A Merrier Christmas

It was a merrier Christmas than we've had in years since I am actually pregnant at long last.  We were able to see the heartbeat again today and everything is looking great!  I am exactly 8 weeks along and the baby measures 8w2d.  Some of my meds are being reduced (progesterone, Vivelle patches) and I'm released to the care of my perinatologist.  While I wait for that appointment to get set up, my RE says I'm welcome to come back there and get another ultrasound if I get nervous.  Um, does she realize I'm always nervous?

I've been offline lately because our computer had a very nasty virus.  Prior to that, I was sick myself (bad cold - nothing major) and have been stuck in the house for most of Christmas break.  This has been boring for the kids and they have exhibited absolutely monstrous behaviour. I try to think "Yay!  This means they're not too pure for this earth!", but somehow this does not cheer me up.  I am thrilled that school starts again on Monday.  Might as well get back to the grind - we are not exactly creating glowing holidays memories that we will cherish for a lifetime.  Maybe next year.

Still this "most wonderful time of the year" has been a big step up for our family and we are very thankful.  Sickness and bad behaviour are mere annoyances.  The biggest stress for me lately involves my brother, who has a serious illness, and our mother who believes he is merely having a "spiritual battle" and is possessed by demons.  She takes him to get devils cast out (mysteriously, this has been ineffective.  hmmm.)  I've already seen two of my siblings buried and now I fear she is going to kill my brother with her denial and negligence.

I know that I need to keep my stress and anxiety down as much as possible for the sake of my baby, but my brother's situation is weighing me down so much.  My other brother (who is, incidentally, a psychologist) says we just need to preserve our own sanity by refusing to be involved in this ugly situation since we have no power to change it.  Giving up on my futile efforts to wrest my brother from our mother's evil clutches is sooo hard to do. Why can't the rest of my family be as sane and well-balanced as I am? *sigh* Sorry for the way off-topic vent.  I'm going to my happy place now.


Happy families are all alike; every unhappy family is unhappy in its own way.   - Tolstoy

Proof of Life

This morning we saw one little heartbeat!  Everything is measuring just right so far (6w3d).  I met with one of my doctor's colleagues since she is out for the holidays, but I'll go back next week for an appointment with her and then hopefully be "released" (doesn't that sound wonderful?) into the care of my OB/GYN and perinatologist.

Since we'd transferred two embryos for this IVF, there was of course the possibility of Minnesota Twins.  For me, though, just having one is better as this pregnancy is already high-risk and we don't need it to be doubly so.  Sure it would be nice to get a two-for-one deal, but I just don't think my body could do it. 

Q and I both come from big families (5 kids and 8 kids respectively) and had wanted four or five ourselves.  That hope died when we lost Miles.  This is not about having a certain number of kids.  It's all about having a happy ending - a rainbow baby after our long and devastating storm.  Even if this pregnancy is perfect and free of complication (wouldn't THAT be a surprise!) we will most definitely not be tempting fate ever again!  Not that we could afford to go through all of this again, either financially or emotionally. 

Down near the bottom of my sidebar, I've added a "Labels" section. The most frequent topics on this blog have been related to infertility and loss, so those are at the top. Pregnancy is new here so it's way down at the bottom (but ahead of tomatoes, hamsters, and Snickers!). Hopefully the coming months will see it grow and come out on top of infertility and loss!

She's Afraid of a Light in the Dark

The clinic called me on Saturday to set up an ultrasound.  It's tomorrow!  I am nervous, naturally.  I've never been able to take a peek at one of my little ones so early on.  My first ultrasounds with Jeremiah and Miles were the ones where we found out they were dead, so I'll certainly be terrified of hearing "I'm so sorry . . ." every time I have an ultrasound with this one.  Tomorrow we need to see at least one little heart beating away.  If not, it's going to be a hell of a Christmas.  Again. 

Last week I was supposed to get a shipment of Lovenox and progesterone in oil, since I am running low.  My insurance forces me to get these by mail from a pharmacy in Florida.  Both drugs must be kept at room temperature, but this was not indicated anywhere on the package.  I was actually home awaiting the delivery, but the FedEx guy didn't knock or anything!  He just left this package with $1000 worth of drugs at my front door and I didn't realize it for half an hour.  It was especially warm that day here in Minnesota (12 degrees), but still a far cry from room temperature.  So that package had to be returned and now there's the extra drama of waiting for a replacement package to arrive before I run out of drugs.

And speaking of drugs, look what my Lovenox did to me last night.  Good thing tomorrow's ultrasound is the pole-in-the-hole variety rather than the jelly-on-the-belly type, because OUCH!

Photos of my battle wounds may come in handy later.  Someday, hopefully, my little one will be a surly teenager who will no doubt refuse to help out around the house.  Then I will break out my album of dramatic photos and say, "What?  You can't even clean up your room after all I've done for you?!"

A Touch of Sin

After each of my losses, I would inevitably hear comments such as "He was too pure for this earth" or "Now you have an angel in heaven", which made me want to punch the commenter in the face.  Heehee...you can tell that I'm not too pure for this earth.  I am hoping the Current Occupant of my uterus has an evil streak like me so that heaven won't want him/her back for a long, long time.  The last thing I need is yet another angel in heaven.  I need a little hellian who will wake me at all hours of the night and later fight with his/her brother and sister and write on the wall with permanent marker.  A lot of moms complain about these sorts of things, but that's what I want.  More than anything.

Early last week, I was delighted to finally have some pregnancy symptoms, namely mild nausea and sore boobs.  But last Thursday all symptoms stopped suddenly AND I woke up to some cramping on Sunday morning.  You can imagine how distressed I was this weekend.  By "distressed",  I mean sobbing and unable to function.  Yeah, being pregnant after three consecutive losses really messes with your head.  I am pleased to report, though, that my lab numbers look good today and I'm feeling a bit nauseous.  Also, my boobs feel sore when prodded, so I prod them a lot to help ease my anxiety!

So, a rough weekend and it didn't help that we were snowed in.  Seventeen inches of snow.  Our annual gingerbread party was supposed to be Saturday.  Other years we've had at least a dozen candy-crazed kids running around our small house on party day.  My kids were very disappointed that no one could come this year due to the storm.  However, we were able to decorate our gingerbread projects: a sleigh with reindeer and the Tardis from the British TV show Dr. Who:

The Tardis, complete with working blue light on top and Doctor Who action figure.
David Tennant can be my Doctor any time! 

