Thursday, January 20, 2011

better than expected

On Friday, I got a surprising phone call. The initial set had all come back normal, which I already knew from a previous call from her nurse. That particularly phone call had been frustrating. This is not Nurse Awesome that I had when we were working towards Robbie, but someone new. She seemed doubtful that I could know that I ovulated without an OPK. She wanted to tell me when to have a progesterone check and simply didn't seem to believe that I had ovulated the day before. She not-so-gently encouraged me to continue testing. I told her I would but that I'd been at this for about 5 years now and I knew I had ovulated. That was met with silence. She was not a believer. I was mildly annoyed, but as I already had my lab order for a progesterone check, I really didn't need her to trust me, so I let it go. This call from Dr. K was about my progesterone and about David's sperm count.

It pleased me that Dr. K called herself. It always catches me by surprise, but in a good way. I also have to chuckle when she calls herself by her first name, almost seeming to insinuate I should to. The doctors in the NICU were the same way. They'd ask me if "Gary" told me about yesterday's results, or if I'd seen "Bill" today. I respect all of these doctors far too much to call them by their first names. There have been a few that I'd gladly call Dr. Bitchy to their faces, but not these. They should be sir or ma'am or doctor, period. (You know, except when I was having impure dreams about a certain one of them. Ahem.)

Anyway, my progesterone was an unsurprising 6.2. Ovulatory but not great- the same as it always was. Dr. K even told me that her nurse had been skeptical that I knew I had ovulated. I laughed and told her I could tell that on the phone. She said that she reassured her that I did know what I was talking about and if I said I ovulated, I did. "She just doesn't know you like I do." Have I mentioned how much I love Dr. K?

I reminded her that OPKs had never done much for me. We reminisced about the first time she got me pregnant, on Thanksgiving day 2006. They wanted a positive OPK then and it wasn't happening, even though I knew I was ovulating. Dr. K was at another clinic then, and I really liked her nurse there. She did believe me that I knew what I was talking about and told me to come on in. Dr. K showed up in jeans and a casual shirt, her hair still wet from the shower. We had to wait for security to let us in- we were the only people in the entire medical complex that day. While sperm scurried their way up my tubes, ultimately finding an egg, I laid with my knees bent comparing sweet potato casserole recipes with Dr. K. That pregnancy had a sad ending 4 years ago last week, but in rehashing its beginning with Dr. K, it was a happy memory.

Then we discussed David's sperm count. This is where the surprise came. It was good. No, actually, it was great. A grand total of 62 million motile sperm. Considering the month before I got pregnant with Robbie, his count was 250,000, that was....well.... let's say unexpected. "Whatever you're feeding him, keep doing it," she said. So, I'm ovulating, even if moderately, and he's making sperm. But we've been goalie-free for 33 months, so now what?

We won't know the answer until my HSG is done. Dr. K is still concerned about scarring to my uterus. The lab results seemed to add to that concern. There are two choices, depending on the outcome of the HSG. If it's normal, 25mg Clomid and 3-4 cycles of IUI. If it's not- IVF.

Today is CD1, so I called to schedule my HSG. It will be next Thursday the 27th. The lab tech is supposed to give me the results on site, so next Thursday, we'll have a plan. If Clomid wins, we'll probably have our next insemination the last day of February or first of March. Suddenly that seems really soon. I'm taking my handful of pills (extra folic acid, prenatal, baby aspirin, Metformin) each day. It's on.


Wednesday, January 12, 2011

A day

I was off work today. I told daycare not to expect Robbie and looked forward to a relaxing mommy-son day.

Robbie woke up at 5:30 a.m. As he normally doesn't get up for the day until at least 8:30, that was kinda early. I drug him back to bed with me assuming he'd go back to sleep. A little after 6, I hear him whisper "toons.. cah-toons..."

I grumble something incoherent to which he replies loudly "CAH-TOONS."

