Tuesday, December 22, 2009

Schrödinger’s Moment

There is a point in each monthly cycle that I like to call Schrödinger’s Moment.

It’s the point where you have already done everything you can that month. You have both taken your fertility drugs on schedule; you’ve had sex exactly when you were supposed to. From this point on, you have a week or two before you know if you’re pregnant.

You hope, you pray, you pray louder. But it’s too late in the cycle for any additional activity to be relevant.

This month I felt that, until I knew the results one way or the other, God still had time to make up his mind. From a biological point of view, the decision had probably already been made, I just hadn’t been informed yet, but who am I to say that God might not change his mind and make it happen retroactively? Until my period comes or I take a test, we don’t know one way or the other.

You can’t be a little bit pregnant. You either are or you are not; it’s a binary condition. But until you open the box, is Schrödinger’s Cat alive or dead? Until I take the test, am I pregnant or not?

This month feels especially Schrödinger-esq, as I’m having symptoms that could be signs of pregnancy. I’m routinely nauseous, I’ve had some cramping, I’m definitely bloated. I think I’ve been peeing more often, but that’s hard to quantify objectively, since I drink so much water that my normal state includes many bathroom runs. So maybe I’m pregnant. Or maybe I’m coming down with the flu. I do have a cough.

Of course, the cough could be from working outside in the cold air last week. That’s when it started. It probably wouldn’t take me well over a week to come down with the flu. Other than the cough, and the nausea, I feel great.

But until it’s time to take the test, Schrödinger and I will just have to wait for our answer.

Thursday, September 24, 2009

Not this month

For those of you keeping score at home, this month isn't the one.

Following the whole schedule actually wasn't as bad as I thought at first. It was certainly overwhelming to process in the beginning, but with the help of a spreadsheet (of course - this is me, after all), it was pretty straightforward.

There were only 5 days that I had to take two pills a day, and it turns out I apparently can have applesauce every single day without getting sick of it. even the suppositories weren't bad. Easy to put in, no leakage. They were shaped like tiny little torpedoes, and had the feeling and consistency of a solid deodorant. Little torpedoes of deodorant, that's just what they were like.

So all that wasn't so bad. Elric's been on the Clomid. I'm still taking Levothyroxine. We had sex on every single day we were supposed to, without fail.

And yet, we failed. Once more, we failed. I figured the answer would come this weekend. Yesterday was day 31, and it could have been anywhere between yesterday and Sunday, day 34. If I didn't know by Monday (Elric's birthday), I was going to take a test. But no. In the midst of baking Elric's cake, I took a bathroom break only to find the telltale red stain that once again dashed my hopes. Usually I get cramps about 12 hours prior, so I'm virtually never surprised, but tonight the cramps didn't come until about 30 minutes afterward.

I had been feeling pretty good about this month. I wasn't letting myself get too excited, but I felt like we tried really hard and finally did everything we were supposed to do, exactly when we were supposed to do it. So what the hell?

So am I upset? I guess so. That probably sounds ridiculous. I don't feel so much upset right now as I feel apathetic. It's 1 AM. I promised Elric I'd be in bed by midnight. I need to get good sleep. But why bother? What's the point, really? It's not like I'm actually pregnant.

I really, really want to get pregnant. I very much want a child. And yet, a soon as I saw the red stain I wondered if I wanted to do this again for another month.

And I get that what we're doing now, with the drugs and specific days to have sex, is not nearly as far as it can go. So many woman have gone very much further, have put up with so much more to have a baby. Why do I feel like flaking out? Why am I not feeling like the strong one, dedicated to seeing this through to success?

Ask anyone, and they'll tell you a strong woman with an even stronger personality. So why the hell do I just want to quit right now? Why do I feel so defeatist about this?

Why aren't I pregnant?

(I feel like I'm writing into a void, by the way. If you happen across this and read it, please leave a comment so I feel like there's someone else out there.)

Tuesday, August 25, 2009


I am thoroughly overwhelmed. Beware that this post contains ~way~ too much detail and is not for the faint of heart.

Where to start? With Elric's appointment two weeks ago, or the drug he had to get from a special fertility pharmacy? With our health insurance changing last week and all the hassle that caused? Or with my follow-up appointment with my GYN, possibly the most overwhelming appointment I've ever had. Ladies and gentlemen, we have a winner!

