The day I lost all trust in my PCP

There is a possibility I could have seen this coming, and maybe you will be thinking the same thing in the coming posts (the metfor.min debate!) but the day came... the day I lost all trust in my primary care physician.

A few weeks ago I went in to have my thyroid tested. I've had some trouble keeping it in range ever since the boys were born, or really, since they were conceived. I've gone in somewhere between monthly and once every three months to have it tested and to have my medication changed either slightly up or down dependent on my TSH level. No biggy.  Well, no biggy until this last appointment.

I went in, had my blood drawn, and chatted with her a bit about how I was feeling. I expressed to her that I was somewhat tired, but I wasn't sure if that had to do with swinging hypo, or if it was because I had two teething babies at home. We talked a bit more and she sent me on my way saying they'd call once my results had been read and at that time they would refill my prescription with any changes. A few days passed and the medical assistant called me. She let me know my results had come back a little high (4.54) and that they would like to change my dose. I said ok, with the understanding that I was obviously being UNDERTREATED and then she said 'we'll be LOWERING your dose to 75mcg (from 100mcg)'. I quickly said that didn't seem right and she responded with, 'that is how the thyroid works, it can be confusing.' I expressed my concern again and asked that she have my PCP look over it again and then call me back. I was sure she'd call back quickly with an apology and a different dose that was higher than my previous instead of TWO steps lower.

She did call back. It was about an hour later, and when she called she let me know that my PCP was adamant this was her plan of care and would like me to be on 75mcg instead of the 100mcg I was currently taking. At this point I made sure I'd heard correctly during the first conversation that my level was 4.54 and went to work on the computer to make sure I wasn't the one who was all wet. It was clear within seconds that I was correct.

I texted hubs asking what the heck I was supposed to do, even though I knew I needed to call the practice and ask for another doctor to read my chart, or promptly change practices all together and be rechecked. So, because I knew it would take some time to get in with a new doctor, I called the practice and spoke with the receptionist. I made it clear there was a problem, explained my issue and she told me 'its uncomfortable to have other doctors checking over another's charts.' While I can appreciate this, I told her I didn't much care how uncomfortable it made my doctor, because I was FAR more uncomfortable with the fact that I was being prescribed the exact opposite of what I should have been. A short time later the other PA in the practice called and assured me that I was most surely correct, and without totally throwing her peer under the bus she told me that she was really unsure how this mistake could have been made.... twice. She then sent in the proper dose to the pharmacy and we hung up.

We haven't really loved our primary care physician or the clinic, ever, but we ended up with them a few years ago when we needed one to refer us to the fertility clinic. I was able to get in with them quickest, so that who we chose. Until now, we've never had a real problem, but now, now it is time to take a little initiative and change providers. I hate this part. I really, really hate finding a new doctor!

Met.formin

Quick question for any PCOS'ers that are still sticking around to read my sporadic (at best!) posts....

My RE mentioned at some point during my treatment that it might be a good idea to go back on met.formin after the birth of our babies/breastfeeding. We didn't talk about it too much, she just said it might help control the PCOS symptoms and I didn't give it a lot of thought at the time because it seemed like a long way off. Well, here I am. Done breast feeding and obviously no longer pregnant- and while I am no where near ready to start trying to get pregnant again, I am thinking about how important it will be for my body to be in the best state it can be once we are ready.

So, my question is this... Did you go back on met.formin after having your baby/ies as more of a maintenance medication for PCOS rather than a drug in conjunction with fertility treatments? 

I saw my primary care doctor today for a thyroid check-up and talked with her about the possibility of starting back on met.formin. She was receptive to the idea, but said we first needed to check my fasting glucose level and my HA1C to ensure that the met.formin wouldn't be adversely effecting my blood sugar.

Growing-ish...

We had our 4 month well baby appointment yesterday, and while both boys are both healthy, only one of them is putting on weight the way he should be.

H (baby A) has always been our bigger boy. He came out weighing 7lbs 11oz as a twin... that is on the hefty side for sure. He then lost a fair amount of weight before we got to come home and was kind of slow to put it back on. He now, at four months, weighs in at 13lbs 3 oz. He still hasn't doubled his birth weight, but I think he will before our next appointment at 6 months! He currently sits in the 15th percentile for weight and the 77th for height at almost 26 inches long. Even though he is still a bit on the skinny side he feels HUGE to us compared to his tiny brother!

