Waiting to Miscarry

So, this one is tough. I mean, TOUGH. So if you are reading this one at work, or feeling a bit frail, hang up the browser and come back later. You have been warned….

So we got pregnant. We never got a full bar on the stupid pee stick, but we saw some kind of shadow. (I, the skeptic, saw only the white testing part compared to the darkness around it, but in hindsight, my DW was correct, there was a hint.) So we slept poorly this week and finally went to the doctor, who then informed us, “Hell yeah, biatches, it worked, you are preggers. Its kinda low, but hey, it worked. See you later this week for a follow-up test.” Hurray!* (See my comment at the end to see why I *starred.)

Wednesday, we go back in for another test and “Umm, heck, its 3 points lower and it should be like 66% higher. This is not good at all, let’s have you come back on Friday for another blood test, and, Hey! look on the bright side, your period may start before you have to make a morally crippling decision.” Though, to be clear, no one said anything like that to us. They were nice, but quiet.  Quiet is the best word. They gave information but, like at a funeral, put their hands behind themselves and commented on how good everyone looked. The number, HCG number, should have shot up. This would have told the body, and thus the doctor, “We are splitting cells and creating life, do not flush the lining, we need it to survive, hugs and kisses, Peanut.”

So Friday’s test comes back and “Hey, look, nothing’s changed, um, geez that’s really ‘interesting.’ Did we mention you really can’t continue like this forever, and we really need to restart your cycle if you want to get ‘really’ pregnant?”  So, looming now over us is this message from the clinic:

Congratulations! Something stuck to the wall of something and sent out the chemical that says you are pregnant (or at least, “Please Don’t Flush Me”), but these numbers are really, really odd/bad. Our Guess (because that’s all we can do given our shit technology) is that you have a clump of cells clinging onto something (let’s hope not a critical organ), and it’s sending these signs to the uterus. These signals, given their strength (or lack of), indicate a not-good fetus/peanut/proto-baby — and at this point it’s really better to think of it this way, because later this week, we might ask you to kill it using the same chemical they use to kill cancer cells.

(Did I mention this would be a tough entry?)

So here we are, waiting for DW’s period to finally start “naturally,” so we don’t have to kill the cells that might have been our baby. Waiting sucks.

I believe in the power of prayer for strength and wisdom. So please pump a lot our way.

Peace.

* At one level, I am glad cause we have never gotten to this part before.  Two years of NOTHING, followed by one try and we have something (even if it is more pain because of hope).

In which I do not have the stamina to POAS incessantly

Read enough forums in the TTC (trying to conceive) circles, and you see that most people deal with the “2ww” (2-week-wait between ovulation and period due) in different ways. By and large, the most vocal forum group includes those who POAS (pee on a stick — that is, do pregnancy tests) constantly during the 2 weeks — sometimes several times a day.

Even if I wanted to, that’s not really an option this cycle. Drugstore pregnancy tests respond to the level of human chorionic gonadotropin (HCG) in the urine. HCG is usually only produced by an implanted blastocyst/embryo, so it’s generally impossible to get a positive pregnancy test before implantation. The sticks also vary in sensitivity: some can detect pregnancy before a missed period, while others can’t. But in this cycle, the ovulation trigger shot contains HCG, which stays in the body for 7-10 days — so if I tested now, it would come up with a false/unverifiable positive.

But even before this cycle, I was never one for constant testing. Sure, the first few months it’s exciting, and we tested early with super-sensitive pee sticks. Those are the same months where it’s still “fun” to “try” on schedule, where you think every abdominal twinge or breast cramp is an early sign of pregnancy, where you’re still thinking of baby names.

Then months pass (and then a couple of years, in our case) — and I found that if I got a negative test before my period was due, I simply didn’t believe it. I told myself it was just too soon, and maybe I could still be pregnant. Lots of stories out there about women who tested too early, got a negative result, and turned out to be pregnant. Problem was, the negative tests were always correct in my case. So what was the point of testing, if I wasn’t going to believe the early test results anyway? The best indicator is if my period starts on time — or not, and at that point I know it’s time to test. I can’t deal with the tension of second-guessing test results from testing too early — it’s like multiple let-downs.

Monday I go in for a beta HCG blood test — so it’s not peeing on a stick, but rather having the HCG tested through my blood, which is a much more sensitive, quantifiable test. (Meaning, not yes/no or pass/fail, but rather no OR yes-and-here’s-the-HCG-level.)

Good progesterone news

The ride isn’t over after the IUI. They had me come back this morning (7 days past ovulation) to check progesterone levels.

