Monday, December 31, 2018

2018 Year In Review and blogaversary

It's been the most difficult and most eventful year yet. We started out with a big trip followed by a hysteroscopy in prep for our sixth FET which ended in disaster and led to the official switch to a new RE.

Our visit to the new RE set a whole bunch of things in motion:
- I saw an endocrinologist to take care of my thyroid
- We saw a male infertility urologist who recommended varicocele repair surgery
- We visited a recurrent pregnancy loss specialist and got through his recommended punch list
- I was put on vitamins and fish oil for three months in prep for IVF 8
- A second hysteroscopy was done in addition to a special stain test that found micro inflammation resulting in multiple rounds of antibiotics to treat it
- For the third time, I did the ERA test, this time in a natural cycle

And now here we are getting ready for our next transfer. We were told that we have officially reached our lifetime maximum of fertility benefits so everything from here on will be out of pocket. Not fun to hear.

This also brings my blog to three full years. I started writing over winter break 2015-16 and went live the first week of January. At the time it obviously didn't occur to me that I'd still be writing about failures and treatment three years later. Writing helps me organize my thoughts and unload when things feel overwhelming. I've tried therapy when I needed something during my lowest points. Even though it was with a person who specialized in infertility and had gone through it herself, it didn't feel helpful. Maybe because it wasn't the right person or maybe it was when things were "unexplained" and transfers keep failing it felt impractical to discuss something that had no known answers. It was also weird to get to a specific realization and wanting to explore it but then be told that time is up and losing momentum.

With blogging, I can take as much time as I want to formulate thoughts, chew through different ideas, rehash experiences as many times as I need, and then have something to go back to later on with fresh eyes and build on it. Writing is like talking to a friend with infinite patience - a finite resource in people. The main drawback is that writing doesn't sympathize or encourage so that where friends come in to complete the support system. Sometimes I wish I knew more people blogging or more people going through this. All the people I followed or talked to when I first started have either had success or stopped writing entirely.

We took chances in 2018. Took a leap of faith in switching to a new doctor; took up a new hobby in pottery; took charge of my overall health in getting my thyroid and blood pressure under control; made working out a priority. We took the trip we kept talking about and got the much-needed vacation even though it was a big expense.

I'm not a fan of New Years resolutions but I do believe that writing down goals helps achieve them. In 2019 I want to somehow find funds to renovate our bathroom and redo our first level floors. I'd like to explore more about my career and it's vague because I'm not yet sure what that means. We need to get mentally and financially prepared for the next FET. I want to continue making working out a priority of at least 30 min three times a week and add to that eating better. If weight loss comes along with that, all the better. I'd like to get better at working with clay and I want embrace the attitude of gratitude.

Happy New Year.

Tuesday, December 25, 2018

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.  

Thursday, December 13, 2018

Thursday thoughts

This morning someone in my family group chat posted a picture of her messy living room after the little kids trashed it with the caption: "This is what my living room looks like <hiding face emoji>" I was feeling a little sensitive and while I normally wouldn't respond, I felt like I was done with complaints about kids and responded with "#blessed Hope my living room looks like that one day." Passive-aggressive? Maybe. But I'm tired of people taking their kids for granted. They're kids. They're going to make a mess; they're going to interrupt your sleep; they're going to come home with snot and fever for at least four months out of the year. That's just life. Enjoy it.

Two women in my community who each suffered the loss of a child in the past two years celebrated incredible miracles this week. One had a girl, one had a boy. Their tragedies brought them close and they were able to get strength from each other. I can only imagine how difficult it is to get to the point of hope and faith to have another baby after such terrible loss. I'm happy for them. I'm sad for me that I'm still waiting but the sadness doesn't take away for my happiness for them.

I'm feeling anxious and antsy. I keep feeling like I'm missing something. Like I'm forgetting to do something and it will have immense consequences when I realize what I forgot.

I'm anxious for results. I want to know already. What takes so freaking long. They already took my money. They said week of the 17th but I was hoping that was an overshoot. The week after is a holiday and I know that if we don't get results before then it will be a ghost town until after the first of the year.

I'm anxious to try again. I'm scared about trying again. I'm scared that after all this wait and delays and treatments and biopsies it will still fail. I'm scared that after all this it will still fail and at that point we won't know why or what to address and won't know what to do to fix it. But if we don't try we don't have a shot at success. If we don't try we won't know if it worked or not.

I feel stuck and stagnant. I just want to feel like I can move on with my life. I'm seeing women who have struggled alongside me planning birthday parties for their 2 year olds. I'm seeing friends my age planning their kids bar mitzvah. I question everything else around my life wondering what life choices brought me to this point and whether I want to keep pursuing something that has been such a massive failure for so long or if I want to cut my losses and just move on without success.

What if I decide I'm done. What if I decide I just won't have kids. Will I live a life of regret? Will I always look back and think I should have tried harder for longer? Will I always feel like I missed out on an enormous piece of life? Will it be all that, but also a huge sense of relief? Will the relief outweigh the missing piece? Will putting an end to the appointments and procedures bring freedom from the anxiety that comes along with them? If I decide to quit it won't feel like quitting, it will feel like taking charge and ending a very difficult chapter.

Only it's not just my decision. And I can't read the future so I don't know what the right choice is. For the time being I'll stay on the path that feels right until it doesn't feel right anymore.

Monday, December 10, 2018

Monday update

Preliminary results from last week's biopsy were incredibly frustrating. On one hand inflammation seems to have cleared up -- but I don't put much stock in that because prelim results last time said the same thing but actual results had a different story. On the other hand, results also said that my lining is pre-ovulatory. WTH. I don't even understand what that means since it was literally timed with bloodwork and medication. Late last week my doctor asked me to come in for bloodwork to verify whether or not I already ovulated. A day later my actual period arrived, so doc was confident about timing. She said to wait for actual ERA results before being concerned. If results are inconclusive regarding ovulation/lining/timing we may have to repeat the ERA.

Chanukah was last week. It was a beautiful, low-key, high-cal holiday. We hosted two parties. One for family, one for friends. I attended two work holiday parties (including two gift exchanges) and we went to two additional parties. It was a lot. I had so many doughnuts and I'm not at all sorry.

My pottery class is winding down. I enjoyed it a lot and decided to take a second class in the winter session. I told a few people about it and they're like, "What? for that amount of money you could buy 10 vases!" Clearly these people don't get it. For me it's not about the end product, but about the journey getting to it. It's art. It's a hobby. It's something else to think about for three hours a week instead of worrying anxiously about the what-ifs. And at the end if I happen to get a vase or a mug out of it, all the better.

