining

The silver lining is that I have truly discovered that I have the most wonderful and compassionate boss EVER. I emailed her last night to give her the heads up on what was going on and that I would need some time off. I had planned on going into work today (I have burned up all of my earned time as of late, so any time I take off would be without pay) but taking the bulk of time off next week. This is her response to my email:

• I feel very sad for you. Your heart is breaking. Words won't comfort.
  I wish you could go to a place to be with women where they would surround you, and attend to you, and hold you, and let you be as raw as you need to be. We would do that here if we could, but we can't, or we can, but only intermittently, moments instead of hours. I fear the reality of what is going on in the external environment will crash into what is going on internally; physically, emotionally, and spiritually for you. I don't want where you are and what you are called to do to create more pain for you in this process. I think you should take care of yourself and think about being away from here now, not next week, but now. This may not be the best place for you to be, in fact, it may be harmful to your vulnerable heart. You are brave. You are strong, but perhaps not that strong. Who could be?
  I trust you to make the decisions that best serve you. I will honor whatever you decide is best and right for you. You are a wonderful nurse, and we appreciate your work here- but not if comes at too great a cost to you. If on the other hand, you will find solace in the rythym of the work, the never-ending cycle, the company of women engaged in carinig for women- then of course, you should come. Only you know.
  I am so very sorry. all my best to you. k

She ended up calling me later in the evening to "warn" me about a fellow co-worker who just announced her pregnancy and people have been talking about it. She didn't want me to walk in and be surprised by this news. In the end, I decided to take today off. I didn't sleep more than about 3 hours last night and yesterday I hurt my back and have not really been able to stand up straight. As it turns out I believe it was a good idea all around, shortly after I woke up I noticed the faintest of spotting, so I think that this pregnancy is declaring itself on its own. I took the progesterone last night, and originally had planned on taking it again today and repeat one more beta tomorrow, but now I truly feel like this is the end. I checked my work email this morning and this is another email from the clinical educator, not really a supervisor, but she has known pretty much every step of my journey.

• I'm so sorry for your loss. While I want to see you and hold you and cry with you, you can know my heart and thoughts are with you now and through the day. I'm glad you chose to stay home where you have more contol over your environment. Please let us know if we can do anything for you. Thank you for letting me journey with you.

I couldn't ask to have a more supportive work environment, I am blessed in that regard. So now I guess I just wait. We are planning on going out of town this weekend, it is my niece's birthday and we have been organizing this for quite some time. I'll call this the clinic this morning to see if there is any reason I shouldn't go. My family knows what is happening and they will all be supportive if I need time just to hang out in the corner. I'll have the next 3 days to myself and any longer than that and I may go batty.

Nothin' good

Today's ultrasound was dismal, although we are not totally out of the game...yet. Gestational sac was seen, but no yolk sac. The gestational sac was not "plump", so the RE said she was not optimistic about the outcome. Of course there is still that miserable thin shred of possibility that things could turn around next week, so for the moment we are hanging on. I got the oh too familiar "I'm so sorry" hugs on our way out of the ultrasound room. It appears that although this cycle is not officially over, hope is gone from a medical stand point. We head over to the conference room to have a little more in depth conversation with the RE now that I am clothed and without a probe up my chickie. She is on vacation next week so she will not be able to follow up personally with me and she wanted to go over some possible scenarios. She is amazing. First off she asked who I wanted to have the appointment with in her absence, which I thought was very sensitive. Then we got down to brass tacks. If this is indeed a nonviable pregnancy, then she doesn't feel like I need to have a D&C, especially given how small the gestational sac is, so the next step could possibly include misoprostol to induce miscarrying the "products of conception". Anyone have any experience they would like to share here? Is this painful? Is it awful? I'm anticipating needing to miss a day's work or so.

I guess I shouldn't get too far ahead of myself, but this is where I feel we are heading. I am also trying to wrap my head around doing another cycle. Because of my age I have always felt like I need to press full steam ahead...I'm not getting any younger after all. The RE did say that she would be ok with a 2 month break for me, but not 6. Maybe that would be just enough time to feel a little more normal, a little less hormonal and perhaps, dare I say it, a little more in shape.

In the mean time, another beta tomorrow. If has plateaued or dropped, then that indicates things are going south. If it continues to rise, then it could mean continued growth of placental tissue, but not embryonic...so that really doesn't mean anything.

I'm working really hard at trying to not feel anything. I don't want to give up totally, but I don't want to have false hope either. I wish I could just find a state of numbness and stay there for at least a week or so. Boy, do I want a drink!!

