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Saturday, May 12, 2012

What's Another Month?

We've stalled again. 

I talked to my RE yesterday about the wisdom of having a 3D sono this Monday.  The concern is that it could inflame the nerves/tissues/muscles that are still causing pain.   My RE told me, not in so many words, that I was batshit crazy to be thinking of having the procedure this soon.  She very politely asked if she had misunderstood from our earlier conversations that we would wait until I felt completely better.  My only defense is that I scheduled the appointment weeks ago when I'd hoped to be 100% right now.  So cute that I had such ridiculous expectations! 

So I cancelled the appointment and we're out yet another month.  I'd been hoping to get the 3D sono out of the way so we could resume TTC in June, but now it's looking like July at the earliest.  SIGH. 

I'm both horribly frustrated and oddly apathetic.  A sense of complacency has set in, unexpected but not unwelcome, possibly related to the cocktail of drugs they have me taking.  I just can't seem to care about anything baby-related.  I tend to forget about babies and TTC until a child or preggo crosses my line of sight.  Weird, right?  When TTC used to consume every waking moment, crowding out all other thoughts required for normal adult functioning?

The pain continues to improve overall, although some days feel like setbacks.  I tried to taper off of a pain medication a few days ago and had some pain return with a vengeance, so I don't think I'll try that again for a while.  I need to be off these meds before TTC again, though, so there's a big incentive to not rely on the meds and kick this pain to the curb soon. 

Walking is an issue.  I can amble around the grocery store pretty easily, but trying to take a very slow walk for exercise triggers the pain.  We're talking about a quarter of a mile, not extreme hiking or anything.  Apparently trying to clean our floors this afternoon wasn't such a good idea, either.  I have a long list of things to do this weekend that involve being active—planting tomatoes, shopping for work clothes, giving our dog her summer haircut—but those are on hold for the rest of the afternoon.

The complete lack of exercise is showing.  My pants and underwear are super tight and my butt is succumbing to gravity.  However, I stepped on the scale this week and I've actually LOST 5 pounds.  It's totally the "muscle weighs more than fat" thing, with fat winning out lately.  Even my boobs are bigger, which just isn't normal when you've lost weight.  I told my husband I'm sending all my fat there.

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Huge congratulations to all the bloggers recently getting BFPs, including Her Royal Fabulousness, Lanie, Unaffected, Miss Conception, Belle, Sass, Mrs. Green Grass, and Sunnyside Up.  Please forgive me if I forgot someone.  Pregnancy after loss and infertility is a roller coaster and I hope you get your fears allayed, little by little, by great betas and ultrasounds.  I'm so excited for you!

Thursday, May 10, 2012

Just Relaxing the Pain Away

Hey there!  I have been drowning in work lately and am missing my blog friends.  I very much appreciate some of you giving me blog awards, even though I'm not great at passing them along.  Thank you!!  Bloggers are really some of the nicest people out there.

So, my pain is....getting better!  FINALLY.  There have been huge improvements recently.  The pain doc increased my gabapentin dose and it's really helping.  Also, I went to my first physical therapy appointment last week and it was amazing.  The physical therapist spent a lot of time looking for the cause of my pain, be it a vertebral misalignment, pelvic floor muscle issue, etc.  She didn't quite find it, but gave me stretches and exercises for some problem areas.  I've been doing the PT religiously and it seems to be making a big difference.  Yesss!  I'm figuring out that taking a walk seems to trigger the pain but doing chores doesn't. Grrr. 

To add another doctor's appointment to the mix, since 14 appointments in 2 months may not be enough copays and missed work to satisfy me, I saw a psychologist last week to see if I'd be a good candidate for biofeedback.  The jury's still out on whether I would be or not—the psychologist is going to talk to my regular fertility therapist and come up with a plan.  The biofeedback psychologists were sure they could help me in some ways, though, even if it wasn't through biofeedback. 

And then they pissed me off.  They said my anxiety was contributing to the pain and we needed to get it under control.  I guess that's one of the general ideas behind biofeedback, so I shouldn't have been surprised to hear it.