Since we didn't get to go to Atlanta because of the procedure, I'm trying to see if we can do a Florida trip in January. I need a change of scenery and now that we got our points back, I want to use them. It doesn't look like there's a transfer any time soon in our future anyway.

Some upsetting news about a family member thinking of moving. I know they have to do whatever is best for their family but my nieces and nephews are really important to me and I'll be sad if they end up moving away. It's not sad news, just a difficult transition for me.

I decided to pull the trigger and join the gym. It needs to happen. I have to work out more often and it's just not happening at home. My goal to start is to get in 30 min 3x week. Eventually I want to be working out 4-5x/week for at least 45 min each, but I know I need to work my way up to that because if I bite off more than I can handle I just won't go at all. Reaching goals start one step at a time.

Saturday, December 1, 2018

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.

Monday, November 26, 2018

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.

Monday, November 19, 2018

Natural cycle: day 14

There are a lot of things frustrating me and I need to vent so let's get right to it.

First of all, the natural cycle ERA is going slower than anticipated. They estimated day 14 for ovulation but the largest follicle is only 10 mm. So everything is pushed until until follicle is close to 20 mm. I have to go back on Friday for more monitoring. Not only am I annoyed that I have to wake up early and go in for monitoring on my day off, but I'm also annoyed that now the biopsy is delayed until 11/29 or 11/30, depending on when I finally ovulate. And what happens if they overshoot and accidentally miss ovulation? It's not a crazy thought but I know they are pros and know what they're doing so I'm not even going to bring this up.

We're supposed to travel the last weekend of November. Because sunset is so early these days, I booked the earliest flight out on Friday the 30th. If biopsy ends up on that day we will have to cancel our plans. I know this takes priority and I'm definitely not skipping an appointment, but I'm also really done with all this taking over our lives. Also, it was delay delay delay for two months and suddenly there's a 5 min procedure that might ruin an entire weekend.

I was annoyed at having 8 people ahead of me this morning even though I tried to make an effort to be there early. Between that wait and then the second wait for bloodwork, the appointment was nearly 90 minutes.

It's busy at work because of the shortened week and everyone is stressed. There's a specific person that gets under my skin and I have to work hard to not let it get to me. While I'm open to the possibility that it's me, I'm hearing issues with this coworker from other people too. I'm keeping my supervisor informed but I can't go complaining for every little issue, and there's usually at least one thing to complain about per day.

It's Thanksgiving season. It used to be one of my favorite times of year. Two years ago that changed with the Wegmans incident, where our fourth FET ended in another failure. It's family time and I'm feeling the weight of our losses on my shoulders. It's hard not to think of the what-ifs had any of our FETs stuck. I'm tired of the wait. I'm tired of the limbo. I'm tired of trying. I'm tired of failing.

They say you should count your blessings. I am grateful for each and every one. I try to focus on the positive. I try to stay hopeful. We've been through 8 IVFs, transferred 7 embryos in 6 FETs spending well into the 5 figures resulting in 4 miscarriages over 3 years in 2 clinics waiting for 1 miracle.

Monday, November 12, 2018

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.

Tuesday, November 6, 2018

2018 Elections

Why vote?
Is it important?
Is it to feel heard?
Is it to share my say?
Is it to send a statement?
Does it make a difference?
Is it to exercise my right as a citizen?
Is it because I'm motivated by recent events?
Is it because of what I'm hearing politicians say?
All of the above.
#vote



Tuesday, October 30, 2018

Processing

Over the weekend a devastating incident took place in Pittsburg where 11 Jews were murdered during Shabbat morning prayers.

As more details come out about the incident it gets harder and harder not to get sucked into depression about the state of our country. There is so much hate and anti-Semitism and intolerance. It takes effort not to give in to the fear.

This morning I had a hard time getting out of bed. I knew I was upset about the added delay in treatment and while I was trying not to conflate the two, sadness is sadness. They both feel personal. Once I started crying I couldn't stop. I texted work that I will be late. I spent time crying, then tidying up. Even after showering and getting dressed my face was still too blotchy to get to work and I spent time davening.

Somewhere along this morning's hopelessness I emailed my doctor asking if it's absolutely necessary to wait before doing the biopsies. I knew that logically it makes sense to wait to do one biopsy for both tests at the same time but the thought of waiting the additional few weeks kept sending me back into heaving sobs. My people are actively being attacked and I feel inadequate in my inability to continue the tribe.

I reached out to a friend asking if I was being ridiculous. I recognize I've lost some objectivity when it comes to treatment. Wanting something so badly makes you feel irrational so I'm glad my medical team and support system are there to keep me grounded. Whatever is supposed to happen will happen.

As for the state of the country, I'm tired of people saying that we need to arm our synagogues and schools and churches and parks. That's not the answer. Less guns is the answer. Less hate is the answer. Even if there was an armed guard at the Tree of Life synagogue on Saturday, the monster motivated by hate may have still managed to get in and shoot people before anyone realized what was going on.

Just because this keeps happening we don't have the luxury of being numb or turning off the news because it's too upsetting. We can't rely on waiting for someone else to fix things. It's not good enough to give up because "I'm only one person." If you have a vote, you have the power to make a difference. Taking the opportunity to stand side by side with millions of other people with similar values and making our voices heard is the best way to initiate change. The answer is more love; the answer is more education; the answer is getting your voice heard by voting next week.

Monday, October 29, 2018

Persistent delay

This morning I was scheduled to go in for the third biopsy to see if the latest dose of antibiotics worked to clear up the inflammation. Before the appointment, I got a call from my doctor who wanted to run an idea by me.

Since it's a teaching hospital, they have symposiums and clinics and world-renowned visitors every so often. Last week my doctor attended a presentation by an RPL specialist and presented my case. In short, the specialist recommended a test similar to the CD138 stain but more specialized in that the results offer the cause (type of bacteria/microorganism?) so the antibiotics can be more targeted. Additionally, he said that the inflammation is unrelated to the ERA and we don't have to wait for one to clear up to do the testing for the other. So my doctor recommended skipping today's biopsy which is just a yes/no test, since it is uncomfortable and won't give us any information we won't get otherwise, and instead doing the new test along with the ERA.

This change of plan doesn't necessarily delay anything. The plan was always to do an ERA test after this biopsy. The results are expected within 15 days for both ERA and new test so we're not losing any time there. It will only be a delay if it comes back positive and then we have to go through antibiotics again.

