Friday, July 9, 2010

The WHOLE stroy

On December 5, 2003 N and I got married. We honeymooned on a cruise in the western caribbean the last week of January. And after that, we decided it was time to start our family. I went off birth control, and after five months, I finally got a period. I realize this should have been a clue, but there you go. Once that happened, we decided to actually try. Five months of nothing went by, and during that last month I was spitting on a mini microscope every day to see if I was ovulating. Nothing. I mentioned this to my NP, who is great. She thought that I probably had PCOS, and sent me for tests. This is great, because you usually have to try for a year before they will do any fertility testing.

Turns out I did have PCOS, which you can read about if you click the link. It basically means I don't ovulate, so we had to find a way to get around that. The first thing they did was give me Metformin, a diabetic medication. When this med came out it was cheap and it worked, so they gave it a lot. Then they noticed a lot of diabetic women getting pregnant. Lots of diabetic women also have PCOS. So they did a separate study, and found that some 50% pus of women with PCOS started ovulating once on Metformin. Guess who didn't?

Then we moved on to oral meds. I tried two doses of Clomid, the most common oral infertility treatment. Nothing. Then we tried Letrozole, another oral agent. Still nothing. Keep in mind, each time we try a new med there's a procss. First you take birth control for a month (I know, seems counterproductive), wait for a period, and then you have ultrasounds to check uterine lining, then take the pills on a schedule and ocntinue the ultrasounds until they see if ovulation happens. If not, back to the drawing board.

Once both of those meds were tried, we moved on to injections. Again with the birth control, have a cycle, start injecting yourself on a day determined by formulas and ultrasounds. They're SQ injections, just a small needle into the fatlayer (of which I have quite a bit). Every day for 31 days I injected myself, until there was an ultrasound when they actually saw progress! I had four follicles that were growing, and could possible be ovulated. That night I gave myself an IM injection in the thigh, to jumpstart ovulation. N and I had to get it on 12 hours later, then 24 hours after that. At the time, the doctors had asked me would I consider "selective reduction" should all four eggs be fertilized. No way, man. By this time, we'd been at it for about three years, and we were taking whatever we could get. Turns out, none fertilized anyway.

At this point, the doctors told us that if we tried injections again, we'd definitely get multiple eggs, or none. If we opted for in vitro fertilization, they could get all the eggs out to fertilize, then control what they put in, so I wouldn't have a litter. So we signed up.

First, you have to attend an informational meeting. Then you have to be assessed by a psychologist. You have to have a general physical. You have to plan how you're going to pay for it. In vitro is not cheap, but we had a great plan with the U. It's a cost sharing plan, built to help out women who were not succesful. You pay the fee, and after three harvest attempts, if you have no baby you get 80% back - which you could use for adoption. Seemed like a great idea. So we jumped through all the hoops and got enrolled in the program.

I should mention that in these years I also got a needle stick at work, from a resident who turned out to have Hep C. So baby making got put off for six months while I figured out I didn't get it. Whew. Also, N's mom had a heart attack and was in the hospital for six weeks. Then my mom came to town six months later and had her own heart attack. All these things made it hard to keep on schedule.

So we finally get enrolled for IVF, and the whole process gets started. I forgot to mention, too, that before the birth control I had to take hormones to make me get a period, since I never did on my own anymore, then start the pill, have a nother cycle, start injections again. This time, after they monitored with every other day ultrasounds, they had me come in to the clinic when the eggs were ready (after another IM injection), and they removed them. Which was good because my ovaries were the size of softballs, and it was starting to hurt to walk. They knock you out, then use a teeny needle on the end of a catheter, go in the business way and suck the eggs out of the ovaries. When you wake up, you ask your husband how many they got. From me? 32. Crazy talk.

Side story- the nurse anesthetist told N that when I came out of it, I would ask how many. But that I might not be clear yet, because of the sedative, so if I asked again, just to tell me again. He told him, no matter how many times she asks, just answer like it's the first time. After I woke up and asked him, I remember asking if it was the first time, and N said yes. Maybe he told the truth.

Anyway, N sat with me until i was clear, then took a trip down the hall to give a sample. They put us together in a couple of petri dishes, and we got 24 fertilized eggs. This happened on N's 29th birthday - August 26th, 2008. They let them grow a few days to watch the quality, and freeze the good ones. They froze 17.