I tell him it's too early and to go back to sleep.

He doesn't bother with words again, he just dives over me to grasp for the remote control on the nightstand. He can't operate it yet, but he knows it holds the magic. I'm too tired to argue, I turn on the Disney Channel and rub my eyes.

David's alarm goes off and he seems confused why we're awake.

A short time later, my stomach feels a little odd. Maybe I'm just hungry. Robbie and I sit in bed and eat cereal.

About fifteen minutes later, I realize that was not hunger I had been feeling, but nausea. I take some deep breaths. Do not hurl.

Robbie hops down and grabs some books. We read 112 of them and then he started to seem sleepy. I wasn't sure if a nap this late in the morning was a good idea or not, but since I really wasn't feeling well, I figured we'd go for it. We snuggle up and I doze. I wake up to him climbing out from around me and slides out of bed. I rub my eyes again and figure that was our last hope. Time to get up.

Two minutes later, I hear him run back in the room carrying something rattly. "Cwackuhs!" (Crackers) he says.
I sit up and reach to get him some crackers and realize his pants and diaper at at his ankles. He's soaked in pee. We're working on potty training but he's not getting all of the components quite yet. I guess he decided pants down meant it was okay to pee. Or maybe he just decided to strip and the pee came on its own. I don't know. Either way, he got stripped and washed up.

Good morning.

As I'm cleaning him up, I realize the urge to hurl has not eased. Could I have eaten something bad? A stomach bug? I don't know. But it's not good.I wanted to take Robbie out to play in the snow and I don't have time to be ill.
I decide to run a hot bath. Maybe I'll feel better then.

I fill the jetted tub and turn it on, planning to get Robbie settled with some toys and return. Before that can happen, Robbie manages to dump an entire package of Goldfish crackers in our bed. Both it and he are essentially breaded in Goldfish crumbs. Guess I'll be washing the comforter today.

I take Robbie to his room for another fresh set of clothing. Before I can finish that task, I hear the tub making an odd noise. Hmm.. better go check that out.

I leave Robbie's room and I can hear water dripping in the basement. That can't be good.

Get to the bathroom and the jets are spraying water EVERYWHERE. I don't quite understand what happened, but the bathroom is a lake. I turn everything off, drain the tub, throw 14 towels into the floor and then head towards the basement to survey the rest of the damage.

The basement is a mess. About a third of it is wet, including water under a stack of boxes. I start pulling out the important stuff, and throw down a dozen more towels. I stop a few times to run upstairs and make sure that Robbie isn't eating paint or building a bomb while I'm distracted and to consider if I'd just feel better if I'd puke.

One of the cats wanders downstairs, yowls in displeasure and runs back upstairs.

By this time it's nearly lunch. I do the best I can with the basement and head upstairs to tend Robbie. I put some chicken nuggets and fries in the toaster oven and sit down on the couch to call my husband and tell him what a crappy day we're having.

As soon as I get him on the phone I look over to see my previously displeased cat poised to pee on the just-washed-and-sat-out-to-dry cover to Robbie's high chair. I throw a book at him, but not quite quickly enough. I consider crying, but that seems counter-productive. I can't even cuss because Robbie's in echo mode and anything I say, he'll say, too. I sigh and retrieve a load of wet towels from the bathroom and start the washing machine. At least I didn't puke while I gathered them.

Lunch is ready. I watch Robbie throw fries and chicken to the cats. At least someone is happy.

I put Robbie down for a nap. He fortunately fell instantly to sleep, allowing me to finish the clean up in the basement and bathroom. I try to lay down but my mind won't shut off. I decide maybe some toast would settle some stomach, so I make some. It takes about 5 minutes to realize that was a bad idea. No nausea, just pain. Screw you, germs.