I'm not a fan of not seeing something through so I'm working through the uncomfortable feeling of this morning's last minute cancellation, but there was really no reason to go through with it given this new information.

I'm already assuming that I'll have to repeat antibiotics because it will just be easier to hear that news if I'm mentally prepared for even more delay. I did the calendar math and if it does come out positive then we're looking at FEB for earliest possible transfer. Can't even process that. One step at a time.

Thursday, October 25, 2018

Keeping score

Here's a story I never published from IVF 7, originally written on 1/2/18:
Tuesday morning I got a call from my nurse with "an update about your cells." As she was talking I hurried out of my office where I have better reception so I can hear what she said. By the time I got outside she'd already moved on to hysteroscopy dates and updates from doc regarding scheduling. When she was done I asked her to repeat the biopsy results because I wasn't sure I had heard correctly. Turns I had heard right the first time: they only sent out the cells for PGD testing that day. I thought she was calling with an update on the results, not to let me know that they had been chilling on ice for over a week. I know in the grand scheme of things it's not a big deal and it doesn't affect the outcome whatsoever but I was upset that I didn't know that they weren't sent out immediately.

She tried to make me feel better by saying, "Yeah sometimes they batch them with other patients so they can send one shipment" which is definitely the wrong thing to say. My fee includes shipping which means that you can't cut costs on my dime. It bothered that no one told me that the cells weren't getting shipped until after the new year started.

What probably happened was that the lab was closed for the holidays and possibly because of all the drama with the idiot nurse, this bit of info somehow fell through the cracks.

What can I do? Raise hell again? Talk to the office manager again? Complain to my doctor? At the end of the day it's a week delay. To them it's no big deal but to me it is. We're waiting every single day to hear results .

Too many things fall through the cracks with them. It's hard not to keep score. I'm seeing a pattern here -- December sucks because everyone's mind is one foot out the door for the holidays. Maybe this clinic sucks and I'm ready to move on.
Reading that back all the anxiety and stress of those months comes flooding back. During this delay I have a lot of time to think and one of the things I think about is how much the old clinic sucked. I had a hard time thinking about switching; not only because of all the retesting we'd have to do and the cost, but also because of the feeling of failure that comes along with moving. It felt like new clinic was a last resort I wasn't ready for, even though the reality was far from that.


Recently someone asked me for an RE recommendation and I gave my new doctor's info along with singing praises. When asked about why I left my old place I gave a general "not the right fit" because that's ultimately what it was -- I know that others have had success there. It got me thinking about specifics and I ended up with a pros and cons list.

OLD CLINIC:

Pros:
- Less expensive
- Reliable
- Known
- Professional
- Pharmacy discount
- Stand-alone fertility clinic so everything is in one place and only fertility related

Cons:
- Sterile environment.
- Very much "fertility farm" feel.
- Doctor not interested in our success

While they never harmed me medically and for that I'm grateful, there were so many errors. A few listed below:
- That one time the doc told us we had two embryos when really we had none because in his haste to get us info quickly he didn't completely read the PGD report (IVF 2, Dec 2015)
- That one time the financial counselor told us wrong info about insurance that screwed us for an entire year of coverage (Dec 2015)
- That time our nurse thought we were batching embryos with a future cycle and didn't send out the cells for PGD testing for over a week while our doc was on vaca and didn't bother asking us (IVF 2, Dec 2015)
- That time the nurse gave me an outdated embryo report and not answered her phone for a full day making me lose my mind from anxiety (IVF 7, Dec 2017)
- That time they forgot to tell me the PGD lab closes for winter break, delaying getting our results by nearly two weeks without giving us a heads up there will be a wait (IVF 7, Dec 2017)
- That time I was getting ready to go to the clinic for FET 6 and got an email from my nurse saying "Glad to hear the transfer went well!" and nearly giving me a heart attack. I hadn't even been at the clinic yet - was it transferred into someone else???? Turns out she was looking at the thaw report and emailed prematurely (FET 6, Feb 2018)
- That one time they tried to take payment for embryo storage when we had asked for those abnormal embryos to be thawed and disposed (Feb 2018)
- That time they sent a bill because they didn't apply our credit to the balance first (April 2018). Then kept sending a bill even after we called to let them know about the credit (May 2018). Then not sending a refund for unapplied funds even after the balance was paid because of "some holdup" with insurance (May-Sept 2018).


NEW CLINIC:

Granted, it's been less than a year. We only switched over officially in March. If I include the second opinion we got last summer, then a little over a year. 

Pros:
- Caring doctor. Professional yet warm, responds to email thoughtfully, open to new ideas.
- Friendly environment.
- Part of a hospital, so they care about the whole patient not just the fertility statistics
- Excellent phlebotomists - one stick wonders every time, even with what were previously deemed my "tricky" veins.

Cons:
- Teaching hospital. That means grad students and fellows at most appointments.
- Cost
- Not as modern setting, for example not newly renovated, not as high quality screens in monitoring rooms.
- Part of a hospital, so while it's more efficient, there are also drawbacks like OR appointment for a hysteroscopy being scheduled between a kidney repair and bone marrow surgery.
- Learning the systems of a new place. New. Scary. Unpredictable.


It's cathartic to get this off my mind. It's understandable to be disappointed with the results from the old clinic, but I don't need to carry around the baggage of the losses.  I can remember without harboring festering resentment to weigh me down. I realize how much less anxiety I have with new clinic even though we're not yet past the ttc phase -- it's just a matter of a different outlook and better care. We made the decisions we did with the information we had at the time so I hold no regrets, but I am glad we switched.

Tuesday, October 23, 2018

When others announce

Last night I worked late and then had a stomach ache so I didn't fall asleep until after 2. Is it possible I'm still feeling side effects from the antibiotics? I stopped taking probiotics when I finished the dose but maybe I should continue for another few days until I'm sure things are back on track. Here are the thoughts I scribbled into my notes app while trying to empty my mind so I could fall asleep.

Amy Schumer announced her pregnancy via Instagram last night. Meghan Markle's announcement just last week didn't phase me at all yet this one gives me all the jealousy feels. They're both the same age. I discovered them both as famous actresses, albeit now one is a royal. I don't understand what's the difference but I really feel that ache.

