Seriously?????

So, went for my pre-op appointment this morning. Since it will be my third laparoscopy, I sorta consider myself an "old pro" by now. I even told hubby not to come with me, he needs to save his "personal time" for the surgery and the follow up appointments. Big mistake! I showed up, they took my vitals and ushered me into the RE's office. He sits me down and we begin the preliminary "pre-op" speech. I have given this speech a dozen times myself to other patients while performing pre-op exams and consults. I know all the risks and signed all of the papers. Everything was on auto pilot until I heard the word "salpingectomy".

"Whoa!"

RE stops and smiles, "Yes?"

"Um, you mentioned a salpingectomy?"

Peering down through his round little glasses, " Well, yes, I am gonna need you to sign this little line that allows me to perform a salpingectomy if needed."

"You mean, remove my tube?"

"Well, yes, assuming that only one tube is compromised from the scarring from the ectopic, we would only need to remove one tube."

My heart sank. He actually thinks he is gonna remove a fallopian tube? My fallopian tube?? And he wants me to sign a paper to agree to it? Where is my husband when I need him? I can't sign this paper. He might actually remove a tube. I could potentially wake up from surgery and be missing a very key portion of my female anatomy. The worst part? I have to sign the form knowing that I won't be able to wake up to make that decision. I will be put under general anesthesia and the doctor will be the one who decides if my tube stays or goes without consulting me first. Granted, I do trust him. At least, I think I do. Of course he agrees that removing a tube is only "if absolutely needed", but at what costs? I really wish I would have brought my husband or at least somebody else to ask important questions...after all, I think I was in shock. But, what choice do I have? If the tube is scarred, my chances of having another ectopic are much higher.

So, I am keeping all my fingers and toes crossed and praying very hard that I get to come out of surgery with all of my parts still intact. My worst fear is waking up from surgery and hearing horrible stories of bleeding, and emergency hysterectomy...I know it's a very long shot, but I guess hearing about the potential of losing a tube has really shaken me up.

Note to self: bring the hubby next time.

How IF has defined me...

So, I have recently decided to take a break from Facebook. It's a big step for me. For years now, while eating breakfast, I would surf the latest updates, and check up on friends. It's how we stay in touch with family and friends from around the globe and it's how we share pics and stories of our everyday life.

During the month of April, I have been posting several articles and blogs about infertility. April is National Infertility Awareness Month, and it was the month of my third IUI. So, naturally, my thoughts and every spare minute has been spent on RESOLVE's website and the INSPIRE support group boards. I find great comfort in surrounding myself (even if only in cyberspace) with friends and allies who are going through the same trials and tribulations that I am. It doesn't help that in my professional life, my days are filled with whiny, pregnant women and unplanned teenage pregnancies that often end in abortion.

Apparently, my blogs and postings have begun to "annoy" some people on my friends list. They have commented and messaged me about my incessant infertility posts. Some have even made vague, but hurtful, comments regarding my posts. So, after dwelling on my posts for a couple of days, I have decided that I need a break. I don't understand, if women are allowed to post status updates about their "baby bumps" and "pregnancy woes", why am I not allowed to post informative blogs and articles regarding infertility? Whatever happened to freedom of speech? Whatever happened to "if you can't say something nice, don't say anything at all?" And if my posts are so annoying, why don't you just ignore them or skip over them? Who knows, maybe somebody else out there would like to read the information in the articles.

So, looking back at my many Facebook status updates, I have begun to reflect upon how Infertility has really impacted my life. In all fairness, I should say "secondary infertility". After all, I have a beautiful and healthy three year old, who was indeed, my little miracle.

HOW IF HAS SHAPED AND DEFINED ME:

1. Infertility has made me a better mother. I honestly believe that having to wait so long for my little one has made me more appreciative of her and the time I have with her. I cherish every minute of being her mother and love every little bit of her. I often see parents who get frustrated with their children and seem to "take them for granted". Many are annoyed by their children and seem to be inconvenienced by them. My little one was conceived after years of prayers, sleepless nights and waiting. I will never take for granted the miracle that took place when she was born, and I have enjoyed every last minute of being a mother.

2. Infertility has made me a better practitioner. Even though it's very frustrating while taking care of whiny pregnant women, and especially whiny pregnant teenagers, infertility has taught me a great deal about patience. I realize that pregnancy and motherhood is a great gift, and I try to teach that to all of my patients.