A (baby B) is our tiny guy, always has been, likely always will be. After yesterday's appointment he has won himself a return trip to the doctor for a weight check in three weeks. We're starting some reflux medication twice a day, and hopefully that will give him a nudge to gain a little weight. As it stands right now, he weighs 10lbs 15oz and is in the 1st percentile. He is maintaining his growth pattern in height (15th percentile at 24 inches) and head circumference (16.5 inches and 38th percentile) so the doctor isn't too concerned, but we'd all like to see him beef up a little.

Otherwise our appointment was uneventful. The boys each had their belly buttons cleaned out a bit- both had some residual scabbing way down deep from when they were born so their doctor got after it with several q-tips, a tongue depressor and some cleanser.... good as new! They both also had two shots one was three mixed together and also an oral gel. They did fairly well at the doctor's office and calmed down within about 5 minutes. The afternoon however was not super fun. Hubs wasn't able to come home after the appointment like he had the last time they had shots and I was WISHING he had! There were two fussy, cranky tired boys who both wanted their mama at the same time. Poor guys!

Hopefully they will be in better moods today- I have some cleaning to get done before we have holiday visitors over the weekend. I am ready for Friday to get here- then we have hubs home for 11 days! Time for mama to have a little break!

Over-sharing...

The title: If you don't have anything nice to say about twin parenting... keep your mouth SHUT, and other unsolicited advice, seemed a bit long, but that is what this post really should be called.

If you've ever shared with someone that through fertility treatments you may be BLESSED with multiples, been pregnant with multiples or had the pleasure of giving birth to multiples you've surely heard some comments about what your life will undoubtedly be like. Some of these comments will have come from people who've parented twins and some will come from people trying to 'help' who  really have no idea what they are talking about. In both situations, the ass-vice is generally not super helpful. 

I heard a lot of this while I was still pregnant with the boys. I usually just took it with a smile and walked away giving it very little thought. My first dose of post-pregnancy twin 'wisdom' came from the OB who discharged me from the hospital. When she came into my room on that Saturday morning, her first comment was 'are you sure you want to go home?' After we assured her that we were ready, she proceeded to lay out for me how my life was over. You see, she herself has twins, so she surely knows exactly what life if going to look like for us. Not only did she share that her twins have NEVER gotten any easier and they are now 2.5 years old, but also that I'd likely never sleep again. She told me that she 'usually' is still happy she had them. I know some of what she said was in jest, but what ever happened to building each other up as mothers? I'm the first to admit that I appreciate some honesty- even when it isn't what I'd like to hear, but to stand there and tell a woman who is preparing to take her twins home how HORRIBLE it is going to be? Probably not super helpful. 

I'm thankful that my attitude toward having twins has always been- I may have my hands full, but my heart will be equally full. I can't even imagine how defeated I would have felt if I wasn't able to listen to her and laugh as she left the room. 

Let this be a reminder to both myself and to you... If you can't encourage (or occasionally commiserate) with another mother, just keep your mouth shut. 

And then we were FOUR!

HOLY COW!

I can't believe it took me this long to get back to the computer and write about these sweet little boys who've stolen my heart, made me cry, changed my life and caused me many exhausted days. But, here I am almost four weeks after they were born- loving life as a mommy... the good, the hard and the mounds of diapers and laundry!

I don't want to forget their birthday, so in an effort to document it- here is the run down!

On the August 15th we woke up bright and early around 3:30am. We needed to be checking into the hospital at 5:30 and knowing that the drive would take about 35-40 minutes and we both wanted to take one last non-rushed shower we knew it would be a very early morning! We both woke up super excited to meet our boys and I was still not feeling an ounce of fear about the surgery that would be starting in just a few hours. We got ourselves ready, packed up the car, took a couple final pictures of our babies in my belly and hopped in the car to go meet our long awaited babied!

We arrived at the hospital right on time, checked in and were taken back to our room. I changed into my gown, met the nurses who would take care of me up until my surgery and then they hooked me up to the monitors to check on the boys. Both little hearts were beating and it was time to wait for my surgery time. The anesthesiologist came in, talked to us about the spinal and what to expect and shortly after my OB came in to go over what would be happening in the OR. I was still not even a little nervous, just super excited to see my boys and hear their little cries as they came out of me. Of course, just as the OB was finishing explaining the surgery, his pager went off and he quickly called the nursing station from my room to find out another of his patients was just about to have her baby just a few doors down. He assured me that it'd be quick as 'this is her third baby, this shouldn't take long'- all with a motion as if to say the baby would just kind of slide out of her. Hubs and I had a good laugh as our doctor (who we love) walked out of the room.

