Christmas Time Again

So another Christmas has come and gone… eight of them with my husband. Kind of crazy. We're still celebrating just the two of us. Kind of depressing. But we will circle back to that.

We had a lovely Christmas morning this year. Normally we are stressed out of our minds, racing around, and inevitably running late. This year, my mom's family decided the all day marathon event they have had in the past was wearing a little thin. We stayed home and had a lovely brunch with my brother, his girlfriend and their baby at mom's. I received lots of fabulous gifts… we'll focus on two.

My mom is obviously interested in another grand baby. Apparently, she thinks this will help:

Victoria's Secret + Ovulation Pregnancy Kit = BABY

Actually, my mom fully understands that this won't be the secret to success, but it was a super funny gift. She packed the matching bra and panties in the same box with the OPK's… a baby making treasure box. Hilarious. And a fabulous gift too because as I discussed in an early post, my bras don't fit. Plus, I used almost an entire box of OPK's this month… still no positive. UGHHHH! Back to that later.

Gift number two, was from my wonderful husband… a trip to the BILTMORE ESTATE in Asheville, NC. I've been asking to go for years.

Tickets to Biltmore… yay!

I've been missing from the blogging world because, well I've been busy living and loving life with the hubs. We just got back today. We had a wonderful time. The Biltmore was lots of fun. We spent the afternoon walking the grounds, exploring the shops, and imagining what the gardens looked like in bloom. The good news? Sam got an incredible deal so we have two more tickets to go back again this year. We ended up going to the "Candlelight" tour in the evening. I have requested a 7 story ceiling so that I can have a humongo tree. Sam said he'll get right on that. 

We suck at getting pictures of us, so it's just me, freezing my tail off.

After surviving Christmas (holy moly) and the awesome trip I just had with my husband, I'm seriously contemplating a vacation for next Christmas. Christmas was waaayyyy worse this year than last. Last year I had lost my baby, but I was healing. There were two pregnant ladies in the family… I thought it couldn't get much worse. I was wrong. I spent three evenings in a row leading up to Christmas with family and kids. I was holding up fairly well. And then Christmas occurred. I showed up at a Christmas dinner to an explosion of kids… where did they all come from? We went from no one under the age of 10, to seven under 8 in the blink of an eye. I cried on the way home from two Christmas festivities this year… it's not a fun way to celebrate and doesn't feel particularly festive. You may remember that my doctor gave "doctor's orders" to take care of myself, do what I needed to do to survive. If we are still in the same place next year, we may do just that. Christmas alone, but happy seems better than Christmas surrounded by family, but reminded every moment of what's missing. I guess we'll see.

I'm currently having a ca-ra-zy cycle. I mean crazy. I had just decided that my body was working perfectly, and then bam! Worst - cycle - ever. I went in for a mid cycle check on CD 12 and I had a 14mm follicle. They assumed that I would ovulate on my own the Sunday before Christmas, CD 16. Well, it's CD21, and I haven't gotten a positive OPK yet.  Ughhh. But wait, it gets better. Check out the chart…

December 2012 BBT chart

I have a follow-up appointment with the doctor, but I couldn't get in until January 29. By then I'll have started another cycle. Blughhh. I don't know why that matters. I'm not doing treatments. I'm saving for IVF. I guess my head is still set it treatment mode. Got to move on.

Anyway, hope you all had wonderful, cheerful, merry, and bright Christmases! 2012 was good to some of my fellow infertiles. Head over to Lisa, Amanda, Jen, Amanda, Belle, Bree's blogs and tell them congratulations and best wishes that 2013 sees all these babies come home to loving arms. For the rest of us, may 2013 be our year!

Infertile for the Holidays

My new doctor sent me home with a flyer the last time I was in on getting through the holidays if you're struggling with infertility. I thought it had some great advice, so I thought I'd share:

How to Survive the Holidays

For many individuals and couples who are experiencing infertility, December can be a cruel reminder of what they are missing. There is an enormous focus on children and babies, and many people mark each holiday season by the number of years they have not had children. Even the normal asylum of a church may not feel protective this time of year, with the focus on the miracle of conception and birth. 

Although some can get into the spirit of the season despite infertility, most cannot. Thus, if you find this time of year tough to cope with, it is crucial to practice the practical skill set of self-preservation. 

You can now officially consider yourself under doctor's order to care for yourself this holiday season. This means...

• Avoiding the mall and toy stores. If there are any children you need to buy for, either order things by catalog or on the internet, and have them wrapped and directly shipped. Do not put yourself in the position of buying and wrapping toys. If you absolutely feel you need to buy things yourself, go to the bookstore and buy books which were your favorite as a child.

• Avoid going to church at your normal times. Christmas Eve midnight mass tends to have very few small children, but other services can be overwhelming.

• If there are holiday parties where you know or suspect there will be children or babies and you don't want to go, be aware that those moms won't want you there since you have a stomach bug (or sore throat or a touch of the flu).

• If your siblings have children and family gatherings are uncomfortable for you, plan to arrive late and/or leave early. 

• Think of traditions that you and your partner can create together for the holidays.

• Consider doing something totally different - some couples decide to go away to couples-only resorts where you can focus on each other.

• Whatever you decide to do this holiday season, try not to focus on what people expect of you or what you think you should be doing. Try to have empathy for what you are going through and care for yourself the best way you know how.

Some of these are a little far fetched for me. At this point, thankfully, I am completely capable of wrapping a toy for my nephew. But Sam and I did manage to skip the toy aisles all together this year, so it was nice not to feel like we have to go "kid shopping". I also love the idea of making traditions for you and your spouse now. I don't know about you, but a huge part of my sadness comes from the idea that I'm missing something. Since the first Christmas we were married, I started making plans for things we would do as a family once we had children. Each Christmas marks another year that we can't do those things, and so I'm sad. It would be nice to make some memories that are "us" focused in the mean time. 

