Saturday, December 18, 2010

Unnatural pregnancy

Let me say up front - no I'm not pregnant - but this month I'm starting to feel the side effects of the drugs I'm on to try and tip the baby make mission odds in my favour.

My clomid / serophene double dose (100mg a day for 5 days) didn't seem to cause any problems when I was taking it, but in the week leading up to when I ovulated, Oh My God!!!!!

A quick recap - the clomid / serophene is taken to block the oestrogen receptors in the brain. The tricked brain sends a message to the body to make more follicle stimulating hormone to get more follicles developing and release more oestrogen... or something like that. In my first appointment with the fertility specialist, he explained that the body creates a certain amount of oestrogen per egg that is ovulated. So if you ovulate two eggs the oestrogen is doubled.

This month my blood tests to identify when I was ovulating were all over the shop. The doctor had me going in every second day, 6 times in total, until finally we got the nod. Last month it only took 3 tests to pick the day. So I think, even though the doctor didn't mention it, that my oestrogen count was higher this month, indicating I was ovulating more than one egg.

I'm pretty lucky in the women's health department as a general rule. I've never really suffered from period pain, or complained of bloating or water retention throughout the cycle. I've often heard other women complaining of these ailments and felt lucky I haven't suffered. Well, this month I suffered. Ughhhhh, my guts felt like they were going to explode. Things I ate were going straight through me and my lower abdomen felt like a balloon filling up under the skin. On ovulation day my left side, down near my hip was aching. It was horrible.

But now I'm on the other side of ovulation and everything is back to normal - thankfully. And I again know this month we have had good timing and am waiting waiting waiting.

The drugs to support the other side of my cycle have been swapped this month. I was gearing myself up for another round of injection perfection to find out Brisbane is experiencing a pregnyl I couldn't get any. The doctor told me it was going to have to the pessaries.

These little wonders are made of wax that slowly melts at body temperature. They release progesterone, that is then absorbed through the uterus lining. Unlike the injections they are time intensive, needing to inserted twice daily, after which you have to lie down for a half hour. So night time isn't a big deal, just insert before going to bed. The doctor told me in the morning I'd have to get up a half hour earlier, only to then have to go back to bed and lie down for another 30 minutes. He also said that my husband should bring me tea and toast....hmmmmm... perhaps I should have gotten Matt to ring in to get his instructions as there hasn't been single tea and toast day yet. I have to do this for 15 days!

Even though I'm not up to the big interventions like IVF yet, it certainly isn't all that natural. Recently I had a few people ask how I felt about having to start taking the drugs etc, whether it was disappointing. I am grateful that this is one thing that doesn't bother me. I actually find it astonishing that it is generally completely acceptable to intervene for as long as we like to ensure we don't conceive and then when we do want to conceive we put an added pressure on ourselves that we must do it  naturally.

Fingers crossed this month I'll have an unnatural pregnancy. Just as good as a natural one in my mind.

Wednesday, December 1, 2010

Close to tears

On Monday we returned from a 10 day break on beach. I definitely feel more relaxed and rested than when I left, but all this relaxing and recuperating has the disadvantage of giving me more time to think.

My first few days of holdiays I was still wondering "Am I pregnant?"...  I don't mind this time. Thinking and hoping.

Having had one pregnancy, I have experienced the early symptoms of pregnancy, so when I started to get sensitive nipples and sore boobs I try to not to hope too much. Having had these symptoms often since the first pregnancy, and not being pregnant, the best thing about getting them is I know the wait is coming to an end. Once these symptoms are happening I'll know I'm either pregnant or not in the next couple of days.

This month, once again the wish was soon brought to an end with the onset of my period.

I didn't dwell on it, but immediately kicked into the plan set for the next cycle. The fertility specialist had already told me to double my dose of clomid / serophene if I wasn't pregnant. I'd packed in readiness for the result and had my drugs on hand. Because I was away I didn't get the same blood tests done to confirm my period had started.  Once I thought my period had started in earnest I started taking the clomid / serophene.