Yes, I have a history of anxiety.  When I'm not taking SSRIs, I have panic attacks, some obsessive-compulsive tendencies, and a generally anxious mindset 24/7.  But I'm taking an SSRI now and am feeling pretty good emotionally, even with all of this pain crap.  I have moments when I'm depressed or anxious (and that's when I tend to blog, so you guys are seeing a lot of those moments), but am mostly ok.

So I'm confused.  I'm supposed to Just Relax?  Even if I'm already fairly relaxed?  It makes me think of the crazy time when I really thought Just Relaxing would get me pregnant.  I worked to achieve a Buddhist monk-like state of calmness for a long time after my first miscarriage.  For months and months, I did fertility yoga videos several times a week.  I meditated daily, practiced mindfulness all the freakin' time, and avoided potentially stressful situations.  And I didn't get pregnant until I gave up on relaxing and took letrozole.

That awful period of Just Relaxing has so many bad associations for me; I can't bear to do the fertility yoga or fertility meditations anymore.  They bring up way too many memories of crushed hope, failed cycle after failed cycle.  It turns out my body needed so much more to get and stay pregnant.

So I guess I get defensive when someone implies that I need to Just Relax, this time to help the pain.  I don't doubt there's ample clinical evidence of anxiety contributing to how you experience pain.  Totally makes sense.  I just don't think I'm very anxious right now.  So there.  /end rant

So, my next step on the road to a healthy pregnancy is a 3D sonogram, also known as a saline infusion sonogram.  I'm scheduled for one on Monday and am freaking out on many counts.  (Of course, these are healthy, normal freak-outs as opposed to pain-inducing anxiety attacks. :))  1)  What if this triggers another pain flare?  I have a call into my RE to discuss the wisdom of having the procedure this cycle as opposed to waiting one more cycle.  2)  What if there's something wrong?  I am pretty sure I will lose it if we see more scar tissue, septum issues, or polyps.

In addition to the 3D sono stress, I have a big work deadline on Tuesday.  If for some reason I'm in a ton of pain after the procedure, I could have major issues hitting my deadline.  Gonna work my butt off until the 3D sono to try to get ahead.

In infertility sadness-related news, why can't I anticipate which events/places will make my heart feel like it's breaking?  Went to my niece's and nephew's piano recital last weekend while I was PMSing, and seeing all the cute kids and parents made me want to weep.  I desperately want to attend all of my niece's and nephew's recitals or big games, but need to steel myself for them.  I'll be going to two dance recitals in June. 

For a moment at the piano recital, though, I wanted to protect myself from ever having to see that many kids and parents again in one place.  Avoidance can be fun!  I considered skipping my family beach trip this summer to avoid the hordes of children.  Last summer during the trip, I was pregnant.  This summer, in all likelihood, I'll start crying at the kid-filled outlet mall.  Good times.

Alright, back to work I go!

Saturday, April 28, 2012

The Good and the Bad

I'll start off with the Good.  I'm so thankful for your thoughtful comments on my last post about knowing when to stop TTC.  I haven't responded to all of them—taking some time to process them and work has been crazy—but I truly appreciate your taking the time to stop by and comment.  The comments warmed my heart.  Hearing from friends I hadn't heard from in a while, reading some of your thoughts about stopping...I'm constantly amazed at the warmth and thoughtfulness of bloggers and other commenters, most of whom I've never met in real life.

A Woman My Age asked if I'd considered alternative therapies for my pain, such as acupuncture.  I did weekly acupuncture sessions for about a month after this surgery.  I got amazing pain relief during the sessions but unfortunately the pain always returned in full force a few minutes after I got up from the table.  I considered continuing the sessions in case they were helping in ways I didn't comprehend.  I asked my main doctors whether I should continue acu treatments; they're both pro-acupuncture in general.  My pain doctor said she expected the pain relief to last beyond the session, and since it wasn't lasting I should stop.  At $90 a session, I was a little relieved.

This week, I'll be starting physical therapy and biofeedback at the recommendation of my pain doctor.  I'm curious to see what PT will recommend.  I don't know much about biofeedback but I'm willing to give it a shot.  In the midst of all of this, I've also been half-heartedly meditating.  My therapist wants me to do it daily but I'm having trouble committing to it.