Just the other day I was discussing with someone how scary pregnancy is. I have all this time to think and worry about complications. The more I think about it the more the thoughts creeps in about how what a huge undertaking it is to overturn your entire life and bring in a child to the world. Your life as you know it is over. The child is absolute top priority and everything else takes the back burner. Not to mention all the medical issues that come up during or post pregnancy and delivery. Who would choose that? People who get pregnant easily and keep their pregnancy likely have freakouts but eventually time marches on and they have no choice but to go through the challenges as they come. For me the freakouts compound with every loss. The little nagging voice asks, "Are you really sure this is worth it?"

It seems as though the time comes for everyone else. My friend is planning to see a specialist in Nov and I already assume she will get pregnant before me. When I meet someone single I just assume they're likely going to find their soulmate, date, marry, and get pregnant before me. It's almost like a defense mechanism; if I expect the pregnancy then I can't get caught off guard by it and feel that familiar gut punch.

With Markle I knew for sure she wasn't going to wait. Having a royal baby is literally her job. There's more pressure on her than anyone. But Schumer? I didn't even know she wanted kids. Not that it matters. But I didn't expect the announcement and I think that's the difference.

It serves as an important lesson to me. It's important to let the ttc people know privately when you're expecting. Give them time to process. Do not put them on a group text. Do talk to them before announcing publicly. Do share your news privately, preferably in writing not in person, so they have the space to react however feels right to them. Ironically I don't have that many to be super sensitive to everyone else has already moved on.

I've been feeling really optimistic and cheerful the past few weeks. Accepting the delay was the best thing that happened to my mental state of mind. I've been focusing on making things better: advocating for myself at work (new title in the works?), organizing the house (tidying up more often in small spurts rather than big cleaning sessions has made things so pleasant), indulging in comfort food (maybe a bit too much) and focusing on positive things. The crisp beautiful fall weather has also really been helpful. But then something triggers the feelings, like an unexpected celebrity announcement, and I'm pulled right back into it.

Maybe it's baby fever? Maybe it's being tired of failing? Maybe it's wanting to move on from this phase? Maybe it's just as simple as being envious of someone else having what I want.

ETA:
Literally minutes after this post was published, a coworker acquaintance announced her pregnancy. It's someone that works across the building in a different department that rarely overlaps with mine, but she's friend with one of our team members, so we see her every so often. Everyone else on my team knew, I was the last to find out. It hit me like a ton of bricks. She's single and religious. But also nearly 40, so she decided to get a sperm donor and it worked the first time. Of course it did. I had to go home for lunch. I occasionally wear makeup and today happened to be a mascara day, but that was because I didn't expect to cry. 

Friday, October 19, 2018

B'shaa tova

Some religious Jews are pretty superstitious. They don't have baby showers before the baby is born. There's no gender reveal parties. Some don't even buy anything until the baby is born. It's as if celebrating the good news might bring too much attention to it and attract the evil eye, at least according some. Along the same line there's a thing that people don't wish an expectant mother "congratulations" but rather use the exclamation of "b'shaa tova" which is Hebrew and literally translated as "in a good time." One explanation for it is offered here:
We recognize not to take healthy pregnancies for granted. To say "mazel tov" would imply "we're sure this will make it to birth," which sadly doesn't always happen. Thus, to show that it's in G-d's hands and not ours, we offer a prayer instead, "may the birth happen at a good time."
On March 15, two days after my fourth and most traumatizing miscarriage, I contacted the RPL specialist in New York for a appointment. They gave me the first available date: 10/17/18. The specialist was booked that far in advance. I thanked the receptionist and pledged to call regularly for a sooner appointment.

I did, in fact, call multiple times a month and in April we got moved to a September appointment. That felt like a win. I kept calling for weeks but nothing moved further. His schedule was booked solid and I started to feel depressed at the thought of having to accept waiting until fall.

Then I got a call. It was late May and the day of my husband's surgery for varicocele repair. I actually missed the call because there was no reception in the hospital waiting room. The message said to call back, but by the time I did the appointment had already been given away. It wouldn't have worked out anyway; it was for the next morning and as I was speaking to her my husband wasn't even out of the OR yet. There was no way we were making the trip that night.

Fast forward three days. It's early Friday morning and I'm out shopping for groceries before work. I get a call and my heart skips when I see the caller ID. It's the receptionist I've been talking to the past few months. She apologized for calling so early. Nothing I could say would get her to understand that there was no possible time I wouldn't answer her call. Schedule shift. Canceled travel plans. Open appointment next week. Must get an answer today and get all paperwork in before the holiday weekend. I was thrilled. I accepted on the spot, knowing my husband was on board. There was no chance I was letting the opportunity slip by.

That was it. The end of May, instead of October. It shifted all our summer plans but at least we didn't wait 7 months. It also overlapped with the mandatory wait while my husband recovered from surgery when we couldn't do IVF anyway. I could look at it that we've had all these delays. But I could also look at it that all the stuff we'd been through: the blood tests, the second hysteroscopy, the CD138 stain - all the things that take up a lot of time - we got a head start on.

Whenever I think about how frustrating it is to be waiting right now. For the antibiotics to work, for test results, whatever... I think back to this story. It all happened when it was supposed to. At the right time.

This week marks the time of when my original appointment was scheduled for. It passed without incident but the was a tickle in the back of my mind feeling like I'd forgotten something. It was only when I was reminded that I realized how this week once held so much significance.

So the wait continues and while I am impatient at times I know that whatever is supposed to happen will happen at the right time, when it's supposed to.

Tuesday, October 16, 2018

Have and have not

I've been struggling with a particular issue and I'm conflicted about whether or not to say something.

I've joined a support group that runs via WhatsApp for people going through fertility treatment. It's a mix of ages, locations, and various stages of treatment with the common denominator that we're all Jewish women. Some have kids after successful treatment while others don't.

There is one recurring issue that comes up for the women with kids: their family or friends don't understand why they still have that yearn for children even after having a child. There is no way to truly explain these feelings to someone who never went through treatment. I'm sorry that these women have been hearing hurtful and insensitive comments from family members or friends that just don't get it. At the same time, though, I feel that it's insensitive to the women in the group who don't yet have children. Any sentence that starts with "I'm so grateful for my child, but...." hurts me.

I admit that I don't fully understand their struggle. My desire to build a family is completely different from someone who already has a child. I didn't go through a full pregnancy, or delivery, or brought home a baby, or went through the infant stage and now have a toddler with all the demands and joys it entails. They have those experiences and they are mothers. I understand there is still that want to continue having children but I think it's different than someone who never had those experiences.