We ended up waiting about an hour for him to be ready for my c-section. I walked myself down to the OR, sat up on the table, was prepped for the spinal and then started to lose it. I still wasn't totally scared, it was more that I was realizing the babies were really almost here. I wanted more than anything for my babies to come out screaming so I knew they were ok, and I think that is what I began worrying about in that moment. As I sat there receiving my spinal (which, while a super weird feeling doesn't 'hurt' more than a pinch) my chin quivered, my nose dripped and a few tears were shed. Both my nurse and doctor stood in front of me each holding a hand and a shoulder. My OB talked to me the entire time reminding me why we were there, there the two most important people in that room were my sweet baby boys and that he was going to get them out safely. He probably promised me 10 times in those few minutes that not only would they be perfect, but that I was already a great mommy and my boys would already know that when they took their first breath. I guess after twenty-five years delivering babies he knows what mamas need to hear to make them both cry and feel confident all at the same time.

Shortly after the spinal was in, I was laying down on the table, drapes were being hung and my belly was being tested for feeling. As soon as it was decided I was plenty numb (SO WEIRD!) my husband was brought into the OR. He sat right next to my head and help my hand. We spent a long time just looking at each other knowing these were the final moments of being just two. It was only minutes after he arrived in the room that our first baby was born. He came out just as I'd prayed for months... screaming! My OB brought him around the side of the table so I could see him before taking him to be cleaned up. All I remember thinking was 'He is HUGE' and 'I'm a mama!' Just one minute later little brother was born. He was rather angry to have been pulled from his cozy home at the top of my uterus and screamed in protest. Along with his screaming he came out pee'ing.... not once, but three times before reaching the head of the bed for me to get my first peek at him. The OR staff just kept laughing as they'd say over and over- 'He's pee'ing again!' My first thoughts of baby B were- 'He's tiny and red!' We'd been told for months that the boys were measuring very close in size, so when I saw my HUGE Baby A (7lbs 11oz) I was waiting for another big baby. When Baby B came out at just 6lbs 5oz (big for a twin) we were all surprised.

After both boys were born and the first checks and cleaning was complete in the OR, they and my husband were taken back to our private recovery room to get cleaned up, receive their first shots and under go their first evaluations. I was left in the OR to be stitched up. My totally weird anesthesiologist proceeded to show me random picture on his phone to keep my mind off the fact that my babies and husband had left the room. He showed me his daughter trying on wedding dresses, flowers in his garden and a photo he snapped on his phone as Baby B was being born. At that point Hubs and stopped taking pictures and was just enjoying to moment with me, so it was fun to see the little man being born- especially as I was laying there in a room away from my babies for the first time EVER.

Once I was all stitched up ( my OB and the assisting OB were talking about home improvements as they put me back together) I was transferred back to my bed (super weird feeling) and wheeled back to my recovery room where my three favorite people were waiting for me.

Hubs and I watched as they both had their first bath and received their first shots. As soon as both of those things were done I was able to hold them both skin to skin and try nursing. Both of the boys were pretty sleeping but H did try his best to nurse a little. A (baby B) wasn't hold his temp as well as the nurse would have liked, so he and daddy had to make a trip upstairs for about an hour to a warming bed were he was fitted with little foot heating pads and then his feet were wrapped in diapers.... he looked like he was sporting tiny baby Uggs- made of diapers!

Once A and Daddy returned to our recovery room we were able to all make the trip upstairs to postpartum.

... In an effort to publish this before their first birthday I'll publish in chunks- and without editing, otherwise it could be Christmas before I get this done!

New Doctor

We had our first appointment with the clinic that will deliver our little guys on Thursday. We saw the doctor who will be our primary doctor, but there is always a chance he will not be the doctor who will deliver our babies of course.
It was really nice to finally be at the clinic where we will be until the end. Up until now, we've just kind of been monitored, its been silly to ask much about delivery or the end of this pregnancy because we've known that we would transfer doctors sometime around 28ish weeks and we were all just assuming/hoping that I'd make it past that point.
So,  it was time to start asking some questions.... Just in case you are interested in the answers, here goes-

• Thoughts on a birthing class? I've read mixed reviews about how useful it really is when it comes to delivering twins because things go significantly different.
• Long story short, its totally up to us. There are a few benefits, but what I've read is correct- twin deliveries are different and there is about a 40% chance that we will be delivering these boys via c-section. He felt like we were pretty understanding of what is ahead of us and said we probably would be just fine without the class. Hooray- that means one less booked up weekend in July :)
• Likelihood of a C-section? 
• Its fairly likely, like I said above, about a 40% chance. Especially if Baby B doesn't flip in the next few weeks. There is the choice to deliver Baby A vaginally and then we can see what Baby B does once he has a little more room. However, that could involve reaching in and turning baby B (uh, no thank you) or having a vaginal delivery AND a c-section which my doctor refers to as the a 'full birthing experience or the full meal deal' to be fair, in his 25 years he has only had to go that route twice. 
• If there are no other complications, is there a point I will be scheduled for delivery?
• The date isn't set in stone. It is totally dependent on how the boys are doing, what the placentas are doing (or not doing) and how my body is tolerating carrying two babies late in the pregnancy. He did said most women are DONE by about 38 weeks which I think is fair and likely totally true. If you're paying attention, that means I will be having my babies in 8 weeks or less! Holy crap. 

