Endo in the Family and Dr. Visit Update

My father was an only child whose parents had him later in life and who both had no living extended family in the area to speak of. My mother died when I was a baby, and her family (consisting of three brothers and one sister) have lived scattered around the world all my life. With all that going on, the only blood female relatives I’ve ever known are my paternal grandmother who passed away in 1998 and a maternal aunt who I met just one time fifteen years ago.

Maternal Aunt recently moved back to the area after living out west for decades. I went to visit Aunt yesterday and to finally meet my cousin—her daughter—who is literally the only blood cousin I have. As we visited, the topic of kids inevitably came up. Aunt said she just assumed that DH and I simply didn’t want any kids. I was very honest with Aunt and Cousin without getting too detailed, telling them the basics about our current journey through IF treatment. In the course of conversation, it turns out Cousin (who has three young children) also has severe stage IV endometriosis, and because of this, achieved two of her pregnancies through IVF. In addition, Cousin is also a cystic fibrosis carrier, so when I told her I was too it solved a big part of the puzzle for them as to whose side of the family CF runs on (even so, not a huge deal because no one’s ever been diagnosed with it in the family history). While I wouldn’t wish IF on my worst enemy, there is some comfort in knowing there’s a family connection and talking with a real person who’s been down the IF treatment road.

What struck me most (and made me laugh to myself) was how us hopefully-mamas-to-be-struggling with IF have absolutely no qualms or discomfort or sense of conversational boundaries when it comes to our IF stories and treatment. I mean, who else in the universe except women who have been through infertility can sit around a restaurant table—barely knowing one another—and feel totally casual and normal discussing semen analysis, follicles, ovaries, ovulation, IUIs, gynecologists, or when they DTD?

Moving on. Today was another Dr. B visit. And it was wonderful! Highlights:

  • DH is not a cystic fibrosis carrier!
  • I have a follicle! OMG! SO AWESOME! ***side note: As much as Dr. B tells me that OPKs are a waste of money and charting is a waste of time, I still continue doing both, and he cannot make me stop hehe. I truly don’t see the problem in either. I believe anything that helps a patient know her body better and gives her a sense of participating in her own treatment is a positive, not a negative.*** I had a smiley face on my OPK when I woke up today, so I was already pretty freakin happy about that. So when the 21 mm follicle showed up on the u/s this morning, even the ultrasound tech woman was marveling over it and congratulated me (which was sorta awkward. Like, I really didn’t do anything here, so how much credit can I take? Hmm.) My uterine lining was 9 mm, which she said was the minimum they like to see. She said OV is imminent in the next 48 hours. DH and I have been preparing for it since Sunday though, cause it’s better to be both late and early than to just be too late.
  • My FSH was a 10. Dr. B said that was on the higher end of normal, but he seemed pretty happy about it nonetheless. I return on Thursday morning for another u/s and even more blood work (yech) to be sure I ovulated.

Update to follow.

headstails IF

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Is IUI Worth It?

I’ve been mulling over DH and my options this week by reading up on IUI success rates (and the procedure itself, which seems pretty basic). The success rates seem ridiculously small! Although we’re back on the TTC merry-go-round with BD (fertile window begins tomorrow—yay!), I keep thinking in the back of my head though that, if natural means fail and we go forward with assisted reproductive help, what our best options would be.

Dr. B recommended IVF during our very first visit with him. He flat out said that IUI wouldn’t likely work, but if DH and I wanted to try it, we could. He’s the third doctor who’s strongly suggested we do IVF. But man is it expensive! (I cynically think sometimes that docs suggest it more to take your money than because a patient truly needs it. Money makes the world go round, and infertile couples strait up will. pay. anything.) Unfortunately for me, Pennsylvania has such screwy health care laws, and like no one in this state has any portion of IVF covered under insurance, ever, or so I’ve been told. So we’d be looking at thousands of dollars for one IVF cycle, not to mention the injections, the procedure itself, time off work, etc. Not saying I’ve written it off as a possibility in the future, but, for now, IVF is still on the backburner.

