Monday, April 16, 2012

A New Frontier in a Familiar Setting

It's amazing how far I've come since my last IVF cycle, and subsequent loss mid-January. I continue to meet with my Chakra Balancer/Energy Healer/Life Coach (and he is all of that and more) every other week, and have been consistently feeling not only more grounded and balanced, but also more bouyant, light, and cheerful than I have in years.  Things that would normally keep me stewing for days or weeks suddenly roll off my shoulders in a matter of hours, or worst case, a day.  I know this sounds corny, but find myself appreciating things like the beautiful blooms on the trees in a way that I haven't in years.  I've been getting outside to exercise much more, taking long walks in my neighborhood in the evenings; inhaling the crisp air and letting it wash through me - being present.  I certainly don't want to give the impression that I have turned into a Pollyannaesque robot, I still feel every emotion, the negative as well as the positive, but the negative doesn't seem to linger as long, and the positive lingers much longer than it had been.  The joy that I have been able to harness these last couple of months has allowed me to appreciate what I have so much more than I had been, and it feels wonderful to be able to do that.

About a month or so into my energy healing work, I began to feel that I was ready to begin working with R to take the next step forward in adding to our family.  We met with my RE in February, and the conversation went just as we expected - this cycle was not pretty, and it was less pretty than the one we did the prior year - it's pretty aparent that doing another IVF cycle with my eggs is very unlikely to produce a different outcome.  The early miscarriage indicates an egg quality issue, and the poor embryo quality really predicted that.  She recommended moving to donor egg or adoption as our next step.  R and I had been talking about our options if we decided to move to DE, we felt that it would be wise for us to leave GW and move back to Shady Grove Fertilty Center, the place where we first began our journey. We knew that they had a pretty big donor progam and had some shared risk and financing options.  Although our outcome with IVF was not positive there, we really did love our RE, and agreed that we would be comfortable returning if need be.  We talked about this with our RE at GW; she agreed that their donor program is much smaller and does not offer the same shared risk or shared donor options that we could find at SGFC.  She was very supportive of a potential move for us, and that made us feel good. 

I soon learned one of the reasons why my RE was so supportive of a potential move for us.  I am not sure if I mentioned that she and I shared a connection - I worked very closely with her husband, who was the Chief Medical Officer of the health care system that I work for.  I knew my RE before I knew him - as I was seeing her before I started my current job.  But this connection made the bond I had with her even stronger, and I had a relationship with her that gave me much greater access to her than her other patients had.  I found out two days after our WTF appointment that my RE's husband took an incredible job in St. Louis - which means my RE is moving too.  This information made our decision much easier, we soon made an appointment with our old RE (Dr. C) back at SGFC.

I won't go into too much detail about our appointment, I thought it was going to be difficult to walk back into that office, but it really felt like a new beginning.  Dr. C remembered us and was thrilled to learn that we had a beautiful, healthy 2 year old - conceived miraculously on our own, after so many failures.  He looked at our records and agreed that we were perfect candidates for their donor program (really, what was he going to say? After 7 IVF's, I think you should go for another?), and gave us an overview of their program.  Of course their stats and beautiful charts impressed us, just as their IVF stats did back in 2006 - so I had to check my emotions and remember that not every DE recipient is created equal, just like not every IVF patient is created equal.  But we did come away from our appointment with a sense of hope that we hadn't felt in awhile.  We even learned about the great shared risk and shared donor options that would help make the process more economical, although we did agree that we'd need to finance a large portion of it, which was a bit scary at first. The best news of all, was that we were able to bypass all of the preliminary testing that patients need to undergo before starting the process, as we had completed all of them prior to our most recent IVF cycle (including the dreaded HSG).  We were able to proceed directly to the mock cycle, the step immediately prior to selecting a donor.

The next several weeks were filled with introductions to my donor team, and starting the mock cycle, which consisted of taking estrogen injections in order to build up my uterine lining.  After 2 weeks of injections, I went in for bloodwork and ultrasound, where I learned that my lining responded really well to the injections, and I was given the all clear to move ahead.  We couldn't have been more thrilled - in theory, this means that if the right embryo is placed into my uterus, it will implant.  We all know that everything always looks great on paper, so who knows what will really happen, but it definitely was encouraging news.

