Monday, August 25, 2008

The First Day

At the end of our block sits an elementary and middle school campus. An award winning, Blue Ribbon, "green" school. It is the type of school you move to a neighborhood for.

Today was the first day of school; a day that encompasses the spectrum of emotions for a family - anxiety, excitement, dread, joy, pride, fear, confusion, confidence and self-doubt.

I always loved the first day of school - the anticipation, the "smell" of the building, the shopping for new supplies, the way it feels like anything is possible and everything is new again. I loved the first day as a student, I loved it as a teacher, & I still relish them today as tutor. Today was different; today broke my heart.

I left the house this morning at 8:30, just in time to see the families arriving for the first day of school. Some families walked to school - complete with the family dog and younger sibling tucked into their Bugaboo strollers while others piled out of mini-vans & luxury SUVs. Moms, Dads, and even a grandparent here or there all along for the "big day." The little ones all dressed up -shiny new shoes, backpacks too large for their little backs, lunch boxes clutched tightly. Parents smiling through their tears while snapping pictures and taking videos. The older kids walking to school in groups, too "independent" for mom or dad. Dressed up in their own right, though you would never know it. The sky was blue and the sun was shining and it was a perfect first day of school in this All-American town...

And yet, there I sat in my VW Passat (purchased 4 years ago when it was voted, "Best Family Sedan"), feeling like an impostor in this suburban scene, bawling my eyes out. Any passerby may have just assumed I had dropped my pre-schooler off for his first day of school, but instead I was shedding tears of sadness, emptiness, envy and bitterness.

When will it be my turn? When will I get to share in these moments? When will I fill this 4 bedroom house in the 'burbs with the sounds of a family, instead of the emptiness that echoes through the empty upstairs bedrooms?

Yesterday was equally heartbreaking. We went to the State Fair. What a terrible idea that was. Beautiful, sun-kissed children everywhere reveling in the joy that is a state fair on a hot, summer afternoon. I think it might have even been multiples day - no joke, we must have seen 5 sets of multiples in the few hours we were there. I was getting all teared up every ten minutes and I felt like one of those crazy ladies making eyes at every one's kids. You know the kind that makes you want to pull your kids closer to you while smiling uneasily at the "crazy lady"?

Last night while watching the closing ceremony of the Olympics, Sean suggested that we look into going to London for the 2012 Summer Games. He was painting a lovely picture - we could visit Ireland first and then stay with his cousin in his posh London pad, maybe see swimming or gymnastics. He was really getting into it when I interjected a bit sarcastically, "Sure babe, I'm sure the twins will love London. Do they let toddlers into the games?" (Yes, I am the typical IVFer - assuming I will have multiples - maybe I just set myself up for more disappointment). To which Sean replies, "I guess I just have started assuming we will never have kids." OUCH!

I guess if I can't have first days of school and summer days at the fair to look forward to, there is always the 2012 Summer Olympic Games...

Wednesday, August 20, 2008

Surgery Update

We are home from Hopkins and everything went very well with Sean's varicocele embolization!

The surgery took about 2 1/2 hours and he was under "twilight" sedation. Recovery was longer than we expected - 3 hours. They needed to make sure there wasn't any bleeding from the incision (they went in through a vein) so he had to lay flat for an hour, then sit a little way up, then eat, then stand & walk to make sure that under stress there was no rupture. He had a little bleeding at one point, but it turned out just to be skin deep - not a rupture or hematoma. The doctor said it was a very routine procedure and everything looked good.

Sean did great until he was released. Then the motion of long trip in the wheelchair (Hopkins is HUGE) and several elevator rides caught up with him and the vomiting began. Poor thing - motion & meds never did agree with him. He was out of sight of the nurses though so he was a free bird :) We headed out and with the help of the air, ice chips and a cold pack for the car, he made it home and is now resting on the couch. He said the pain is tolerable, but uncomfortable - like he was on the receiving end of a swift kick or 2 to the "nether regions." YIKES!!! He has pain meds if needed.

Now the waiting begins to see how successful it really was. He should be back to normal activity by the weekend, the pain he had from the varicocele should diminish within a few weeks, and improvement in sperm counts should happen in 3-6 months.

It was an incredibly long day & we are both pooped! Chicken soup is on the menu for tonight!

As always, thank you for your love and support!!

Tuesday, August 19, 2008

Cry Baby

Had a strange day today. Very emotional. Found myself in tears a few times. Not an all out ugly cry, just all teary and brimming with emotion.