Finally, not just one but three bloggers recently nominated me for the Cherry on Top award. They are Maria at Mission: Fertile Soul, Oak at The Acorn Chronicles, and runnyyolk at Yolk.  Awww, thanks girls! I'm finally getting around to passing it on:

1) Meim at Tears Are For Babies.  Make sure to stop by her blog as she should have beta results soon!

2) Shandrea at Loving My Angels.  She just had surgery, which hopefully will help her get her long-awaited rainbow baby!

3) Landert at Not a Fertile Mertile, who is transitioning to adoption mode after a long hard infertility fight.

4) Megan at Illuminating Sadness, who is a very good writer but seems to have gone missing from the blogging world lately.

5) Nicole at Caroline's Family, who is missing her very recently stillborn daughter. 

Whew - it's hard to pick just five!  Now it's up to you ladies to pass it on.

I Did Not Have Sexual Relations with That Woman...

...but she's knocked up anyway.  Annie's husband Q here.  Now that I have got your attention, we got good news on the labs today.  Over four days, beta rose from 88 to 746.  Also, progesterone is now in the normal zone at 60. 

As you know, Annie has been aggressively seeking ways to increase the size of our family for quite some time. It was fun at the start, but after months of failed efforts it started to get a little scary.  Honestly, it is quite stressful for a man to come home and be required to perform on command. Call me old-fashioned but I prefer a little romance leading to the moment.

Sex on Demand

Once we learned that the traditional method of having children wasn't working, we began IUI. Annie has done a great job covering the science behind this so I won't go down that rabbit hole. However, I will provide a glimpse into what the man must do for his part of the process. Let me start by saying that as a kid growing up in a religious house, one was expressly forbidden to "shake hands with an old friend". Likewise, lad mags were a no-no, although I have come to find that the articles are great.

Any-hoo, when it was time for me to contribute for IUI or IVF, I would haul myself into the reproductive center for some personal reading. Each time I arrived, the nurse would have me submit my government ID to prove that I was the man I claimed to be. They then would have me wait in a small closed area until a room became available. During the wait, I would encounter other men's wives who would give me the "I know what you're going to do, you sick pervert" look while they sat in the same area waiting for their husbands to complete the exact same task.

Once a room was available, the nurse would walk me in and provide the necessary instructions on how to dim the lights, raise the volume to the music, and where to put the deposit once finished. From that point forward it's a race to see how fast you can get done with your business. No kidding, I have seen guys go in and come out in about 2 minutes, as if the staff is gonna charge for every additional minute in there. My thoughts are, what's the rush?

Okay, maybe it's the awful music they play in the room. I mean come on, Michael Bolton, really??? Great to wake up to for the wife after a retrieval, but for us guys? I have gotta have a beat - at least play Michael Jackson's "Beat it" or something. Also, what's up with the paper thin walls? I didn't enjoy hearing about the staff's plans for the weekend or grocery ideas when I was trying to focus on the task at hand. No matter how loud I blared Michael Bolton, I could still hear them.  When the deed was done and in the cup, I headed back to work, knowing that was the most action I was likely to get that week or the next.

Word of advice to the wives:  Have your man purchase his own reading material. Basically, it's just wrong handling something that was handled by another guy in that same room. Uuggh!! Nothing is ever too clean there. Besides, Hugh needs some more cash to support all those bunnies of his. For me, I had never bought this sort of reading material before. I quickly learned to have Annie go with me or I would go late at night when women were less likely to be out and about. Oh, the shame of it! People would give me looks when I went with Annie, probably wondering why I needed that lad mag when I already have a hot wife.

Now, after weeks of sex deprivation, I'm still not able to score with the wife. For our 9th anniversary last week, Annie bought a little something from Victoria's Secret and then refused to put out until the OK is given by the doctor. So please persuade her to cave in so I can have sexual relations with that woman.

[Bad news for Q.  Instructions from the clinic clearly state:  It is advised that you avoid intercourse and/or orgasm until your ultrasound appointment with your doctor around 6-8 weeks gestation if you have undergone in vitro fertilization.  So there! - Editor]

Bless This Mess

Well, it appears that for now at least I've managed to get around infertility.  It's a great time for this great news since hubby and I just had our nine year anniversary yesterday AND it's December, the hardest time of year for me. Good news really helps.  But I can't help but wonder - is this my long-awaited miracle or just the precursor to more tragedy?  Will this little one stick?  Over the course of one day, I've transitioned from total despair thinking this cycle failed to both excitement and abject terror in equal measure. I try to distract myself, but I'm good at multi-tasking.  No matter what I'm doing, I can also obsess about this at the same time!

Now that I've got a minute, I'll tell you the Tale of the Two Week Wait in Hell.  Actually, it was only nine days from transfer to beta, but it sure seemed longer.  Post-transfer I was optimistic for two whole days.  I was high on hope and drugs.  Then I started to go downhill, reaching Soul-Crushing Despair Mode by late Saturday, five days post-transfer.  Sunday through Tuesday I was certain this hadn't worked thanks to some cramping and ovarian pain, which I assumed was the endo preparing for action.  Wednesday I grabbed a test from my bathroom stash and used it.  It looked like there may be a second line, but it was impossible to say for sure.  I wasn't even certain the test actually was a pregnancy test as opposed to an ovulation predictor test.  The only markings on the wrapper were lot #, expiration date, etc. and that's all I had at the time.  I acquired a digital pregnancy test and used it early Thursday, fully expecting it to be negative.  It wasn't!

This is the sixth time I've been pregnant.  Every previous pregnancy featured symptoms (sore boobs, nausea) for at least a couple of days before my period was expected.  This time there is nothing and that terrifies me.  Now I know why - low progesterone - and I've upped my doses but still no sign of pregnancy symptoms.  I want to have sore boobs.  I want to spend my mornings throwing up.  I want to feel awful so I can feel good about this pregnancy.

I'm extremely frustrated that because of the weekend, I have to wait clear until Monday to find out if my hormone levels are rising.  With my last pregnancy nearly TWO YEARS ago, I got a positive test only to find out three days later (yes, another wretched weekend wait!) that it was not viable.  To say that I am petrified is a gross understatement.  I'm a spectacular mess and I've really appreciated all of your prayers and kind words.  It means a lot.  Please keep those prayers coming for this little one!

Not "Expecting", But ...