After the follicle releases the egg at ovulation, it closes up again and forms a “corpus luteum,” which then releases progesterone. Progesterone at this stage (the “luteal phase”) sustains the uterine lining so that a fertilized egg has a comfy, cozy place to burrow into, or “implant.” One common (but disputed) cause of infertility is progesterone deficiency, where the body isn’t sustaining the uterine lining to nourish a fertilized egg.

My level today was 36 ng/mL. This is great news! For a “normal” (unmedicated) cycle, they want a number >10 ng/mL. For a medicated cycle (more follicles = more corpus luteums, or corpora lutea? ), they want a number >15 ng/mL.

36 ng/mL would definitely be over 15. One more thing to cross off the list.

So that leaves us with a final acupuncture visit Saturday, and one final scheduled clinic visit next Monday for a pregnancy test. Fingers crossed! Otherwise, period starts, and we begin again.

Doing My Part

So as Primary Female Unit 01 mentioned, today was the day for IUI and what a day it was. Dear Wife (DW) mentioned most of the important details, but left out a few things from my perspective which I thought would be important to anyone going through this process:

1. Masturbating on demand is hard. Oh, and toilets are very, very unsexy. Okay, so the guy has to get out the sperm, and really there is one best way. The way that (we were told) leads to blindness and hairy palms, but for some reason, no one mentions that here in the adult world. So they put you in this room with a little cup, some god-awful picture of a smiling couple in front of a fire (of the wrong race for me), magazines in a rack (some of which were for the other team, and I don’t mean girls), a chair and, I swear, a toilet with a seat but no lid. I mean, is this prison?  Is there going to be a lights-out call? Should I sharpen my shank now? Toilets are for some other business and nothing NOTHING to do with sex. I positioned the chair to avoid seeing it, but I could still think of it, lurking behind me, grinning its eternal poo-catching grin. (Okay, my rant is over.)

2. The painful part of the IUI for DW was hard to watch as the powerless partner. So I grabbed her hand and said, Crush it, squeeze as hard as you need to. And that apparently helped a great deal. We sat in the dark afterwards waiting for the uterus to stop being quite so pissed off, and it was very sweet. I stroked her head and she groaned, but eventually we got there. The staff was very nice and very respectful.

3. Given the timing requirements of the day, it was important to try and do less than originally planned. If you go through this process, I strongly recommend not planning on driving around the city for appointments, back and forth.  The time we spent sitting in front of the cafe was time well spent. It gave us a measure of control over something that was clearly out of our control.

4. I did this thing with DW that worked well for us (well, I know if worked well with me, and I suspect her) which was to create this ’shell’ of glowing light around us. I put my arms around her in a circle, forming a ring around us, and I said, This is our space, nothing comes in that we do not invite, nothing exists before or after this, just be HERE with me, and fill it with light. And it gave me an excuse to filter out all the crap that tries to creep in. Later she confessed her light was white, like the moon, and that was awesome. She had taken that moment and run with it. A nice trick to try and protect yourselves from the chaos that threatens.

All in all, as we said to each other on the way home, no matter what, it was a great first time. It was the hardest time, that first one. Now, sadly, we know what we are doing, and while we don’t want to have to do it again, it has turned out to be an experience that has brought us even closer. Taking turns going insane, each of us respecting the other’s talents and natures, forcing out the things that distract or confuse us, being gentle with ourselves and each other: these are a few of the things that carried us through. We had these features and understandings before, but it was very gratifying to ‘weapons-test’ them. To take all these responses to stress and to watch them all work.

I had a bit of a meltdown internally on the way home, and DW did everything right to do what I needed to feel better. Listening in the right way without judgment, maintaining physical contact, and just being present without feeling judged. She’s a keeper.

Release the hounds!

Yeah, so we’ve had a whirlwind few days!

Monday (yesterday?) I went in for a scheduled blood test and ultrasound to check egg follicle size and maturity. Meaning, how close to ovulation are we? The PLAN was to find that the follicles were pretty mature, take the “trigger injection” Monday night (to complete maturation and trigger ovulation), and then do the IUI (intra-uterine insemination) Wednesday. The trigger shot is supposed to cause ovulation about 36 hours later.

Now, my abdomen has been bloaty and twingy since the weekend, to the point where my usual work slacks don’t fit comfortably. I joked to DH that I felt like a fish full of eggs, and I hoped that’s what we’d find Monday.

