the consult — May 21, 2015

the consult

I just realized I never followed up after the consult we had at the doctor’s office. We went in to see Doctor G a week after the negative pregnancy test. The good news is that he has several things he wants to try when we go into our next round of IVF. The bad news is that he really has no idea why the first round was unsuccessful. He told us that since we did the genetic testing, we knew it was a good embryo. We also knew my lining looked perfect. He said that more than 2 out of 3 times for women my age, it should work. It could have been a case of bad odds. It could also be something medical that has not been diagnosed. I’ve had countless blood draws in the last 2.5 years. At two different occasions I had more than 20 vials of blood taken at one appointment. They’ve explored everything they know to look for, but they are still making medical discoveries every day.

What we know:

I have MTHFR, which is a mutation on a gene responsible for the breakdown of Folic Acid. Folic Acid is absolutely necessary for the process of cell division. When the egg is fertilized, the cells are splitting rapidly in those first few days of pregnancy and that is when brain and spinal cord development take place. Folic Acid is basically B vitamins. I am currently taking about 400% folic acid each day. Doctors are divided on just how much an MTHFR diagnosis affects pregnancy. Taking extra B vitamins for some added insurance isn’t going to hurt anything.

We also know that my FSH (Follicle-stimulating hormone) level should be at a 3 for someone my age. Mine is at 0.462. Yeah. It’s low and the doctor is somewhat concerned about this because since he has been following my progress for the last two years, that level as decreased.

I’ve had 4 miscarriages, which tells us that I am able to get pregnant, but not able to sustain the pregnancy. The doctor shared a theory that due to my low ovarian reserve (available eggs), the odds are that they might find 4 good eggs out of every 10. Again, this is just a theory and not scientifically proven, but due to the recurrent miscarriages, bad eggs are most likely being fertilized. My body is recognizing this and the natural process is a miscarriage.

What we will try next:

Doctor wants to put me on Lupron before beginning the stimulation drugs. From what I understood at the appointment, this will help somehow with my ovaries. Then, I will begin the Menopur and Bravelle, which are the two stimulation drugs they give you before an egg retrieval. Your ovaries take turns releasing eggs. One month your right ovary will release the egg and the next month the left ovary will release the egg. The follicles in your ovaries battle it out each month to see which one can release the best, healthiest egg. That one egg is released, makes its way thru the fallopian tubes and is deposited into your uterus to wait to be fertilized. Too bad I didn’t retain all this knowledge from the semester I took Human Anatomy…I’m having to learn all over again. It wasn’t really applicable back then.

During our first round of IVF, Doctor prescribed more of the Menopur compared to what he normally prescribes due to my low FSH level. He is going to increase it even more the second round. The first round, he was able to retrieve 6 eggs, which he said he was very happy with, considering my levels. We are hoping for at least 6 eggs again, maybe more. Out of those 6 eggs, just one made it to the point where it could be transferred during the first IVF attempt.

He will also introduce a more aggressive blood thinner. I have been taking a baby aspirin for the last 2.5 years. They prescribe the baby aspirin because it might help, but it definitely won’t hurt anything either. Why not? I’ll give it a try. Well, now he is going to put me on Lovenox after the next transfer. Lovenox is a daily injection I would give myself. It would begin after transfer of the embryo and if I have a positive pregnancy test, the injection will continue thru the first trimester. At that point I will graduate to my regular OBGyn and she will begin following the pregnancy. Doctor G and my OBGyn will consult and decide if the Lovenox continues in the pregnancy or if I stop. If it is continued, it will be until I am within few weeks out from giving birth and they would switch over to Heparin to avoid any complications during delivery.

What we need:

Prayers. Encouragement. Wisdom. We will most likely wait until the end of the summer for our second IVF attempt. Time to kick back, relax, enjoy the summer and finish the remodel of our kitchen.

**Note–I am not a medical professional. The descriptions above are the things I can recall from what the doctor shared with us. It may not be correct, but this is to the best of my memory.   😉

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the next day — May 7, 2015

the next day

For those of you who know me, you probably know that I am not a morning person. Luckily for me, due to the nature of my job, the earliest I have to be at work is 10am on most days and 1pm on other days. It just depends on which groups I’m leading. The day after getting the negative test result, I did not have to go in to the office until 1 in the afternoon. I am normally lazy on those days and will sleep in or catch up on tv shows. On this particular morning, I decided to get up and take a walk. There are trails all over our neighborhood and there is a 2 mile route I like to take.

