Wednesday, December 28, 2011

IUI Week 3

If you're just joining the series, this is post #3 of 6.  If you'd like to start from the beginning, scroll down to the bottom and click "IUI" which will pull up all posts associated to our IUI process.  Once the refreshed view generates, scroll to the bottom and read up.  As I stated in the series introduction, please don't make any assumptions, ask any questions or post any comments until the series is complete...you never get the full picture until the puzzle is finished.  Thanks!

Day 15
Today was the big day...insemination.  We woke up before 7...on a Sunday...and arrived at Dr. K's office about 10 minutes to 8.  We pulled into the parking lot and were the only car.  Luckily, the front doors of the office building were unlocked and we proceeded to the 2nd floor.  As we stepped off the elevator, the clinic doors weren't open and the lights weren't on.  Oh no...did we go to the right place at the right time on the right day?!  Sigh of relief...a few minutes later, Dr. K's nurse came in and opened the clinic.

The technician called JPug back once she arrived and he did his thing.  It would take the technician about an hour to wash his sample so we left the office and enjoyed a quick breakfast.  Once we returned, we waited in the office for about 15 minutes before Dr. K's nurse, Jamie, escorted us back into an exam room.  She answered a few questions we had and reviewed the results of JPug's sample.  Good news...the numbers were improved from the previous 3 samples...still below the target numbers but literally 100% better than they were previously so JPug and I were pleased...guess the medical food is actually working :)  Jamie provided a gown, asked me to change and returned about 10 minutes later to complete the procedure.  The procedure is similar to a yearly exam...slightly uncomfortable but no real pain.  Once she was all set up, she inserted a catheter into my cervix and inserted the sample into my uterus...insemination complete.  I laid back on an elevated table for 15 minutes and we were free to go about our day.

Now comes the hardest part...waiting.  We'll wait two weeks before we take a pregnancy test.  Right now, two weeks seems like FOREVER.

Day 20
Today I began another medication, Endometrin, to ensure the lining of my uterus stays thick enough to support implantation and a maturing embryo.  I’ll continue to take the pills once a day until we take “the test”.  If it’s negative, I’ll discontinue the Endometrin and allow my body to cycle.  If it’s positive, I’ll continue taking the pills through my 10th week of pregnancy.  The pills are literally the biggest I’ve ever seen but at this point there’s no denying I’ll do whatever it takes to give a potential baby Pug the best chance to come on board and stay on board for a full 9 months.

Going through the process…the hurry up and wait…I’ve been doing a lot of reflecting.  On one hand, it sucks that we couldn’t conceive naturally and we had to turn to modern medicine for assistance but on the other hand, modern medicine is literally giving us the hope that we will one day have our own, biological child(ren).  The advances in medicine, understanding of the reproductive process and steps doctors can take to make positive changes…the whole process is TRULY AMAZING.

Saturday, December 24, 2011

IUI Week 2

Day 9 - AM
I finished my first round of Clomid two days ago and I'm happy to report that I experienced NO side effects.  JPug is the big winner in this situation because that means no moodiness.  This afternoon I go for my HSG (hysterosalpingogram) which I'm secretly dreading.  An HSG is an x-ray procedure where dye is injected into my uterus and should flow into my fallopian tubes.  Hopefully, it will ensure the structure is normal and no blockages exist (if there's a blockage, the egg is unable to meet the man's sperm for fertilization in the fallopian tube which is crucial for conception).  When Dr. K's office told me they'd be performing the procedure, they also added the caveat to stay off the internet.  HSGs are notoriously painful if a blockage exists as the contrast dye builds up in the woman's fallopian tubes until the pressure clears the blockage (good thing but painful during the process).  The internet provides a wealth of information regarding the procedure but it's also a place where women who have had bad experiences come to vent; for the most part, I stayed off the internet.

Day 9 - PM
I left work at 2pm and headed to a diagnostic imaging center.  As I left work, I realized I forgot to take the recommended 400mgs of Ibuprofen 1hr before the procedure so I detoured by a pharmacy on the way.  After checking in, I was moved into an x-ray exam room where they provided a gown so I could change.  Before beginning the procedure, the technician explained what the radiologist would be doing and asked JPug to take a seat in the waiting area.  They would be inserting a catheter into my uterus, inflating a small balloon at the end to ensure the catheter doesn't fall out and injecting contrast dye while taking x-ray pictures of the structure...sounds simple.

