9 Months

9 Month Check-in

Weight: 18 lbs 10 oz. He only gained half of a pound in a month and he dropped down a bit percentile-wise, but his doctor said not to worry. The important thing is that he is gaining!

Height: 29.5 inches 

Hair: Still rocking the mullet comb-over, still a little blondie

Eyes: Blue

Sleep: Another month in sleep hell  for us! I had flashbacks to our rock bottom four months ago. It's been the perfect storm over here - separation anxiety, teething, leaps. On our worst night it took me two hours to get him back to sleep, then he woke up two hours later and it took me another two and a half hours to get him down again. Fun. Most nights aren't that bad. It's tough with the teething because he gets super clingy. Sometimes I just give up and we sleep in bed together. We manage to get 5-7 hours blocks of sleep that way. In better news, he's been napping well! His first nap has jumped from 30-45 minutes to 60-90 and his second nap went from 25-40 minutes to 45-90. I'll take it!

Milestones: 1) He got his third tooth (Did he have that last month? I forgot to record it in his baby book.). He currently has three more coming through but they're taking their sweet time. 2) Still working on standing, but he can hold it for longer stretches. 3) He's taken a few steps. I definitely wouldn't call it walking, but they were really steps not just diving falls. 4) He waves! This actually happened at 9 months 3 days, but whatever, I'm putting it here. The first time he did it, he waved hi to my dad on Skype and it was like he'd been waving his whole life.  Then later that night, he waved bye to Seth at bedtime.

Likes: Reading, his dogs, skeletons (Halloween decorations), scrambled eggs, puffs, his snuggle bunny doll and book, swimming/bath time, club soda, drinking club soda out of mom's cup, birds   

Dislikes: I don't even need to change this one. Still hates - HATES - having his diaper changed and getting dressed. Also hates raspberries and kiwis.

What's going on: The biggest change has been with E's eating. We changed formulas and it has made a dramatic improvement. He eats! He finishes every bottle that I offer! I don't have to worry anymore! I'm not sure if he prefers the taste or if he knows this formula doesn't bother him, but something makes him like this one better. It has been an enormous relief for me. It used to be a battle to get him to eat 1 or 2 oz and now he will eat 6-7 oz in just a few minutes. He still spits up a lot, but it doesn't matter because he's eating enough.

We also stopped breastfeeding. It's been two weeks since he last nursed. My heart is still broken. It was hard, really hard. Probably more so for me than for E. I miss it so much. If I think about it, I start crying. I hate that I felt like I had to stop earlier that I wanted to. I hate that I felt like I was stuck with shitty options because of my endo (1. keep nursing, but stay on the mini pill and go crazy, 2. stop nursing and try different BC that doesn't make you crazy, 3. stop nursing and try to get pregnant). But this is how it is. I'm sure I'll feel better eventually. E seems okay. He sometimes tries to latch onto my chest and his new comfort mechanism is to put his hand down my shirt (fun), but overall I think he handled it well. Still. I'm sad. Did I mention that already?

What's Next: E will have to go in for his second flu shot next month and then hopefully he won't need to be seen again until his 12 month (12 month?!?) well visit. I've already started planning his first birthday party. We're going with the "Winter Onederland" theme. I'm making the invitations and decorations and I found a winter theme clip art set on Etsy with a little husky dog. I'm so pumped!

Snow Bunnies Update

Our second/successful IVF cycle was in April. When we filled out all of the paperwork regarding frozen embryos, we choose to have them stored at the clinic for 6 months and then transfer them to a long-term storage facility. It's November now. I knew that their transfer was going to be happening soon but I didn't know when and it was making me so anxious.

So I called the clinic. And I called, and I called and I called. For two or three weeks. And left a bunch of messages. And never heard anything. Eventually, about a week ago, we got an email saying that we paid for our last month of storage at the clinic so I knew the transfer happened. I called again and I left a message with the receptionist rather than the embryologist and she offered to walk my information over to the lab herself to get me some answers.

They finally called me last night! Despite the three week wait, I was still impressed that they called me so late at night. I am easily pleased, especially when the call brings good news.

The woman I spoke to was able to read me the full report regarding our frozen snow bunnies. We've known since April that we had six embryos and we knew that some were ready on day 5 but that they were continuing to watch a few others until day 6. What we actually have is 5 day 5 embryos and 1 day 6 embryo. The grades for the day 5ers are 3AB (x2), 4AB, 4BB and 2BB. The day 6er is a 4BB. This baby was a 4BB embryo too.

Lab lady said that we are in great shape! She said that the lab gives them a rank of good, fair and poor. We have 4 goods and 2 fairs (I'm guessing that's the 2BB and 4BB day 6er). She also explained to me how they choose an embryo for a transfer and things like that (ours are all frozen individually, which I'm happy about). I'm sure it sounds crazy to be thinking about it now, but I am crazy so I'm happy to have all of this information.

