Wednesday, March 23, 2011

The Status of Cycle 9

The results of today's baseline ultrasound / cyst check:

2 cysts greater than 30mm in size = no medication for ovulation induction this cycle.

In the process of stimulating the ovaries to grow follicles and produce an egg, the cysts would also be stimulated to grow and we don't want that. As a result we're on a forced rest cycle in hopes that they will come down in size and we'll check on them again next cycle. We can still try on our own in case by a slim chance my body does decide to ovulate on it's own for once but we can't use any medication to help it get there.

Dr. M believes that the first cyst we found on my follicle check last cycle is one of these two and that it has shrunk a bit but it didn't burst last week as we thought. He has suspicions that the other one may be the 12mm follicle we saw and instead of rupturing with the trigger shot it kept growing. Great. :(

The question about a Christmas baby has been most likely resolved.

We have a slim to none chance at a 2011 baby.

Our 1 year anniversary of trying to conceive will come and go.

The window for having 2 pregnancies during residency (which we had hoped to do to take advantage of our good maternity coverage) has been most likely slammed shut.

Needless to say, I'm bummed and I'm getting tired of being bummed.

I feel like we had to wait patiently to be even be able to try medication, due to my funky cycles interfering with timely completion of our testing, and we got 1 try before having to wait again.

I know I previously waffled on whether or not we would try this cycle, but I had made a decision on it that I felt good about. I was ready to go. Having that ability to chose taken away and instead having a break thrust upon me is frustrating.

I feel like everywhere I turn lately I run into road blocks of one kind or another and it's taken its toll. Usually I'm a fairly positive person, but I look back at the posts I've made on this blog and I see a lot of frustration and sadness. Now part of that is just the nature of this blog being an outlet for me and while it is cathartic for me it's not necessarily a fun read. I apologize for that and for the negativity, I hope to be able to have more positive and uplifting posts soon.

Tuesday, March 22, 2011


That's how you spell bust and the ending of our first Clomid cycle.

Our cycle started out full of hope and promise, and up until Sunday I believed we had a good shot at success. I had responded well to the medication with good follicles and endometrial lining. We had pretty good timing. I ovulated! We entered the dreaded two week wait and I felt positive that we had done it. We would have a little turkey in our family soon. I handled the first 8 days of the wait with ease as they seemed to fly by since I was more occupied with residency matters at the time. Then 9 days into the wait I started spotting, though I wasn't too worried about it given (TMI alert) the color and consistency. Dr Love even pointed out that it could be related to my cyst which we believe ruptured a week ago. Then everything turned on a dime.

I was still charting my basal body temp (BBT) this cycle and woke up Sunday morning to a temp drop that took my hopes with it. Dr Love came home from call to find a despondent wife trying to pull herself together. "It's not over," he said. "Temps don't tell everything." I wanted to believe him, truly I did. Aunt Flow, on the other hand, had other plans and came furiously storming in several hours later.

And that was the end of it. We (though really it's more me) had failed. There would be no little turkey coming to our home in November. Furthermore I didn't even make it to my test date and only lasted 11 days after my trigger, which is much too short. I'm left wondering what happened. Was my progesterone too low? Do I have some other kind of luteal phase defect? Were we successful but something wasn't right so my body halted any further development? Do I have rotten eggs? I know my mind is running away with me on the what ifs, and in the end the truth is we probably won't know and all we can do is look into it next round and adjust accordingly.

When we first started this cycle, I contemplated for a brief moment whether or not we would try again immediately after should we (in my RE's terms) "not reach our goal." Part of me had thought no, as we could potentially have a Christmas baby and I know kids hate having their birthday at Christmas. Now that I'm here, however, knowing that we may have other issues to address, and realizing that April will mark our 12th month of trying to conceive, I can't bring myself to throw away a cycle. If God wants us to have a Christmas baby, we'll have a Christmas baby.

So tomorrow I go to see Dr M. for an ultrasound cyst check and to learn the fate of this cycle. If things are clear, then we'll be a go for starting my next round of meds. If I have cysts that they're concerned about then we'll have to take a break from meds this cycle and that answers the Christmas dilemma on its own.

Only time will tell.

Sunday, March 20, 2011

The BIG Reveal

Thursday was officially dubbed St. Match-ricks Day as med students and residency programs around the country found out who their new intern class would be. For days they knew that they had matched but it wasn't until then that they learned the where.

