IVF 8: CD10

Back today for more monitoring. I overslept this morning. I couldn't get out of bed when my alarm rang and then dozed off, resulting in a half hour delay to the start of my morning. Worked out fine because when I got in, there were only three people ahead of me instead of the usual 10+ and even though I got in at 8, I still got seen at 8:20 like I have the past two times getting there an hour earlier.

Bloodwork and ultrasound were fine. Follicles are now measuring in the 12s. They told me to make sure to have enough meds to get me through the weekend. Retrieval might be Wednesday or Thursday.

My blood pressure is much better. The headaches are slowly receding. I feel the intensity lessen every day. On Thursday I called my PCP, who is back from vacation, to ask if I need to come in for the headaches. She said that it takes time for the medication to address that symptom, even if the bp readings have stabilized. I could take something for it, like Tylenol, but wanted to make sure it wasn't something more. I'm glad that was a quick phone call instead of another appointment. I don't even care if I sound like a crazy person calling the doctor for every little thing. I'm paying for insurance premiums, this is what it's there for.

I'm 14 lbs down from the start of the summer. Still a while to get to my goal. I hope to lose another six before I get the glucose/insulin testing done again for the specialist. It's an arbitrary number but it would make for a nice round figure lost during the summer. I know the retrieval will throw a monkey wrench in this plan because I tend to crave comfort food after surgery and my will power is shot, plus the bloating and fluid retention don't help. I'll have to meal prep healthy food in advance so we don't rely on takeout.

I had to run to the specialty pharmacy for the third time this cycle to restock meds. I was trying to only take as much as I needed without going over because they're so effing expensive. But it's running me ragged. There's no delivery option and it's a 20 min drive in each direction. I know it's not a lot in theory but it's proven to be a challenge. Even more of a challenge: finding a quarter to pay the meter to park near the pharmacy. Who carries quarters anymore? It's likely that it only seems like a big deal because I've been so tired and dealing with a non-stop headache going on for a month now which sap all the energy from me.

I've been having bad dreams the past few days. Most of the time it's around 5 am and when I'm up, I'm up. It's not helping the fatigue. I think it's a symptom of all the meds. Or maybe I need to cool it with the murder mysteries on Netflix.

During my month-long quest to figure out the cause of my headache I asked my endocrinologist if I could come in to get my TSH checked to see if the dose needs to be tweaked. I went in over two weeks ago and bloodwork isn't back yet. I think they lost it. I don't love the location and I'm not wowed by the doctor - she didn't come recommended, just picked her out of an insurance list. Not sure who I'd go to instead, and now that TSH is basically under control with only 6 month follow ups, is there really a reason to switch.

IVF 8: CD6

Back today for more bloodwork and ultrasound. They found a few 8s and 6s on the left; a few on the right too small to count. They're a lot more conservative with the meds in this clinic, even knowing that I was on bc pills which are known to suppress the ovaries.

Speaking of bc pills, I've had adventures with my blood pressure. I've been monitoring it for a few weeks now, ever since the headaches started. It was slightly high but nothing crazy, like 130s over 80s. I know that bc can cause elevated blood pressure in some people who are sensitive to estrogen. I had that a few years back. But over the weekend, my pressure spiked to 150s over 100s. Then it just stayed there. It also came with a headache which really concerned me. I spent Sunday in bed, trying not to aggravate it lest it become a full-blown migraine. I took tylenol at some point which made it bearable. All day I kept taking my bp and even after lying down for a while it was still high. I have an appointment with my PCP to follow up about blood pressure but I wasn't sure I should wait that long. Eventually it freaked me out enough to go to urgent care.

The first reading they got was 175/92. If I wasn't already at urgent care that would have set me in a panic. They retook it again a few min later and it was back to the 150s I'd been getting all day. I'm not in denial but I think the first cuff they used was for kids. In any case, the doctor there wasn't as concerned about my 150s but he took blood and urine to make sure kidneys aren't malfunctioning. He said that if it spikes to 180s or above to go to the emergency room, not even urgent care because they wouldn't be able to deal with that.

This morning I called my PCP and asked for a sooner appointment even though I know my doc is away on vacation. I didn't want to leave this untreated, especially because of the headaches but also because it's freaking me out. When I came in the doc there also wasn't alarmed at the 150s but looking back at my history and seeing the repeated elevated levels, he recommended starting medication to help lower it. He said to keep my appointment with my own doctor for next week but in the meantime he gave me a prescription that needs to be taken every 12 hours. Hooray, another pill.