I hesitate to say something because I don't want to bring something up just to play 'devil's advocate' - I don't think there's room for that in support circles. No one can tell someone how to feel, regardless of their circumstances. If I do bring it up, will it fall on deaf ears because they're just not in a place to receive that feedback? Is it even my place to say something? I'm not the sensitivity police. It's a support group and people talk about whatever is on their mind, not everything is going to be exactly to my liking. At the same time, if I'm feeling stung every time this comes up then there is likely someone else also hurting for similar reasons.

What would you do?

Monday, October 15, 2018

Delay: phase II

The weekend was great - we had fabulous fall weather to enjoy. We spent Sunday enjoying being home, catching up on Netflix and binge watching Homeland.

I signed up for a pottery class that starts in November. I'm excited to learn something new. I also toured a gym nearby and started the trial period. I was sore from Thursday's workout and loved it. The holiday weight needs to come off, and then some. I already miss my Cinnamon Toast Crunch for breakfast but it's so much easier to avoid eating 400 calories rather than try to burn it off later. So back to calorie counting for me. I have a very realistic goal weight in mind before we attempt a transfer and I hope to reach it. I can only do that if I get back in the better-eating mindset.

Friday morning was the final dose of antibiotics. I had a sour taste in my mouth throughout the two weeks of meds so I'm glad they're done. I hope this did the trick and that I won't need a third round. We are now at phase II of the delay: two week wait before biopsy. After that is the wait for results.

We're looking for a destination for a mini vacation. Last year we were itching to get away and hadn't yet decided on whether we could make a major trip to Israel work (it did, in Jan). We ended up doing a fall trip to Boston for a few days and really enjoyed it. 

Now that the zika ban has lifted, I really want to visit Florida. I miss the beach. We spent all our points last year on the major trip, so we would have to pay for the Florida trip out of pocket. It doesn't seem like a lot at first, but without points we're looking at nearly $1500 for RT airfare, car rental, and hotel for three nights. I could probably find a few deals and get it down closer to $1000 but that's still a chunk of change to spend on a weekend.

So I'm also looking at more local getaways, and maybe do a Sun/Mon instead of including the rest of the weekend to cut costs but still get the flavor of a change of scenery before we move forward with treatment.

I've applied to three different jobs so far. I'm only applying to positions I would actually consider leaving my job for. I know I won't find anything that has all the same perks, but I also know that a new position is a new opportunity to learn, grow, bring in more income, and hopefully be more stimulating.

Monday, October 8, 2018

Monday

We are back to full week of work after the month-long holiday season. Essentially being the first real work Monday of the new year, it's the Mondayist Monday ever. After a rough weekend with a family member's in-law passing away and my husband traveling for an unrelated shiva visit, I expected today to be difficult. I feel the opposite.

Last week I definitely overdosed on media coverage. With every article, news clip, or senator's remarks I felt my blood boil at how this man could possibly be put on the highest court with all the accusations against him. They are so focused on winning that they are blinded to what is right and wrong. It feels like the days after Hillary's loss, except we saw this train wreck coming and were helpless to stop it. I don't think the stress has dissolved, but being past the vote is almost like permission to put it on the back burner and allow other things to take up some mental space.

I've also accepted the delay in our timeline. There's nothing I can do about it, so may as well enjoy the "time off." I looked into pottery and woodworking classes. Those are really expensive! I want to work out more and am still considering the cost of joining a gym. There are a finite number of dollars and I need to decide how to spend them. Speaking of which, I also sent out a few resumes. Every so often I say I'm ready for a new job but then remember the perks of my current position and reconsider. This delayed timeline gives me time to think, and I think I'm ready to see what's out there.

I'm happy to be back in routine and get back to a schedule. We'll see if I'm still as chipper about this by Friday.

Thursday, October 4, 2018

Antibiotics

As expected, the antibiotics are wreaking havoc on my stomach. While I don't normally drink that much caffeine or alcohol, right now I'm having none. Drinking a lot of water. Having the medication with food helps, although I need to time it correctly in the mornings with the synthroid. If I take them at the same time and then can't eat because of the synthroid wait window, I get nauseous. But if I take the synthroid separately then I worry I'll forget the ab and miss a dose. I'm taking probiotics. Also brushing more often to try to get rid of the gross taste in my mouth. One more week to go.

My doctor wants to wait at least two weeks after the last dose to do the biopsy. Of course. It's not like I had in my mind that I finish the last dose one day and then do the biopsy the next. This whole deal delays the timeline by six weeks.

It's fine, I'm fine, we'll be fine.

Friday, September 28, 2018

Persistent Endometritis

Yesterday I drafted a post about how drained I was feeling. Emotionally exhausted and mentally spent. The constant rain, the seemingly endless holidays, the lack of routine, and the perpetual wait for results all having something to do with my mood.

But I didn't post it because it didn't feel fleshed out. I feel numb in many ways, but then I'll get a burst of energy and get so much done. I watched part of the hearings yesterday and felt a slew of emotions not only for those testifying, but for all of America and how broken the country is right now. I felt like my personal fatigue is a luxury our nation can't afford. That sounds more dramatic than I mean, but the post has a complainy vibe to it that I wasn't happy with so I put it aside to maybe look at again with fresh eyes.

Then this morning I got a results update from my second CD138 stain and it came back showing persistent endometritis. Of course. I'm in the 20% of the population that didn't have it cleared up with the first go around of antibiotics so they're putting me on a stronger dose for twice the time.

As numb as I thought I was, there's nothing like being told there's a delay to bring on the sting of tears. I'm obviously on board with wanting to clear this up before moving forward. The more it comes up the more convinced I am that this is probably the cause of our RPL. Still. That doesn't soften the blow of knowing that we've just added another month+ to the wait before a transfer. What happens if it doesn't clear up? I asked my doctor that question even though the answer scares me.

I feel lucky and conflicted at the same time. I feel lucky that we have something tangible and (hopefully) fixable that we can work on. We have a defined plan and timeline to hold on to while we wait. Having to wait in between cycles is really hard but at least there's a finish line. It's difficult that the finish line keeps moving. So long as it's somewhat visible, though, there's still hope. 

I'm waiting to hear back how long after the ab treatment, if any wait, is needed before they can retest. I'm preparing to be told that they want at least a few weeks after the end of treatment before another biopsy, which delays it more by yet another month.

The original schedule was:
Aug retrieval
Sept CD138 retest
Oct ERA
Nov transfer

Now we're looking at:
Oct antibiotics treatment
Nov CD138 retest again
Dec ERA
Jan transfer

This requires an infinite amount of patience, hope, and stamina which I just don't have right now. Maybe I'll find some calm at the bottom of a pint of ice cream.

