A blog about babies: the babies I lost, the babies I never had, the baby who made me a Mama.
Showing posts with label RE. Show all posts
Showing posts with label RE. Show all posts

Thursday, September 30, 2010

Answers, Maybe; or Action, Definitely

My head is reeling right now at how fast everything is happening. I'm heading into Manhattan in a few minutes to pick up my Clomid prescription. We're planning an IUI for this cycle, and as I'm CD 6 (or CD 5 depending on how you calculate CD 1), I need to take the medication in the next three hours.

Wow. Wow, wow, wow.

To back up a little, my RE called me last night at 7 pm, as I was just about to leave the house to meet Lawyer Guy, my sister and her fiance for dinner. She was calling with the results of LG's semen analysis--one day after he had the test!

(And for the record, I am soooo impressed that she called me that quickly. This makes me very optimistic for the state of my care at Cor.nell. I think I need to find a new code name for her. Dr. Woman is not very descriptive, you know? So I will provisionally adopt Dr. Wonderful as her name)

So, the results of the test: Count good at 30 million. Motility good at 57%. Morphology not good at 3% after a wash (4% is now considered normal. I don't feel comfortable giving the pre-wash numbers, because of LG's sensitivity around this subject).

Based on this, Dr. Wonderful counseled going directly to monitored Clomid + IUI, as this will give the sperm a better shot at reaching an egg and more eggs to be potentially reached. She did say it's not impossible for us to conceive on our own with these stats (obviously, as we already have) but cautioned that it will likely take longer.

After all these months, this might be an answer. I don't know yet if we can say that this has been causing our problems, but it's definitely a red flag. And the plus side to morphology issues (I guess) is that if we must go the IVF route (and I'm not ready to say we need that yet-- Dr. Wonderful didn't even mention it), it appears there will be every likelihood of success, especially if my HSG results are normal.

I was relieved when she first gave me the results (I had feared learning LG had, like, only 2 million sperm in his sample). Then the more I thought about it (and googled-- bad Sloper!) the more nervous I became. Then I started thinking about getting my prescription and when the pharmacy would open and how I could do this all before leaving at 8:30 to teach. Answer: I couldn't, so I canceled class. Some things are just more important.

Ultimately, I'm still not really sure where this leaves us. I've read conflicting information on morphology, from "It's the only thing that matters" to "We don't give a crap about it." I don't want to read any more and Lawyer Guy wants me to avoid independent research into it, too. If you have anecdotes or experience with this, please just hold off on sharing for a while, because we want to sit down and chat with Doctor Wonderful about what all this means to her before we start hearing from other sources. We're seeing a fantastic doctor at one of the best clinics in the country, and if we can't trust the care we're getting here, what can we trust?

So: it's an IUI. I don't expect our first shot at bat to win the game for us, but I'm excited to be starting nonetheless. I'm happy that we're learning more about our situation. I'm happy I have a doctor I trust and like who is prompt and active in managing our care. I'm happy that Lawyer Guy seems to be taking all this okay. He's very pleased that his count and motility #s are good and is refusing to speculate about what the consequences of the morph #s will be until we speak with Dr. Wonderful. I know that men--and my LG, in particular--can be amazingly good at refusing to look at things that bother them and refusing to acknowledge their pain, and I'm a little worried about how this is going to pan out emotionally for us. But I trust him and me to do the best with this situation and to love each other fiercely regardless of our temporary and momentary traumas and distress. I'm going to have to work on being as much of a support for him as he has been for me, because we're both in this together. And that's the way it should always be.

Monday, September 20, 2010

On Pause; or, Once Again Waiting.

After last week's frenzy of appointments and decisions and activity, I feel again as though I'm suspended in liquid waiting to be allowed to move. The HSG appointment with NY.U is canceled, and we're waiting.

Waiting for me to get my period, so I can call Cor.nell and set up a different HSG appointment. Waiting for Lawyer Guy to return home from his business trip so he can call and schedule his semen analysis (he was making vague noises about getting it done "next week," which honestly is not what I want, but he's so anxious about it that I don't have the heart to push anything). Waiting to find out what our treatment options are and if we can try anything this upcoming cycle. Back to waiting, and I'm not any better at it than I was 18 months ago, despite the excellent practice I've now had.

I'm fat and broken out and lethargic and depressed and disgusting, so it's obvious my period is coming (set to arrive this upcoming weekend). I've accepted that and given up much hope of conceiving without assistance, though LG was deeply upset when I mentioned how crampy I was feeling over the weekend. He'd thought we might get out of all this at the last minute. No such luck.