3. Infertility has taught me patience. I guess that old saying, "anything worth having is worth waiting for" is really true in regards to parenthood. It seems that while waiting to expand my family, all I do is wait. I wait for my cycle to start, wait for my medication to take effect, wait for my IUI, wait for two weeks for my pregnancy test, wait again for my cycle to start, wait to save enough money for the next round of treatments...wait...wait....wait.

4. Infertility has brought me closer to my husband. While battling infertility, every part of my marriage has been tested. My husband and I have invited strangers into the most intimate parts of our relationship in order to help facilitate the expansion of our family. We have doctors telling us "how to do it, and when or when not to do it". We have been pushed to the exhaustion of our financial, emotional and physical resources. We have spent hours, crying, hugging, talking and consoling each other. I have realized what a great partner that I truly have. I wouldn't want to walk this path with anybody but my Brad.

5. Infertility has taught me that I am stronger than I ever would have anticipated. Through the years of hurt, both physical and emotional, infertility has pushed me to the most extreme limits. I have had the best of times (the birth of my daughter) and the lowest of times (the ectopic pregnancy this past fall). Most importantly, I have survived the worst of these times and have emerged a stronger person. Looking back now, I don't really know how I survived many of those dark days of pain and tears, but I did.

So, as I look back and reflect upon the recent posts of this month, I realize that I do obsess over our "secondary infertility". However, either you accept me for what I am, or all you have to do is "defriend me". Infertility is a big ugly scab that has scarred me for many years now. Everybody has baggage, this is mine. Take it or leave it.

Brad's "Christening"

Well, it's been long overdue...I feel like Brad has officially been welcomed into the "Daddy club". I know, after three years, you would think he would be a professional by now. However, there has been one last event that has failed to occur in our little home...until last night.

We knew Libby wasn't feeling well last night, she went to bed grouchy and cranky, and woke up at midnight in tears. She never wets the bed, but she had wet the bed and was screaming for "Daddy!!!" So, my sweet little husband got up and dutifully attended to her, changing her clothes and cuddling her back to sleep. She woke up again some time after 4 am screaming for Brad again. Once again, he rolled out of bed and groggily raced to her room. Why is it she screams for him at night??? I am not really sure, although, I distinctly remember yelling for my daddy at nighttime when I was scared or sick. This time, she was very feverish, so he sat on the couch with her and cuddled and watched cartoons. He wanted me to be able to sleep...yes, he is pretty great. A few moments later, I heard her screaming for me, so Brad grabbed her and began walking to our bedroom, when it happened....poor Brad was finally "christened"...my poor baby (well both of them!) had gotten sick all over Brad's bare back and the floor. He stood, frozen, not knowing what to do. Normally, Brad is a "chain puker", in fact, when I was pregnant with morning sickness, it made him sick to hear me getting sick. But, my little trooper stood there patiently, while I grabbed towels and the baby and cleaner her up.

I had to leave for work this morning, but both of my poor babies were on the couch, cuddled under blankets, exhausted. I am so thankful for my husband. He truly is amazing, and I don't know what Libby or I would do without him.

Book Review...

So, while I am on temporary hiatus from my IUI attempts, I have decided to read a new infertility book. Its' called, "Outside the Womb-A Moral Guidance for Assisted Reproduction" by Scott B. Rae and D.Joy Riley. The authors are both very conservative Christians, one is a physician and one is a professor of Ethics at a Seminary. I purchased the book at the Christian Bookstore, so I was prepared for the book to be very conservative. I was interested in exploring a more conservative and biblical based view on Assisted Reproductive Technology, since I look at it from a very scientific, medical perspective.

I have to admit that the beginning of the book was very boring and I was bogged down by all of the discussions of ethics and theology. It brought me back to my college years sitting in my intro to Bib Faith and Ethics classes. I have to admit that I briefly skimmed through some of the paragraphs detailing the concept of "Substance and Property-Thinking" which questions whether embryos are truly "persons" or simply "property of the donors".

The book does an excellent job of detailing the Catholic Church's views on Assisted Reproductive Technology (ART). I knew that the Church prohibited IVF, but it was very interesting to read some of the more "official statements" regarding fertility treatments. I have to admit that I am glad that the Protestant Church is a bit more open-minded.

