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.

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.

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.

It's about time

When I talked to the therapist, I told her I wanted to be able to control my emotions. I want to decide whether or not I want to cry, instead of it happening without being able to hold it back regardless of where I am.

She assessed that the best thing to help would be time. It takes time and distance to process the incident. I'm seeing the truth to that. I'm able to absorb triggers without letting them affect me as much. I think about it rationally -- it was a medical incident, what's the big deal -- and I realize that's how my doctor sees it. He's been treating patients with infertility for decades so he's super desensitized to failure. It's a miracle he's able to muster up condolences at all. I'm not saying this angrily or bitterly; it helps me understand his side and now I know what to ask for in my next cycle.

As the weeks go by I'm able to discuss the blighted ovum without falling apart. There's still a sadness about what happened and I know I'll carry it for some time. While I'm anxious about the possibility of it happening another time, it's not going to keep us from trying again.

Also, it's baaaaack! I don't think I've been as happy to get my period since middle school when it came for the first time. It's about time.

Mid-summer Monday

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I went in this morning to get a "no menses panel" which is basically ultrasound and blood work, similar to monitoring. Blood work came back normal but my lining is a little thick so they want to start me on provera. I really don't want to be on more meds. And provera is just progesterone to take for a week and shock the system into a state lacking progesterone to induce the period. Seems counter intuitive if you ask me but apparently that's what works.

My oven saga continues. I need to decide if I want to upgrade to a convection oven. I've never used one so don't know the benefits but apparently it's all the rage, and if I'm already buying I'd like to buy a good one. My old oven was a dying 15-year old hunk of metal that barely clunked along so I think anything new would be good. In any case, we need an oven soon or we'll run out of money just on takeout food.

I've been distracted and disoriented at work. I'm either googling medical stuff or reading my file or researching ovens. I'm usually two steps ahead and am organized and on top of things. But these days I feel like stuff keeps sneaking up on me. For example, my supervisor asked me about something happening tomorrow and I smoothly transitioned into discussing it, even though in my mind I was freaking out that I had totally forgotten it was happening.

It feels like the days are flying by and things are so busy I'm barely keeping up. Very different than the usual summer pace and totally contrasted to the stand-still in other aspects of my life. Trying to enjoy the season before it's over.

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Medical records have successfully been copied and sent to new clinic for review. My file was over 16MB, while my husbands was 800KB. I took the time to read through my entire file. I didn't understand some of it. The stuff I understood was depressing. I remember each of those cycles.

My oven is broken. We've been alternating between simple takeout and sandwiches for dinners. The repair guy said there are too many pieces that need replacing and since it's an old oven it may be better to just replace which is what he recommends. Waiting to hear back from home warranty company but they are impossible to get on the phone. I've commented on their fb page and sent an email.

Still no period. Scheduled the no menses panel for next week.

I'm happy for all the people having babies. It does bother me that it's everyone but me. I sent baby gifts to two friends with new babies this week via amazon. I'm not expecting a thank you note but it would be nice to know they were received. It seems like people just fall off the face of the Earth. Even bloggers I started following years ago have moved on and stopped writing. It's hard not to feel left behind, especially when it's so literal. I can avoid fb and I can avoid the internet, but to what end? I can't avoid work. I can't avoid the grocery store. I can't avoid my own thoughts.

I hope the second opinion helps. I hope we get some good news soon. Shabbat shalom.

Really?

I was in a meeting today with 7 people which included three heavily pregnant women. Of course there were plenty of non-work-related conversations about pregnancy and delivery and child care peppered throughout. At one point in the meeting we were discussing a coworker's availability for a specific project and someone mentioned that she, too, is expecting and therefore cannot take on this extra project which is due during her anticipated maternity leave.

Not only am I not going on maternity leave, but I'm also being tasked with picking up slack from the people who are. It's not only the irony that's killing me.

If "ifs" and "buts" were candy and nuts

If the April transfer had worked I'd be 15 weeks pregnant.

If our November 2016 transfer had worked, I'd be 37 weeks pregnant right now.

If the June 2016 transfer had worked we'd have a 5-month-old baby.

If the December 2015 transfer had worked we'd have an 11-month-old baby.

If the September 2015 transfer had worked we'd have already celebrated a first birthday and likely contemplating starting again for another baby.

Instead we're still waiting for my period to come, recovering from yet another failed cycle, and worrying about the path forward. This makes me realize that I've always taken my period for granted - it was always such a given. It's been nearly 7 weeks since the D&C (over 3 weeks since the negative hcg test). I understand sometimes it takes a little longer when the body needs the time but it's adding a layer of tension to this already stressful ordeal. Also I need to remember to stay off Google - there's nothing helpful there. My doctor told me to come in for a "no menses panel" if it doesn't come by the end of the week. More tests. Ugh.

New and Different

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I love figuring out and trying new things. Sometimes it's at work, sometimes it's in the kitchen, sometimes it's something else entirely.

Today it was searching and discovering a new Excel formula: COUNTA. I wasn't even sure what I needed to search and was just typing in random phrases of what I wanted in Google. After trying several different formulas that gave me similar but not exact results I was looking for, I discovered counta. It was almost as exciting as the day I discovered VLOOKUP which completely changed my world. Yay for new things!

Second Opinion

We met with a new RE from a different clinic for a second opinion. I originally scheduled the appointment as a knee-jerk reaction to the loss, not really planning to switch but wanting to hear from another clinician taking a fresh look at our situation.