Robbie wakes up as I'm finishing washing the dishes, so we play a little while. I attempt to bundle us both up snugly to go play in the snow. Robbie objects to a second pair of socks, so I just go with it. He was NOT a fan of the snow. It was amusing until about the time the snow his his ankles, I think. He should have listened to me about the socks. I should have insisted anyway. Though I might have had to sit on him to make it happen.

He starts to cry, "NO SNOW!" I put him back on the porch and make a big show of making a snow angel. See, snow is fun! Even when you feel barfy, yay snow!

Robbie makes a show of giving it a second shot but is clearly unimpressed. He looks visibly relieved when I ask if he wants to go back in. He makes a bee-line for the door. "Ih-side!" (inside) he says with relief.

I get us in and change him into warm, dry clothes. I try to remember how many outfits he's been in today. I don't have time for kid laundry, I'm still washing towels.

It's only mid-afternoon and I'm exhausted. I attempt to distract Robbie with a movie. He much prefers to read books. I curse myself for being an attentive mother. If only I'd taught him how to veg in front of the TV all day. Heh. All I want to do is lay down.

I take my temperature and don't believe it when it says it's normal. I feel like crap, I need some statistics to prove it.

I think about what a terrible day this has been. I used a vacation day for this? Robbie would have been better at daycare where he could have some attention and working at a desk job would have been infinitely easier than the series of catastrophes this day has heaped upon me.

Robbie comes running in with yet another book. "Mo' book," he says. Okay doll, more book. I pull him into my nap and try to arrange him so he's not pushing on my angry stomach.

He snuggles against me and I smile.

I kiss his cheek and wrinkles his nose happily.

I ask "kiss?" and he presents his cheek again.
I nom it playfully and he giggles. He presents his cheek yet again.

"Kiss?" nom-nom-nom. More giggles.

We do this several times and then I wrap him in a tight hug, "I love you, sweet face."

I sigh with contentment. Man, this is the best day ever.

Wednesday, January 5, 2011

The Plan

Well, as expected, the appointment with Dr. K went well. It's nice to have a doctor I really love.

She asked about Robbie and was stunned to learn I'd delivered at 26 weeks. Then proceeded to say "wow" and "okay, then" approximately 47 times. At point she even said "I keep saying wow!" She said that we definitely made her nervous, but was glad we'd seen the peri (Dr. Bitchy) and passed all our tests. She did mention that she could help us with a surrogate and that she's had people who delivered even at 33 or 34 weeks go that route. Maybe she thinks we have a money tree, too?

Otherwise, the appointment was as expected and good. Standard workup. They drew a number of labs to check my various hormones and levels. I need to have a 7dpo progesterone drawn. David needs a repeat semen analysis. She wants me to have an HSG next cycle because apparently having a c-section early is a great risk for scarring. Apparently if the uterus gets very large, the scarring is minimal, but if it's still somewhat smaller, it's worse. Thank you again, prematurity.

We talked about how to reduce the risk of multiples. This was a big one because Dr. Bitchy was absolutely adamant we can not have more than 1 baby. She was extra bitchy on this topic, if you will. Dr. K agreed. Though she managed to do so without being bitchy. The biggest hope is that my labs (particularly my progesterone) are normal. If so, we're going to try a med-free IUI. That would be lovely on a lot of levels. I certainly wouldn't be sad if my ovaries didn't have to swell up like softballs again.

Of course, the likelihood is that it'll be low like it always was and I'll need Clomid. I've had three singleton 50 mg Clomid pregnancies, which is good. But Dr. K says she's had patients with triplets on 50 mg. We can not have that. Dr. Bitchy's head would explode. (Along with my liver, I'm afraid, or that might almost be fun.) Fortunately she completely agreed with my suggestion to half it. So if I need it, 25mg it is.

If that doesn't work, or if David's swimmers have gotten even worse, we'll go straight to IVF with a single embryo transfer. We are very, very fortunate to live in a state which mandates infertility coverage, so if we go that route, the money part is there. Of course, IVF has a limit, and comes with its own issues. But it also allows for a lot of control when it comes to multiples, so it's a good option.