Overall, we were really happy with our doctor! We have another appointment June 26th with him and then we'll see his partner on July 12th in addition to an ultrasound. We've never had to go more than 5 weeks without seeing our boys, and this time it will have been six. I'm ok with it though, feeling them move constantly and knowing this pregnancy has gone so well so far makes me feel pretty confident that things are going well in there.

In other news, it appears my official due date (that means absolutely nothing) is one day earlier than we were originally told. All this changes is that my weekly updates are now switching to Mondays. So, I'll be back tomorrow with an update!

A little of this and a little of that...

I've reached a point in this pregnancy that just seems surreal. Like it all happened so quickly, and now we are finally in the home stretch. As things get marked off the list (like making curtains for the nursery and a blanket for each of the the boys!!) it becomes a little more real that these boys are coming... and SOON-ish. At the moment there is a bouncy seat in my living room, a pack'n'play in our bedroom and a fully set up nursery. We have our hospital orientation/tour scheduled in a couple weekends and we are still on the fence about a weekend birthing class at the beginning of July.

This is all becoming very real. Pretty soon, we will have two baby boys, and those boys will completely and totally rely on us... for everything. It is no doubt a daunting task, but it is also a pretty exhilarating feeling. Soon, these babies will be here and we will be parents of babies that reside on the outside of my body! It doesn't help that the two people I've talked to recently that have twins, had them at 33 and 35 weeks. To be clear, that is 4.5-6.5 weeks from now- as in having my babies NEXT month. Holy cow.

I am praying my little heart out that these little boys will stay put until sometime in August, but I'm slowly preparing myself for the idea of them not. I'm anxious to see our new doctor next week and hear his thoughts on the when and how of our boys' birthday. I'm a planner and I love to have an idea of how things might go. I don't need it to be set in stone, but it would help me start preparing a little better, because at the moment it still feels like a very surreal day that will happen waaay in the future.

The list is dwindling and I'm nearly sure it will be complete or almost complete by the I'm 30 weeks... yahoo! This weekend my mom and I are going to cook a few things to put in the freezer, and next week I have a couple of friends coming to spend the day and cook up a couple more freezer items. I am trying to be as prepared as possible for the days and weeks following the birth of our little guys.

On a completely unrelated note... the twin episode of Pregnant in Heels? Holy crap. It was really reassuring when that a mother who admittedly had no idea what she was doing just weeks/days before her babies came said it all came very naturally once they were there- hopefully the same will be true for us! The main thing that was overwhelming to me was the stack of bottles the woman said you would need for ONE DAY! We do plan to breastfeed at least part of the time if not exclusively, but that stack of bottles really stressed me out. We have some bottles, but I'd estimate only about 14 of differing brands and styles. Is this going to be enough to get started? Sure we can always wash bottles... it isn't like it is the end of the world. Those of you who have done this ahead of me, what would you do? Also, was it a good idea to get multiple types of bottles to see what works best for us, or should we just offer one type and then have them get used it it?

Another question for twin mamas... I think the last thing on our 'to-buy' list is a twin nursing pillow. Is this something you used or would have liked to have had? In our multiples class it seemed useful for even bottle feeding two at once, but obviously I don't have any real like experience. Thoughts?

5w1d

Yesterday I reached the five week mark. It is a weird to think that it will have been a little more than two weeks since any kind of testing when we go in for our ultrasound at 6w3d. I'm looking forward to it, but it is all a little scary at the same time. After having a miscarriage in August I feel like there is just this 'what if?' hanging over our heads. I'm trying really really hard to ignore it, but it is there. All the time. 

I had my check up with my PCP yesterday to go over my thyroid levels from Thursday. He agreed that while it would be good to have it lower, we caught it super early and it really wasn't super high. He drew blood again yesterday and it was only 2.47 instead of the 3.75 it was on Thursday (different labs). I have a feeling it has to do with my dose of estrace being cut in half beginning last Wednesday. I had been taking the morning dose three hours after my thyroid medication (as recommended) but I just have a feeling that made it spike up. My doctor did increase my dose yesterday from 75mcg to 100mcg,  and even with my level coming back at 2.47 yesterday I think my body will do fine with the increase. One less thing to worry about. We'll recheck in 4 weeks. 