I was impressed with the doctor we met. She's young and ambitious and showed what felt like genuine interest in our case. Our current doctor has experience that the young doctor doesn't yet have, but she makes up for in enthusiasm. Our current clinic is a fertility farm and this new place felt nothing like that. There are obvious pros and cons but it's going to be a big decision.

I had not transferred my records prior to our appointment because I didn't think we were switching. When new doctor asked us specific questions, like the grade of the embryos transferred or whether they tested for xyz, I had no idea. I felt dumb for being so uninformed about my own treatment. I didn't know to ask and my current doc didn't mention it. I was able to give her the information I did know, such as number of eggs retrieved, those reaching blast, and all transfer dates.

She answered all of my questions and based on the information we provided, she offered a few suggestions. Without seeing any records, she said she can only offer a superficial opinion which is that we're dealing with an implantation issue. She suggested a few things we could look into, such as endo scratch and checking progesterone levels. We left feeling like we had a lot to think about. Not even an hour after we left I got a phone call from the new doctor. She started by saying, "I was thinking about your case and...." and had a follow up question. It was a completely new experience feeling that the doctor actually cares.  In contrast, I emailed my current doc about how long it would be for my period to come already. He did answer within a few hours with a short message saying that if it doesn't come back within a week to contact the office to schedule a "no menses panel." He hasn't heard from me in six weeks and not even a simple, 'How are you doing?' My current clinic isn't doing anything wrong but the detached mannerisms bother me.

One thing the new doctor did give us clarity about is that now is the time to be banking embryos. At age 36-37 my ovarian reserve takes a major nose dive. As long as I'm getting good results and responding well to stims it's worthwhile to spend the time on IVF. I agree, so does my husband, and it's nice to hear a professional confirm it.  For that alone it was worth the trip.

Even though it was only one meeting I like the new doctor. I got a good feeling about her specifically but don't really like the new clinic. One major drawback is that the new clinic is nearly 35% more expensive.

Switching is a big deal. Moving records, redo some testing, figure out new protocols, sort out financials. If we switch we would need to spend at least a cycle to get situated. I hate to use this as a factor in making the decision, but if we switch clinics it feels like we're not only giving up on our current clinic, but that we've changed to a last resort option. I know that's not actually the case. But I can't shake the feeling that switching equals failure. On the other hand if one place isn't working is it worth sticking around. So hard to decide.

Since my period still hasn't come we're just waiting around and can't do anything anyway. We were hoping we'd be able to squeeze in a cycle before the high holidays but now who knows. Really sucks. Impossible to plan. Hard decisions and no way of knowing if any of them are the right path. Even after all this we're guaranteed nothing.

Happy 4th

Happy birthday, America!

The pets and veterans with PTSD aren't the only ones with fireworks anxiety. I'm not sure when it became the norm to have fireworks every day of the week leading up to the 4th. Logically I know they're fireworks even though I can't see them. But in the back of my mind I think to myself, what if tonight they're actually bombs? What if a flying piece falls on my house and it catches on fire? I'm not so much a stick in the mud that I think there should be no fireworks at all -- if someone wants to waste lots of money on an evening of sparklers and there are people willing to brave the crowds and endure the heat to enjoy, by all means, have a great time. But it should be one night and under professional supervision, not every night amateur hour in the backyards.

At 18 months in, my blog is old enough to have a this time last year feature. Having just gone through our first miscarriage, I wasn't in much of a celebratory mood last year either. I can only guess what this time next year will bring.

Tomorrow marks 6 weeks since the D&C. If the pregnancy would have lasted I would be well into the second trimester at 14 weeks. Instead I'm anxiously awaiting for the return of my cycle so we can start the ball rolling for another try and finally put to rest the conversation of "what's next?" We were advised it may take 4 to 6 weeks and even though I knew it may take a while that didn't stop me from scrutinizing the color and consistency at every bathroom trip since week 3. More than wanting the next chapter to start, I need the miscarriage chapter to end. I need this failed cycle to be behind us. I am feeling sensitive and irrational so maybe that's a step in the right direction.

Flag cake! Courtesy of Google

Yesterday was the first time I've been in the gym since the last IVF cycle. I need to lose the 8 lbs I put on since the D&C when I gave no thought to what I ate. Unfortunately ice cream for breakfast is off the menu for the same reason. Other than that I want to tone my arms and overall just feel better. Once I'm at the gym I'm motivated and energetic - it's getting there that seems to be a never ending negotiation in my mind.

Hope you're having a wonderful 4th, whether you're celebrating or not.

Goals

Sometimes the lines get blurred between goals I've set up for myself and goals inspired by other people's experiences. I need to remember that I can't measure my life based on other people's highlight reel. In less words, I need to stop comparing what I want to people's fb photos.

Someone posts pictures of their magical trip to another country and I immediately think, "I want to go on a trip!" Someone else posts pictures of their renovated kitchen and I think, "I need a new kitchen!" But we can't afford those things without going into unnecessary debt.

There are choices we made that led us to this point: prioritizing fertility treatment, purchasing a house, and keeping jobs that rank higher in flexibility (me) and health insurance (him) over salary. Keeping these priorities in the forefront of my mind gives me clarity when I get sidetracked by seeing what other people have. Sometimes it feels like we're missing out. What helps me stay grounded is taking a moment to think of all the gifts we regularly take for granted: living in a place of freedom, having safe shelter, clean water, indoor plumbing, air conditioning, and enjoying an abundance of resources. Just for starters.

Sure, a trip and a renovated house would be great and maybe one day I'll spend money on those. But for the time being, I choose to spend my money and energy on other things. It may or may not work, but I won't regret giving it the best chance possible at the expense of a few less materialistic things to post about this summer.