We Have A Protocol!

So, Its been a hot minute since my last post. And I've re-edited this to include a little bit more of the story.


My last post included information that we were about to go to our follow up apt with the RE (doctor). Knowing already that we have to wait until my thyroid levels out, I wasn't so sure that this appointment was going to be what I wanted it to be. Would the doctor strike my plan out until further notice? Would we have to wait even longer to start? And the results of everything, what would be our official "diagnosis"? Was it "me," was it "him?"


Feeling everything at once, I was more excited than anything. This doctor apt meant one step closer, even though we had to wait. It was 'movement' in our baby to be journey.


The results. Everything is just fine with the husband. So that meant it was "me." I mean, after close to 11 years of not,not trying I kind of already knew this. I'm the one with all the funky ailments. But to hear it officially, was hard for me. Yet at the same time (unlike the last diagnosis) we had a base line on where to go from here. Continuing down the list of results, my sugars are fine, everything is ok from the PCOS panel done. My ovarian reserve was a disappointing 2, when they like to see a 4 or better. This could mean that I might not have any good eggs left, or that the eggs I do produce are not good enough to sustain life. When I heard this, I knew exactly what the doctor was saying because I have done enough research to know what "ovarian reserve" meant. And I lost it. The tears just pored, I couldn't help it. Even now as I'm typing this I'm getting teary.
But with that said. Like every fingerprint, every ovary is different. This is just one number out of all the other factors that are involved in this awesome science experiment I call "getting pregnant." So, I push this information all the way back into my mind and decide to focus on the positive.
Then I get hit with the hemoglobin number. I am border line 5.7, when they want to see a 6 or below. So after the holidays, it was time to again-focus on me, myself and I and get my mind right and lose the weight. I have to admit, its been a struggle. More of a struggle than I thought I would be. I've done it before, so what's this issue? Well, as silly as it sounds I'm an emotional eater. And this is one heck of an emotional roller coaster. Hence, the struggle. I have to give credit to my dear husband. Being a man, he is kind of removed from emotions of what a women would be going through and has always brought be back to earth, or eased my pain, or just be there when I needed to vent.

But! I did get what I ultimately wanted. We have our protocol (game plan!!). I am getting my blood work done this week and then impatiently wait by the phone to hear from my endocrinologist "go!"  Once I get the go, its time to order all the meds and then we'll be starting our treatment plan apx Feb 20th. So long as my PCOS doesn't rear its ugly head, and its a normal cycle.

So here goes; I'll put it all in lamens terms:

Medications I'm currently on:
Metformin 2000 mg
Synthroid 88 mcg
Prenatals

Day 1 I call into the doctors to say Hey!
Day 3 will be blood work, and sonogram to check out everything. I'll get the results in the afternoon and given instructions regarding the Clomid, Gonadotropin and schedule monitoring appointments.
Day 3-7, Clomid 50mg 
Day 7 & 9, Injections. Fun. Gonadotropin (Bravelle 75iu) injection as instructed.
Day 10, ultrasound and bloodwork. Will be called in the afternoon with results. Possible 'trigger injection' (Ovidrel). Also start Prometrium (progesterone) until told not to. (BFN).

Then we "try" and hope and pray for the best.

We'll do 2 or 3 cycles of this. Then move onto IUI. Same procedure, but instead of timed "trying" they'll take his sample, clean it out so that they get the best of the best and shoot it up in the catheter so they'll end up near the tubes.
Then pray.
Another 2 or 3 cycles of this.

If that doesn't work, IVF here we come.

We'll cross this bridge when/if we get close to this process (if the other 4/6 cycles don't work, we're looking at late summer, early fall). All I really know is that is the same sort of process as above, but they'll take out any/all eggs and match it with the clean husband sample.. cross their arms, wrinkle their noses and poof.. we'll have embryos. Then the embryo's goes through their own 5 day process..  and whatever makes it though, we'll decided to put back in 1 or 2 embryos..  and do my down crossing arms, wrinkle my nose... and poof -twins-.

Twins? I'm down for it. I know what it means. I've thought about this for a long time. So long as there is no major complications, its kind of what I want to happen. But that also means huge lifestyle changes. We have a 2 bedroom 1 bath house.. so eventually we'd have to move. I have a tiny 2 door car, that I will try to make it work. But if my husband cant get fit his lunch box in the back seat, how I am supposed to fit a car seat, let a lone car seat with a baby or two? So that means a new car. And probably a second new car. My husband has my older crv, but has turned it into a 'man car/contruction' vehicle. Ok -yes we can clean it up...  but the car is also used to haul trash on a weekly bases. Would you put a car seat in garbage truck? probably not.. so.. that's my answer.