I'm supposed to take it at the same time every day. I stuffed up one day and simply carried away with beaches and swimming, but still managed to take it within a couple of hours of the set time. I'm not worried about that as all the blood tests have shown I'm ovulating every month, so a think a few hours late on one day of clomid / serophene won't be a problem.

The five days of medication taking pass and I've done all I can do. Then the waiting begins. Waiting for the fertile window. Last month this was the peaceful time, this month not so peaceful. I start in on myself mentally, I remember every glass of wine, every late day in the office, every coffee, every unnecessary calorie, every gym class missed. Having the plan and everything in place simply delayed the anxiety. I'm on the edge of tears all the time. Almost anything could set me off.

Yesterday I went to work - one day in the middle of my holidays - to ensure everything would be in place for a big meeting I have on my first day back. I was immersed in busy-ness. Rushing to meet a deadline, try to purge some of the hundreds of emails in my inbox and get the presentations completed for next Monday. The busy-ness distracts me from all the worry.

I think the worry really doesn't help anything, but finding the off switch, other than work, is hard.

With Christmas holidays around the corner, I'm beginning to dread the free time and all that time to think.

Oh well, coming soon is my next fertile window and I'll have the week of hope and contentment.

Sunday, November 14, 2010

Injection perfection

On Thursday I visited the fertility specialist to get my first pregnyl injection. As I understand it this injection puts a little bit of HCG in my system, therefore preventing the premature breakdown of my uterus lining that I experienced last month. 

The doctor had me prepared with the prescription, so I had my drugs ready to go and knew what to bring with me. Instead of being worried about the impending injection, all I was thinking about was the holiday notice. I wondered if it would be fixed, or if I would be subjected to erroneous notice for the duration of my wait. 

Needless to say, I was smugly pleased to see the notice had been fixed in the week between my visits. So much so I snapped a record on my iPhone while the receptionist was out of the waiting room....

Having learned from my last visit, I skipped the pile of magazines. While I enjoyed what felt like a win on the revised holiday notice I didn't want to spend too much time looking at the baby notice board either. Instead I immersed myself in my day ahead, reviewing my diary and reading my emails.

My wait was much shorter and I felt great when the doctor called my name. 

So the purpose of the visit was not just to get my injection, but to learn how to do them to myself, so I could be self reliant for future injections. For this particular series I only needed the three injections, one on Thursday, then Sunday (today) and then the coming Wednesday. But as it turns out there was a lot more to it than just the injecting bit.

I needed to be shown the technique for breaking open the glass vials in which the two separate elements to the drug have been provided. My hands were shaking as I was trying to crack them open. Once cracked open, the doctor shows me how to put a syringe together and then draw the liquid out of the first vial. The doctor then squirts the liquid back in the vial and hands it back over to me to do the same. Drawing the fluid up is pretty easy. I then squirt the liquid into the other vial that contains a powder. The powder quickly dissolves and the doctor instructs me to give it a stir with the needle. I then have to draw up the combined liquid into the syringe. This is when it starts to get tricky. I have to be careful not to suck up too much air. Once it is all drawn up I have to hold the needle point up and flick the syringe to tap out any air bubbles. Its just like on tv - only I'm going to inject it in myself and I'm genuinely worried about air bubbles! The doctor tells me the amount of air left in the syringe won't hurt me. So, now I have to swap from the horse needle I've been using for all the drawing up etc to the finer injecting into myself needle. 

This is all pretty simple, but brings me closer to the sticking point, where I have to jab myself. The doctor tells me to pinch some of the F A T (yes he spelled it out) on my tummy and then I need to push the needle in half way. Away I go.... While I'm jabbing the doctor tells me this is the worst of the needles he teaches his patients, because it stings the most. Meanwhile I'm thinking - I'm brilliant at this, it doesn't hurt at all. The doctor gets me to push the needle in a bit further and then I have to slowly push in the syringe. It really isn't hurting. I'm really pleased about that. Once it is all squirted in I slowly pull out the needle. The doctor tells me I've done really well and starts to pack me my very own drug kit for home. Extra syringes, needles, a little plastic cap to help crack the viles open and my very own sharps disposal kit.

