Making the wait count

Things have fully transitioned to summer mode around here and the change has been nice. Things are slower at work, the weather is finally hot, and it seems like we're on our way to getting our summer projects started.

I'm still learning about insulin. I don't understand how my fasting and 2hr glucose are both well under the limits but my fasting/2hr insulin is high. I think I broke Google trying to come up with an answer because it doesn't seem to know. Beside that there are conflicting opinions about what to eat. Some say to strictly limit all forms of sugar while other opinions say that fruits are fine. Cutting out fruit entirely would be really hard for me so I'm not doing that yet. I have a call in to the Registered Dietician and in the meantime I'm working on cutting out white flour and refined sugar. I think that if I try to change too much too quickly then it will backfire so I'm focusing on small steps to help the changes stick.

This week's changes are to include at least 30 min of activity most days. That's up from 0-2 per week ever since the March loss. I'm also back to counting calories and, while not cutting it out entirely, limiting white flour and sugar. I found some recipes from an Instagram blogger that I'm excited to try. One is a lemon-garlic chicken and the other is a zoodles salad recipe. Very diet friendly and they both sound delicious.

The biggest challenges are going to be planning ahead and avoiding cereal. Planning ahead is crucial to having healthy food already in the house so that we don't resort to take-out which has been a major go-to in the past few months. Cereal is my food drug of choice in all forms and flavors. I can easily inhale two bowls for a snack, or instead of any meal of the day. It's not only a lot of processed sugar but there's also barely any nutritional value and it's a waste of calories. I'm not going to attempt to go cold turkey but it will have to be eaten sporadically and within small controlled portions.

In treatment news I'm getting ready for the hysteroscopy scheduled for the end of the month. I'm still on bcp so I can schedule my period around when it needs to be. The tricky part is with regard to mikvah since the procedure needs to be on a certain day of the cycle and will likely cause spotting. Hopefully the procedure will go smoothly with limited recovery which won't delay anything. After that I get a two week break while they get the results over to the RPL specialist and we all wait for the start of my next cycle.

If all looks good, we'll start an unmedicated ERA in that cycle. I've done two already but they were both with the medicated FET protocol. Per the medicated ERA results I need an extra day of progesterone for my lining to be receptive. The RPL specialist wants to see if I still need that extra day if I'm not on any meds. Obviously we don't want to miss the window if I do an unmedicated FET with an actual embryo, so we can't use data from a medicated ERA. I understand the reasoning, I just hate the idea of another uncomfortable biopsy.

I'm trying not to "bird view" the summer because thinking of all the things ahead makes me anxious, but it's helpful to think that if all goes well with the hysteroscopy and ERA then the next step is a retrieval. That finally feels like progress. It's also the biggest hurdle before a transfer, since we have nothing to transfer now. So while things are slowly moving forward, there are still a lot of steps to happen between now and a potential pregnancy.

In the meantime we're working on taking one day at a time. We also added a new project: enjoy the wait. The time will pass regardless of whether we're anxious or not, so we may as well do things that make us happy in the meantime. There's a time to be sad and anxious and worried, but it's not all the time. It's a gift to wake up every day and our time shouldn't be wasted harping on things we can't control. We'll work toward what we want and we'll put in everything we can in to it. But at some point it becomes up to Him and our job is to just wait. So why not enjoy the wait. It's easier some days than others but it's a mitzvah to be happy and it's worth the effort to prevent becoming depressed and bitter. We don't have money or PTO to do lavish trips around the globe but we can do outings and things on a smaller scale. Yesterday we went to see The Incredibles 2 (3D) and it was fun. Highly recommend.

One at a time

Patience isn't one of my strong suits. I work hard to suppress this personality trait in my every day life: when talking to people and they have boring stories I'm not interested in hearing; when dealing with slow clients on the phone; when coworkers come for a chat I'm not in the mood for; when people have solvable problems they're whining about; the list goes on. There are times my impatience wins but for the most part I'm able to function in society like a regularly patient person.

It's been difficult to keep my frustration at bay with how long everything takes in fertility treatment. I was frustrated when we needed to see the urology specialist who scheduled us for May but ended up having a cancellation in March. I was further frustrated when we discovered we'd need to do surgery which would delay any IVFs for three months, and then even more frustrated when the first available opening was at the end of May even though we were seen in March. I almost lost my marbles when I found out we'd have to  wait to see the RPL specialist in October but then it worked out that we were able to go sooner and got an appointment in May. That was nearly a miracle. And now I'm realizing how stressful May ended up being.

It doesn't end there. The RPL specialist wants me to repeat the hysteroscopy because the images sent from old clinic didn't have what he's looking for. I'm not thrilled about another surgery. I'm really unhappy about it, actually. But beside the fact that it needs to get scheduled around a period, they also need to do some work to figure out what the stain test is because it's not standard protocol. So I was able to schedule it only based on next month's estimated period, not this month. This pushes back everything else.

In addition to all the waiting, the RPL specialist recommended repeated the ERA, this time unmedicated. I'm really not thrilled about another unpleasant biopsy, especially since I already did this twice at $800 a pop out of pocket. Unmedicated means no FET drugs or birth control. He wants us to go straight from that to a retrieval cycle. The reasoning behind that is to take advantage of the cycle of not suppressing the ovaries with bc pills and possibly needing less medication to stimulate. From there he wants to go straight into an unmedicated FET in the third month. All this needs to be timed so that the retrieval month falls out after the necessary recovery period of the varicocele repair.

Looking at it all at once is very overwhelming. I'm seeing a very frustrating summer ahead and I get annoyed and upset and frustrated at everything that needs to happen, at just the right time, for us to even start thinking about a possible retrieval or transfer. All things considered, we're know we're so lucky we were able to get in to see the RPL specialist sooner rather than later for obvious reasons. But this is rough. It's really rough to just wait. It's really tough to see my friends starting to think about bar and bat mitzvah celebrations for their preteens. We're not even any closer to having an infant.

In the grand scheme of things it's only a few weeks. I know that logically and most of the time I'm ok with it. I've been able to shove down most of my frustration and impatience under the guise of "doing something" with these appointments. But every so often something pops up and I get reminded of how frustrating it all is. I'm upset today because the hysteroscopy was scheduled for end of June instead of next week. But the reality is that a few weeks don't make that big of a difference. I'm thinking of it compounding and if everything takes "just a few weeks" then it builds up to months and months of waiting.

I know I can't think like that. I just won't survive. My blood would boil in anger at the injustice and then they'll delay things even more to treat my sky rocketing blood pressure caused by all the impatience and frustration.

My husband made me feel better by saying we should just take it one day at a time. I can't think of a better way to tackle this. We really have no other choice. Every other year the summer seems to fly by. So maybe if I focus on one day at a time it won't seem so long. While I can't help but be impatient, I can try to incorporate fun summer aspects sprinkled throughout to help it go by faster.

When thinking about the difficult aspects of infertility, there are a lot. The first ones that come to mind are the devastating negative betas, or the traumatizing miscarriages, or the emotional roller coasters during stim days and embryo development. I'd rank these waiting days among the top five as well. Waiting for each procedure, each test, each surgery, each appointment one at a time with weeks in between trying not to scream in frustration while attempting to go about your daily life as though this is normal is pretty mind boggling.

So I had a cry. I got some hugs from people I love. I got in a good laugh and made some food for Shabbat. And now we just wait #oneatatime.