Also in the Good category is that my RE (reproductive endocrinologist) gave me some good news this week.  She did a regular ultrasound of my unbelievebly screwy uterus and things actually looked good.  Before the most recent surgery, there was a pucker where one side of my uterus seemed unnaturally drawn to the other side.  I think it was scar tissue, adenomyosis, something of that nature.  The pucker is now gone.  I'm breathing a small sigh of relief, not a huge one yet, because the real picture of how I'm healing will be a 3D sonogram.  Not sure when I'll feel good enough to do one.

Which leads me to the Bad.  I'm still feeling shitty.  The pain feels like it's here to stay, regardless of my doctors' reassurances that I will get better someday.  Instead of hurting in the uterine area, it mostly hurts under my ribcage, which totally weirds out my RE.  The pain doc still acts blase (accent over the "e"—don't know how to do them in Blogger) about it all, like she sees uterine surgeries resulting in burning upper abdominal pain all the time.  She increased my gabapentin dose, which seems to be helping already.  She also gave me a great answer to my question about how much activity I should be doing.  She said resting too much was more of a concern than being too active, so I should try to be active within reason.  So that was actually a Good buried within the Bad.  I'm glad to be given the green light to being more active.

Blogging and commenting has had to take back seat lately as projects at work keep piling on.  I'm a medical writer, and I've been lucky lately to be writing about oral hygiene.  Sometimes it's much worse—chronic diseases, diarrhea, or...oral contraceptives.  Fortunately the oral contraceptive project got put on hold because I did not enjoy writing about the magic of conception.

Anyway, I'm here and reading your posts even when I'm not able to comment much.  Hope you're all having a good weekend!

Sunday, April 15, 2012

My Body's Saying "No"

I'm not sure how much more TTC I can take.

I'm tired of feeling bad.  We can't seem to stop messing with my reproductive organs and I'm afraid we're screwing up my body.  Hormones, surgeries, uterine balloons...whatever we've done that's so pissed you off, Body, I'm sorry.  I know you want to get on the Pill, calm down the endo, and forget about having children, but I don't think I'm ready to stop.

I've felt bad enough with all the post-op pain lately that I often forget why we're doing this.  A baby seems like a fantasy, like I'm kidding myself to think I could possibly ever have one.  It's not helping that I'm not sure when I'll feel better and my uterus will cease to be messed up, both of which need to occur before we try again.

To check the architectural/healing status of my uterus, I need to have a 3D sonogram during the early part of a cycle.  Although Aunt Flo came a few days ago, I'm skipping the 3D sono this cycle.  My doctor and I decided it would decidedly not be a good idea since my uterus is still pissed off from the last procedure.  We can hope that I'll be feeling good enough to have the 3D sono next cycle, but who knows.  It might be a couple more cycles until we can TTC again.

Trying seems very abstract after being TTA so long.  And like I said in a recent post, being TTA is freeing.  I desperately still want a child but haven't been forced to focus on getting there.  I'm living my life.

But I want my life back in full.  I want to be healthy and active again and doing my normal activities.  I'm tired of having to constantly plan around pain.  I'm tired of surgeries and doctors.  I'm tired of having my clinic on speed dial and knowing the nurse line options by heart.  I want yoga, walking, cooking, and everything I normally do.

I'm sure my struggles so far are a small price to pay for the chance at having a child.  The thing is, I don't know how much longer this will go on, and I don't know how much more my body can take.  Our bodies don't have long to be on this planet and I want mine to be as healthy as possible.  What if I'm irreversibly damaging it by going under the knife time after time?  What if my nerves, damaged by endo, are getting so pissed off that they will act up the rest of my life?  What if the hormones I've taken cause the endo flare to end all flares?

I won't even go into how I don't know how much more of trying my heart can take.  But I don't.

There's also the question of how my body would behave with a pregnancy that lasts beyond 7 weeks, the time both of my miscarriages were diagnosed.  I think we've established that my uterus is cranky, to say the least.  Am I setting myself up for a pregnancy full of complications?  Will I be in pain and on bedrest for 9 months?  My two short-lived pregnancies were probably farther on the crampy/twingy continuum than most, but not awful.  But I haven't experienced anything beyond 7 weeks.  How in the world will my pissy uterus deal with an actual fetus? 

