Wednesday, May 29, 2013

The Two Week Wait

Anyone who has ever tried to conceive a baby knows what I'm talking about. It's the two weeks between ovulation and the day you can expect either a positive pregnancy test or your next period. I most often hear it described as an absolute mindfuck and unfortunately I think that's a pretty good description. It's as if your body and the hopeful, irrational part of your brain gang up on the realistic and rational side and totally fuck with your feelings.

For me, the TWW always starts off pretty good. I'm feeling great, hopeful. We have done everything that we can possibly do and now it's out of our hands. The pressure is off. I can just sit back and "relax" for the next two weeks or so. This feeling usually lasts for the first 5 or 6 days post ovulation (dpo).

Next, comes the period of time where I start to analyze every little twinge or unusual feeling my body experiences. It lasts from around 7-10 dpo. This is time where, theoretically, a person could actually start to experience pregnancy-related symptoms because implantation typically takes place around this time. Of course my body chooses this time to be super tired or extra crampy. My face suddenly looks like that of an adolescent boy. My boobs are killing me (TMI? sorry). This is the time when the crazy side of my brain starts yelling "OMG it worked! You're so pregnant!" and no matter how many times it's made this false claim in the past, I let myself believe it, just a little bit. Even though my rational side knows that it's early and everything I'm feeling is most likely due to extra progesterone and PMS, I still feel hopeful.

For me, the next few days are complete agony. By 11 or 12 dpo, I can usually tell that I'm not pregnant. My temperature starts to drop. I have stronger cramps. Sometimes I just have this empty feeling. I wake up just knowing that it didn't work. Maybe that's crazy, but since I've been right 11 times out of 11 cycles, who knows? I find these few days more upsetting and frustrating than when my period actually starts because I know there's no hope but there's absolutely nothing that I can do about it. This is usually when I let myself have a good ugly cry and feel angry at myself. Angry that my body doesn't work right. Angry that I let myself feel hopeful.

My period usually starts 13 or 14 dpo and I actually start to feel better, often with the help of a good bottle of wine. It's like a fresh start. We hold some of the cards again. There's a reason to be hopeful.
Cupcake Sauvignon Blanc - one of my favorites. It's super light and crisp with a hint of citrus flavor.
I have a feeling this month will be tough for me. I'm not really sure what's going on with my body since the HSG, but I'm pretty confident that I'm now in the TWW. I'm not sure whether I have one or two working tubes. Who knows which side I ovulated on? Maybe it was the bad side and we have zero chance. Maybe it was the good side and our chances are better since I had the procedure. I have no idea. It's frustrating and scary (have I mentioned that yet?). I have a feeling my irrational side is going to go buck ass wild this month. I'll have to be careful to keep my expectations in check. Luckily, my follow-up appointment with the R.E. is next week. I'll test that morning just in case, but even if it's negative it's nice to know that we're on the right track and we'll be coming up with a plan on how to move forward.

Tuesday, May 28, 2013

Travel Tuesday: Antigua Guatemala

Seth and I love to travel. My in-laws are not originally from the United States and so my husband's family is spread out in five different countries (including the U.S.). This means that we get to travel often so I thought it would be fun to share some of my favorite places with you. Let's start back at the beginning, with the first trip that Seth and I took together. In June 2008, about a year after we met, I traveled with Seth to Guatemala. That is actually where Seth spent most of his life, so we were going to visit his family.

Guatemala is not a big country, but most of the country is not very developed so it can be difficult to travel within the country. Even though I have been there several times, there are many places that I still haven't seen. There is such a wide range of environments in Guatemala - beaches, mountains, rainforests! It's really a beautiful country and the people are wonderful too.

Anyway. The first trip. Seth grew up in Guatemala City, but his mother now lives in Antigua Guatemala so that's where we spend most of our time. Antigua is amazing. It's such a beautiful town. One of my favorite things about the town is the architecture and the abundance of churches. Antigua was founded by the Spanish in the 1500's, so the streets are cobblestones and  most of the buildings are of an old colonial style. They're brightly colored with big wooden front doors, high outside walls, iron scrolling on the windows, and sunny central courtyards.