As he is packing it all up I check out his tie, this time it is storks delivering babies. This guy clearly likes the novelty tie. He is really warm and likable and the novelty tie really suits him.

My drug kit

Today I had to repeat the injection process at home. I laid everything out and was impressed at my drug kit. I did pretty well repeating the process, only making the one mistake, where I prematurely changed the needle, preventing me from being able to draw up the completed potion. I then had to lever open my sharps disposal container to retrieve the big needle to draw the combined potion up. I flick the syringe to knock out the air bubbles and swapped needles to the finer injecting one. I get ready for the injection - just like in the doctor's surgery, only I swap sides as the doctor had told me to try not to do them all in the one place. I pinch some F A T and got ready for the jab and it stings like a bastard!!!!!

Giving myself my second injection

I don't what I did differently at the doctor's office, but this needle is unpleasant. I persist and push the syringe down. When I draw out the needle I'm left with a little hole that bleeds a little bit. I check and yes I have definitely changed to the small needle. I've got no idea why but this time the injection giving was really unpleasant.

At least there is only one more to go.

Tuesday, November 9, 2010

When the 'love doctor' calls

After remarkably fewer blood tests monitoring my hormone levels than last month (only three) yesterday the 'love doctor' called. 

In our very first appointment we all giggled and thought it was funny when the fertility specialist advised the 'love doctor' would give us a nod and a wink when the blood test revealed the LH spike that means that the next day I will ovulate. In fact last month literally we were told "all go for tonight". It really is strange to have someone (and now anyone who reads this) being across what (and more specially when) we are getting funky.

I love knowing that I am ovulating and when I'm ovulating, but it does mean spontaneity and romance have disappeared from our sex life. But what surprises more is that even with the lack of spontaneity and romance the quality has improved remarkably.

I guess the spontaneity had left some time earlier. Something kicked in after trying to conceive for months/years, where resentment, or anger, or disappointment seemed to underpin much of our baby-making efforts. And then there were the questions about the activities undertaken by one or the other partner, that seemed counter to the baby-making efforts. So for me, Matt would ask questions like why should we even bother when this weekend we are going to be going to [INSERT ANY PARTY] and you're going to drink a bottle of wine, thus undoing the efforts. And for me, I'd wonder, perhaps I've had too much caffeine this week, or sugar, or haven't done enough exercise, or I've worked too long, or drank a glass of wine at lunch....and so on and so on and so on....

Having access to information from the fertility specialist certainly helps because at least now we know our timing is on the money - hence removing a whole bunch of thinking about getting that right. Also given that both Matt and I have quit smoking ages ago and drink very little most weeks the fertility specialist has advised the occasional bender isn't going to be a big fertility issue, reducing the worry about the times we let our hair down.

Less stress about the peripheral issues seems to have made things a lot better for us in the bedroom.

Right now I'm still feeling positive, having just gone through the fertile window and knowing that this could be the month that it all come together again. For those that haven't figured out how this works just yet, in a week or so I'm going to be on the rapid down hill slope in the hideous waiting period - but you'll hear more about that when I get there.

Today I picked up my prescription for the injections I have to start giving myself later this week. I have a short appointment with the fertility specialist to learn how to do this on Thursday morning.

It is hard to put a lot this down, so thanks again to all the great emails, comments and messages of support.

Saturday, November 6, 2010

Melbourne Cup Melt Down

On Melbourne Cup day I had a 9.10am appointment with the fertility specialist. This appointment was going to be my first opportunity to find out what my early not period meant and what my next options are. I felt pretty good in the morning and got the surgery quite early. This was no doubt my first mistake. Sitting in the doctor's surgery with a whole lot of time to think.

I introduced myself to the receptionist, picked up the magazine from the top of the stack and took a seat. Flicking thoughtlessly through the mag I then look up and around the surgery, taking in all the photos of babies that happy mothers had sent in to the doctor, thanking him for their little bundles of joy. All perfect little faces, fingers and toes. I started to wonder how many babies don't make the board because they aren't so perfect. Or how many sad would-be-mothers haven't got a photo to send in. How do these thoughts even come into my head?

