Not Bad

Welcome to Microblog Mondays! Want to learn more and read more? Head over to Stirrup Queens for the details!

Today was my first monitoring appointment. The news in the room was actually pretty good.

Alas, as happens nearly every time, the follicle sizes I heard during the ultrasound are not what showed up in the final report. I'm not sure why that happens, I suspect it's because they take multiple measurements, and the nurse reads one while a different one winds up on the report. Either way, three follicles in contention, lining at 5.2 and triple stripe. For day 4, with half my usual estrace dose, that's not terrible. My dream is three mature at trigger with a lining of 7mm and triple stripe. Here's hoping I can live the dream!

Here's the crazy chart:

Stim Day		7/16	2/17	12/17	2/18	18-May	7/18
	AFC	9 L=3; R=6	4 L = 2; R = 2	7	5 L=3; R=2	6 L=3; R=3	9 L=5; R=4
0	E2	49.1	18
	P4	1.81	0.31
4	L follies	12.5, 8, 8	6.5	12, 10.5	14, 11, 8.5	5, 4.5, 3	9.5, 8.5
	R follies	11, 9, 8.5	9.8	5, 3.5	7,4	5.5, 5, 4.5, 4	11
	E2	803	585.5	188	622	725	691
	P4	2.68	0.07	<.05	0.07	<.05	0.1
	LH	8.24 miu	2.73	3.38	2.12	1.32	1.58
	Lining	6.9 triple	5.7, fluid	4 uniform	5.7 triple	4.97 triple	5.2 triple
	FSH	600	600	900	1100	1100	900
	Menopur		0	300	300	300	300

Well Past Yet

In July of 2016, I had an 11 day luteal phase. When I went in for my first ever baseline ultrasound, I had an antral follicle count of 9. I was thrilled by that, it was low, but not horrible, given my AMH.

That cycle gave us our twins.

This July, I just had the first 11 day luteal phase I've had since July of 2016! They've all been 8-10 days since. And, best of all, my antral follicle count today was 9 again! I've been as low as 4 and only as high as 7 since 2016, so I'm overwhelmingly thrilled by 9.

I got the call confirming I can start, and I've done my Menopur, Gonal-F, Saizen, and doxy, and I'll do the estrace and sildenafil at bedtime with the first prednisone alongside breakfast tomorrow.

All the nurses I talked to today told me they, and Dr. B, really want to see things work for us. Perhaps that's because during today's ultrasound, when the nurse innocently asked me what I was doing this weekend, I told her it was the anniversay of Quinn's birth and passing. Perhaps it's just because they're all sick of me asking questions and following up when things don't seem right! I hope it works for us, too, so I'm writing a letter to the universe today:

Universe, I'm asking you very nicely, could you keep this cycle looking the same as our July 2016 cycle? I'd like it to be exactly the same, right up to 16 weeks, 6 days, and then a change would be good. 

I know that's a lot to ask, but Universe, you've thrown a lot at me in these two years. I've withstood it all, but now is the time for something good. And now is the time for that good to be lasting. If you want to throw something else at me, could it please be 'the terrible twos', in another two years, nine months? 

I know the top of this page says 'not my lines yet', but Universe, I'd really like you to know that 'yet' has come and gone, and it is definitely time for my lines. It's time for my babies to come home with me, alive and healthy. Please and thank you. 

Love, Me.

Just Riding Along

Welcome to Microblog Mondays! Want to learn more and read more? Head over to Stirrup Queens for the details!

My grandma was a worrier. World class. Grandma would start out by observing that there were clouds in the sky and somehow work her way around to worrying that you'd wind up with pneumonia or die in a car accident if you went out. No matter how remote the possibility, grandma could find a way to worry about it. (Her guilt trips were also things of legend.)

Apparently I inherited the 'improbable chain of causality' worrying gene. I also seem to have my own 'irrational anger based on fear' gene that's playing a role.

DH is on a 10 day trip, wherein he and his buddies have done hundreds of miles of bike riding. This is his stress relief and his social network. I support his riding because of its importance to him, but the hours-every-day right before our next cycle is killing me. Our 'male' list from CCRM lists 'don'ts', and one 'don't' is bike riding. Of course, DH's count is fantastic, and clearly we don't need IUI to get pregnant. So what's to worry about?

Well, in my improbable chain of causality, I start by freaking out that all the riding is going to result in high DNA fragmentation which will lead to more losses.  Then, without knowing whether or not that's true, I get angry at DH, because I'm doing insane things to try to make my eggs healthy and he's (maybe) literally cooking his sperm. I try to remind myself that we don't yet know that his riding has had any impact. 

Even as I'm reminding myself we have no idea if biking has an impact, I start to remember that these are my last three shots with my genetics. Then the fear and anger really set in. I know I'll be livid if his bike riding has reduced our slim chances even further. He's a dude, so he'll be able to take 3 months off the bike, improve his counts, and then knock up donor eggs. He'll still get genetically normal kids. My about-to-be-39-year old eggs are cooking more every day despite my yoga and pills and acupuncture. Once my mind reaches this point, I pretty much want to strangle him. 