In a bit of serendipity, it turns out that the clinic is conducting a study on pregnancy outcomes. They are looking for information on pregnancies which result in miscarriage, preeclampsia, preturn delivery, ectopic pregnancy etc. They just want spare fluids for testing. So they will take extra blood when I have blood drawn, if I were to have an amnio, they'd take extra fluid, a piece of the placenta if I deliver there (which I won't, but if I did, they could have it.)

I was more than happy to agree to anything they wanted. Obviously it won't help me, but hopefully someday the research they do will help Robbie and other children. I honestly choked up with tears when I heard what the study was about. She walked me out to the coordinator in charge of the study and presented me to her, "You want her."

The only real disappointment in the appointment was that she also didn't agree to put me on Lovenex. Dr. Bitchy said she didn't think it would help but I could ask Dr. K. Dr. K said she doesn't keep up with pre-e research, since she doesn't see patients who get it ("but you came close! Twenty six weeks, sheesh!") so she would defer to Dr. Bitchy. Which means no. I realize that the long term studies don't show it helps, but some of the short term studies do and I am all for anything that would help. But since this made doctor #3 who said no, I can't really argue any further.

So The Plan is set. Now we just see how things go.


Monday, January 3, 2011

tick tock

My appointment at the RE is in 8 hours. Earlier tonight I was feeling pretty good about it. We can do this. We're good parents. We're prepared. Dr. Bitchy signed off. I've lost 20 pounds. We're ready.

And then I watched Desperate Housewives. Yes, one of the dumbest shows on television caught me. For those of you with better taste in television with better things to do who don't watch it, I'll explain. One of the cast members was trampled in a riot (look, I know it's a stupid show, okay?) and lost a kidney. Her remaining kidney is "deformed" and doesn't function well. They discussed dialysis. At one point, she tells her friends to be sure to look after her son if something happens to her.

I thought about my own kidneys. They suffered during my pregnancy with Robbie. They were in worse shape than I knew. Dr. Bitchy was surprised they'd recovered. They'd been close to failure. What if I get sick again and they don't recover this time? What if it's worse than that? What if I die? What if I leave Robbie without a mother? Another baby without a mother?

I know that preeclampsia deaths in this country are rare. (Though they are disgustingly common in third world countries. Don't even get me started.) But they happen. What if....

I recognize this is anxiety getting the better of me. I've consulted the experts and passed all the tests. On paper, everything should be okay. But life isn't paper. And the odds have never seemed to favor us. Between the infertility, miscarriages, early preeclampsia, Robbie's stomach issues, we often find ourselves in the minority of statistics. Dr. Bitchy said I'm "an outlier." Being unique is highly overrated.

This is what I want. It is. I want very much for Robbie to have a sibling, for us to have another child. Growing up, I thought I wanted one child. I was an only child myself and thought it was pretty alright. But as an adult, I often find myself wishing I'd had someone to share my experience with. I watch friends and their siblings and find myself wistful. I know not all sibling relationships are good, but sometimes they are, and I'd liked to have the chance. So I thought we'd like two. Then along came Robbie, and I've so enjoyed being his mom that to be honest, I'd like more. I'd be happy with 3 or 4. David freezes when I say that, laughing nervously. "Where would we put them?" I just shrug and say we'd figure it out if we needed to.

I know that won't happen. Even if we managed to get and stay pregnant and deliver a full term, healthy child, I'm not getting any younger. I'll be 35 this year. David is 40. As we're already fertility challenged, the clock is ticking. If I can convince David, I'd like to try to adopt a child or two from foster care. So far he's not on board with that, though. So if we manage to make another real, live baby, this will likely be it for us. And I want at least that.

But the process is terrifying. I'm scared to hurt another baby. I'm scared to let down my husband. I'm scared to let Robbie down. But I guess I'm more scared not to try.