I sometimes take the teenagers I work with on walks. Nothing crazy, as we are limited to the parking lot around the building, but we normally find a good spot in the shade to spend part of group. We discuss how walking and enjoying nature can be a coping skill. We talk about what we can see, hear, touch and smell. I took some of my own advice and put it into action. I went on a walk and admired the scenery as I went. I had a lot of things on my mind that morning, but I was also able to stop and take the time to enjoy the things I saw along my walk.

I took several pictures along the way of flowers. I enjoyed feeling the sunshine and hearing the trees rustle in the wind. We live in a very wooded area and as I walked along the trails, I thought about how life is very much like the walk I was taking. There were long sections of shaded path, but then I would come to an intersection. The trees parted and I felt the sunshine intensify.

  
Just like life is a journey, we sometimes are not always sure of the direction we are headed. We might feel as though a certain path may never end, but then the shadows part. We may feel vulnerable or exposed in a new situation, but it can also give us a sense of relief.

  
A storm had recently passed through the area and I came upon some tree limbs that had fallen. A tree can still stand strong, even after it loses a limb. Later that night, during the family group I was leading, I had the teenagers pair up with their parents and they drew a boat, storm, and lighthouse. The boat represented the family. The storm represented the difficulties they had experienced. The lighthouse represented hope and a goal. I had my families discuss the journey they were on, the progress they had made during their journey and where they hoped to go.

Life is always moving. I want to be able to enjoy life in the present and keep hoping for the future.

the hurt —

the hurt

Negative.

My heart sank as I listened to the nurse tell me, “I wish I was calling with better news…”

I had left the office about 20 mintues earlier and stopped to grab some lunch for Ross and I before heading home where I was going to meet my mom and talk. I was standing in the kitchen talking to Ross when the phone rang and I remember answering it, looking at Ross and shaking my head in a “no” motion. I tried to hold it together as I asked the nurse if this was it? Was there any possible way it could still be too early? She asked if we wanted to come in for a consult with the doctor that day, or to be added to his call list at the end of the day. I preferred the phone call.

I got off the phone and broke down. Twice. Okay, maybe three times. Ross held me as we stood in the kitchen and I wept. I kept looking out the window to watch for my mom. I was eager for a reassuring hug from her. There’s just something about a hug from my mom that can make things a little better.  Mom got to our house, I told her the news, and I received the hug I had been waiting for.

The text message marathon began. I had at least 15 people waiting to hear the news. I just wish it would have been more positive. Although my news was negative, the responses I received back from those who love us were all positive. They were uplifting and encouraging. Some told me it was okay to be mad or sad. Most everyone told us they loved us and would continue their prayers.

Earlier in the day, I had posted this picture on my Facebook newsfeed:


I knew that no matter the outcome that day, things were going to get better. There is no doubt in my mind that although this was a very difficult day, good things will happen.

My brother-in-law posted this picture on Facebook today, and I felt it described this journey very well.


This day was filled with tears (red, puffy-face crying). An army of people came over, called, or sent text messages. Ross called his parents to let them know. My mom was able to stay the rest of the day. My best friend was able to come by for a few hours. My dad came over before he had to go to work that evening. My cousin’s sweet wife and dear friend came by for a while. Another good friend and neighbor stopped by. We were surrounded by love all afternoon. This did not always stop the tears, disappointment, and hurt, but it did go a long way to ease the pain.

People all left to go finish their days and Ross and I were at home figuring out what to do with the rest of our evening. My doctor called just after 6pm that night. All of a sudden, I thought I might have to cheer him up. He sounded almost as disappointed as I felt. He was on speaker and talking to both of us, telling us that he really thought we would be having a different conversation. He thought we would have been “high-fiving” and that this would be a much happier discussion. He explored a few options on the phone with us, but, more than anything, he wanted us to talk about what we wanted to do next and to get back to him when we were ready.

We went to dinner that night, came home, and I started this blog; although it has just been a week, this blog has already proven to be therapeutic. You see, I have dealt with depression for the last two years. Well, more accurately, you could say that I have only dealt with it for the last year. The first year I was experiencing depression, I was not dealing with it at all. I was not coping with the 4 losses we had experienced. This affected me personally, but it also affected my marriage. I.Was.Depressed. It was bad. I was numb. I had no motivation. I sat in the doctor’s office and cried as I asked the Physician’s Assistant if she was sure. Through my tears, I asked multiple times if she was sure I needed help. She gently told me “yes.”