We don't really adhere to these too much. I would feel too "selfish" if I skipped Christmas or left early just because our nieces and nephews were there. And honestly, I want to see them. I love them. I don't want to miss out on their childhoods just because I'm dealing with sadness. But I think the general idea here is to take care of yourself. Do what you need to do to survive and leave this holiday season with as few scars as possible.

For instance, Sam saved me today. Our church had a Family Christmas Celebration today. I was totally prepared for children to be present in the service. What I wasn't prepared for was a child focused service. Sam is on the parking team and when he caught part of the service, he immediately realized that this is "not for us". When I got finished keeping the kids, I met up with him and he explained that the service doesn't just include children, it is predominantly for children. For families with children. I decided that this wasn't the best atmosphere to put myself in two days out from Christmas, so we headed home. 

To my infertile friends, take care of yourselves this Christmas. Behave with grace and tact, but don't be ashamed to hurt some feelings or frustrate your friends and family. Let's all get through this holiday with our hearts intact so we can move on with the next year... it's going to be good ladies! I have faith! Hang in there and Merry Christmas!

Deck the Halls

This year we are living with my mom for Christmas which means hard labor in the kitchen every day. She loves to bake. I hate it. But I enjoy spending time with my mom and continuing Christmas traditions from years ago. This is the first Christmas since getting married that we've been home longer then 4 days… nice. It also means that there were twice as many Christmas decorations to choose from. I stretched mom a bit out of her comfort zone and convinced her to use some of my ornaments. Mom's a pretty traditional gal; she likes RED and GOLD. That's about it. Sam and I aren't gold people so we snagged a ton of shatterproof (Sterling Proof) red, green and silver ornaments our first Christamas. It took some convincing. I don't think mom was too keen on silver or green on her tree, but I think it's the best year in a while.

Enjoy:

We'll start with the formal living room. Mom's a collector. She's collected Dept 56 Dicken's Village and Snow Village for years. More recently she got into Mark Robert's Christmas Fairies. Sam HATES the fairies, so you'll never see them at our house. The fairies are normally on the tree, but we went crazy this year and changed things up. I think the less frou-frou tree allowed her to let her hair down… we got rid of of all the ribbon and puffy bows. I like a good ornate Christmas as much as anyone, but sometimes it's fun to see what else you can do.

Living Room Mantle:
Mark Roberts Fairies and Pottery Barn Stockings

Mom liked ours so much, she caved and bought new ones

Don't worry, Sterling and Boo Boo are still represented,
Mom didn't like them on the mantle, but I'll sneak them in

Fairies in all the little hidey holes

Detailes of my favorites

Dept 56 Snow Village

Mom's Snow Baby Collection

New banister decorations

Detail of the giant ornaments on the banister

View from the foyer into living room

the Tree

details of my favorite ornaments

my Lenox Princess Kitty ornament: for Everest

My favorite, favorite

Presents didn't fit under the tree this year: hostile takeover

view from the staircase

you can't see it in the pictures, so I wanted to show
 the tree skirt I SLAVED over… Oh, Pinterest!

In the dining room, we usually have Christmas dinner, but Christmas is at my aunt's this year. We still put out Mom's Dept 56 Dickens Village. I contributed my piece as well. : )

the whole village

details of Dicken's Village

The keeping room is a little less formal and more my style… possibly because it's all mine! On full display in all of their glory is my Nutcracker collection. I have too many to fit on the mantle, so they are spread around the room as well.

Keeping room mantle

Details of the mantle

My favorite- the skier

Mom's Cinnamon Stick tree

In addition to the Nutcrackers, I also contributed some FABULOUS dishes. I've had my eye on Pottery Barn's Reindeer dishes for years. Last year after Christmas, we snagged the dinner plates for more than fifty percent off. Yes, sir! We had my brother, his girlfriend, and my niece Alexis over for dinner, so I broke out my dishes for the first time. Ta da!

So that's it… Christmas at my mom's is a little bit more impressive than the traditional Greavu affair, but it's been fun to decorate this year with my mom again! If you've made it this far, Merry Christmas! Wishing you and yours a special holiday season. And may all of us who are yearning, find baby dust in the new year!

Daunting Tasks

Tonight I feel overwhelmed. Overwhelmed and sad. I'm sad because I want to hold my child in my arms. I want to bury my nose in his sweet skin, breathe in her baby fresh scent, snuggle him close to my heart, kiss her tiny toes. My heart is aching. It's Christmas time again and there is no new stocking hung by the fire. I had been doing pretty well for a while, feeling confident that someday, someway I would get my blessing, but today I just feel like that day will never get here. I think the turn in my mood is probably hormonal (it's almost ovulation time), plus some holiday influences. And the sudden rash of babies being born and pregnancy announcements on Facebook isn't helping I'm sure.

The plan as of now for us is to pursue IVF as soon as we have the funds together (hopefully sometime in 2013). We are also looking seriously into adoption as well. We plan to move ahead on both fronts, possibly even simultaneously. We need to do a lot more research. Which is where the daunting part comes in. Both IVF and adoption feel impossible right now. They feel so incredibly far away. They feel like solutions for the wealthy. They feel like mountains to climb, and not just Blood Mountain high, but Mount Everest high. It feels like getting to the moon would be easier than IVF and adoption.

IVF currently seems the easiest of the two, but certainly still daunting. The price tag is huge, practically insurmountable at this point. The statistics leave a lot to be desired too. We are looking at $15,000ish for a 40-50% chance of bringing home a baby. The terrifying thing in that sentence for me isn't the money, the money is only terrifying in that I don't have it. But I figure many Americans spend $15,000 on a car, and a child seems infinitely more worth it than a Ford Fiesta. No the pee my pants stat in that sentence is that the likelihood is that I will NOT bring a baby home. Just writing that makes me want to puke.

For all of you in the process of IVF or getting ready to start, ignore me. I'm in a funk. It's worth it… go for it, and may you ALL be the exception, may you bring home your baby THIS ROUND. I pray your dreams come true.