Today we received the access code that DE patients receive in order to access the donor database.  There are currently only a few donoros who are slated as 1:3 donors - one donor to 3 recipients, which we have decided to do.  We took a look at the database and weren't blown away by anyone just yet - I guess I thought I would go onto the database and we'd fall in love with someone immediately and want to select right away, but clearly that is not how it's going to work, and that is o.k.  We want to take our time and make sure we are comfortable with whomever we select.  It's definitely an interesting process - the donors provide baby pictures, some also provide adult pictures, and they complete an extensive survey about their family, medical, social and educational histories.  I think this will be just like everything else - we'll know when it's right, even if we have to wait a few weeks until the right donor is available.

I do plan on posting more often as we get further into the process, there are so many details that we have to get through once we pick a donor.  With a 1:3 match a lot of coordinating has to take place, and depending on your "position" as a recipient, there is a chance your cycle could get cancelled if the donor doesn't produce enough quality eggs.  One donor and 3 recipients means coordinating 4 womens' cycles, which I'm told is not as complicated (or as lengthy of a process) as it seems to me.  One thing is for certain - we know we need to be patient, as this new frontier could lead us through some bumpy terrain, but hopefully will ultimately lead us to our new little bundle.

Sunday, March 4, 2012

Finding Me Again

On this night 23 years ago, I was a bright eyed, innocent 13 year old, who had just achieved a milestone that most Jewish young girls strive to attain - a Bat Mitzvah.  On the evening of March 4, 1989, I was surrounded by a slew of family, my parents' friends, and at least 50 friends of my own, at the party that my parents planned for 2 years, and one that went down as one of the most memorable among my circle.  My father always liked to do things big, he spared no expense to throw a party that would provide an original theme, the best food, the best band...a wedding 13 years in the making.  I look back at that night, thinking of how vibrant my parents were, how my beautiful baby brother (2 and a half years old at the time) was running around in his adorable tuxedo until he was wisked away by a babysitter for the evening, and how I was filled with a sense of innocence, and pride for what I had accomplished.  If I could only go back to that night and hold my family tight for just one moment, maybe it would help ease the ache in my heart for all that's been lost.

Aside from the nostalgia that I am feeling this evening, I have made some strides in the last month since I last posted.  I didn't have a lot to say for awhile, and just did what I could to move past the most recent IVF/loss.  Every day I went through the motions of getting out of bed, getting Smiley ready for school, going to work, picking her up, scraping some sort of dinner together, putting Smiley to bed, and collapsing on the couch.  I had zero energy, I felt heavy, downtrodden, sad.  R and I weren't connecting, I didn't want to talk to anyone about how I was feeling, including my therapist.  I was overwhelmed by what our next steps in our journey would be, and I started thinking about ending our journey for a second child completely. 

A couple of weeks after my beta, I got a call from a friend of mine who had lost her mom over the summer to an agressive form of leukemia, and has a daughter 2 weeks older than Smiley.  This friend had been struggling since the passing of her mom, and had fallen into a pretty deep depression.  She has also suffered a couple of miscarriages; the loss of our mothers is not the only thing we have in common, so I consider her a "safe" person that I can open up to.  My friend shared with me that as she hit her lowest point in October, she was introduced to the practice of Chakra Balancing, and had begun seeing a Master Chakra Balancer, through the Washington Institue of Natural Medicine.  The techniques this person uses are unconventional to Western physicians, and not always looked upon as valid.  But my friend shared how she went from being extremely depressed, to feeling rejeuvenated and alive again - so much so that her husband began treatments as well, and the two of them are in a place they haven't been since they first got married.  She encouraged me to go see this person (I'll call him "D") at least once, to see if this could be a process that would help me feel better, get my energy levels up, and put me in a place where I could be more clear headed in our "next step" decision making. 

I had my first session with D in early February; my friend came with me to lend some moral support (which I very much appreciated).  D is an unassuming, average sized man, who greeted me with a big smile.  This first session lasted an hour and a half, we spent much of the session talking about my life, talking about how D became a Chakra Master (he basically left a crazy life on Wall Street in search of spiritual peace..of which he found, and has been helping others achieve for 17 years), and the rest of the session I was laying on a massage table, having my Chakras evaluated by D, through various energy healing techniques.