We have no idea how we'll feel or what we'll do after this baby is born. We do know that we don't ever plan to try to conceive on our own again. Before we decided to go forward with IVF, we agreed that we would transfer any frozen embryos before we tried on our own and we still feel like that's the best decision for us. I think I would feel that way even if I didn't have a strong suspicion that my tubes are too fucked up to function.

Anyway, the tentative plan is to go on the mini-pill after baby boy is born in order to keep my endo under control. Depending on if and how long I am able to breastfeed, we'll consider going in for a FET consultation when this little guy is 9 months old. I probably wouldn't want to do a transfer before one year, but I imagine it could take time for my cycle to regulate and for any repeat testing to be done.

I am beyond thrilled and ridiculously grateful that we have these little snow bunnies. Even though we are painfully aware that there are never any guarantees, it is nice to know that we have a chance at having a sibling (or six) for our son.

One More Sleep

Only one more sleep until our second ultrasound. Less than 24 hours. I'm so, so nervous.

Tomorrow is our second "baby scan" at the clinic and if everything looks okay, we will graduate from the RE. I'm worried that everything is not okay. I'm worried that I was wrong about the incident over the weekend. I haven't had any bleeding or cramping, but I know that is not a guarantee that everything is okay. Part of me realizes that there is a 90% chance that the baby is fine, but another part remembers that there was an 85% chance that we would get pregnant on our own in under a year. There was a 60-70% chance that my endometriosis would not cause infertility. I'm a statistical loser, so I worry.

I'm making a deal with myself. If all goes well tomorrow, I'm going to take the day to just be happy. I'm not going to worry. I'm going to let myself feel excited about this and enjoy it even if it only lasts for a few hours.

Mini Break

Yesterday, Seth and I took the dogs to the Keys for a nice little mini vacation. My BIL just bought a house down there so we decided to first take the dogs to a new state park in the morning and then spend the day visiting Seth's brother. It was so nice. The park was really similar to the state park that we go to near the house. Lots of trees and shade, but it was less crowded than our park. There was a lot to see too - lots of limestone with fossilized coral, birds, butterflies, and new smells for Binks and Bear.

Then we went a little farther south to the next Key were my BIL now lives. The house was so cute. It's just a little cottage type place (that needs a bit of work) but the yard was awesome. It's big in the front and in the back and it's completely fenced in so Binks and Bear could stay outside all day. There's also a wide deck along 3 sides of the house and docks along the canal. It was nice to just sit on the water and watch the dogs chase the iguanas off the dock. Seth and I also brought our kayak down and took it out into the bay. We saw a nurse shark!

We also "came out" to some IRL friends for the first time too. We knew that they were having trouble because my BIL mentioned it to us, but I didn't feel like it was his information to share so we never talked to them about it. Yesterday, the wife told me us that she was getting ready to try IVF so we told her that we were doing it too. It turns out that they have been trying for eight years. EIGHT years. It didn't sound like they were really trying the whole time (she and her husband lived in separate countries for a year or two at one point), but that must have been a very long and difficult eight years. She tried IUI twice and also had laparoscopic surgery. Her diagnosis is unexplained infertility. They just started working with an RE in the US and expect him to recommend that they move to IVF now.

It didn't go like I imagined it would. I thought that it would be nice to have someone to talk who would understand what we're going through, but I'm not sure that she will be someone that I can really relate to about this. She's a wonderful person, incredibly kind, but we're very different. She's more like Seth - unfailingly optimistic whereas I'm more guarded and realistic. She seems very confident that IVF is going to give her all of the kids she wants, while I'm still terrified that I might not even get one.

She also said some things that bugged me. When I said that I was diagnosed with endometriosis, she told me that it was great! At least I have a diagnosis and most people with endometriosis have the problem fixed during surgery. While that may be the case for some people, it hasn't been true for me. It bothered me that she thought I should be happy that I have a disease that will cause me pain and problems for most of my life. I understand that it's frustrating to not know what the problem is, but it's also frustrating to know what the problem is and not know how to solve it. Surgery didn't work. IVF #1 didn't work.

Another thing that bothered me was when she said that I didn't need to go through treatment right now because you don't really need to worry until it's been two or three years. As if we were jumping the gun and overreacting. Umm, 12 months is the medical standard. Maybe we don't need to do IVF. We could decide to give up and not pursue treatments. But we don't want to. If we want a decent chance of having a child, we do need to do this now. I can't imagine what eight years of infertility feels like, but that doesn't mean that 20 months doesn't suck too. Again, I understand why she'd say this - she's 10 years older than me - but I couldn't help feeling like our pain was being minimized.

Gosh that was long. I just needed to get that out. Like I said, she's a wonderful person. I don't think we'll be IF buddies but I'm sure she's the type of person to add me to her prayer list and that means more than enough to me.