Clockwise from top left: Cobblestone street in Antigua, One of the many squares located around the town, 
the church of San Pedro, and the Cathedral in Central Park.

Another thing that I absolutely love about Antigua is the scenery. Antigua is located in a little valley in the central highlands of Guatemala, about a mile high. It's surrounded by green hills and three towering volcanoes - Agua, Actatenango, and Fuego. Only Fuego is currently still active and you can see it puffing smoke and ash on a regular basis. Sometimes you can see lava erupting as well! When it's cloudy or the air is dusty, you can forget that the volcanoes are even there but when the sky is clear, the view is amazing!

Clockwise from top left: View of Volcan Agua from Cafe Sky, Fuego and Acatenango,
Fuego erupting smoke and ash, street view of Agua.

It seems like there is a Catholic church on almost every corner. They're all very old and so beautiful with their bright colors and ornate details. Since Antigua lies along a large fault it has experienced many earthquakes throughout it's history. Many of the churches (and other buildings) have been damaged at some point or another. Some are repaired and rebuilt, but some were abandoned and you can explore many of the ruins around the town.

Top: Ruins of the Santa Clara convent
Bottom left: Wall outside the church of San Francisco
Bottom right: Ruins of Santo Domingo monastery

Antigua is such a wonderful place to visit. The local markets are full of handmade products made by people from all over Guatemala. You can visit plantations and taste the coffee made from locally grown beans (which amazing with warm milk - cafe con leche). 

And the food. Oh my God, the food. Antigua attracts people from all over the world and many love it so much that they decide to stay. This is neat because it means you can find a restaurant serving almost every type of food - typical Guatemalan, Italian, Thai, Mexican, Japanese...the list goes on and on. Dining is pretty much my favorite thing to do in Antigua because all of the food is delicious and it's super cheap compared to the United States.

If you ever get a chance to visit Antigua, I highly recommend it. It's wonderful to experience the mix of cultures, the gorgeous scenery, and the amazing food!

Seth and I in front of the famous Arch of Antigua, during our engagement photo session.

Saturday, May 25, 2013

Spearmint Smoothie

I am obsessed with fruit smoothies. Or slushies, maybe. Is it still called a smoothie if it doesn't have any yogurt? Either way, I love them. I really don't like eating fruit. It's not that I don't like the taste of fruit, it's just that I don't really get excited about it. I want to eat it because having a healthy diet is important to me, but I guess I'm just more of a vegetable person. However, itt turns out I actually enjoy eating fruit when it's in this blended, icy form!

When we were in Guatemala in March to visit my mother-in-law, we went to a little restaurant that specialized in fresh smoothies and sandwiches. My sister and I became obsessed with the smoothies. We would order different drinks and analyze them to figure out which ingredient made them so freaking delicious so that we could learn to re-create them at home. Our studies indicated that the pineapple, passion fruit, and spearmint were most often the key ingredients.

I started having smoothies every morning since we returned from our trip. I thought it would be awesome to be able to make my own smoothies at home using "local and organic" ingredients. It is pretty awesome. We already have a bunch of pineapple plants at our house, but it grows slowly (and only bears one fruit per plant) so I often have to substitute with store bought or frozen. Spearmint from the store usually goes bad before I get to use it all, so I made sure to plant some in our garden. It's going wild! I'm never going to run out.

Today was the first time I used the spearmint from the garden and hot damn this smoothie turned out fantastic. I don't use official recipes so my smoothies don't have names. We'll call this one Citrus Spearmint Smoothie. It is seriously delicious. The spearmint flavor is unreal.
Citrus Spearmint Smoothie

Citrus Spearmint Smoothie
2 cups ice
6-8 oz. of juice or water (any kind - I used grapefruit today)
1/4 to 1/3 cup pineapple 
1/4 cup blueberries
1/3 cup peaches
1 orange
10 spearmint leaves

You can use fresh or frozen fruits. Put all of the ingredients into a blender and blend until nice and smooth. If it's too thick, you can just add more juice or water.

