Tuesday, June 28, 2011

One is the loneliest number

Last weekend it was time once again for my monitoring ultra sound.  If nothing else at least it feels like this cycle is passing quickly.  As usual, I started to feel nervous in the hours leading up to the scan.  I won't drag it out and leave you in suspense, the results were nothing new.  One single 19mm follicle on the left ovary and good uterine lining.  I think we have successfully established that this 50mg dose of Cl.omid just gets me up to operating at a "normal" level of one follicle with alternating ovaries.  Normal is great...if you haven't been working at this for over a year already and had hoped to be pregnant several cycles ago.  I think we've finally established that if we aren't successful this round that we'll be doing something different next cycle, though I'm not counting us out this time around.

I did have a brief infertile panic attack before my appointment.  My doctor's office calls my trigger shot and progesterone supplements into a small specialty pharmacy that has a location right above their office.  I don't typically use this pharmacy for other medications and I usually only stop by when I have an appointment at my RE's.  Since my Saturday monitoring appointment was the first time I was going to be at the office this cycle I figured I would make one stop and show up a few minutes early to pick up my prescription before my appointment.  So imagine my surprise when I walked up to the pharmacy to find the door locked, the lights turned off and a sign that read they were open Monday through Friday.  My heart started to race as fears that I had just ruined the cycle filled my head.  I sent an urgent text message to my father, a pharmacy manager at one of the big pharmacy chains, to see if they happened to regularly stock the meds...they don't.  It was an IF nightmare, following my protocol to a T and putting myself through 2 weeks of hormones only to drop the ball at the goal line.  Luckily my nurse saved the day as she remembered that the specialty pharmacy had a location a half hour away that was open until 12:30 on Saturdays.   With the clock ticking away, once my appointment was done I hustled to get across town before they closed.  I made it just in time and breathed a sigh of relief that I hadn't screwed up the rest of our cycle.  I guess I will be making a point to get to the pharmacy sooner the next time around...if there is a next time around.

In addition to my panic attack I did get a nice little surprise while sitting in the waiting room.  Dr Love was on call that day so I went to the appointment by myself, which wasn't anything new as I've attended most of the appointments alone.  In the midst of trying to solve my shot dilemma I received a text from Dr Love that he was on his way.  The senior residents were kind enough to cover the floor for a hour in order for Dr Love to be able to come.  Even though it was only for a short period of time I know we both appreciated the fact that he was able to be there.  He wants to be involved but like a lot of husbands whose wives are having fertility treatments, he struggles with feeling out of control of the situation.  He's not the one taking the medications, dealing with the side-effects, or having regular dates with Wanda (the vag cam).  The only thing he can do is be supportive and one of the ways he can do that is to come to my appointments but his schedule has made it difficult to do that.  He definitely paid for that hour off the rest of the day and evening as there was a never ending stream of patients/admits at the hospital once he returned.  Regardless I think he'd say it was worth it to be there with me.

Now we wait to see if we finally got that winning follicle.  At the very least I find comfort that if we don't, we will have a more aggressive approach next round.  Fingers crossed.  

Friday, June 24, 2011

They're Heerrree

The interns are here, the interns are here!  The welcoming activities are officially in full swing and I'm interested to see how everything all turns out. 

We kicked things off with a resident sponsored welcome dinner last Thursday that we almost didn't make it to.  In typical expect-the-unexpected medical fashion, Dr Love got pounded with a stream of hospital admits that afternoon which had him running all over the place in addition to his regular floor work and was thus 2 hours late leaving the hospital.  As a result he came home tired, a bit grumpy, we were both hungry and 2 hours late for the welcome dinner.  We pondered if it was really worth going to at that point (would anyone still be there?) and I made the point that if anyone would understand the impact a bad day at the hospital can have on your previously laid plans it would be this group.  Despite all my logic of why we should cut our losses and stay home, Dr Love's team player attitude won and we made the drive over to the resident's house hoping there would be food and people still there.  Considering only 2 of the interns RSVP'd that they were going to attend the dinner, I was pleasantly surprised to see that 6 out of the 9 came and were still there several hours in.  Hooray we didn't scare them off!  Though really only 1/3 of them RSVP'd?  Come on folks maybe I'm old fashion but I've always thought work related events warranted higher levels of etiquette.  Rant aside we did have a nice time chowing down on carb-a-licious food and chatting with everyone.  A number of the incoming interns had that deer in the headlights look that I remember well from last year as you're the new kid on the block surrounded by people you don't know (though you will soon see them more than your own family) and you're about to embark on a huge journey.