I was very resistant to going on bp meds as a preventive measure. It felt like a personal goal to try to control it with diet and exercise. But at this point my ego is shoved aside as panic mode sets in and I'm freaked out enough that I'll take whatever medicine they tell me to get things back in order. I don't want to fear the veins in my head are going to pop, or that every twinge out of place is an impending heart attack. I have enough stress with the cycle that I don't need those fears lurking behind high bp. All that aside, I need to make sure this is under control before even considering a transfer.

I confirmed with my RE that there's no adverse reaction to adding bp medicine to the mix. And I confirmed with the PCP office that whatever medication he gives me is safe for pregnancy so that I don't have to deal with switching it and finding a new dose once we're ready for a transfer.

Other than a blip over the weekend I've been doing well on my diet. I don't know if that's a contributing factor to the elevated bp, but even now 48 hours later I doubt that food is still in my system yet my bp was still high. I'm down 12 lbs from the start of the summer. I cut out most sugar/flour at the suggestion of the specialist to try to get insulin under their preferred numbers; and now I've cut out most salt and sodium as well. My daily food consists of a lot of colors and while it's not fabulous, I'm not hungry and I'm not bored.

I'm concerned about retesting my glucose and insulin in the fall and being told that everything I did wasn't enough and that I'll have to add metformin to the mix. I will if I have to, but I was really hoping I wouldn't have to. Another ego thing, plus I hate taking all this medication.

At monitoring this morning there were a lot of couples. I don't remember seeing so many at the last clinic. I'm still working on a post comparing the two. Every time I list the crap the old clinic did I get angry and put the list away for another time. I don't actively trash-talk them but if someone asks about my experience, like on the fb support group, I'll share my thoughts in private.

This week

This was a rough weather week and a lot of people didn't feel well, myself included. For some people it was their joints aching, for others it was constant headaches. For me it was sinus pressure and neck pain. On Tuesday I made a same-day appointment at my pcp and went in to get it checked out. I was complaining of dizziness and lightheaded feeling. It alarmed me because at one point I thought I was going to pass out. It had started a few weeks ago, right around the time I cut sugar out. I thought that I was cutting too much sugar out so I had slowly reintroduced some back in, but the lightheaded feeling didn't go away and just got so much worse during the week with bad weather. Maybe it's related to the anesthesia from my hysteroscopy? No idea.

The doctor who saw me -- not my pcp but whoever in the practice had an opening that day -- did an exam, asked questions, took down history, etc. He couldn't find anything specific other than pressing on my sinus causing discomfort so suggested that I treat the sinus pressure symptoms to see if that helps. One thing that did concern him was my blood pressure: 160/90. It concerned me too. I know it usually reads high at the doctor's office, but it's been closer to 130s/80s the past few times I've been to - even as recently as all my pre/post op appointments for the surgery. He said he wouldn't put me on meds just for one reading (even though it was two within the time span of 30 min, same results). His recommendation was to record readings for a week at home and if symptoms persist to come back.

The next day I was scheduled at my clinic to take their two hour IVF class, which is mandatory for all new patients regardless of whether you've done IVF before or not. I didn't necessarily learn anything new but I did get more acquainted with the clinic, nurses, and protocols. It relieved a bit of the anxiety that has been sitting on me about starting another cycle and a new clinic.

I brought in my blood pressure cuff with me. After the class I asked the nurse if she could help me calibrate my cuff: she would take my pressure on their machine, then I'll take it on mine, and I can compare to see if it's at all similar and whether I could rely on it. Came out to 150/85 -- similar on both machines and still high. I thanked her and left for work.

This morning I tried my cuff again at home. I took three readings and they were each different, even though they were two minutes apart: 150/86, 142/89, 120/84. The last one is basically normal! I also noticed that the pulse was going down with each one.

I know some people have this "white-coat" syndrome where their bp spikes when it's about to get tested. I have mixed feelings about this - if something makes you nervous and your bp spikes then you have high bp. If someone cuts you off in traffic and your bp spikes? If you're caught off-guard and your bp spikes? Basically if you're getting these really high spikes then you have a bp issue, no? Maybe I just don't entirely get how bp works. I assume it's like your pulse that rises and falls throughout the day but that the baseline should test normal.

Anyway. Apparently I have this syndrome because I've had issues with my bp for years. At one point they put me on medication to lower it because every time I had it tested at the office it would be high enough to alarm them, even though when I was testing it at home it was fine. Eventually the meds were making my bp so low that I advocated to get off them and I did with doc's blessing. I haven't been on them for years. I even remember that some of the bc pills raise blood pressure and I had to switch from that. I feel like I'm back on that brand now and that might be a factor too.