... I'm pregnant!!  Beta is 88, but progesterone is low at 13 (should be 30-50).  Will go back on Monday for another blood test.  No time for the whole dramatic story of the 2 week wait, as I have a PIO shot calling my name and then I'm off to get my kids from school.  For now, we here at Cradles and Graves are crying tears of joy for a change!

Telephone

Today is beta day and the blood has been drawn.  I thought I knew what the results would be, but now I'm getting mixed signals and have NO idea what to expect.  Waiting for the phone call is excruciating ...

Whole Lotta Lovenox

After losing Jeremiah and Miles, blood clotting issues were suspected and a perinatologist recommended I take Lovenox (unfractionated heparin) in any subsequent pregnancy. I'm still waiting for that chance. For this IVF cycle I'm trying it from transfer in hopes of improving my odds.  It's a long shot since it hasn't been proven that I have a clotting disorder nor has it been proven that heparin from transfer would help.  But I'm desperate and I don't mind stabbing myself in the belly.

Maybe I'm a little weird, but I like to know what I'm injecting into myself.  We already explored what is used to make stimulation meds (Human pee.  Yes, really!). Today let's take a look at the making of heparin.  You might want to get a barf bucket . . .

"In a small, damp factory here [in Yuanlou, China], blood-smeared men wring pulp from pig intestines, then heat it in concrete vats. The activity at Yuan Intestine & Casing Factory is the first step in the poorly regulated process of making raw heparin, the main ingredient in a type of blood-thinning medicine."

China is the source of approximately 70% of the heparin used in the United States.  Some of you may recall the Heparin Recall of 2008.  Heparin sourced from China was found to be contaminated and there were a lot of deaths because of it.  Worse, the contamination was almost certainly deliberate. 

This heparin recall happened right when I started trying to conceive again after losing Jeremiah and Miles.  Yeah, back when I thought I could get pregnant again just by having lots and lots of sex.  Ha!  I actually called Aventis, maker of Lovenox, and they assured me they are not sourced from China.  The heparin I now have is the generic of Lovenox and there's no telling where this stuff came from.  Now I'm no xenophobe, but I really hope it contains the intestinal mucosa of Western pigs.   

Mmmmm.  Pig intestine.  How do I get that goodness in me?

You guessed it - MORE needles!

Enoxoparin sodium (generic of Lovenox) -  Street value: $915!! 

Yes, generic costs that much!  Thank goodness for insurance.  My copay: $25

They're In!

The last few nights have been rough.  I kept having nightmares that my three little embryos didn't make it to transfer.  Thank goodness those dreams did not come true.  Transfer was this morning!  One of America's Most Wanted embryos was arrested at the 9 cell stage. BUT the other two made it to Day 5 transfer and are now on the inside!  Here they are, a beautiful blastocyst and a morula (stage before blastocyst):

I would just love to show them this picture someday.  Hopefully at this very hour they are settling in for the long winter and beyond.  By the way, I really don't like the phrase "PUPO" - Pregnant Until Proven Otherwise.  It's the "until" that bothers me.  Makes it sound like having it proved otherwise is an inevitability.  I propose the term be changed to "Pregnant Unless Proven Otherwise", which I think sounds a bit more optimistic.  Who's with me?

Thanks to my brother, my kids have been chauferred around and well cared for today while I've been in bed.  Having him here with us has been such a blessing.  I was actually in bed for most of Sunday and part of Monday as well due to being sick.  Tomorrow will be another lazy day.  I am getting so spoiled!

Lovenox started today (OUCH!  That stuff burns!) but tomorrow will be my last PIO shot before transitioning to Endometrin suppositories.  This is to avoid any bleeding and bruising from the PIO shots that may be caused by the blood thinners.  Works for me!  I much prefer the "ick" of suppositories to the "ouch" of those big needles.  So all good news today and I hope it just keeps on coming!

America's Most Wanted

Mixed news with today's fertilization report.  Of the eleven eggs retrieved, only four were mature.  This, obviously, is an enormous disappointment.  However, three of the four fertilized and were looking good at the four-cell stage as of this morning.  I will get a call early tomorrow regarding whether we will transfer then or wait it out until Tuesday.  I asked whether it's possible to have all three transferred since I am now over 35 by a whole nine days.  I'm guessing the doctor will say no if they all (hopefully!) look stellar and maybe yes if they don't. 

Please pray that at least two of them will be perfect for transfer!  These little embryos are among America's most wanted and I would love nothing more than to sentence one or two of them to nine months on the inside.

No, these aren't them.  This is just a sloppy Photoshop job.

Update:  As of Sunday morning, all three are still growing strong.  We're shooting for a Day 5 transfer on Tuesday!

A Giant Sucking Sound

The eggs were sucked out of me this morning.  I was far less nervous about being medically assaulted this time around.  I ditched my dignity at the door, calmly stripped off, donned the gown, and assumed the position.  Hubby was dispatched to the Back Room to peruse the festive selection of literature.  This month's spread:  Ho's for the Holidays.  At least that's what I imagine.

Got eleven eggs this time.  I feel neither happy nor crappy about this number.  I'm trying not to think about it until I know how many are mature, how many fertilized, and most importantly, if there are any great ones to put back.  I need one with staying power. That's all that matters.

"Eggs from heaven!"

"No...from her bum!"

This part of the process is really not fun.  Up until now I was being proactive - stabbing myself, going to appointments, and getting probed.  I could see and feel progress happening.  Now it's all out of my control.  Of course, things have really been out of my control for a long time, but now it's even more out of my control.  I hate that.  All I can do right now is lie around the house like a slug on drugs.

Hurts So Good / Switch Flipper

The lone ovary has done surprisingly well despite the endometrioma that I'd feared would ruin this cycle.   I've been feeling sore and lopsided for the last couple of days.  For most of the past nine years, pelvic pain made me terrified and anxious because it meant something was wrong.  It's nice for a change that hurting down there is a good sign. 

Stims this time around actually produced more follicles than last cycle, and in a shorter period of time.  Today's ultrasound showed three mature-sized follicles and five more that should be mature by retrieval on Thursday morning.  Eight would be great!  Last time I got six that were mature.  Just minutes ago I injected myself in the rear with the HCG.  Even though I know it really doesn't hurt, that big needle made me nervous for a moment.  But it's all over now and tomorrow there will be no needles!