Clearly this board isn't supposed to trigger these types of thoughts. And then I notice the notice. Printed on a regular A4 sheet of paper with black type...The doctor is going to be on holidays from 18 December 2011 to 16 January 2011. Hmmmmm.... I think to myself, clearly it is supposed to be 18 December 2010 to 16 January 2011 - I can figure that out. Then I wonder, should I let the receptionist know? Has she already been told by someone else? Does it matter because I obviously figured it out. I would hate that mistake hanging in my foyer, so I resolve I will mention it in passing as I'm leaving. This is so easy and cheap to fix, and maybe she doesn't know and would like to have it fixed.

Back to the magazine (my second mistake) - I read a story about AJ Rochester - the former Biggest Loser host. She has an 11 year old kid. It was only after he was born she decided she needed to trim down. So she was overweight - and a lot bigger than me - when she conceived. I read about how much fun AJ had when she was fat and how she now has healthy relationship with food.

Continuing to flip through the pages there is a story on Octomum, another on the lesbian couple who is pregnant with quintuplets. I flip on, and there seems to be story after story about miracle babies.

I hear the receptionist telling someone on the phone about the holidays the doctor has scheduled, 18 December to 16 January, and think - this is a good time to mention the mistake on the notice (my third mistake). Once she hangs up I say in a friendly tone "Actually the notice on the board says December 2011, instead of 2010." The receptionist replies, with rolled eyes "I think everyone knows what it means." She pauses looks away and says "but thank you."

I try to remain calm. But I start thinking, surely she could have just said, "okay, thanks" even if she didn't intend to change it. Why doesn't she care? Doesn't she hate having that blatant error just hanging there. What about the doctor? Does he care it is wrong? How much of a shit does this surgery give about detail - whether it be the notice about the holidays or my medical details. I try to stop myself thinking about it, but it just goes round and round, until I'm beyond the point of no-return. I start to cry. I walk out of the doctor's surgery and find the bathrooms were I proceed to cry and cry. I'm trying to calm down - after nearly 30 minutes of waiting I find myself unable to pull it together just as my appointment time comes up.

Eventually I manage to dry my eyes enough to go back in. I sit down and pretend to flip through the magazine. Kerry-Anne is on the telly in the corner and another patient is now also sitting in the waiting room. Suddenly the receptionist is really friendly and trying to make small talk with the other patient. She starts talking about how she's a wonderful grandmother and I want to punch her in face. Perhaps the other patient isn't so sensitive on the mother/grandmother thing, but I can't believe this is part of the small talk she attempts in this surgery. I try to stay calm. Ignore her. Just the sound of her voice is now enough to set me off. Breathe.

Finally the doctor calls my name and as soon as I'm out of sight of the receptionist I'm in tears again. The doctor keeps asking if I'm okay - I'm quite certain he is accustomed to crying women given the strategic location of tissues next to the patient chair. He asks if it is something "we've done". I'm quite certain the receptionist has let him know there has been waiting room incident, but what's the point in saying, "your receptionist took a tone with me when I pointed out the mistake on the notice about your upcoming holidays." Normally such a tone wouldn't bring me to tears. So I say no, I'm just a little sensitive about all of this.

And the doctor starts to talk to me about the results of the 10 or so blood tests I've done in the last month. The ones that show the increase in oestrogen, the one that shows the LH surge that indicate when I should ovulate, and then the ones that show I really shouldn't have had my period when I did. I really like the science of it all, and it does calm me down to talk rationally about what's going on.

Given the premature break down of my uterus lining we now need to introduce some additional tricks with hormones to give me the best of chance of getting knocked up. We talk through the options. Doubling the clomid dose is a definite for next cycle, if we aren't successful this cycle. Additionally I can choose between learning to give myself HGC injections (the pregnancy hormone) to trick the body into thinking it is pregnant, and therefore keep the uterus lining, or I can get a compound chemist to whack together a pessary (for the uninitiated that is a pill that gets inserted in the vagina) - delightful - which I have to insert twice a day - and lie down for half an hour after doing so, to also trick the body into thinking it is pregnant!!!