I am a therapist. I already knew this. I had mentioned to several people that I thought I was depressed, but I never followed up. I never reached out to ask for help. If I leave you with just one thing today, please, please, when you know something is wrong…When you know something just doesn’t feel right…please know it is okay to ask for help. I waited too long. I was a complete mess. It was much easier to focus on the problems of others and help them process their hurt and grief rather than accept the hurt and grief I was experiencing.

The same night I started the blog, I also reached out to a counselor who specializes in infertility counseling. I knew I did not want to go back to the low point I had been to. I have made a lot of progress with my depression in the last year, but I wanted to be proactive this time and reach out for help before I might even need it.

I want to thank you all for the support and encouragement I have received through starting this blog. I have always wanted to write about my experience, but your kind words have kept me going.

I’ll leave you with one last thing tonight. I received a text message from my cousin that was very powerful and encouraging on the day we found out the test was negative. I wanted to share the hope I received from her with you. Part of the message validated that it was hard and frustrating when you feel disappointment, but that what we see is only a small square inch by square inch section of a beautiful mural that only God can see. She shared with me that she was hurting for me, but that as she sat there crying and grieving with me, she felt God’s arm around her and Him saying to her “It’s okay, it’s okay…just watch!” This BLEW me away. I was touched beyond what words can describe.

Something I am always telling the teenagers I work with:

Just one day at a time…Just one moment at a time.

 

the two week wait — May 5, 2015

the two week wait

When I was first told I would need to be on bed rest for 3 days, I was looking forward to it. I was going to get to stay home from work for three days, relax, read, watch tv…whatever I wanted to do. And, it was doctor’s orders. I quickly realized just after about 3 hours that I was not cut out for this. It’s one thing to think you are just going to relax and be lazy all day, but it’s different when you CAN’T do anything else but stay in bed. Plus, Ross works from home and was keeping a close eye on me. I couldn’t even get up to use the restroom without an interrogation from him. He knows me better than I know myself! I thought this would be a piece of cake, but he knew I would try to break the rules and get up more often than I was supposed to. All of a sudden, I was coming up with reasons for why I HAD to get up, when, on a regular weekend, you can hardly get me up and going to do anything.

The day I got home, my bestie brought over lunch and hung out for a few hours. My parents came over that first night and made dinner for us. The next day, another good friend brought lunch and stayed for several hours as we visited and planned a baby shower for a mutual friend. The last day of bed rest, my best friend flew to Houston to stay the weekend and support us by walking with us in a fertility Walk for Hope that we had signed up to be a part of. My cousin stopped my with her kids and we were able to visit a while. Again, the support we were already receiving was so humbling to me. It was a great encouragement to know how many people love and care for us.

Finally Saturday came and I was FREE!! I had a list of things that I needed to do and had a great friend by my side and was able to check things off my to-do list. That afternoon, her husband came into town and we were able to spend a great afternoon together. It is such a blessing that our husbands get along so well. It was really a requirement since Dana and I had been the best of friends since we were 5 years old. Ross’ cousin and his sweet wife arrived at our house just in time for all of us to go to dinner. We had a great time that night and woke up early Sunday morning for the walk.

It was just a 1 mile walk, but the purpose of the walk was to bring awareness to the very real struggle of fertility. 1 in 8 couples in the US face the struggle of infertility, however, it is still not talked about as openly. I’m sure there are a lot of reasons for that. I feel like for a lot of people there is a sense of shame or embarrassment when they are unable to conceive. It is also very personal for many people and they may feel uncomfortable sharing about their struggle.

Another couple we are very good friends with also attended the walk with their sweet kiddos. Ross and I had a team there of 8 people.

 

Ross and I at the walk
  
Doctors, staff, and families of Houston Fertility Institute
  

We finished the walk, had lunch, and then people headed their separate ways to finish their weekends. I was looking forward to going back to work the next day and getting settled into my routine again. There is something so reassuring to feel like I have at least a little bit of control over something. With IVF, you really have to give over just about all control to the doctors, nurses and lab technicians. I love what I do and truly enjoy the teenagers and families I work with. My colleagues are the best, and I’m not just saying that because some of them might be reading this…its true!

Back into a routine, the days quickly flew by. I was busy later that weekend, as Ross’ parents were in town visiting. I also had a baby shower to host that Sunday. It was a whirlwind. Monday and Tuesday flew by and then, it was the day. Wednesday April 29th, just last week, was the pregnancy test. I woke up and took a home pregnancy test. It was negative. I was not really sure what to think. I knew there was still a very real chance I could be pregnant. That did not keep me from freaking out. Twice, Ross had to come to our room as I sat crying and worrying about what was to come. I got myself together and made it to the doctor’s office for my blood test. I was in and out very quickly and on my way to work. I was a jumble of nerves and knew they would be calling with the results early that afternoon.