But I also know that we can very well put in 2 embryo's and only 1 can 'stick'.. which is also totally cool with me. One baby is all I ever really wanted.
We'll only have to make such decisions if we have to go that route. Hopefully not. Hopefully it will all happen the 1st round. I guess we'll just have to wait and see.

So this brings me to the very end of 2014. Just like 2013, this year couldn't end sooner. My very good friend told me that this year (2015) will be the "Year of Kim." And I have no doubt, she's right.

2015 - I cant wait to meet you.

"You're up then you're down"

That's exactly how it has been for the last two or so weeks. I'm getting back up there. Every time I feel less than, I try to mentally throw my hands up to the Lord, take a deep breath and pray for strength and comfort, remembering that he works at his own pace and to trust in that.
I keep getting signs from him which I find encouraging. Another random experience with the nurse who was there when I had my procedure done (more on that in a minute) that she too has PCOS and is on the same medication as me and has had two kids, trying for a 3rd. Another one during my doctors apt yesterday (more on that one too), she was telling me that one of her patients was able to get pregnant on just Metformin too. I hope its just that easy for me.

This entry will just be a quick update. There hasn't been any major changes, and probably wont have any in December except for one more doctors apt, which is our follow up with the fertility doctor. 

Last week I had my procedure done to remove the polyp. I didn't end up getting knocked out, but probably should have been. It was painful. I hope I never have to do that again. I wasn't in the 'picture taking mood,' but I wanted to capture this poster of a beach scene on the ceiling, so when you're laying on the table, you look right at it. Its a nice gesture I suppose. I spent the rest of the day on the couch watching all my dvr episodes of all things Bravo TV.

Yesterday I met with my endocrinologist to discuss my results of my now Hyper thyroid, I am usually Hypo. We also discussed my actions with the fertility doctors, she was happy to see that I am trying for a baby. I have been with this doctor for years now, so its nice to go through 'life events' and it seem like she truly cares that I am successful. Because of this change, my dosage has been adjusted and she wants me to wait until 6-9 weeks (until blood test show my levels) before I start any treatments with fertility.
Having a hyperthyroid increases the risk of miscarriages, low birth rate, among other problems.
Another road bump, but...  I will gladly (after a quick prayer and a deep breath) wait another cycle or two in order to have the most healthy and successful pregnancy. This will now put me late January, most likely February before I can move forward with treatments.

 

As mentioned, we are having our follow up apt with the fertility doctor on the 18th. All test, procedures, results will have come back and reviewed. I'm hoping to come out of this appointment with "the game plan," even though we wont be able to start it right away.

 

Until then, I will enjoy the holidays with family. Bake cookies. Take advantage of any nice days, go for walks. Get into some good books. And start the new year with a clear head, ready for my mission.

"Don't worry about anything; instead, pray about everything; tell God your needs and don't forget to thank him for his answers. If you do this you will experience Gods peace, which is far more wonderful than the human mind can understand. His peace will keep your thoughts and your hearts quiet and at rest as you trust in Christ Jesus." Philippians 6-7

Now... Where did I put my Genie?

It’s only been a week or so into this process and I just want to wiggle my nose, cross my arms and blink twice. *POOF* I have a baby growing in my tummy.

 

Today my saline sonogram showed that I had a 11mm polyp in my uterine lining. A saline sonogram is where a saline solution (salt solution) is inserted via catheter into the uterus through the cervix. The catheter is removed, then the ultrasound portion begins (I’ll spare you the details). The polyp will need to be removed as it will disrupt any successful embryos from attaching to the uterine wall. It’s enough of a surgical procedure to put me under. 
After taking the weekend to push the 'reset' button I'm realizing that it’s not a huge issue but it will set us back at least 1 or 2 cycles from being able to start the medications. This even sets back the 2^nd follow up appointment before we meet back with the doctor to go over the next steps. It’s discouraging, but this will force me to stop and slow down. We’re not in a race. (Even though I feel like everyone has already crossed the finished line except me). Something I know to be true, is that its ok to be upset. Have a sad moment, but then, pick up and move onto that next phase. I'm going to need all the energy and strength to get through this. During the weekend I kept thinking as I was switching my summer wardrobe to the winter clothes, "I hope I'm wearing maternity close next summer." Hey genie - is it April yet?