We waited with baited breath for the list to come out. When the list finally showed up in my email from Dr. Love, I quickly scanned the pictures to see if I could find the husband of my interview crush. I looked and I looked, and he wasn't there. Then I noticed something interesting about the class....

Out of the 9 spots available, 7 were women.

We're a MD residency program, yet 5 of the interns are from DO schools.

One of the interns is in her 40's.

I realize that this is a very interesting class in terms of demographics and diversity. In the long run it could bring a different flavor to the program. Regardless my heart sank when I realized the people I was hoping for weren't there, and further more the 2 men are single. As a result, no new wives are coming.

I knew that the absence of spousal support had bothered me, but it wasn't until I saw that no new wives were coming that I realized how much it bothered me. The weight of loneliness that had been quietly growing was thrust into the forefront, crushing me under its weight. I buckled. I broke. It caught me by surprise.

I'm cognizant of the fact that all the hormones running through my body at the time probably are to blame for amplifying everything I was feeling. None the less, the absence of wives lit the fuse of an emotional dirty bomb that consumed me in a mushroom cloud of any frustrations I had felt recently.

Boom: I don't fit in at our residency program

Bang: I don't fit in with my friends

Crash: I don't fit in with the other women at church

Kablam: I don't fit in at work.

It is strange to feel so loved at home and yet feel out of place in so many other realms of my life. Maybe I'm being selfish and expecting too much.

I know this post sounds kind of depressing on a day that is so exciting and full of jubilation for many others. I'm sorry, really I am. I'll get there one day too as I've over the last few days I've tried to climb out of this hole and I'm just hoping for something to grab on to that will help get me over the top.

Tuesday, March 15, 2011

Match maker, match maker, make me a match

This is the week that fourth year medical students across the country have been waiting anxiously for. This week is THE MATCH!

For those unfamiliar with the process The Match is like speed dating for doctors and residency programs. In their fourth year, med students take a look at their options for residency programs, consider what specialty interests them and where they'd be willing to go. They submit their applications to programs and wait for an invitation to interview. During the fall interview season, students jet across the country to schmooze and check out the programs they were invited to interview with. There' s lots of hand shaking, questions, and food. Oh the free food! That truly was the best part of interview season. Months later after meeting everyone, asking all the questions, the med students make a rank list of programs in order of which they liked best.

Meanwhile the residency programs are doing the same thing. They've met with tons of students and as a group, the residents and faculty get together and rank who they liked best. Then the registry super computers crunch the numbers through various algorithms and match up the students and programs. For example, if Joe Schmoe Med Student ranked Residency Program A as his number 1 choice, and Residency Program A ranked Joe Schmoe as one of their top X (depending on the number of spots they have to fill) choices, Joe Schmoe and Residency Program A are matched together and sent off for 3-4 years of residency bliss.

{you like me, you really like me}

Now if Residency Program A had not ranked Joe Schmoe, the computer would look at his second choice, Residency Program B and see where they ranked him to see if there is a match. And so on and so forth until Joe Schmoe is matched up with a program. The process can get quite complicated but it is intended to try to find the best possible fit between students and programs. After all if you're committing to someone for 3-4 years it behooves both parties to make sure it's a good fit.

If the student does not match with any of their ranked programs, OR if a program does not fill all of their spots, they go to the SCRAMBLE, which isn't nearly as delicious as it sounds.

It would be more appropriate to call it PANIC TIME, but that could scare people off. Basically they go back to the pool of remaining programs / students and try to find someone, anyone, to take them in. It is the desperate equivalent to 3am last call at the bar where you're just hoping you don't end up alone (Or so I imagine. I don't actually have first hand experience of last call).

This time last year Dr. Love and I were sitting on pins and needles waiting to find out if and where he had matched. I feel so very blessed that he ended up matching at his number 1 choice. I'm still so proud of him for that.

It still feels so strange to be on the other side of the table in the match process. Not long ago we were waiting to find out where we were going, now we're waiting to find out who is coming. Luckily our program filled all of their 9 spots and didn't have to go to the scramble. I will admit there is at least one, maybe two people that I'm hoping we'll get as I really liked the wife.