Not much more to report. I have a few symptoms here and there but nothing horrible. I'm pretty sure the highlight of my week was picking up my endometrin refill this morning and not having to pay a cent for it! $45 copay + $ 50 coupon = ZERO out of pocket!!

Always Something...

When I had my second beta drawn on Thursday my TSH (thyroid stimulating hormone) was elevated. Not off the charts elevated, in fact it was still within therapeutic range, so not horrible, but concerning just the same. Since the prescribing physician is not my RE, they are requesting that my PCP (the prescribing physician) monitor and manage my thyroid care. Thankfully I was able to make an appointment for Tuesday to check in with my doctor and see where I need to go from here. I'll be five weeks tomorrow and hope the changes in medication will take effect quickly. When I started thyroid medication last year within 4 weeks my level had nearly cut in half and within 8 weeks it was less than 1/4 of what it was when I started, so I'm feeling pretty confident that we caught the rise early and it will quickly be remedied.

When I consulted Dr. Google on the matter I read all kinds of scary things, but I also read that high levels of HCG (hello 889 @ 11dp5dt) and increases in estrogen (2036 @ 9dp5dt) can elevate TSH. My RE reduced my estrace dose down to 2mg /day from 4mg/day starting last Wednesday, so that too could help improve the levels. We'll see.

The moral of this story? Even if you don't have thyroid issues pre-pregnancy it is a good idea to have your levels checked early in pregnancy. It isn't something my clinic tests right away, so I had to ask to have it done and I'm SO glad I did!

I'll be sure and update tomorrow after the appointment!

A little of this, and a little of that...

I started birth control on Wednesday and I'm already counting down the days until it is over... 22.

In reference to yesterdays post- Don't get me wrong, I do think her comments were well meaning. And I can understand wanting to make a connection with people, especially when they are hurting. It all was just a lot too soon, and not at all in a sensitive manner. But, that is kind of the way she is... words coming out with zero thought.

I scheduled my suppression check and it just so happens my doctor is going to be out that day. However I was able to get an appointment with my second favorite doctor. I'm just hoping my favorite nurse will be in (its the day before Thanksgiving) to draw some targets on my rear, because I don't drop my pants for just anyone. Who am I kidding, I totally do. Ahhhhh, infertility. 

I FINALLY made an appointment with the OBGYN we hope to use for prenatal care once I finally get/stay pregnant. I had previously been seeing a NP at a women's care clinic about twenty-five minutes away. We now live less than a mile from a great (but small) hospital, and assume we will deliver there provided it is a normal (read: not multiple or otherwise high risk) pregnancy. The doctor we are seeing has rights at this small hospital as well as the large university hospital near by. I do really hate seeing new doctors though. I hope I like her, because I'd hate to do this all over again! 

I've made it to the weight that my doctor wanted me to be prior to this next round of IVF. It was in no way a stipulation on treatment, more a suggestion, but I'm glad I'm there. This also makes me about 2lbs. away from a VERY large goal that I NEVER thought I'd reach. 

Speaking of weightloss, and I know I've said this before, I'm running out of things to wear. Yesterday, I pulled out the smallest pair of jeans I own. They are from college and haven't fit in literally years, but they are the kind of jeans that have A LOT of good memories, so I've kept them. Well, they totally fit. However, why did I ever think low rise (like ultra low rise) jeans were comfortable? And that wash... wow.

I'm starting to think I have forgotten a little about our last IVF cycle. You know how mothers always say you forget the pain of childbirth over time? I think I've done the same with IVF to a certain extent. I know with everything that I am, that it is worth it- so whatever it takes, I'm all in. Except for one thing. There is one piece that I've not forgotten, and I could certainly do without. It starts with a G and ends with atorade. I've already started stocking up when I've seen it on sale and I have a nice assortment of flavors (I learned that the hard way last time!)  I'm already dreading the countless bottles I will consume. Buuuuuut, it is far better than the alternative (OHSS and a freeze-all situation) so I'll comply. 

And with that... its time for my birth control pill.... 21 more :) 

Picture This...

...my husband, a RE, a nurse and myself all in a TINY exam/ultrasound room. I am not exaggerating on the size. Within the room there was the exam table, a small stool for the doctor, a counter with sink and cabinets, an ultrasound machine, one chair, a large garbage can, a magazine rack and one of those bendy spotlight things. Keep in mind that this room, containing all of the previously mentioned items and people, is only about 6'x10'.