I laid back and the radiologist began.  It took a few minutes to get everything set up and in place; thus far, the procedure had been uncomfortable but not too bad.  Once she was ready, the radiologist said "OK, I'm all set".  I lifted my head (which had been turned to the right watching the monitor) to acknowledge her comment but she didn't make eye contact.  Before I knew it, I turned my head back to the monitor and could see my uterus and fallopian tubes clear as day.  I didn't get a chance to ask if the procedure had been a success before the radiologist said "Wow, you're almost finished"; she snapped a couple pictures and I was done.  The procedure had been slightly uncomfortable but wasn't anything near the pain some women expressed online.  I would classify my visit to the radiologist as a complete success.

Day 11
This morning, JPug and I stopped by Dr. K's office for my second ultrasound.  As the process continues and I near insemination, the ultrasound technician is looking at the size and number of maturing follicles (each follicle contains an egg) as well as the thickness of my uterus (which will hopefully, eventually support a maturing embryo).   Today the radiologist found 3 maturing follicles (one larger than the other two) but noted that my uterine lining was thin.  I'll begin taking Estradiol for the next 3 days which is a drug that's used to enhance the thickness of my uterine lining.

Day 13
Today is my last day of Estradiol and I'm happy to report I haven't experienced any negative side effects.  Today is also the day for my Ovidrel shot which I'll take between 8 and 10pm to trigger ovulation .  Please note...I'm REALLY not looking forward to giving myself a shot.  Neither Dr. K's office nor the pharmacy provided directions regarding administering the shot but I was lucky enough to find some on YouTube...the internet is pretty cool, huh?!

Around 8:30pm, I finally mustered enough courage to give myself the shot.  I was at a baby shower for a friend so I excused myself to the bathroom, laid out all the supplies and began.  First, the alcohol swab...somewhere between both hips and below the belly button.  I allowed the alcohol to dry and pulled out the syringe.  I pushed the excess air through the syringe, pinched the previously-swabbed area, stuck the needle in and shot away.  I have no interest in becoming a regular drug user but the shot wasn't too bad.  I cleaned up my supplies, left the bathroom and rejoined the party.

Thursday, December 22, 2011

Simply Divine

Interrupting my regularly scheduled blog series to bring you something delicious...
I recently (well, not so recently anymore) discovered Dove's Raspberry & Dark Chocolate Swirl Silky Smooth Promises.  If you like raspberry and dark chocolate and don't mind artificial flavors in limited quantities, these little chocolates ARE.AWESOME.  They come in small squares (maybe 1sq. inch) and are wrapped in brightly colored pink foil with a fancy brown swirl.  Each candy comes with a little message on the inside wrapper (Dove calls these Promises) which always makes me smile.  Indulge a little and pick up a bag next time you're out and about...hopefully they won't disappoint.  Enjoy!

Tuesday, December 20, 2011

IUI Week 1

Tuesday - Day 3
Today was my first of 4 or 5 appointments at Dr. K’s office over the next month.  Since seeing Dr. K for our initial visit in August, we’ve gone through a battery of tests, I started a synthetic thyroid hormone supplement and we consulted Dr. N for a full JPug check.  All the while, one thing remained the same…I was to call Dr. K’s nurse line on the first day of my cycle.  My cycle started Sunday and I went in for the first of many appointments today.  I’m sure each physician practice has their own way of doing things…our experience is with Dr. K so that’s what I’ll share.  

Day 3’s appointment was quick, easy and painless…hurray!  It’s been 5 weeks since Dr. K increased my  supplemental thyroid hormone dose and it was time for a re-test.  My last TSH level was 2.7 and Dr. K looks for 2.5 or below so we’re hoping for good news later this afternoon. After the blood draw, I moved into an ultrasound exam room where the technician completed a baseline transvaginal ultrasound to check my uterus (thin lining, free of pollups and clots, etc.) and ovaries (no large follicles which could react poorly to medications during the cycle and cause problems).