Thursday, September 13, 2018

Results and next steps

We got genetic results back. Of the four embryos sent for testing three are healthy and transferable. To say that was surprising is a complete understatement. I was so upset when they got "so few" eggs! I braced myself for another busted cycle even while hoping for the best. When we got close to end of the embryo growth stage and it was possible we'd have 4, even 5, embryos biopsied it was amazing. Even more amazing to get the genetic results back that they were 75% are healthy. Amazing. We're obviously thrilled with the news but we're very, very guarded. Embryos don't mean babies... we already know that. I'm really happy it was not a busted cycle after all.

My headaches have gotten less intense since I started the bp medication but they're not gone completely. I followed up with my pcp who sent me in for a CT scan. All looked ok in the scan. She said if they persist she'll send me to see a neurologist. I'm hoping that with the weather changing it will continue improving without needing any more intervention.

Today I went back for the CD138 stain retest. There's an 80% chance the inflammation cleared up. If not, then we go another round of antibiotics. My gut flora is already unhappy. I found some probiotic yogurt and hoping it will help.

If it is confirmed that the inflammation is cleared, we start the natural ERA next cycle. My doctor went over the schedule for the next few months. Each step gets us a little bit closer to a transfer. Embryos in the freezer contain so much hope and possibilities. But I know we need to risk one for a transfer. I know. Just scared it will end up like all the other transfers. My doctor is very optimistic and it's helping to keep me positive.

Wednesday, September 12, 2018

Rosh Hashana 5779

Sunday evening was the first night of Rosh Hashana, the Jewish new year. In past years I've posted about the upcoming holiday and our hopes for the coming year, but I wasn't feeling it this year.

I feel like I came into the holiday with a different perspective this year. Not defeated, but one of acceptance. Whatever will be, will be. I will pray for what I hope will happen, but I know that ultimately it's not up to me. It's not within my control.

An older friend lost her husband last week. He was in his 40s or 50s and ill from chemo but the passing was incredibly sudden and completely unexpected. She is devastated. The burial took place in Israel right before Rosh Hashana. Shiva was observed locally and when I went to see her she was fiddling with his wedding band and holding on to one of his shirts while sobbing.

I know things can turn in an instant. For good or otherwise. I think this friend's crisis brought that home for me. Only He is in control and He is the one that decides. I can only do my best. I go to my appointments, take my medications, and pray for the best outcome possible. The rest is up to Him. In the meantime, I don't want to take the blessings I have for granted. Somewhere deep down I still have hope. I don't think I'm numb but I do feel more reserved with my emotions.

I'm still hopeful; I still want things to work out; there are still things I pray for. But this year I didn't go into the year with the blind optimism of before. It's been a tough year, weighed down by the baggage of past losses. I feel very grateful for the blessings we've been given and I've turned the focus on finding the happiness for what we do have.

May this year bring happiness, health, prosperity, success, and luck.

Friday, August 31, 2018

Summer 2018

One of the most popular questions people ask around back-to-school season is "what did you do over the summer?" I feel like honesty in this case is TMI. I had a lot of procedures and spent most of my time in doctor's offices? I cried a lot? I worried about the future? It was too hot and gross to be outside?

It wasn't the most relaxing or fun-filled summer. We did accomplish a lot though, such as crossing off several items recommended by the RPL specialist. Whether or not that means we're closer to our goal, who's to say. It was an investment in our future so I don't regret spending it this way.

May
- Varicocele repair surgery
- Visit to RPL Specialist in NY

June
- Glucose/insulin testing
- Toxins bloodwork
- Hysteroscopy and CD138 stain

July
- Quest to figure out cause of headaches, including visits to: ENT, physical therapist, eye doctor, PCP, and endocrinologist
- Start medication for blood pressure

August
- IVF 8
- Pathology results for CD138 and start of antibiotic treatment
- Post-op appointment for varicocele repair

Maybe next year we can do a relaxing beach vacation or fun travel trip. For now, this is the honest answer to what we did over the summer.

In store for the fall season, in no particular order:
  • Retest CD138
  • Natural cycle ERA
  • FET or IVF, depending if any embryos available
  • Retest glucose/insulin
  • Follow up blood pressure

Thursday, August 30, 2018

IVF 8: Embryo update day 7

Two additional embryos were biopsied yesterday making it four total frozen. Two were in poor condition and had stopped growing so they were discarded. There was one that had reached close to blast so they gave it an additional day to grow. I didn't get the usual early morning phone call so assumed it didn't make it. By 11 I still hadn't heard so I called and left a voicemail. News was as expected - didn't make it. 

In total we have four embryos frozen and the cells are on the way for genetic testing. Obviously at this point there's really no way to know and no point in speculating. In IVF 2 we sent six embryos to get tested and 0/6 were transferrable and all discarded. Over a year later we sent another six embryos from IVF 4 to get tested and three came back healthy. We'll have the final tally of how many are transferrable, if any, once we get results. Hopefully it won't take longer than a week, but it may due to the holiday weekend.

Taking it day by day to keep the anxiety down, sometimes minute by minute when the stress gets overwhelming. The time will pass, I know. We just have to get through another wait.

In the meantime I'm trying to avoid social media and the adorable gut-wrenching milestone first-day-of-school family pictures. A fellow anti-social friend asked if there was an app that changed back-to-school pictures with videos of dancing cats. If only.

Tuesday, August 28, 2018

IVF 8: Embryo update day 5

Two embryos made it to blast and were biopsied today. That seemed like good news to me, especially considering that in our prior seven cycles we've never had anything biopsied before day 6. 

They're still watching five embryos. Three are in compression stage which is right before blast, plus two others in various stages of development. They're giving all five an additional day to grow.

We got the news first thing in the morning so I appreciated that they didn't keep us on pins and needles all day. As the day wore on and things got more stressful at work I got annoyed and upset. At one point I felt like I had a severe hormonal dip because all I wanted to do was cry.

This is a stressful ride. I'm trying not to hold bitter feelings toward people who didn't check in during the roughest patch. For example I found myself being upset at coworkers in whom I've confided in the past and knew surgery was happening but didn't check in day of surgery or the rest of the weekend. Only when I came in on Monday did they ask about it. Yes they were on vacation but they're so addicted to their phones that they responded to email the whole time away from the office. It's not that hard to send a text. It sucks to go through something that feels huge to me but means little to someone I thought I was close to the point of forgetting.