Moving on.

Upon arrival to the room, the nurse gave the usual instructions about undressing from the waist down and then we were left to wait for the doctor. Once the doctor arrived he gave us all of the information about my husband's sample (which was the best one yet!!) and then briefly explained what was about to happen. All the while I am thinking to myself, "really, you are going to explain an IUI to me right now? Check out my chart, this is NUMBER SIX! I am pretty sure if you gave me a mirror and a third arm I could do this myself!"

Once we were educated on what was about to happen, he grabbed the end of the bendy lamp out from the side of the exam table that was right up against the wall and asked me to put my feet in the stirrups, lay back and scoot to the edge of the table. As the doctor begins "preparing the cervix" the bendy spotlight flickers and then goes out. Perfect.

It is important to note at this point, that said spotlight was plugged in behind the exam table that was pushed up against the wall of the tiny exam room. Let me also point out the the outlet it was plugged into was about half up up the exam table, about mid torso while I was laying down.

So, once the doctor realized that it may be an issue of not being firmly plugged into the outlet he stands up and proceeds to examine the issue from right between my legs... which of course are still in the stirrups. He is reaching for the plug to make sure it is fully engaged in the outlet and all I can think about is what if he loses his balance as he reaches? He is going to end up in a VERY awkward position!

This of course all took place moments after the "scoot to the edge of the table" comment that nearly always makes me giggling after another blogger (who shall remain nameless... HI!!) told me about her not so graceful, unintentional dismount from the exam table at her IUI recently. Let's just say I scoot with a little more care now!

Needless to say, number six was memorable!

I am feeling really hopeful about number six. I had two follies, a nice lush lining, we had a great sample and the doctor said that the insemination went perfectly and he was able to get right up to the top of my uterus. I REALLY hope this is it!

A Few Random Things....

-Overfilled follistim cartridges make my day. I had a full extra dose in my cartridge last night. That is like finding $150 under your pillow! Yahoo!

-On a less thrilling note, I had a date with the wand this morning. Currently there are 6 follies growing between the two sides. On each side there is one follie at 8.5, 7.5 and 6.5. Assuming that my E2 comes back normal for what we saw today, I will continue with the same follistim dose (75iu) through Sunday night. I'll have another ultrasound and E2 draw on Monday morning to see how things are progressing. Slow and steady wins the race, right?

-I am crossing my fingers for a couple of things right now. First, that the insemination will happen sometime late next week and not over the weekend. I have family heading into town and I would rather not have to explain why I have a doctor appointment on a Saturday when I'm not sick :) And second, hopefully a couple of those follies will pull away and grow quicker than the others. Right now they are all fairly close in size, and we DO NOT want all of them to grow. If they do, my cycle will most likely be canceled.

-My doctor is now officially on maternity leave, so I am now being passed around the office until I decide who I want to stick with. There are three RE's in the practice (including my doctor) and I've seen two of them. Monday my ultrasound will be with the final RE, and all that will be left is the nurse practitioner. I am confident that any of them would do a fantastic job managing my care, but I do wish I could keep my doctor. However, she is is likely in the middle of birthing a baby as I type, so I guess she should get a little time off!

We have a plan...

I am feeling so much better after our discussion appointment this morning . I had convinced myself that IVF was next, and after talking with our doctor we found out that we had more than one option.

Obviously the best success rates are going to be with IVF. Our doctor told us that for our case we would be looking at about a 70% chance of a pregnancy and about a 65% chance of live birth. These are fantastic odds, and they certainly make me feel confident that this IS going to happen eventually. At our clinic IVF is about a three month process from start to finish. First comes a month of testing, a month of BCPs and finally the stim/retrieval/transfer month. So, IVF with ICSI is option one.

Our second option would be to continue on with the same plan we've been using- IUIs in conjunction with clomid. I feel like we've already exhausted this option. Although we've seen a good response, it hasn't worked. Its time to move on.

Our third option was to continue with IUIs, but move on to injectable (follistim) medication in place of clomid. Switching to injectables will increase our chances of pregnancy by 5% each cycle, but also will increase our chances of having a cycle canceled due to over stimulation.

We chose option three. For me, I feel it is necessary to exhaust our options before we move on to IVF. Our RE agreed with our choice and said it would be a good way to transition into an IVF cycle. She suggested doing two or three injectable IUI cycles, but said we can choose to abandon IUI at any time and move over to IVF.

Even though we are in the midst of our current IUI cycle, we will begin preparing for injectables this week. I have a teaching appointment scheduled for this Thursday. Soon, I will know more than I ever wanted to about giving my self injections as part of our quest for a baby.