And then the moment (or hour, or day) will pass, and I'll find myself wondering if we should move straight to donor, because there would be such a relief from having PGS-tested embryos. Which leaves me thinking to myself: 'if you're ready to move to donor, then why on earth were you angry at DH because his bike riding *might* reduce your chances of a biological kid?' 

Sigh. My brain makes no sense. 


DH agreed to do a frag test. My real worry, the one that's actually founded on knowledge of myself, is that it's going to be hard on both of us and our marriage if it comes back with high frag. I really hope this cycle works so we don't have to cross that particular bridge. I love that he gets to ride. I love riding with him on occasion. I can't wait for next weekend, so we can go out to my favorite trail, which is where I snapped the picture above yesterday. I can't wait for a life when neither of us has to worry about our gametes. 

Going Abroad

For much of 2017, I saw a therapist who specialized in loss and pregnancy after loss. She was a loss mom herself, and it was helpful. By the start of 2018, I was in a place that wasn't great, but also wouldn't be improved by therapy. I'm an introspective person, I was already engaging in about as many self-care activities as I planned to, and there wasn't much new that a therapist could help with. I stopped going in January.

As we're approaching the DINK/donor decision, I felt that it would be beneficial to talk through my thoughts with someone removed from the choice. I feel like I have a very good grasp on the situation, the perspectives I'm bringing to it, the reasons behind them, and my choice points. That said, it would be nice to run that past someone to see if there's anything I've overlooked. I sent a text to my therapist in June to see if I could schedule with her. I never received a response.

Figuring that perhaps the silence was because it had been ~6 months since our last visit, I called the office. At first the woman on the other line told me that my therapist does her own scheduling, and I noted I'd tried that approach. After a few minutes, the woman informed me "Oh, she's in Germany for a year."

Germany. I guess that explains the radio silence. Her picture is still on the practice's website. She still shows up with my insurance. I half wonder if "Germany" is the code the practice uses when they have a loss/infertility patient whose therapist is visibly pregnant or on maternity leave. It's probably far less painful for the patient to hear 'Oh, your therapist is in Germany", than "Oh, you know how all your babies are dead and you can't seem to change that? Yeah, your therapist is happily pregnant and/or nursing her perfect, healthy newborn right now. Would you like to schedule with one of her colleagues who's old enough to no longer take trips to Germany?"

Now I'm hoping for some robust international travel of my own! Moreover, I'm hoping that if my therapist did want a second (living) baby, she's enjoying one now, be that in Germany or in Minnesota.

What's Good vs. What Feels Good

Welcome to Microblog Mondays! Want to learn more and read more? Head over to Stirrup Queens for the details!

I've dedicated much of the last several years to doing things that are supposed to be good for me, from a fertility perspective. I've changed my diet to something that can be described as: if it tastes good, I don't eat it. I've taken enough supplements to sink the Titanic. I've done acupuncture. I've changed my exercise habits to focus on gentle, blood-flow-stimulating options and drop the high-intensity, endurance approach I once enjoyed. I've been through so many surgeries that I've actually lost count. I've filled two sharps containers with used needles from the injections, and suffered through months of vag pills and more ultrasounds than I can count. Some of these things were more pleasant than others, but most were decidedly un-fun. Not one of them is something I would continue doing if I didn't think there was a chance it would help me bring home a healthy baby.

Now it's summer. In the summer of 2015, before TTC, I started doing distance cycling. I'm talking about the kind of cycling one does on a bicycle, not the kind of cycling that one does at a fertility clinic. We have beautiful, tree-lined bike trails, along amazingly scenic lakes. I took advantage of them. I put about 2,000 miles on my bike that summer, culminating with my first bike century in September 2015. On the drive home from that century, DH and I agreed to start trying for kids. In 2016, my riding was interrupted by the first hysteroscopy, then by fertility treatments, then by morning sickness. I got a handful of rides in, including an event with a co-worker in June '16, but not many. In 2017, I rode precisely twice. The first time I tried to go out, I puked on my bike shorts, changed into another pair, and tried again. The second time, between 15 and 16 weeks, I commented to Adam that riding while pregnant made me feel like my cervix was going to fall out. Sadly, that was foreshadowing.

This year, following the advice of acupuncturists, Mayan abdominal massage therapists, and fertility yogis, I've limited my exercise to gentle walking. My gorgeous, sexy road bike has sat in the garage, staring at me each time I drive in. (Yes, a road bike can be sexy. Mine totally is. Why are you looking at me like that?) Two weeks ago, I decided that this was one area where I was finished with the 'what's good' approach. I was going back to the 'feels good' approach. I got a 15 miler in that weekend. Then a 23 miler the next. My attempt at a 30 mile ride on the 4th was stymied by torrential rain, but the weather conditions forced me to prove that yes, I can still sustain 16 miles an hour for 90 minutes!  Yesterday I got the 30 miler in. I'm hoping for 40 this weekend. I'm having a tougher time with nutrition, probably as a result of the lower carb diet I've been on. Even so . . .it feels so good! Being out, sun on my shoulders, breeze keeping me cool, actually seeing my body do something positive: it's fantastic!