I had a hard time keeping things together at work that morning. Luckily, I was on the phone with insurance companies all morning. This is usually a task I look forward to the least. It is definitely not my favorite part of the job, but I was thankful for it that day. I was able to close my door and sit on hold most of the morning. I had privacy and it was okay if I let my composure falter a bit now and then.

I finished my phone calls just before noon. I called my mom and suggested we meet for lunch, but that we pick something up and meet at my house in case I couldn’t keep my emotions in check. I had just arrived home with lunch and Ross met me in the kitchen. We had been talking for just a few minutes when my phone rang.

It was the nurse and she had the results.

the wait {part 3} — May 4, 2015

the wait {part 3}

One thing I’ve learned about the IVF process is that waiting is a huge part. We waited another few weeks. These weeks were filled with blood work and ultrasounds. Everything was looking good. No fluid in my uterus this cycle. We were set. Once again, I asked for a few days off work for the prescribed 72 hours of bed rest, but knew I would actually be taking these days off. We shared the news with family and friends. Everyone was excited for us.

I learned a while back that it is better to share what’s going on with this process rather than keeping it to ourselves. At least for Ross and I. Or maybe just me. When I had been pregnant before, we were keeping the good news to ourselves, hoping to have a surprise announcement for everyone. The “surprise” announcement ended up being that we were having a miscarriage, rather than a pregnancy. This happened 4 times. It was too much and the emotions were too hard to keep to ourselves. I wanted to share our good news while we could, as the outlook at times appeared so bleak. We have had a lot of support throughout this process. There have been so many encouraging emails, texts and calls. I feel so blessed to have so many wonderful people in our lives.

We knew we had just the one embryo, but we also knew that it was healthy. My uterus was looking good. We went in feeling confident. The doctor was confident. The process of the transfer was very interesting. I was alert and able to watch the monitor to the side of the bed. The nurse handed us a picture of the thawed embryo from the lab.

 

5 day old embryo

Things were continuing to look very promising. The transfer was a quick procedure. I was in the OR for about 15-20 minutes. We were talking to the doctor about our weekend plans and the procedure was over before we knew it.

 

the squiggly arrow is pointing to the bright white spot that shows where the transfer took place.

We spent a bit of time in the recovery room when the wheelchair came by to pick me up to take me out to the car. We drove home and 72 hours of bed rest began.

Now it was time for the 2 week wait before the pregnancy test.

the wait {part 2} — May 1, 2015

the wait {part 2}

We knew we had one itty bitty baby. A 5 day old embryo that is technically called a blastocyst. I now know more medical terminology and have more knowledge of the inner workings of my body than I ever cared to know. I definitely was not prepared for all this. I mean, doesn’t this baby thing just happen? That’s what I was always told anyways.

So, back to the waiting part…It was a few days before our scheduled transfer. I had already asked for three days off of work, as my doctor was prescribing bed rest for 72 hours after the transfer. I was taking an estrogen pill three times a day under the tongue and wearing an estrogen patch that was changed out every 3 days, along with about 8 other pills each evening…a mixture of prescriptions and vitamins.

It was Friday morning and they saw fluid in my uterus. Fluid that should not be there. The nurse assured me they see this sometimes and that when I came back on Monday, the fluid would be gone since I was to begin my progesterone shot that night. A 1.5 inch needle. Intramuscular. A syringe filled with an OIL based progesterone so thick it takes almost a full minute to administer all the medication. A shot Ross had to give me on my backside…lovely. I’m making it sound worse than it was. It really wasn’t that bad.

Back to the doctor Monday morning. I had my regular blood work and the nurse was doing the ultrasound checking the lining of my uterus when, guess what? The fluid was still there. She assured me that my doctor “has many tricks up his sleeves” and that they would contact me later that day with the results. 

The nurse called that afternoon to let me know that the transfer would be postponed. This was definitely disappointing, but she reminded me that, with the one embryo, they wanted everything to be as perfect as possible. I was getting off the phone with the nurse when I received another incoming call. I answered and it was my doctor (have I mentioned how awesome my doctor is? No? He’s awesome). He reiterated what the nurse had just shared.

So now, we were waiting again.