On the bright side, during our conversation she kept struggling to find the right words (she speaks Spanish) for all of the reproductive terminology and testing and Seth was able to translate everything. I was so proud. He might not have much to say, but it's nice to know that he's always listening to me <3

IVF #2 Progress Report
Status: Suppression phase
BCP: 13 down, 7 to go
Days until baseline: 10

IVF #2

Yesterday I headed back to the clinic for blood work, ultrasound, and a quick meeting with the IVF nurse. Everything looked great - AFC was 17, FSH was ~6, E2 was 64 (on CD4) - so I was given the green light to start BCPs last night! I'll take these for 20 days and then go in for my baseline appointment on April 16th. Stims should start that night and ER is estimated for April 26-28th.

TB April '14 Snuggle Bunnies IVF Badge

I feel nice and calm right now. I'm glad that my AFC is still good (it's been lower in the past and I just didn't want to do IVF on a low month). I'm looking forward to the three weeks of BCPs because it's nice to just have a break from everything and also because I'm hoping the pills contributed to the lack of pain that I had in January. It will be so nice if I get some relief for a few weeks.

I'm also feeling hopeful. I am praying that the change in protocol will give us better results and a better chance at a BFP.

I probably won't have much to say during the next few weeks. I'm going to do my best to relax for a bit, but things will probably be pretty busy around our house. Sometime between now and our estimated ER date, Seth is going to be submitting his dissertation! I am so proud of him and so happy that he's almost finished. I hope that when it's time for him to defend in May, we'll have more than one thing to celebrate.

IVF #2 Progress Report
Status: Suppression Phase
BCPs: 1 down, 19 to go
Days until Baseline: 22

We've begun our initial descent

My optimism was pretty short-lived. Right after I made the mistake of admitting that I was feeling hopeful, my body kindly smacked me right back to reality. I've had cramps and extreme rage since Monday afternoon. I've also had really bad pains on my left side. I thought surgery was supposed to fix that? Maybe two full cycles isn't enough healing time? My temperature started dropping yesterday. We've begun our initial descent into Cycle 18. I expect CD1 will be this weekend.

As if that didn't suck enough, I'm pretty sure that Seth has a MRSA infection. When he was getting ready for bed last night I noticed that he had a GIANT "bug bite" on his leg. Okay, we live a sub-tropical climate and we were outside all day Saturday - mosquito bites are common. But this thing is huge and I know from reading all of my MRSA safety materials that people commonly mistake MRSA infections for spider bites. I looked at it more closely and it has an even bigger pink ring around the main "bite". Fuck fuck fuck. I'm so worried because this is much bigger than the one I had. We're hoping that if we explain the situation, our doctor will be able to squeeze him in early this morning to get it checked out. Fingers crossed.

In other news, good news (or as good as this type of news can be), I think Seth and I are finally on the same page and ready to make a decision about our next step. We watched a video on endometriosis and IF and talked through all of the research and we really feel like IVF is going to be the best option for us. We're still going to be open-minded about what Dr. M has to say when we meet with him in two weeks, but it feels good to know that if he also thinks IVF is the way to go, we're ready to make the jump.

Update: I checked the suspicious "bite" again this morning. The pink rim is still there, but it doesn't feel hot and there's no drainage either, so maybe it really is a bite? Seth wants to keep an eye on it and if it doesn't change or it gets worse, he'll see the doctor on Friday. I know I'm a worrier, but I think he is too relaxed sometimes. It's so annoying :P

Planning for Failure

My good mood has fizzled out quite a bit over the past few days. I just can't shake the feeling and the fear that I'm starting the TTC process over again and that it's going to end the same way - lots of waiting and hoping and disappointment and more time "wasted".

It's so hard to balance the practical aspects and the emotional side of infertility. I know that it's possible that my fertility has improved because of the surgery. Studies show that pregnancy without help can happen after surgery. But emotionally, I just can't make myself believe that I'll be one of the lucky ones. I've been feeling really...flat lately. Just sort of resigned to the possibly that this isn't going to happen right now.

Seth and I talked again the other day about how we want to proceed over the next few months. I'm not sure if I can handle another six months of this, but I also don't want to spend the time, money, and emotional energy on treatment cycles if we don't need it. Then there's the odds to consider. Some people with endometriosis do have success with IUI, but in general IVF is a safer bet. A much more invasive and expensive bet. I asked Seth if he would rather try on our own for three cycles (1 down, 2 to go) and then try IUI or try for six and then move right to IVF. He surprised me by choosing six months and IVF. My practical side is ready for IVF, but I don't think I'm emotionally ready for it. I just don't know if it's the right choice for me. We still have a lot of research and talking to do before we make this decision, of course.

I hate that everything has to be so planned with infertility. The whole "just relax" and "try not to think about it" advice is such a ridiculous joke. You always have to be planning ahead. If you don't plan ahead, you don't get an appointment with the RE. You miss your window to have the monitoring required for a treatment cycle. If we decide to go through with treatment after three cycles, I need to call Dr. M to make an appointment this week because they're usually booked a month in advance. It's so hard to be hopeful when you're always planning for failure. We can always cancel later, but since we're 100% OOP now I don't want to go through with the appointment until we're sure about what we want to do. Every penny needs to count now.