Right now, I really just want to get started. I want to do something--anything!--that will improve our chances. I want to take a shot in the dark just for the satisfaction of no longer sitting on my ass praying the fertility gods will bless me.

I read the blogs of women undergoing treatment, and they often seem tired. Tired of the blood draws and the injections and the pills and the ultrasounds and the doctors' appointments and the failures. I'm sure I'll get to a point, too, where the charm of reproductive intervention ceases to be charming. But at this point, I'm so tired of doing nothing and leaving it all to fickle chance. I just want my shot. I want to feel like I've started something new.

Watch me eat this words about four months from now. But this is where I am today.

Friday, September 17, 2010

RE Consult #2; or, Things Are Looking Up

AAAAHHHHHHH!

I am so mellow and relaxed after the loveliest massage. Thank you, considerate friend who bought me it for my 30th birthday! And thank you to myself for so cleverly saving it until a day when I really, really needed it. I will definitely be adding monthly massages to the "Keep Sloper Sane While She Undergoes Fertility Treatments" regimen I'm concocting.

So to begin the recap of today's second consult, I need to talk a little about yesterday. Yesterday was a hard day. I woke up and it hit me: We need help. We can't do this on our own. We're going to an RE. I was feeling so low and down about it all day, crying periodically. I saw myself on a long road stretching inevitably to IVF and I started thinking about how we'll pay for it, and how we have to start saving now, and whether to spend our money on that or adoption. It culminated in a long cry during a long phone call with my mom (who was miraculously wonderful and non-judgmental). Yet another low point in a series of lower and lower points.

I woke up today feeling tired and not too excited for the next consult, especially since Corn.ell is so annoying to get to from Park Slope. But I went and met the new doctor.

Right away I really liked her. She's younger (probably late 30s) but has great schooling and fellowships and a really warm and encouraging manner. She gave us the more positive spin Lawyer Guy had wanted, saying, "I'm going to be talking to you about contraceptive options one day." (To which Lawyer Guy responded, "Contraception? What's that?" while I pondered for a moment why I'd need contraception if we were trying to get pregnant).

She didn't spend a lot of time giving us statistics, but did let us know what seems promising about our situation (my FSH/age, our previous pregnancy) and which pieces we'll need to still figure out. She didn't mention IVF at all or polycystic ovaries, though she did say we could use medication to regulate and shorten my cycles and would go ahead with IUIs depending on Lawyer Guy's SA results.

She congratulated us on starting to try for a family at a relatively young age for NYC (I was 28), which allowed us to detect problems while there's still time to fix them. She seemed to be leaning toward thinking that MFI may be our primary issue, though she asserted that LG's sample must have at least 1 million + for us to have conceived on our own, and that even if it is that low they can work around it. She also said there was a chance that one of my tubes was blocked or clogged (I guess the left, since I ovulated from the right when I got pregnant), which would explain the delay, as well.

(Incidentally, Lawyer Guy seemed oddly okay with the thought of getting less than great results from the SA. "I'd be more nervous if you had never gotten pregnant" he said, happy that we know he has sperm and can conceive a child, whatever the quantities. He did ask if I would be angry with him for "causing our problems" if it turns out his counts are low-- and I asked him if he was angry with me for miscarrying our baby, which I think helped him see my feelings about this).

Her approach and Dr. Man's were very different. He presented factual and statistical information and said it was up to us to decide what we wanted; she delved more into the details of our situation (as we know it so far) and offered a course for what she thought should come next. Lawyer Guy really liked her optimism and the fact that he felt he understood what the plan would be after we left her office.

Both doctors and clinics are really good, and both have points in their favor. Dr. Man is more established and well-known (Lawyer Guy said he got the impression he was "a bit of a celebrity" and noticed a photo of the doc and Katie Couric in his office), very systematic and direct, and --I would guess--has a lot of clients at any given time. His office is more conveniently located for me both coming from home and getting to school.

Dr. Woman had a patient manner that felt more comforting and personal and the staff at her clinic was incredibly nice. I liked them a bit more than N.YU's.

We haven't made a 100% final decision, but I think I want to go with Dr. Woman. Yesterday, I felt like I was staring at a huge blinking clock counting down to the letters I-V-F and I was terrified. I felt like every treatment we tried would be delaying the inevitable and wasting our time.

Today after my consult, I felt freed from that worry. I felt hopeful that this may work with less intervention and that I might actually have a baby!