Saturday was a bitter sweet day as we attended the graduation ceremony for the current 3rd year residents (even though they are here through the end of the month).  I'm sad to see several of them go.  This group played a big role in recruiting us to come here.  They were the first ones we socialized with and came to know.  They're strong doctors and good leaders.  They've been a valuable asset to the program and I'm sad to see them go. 

With this changing of the guard comes LOTS of other changes as well.  During graduation one of the attendings noted that Dr Love's class will go down in history as the last "true" intern year.  As some of you know the restrictions on interns have undergone a major overhaul.  Recently the AC.GME (THE grand poobas of ALL the residency programs in the US) decided that interns are now limited to 16 hour shifts, which is down from the 30 hour limit that was previously in place.  I can only imagine how prospective interns across the country breathed a sigh of relief since 30 hour shifts are not fun but this change has further reaching implications, particularly the necessity for a night float system.  Since what previously was one shift has now been split into two, the rotations had to be reworked in order to implement a night shift (aka night float).  I already hate call nights where I have to spend the evening alone, now there's going to be a whole month where I won't see him in the evenings (or possible at all) 5 days a week.  SIDENOTE: I really hope we're either pregnant by the time night float comes, though I guess it could make scheduling an IUI easier since he'd be free during the day.  Ah the joys of trying to work life around the demands of medicine. END SIDENOTE.

In addition to the change in work hours, the AC.GME also decided that interns need "close supervision."  No big deal right, except that the powers that be with the family medicine association interpreted "close supervision" as recommended in room supervision for a time period to be decided by the residency programs.  This means that for a certain period of time an intern can not see a patient, do a simple history and physical, anything, without a senior resident or attending present.  In essence they need a babysitter.

The current residents joke about giving the interns backpack leashes or creating intern-bjorns and just carrying them around everywhere.  The administration has assured everyone that they are working on a solution to make this babysitting time as short as possible but so far there's been no word on how they plan to do that. 

So we have smashed 2 residents into 1 and split what used to be 1 shift into 2 which equals (if my math is correct) more work for everyone.  Buckle in cause this ride just got more interesting.  In the end I'm sure it will turn out fine (if it's not fine it's not the end) but in the mean time I fear things are going to be a bit messy. 

Monday, June 13, 2011

Strike 3

Cl.omid cycle  #3 and mega follie were not the one.  As usual Saturday's test was negative with one lonely line and Sunday AF made it official by storming in.  I wish I could say I handled it like a champ and that I have a cheery / hopeful outlook for what lies ahead.  I wish I could say that but right now I can't.

In preparation for the possibility that Saturday could be a bad day, Dr Love brainstormed a list of things we could do to get our minds off of the BFN and lift our spirits.  First up was a nice 11.5 mile bike ride.  We hit the pavement only to find that our path took us head first into the wind.  I don't know if you've ever rode into the wind but even a slight wind can make things difficult and a strong wind makes it feel like you're peddling through quicksand.  Maybe it was just the frame of mind I was in but as we rode I felt like it was metaphorical of what we are going through.  I wanted to move forward but the forces ahead were working against us.  We paused at the crossroads waiting for the road to clear and then I threw everything I had into moving forward.  My legs and chest burned and ached but I didn't want to stop.  I didn't want to give up and give in to the forces that were making the journey difficult to reach the end.  We reached what I had remembered being the last stretch and I was relieved to be near the end but as we continued down the stretch it didn't look like the end.  I felt the tears start to well up at the thought of having to go further; my body was exhausted and I didn't think I'd be able to go further if we had to.  Just then I saw the end of the path, we were there, we had made it.