The better-than-expected follicle count has gotten my hopes up a bit.  Hope is a scary thing for me anymore.  I've noticed that my life tends to go in 5-7 years phases.  When it's good it's very very good and when it's bad it's horrid.  Things will run overwhelmingly one way for years and then turn around and go the other way as suddenly as if someone flipped a switch. 

Before the Really Bad Phase kicked off with the death of Jeremiah, I'd had a seven-year Good Phase which got me a college degree, the opportunity to live abroad and travel to 30+ foreign counties, a wonderful husband, and two living children.  This current Really Bad Phase has gone on for nearly four years.  Switching back to Good now may be a bit premature, but I believe an early reprieve is in order since these last years have been SO terribly bad.  I'm praying that the Switch Flipper will see fit to go ahead and flip it right now!

In the Closet

First, a cycle update:  Today is Day Six of stims and the first ultrasound.  There are seven follicles between 10 and 16 mm.  This appears to be a great improvement over last cycle, which had just two measurable follicles at this point.  I wonder, though, if one or two of these are actually shrunken endometriomas?  One definite endometrioma is at 2.7 cm.  Sure wish I didn't have this confounding factor to deal with this time around.  Trigger is projected to be on Tuesday, after just seven days of stims.  That's three days shorter than last cycle.  As always, I'm wondering if that's a good thing or a bad thing.  More appointments tomorrow and Tuesday.  Until then, I'm trying not to obsess about everything too much (ha - too late!).  And I'm definitely not talking about it anywhere but here.

I've never been very public (in real life, at least) about my infertility.  It's easier to keep it quiet with secondary infertility.  Plus, since I've had two late losses, I imagine many people think I've just given up.  So for this IVF cycle, I've decided to go with a strict Don't Tell policy, except with a few family members and geographically distant friends.  I'm just trying to prevent the news from getting out in my immediate circle so I don't have to deal with unexpected questions and comments when I'm out pretending to be a normal person.

I wish I didn't have to lock myself away in the infertility closet, but it's just not worth the effort and aggravation of being "out".  I'm not willing to risk platitudes, stupid comments, judgment, and gossip.  I know that being "out" can help others better understand the difficulties of infertility and how to be more sensitive towards those who struggle with it, but I'm too beaten down to care. 

How about you?  To what extent are you in the infertility closet?  Do you try to help others understand what infertility and/or loss is like?  Do you want family and "real life" friends reading your blog or do you try to limit readership to others in the loss/infertility community? 

None of my local friends and acquaintances know of this blog (except other local bloggers I've met - Hi girls!).  I aim to keep it that way.  If everyone around me knew, I imagine that blogging about such intensely personal matters would begin to feel something like this:

Back in Fighting Position

My body has decided to cooperate after all. Yesterday I was blessed with The Curse. Today's ultrasound showed further shrinkage of the suspected endometriomas (now 2.7 and 1.2 cm). The third is likely masquerading as an antral follicle, which are numbered at nine. Stims begin TOMORROW!

In other good news, my brother finally arrived yesterday, a month later than planned, and will be staying with us for the near future. This is a mutually beneficial situation, as he is now able to study away from the hostile environment of our parents' house and I no longer have to stress about finding child care on short notice when I have to go to the clinic. Plus he is awesome with the kids!

So tomorrow: the protocol this time around is 5 units Lupron and 150 IU Menopur in the morning and 300 IU Follistim in the evening. That's double the Menopur and triple the Follistim I started out on last cycle. I'm hopeful the higher doses will improve my chances, but of course I have no idea how the endometriomas will affect things.

My greatest fear is that this will end badly and the hope that has sustained me these last few years will die a sudden and horrible death. I'm not sure how to live with that. Because of all the drama going into this cycle and the fact that it may be the last, it's been hard to feel ready. Frankly, I'm shocked that I have any fight left in me at all at this point. I guess it just goes to show how desperately I want this. So I'm hoping very hard that this will be our last cycle because it works and not because financial or physical constraints prevent any further attempts.

Clueless

Today's ultrasound left me even more confused and clueless than the last one.  My estrogen has gone down from 191 to 79, but there's still not so much as a spot or a cramp happening.  Even so, my lining managed to shrink from 9mm to 6mm.  I don't get it.  Physically I feel fantastic but I can't even enjoy it because it means something is really wrong.  I need to be bleeding (which means hurting) so we can get this show on the road!

The endometriomas (if that is indeed what they are) have all gotten smaller - 2.7, 2.2, and 1.2 cm.  Good, right?   But the antral follicle count also got smaller - 5 today, compared to 8 last Tuesday.  This has me worried.  Tuesday my doctor told me that because I had 8 antral follicles, that would be the upper limit of eggs we could possibly get, assuming I even get to try.  Today I didn't get to talk to the doctor, but the nurse told me antral follicles "go in and out of you" and can change day by day.    Any chance the number can go UP from here?  If not, is there any point to this?  That's what I get to agonize about until my next appointment on Monday.

[Note: My belly looks exactly like this!  Except I have multiple surgical scars and bruises from injections.  Plus I have stretch marks I wouldn't trade for anything!]

A Shocking Development

I've been dying to write a post saying I've got good news for a change and I was hoping today would be such a day. For the last two weeks, I've been feeling pretty great. We had a nice little vacation to visit family. Also we've been on lots of fun family outings nearby lately thanks to unusually warm and wonderful weather here.

It's totally off-topic, but this is pretty funny (must have some humor because the rest of this post sucks):



The best thing about the last few weeks is that I've had hardly any pain at all. I certainly took this as a good sign. I was finally able to get excited about IVF #2, which would feature much higher stim doses and Lovenox from transfer. I felt these would be two big improvements over last cycle. I dared to be a little optimistic. Stupid me. I should know better by now.

I've been on Lupron for 10 days and took my last pill Wednesday of last week. But nothing happened. No bleeding. No spotting. It's quite bizarre that after years of desperately hoping my period wouldn't come, I am now desperately hoping that it will.

By yesterday I knew that something was very wrong, so I went into today's ultrasound with dread in my heart. The endometrioma is still there, same size, but has now been joined by what appear to be TWO MORE endometriomas. One ovary. Three endometriomas. *sob* The antral follicle count is eight, which seems pretty dismal. Last time there were eleven. But it is completelly irrelevant at this point because obviously I can't move forward. I have to bleed first, and there's no sign of it happening. Also my estrogen is too high (192 - should be under 50). My doctor called and said to stay on 20 units of Lupron and come back on Friday. IF I bleed and get the estrogen down, I might still be able to proceed, though not with much optimism. If not, this appears to be the end of the road for me.