So this morning was my follow-up with the GYN, Dr R. At the last appointment, Elric and I were tasked with having appointments or follow-ups with a couple other doctors (the urologist for him and the endocrinologist for me), and with using an ovulation test kit each month. Our plan was for Elric to attend today's follow-up with me, but at the last minute he needed to work, so I went ahead on my own.

I was able to report to Dr R that Elric and I both had our other appointments. I've already written here about my appointment with the endocrinologist and going on the thyroid medication. At Elric's follow-up with the urologist, the doctor felt that his slightly lower sperm count was cause for concern, prescribing Clomid for Elric to take every other day. We have been using the ovulation test kit for the past two cycles, and I showed the Dr. R the spreadsheet I created to track the test results, my cycle, and the dates we have sex. (Elric jokes that I have a spreadsheet for everything, and yes, it's very true.)

Dr R said that my ovulation cycle looked good, and she was pleased to hear about the medication Elric and I are now taking. Since I've only been on he thyroid hormone for a month, an Elric started the Clomid less than two weeks ago, Dr R felt that we had two options.

We could leave things the way they are for a couple cycles, giving the measures we've already taken a chance to work, and have a follow-up in a few months to look at out next step. Or, we could go ahead and take the next step now. Given that the magic age of 35 is fast approaching (the age at which pregnancies are deemed "higher risk"), I opted to move forward with our next options now, instead of waiting another few months first.

The next step is to put me on Clomid and, as Dr R put it, if we're going to put me on Clomid, we might as well put me on progesterone also. Dr R said that the science doesn't back up the use of progesterone here, but that they have seen positive results with it.

I'll save you the detailed explanation about how the body normally produces progesterone when an egg is fertilized, but that the body doesn't always recognize the fertilized egg and that taking the progesterone medication can fool the body into giving the egg longer to implant.

I asked Dr R about side effects, and drug interactions with the Levothyroxine. No drug interactions, although I can't take the Clomid at the same time of day as the thyroid hormone. Side effects: Twins. That's a big one. 5-7% increased chance of having twins. I didn't ask about the percentage of having triplets. We're not discussing the likelihood of twins today. That's not a topic I can handle right now, so I'll think about it tomorrow. (Name that movie.) Other side effects: ovarian cysts, nausea, mood swings (fun!) and some other things that seem uncomfortable, but that Dr R said would only last the few days that I am taking the Clomid each month. The Clomid may also extend my cycle, so I may ovulate a little later than usual, and then get my period a little later.

Doesn't that seem rather straight forward? Take these two medications (in addition to the one you're already on), give it a few months and see what happens. Sure, until you see what the schedule is for taking these things.

And let's remember that until last month, I never took medications regularly. I've been remarkably healthy, without ever even a serious injury before fracturing my shoulder in February. The adjustment already to taking a pill every day has been a big one, especially knowing that I'll eventually need a replacement dose of the thyroid hormone, which means that in all likelihood, I'll now be taking a pill every day for the rest of my life. This is a whole new world for me. My default position has always been to avoid medications that I don't absolutely need, so other than the occasional antibiotic, I've never taken regular medications. even when I was on birth control, I took Depo-Provera, a shot that I got every three months. It was just a semi-regular doctor's appointment, not a pill to deal with every day.

Did I mention that I can't swallow pills? I've tried, and tried, and tried. Please don't give me your fool-proof tips in how to swallow a pill. I've tried it. It doesn't work for me. I get that this is an entirely psychological issue, but it's not one that will be resolved right now. My solution, when needed, has always been to crush the pill and mix it in applesauce or pudding. This past month, I've been having a few scoops of applesauce every morning with my thyroid pill.

So below is the schedule I'm supposed to keep track of. This probably seems very simplistic for anyone who has gone further down the path of fertility treatments, but this is all quite overwhelming to me.

Day 1: first day of my period.

Day 5-9: Take Clomid for 5 days. But don't take it at the same time of day as the Levothyroxine, so make it the thyroid hormone in the morning and the Clomid at night, along with my now-usual applesauce with each crushed pill.

Days 10-12: Wait. (This is the easy part.)