More Beta news

I'm not even sure where to start. Yesterday would have been my due date from IVF#1/miscarriage. I was sad, and funky, but was relieved to have some good news with my last beta and a smidgen of hope.

Today I was called in to work and I thought "well, this will be good, I will work today and all weekend and it will keep my mind off the impending ultrasound on Monday". I've been having some pregnancy symptoms and was expecting to have a nice jump today. The nurse on Wednesday said she was hoping the beta would be in the 1,000 range. Today's beta is...drum roll please.....874. Fuck! Now it has done it's 66% rise in 48, so officially things are still okay. But the nurse also said that for as far along as I am, 23dpo, she would expect the number to be higher. And then....I lost it. I went into 3 separate fits of uncontrollable crying while trying to hide myself away from my co-workers. I'm getting the double whammy of reliving the miscarriage as well as this freakin' back and forth with the betas. I am trying to hang on to the idea that 1/3 of women don't have a typical rises in their betas, and I now wonder what happens to the betas to those fertiles that don't have all of this lab work. I don't think I ever had a beta with Z.

Anyway, I was able to leave work...well I HAD to leave work, they really didn't have a choice. I would have been circulating and recovering a c-section which means I would have been one on one with this cute little fertile intact family. The idea of having to handle the baby was enough to send me into a small panic attack. So here I am at home, trying to find some sanity so that I can go back in to work tomorrow....and the next day, and not lose my ever lovin' mind.

Just a quick post...beta yesterday was 503, which more than doubled. Still extremely cautious, but feeling a little less insane. One more beta tomorrow, then ultrasound on Monday.

Thank you everyone for your encouraging words. I'm so behind on my commenting....part of my grand effort to keep myself out of the house and very busy so I don't have time to mope. I've also been on call for the last couple of weeks, which is good money, but lots of extra time at work. I'll catch up soon.

...and the roller coaster starts to climb.....

I called my IVF nurse on Saturday and talked with her a little more about my third beta. I didn't think that I could wait until Monday and asked if it was okay if I had it drawn on Sunday. She said "sure" and that she understood that the waiting can be torture. I was relieved that I would not have to wait....but then I started thinking.... I would be at work on Sunday and if it was bad, which is what I was expecting, then I don't think that emotionally I would have been able to stay at work. As it turns out, Sunday was a mad house, partly because a couple of nurses called out sick, so it would not have been good to risk it by having the beta and then be miserable at work, surrounded by babies. So I decided to do the beta on Monday. Right after I got the results of beta #3, I thought "I just can't do this again". In an effort to start formulating my next plan, I took a look at job postings in other departments and other hospitals. I also did some research on adoption (which was terribly depressing) and finally I started looking into a Master's in Nursing Informatics. Then I thought about when I would go out and get good and drunk and color my hair (my mousy brown and grey roots are tragic).

Yesterday, I met a friend of mine who has also had fertility issues and some pretty horrific pregnancy related losses. Anyway, she has been doing IUIs over the last few months and she had her last IUI 2 days after my retrieval. (Can you see where this is going?) Well she is pregnant and she had to have her second beta drawn on Monday as well. We decided to make a day of it to take our minds off waiting around for the phone call. We went to the hospital, then lunch, then shopping. On our way home the clinic called. My beta is 194. I was in shock...it is still not where they would like it to be (they wanted it around 216), but they are encouraged. In a daze I heard her saying things like "we are optimistic" "there is reason for concern" "we are just going with it" and my personal favorite: "one third of all betas don't have the rise they expect, and everything turns out fine". It was the most bizarre feeling to be sitting there, not happy, not sad, just surprised. I have learned to live my life in 48 to 72 hour increments...and I think that I am doing fairly well. I'm trying to keep myself real busy, lots of activities planned on my days off. My ultrasound is scheduled for next Monday and the nurse said to keep the appointment...at least for now. My next beta is tomorrow morning...stay tuned.

Incidentally, my friend's beta was over 700.

the pain of waiting *update*

Trying my damnedest to live one day at a time. Last beta (on Wed) was 62. Of course I looked this up myself, so I didn't have he benefit of the IVF nurse to ask questions right away. During my last positive cycle my second beta was 97...so I panicked. After fretting about it for awhile, I decided to call the nurse. She was pleased with the number. She said they were looking for it to go up by 66% and since mine more than doubled, it was up by over 100%. I've had some pretty intense cramping the last couple of days which is freaking me out. I've been obsessed with my b.oobs, I can't tell if I am getting used to them or if they have deflated. It is an effort not to feel myself up at work to check 'em out.