Dr. Man could be right and IVF is the quickest and most effective route to having a baby. But LG and I are not prepared for it: not financially, not emotionally, not mentally, not physically. So if I'm going to be trying other treatments (which would be the same at either clinic-- monitored Clomid or injectibles plus timed intercourse or IUI), I want to be with a doctor who has definite confidence in their success and who helps me feel that confidence. If I'm going to spend the entire time dreading the point at which we finally give up on them, why do them at all?

They might not work, and I might be facing IVF or adoption, regardless, but at least this way I will know we gave this process our very best shot. Plus, this is not an irreversible decision. I feel good about our choice, but I know that we can always change course in the future if we want to.

So now: I have to cancel the HSG at N.YU (anyone have any advice on how to do that? Just call and say that we're going with a different clinic for treatment?). I have to sit out the rest of this two week wait (which I'm pretty positive will not result in a baby), and schedule my HSG on day one of cycle 8/15. Lawyer Guy needs to schedule his SA. I need to call Dr Woman's nurse and find out if I can try Clomid the same cycle we do the HSG.

And then...I guess we'll see. I'm trying to take this one hopeful step at a time.

Wednesday, September 15, 2010

Re Consult #1; or, Decisions, Decisions

Thanks so much for all the support and well-wishes you left on my post yesterday. It means the world to see the faith you all have in this process and where I'm going. On my better days I feel the same way, and on my worse days it's good to have reminders that there are people out there who believe this can happen for me.

So...on to the appointment recap!

I guess I'll start by saying that Dr. Man (at NY.U) was very nice and approachable, as well as direct and informative. He wasn't a major cheerleader but he gave us the information he has at this point about our situation, ventured some supposition into what might be going on, and laid out some possible options for the future.

The first bit of (good) news was about my CD 3 bloodwork from a few days ago. My FSH was 5.2, which Dr. Man said was really good and an indicator that I've got lots of healthy eggs. He didn't tell me the estrogen number (and I forgot to ask) but that's probably just as well, because that's less for me to google.

We discussed my cycle history. I told him the lengths of each of my fourteen cycles of TTC and whether I had confirmed ovulation or not on any of them. Dr. Man also said that given the amount of time we've been trying, our likelihood of success without assistance in any given month is about 3%, a disappointing statistic to say the least.

He did an ultrasound and said that my uterus looks good, my lining is thick, and my ovaries look healthy. He showed me the corpus luteum on my left ovary where I ovulated over the weekend (And btw, this totally confirms my little theory about my ovaries. Last cycle I ovulated from my right ovary about 5 days late. In the cycle I got pregnant, the same thing happened. And now I had normal--for me--day 21 ovulation from the left ovary. I think that right ovary is a lazy slacker!)

Thanks to my somewhat irregular cycles, Dr. Man suggested I may have some (mild?) form of polycystic ovaries. He emphasized, however, that he didn't want to call it a "syndrome" because I *am* ovulating most months and that cysty ovaries at the start of a cycle are quite common and don't mean there is anything wrong with the way my body is working (he feels that women are overdiagnosed with what can be a relatively normal condition). He doesn't want to run the tests for insulin resistance because he thinks I am basically normal, and as I'm not overweight, not terribly hirsute, and have no family history of diabetes, he doesn't want to needlessly worry me. He also believes the link between PCOS and miscarriage has not been adequately proven (or not proven at all). He thinks I have lots of good, healthy eggs that take a bit longer to pop out and that we can shorten that time and give me more chances to get pregnant each year.

He ordered an HSG for next cycle, even though he said he doesn't think we'll find any major abnormalities of my uterus or tubes.

He also ordered Lawyer Guy an SA (of course) and confirmed our suspicion that the pregnancy means he definitely has sperm, but it might be of borderline quality, which would help account for our difficulties.

He ran us through our options from least to most invasive and expensive. I know you're all familiar with them, so I won't bore you with the recital. He stressed that he's willing to go at our pace and according to our comfort level, both emotional and financial.

He also told me that I can do a clomid cycle with or without insemination next month even though I'll be getting an HSG, which was good news, as I'd assumed October was out for any treatments given the additional testing I'd need.

I asked him before we finished the consult if he was optimistic about our chances of getting pregnant, and he said he was. He said egg quality was the toughest thing to overcome, and that we seem to be okay in that regard.

It was an intense morning, and Lawyer Guy and I did some talking afterward. I liked all the nurses we met and found Dr. Man approachable and professional. He wasn't super warm and touchy-feely, but he was good about giving us information and data and talking us through different possible actions to take based on that data.