I think I'm also sensitive about this because it's not like the list of people I confide in is so long. I've distanced myself from friends and relatives and really anyone else whose presence added to the hurt over the years. I've unfriended or unfollowed people on social media if their posts were too much. I've declined invitations to lifecycle events that didn't seem like would be a good idea for me to attend. I may have done too good a job keeping the distance because now it feels isolating and lonely. A while back I though it would be a great idea to befriend people in similar situation. The plan worked until those people got pregnant and moved on.

Maybe I'm hormonal. Maybe I'm just expecting too much of the people I've kept around. Maybe I'm sensitive about it and this is just normal relationships. Maybe I've become a sucky friend over the years and just don't realize it.

Monday, August 27, 2018

IVF 8: Embryo update day 4 and recovery

Yesterday I got another call from the clinic with an update. There was actually no news which was good news: they were all still being watched. The call woke me up on Sunday morning - not that it was so early but we had stayed up late watching Parks and Rec on Netflix - so I didn't catch the information when she mentioned the grade of each embryo. It didn't bother me to miss it because I knew the only thing that matters is the number that makes it to blast. I don't think we get another call until tomorrow.

Recovery has been going pretty well, all considering. There was an episode where I was incredibly uncomfortable due to the constipation but eventually that worked out too. There were probably a few factors that led to the easier recovery: less eggs retrieved, I knew what to expect and prepared in advance, started drinking electrolyte water in a few days before retrieval. Or it was a different clinic and their methods are just different. There's no way to know for sure. Regardless, the physical aspect has been pretty manageable. I used the heat pad for the first two days. No Tylenol or other pain meds needed at all.

After the retrieval we both started our dose of antibiotics in prep for the retest of the CD138. Over the weekend we discovered that not only do I not tolerate doxy, but my husband doesn't tolerate it either! Half an hour after taking his first dose, he was feeling awful. At first he thought his stomach was upset because it was empty so he ate something. That was a bad idea because shortly after it ended up being projectile vomited, redecorating our living room with some even making it into the toilet. So now we have matching z-paks, clearly labeled with our names.

I'm back at work today. I've been feeling better every day since the procedure, but I think that's because I've been home in my PJs and mainly chilling in bed. Today is the first day I'm up and dressed and expected to be alert as a functioning adult and it's really hard. I have a headache and I'm slightly nauseous. If I make it to the end of the day, great. If I feel like I need to go home, I will. I planned enough ahead at work that even though it's a really busy time of year for us I'm on schedule and won't fall behind if I need to take another day to recover. I'm lucky I still have 2 use-or-lose sick days that expire at the end of the month so I have no problem using them.

Friday, August 24, 2018

IVF 8: Embryo update day 1

I let the call from the clinic go to voicemail this morning because I was scared to hear what they were going to tell me. Then immediately checked voicemail because I had to know. Obvs.

Of the thirteen eggs that were retrieved, seven fertilized. I wasn't immediately disappointed by that number but as the news sunk in I got more upset and worried and then spent a few hours crying.

We've already gone through worst case scenario -- three times!! -- so I already know what to expect and already know we've been ok after. IVF cycles 2, 3, and 7 were all a bust with zero healthy embryos to transfer even after retrieving a combined 56 eggs from those cycles. It just shows that it doesn't matter how many eggs are retrieved or fertilize or make it to biopsy - the end result is the only one that matters. I was still upset. For sure the hormones have something to do with it.

Pain levels are being managed entirely with taking it easy. I ordered in food for the weekend. So far no pain medication at all necessary - not the prescription stuff or anything OTC. As long as I take it easy I feel fine. It is a world of difference from previous retrievals.

Thursday, August 23, 2018

IVF 8: Egg retrieval

We woke up at an absurd hour to get in at the time they told us: 6:00 AM. We waited nearly an hour in the waiting room before they took me back. I'd like to think that there was a reason for asking us to get there so early, like maybe they can't set up the OR until the patient arrives or something.

Because we arrived so early they wanted my husband to produce at the lab instead of at home. That was one of a few differences in the the new clinic vs the old clinic. The other difference was that we were the only retrieval scheduled for the day. They don't batch their patients like the last clinic so it's based on people's natural cycles - when you're ready, you're ready.

At my scheduled time they wheeled my bed toward the OR. At the doorway they had me walk over to the bed and started setting me up. They put on an oxygen mask and I was out within three breaths. I came out of anesthesia back in the prep room about 40 min later (they let me wear my watch). The pain was not that bad and I wondered how much pain killers they gave me.

Shortly after the nurse came in to tell me how many eggs they got and I realized why I'm not as bloated. They got 13 eggs. In the past they've gotten nearly 30. To say I was disappointed is an understatement. I couldn't stop sobbing. So much so that they went to get the doctor to come explain things to me. I wasn't confused, just so sad. I felt like there's so much attrition to our numbers that starting out with thirteen was basically telling me our cycle is doomed.

They tried to make me feel better telling me that I was on a low dosage to get quality over quantity, and that the embryologist had already looked at the eggs and determined that they were "great," whatever that means. I tried to reel in the tears -- at least when I cry at home no one bothers me. I didn't want them to waste time trying to make me feel better, nothing they said was going to help. It wasn't just the disappointment of the fewer number of eggs; it was the whole summer and everything we've gone through, plus all the hormones just making me feel like a complete mess.

I managed to hold back my tears to get recovery instructions, get dressed, and be discharged. When we got home I spent some energy alternating between crying fits and yelling at my husband. After eating something I passed out for like 4 hours and woke up a different person. I'm a lot calmer. Logic seems to make sense again. I know a lot of people would be thrilled with thirteen eggs; I shouldn't let our past failures bring me down before anything even happens. At this point it's too soon to know and it really can go either way.

Other than my parents no one has checked in. I've mentioned that we're in the middle of a cycle to friends and other family members, and a lot knew that today is surgery day. Nearly everyone I know is traveling or at the beach or on vacation, getting a few last minutes of summer before school starts. It feels like everyone is kinda sick of hearing about ivf that maybe it's easier to ignore and forget about it.

Pain is at a 3 out of ten. So far I haven't taken any meds - I have ibuprofen and some of the good prescription stuff but just don't feel like I need it yet. I have eaten a ton of junk food though. No regrets.