Blah.  I know I need to talk to my doctor about my fears but we're in survival mode currently, just trying to get past this painful post-op time.  Communications with my doctor involve plans for the immediate future only.

A part of me, the part with feelings, isn't just in "making it through the day" mode, though.  Tomorrow is my due date for my last pregnancy.  I've been reflecting on the tiny little baby we saw on the ultrasound screen, perfect except for not having a heartbeat.  We found out a few weeks after my D&C that it was a girl.  I miss her.  I wish I was worried about labor and delivery now and not when to stop trying.

Tuesday, April 10, 2012

Volunteer Petunias


My pride and joy
I'm a beginner gardener and had no idea what a "volunteer" plant was until a couple of years ago.  Perennials came back each year, annuals didn't, and that was that.  Until the petunias I planted as annuals came back the following year.

Apparently being lazy and leaving the dead (or dormant) petunias around, unkempt and dead-looking all winter, has its advantages.  The seeds sprouted by the old plants can stick around over the winter and become beautiful petunias in the spring.  These are called volunteers, as I understand it, because they aren't guaranteed to come back as new plants but do anyway.

Tell me these aren't the most beautiful flowers you've ever seen.


Flowers around my mailbox

I adore them.  I regularly stand and stare at them; I am totally the weirdo gardening lady. But what's not to love with these plants?  They're beautiful.  They're hardy. I deadhead them sometimes and give them some water in the scorching summers, but mostly I leave them to shine on their own. 

The original petunias I planted were white but the volunteers are pink; I'm told that flowers revert to pink in the wild.  I'd very carefully picked out white flowers for this bed; pink was not part of the plan.  After we got this house, I looked at tons of landscaping books and had grand plans of color-coordinating foliage and flowers.  I'd have a bed with cool colors, maybe another with reds and yellows, but certainly nothing clashy.  After I came to terms with my lazy gardening approach, I realized that getting abundant flowers of any color is a victory, so the potentially clashy petunias will be left alone.

I'll sign off with a few more photos from my garden this spring.  Maybe my color scheme is pink and pinker.  

Azaleas planted by the builder

Camellias.  I planted three of these last year after they'd bloomed and hadn't
known how pretty the flowers would be.  Love them!

Wednesday, April 4, 2012

What I'm Doing On My "Trying to Avoid" Vacation

Note:  In fertility/infertility circles, "trying to conceive" = TTC and "trying to avoid conception" = TTA. 

Taking time off when you're trying to conceive can be good.  Regroup, relax, stop thinking about planned sex.  Give your body a break from fertility medications.

I've been on a medically-induced break for months.  Months and months.  Since my second miscarriage last September, actually.  First it was waiting for the hCG to leave my system so we could do the repeated pregnancy loss panel.  Then it was waiting for test results.  Then uterine imaging times eleventy, surgeries, blah blah blah.  Waiting indefinitely is a cruel thing to put a mid-30's infertile through.

However.  I'm trying to see the positive side of time off as we look toward yet more months of waiting to try again.  There are definitely positives.

1.  I'm drinking all the coffee I want.  Not really, because I get super jittery after 1.5 cups/day, but that 1.5 cups is a beautiful, life-affirming elixir each morning.  I was drinking one cup a day before I knew I was pregnant last time, but guilt was involved.  There is zero guilt right now.

2.  I'm drinking wine sometimes.  I don't drink often because of heartburn.  Alcohol is a major culprit, along with citrus fruits, cheddar cheese, anything with tomatoes...the list goes on.  But when I'm prepared to deal with the gastric side effects, I can totally drink.

3.  I'm not taking my temperature.  I half-heartedly kept charts for a few months after my last miscarriage, but that's gone out the window.  My doctor has records of all the cycle-disrupting hormones I've been taking for the last few months.  I'll let her do my only record keeping for a while.

4.  I'm off people's "baby bump" watch list.  When people know you've just undergone surgery, they tend to assume you aren't currently pregnant.

5 . I'm not having timed intercourse. Typical conversation when we're TTC for the umpteenth month in a row: "Should we do it before or after we watch Project Runway?" "Eh, let's just do it and get it out of the way." We haven't had to have that conversation in quite a while.

