waiting and what ifs

4 Apr

It’s no big secret that we are having some major issues conceiving a baby, and honestly I’m not really one for secret-keeping or sugar-coating things.  Being a social person, and knowing that so many people are thinking of us and sending good vibes our way, I feel like I have to keep my friends “in the loop.”

 

So first, in case you don’t know the reasons behind our issues, I have polycystic ovarian syndrome, or PCOS.  It’s a hormone imbalance that manifests differently in everyone, but basically most women experience irregular periods, cystic acne, either excess hair or hair loss, and some have insulin resistance problems (I am one of them), which can cause weight gain/difficulty in maintaining a healthy weight.  It blows.  I hate every part of this disease, and I don’t understand how we can know so little about what causes it.  I am absolutely convinced that it has to do with environmental factors, from the foods we put into our bodies to the things we put on our skin (anyone else get nervous that they’re rubbing cancer on their armpits when they put on deodorant in the morning?).  In any event, it’s awful and I hate it.

 

To diagnose, they start with physical symptoms, then run blood tests to see what hormones are fucked up (everyone with PCOS is a little different–it’s a blanket diagnosis really for hormonal issues), then do some ultrasounds.  Many women with PCOS have lots of little cysts on their ovaries.  That’s because our bodies produce the hormones to start them (which is normal–they should become follicles, which will eventually release an egg, if your body is making the hormones necessary for this process).  My body, unfortunately, does not.  So each month, it makes a cyst which never matures and then just stays there on my ovary.  Over time, they start to form a ring that looks like a pearl necklace.  My ovaries have impressed every tech/dr who has ever seen them (and at this point, that’s a shit ton of people–I have made a lot of jokes recently about how many different people have been “up in my bizness” these days).  There are a LOT of cysts.

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Not mine…but that’s what they look like, although I think I have more cysts actually and they’re smaller…

So according to every doctor I’ve seen, this should be relatively easy to fix.  Everything else is normal–most of my hormone levels are actually not too fucked, and Eric is completely normal (which causes me a fair amount of shitty feelings thinking about how if he had married someone better, someone with a functioning body, he’d already be a happy daddy–even though he assures me there is no one better).  Really all that’s missing is the egg (at least in theory, but we’ll get to that worry later).  So the meds that they have me on are supposed to trick my body into making extra hormones to get follicles to mature and eggs to release.  For many/most women with PCOS, Clomid or Femara works.  It can sometimes cause too many follicles to mature, so they start you on a very low dose, and then slowly build it up if needed.  The most times you can do these meds is 6 cycles (then you have to take a break before restarting), because there’s the risk of literally exploding your ovaries.  Therefore, each cycle, I have to be monitored to make sure that everything’s ok and my ovaries aren’t swelling too much and I’m not producing too many eggs.

 

In addition to the doctor monitoring, I also take my temperature every morning.  As a woman goes through her cycle, when she ovulates her basal temperature first thing in the morning will increase.  It will stay elevated until she gets her period, at which point it goes back down.  I had no idea about this before we decided to start trying to conceive, but I have a lot of friends who have been able to get pregnant relatively quickly by charting and timing sex.  So I’ve been charting my temperatures for the past 4 years now.  My temperatures are almost always the same–they never elevate.  I have, to the best of my knowledge, ovulated once in almost 4 years (not positive though…we’ll get to that).  It sucks–to be accurate, you have to temp around the same time each day, before you do anything else.  That means every day alarms set for 6 AM so I can get up and turn on a light and take my temperature.  Lame.

 

I started on 50 mg of Clomid back in October, after about 3 months of initial fertility workups (blood work, ultrasounds, pelvic exams and the dreaded HSG dye test).  My temperature never elevated, but I also didn’t get my period.  I took pregnancy test after pregnancy test, even though deep down I knew that if I hadn’t ovulated, there was no chance that I was pregnant.  Sure enough, they were all negative.  I was 40 some days into the cycle when I finally called my doctor.  They made me come in for an exam, commented how strange it was that I never got a period (because NORMALLY you would but my body doesn’t do anything normally–my doctor even consulted with other doctors in the practice and excitedly told them when I came in that I was the one so everyone could look at me ha).  They gave me some hormones to jump start my period so we could try another round of Clomid.  2 pelvic exams and a week and a half’s worth of hormones, and we were ready for cycle 2.