Hmmmmm. I choose injection. From what the doctor is telling me the pessary option is quite unpleasant and then there is all the time just lying around when I'm already struggling to get ready for work in the morning I don't need the half hour of lie down time.

We talk about the results of all the other blood tests that indicate despite the chromosome problem that caused our first miscarriage, neither Matt nor I have any underlying issues with our chromosomes that would have caused that. Matt's got all the right hormone levels to make his contribution as do I. So on that front it is all good.

I tell the doctor I'm pissed off that I waited so long to get to be referred to which he replied, "there's no need to worry, there's plenty of life in the old girl yet." I tell the doctor I like his novelty tie, that is filled with hundreds of different coloured jockey hats.

So I've calmed down and leave again with a fist full of blood test forms to continue with the monitoring of my cycle and help get our timing right. I manage to resist punching the receptionist in the face and take a mental note that if possible I should make appointments for the afternoons, because she only works morning.

I make it to the office by 10am and only have to fend off a few questions about whether I'd been crying.

The rest of my Melbourne Cup was incredibly uneventful. I still felt sad, and have continued to feel sad this week. Rationally I'm so good at dealing with all this, but emotionally it is just so hard.

Sunday, October 31, 2010

Two year anniversary

This week Matt and I celebrated our 2nd wedding anniversary. For my part, it has generally been an excellent two years. We've been very happy. We've settled into our little home. We've grown together.

I remember before I met Matt and I thought about the ideal settling down situation, I used to think if I married, I'd like at least two years married together, before complicating the situation with having children. I guess I dreamed up this perfect scenario when I was younger, because it is only been during this week of our second anniversary that I've really remembered it. So this week I've reflected on some of the good things about this extra time we have together without children.

Primarily it is a selfish thing. I've had two years of not having to share Matt with anyone. And for the both of us, we've been able to continue to enjoy, although less regularly, some of our vices (mostly resulting in terrible hangovers). I expect having children would have certainly slowed us down a lot more.

We've also gone through the incredible high and subsequent low of our first pregnancy and miscarriage. I am emotionally fairly solitary when it comes to the unhappy spectrum of emotions. I prefer to deal with these things on my own. But over the last year I've had the quiet support of my husband. Going through this together has certainly brought us together more.

One clear advantage is the balance sheet. Last year we lived large and this year we've been able to afford (just!) for Matt to study full-time, working only during the holidays. The skills we have developed this year to better manage our finances will also be handy when we do have children and have only one income again. But I'm already planning for what we will be able to fund next year when the both of us are working full-time again.

Of course celebrating two years of marriage also marks two years of trying to conceive, but this hasn't been top of mind this week. Instead I've been focussed on the benefits of those two years with just the two of us.

PS: Tomorrow I'm going to head in for another blood test in preparation for my Tuesday appointment with the fertility specialist.

Sunday, October 24, 2010

The peaceful time

Right now, I'm in what I call the peaceful time of my cycle. I absolutely know I'm not pregnant and am over the disappointment of last month with my sights firmly set on the next fertile window, which should be rapidly approaching.

On Thursday last week my second blood test definitely confirmed I was not pregnant - even though I was already certain of it - and that my period had now officially in hormone terms commenced.

I mentioned clomid in my last post. The fertility specialist has suggested I continue to take it just to ensure I do ovulate each month. This entails taking one pill for 5 days at the beginning of your cycle.  The fertility specialist told me to start taking my clomid on that day. I've got just the one tablet to go.

I've also made a follow up appointment with the fertility specialist to discuss the issue of the later part of my cycle. I'm guessing another drug will be involved in helping my luteal phase be more suitable for conception. I don't see the specialist until 2 November.  I anticipate more blood tests will required also.

I like this time. It is peaceful mentally.

Also, I'm really grateful for all the messages I've been getting in. Thank you to everyone for your support and good luck to those on their own baby making missions.

Wednesday, October 20, 2010

So what's been going on till now?

I rang the Doctor's office late on Tuesday night, unfortunately a little too late to get the results of my blood test. The answering machine gave me an after hours number to ring, and that message gave me another 'urgent' pager number. I decided the results of this blood test can wait until the morning.