I'm about to leave the house for beta #3. Unfortunately I have to have this lab work done at the local hospital, so I won't be able to look up my results...I'll have to do this the old fashioned way and wait for the nurse to call me! I'll post an update when I have it.

*update*
Isn't it amazing how one little phone call can send you into a tailspin? Beta #3 was 80...not good. They wanted it to be over 102. The nurse said "don't lose all hope"...I'm not sure that is possible. She said she has seen all sorts of different things happen with the numbers, but I am not optimistic. I am to continue with my progesterone and next beta will be on Monday. I'm devastated....can't stop crying. I just don't know if I can do this all over again.

Did you miss me?

Did you know I was gone? In a grand effort to force the time between transfer and beta to go much much faster, I have stayed away from blogs. I went to my brother's for a short visit, cleaned out the closets in my house...you know just stuff to keep my mind from racing.

So here is a recap: We did a 5dt of 2 blasts. Everyone said it was a great report. After 10 out of 10 eggs fertilized, one arrested and one fragmented. So going into the the transfer there were 6 still growing for potential freeze. 2 actually made it freeze. So overall I feel like this was a good "batch". After looking up the grade of blasts that they transferred (one was a 4BB and the other was a 1BB), I decided that they are just middle of the road quality blasts. Wish there was an "A" in there somewhere, but I am 40 after all. We now have 4 total in the freezer. Although according to the nurse practitioner, we should do as many fresh cycles while I'm on the younger side vs an FET...but lets jump off that bridge when we get there.

My beta was yesterday. I had a good idea of what the result was going to be before I did the test. I've had some heartburn, my boobs are huge and sore......my beta was 29! My clinic does a very early beta at 7dp5dt so the number doesn't sound great compared to the initial betas I see on other blogs, but it is a BFP and I'll take it!! They are supposed to freeze this 1st specimen and not run it until the second one is drawn 2 days later so they can evaluate doubling time...but this lab always runs it the same day. Because my beta is so early, I don't usually have to fight the urge to POAS, but I do cheat a little and look up my results in the computer before my clinic calls. By the time the IVF nurse calls to congratulate me, I've already called C and told him the news. Last night I did contemplate POAS, just so I could see the lines...how crazy is that?

I am taking this one step at a time. I am happy, but not ecstatic. I am hopeful, but realistic. I am trying desperately not to look too far ahead, but yesterday I had a little daydream about my daughter (who will be 5 this summer) rubbing my belly and feeling the baby move.

My next challenge is to stay in the moment, and only look as far ahead as the next test. Fortunately at this stage of the game, the next step is usually only at the most a week away. My next beta is tomorrow.

10/10

So maybe they are a perfect 10....ALL ten fertilized. I'm amazed! If all stays on track we will be doing a 5dt on Monday. Keeping everything I've got crossed!

A perfect 10

Well.....at least I'm hoping so. Honestly it doesn't feel so perfect. 10 eggs retrieved today. I thought it would be more. I felt more bloated during this cycle than previous, I had more antral follicles than before....but I only need one right? I shouldn't complain, I know there are so many out there with cancelled cycles due to poor response...it just isn't what I was preparing myself for. I'm starting to mentally prepare for a 3dt. I guess we'll know tomorrow after the fert report.

In most excellent news, I had my A team there with me this morning. Dr. J, my kind and sweet anesthesiologist was there and gave me some really good stuff. IV was established on the first attempt, no problem with specimen collection from C, and I didn't bleed internally...all in all it was a good day. I was only a little woozy when I initially got up to go, and decided to not rush things and have some crackers and a nap before I left. We were home by about noon and I slept most of the day. So now I am wide awake....yet tired. My bed is calling me so this will be pretty short.

I got thinking about the "meant to be comment" by my co-worker. First off, I do believe that things work out the way they need to. Ultimately things are not in our hands, although I also believe that our destiny is dependent on our actions....a pretty paradoxical thought. I don't think that I can get pregnant without a lot of help, so to say "it wasn't meant to be" doesn't mean that I can't do something about it. If this does not work for me, and as we are now 1/2 way through what our insurance will pay for, I have to start accepting that that could very well be my reality...anyway if it does not work, I am confident that years from now I will look back and feel that there is some good that has come from it. At this point and time I cannot fathom what that good might be. Now, that said, hearing someone who has ABSOLUTELY ZERO understanding of what IVF treatment entails, and I don't think that it is possible to have that understanding until you have lived it....doesn't count if you have a friend, sister, cousin or co-worker going through it...then saying something like "it wasn't meant to be" is down right hurtful. It is easy for that person to say it, because it doesn't apply to them. "It wasn't meant to be" is not comforting for a moment because it opens up the whole new can of worms "why not?" Is it because of the street drugs I experimented with in college? Is it because I had an elective termination at 20 because I was date raped? And if not those things.....then WHY?!!! I think there should be a ban on "it wasn't meant to be", it just plain doesn't work for anyone who is grieving. I know I'm not saying anything new....but I was finally able to put a finger on why that phrase irritates me so much.

