Wednesday, August 16, 2017

Treading water

I thought I was doing much better. I thought I was starting to get excited for fall: the weather starts to cool off, the leaves start changing, #pumpkinspiceeverything, and just an overall change. We're gearing up for IVF 6, and with it comes a fresh wave of hope. I know there are things still to be done before a transfer, like a hysteroscopy and making sure my thyroid is ok, but there's a path and a clear way forward. I thought I was ok.

But then shit happens and I feel myself being sucked under, fighting to not give in to depression.

  • I had my formal review on Tuesday. While I can't complain, I'm disappointed. When I had my mid-year review in January I was told I'd tentatively get an 8% increase and a new title. I walked away with an excellent review but feeling punished because I didn't get what I expected. No new title, "only" 5% raise. I'm grateful for the increase and I know I'm lucky to be employed in a great place, but annoyed because I expected more. I was given the excuse of budget cuts. Please. I know I can start looking for another job, but it's not as easy as it sounds. The mental capacity needed to interview and make a good impression in a new place is just not something I want to focus on right now.
  • A young family member went in for a colonoscopy due to bleeding in the bathroom. Waiting for results but they did find inflammation. Scary and worrying. Maybe crohns? 
  • Trump is ruining the country. Not only politically, but people are literally dying. He's egging on North Korea into war. Not just any war: nuclear war. He's giving Nazis and white supremacists a strong voice. It's scary. I'm scared and worried. Not just as a Jew, but as an American citizen living in this country. We can't hide in bomb shelters for 3.5 years until his term is over, if he even makes it that long. I'm sick of seeing his face on breaking news alerts every single day.
  • I found out a friend is expecting #4. She had her last baby Feb 2016. I haven't even had one yet. It's hard not to compare. Just when I think I'm ok, I hear someone make an announcement and it's like a punch to the gut all over again. It's demoralizing and sucks all the wind out of me, making it feel like I'll be on this merry-go-round from hell forever while everyone else moves on.
What's a gal to do. It is what it is.

I held my tears until I got home from work. I realize I haven't cried in a while - definitely been almost a month. I davened mincha. It was the first time I picked up my siddur since our loss back in May. I just poured out my heart, sobbing. Only He can make a difference. I can't control the things I can't control. Then I went for a 2 mile walk.

The prayer, cry, and walk were an incredible release. As I was wrapping up my walk I stopped at the store to pick up eggs and headed home. I was around the corner from my house when it started pouring. I didn't mind - rain doesn't bother me and it was great to cool off. Someone stopped her car and offered me a ride home. I said I literally live a few houses down but thanked her for stopping. It was such a nice gesture. Maybe the world isn't all complete garbage. Kindness goes a long way - she didn't even do anything, just the offer was enough to cheer me up. I decided I should aim to be more kind.

Friday, August 11, 2017

Thyroid

Doc from new clinic called last Friday regarding my thyroid testing with surprising results. The TSH came back at 2.98. Even though the normal range is up to 4.5 for regular people, both clinics like to see the number under 2.5 for women trying to get pregnant and during pregnancy. It's the first time my thyroid has been flagged at all abnormal.
 
Bright and early Monday morning I started stirring up some dust and placed calls to my RE, PCP, and OB/GYN to get values from previous TSH testings. It would have been mentioned  in the past if something was elevated or abnormal, right? RE nurse was first to call back and my number was 2.09 in January earlier this year. I asked her to send me a lap slip to get it retested so that current clinic has accurate numbers before we start up again and I went for bloodwork Monday afternoon.
 
PCP called back and said my level was 3.81 in March - yikes!!! It was 2.01 the year prior. PCP mentioned that anything under 4.5 is considered normal and that she wouldn't put me on medication for 2.98. She said it can fluctuate greatly between labs so she recommended getting retested to make sure.
 
IVF 6 baseline was supposed to be on Monday. I'm not ready. I don't want to start yet. We don't have finances straightened out, I didn't place my medication order yet, and I'm not ready for the pain and discomfort, and I'm still working on losing weight. I could use another month or two off. But we want to get a cycle in before the holidays so that we can rest and recover during that time, not to mention trying to enjoy the holidays.  I don't want to postpone a whole cycle to October but I also can't start a cycle next week. My nurse was out on vacation this week so I figured out the timeline with someone else. I needed an extra week. I wanted just a breather before we jump into it again. My RE said I could either do a 5th week of bc pills or have a mini menstrual cycle before starting which is what we chose. Even though it's a logistical niddah nightmare, I don't want to suppress too much before starting a stim cycle.
 
