Christmas 2018

Results came back and they're good.

ERA: as the two previous ERA tests have told us, my lining was pre-receptive and I need an extra day. This wasn't news, but we wanted to confirm since the past two were medicated and this was in prep for a natural cycle.

EMMA: no significant signs of inflammation from bad bacteria. While this is great news, it was surprising. Obviously it's good because we've already treated it multiple times so thankfully it's finally confirmed gone. On the other hand I kind of expected there to be a big announcement about what the cause is of the persistent inflammation that wouldn't go away, then use a cycle to treat it, then biopsy again to make sure it's gone... in short - I wasn't prepared for the all clear. It had taken time to accept the long delay that having a change in schedule, even for the better, kind of shook me. I'm just not mentally prepared to brace myself for another transfer and all the baggage that it reminds me of. We spent the past year doing one thing after another getting ready for this point but it feels like it suddenly snuck up on me. The past six FETs failed; four of them in miscarriages. I always knew getting myself psyched up for another try was coming but and I hadn't expected it to be time to start.

For a hot second, we had a conversation about possibly delaying a transfer. Talking through it I realized it's not what I want, but it crossed my mind when I panicked at the results. I also realized I didn't want to tell anyone the results because I was scared of the predictable next question: "so when are you transferring?"

My instinct is to respond with "well that's really none of your goshdarn business" but is that fair to someone who has been by my side every step of the way? When I call crying or I text with bad news to help spread the burden so that it doesn't crush me? I know I don't owe anyone anything, but shouldn't the support system that has been around all this time get to know the good news too? I don't want to tell people when we're transferring, but I know I'll be calling if there's another failure, so maybe it doesn't hurt to give them a heads up about good news for once.

For the time being I deflect by vaguely talking about the persistent endometritis and how there's just constant delays, and how everything takes forever because it relies on my natural cycle. Not lies; just not the full truth. As it stands now, my doctor wants me to use a probiotic. While the bad bacteria didn't register in any significant quantities, apparently the good bacteria was low also, so doc suggested a vaginal suppository. It doesn't delay anything because we still need to wait for my period. We missed this cycle because of waiting for results so even without any additional delays, I estimated a transfer in Feb. That's fine - that will give me time to get my head in the game.

Here's what else that has been keeping me busy:


Work

End of year is always a busy time at work and this year was no exception. Since my office officially closes for the last week of the year, I wanted to get as much done as possible before the last day. Things kept popping up with last minute emergencies which made the week really hectic but thankfully it all got done.

Saying yes

A few years back I read a few books about people saying yes to things (Amy Poehler, Shonda Rimes). At the time it was interesting reading but I didn't really make any changes based on them. More recently I noticed I was feeling like I was saying no to too much, to the point of not having much to do. I didn't immediately do a 180 and start saying yes to everything, but I made more of an effort to rationalize my no's to myself. Why am I saying no? Could this actually be a yes? Is this an opportunity I'm missing because I'm so used to automatically saying no? So I've taken on a bit more and already it feels like a huge shift, especially to an introvert, homebody such as myself. Even though I'm happy with the shift, I'm continuously monitoring to make sure I don't overextend and burn out.

Pottery

There are a lot of things that make me happy about this. It's not an inexpensive class, but I feel like I'm getting my money's worth. I've also taken to watching youtube videos of other potters making things to get ideas and watch techniques. There's more to it than just the evening of class because the clay dries out so there's also in between class visits to trim and glaze. It takes up time but I don't mind. I debated whether to take the same class again or try a different clay class. I want to get better at throwing pots but I also really enjoy new things. Turns out that as a paying student taking any class I can use the studio while there aren't classes in session and practice on my own. So for the winter session I signed up for a sculpting class and I'm excited about it. I do plan to continue practicing the techniques I learned this past semester and maybe take an intermediate class at some point once I'm more comfortable with the basics. I love the options. It was also really exciting to bring home my first items fresh from the kiln. Even between the very first bowl to the most recent mug there's already a huge difference. I can see that I'm getting better and it's really exciting.

The other part of this is that it is tiring. There are a lot of steps to get set up at the wheel - get water, get your clay (most times hauling out chunks of 20+ lbs), set up tools, adjust the wheel. Then sitting in the squat position leaning in really takes a toll on your body if you're not used to it. I remember after the first few classes I felt sore the next day, almost as though I've had a full workout. After throwing pots, you need to find a place to store them. Then cleaning up is a whole ordeal. By the time I put away my clay I'm exhausted. It's a great feeling. 