In fact, now that I stop to think about it, this has been happening since the weekend. I don't really know what it is about. Well, ok, I know what is about, I am just not sure what the trigger has been recently.

The Olympics certainly are not helping. I am tearing up every medal ceremony, Michael Phelps sent me over the edge 8 times, and those damn Morgan Freeman Visa commercials...

I am irrationally nervous about Sean's embolization tomorrow. I don't know why. I not usually emotional or overly nervous before my ER and this is on the same "level." Are you always more nervous when you are the one in the waiting room? In the waiting room I will be for upwards of 2-3 hours. Send some positive thoughts our way!

In the words of Oprah, I had a few "A-ha moments" this weekend. I am *ready* to do something about my weight. Not a short term fix, but a long term lifestyle change. I have never been overweight in my life and then the last 4 years have found me in a body I now longer recognize. I know I am an emotional eater and it is no wonder that this IF journey has helped me pack on the pounds. Add in the fact that we have moved 4 times in four years, changed careers and opened a business among other major life changes and I am a card carrying member of the "plus sized" club.

Sean & I checked out a few gyms this weekend and found one that we feel fits our lifestyle, or maybe I should say our desired new healthy, active lifestyle. We are doing a 7 day free trial to see how it "fits." I am also contemplating adding Weight Watchers and/or Dr. Oz "You on Diet" back into the mix for the nutrition piece. I want to make sure we are making small, manageable changes that we can incorporate into our lives in the long term. It is really important to both Sean & I to be good models for our future children. I am not looking to be a size 4, but I am shooting for healthy and active. Sean does not really need to worry about his weight, but his shoulder surgery was almost a year ago and he is really feeling the need to build up his upper body strength again. We could also both use the energy boost that comes from being more active. I know this sounds like the ultimate put-off, but we are getting on track as soon as Sean's surgery is behind us, but I don't mean an indefinite time frame, I mean this weekend!

Anyway, sorry for the ramblings, I am just in a strange place emotionally right now...

Thursday, August 14, 2008

"It's Not a Tumor"

says me in my best Arnold impression!

The MRI of my pituitary was clear!!! I was relieved to say the least. Dr. M will treat my excess prolactin with a drug that I take 2x per week, starting tonight. The MRI did show some "mild abnormalities of the white matter in my frontal lobe." It could be some kind of vessel or tissue disease or it could be nothing, or it could be from a fall or a bump on the head as a child. Thanks, that makes it so much more clear Doc! It is pretty uncommon to see in someone my age & we can see a neurologist if we want, but unless I start to present with "neurological" symptoms, it is something we can just file away for now. I think we will watch and wait.

As for the polyps, the bad news is that he is almost positive it is back based on the HSG. He wants to do a SIS next month on cycle day 5ish. Then, if a polyp is confirmed, he would like to remove it using a new, less invasive laser surgery. I had them removed via hysteroscopy before. He would also like me to go on BCP during extended breaks since I seem prone to polyps.

Although I can start BCP for IVF #3 as early as next month, we decided we will wait until Oct or Nov. Dr. M's theory is that will be 3 months after Sean's surgery and will be into his first sperm cycle post op. Typically, the most improvement is for a varicocele embolization is noticed during months 6-12, but we may see slight improvement in 3 months. Sean & I have already been on a 3 month break and another 6 months + is not very appealing and probably unnecessary. We are not doing the embolization expecting miracles, just trying to alleviate some pain and discomfort and preserve what little sperm Sean does have.

In other good sperm news, we got the preliminary report for Sean's SA and it was his best one ever! Almost 3 million sperm and 41% motility! That is incredible for him - usually he is less than a million post wash. Dr. M advised we freeze a sample, so we did that with this SA and ended up with 6 vials. Woo-hoo!!!

We spend the day at Hopkins tomorrow doing all of Sean's pre-op testing and hopefully we will get the clear from the surgeon in the afternoon. His surgery will be Weds. Aug. 20th if we get the go-ahead.

Oh, and on the PCOS self-diagnosis, Dr. M said I could have a "touch", but he thinks it is a non-factor at this point and does not want to test or treat for it. Fine with me. Damn that Dr. Google! :)

Thank you all for your love, support, prayers, emails and kind words over the past week! It means the world to both of us!

Tuesday, August 12, 2008

Damn, Damn, Damn

DAMN! It looks like my polyps are back in the ol' ute again! Implantation failure, much???

Had my HSG today and sure enough, the radiologist thinks she sees either a polyp or fibroid in the uterus. No pain, just a little cramping this time around. Next step: Saline Sono to confirm and then likely a hysteroscopy...AGAIN!!!