A big part of me just wants to say fuck it all. Fuck the charting, fuck the OPKs, and let's just go back to the way our life was before we started TTC and just see what happens. Seth also surprised me by saying he would really like to keep actively trying. I guess he's right. It will be so much harder to move forward with treatment if I don't feel like we gave ourselves the best chance possible after surgery.

Ah well. At least it's Friday, right?

Official Post-lap Report

Today I was supposed to see Dr. M to check on my surgical site infection, but when I got there Justine said that he was going to do my full post-op appointment so that I didn't have to make two trips. I was nervous at first because Seth wasn't with me today, but I figured we had plenty of time to make decisions after I relayed the report to Seth.

First, Dr. M checked out my wound. He said it looks like it's healing fine which is great news. However, he still wants me to see an infectious disease specialist. He said that he doesn't have a lot of experience with MRSA and wants to make sure that I'm treated correctly. I'm glad that he was honest about it but I'm bummed that it's not over yet. My new insurance is a giant pain in the ass so I have to go see a PCP, get a referral from them, and then make an appointment with the specialist. Fun.

Next, we went to his office and Dr. M went over all of the results of my surgery. It was pretty much exactly what he and Seth discussed on the day of my surgery, with just a little more/different information.

1. I had Stage 2 endometriosis (very abundant, widespread, blah blah). Dr. M said that there wasn't enough to call it Stage 3 (no adhesions or scar tissue!) but there was absolutely enough to cause fertility problems. Almost all the endometriosis was removed.
2. A "strip of endometrium" (piece of tissue) and a small polyp were removed from my uterus. They were both benign. The "strip of endometrium" was pretty big, so now that it's been removed my uterus is nice and clear (thanks for the reminder). There were no other issues with my uterus.
3. The cysts were not on my ovaries like I initially thought but on both of my tubes instead. A large paratubal cyst was "obliterating the span of the fimbria" on my left side. A smaller paratubal cyst was also interfering with the fimbria on my right side. They "were both removed hopefully to improve ovum pickup". The cysts were also benign - everything was just endometrial tissue.

Dr. M said that the surgery went really well. He said he found exactly what he wanted to find. I'd have liked to have not found endometriosis at all, but I know what he means. At least we know what the problem is. Then he said something that I didn't expect. He says that he recommends that we do nothing for now. No treatment. Just try on our own for 3 to 6 months or however long we feel like it. He doesn't think clomid is a good fit for me and since we don't have an MFI issues, IUI wouldn't really be worth the extra money. Dr. M also said that he felt like I had a 50% chance of getting pregnant in the next six months.

I felt really, really disappointed. I cried. I cried in the office and I cried on the way home. Shouldn't I be happy that he doesn't think I need any additional treatment? I know that surgery is a form or treatment, but everything I've read seems to indicate that it may not really improve fertility rates. One study showed that the natural conception rate for women with Stage 2 endometriosis was only 44% for the first year after laparoscopic surgery. Two other studies reported that, even with superovulation, conception rates were only 2-15% per cycle for women with surgically treated Stage 1 or 2 endometriosis. Even Dr. M's "50% chance" just sounds like he's covering his ass. Really? You're 100% sure that I'll either get pregnant or I won't? Good to know.

Maybe I'm depressed or maybe this is the "IF brain" that I keep hearing about, but I'm having a really hard time feeling happy. I know that the surgery was important and helpful, I'm just having a really hard time believing that I'll be one of the lucky ones.

So that's that. We're just going to continue trying on our for who knows how long. I hate to end on a post on negative note though, so I'm going to try to focus on the positive.

The positive OPK I got today. YAY for a "normal" post-surgery cycle! The little smiley face is very comforting.

ETA: To be clear, I will be THRILLED if we don't need any other treatments. Obviously, that's what we always hoped would happen - to just get pregnant on our own. I'm just having trouble believing that it will happen that way and I'm afraid of giving the endo a chance to grow back. I'm just terrified of getting my hopes up too high.

Off the Bench!

Cycle day ONE bitches!!! 

This is the first time I've been happy to get my period in a long time and I'm going to fucking celebrate it. Today was CD25 before it turned into CD1 which is perfectly "normal" for me. Thank you, body. You may have endometriosis and you many not be able to get pregnant, but thank you for being so dependable. I am so grateful that surgery didn't fuck up my cycle. I mean, I guess there's still time for that but let's just enjoy the moment.

I am so pumped to be off the bench. I feel like this is the first time since we started TTC that we may actually have a chance. We have a meeting with Dr. M two weeks from today. At that point, I should just be starting the TWW. We'll be able to come up with a plan for next cycle so even if things don't work out for us this month, I feel like there is hope for us. After 13 months and 15 cycles of nothing, we're finally taking steps in the right direction.

Bonus: I'm feeling pretty good, all things considered. I have heard that the first post-surgery period can be absolute hell and that it can take a few months to notice an improvement in your pre-surgery symptoms, but right now my cramps are non-existent to mild. Let's see how long that holds up.