So, I'm mustering up some good thoughts for those little embies that are dividing away, all the way in another state no less. I'm starting to feel more hopeful and less desperate (although I know this post probably doesn't sound like it). I think part of it is getting off those freakin' stims....next up twice daily proges.terone suppositories!!! I treat my rectum to one every once and a while, so it doesn't get jealous of my va-gagay.

Praying for incident free retrieval

Let's see if I can sum up my life in about 10 minutes...'cuz I gotta get to bed. I've just take some a.tivan...so who knows how this will all turn out.

Retrieval is tomorrow AM. We will leave the house at 6:30, hopefully be in the waiting room at 8:00, assist C with specimen production (see "the incident"), procedure at 9:00, home hopefully before dinner time (see the second "incident").

I'm incredibly anxious (note the earlier mention to a.tivan). I have been a raving BEOTCH for the last couple of days. Yesterday it came to a head and I was ready to rip the head off anyone who dared say the wrong thing to me....although who knows what that wrong thing could be....it could've been "hello, you look nice today". All of this was precipitated by my ride home with my co-worker who started off telling me about her SIL who is 31 weeks pg with twins via IVF. She started saying things like "I think IVF is such a miracle, and it's amazing what women will do to have a baby, I admire them...blah, blah, blah" Right as I was about to open my mouth and spill my beans, she keeps going on to say "But then I think maybe these women were just not mean to have kids". At this point I have closed my gaping mouth and tried to figure out a cool way to change the subject. Maybe driving us off the road will be subtle enough. I've read so many blogs that blame l.upron for wicked moods....but it is the tail end of my stims that make me insane. I was essentially on the same protocol as the last 2 cycles, but the last couple of days I've taken both AM and PM meds, usually it is only one or the other. My therapist that I saw today said that she would rather deal with clients that are on heroine or cocaine versus us juiced up on hormones. Physically I feel terrible, I'm so bloated. I've gained 5 pounds this week and I swear I can feel every ounce with each step. I almost called out sick yesterday, but thought "I'll be fine as long as I don't have to break out into a run". Well....guess what happened....we had 2 STAT c-sections going on at the same time and I had to run all over the unit.

I'm not going to turn this purely into a bitch session....mostly because I feel like I wouldn't know when to stop. The good news is that the a.tivan seems to be kicking in. I've had several conversations and emails with my anesthesiologist friend who will definitely be there tomorrow. He has been so attentive and is determined to make my sedation top notch. It's funny because he is not so much a friend as a very friendly colleague...but in his last email he signed it "Sweet dreams and happy thoughts"....less collegial, more friendly....and incredibly sweet. I feel like I am in good hands tomorrow. My favorite nurse should be there, they all know that either the IV team or anesthesia will be starting my IV, my favorite RE is doing the harvest and of course my anesthesia buddy (and his supervisor....a BIG head honcho in the department). I don't know that I am feeling that nice little hopeful feeling, but rather desperate. I find myself thinking "this HAS to work". Last night, amidst the sobs I thought "I don't have the strength to do this again". Will revisit that when I am a safe distance away from the hormones.

Wednesday

I'm a go for Wednesday! 9:00 am. I was hoping for ER on either Monday or Tuesday....but so far this cycle is following exactly like the two previous. I have one lead follicle at 19mm that they are going to let go by so the more plentiful smaller ones will come forward. They measured 16 follicles today....which I believe is more than prior cycles. I'm feeling every bit of them, last night C gave me a big hug and I had to tell him to back off a little. I'm NOT looking forward to working 2 more 12 hour shifts. It has been very busy on our unit lately and there is not any signs of stopping. So not only will it be long days, but they will be very hectic as well.