6.  I'm not failing a test every month.  You can't fail when you haven't tried.  Sure, I still feel like a broken woman with a Franken-uterus, but the sense of failing an all-important, life-changing test every month is gone.

7.  I'm eating what I want.  Back to consumables.  Lunch meat?  Sure!  Soft cheeses?  Bring 'em on.  Iffy leftovers?  Eh, won't kill me.  All the stuff I worry about when I'm trying isn't even close to being on my radar now.  One could argue that I could keep doing my normal activities—coffee, soft cheeses and all—and get pregnant safely. But I know better than to try. I'm a worrier and it's better for me to skip the Intro to Kick-Boxing class when I'm TTC. It's not worth the worry that I'm going to harm my developing ova/blastocyst/zygote.

8. I'm not living my life in 2-week increments. No follicular phase freak-outs. No two-week wait. No mental breakdowns when Aunt Flo arrives involving crying in the bathroom, eating giant cookies, and spending money.  (Of course, I've exchanged follicular and luteal phases for pre-op and post-op weeks, but I'm trying to be positive here.)

Of course, I desperately want to be TTC again.  I want a chance of being pregnant.  Even the hope roller-coaster sounds good about now.  But I'm going to try to enjoy this break since I don't have much choice in the matter.

Post-op pain update:  Pain still very much present but I'm seeing incremental improvements.  My yoga muscles are atrophying and I'm not dumb enough to even try to stretch right now, so I'm still lying around a ton.  Getting some amusement out of ordering my husband around.

Monday, April 2, 2012

Open-backed Surgical Gowns and Other Issues

Right before my first post-miscarriage D&C, the nurses had me walk from the pre-op area to the OR in an open-backed surgical gown.  Down a hallway, past other patients and healthcare providers, holding the back of the gown closed so I wouldn't show my butt to everyone.  It was completely humiliating and not what I needed while I was losing a baby. 

I've had lots of surgeries and procedures, especially recently.  I realize we have to tolerate certain indignities for the sake of efficiency.  And I'm all for efficiency...to a point.  I want the kind of efficiency that means a nurse will at least make sure I've tied the back of the gown correctly.

My husband took me to the ER two weeks ago as part of this whole post-op pain drama.  That was an eye-opener.  At first I thought the patients waiting with catheters in their arms must be in especially bad shape, but after getting an uncomfortable catheter of my very own, realized it was par for the course.  Going to the ER means you get to sit around with a catheter.  There's no mistaking the patients for the caregivers.

One of the most surreal parts of my ER experience occurred when a nurse handed me a urine cup while I was still in the waiting room.  She instructed me to provide a sample using the public bathrooms.  Not wanting the 100+ person audience in the waiting room to know I was providing a pee sample, I used my purse to transport the cup to and from the bathroom.  I know, ew.  Of course, my efforts to hide the cup were in vain, anyway, because I had to do a very public hand-off to the nurse in front of everyone. 

I'm not blaming individual nurses or even managers.  But it sucks.  I'm trying to retain some of my dignity through this whole stirrup-filled infertility odyssey, but I'm starting to feel like I've lost it.

Navigating work with post-op pain has been embarrassing, too.  I am so grateful for the outpouring of support I've received, but am having trouble just accepting it.  I've been shuffling around the hallways in obvious discomfort.  I start the day sitting at my desk and within an hour, am working from a couch in an unoccupied office because sitting up is too painful.  People fuss over me and bring me extra pillows.  Coworkers kneel next to the couch to discuss projects.  I hate it.  I know we're all sick sometimes and it's not a sign of weakness, but it's not the person I want to be at work.  I want to be vibrant and efficient and strong. 

The gabapentin I'm taking is definitely helping the pain.  It's just not helping quickly enough to suit me.  I'm adjusting my expectations of how long this recovery will take, but sometimes I want to pitch a temper tantrum and insist this all ends now. 

If you haven't headed over there already, stop by Cristy at Searching for our silver lining to offer your support.  She's going through her second miscarriage after an FET.  She is one of the kindest bloggers I've come across and I can't believe she's going through this again.