Financially we cannot proceed with treatment after January 1, 2011. Months ago we paid for a three try cost-sharing plan under which we get our money back if we don't end up with a baby. Try #1 failed, try #2 could fit it this year but is now in jeopardy, and time constraints make it impossible for there to be a #3. The plan we're on covers the actual IVF but not the drugs or monitoring, which easily total $7000 per cycle without insurance. Right now we're fine because we have great coverage, but as of January 1 the COBRA plan we're using for infertility will no longer provide any coverage. No coverage is available through hubby's new employer. In just days we lost the hope of a third try and also quite possibly a second. Without the IVF, we have NO hope.

I am so grateful for my two living children. Without them I could not get up in the mornings. Ending my family with burying two babies, though, has left gaping wounds. It has caused such destruction in all aspects of life that some days I wonder if hubby and I will be able to keep our little truncated family intact. The person that my husband married died in 2007 and I am a very poor substitute.

I fought SO hard to have this chance. Dodged bullet after bullet . . . the stupid counselor, unemployment, and horrible insurance just to name a few. Next week I turn 35 - the dreaded fertility drop-off. What a heartbreaking plunge it might be. It can't end this way. It just can't.

The Winners!

The winners of my contest are . . .

First prize:  Jrs with 24 points

Second prize:  Cherbear with 20 points

Congratulations!

What Not to Watch

One evening when I was bored, I considered watching this on Netflix:

Has anyone seen this? I ended up watching something else and I'm glad I did. A friend has since told me it's quite scary and offers little in the way of hope for the chronically stressed. The title alone is enough to stress me out - Stress: Portrait of a Killer.

We all know that many health problems are caused or exacerbated by stress. According to this documentary, prolonged stress can "shrink our brains, add fat to our bellies, and even unravel our chromosomes". After nearly four years of extreme unrelenting stress, I don't even want to think about how badly my body has been damaged. Or how much my life has been shortened.

My vacation was quite relaxing and actually almost pain-free, which was fabulous. The insurance issue, though, has continued to be a major source of stress. I was unable to get any clear answers regarding what my new insurance covers. The benefits manager at my husband's work was likewise unable to get any straight answers. Finally today the clinic's financial coordinator called to say that she finally got a response from the insurance company. They will cover exactly nothing. Not ultrasounds. Not blood tests. Many insurances that don't cover infertility will at least cover that. But not mine. Figures.

I think keeping COBRA coverage under these conditions is legitimate, although I'm sure some would disagree. It's a grey area I plan to take advantage of because it's high time something works out in my favor. We have $1200 in infertility coverage left on that policy and I intend to milk it. I'm glad to finally have some answers, painful as they are, just in time to get the COBRA premium paid. Why do we always have to cut these things so damn close? [Speaking of cutting it close, don't forget to enter my contest (see last post). There are just three days left!]

This employer-based insurance system really doesn't make sense. Why should an employer dictate my insurer and coverage? Having the government do it would be worse still. I want to be able to compare insurers and plans. I'm smart enough to decide what makes sense for me and my family. So are you! Power to the people!!

100 Posts!

This is my 100th post! In celebration, I am having a contest - a matching game of the literary and cultural references in my blog. Yes, it's always high culture and fine whining here at Cradles and Graves!

Here's how it works:

• Match the items in The List below to the post(s) referencing it - you can use the post title or date; you get one point for each match. Anyone can enter - you need not be a babyloss/infertility gal. Lucky you if you're not.
• This is intended to be EASY. Almost all of the answers are in the post titles, so just look at the archive list. The few that aren't there can easily be found using the handy "Search This Blog" feature on my sidebar.
• Email me your answers on or before November 1; DON'T put your answers in the comments section below - that is just helping the competition! My email is cradlesandgraves at yahoo dot com. [Update: As of October 28, the top score is 24.]
• Items with a * have multiple references, so there are bonus points available! There are also a few pictures on the blog that match up to items on the list. Bonus points for that, too!

• One winner will be chosen randomly, so you win even if you only find one match! That prize is a $10 Great Harvest gift card and a jar of pomegranate jelly (pomegranates are a symbol of fertility).

• The person who has the most points by the deadline wins the prize shown below. If it's a tie then the prize goes to the person who got the score first. It's fine to send multiple emails - send them whenever you find matches and I'll keep a tally of your total.
• Because infertility / babyloss can kill the laughter and romance in a relationship (don't I know it!) the prize is intended to help you get a little of it back. The person with the most points wins a $25 Vicoria's Secret gift card, comedian Brian Regan's DVD The Epitome of Hyperbole, and some snacks to eat while you watch it with your significant other. If a winner lives in an area where they can't use the gift cards (overseas or in the middle of nowhere), then we will figure out a comparable prize.
• Questions or comments? Leave them in the comments section below.

The List

1. AC/DC
2. Tori Amos (*)
3. Lance Armstrong
4. Jane Austen
5. George W. Bush
6. Charles Darwin
7. Charles Dickens
8. Dire Straights
9. INXS
10. The Lone Ranger
11. Matchbox 20
12. My Fair Lady
13. Sir Walter Scott
14. William Shakespeare's Julius Caesar
15. The Simpsons (*)
16. Dr. Suess
17. Toad the Wet Sprocket
18. Wicked
19. Winnie the Pooh (*)
20. The Wizard of Oz (*)
21. A prophet from the Bible
22. Book about pregnancy by Heidi Murkoff
23. Movie from 1997 - A single mother/waitress, a misanthropic author, and a gay artist form an unlikely friendship
24. Movie from 1999 - A comedy about a psychiatrist whose number one patient is an insecure mob boss

Thanks also to everyone who has read and commented on my blog. Loss and infertility has been so difficult and isolating. It really means a lot to "meet" so many wonderful people who are going through similar struggles. I also appreciate my "real life" friends who aren't going through similar struggles, but who come along on my journey through my blog.


A big thank you also goes to Q, my hubby, for being so wonderful even as we've been through such horrors together in the last few years. He has never posted on this blog but he helps by finding pictures for it, which explains why there are pictures of girl fights and scantily clad women. Also, it was his idea to have the Victoria's Secret gift card as a prize.

