Here goes nothing

Took my first dose of Femara today.  I am thrilled that they are teeny-tiny little pills and not giant horse chokers.  I documented the moment with a video log.  Not sure what I’m going to do with this video log I’ve been keeping since November, but I try to capture all the milestones.

I was able to move my Seattle trip to accommodate the Day 10 ultrasound (at a cost of $137).  There are so many variables between now and an IUI.  But I feel like I reached one hurdle just being cyst-free and allowed to take the meds and proceed with the cycle.

So Day 10 could reveal a few things.  I could not respond to the meds and have another canceled cycle.  I could respond too well and have a canceled cycle.  There could be some other unexpected problem (lining too thin, etc).  However, all of these are pretty rare and unlikely.  Then there’s the issue of follicle size & when to trigger.  I am hoping against hope that I can trigger once I get home Monday night and not have to bring a syringe and a controlled substance on an airplane, also have to shoot myself up at some stranger’s house, or more likely, in the bathroom of a cramped, sweaty dance event while I’m about to go on stage and sing.  That would SUCK.  So I am just PRAYING that the growth is slow enough that I can trigger Monday night or later for a Day 15 or 16 IUI.  But, you know what?  I’ll do what I have to do.  If I have to come home early and spend another $137 to change the return leg of my flight, I’ll do it.  If I have to cancel the whole trip and piss everyone off, I’ll do it.  I’ll do anything.  Because this is probably my last chance for a long while.

I hate the idea of being 6-7 weeks pregnant at my event at the end of July, which is off the charts stressful and full of not eating, not sleeping, and heavy lifting.  Not exactly ideal for a new pregnancy.  But you know what?  I’ll just have to figure it out.  I’ll have to ask for help, force myself to eat regularly (I usually don’t just out of stress), let myself sleep in the mornings (have someone else do the early morning set ups for once), and practice my new found stress-relieving techniques.  I know I can do it.  And if I tell a few key people my situation I know everyone will rally ‘round and help me.  So, it can work.  It’s just far, far from ideal.  I would hope though that if I do achieve a pregnancy this time that I’ll be so thrilled I’ll be willing to put up with any inconveniences.  After all, I accept that if I have a kid everything will be inconvenient from now on, so might as well start now!

I’ve been thinking about the process for this “try” – the medication, the trigger shot – and (perhaps naively) thinking, “how could this possibly not work?”  I mean, I’ll be so closely monitored this time (two, maybe three ultrasounds before we go) that we won’t miss anything; and the meds + trigger shot should pretty much guarantee ovulation, and a good “strong” one at that.  We know the sperm is good; there will be no more ambiguous OPKs (thank God).  So…how could this possibly fail?  And yet I read other bloggers’ long, heartbreaking stories of BFN after BFN with no explanations.  If I do get to try this time, I just don’t know what I’d do if it didn’t work.  Especially considering the fact that unless my cycles switch around pretty dramatically, I’ll only have ONE more try for this entire year, since I am out of town or unavailable EVERY ovulation cycle until January.  So, if June gets canceled or fails, this is going to be a pretty grim second half of the year, I’ve got to be honest.

Whew!

So after a night of freaking out trying to figure out how to structure all this around my five day trip to Seattle (contemplating everything from canceling the cycle all together and going or canceling the trip and pissing tons of people off – and not being able to explain to anyone why I’m canceling), the clinic called this morning.

They told me they absolutely have to do a Day 10 ultrasound since I’ll be medicated and I need to be monitored.  Day 8 just won’t do.  So I thought, ok, I can shimmy my departure date a bit and still make it to the part of the trip I actually have to work.  So that leaves just the issue of the day I actually ovulate – but they said Femara tends to slow growth (that’s how it helps your lining, apparently – it gives you more time to build it up), and since I tend to be a Day 15-17 kind of person, they weren’t too concerned about my missing it (I get back in town Day 13).  They also said they’ll put me on the “trigger shot” to give myself 36 hours before the IUI so the timing will be just right and the eggs will be shot out of their homes.  I’m cool with this because it means not worrying about mixed up timing.  So what they do is measure your follicle growth on Day 10, then based on that and typical growth rates, they know when you should “trigger” and when to do the IUI.  That all works for me.

So I was about to e-mail Seattle lady to grovelingly ask my flight to be changed…when the phone rang again.  Oh, I have to go in for a baseline ultrasound today to determine if there are cysts, because if there are I can’t start Femara and have to junk the cycle.  Ahhh….what?  Somewhere in my subconscious I knew there was something about checking for cysts first…probably back when we were talking Clomid…but it hadn’t really occurred to me that I might not be able to take Femara at all; I just assumed I’d take it and then we’d see what happens on Day 10.  But no – they have to check me out first.  My heart started pounding.