The conclusion I've reached is that sometimes, what's good is what feels good. Sure, a 3-hour ride might sap my 'life energy' like my acupuncturist warned me. It might worsen the position of my uterus and negatively impact blood-flow like the Mayan massage therapist claims. But after 3 weekends of riding, I have more energy and more joy today than I've had in months. I feel more like the person I was before all this heartbreak. I think my life energy is *growing* with my saddle time. Even if it isn't, I'm willing to make that trade-off at this moment. Here's to finding balance and seizing energy where it exists for you!

When the Anniversary Isn't Yours

The day I returned from maternity leave after losing Quinn, my across the aisle work neighbor had also just returned from adopting her son from China.

Apparently today is one year since his adoption. She is, very deservedly, celebrating. She's reading aloud to our coworkers the letter she wrote to him this year about their year together. About how much she loves his kisses each morning. About how he's changed her life and all the other amazing things he's brought her in the last year. She's sharing the video of his adoption. She's so excited and so happy.

I think what she's doing is beautiful and wonderful and I hope her son appreciates it when he's old enough. Heck, I write letters too.

She's not only excited and happy, she's loud. Really loud. Hear-it-with-my-door-shut loud. Sitting here and hearing all this is gutting me. The only saving grace is that it's the day before the holiday, and that means there are only about five people in the office today that she can invite over to her desk to see and hear everything. So I only have to make it through this five times. We're through the first three.

I have meetings this afternoon so I can't leave, but I did ask a friend to meet in her office, out of hearing range from mine. She says I can camp out there if I need to today.

This is one part they don't tell you about loss: not only does it take your own joy away, it can also take away your ability to be wholly joyful for others. As someone who deeply values vicarious joy, and who loves to see others happy, this experience is new and hard. And I know that any other month, I would be able to be happy for her, but right now, with my own anniversaries looming so large, it's brutal.

Work In Progress

Welcome to Microblog Mondays! Want to learn more and read more? Head over to Stirrup Queens for the details!

A year ago today, I went into the hospital, pregnant and bleeding with Quinn. DH was out riding his bike and couldn't feel his phone vibrate when I called him, so I drove myself in. A year ago today, he walked into the same triage room we were in with the twins, and all I could do was shake my head to tell him it wasn't good. A year ago today, I was taken by ambulance to the University hospital, and I went into surgery very late that night. A year ago today we started counting days until viability, a countdown that never reached the hoped-for conclusion. 

A year has passed and where am I? I'd like to say I'm physically healthy and as mentally sound as I can expect to be, given the circumstances. Saying that might be utter bullshit, but I'd like to say it anyhow. 

On the physical front, my digestive system behaves as long as I'm very careful with what I eat. I did my first >25 mile bike ride of 2018 this weekend, and I'm feeling good. My goal is to do ~40 on the 4th, and ramp up from there so I can do a century in September. I know that my acupuncturist and yoga instructor would both tell me that endurance exercise is bad for fertility, but these rides are fantastic for my mental health, so I'm prioritizing that! Overall, health is good, and yet ovulation is once again missing. I should be less than 10 days out from CD1, but despite signs of high estrogen for days now, OPKs are very negative. It's so disheartening to be doing so much for my body, and to have the apparent signs of fertility getting worse. 

On the mental side, I feel peace that my girls are with me. I am not my former Type-A, 'make sure everything is perfect at all times', self, but all the critical things are getting done. Work is going ok, my house is clean enough, all the bills are paid on time, I'm keeping up with friendships. I am actively engaging in self-care. I spend far too much time on the interwebz,when I could be doing more 'productive' things, but I'll keep giving myself a pass on that for a bit longer. Overall mental health is good, yet I can't stop ruminating about fertility-related things. I've always had a 'one-track' mind, so it's no surprise that I still do, and that track is focused on reproduction. I'm just suspicious that it's not helping me much at this point, even if it isn't hurting me much, either. Aside from shutting down my blog and getting off the interwebz, has anyone had success in actually getting your mind to focus on other things, while in the midst of fertility treatments? If so, how?

I guess this is to say that a year has passed and I'm a work in progress. And I think that's a good thing. If I stop being a work in progress and consider myself 'done', that would probably be the bad sign! 

________________________

On second thought. . . . I typed this up, saved it, and then went to walk a lap around my office complex. The memories hit me so hard on that lap. Walking the same route in December 2015, absolutely bursting with excitement that I was pregnant and we were going to have a baby in August '16. Doing a lap last year, on the Friday before the 4th, right after the bleeding had started when I was just angry that my body was giving me shit at 18 weeks and not yet scared. Then I got back to my desk and started sobbing. Guess I have farther to go on the mental side.