Money For Nothing

Today I was hoping to write a happy post (we sure need one around here!) about our new insurance that kicks in on November 1. Before Q took his new job, we asked about the infertility coverage and were told that there is $5000 for medical. They refused to tell us if there was also coverage for drugs until we got a member ID#, but we were hopeful there would be some $ there as well.

The new insurance cards arrived today. I immediately got on the phone to see if there is any drug coverage. I have most of the drugs for next cycle, but still need more Follistim and Menopur. Can't get anywhere without those. Since I'm supposed to start those drugs on November 5, I was hoping I'd have some insurance coverage as of November 1 to help finance it.

As you know if you follow this blog, things are never easy around here. Not only is there no drug coverage, there is also NO INFERTILITY COVERAGE. None at all. Not even for blood work and monitoring ultrasounds. This is according to the representative at the insurance company. I, of course, am forbidden from seeing the actual policy myself until November 1. This really throws a wrench in our plans. Can we even go through with this cycle? We can't be throwing thousands more into this!

All the actual IVF is already paid for out-of-pocket, leaving our pockets pretty empty. It's the monitoring, bloodwork, drugs, and consults that are at issue. Our current COBRA policy has maybe $1000 left for infertility but the drug coverage is exhausted. It does cover the monitoring and blood work without a limit. So I looked into whether we could keep that policy beyond when Q becomes eligible for crappy coverage at his new job. Here's the scoop from COBRA's website:

If you start a new job and enroll in their group health plan, you can still qualify for COBRA if your new plan imposes limits, exclusions, or waiting periods on your coverage.

Well, it imposes an exclusion on coverage for my medical condition, infertility. So does that mean I can/should keep the COBRA? Or would I end up in jail or something? After all, infertility isn't a real health problem (please sense the sarcasm here). It's just an inconvenience. It's just a lifestyle issue. I know I often think so when I'm so depressed I wonder how I can go on. Or when I'm sobbing on the floor because of endometriosis pain, which can be put into remission by having a baby.

That "just relax" thing? Still not working out so well. It was all I could do to remain civil while getting the run-around on the phone with the insurance company today. It doesn't help that I already had a visceral hatred toward this particular insurance company. I used to do medical billing and everyone in the office hated this company because they are always finding ways not to pay claims. And now they're going to be my insurance company. [Bad word.] [Very bad word.]

I have two days to sort this out, because then we are off to exotic Illinois and I really don't want to take this worry on vacation with me. I've got plenty of baggage already, including that beastly endometrioma that makes it feel like I'm being stabbed repeatedly in the ovary. Also, it KILLS when I sit still for more than an hour. And we're driving to Illinois.

This blog noir phase is dragging on and on and on, isn't it? The next post will be #100. I promise it will be a happier one!

Just Relax?

With just over a week left until I start Lupron in preparation for IVF #2, I have been attempting to "just relax".  It's proving very difficult.  It seems that every time one stessor is removed or lessened, another stressor takes its place, often adding even more stress than before.

After the first IVF failed, I met with a perinatologist who will let me try Lovenox from transfer and she has me taking lots of supplements.  Also, I will start at much higher stim doses next time around, so I was encouraged that the next cycle could go better.  Stress level - down a little. Then of course it went way up with the endometrioma discovery.  WHY does it always have to be one step forward and two steps back?

Then yesterday I found out that my youngest brother is hospitalized indefinitely.  Suddenly my problems seem pretty small.  Or at least less likely to kill me.  Soooo . . . I'm trying to just relax.  I managed to have some fun in the kitchen with my kids.  Here's what we made:

Hughes Syndrome

The search for an explanation of my losses and other pregnancy problems has always led to two theories: 1) a blood clotting disorder or 2) a genetic issue. The genetics theory is discussed here.

Since my recent visit with the perinatologist, I've been wondering more about the clotting theory. As I posted previously, there are some clues that this might be the case but my lab test results don't fit neatly into the diagnostic criteria. To get an official diagnosis one has to exhibit certain symptoms AND have conclusive positive lab tests. Here are the symptoms of the clotting disorder Hughes Syndrome (a.k.a. antiphospholipid antibody syndrome) and whether I have them:

Blood Clots that cause "young" stroke or heart attack (under age 45), pulmonary embolism (clot in lung), or deep vein thrombosis (usually in the leg).

I've had none of these (yay!). There's no family history of this either. The only clot problem I've ever had was a *blush* debilitating thrombosed hemorrhoid following my first child's birth. According to my doctors, this clot does not count. I can tell you, though, that the indignity of stirrups is nothing compared to the humiliation of butt surgery done under only local anesthesia.  Moving on . . .

Pregnancy problems -
Intra-uterine growth resriction (IUGR) - Yes, my first child had this
Placental abruption - Partial abruption was suspected during labor with my second child, but it was never confirmed
Miscarriage, particularly in mid-pregnancy - A big YES on that one
Pre-eclampsia - No
Infertility - yes

Memory loss - My memory has not been great in recent years, but it's improved since this. I've always attributed it to trauma, inadequate sleep, anxiety, and all the drugs I've been on. My kids never let me forget that I'm "not a good rememberer"!

Headaches, especially migraines - I've never been one to get a lot of bad headaches but lately I've noticed subtle headaches practically every day. They rarely interfere with my normal activities. I suspect (and hope!) they're caused by stress, anxiety, etc and not by tiny blood clots in my brain!

Cold skin - I seem to have poor circulation in my hands and feet compared with most people. I've noticed my feet sometimes turn purple (but aren't uncomfortable) when I stand in one position for 15 minutes or so. Also my hands are like ice all winter even if I'm indoors all day. I noticed this long before I ever tried having babies, but I never thought for a moment that having icy hands could be a harbinger of doom!

Purple-blue discoloration of the skin, particularly around the knees and elbows - I've noticed this around my knees sometimes after showering.

Shortly after my losses I mentioned these supposed signs to my doctor and he dismissed them as "grasping at straws". As a result, I haven't brought it up again with subsequent doctors, but maybe there is something significant here after all.

Other than the pregnancy issues, most of the symptoms I have could easily be dismissed as subtle or subjective. I mean, everyone gets headaches. Everyone forgets things. Everyone gets cold, especially here in Minnesota! How do you know when you're outside the normal zone?