The summer is already starting to come to a close and I kind of feel cheated out of a break. We spent most of June and July grieving and recovering. I have a mental block in my mind about planning a vacation even though we could definitely use it and summer will be over before we know it. While I'm sad we didn't get to do any kind of trip or fun stuff, I'm kind of glad it's almost over. I need the pressure and questions of "are you going away this summer?" to end. There's no reason we can't plan getaways for the fall or winter or spring. Another post for another day.

My thyroid results came back from testing earlier this week: 1.91. So I guess it's not elevated? I'll bring it up to my RE before a transfer but it's interesting that there's so much fluctuation between labs. The tests were done 4 days apart.

IVF 6 baseline was moved to end of August, so we're gearing up to get started again.

Monday, August 7, 2017

Architect

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Earlier this summer I talked about updating the furniture to our bedroom. It's all functional but needs serious cosmetic TLC. Instead of spending the money on furniture, I decided to hire an architect to give me some ideas on how to remodel my upstairs. A master bathroom is more important to me than furniture, and if I restructure some walls, I don't want to get into a situation where my new furniture doesn't fit right with the new room size.

Architect spent about an hour measuring last week. I'm excited to get drawings and see different options.  I'm not sure how much a project like that even goes for: $20k? $50k? I'm not thrilled about taking out a second mortgage and getting into debt for renovations. On the other hand I want to enjoy my house and I'm sick of making decisions based on fertility stuff (like holding off on renos in case we need the cash). If it comes to it that we need to sell the house to afford a cycle, we'll cross that bridge when we get there. I'm done living in the what-ifs and am focused on the things I CAN do now rather than what's on hold while we work on building our family.


Thursday, August 3, 2017

Follow up with second clinic

This morning I met with the doctor from the second clinic to hear her opinions about our file. Between transferring records, her vacation, and getting an appointment on the books, it's been about a month since our first appointment. We've already decided we're not planning to switch because of the cost so it's not such a rush but I was interested in hearing what she had to say.

She read through my entire file and made a colorful spreadsheet summary to reference during our discussion. I definitely love her. We talked for about an hour discussing her thoughts on my file, differences she would do, pros and cons of scratch and other things. The major takeaways were two things: first, she recommended to retest thyroid. For some reason something specific she was looking for wasn't in the file and it was a simple blood test so I just did it this morning; results expected in a few days. Second, she recommended a hysteroscopy. She said it could potentially give valuable information and discover whether there is anything that is preventing implantation. The chances are slim that they'll find something but she said the benefits to make sure outweigh the risks. It can be done under anesthesia, in which case if they do find something they can just remove it then and there, or in the office as a regular appointment and if they do find something they would reschedule in the OR to remove. It's an interesting concept and I'm not opposed but there are risks and I'm not sure I'm ready for it. She said if I do it, it kind of doubles as a scratch since putting a camera (or anything) in there irritates the lining enough for it to count.

We're going to try to get a cycle in before the Jewish holidays which start with Rosh Hashanah on 9/20. Then take a break for the holidays, and hopefully transfer in October after all the holidays. Hysteroscopy would be after I get my period from the IVF but before a transfer so maybe between things during the holiday season. Apparently studies show that the scratch is effective within 60 days of transfer.

I feel like pieces are starting to fall in place with next steps: IVF, break possibly including hysteroscopy, then transfer. We'll see if anything comes back from the thyroid testing. As always, I want to go into the next transfer feeling like we did everything possible to get the embryos to stick. I'm comfortable with not making the decision right now.

One step at a time.  First up: IVF 6.

Sunday, July 30, 2017

Oh that's why

I haven't been feeling great.  It was partially the nausea and headache from the the bcp. My eyes puffy and irritated, feeling light-headed, dizzy, and out of it. I thought I was dehydrated or hadn't gotten enough sleep or was recovering from the heavy period. But as the week wore on, even though I was doing my best to get close to 9 hours of sleep to "catch up" and keeping hydrated, nothing seemed to help.

I went to my eye doctor thinking maybe my prescription needs an update. Turns out my glasses are fine but I have a touch of allergies that manifest as tired, puffy, itchy eyes. She gave me drops and they helped. Since there's no change in my prescription she couldn't say why I'm dizzy or light headed and recommended a trip to the pcp. That night my hearing started to fade on my left ear and I got nervous enough to call my pcp's office. With all the hype about John McCain in the news you know where my mind went.