I wish I could provide a detailed explanation of what the Chakra system is, but I confess that I am still really learning about it all, as I go through the process. I can refer you to this wikipedia article for a crash course in Chakras http://en.wikipedia.org/wiki/Chakra, but basically the Chakras are energy centers that act as "energy junctions" in the body.  There are 7 major Chakras in the body that are patterns of energy that correspond to a unique aspect of our being.   At the most basic level - if your Chakras are out of balance - you feel like crap.  Pure and simple.  A Chakra Balancer uses specific techniques to help "unblock" the energy flow to each Chakra, and help restore balance to the system.  I have had 4 sessions total with D, and I can honestly say that I have felt a huge improvement comparied to how I was feeling before I started seeing him, so much so that I have taken a break from my therapsit, and have committed to 6 sessions, and will likely commit to more. 

R has been very support of this process, which I am so relieved about.  I wasn't sure how he was going to feel about it - it really does sound hokey when you try to explain it, for some, it is very "out there."  It is really not much different than trying accupuncture; it's just working on a different aspect of your energy system.  I am not going into this process thinking that it's going to help me get pregnant, rather I am doing something to help me feel better, to be a better parent, better wife, and be better to myself. So far, I am so happy with how this is going, and I believe that others can sense that something is different about me, but they don't know what it is. If they were able to look into my being, they would see that I'm beginning to feel like myself again - and really since my mom died 9 and a half years ago, I had forgotten what being me felt like.  I'm looking forward to re-discovering myself as I go further into this process, and to feeling like I'm living life again instead of merely getting by.  I think the me from 1989 would be proud :)

Monday, January 23, 2012

Negative

My beta today came back negative.  I knew it would, given what I've been physically experiencing - but there was still that part of me that hoped for a miracle, given that I was sure that I was having a miscarriage when I learned I was pregnant with Smiley. 

I left work early today and plan to keep it light tomorrow.  Given this is a very early loss, the cramping is moderate but not severe (I've had worse during other losses that were farther along) but I think I have earned the chance to relax a little and regroup, and will then move on to figure out next steps.  I drove to a 7-Eleven on my way home and picked up a big gulp of diet coke, and we have our take out sushi menu ready to go for tonight's dinner. 

I am grateful that this was not dragged out like it has been in the past - one, two, or 3 weeks of pregnancy and then an ultrasound that reveals no heart beat - or spontaneous bleeding that sends me to the ER in a panic.  It was barely 24 hours of being semi-hopeful, but wary of a low beta.  Still an extremely sad and disappointing turn of events, but given my track record, not a surprise.  It still hurts, and I never get used to the disappointment.

On that note, I am going to give my sweet daughter a huge squeeze, and will likely not let her go until I put her to bed tonight.  I have much more than so many in this community have, and I don't take that lightly.  Hopefully once this pain subsides, we will be ready to decide on a next step, but for now, it's time to heal.

Sunday, January 22, 2012

From hope to disappointment in less than 24 hours

Friday was definitely a nail biter of a day for me.  I was up at 5:30am to head into DC for my beta, had it drawn by 7:00am and was at work by 8:00am.  That made for a very long wait.  I didn't have much going on at work until 1pm - I had one meeting at 10:00am and I realized during that meeting that I was shivering from nerves so badly that my teeth were chattering.  I hoped that no one noticed and did my best to take deep breaths and try to control my nerves, but it was a very difficult task, and I pretty much shivered in the conference room for 45 minutes. 

By 12:30 I was starting to get really anxious, at 1pm I had to drive to a lunch appointment with my boss, and I really did not want to have to answer that phone call while he was in the car.  I called my RE's office and they didn't have the results yet, they would call between 1pm and 2pm.  Lucky me.

At 1:15 I got the call, as expected, with my boss in the car. I tried to maintain a very neutral tone to my voice, when the nurse (unfortunately not my usual nurse, she was off on Friday) said, "congratulations, your test came back positive."  In a pleased yet controlled voice I said that was wonderful, and to share the details.  She said my beta was 25, not as high as they'd like, so they want me to come in on Monday for beta #2.  I asked if she's seen people with betas that low have successful situations, she said, "sometimes."  So now I had to go into a lunch meeting with 3 physicians, and pretend that I wasn't out of my mind nervous.  Did I have a late implantor?

Unfortunately, yesterday afternoon I started spotting, and throughout the day, the spotting turned into a regular flow.  I called my nurse and asked if it was possible to come in this morning for a blood draw, but she said that there were no procedures scheduled for today, so they weren't going to be in the office.  I'll have to wait until Monday.  I am pretty sure this is the end of the road for this cycle, even though I had a lot of bleeding with Smiley during my first trimester, the subchorionic hemorage showed itself after the embryo already had a sac and fetal pole - my beta was in the 10,000's by then.  I bet that tomorrow, my beta will be down to zero.