If Dr. K thinks everything looks good, I’ll begin my first dose of Clomid later today.  Clomid, the brand-name for clomiphene citrate, is a well-known fertility drug that’s used to jump start ovulation in women.  If you’re interested in additional information on Clomid, read this article.  I’ll take it for 5 days (cycle days 3 – 7) with the hope that it enhances egg production, producing one (or potentially more) mature eggs.  Dr. K will likely start me on a low-dose of Clomid (50mg) which my body may not react to.  If that’s the case, that’ll be another piece of our ever-evolving puzzle and we’ll wait to increase the dose and continue our journey next month. 

Clomid does have a handful of side-effects including mood swings (lucky JPug) and over-production of eggs.  Multiple mature eggs increase a couple’s chance of multiples and could even cause a woman’s ovaries to twist or rupture…neither of which are considered “good” outcomes.  The prospect of having multiple babies might seem cool and exciting but for a couple experiencing infertility, the goal of treatment is to have one healthy baby in utero and deliver a healthy baby at full term.  Multiple babies are more likely to deliver early and have complications related to pre-term delivery. 

I heard from Dr. K’s office a few minutes ago and my morning ultrasound looked “good” (or maybe even “great”…I can’t remember).  They feel comfortable moving forward with Clomid for this cycle (as well as two other drugs which I’ll explain in a future post) and hopefully the tricky Thanksgiving holiday timing will be on our side.  I’m happy to report that we continue to make steps in the right direction and am cautiously optimistic that the procedures will lead to a baby Pug on board.

Wednesday - Day 4
One more quick update...I heard from Dr. K's office just after lunch and the results of my TSH evaluation are in.  Drum roll please..........it's 1.46.  YIPPEE!  One step closer.

Monday, December 19, 2011

The Process

Over the past month and a half, I haven't published many posts but I've been blogging like crazy.  TeamPug went through our first round of IUI and the roller coaster of emotions associated with it.  The posts, organized into a series of 6, will be published over the coming weeks.  They track the process and associated emotions every few days.  The posts were written in real time...as we experienced the ups and downs...so what you'll read is pure.  I have one request...please don't make any assumptions, ask any questions or post any comments until the series is complete...you never get the full picture until the puzzle is finished.

Friday, December 16, 2011

Sew What?

Two and a half years ago, one of my best friends from high school delivered her first child, a baby girl, 7 weeks early; after a couple of tough months, Ava finally came home.  Today, she’s a healthy, thriving little girl shows no signs of prematurity.  During her stay in the NICU at Mercy hospital in St. Louis, Ava received a different crocheted hat every day to keep her little head warm.  The hats were donated by various individuals/groups in the STL metro area…not only did Ava receive a hat but every child in the NICU did…every day.  Inspired by the kindness shown to her family and a love of crafting from her childhood, Ava’s mom Sarah began crocheting.  Before leaving the STL area, Sarah and her husband Andrew returned to Mercy and provided replacement hats for every day of Ava’s stay…paying the love they received forward.

I’ve always wanted to pick up a hobby I could work on while watching TV in the evenings.  After joining Children’s Mercy Hospitals & Clinics in February, I thought crocheting NICU hats similar to the ones Sarah gave to Mercy would be a great start.  I consulted Sarah (who has continued crocheting since Ava’s arrival), watched a couple of YouTube videos, made my first supply trip to Joann’s and got started.  After I had a handful of hats to donate, I stopped by the hospital’s volunteer services office to make my donation. 

Hit the breaks…upon my arrival at volunteer services, I found out that Children’s Mercy doesn’t accept crocheted hats...only sewn hats made with a specific type of fabric (stretch cotton) from a single, approved pattern.  Well shucks, what’s a girl to do with a handful of tiny hats, no sewing machine and limited knowledge of sewing?  In swooped JPug with a sewing machine for our fourth anniversary (in June) and I got to practicing.  Along the way, I picked up the necessary fabric and thread for the NICU hats and convinced a couple of friends to sew with me.  Now we have a nice little sewing “club” that meets once a month…making NICU hats, baby items, holiday gifts and household items (to come).  The first projects weren’t great but we’re continuously improving and that’s what matters.

