#3

I've come to accept that I don't live in a world where positive pregnancy tests mean you're going to have a baby. At least it was a new ending this time. Instead of "there's no heartbeat" we got "I can't find anything". A more sensitive ultrasound showed "something" in my fallopian tube. A week of slowly increasing betas, and a New Year's morning where I thought I was passing a kidney stone led to another ultrasound showing the "something" in my tube had grown to fill it. It had bled, but there was no active bleeding, so I took the option to take chemotherapy drugs to stop the growth of the "something", leaving surgery for backup.

My numbers decreased well over the next two weeks, but another Friday night and Saturday morning of pain sent me to the ER with internal bleeding. The "something" had increased in size due to the bleeding, and I was going to rupture. They did emergency surgery to remove the damaged tube and ovary. I'm a couple months out from surgery, and doing fine.

This one was the easiest, ever since I started crying in the exam room before the very first ultrasound. I didn't *know* something was wrong, but my body obviously knew it. Maybe it helps that the blastocyst never resolved itself into anything, and I didn't have to (get to) see that little shape on the screen, with a head and arms and legs that was supposed to be my baby. Maybe I was so caught up in the physical trauma that the emotional stuff took a backseat. Maybe I'm becoming desensitized to pregnancy loss.

My recurrent pregnancy loss panel didn't show anything aside from my progesterone problems, which we've already got under control. From everything I've read, having only one tube or ovary doesn't decrease your chances much, as the remaining parts just take over. My right ovary was less responsive to medication anyway, so taking it out of the rotation might actually be a good thing.

Since my tubes weren't blocked and ectopics aren't really caused by anything, it's still the "bad luck" diagnosis. I saw a reproductive endocrinologist at the University hospital for a second opinion, and that was a comfort. She confirmed we were on the right track, put me on some extra medication to be on the safe side, and I go back in six months if we're not pregnant or if we have another loss.

The due date for my second pregnancy passed without fanfare last month. All the women I know who got pregnant about the same time I did have now had their babies, so it's been pretty painful getting all that news. We're trying again, because it hurts more to not try than to try. In the meantime, we're trying not to live our lives on hold.

Mother's Day

Yesterday was a lot harder than I thought it was going to be. The first thought that popped into my head was "My baby would be nine months old, and this should be my first Mother's Day." I got most of my crying out early, but my cousin Cassie got me going again completely inadvertently when she was giving me her kids' pictures, "You know, not everyone gets these. I think of you more like a sister, even though we don't talk too often. I trust you with my kids." It was just a really, really nice thing for her to say.

 Mom really liked what I did for her. Grandma had given out some of Great-Grandma Ketelsen's crochet work, and Mom had claimed a doily that said "Mother" on it, but was in rough shape. So I mended, cleaned, and framed it, and it turned out very pretty. I wish I would have had the chance to try to sun-bleach it and maybe some of the other stains might have lifted more, but she was alright with it the way it was.

I played quite a bit of catch with Hayden. He's started t-ball, and his first game is already this week. We're already coming back for his preschool graduation on Thursday. I asked him if he was practicing any songs for the ceremony, and he had no idea, but he thought awfully hard about it. I ordered a cookie cake, like I did seven (!) years ago for Calvin.

I'm ready to start making a push for more testing, to take the next step. We were all hoping for an easy fix, and that's not happening.

The Weight of the World

BUFFY : This was when I quit, Will.

WILLOW: You did?
BUFFY: Just for a second.

BUFFY: Nothing special about it. And then it hit me.
WILLOW: What hit you?
BUFFY: I can't beat Glory. Glory's going to win.
WILLOW: You can't know that.
BUFFY :  I didn't just know it. I felt it. Glory will beat me. And in that second of knowing it, Will...I wanted it to happen.
WILLOW: Why?
BUFFY: I wanted it over. This is ... all of this ... it's too much for me. I just wanted it over. If Glory wins ... then Dawn dies. And I would grieve. People would feel sorry for me. But it would be over. And I imagined what a relief it would be.

Buffy is my security blanket. When I need comfort, I watch Buffy. There's always something that Buffy has gone through that I can relate to my own life. Hers is invariably worse, and it makes me feel better.

I had this scene. Instead of re-shelving a book, it was carrying my tea back to my office. And I gave up. I imagined what a relief it would be to give up on having children, and not have to carry this weight on my shoulders anymore. I imagined my life without kids and I accepted it and I wanted it to happen. I would get to grieve only once, and then it would be over.

I haven't truly given up, of course. I'm still trying; I'm still hoping. But the idea is there and it pops in from time to time. It's not necessarily bad. It helps temper the hope so the fall of disappointment isn't too great. Maybe it's a step in the direction of acceptance. Maybe I just needed a moment of respite, to give me strength to keep on fighting.