Adoption seems IM-FREAKING-POSSIBLE. Impossible that we could ever raise, earn, collect $30,000. Impossible that my heart won't EXPLODE before the child would be ours. There has to be a reason for all the red tape, restrictions, monetary requirements, etc. but right now, it seems RIDICULOUS. There are MILLIONS of children in orphanages across the world waiting for someone to rescue them, waiting for someone to bring them home. I am not a murderer, or a rapist, or a pedophile. I can provide a good, loving, structured life for a child. I can give them so much more than an orphanage. So why, why, why does it take 2+ years and thousands and thousands of dollars to save a life?

I know that if either or both of these is on the path that the Lord has planned for us, then He will see us through to the other side. I know that IVF is possible, that it does work, that every day women deliver miracle babies due to the science of IVF. I also know that adoption is possible, that the horror stories are not the norm, that every day orphans are made sons and daughters. And no matter what, I know that it will all be worth it, but right now, the path laid before me is too daunting to comprehend.

Shifting Body Image

Let me first start out by saying that recently I have been reminded over and over again that my audience is not necessarily female. Allow me to clarify: boys, males, men, whatever you want to call them, members of the opposite sex, other than my husband read this. It shocks me every time! So with this in mind, I feel like I need to offer disclaimers if the post is edging towards female friendly areas. If the title of the this post didn't scare you fellas away, let me tell you straight up; I'm about to talk about weight gain, bra sizes, etc. Now, with that said, feel free to read on.

Let's just get this over with: I'm gaining weight. Ughhhh. I'm not going to talk scale numbers here, because everyone's ideal number is different. And the specific number isn't the point, it's the changes that are occurring. Since I started hanging out with Sam in 2005, I've gained 25% of my then weight. Now, let me be real honest here; I was underweight then. It was my freshman year in college. I was waaayyy to poor to eat out, none of my friends lived anywhere near me on campus, and I only had a microwave in the apartment. It wasn't unusual for me to eat lunch on campus and then skip dinner for some snacks around the apartment instead of going out to eat alone or riding the lovely campus buses for 20 minutes to eat with friends. In addition, my high school romance had ended; food wasn't my highest priority.

The bigger issue is that since marrying Sam, in 2010 mind you, I've gained 16%. Meaning take my weight on my wedding day and add 16% to that and you will find my current weight. It's been just over two and a half years. I couldn't fit into my wedding dress if I had 10 pairs of spanx, a corset, and a team of helpers. Seems kind of rapid to me. Where did this weight come from? I have some hunches:

• I married a foodie. I'm cool with cereal for dinner. My husband's favorite store in the mall is Williams & Sonoma. I would never cook for one. He makes himself crazy complicated breakfast and lunch dishes all of the time. He also thinks that because I can eat as much as him means that I should. 

• I'm getting older. I thought this was something that happens at 40 or 50, but maybe 26 is the new 40. Maybe my metabolism took a nosedive a smidge earlier than I anticipated. 

• Sedentary life. In college I sat a lot. Classes, art projects, bus rides, basketball games… but I at least walked some. I had to get my butt around campus, and sometimes, at UGA, it's honestly easier to walk then wait for Orbit. But post college, what jobs I have had consisted of sitting allllll daayyyyy. And being jobless is not as motivating to hit the elliptical as you might think.

• Infertility. I don't honestly know what, if any, effect the medications I've taken have had. Most of the weight was already there, but lots of people say that fertility medications cause weight gain.

• Depression. It's a vicious cycle. You eat because you're bummed, then you're bummed because you're jeans don't fit, so you eat. I've noticed that I tend to give myself free reign after my period starts. Want a whole box of Publix chocolate chip cookies, Amanda? Go ahead, you deserve it. You're life is pathetic and you're uterus hates you. And then I also indulge in Starbucks, and cake, and brownies, and ice cream. You get the picture.

What a lot of people don't know about me is that I was heavy before. I was always a very thin child, but in middle school I was dealing with a lot of depression and I was put on some medication. I put on thirty pounds in one summer. Before I knew it, I was about sixty pounds heavier. Needless to say, I went off the medication; it was obviously not the right one for me. But the weight loss took a lot longer than the weight gain. High school was a pretty crazy transformation. I went to my freshman homecoming dance in a size 10 and my senior prom in a size 2. 

After losing the weight, I really did NOTHING to manage it. I ate what I wanted when I wanted it, and I had no changes in weight. I was one of those girls. I put on a few pounds after freshman year when happiness returned to my life, but after that I stayed the exact same for years (and years), And then BAM! My clothes don't fit, the scale is broken, and my body looks way different than I remember.

Last week, as I was getting dressed and trying to shove my boobs into my bra, Sam noticed it was a bit too much of a task. Sam said, "I think you need a new bra". Ummm… no I don't. I've been the same size for 10 years. Believe me, these girls don't change. I looked in the mirror. Ewwww, I have side boob. And my girls barely fit within the confines. Okay, so maybe I do need a new bra. 

Armed with thirty dollars in coupons, I headed to Victoria's Secret. I found the cheapest bra I could and snatched one in a larger size: one cup size up. Upon entering the dressing room, I changed bras, but I barely looked any different. Right about then, one of those pesky ladies with a tape measure around their necks knocked. I poked my head out to ask if this bra runs small. "No, can I take a peek?" she asks. Sure why not, it's just boobs. Half of Atlanta has seem my hoo-haa. She comes in and says, "well, I think we need a few more inches". So let me get this straight, not only do I need a larger cup, but more inches too? I tried in on, and voilà, no more side boob. Squishy back fat was minimized as well. I was sorely tempted to replace all of my too small bras with comfortable options, but then I realized that I am not okay with this gradual increase in pants size, bra size, scale display. My body is changing, and while it's not drastic, I know that as my body shifts, my body image can too. It's time to head this thing off before it gets out of control.