In October, I got the first frozen embryo transfer. You again do the cycling meds, then start progesterone injections, twice daily in the butt muscle, and an oral hormone as well. The day of the transfer you take ibuprofen and valium, then head to the clinic. You get to see the embryos they have thawed out under the microscope. Although they really only look like little bubbles, it takes your breath away. Then you lay on the table, and they use a catheter to put them (two embryos at a time) into your uterus. It takes about ten minutes, then you lay flat another ten. They recommend bed rest the rest of that day. Ten days later you go in for a blood draw, then again two days after that. They don't tell you the first results, because there are a lot of false readings, I guess.

That first attempt, nothing took. I felt guilty for not extending the bed rest. So for try number two in January 2009, I did it on a Thursday, had Thursday and Friday off from work, and then kept myself on at least couch rest until Monday. It worked. I got the call on day twelve saying that I was pregnannt. But the hcg numbers weren't as high as they would like. So N and I tried to celebrate, but it was nerve-wracking. A week later I got my blood drawn again, the numbers were good. Yay! About two and half weeks after that, I had an ultrasound, to confirm. There was a baby in there, but it was measuring small. They said come back in after a week to monitor. When we went back in, there was no heartbeat. Miscarriage.

Although I had had nothing but bad news, and therefore no way to filter what had been good news and no time to really believe it, I thought it was going to break me. To make matters worse, it wouldn't expel on its own, and I had to go in for a D&C. N and I took a trip to the Cape afterward, to try and recharge. That was March. That June, we went on a cruise to Alaska. We had decided to take the summer off, regroup, figure out the next step. The doctors were saying that the fact that I had gotten pregnant was good news, but it didn't seem that way.

The summer off turned into even more time off. We didn't know if we wanted to try again. It seemed so masochistic. But then we decided we had to give it one last try. We had the third transfer on January 29, 2010. They had thawed out two embryos and one didn't make it. So they thawed a new pair, and those were transferred. Twelve days later, they said I was pregnant. Again, though, the hcg was a little low. Retest was good. First ultrasound happened and all looked good, but they wanted a follow-up, because of my history. Second ultrasound was good. They dismised us to an OB clinic.

Finally, it seemed like we could be happy. Things were gong well! We saw the OB at ten weeks, we told people at 12 (almost 13 - I was reluctant). Regular apointments have been going well. And still, I would say we are cautious. It just seems impossible that after six years, this could rally be happening for us.

Last thursday, I had to do the one hour glucose test and I failed. I did the three-hour test on Wednesday and today I got the results. I failed. I have gestational diabetes.

I know that really, this whole journey has been easier than many people. And I know that watching my blood sugars won't be the end of the world. But right now, I'm devastated. I promised N and myself that I owuld not compain about anything about pregnancy if I could ever get there. And I won't. But I will just say that it has been difficult to eat in the last six months, and this will only limit me more. But really, more than the inconvenience for me, I'm scared for the baby. I really need this baby to be healthy. I don't want to do anything to jeopardize that. And I'm terrified I won't be able to control this.

Also, I'm angry at the clinic. I did the test Wednesday. They didn't call until Friday. It doesn't take that long, I'm a nurse, I know. Then they tell me to call and schedule an appointment with a diabetic educator and when I do, I find out they don't take apointments on Fridays. I can't do it until Monday. What the hell? If they had called yesterday i oculd have taken care of this! Not to mention, I'm going out of town on Wednesday. I have an OB appt on Tueday afternoon, and I better be able get in after that, because I can't miss any more work. Arghh!

I'm aggravated, and sad, and frustrated, and annoyed, and really scared. And that's the rest of the story.

Tuesday, July 6, 2010

Glucose issues

At 24 weeks, I had to take the one hour glucose test. For those of you who have been through this, you know that you have to drink the botlle of ickiness and get your blood drawn an hour later. Well, I failed it. I was supposed to be lower that 130, and I was 164. Blah. Not terribly bad, but bad enough to have to do a three hour test. Yuck. So tomorrow I have to report to the clinic in the morning, get my blood drawn, drink another bottle of ickiness, and then give a blood and urine sample every hour for three hours. Fun stuff. While I would usually not be upset about an excuse to read all morning, I am feeling guilty about not being at work for half a day. And I don't really have the type of job that allows to bring work home with me. Three people I know who have had babies in the last two and a half years told me this weekend that they also failed the one hour, and passed the three hour. I hope I'm in that boat too.

I'm 25 weeks today, and I still can't believe it. Now I can feel the baby move on a regular basis, N has felt it a few times, but not consistently. And I know I should start planing and maybe buying things, but I think I'll put it off a little longer, just to make myself feel better. I don't want to go taking anything for granted.