Thursday, February 23, 2012

Holding Down the Couch

Welcome, February ICLWers.  It has been such a devastating week in the ALI community and my heart goes out to the bloggers who are experiencing losses.  The support and care you've shown to them really make me grateful to be a part of this community. 

You can find a brief subfertility/loss timeline on my right sidebar if you're new to my blog.  Most of our issues have to do with my uterus.  Recently, though, for the first time in 60-something charted cycles, I've become fully aware of my ovaries.  They tried to kill me this cycle.  It was my second cycle on letrozole and I got pregnant the first cycle, so I'd assumed the pains that first time around were (totally worth it) implantation-related ones.  Had the exact same pain this time, though, but for a much longer time, and this time I had zero chance of a little embryo implanting.  We'd found out post-letrozole but pre-ovulation that we had not yet optimized my uterine environment (that's doctor-speak for "needs more surgery, or at least more procedures"), so we opted not to gamble with trying this cycle.

For the past two weeks, it has felt like my ovaries had been replaced by angry baseballs of pain (they're probably smaller than that, but "angry golf balls" didn't sound right).  I feel ridiculous complaining about it when so many of you have gone/are going through IVF; I know I am not getting the Treatments gold in the Pain Olympics.  But it's sucked lately.  The only thing that eases the discomfort is lying down, so when I'm not at work, I'm on the couch feeling like a sloth and indulging my new Downton Abbey habit.

I'm excited to get my period today because it means the ovary pain will end soon.  I'm sure the period will be epic—hello, worst cramps ever (they're always the worst ever)—but at least it's a different kind of pain.  I'm tempted to try a lower dose of letrozole next time to attempt to decrease the hellish ovary pain.  I realize that might be crazy talk, because my doctor says this dose works well for me: nice follicles, progesterone of 22, and, of course, the fact that I got pregnant on it before.  However, the thought of going through this madness again with only a 10% chance of getting pregnant each cycle drives me to despair.  Then I feel guilty about not being willing to submit to two weeks of pain and slothfulness for a possible pregnancy.  Will have to discuss further with my doc.

My next hysteroscopy is March 9.  I'll start taking testosterone tomorrow to thin my lining for the procedure.  Can't wait to take a new hormone, and a male one at that!  My random black chin hairs do not need that kind of encouragement.

My doctor sounds optimistic that she won't see scar tissue next month, but I don't know how much of her talk is just to keep me from feeling hopeless before the procedure.  By giving me hope, I'm trading being depressed now with being depressed later if she unexpectedly finds more scar tissue.  Hope can be brutal.

Between watching TV and chatting with my fertility clinic almost daily, you might wonder if I have time to fit in anything else.  I've managed to fit in a few social engagements, which has been a mixed bag.  Lately, more than ever, there are tons of coworker pregnancy announcements, lots of "I understand such-and-such because I'm a mom," complaints about kids, etc.  The good parts of being social are still outweighing the bad, but the emotional fall-out afterward has been intense.  I don't want to isolate myself like I did after my first miscarriage, but I feel so powerless in the face of "Let's compare labor stories!" and "OMG nursing is soooo hard!"  I completely lose the ability to change topics.

In baby-obtaining news, my husband and I have been fantasizing about convincing his brother to hand over baby #4 to us.  We'd start small, asking for just a weekend here and there.  Eventually, we'd "babysit" more and more often and brainwash the baby into thinking we're his parents and he wouldn't want to go back.  That should work, right?  Baby #5 is coming this summer, so I'm sure the parents will need our childcare services soon.

I received a funny message from an infertility nurse last week.  She left me a voicemail saying that she couldn't answer my question, so my doctor would call me later.  The nurse seemed to be irritated that she'd gotten my voicemail and said, "Please be available when the doctor calls you back."  She didn't give me a specific time or range of times to be available, so it felt like "Don't go to the bathroom, drive, attend meetings, or otherwise live your life until your doctor finds a moment to call you back."  No one would be more thrilled than me never to miss calls from their doctor, but come on.

Tuesday, February 7, 2012

Still Benched

My hysteroscopy yesterday dealt us another setback and I'm feeling numb. 

My husband dropped me off at the clinic 30 minutes early because he had a work commitment he couldn't get out of.  I told my sister to come pick me up around 10:30.  That's kind of how it is these days.  Get a ride from whomever is available, go home, sleep it off.  Repeat.  Procedures and anesthesia seem to be my new normal.  My uterus has been poked around in five times in the last 6 months, three of those with anesthesia. 

So having one or two more procedures in the next couple of months won't make much of a difference, right?  Yeah, right.  Waiting for just an opportunity to conceive has become really hellish.

My doctor removed a little more scar tissue yesterday.  She hesitated to call it scar tissue, like maybe it wasn't quite bad enough to fit that criteria, but I'll call it that for lack of a better term.   One area in the upper left corner of my uterus just doesn't want to behave.