I think Lawyer Guy was a little bummed by Dr. Man's professional caution. Some friends of ours were told by their RE at their first appointment, "We are going to get you pregnant," and LG mentioned to me he was hoping to hear something like that. But I don't fault Dr Man from holding back from that kind of enthusiasm, especially because we don't know anything yet about how I respond to medications or LG's sperm quality. When put to the point, he seemed optimistic, so that's good. But LG's desire for a more aggressively optimistic doctor is something for us to keep in mind as we continue our search.

Lawyer Guy didn't want to talk about any of the specifics of treatments until after our meeting with Clinic #2 on Friday, which I can understand. We'll make our decision that night and get set for what comes next.

But of course, I've done some thinking. I'd like to start with a clomid cycle in October, especially because we've got to put treatments on hold for November and December in anticipation of my sister's wedding. If LG's sperm numbers come back good, then I think I'd like to try clomid with intercourse; if they're borderline or bad, then try an IUI.

We have unlimited IUI coverage with our insurance and zero IVF coverage, so doing a large number of medicated IUIs makes sense for us, until we just can't take anymore. And then we'll need to think hard about IVF and adoption and how we want to use our money. But we're not there yet.

I guess I'm feeling cautiously optimistic right now. I entertained a brief daydream about giving birth to twins and holding them at the hospital after the consult, which is positive. I also recognized that I am sad to be here. Part of me secretly hoped we'd show up and Dr. Man would say, "Are you crazy? You're not infertile! Get outta here!" But we're going to make the best of this, and maybe even get some twins out of the bargain.

RE appointment #2 coming up in two days, and then we'll really be able to make some decisions.

Tuesday, September 14, 2010

That Girl; or, This Girl

I've double-checked that my Ob-Gyn records arrived at the RE's. I've booked a (desperately needed) bikini wax. I've reordered my prenatals (possibly for the last time, since I think the prescription officially expires this month). And I've printed out 17 charts--the record of almost two years worth of my body's reproductive efforts. Late and early ovulation. Long and short cycles. Temperatures and fertility readings and spotting and periods. One positive pregnancy test followed 30 days later by a red dot.

I look at that first chart from November 2008 and the age listed at the top (28) and I think: I am not that girl.

That girl who thought if she read the right books and did the right things and planned and predicted and started early and left nothing to chance she could win at having a baby just like she'd won at everything else that mattered.

That girl who was both so smug and so scared, but mostly smug. Who whispered to herself awful things like "I'm not fat, so I won't have any problems" and "I have a regular cycle, so I won't have any problems" and "I'm starting nice and young, so I won't have any problems" and thought that just saying the words would make them true.

That girl who told her friends, "We're going to start trying to get pregnant now!" and thought it meant, "We're going to have a baby." That girl who thought that making the decision to try was the hard part.

That girl who figured out her first potential due date (thinking it would be the only, not thinking it would be the first) months before she even ovulated. That girl who planned for the "perfect" month to give birth in and the "perfect" way to break the news and the "perfect" labor she was sure to have.

That girl who wondered if she was ready to be a mom even as she cried over her very first negative test.

One year to the week later, we found out the m&m was dead. Twenty-two months later, we're visiting the doctor bearing stacks of paper dotted with little eggs and hearts and acronyms and numbers.

In September of 2010 (age: 30) this girl doesn't bother with the books any longer (thanks for nothing, Toni Weschler). This girl doesn't bother with the thermometer and barely bothers with the charts.

This girl doesn't want to know what her potential due date is. This girl assumes due dates are only and always potential.

This girl doesn't call her friends to talk about another failed cycle, another peak reading, another hopeful or hopeless two-week wait. This girl has watched her friends gain so easily what has come so hard and taken so long. More than anything, this girl wants to be left alone.

This girl has realized there's a depth of jealousy and anger and frustration in her heart that she never could have imagined. This girl has watched it poison relationships from the inside out, wondering how to make herself care when everything feels so bleak.

This girl has discovered sources of incredible empathy and support that she never thought she would.

This girl has fought her own heartache and won. This girl has been defeated by grief and sadness over and over and over again.

This girl doesn't know what comes next. This girl is incapable of prognostication, and finally admits it.

This girl knows that one day in the future she'll be "That Girl" again, unknowing of her destiny, ignorant of the choices she'll make, unaware of the happiness in store for her and the steps required to reach it.

This girl is afraid to hope.

But this girl hopes that day comes soon.

Monday, September 13, 2010

More Pictures While We Wait; or, Scandinavia, Part II

In just two days, we finally go to the RE. As the time has ticked down to the visit, I've gone from excited to terrified and back again. Last night I spent hours googling PCOS and convincing myself I have it (then convincing myself I don't). I think I'm afraid of being told there's something definitively wrong with me but also afraid of being told there's nothing wrong with me and nothing can be done. Or maybe I wanted to check in with that cold-hearted Dr Google one last time before turning things over to a professional.