 

The next cycle was in December (because remember my other cycle had been over 50 days when all was said and done), and I was on 100 mg of Clomid.  I had terrible side effects–I wanted to murder people, scream, throw temper tantrums and then sob.  I had horrible hot flashes and bloating.  I was scheduled for an ultrasound to check the progress right before Christmas, but I decided last minute to cancel the appointment.  I have to take time off from work for each appointment, so as you might imagine, I’ve taken A LOT of time off this year already.  More than I’m really comfortable taking. I also decided I didn’t want to ruin my Christmas with shitty news from the dr.  Ignorance is bliss and all that crap.   However, based on my temperatures, my guess is that I did in fact ovulate this cycle, making it the one and only time I ovulated in almost 4 years.  My temps went up and stayed up for 16 days.  I tested every day starting on day 12, excited beyond belief that I was finally pregnant.  When I got my period on day 16, I sat on the toilet and sobbed. (My normal MO post failed pregnancy test/period is usually to go back to bed, wake Eric to tell him the bad news, then cry myself back to sleep while he rubs my back or holds me.)

 

I tried to stay positive because hey I ovulated.  When I went back to the doctor, they assured me that temping is not accurate (which is completely untrue I think…) and that I needed to go for ultrasounds to confirm ovulation (which is stupid because U/S can’t always confirm that you ovulate, just that there’s a follicle that’s mature and ready…unless you JUST ovulated) and that I couldn’t have ovulated as late in my cycle as I thought I had (it was very late, but apparently with PCOS this can happen, as I would later find out from my RE).  Anyway, they agreed to give me 100 mg again, and I was so happy and convinced that FINALLY we were on the right track.  I started the next cycle of meds in January.  And nothing happened.  I was devastated.  After my ultrasound, the doctor called and told me that we could bump to the next highest dosage of Clomid.  But she was concerned because one of the side effects of Clomid is to dry up your cervical mucus (sorry if that’s TMI), which helps to provide a good environment for the sperm to get up through your cervix and uterus and into the fallopian tubes.  So she said that it was probably time to see a Reproductive Endocrinologist (RE), who would want to do Clomid with IUI (intrauterine insemination–they take the sperm, pick out the best swimmers, then “turkey baster” you by inserting a catheter up past your cervix and into your uterus so the sperm don’t have as far to swim to find the egg).

 

I had already kind of thought that we were going to have to go into even more medically invasive treatments, but it was hard to hear anyway.  Since day 1, I’ve wanted no part of medicine, and I certainly wanted no part of a specialist.  I am pretty much dead set against IVF–it’s emotionally and physically difficult (lots of hormones to get you to ovulate, then extraction, then they inject your embryo into you and hope it implants and grows), super expensive and comes with no guarantees of actually working.  If we’re going to spend that kind of money, I’d rather look into adoption, which guarantees a child (albeit usually after months or years of waiting). IUI also freaks me out.  My only other experience with being catheterized through the cervix was my HSG, and it was the most painful experience of my life (which I would later find out was because OB/GYNs use balloons and hard catheters to blow your shit open, which results in pain similar to childbirth).  I reluctantly made the appointment anyway.  Suck it up, buttercup.  Since then, I’ve been grieving the loss of “baby-making the fun way.”  We obviously will still have sex, but it really sucks to have a baby this super unsexy way, and I’ve been thinking a lot about what we do when we have an IUI–like does Eric hold my hand, does he kiss me afterwards, do I cry, is it weird if I cry…Have I mentioned that I overthink EVERYTHING.  I mean, seriously, just let the good doctor turkey baster you and go on with your day, Shme.

