Wimp

It wasn't so much the actual stabbing or any kind of fear of needles or even the welts and bruises. But when I began waking up so many times every night in pain - whenever I rolled over, or my husband flopped his arm against me - I decided I just couldn't take it any more.

So, against my superstitious better judgment, I am switching from the PIO to progesterone suppository. I know there is a sort of hard-core IVF badge-of-honor tradition to the agony of the PIO injections. And sure, I get that after all it takes to even make it to this point, I should be willing to do whatever I have to in order to support a positive outcome. But waking up whimpering in pain six nights in a row has done me in.

It really wasn't so bad at first. Even though that needle is long, you don't feel anything past the surface nerves anyway. It's the swelling - and possibly a mild allergic reaction - that was my undoing. I could massage with a hot washcloth until I was sure there were no lumps of oil coagulating in my muscle, but there wasn't much to be done about the general swelling. I rotated sides, of course, and used different spots each time. But after a few weeks there just isn't any undamaged tissue left to puncture. The last few days I have had large pink spots on each hip, swollen tissue that is so sensitive that I have to wear soft elastic-waist pants and pretend I am just on my way to a yoga class all the time.

I know the suppositories have a bad rap - they leak, they itch, they ruin your panties. They can cause irritation that can lead to bleeding - and, thus, panic - and progesterone levels can't be reliably measured with a blood test since the effect is so localized. I was hoping to talk to my doctor about Claudia's secret sub-Q progesterone alternative, but since my appointment was canceled I decided I just couldn't go another week without a switch.

I've read a lot of studies that show no difference at all between intramuscular and intravaginal progesterone. Then there are studies showing that one is better, and studies proving that the other is better. There are even studies suggesting that no supplementation at all (past a positive beta) is just dandy. It's ultimately impossible to make the right decision based on all this vague information. Even though I used to be paranoid about changing anything or doing anything that might possibly cause some kind of disaster, I've been worn down by exhaustion and worry and the business of trying to stave off hope. So, I don't know. But I'm damn glad that I'm not icing my ass while I type this.

Waaaahh!

My ultrasound got rescheduled. Now I am feeling very bah-humbuggy about this holiday thing, and the fact that my doctor actually seems to want some time off. Hmph! And because of my own guests and then some big client meetings that can't be moved around, I will have to wait another week. Just when I thought I was almost kinda maybe going to make it until the 26th!

I know I should just be happy that so far things at least haven't taken any dramatic turn for the worse. But it also seems that, for all of us, reaching whatever milestone was the one that wasn't reached before is so emotionally fraught. A first-heartbeat ultrasound is still so early in the game, it doesn't guarantee anything, really. But my last two pregnancies more or less ended on that murky screen, so this is especially nerve-wracking for me. I'm sure that, if all goes well at this stage, I would go on to panic over the nuchal-fold test, the "big" ultrasound, reaching viability... none of us can take any of those things for granted after everything we know. But this has been my particular obstacle, and the anxiety is making me crazy.

It should be a good sign that I haven't had any cramping or bleeding, but I have never miscarried so obviously. Mine have been "missed miscarriages". Weeks without a heartbeat, and nothing ever happened. I had the D&Cs because it was just too hard to wait any more, just impossible to think about anything else at the time. When we decided to have the pathology work done it did show a chromosomal defect, and I am grateful to have that information. Some kind of explanation is better than just not knowing.

Anyway, in a convincing feat of pollyannaism, the nurse did tell me that at 7w2d the scan would be more definitive - before 7 weeks it might not be possible to see the heartbeat as easily. So, there's that - a more conclusive result. As long as the result is going strong, a tiny flicker in a grainy image.

Meanwhile

Time is so not flying that I can't believe this is only Wednesday. What happened to those crazy days that run together in a blur? I thought the only reason we all know what "tempus fugit" means is that it's been so true for so long. But - at least for me - tempus dragit is more like it (how's that for five years of Latin?) and I feel as though I will rot and mold before next week even manages to show up.

I have absolutely no symptoms, except for the sore PIO boob effect. No nausea, no dizziness. I am still bloaty and blob-waisted, and I've been exhausted by mid-afternoon for the last few days... I want so badly to take those as actual signs of continued well-being, but I definitely had those problems before my last miscarriage.