Day 13: Start using the ovulation test kit. Start having sex every other day. But wait, it's not that easy. Don't get up in the morning and pee before I'm really awake and start my routine. I have to make sure I've got my little cup ready to pee in, and the little strips all ready to dip in the cup. But the little strips don't like humidity, so don't store them in the bathroom, and remember to grab them before you head in. And the sex? Scheduling sex is always fun and romantic, right? Don't get me started about "keeping it interesting." Yeah, we get it. We know the tricks. And we're still tired of appointment sex.

Days 13 until ...: Keep testing every day and having sex every other day until the ovulation test kit comes back positive. The day the test is positive, I'm to start taking the progesterone, and we should have sex that day, as well as the next day.

Did I mention that the progesterone is a vaginal suppository? I'm to put it in at night. So, here's an every-other-nightly routine: Get home between 8:30 and 10pm, maybe Elric's home, maybe not. One of us figures out dinner, so we eat around 9:30 or 10:30. If I don't try to get any work done from home, and we actually crawl in to bed together, we better have enough energy for sex. At that hour, who has extra energy to make it interesting or romantic? We're lucky we can stay awake long enough. But then, instead of cuddling up and falling asleep in a post-coital coma, now I've got to get up and put in a suppository before going to sleep. Then Elric's alarm will go off at 4am. I get to sleep longer than that, but I better be awake enough when I get up to remember to have the test kit ready before I hit the bathroom. But the progesterone and the sex only overlap for two days, thank goodness. We don't have to keep having sex beyond the day after the positive ovulation test, unless we want to, Dr R says. Want to? At this point, I just want to get a full night's sleep! Frankly, for a woman with a pretty high libido, I wouldn't mind being done with sex for awhile.

So then I keep taking the progesterone every night until I get my period, roughly two weeks. (Hang on. Will the suppository leak? Do I have to wear panties to bed for two weeks? I've never used a suppository before. Apparently it all gets absorbed, so there's nothing to remove in the morning. But could it leak? I have no idea, and just thought of this now, so I didn't ask Dr R.)

Then I get my period, realize I'm not pregnant, and debate slitting my wrists. (Not really. I'm not actually suicidal. You don't need to schedule an intervention. I'm already seeing a therapist and I'm not a danger to myself. But some days it does seem like it would be easier.)

Dr R mentioned that the drugs could extend my cycle, so it might take a little longer to get my period than normal. If I my period is a week late, I'm to take a pregnancy test. If the test comes up negative and I still don't get my period, then I have to call the doctor, as something could be wrong.

We're going to try all this for three months and se what happens. Of course, we hope it doesn't take three months for us to get pregnant. If we don't succeed, we see Dr R again the Friday before Thanksgiving to follow-up again.

This encyclopedia I've written so far gets me to about 10am today.

Did I mention that Elric had to get his medication at a specialty pharmacy? CVS said the insurance wouldn't let them fill it, and sent us to a fertility pharmacy. Dr R said if CVS couldn't do Elric's medication, they wouldn't be able to do these either, so she'd send the info to the fertility pharmacy.

And did I mention that our health insurance just changed? And that I went through six layers of Dante's Inferno trying to get the information I needed to refill my thyroid hormone last week? I never did get all the info I needed, and ended up paying for that script out of pocket. We've been on the new insurance almost two weeks, and we still don't have our insurance cards. The insurance agent is a complete waste of air and I'm not going to talk about him right now, because I don't want my blood to boil.

I called the pharmacy to see what info they would need to fill the prescription, dreading having to call Kevin, the worse-than-useless insurance agent. (Keep it up Kevin, and I'll publish your last name and phone number here.) Although the pharmacy did need more information than I had, I was luckily able to get the info I needed from Nicole, the lovely office lady at Elric's company. (Thank you, Nicole!) So the prescription has been ordered and Elric will pick it up Thursday night.

I made all the prescription-filling phone calls on my way to work after my appointment. Work was actually pretty good today, and the one person who drives me right up the wall was (oddly) very well-behaved. One of my sweetheart co-workers even brought me a coffee frappe (my favorite comfort food) to improve my day. I spent the morning trying not to cry for sheer overwhelmation. (Yes, that's a new word. Deal with it.) I needed some serious horse time today, and only lost it a couple of times when I was alone with a pony who I could hug and tell my troubles to. Once I started teaching (and once I had my frappe), the work day improved.