So my next step is meeting with an ‘outside’ OB next week to go over what the sonogram showed, and try to time out and schedule this procedure (I’m learning everything is ‘cycle’ based. I’ll be living off a cycle based calendar-Joy!) Oh – and did I mention yet another blood test? This time I’m getting a full thyroid panel, I'm thinking that my dosage will need to changed. My arm has had a bruise all week.

Recently I have been immersing myself in every and all information about infertility, the processes, IUI's, IVF's, happy and sad endings. I've been reading other blogs, and it has terrified me. Its hard to tell whether or not I should be reading these things, its like the doctors always say "don't diagnose yourself via the Internet." (FYI not everything you read on the Internet is true - - Can you sense my sarcasm?). I want to be informed, but also want to remain naive. Staying naive will help me keep the hope that it wont take long to be successful at this. From reading other blogs I've picked up a few good books to start on. Recommendations are listed on your right.

I am still very much excited and hopeful because I have had a lot of random (like, really random!) occurrences where I've met women who have had fertility issues and having PCOS and they have all had babies, or are pregnant. I see these a Gods little signs to me, "I see you, I'm watching you and I am with you." In a world where its so easy to get knocked down, having faith can really pull you through. When I read about what other women have gone through, and some of the medical processes that I am probably going to face its going to be a long emotional road - the marathon that I mentioned earlier. You ask, is it really worth putting your body through all of this, the injections, the hormones, pills, tests? For me, the answer is yes.  I don't think I can ever 'get over' not being able to have a baby unless I try my hardest...at trying. To know that I have exhausted all options, is when I can start to morn that part of my life, pick myself up and lean on my support, my husband. (A possibly get another dog.)

I'm learning to "let go and let God." This will all play out to His timing. And I have complete Faith.

Some of you may have read my blog earlier. I went off on a tangent so I've edited all of that out and will say only this: To the negative Nancy's, I wont give you any of my energy. Even this sentence is to much for you.

For now, this is it. Seth will do his part and have blood drawn for the genetics test and will take 3 weeks for the results to come back. In addition to having my procedure I'll be meeting with my endocrinologist Dec 1st. Since we have to wait for the blood results to come back I imagine we'll have our follow up apt with the fertility doc in early-mid Dec. Prayers and positivity are always welcome.

"For I know the plans I have for you, declares the Lord, plans for welfare and not for evil, to give you a future and a hope." Jeremiah 29:11. 

I always knew I was a Charlotte.

Though I did have a Carrie moment when I dyed my hair dark like her in the 1^st movie. I am a huge Sex and the City fan. I have all of the seasons; have both the movies and praying for a third (I'm hoping the rumors are true!)

So I was watching the 1^st movie on TV by chance, decompressing from the previous 48 hours and began to realize that Charlotte was one of the 1^st characters to bring infertility to TV, to a young audience. Even though it’s Hollywood, her story brought a happy ending in two ways. She adopted a girl at the end of the TV series, and then she got pregnant in the 1^st movie. It just made me smile. I hope to have a Hollywood ending.

Seth and I had our first consult apt with the doctor on Oct 30^th. When he came to pick me up, I remember looking down at my hands and I was shaking all over as I reached down to the door handle to get in. This was it!! 10+ years in the making, it was all coming together at this moment.

On the way there, I had to practice breathing techniques to slow my heart rate and blood pressure down. From the moment we walked in the doors, it was an overwhelmingly positive experience. To the calm colors in the office, coffee and tea to your left, smiling faces to your right. Everyone was so nice, and gentle. Even though we had the last appointment of the day, the doctor really took her time to explain everything out, talk to us as if we were good friends at the dinner table. Explained all of the testing I would have to do, and the ONE test Seth would do. We talked out possible reasoning’s behind why I haven’t been able to get pregnant, and she reassured me that at every turn that she would do everything possible to help me have a baby. Then, it’s like a flip switched and we were in hyper mood.  We briefly spoke to the nurse that would be handling my case, and was able to make an apt for the next morning to start my 1^st round of test’s. Went over the loads of paperwork given to me, and I tried to keep up. The nurse who has a lovely New York or Boston (?) accent was amazing, she saw the look in my face and slowed down and told me she would be with me every step of the way, told me that she wouldn’t leave me feeling confused or neglected. God put me in the right hands for sure!