The authors then began a very indepth look and discussion at exactly when an embryo/fetus becomes "human". This is very a important concept when discussing the ideas of disposing of excess embryos, selective termination and abortions for various genetic conditions. The authors suggest that "being human" begins at conception, and hold a very strong stance against selective termination, excess embryos and abortion. I of course, agree with many of their ideas, but am concerned that some readers could take offense at some of their ideas. Specificially, their views on surrogacy, egg and sperm donation and any other use of  "third party reproduction". I caution any readers who have used surrogacy or either egg or sperm donation as means to conceive proceed with caution. I would like to believe that my views are a bit more open minded, and I look at "third party reproduction" as one of the many ways that God can use to help Infertility patients complete their families.

I will summarize the ideas of the authors in one closing passage, "Technology is a gift of God's grace, but must be employed as such, in recognition that it is to be utilized humbly, responibly, and gratefully. As a gift, it offers hope and fulfillment to many couples. But, as with any good thing, its misuse can have adverse ramifications: the panacea of reproductive technologies can inadvertantly become a Pandora's box of long-term detrimental consequences."- Susan M. Haack (2010).

Myth Busting in honor of NIAW...

My Friday began much like any other typical Friday. Hitting the alarm clock, hurrying through my shower, a quick kiss on the cheek to my husband and trying to wrestle with my three year old daughter to get to Preschool on time. Everything was normal except for the day. This particular Friday marked the end of the two week period of time following my third IUI procedure. This “dreaded two week wait” was finally over! I could finally take that long awaited pregnancy test and confirm my suspicions. For the past couple of days, my breasts had become increasingly tender and I had been feeling incredibly fatigued.

I made it to my office and slipped on my lab coat, then headed to the restroom to pee on a stick. I noticed my chart rack was full of patient’s charts, which meant I had a busy morning. So, I quickly peed on the stick, wrapped it up and slid it in my pocket. I didn’t even have the five minutes necessary to wait for the test to complete. I quickly became immersed in a pile of charts and patients. I saw a few pregnant patients, all they while, secretly smiling and knowing that I ,too, would be joining them very soon in the mommy to be club. Finally the morning ended and I sank into my desk chair before remembering I still had that silly pee stick in my lab coat pocket. Excited, I grabbed the stick, and turned it over. Hmmm….well, that’s not what I had expected. There was supposed to be two pink lines. But, instead, there was one, lonely little pink line staring up at me. My heart sank. I was confused. What about the breast tenderness and fatigue?? This cycle was textbook perfect. It didn’t make any sense. Quickly, those old, painful memories and feelings began filling my mind. My stomach began churning and I felt a big, empty pit swelling. My eyes began to fill with tears, and I had to restrain myself from sobbing uncontrollably. I quickly ran to the bathroom to try and compose myself. It just didn’t make any sense. Suddenly, I heard those old familiar voices in my head, well meaning voices who never knew how to comfort me on days like this. Voices and words from family members, colleagues, and friends who tried to console me with old adages and sayings like, “All in God’s timing,… Maybe if you would just relax…Have you thought of adoption?…” Each more painful than the next. All were meant with the absolute best intentions. People just don’t know what to say anymore. Maybe I am just too sensitive. Perhaps, the absolute worst possible way to console me is by suggesting that somehow God’s greater plan doesn’t include me having more children. This brings me to the most painful myth regarding fertility that I would absolutely like to explore.

MYTH: “IF GOD WANTED YOU TO HAVE CHILDREN, YOU WOULD HAVE THEM ALREADY.”

Growing up there are a couple of dreams that every young girl has. First, all little girls dream of their wedding day. Walking down the aisle in a beautiful gown and being swept of her feet by her own Prince Charming. Then, we all envision settling into our little homes with white picket fences and cute little curtains and maybe a dog or a cat. But the one dream that most young girls all desire is to be a mommy. Growing up in a Christian home, I was also taught that God has commanded us to “Go and be fruitful and multiply” (Genesis 1:27). We all knew that we would grow up and get married and have babies. That’s just how it was. So, I found my Prince Charming, married him and settled into a beautiful starter home with my two little dogs and fancy window treatments. We were ready for the next stage of our lives. So, we waited and waited. Nothing happened. Naturally, we visited our OBGYN (or in my case, my collaborating physician) and he suggested that we begin the preliminary workup for infertility. Wow…didn’t expect that. We were young, married, and healthy. We didn’t fit that “infertility“ mold. So, we began the journey of testing, ultrasounds, blood work, medications, a surgery and finally we conceived our little miracle baby. While bringing her home from the hospital, I looked up at my husband and said, “You know, we aren’t done yet. Our family isn’t complete.” He nodded in agreement. We both knew that we intended to have more children.