On the brain front, I had my MRI of pituitary today as well. They started by taking some photos, then, the nurse came in and said the Dr. "wants a closer look." So, they injected some contrast dye in my arm and took some more images. Of course, they don't tell you anything.

I see Dr. Mottla on Thursday morning and should have some more answers then... Send a prayer and some positive vibes my way!

The fun continues tomorrow when Sean has a repeat SA! Stay tuned...

Wednesday, August 6, 2008

Yep, it's still high...

I spoke to my nurse this afternoon. My prolactin is still high and she has ordered the MRI - just to rule out a pituitary tumor. It seems to me, my level would be way higher if a tumor were involved, but I would rather check it out and know for sure. I need to call in the morning and get it scheduled.

She said Dr. M is more than likely going to start me on a drug called Bromocriptine to regulate my prolactin levels. I will stay on that until pregnancy is achieved. Dr. M is out of town until the weekend, so she will get back to me as soon as he has had a chance to review everything.

In all my consultations with "Dr. Google" this week, I am also beginning to suspect that I may have PCOS. I was diagnosed with it in my teens by anendocrinologist, but my last RE dismissed it. When I was a teenager I used to lose my hair, bleed 20-25 days per month, and had high level of androgens (male hormones). At the time, I went on BCP and that seemed to control all my symptoms. Since going off the pill in 2004, I don't seem to have any of those symptoms, but my androgen levels haven't been tested in years. I have also struggled with my weight, have slightly elevated cholesterol and now high prolactin. These are all symptoms of PCOS. I am curious about insulin resistance - my fasting glucose has not been tested in a few years either and it was borderline high (in the 90's and 99 was the limit for normal) and I have gained weight since...

I mentioned all this to my nurse and she said she will put a note in my file and that Dr. M and I need to have another consult, ASAP. So, for now testing, testing and more testing! I am not getting my hopes hope up starting BCP for IVF #3 in August. Oh well, 'tis more important to get to the bottom of all of this! I am soooooo glad we went for this second opinion!

We are off to Buffalo for the long weekend to visit family and celebrate our 4 year wedding anniversary!

Up next: a long week of testing for both Sean & I!

Monday, August 4, 2008

Some puzzling results...

Ok, so this post is not likely to be usual novel. I think I hear sounds of relief all across the blogosphere:)!

I had my cd 3 and baseline u/s at Sh.ady Grove yesterday morning and I got some results today. The good news: My antral follie count was 13 - right in the "normal" range. E2, LH and progesterone were all "normal" as well, though I did not get the #'s.

The bad/puzzling news: #1-My FSH is now at 9.5. That is more than double what is was in January when it was 4.3 and almost double what is was in March at 5.1. So, why the hell is my FSH rising??? The nurse said she wasn't overly concerned at put me in the "slightly elevated" category, and said that since my antral follie count was in the normal range, that was a good sign. She also said Dr. M may have more insight for me.

#2- The biggest mystery- my prolactin (which I cannot determine if I have ever had tested before) was 32.3 and normal is 25. I asked what this could mean and she was pretty tight lipped. She said that it is connected to the pituitary gland and is a major hormone center and could impact fertility. Then, she asked if I have been having headaches and I told her I have been having really terrible headaches all summer. So, we are repeating b/w tomorrow and she wants me to fast (I had pretty much been fasting for the 1st round of b/w too, I had only had about 2 sips of water). She added that Dr. M. will likely order an MRI. Great - more testing. I think they use us infertiles as guinea pigs:)

I have not had any time to consult Dr. Google, but I am pretty sure the concern and MRI order is to rule out a "growth" on the pituitary gland. Other than that, I have no idea what this could mean, I know I have never heard anyone on the boards say they couldn't get PG b/c their pituitary gland was effed up...

Any insight or experience would be appreciated! I'll let you know when I know more!

My HSG is on Aug. 12th - more fun and games to look forward to!!

Oh and some other fun news that I know you will all get a kick out of - I heard from a friend of mine from college over the weekend. We hadn't spoken in over a year, but she wanted to share her big news - her partner is pregnant. Yes, she is a lesbian and yes, they are pregnant! I love her to death and am over the moon for them, and I think it is amazing that we live in a world where it is even possible, but Sean and I got a laugh that even lesbians get pregnant before us! FYI- anonymous donor sperm, 1 chem. pg on IUI #1, IUI #2 with Femara was a success and they are 9 weeks...