Below are a couple of pictures from our first go at sewing NICU hats.   To date I think we’ve donated about 100 hats and have enough material to donate a couple hundred more.  As I have time, I’ll continue to blog about our sewing adventures…patterns, how-tos & the finished products.  If you enjoy sewing and are interested in donating NICU hats to Children’s Mercy in KC, just let me know and I’ll forward the information on.  Last but not least, if you’re on Facebook and are looking for beautiful, handmade children’s items, check out Sarah’s B.I.B.S (Baby Items By Sarah) page and see all the terrific items she’s been crafting up.

In progress...sewing the top of the hat.

Finished product!

Saturday, December 10, 2011

A Mile in My Shoes

I believe the saying goes… “You can’t fully understand a person until you walk a mile in their shoes”. So, I thought I’d give you a chance to try my 7.5 (sometimes 8s) on for size...

The “I” word (you know that big elephant in the blog) is as much physical as it is emotional. I haven’t talked about emotions much…sure, I may touch on something here or there but I wanted to devote an entire post to the topic. I know you won’t be an expert after a few paragraphs but hopefully you’ll have a better understanding of how I feel and where I’m coming from.

As I stated in a previous post, emotionally…the process of infertility is tough. In one moment, you’re full of hope and excitement but the next moment may bring disappointment and heartache. These emotions are typical for everyone…for so many things that can happen in life. For Team Pug, these emotions have been on a constant loop…regarding the same topic…for 17 months and counting. Trust me, there’s a point in time when it becomes exhausting. But, at the same time you have to stay strong, keep hope alive and keep trying because what if that one month you decide to give up was supposed to be your magic month?!

Because JPug and I have been married 4 ½ years, it’s natural to field questions about when we plan to start a family. When we first got married, I told everyone 5 years for no better reason than to get them off my back. Things fell into place sooner than we both expected and we decided to start trying just after the 3 year mark. Before infertility…I’ll be honest…I was one of those people who asked when a couple plans to start a family. Now, absolutely not…what if the couple is experiencing trouble and I’m rubbing salt in an open wound with my probing questions? I’ve also gotten firmer in my own response. At first I’d stick with the original “5 years” or “eventually” but now I find myself saying something to the effect of “The process doesn’t work for everyone”. By no means am I saying that you have to censor what you say around couples experiencing infertility but sometimes a question that may seem mindless really isn’t mindless at all on the receiving end.

When you long for a child of your own, I think you pay more attention to babies in general…in a cart at the grocery store, in commercials on TV…sometimes it seems like they’re everywhere! I’m not one to go home and cry myself to sleep but on bad days even a trip to Target can be overwhelming. At an age/point in our lives when a lot of friends are expecting, I won’t say it’s not hard. I can think of 8 babies due between November and April right off the top of my head…some are acquaintances from work and others are close friends but Holy Baby Batman...that is a lot!

The emotions wrapped up in friends expecting children are so mixed…a healthy dose of wow, that’s awesome/exciting/congratulations, mixed in with some fear and jealousy. Fear that as my friends’ families expand, change and grow that they’ll leave Team Pug behind. You tend to migrate toward friends who are at the same life stage as you…we’re friends with some pretty terrific people at this stage of our life and I don’t want to lose them just because they’ve moved on and we haven’t. Jealousy, which is a natural, human emotion, rears its ugly head because others have what you so desperately want. I don’t like it, don’t like the way it makes me feel but it’s a fact of life.

Before I finish, I’ll leave you with some food for thought…a few comments I’ve fielded over the past 17 months for better or for worse. Luckily, I understand folks don’t always mean what they say.
  • I’m not sure how to react to folks complaining about unplanned pregnancy or sickness because the process worked as intended...I empathize but definitely don't sympathize.  My best suggestion is that a woman experiencing infertility is not the person to go to for sympathy.
  • "You'll probably love your children more because it’s been harder to conceive".  Jeez I hope not...or maybe we will (wink, wink)!  Let's not make me question the love you have for your own flesh and blood...
  • "Being pregnant isn’t all it’s cracked up to be".  I wouldn’t know because I haven’t been there... 
  • JPug and I literally had a conversation with someone he's known since his childhood that went like this:
    • A: “ When are you going to give Ralph & Bev a grandchild?”
    • B (Team Pug): “The Process doesn’t work for everyone.”
    • A: “Well, you’re obviously doing something wrong” (in an overly snotty tone).
    • B (LPug - comment in my head): “Well $%&@!#$%...go fly a kite!”

