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Archive for March, 2011

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It was a good meeting with my RE, Dr. Zimon, on Wednesday. I held it together for the most part but of course I ended up crying when I was explaining how the bleeding happened and how scared I was. In a nutshell, I asked about the bleeding and she said it could have been a number of things but that it doesn’t concern her. She said it happening once could be a fluke but if it happens again then we’ll have to revisit and figure it out because then it does become a trend. She said it could have been implantation bleeding but that the egg never took, it could have been just breakthrough bleeding, etc… I asked if it could have been a mini period and she said highly unlikely because all of my labs last Saturday showed me at baseline so it appears that I haven’t gone into my next cycle. She said that often her patients will have one “wacky” cycle, but it doesn’t usually happen as the first. So of course it’s tough for me because I haven’t experienced a “normal” and the first shot out was different / unusual.

Dr. Zimon said it is hard for her as a doctor to sit across from me and tell me that there isn’t anything in my labs or testing that has her concerned about my ability to get pregnant. Actually, she was quite happy because the Clomid worked to build the follicle and the system and trigger shot worked because they confirmed I did ovulate – those are two things my body wasn’t doing before and there are many women with PCOS who don’t respond to the meds at all. She sees no red flags at this time but knows it’s hard for her as a doctor to look at all of the medical stuff and say “this is good” but for me as a patient to not feel like this is good. I asked why the switch to birth control pills to induce a period and also asked that why, if I ovulated, don’t I have my period naturally. She said that many women with PCOS, even with ovulation, won’t cycle on their own – it’s a common occurrence and basically is what it is. She said that if I preferred the Provera to bring a period (straight progesterone) she could do that and I told her I wanted to do whatever she thought was best. She said the birth control pills (for two weeks) contain both estrogen and progesterone and she’s doing this to try and basically wipe things clean – bring on my period (and a good one) and then start again.

She was very nice and I think the trouble is that I have to come to terms with the fact that although this is a science, it’s not a perfect science and there may not be one specific answer / explanation for everything I experience. She reassured me and actually told me that I should feel comfortable calling her if I have questions – obviously not after every lab but if I have concerns like with the bleeding, etc…I can schedule time and speak with her. That made me feel really good.

So – today will be the 3rd day of the pills and I have 11 more to go. Once my period comes that will be cycle day 1 and we’ll start the Clomid on cycle day 3 and start all over again. For now, I shall drink loads of wine and coffee and wait for it to all come together!

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I spoke with Nurse Karen yesterday and she had spoken with Dr. Zimon and they apologized for the negative result on Saturday.  When they ran the beta pregnancy test, they also ran a check of my hormone levels and everything was at baseline so I should have a period.  But I don’t.  BAH.  *yells at lower abdomen region*  WHY DON’T YOU CYCLE LIKE A NORMAL PERSON?!

So, Nurse Karen said she was going to call in birth control pills (BCPs) to take for two weeks to induce a period and then we would start with cycle #2.  I was utterly confused as for the going 18 months I’ve been off the pill, I’ve only used Provera to bring down a period.  I asked her about this and she said that Dr. Zimon uses BCPs and Provera interchangably to induce a period, but if I wanted to use the Provera I could.  I asked if there was any specific reason for the change and she said she didn’t think so.  But, that seems weird to me?  Well, I’m not one to argue with a doctor so I said “sure” and she called in the BCPs (and I of course forgot to pick them up last night so I’ll go today).  This just adds another question to my list of questions to ask Dr. Zimon.

Nurse Karen said she saw where I’ve requested to have a follow-up with Dr. Zimon and I said that I thought it was important since I have a lot of questions, I had the bleeding, and I generally want some more information.  So, I was transferred to Dr. Zimon’s assistant and scheduled the appointment for tomorrow at 2:30pm. 

I have a laundry list of questions about everything that I need to be sure I have all of them written down.  Chris said he had questions, too, but can’t be there so I asked what they were.  He said, “why the fuck did you bleed?”  Nice.  Obviously this is one of my questions as well, minus the f-bomb.   I think through my list of questions it’s safe to say that we’ll cover his questions as well…he’s just frustrated and I understand. 