Which leaves us with our current path of doing IUI. From what Dr. B says, our 4% chance of conceiving naturally jumps to only 8 – 20% chance using IUI. And it’ll cost around $800. And insurance covers nada. I’m wondering if IUI is worth such small odds? It doesn’t sound terribly effective. Does anyone know someone who’s conceived with IUI? Or have you been down the IUI road and don’t think it’s worth it? I’ve been scouring websites and blogs and haven’t really read anyone’s story who has. Yet.

On a Happy Spring Friday note (it’s 50º in Philly—heat wave!), I leave you with my two fave infertility memes:

favememe endoovercome

The Plan of Attack

Yesterday I had my second appointment with my RE, Dr. B. It was actually encouraging, and I feel SO MUCH better to now have a plan of attack. Although DH and I will continue our TTC the old-fashioned way, there is now a “Plan B” underway and I finally have a medical doctor monitoring my progress, so I feel very optimistic about things.

AF showed up last Friday morning and was gone by Sunday evening. Although it was another abnormally short period like I’ve been getting lately, the intensity of the pain more than made up for its length. I had to call out of work on Friday because the cramps were just too much to bear. I spent all of Thursday evening, all day Friday, and most of Saturday morning in bed with mind-blowing cramps.

The one time I did get out of bed Friday I experienced a “popping” sensation on my ovary, followed by a jolt of pain that was so severe it had me doubled over and crying. I think that was the cyst rupturing. I’ve no idea if that’s good or bad. See, endometriosis can cause these “chocolate cysts” that can rupture, causing the contents of old blood to release and, if there’s a lot of adhesion action going on in that area (which in my case is pretty much a certainty), that spilled blood has nowhere to go. Yikes.

Anyway, a few highlights from yesterday’s visit:

  1. The u/s showed that the cyst they found on my ovary 11 days ago is gone: AF took care of that. See above paragraph.
  2. Based on the blood work drawn at my initial visit, I am a carrier for cystic fibrosis. This was especially interesting because I’ve researched my family tree all the way back to my 6th great-grandparents, and there was no mention on either side of cystic fibrosis. As a result of this finding, DH’s blood was drawn yesterday so Dr. B can ensure he’s not also a carrier.
  3. I am Vitamin D deficient. I KNEW I needed more sunlight! Yes—an excuse to tan!
  4. My thyroid is out of whack. This point alone was worth all of yesterday’s visit. I’ve suspected for more than a year now that my thyroid was off. My mom had a thyroid disorder. My oldest brother has a thyroid disorder. My sister likely has a thyroid problem. Last year I had my thyroid tested twice. Both times my numbers were out of range, but my crappy, evil family doctor did nothing except tell me he wouldn’t do anything to correct it. Dr. B, on the other hand, immediately put me on Synthroid to get it corrected. An unbalanced thyroid can contribute to infertility. Hey—I’ll take all the help I can get.
  5. DH is getting his fertility tested too. Dr. B was surprised to learn yesterday when I told him DH had never been tested before, so off DH went for blood work and then Dr. B presented him with The Cup (“Fill it up and get it back to me ASAP” was about all the medical advice given there). Although DH is over 35, I’m pretty confident things are moving along swimmingly on his end (bad pun, I know). Even though, my feelings on it mean nothing without first making sure everything’s good in that department.

So I’m on what Dr. B’s office calls “tracking,” where I go in for weekly visits throughout this entire cycle and they check to be sure I’m ovulating, to have my egg fragility and age tested, and to continue monitoring my hormone levels. I return in one week from today for the ovulation test. I honestly don’t know what to expect from that.

Following my month of tracking, Dr. B plans to start me on three cycles of Clomid followed by IUI.