Whatever the case, the upshot is that right now is a time full of anticipation but very little information to impart. I ovulated recently, which is nice I guess, but I don't have much expectation of it leading to anything--except for those days when I do. So before our rash of RE visits and the recaps that will no doubt follow (and the decisions that will have to be made and the appointments that will have to be scheduled), I figured I'd finally catch everyone up on the rest of our Scandinavia trip.

When last you left our fearless heroes, we had spent an action-packed evening at Tivoli Gardens on their last day in Copenhagen. They next morning, we boarded the high-speed train to Stockholm and arrived in that fair city some 4 hours later.

As with our arrival in Denmark, we got to Sweden on a grey, cloudy, mucky day. And since we'd read in our guidebooks that Scandinavian taxis are hella expensive (the meter STARTS at $9), we decided to walk from the central station to our hotel in Ostermalm. Which required us to cart several large carry-on bags and a massive 60-lb suitcase on a 15-20 walk through downtown Stockholm in a drizzle. That turned into an abrupt thunder shower. And we only had one umbrella (that I shamelessly commandeered).

But we arrived at our hotel no worse for our drenching and quickly settled in. This hotel was not in the red light district as our previous one was, but right on the harbor in an area that we kept likening to Madison Ave on the UES. Lots of great shopping and restaurants nearby. On first night there, we ate on the recommendation of the concierge at a local restaurant that seemed to be more Swedes than tourists and then wandered around the city by night, getting our bearings and checking out the shopping and nightlife:

The next morning we were up early for breakfast and a long walk (thanks to the price of taxis, long walks became a routine with us). Stockholm is built on a series of smallish islands connected by bridges. We walked along the waterfront to Djurgarden, a huge island of parkland where several museums are located. We visited the Vasa Museum, which is dedicated to a salvaged 17th-century Swedish warship that sank on its maiden-voyage and was discovered, pulled up, and preserved in the 1950s. Then we walked through the park to Rosendals Tradgard, a nonprofit working organic garden in the middle of the island. Here's the pick-your-own flowers plot:
They had a lunch stand with organic food grown on the premises (Lawyer Guy had a sandwich and I had an amazing rabbit & veggie risotto) where we ate before starting the 45-minute-or-so walk back to our hotel.

We were quite tired when we returned to our neighborhood, and it was later than we planned, so we scrapped our intended sightseeing trip to Gamla Stan--the old city--and instead made a reservation at a restaurant there for dinner that night. We had a few late-afternoon hours to see things, so we went to the National Museum for an hour before it closed. Then we sat at a sidewalk bar at a nearby hotel and had beers while overlooking the harbor and the palace across the water.


Interestingly, most sidewalk cafes have seating facing out to overlook the water or the street rather than seats that face each other across the table. I guess Stockholmites really enjoy people/boat watching!

After returning to the hotel and changing, we walked to Gamla Stan for dinner at a modern Swedish restaurant in a 17th-century tavern. (We both sampled reindeer mousse!). We then wandered about the old city by dark, ducking into teeny little alleys and posing in front of short, narrow doorways, before walking back to the hotel.

The next morning, we woke up early and headed back to Gamla Stan to tour the royal palace the moment it opened. Poor Lawyer Guy did not enjoy this part of the trip. He has zero fetishistic enjoyment of European royalty and is strangely unmoved by antique furnishings or dec arts museums. Sad. I, however, fully enjoyed seeing the largest (or was it the oldest? I can't recall.) European palace still used as an official residence. And yes, it was quite large. We saw the ballroom where the crown princess's wedding was recently held and the banquet room where the Nobel prize winners are given a dinner following the ceremony. The crown jewels were also fun to see (and Lawyer Guy did like trying to figure out their value).

As we left, we ran smack into the changing of the guard, an impressive (and very loud) spectacle on horseback:


We then wandered about the old city for several hours. I visited the Cathedral, across from the palace, where there is a famous wooden 16th-century statue of St. George slaying the dragon. A bronze replica of it stands in a small square nearby:

We ate lunch and did some shopping (I bought Swedish yarn for my knitter best friend for Christmas and LG got his mom a linen shawl in thanks for her dogsitting while we were away). We ate lunch as a small tavern-looking restaurant decorated with vaguely Viking-ish murals. We ate herring and meatballs for our most authentic meal of the trip.