This recipe made about 2-3 cups of smoothie. Normally, I would drink the whole thing myself but Seth wanted to try our homegrown spearmint so I shared it. It has about 2-3 servings of fruit which I think it pretty good considering I used to eat only 2-3 servings of fruit per week! And did I mention that it's really delicious?

Thursday, May 23, 2013

The Results Are In

Sort of.

This afternoon I went in to have the HSG. I've spent the last few weeks researching it and asking questions and worrying. I am happy and grateful to report that it was not nearly as painful as I expected. I'm feeling a tiny bit of post-procedure cramping, but all in all it wasn't too bad!

I went into the x-ray room, pants-less, and the very kind technician helped get me set up on the exam table. Then the doctor (another R.E. at the practice, not my regular guy) came in and explained what was going to happen. As he went through the procedure, he explained what was happening and warned me before he did everything which was great. Honestly, getting every set up was the worst part for me. The doctor inserts a speculum and it clicks into place. That was kind of painful and the pressure is really uncomfortable. Then he cleaned everything of with some cotton balls - again kind of painful and very uncomfortable. Finally, he said something about numbing the cervix and feeling a "mosquito bite" so I'm guessing it was a needle with the anesthetic. That hurt too, but as soon as he was finished the pain went away and I mostly just felt the pressure. I didn't feel the catheter being inserted at all. I was feeling really overwhelmed at this point.

Once everything was in place, the doctor started injecting the dye. I felt nothing! No cramps, no pain, nothing at all. I took two regular strength Aleve pills about a hour before my appointment (which was delayed, so it was probably closer to two hours in advance), but like I said, I think I was very lucky to feel nothing. The doctor explained everything as we watched the dye fill up my uterus. You could see the dye sort of puffing out and fading away on the left side of the screen. On the right, a black ball started forming with only very tiny amounts of puffing.

The doctor turned the x-ray machine off and had me roll to my right side. He said he wanted to give the dye a chance to drain out of my uterus. While I was laying there, he explained that my uterus looked fine and the tube on the left side of the screen (I think that makes it my right tube) was totally clear. He said that the formation of the black ball indicates that the dye wasn't properly draining through that tube. It could be because it's blocked - though probably only partially because we could see a tiny amount of dye leaking - or it could just be a poorly formed narrow tube. This was interesting to me because even though my pelvic pain is generally all over, whenever the pain is one-sided, I feel it on the left.

Next, he had me roll onto my left side for a few minutes and then return to my back so he could take two more x-rays. This time the black ball was gone, which means the dye able to drain. Hopefully that means that the dye was able to push through the blockage, but I won't know more until my regular doctor reviews the images. This doctor did say that it was a good sign that the dye had cleared, though, so that's good news.

So, I guess I sort of got my wish. Right tube was totally clear (scenario #1) but the left tube might have been blocked and cleared (scenario #2). It's entirely possible that the reason I'm not pregnant yet is because I just haven't ovulated from my right side very often. Hopefully, the left tube cleared or I'll ovulate on the right side this month! It's also possible that there's still something going on in there which would require surgery, but I'm not going to worry about that until my doctor confirms that. For now, I still have hope! We still have a chance. Maybe I will be one of the lucky women who are able to conceive quickly after an HSG.

Wednesday, May 22, 2013

Beauty School Dropout

Well, no. Not really. Not at all, actually. I just have that song from Grease stuck in my head because today I officially dropped out of the Ph.D. program. My contract isn't up until the end of August, but I had a meeting with my committee today to discuss my progress and future goals and I told them that I would not be coming back in the fall.

It was a really difficult decision. I thought about it for a very long time. During my second semester, I took a leave of absence because I was already having second thoughts about the path I was on. See, after I got my Master of Science degree I switched specialties. I was still in the same general field, but it was more or less an entirely different topic. It seemed like a good idea in terms of gaining new experience and being qualified for a wider range of jobs, but I just could not get interested in my work. Sometimes I'd be working in the lab or having a meeting with my advisor and I'd think "This is not my life. This is not really happening.". I could hear myself having conversations about my research but I'd still be thinking "What the fuck am I talking about and WHY?". It's been kind of a mess.