I didn't leave work until past 8 tonight. My new schedule will have me there until 7:45, but I got chatty with my last client and her mom. Then I started driving home.

Of course, I haven't mentioned the car problems we've had for the last two weeks. The mechanic said the alternator was just fine, nothing wrong with it. Lots wrong with other things, major safety things, so we dropped about $560 on the car about a week ago. Had the same problem Saturday night and the car wouldn't start to take me home. Elric bought a new battery ($65) on Sunday and put it in.

Tonight, the car didn't make it home. I called Elric, he came out with the jumper cables to rescue me, and it wasn't enough. The car couldn't get enough juice to start. AAA towed it for us, but it'll be parked at my folk's place until at least this weekend. Not sure how I'm getting to work tomorrow, or Thursday. Friday is payday, then we get to decide: pay rent or fix the car? Without the car I can't get to work, but the rent's already partly late. Apparently, the problem IS the alternator.

I planned to tell Elric all about the fun doctor's appointment over a cup of tea in our living room tonight. Instead, we had the conversation on the side of the road, leaning against an inoperable vehicle.

But wait ... my overwhelming day isn't over yet! While I'm on the side of the road, on the phone with AAA, a cop pulls up. Earlier this year we had a little issue renewing our registration because of overdue excise taxes. I was driving on an expired registration for awhile, and racked up three tickets for it. We paid the excise taxes, renewed the registration, and I thought I paid all three tickets. It turns out I only paid two of the tickets. So the ticket that I forgot to pay? Yeah, it caused the RMV to suspend my license, which the cop was happy enough to point out to me. Since I don't have a car to drive for the next few days, this is rather academic, but let's add paying the ticket, the late fine, and the license reinstatement fee to the pile of things I can't afford right now. If I don't have my license, I can't drive to work. If I don't fix the car, I can't drive to work. If I don't go to work, I can't pay the rent. So let's use the rent money to fix the car and reinstate my license. But that still screws my landlords, who are very nice, and very, very sympathetic people. No good way out of this one.

After getting the car delivered to my parent's place, we finally got home at 11:00. Elric turned the oven on and finished cooking the dinner he had started before I called. And today is over. And I have stayed up way too late writing this, knowing that if I wait to finish it tomorrow, it'll never get written.

In closing, here's the refrain that got stuck in my head while we followed the tow truck:

"They're coming to take me away, ha-ha, he-he, ho-ho, to the funny farm, where life is beautiful all the time and I'll be happy to see those nice young men in their clean white coats. They're coming to take me away! Ha-Ha!"

Sunday, July 26, 2009

Endocrinology Appointment

This past Monday I had my first appointment with the endocrinologist. My mother has a variety of rare hormonal issues (thyroid and adrenal), so I opted to see her endocrinologist (Dr. W), who is the chief of endocrinology at one of Boston's major hospitals. Why mess around with someone else, with whom I'd have to spend 10 minutes just updating on my mother's conditions, when I can go straight to the big gun, who already knows the family history, and actually knows it better than me?

The doctor was great, giving me plenty of time to ask questions. When we say the GYN, she told me my body was making antibodies against my thyroid gland, and she did give me the lab report with the results, but I hadn't really looked at the numbers. There are two thyroid antibodies that they tested for. The thyroglobulin autoantibodies were described by Dr. W as being less sensitive, while the thyroid peroxidase autoantibodies are more sensitive. For both of these the numbers (U/mL) should be under 60. Apparently, I'm an overachiever. The less sensitive on came in at 113, while the more sensitive one came in at ... (are you sitting down?) ... 4553.

Apparently these antibodies can affect things other than the thyroid. Anything foreign in my body (e.g. a fetus or sperm), could also be affected by the antibodies. Although the levels of the thyroid hormones themselves came back fine, Dr. W recommended that I go on a low dose of thyroid hormone. He says they don't know why this works, but it often does. When asked if the medication would lower the antibody levels, his reply was a shrug and "Hope springs eternal." He has had other patients in a similar situation with normal levels of thyroid hormone and abnormally high antibodies who had trouble conceiving, then were able to after being on a low dose of the thyroid hormone.