The Fine Line

There's a fine line between being optimistic and being realistic (and being pessimistic too, I guess). I'm so glad that I know that I have endometriosis and I think it's great that it's been removed. But I can't help wondering if that's the ONLY thing that's wrong with me. I'm still worried about my weight. I'm still worried about my short cycles/early ovulation.

When I tell people about my diagnosis, they seem really excited. They keep telling me that now is the best time to get pregnant, that my chances are really good for the next six months. I'm not sure why they think that. It would be awesome if it's true. I want to believe it. The articles I've found don't necessarily agree with that though. One article said that only 29% of women surgically treated for endometriosis were pregnant within 9 months. That's less than half the rate for a typical, healthy woman/couple. I'm supposed to be excited for that?

There's also a fine line between being educated and scaring the shit out of yourself. I need to come to terms with the fact that I'm going to have endometriosis for the rest of my life. This isn't something that will go away if/when I'll get pregnant for the first time. I want to learn more about it so that I can decide if there are any changes that I want to make (diet, supplements, exercise, BCPs eventually), but there is so much depressing information out there. I don't want to bury my head in the sand, but I don't need to freak myself out right now either.

I'm trying to stay positive, I really am. I'm looking for any little thing to give me hope. Having the cysts removed from my left ovary sounds like it was really helpful. Maybe that was a bigger problem than the endo? Except if that's true, what the fuck has my right ovary been doing this whole time? Thanks, dude. I need to turn my brain off. There's no point worrying about it. I've done everything that I can do to change or help my situation for now. Hopefully once I start working again it will be easier to distract myself. I have WAY too much free time on my hands right now.

Finally, some answers!

Well, after going through the laparoscopy and hysteroscopy on Thursday morning, I'm finally feeling a little bit better. My pups are feeling better as well - they never got sick after leaving the vet so I think it's safe to say that they're going to be fine.

So. About the surgery.

Surgery day and Recovery - I arrived at the hospital around 6:30 AM and they took me straight back to the prep room. I changed into a surprisingly comfortable gown and they put me under a nice little heated blanket. The nurses asked me a bunch of questions and then they hooked me up to an IV. Seth and my parents were allowed to come back to sit with me while I waited. For two hours.

Finally, Dr. M came back, explained exactly what was going to happen, and then it was time to move to the operating room. The nurse gave me some meds through the IV to help me relax. They wheeled me into the operating room, I read a sign that said "Biohazard", and the next thing I remember is waking up in the recovery room. I never even saw the anesthesiologist. So that was nice.

The nurses gave me some medicine for the pain and nausea before I left the hospital (around 1:00 PM), but the nausea was pretty unpleasant for the first few hours. I ended up getting sick on the way home, but luckily I had my supply of saltines and ginger ale. That was really helpful until I was able to take some Zofran when I got home. The nurse also gave me a cold cloth to hold on my face and that also helped me feel better.

After the drugs from the hospital wore off, the pain in my abdomen was pretty intense. Not the worst ever, but bad. Vicodin sucks. I think I'm immune to it. It really didn't do much for the pain so I couldn't get comfortable enough to sleep. I was hoping it would at least make me tired so that I would pass out, but no luck. I didn't sleep at all on Thursday and I only slept for a few hours off an on Thursday night. That really sucked. On Friday, I was able to take some Tylenol 3 instead and even though that's not as strong as Vicodin, it worked much better for me. I was able to get some rest and slept pretty well last night.

Now, the pain in my abdomen isn't unbearable. I have one spot on my left side that hurts a lot, but otherwise it feels like I just did a really intense ab workout. I think I'll probably be feeling back to normal in a few days.

The bloating and constipation are unreal. Colace did absolutely nothing. My friends who have been through this before recommended I try a laxative, but it's still not working. It sucks.

Initial Diagnosis/Results - While I was in recovery, Dr. M went out to talk to Seth (and my parents). This is what he found during the surgery:

• The endometriosis was "extensive and widespread". It was everywhere - covering my ovaries and bladder and also all over my bowl, rectum, and abdominal walls. He was able to remove most of it, but it's too risky to get all of it from the bowel and rectum so that had to stay. Dr. M said he would classify it as Stage II endo rather than Stage III because he didn't find any scar tissue so that's good news.

• There were a few "insignificant" polyps in my uterus. Those were removed and they'll be sent out to be tested, but chances are good that they're nothing to worry about.

• Several cysts were removed from my ovaries (maybe just the left one, I'm not sure). The cysts were partially blocking my left tube. When they were removed, the little fingers on the tube were able to open up completely. The cysts were not endometriomas. For some reason, Dr. M thinks that they have been there since I was born. I have no idea why he thinks that or why they didn't show up on any of the ultrasounds, but I guess we'll find that out later.

Overall, I'm feeling pretty positive. I am 100% sure that surgery was the right choice for me/us so that feels good. I'm also relieved to know that I'm not crazy and that I wasn't imagining the pain. While it absolutely sucks that I have endo, I am grateful that it is only stage II and that most of it was removed. Now we know why my left tube looked funny on the HSG. It's great to know that the tube isn't obstructed anymore. It's nice to know what was causing the pain on my left side and hopefully now that the cyst is gone, that will go away.