I got all amped up to lose allllll these pesky pounds, and then I remembered a BMI index sheet from one of my doctors. It is a generic sheet telling you where you should be as far as BMI for optimal fertility. It also explains at which points they will refuse medications or other procedures. I found my height, and yep, I'm in the "healthy BMI". I looked across the chart at the lowest possibility, and well, it's more than my initial goal. For my height, they don't want me to weigh less than 132 pounds. So that's my goal. I don't know what size of pants or bra I'll be at that weight, but after my mom's bake a hundred sweets a day season, I'm on a mission to safely and wisely lose 9% of my current body weight. Stay tuned for future posts about how this is to be accomplished.

the Gifter on a Budget

I'm sure most everybody has heard of Love Languages by now, but if not, it's a great thing to know about yourself and your spouse. I am a gifter. I know, I know, it's like the worst language to have. It means you're superficial, high maintenance, needy, and that you enjoy things way too much. The good news for me is that I have a very close second love language: physical touch, and that my friends is FREE!!!

Another good thing about me is that gifting is most certainly the way I tell someone they are loved, but it isn't the only thing that works for me (remember, physical touch), so I'm not completely impossible to live with. But I sure do like random gifts like surprise flowers, or even cheap stuff. When Sam and I were dating (early on in the "please like me" stage) he'd show up with a half gallon of Blue Bell ice cream if I was having a bad day. Winner! As you can imagine, birthdays, celebratory milestones, and Christmas are BIG DEALS for me. Sam kind of hates it because I momentarily lose my mind at Christmas and spend 6 months worth of budget (mild exaggeration) in a mere 2 weeks (not an exaggeration.). 

I set the bar pretty high early on in our relationship. Way back in 2007 (Christmas #3), I got Sam the iPhone. Remember in 2007 the iPhone didn't come with any discounts… you couldn't buy an iPhone for a penny, it was full price baby. Awesome gift if I do say so myself. In 2009 (Christmas #5), we were engaged and 4 months away from the Big Day. I bought Sam a 40" TV (at an amazing price). All of this is to say, that when I get an AWESOME idea, I hunt like a mad woman for the best price, but somewhere along the way, things like common sense and budgets go out the window and love overwhelms my wallet and… boom! I LOVE YOU gets wrapped up with a big bow and shoved under the tree. 

Enter Christmas 2012, the year I was jobless for the past 5 months, the year we spent $5000+ on fertility treatments, the year we decided to pursue IVF. The empty wallet is really cramping my style. I've told everybody that what I want for Christmas (besides a baby) is either cash (to put in the IVF savings account) or things to get my body ultra-ready for IVF. Things like yoga classes, acupuncture sessions, etc. But I don't feel like I can expect the husband to give up Christmas presents for the future IVF procedure. And other people in my life certainly don't deserve the shaft just because my body can't get it together. 

So to compensate for my less than bountiful bank account I'm putting extra thought into all of the gifts this year. A lot of the gifts will probably be kind of boring compared to flat screen TV's and iPhones because they are needed items. Bor-ing. But it is what it is. I'm also trying to think back at some of the smaller gifts and remember what Sam really liked. I figure if I get things that he really likes, wants, needs it can make up for the smaller size, price, quantity.

I know that the Christmas season isn't really about gifting. I know that this is probably a great year for us to chill out and make some memories as this will be the last Christmas that Sam will have off for school. From here on, we will be regular ole' working citizens with a measly 2-3 days off for the holidays. And believe me, I am soooooo thankful that not only am I home for the holidays, but my mom and Sam will be off all the way through the new year. Beautiful. But this is really stretching me… how do I communicate love to my family, in particular my husband, when my language of love requires cash? I was struggling mightily with this earlier when it dawned on me that giving is not Sam's love language (bummer). Ah-ha! Show him I love him in his own language… and then I remembered, his love language is words of affirmation. So do I stand in front of the tree and recite all of the reasons that I love and respect my husband on Christmas morning? My creativity as far as words of affirmation go is pretty slim as you can tell. If anyone has any great ideas, pass them along!

Man Stuff… the Land of the Unknown

So I've mentioned a couple of times and posted on my TTC Timeline that we had an appointment with a Urologist last week. After receiving a green light from Sam, I'm free to post about all of his maleness to my heart's content.

We decided to seek a slightly more thorough examination of Sam after our third failed IUI. The reason was specifically due to numbers. Here are our numbers:

SA #1- 72 hours abstinence, 220 million, 4.2ml, 55% motility, 6% morphology

___________________________________________________

IUI #1- 50 hours abstinence, 140 million, 44 million post wash, 31.5% survival rate

IUI #2- 30 hours abstinence, 110 million, 16 million post wash, 14.5% survival rate

IUI #3- 35 hours abstinence, 298 million, 11 million post wash, 3.7%  survival rate

My doctor at ACRM always assured us that everything was completely fine as long as we had 5 million post wash. However, you can understand my frustration when upon hearing that we had MORE THAN DOUBLE the total motile sperm in our third and final IUI than in our previous best and yet only a QUARTER of the post wash numbers.

We met with the Urologist at RBA very briefly during a new patient seminar back in November. We very quickly explained the survival rates and he agreed that this might be cause for concern. He informed us that they like to see at least 50% survive the wash treatment. He recommended that we schedule an appointment before having any additional treatments or tests. So we did. Sam had his appointment last Monday.

Side note rant: get ready ladies… Think back all of you infertiles and you will probably find like a zillion slightly to severely embarrassing moments in which your husband was in the room. Sam likes to hum the whole, "ba da da da dum" stripper song, while I undress, point out awkward things in the office, and chuckle as I attempt to cover all the pertinent parts with my paper sheet. Most recent embarrassing moment for me was when Dr. Massey asked if I had lots of facial hair. Unsatisfied with my answer, he decided to give my chin a good rub. Good grief! A girl deserves a few secrets. Now get this, before Sam's exam, the doctor politely asked me to LEAVE THE ROOM. I'm sorry, but huh? I have to spread my legs in the stirrups over and over and over again, and no one says, "Amanda, would you like some privacy?" My answer would be "no," but still. Anyway, I digress.