More to come after my appointment tomorrow.  Hopefully a lot more information and answers.

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I guess the wall I created with thinking I wasn’t pregnant helped when the blow came.

We got up early and drove the hour and 15 minutes or so to Waltham for the 5 minutes it took to take my blood. The Phlebo was very nice and she told me I would receive a call between 12:30pm and 3:00pm, but that it could be earlier but she wasn’t suppose to tell me that. Chris and I decided to go out for breakfast while we were up there. We talked about it over breakfast and I told Chris that I knew that I wasn’t but there was a little part of me that had hope. We drove home and I was watching some shows from my DVR when the call came – Chris was upstairs.

The woman was very nice and immediately said (after confirming who I was twice) that she wasn’t calling with good news. The pregnancy test was negative. She advised me to call Nurse Karen on Monday and discuss next steps. She asked if I had a menses yet and I said no. She also said that she saw I had bleeding mid-cycle and that I need to absolutely speak with Karen. Once off the phone, I cried a little bit.  I sent out a group text to some friends letting them know. As the return texts came in, many made me cry. It wasn’t a hard cry and not even remotely close to the breakdown the week prior, but I was truly disappointed.

We decided to have Chinese food and drinks with Lynne and Joe and it was a good way to decompress.  I slept soundly Saturday night (I’m sure the bottle of wine helped) and woke up Sunday like it was just another day.  We had a wonderful time with Lynne and Joe – it was exactly what I needed.

The part I’m really struggling with others is when people have said to us well, it was your first try so hopefully the second try will do the trick! It wasn’t our first try. Technically, this was our 17th try. Yes, it was our first medicated try with the assistance of IUI but we have been trying for SEVENTEEN MONTHS. This was my SEVENTEENTH negative pregnancy test. If you think about it that way, the situation looks a little different. This was a glimmer of hope – getting the worlds aligned to maybe, just maybe, get a positive. Although I appreciate all of the nice sentiments, I wince every time someone has said, written, texted, etc…”it was your first try…”. That phrase is right up there with the word menses…and moist.  I’m not mad at anyone who has said this, but I do want to give our experience a bit more context.

I know this will happen for us – it HAS to. We just have to figure out how to get there. I’m demanding an appointment with my RE to discuss the results and the bleeding. I feel that an explanation of the bleeding is owed to me as OBVIOUSLY it wasn’t implantation and I think it’s a critical flag to raise. I need to better understand what could have went wrong with this cycle and how we’re going to approach the next. I have questions that need answers and I need the doctor involved in this – I’m bound and determined to get it right and I need her to feel the same way and to grant me the time to ask the questions I have and to provide the information I’m craving.

In the meantime, I appreciate everyone person in my life who has taken the time to encourage me. I need that to continue – keep pushing my back and holding me up.

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Cycle #1: Pregnancy Test Result

Negative. *sigh*

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I called my RE’s office yesterday and asked Nurse Karen some additional questions:
 
Q – Was my progesterone checked?
A – They checked my progesterone prior to the IUI (on the Thursday before the procedure when I had bloodwork and my pelvic u/s done and was told to do the Ovidrel trigger that night) and it was elevated.

Q – Could the bleeding be from low progesterone / luteal phase defect (LPD)?
A – When I asked about luteal phase defect Nurse Karen said “not all doctors believe in that”, which I thought was an interesting answer and something I’ll have to bring up the next time I see my RE.

Q – Can we revisit the bleeding now that my head is clear?
A – I walked her through the bleeding day by day:  Thursday night was when I noticed it and it was just brown mucus, Friday and Saturday was dime to quarter sized drops on a pad but a lot when I wiped, and it has essentially stopped Sunday and Monday with just a little residual.  She is still leaning towards implantation bleeding because it wasn’t a full flow. I’m absolutely NOT getting my hopes up – so we shall see.

Q – Can I take the pregnancy beta test on Friday in the Quincy office vs. Saturday in Waltham?
A – Office protocol is 14 days from IUI because they have experienced false negatives with women who have come in early, so no.