I was recently at an appointment with an educational psychologist (to discuss my daughter's ongoing misery at the idea of going to school) and she asked me if I was going to have any more children. I was so unprepared for that question at the time that I'm sure whatever I managed to say had all kinds of odd implications. I think I said something like "Well, you never know...", but honestly I can't remember.

People used to ask me that all the time, back when my daughter was still really young. Now that she's ten I guess it seems obvious that we either can't or don't want to have any others. These days I'm more likely to get comments about the hazards of raising an only child. Which is even worse than the baby questions, because someone may not know that we have infertility issues, but it's certainly clear that we can't go back in time and create siblings.

So, another week will crawl by. I know that the bottom line is that there is no way to second guess any of this. It is what it is. I just hope that it is what I want it to be, too.

Thanksgiving

Eleven days until the first ultrasound. That seems like forever, but I do have a trick for making the time go by more quickly: houseguests.

My dad and ... his wife? My stepmother? Mrs. W? I never really know what to call her. I usually just use her first name, but when referring to her I get flummoxed. They got married after I was out of college, so she never had much of a mother role in my life. But I really, really like her, so it isn't that I don't want to use any variation of the "mother" word to describe her. In fact, I have a much better relationship with her than I do with my real mother. Anyway, they are coming for the long weekend.

We are not groovy enough to abandon all tradition and just make a great dinner. We'll be having turkey, stuffing, cranberry sauce, brussels sprouts, some kind of potatoes, some kind of other vegetable, and some kind of pie. My husband will smoke the turkey all day, after it has soaked overnight in a cider and spice brine. I'll probably make a few different kinds of potatoes in the next week to test possible options (which is silly, since we will inevitably go back to the mashed potatoes anyway). Plus, I'll have to try out something that will result in gravy since the smoking method doesn't make pan drippings. And there's always the sweet potato conundrum - if you already have potatoes, are they really necessary?

So, I can keep busy for the next eleven days. I have to finish a project at work which involves a mini-waterpark as part of an over-the-top backyard pool renovation. The research alone should occupy me for at least a few days, and the drawings will probably take forever, so it's possible that the 26th will just creep up on me and I won't notice the time going by at all. Right?

159

Doubling time of 1.54 days.

Which could mean all kinds of things, given a x3 transfer. There could be one overachiever going strong or some combination of success and failure amongst the three. I'm just crossing my fingers for the one really good one, and since I won't have any more beta testing before the first ultrasound, there's not much else to do but sit tight and hope for the best.

The last time I was officially pregnant, the time that ended in a pathology report of trisomy 17, I couldn't shake the feeling that something wasn't right. I felt really ambivalent about being pregnant, and I questioned everything about my decision to go through so much to have a child and then feel so lackluster about the pregnancy. Of course, I realize now that it was just a defense mechanism, that I was probably willing myself to be detached from the experience just to keep myself from completely falling apart if it didn't work out. And it didn't work out, and I fell apart anyway.

I feel much more able to accept whatever comes now. I'm not sure what the difference is - but I know that having read the stories of so many women in the IF blog world, I don't feel so alone and ashamed and unsure. It has been really meaningful to know that there are amazing women out there who are facing the same obstacles that I am - and just the fact that they can so beautifully express and clearly reflect the experiences of infertility has made me stronger and more resilient to the insecurities of the process. Thank you for sharing this with me and giving me what I never had before - a sense of understanding in the midst of what seems mostly unfair and unlikely and desperate and embarrassing.

I have managed to make at least one egg that fertilized to the point that it could implant, and it's hung on long enough to make satisfactory lab test results. That may not mean anything in the long run, but for now there isn't really any more I can do one way or the other. I'll go to acupuncture, take my vitamins, no coffee, etc. - but other than that, the die is cast. From now until the 26th (first u/s appt.) I'll try to just appreciate the fact that things have progressed to this point, to be happy for what might be.

Toad Lady Strikes Again

At least I nabbed one of the four metered spaces right in front of the hospital this morning. But the lab experience was as Kafkaesque as the last time. I had to fill out all kinds of paperwork that for some reason hadn't been necessary on Monday, and then there was some big argument about whether or not the tests could be ordered "stat".