I've been pretty crabby these last couple of days and today is no exception. I've worked the last two days, I have today off - but had to make the 2 1/2 hour round trip to the clinic for b/w and u/s and C has invited my in-laws down for dinner tonight and the house is a disaster and I have to do major laundry in order to have scrubs to wear to work. I have to go to bed early tonight because we are getting more snow tonight and I might have to get up as early as 4:00am tomorrow to go to work. I'm feeling a little overwhelmed with all that has to get done. I'm trying to let it go and just chillax, but I'm the type that can't kick back until the house shows some resemblance of order...oh did I mention that C went off to work and is not sure when he is coming home....possibly just in time for the dinner that I am apparently making for his parents. Yep, that pretty much sums it all up....cue the video:

Okay, I'm done griping....guess I better get crackin'!!

Yesterday I enlisted a fellow nurse to do my AM shot. I've tried to give myself my own IM injection during my first cycle, but it just felt so wrong holding that 22 gauge 1 1/2 inch needle above my thigh. I applaud all of you out there that can do their own IM injections!! Maybe it is an occupational hazard. Whenever I am starting an IV or giving an injection and my patient says "I hate needles". I usually respond "I don't mind them as long as I am on this end of the syringe." I've talked about how much I don't like being on the receiving end of needle for so long, even if I was joking, I think I have said it too much that it is now true. Anyway, I would have thought that the injection my co-worker would be doing would be less painul than my amateur husband...not so much. Maybe it was because it took 10 minutes for us find an inconspicuous room that was far away from the nurses' station (so it didn't look suspicious that we were walking into an empty room then shutting the door), or maybe it was because I was standing rather than laying down....and a little tense that someone would walk in. Whatever the reason, kudos to C for doing such a wonderful job.

I also talked to my favorite anesthesia resident yesterday. They rotate services every 4 weeks, and he is back on the OB rotation, which means he also does ERs. He was so awesome and attentive about what my needs would be. I told him about my IV nightmares, and he seemed open to giving me something for anxiety before the whole process...yeah. Unfortunately, I got an email from him this morning saying that there are 4 days this month when he will be on the cardiac unit....and the day that I am anticipating my ER to be, is one of those days. My second option in anesthesia docs is a good fall back, I was just hoping to be able to hand pick who would be in on my case.

I've gained 3 pounds. Not sure if it is stims, or all the CRAP I've been eating!! I had absolutely no control over my eating over the holidays and did zero exercise....I feel like a blob. I am such an emotional eater, and it wasn't until our company left that I realized that I was still shoveling food in my mouth. Yesterday I finally had the epiphany that it was because I'm stressed.

Z has been on another baby kick. Every couple of months she will start asking all sorts of baby questions. She will tell me how much she wants a sister, asks how do babies come out of mommies tummy (incidentally she decided that they come out of your mouth, and was then asking me to open my mouth as wide as I could. Z's BFF asked her mom the same question recently. She opted to be anatomically correct....this resulted in her daughter wanting to make a snow-woman complete with b.reasts and a va.gina. I think I will go with the mouth theory for the time being). She has also if she could name "the baby" Susannah. When I ask "What baby?" she says "the one in your tummy". *sigh*

I've decided that I'm going to start posting some more pictures...I love seeing pictures on other people's blog...so here it goes.

Annual Christmas or Thanksgiving Pre-hike photo of my family

(it was 12 degrees with the wind chill)

My latest obesession- cake decorating....

this was a cake for my brother's birthday (he's a hockey referee)

Hope

So I'm reading a lot of New Year's blogs...reflections of this last year and expectations/hopes for this one coming. For a brief moment I think "I should do that too". Except, I don't feel like looking back, and I'm afraid to look ahead. There are so many things that I am thankful for and C and I talk often about how lucky in life we are. But I don't want to look back at what I endured this last year. It is still too painful, and I'm fearful that if I take the time to reflect, I will get into a deep emotional rut.

As far as looking ahead, I'm trying so hard to muster up some hope...that four letter word in IF circles. It is the conundrum of not wanting to get my hopes up only to be shattered versus going through the process of an IVF cycle with no hope of it working. Neither option feels like the right one....so I sit in limbo. I am willing myself to have hope. Having a very busy holiday season has helped my mind stay in the present rather than running away with the "what ifs".

I started stims yesterday. Here is my protocol. 75 F.ollistim, 2 Me.nopur, 5u L.upron in the AM and 150 F.ollistim, 1 M.enopur in the PM until Wednesday then I switch to only PM meds. My baseline ultrasound showed a nice thin lining and 15 antral follicle count (which is more than I've had in the previous cycles). Next U/S and bloodwork are on Friday.

Congratulations to all those BFP out there....something is going around out there, I just hope I can catch it.