From what I'm reading, limiting salt is a factor in controlling bp via diet. Oh awesome. So now I can't have sugar or salt. This is fabulous. I also read that getting rid of inches off your waist is a big help in lowering bp: approx 8 lbs off for every inch you want to lose.

So what's the moral of this story? Exercise is important to get blood pressure under control, to lower resting heart rate, and to control insulin. As much as I can't get away from it, I have every reason to up my exercise.

I treated the sinus pressure with some not-yet-expired flonase spray I had from last year's sinus infection, plus the weather finally cleared up, and some of the sinus pressure receded. I was still feeling fatigued and lightheaded. I used to wake up in the morning full of energy - I'd get up before the alarm most days, get up and immediately do things like load the dishwasher, fold laundry, or some other noisy tasks that would annoy my husband. These days I'm so tired. I feel alert and awake for maybe a few hours before I feel like I need a nap, and when I don't get a nap I just function at like 40% capacity until I collapse into bed.

The tightness in my neck led to the base of the skull and felt like heavy cement just hanging out there. I debated whether it was worth going for a massage or going back to the doctor. I decided to visit a physical therapist. I got in on a cancellation appointment on Thursday morning and got a full workup. She found that my right side is more tight and after several prodding questions deduced that it was probably because of the way I sit at my desk at work. She asked about medical history (I skipped the whole fertility part), did a few diagnostic tests, and then put heat on my neck and back for 15 minutes. After cooking my muscles she started to work on them.

It. was. painful. I didn't actively cry, but tears sprang up when she touched the sore muscles. She worked on my head and neck for a while "loosening" up whatever was tight in there, but less like loosening it felt like the worst pain I can remember having. At one point she was working on a neck muscle that triggered a really bad headache/dizziness, literally like an on button. She then worked on my back to loosen the headache she caused. After that she moved to my lower back and the agonizing pain continued. At one point I asked through clenched teeth, "is it supposed to hurt this much?" and her response was that she wasn't going to work on a muscle she didn't feel needs work. In other words, if it feels good then she's wasting both our time. The full appointment took about 2 hours from paperwork to leaving. The torture massaging lasted about half of that. While my muscles did feel looser in the areas she worked, everything else hurt. My skin was bruised and my head was pounding. I didn't even have energy to buy lunch somewhere and just ate the small snacks I brought from home.

Today I'm just sore and tired, with remnants of a dull headache in the back of my skull. We were supposed to have out of town company for the weekend but they rescheduled for another week. I'm thankful to have the weekend to rest and recharge.

For the time being, or at least I can come up with a new passion project, I need to make my health my main focus.
- Balanced eating
- Drinking water
- Exercise

I want to get my blood pressure under control without medication. On the other hand, I'm exhausted. Tracking food is exhausting. Constantly utilizing self-control is exhausting. I'm limiting sugar and carbs, and apparently now salt is limited as well.

Exercise is my biggest challenge. I know it needs to happen. I know all the benefits: healthier weight, lower blood pressure, lower resting heart rate, insulin benefits. Secondary benefits are to look better and feel better. All those things are excellent motivation and yet this is a real struggle for me. I need to find a solution.

Let's say I don't do it? That means adding blood pressure medication and metformin to my cocktail of daily meds. That means side effects. That doesn't solve other problems that come along with unhealthy lifestyle which will eventually catch up with me, regardless of how many meds I take. Not least of which, not addressing these issues could mean complications during a potential pregnancy. I'm not there yet, but this is my chance to address and reverse these unhealthy issues.

Every single day I need to make the choice whether to take care of my body or to put in on a back burner behind... netflix? social media? What am I prioritizing instead of it? Whatever it is, it's not as important. I need to make an effort, make the choice, and just do it.


We're gearing up for IVF 8 as August gets nearer. The cycle starts as soon as I get a period so it's helpful to have somewhat of a say when that is with the bc pills. We're waiting for my husband's recovery window to end. In the meantime we got approved by insurance to move forward; I'm getting my meds ordered; and finalizing any last minute things with the nurses so nothing is held up once we're ready to start. This might change as we get closer, but I'm not worried or excited for it; it just seems like one more thing to check off a list.


I'm looking forward to the weekend. I'm excited to relax and catch up with people I'm too busy to talk to during the week. Shabbat shalom.