After lunch, we walked south to another island, Sodermalm, which we insisted on calling "the Brooklyn of Stockholm" (yes, we are your typical myopic New Yorkers who insist that NYC is the benchmark by which all else must be measured). The main character from The Girl With the Dragon Tattoo lives here, and as Lawyer Guy was reading it at the time, we decided to visit his address. We went down to SoFo, which the Times travel section had just featured as an excited shopping destination, and checked out the super hipstery stores and restaurants and tried on fedoras and marveled at the global commonality of hipster fashions.

We also sat and rested our (by that point) aching feet in several pleasant, shady squares and churchyards. I accidentally hit a color-highlight button on our camera while trying to take a picture of Lawyer Guy in one of those churchyards and took what turned out to be a pretty cool picture (the building was a sandstone-y color, the pink and yellow are just the patches of shadow and light turned into color):


We had dinner reservations for our final night at a restaurant called Le Gondolen just over the bridge from Gamla Stan in Sodermalm. There's an early 20th-century iron elevator/gondola that takes passengers from the bridge up to the level of most of Sodermalm (otherwise you have to climb about 300 steps cut into a stone wall). We rode the gondola when we first arrived, wandered around the neighborhood, and then came back to our restaurant, which is in the gondola structure in that glass-windowed space suspended in the air:


You have an incredible panoramic view of the harbor and the city from the window, but unfortunately I didn't get any particularly great shots of it. We need a better camera, clearly.

After a very good dinner and some very good wine, we walked alllllll the way back through Gamla Stan to our hotel on Ostermalm. Because we'd had such an early reservation, we walked home just as the sun was setting and got some lovely pictures of buildings in the harbor with hot-air balloons floating over them (I kind of wanted to take a hot-air balloon ride, but am afraid of heights, so these pictures took the place of one). Here's a red balloon over the National Museum:

And here's a green balloon over (what I think is) Skeppsholmen, a smaller island near the art museum:

Not bad considering I was rather drunk when I took them!

We had talked about getting a reservation to go to the Ice Bar than night but were so, so tired from our 8+ hours of walking that we just got a drink at our hotel and then went to bed very sleepy.

The next day we were up and out early and back to Copenhagen for one last night before flying out. We got into the city around 5 pm and headed to our next hotel, in the lively Nyhavn district. Our hotel was in an 18th-century warehouse right on the harbor, as you can see from this picture of the view out our window:

We were upgraded to a suite with windows overlooking both the canal (the one shown above) and the harbor itself. We had dinner that night at a great nearby restaurant called Salt (in another reclaimed warehouse) and walked around Nyhavn for a bit before going to bed-- only to be woken by what sounded like bomb blasts but were actually fireworks over the national theater next door. I had a great view from the other window. After that settled down, we went to sleep.

The next day we had to leave around noon for the airport, but I insisted we spend some of the morning exploring Christianshavn, the Free City where hippies have lived commune-style in free apartments since the '60s. It was the nicest day we'd had in Copenhagen on the trip (the weather was better in Stockholm), and we enjoyed walking along the water and seeing the beautiful canals (like this one in Christianshavn) from the shore rather than a boat:


Disappointingly, though, nothing was free. Maybe we didn't walk far enough into the Free City, or maybe they know a non-hippie foreigner when they see one.

Then it was back to the hotel and into the first taxi we took all trip for our ride to the airport. And 9 hours, one beer-stained carry-on (thanks to the passenger in front of me) and a spot of petty theft in our building (everything fortunately recovered), we were home and ready for a jet-lagged night's sleep and a return to work, school, and many hours of paper writing.

But Scandinavia was great and I definitely need to return to Stockholm one day, which is one of the prettiest cities I've ever seen.

Thus ends (for now) the travelogue portion of this blog. I hope it was illuminating!

Tuesday, August 24, 2010

UPDATED Help Me, Bloggers!; or, An Unexpected Call

I'm working on a photo-filled Scandi trip recap, but it is getting stalled by my syllabus planning schedule (I return to teaching on Thursday and am woefully behind in planning my new courses), so you'll have to wait until the end of the week for our virtual tour of Copenhagen and Stockholm. But! In the meantime! Some news and a request for advice!

I posted in the past about the insurance issues with the office of the RE at N.YU (Dr. Man) I had originally wanted to see. Because of a lengthy on-going contract negotiation between that office and my insurance company, I went ahead and made an appointment with a different RE at Cor.nell (Dr. Lady) for a few weeks from now.

Well, yesterday the very friendly nurse from Dr. Man's office called and left me a message saying that the insurance contract has been finalized and they now accept my group.

So I'm putting this to my RE-adept readers. Should I make a second consultation appointment with Dr. Man? My appointment with Dr. Lady is the 17th (which will most likely be after ovulation). I would hope to get an appointment with Dr. Man this month, as well.