As we left my head was spinning. There was so much information to take in and 1,000 thoughts flowing through my brain. Over dinner (screw the diet; I wanted a grilled cheese sandwich!) Seth and I talked and talked and talked about all of the outcomes, the situations that we might cross (finances, jobs, insurance coverage). I began to get my running shoes on because I wanted to run and cross the finish line.  I wanted to have a baby yesterday, I felt like I have waited long enough and that I deserved to have one.  I heard a really good quote this morning; this will be more like a marathon than a 5k. There will be lots of training and miles ahead of me. I'm rushing to get all of these testing done in a week and I need to remember to keep my eyes wide open. This may not be a smooth process. I have to remember that there might be sadness, challenges and unexpected trials and tribulations. Another show that comes to mind is Guliana and Bill and the struggles they shared. It gave me some insight on what I might have to go through. They too ended up with a baby, but went through huge disappointments to get there. On the other hand I could end up with multiples.  My husband has been really good at bringing me back down to earth, back to reality. I need to slow down and really take time with each step. I want to know what’s happening with these tests and understand what they mean. And I have to remember, God has his own timing and story ending for me and I have to have faith in that.
 
My 1^st round of testing included a Baseline Sonogram, which the measure the reproductive organs and uterine lining to see if everything measure’s normal. Which mine did except for the thin uterine that the doctor suspected I had.(Another symptom of PCOS). The blood work was just a baseline blood work to check my Thyroid levels (which are not normal, so I have to make sure I bring this up with my endocrinologist), and other normal levels, like liver function, vitamin levels, etc.  With the exception of the thyroid, every thing is normal, which is a good thing (but also brings me back to the question of why haven’t I been able to have a baby? – But I only focus on that for a moment before moving on. I am doing everything in my power right now, and that’s all I can do).

So then my 2^nd round of testing was going to an outside lab to give away gallons of blood. At least that’s what it felt like. It was more like a pint. I think I counted 8 tubes? I’m hoping to have the results within the week. This was the nitty gritty blood work where they are testing everything. When I handed the paper with all the check marks, the nurse looked at me with a "wow!" look. One of the symptoms with PCOS is having more testosterone than the average female. And the extra testosterone suppresses one of the elements that help develop the follicle that later becomes an egg. This is the reason I believe behind my infertility. I never ovulate an egg. It never gets released and stays in my uteri and becomes a cyst (hence, poly cystic=many cysts).

 
This Friday will be my third round of tests and will be a saline sonogram, and more blood work (I stopped asked “for what” at this point and do what they tell me). This is where they will flow a saline fluid through the uterine cavity to see if there is any blockages, or polyps (which would need to be removed), anything that would compromise development of an embryo. I’m pretty anxious to go through this. This might be a big result as to what we will end up doing for a treatment plan.

During our appointment the doctor and I briefly discussed what sort of treatment we’ll be looking at. Seth and I are both doing a genetics’ test. Meaning they’ll take our blood and send it off to test for 113 genes of things like sickle cell, autism, etc. If Seth and I both come back as carriers for something, we go straight to IVF b/c they can take that diseased gene out of the embryo before implanting it. Isn’t that amazing? I don’t think we’ll have this issue (right Mom??).  So in that case, we’ll start off with the medications. Drugs that would induce egg development. I don’t know all of the details yet, so I’ll update you as I learn about the process.

Seth has to do his part, and also get a small blood test done. Then we meet with the doctor to go over what our plan of attack will be. I appreciate all of the kind words, prayers and positive thoughts and energy sent my way. God has helped me moved mountains for me already; I am learning to have faith for one more mountain.

Stay tuned for more! And remember, don’t be afraid to talk about this with your person who might be going through this too. I love to answer questions and have this be more like a conversation than to have someone be afraid to bring up babies b/c they think I would get upset. Your support and encouragement means the world. 