When I originally imagined what it would be like to be a wife of a resident, I had dreams that I would be hanging out with other residents' wives. I imagined we'd keep each other company while our husbands were away on call, we'd have book clubs, we'd dish about the trials of residency over lunch, or go out for pedicures. I thought I'd have a new group of girlfriends that understand what this is like and we could support each other. Like most things, it hasn't quite turned out the way I'd imagined.

In Dr. Love's intern class we are the only married couple; a few of the other interns have girlfriends but they're either out of state or not interested in hanging out. Within all of the residents, Dr. Love is one of four that is L.D.S., thus as a result we don't do the same recreational activities that the other residents do (i.e. drinking and going to clubs). Out of all the married couples there is only one other couple that does not have kids and that's predominantly because they're newlyweds and she's finishing up med school in another state.

So while I LOVE his intern class, and I LOVE his senior residents, and I LOVE the program, I feel like I don't quite fit in. The spousal support isn't quite there and I feel kind of alone; hopefully some fresh blood will help that.

Monday, March 14, 2011

I'm Coming Out, I Want the World to Know....

Ok maybe not the whole world but at least my immediate family. Last Sunday while at my parents' house for dinner, we told my family about our struggles and the fact that we are working with a RE. When we first started with Dr. M I didn't say anything as there really wasn't any news to tell. I felt the same after all of our testing came back clear and that it appears it's only my old hormone problems that are the source of our problems. I knew it would just be a matter of time before either A) they asked, or B) something happened that I wanted to fill them in on.

After our follicle check showed a nice sized cyst, I figured it was time. In the event that the worst case scenario happens and the cyst bursts requiring a trip to the emergency room, I knew I wouldn't not be able to keep that a secret. The next obvious question would then be how did Residency Widow get a cyst in the first place? The spiral of information from that would inevitably lead to discussion of our reproductive efforts. So in an effort to squash the potential for hurt feelings and have the chance to reveal the information on my own terms, I decided Sunday would be THE day.

Regardless it's not the easiest subject to bring up. Rarely does normal dinner conversation lend itself to a discussion of one's reproductive organs. "Please pass the gravy, and oh by the way my ovaries suck," just isn't my style. So I waited for a good window.

Window #1: Mom's family's history of health problems

During dinner we got a surprise call that my uncle was being admitted to the hospital for heart surgery. After the initial shock we got talking about all the family's healthy history. "Perfect chance," I thought. Right as I was getting ready to blurt, "guess you can add infertility to that list," the phone rang and the moment was gone.

Window #2: Grandma skills

We took our dog Buster with us and he always gets spoiled by my Mom with doggy treats. Buster LOVES it and subsequently Buster LOVES my mom. Dr Love and I were teasing her about it and she said, "I'm just practicing my grandma skills." That would be great....except Dad had left the room moments earlier to help my brother with something. This was a discussion I wanted to have with both of them.

Window #3: Baby bonanza

When my dad came back some how the discussion took a turn towards the number of people we knew who were pregnant or recently had babies. But again just as the words were about to spill from my mouth, the topic shifted and rolled in another direction.

So after all those windows of opportunity, I decided I had to make my own window.

Window #4: Buster's bump

Occasionally Buster gets a little bump on his thigh. I noticed it again at my parents' house and brought it up to Dr Love. "Dogs can get little cysts just like humans. I wouldn't worry much about it," said my Dad.

"Guess who else has a cyst?" I blurted.

Yep I used the discussion of a cyst on my dog to bring up our struggles to conceive.

S-M-O-O-T-H-E is how you spell my middle name.

Overall the discussion that followed my awkward ice breaker went well. After giving them the full run down my dad's first question was to ask if we needed help with the treatments. Not in a "are you asking for money?" kind of way, but instead it was a caring "I can't do much to help other than offer financial help," kind of way.

Mom seemed to be a bit surprised of the stage we were in but not surprised that we were having trouble, given her knowledge of my history. "When we didn't hear anything for a while I kind of wondered if something was up, but wasn't going to push about it unless you guys brought it up."

So the cat's slowly creeping out of the bag and I think in the long run I'll be happier for it.

Wednesday, March 9, 2011

Hit me with your best shot!

Yesterday was trigger day! Hooray for ovulation! Boo to getting a shot.

I've read a number of other women's accounts of their experience with the HcG shot. I knew it wouldn't be a big deal. I knew it was a small needle. I knew it would be over quick. I knew I'd have Dr. Love do it, after all we might as well get all the use out of his medical knowledge that we can. Still when the time came to actually do the shot I got nervous. I mean we're puncturing my skin and injecting foreign substances into me.