 

So back to the RE appointment.  When we discussed my side effects from Clomid, she said that we would try something else–Femara.  It’s actually a drug used for breast cancer or something, but it apparently can trick your body into ovulating, too, especially in women who are clomid resistant.  So we were hoping this would do the trick, and she seemed very confident.

 

So last Thursday, we went for an ultrasound.  I made Eric come with me, because if there are mature follicles, they will either give me a shot in the gut at the office to force ovulation (rather than take the chance that my body might fuck up and not produce the correct hormones in the correct amounts) OR send us home with it for a day or two later.  And there is absolutely no way I’m giving myself a shot in the stomach.  Hell to the no.  As many jokes as I made about how excited Eric was to stab me with a shot in the stomach (or ass…some of them go in the ass cheeks, which is also extremely romantic baby-making foreplay), I am terrified of this.  I do not like needles and have seriously considered the possibilty of natural child birth just to avoid the epidural needle…I mean, seriously.  Not good. So Eric’s gotta come along, for moral support and also to learn how to give me shots in the ass.  Joy.  We we went, and I was worried about the shot for no reason–because there was NOTHING there.

 

So I’m laying there, legs spread, looking up at the ceiling while she simply says, “nothing,”  and just thinking about how much my  life in that exact moment sucks and I want to cry but this doctor is here and I’m half naked spread eagle, so it’s not really prime crying situation so I’m blinking back tears.  And then the next thing I know, she is talking about our options, and I have to stop my pity party, sit up and pay attention.

Option 1 is to try Clomid 150 mg starting today–5 days of it.  Option 2 is injectible fertility drugs (terrifying), but her concern is that I have so many follicles already there that the potential for too many mature ones is really high, so how do we feel about IVF.

 

The fuck???  We go from oral meds to IVF that quick???  I balked a little bit, but said that I wasn’t really sure IVF was an option for us, so I guess we’d go option 1.  I put on a brave face (or at least I think I did), but hearing “IVF” sent me into a major tailspin (that I’m still recovering from), because essentially she was saying there was no chance for a biological child if Clomid didn’t work (if we truly don’t feel comfortable going the IVF route).  She wrote the script and sent me on my way.

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cl2

 

Which brings  us to today.  All week, I’ve been cranky.  Clomid makes me angry and sad at the same time–it’s like Dr. Jekyl and Mr. Hyde over here.  I’ve also been bloaty–yesterday I was actually in pain from it and got nervous that we may have overstimulated and my ovaries were going to explode.  I went to the ultrasound appointment today prepared for the worst.  So she’s poking around and finds one follicle that is slightly larger than the other ones.  Most of those are about 8-10 mm long, this one is about 13 mm.  To trigger ovulation, they need to be closer to 20.  So it’s not necessarily bad news–at least SOMETHING is happening.  But it’s not good news either.  I have to go back next week for another ultrasound (which means MORE time off of work) to see if it’s either grown big enough OR alternately it’s shrank and we have to do something else.

 

And so we’re back in limbo again.  In some ways, I would have preferred to have gotten bad news today, because at least then we’d know and we could be doing something or making decisions about next steps.  I am terrified of what’s going to happen.  I hate waiting, I hate not knowing what’s going on, and I love to play what if.  I have, prior to this cycle, just always thought that once I ovulate, I will just get pregnant.  The truth is, just because I ovulate doesn’t mean that I will get pregnant.  And just because I get pregnant doesn’t mean that I will carry a baby to term (miscarriage runs in my family and is also a problem for women with PCOS).  And just because I carry a baby to term doesn’t mean it will be healthy (or that I will have any idea what to do or how to juggle being a mom with the rest of my roles and won’t completely ruin a perfectly good human being).  This 9-month-hell is just the first obstacle that we are crossing.  And it’s taking forever to cross it.  I never thought in a million years that we’d still be at this point.  I watch all of my friends getting pregnant, having babies, raising beautiful families and a huge part of me is so jealous and hateful, which only makes me feel worse about myself.  Every time I express these feelings, Eric reminds me that I don’t hate anyone, I hate our situation and am reminded of that every time I see all the people who have what we want.  Anger is sadness’s sidekick, so it makes sense to feel this way I suppose.  I never knew it was possible to cry so much.  Every 2 weeks or so, I have been crushed–devastated–thrust into dark thoughts and sadness.  That’s a lot to handle and there’s never much recovery time before the next crushing blow.  I keep hearing “think positive,” and “be optimistic,” but the truth is that it’s really hard to let yourself get hopeful only to be smacked in the face with the reality that your shit is royally fucked and beyond medical repair.