Obviously we haven't hit the final stretch on this ride yet.  So far it seems we've only come up to a number of crossroads waiting to move forward and throw all we have physically and emotionally into making it through the wind beating against us and down the path hoping this will be the last stretch.  Currently I don't see the end in sight but I don't know how much more I have to give.

In light of the recent emotional struggles we've had, Dr Love and I decided that we need to utilize our support resources more.  "I see my wife holding on by a thin thread and circling closer to being clinically depressed," Dr Love said.  Even though I knew this, it was hard to hear him say it out loud.  As such we decided to let Dr. Love's family know about our IF struggle and treatment.  It's a relief to know we no longer have to hide from them and that they are in our corner to support us.  Since they have gone through this before with my sister in law they understand the pain, heartache, and discouragement that we're going through.

Today I spoke with my nurse to get the plan for the next round.  Since we have told them that we would not consider selective reduction in the case of 4 or more embryos, and given my "optimal response" there is no change in my medications or dosages, they think we just need more time.  I trust their opinion and I know they want to get us to our end goal of a healthy pregnancy but the prospect of "more time" brought tears to my eyes.

I know I will rediscover my faith and hope in this process but for now I'm just going through the motions, hanging by a thread, and peddling as hard as I can muster the strength to do so.

Friday, June 10, 2011


I'm apologize for being such a bad blogger lately.  Hopefully there are a few of you still around and not all my readers have left.  Truth be told I've felt a little like this recently....

Sad, down, blue, depressed.  I'd like to say it's due to the hormones but I think that would be a bit of a cop out as I've had these feelings, albeit in fluctuating levels, for some time now though they've recently hit a high (or perhaps more appropriately a low) point.  As such I've had a difficult time thinking of anything to write lately. 

Now some may say that it is understandable and even a bit expected to feel depressed from time to time when dealing with infertility but the root of it is more than just our infertility.  Sure that is part of it but that is not where my frustrations with my body end.  Like most women I have struggled with my weight since getting married and my condition plus the medications make the struggle increasingly difficult.  I eat well...most of the time, and I've made an effort to add regular exercise into my weeks which is where my body thwarts my worthy intentions yet again mainly in the form of persistent and unrelenting shins splints despite stretches and new shoes.  I have so many good things I want to do but my body just keeps saying no. 

In addition to my frustrations with my body I've grown increasingly dissatisfied with my job.  The subject matter in itself is steadily losing interest to me and the environment feels cold and detached which I find odd when there are only five of us.  This is my first time working for a small office and everything I had heard lead me to believe it would a tight cohesive environment full of teamwork where everyone looked out for each other.  After being here for almost 18 months I realize it is not, it's actually quite the opposite and feels very individualistic and impersonal.  I work hard but I feel as though most days it wouldn't matter if I showed up and thus it's getting harder to convince myself to do so.  The obvious answer here is to find something else but fact of the matter is I don't know what I would like to do which is probably due in part to the last aspect of my blue mood.

Aside from my marriage (which is still healthy and strong), I feel like I've lost sight of what makes me happy.  I haven't been inspired to do much cooking, photography, crafty projects or write.  The general joie de vivre has dimmed and I don't know how to get it back but I know that I do want it back.  I do want to be happy with myself and have my passions back in my life but I'm struggling to know how to light that spark again.

Lastly I'm a bit afraid of what the results of this last treatment cycle will bring as I'm not sure how I would take another BFN in my current emotional state.  I know I have to test to find out but I'm dreading it.  I'm dreading those long minutes where you wait to find out if the weeks of medications and appointments have been worth it.

So that's it.  That's where I'm at.  I wanted to let anyone still reading out there know I hadn't abandoned the blog and give some reason for the radio silence.  Let's face it blogging can be a cheap form of therapy too.

I'm crossing my fingers that I'll have much better news to share in a couple days.