Dr. W said that given the history and the high levels of the antibodies, I should definitely expect to have an underactive thyroid at some point in the future. Even without the antibody issue, I already figured this would be the case, because of the history. On the basis of her history, Dr. W decided we should test my adrenal gland as well, which I'd never had done before. He'll email me with the results of that test, which haven't come in yet.

In my mother's case, her thyroid gland went over- and underactive at the same time, and her adrenal gland failed completely. She had already experienced (very) early menopause. This combination of polyglandular issues is quite rare, which is why she sees such a high-level specialist. Luckily, with medication, she's quite healthy. The early menopause definitely hasn't happened to me yet, and I'm six years older than she was at the time. As far as other symptoms, my hair is thinning at a much faster rate than hers has, and I definitely have some dry skin issues, but not nearly as severe as hers.

The interesting thing about all of this is that we never knew what caused my mother's endocrine problems. We're wondering now if this antibody issue could have been what precipitated mom's endocrine nightmare. By knowing about it before it becomes a crisis (which it did with her), maybe it will be more gently discovered and managed in me.

So I'm now taking 25mg a day of Levothyroxine. A replacement dose would be 100mg/day. I have never in my life been on any regular medication, other than birth control and my chewable multivitamin. (Yes, the multivitamin has plenty of folic acid in it.) I've never been able to swallow pills (even very teeny, tiny ones), so I used the Depo Provera shots for birth control. The Levothyroxine doesn't have any side affects, so I'm pretty much expecting that I will be on this drug, at roughly this dose, until my thyroid eventually fails and I end up on a replacement dose. Which means a pill a day for the rest of my life. This may not seem like a big deal, but it's definitely very new for me.

I hope that over time I'll be able to just swallow the pill, but in the meantime, I picked up a pill crusher with my prescription. This is different from a pill cutter in that it actually pulverizes the pill into a fine powder. In the past we've always used a mortar and pestle to crush pills, but it's much harder work. When I fractured my right shoulder earlier this year, Elric had to crush my giant ibuprofen pills for me every night, as it was too painful for me to do. The pill crusher is pretty amazing. It works very well, very quickly and easily. I should have bought one long ago!

Hopefully, the medication will make the difference we need and let us get pregnant. And hopefully August will be the month for it.

Saturday, July 25, 2009

Not this month.

We've been waiting on tenterhooks for the past week, with each passing day suggesting that maybe, just maybe, we have had success this month. Previous cycles indicated that I would know anywhere from Monday to Saturday of this past week, so when Saturday afternoon arrived without a new cycle beginning, I had really started getting my hopes up. The plan was to give it an extra couple of days, then take a pregnancy test on Monday. I wanted to take the test early, on Sunday, but Elric encouraged me to stick to the plan, reminding me that it wouldn't change things either way.

And of course it was all moot, as the new cycle began tonight. And so we try again.

Sunday, June 28, 2009

Melancholy Day

Had a pretty melancholy day today. The morning felt good, especially since I spent it reading the last hundred pages of a book I love. The afternoon wasn't very productive, and my mood started to go downhill. As the evening approached, my productivity increased and my mood continued to plummet.

I did manage to get one project pretty much done today -- done enough, anyway. I did a bit of laundry, put away a few dishes, but didn't get to half of what I planned to do today.

Elric was out all day, from before I woke up until past 11pm. My phone didn't ring all day, until he called to say he was on his way home. I felt more and more lonely, and alone, all day. Even after he got home, I still felt alone.

Saturday, June 27, 2009

Staying Up Too Late

Why is it that the later in the evening I stay up, the more depressed and despondent I feel? I keep telling myself to get to bed by midnight, and I keep letting it not happen. And yet, the longer I sit on the couch, the more miserable I am. It's not just that I'm the only one awake; it starts before Elric hits the sack. Then there's always on more thing I want to finish. But once he's gone to bed, I'll throw on a TV show from TiVo. I'll have finished whatever I wanted to work on, but now the show's not over. (Don't try to give me the logic that the show is on TiVo and I can finish watching it whenever I want -- this is accurate logic, but it apparently has no place in my midnight mind.)