Q – If it is a negative on Saturday, would I see the RE and we would assume this bleeding to be my period?
A – I would see the RE and we would talk about what to do for the next cycle and if anything has to change but that I should experience a full flow anytime between yesterday and the next few days if I’m not pregnant. Interesting. So, basically, if Saturday is negative we’ll wait for my full flow and will start the next cycle (with an office visit with my RE to discuss any changes, etc…) and if it’s positive then well…we shall see.

It’s all very crazy – I apologized for being the nutty patient and she said absolutely not. I heard her typing and she said she is putting all of our conversations in the notes so I know my RE is getting them which makes me feel good (assuming she would step in if needed). She reminded me that this is science and we’re all so different and that’s what makes it so hard.

I’m feeling much better than I was on Friday – Friday was very hard. But, now I’m of the attitude of “I can’t control it” so I have to work on the things I can control (continue to go to the gym to make my body as healthy as I can to eventually carry the baby, continue to “act” pregnant by eating right, etc…).

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Well, I’ll be honest and say that yesterday was bad.  The nurse didn’t call back until around 2:00pm, so I spent most of the day in bed, crying on and off, and just going through a whole host of emotions.  It’s not just about this first cycle not working, it’s about not being able to give my husband the best gift of all – a baby, it’s about defeat over and over again for 16+ months, it’s about wondering why / how my period came 10 days early and if the doctor can figure that out.  I’m sorry but it’s fucking scary to be bleeding when you’re NOT SUPPOSE TO.  Anyways, I told the nurse that it was not a full flow, but it was red when I wipe and a good amount when I wipe.  She said that she wasn’t making any guarentees but that it may be implantation spotting which timing wise would be around now but that it could also be my period.  She said if it starts to become a heavier flow, to call and let her know.

I’ll be calling on Monday.  There’s just too much – yes it’s not coming out like a normal period but it’s just too much and too period-like.  I’m going to ask to be seen and find out from the doctor what could have caused this and what can be done to prevent it the next time.  Part of me wonders, especially with a 25.5mm follicle, if the drugs worked TOO much.  I don’t know – I’m not a Reproductive Endocrinologist so I have to put all the knowledge and power into her hands.  Part of me also wonders if we’ll have to wait a month to try cycle #2 if this is, in fact, my period?  It’s all just so confusing.

Chris came home from getting the dogs groomed and visiting with my mother and he was really great.  He told me that I have to stop worrying about letting him down and that I am his soulmate and that we will have a baby together.  He told me he wants a baby with me and doesn’t for one second regret marrying me, etc…  (yes, these are all things I howled out while crying)  It really meant a lot to hear him say those words – I know deep down he doesn’t resent me, but it’s hard not to feel that way when you’re at your lowest point.  He brought me up a bagel and some water and I ate and we talked.  I finally napped soundly for a couple of hours and I got up and made dinner.  He picked out a funny movie for us to watch (Weekend at Bernie’s) and we cuddled up on the couch with the dogs and had a nice night. 

This morning was a new day.  I got up early and went to Dance Class and it felt good to let it all out and burn 1,000 calories while doing so.  I stopped and got some pantyliners since the nurse said no tampons – gosh, I haven’t used pads in seriously like 15 years.  It feels like I have a banana inbetween my legs and I got the thin ones!  I did some texting with my friends and my mom and talked through how I have to just focus on finding out why this happened and making a plan for cycle #2.  I’m still doing all the right things (decaf, no alcohol – which we have a wedding today so that stinks) and I’ll still take the pregnancy test, but I’m going to see if I can take it at the local office on Friday rather than driving all the way to Waltham on Saturday.  With all this, I really don’t think it’s necessary to go to Waltham…

So – here I am, still not knowing what the bleeding is but absolutely leaning more towards a period than something positive.  It is what it is – I have to keep fighting the fight.  I may get knocked down, I may feel like I can’t do this anymore and that is okay.  As long as I can start a new day and continue to be strong again, a little weakness never hurt anyone.

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