Wednesday, August 22, 2018

IVF 8: trigger and CD138

Yesterday I went in for this cycle's final monitoring. Those lab techs are the best I've seen - one stick every time for bloodwork. Results came back and we triggered last night. Egg retrieval is scheduled for tomorrow first thing in the morning so I took off Thurs and Fri from work.

During my hysteroscopy in June they took a biopsy for a test that the RPL specialist recommended called the CD138 stain. The hysteroscopy was one way of checking for inflammation (and possible other issues) and this stain was another test for something similar, looking for micro inflammation not as easily visible and oftentimes overlooked. It took a while to get the results back and then send them out again for more testing - a total of 7 weeks for the process. 

My doctor called me yesterday with the results: turns out the test came back positive for micro inflammation, aka chronic endometritis. This is a known factor to hinder normal implantation of an embryo and its subsequent development. When I got the news I kind of just took it, asked the doctor my initial questions, and listened to the next steps. As the afternoon wore on and the more I thought about and researched it, I was overwhelmed by emotions:
  • Hope: this is finally it - the reason for all the loss
  • Skepticism: some articles say that past history of abortion causes CE, so maybe it's not the original cause of the issues but rather a side effect of all our treatment
  • Sadness: why wasn't this thought of sooner. it's such a simple fix, why did we go through all that we did if this is answer
  • Fear: what if treatment doesn't fix the issue. what if we fix this issue and still lose the pregnancy. what if we fix the issue and it comes back before the transfer.
According to this article, "pregnancy outcomes after treatment for CE in women with RPL are encouraging." The treatment is a dose of antibiotics. I just want to cry.

So what does this mean now? After the retrieval both my husband and I take a round of antibiotics. Then we wait for my period and retest this CD138 stain next cycle. We'll wait for the results before scheduling the ERA/transfer because obviously we want to ensure that the lining has been cleared up before attempting a transfer.

We were originally going to take September off for the Jewish holidays, but now I'll plan to do this biopsy during my September cycle. It wasn't feasible to do a natural ERA cycle with all the yamim tovim, but a scheduled biopsy is plannable and there's no reason to wait, especially if results take a while to come back.

I've stalled on my diet. Not because I'm eating differently but I think I'm retaining fluid from my expanding ovaries. Is that a thing? I also lost a lot last week so I think may just be a natural plateau. In prep for the retrieval I started drinking smart water yesterday so that it's already in my system. I'm also looking at nearby gyms and will consider joining if I can make it work with my schedule. The weather has been too unpredictable to be outside and as much as I want to make it work, I'm just not working out enough at home. I got my cleaning crew in yesterday and caught up with laundry to make sure I'm not tempted to overdo it after retrieval.

I really hope this is it. I don't know how many eggs will be retrieved. I don't know how many will fertilize and make it to blast and through the other side of genetic testing. Of our previous seven cycles, three cycles results in no embryos to transfer. Going into our eight egg retrieval, I know the next weeks are going to be a roller coaster of emotions. I can only hope we get a few good embryos to finally start our family.

Monday, August 20, 2018

IVF 8: CD13

I was in yesterday for monitoring; back again this morning. I think I've figured out the system: since the bloodwork lab is on a different floor than the rest of the clinic where ultrasounds are done, and each has their own sign-in sheet and wait time, it has to be properly managed for maximum efficiency.

Since ultrasounds take longer between people, it's key to check in and get on that list first. Then you count how many people are ahead of you and multiply it by 5 minutes each. Even though it takes longer than that per person, there are multiple monitoring rooms so it averages out. If there are more than 3 people ahead, it's worth it to go down and to try to get bloodwork done in the meantime. When it's not crowded, bloodwork takes about 5 minutes total. If it is crowded, the wait can be up to 3 minutes per person in the waiting room, because there are multiple people drawing blood. The most I've seen was a full room with 20 people. It's a crapshoot and you never know what will be until you get there.

This morning I got there at 7:15 am and signed in upstairs. There were 8 people ahead of me so I went down for bloodwork. There was only one person ahead of me there. I was back upstairs with only one person ahead of me. Total time from leaving the parking lot to back to my car: 38 min. Score! That's a lot better than last Monday when it was 1 hr 45 min.

My dosage is a lot more conservative than in previous cycles but I'm still responding well. Some follicles measured in the 18s this morning. There were some 15s and 16s so I bet they'll stim another day to give them a chance to grow. There were also some smaller ones in the 9s and 11s. It was about 20 all together but I don't think the smaller ones count if they don't mature and fertilize.

I have enough meds to stim tonight. If they decide to go longer I'll have to reorder meds. As it looks right now, I think they'll stim tomorrow with a retrieval Thursday. Waiting for bloodwork results to confirm.

Friday, August 17, 2018

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.

Monday, August 13, 2018

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.

Thursday, August 9, 2018

IVF 8: CD2 - Baseline

I went in for bloodwork and ultrasound this morning. All told it took an hour and 45 min. I know there's a better way, I just need to learn the system. When I have time, I plan to write a list of all the differences I've found so far between the old clinic and new clinic.

There were a lot of stories from this morning but I don't have patience to write them out. It had to do with the resident doctors, the fact that the labwork is on the first floor of the building and ultrasound is on the third, and just in general things being run differently. Also it was weird and uncomfortable to have an ultrasound on my heaviest bleed day.

One story I will mention: as I left the ultrasound room rushing to make sure to get to bloodwork before the morning cutoff time, I saw my doctor who greeted me warmly and mentioned offhandedly, "Hey, did you know your records indicate you're not immune to Rubella?" I had this issue before and had to get the MMR vaccine in 2015. I told my doctor I can resend the immunization report. She said in the meantime she'll add the rubella to my bloodwork to verify whether or not I'm actually immune. Spoiler alert: report is back and I am.

Bloodwork results came back and I got a call around 11:30 - good to start. I started shots this evening and we're off!

Wednesday, August 8, 2018

IVF 8 eve

We're on the cusp of our 8th IVF cycle.

It hit me like a ton of bricks last night and now I'm terrified of another failure. The thought that we did all that we did to get to this point, and made all those changes in hopes for a better outcome, only to be dealt the same story is terrifying. It's terrifying even more because I don't know where we'd go or what we'd do from there. I hope we don't have to find out.

I dread the physical pain my body is about to go through but it's not nearly as bad as the emotional roller coaster during a cycle. Both of those together are a fraction of the anxiety and pain of a failed cycle or another loss. The alternative is to stop trying and I'm not ready for that.

We checked off everything on the list, I have the meds, I took the class, and called in my CD1, so.... here we go again.

Friday, July 27, 2018

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.

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