And So My Story Begins

When you're young, you never really think about the bad things that can happen when you "grow up," you never really think about the problems you could face as an adult or even how to overcome them. Going back, I don't ever remember thinking a lot about children, I just kind of assumed that one day I will marry and have kids - The End.
It was the summer after Seth and I started dating, I started to think about baby names. I already knew what our little girls name would be, and throwing around boy names just in case. It had only been a few months into our relationship (after a long friendship), but I knew I would marry this man. I knew it when I first saw him (so cliche, but true). We were an instant hit. The way we were headed, I knew that a baby would come at fate's choosing. A few years passed, the relationship turns into an engagement, soon after, marriage. I wish I could get married everyday. To see the Seth's face over and over again when he first looked at me walking down the pier over looking the bohemian island would be a dream come true.
The questions you face as a couple started. "Whens baby coming?, what are you planning, etc?."   Not one person in my family (and I have a large family) has ever had a problem having children (more thoughts on that later), so when we started to seriously try and nothing happened, at first I really didn't think much of it. But after a few doctors apt's and being diagnosed with not only a Thyroid condition but also Poly Cystic Ovarian Syndrome (PCOS for short) I was completely devastated. I can remember that night after getting home from the doctors, calling Seth and telling him, crying to him while on the floor, that we may not be able to have children. *Side note, one of the main symptoms of PCOS, among a slew of others is infertility.* I had all the signs of this for years, and the doctors had always just thought it was hormones, I'll grow out of it. Never ONCE looking at all of my symptoms as a whole and investigating further that I might actually have a problem. For this, I was so angry. Angry at the doctors, angry at God, angry at my body. Seth's first response to me in a calm voice was, "don't worry, we'll figure this out together." He may not realize all of this, not realize that I remember these things, so when you read this hunny bear, I love you!
Anyways!
A few years ago I had made it my mission to find out what was "wrong" with me, so I made an apt with Shady Grove Fertility. I remember this being November because I wanted to make it a new years resolution to start having a family, to do whatever it took. So I went, did all of the tests. Seth did his part, his easy part! At the end of this, I was told it turns out there is just no rhyme or reason as to why I wasn't able to get pregnant. Out of 100 couples, 25 come back as having issues, and of those 25, 10 couples have no reasons. That might sound like good news, but again I was devastated. After one of the painful tests (HSG for any other those whose had one-ouch!) the doctor who was administering it told me I had wonderful tubes and no blockages, that I didn't need roto rooter. Right there on the awkward table I burst out crying, like hysterical ugly face crying - then why wasn't I able to get pregnant??!! I was desperately seeking something to be wrong with me, so that I can fix it. This put in me a state of limbo, not know if I can truly have kids or not. We weren't ready to move forward with treatment at that time. So I focused on myself, I knew I needed to have the stars align to get through this.
I started to run and enjoy it! A mere acquaintance at work invited me to train with her for our first 5k. The last time I had run, was high school track. But I decided that I needed this, needed this to take the focus away from babies. I ran that 5k and I felt so accomplished, that was the first of many races I would soon run. And that mere acquaintance and I are now the best of friends. She may are may not know this, but just being there and inviting me "in" kind of pulled me through one (of many) of my darkest hour. I continued to run, lose the weight I needed to and started to financially plan for treatment, whether that meant IVF or not. I knew from my initial apt that my insurance (at the time) would cover up to 50,000. So that meant I could fit in possibly 2 rounds of IVF.
After talking with Seth, we decided that Sept 2013 would be it. We were going to take the plunge and go for it, whatever "it" meant.
2013 was a really rough year as it all completely fell apart. Starting in January and each month to follow I had a lifetime event blow to my life. I wont go into details (to much to type) but I'm amazed that I got through that year without completely losing my mind. Out of the many blows that I suffered, losing my job was in the top 3. Losing my job, meant losing my benefits, meant losing the opportunity to have a child. I was more upset about losing my benefits, than losing my job. I thought, wow - this is never going to happen for me.
As each year passed, and each birthday passed (at this point it has been 10 years of "not, not" trying if you catch my drift) I kept getting more discouraged. Having a Godawful job didn't help either. That place really chewed me up and spit me out. So to pull myself out of this nightmare, I decided it was up to me. I started to look for another job and that's all I could focus on, getting the heck outta there. I had a great interview and promise of a new job in early February, but that didn't work out. I tired to not let that bother me and my faith grew stronger after every phone interview.
A few more months made their rounds, and then I started to look for a job close to home. Why not? I knew it would be a pay cut, but I thought of all of many benefits of working within 20 min of my house (being able to go get my child sick at school for instance). It was now April of this year (2014) and I had applied to two jobs, getting interviews for both. And I weighed my options out and ended up getting a lifetime opportunity that I love to this day.
This is all seamlessly working out to Gods glory. Because, guess what?  The benefits that come with this job will completely 100% cover treatments, and cover up to three tries per baby. That means I could have A  LOT of babies :)
So, today marks the day of the beginning. My husband and I couldn't be closer and more excited about starting this journey. We have our 1st apt today to see what our options are, and to move forward with them. I am going journal this journey for a couple of reasons. I hope I get a book deal, then a movie deal. haha. The main reason is that I'm sure you know of someone who has gone through this, but probably (under normal circumstances) wouldn't know all the details, the struggle, the feelings of a couple going through their infertility journey. Maybe it could bring just a little bit more awareness to these types of issues. And of course, the more support I get the better. All positive thoughts and prayers are welcome! So here we go!