I spent the morning doing busy work and getting increasingly anxious, then headed up there for yet another $200 ultrasound.  I swear I nearly had a frickin’ heart attack thinking that after ALL THIS this ffing cycle could be canceled, too, before I can even take the meds (that I already paid $160 for).  But for once, just once, an ultrasound revealed good news for me – no cysts, just nice resting ovaries, safe in their slumber, with little baby follicles developing as they should.  So the only issue now is what happens next Friday.  This will tell me if a) I respond to the drug at all (the clinic said they’ve only seen one person not respond, and she had severe PCOS); if I don’t this means moving on to injectables which I kind of can’t wrap my mind around right now, and b) when to trigger/do the IUI.  If I suddenly start developing early and it looks like we’re going to have to go on Sun or Mon, I’m telling you right now I am canceling this trip.  No way I hell I’m missing my shot for that bullshit.  Hopefully we’ll go Tues and the worst thing that will happen is I’ll have to bring the hcg shot on the airplane, which apparently involves letters from the doctor and ice packs.  But again hopefully I can trigger Monday night when I get home.

I don’t mind admitting as I made my way from the clinic through the beautiful seminary grounds next door to my remote parking spot, I said a little prayer.  Hey, there are no atheists in fox holes, right?  And if this isn’t a fox hole I don’t know what is!

CD 1

Ok, so my period started today.  Which means a few things.  One, it means that if you go with what the OPK said for May, it’s spot on, so the day I was supposed to have ovulated (May 5^th) is the day I was supposed to have ovulated.  So this does mean that I am not an “outlier” – no early ovulation, no late ovulation, the OPKs are correct in detecting the surge. 

Next it means that this month is going to be a real nail biter, since I will now be out of town from CD 9-13.  Ugh.  This means no CD 10 ultrasound, and if I ovulate early (the Google jury is out as to whether Femara makes you ovulate early, late, or has no effect) I will miss this month and it will be ANOTHER WASTE.  This is especially heartbreaking when you consider I have a $160 bottle of Femara sitting in the medicine cabinet.  Do I take it and risk wasting it on a cycle when I’m out of town?  Do I not take it and risk trashing yet another cycle because if only I’d taken it I’d be able to proceed?

In checking my charts since December I see I’ve never ovulated earlier than Day 13, even when they were fake ovulations.  Usually I’m more of a Day 15-17 person.  But what if Femara pulls me up a few days? 

I put in a call an hour ago to my clinic to see what they suggest, I imagine we’ll come up with something tomorrow.  The last day I’m in town is CD 8 – maybe they’ll suggest doing an ultrasound that day, although that seems awfully early.  Worse comes to worst I could always zip back down to Seattle for a “procedure” if I needed to – it’s not like I’m flying to Europe, and I can happily use my miles for an expensive last minute flight.  But with things being so difficult to pinpoint I really don’t see that happening – why go through all that just to be told upon arriving that we missed it or it’s still too early?  No, the normal, sane thing to do would be to just accept that June is a loss and get over it.  But can you see how hard this is?

The only thing I can do is pray that a) I actually ovulate this month (after all, don’t forget the Femara might not actually work), b) I don’t get hyperstimulated, c) I ovulate day 14 or later.  If these three things happen, I’ll be fine.  One of them doesn’t work and I’m out.  Damn it, why couldn’t I have gotten my period just a couple of days later????

You'll get nothing and like it

Out of nowhere my estranged mother e-mailed me this photo of her mother (upper right) and her siblings – the three women I knew (my grandmother Edith and her sisters Peggy and Helen), her brother John I never met, maybe he died before I was born…?  I guess a cousin of my mother’s sent it to her via Facebook so she forwarded it on to me.  I put it on my Facebook page and someone commented that people who lived through the depression were tough, and this is so true.  My grandmother definitely belonged to the “you’ll get nothing and like it” generation.  Which I felt an appropriate opener for the whiny, self-pitying post I’m about to write.

So I had one of those days yesterday that just made me laugh because it was all about the universe trying to tell me my life sucks and everyone else’s is SO GREAT when I know this isn’t true.  My day started with the lady who runs the event my band is playing in Seattle a couple of weeks from now calling to firm up details – and mentioning that she’s “sold out” and everything’s going great.  Now, I don’t know what “sold out” means, and I didn’t ask (most event planners are reluctant to admit their actual numbers to their competitors), but I sure was curious.  I remember a few years ago she was contemplating canceling the event entirely because it was so poorly attended – now she’s “sold out” (and I have been there recently and yes, it is very well attended).  I know just from her Groupon that she sold 800 tickets to her opening night.  My event is two years older than hers, and I am barely clinging to my attendees by the end of my fingernails.  How is her event thriving and mine is barely hanging on?  What is she doing that I’m not?  Is there anything I can do about it?  It’s maddening, because I can’t blame the economy for my “meh” numbers when this plus a couple of other events are doubling their attendance every year.  It certainly puts the fear of god in me, I’ll tell you that.