My mother in law was here this weekend and I did not make for good company.  I spent most of the weekend in my room - I tried to make it out with R, Smiley and my MIL for dinner, but I ended up feeling really lousy, and had my dad take me home. 

I guess we now really need to decide what our next step will be.  If I was 100% sure that this was all an egg quality issue, I would want to start the DE process tomorrow.  But there is still a nagging voice in my head that is telling me that it could be something that they still haven't idendified that causes me to miscarry, and DE is not the silver bullet answer, in that instance.  Maybe adoption is the best answer for us?  I just don't know.  All I do know is as soon as I know that my beta is dropping, I will be opening a bottle of wine.

Thursday, January 19, 2012

The Eleventh Hour

I have my beta tomorrow, and it can't come soon enough.  I have been a bit of a mess these last two weeks, I'm not really sure why.  You'd think that after having gone through 6 previous IVF cycles, I'd be used to this wait by now, and should be able to breeze through it.  Somehow, I breezed through the cycle itself, but once the transfer had come and gone, my anxiety about the outcome of the cycle went into overdrive. 

My overall feelings about the cycle are pretty negative.  I think about the quality of my embryos and know that they were not great.  I did not ask my RE what he thought the chance of success was, but my nurse assured me that she sees people come in with embroys much worse than mine, who end up having success.  It's hard to be hopeful when your embryos aren't stellar.

I am comforted by the fact that I will know either way very soon, and I can move on.  I am not really sure what moving on will mean - but I'm pretty sure this is it for my eggs.  Do we move on to DE?  Do we explore adoption? Do we do nothing?  I think about my super small family, and I feel so sad for Smiley.  My brother is a poor excuse for an uncle and if he stays out of jail or alive long enough to really make an impact on her life, it will be a surprise.  My father's heatlh isn't great, so who knows how much longer he has, realistically.  That leave's my MIL.  No cousins for Smiley, no other aunts and uncles.  I am very thankful for the extended family that we have, who do make an effort with us and include us in their lives, and of course, our wonderful friends who have truly become our family.  But I can't help but think that Smiley deserves to have a sibling to journey through life with.  I think I would feel differently if I knew she wouldn't some day be alone.

I have to get these negative thoughts out of my head - it hasn't helped that things with my dad and brother have been difficult lately, that extra added stress has been unnecessary.  Something else that I should just be used to by now, given that we've dealt with this for the past 9 and a half years since my mother died.

For now I will just keep myself as busy as possible until tomorrow morning.

Sunday, January 8, 2012

The 2WW, how it magically slows time

I had so many intentions of blogging frequently throughout this last cycle. I am not sure why I didn't, I think I wanted to just take things day by day and blog about it after the fact.  I ended up beginning the suppression part of my cycle on December 17th, where I started a regimine of Cetrotide and Provera for a week.  Then I began my Follistim, Menapur, and Ganirelix on Christmas eve.  I had a very different type of experience cycling this time around.  Cooincidentally everything fell during the holidays, and I had decided a couple of months ago that I was going to take time off between Christmas and New Years.  This was the longest amount of time I had taken off in a year, since my ectopic last December.  From December 23rd until January 3rd I was on a blissful "staycation", which I thoroughly enjoyed.  My only inconvenience during this time was having to make my 7am monitoring appointments.  I live in the suburbs of Washington, DC, and my clinic is right in Downtown DC, so on my monitoring days, I would wake up at 5:30 so I could leave by 6:15, to make sure I could get a decent parking spot by 6:45.  Luckily, I was able to turn around and go back home after those appointments, as opposed to going into work, which was what I've done during previous cycles.  There was something about eliminating the work related stresses this time around, that made everything so much easier on me.  I spent so much quality time with Smiley, R, good friends and family during those 11 days, it made the injections and the monitoring appointments a piece of cake. I honestly think that the holidays themselves were more stressful than my cycle.