Moving Right Along

My latest ultrasound showed the ovarian cyst is gone, so I'm onto another round of treatment. I'm trying a new drug - Femara - this time. It's not FDA approved for infertility (it's actually a drug used for treatment of breast cancer) but it does the same the same thing as Clomid, and has less risk of side effects like cysts. I didn't have any of the moodiness and nausea the Clomid gave me, so I like it already. As long as it produces results, of course.

Mom's transplant doctor is recommending that they plan the bone marrow transplant sooner rather than later. We found out last week that both her sister and her brother are matches, so that was a pretty incredible blessing. We were told that they wanted to see the cancerous cells in her bone marrow at less than 50%, but new thinking is that as long as an upcoming PET scan doesn't show cancerous cells in other parts of the body, they want to go ahead and do the transplant while she's healthy so she has a better chance of fighting back.

It Just Keeps Getting Worse

The cyst is still on my ovary, so I'm on birth control until it goes away. Actively preventing something I want so much is breaking my heart.

One of the Bad Days

So much for trying to post every day. It seems like I only feel the need to post when I'm emotionally overwhelmed. I suppose that's all right; it is my blog after all, and I use it how I need to use it. I just thought it would be nice if I could post some happy things once in a while.

I'm upset again over trying to concieve. A year ago tomorrow we found out I was pregnant. I was on the exact same course as last year; if I conceived this month, the due dates would have been the same. I was so torn this about the possibility of doing everything exactly one year later and now that I know that's not a possiblity, I realize I wasn't torn at all.

I recently read a description of the grief of infertility. With normal grief, you lose your loved one, and you *know* they're never coming back. With infertility, the cycle is never ending, never healing: every month you hope, and every month you're disappointed and you grieve your dream. I grieve the baby I lost and the baby that will never be, every month. I try to temper the hope to mitigate the disappointment, but it's never enough.

The grief is normal in that some days are better than others. This is just one of the bad days.

1st

I'm contemplating doing NaNoBloMo this year. I'm not back in the blogging habit, and I'm still trying to figure out what I make public and what I keep private. It's not just me anymore, and my husband is not nearly as public online as I am. I'm hoping that by doing this exercise, I can figure out that balance.

I had very good results from my blood test for the second round of Clomid. My progesterone levels were 48.3, compared to the 15 they wanted to see, so the medication is doing what it's supposed to do. It turned out that last month, the medication made me ovulate a week later than normal, even though my temperatures initially indicated otherwise, so the progesterone level they measured was not at the right time in the cycle.

I'm hopeful. Maybe a little too hopeful - I try to temper it, because if I don't, the disppointment every month when I'm not pregnant is just too much to bear. The waiting game isn't easy, but at least now we've got a proven strategy to fix the problem.

One Step Back

I'm frustrated. My progesterone level came back at 1.58, much less than the 5 I got last month on an unmedicated cycle. I knew it wasn't going be good news, since my temperatures had been in the basement since Sunday, but I wanted to be hopeful. To add injury to insult, Clomid can mimic the symptoms of pregnancy, so my boobs hurt and I'm moody as hell. I try to keep from taking it out on Joe, but he can sense it anyway, and I thank him all the time for putting up with my whacked-out emotional state.

Next month, my dose is doubled. I agree with the strategy, as I'd really like to get my body to produce the hormones it needs on its own. Also, I guess it's pretty common to have spikes every other cycle, so that would be a bonus. I'm on the right track...I just feel like I'm wasting time my biological clock doesn't have.

Answers

My blood test last week actually gave me some answers. Everything was normal except my progesterone was low. It is supposed to be around 15 during that point in the cycle, but mine was at 5. I did have a couple symptoms of low progesterone, like a short luteal phase (time between ovulation and menstruation), so this is not a complete surprise. Low progesterone might also have been a contributing factor to my miscarriage, too. We'll never know for sure, and I'm sad that it was something that might have been prevented if we'd known, but I'm glad it's something that can be monitored and fixed.

So now it's experimentation time, to see what combination of treatments will get my progesterone levels where they need to be to have a healthy pregnancy. My doctor has started me off on Clomid, which is a drug to help strengthen ovulation. The hope is that a more mature corpus luteum, which forms after the release of the egg, will produce higher levels of progesterone for longer, in effect, kickstarting my body's own progesterone production. If it works, my next blood draw will show a more normal level of the hormone. If it doesn't, more tweaking.

I'm not looking forward to having my blood drawn every month, but women have done much worse in order to have babies. One woman on my support forum just got a positive, and is now facing 36 weeks of bedrest (two third-trimester losses, your heart breaks just thinking about it). It's worth it.