We have a revised plan in place right now to try to become pregnant. I took concrete steps today toward furthering the plan. (More on that in another post.) I heard about some things today that are encouraging, and certainly supportive. Many people are praying for us, and for me, everywhere from locally, a state or two away, and even as far away as Nicaragua.

So why am I still feeling despondent tonight? With so many people praying for me ... with friendships being renewed stronger than before ... with friends sharing their own, similar experiences ... why do I still feel so alone?

Thursday, June 25, 2009

Follow-Up Appointment

We had the follow-up appointment with my OB/GYN this evening. All the fertility bloodwork came back fine and normal for me. The HSG (internal X-ray) they did of me was very good, showing no blockages or obstructions in my tubes.

Test results for my husband (we'll call him Elric) came back close enough to a normal count that the doctor wasn't concerned about it (44 million when a normal rage is 50-150 million). He has a follow-up scheduled with his doctor about the results that did show some red blood cells in his specimen, which is sometimes evidence of an infection.

We also ran a few different thyroid tests on me, as I have a family history of thyroid disease, and have been borderline underactive in the past. My TSH (thyroid hormone) levels came back normal, which is good. If they are low, that can make conception difficult. However, it turns out that my body is manufacturing antibodies against my thyroid. It's as if my system doesn't recognize the thyroid as being my own.

We made an appointment for another follow-up at the end of August. In the meantime, Elric will have a follow-up with his doctor, I'll go to see an endocrinologist to discuss the antibody issue and see how we want to address that, and we're going to pick up a fertility test kit.

The doc recommended Clear Blue Easy. On her orders, we'll continue to try on the schedule that we have been, but we'll make sure it coincides with the results from the test kit. The doc also wants me to track the results from the kit tests. Today is day 5, and we're to start testing around day 10 or 11, so I'm going to buy the kit tomorrow. We'll start trying again on day 10, and go for every other day.

I'd love to have a follow-up with the GYN before the end of August, but she wants us to have enough time to have our appointments with the other doctors, and to try a few cycles with the fertility test kit. If we don't have luck by the time of our follow-up with her, we'll look at putting me on Clomid or something similar.

We'll see where this all goes!

A Little History & Welcome

I'm Friday. I'm 34 and my husband and I have been married for 13 years as of this past weekend. I'm quite focused on (some may say obsessed with) getting pregnant. I very much want to be a mother, and while I know having children won't be easy, I never dreamed that just conceiving them could be this difficult. This blog is my way of sharing the journey I'm on.

A little history about our background in attempting to conceive...

We started trying to conceive almost three years ago. I got pregnant almost right away, in December of 2006. At 8 weeks, in February of 2007, I miscarried, and we've been trying again ever since. We consulted a midwife, but have pretty much just been trying on our own, attempting to time it correctly by the calendar.

A few months ago, I finally admitted that we weren't having any luck. The clock is ticking too quickly (and very loudly), so over the last month we've been doing a number of tests to find out what's going on. We have a follow-up appointment with my doctor this Thursday night (tomorrow!) to find out all our test results, and come up with some kind of plan.

I'm finding it harder and harder to stay on an even keel emotionally, and I have very conflicted feelings about what I want the test results to say. Part of me doesn't want anything to be wrong ... who wants to find out something's wrong with you? But at the same time, if nothing's wrong, why am I not pregnant? So maybe I do want the results to show something wrong, so that we can then address it. At the same time, I really don't want to have to go through fertility treatments. I've always been so sure that I wouldn't need that ... I may be getting my comeuppence!

I'm having a difficult time dealing with the repeated disappointment each month. I very recently started seeing a therapist to try to deal with this issue. I'm hoping the therapy helps, but this blog is also part of my self-prescribed treatment. If I'm lucky, this will give me a place to open up and vent my hopes, fears, frustrations, disappointments, and (very hopefully) successes in this odyssey to become a mother.

Thanks for reading. I'm going to be as open as possible about what I'm going through. Although I often feel completely alone in this pursuit, I know I can't be the only woman going through this. Comments are open and will remain so, unless I'm haunted by trolls. I intend to retain my anonymity here, so if you know me in real life, please respect that.

Welcome to my journey.