"Our niece does this every day with her insulin," Dr Love assured me. Yet somehow knowing that my 11 year old niece could handle needles better than I could didn't help. Heaven help me if this shouldn't work and I need to move onto injectables at some point or end up with diabetes one day.

I walked Dr Love through each step of preparing the injection that was listed on my instruction sheet. I realize this was probably more for my benefit than his as I'm sure he already knew how to draw up the liquid and inject it into the powder vial.

I tell myself that if I had to I could have done this all on my own. I'll admit though that it was nice to just lay back, close my eyes and let Dr Love handle it. Today the injection site is a little bit tender but if it works it will be worth it. Now the countdown begins to see if this medicated cycle worked and will be our one and only. 16 days to go!

Monday, March 7, 2011

Check 1, 2, 3, Check

Yesterday morning I went in for my cycle day 14 ultrasound to monitor the effects of the Clomid. Ever since I started taking my meds I've been eagerly awaiting this day. Much like Goldilocks and the Three Bears I've wanted to know if I'm overstimulating (too hot), not responding at all (too cold), or responding just right.

I'm happy to say that the ultrasound went well and it looks like the state of my ovaries and uterine lining are just right. I have a 19mm follicle on the right, and a 17mm on the left. For good ovulation they want to see follicles over 21mm. At the rate they're growing, those two should definitely be ready to go this week when I trigger ovulation with a shot of HcG and then there's another 12mm on the left that MAY catch up in time but I doubt it. So that's 2, maybe 3, chances at getting pregnant this cycle.

In addition to the good follicles we also found a 3cm hemogenic cyst (that's about the size of a ping pong ball) that has come out of no where in the last couple weeks as it wasn't on my baseline ultrasound. That has me a little nervous but Dr M said it won't interfere in our other plans, we'll just need to keep an eye on it. I'm holding out hope that the cyst will resolve on it's own without rupturing.

All in all I feel very relieved and hopeful after yesterday's appointment. I'm glad that we made the decision to go with a RE in our treatment so that we could know what was going on and direct our course of action and expectations accordingly. Now lets go Turkey hunting!

Friday, March 4, 2011

Let's give them somethin' to talk about...

Tonight Dr. Love is on call at the hospital. Not wanting to spend another weekend at home by myself, like I did all last weekend as I was sick, I decided to get together with my dear friend MK. MK and I have known each other as part of a larger group of girlfriends for over 13 years. Even though we have all gone our separate ways and can go years without seeing each other, it's that kind of friendship that when we do get together we pick up right where we left off. I count these girls as some of my closest friends and the nearest thing I have to sisters. We've watched each other grow up, have heart break, get married, and become parents. Together we've gone from silly teenagers to responsible adults. I know if I ever needed anything I could depend on any of them.

Recently, however, I have felt like I'm on the outskirts of the group. I was the last one of the group to get married, and likewise I am also the only one without kids. This outsider feeling has become even more apparent during a recent gathering of our group where I felt like I had very little to contribute to the discussions at hand. While most of the talk revolved around stories of junior/juniorette, I have my dog and a job that doesn't offer much to discuss. Processing bills and researching lot counts isn't very interesting to a group dealing with childhood development, sleeping through the night, and school. Heck most days it isn't very interesting to me and I'm the one doing it.

During tonight's girl's night out, MK and I got talking about how I was feeling in relation to our group. MK responded, "well you have to give us something to talk about." In her blunt way I know she is right, but I don't know what to do.

"Get a hobby," she suggested. I have hobbies but I don't have a lot of time to devote to them. I work all day, Monday through Friday, come home, make dinner for Dr. Love and I, spend a little time with him and then it's time to go to bed. Saturday is busy getting caught up with all the essential to-do's that I can't get to during the week. Then Sunday is church and a bit of rest to get refreshed for the next week.

"Quit your job for something you love," MK commented. I'm not sure I can bring myself to do this. I've worked since I was 16 and seeing as I want to be a stay at home mom, I feel like now it's my responsibility to contribute as much as I can to our financial stability.

In the end I know MK is right and I'm left pondering what I can do or change to bring some sort of excitement / interest back into my every day life and kick me out of my rut. Our next big gathering is a couple months out so I guess I better get cracking.