My pcp was able to fit me in Friday morning and as I sat in the waiting room I contemplated why it felt like I've spent my summer in doctor's offices and whether this was a waste of time. After a quick check and some questions the doctor figured it out easily: sinus infection. So not only hormone side effects AND allergies, but also a freaking sinus infection! As crazy as it is to have all at the same time, I was happy to hear that it wasn't something more.

There's so much fluid trapped that it's causing dizziness, faded hearing, and incredible pressure and headaches. There was no coughing or stuffy nose or any of the classic symptoms that would have made me think of it, but once it was mentioned it answered all the symptoms I'm having and made so much sense. When thinking back on the past few months I just attributed the congested face feeling to frequent crying and didn't connect the other symptoms.  I've started antibiotics and already feel better.

Monday, July 24, 2017

Weekend

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It's a common question people ask each other on Monday morning: "So, how was your weekend?"

I've never been a fan of small talk. This question in particular irks me though until recently I couldn't pinpoint why. If I did something fun, I don't want to brag. If I had it rough, I don't want to air out my dirty laundry. Not only do I not want to talk about my weekend but I also don't want to discuss someone else's.

I recognize that small talk is a social lubricant that enables people to connect on a superficial level before deciding whether to invest more time in the relationship. But to me this question seems like a minefield of innocent comments that could turn awkward at any moment.  What did you do this weekend? "Oh, I spent time with my family at a water park - your kids would love it!" Awkward.  

When I got asked this question this morning, in my mind I flashed back to Saturday where I spent the day either hugging the toilet or laying down in bed wishing the headache away. I restarted the bc pills in prep for the next cycle and I got the expected reaction I do when I go from no hormones to hormones.  Instead of discussing that, I went with my go-to answer which is a smile with, "fine, thanks" and left it at that. I don't love that it comes out as standoffish but I'd rather not risk triggering the minefield.

Friday, July 21, 2017

FET 5 follow up appointment

I met with our RE yesterday to discuss next steps. While I left optimistic, he didn't give us any new information. He doesn't count the losses as implantation failures as I had originally thought. The chemical pregnancies are borderline implantation issue, but last one was definitely a pregnancy loss. My RPL workup came back negative and he doesn't have anything else to test for. The reason I'm hopeful is because as awful as treatment is, not doing anything felt worse. I'm happy to get back on the wagon to try again. It was a necessary break and it had to happen, but I'm glad it's over. Our options are to keep trying or to stop. So for now we're trying.

I made sure to mention that the way things were handled at the last loss were not ok. When we went in for our ultrasound on that Friday morning, the doc on call gave us the bad news and told us our doc would call us. We left and then spent the day at home crying, trying to figure out what the hell to do next. We didn't know if we need a second opinion; we didn't know whether to stop meds; we didn't know our options for what to do next; we were completely lost, not to mention emotionally devastated. My RE called at 4 pm. My nurse didn't email until Tuesday with condolences. I told him that was just not ok. That's too much time to go by after such a thing happening. He apologized profusely and said that's not how things should happen. He said that even though it's a big clinic, it's a small team and they have protocols in place for this. I told him that I'm not looking for someone to hold my hand, and that the medical aspect of treatment has been excellent to date, but that the way things are handled at losses leaves much to be desired. I don't know if anything will change, and I hope this never happens again to find out, but it needed to be said and I'm glad I brought it up.

We discussed IVF 6. The plan is to get an IVF in before Rosh Hashana and aim for a transfer after the holidays, in October. We will stay with the protocol including blood thinners and anti-inflammatory meds, not because he believes in it but because he doesn't want to change something else. We talked about doing the endometrial scratching. In our clinic they do two scratches in the same cycle of the transfer. I've read mixed reviews about them, anything from people swearing by it to as extreme as leading to Asherman's. It's hard to know and I don't know what we'll decide, but we have time to make a final decision before a transfer.

As for the second opinion, we're still waiting to hear back. We sent over the records but that doc went on vacation before having a chance to review them. I was told I'd hear back by end of  next week. Unless we hear something completely new that our current clinic refuses to try, I'm not sure a move is the right way to go especially with such a significant cost difference.  Keeping an open mind and looking forward to trying again.

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