Is it kosher to have preliminary meetings with more than one RE office? If I do, should I be upfront about the fact that I'm looking at another clinic as well, and take time before moving on to testing with either office? If I do set up this second appointment, what sorts of things should I consider in deciding which to work with? What kinds of questions should I ask? I know many of you had disappointing experiences with your first REs. Are there any warning signs you would recommend looking for to stave off that possibility?

If I can get this sorted out by tomorrow, I'll feel much better about beginning the semester in two days: new school year, new classes, new hope on the TTC front, all in time for the anniversary of the m&m's conception. Maybe things will start looking up for me soon!

UPDATE:
I called and made the appointment for Dr. Man (two days before my appointment with Dr. Lady). And I mentioned I'm on CD 3. And I'm going in for blood work today after my therapy session (conveniently around the corner from Dr. Man's office).

Holy crap, this is really happening.

Thursday, July 29, 2010

Abandoning Hope; or, Finding It Again

I'm not sure if this is a sign of hope or despair. I'm not sure if I'm taking action or giving up. But I took a really big step today: I made a firm appointment for my first RE consultation.

This cycle is not going so great, and it's had me down for the last few days. After all my optimism about vitex last month, I'm on CD 17 with no EWCM and still showing low readings on the CBEFM. Even worse, the mid-cycle spotting is back, despite continuing with my raspberry leaf tea. It's not a lot of spotting (not like it was in Spring 2009) and it's brown and faint, but this is not making me happy, to say the least.

Now in the past, cycles like this would send me into a tailspin. I direct your attention to this post (coincidentally, also on CD 17) from last September as case in point. But a few factors have modulated my emotional reaction into something more like vague unease and disappointment rather than vicious self-recrimination and dismay.

a) Time. Seriously, I'm no longer capable of getting all worked up over every fucking bump in every fucking cycle. After eighteen months, I just don't have it in me any more.
b) Options. Knowing that I have decided to go to the doctor, to get tested, and to finally have some assistance on this road is taking a huge burden off my back. So what if this is a fucked-up cycle. I'll soon have a professional on the case.
c) Experience. I've cried about screwy cycles before. I've worried I wouldn't ovulate. And I (almost) always have. I even got pregnant during that crazy-making screwy cycle last September, so I'm not shedding all hope now.

Make no mistake, despite my reasonably calm reaction to these setbacks, I am not a happy Sloper right now. So I decided to call the Dr's office at N.YU to find out if the insurance hurdles have been surmounted yet. They haven't (though the nurse is very hopeful for September 1st). That's okay. When they are, I'll make the appointment for the consult there.

In the meantime, I've got a consult with a Dr. at Cor.nell! Who takes my insurance! And has good patient reviews online! Once I get the appointment at NY.U, I'll go to both consults and figure out which doctor I feel more comfortable seeing.

So come September 17th, my RE adventure begins. The door on getting pregnant unassisted is starting to close for me, and I pushed it a little more by making that call. But a window is definitely opening, and the breeze feels good.

Thursday, June 17, 2010

Friendly Nurses; or, Insurance Executives Always In the Way

Things are moving, slowly but surely. I played several rounds of phone tag with the appointment nurse at the office of the RE I've targeted (Jay at 2 Week Wait, I'm looking at your new RE) and finally connected with her today. She was so, so nice. I was very nervous to make the call, but she was reassuring and kind, which gave me a good feeling about the office.

I didn't schedule the appointment yet because of an insurance snafu. As of now, they don't work with my particular group, but are in talks with my provider to handle all of its groups soon. She said the deal is supposed to have gone through months ago, but they're still working on it and still waiting for the contracts to be signed. She thinks it will be all complete by August 1st.

Since I don't want to make my appointment until the last week in August or first couple of weeks in September anyway, we agreed that I will call back to schedule the appointment once they get confirmation that my insurance is now accepted. She promised to call when the deal goes through and let me know (she said she's keeping a list of patients to notify at that point). She also said I won't have a problem getting an appointment in September if I call in early August.

And finally, I told her that I've had no fertility testing but had a miscarriage in November. She said that when I do come to the appointment I should bring the testing results from the miscarriage, any ultrasounds that were taken during the pregnancy, and my results from my regular gynecological exam. She also suggested that I could have my gyno test my CD 3 FSH and Estradiol levels to save time with the new office.

While I'm frustrated and irritated with my insurance provider yet again (can you believe that we actually have good insurance?) I'm optimistic about working with this office. I hope that it won't get to that point, but it sounds like they really care about their patients just from the brief interactions I've had on the phone.