Apparently, "stat" means there is some kind of emergency involved, and Toad Lady decided that a second beta doesn't constitute anything dire enough to be called an emergency. The blood was drawn at 9:10 am and as of 6:00 this evening (when my nurse called to say she was on her way home) it hadn't even been sent to the main facility. This is a main branch of Quest, right next to a big hospital. It seems crazy that they can't just run some bloodwork by the end of the day!

Toad Lady was slightly more efficient today, but she did call my name and then stand right in the middle of the doorway while having a conversation with the other person in the waiting room about how wearing ten-year-old shoes is perfectly fine as long as they were resoled as needed and the stitching was very high quality. The other person then took off her ugly perforated pink sandal so they could inspect the stitching together. It was decided that the shoe, being German-made, was a good candidate for the ten-year-plan. Yay! Congratulations on your ugly, worn-out shoe, lady!

The only consolation in all of this is that the FRER this morning was significantly darker than Monday's. That's not as scientific as actual doubling numbers, but I'll take what I can get.

Lull

It's been an odd day. I am so conditioned to keep any kind of hope thoroughly squashed down that I haven't even let myself think about tomorrow, much less anything beyond that.

The lab where I had my draw yesterday is in a medical building next to a hospital. Absolutely no parking except for the seven-dollars-per-twenty-minutes lot next to the ER. And of course the woman at the front desk of the lab was like a Coen brothers version of a receptionist: thick stubby older woman with a giant flattened bouffant and thick mad-scientist glasses. After I gave her my lab slip she went to the back of the office and stood with her back to me shredding documents for a good five minutes. I kept checking the clock, thinking of that parking total.

When she finally shuffled back to the desk and entered my information on the computer I figured we were almost done - there was nobody else waiting, so I assumed I was next. She was clattering away on her keyboard for a while, and nobody had come out of the back for a long time. It seemed weird, because most lab tests just need a quick vial of blood or a cheek swab or maybe some pee in a cup. It had been a half hour and nobody had come or gone. The receptionist had turned the back of her lopsided bouffant to me and was busy going through some mail. I began to wonder if the phlebotomist was out on a break.

Except, then the bouffant lady called my name and trudged around the side of the office to open the door for me, and suddenly it was she herself pulling on gloves and a mask and getting out the tubing and the vial. Her? The crazy toad-in-a-housecoat character? The receptionist lady was going to draw my blood? What?

I had to pay $21 for parking because I was there for almost an hour. And in the scope of an IVF cycle that's nothing, really. But the whole thing was so pointless and bizarre. Tomorrow I'm parking at the Rite-Aid and walking six blocks. And hoping that Toad Lady has the day off.

65

The clinic coordinator called me this afternoon to find out where I had gone for the draw. They had ordered it stat, which is supposed to mean they get the results in 3-4 hours, but they hadn't heard anything. Somehow, she tracked down the paperwork and called me back this evening to let me know that first number.

65 at 9dp5dt is not bad - not as bad as I feared. It just goes to show that you can't play lab director in your own bathroom with any degree of certainty. I was prepared for a low number along with cautionary advice about falling betas, etc. I'm still giving myself all kinds of cautionary advice, because I've been in this exact same position before - normal beta, good doubling, nausea, etc. - and then the first US showed a slow heartbeat and it was all just a matter of time after that.

I know better than to get any kind of hope up at all (but thanks for the capital H, Shelby!) at this point. I'm not even nervous for Wednesday. I'm kind of in shock that any part of this has appeared to have worked at all. Isn't it funny how it's hard to just be happy for something that you really want if you think you might not actually get it?

Maybe

I know enough to know that it doesn't look good. Accounting for doubling time, a positive beta without a faint line yesterday would be very very low - not a good sign. But I can see some kind of a faint faint line today, the palest wisp of pinkishness. So, there's a maybe in there somewhere.

The maybes are where that faint faint line gets blurrier. Maybe it's a chemical. Maybe it's just a later implantation - the morula instead of one of the blasts? Maybe there's a chromosomal problem. Maybe I just have overly diluted morning pee? See - I can come up with a reason to support almost any conclusion.

Lab test in exactly 58 minutes.

