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.

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.

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.

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

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.

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.

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.