Even though I've known that I was really unhappy and entirely unmotivated to do this kind of work, it was still difficult to give up. I felt like a failure. I felt like a quitter. I worried that I would regret it and be ashamed of myself some day. I was afraid people would think that I didn't finish the degree because I wasn't smart enough or because I was lazy. Then I realized - I don't give a shit about what about other people think. I mean, I want people to think I'm a good person, but beyond that I don't care what they think of me. Especially not people who would look down on me for making this choice.

Today, I'm proud of myself. And relived - gosh, I am so relieved to be done with this! I have no idea what I'm going to do now (and it was obvious that some people thought I was crazy for that) and I have no idea if I'm going to be happier, but at least I took a chance. I feel very lucky to have the option to move on and try something else. Not everyone has the choice to do whatever they want and I don't take that for granted. So maybe I have to start all over. Maybe I'm nowhere near having that sweet job I always hoped for. But I think I'm finally headed in the right direction. Maybe the only way to move forward is to first go back the way I came.

Tuesday, May 21, 2013

The Hysterosalpingogram

On Thursday afternoon, I'm having a hysterosalpingogram, or HSG. An HSG is a technique in which a dye is injected into the uterine cavity so that the uterus and fallopian tubes can be seen by x-rays. Dr. M, the reproductive endocrinologist that I've been seeing, recommended that we start with this procedure before we determine whether or not we should move forward with laparoscopic surgery. This way, if I have any issues we can discuss the options and procedures before the actual surgery. He said it would suck to wake me up from surgery and say "Surprise! You had tons of scarring and I removed both of your fallopian tubes". I totally agree.
During the HSG, dye is injected into the uterus through a catheter. The dye should
spill from the uterus into the fallopian tubes. 

Dr. M explained to me that there are basically three possible outcomes or conclusions to be reached from the HSG:

1) My tubes are completely clear and free of scarring or blockages,

2) My tubes have scarring or blockages that are removed by the pressure of the dye injection,

3) My tubes have scarring or blockages that may or may not be removed by surgery or medicinal treatment (such as hormonal birth control).

Of course, there are some other scenarios as well. Dr. M will also be able to see whether there is any scarring or abnormalities with my uterus. These, hopefully, would be able to be corrected with surgery as well, but who knows.

In my mind, only one of those outcomes sounds positive - #2. I think I will feel best if that is the scenario I'm dealing with. In that case, it's entirely possible that the only thing keeping me from getting pregnant was the blockages and once they're removed we should have no trouble getting pregnant without additional help.

Scenario #1 seems great on the surface, but if I never had any blockages then there must be some other reason that I'm subfertile. If this case turns out to be true, we'll have to discuss whether or not we want to move right to laparoscopic surgery or take some time to consider other treatment options.

Outcome #3 is too scary to think about right now, so we're not going to worry about that unless we have to.

Right now, I'm a mix emotions. I'm nervous, excited, scared, hopeful, and impatient. I just want to get this over with. I just want to know if there's anything wrong. I'm excited because I feel like we're finally trying something new - we've done everything we can for 11 months and we've had no luck. Maybe we're finally on the right track. I'm hopeful because Dr. M said that there is some evidence that women have an increased chance of getting pregnant for three months after an HSG (as long as there are no blockages). I'm terrified that I'm setting myself up for disappoint.