Beside all that, I enjoy the non-screen time of the activity. If you want to talk to someone, you just turn to them and talk face-to-face. Your hands are dirty so you can't pick up your phone anyway. I leave it locked up for the duration of my time in the studio and it's a relaxing, freeing feeling. This is coming from someone who greatly enjoys screen-free weekends every shabbat so it's not at all a new concept, but there's something about it being allowed and purposely choosing to do something else. 

Working out

I'm working on getting to the gym for 30 min three times a week. I've chosen a great gym with a six minute commute door to door and it's still a time suck. Why? It takes to psych myself up to get there and make sure I have clean workout clothes and schedule so that I have enough time to shower and dress after and eat something before working out, but time it correctly with the morning meds which need to be taken on an empty stomach and then no food for 30-60 min.

Once I'm at the gym, I'm good to go and have fun working out. Once I've gotten everything aligned, and it is getting easier the more often I do it, then it's a breeze. I like sweating. I like feeling stronger. I can already tell I'm not as out of breath as quickly. I even noticed a slight dip in my blood pressure, which is thankfully normal, but no longer starts to rise if I'm late with meds. I enjoy checking it off my list once I'm done  working out for the day. But it's still an effort and the transition of getting used to it takes time. I know it's lame to make a big deal of 90 min of exercise a week, but whatever it's my #firstworldproblem. 

That's the latest for me. Hope you're enjoying today, whether you're home or travelling, whether you're celebrating the holiday or just vegging out.  

ERA/EMMA

On Friday I went in for the biopsy. It was a short day and even though I took the day off work I crammed in a lot of errands after the appointment so I never had a chance to type it up.

My appointment was scheduled for 9 am. The waiting room still had a few monitoring stragglers but they seemed to be running on time. The doctor called me back herself, not a nurse or a med assistant. They first did the obligatory pee stick test to make sure there's no pregnancy. By the time we were settled it was about 9:30 am when the actual biopsy was taken. I've had it 4 times before (once while under during this past summer's hysteroscopy) so I knew what to expect.

As the doctor and nurse were getting things ready, we chatted about next steps and she answered a few of my questions. We went over paperwork, signed a few forms, and did the procedure. They needed to go back in a second time because there are several samples going out to a few places and they wanted to make sure to have enough. It's so uncomfortable and painful as they're doing it - the best I can describe it is getting so cramped up that it feels like you might have to poop even if you don't have to go. It's a weird feeling. As soon as they stop the pain goes away and is replaced with period cramps that get milder as time goes on. I didn't even cry this time from the procedure.

Then we talked specifically about the results. If it comes back that the inflammation is cleared up, then the next step is a transfer. If not, then we'll take the information the results give and apply it next cycle, pushing a transfer to late-Jan or later (depending on what treatment is needed). My doctor said that at that point she herself will be on maternity leave. I said congratulation and smiled - genuinely happy for her. She said she'll still be involved and will give me her cell number. At that point I started to crumble. It was partially a delayed reaction to the hurting procedure, partially because she just cares so much. I started to tear up, and when I knew the waterworks were coming, I knew I could no longer talk without going into full sobbing. She thought that I was upset because I was feeling abandoned but it was the opposite - I so much appreciated how much she cared. She said that if my transfer happens to fall out during her leave that she'll try to come in for it. I managed to squeak out, oh you don't have to do that. To which she responded that she wants to. That just made more tears come and all I could do was nod.

The doctor left and the nurse was finishing up with the packing of the biopsy. She brought me tissues and said she understand how hard this is because it took her six years to get pregnant. She said, "I was on that table 19 years ago." When she left I let myself cry for real while I got dressed. I took a minute to calm down and left. Cried some more in the car. I've repeated the story a few times over Friday and it makes me tear up every time.

It wasn't the physical pain of the procedure that got to me; it was 100% the emotional part. It's a really hard journey. Finding a doctor who is so committed and professional and exudes so much care at the same time is truly a blessing.