Top Ten Reasons and Excuses

1. Technically, the test was expired. Although only by two months. But maybe those tests are really sensitive to being old? But probably not.

2. 7dp5dt is really early. But not unthinkably early. But early.

3. I have had negative tests with actual pregnancies before.

4. Yeah, but those pregnancies didn't turn out so well...

5. It's too early.

6. It's better not to get any hopes up. All pregnancy symptoms are just the side effects of the PIO. Hope is that thing with 1 1/2 needles poking you in the hip every night.

7. Don't test tomorrow - it's just a waste of money. The lab work has to be done anyway.

8. Maybe tomorrow there will be a faint faint line? It would be so nice to have some kind of idea before going in for the lab work. Although even if it is negative I'll still hope that the blood test is positive, so maybe it doesn't matter...

9. It is what it is - testing doesn't make any difference.

10. I shouldn't have tested.

Spit Shine

I have one real-life infertile friend. She has been trying to get knocked up for about three years, to no avail. They don't have insurance for infertility (surprise) and have been trying to save up for treatment. They really live on the edge of every paycheck, so it's been a long process for them. She couldn't even figure out her cycle with the OPKs since she was so irregular and she couldn't afford to keep buying the kits. She did get one of those saliva-monitoring tests, though, and she watched her ferning pattern for weeks. When it finally kicked in, they just spent two days in the sack and - voila! Pregnant. After looking at her spit.

Of course, it's early days. You or I would know better than to announce a pregnancy before a satisfactory ultrasound or at least a good rising beta. She is six weeks pregnant and thrilled to the eyeballs - and was very gracious about telling me. And I am ecstatic for her- she will be an amazing mother. She is truly a remarkably compassionate person. But, damn - spit? Really?

The stories about eating whole milk products, timing sex with the phases of the moon, tying red string to the end of the bed - the fact that these ever work at all has got to be purely coincidence, and yet they persist. And I know the ferning is more scientific than that - it does give some kind of useful information - but it's one more story about how all you have to do is ___________________ and all your problems are solved.

The real kicker is that I would so love for us to be pregnant at the same time. We live so far away from each other, but it's still like time has never passed whenever we manage to get together. But try as I might, I don't feel pregnant. I feel hopped up on progesterone, but I know enough not to confuse sore boobs with an actual pregnancy. At 5dp5dt, I feel bloated, tired and frustrated, but I don't feel at all pregnant. I know it's too early to make a definitive statement, and of course I would love to be proven wrong, but I've been pregnant enough times to know that I usually have some kind of early inkling.

I have never been much of a POASer. But I may have to break down and do it just to prepare myself for the lab results on Monday. I think a negative is easier to take if you aren't holding out hope. That said, my clinic doesn't even call with the results until after the second beta - the theory being that until the numbers rise it doesn't mean much anyway - but I think I can have the lab call me directly with the results.

Luckily, I have an incredibly busy weekend booked, maybe I won't have time to think about not feeling pregnant...

And Then There Were Three

For some reason I only have a photo of two of them. There was a certain amount of hemming and hawing about how many to transfer. It seemed obvious to me - the 7-cell had stopped growing yesterday, so we were left with three. The day-3 10-cells had become compacted blasts, one of them being a quite nice grade 2 and the other a slightly raggedy grade 3. The day-3 8-cell was still a morula (day-4 stage) but looked good enough to be graded a 2. So, the good blast was a shoo-in, but it was impossible to decide which of the others might have a better chance. I really didn't want a single frozen blast left for a FET, so we decided to go for all of them.

This really barely raises my chance of multiples - maybe by 1% - but it does increase the chance of pregnancy by 10%. Seems like a no-brainer, really. We had the requisite discussion about selective reduction, and apparently I gave the reasonable answer and that was that. Now, I know that stranger things have happened, etc. etc., but after everything we have gone through to even get to this point I just have to plan to cross all other bridges when (if) I come to them.

I have my lab request for two betas, 11/10 and 11/12. In the meantime, PIO at least until the first ultrasound (if, of course) and then maybe onto Claudia's secret sub-Q progesterone. Plus, I get to add an estradiol suppository starting tomorrow. Other than that, time will tell. It's going to be a long 2WW, even if it is only eleven days.