THEN I went to see “Bridesmaids” with the bride who’s wedding I was in in March and…the other bridesmaids.  The movie was ok, entertaining enough.  But did I mention  the elaborate music video/wedding video we shot all during the wedding that then went viral and has been all over every website and TV show for the last few weeks, even having the gushing bride and groom interviewed on various talk shows about their fairy tale wedding?  I even get RECOGNIZED for being in this video by people who don’t know the bride or groom, that’s how popular it is.  I had hoped that by the time I got to the pre-“Bridesmaids” dinner late that all discussion about how amazingly popular their wedding video has become would be over…but no.  Nope, that’s all we talked about.  I had to endure a year of non-stop discussion and participation in this wedding, and now that it’s been over for two months I still have to participate in it.  Oh, that, and the bride showing me on her phone photos of the unbelievably fabulous 4 bedroom 2 bath Craftsman home she and her new husband are planning on buying – for $775,000.  All I can say is if this chick gets pregnant before me I am seriously going to start punching holes in walls.

Now you know this is all in good humor and I don’t really resent my friend or begrudge her her happiness.  But it sure is hard to be a single woman, running your own business, always worried about money, trying to have a baby on your own and worrying about all the implications of that, when your friend seems to have everything handed to her on a silver platter, and get all the things you know you’ll probably never get in your life (fabulous husband, fabulous house).  Once again, sometimes it really does feel like good things only happen to other people.  I know this isn’t true, but let me wallow in this for a moment, would you?  One thing I loved about “Bridesmaids” was the depiction of jealousy and competitiveness among women.  As you know this is a favorite topic of mine, and something I experience a lot personally!  However, when I got home I watched the psychotic premier episode of “The Real Housewives of New Jersey” and that cheered me up considerably. 

Anyway that was my day yesterday.  In the meantime I am sitting around waiting for good ol’ Aunt Flo to show up so I can start Femara, and have taken on this bizarre paranoia that I’m going to get my period super early for some reason and it will screw up my next three cycles (due to travel, event, etc).  But so far so good – every day I don’t get it I take as a personal triumph.  I should get it around Saturday, I hope.  If I get it when I’m scheduled to this will also dispel the myth that my ovulation happened early this month, so we can rule that out as a possible “what went wrong” for May.

In the meantime, I like my life because it’s mine and it’s all on my own terms.  So, I guess there’s something to be said for that!

A little advice

OK, I was going to wait until I was actually pregnant to post this, because since I haven’t been successful yet I’m sure the response will be, “how the hell do you know?  You’re not even pregnant!”  But the more I thought about it the more I realized it’s fresh in my mind now and may actually help people.  So, here it is:

I’ve been thinking about my TTC “journey” which for me began last November but thus far has only consisted of one actual try and two canceled attempts.  So I started in the Theory phase (measuring this whole Single Mom By Choice thing in my mind, justifying it to myself, seeing if it’s a fit for me); then in March moved into the Trying phase (going in for ultrasounds & IUIs), and am now in the Assisted Trying phase (meds).  I look back often over the last couple of months and wonder if I could have done anything differently to avoid some of the expense, heartache, and time wasted.  And of course I see I really couldn’t have avoided everything that happened; there was just no way of knowing what was really going on, or no reason to think I had a problem until now.  However, I read other blogs of Tryers and see what they’re going through, and talk to women who may be considering this route one day, and I think I can pinpoint the things I did right and the things I did wrong.  I know every woman is different (and my situation is especially bizarre, considering I wasn’t ovulating yet was showing all the signs of ovulating, which is unusual) but I hope I can at least pass on some things I’ve learned thus far:

Do your homework.  The most valuable thing you can do if you decide to try to get pregnant is chart your temperatures for a couple of months to see your standard pattern.  There are many signs of ovulation – cervical mucus changes, cervix position, ovulation predictor kits, changes in libido, Iphone apps that predict your ovulation day – but let me tell you something – the ONLY true sign of ovulation comes after your ovulation has already  passed, which is a sustained rise in temperatures in the second half of your cycle.  If like me you see a temperature spike but then your temperatures drift back to the coverline, listen to me when I say YOU ARE NOT OVULATING.  I thought because I got positive OPKs and CM and all that stuff, plus a predictable temp drop followed by a spike every month and had regular cycles that I had to be ovulating.  Nope.  If you’re in doubt, run a progesterone test at cycle day 21 just for kicks.  The number will tell you if you ovulated or not (I believe it should be around 10 or up for a good strong ovulation – mine was at 3 which means it didn’t happen).