If thrombophilia (too much clotting) IS my problem, then there may be hope for me assuming I can ever actually get pregnant. According to several studies, Hughes Syndrome patients' odds of successful pregnancy are about 20% without treatment.  My success rate thus far is 40% - lucky me!  With aspirin and heparin treatment it goes up to about 80%. I'd love to give heparin a shot! Now if I could just get pregnant . . .

Tired of Holding My Head Up

The recent bad news about my endometrioma has seemed like the last straw.  I try to keep holding my head up and pretending that everything is fine, though I feel like I'm about to collapse under the weight of all the accumulated bad luck and rotten news.

Q (my hubby) and I needed a little break from it all, so on Saturday we went out on an actual date!  This does not happen very often.  In fact, the last time I remember going out together for the evening was when we went to an IVF seminar.  All that talk about taking a giant needle in the ovary sure got me in a romantic mood.  My mom called in the middle of it - "Oooh, are you guys out on a date?" "Um, yeah." 

So it was high time for a real date.  We went to see our favorite comedian, Brian Regan.  I thought I'd die laughing, but no such luck.  Ok, so that's not funny.  If you want funny then check out the Brian Regan clips at the bottom of my sidebar. 

Also, here's a little comedy from Margaret Smith.  Sorry, couldn't find a video of it, but you can just listen while you browse around the internet.  There are bits about depression, adoption, and therapy . . . that's comedy gold right there!

The Endometriosis Diet

Soon after I was diagnosed with endometriosis, I found information about a diet that's supposed to help with the condition. I printed out a cookbook full of endo-diet compliant recipes. Here are the diet No-No's:

Wheat and Rye
Meat (except chicken and some fish)
Dairy
Sugar and pretty much every other sweetener
Soy
Eggs
Coffee, Tea, Alcohol
Vegetable Oil
Most canned and frozen foods
Chocolate

That covers most of the food pyramid! So what is allowed, you ask? This is a short list:

Seeds and nuts
Fruits and vegetables (organic!)
Chicken (organic!) and some fish
Grains other than wheat and rye

Imagine dining day after day on such gastronomical delights as mung bean salad, yam pie, and lentil pate . . . this is the stuff of nightmares! In addition to being a life-threateningly boring diet, it is uneconomical and labor intensive. Also, I can find no solid evidence that it would help at all.

After looking through the cookbook, I realized that this diet is the most effective means of endometriosis management I've seen so far. I knew this diet would end my endo pain for good. How? By being so restrictive that I'd soon starve to death and never again be troubled by endo - or anything else!

Finally Feeling Fabulous!

I'm still alive, so obviously I didn't try the diet. I try to eat well (organic produce within reason, little red meat, limited sugar, no caffeine or alcohol, rBGH-free dairy products, etc.) but a girl's gotta have some chocolate on a rough day! Also I just don't believe dairy, eggs, and wheat are bad. Other than that, my responsible and diverse diet actually goes along with a lot of what the endo-diet recommends. I just don't take it to ridiculous extremes because it seems that strictly adhering to this diet would inflict more misery than it could possibly relieve. If you have endo and have discovered that such a diet really works, do let me know. In the meantime, I shall be enjoying some mint chocolate chip ice cream.

The Devil Inside

The year that Jeremiah and Miles died, 2007, I felt like I'd been run over by a truck.  For the last few years I feel like I'm getting whacked in the head repeatedly with a 2 x 4.  I get hit by bad news followed by more bad news followed by even more bad news.  It's better than being hit by a truck, but can't I get a break? 

Last Friday was my ultrasound to check the status of my evil twin cysts.  I went into it knowing I probably would not get great news (I've had a lot of pain the last few days - that's a bad sign) but I didn't expect to get hit with horrible news either.  That's what I got though, and I'm still reeling from the blow.

One cyst is resolving and is now 1.5 cm compared to 3.5 cm three weeks ago.  OK that part's good, but wait for it . . . The other diabolical cyst remains 3.5 cm and my doctor thinks it is an endometrioma.  If so, then the only way to get rid of it is surgery, which she strongly discourages.  She recommends proceeding with IVF anyway and she will try to work around it.  The cyst is likely to have a negative effect on follicle production.  I only got 6 mature eggs with my recent cyst-free IVF and just two embryos made it to transfer.  I don't feel very hopeful about my prospects with yet another handicap on top of all my other crippling handicaps.

Regardless of whether I proceed with IVF or not, one thing is certain - I will continue to face a lot of pain in my future.  What can I do but plow ahead as long as there's any hope of obtaining great joy to go along with that pain?  So I'm off The Pill for a few days and then will start back up and head into another long Lupron IVF cycle.  IF this all goes off according to plan [laughs bitterly] then stimulation meds would begin in early November, with retrieval right around my 35th birthday.

More Answers or Just More Questions?

First, my daughter Tania's artwork is featured on Still Life 365 today! 

Now down to business.  Today I finally got the clinic notes from the perinatology consult I had earlier this month.  To my surprise the blood tests actually yielded some interesting results, however this does little to clarify why my pregnancy history is so tragic or whether there's any hope for the future.  I'll spare you the life-threateningly boring science lesson about clotting disorders and just link to the heavy scientific explanations.  If you want to make your head explode, go ahead and try to understand this stuff.  Here are the results from my perinatology consult:

ANA (antinuclear antibody) – Positive 1:40 with speckled pattern
Apparently this is a low positive, so there's absolutely nothing definitive about it.  Just another positive result that makes doctors go "hmm", but not "AHA, now we know what's wrong with you".

Beta 2 Glycoprotein 1 -
IgA: 69.46 U/mL
IgM: 4.84 U/mL
IgG: 3.72 U/mL

Note from Mayo Clinic Lab for IgA, IgM, and IgG interpretation:
10.0 U/mL or less = negative
10.0 – 14.9 U/mL = borderline
Greater than 15 U/mL = positive

If IgM or IgG is positive, the diagnosis would be antiphospholipid antibody syndrome (a.k.a. Hughes Syndrome, which is certainly easier to say).  Only my IgA is very elevated and (surprise!) there is not adequate research to indicate what this means.  Again - "HMM" a little louder this time, but NOT "AHA!!".

In 2007 just after my first loss I tested positive for Anti-cardiolipin antibodies.  Results from testing immediately after delivery showed a "Moderate Positive" for IgG, followed by retesting the following month which showed an "Inconclusive" level.  Tests for IgM were negative.  Positive IgM levels indicate a problem.  Positive IgG levels - well, no one's really sure exactly what that means.  Hmm - not AHA.  Are you seeing a pattern here?