I need to have another hysteroscopy next month to make sure it healed.  My doctor gave me the option of trying to conceive this month, since my follicles are rarin' to go after taking letrozole, but I can't.  I told her I'm not in a gambling mood.  If scar tissue puts me at risk of miscarriage, why would I risk it?  I'm desperate but not reckless. 

My procedure next month will need to be performed at the surgery center instead of the clinic.  My doctor wants to have access to special surgical scissors in case she sees more scar tissue.  If she does remove more scar tissue then, she'll insert a balloon afterward to promote healing.  Then there was something about removing more of my septum so that the balloon is more effective, something that didn't make total sense in my Versed/fentanyl haze.  She's going to call me today to discuss it further.  Oh, yeah, and I would need to have yet another hysteroscopy in April to check out the healing.

In addition to the whole waiting thing, which SUCKS, I'm not psyched to go to the surgery center again.  My surgery in December was there and while everyone was super nice, it was quite a process.  Lots and lots of instructions and phone calls before the surgery, hard-core anesthesia that required a longer recovery, and an audience of anesthesia people, surgical nurses, and random people off the street who wanted to see my freakish uterus up close and personal.  I much prefer feeling less like a circus act at the clinic with just my surgeon and one nurse in attendance.

My husband wants to do another letrozole cycle next month in case everything looks good at uterus imaging session number 252.  I was on board at first but am not feeling it anymore.  First of all, I have zero hope that my uterus will look stunningly clear.  Its track record lately isn't very good.  Second, letrozole isn't a walk in the park.  Taking it makes me giddy with hope, and I'm just not willing to be let down by an aborted attempt like this month.  Not to mention the side effects.  They admittedly don't get bad for me until the last day of taking it, but at that point my fatigue becomes crushing and I almost start crying in the produce department because I can't find my husband.

I'm pretty devastated.  I knew we might not be able to try this month, but holding onto hope that we could was keeping me going.  Two or three or four months isn't a long time in the scheme of things, and when you aren't the one going through it, it's really not.  But when it's your life and your body, it feels like it will never end.  In the next few months, I'll turn 35, lose my opportunity to have a 2012 baby, and possibly get closer to losing my mind.

I have to say, though, you guys are helping to keep me sane.  Your support has been tremendous and is making such a difference in my life.  I am enjoying getting to know each of you.  Thank you!   

Thursday, February 2, 2012

3D Sono and the Faulty Ute

I'm seriously thinking about trading in my uterus for a new one.  All of our problems in the 2.5 years of trying seem to come from my getting a generally crappy one.  There's its evil endometrial tissue that migrates into my pelvis and gloms onto other organs.  Scar tissue, souvenir of a D&C.  A subversive septum.  Possibly harmless (friendly) fibroid and, of course, a pesky polyp for good measure.  My ovaries aren't superstars but they're Meryl Streeps compared to my Kristen Stewart uterus (love ya, KStew, but hope Twilight wasn't your peak).

I had my post-op 3D saline infusion sonogram today and everything was not as I'd hoped.  I'd visualized a squirt of saline illuminating an almost flawless uterus, except for the resident thyroid and screwy arcuate shape to give it some character.  The doctor would high five me and she'd show her students images of my uterus as a success story.  "This woman had a REALLY messed-up uterus, but I fixed it and now she's had 10 children!"  Or two children, something like that.

Instead, 30 minutes of medieval torture, complete with two balloon and saline catheter sessions, yielded inconclusive results.  A fuzzy spot near my left tube wouldn't infuse properly.  Well, shit.  It could be leftover period stuff because I'm only on day 5.  Or it could be more scar tissue and I WILL HURT SOMEONE if we have to go into waiting mode again, have another surgery, etc.  Of course we want to optimize the uterine environment, but what about optimizing my sanity?  If I lose it, I'm blaming it all on my ute.  

The plan for now it to continue with letrozole and have a hysteroscopy on Monday.  Depending on what we find then, we'll either try this cycle or not.  I'm not willing to admit we're out just yet.  I can't.  It would be one thing if I knew we'd only be knocked out one cycle, but my last surgery benched us for 3 or so.  My doctor is optimistic that it's nothing, but I'm freaking out, of course.

My lovely sister will have to drive my twilight-sedated body home from the procedure, the third time she's done this in the past few months.  My husband's schedule is really inflexible on Mondays, Wednesdays, and Fridays and isn't jiving with my doctor's inflexible schedule.

Perhaps uterine water torture and iffy fertility-related news wasn't a good set-up for having lunch with a friend who is about 40 weeks pregnant.  Said friend is officially lapping me, or close to it, since I started trying when she was pregnant with her first.  Seeing her was actually not as difficult as I'd imagined (hadn't seen her in ages), but still stress-inducing because my prolonged torture session caused me to be late.  Way to force your very pregnant friend to wait around for you.  Yeah, I know.

Please send your healthy uterus vibes my way on Monday.  I mean, let's hope it's healthy already, and that we can see that it's healthy on Monday.