The consultation didn't yield much. The doctor did think it unusual that so many swimmers died in the wash, but he still said that the numbers were sufficient to provide pregnancy. Those that survived the wash were high quality, grade 3 and 4. The only thing that the exam did yield was the presence of varicose veins, also known as varicoceles. This may or may not turn out to be anything. We won't know until further testing (an ultrasound) can be done. He has also requested additional blood work and  semen analysis.

We are looking at Sam's LH, which stimulates testosterone; FSH, which stimulates sperm, PRL, and testosterone. As far as the semen, he wants to do another analysis (we've technically only done one); another test wash; a Hyaluronan Binding Assay test, basically looks at the sperm's ability to penetrate the egg; and an Immunobead test, which looks at antibodies that might kill the sperm.

After the ultrasound and all of those test results are back in, we will meet with the Urologist again to see if there is any reason to suspect any level of MFI. If there is anything, we will obviously discuss treatment options prior to moving on to IVF. This will also tell us if we will need ICSI if we ever do get to IVF.

If you are equally flabbergasted and confused by all the maleness going on, welcome to my world. We've entered the land of the unknown, ladies and gentleman. The good news is that this gives me a lot of dates with Dr. Google as I research what the heck all of this means. But Man Stuff is CONFUSING and full of awful words that I don't like to say… gross!

Second, Second Opinions

If I thought I was confused after round two of appointments, I am well past confused after today's appointment. Today was with a well established clinic in Atlanta. It was the first IVF clinic opened in Georgia, way back in 1983. They, as a group, have certainly made a lot of advancements in the treatment of infertility. How does that help me? I'm not sure yet. But back to my confusion.

Let's go bullet style on the topics on which there are varying opinions:

• Progesterone- ACRM puts me on Prometrium unless my progesterone is 15, medicated cycle or not. Dr. Massey at SMFI told me that it sounded like they were hunting for an idealized number; he was satisfied with all of my levels. Dr. Slayden at RBA said mostly the same thing. The level 15 is based on an old study from the 80's. He said that progesterone is a hard thing to place as it is constantly moving. A progesterone level can vary A LOT from one hour to the next. He did not recommend progesterone supplements and was more curious as to what my luteal phase might have been naturally. 
• Fibroid- Dr. Massey saw a fibroid, "clear as day" he said. He couldn't understand why no one else had found it. His nurse was in the room and she said the same thing. None of the doctors at ACRM ever said anything. Dr. Slayden specifically hunted for a fibroid today and said that there is nothing, not pea-sized, not walnut-sized, and certainly not lemon-sized. 
• AMH- ACRM tested my AMH level in May of this year. It was 5.4. This of course started the PCOS Debate of 2012, but ultimately, it was decided that I am young, with a lot of eggs, and that explains the elevated number. Last month, I went to a seminar at RBA and I got my results today: 2.54. WHAT THE????? I asked if it normally varied this much, already knowing that, no, it doesn't. AMH isn't on a scale of 1-100, it's more like 0-10, but mostly 0-6. Dr. Slayden confirmed that it shouldn't change this much, and commented that it is probably an issue with different labs. Lovely. I will definitely ask for a new test in a couple of months. Dr. Slayden was happier with the 2.54 as it is not indicative of PCOS, I on the other hand, like the idea of lots of baby making years ahead of me, as I will most likely need everyone.
• Endometriosis- My doctor as ACRM shrugged my endo questions aside explaining that most women have some degree of endo, and it won't change treatment unless it is grade 3 or worse. She didn't feel that I had stage 3 or higher, therefore, no laparoscopy. Dr. Slayden disagreed, saying even stage 1 can affect pregnancy rates. He is curious about endo, but doesn't think it's a sure thing. He didn't see anything on the ultrasound and I was "smooth" as far as the pelvic exam went. He wants to run some blood work and discuss endo further in a month or so.

Despite the confusion, we both L-O-V-E Dr. Slayden. He was soooo nice, very talkative, extremely knowledgable, and he really thought outside of the box. He also listened to all of my thoughts, and appreciated my overly anal, borderline OCD display of medical records, BBT charts, and TTC timeline. I love being appreciated.

So, what is Dr. Slayden's plan of action? Well, run a whole bunch of other tests for starters. Another pint of my blood was lifted today. Yeesh! I'm on my period and I'm already anemic. He wants to test for chlamydia. Yep, you heard me. More specifically he wants to see my antibody levels in regards to the bacteria. The bacteria can apparently cause issues in the tubes whether the bacteria was obtained via sex or breathing. Didn't know you could get chlamydia that way? Me neither. He also wants to look at my CA125. As far as I can tell, this is to see if I might have endometriosis, or if further testing is worthwhile. And because it wouldn't be right to skip over PCOS, we are going to run more labs to hopefully confirm once and for all that I do or do not have PCOS.

We've unanimously decided to go with Dr. Slayden for the time being. I say for the time being because, obviously, we reserve the right to change our minds, but if we do actually get to the IVF point, we might revisit Dr. Massey for his 40% discount. Or we might say "screw US healthcare" and go abroad for a vacation plus IVF for the same cost. Time will tell.

So, December looks a lot like a medicated cycle for the Greavu's. We have A LOT of appointments. Sam is seeing a urologist for a few more tests (more on this later) and I am going to be monitored off meds. Dr. Slayden wants to see what I can accomplish on my own. Hopefully, after this cycle, we will have gained greater insight into what the heck is going on and have a clearer plan forward. Because the one thing that all three doctors do actually agree on is this:

I should be pregnant by now.

Well doctors, we couldn't agree more. So lets get this show on the road.