In a way, I also feel kind of fortunate. Obviously, in a perfect world I would be pregnant already and wouldn't even be thinking about this, but that's not how life happened. The reason I feel fortunate is that some people, regardless of the severity of the endometriosis, have no symptoms (other than infertility, which is defined as trying to conceive for 12 months without success). They have no reason to believe anything is wrong and so they wait a full year before they can pursue treatments, which they typically have to pay for out-of-pocket. Since I've had a pelvic pain for over a year, my doctor was able to suspect that there was a problem sooner - and endometriosis is a real problem whether you're trying to get pregnant or not. So not only am I able to seek help to diagnose the problem sooner than I would have if I wasn't experiencing  pain, but I also will have insurance coverage for the HSG! I've heard people pay up to $1200 for an HSG. Mine will cost $40. There's the silver lining that I'm going to focus on. It's complete bullshit that infertility testing and treatment is considered a "luxury" by insurance companies, but that's another story for another day. For now, I'm just going to be grateful that we're able to take these necessary steps without blowing through our savings. Fingers crossed for a positive outcome on Thursday!

Saturday, May 18, 2013

How Our Garden Grew

Seth and I like to cook and we try to use as much fresh food as possible. It can get really expensive. We already have a few fruits trees in our yard, so we figured it would be a great idea to try growing our own vegetables and herbs as well!

Our two huskies love to dig in the mulch, so a regular garden wouldn't work for us. I had seen plans for raised gardens all over Pinterest and Seth agreed that it looked like a simple, fun project for us to work on together. We measured the area we planned to use for the garden and headed off to Home Depot.

We wanted to have two 4 x 4 or 4 x 5 beds and we spent a good amount of time browsing the lumber aisles to see what types of wood and cut would work for us. Admittedly, we took the easy way out. We found pre-cut 1 x 12 x 4 pieces of pine board for less than $7 a piece. Not too bad. We already had all of the tools - hammer, nails, screws - that we needed to build the boxes, so we moved on to the garden center. In order to keep our dogs out of the beds, we also bought some garden fencing (something like this). Finally we grabbed some river pebbles to use as ground cover around the beds and picked out a selection of herbs and vegetables, both potted and seeds.

Seth put the beds together (with a little help from me), first using nails but then switching to screws. The ground isn't really level so the beds tilt and it was putting some pressure on the front boards. The screws do a better job of holding it all together. Brackets would work well too!

You can see that we underestimated the amount of top soil we would want at first, so we had to head back to Home Depot for more.

All finished! On the left we planted two types of tomatoes, jalapeños, green peppers, and two rows from carrots from seeds. On the right we have basil, oregano, chives, cilantro, lemon thyme, spearmint, and chamomile from seeds.

Binky and Bear love their new garden. The potted plant in the middle is a lime tree that has been planted to the left of the garden. I'm so excited for that - I can make limonada con soda and fresh margaritas whenever I want!

It's been almost two weeks since we planed everything and you can see the carrots starting to come in along the front of the left bed! Bear approves of the progress.

All in all, I think the gardens probably cost a bit more than we expected but like I said we took the easy way out. We're really happy with how they look. We might choose to stain and seal the wood or use cedar next time, but we'll see how these hold up through the hot, rainy summer. Yard work is a whole lot more fun now that we have something to look forward to. We already enjoyed our first garden meal - homemade pasta sauce made with fresh basil and oregano. I can't wait for the jalapeños and the limes!

Friday, May 17, 2013

Here we go!

This is the first month that we're officially seeking help with our efforts to have a baby. Today is day 2 of month 12 and I just had my first non-consultation appointment with the RE.

It all started in April 2012. I started experiencing pelvic pain during the second half of my cycle. At first I just figured I was getting older, my body was probably changing again, no big deal. After talking to some friends, I started to get the impression that it was NOT normal to feel pain so frequently. I called my doctor and she recommended that I come in for an ultrasound to check for cysts. I had my first transvaginal ultrasound in June and, thankfully, everything looked fine. I told the doctor that we were ready to start trying for a baby and she said that should be no problem! In fact, she said I would have "no trouble" getting pregnant and suggested that I consider egg donation! Awesome.

By December, I still wasn't pregnant and the pain was getting worse and more frequent. There was no pattern to when I felt pain. It happened all throughout my cycle. I called the doctor again and she had me come in for a second ultrasound. Again, everything looked great. It was at this time that she first suggested that my symptoms sounded like endometriosis.