With all these upcoming doctor’s appointments, I had to tell Boss something. While reviewing our calendar for the rest of April, I told him I’d be in late next week for my next doctor visit. Boss has been concerned about me lately, asking if I’m okay and such, and I knew I couldn’t continue being vague about what’s going on here. I very uncomfortably, and without looking at Boss, said that “we’re seeing a fertility doctor, so I have to go there kinda often for now” and left it at that. Boss simply replied “Oh.” Later yesterday afternoon in the elevator, Boss said to me “I’ll be praying for you about what you told me earlier. And don’t worry, I won’t say anything to anyone about it.” I awkwardly thanked him and said something about how some things can’t be kept a secret forever. In an attempt at lightheartedness, Boss said if I was pregnant, that there’s no way I could keep that a secret forever. I murmured a reply that I wasn’t pregnant. As if I needed another reminder.

Topping off all of the above, I had another session with my therapist, Dee last night. It wasn’t as emotional for me as our usual sessions, and I didn’t even tear up once! We discussed my medical treatment with Dr. B, who Dee told me she’d once visited once herself.

We spent most of the session discussing my discomfort relating to DH about the spiritual side of this TTC. See, DH is a big proponent of faith healing, as he’s been brought up spiritually in a more Pentecostal, charismatic sector of Christianity than I was. On the other side of the coin, I was brought up in a very conservative Baptist church, and—while I don’t necessary adhere to a great deal of the denomination itself—there are some things that have stuck with me over the years, and I find the notion of “Name it, Claim it,” “Blab it, Grab it” to be unbiblical. The rift between DH and I on this issue is an entire blog topic in itself that I don’t have the time or inclination to get into today. I’ll think that one over some before I write much more about it.

So, end of post, there is now a plan of attack. And I’m ready to attack.

All-Consuming TTC is Too All-Consuming

Idk if it’s a matter of putting the cart before the horse, but I’ve been stressed lately from what feels like a life all-consumed with TTC and I wonder if this here little blog is contributing to it. Between the OPKs, BBT temping, documenting of every symptom into my Period Calendar, therapist visits, REI doctor visits, learning of two people’s pregnancies in a matter of four days, reading other peoples blogs, and writing my own blog, I feel like all I ever think about lately is this infertility “problem”—to the exclusion of everything else. I’ve slept terribly for the past three nights, and I’m usually a pretty sound sleeper. Lately my sleep is very light and accompanied by strange, ominous dreams, followed by waking up completely exhausted. The stress of waiting for my lab results from Dr. B and anticipating the imminent arrival of AF only add to my craziness of late.

I know I must make some decisions here. We simply cannot go on and on and on TTC with no help other than the BBTs and OPKs. Despite Dr. B’s suggestion, IVF is a huge, HUGE, gargantuan, step that I’m not prepared to enter into just yet. Maybe I need to test the waters some first before I’m ready to make that leap. Like Clomid. Or IUI. Or the like. And, absolutely NO MORE SURGERIES! I have four under my belt to date, and the idea of a fifth surgery to remove scar tissues, which ultimately only results in MORE scar tissue, is out. of. the. question. Period. But, I have to seriously get down on my knees and seek God here, because decisions must be made and I absolutely want to make the right ones.

What my mind keeps coming back to is work. There’s only me and Coworker here working for Boss. That’s it. It’s a very small office. So knowing that I just missed 2.5 hours of work on Thursday for a doctor’s appointment, and that I’ll likely have to give boss notice of a matter of hours on Monday for a subsequent doctor’s visit, might cause some red flags. This is such a personal topic that I’m certain male Boss doesn’t want the deets on, but I will eventually have to tell him something when it seems like I always have to leave for doctor appointments, and I’m totally not comfortable going into my personal life with a man old enough to be my father.

God has a plan here. He’s not making things difficult for me just for fun and to see how I respond. He knew this was coming. Therefore, He has to have made a way of escape. After all, the only way out of something is to go through it. Yeah, I know there’s the whole “say unto this mountain be removed and cast into the sea” part of the Christian life, but that doesn’t exempt everyone from ever experiencing a challenge. There are circumstances applicable to that scripture, but not all problems neatly fall into the “mountain-sea-removed” category. Victory is also obtained—and experience and empathy gained—by having overcome obstacles. And I am not taking this infertility lying down. It will not beat me. It may be trying to consume me, but it will NEVER get me to simply lie down and take it.