Valley of the Shadow of Death

Confession time: I'm scared to die. Not particularly the after part, I mean sure I have questions like: "will I wake up in Heaven, or will there be 'down time?'", but I feel pretty confident that I know what the after is all about. It's the act of dying that scares me. I often feel really guilty about this. Christians are supposed to be confident, right? Have the attitude of "If I die today, I'll meet Jesus, so I'm okay with that." I don't feel that way at all. I want a nice, loooooong life and then to unknowingly go in my sleep.

I remember telling a friend that I plan on living to 100, his reaction was so adverse to the idea. I was shocked and then felt guilty. He basically told me that there is nothing here on earth that would make him want to stay so bad as to suffer in later years; he's rather go Home. I want to go to Heaven too, don't get me wrong, I just want to skip the dying part.

I haaaaate when other people die too. Since I was a very little girl, death has profoundly affected me. I don't like for anything to die… not people, not animals, not plants, yes I said plants. I always feel guilty about digging something up if I don't intend to replant it. Who am I to say what lives and dies? My mom was also planning to live to 100, but then I realized that if we both live to be 100, I'd be 29 years without her. I'm not okay with that. So I've decided (for her) that she must live to be 129 years, 5 days old; we'll go together. Sam can go at 99 years, 361 days.

In my 27 year life, I've been very fortunate. Very few loved ones have passed. Instead of being thankful, I'm just frustrated that anyone had to go at all. My great-grandfather died when I was 8 years old. When I was 13, a friend in my grade died from complications with pneumonia. This was the first time that it really hit me, I might not live to 100 (or 94 like Grandaddy). When I was 16, my grandmother passed away. This one really affected me. I'm still so scarred by the final days of her life. She was terrified to die. They say she made her peace at the very end, but I wasn't there to witness it. She was one of my favorite people in the world (and I hers), and to see her so scared, but literally unable to give her peace or will her to live; it was awful. When I was 23 my cat Soo Ming died. I'd had her since I was 8 years old. I was literally tormented. I cried every day for over a month. I will still cry today if I think about her. When I was 24, just days before our wedding, Sam's cousin's son died at 19. It was horrible, and shocking, and heartbreaking. And now, at 27 Sam's aunt has passed from stage 4 breast cancer at 45.

Last night was the visitation for Kelly. I did pretty well, but I managed to only hug like two people (hugs=tears). I feel so guilty. Here is her husband telling everyone that he talks to (which was hundreds of people) that he's at peace, that he's happy for her, and if I hug him, I know I'll lose it. I'm not at peace, not at all. I get the argument that she's not in pain anymore, and that is wonderful, truly. But she was 45, she's not supposed to die. She's not supposed to be diagnosed with stage 4 breast cancer that has metastasized to her lymph nodes and spread throughout her body at 40. She beat this once, and was "cancer free". It's not supposed to come back and kill her. That's what doctors are there for.  To find it first and beat it back before it takes a grip again. But that's not how it happened. Kelly passed away less than two weeks after starting chemo again. I'm not at peace, I'm angry.

This death is particularly painful to me as Kelly and I shared a lot in common. Kelly married into Sam's family the same as I. Family dynamics can always be interesting with the "other" side. When Kelly was diagnosed with breast cancer in 2008, I walked the Breast Cancer 3-Day in support of her that year. I don't think I ever saw her, her husband, or her mom that they didn't thank me. I always thought I would do it again one day, when she was strong enough to walk 60 miles herself. Maybe I'll go with her husband one day. But more recently, Kelly and I have shared even more. Kelly and Mark battled infertility. In fact they were unexplained, the same as us, and tried the exact same course of action. They made it all the way to IVF, hoping for a few frozen cycles because they decided that one round was it. Sadly, IVF failed and there were no successful frozen embryos. Heartbreaking. They spent all of their money on IVF, and felt that they could not adopt after that. They lived childless.

I see Kelly, see Kelly's incredible legacy, the hundreds of people who loved her, who were touched by her, ministered to by her, inspired by her, led to salvation by her, and I know I should think, "if only I could be like her". But if I'm honest, I'm terrified of my story turning out like Kelly's. It's literally my worst nightmares all rolled into one. To fail at childbearing, to get cancer, to die while suffering, to die too young, to leave my husband all alone, Literally nightmares.

Today, Kelly's family and friends will lay her to rest. And 99% percent of them will be at peace, simply thankful for the life she lived. I will be bitter asking God why, why she couldn't have just one little child to love on, why she had to suffer from such a terrible disease, why she had to go so young. I think God would say that Kelly lived her life in such a way, that she fulfilled parts of His plan. People came to know Him because of her testimony, and to Kelly that was enough. And here I am saying, "write me another part". Guilty. May I come to want to be a part of His plan so much, that I would willing walk through the valley of the shadow of death.

An Apple a Day...

I love apples. Honeycrisp are my absolute favorite. I could literally eat them everyday. But they're supposed to keep the doctor away, right? Then why am I fully booked for the next few months with doctors?

Appointment rounds 2 and 3 occurred today. Round 2 was with a low cost IVF clinic in Atlanta. I know what you're thinking... sketchville, right? Well there are some definite shortcuts, and I'm not sure yet how they might affect quality of care. The doctors rent hospital space to perform the IVF procedures. That's apparently the biggest cost savings. Other things I noticed: there is no full time receptionist. Most of the time, it appears you leave a message and someone calls back. Second point of interest was the ultrasound machine. It's portable. Huh? The monitor part basically looks like a laptop. Sam assured me it was legit.

I bring up the ultrasound machine only because there was some frustrating information gleaned from it. The doctor immediately sees something and exclaims, "how interesting". I'm so sick of people all up in my space exclaiming over interesting things about my who-haa. Anyway, I digress. Apparently I have a "large uterus". Does this mean I can fit more than one baby more easily than most? Because multiples is starting to sound better and better. (Don't tell Sam) Even more crazy was that I have a fibroid! What?!?!?? I've had about a million ultrasounds in the last 3 months and NO ONE has said ANYTHING.