"Endometriosis (en-doe-me-tree-O-sis) is an often painful disorder in which tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus (endometrial implant). Endometriosis most commonly involves your ovaries, bowel or the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond your pelvic region. Endometriosis can cause pain — sometimes severe — especially during your period. Fertility problems also may develop. Fortunately, effective treatments are available." (From Mayo Clinic)

My doctor ran some blood work just to rule out some other possibilities. She recommended that we try for three more months and if we had no success she'd send me to a specialist.

Three months came and went without success and that's how I came to have my third encounter with the dildo camera this morning (don't know the results of this ultrasound yet). Two weeks ago, I met with the RE and discussed my symptoms. He agreed that it sounds like endo is the likely culprit. We decided that I will first have a hysterosalpingogram (HSG - more on this next week) and then depending on the results, I may also need laparoscopic surgery. Lap surgery is the only way to diagnose endometriosis. Sometimes, the doctor may be able to treat or remove some of the extra tissue during the surgery.

I don't really know what to think. I hope that I don't have endometriosis, but on the other hand if I don't have it, then why are we having trouble getting pregnant? It is so confusing and sometimes really scary, but for now, I've done everything that I can do. All I can do is hope and pray for positive results (whatever that means) next week. The rest is out of my control. My husband and I talked last night and we decided to pretend that the last 11 months never happened. We want a fresh start and fresh attitude. This is the month we're really starting to try for a baby. We're hoping this will help us to keep thinking positively.

So. Today is Friday - woot woot! I'm taking the weekend off from my fertility woes. I plan to spend the weekend snuggled up at home with my husband (let's call him Seth from now on) and my dogs (we can call them Bear and Binky, two of the many nicknames that I have for them).

Thursday, May 16, 2013

The Happy Life Plan

I recently turned 28 years old. During my birthday dinner someone said to me, “Ten years ago, you were 18. Is this how you thought your life would be in ten years?”.  My answer was, “Fuck no”.

When I was 18, my late twenties and true adulthood seemed so far away (true adulthood still seems so far away, if we’re being honest).  I imagined that by the time I was 28, I would be finished with school. I’d have a sweet job. I’d be married to a wonderful man. We’d live in a perfect house with our two perfect children. Well, now I’m 28 and I’ve only checked one item off my list - I do, in fact, have a pretty awesome husband. Other than that, my 18-year-old self would be pretty disappointed in us.

I definitely don’t have a sweet job yet. Actually, I don’t really have any job.  As it turns out, I really don’t like what I do so I’ve decided to drop out of the Ph.D. program that I’ve been in for 3 years. It was a really difficult decision but I think it’s for the best. In three months, my contract will run out and I have no idea what I’m going to do next. It’s terrifying.  Since my husband is still a student, this is also means no perfect house for us either.

It also turns out that I am somewhat...let’s say ‘subfertile’. After over a year of chronic pelvic pain and 11 cycles without success, I’ve been referred to a reproductive endocrinologist. We’re about to start the process of poking and prodding to figure out what’s causing the pain and determine if it’s something that’s keeping me from getting pregnant.  Again, it’s terrifying. It’s incredibly frustrating. It can be very lonely. I definitely didn’t see this one coming when I was 18.

It’s so easy to dwell on everything that we don’t have yet. No job, no house, no baby. It’s easy to worry about the future. Will I find a job? When will my husband graduate? When will we buy a house? Will we ever have a baby? How? When??? I’m so tired of feeling like I’m waiting for my life to start.

For better or for worse, this is my life and I really am fortunate in so many ways. I’m grateful that I have the freedom to quit my job and pursue other options. I’m thrilled that I have such an awesome husband who’s been a wonderful partner throughout this process of growing our family. And I do have two perfect “children” – I have two of the sweetest dogs in the world who never fail to cheer me up!

That's one of my favorite quotes from one of my favorite books - Harry Potter and the Sorcerer's Stone. I think it sums up my feelings and reasons for starting this blog pretty well. I plan to use this blog to help me stay focused on all of these wonderful things and accept that there is so much that I just can’t control. I plan find the positives wherever I can along the path from here to tomorrow. I plan to have a happy life.