This journey for baby #2 has been a long and arduous journey. We have almost succeeded (one ectopic pregnancy following IUI #2) and have felt very discouraged. However, there is one verse in the Bible that I must cleave too. “For I know the plans I have for you,” declares the LORD, “plans to prosper you and not to harm you, plans to give you hope and a future.” (Jeremiah 29:11). I have to believe that God wants the best for me, and has given me a very strong desire to have more children. I also believe that God has allowed the advancement of science to help those of us who need a little help in the reproductive department. Infertility is a disease process. It’s a horrible, painful disease that causes both emotional and physical pain and scarring. Just like any other disease process, God has allowed advancements in “treatments” to “treat and cure” infertility. Just like you would never tell a Diabetic, “If God wanted you to live, he would make your Pancreas produce enough insulin,” you should never tell an infertility patient, “If God intended you to have children, he would have already given them too you.” You would never tell a patient with a horrible infection to simply wait and not take antibiotics, you would say, “Go ahead, take this medication as prescribed and you will feel better”. Besides, none of us have the right to speak for God. I believe that God has given me a strong desire to have another child, and just like everything else I have ever prayed for, his answer will either be, “yes, no or wait.” But, I would like for God to make that decision and not me, or any other person trying to find something nice to say. Besides, whatever happened to my favorite old saying, “If you can’t find something nice to say, don’t say anything at all!”

Physical Pain of Infertility

Throughout the IF world and blogs, you hear and read of the emotional pains that are caused by infertility. The horrible pains that IF patients are subjected to month after month is unbearable! Unless you have personally suffered from infertility or pregnancy loss, you can not possibly imagine the depth of pain that it inflicts upon your whole being. It's like this deep pit of sorrow and hurt that can't be filled. You just feel sooo "empty".

There is also the financial pain the infertility causes. Infertility treatments are often not covered by insurance companies. It's so unfortunate. Infertility treatments are very expensive. Just this past year, I have personally spent over $7,000. That's all in cash. You have to pay up front for medications and procedures. No payment plans, no credit cards, all cash. That's a LOT of money to pay and still have no baby to show. That's not even including the co-pays, days of work missed, or gas for driving over 50 miles one way to the doctor appointments every other day.

Nobody ever talks about the physical pain of infertility. First, there are the countless blood draws and transvaginal ultrasounds done every other day first thing in the morning. At night, you have injections with medications that sting and leave bruises on your belly.  Then, there is the HCG "booster" shot that causes ovulation. This injection will cause your already swollen ovaries to burst and throb and ache very badly. The insemination process itself is similar to having a pap smear, but that's unpleasant enough as it is! Then there is the horrible bloating and ovarian pain and cramping caused during the actual ovulation process. Imagine menstrual cramping intensified for two weeks...if you are like me, and develop cyst after ovulation, your ovary can swell to ten times or greater it's normal size and all of the swelling and fluid will cause you to gain 5-10 pounds overnight. Then, while your superhuman ovaries are large and overstimulated, you are unable to exercise or move for fear of an ovarian torsion which is very dangerous!! The ovaries can become so incredibly large that they can actually twist upon themselves and the blood flow is then compromised, this usually results in intense pain that sends you directly to surgery! Along with the hyperstimulation, you are also given doses of progesterone to supplement during your waiting period. This horrible hormone causes breast tenderness, irritability, moodiness, sleepiness...etc...it's like two weeks of the worst possible PMS ever!

So, during fertility treatments, my body is poked, prodded, probed, and it responds by making me bloated, moody and generally unhappy and cranky. My husband is very supportive and helpful, but this has easily been the worst cycle of treatments in our six year marriage. The worst part? This entire painful process may not even end in a successful pregnancy. So, maybe that's why I am so cranky when women complain to me about their "two day cramping before their period starts"...really? Two days??

April is Infertility Awareness Month

In support of Infertility Awareness month, I am participating in a contest to "Bust the Common Infertility Myths". There is a list of common "myths" regarding infertility, and we are supposed to pick one myth to "bust" in a blog post. After reading through the list and contemplating for a couple of days, I have decided on my "myth to bust"....

Myth: "If God wanted you to have children, he would have given them to you?"

As a Christian, I find this statement so incredibly flawed. There are so many different angles that I could attempt to blog about and still not successfully bust this myth. In my profession, I see pregnant women daily who very clearly do not "deserve" children by the world's standards, yet, they are pregnant for the third, fourth or even fifth consecutive times. Unfortunately, I do have to research the other side of the myth.