Dr. B Report

So, last Thursday was the Big Day, the day I went to see my new REI doctor for the first time, Dr. B. DH met me at the doctor’s office and off we marched into the unknown.

Dr. B’s office was very nice, clean, spacious, professional, and modern; his staff friendly, efficient, and quick; however,  he Dr. B. himself was a bit odd. Possibly the misunderstood genius type? He was very soft-spoken, so I struggled to hear him at times. They drew 8 vials of blood from me, he performed a physical exam (not comfy!), and ran a vag u/s. The u/s showed a 4 cm cyst on my ovary and that my uterus was tilted upward and pushed to the right, probably pushed over because the cyst was taking up space.

It was not an encouraging visit. Upon reviewing my 16-page patient history, Dr. B. looked up at us to say he “liked a challenge.” After all my exam and blood draw were finished, we went back into Dr. B’s office to talk. He bluntly told me that my insides were “a mess,” that it was very likely (after reviewing my prior surgery reports) that all the endo plus some was back, and that DH and I needed “closure.” He told me I should have another surgery to clear the endo up. I told him no more surgeries. He immediately recommended IVF. I told him I wanted to try less invasive techniques first. He told me the noninvasive techniques were shots in the dark, that I could try Clomid/IUI/etc. if I really wanted to, but it likely wouldn’t work. Ouch. I’m to call his office the first day of my period (due on Saturday; today’s Monday) and he’d see my the following day to get started on things; the problem is, I can’t remember what he said we’re getting started on! Considering the spotting, cramping, and ovary pain I’ve been having the past 2 days, it totally looks like—in the natural at least—that AF is on her way.

I’ve been kinda an emotional roller coaster since Thursday’s appointment. I cry often, and over seemingly nothing. I cry and sob and weep and generally have a tough time keeping myself together. Today has been better, as I haven’t cried or been moved to tears once yet.

Today I choose to thank God for all the many, many blessings He’s given me and that He is a good God who has plans to give me hope and a future. That this too shall pass. That I’m only in the very beginning of a journey into the unknown that, in the end, He has fully in His hands.

I Think I Finally Found a Doctor!

In my quest to find someone to help me by Googling terms such as “endometriosis doctor Philadelphia” etc. this one certain doctor (we’ll call him “Dr. B”) kept showing up in my search results. Initially I was wary of Dr. B because he’s not affiliated with a practice group, has privileges at a far away hospital that I’ve never heard of, and has his own website. He is on my insurance network though, so I took a risk and called for an appointment. The staff was super friendly, caring, and helpful, and he had available appointments as soon as 3 days from the date I called. Because of other obligations, my appointment isn’t for another 9 days. I filled out the more-than-comprehensive 16-page (16!) new patient background form and have all my previous medical records ready to take with me.

I couldn’t get over how Dr. B genuinely seems interested in knowing all about me and, specifically, what my concerns and symptoms are. He’s extremely well-studied and accredited in infertility (and, more importantly, endometriosis) and does regular GYN visits in addition to REI. He ALSO does in-house ultrasounds! I always had an in-house u/s done at all visits with my prior out-of-state OB/GYN (“Dr. S”) and was astounded at the way PA docs always want to send patients to the hospital for a routine u/s. Among other things, Dr. B’s website discusses how most GYN’s “feel” for endo by pelvic exams only and how that’s such b.s. since one can’t “feel” endo. I know for a fact that that is an absolute truth. The GYN I’ve seen twice since moving to PA (we’ll call him “Dr. M”) always simply performs a brief pelvic exam on me, then “clears” me because he didn’t “feel” anything. When I pressed Dr. M for an u/s at BOTH of my visits to him he blew me off each time. Unfortunately, Dr. M. was always and only concerned with referring me out to another doctor anyway. Needless to say, I am so freakin excited because–even though I haven’t met him yet–I really think Dr. B could be my guy. And I really need a guy.  If Dr. B turns out to be my guy, adios y vaya con Dios to Dr. M.