Sure enough. Awesome Nurse L (who is just so positive and upbeat) does the ultrasound, and she immediately finds 3 large follicles on the right ovary. Follicles are “bubbles” or caverns on the ovary where an egg matures each month, one in every follicle that is stimulated. (For those keeping score at home, a follicle that grows to at least 18mm is considered adequate/almost mature. The 3 on the right had grown to 26mm, 22mm, and 19mm. The right ovary also had a 10mm one that wasn’t mature.) She had to dig a bit* to find the left ovary, which turned out to have just 1 slightly unripe follicle (15mm). Finally, she was very happy with the uterine lining (13-16mm, should be >7mm). Then we did the blood draw to check hormone levels, and Nurse L said she’d call late afternoon to give us final marching orders about timing for the next events.

(* For those who don’t want to read icky girl-stuff details, I put these in white text. You should be able to select them with your mouse to read the text. OK, so these ultrasounds are transvaginal ultrasounds, which means they stick a wand up your vagina and poke around a bit. And I mean poke. This one was by far the most uncomfortable/painful, because my ovaries are so enlarged that they’re rather unhappy when anything brushes up against them. If the nurse had grazed my right ovary one more time, I was going to leap off the table through the ceiling.)

As of 3:30 Monday, the entire plan got shifted up. It seems my hormone levels, plus the follicle sizes, suggested I was about to pop in less than 24 hours — not in 48. Release the hounds! So Nurse L tells us we’re doing the IUI Tuesday, not Wednesday, and to do the trigger shot at 8pm Monday night, which at this stage would drive ovulation over the edge pretty quickly. (You can imagine my joy at having to tell work that I would be out Tuesday, not Wednesday. I’m doing my best to keep the office informed about my whereabouts, without having to divulge why I’m out, but I can’t control pharmaceutically hyperstimulated Mother Nature. People will just have to come to their own conclusions.)

(Side note 1: Nurse L continues to be my favorite person at the clinic. She thinks everything looks spectacular on the labs and ultrasounds, so she says, “Come in tomorrow, and we’re going to get you pregnant.” I didn’t think the health care people were allowed to say things that sound like promises, but I really appreciated how upbeat and affirming she is.)

(Side note 2: That said, nothing screams “conception by committee” more than “we’re going to get you pregnant.” Remember when that was something DH and I were supposed to be able to do, just the 2 of us? Now we need a whole team of people. This isn’t how we wanted it to happen, but I guess we should thank God for giving us the knowledge and technology to be able to overcome whatever is keeping us from achieving it on our own.)

So I was a nervous wreck the rest of Monday, but a quick pre-IUI acupuncture session really helped to calm nerves. If you have access to acupuncture, I highly recommend it — if only to keep stress levels down, whatever their cause.

This morning, up at the ass-crack of dawn to get to the Clinic by 7:30 for DH to make his “contribution” in this transaction. Then we hung out at a sidewalk cafe for 2 hours while the lab processed said contribution. (We got to watch a crazy guy yell at the 911 dispatcher to send someone to fix his wheelchair, and then a hook-and-ladder truck full of firefighters showed up in response. I love the City. So much to see.) Then back into the Clinic for the IUI itself.

If anyone tells you IUI is painless, don’t believe them. I don’t want to go into detail — honestly, I’m still having body memories. Suffice to say that the prep alone is painful (especially with all the organs so bloaty from the meds), and the uterus does not like having tubes inserted into it and stuff injected into it. Sharp cramps, unable to catch my breath, for about 5 minutes. Worth it? Yes (at least we hope so). Painless? Not so much. And unfortunately, our regular awesome doctor was out. So we had a doctor we’ve never met before, and although he was sweet personally, he was a little rough with the procedure.

Then they send me off to “resume normal activities.” Which — just, no. I felt like hell by that point. Plus we had a post-IUI acupuncture to get to.

The acupuncturist then sent us home to “snuggle” — this, really, is the best advice. First, I was pretty worn out emotionally and physically. But second — this is such a mechanized process, it would be easy to lose sight of just the two of us, as a couple, trying to make mini-”us”-es. Going home to snuggle is a good way to reconnect and get back to basics.

So that’s our week. We go back next Monday for a blood test for progesterone. Then the following Monday or Tuesday for a beta-serum (blood) pregnancy test.

Thanks to everyone for the good wishes and comments! Please keep us in your prayers! I owe a couple of you e-mails — I’ll get to that soon, it’s just been a little overwhelming.

Stay tuned

Today is IUI day, a bit earlier than expected. Stay tuned.