Things began to get interesting right after the New Year, right as I had to go back to work.  Wednesday 1/4 was my retrieval, and my transfer was Friday 1/6.  During my retrieval they were able to get 12 eggs, 10 that were mature.  Of those eggs, 6 fertilized, but only 5 normally.  My doctor decided that he wanted to do a 2 day transfer, because he believes that embryos ultimately do better in the womb (rather than in a dish) and I didn't have too many stellar ones to choose from.  There were really only 2 that were not fragmenting by day 2.  In the end, we transfered 4.  My doctor gave me the required speech about the risks of transfering so many, the possibility of multiples, but he understands that our track record dictates that it's not too likely that this will happen, that we'll be super lucky to get one out of this, and hopefully one that we won't miscarry.

And now, we wait.  I had my 24 hours of bedrest, and hope to stay as busy as possible over the next 2 weeks.  My birthday is next Monday, so there are lots of birthday related activites that will be starting next weekend, and will take me through beta day.  It is a true 2ww, given that my transfer was so early.

I always find that these 2 weeks go slower than any normal two week time frame.  It's like as soon as those embryos are transfered, some magical force slows time to almost a standstill, especially during those last few days before beta day.  I am not sure if I am going to break down and test this time around.  I tell myself to wait, and then ultimately I end up testing, but this time I really want to hold to it, so it doesn't ruin my birthday plans.  We will see what happens, it's all out of my hands, and I can only continue to be grateful for my beautiful girl.

Sunday, December 18, 2011

IVF #7 has begun

I have officially begun my protocol for IVF #7, which is my 2nd IVF post miracle baby Smiley.  It's so hard to believe that a year ago yesterday I had emergency surgery to remove my ruptured tube, thanks to an ectopic.  So much has happened this past year, it's hard to believe it all happened in just one.  My last cycle began in Feburary and was over and done with by March with a BFN.  We took a break with all intentions of putting our house on the market and moving over the summer, with the hopes of doing another cycle early fall.  Of course things didn't happened the way we'd planned (as they rarely do) and it took us much longer to sell and move, but I'm thinking that the extra long break was a good thing, given that R's new job brought new fertility coverage for us, including meds.  When I first began my TTC journey I was working for a large pharmaceutical company that provided amazing fertility coverage, I was able to get through 3 IVF cycles with 100% coverage, including meds.  With my last cycle, we had to pay out of pocket for meds, (and PGD) which left me reeling about how much these drugs and procedures cost, and how multiple cycles could easily send someone into bankruptcy.  Being back on the other end of the spectrum again, I was in tears when I leared our coverage was so robust, and I feel very grateful for this.

I did have to jump through some hoops and had some near misses with starting my cycle, when getting pre-authorized and ordering my meds from Aetna specialty pharmacy.  The timing was super sensitive, as my RE wanted me to start Cetrotide on day 22, prior to the start of my period.  Aetna was taking forever to confirm that my prescription was in my system, and my nurse had to called a few days in a row to get it all squared away. Thankfully, by the skin of my teeth, my meds arrived Friday morning (starting them yesterday, Saturday!) and wouldn't you know it, my period arrived first thing yesterday morning - on day 22.  Some cycles are 22 days, some are 30. Thankfully I was able to text my nurse and find out if I could still start my cycle, and it turns out we're just making a few tweaks to the protocol.  So last night, during Hankkah party and a house full of family - I went upstairs to mix my Cetrotide, and give myself my first injection since March. After 6 years of being on the TTC rollercoaster, it really is like riding a bike.

I am not sure how I feel about this cycle - my track record with IVF is not good, only one has been successful, and it ended in a miscarriage at week 9.  Smiley was conceived naturally.  My last IVF did not work.  We've decided to forego PGD, as we've done it twice and it has not helped us at all (we even did it the cycle that ended in miscarriage, a very rare occurrance).   For some reason I feel hopeful, I guess part of me believes that if we could have one baby, we should be able to have another - but my brain also recognizes that I am 3 years older than I was when Smiley was conceived.  It was not easy for us the 1st time, it's not going to be that easy this time.  

This could be our last cycle usin my eggs.  We have said that we are open to moving on to DE if this doesn't work, but I really want to take this cycle one day at a time, and see how I feel.

On a side note - I went to a friend's son's 5 year old birthday party today.  Every year I think about how I was pregant the same time this friend was, and lost my baby in a miscarriage at 7 weeks.  I should have a 5 year old.  If I want to get nit picky, I should have 6 kids with all of the pregnancies I've had, but I am luckier than so many women, and can say that I have one, amazing, perfect little girl.  If in the end, she is our only child, I will be so grateful for that.