Just this week in my practice, there was a patient who came in for a follow up after her Essure procedure. The Essure procedure is an in office tubal ligation procedure, and the patient is required to have an HSG 3 months after the procedure to confirm that there is no tubal spillage. This particular patient had a very concrete HSG...however, here she was for her "follow up" and 15 weeks pregnant. Her first words were, "Well, I guess God wanted me to have another baby." This was very hard for me to hear as a woman suffereing from IF.  This is definetly an avenue I need to ponder and research.

6 dpiui...

Well this weekend was pretty rough. I knew by the end of last week that I was fairly sure that I had a couple of ovarian cysts. Well, by Friday night, I was in so much pain and had gained about 5 pounds in fluid. I couldn't button any of my pants and I couldn't eat. I am pretty sure that I have developed a mild case of OHSS. Since Libby was with her aunt this weekend, I loaded up with gatorade and rested on the couch all weekend. Brad was a pretty good support partner, he took care of the household chores and allowed me to rest and recover. This morning, I am feeling a bit better, but still bloated and uncomfortable. I told him on Friday night, " I can handle this if it means I am pregnant. However, if I have to go through this and still not have a baby, I am gonna be seriously upset."

I am trying hard to remain optimistic. Here we are, half way through our two week wait. Yesterday, I felt an overwhelming sense of defeat and depression. The thought of going through this whole process and not getting pregnant is a tough pill to swallow. It's like this big empty pit in my stomach that keeps gnawing away at me.

3 dpiui...

Lots of bloating and cramping again...so uncomfortable...while I am waiting, I did manage to get the pics from Libby's third birthday shoot!! She's growing up way too quickly...

2 DPIUI...

So, here we are in the wait. I wish I had a vacation or something planned during this time to keep me occupied! Last night I was having some pretty intense cramping, and then again this morning... I am trying to be faithful and optimistic. It's hard not to be discouraged and feel defeated month after month. On my online support group, many of the girls have received positive pregnancy tests this week...I am hoping that I am one of the next ones. It doesn't seem to make any sense why it wouldn't work. It just proves that God's hand is involved in the very delicate process of becoming pregnant. I had four great sized, very controlled follicles ovulate, and all of the "pieces" were in place during the right time. It's just a matter of timing and patience. There really is no scientific explanation why super ovulation and timed IUI doesn't work. Sometimes, it just doesn't. So, for the remainder of the upcoming two weeks, I will be on pins and needles, anxiously analyzing every twinge and feeling, desperately grabbing at any potential pregnancy symptoms. I will spend countless hours scouring the Internet for other IUI success stories and early pregnancy symptoms. It's not my first time, so, I know exactly what to expect...the unexpected. My prayer is that this is successful and I am able to have a healthy, happy pregnancy. In the words of Libby, "Please God-send me a baby for Christmas."

THE BIG DAY!

So today was THE DAY! IUI #3. On Saturday, we went to the clinic bright and early for our scan, had at least four good follicles that were developing nicely, but the RE wanted to "coast me" for one more night to increase the size and chance of maturity of each follicle. So, Sunday night was the trigger injection at 10:30pm. Yesterday, the girls at work scanned my little follies, and there were two over 20mm and at least two more that were larger than 16. So, that combined with my estradiol level suggests that I will ovulate 4 good follicles this cycle. :) That's the most my clinic will allow for an IUI cycle to diminish chances of high order multiples. Isn't it ironic that every cycle they warn me about "multiples" but I have yet to get one baby out of it?

So, I was a nervous wreck last night and unable to sleep. There was a horrible storm that kept me up and my nerves were shot. We arrived at the clinic at 9 am so that Brad could have "his appointment" and then we headed to Waffle House for a nice breakfast. I was so glad that he was able to be with me this time and literally hold my hand through the procedure. After breakfast we headed back to the clinic.

They called me back and led me to my room. Our counts were great, 20 million, 100% motility and grade 4 after the spinning. (Sorry, if this is tmi, but I would like to remember for my records.) The RE came in and said he was pleased with our sample and also my follicular response. I asked him about the risks of another ectopic, and unfortunately, it's a risk. So, they are going to monitor me very closely. For some reason, if this cycle is a bust, he wants to discuss another laparoscopy to evaluate any damage from the first ectopic. Since we know I have at least one tube still open, he wanted to try a cycle before the surgery. Before he left, he shook my hand and said, "Good luck, our fingers are crossed for you. Call me when you miss your period." I think he's optimistic. So am I. So, now we begin the next phase of the waiting game...