Day 10 test

So part of this cycle is a “clomid challenge test,” which can predict low ovarian reserve, or basically a low number of eggs remaining (which in turn can mean poor quality of the eggs remaining, as well). A positive (abnormal) test definitely means there’s a problem. A negative test technically means that nothing was found to be wrong — it is possible to still have an ovarian reserve problem that the test doesn’t detect — but it does make that less likely to be the case.

Here’s a link that explains it a little better: http://www.clomid.havingbabies.com/clomid-challenge-test.html.

So my Day 3 FSH was 4.4, which was good — they want it under 10. Then I took generic Clomid for 5 days (accompanied by “power surges” and some minor moodiness, fun).

Today was the Day 10 FSH — and it also came back just great, 3.9. So we have more confidence that our fertility problems are not from early ovarian failure or something. One more possibility to check off the list.

Which I have mixed feelings about.

On the one hand — then what is keeping us from getting pregnant?

On the other hand — crossing this off the list seems to indicate a better chance of getting pregnant with IUI. For example, if the sperm are having trouble getting into the uterus — which can happen for a variety of reasons — then IUI would bypass that kind of problem.

I hope so…

My latest fear

I would have to say my latest fear on this project has been the horror scenario where my wife is impregnated with someone else’s sperm.  Where they lose track of my sperm or the doctor in a fit of evil replaces it with his own and I get short, Southern-Drawling, effeminate children instead of the Cyrano de Bergerac style children I am sure to produce.

Though this morning, I was asked, ‘What would it change?’  I answered, ‘You mean besides suing the shit out of the doctor?’  And I realized, given my deeper angel nature, and pushing aside my ego/demon needs, it really wouldn’t matter at all.

Admitting and sharing the fear allowed me to get over it.

A Separate Peace.

Chicken Soup for the Uterus, Part II

Just to clarify, my acupuncturist is also a TCM (traditional Chinese medicine) herbalist. So I’ve been taking herbs along with acupuncture for the last 8 mos. But with the advent of fertility treatments (aka Clomid, IUI, etc.), they tell you acupuncture is still okay, but to stop taking herbs.

That being said, my acupuncturist has a chicken soup herb package that is entirely safe when undergoing fertility treatments. It’s “tonifying,” meaning it just boosts nutrition to improve overall bodily health (qi, yin, yang). It’s got a bunch of twigs and leaves and astragulus bark and stuff that’s inedible (strained using cheesecloth). Then it has other edible stuff like certain mushrooms, seaweed, berries. I’m supposed to eat a bowl every day during the follicular phase (the first half of the cycle, when the ovaries are maturing eggs and preparing for ovulation and, we hope, fertilization), finishing on the day of the IUI.

So SingularityIsNow is making me chicken soup with the herbs today. =) It really is Chicken Soup for the Uterus.

Chicken Soup for the Uterus

So, I find myself, as the DH to this couple, the chef for the majority of the food stuffs.  In this case, I have been brewing a witches brew (almost literally) of herbs and spices and chicken for the last few hours.  So, if you ‘Others’ out there find yourself having/beingallowed to cook this kind of thing for your Other, allow me to offer the following steps:

1. Resign yourself to being the harbor.  Harbors do not have storms, except when scheduled. So time your outbursts for moments of great closeness and the Other’s ‘good spaceness’.
2. Buy a roaster chicken, cut into good sized chunks, remove guts and spinal stuff.
3. Heat some oil, black pepper and any non-medicinal spices you feel are appropriate (I like garlic).
4. Sear at high temp the chicken parts (note: bones are included so far)
5. Add three cups of water when chicken is bown/speckled with black, cover and cook for 10-20 minutes reducing heat to medium.
6. Remove chunks, de-meat the bones and skin, put the skin and bones back into the pot and cook on medium for 20 minutes. Mince meat into small chunks.
7. Mince any veggies you plan to use. Crush any edible of the dry herbs/mushrooms they gave you.
8. Remove bones and skin from broth.  You are looking for brittle bones or a nice creaminess to the broth that will be surprising given the lack of milk or starch.
9. Add in herbs/mushrooms. Add in long cook veggies. (I personally add in about a cup of noodles(small) to help thicken up the broth) Cook for 30 minutes on low.
10. Add in meat. Add in short cook veggies. Cook for 10-20 minutes.
11. Ready to eat or break into small containers for easy reheat. This ’soup’  helps with all kinds of stuff (hot flashes, low energy, nausea, you name it).

And as with all things, the most important ingredient is Love.  If you are grouchy or feeling put upon, don’t bother. Trust me, get into a good space and maybe grab a glass of wine and make the best damn Chicken Soup you can.

Namaste.