One second of the exchange with my new doctor was more compassion we've had during our three years at the old clinic combined. Speaking of, on Friday morning I randomly received a check-in email from my last nurse at the old clinic asking what's up. I'm debating whether or not to answer. I don't really owe them anything, let alone an answer. On the other hand maybe I want them to know that they missed such an important piece of my treatment.

So now we wait a few weeks for results and see where the path leads us next.

Natural cycle: continued

When I got the results from monitoring last Monday, things were going slower than anticipated. That continued to be true all week. Day 18 was Friday and I was called back for monitoring. It was swamped. There was only half the staff because of the holiday weekend but just as many people in the waiting room. The doctor who did the ultrasound measured the lead follicle at 17 and said "We'll likely see you tomorrow" but wanted to wait for labs to come back to make sure.

Coming in on a Saturday is tricky for me. Some people avoid it all together but I'll use whatever religious loopholes are available in order to keep the cycle on track and still keep Halacha. Just because I choose not to drive on Saturday doesn't mean I can't arrange for someone else to drive me. Because they were so swamped on Friday, I expected to wait longer to hear results, but after noon passed I was starting to get nervous. If I need to make arrangements then I need to know soon, especially since a lot of people were out of town and my default go-to person wasn't available. At 1 pm I called the nurse's line and left a message. At 2 pm I paged the nurse on call. All the while worrying about the what-ifs and different scenarios.

Worst case scenario, I do need to come in this Saturday and I don't have a ride in place. Best case they would tell me to come back Sunday for more monitoring. All the while keeping in mind that whatever happens this weekend, 6-7 days later is next weekend where not only do we again have a Saturday issue, but we also have plans to be OUT OF TOWN. Never did I imagine that the cycle would be this long or I would never have made plans to fly somewhere else.

Finally at 2:30 someone returned my calls. They were waiting for my doctor to weigh in because even though she was out for the holiday she still wanted to be informed on everything and decide the next step (isn't that amazing?). My doctor made the call that based on my blood work results, I should take the ovidrel on Friday and come in 7 days later, the following Friday, for the uterine biopsy. It took me by surprise because I thought the lead follicle needed to be at 20 for something to happen but I guess it didn't. Luckily I had ovidrel from my Aug IVF cycle that was still in my fridge. I took it at 3 pm and made sure to note the time in case it becomes relevant in the FET cycle.

So one stress averted - don't have to go in on either Saturday. The next stress is scheduling the actual biopsy. I was advised by the nurse to call the scheduler on Monday to make sure to get on the schedule for Friday. I've been calling all morning and left two messages so far and no one is responding. I'm assuming they're catching up from the weekend, but c'mon. You're a medical office and someone should be picking up the phone. I'll keep calling but it's frustrating. We're trying to see if they'll take us early enough that we can still make the getaway over the weekend. It's a slim chance but I don't want to cancel before I know for sure.

I know they likely won't have appointments before 9 am because of monitoring. The flight is less than 2 hrs but it's a short Friday. With unpredictable delays and getting through an unknown airport, even without checked luggage, I don't want to risk getting too close to Shabbat. I'm comfortable flying before noon, but there are no flights before 1:30 pm on the airline we're already booked on and switching to another airline will cost about $720 for one way. While I'm fairly certain we're canceling the trip I'm having a hard time doing that and letting everyone know before booking the actual appointment.

Natural cycle

We started the natural ERA/EMMA cycle. The protocol calls for an ultrasound on day 10, plus possible blood work. Once the follicle reaches 20mm in diameter, if an LH surge is detected, then biopsy will be scheduled 6 days later. If no LH surge, then I need to take Ovidrel and the biopsy will be scheduled 7 days later. Whatever we do for the ERA cycle will be repeated for the FET. 

It takes 15 days for the results but we won't start a transfer cycle until it's confirmed that the inflammation is cleared up. We'll need to wait and find out the results of the EMMA to see if there is still inflammation present and, if so, treat it correctly once and for all.

Over the weekend I got a text from someone telling me to keep a mutual friend in mind while she undergoes emergency surgery. Her baby was born two weeks ago and she's suffering from some unknown infection or delivery complication. I have no idea what specifically but the situation sounds terrifying. The more horror stories I hear about pregnancy and delivery the more I feel like I should be reconsidering whether it's something I want to fight so hard for. There's so much time to think that it's impossible not to let the mind wander to the worst case scenario. I don't think that's what would make me back out but it's very scary and has been preoccupying my mind lately.