pain2

Charlotte Bronte–beautifully-written angst-filled novels. Love her.

 

I came home today to a note on the door to go directly to the kitchen.  Eric had a lot of flowers and a card for if things today went well and a card if things didn’t go well.  I texted him to ask which to open, because this news doesn’t necessarily fall into either category.  I opened both.  We are apparently going out tonight. and I have to wear a dress.  If I had to pinpoint something good that is coming out of this struggle, I’d say that it’s brought the two of us closer together.  I can’t really imagine going through any of this with someone else.  He can make me laugh when I least feel like it (but most need it).  Today, as we walked out I said, “See you next Tuesday” (I swear it wasn’t intentional) and we instantly dissolved into giggles as he said “appropriate given what they’re looking at all day.”  Then he assured me that he could help to incubate my little egg by sitting on my stomach like a penguin or other bird.  He is the one who reminds me to take it one day at a time, to cross one bridge at a time, to stop worrying about the what ifs and start focusing on the here and now.  He is the one who encourages me to go out to run or to see friends when what I *think* I want is to sit on the couch and bawl.  Conversely, he is the one to know when I need to just sit on the couch and bawl, and he’ll sit with me, hold me through the tears, and not look at my ugly-cry-face.    I am so thankful to have a best friend who loves me, even at my ugliest moments…

To all of our friends who have been supportive, thank you.  Your kind words mean so much–and sometimes it’s hard for me to express that without getting overly emotional, so I don’t express it as often as I should or in the ways that I should.  But knowing that people are there and thinking of us and if we needed something they’d be there for us…that means a lot.  And I can’t wait to someday have a baby that will be loved by so many people who have been waiting for him or her for so long…

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2 Responses to “waiting and what ifs”

  1. Nancy April 7, 2014 at 5:03 am #

    My dear Daughter In Law and wonder Son. I love you both so very much. Thank you for finally sharing with me the story. It meant the world to me to understand and see where you both are. Dad and I tried for several years to have a baby and gave up and never thought we’d have children and we finally did. Problems along the way yes, crying when our friends were all having babies, angry I was not it all sounds so much of the same. But you have indeed gone through way more in the Dr. department and the drugs. My heart breaks for you as I pray every single day for you two to have a baby. Doug and Nycole had to go through a lot like you and had the invetro. It did not work the first time and after I gave Nycole the prayer I gave you a while ago she got pregnant. Like I said before it has worked for everyone and there are no drugs or Dr.’s . If you don’t have it and would like to have it let me know. Prayer can be a very powerful thing. Look at Dad, he’s a miracle that his mind is almost back and I believe he will walk again etc etc. You have to believe. You two are two of the most important people in my life and Dads. We pray God will watch over you and give you the change to have a baby. You are perfect for each other and your love it so VERY SPECIAL. I admire you for that. You were difinately made for each other. Thank for putting me in the loop in really made me feel connected for the first time. I love you more then anything and will do anything I can to help you in the toughest time in your marriage. I am always here to listen, to hug you to cry with you anything you need always and forever. Thanks for sharing. Love, Mom xoxo

  2. Jen April 7, 2014 at 2:05 pm #

    I agree with Eric that he couldn’t have found a better wife than you! I’m continually inspired by you each as individuals and by your marriage. Infinity of hugs and well wishes!

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