Obviously, our plan is still to try to get pregnant as soon as possible. We want to make the most of this time after surgery when we know that the amount of endo present is minimal. My follow-up appointment isn't until September 6th, so we won't be starting treatment during my next cycle (#16). After that, I think we'll be moving to medicated TI or IUI. For now, I'm just going to try to stay positive. I know that surgery isn't a magical fix for infertility, but it was definitely a necessary step for me and I'm so glad that it's over!

Prayers for my Pups

When we left for the hospital this morning at 5:45 AM, I just grabbed my wallet and left my bag on the dining room table. When we got home, my bag and all of it's contents were on the living room floor. I freaked out because I had two (almost empty) packs of gum and I know that there's an ingredient in sugar-free gum that is toxic to dogs.

Awesome just what I needed. I may have gone a little nuts, but I couldn't help it. I was already feeling sick and anxious and I just completely panicked. We can blame the drugs, but I would have been just as worried any other day. I felt super guilty since it was my bag and I should know better.

First Seth tried to get them to vomit. Binky did and we could see that he ate the gum, but Bear was being stubborn. So we called the vet and they said to bring them in immediately. Thank God that my parents are here. Seth and my dad took the dogs to the vet and my mom stayed home with me.

The vet got Bear to vomit and it didn't look like he ate anything. However, he got really sick so the vet gave him so fluids through an IV. She wasn't worried about Binky since is seemed like he got rid of the gum. We just need to keep an eye on them for the next 24 hours. If they act weird or get sick tomorrow, we have to take them in right away. I feel a little bit better now. We found out that they had only been left alone at 1:00 o'clock and we were home by 1:30, so Binky didn't really have time to digest anything. If you can spare some prayers or good thoughts for them, I'd appreciate it very much.

My poor little babies. This picture isn't from today, but this
is what they look like after getting sick this afternoon.

As for me, I'm okay. The surgery went really well. I was sick earlier and I'm feeling a lot of pain right now. I haven't been able to sleep at all since I woke up at the hospital, but hopefully I will get some rest tonight. I do/did have endo, so I'm really glad that I decided to do this. I'll give a full update tomorrow after I calm down and get out of my drug haze.

Preparing for the Laparoscopy

Less than two days until my surgery. I'm really nervous. Mostly about the anesthesia. This will be my first time going under the full anesthesia with the breathing tube and that freaks me out. I'm feeling okay about the actual surgery though. I feel really comfortable with my doctor and I'm looking forward to getting this over with and finding out what's going on. If there even is anything.

Since we scheduled the surgery, I've been doing a ton research to figure out what the recovery will be like and what I can do to make that easier. Luckily (for me, not them) I have two friends that have had laparoscopies to remove endometriosis in the past so they were able to give me a bunch of tips as well. I figured it would be a good idea to make a list of what I have and, after surgery, what was actually helpful in case I ever need to do this again or in case anyone reading this needs to go through surgery as well. So here is my           Pre-Laparoscopy Checklist:

1. Loose clothing - Doctor will make three incisions in my lower abdomen and I'll also be puffed up with CO2, so it's a good idea to wear loose clothing to the hospital. I bought a cotton t-shirt and a pair of PJ-ish sweatpants that are a few sizes too big. Seth was surprised that I "needed" a new surgery outfit. Duh.
2. Prescriptions - Picked up all of my prescriptions a few days ago so I don't need to worry about it on the day of the surgery. They, and all of my other OTC supplies, are in a box next to my bed.
3. Heating pad/hot water bottle - I've heard that one of the most painful things about the recovery is when the CO2 moves around and gets trapped around your shoulders/collarbone. A heating pad should help the gas get re-absorbed more quickly and ease the pain. I have a really awesome memory foam heating pad. It was a birthday gift from Seth. He also gave me a TempurPedic pillow and a bottle of vitamins that year. I believe I was turning 65 25.
4. Over-the-counter supplies - Your throat may be sore from the breathing tube, so I picked up my favorite throat lozenges. Gas-X can help with the extra gas and bloating. I've also seen Colace (stool softener) recommended many times. I forget why - either the pain killers or the anesthesia can mess with your digestive system and since your abdomen is already in pain you don't want to get...blocked up. I also grabbed some baby wipes and tissues. Just because I felt like I might want them.
5. Mild foods - The anesthesia and pain killers can make you feel sick, so it's a good idea to have some bland foods handy. My friends recommended saltines, graham crackers, ginger ale, and mashed potatoes. I also picked up some gatorade to help with the bloating.
6. Movies/books/activities - My friends told me that they weren't in too much pain for long, but they felt a general crappiness for a few days after the surgery and spent a lot of time in bed or on the couch. I picked up a few books from the library and I have my yarn and crochet needles to keep me occupied.
7. Clean sheets - Tomorrow, day before surgery, I'm going to wash my blankets and put fresh sheets on the bed. I hate when sheets feel "old" and if I'm going to be spending a few days in bed I want everything to be nice and clean.
8. Pillow and plastic bag - Apparently it is a good idea to bring a pillow with you so that you can hold it over your belly during the car ride. I think I'll ask my dad to drive. Seth's a wild driver - too many years driving in Guatemala City. The plastic bag will serve as a barf bag. Yay.
9. Baby gate - This one makes me really sad, but I think it's necessary. We're going to put up one of the gates in my bedroom doorway so Binky and Bear can't get in. I know they'll want to jump in bed and snuggle with me, but it's probably not a good idea. They think they're lap dogs, which I love, but I might not want 50 lbs resting on my stomach for a few days.