On the dot of 8am today I rang and was told that the blood tests show my period hasn't started properly yet. I don't what this means for the whole fertility deal yet, it just seems weird and has me wondering what's been going on for last however many months. 

When did my period starting stop being my period starting?

Since my first pregnancy miscarried and having a suction DNC (curette) in August 2009, my cycle has not been what it used to be. My cycle could vary from 26 to 40 days in length. When you are trying to get pregnant there is nothing you would like more than a nice regular cycle. The irregularity is bad, but it is the long cycles that mess with your head, make you do a million pregnancy tests, get your hopes up to the highest heights and then send you crashing back down.

I reported all this irregularity to my GP, who referred me back to my original obstetrician, who said I needed to be patient. After another month or two of patience I went back to my GP who I have been seeing for about 10 years. In tears again my GP said all this patience was ridiculous, given the emotional distress it was causing, so she prescribed Clomid to try and aid in a speedy pregnancy.

So I've had the clomid for a few months and the irregular cycle has settled down, but now I find out that everything is haywire anyhow.

So how does this result make me feel? Better than I have in months. I feel better because someone is looking into it. The doctor wants me to repeat the same blood test tomorrow. And I hope that the results tomorrow shed more light on what the hell is going on. I certainly hope even though I've got no idea what is going on, that the doctor will.

Monday, October 18, 2010

How do I know it's my period?

My obstetrician was particular about my waiting 12-months. She tells me the high percentage figure of healthy couples that will conceive naturally in this time period. Given the fact that my husband and I had conceived once naturally in 2009 she assured us that patience was necessary. 

Having lasted about 10 of the full official 12-month waiting period, last month I managed to get a referal to see a fertility specialist.

Our appointment was a great 15-minutes in front of a professional who like the obstetrician said given the results of a few test we'd already undertaken so far there wasn't too much to worry about. My weight could be a problem, so perhaps I should try and loose some and step up the exercise program (which he acknowledges this sometimes more difficult than it sounds). 

He sent us away with a lot of blood tests. These tests to be done by me over the course of the month would allow the doc to follow the rise of fall of certain hormones. We left with the certainty that this month the 'love' doctor would give us the nod ensuring our baby making efforts were concentrated around my most fertile window. It wasn't much, but it was enough to bring back hope. At last we were doing something, we had some support, we had scientifically accurate information about my oestrogen, LH and progesterone levels and a phone number to ring. 

With science on my side, I have also stepped up on my part. I've renewed a gym membership and have been getting a lot more regular exercise. I've also been seeking some alternative therapies to help me with some of the emotional difficulties I've experienced around my failed pregnancy and my general well being.

Today I decided that I would ring the fertility specialist to report that my period had started 7 days after I ovulated. Having done swathes of internet research I knew this was bad news. A short luteal phase doesn't allow the body enough time to get pregnant - or something like that. The doctor wasn't there when I rang, but with the receptionist informed of my concerns, I was advised I would either receive a call back later in the day or that I should call again in the morning.

I was pretty bloody happy when the doctor rang me back in the early evening. I found myself talking quickly and openly about spotting and light bleeding and how it all started just 7 days after the date of confirmed ovulation. I was however surprised by the doctor's response, "how do you know it's your period?"

I've been having periods for let's say 23 years. Yes, this bleeding is light, but it has been going for 4 days and doesn't look like easing up. Last month was just like this, long period, but slow getting started with lots of light days. I have done a few cheap internet pregnancy test, but they all come up negative so I don't think it is implantation bleeding. But when it comes down to it, I guess I don't know, I just assume it is.

The doc sends me to the pile of pre-prepared blood test forms that I left his office armed with from our 15-minute meeting and tells me to get a 'quantitative hcg' test. This test will confirm if I'm pregnant or not and all the other results of oestrogen, LH and progesterone levels will confirm if my period has started, or not.

I'm so glad I weaseled my referral a month or two early and that finally I am getting some help. Tomorrow morning I'll be there when the Sullivan Nicolaides doors open at 7am for another jab. And in the afternoon I'll ring that number to find out whether it is my period or not.