And thanks again for the advice! This is a scary step and I'm not sure how I would have made it without having followed your stories and hear your recommendations over the last year.

Tuesday, June 15, 2010

Moving Forward; or, What Comes Next

I did it! After reading through all your comments and e-mails and listening to my gut, I called to set up my RE consultation. I called kind of late and didn't get through to the nurse, but I left my information and I'm hoping to hear back (or call again) tomorrow. I'm shooting for an appointment date in late August or early September, right around the time I estimate cycle #7 post-miscarriage will begin.

After I made the decision to set the appointment up, I began to second guess myself. What if I'm moving too fast? What if I'm not giving us enough time to get this done on our own? Four months isn't that long to try-- we got our BFP in cycle 7 last time. Maybe we just take a little longer than most people. But then again, Taking Charge of Your Fertility recommends seeking help after four cycles of timed sex that don't succeed.

I still have this fear that I'm making problems up where none exist, and that by worrying over when we'll get pregnant I'm preventing us from conceiving. I think when I schedule the appointment I'll feel a little more secure. And of course I hope that we get pregnant before the appointment and have to cancel. That would be the best outcome! But with only two cycles left to try, I need to be prepared for what comes next.

With all I'm doing this summer-- learning German, renovating our closets, traveling to Scandinavia, writing an article to submit to a journal and a paper for my conference, studying for my orals and working on several seminar papers--it will be August before I know it. And then this show will really start.

Sunday, June 13, 2010

Taking Stock; or, Advice from the Blogosphere

Well, Cycle #4/#11 followed in his brothers' non-baby producing footsteps. Time to see what Cycle #5/#12 can do.

The days before I get my period are always the worst. I try to keep my hopes up, but the fact that yet another cycle has failed becomes increasingly hard to ignore. I rapidly leap from realizing that this cycle didn't work to predicting that no cycle will ever work.

But on CD2, cooler heads prevail. The past 16 months have taught me several good things about my and my husband's chances of conceiving a child. I know that:
  • He's got sperm, of whatever quantity or quality, and at least some of it is capable of swimming up to and poking an egg.
  • I have produced at least one egg at the time when my CBEFM said that I did.
  • I am capable of building a uterine lining thick enough to allow implantation.
  • I've got at least one clear tube.
Those are all positives, I'm aware. And while it's hard to watch other women conceive on their first tries without feeling like a failure, I do believe that left on our own, Lawyer Guy and I would eventually conceive another child.

But I also know that 18 months is long enough to try on our own. 18 months is a good, serious shot. 18 months is time to start looking for answers and possibly even solutions.

We're giving the unassisted baby-making a few more goes and then will visit our first RE at the end of August, right after our sixth cycle of TTC post-miscarriage and right after we get back from Scandinavia. I hope we get happy news before that point, but with only two cycles left, I'm prepared to begin testing.

And this is where you come in! I've done some preliminary research and am considering N.YU Fer.tility Center, based on their reputation and IVF results and the fact that they claim to accept my insurance. (My insurance covers testing and prescriptions but not procedures, so any iui or ivf would be out-of-pocket). I know that there are other good clinics out there, though, and I want to hear from NYC loss/IF bloggers. Please tell me who you see and why you like their practice. If you are not from NYC, never fear, I care about your opinion, too! How did you find your RE? What factors are important to consider when looking for one? How did you make your decision to start visiting a specific clinic?

With this info, I hope to schedule my appointment this month for the end of August. Scary, but exciting!

There's one other issue I'm looking for bloggy advice on. Over the 7 months since the miscarriage, I've put on some weight. Not enough to be "heavy," but enough to feel like my clothes don't fit great and I'm not happy with the way I look. I forced myself not to worry about the weight I was gaining because I didn't want to add stress to my life while we tried to get pregnant. But with that pregnancy who knows how many months away, I need to get back to liking the way I look and feeling good about my body again.

I want to lose 5-7 pounds and don't have a strict time frame in when it has to happen. Does anyone have any good weight-loss strategies? I belong to a yoga studio rather than a gym and I attend 2-3 classes a week. I try to eat healthily, though I do eat too many carbs and too much dairy, and I tend to snack when I'm in the 2ww and depressed. Any advice is appreciated--not just for the kinds of foods recommended to eat (most of which I can probably guess) but also for how to judge portions, figure out how much of what kinds of food to eat in a day, how to keep track of your calories and stuff like that.

By the end of the summer I want to be lean, relaxed, and pregnant, but I'll take the first two if that's all I can get.