They hate being separated from us. They also haven't figured out that they could easily
A) jump over the gate or B) bust right through it.

I think those are the highlights. We'll see what is actually helpful (the new surgery day outfit is going to be key, I know it).

This morning, I went to the hospital so they could collect some blood. I'm scheduled for 5:30 AM on Thursday, but they'll call me tomorrow afternoon to confirm that. My parents are arriving tomorrow morning and I can't wait for them to be here. Having them here will make the day go by quickly. Before I know it, it will be Thursday afternoon and all of this surgery bullshit will be over. I can't wait for that!

And the winner is...

Hysteroscopy and laparoscopy. Surgery.

Well, we finally made our decision. I'm going to have the surgery in about two weeks.

Our appointment with Dr. M was great. First, he went over the results of Seth's second semen analysis. They were great! This is obviously good news from one point of view. I'm glad that Seth is healthy. However, it's not really good news for me. Dr. M said that because Seth is fine, it is looking much more likely that I do have endometriosis (or some other problem that we haven't discovered yet).

It also means that medicated IUI no longer looks like a decent option for us, right now. Without treatment, my chances of getting pregnant are only 2-10% each month. On a medicated IUI cycle, those odds don't really increase by too much (for someone with endo) and you're still below the 20-25% chance that a typical healthy couple has each cycle. It just seems like a huge gamble to spend ~$1500 per cycle on something that probably won't work for us. I don't think I could handle the disappointment and feeling like we totally wasted our money if it didn't work.

Dr. M said that our best choices were surgery and IVF. There's no reason for us to believe that we need IVF, he just mentioned that some people want to avoid surgery at all costs and IVF will pretty much get around any problems that you might have. Unfortunately, we can't afford to be those people.

Surgery sounds like a good choice for me. Or it sounds better than nothing, at least. I don't think, and Dr. M agreed, that it would be a good idea to put the surgery off either in hopes that we beat the odds or until we can afford IVF. If there's an 80% chance (what Dr. M said) that I have endometriosis, I don't want to ignore it and let it keep growing and spreading. The good news is that Dr. M was able to rearrange his schedule so he will be able to perform the surgery! I'm really glad about that part. He seems really great and I feel comfortable with him.

I feel relieved and sad at the same time. I'm relieved that Seth is fine and I'm relieved that we finally made a decision. I'm just sad that surgery is the best decision for us. I wish it didn't get to this point.

The 12th Month

Well, today is July 1st. This starts our 12th month TTC. We are just about one month away from the official diagnosis of "Infertile". I'm pretty fucking bummed.

This morning, at 10 days post ovulation, I took a pregnancy test and it was negative. Surprise! I usually take one or two each cycle, but my expectations are always pretty low. I felt somewhat hopeful this morning because I have had very little pain this cycle, my temp dropped by about 0.5 degrees yesterday, and then it went back up by the same amount today. No luck though. It's still early and there's still a chance of course, but I'm feeling pretty crampy which is normal for me at this point in my cycle. I will be pretty shocked if I get anything other than my period in a few days.

Assuming this cycle was a bust, we will  have one more chance before being labeled "infertile". After that, I don't know what we'll do. We had pretty much decided to do nothing but the whole insurance situation changes how I feel about that. If I have the laparoscopic surgery before August 19th, it will be mostly covered by my insurance. I have already met the $100 deductible and my insurance covers 80% after that. If I don't do it in August, it will probably cost us a lot more money because the insurance we will have in the future will probably have a very high deductible. We'll probably ending up paying for most if not all of the surgery out-of-pocket. I hate to let finances pressure me into making such a big decision, but it's a lot of money. I can't ignore that.

I'm also wondering if putting off treatment is a good idea for my health - both physical and emotional. Endometriosis is a progressive disease. I started feeling symptoms about 15 or 16 months ago. Maybe I only had stage 1 last year, but who knows what I have now? Maybe I only have stage 1 now, but who knows what I'll have if I wait to seek treatment until after my husband gets a job (hopefully in January, but that's the best case scenario). It's already been 11 months, 12 cycles, without success. I don't know if I'm willing to jeopardize our chances even more. It doesn't seem like a good idea to do absolutely nothing when we know there is a good chance that I have a problem.

I'm making a call to Dr. M, the RE, today to set up an appointment to go over all of our options again. We can find out about the surgery, find out about the financing options for IUI, find out where are best chances lie. I'm so nervous. Every option seems like the "wrong" decision. How the hell are we going to choose?