So now I'm in a dilemma. Do I believe this old guy, who well, is old, but also crazy experienced and has a resume a mile long with his ultrasound machine/tough book? Or do I believe all of the other doctors? Believe that they would have said something if it was there?

New doctor, the old guy, he's precious by the way, wants to do a saline infusion sonogram. He wants to see exactly where the fibroid is attached. If its a problem with implantation, then I get to have a laparoscopy to have it removed. Yay?

As you can imagine, I'm confused. Where did this come from? Why is this the first I'm hearing of it? Is it really there? Is this "the answer"? Was it this simple all along? I won't jump there, I'll let my mom run down that rabbit hole. But wow! Talk about shocking news.

Before I call my RE at my current clinic, ACRM, and freak out, I'm going to wait for next Monday. I have another appointment (3rd IVF consult). It's a new doctor and they said to expect a physical exam. I'll make sure to ask, "do you see any polyps, fibroids, cysts? Anything I should know about?" Depending on what he says, I'll have to make some decisions.

Ultimately, today was confusing. About half of what my current RE has said, this guy disagreed with. He wouldn't put me on progesterone; he thinks my numbers are fine. He doesn't think the tests recommended to us are worth the money. He's not in a rush to move on to IVF. He was very concerned that I might have a missed PCOS diagnosis (here we go again). I asked why and he said my AMH was high, really high. 5.4 is apparently either a gift straight from God or an indication I have PCOS. He was going to refer me for some insulin test, but then during the exam, he did a good once over my face, INCLUDING a chin rub! Geez old man! I apparently passed his PCOS test because he dropped it after finding the fibroid.

It's becoming more and more clear that infertility has some murky waters to wade through. The doctors don't see it as black and white, and that's frustrating. Especially when it seems like it will probably take exact science, exact proportions, exact combinations to yield a baby. I sure would like to get a miracle and not need them anymore. They are all so frustrating!

The Fear Factor

So I just read Emily's blog: she's facing a second miscarriage. Trisha is dealing with her fourth loss. A friend from high school emailed me this week: she's recovering from her third miscarriage. As I read other blogs, hear other stories, I'm realizing something, something awful. You know that statistic that doctors quote at you after a miscarriage, the 20% of all pregnancies end in miscarriage stat? Well, I'm beginning to realize that infertile couples carry the brunt of that load. I know this shouldn't be a revolutionary idea, no lightbulb moment involved. But I'll be honest, it never dawned on me until I started talking to other infertiles, hearing other stories of heartbreak that I might experience the loss again. I guess the odds seemed with me somehow, and a second loss seemed to cruel. Spread the wealth, right?

As I realize that my chances for miscarriage are even greater simply because we are an infertile couple, simply because we have experienced a loss before, I am gripped with fear. Am I strong enough to survive that kind of heart ripping, soul shredding loss again? I was a real mess for a while after that dreaded phone call. And I was in a MUCH better place emotionally, physically, spiritually then, after only 3 months of trying, than I am now, 16 months later. So many women are recovering from their fourth, fifth, or even 6th miscarriage. They are all so strong. I don't know if I am that strong.

I guess I'm willing to risk it. I'm not on birth control, we aren't using condoms, and we are discussing IVF. And I guess, yes, I am willing to risk it. I'd walk through fire to bring a baby home. But what kind of woman will I be on the other side? Will I be refined by the flame or scorched and scarred?

Flustered, Frustrated, Furious

Well, IVF appointment round 1 was a DISASTER! Ughhhhh! What an afternoon/evening! I told Sam on the way to the appointment that I felt out of sync. The time since finding out about the failed IUI has just allowed my brain to become mush. Instead of feeling engaged and active, I felt benched and out of the loop. I had made an extensive list of questions as always, but still not very confident.

And then the insanity ensued. We were concerned about Atlanta traffic at 5:30, so we left pretty early. Traffic was actually great, so we got there with 45 minutes to spare. Sam wanted to get a coffee. I was hesitant, but figured we could go 3 miles and back in that time even in traffic. We grabbed some Starbucks, but when we tried to leave, the car wouldn't shift from park. Ahhhhhh! This has happened before, for brief moments, but it always works after a few tries. Alas, not this time. We were stuck for 25 minutes trying to switch gears and reading what to do online. Nightmare! To make matters worse, my appointment was technically after hours, so I couldn't call and explain. We did actually make it to the office (10 minutes late), but needless to say, I was flustered.

The appointment started off horribly. She began with "I think we should take a break." Huh? She said she figured we weren't financially prepared to do IVF (true) and that was that. End of consultation. I think that was the entirety of what she had prepared. Obviously, I got my questions out, and she graciously answered, but I felt like she was half answering and dodging questions the whole time. It almost seemed like she thought the consult was a waste of time since we aren't financially ready to move on.

Basically, we concluded that IVF costs $12,500 per cycle or $25,000 for 2 fresh and 2 frozen (no refund if it fails, no refund if you get lucky round 1) or $30,000ish for 3 fresh and 3 frozen with 70% refunded if you don't take home a baby, but NO refund if you get pregnant round 1 (or 2). Well thank you for the bargain! Cue the frustration!

I get that this is expensive stuff! I really do. But I feel like I'm being taken advantage of. The more we talked (and the more I read after) the more I got the feeling that this is a well oiled money making machine. If your cycle gets cancelled after your baseline, but before you start monitoring, you will be refunded 90%. Sounds great, right? Until you realize that your baseline ultrasound and blood work costs $1200! WHAT!!!!! My baseline has been $485 and that's one of the most expensive I've heard of.

I read somewhere online that Atlanta is one of the most expensive cities in the country (if not THE most expensive) for IVF procedures. I'm starting to believe it. Keep in mind that the $12,500 does not include meds or additional procedures like ICSI or assisted hatching. Ahhhhhh!