So, there you have it. In thirteen days we will find out if this discussion was even necessary. If it was, we will be ready to move forward with injectables just a few days later.

Sadly, we also found out today that my doctor is nearing her maternity leave, so she may or may not be around when/if we do IVF. I have really liked her throughout our treatment, but also feel completely and totally confident that I will be equally happy with all of the other doctors in her practice.

oh-my!

For the past few days I've written and deleted more posts than I can count. I just didn't have much to say. I'm on CD 7, just finished my last dose of clo.mid and things are just floating along.

I was just realizing that my days of going to the gym in the morning are almost over for a couple of weeks. My doctor would rather me not do too much cardio in the 2ww, or super close to ovulation for that matter. So, that means I've got a few more days to enjoy my morning frolic on the elliptical while I watch garbage on TV. Wondering how common it is for women to be cautioned about exercise when it comes to fertility meds, ovulation and treatment cycles in general I consulted Dr. Google.

It turns out that it is pretty common for doctors to ask patients to limit the vigor of their exercise as the cycle moves forward. This was exactly what I expected to read and also what I intended to do.

I am sure at this point (if you made it to this point), you are wondering why I didn't write and delete this post along with the others I've written. Hang tight.. there is a punchline to this story.

As I was reading about exercise on one website (dedicated to infertility) I noticed an ad on the side bar. An ad for Plan B. Really? You have an ad for PLAN B on an infertility website? Such a slap in the face. I would have an adverse reaction to any birth control being advertised on an infertility website, but come on, Plan B... that is just too much.

Hopefully I will find something to talk about sometime in the next week... otherwise I'll be back next Thursday after my appointment with the wand!

Paper Sheets....

You know, those glorious sheets with which you cover yourself for ultrasounds and other gynecological procedures. I have never, I repeat NEVER had a problem with one. I am typically wearing a longish shirt and tuck the top of the sheet into the bottom of my shirt and then sit and patiently wait for the doctor to knock and come into the room. Well, on Wednesday I had my first and hopefully last 'paper sheet malfunction.'

All was well until the doctor said "Lets get started. Go ahead and lay back and relax your legs." Riiiiiiiiiiiiiiip, there went the sheet! Honestly, my modesty went out the window the first time I was violated by the wand. So, I wasn't too worried about my compromised paper covering. Sure there was now a huge gaping hole in the paper sheet right over my lady bits, but lets be honest the doctors head was between my legs and the nurse was down on the business end of things as well. The only other people in the room were my husband and I, and if either of us was offended by seeing those parts there might be some other issues that need to be addressed in terms of why we aren't getting pregnant! The doctor quickly jumped up, got me a new sheet and re-draped me to ensure complete coverage- I just kind of laughed inside. I know he was just trying to make me comfortable, but come on, you've got a spotlight shinning on my whoo-ha for heaven sake!!!

Oh the joys of infertility!

Tomorrow...

Tomorrow is our second IUI and I am oddly calm about it. Not that I am complaining about this new relaxed nature that has come over me, but it is weird. Last night I gave myself my trigger shot without an ounce of fear. Sure I would have rather NOT done it, but it was no big deal. I didn't stand and stare at myself in the mirror for ten minutes convincing myself that it had to be done. I just cleaned the area, jabbed that needle in and injected the medication. Easy.

Today as I thought about the fact that I will have someone other than my doctor doing my insemination I really didn't have any nervous feelings about it. I have never had a male doctor examine me below the belt, and I am typically a HUGE worry wart about all medical procedures, but here I am not worried in the least. I LOVE IT!

I am ready for tomorrow! What I am not ready for is the 12 painfully long days that will follow before my beta.

Infertiles Say the Darndest Things...

Today my husband and I were talking about our upcoming IUI. While we were talking he said he was hopeful that it would occur over the weekend because he had already taken Thursday and Friday of this week off when we assumed that our insemination would be this week. I informed him that I was crossing my fingers for Monday or Tuesday so it would be my doctor performing the insemination instead of whoever is on call over the weekend. Being slightly dramatic I proclaimed, "I am SO tired of having people I don't know in my vagina."

My husband looked at me with a blank stare and then started laughing. I have a feeling I will be hearing that one quoted for awhile!

Together...

For about the last year I've been fairly confident that we would need some type of reproductive technology to achieve a pregnancy. About this time last year we were reaching the end of our 6 months of clomid treatment and we were no closer to a baby than we were when we started. I had come to the conclusion that this probably wasn't going to happen on its own "the old fashioned way."