On the other side of things, I had my initial appointment with the therapist a week ago (Dee). Despite the drive (which went decently after all) and my generalized nervousness at the whole situation, it went extremely well. Dee was kind, compassionate, thorough, and a good listener. She used some kind of “relating” technique with me where she pretended to agree with my frustrations as though she’d experienced them herself (which I know isn’t true because she has kids). IDK if I appreciate that or whether I see it as an obvious psychological tool that she didn’t realize was quite so apparent. Regardless, I’m scheduled to see Dee again in 2 days. Technique aside, she was very helpful and it was such a humungous relief to discuss this issue with someone other than DH or any number of my friends who can’t relate because they are moms and have moms and it all just went so darn smoothly for them.

Things seem to be on a moving trajectory with this issue these days, which is a tremendous relief since they’ve essentially been stagnating for 3+ years. I really feel there is hope. I am coming closer to the point where I can believe God for healing and believe that He’s not mad at me all the time. I also believe that God uses medicine and doctors to heal, and perhaps he’s led me to Dr. B. I don’t want to compromise or walk the line or have the best of both worlds. I just want relief, healing, and a baby of my own. However God chooses to do that (if having a baby is His will. I really hope that it is) is okay by me.

Hopping Back on the Merry-Go-Round

Tomorrow I have an appointment with a therapist. Why, you ask? Because. Because I think I’m going totally crazy. Crazy with baby obsession. If I don’t get this out of me with someone objective, I feel it may eat me up inside even worse than it already has and is. Example: I walked past a rack of baby clothes at a store on Saturday and became teary eyed. And that’s not the first time that’s happened.

Today the younger sister of one of my dearest friends had her first baby. This is a girl who I’ve known since she was 2 years old. When I first learned last fall that she was pregnant I felt like a miserable failure and refused to offer a congratulations or well wish: here is someone 3 years younger than me, married for only 8 months, decided to have a baby, bought the same pre-baby book I own, and—BAM!—pregnant. When I saw the news on FB today that baby had arrived I felt even worse. Depressed. Jealous. Sad. Lost, After mulling it over some, I decided that I’d like people to be happy for me if it were my first baby and that I should extend the same well wishes to someone else, no matter how much it hurts.

Yesterday AF reared her ugly red head. She was 2 days late. Off an on during those 2 agonizing days  of waiting I foolishly allowed myself to hope for the best, and even pretended for a moment or two that I was pregnant. Oddly, I’d had literally no symptoms leading up to AF except for one day last week when I was being down and out with gut-wrenching cramps. I entertained the idea that perhaps, since AF was so late, maybe it worked this time and no AF was on the horizon.

So, when I woke up yesterday morning to shower and get ready for church you can imagine my utter dismay at the doubling-over, mind numbing, soul-crushing, extraordinary cramping that proceeded. Needless to day, the waterworks unleashed. DH came to console me as every emotion of failure, sadness, hopelessness, despair, guilt, and anger came pouring out. To top off the nightmare, a huge, HUGE blood clot came out of me while sitting on the commode, sending me into even further hysteria. And the pain! My God, the pain. I’m already running out of prescription painkillers, no matter how much I try to supplement them by relying on massive doses of ibuprofen instead. I literally spent the entire day yesterday in bed, crying and taking medications, pressing the heating pad into my aching uterus and ovary, praying and pleading with God to just allow me to get pregnant, examining myself spiritually to determine why God could be so mad at me, hopelessly angry over the fact that my health plan does not cover infertility treatment (that’s another post in itself).

Today the pain is relatively better: I can get out of bed and actually interact with the world, hide my sadness as I’ve become so accustomed to, and actually take myself to work. But inside….. inside it eats at me and torments me, and mocks me, and taunts me: You’re not good enough, you missed the mark, you’re not worthy, you can’t have a mother and you can’t be a mother, you can only watch as even the most wicked, Godless, messed up people you know procreate time and time again. This is my world.

Laughably, in only one short week from today my fertility chances again increase to medium, then high, as the next ovulation window approaches! And back to it I will go! It will be another round of chart analyzing, CM analyzing, OPK tests, and timing BD to hop back on this merry-go-round of hope/disappointment, hope/disappointment, hope/disappointment that anymore consumes my life.