If you’re older and want to eliminate any fears about egg quality/reserve, get those Day 3 labs run (FSH & Estradiol).  I put this off because I was scared, but for me these tests were a huge boost – my numbers were good, so I no longer had that nagging feeling that I was too old or my eggs were running out.  And even if your numbers aren’t ideal there are treatments for this, too.

Don’t waste time.  Unless you’re younger or have the mentality that you just want to take it step by step and not be aggressive, don’t waste time on fantasy.  Don’t be like me and assume everything is ok just because it “mostly” looks ok, or assume the one month things went wrong was just a “fluke”.  Had I paid attention to my four months of charting and not just disregarded what they were telling me I could have been on meds back in March and possibly be two months’ pregnant already.  So if you want to get aggressive and don’t just want to “wait and see”, for god’s sake, do it.  The meds aren’t going to bite you.

Don’t freak out.  If you do find you have a fertility problem, don’t freak out.  It’s amazing how common this is at any age, and it’s also amazing what an easy fix most things are.  I had assumed “not ovulating” was this horrible, dire thing.  Turns out it’s really common and doesn’t mean anything about your future fertility as long as you take steps to correct it.  Remember that the people you engage to help you in this really want you to be pregnant, too.  They will help you overcome whatever ails you.  With this said, however –

Be your own advocate.  I can’t stress enough how important it is to be educated about fertility and your own body, to know the medications, to know symptoms.  Read Taking Charge of Your Fertility. Google every question no matter how dumb it is (but be sure to get your answers from actual pregnancy/fertility sites and not just discussion groups that are rife with misinformation).  Google medications if you think you might need them, know the costs, how to take them, and the possible pitfalls.  Don’t feel bad about second guessing your doctors or asking about something they haven’t brought up.  I had to point out my low post-O temps to my clinic before they mentioned it; I had to ask about Femara vs. Clomid; I had to ask for an ultrasound that seemed to the clinic to be unnecessary but saved me another wasted IUI.  So, trust that these people have your best interests at heart but trust yourself more.  “Trust in the Lord, but tie your camel”.

Be prepared for canceled cycles.  You may find your “journey” to motherhood is taking way longer than you expected.  For some reason I thought once you decided to start actively trying you’d be trying every month, and surely within six months or less you’d be pregnant…right?  Turns out a lot of things get in the way to trotting off to an IUI every 28 days.  You travel.  You get sick.  You randomly don’t ovulate.  You routinely don’t ovulate.  You have plans you just can’t get out of.  Your lining is too thin.  You don’t respond to the meds.  You respond a little too well to the meds.  You develop cysts.  The cysts don’t resolve in one month.  Did you know you have fibroids?  All kinds of fun stuff.  Now I understand that for many women the actual “tries” are surrounded on all sides by attempted tries that get canceled for your health.  So it’s best to understand that you won’t get to try every time you want to.  And it’s good to let go of a timeline.  I had a specific time I wanted to be pregnant so I could make big announcements or schedule it around travel or work – I’ve thrown all that out now and just accepted that it’ll happen when it happens.  And the sooner the better.

Keep perspective.  When you’re trying to have a baby and it’s not working out it sometimes feels like it’s the worst thing that could ever happen to anyone.  You also come up with a false timeline of how long it’s been that you’ve been trying.  I feel like I’ve been trying since November because that’s when I decided to do it; to date I have only had ONE IUI and two canceled cycles.  I have a friend who felt like she was trying for two years, when in fact they only had about five actual medicated tries before reaching the goal line.  So it’s easy to get so caught up in this that you feel like it’s taking forever or is the worst thing ever.  Look around you, look at the world.  Trust me, there are far worse things than this going on.  Just think, you’re trying to make a happy, joyful thing happen in your life.  Many people are just trying to cling to life.  If your goal is to be a parent of someone, you absolutely will meet this goal one way or the other, even if it’s not how you originally planned. 

Now I understand it’s totally impossible to breeze through the TTC process, especially a difficult one, without all sorts of highs and lows and really, really bad days where you want to drive off a cliff.  This is all normal and shouldn’t be suppressed.  You’re entitled to your feelings.  But do remember that once you’ve met your goal none of this part will matter – you’ll barely remember it.  Let’s all lift our glasses of (non-alcoholic) cider to cheer the day when we all get our BFPs!!!