It took me a long time to be ok with that, hence the super long break we took. I wasn't sure how I felt about getting pregnant in an office with someone other than my husband doing the impregnating. It was weird for me to think of him sitting or standing next to me while our doctor inseminated me or transferred embryos.

I thought for sure the process would take the romance out of things. I thought it would make it so much more clinical (not that timed intercourse is really all that romantic.) But, I was wrong. Somehow going through all of this together, having him there to say sweet things, make jokes and take silly pictures made it easier and made me remember all of the reasons I love him. I've spent the last couple of days hopeful and more in love with my husband than I have ever been. We are walking a hard road right now, but we are stronger because of it.

If you would have told me this would be part of our story when we got married I would have been terrified. Although it hasn't been fun, it has been a growing experience. I understand now that we are strong, and we can do hard things... together.

I am hopeful that this cycle will work. I am well aware that it may not and that we may have to do this all again in a few weeks, but for now I am trying my best to be in the moment.

Psalm 113:9

"He settles the barren woman in her home
as a happy mother of children.
Praise the LORD."

Psalm 113:9

This past weekend I had the opportunity to surprise my parents early on Sunday morning. They live about two hours away and since my husband was going to be out of town for the majority of the day I decided to head down to visit them and some other friends and family that I don't get to see nearly enough.

I had previously thought I'd go later this week,but when it became apparent that AF would be visiting soon I figured in the interest of being around for a baseline internal ultrasound (more on that later) I should go sooner rather than later. Boy, am I glad that I did.

The verse at the top of this post was part of the reading from last Sunday at the church I grew up in. When the words were read it was like there was not a single other person in the sanctuary. It was as if the little old lady behind the lectern was looking me in the eye reading those words directly to me.

They were words I needed desperately to hear. I was getting anxious about the cycle that is ahead of us. It will be our first time cycling with our fertility clinic which means a lot of new territory and a lot of unknowns. It was as if that reading had been chosen just for me, a perfect reminder that God is with us in the midst of this. Such a good feeling!

In other news, I went in today (CD2) for my baseline internal ultrasound... all I have to say about that is it was gross, and if I don't ever have to do it again I will be one happy gal! The ultrasound showed a fairly thick lining and lots of tiny follicles or cysts on my ovaries. Those tiny cysts in addition to some other symptoms won me a prescription for metformin. Judging by what the doctor said, it should be a pretty enjoyable (NOT!) drug to take. I also got my Rx for clomid, a blood draw, and orders for an HSG. I feel like all of a sudden everything is moving at lightening speed! I have my HSG scheduled for next week and I will have another ultrasound the following day to check on my little eggies. After that we may or may not trigger and then we will be doing an IUI. Crazy!

One more thing... I think my RE is pregnant. At first I couldn't come up with a good reason to see a male RE, I think I found one :)

Men are from Mars, Women are from Venus...

So, today after the appointment that I referenced in the previous post I had the following conversation via instant message with my husband while he was at work....


ME: My appointment was good and bad.

HIM: hmmm. Do you want to explain now, or tell me in person?

ME: The good was that the Dr said that I don't need to do the biopsy. The bad is that I nearly punched a pregnant intern.

HIM: Ha, those are BOTH good!

ME: She was interning with my Dr. and nearly uttered the words turkey and baster while I was chatting with my doctor about our plans for IUI... Wow, so professional. I shot my Dr. a look and she quickly explained what it was to the idiot fertile.

HIM: NEARLY punched = good ACTUALLY punched = not good

ME: Gosh fertile people are so dumb. Plus, who brings an obviously pregnant intern into an infertile woman's appointment? There is nothing like talking about our lack of baby while another woman sits and rubs her belly. Seriously. Shoot me.

HIM: Wow. I would think that infertile women would be happy to have a prego around. (ummm did he really just say that??)

ME: Absolutely NOT!

HIM: Who is to say that she isn't a successful result of the process we are currently going through? (Always the voice of reason)

ME: She isn't... she made that clear.

HIM: Maybe you should take a little extra dose of the bitterness when you wake up in the morning!

ME: No infertile woman would even consider saying anything about a turkey baster.

HIM: I have heard YOU say it... so.... (Crap, got me there!)

ME: Um, am I a doctor? Not to mention when I've said it I was I kidding, not thinking it was an actual medical procedure! There I was talking about iui and she said "is that the turk......" I shot my Dr a look and pregnant intern tried again with "what is iui?" followed by.... "you can do that at home right?" I hope she has A LOT more school before she is actually seeing patients in that setting. But no, I am not bitter :)

HIM: uh-huh :)

I was cracking up through this entire conversation... it is so funny how differently men and women perceive the same situation.