We should know for sure whether this cycle was a failure by Friday. Fingers crossed that I won't ever have to make any of these decisions!

Annnd We're Off!

Officially back in the two week wait today. Time to relax!

For the past few months, I've considered not temping during the TWW but I just can't stop. I've been looking forward to seeing a BFP chart for so long. The little line turns green when you enter a positive pregnancy test. I can't wait for that to happen for me. If something so little can help keep my hopes up, I'm not going to take that away.

This month has been weird so far. I hardly had any pelvic pain at all. Maybe one of two days of a really dull ache and one day of moderate pain, which was triggered by working in the garden. None of the really sharp pain that I get on my left side at all yet. I'm not going to let that affect my expectations though. It more than likely means absolutely nothing, but I think it's worth noting since I've become so accustomed to feeling pain.

In general, I feel okay. Since Seth and I decided we're not ready for treatment a lot of the pressure I had been feeling is gone. I've been so terrible about making decisions and it's a relief to have a few more months before we need to do that. I'm still not sure that putting off surgery is a good idea, but we'll talk to the Dr. M about it next month before we make the call.

This week is also the start of the Summer B session at the university, which means I actually have to start working again. It's not a bad deal though - I don't have to teach, just do some grading for one of the professors. I'll only need to show up on campus to administer the three exams which is awesome because I love working from home. At least I'll have something to keep me a little more occupied!

The Plan

This morning I went to see Dr. M to discuss the results of my HSG. It was pretty overwhelming. I had been feeling pretty good about it since I felt like I prepared myself for many different possibilities, but as I sat in the waiting room I started to panic a little bit. Seth couldn't be there with me today because he's teaching and he's taking the day off to go to another (unrelated) appointment with me tomorrow. Anyway, I survived the twenty minute wait and then one of the nurses took me back to an office where I met with Dr. M.

First he reviewed the ultrasound results from CD2. Everything looked great on there. My uterus is the correct size, shape, and thickness. I have plenty of follicular cysts (14, I think), but no harmful or unusual cysts. No large endometrioma. Nothing to be concerned about. Great!

Next, he pulled up the x-ray film from the HSG. Deep breaths. Dr. M showed me the right tube, how it's long and thin and had puffs of dye pouring out the end. Then he shows me how the left tube starts to fill up like a balloon. You don't see the long, thin line of dye like with the right tube. The black balloon starts to puff up right near my uterus, but you can still see a little bit of dye coming out. Dr. M said he does not believe the tube was blocked. He explained that when you see a balloon like that, it is more likely an abnormal tube. It could be misshapen - wide in some parts, narrow in others - or maybe it's just in a funny orientation, such as coiled up on itself. Either way, he said that because the dye was cleared on the final x-rays, there is no reason to believe that it's not functioning properly! AND even if it's not working perfectly he said it is possible for the right tube to pick up an egg from either ovary. I did ask how they know that the dye didn't go back out the way it came and he said that the tube is too narrow. The only way they get dye to go in to begin with is from the pressure of the injection.

WOOHOO! I am so relieved. I was so sure that the results were bad and that Dr. M was going to recommend surgery right away. That's not what he suggested at all. He believes that it is still very likely that I have endometriosis (the HSG results do nothing to confirm or refute this) but since my priority right now if getting pregnant and not managing the pain, he doesn't think we need to start with the lap.

The first step will be for Seth to have a semen analysis to make sure everything looks good with him. If the results are good, we will just continue doing what we're doing and hope that we're one of the lucky couples who get pregnant soon after an HSG. If there is anything abnormal about Seth, Dr. M recommended that we start trying intrauterine insemination (IUI) with or without a medication that would stimulate my ovaries to produce more or better quality eggs. This would help to increase our chances of getting pregnant if, for example, Seth had a low sperm count.

Either way, I think I'm going to choose to have the laparoscopic surgery in August if I don't get pregnant before then. Since I quit my job, my insurance will be changing in mid-August and I'd like to do the surgery before that happens while I know I still have good coverage (plus I already met my deductible for this year). That still gives us three cycles (including the one I'm in right now) to get pregnant after the HSG like Dr. M and I originally discussed. It also puts us past the dreaded official one-year mark. After August 4th, we'd probably start pursuing infertility treatments even if we didn't suspect I had endo.

Overall, I feel much better than I thought I would feel. Obviously, it's great news that my tubes are clear. It worries me a little bit because, like I mentioned in an earlier post, if they're clear then I'm afraid there must be something else that's keeping me from getting pregnant. I can't worry about it now though. That won't help at all. For now, I'm just going to try to stay hopeful. If it doesn't work this cycle, it might work next month or the cycle after that. If it doesn't work, at least we have a plan. It's kind of bittersweet. I'm happy that we have this plan, but I'm definitely not thrilled about what the plan includes. It's just not that perfect "love, marriage, baby" model that most people assume they'll experience. Such is life.

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.

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!

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).