When Sam and I left, we were both bummed. It wasn't a very informative or helpful consultation. The more we talked the more furious I became. My doctor talked about people going into life-long debt, taking out home equity loans, medical loans, credit card loans, like it was nothing. It was so cold, so clinical. So matter of fact. Now I get that she has to make money. Believe me, the husband and I understand college loans, particularly the med school variety. She'll probably be paying for her student loans forever, but really, have a heart.

I remember being little and my dad (a dentist) would be soooo upset over his patient's financial conditions. He would do "favors" and work for free all the time. All the time. And my dad isn't even all that nice. But he earnestly cared about his patients and couldn't handle the idea that a patient would want treatment, but couldn't have it, based on finances. I'm not looking for a freebie, but lets be reasonable. I'm not here to personally finance your monthly mortgage, car, and student loan payments.

The real FURIOUS part came as we discussed all the times we've spent hours fighting for refunds from them. Currently, we are fighting a $120 bill (that my insurance already paid) and for a $500 refund for bills that my insurance covered after the fact. I feel like I have to suit up for war to deal with their finance people. Zero customer service available. Shouldn't they be groveling at my feet to win the chance to perform IVF on me. If you want $12,500+ from me, at least graciously handle my small potatoes (to you) refunds.

Hopefully, the other appointments will go better. We go to a "low-cost" clinic on Monday. I have no idea how that will turn out, but we felt like it was certainly worth an hour of our time to learn about all our options. And at the very least, kudos to those doctors for giving a darn.

Choose Hope

When Life meets Reality:

Choose Hope

You may remember in a previous post that I talked about how my emotional status seems to be cloudy with a forecast for more cloudiness. This chain of thought was brought to fruition because of a series my church was doing called Climate Change. Well don't you know, three weeks later, the last message was just for me. I'd really encourage you to listen to the message. I think it speaks to EVERYONE, but it really, really speaks to most infertiles. And the good news is you don't have to be religious, or know where you stand on the Bible: it's just a great message about what to do and how to handle life when your expectations aren't met.

The message discusses a kind of chain of events. Let me diagram this for you:

Expectations

I

I

V

Suffering

I

I

V

Perseverance

I

I

V

Character

I

I

V

Hope

The idea here is that no matter how happy or optimistic, no matter how bubbly your personality is, there will be seasons of your life where your expectations are not met as to how your life should go, and in those seasons, our natural inclination is for our emotional climate to look like a bunch of storm clouds. I don't know about you, but I'm in a season of unmet expectations right not. The way I thought my storybook life would unfold is just not reading quite right. We seem to be stuck on page six, and I want to get to "and they lived happily ever after". As I said before, my emotional state is pretty much cloudy all the time. Sure the sun breaks through, but in the quiet of the day, I'm not radiant, I'm not filled with hope, I'm sad, I'm wishing for more. 

Jeff, the speaker, says that when life happens, and expectations aren't met, the storm clouds roll in over your heart and push hope out. Our heart gets sick, an unhealthy emotional climate is created, and we become Debbie Downer. I don't know about you, but I'm often Debbie Downer. I think it's partially just my nature, partially that I'm just sad, and partially that I'm in a place in my live where good things aren't happening. I'm in a place where my millions of prayers aren't being answered. I'm in a place where I feel like it's probably better if I don't pray for others, because they are more likely to be healed, fixed, forgiven if I don't add my two cents. Debbie Downer, right?

So what's the solution? What do we do when our expectations aren't met? When life knocks us down? Apparently, it's several steps, but in the midst of our suffering, we persevere. I think infertiles have MASTERED this step. I don't know if I've ever met another group of people who get knocked down as often or as frequently, and yet CD1, while a crushing blow, is also another chance, and we pull ourselves up, haul ourselves to the pharmacy, or doctor, or acupuncturist, and start all over again… that's perseverance. 

I'm currently under the "suffering" category. An incredibly interesting point that Jeff brought up is that we don't like to think God is forcing us to walk though suffering because we don't see suffering as a blessing. Ohhhhh, this is so me. I keep asking God to get me out of here and I don't want to think that maybe it's God who is making me walk this journey. But maybe, just maybe, He's trying to build His character in me, and give me hope. Maybe He's asking me to trust His ways and walk through the suffering to the other side. 

The message explains that the leap from perseverance to character is a "then God" moment. These are the places that God shows up. I love the idea that through this I might gain more of His character, that I might look more like Him on the other side. But man oh man, am I far, far away from having any character in this, let alone His. I pray I learn fast because otherwise, I might be here for awhile. And having hope, real true hope, even in the darkest moments? Yea, I'm a long way from that.

I mentioned before that I'm wishing one of the many doctors I will be seeing starting this week can give me some hope. And I still feel that way. After three failed IUI's, I've become disillusioned with the medical world and their ability to solve our problems. My doctor never gave us odds for the success of the IUI procedure, but I felt like my OBGYN in Augusta and the RE in Atlanta felt like that would work for us. They have always talked like our infertility was minimal, like our problem was so small. It made me feel that despite reading hundreds of blogs and thousands of message boards where IUI failed, despite only knowing one success story when we started, I felt like it would work for us. We would be the lucky ones. Never once has my RE voiced any reason to suspect that there might be more going on, that we might not be "easy", that IUI might not work. My first appointment in this marathon of appointments is with my RE this Thursday. I'm 99% sure that I know what she'll say: there is no explanation for why IUI didn't work for us, but she would recommend moving onto IVF. But I want answers. I need more than "standard procedures". I want someone, whether it be my doctor or one of the other two we are seeing to offer some hope to make me believe that they have a plan, and a reason for that plan. 

But after listening to this message (for the third time), I'm thinking that maybe it's not the doctor's words that will give me hope, maybe it's walking through this wilderness, spending my forty days out here, maybe it's the journey that leads to real hope. I think the scariest part is knowing that my hope isn't supposed to be placed in eventually having a baby, but instead my hope is in the One who loves me and cares for me, whether that brings me a child or not.