Subsequent Anticardiolipin testing has been completely negative both after losing Miles (July 2007) and now (September 2010).  As if things needed to be any more unclear, results on all of these tests are transient - you can test positive and then test again later and be negative.  Or vice versa.

Additionally, I am heterozygous for MTHFT mutation C677T.  This means I have one copy of the gene.  The significance of this, as you may have guessed, is unclear.  Hmmm. If I were homozygous (two copies of the gene) then it would be clinically significant. 

So those are all the answers I've gotten from 40+ vials of blood, not to mention buckets of tears. I never expected any definitive answers about my horrible pregnancies from the perinatologist.  Indeed, I'm convinced that there's not a single person anywhere in the world who can give me solid answers.  Still, it's depressing to hear yet again that there is no certain explanation for my losses and no clear way to prevent it from happening again (other than remaining Super Infertile!). 

I've been reading more about Hughes Syndrome and I do fit a lot of the descriptions.   This post is getting pretty long, though, so we'll get into that later.  Sorry to keep you on the edge of your seat!  Seriously though, this blog is meant for the poor souls who will inevitably follow in my unlucky footsteps so we have to get into boring clinical stuff from time to time.

Our Family

My daughter Tania, who just started half-day kindergarten, drew this picture of our family for her class:

On the right she drew Daddy, then Mommy (me) with Jeremiah and Miles next to me, herself, and her brother David.  I was amazed that she thought to draw her lost brothers in the picture.  She was one when we lost Jeremiah and two when we lost Miles.  They were both five months along, so of course she never saw them or knew what was happening at the time. 

Ge-ge and Mei-mei head off to school

(That's "big brother" and "little sister" because

they go to Chinese school)

Now that both David and Tania are in school, I have two hours a day without any kids. It's more "me time" than I've had in years. It's nice to have some uninterrupted time and I get a lot done, but the house is just too quiet! Sure wish I could get rid of these cysts and have another shot at a rainbow baby.  I'd love nothing more than to bring the "me time" back down to almost zero! 

"What to Say"

It's been interesting lately to look at the new stats section on blogger.  One post on this blog gets far more hits than any others.  It's What to Say When Someone Loses a Baby.  I posted this a long time ago, before anyone even knew this blog existed.  I hope it's been helpful to the people who've found it.  No one has ever left a comment, but it's good to see that so many people are looking for ways to help friends through a difficult loss.  Let's help them do it right!  If you have any words of wisdom to share with friends of baby-loss parents, please click over to the post and add your thoughts! 

A Drug Deal Gone Bad

I actually had been handling Monday's bad news (IVF delayed because of cysts) rather well, I thought. Maybe it's because cysts are no surprise at this point. It's more of a surprise if I don't have them. I got the dates for IVF #2 soon after learning that IVF #1 had failed, but I never really let myself believe things would go according to plan. Never told anyone what the dates were. Never put any of the dates on my calendar or on this blog. I did joke to hubby, though, that if the IVF worked I could have big sore Boooooobs for Halloween. What a treat that would have been.

Anyway, I was managing very nicely until my drug shipment arrived yesterday along with a nasty surprise - my $10K drug coverage has just been exhausted. Price tag for the package - $4832!!! I thought we still had enough coverage for this next cycle, but it turns out that the pharmacy my insurance makes me use is the most expensive of them all for the drugs I'm on. Therefore, the $10K drug coverage was burned up after just one IVF and 3 Follistim IUI cycles. The pharmacy was supposed to call me in advance with the post-insurance cost of this cycle's drugs, but they didn't! They were also supposed to email me when they sent the package out, but they didn't. If they had, I obviously would have only ordered what was covered by insurance.

Q and I had a very tense 24 hours wondering if we'd be stuck with this bill. We thought we had this IVF thing figured out so could handle it without ending up in the poor house or the nut house or in separate houses, but this latest drama had me worried we'd be pushed over the edge. We were feeling the burn in our wallets, and then...

Finally this morning the pharmacy called me back to say they will take the drugs back since they screwed up by not calling me. Hallelujah, I'm saved!! *HUGE sigh of relief!*

Thanks to my cysts, I now have ample time to shop around for more reasonably priced drugs. Yesterday as events were unfolding, I got an email from another blogger who has leftover Follistim and is Lucky enough not to need it. How awesome is that? Can't get over the timing. Since I have some drugs left from last cycle, it shouldn't be too expensive to get the rest of what I need - certainly not $4800. Good thing, because we're still recovering from the recent bout with unemployment! So, that's the latest here at Cradles and Graves, where nothing happens without a great deal of unnecessary drama!

Evil Twins

Today's ultrasound and nurses consult for IVF#2 did not go so well. Can you guess why? Yes, cysts. Cysts are a dominant theme on this blog. I have evil twin cysts, both 3.5 centimeters. I was supposed to start Lupron next Sunday, but everything is now delayed indefinitely. We'll check in on these cysts again in two weeks, though I've never had one go away in less than 3 months. Until they go away I'm on The Pill continuously, then I'll jump on the Lupron as soon as I get the green light. We were lucky to be able to talk with my actual doctor (!) about all this, since she was out joking around with the receptionists as we were leaving the office.

This year has at least been a big improvement over last in the pain department. Last year there were six months of constant pain from cysts. This year - zero months of constant pain, even with multiple cysts. But I still keep getting delayed and keep not getting pregnant. This year could be a lot better. Could be a lot worse too, though. No constant pain, no dead babies, and no other deaths in the family. What a great year! Well, at least compared with the last few.

Yesterday marked one year since my big little brother collapsed and died while running in our hometown's annual 10K. My parents and another brother ran in this year's 10K in his memory. Amazingly, all three family members won in their respective age groups, even with 400 other runners competing! Since we couldn't go to my hometown, my hubby and I ran 10K here. It's still hard to believe my brother is gone, especially since his death was never adequately explained.

The last time I was in my hometown for the annual festival and 10K was in 2006. On the morning of September 10, I took a pregnancy test (postive!) and then ran the 10K - slowly. I was pregnant with Jeremiah. The next day, we went to my sister's grave at the city cemetery. I have a picture of me pregnant with Jeremiah and sitting by my sister's grave - the same grave where Jeremiah would also be buried just a few months later. My hometown festival used to be pure fun, but now it is fraught with disturbing memories.