Wednesday, December 7, 2011

Did You Know?

The Mayor’s Christmas Tree, located in downtown Kansas City’s Crown Center, is shipped to KC as a trunk that’s been completely separated from its branches?  Shocking, right?!

Let’s back up a little…I’ve lived in KC on and off since January 2006 and didn’t pay much attention to the Mayor’s Christmas Tree the previous 5 Christmases. I started a new job with Children’s Mercy Hospitals & Clinics in February of this year…the hospital has grown so much that a good majority of non-patient care associates (including me) work in the office buildings surrounding Crown Center which is just across the street from the downtown hospital.

For you non-KC folks, here’s the low-down on Crown Center from www.crowncenter.com. “Located in the heart of downtown Kansas City, Crown Center is often called a city within a city. Three levels of great shopping and dining complement two of the city’s most luxurious hotels, exquisite office buildings, a residential community and several entertainment attractions. It all surrounds the worldwide headquarters of Hallmark Cards, Inc.”

Sometime in November, just beyond the windows of our floor, the Mayor’s Christmas Tree started taking shape…literally. First the trunk, which is nearly 100 feet tall, was anchored to the plaza floor. Next, a couple of guys with cherry pickers would take individual branches and somehow affix them to the trunk. A few weeks later, the tree was finally finished.

I have so many things to say about this process...
  1. Do other major metro areas (NYC’s Rockefeller Christmas Tree, DC’s White House Christmas Tree) put their trees together in this same fashion? Maybe I’m totally ignorant regarding the ways of Christmas tree delivery but I thought a tree was cut down, carted across the country and set-up…branches virtually unscathed. Unfortunately, my hypothesis is likely wrong…
  2. Wouldn’t children be somewhat horrified to see a major symbol of the holiday season hacked down, taken apart and put back together like Frankenstein? Good thing kids are resilient… 
  3. The guys who put the tree back together…is that their “normal” job?! Or…are they power company employees who go rouge for a few weeks in November?! 
  4. HOW THE HECK do they do it?! Our local news reporters report on all sorts of investigative topics…please, please, please report on this next year because the process is very intriguing (in my humble opinion).
I had a few pictures of the process but they didn’t turn out so you’ll just have to believe me on this one. The tree, as it stands in its completed state, looks nice…a little barren on the branch-front but nice. I’m sorry if I’ve crushed the perfect picture of a metro-area Christmas tree delivery and set-up in your mind; I’ll try not to give away and more dirty little secrets until after the first of the year.

Sunday, December 4, 2011

Unexpected Hiccup in a Regular Routine


The past few months, I’ve been getting out of bed in the middle of the night to use the bathroom…I think it’s a small sign that I’m getting older or maybe I just need to drink less water in the hours before bed.  Either way, I wake up…do my business…crawl back into bed and fall back asleep.

Last night was no exception.  I felt like I had been sleeping forever and figured it must be close to alarm time.  I checked my phone and discovered that it was only 3:30am…YES...2 ½ more hours of sleeping bliss!  I jumped up to do my business, made sure I didn’t step on the dogs on the way and entered the bathroom.  From there, it’s a regular routine…pants down, sit down, go.  Except this morning wasn’t regular…there was a major hiccup between the pants down and sit down.  

The new few seconds transpired as follows…pants down, sit down…wait…oh no…I’m sitting much deeper than usual (2 or so inches is “much” deeper when 1/1,000 sits is a longer journey).  PHEW…I didn’t miss the toilet completely but the seat seems very narrow.  Oh s*!t…JPug, you forgot to put the toilet seat down (I thought to myself).  By this time, my body had already moved on to the 3rd step and I couldn’t stop it…go, go, go.  There I was, trying to finish my business, hoping not to fall in and slightly annoyed with JPug.

I’ll admit…this sort of slip is rare for JPug which in my mind almost makes the situation worse.  If I knew he was a serial seat leaver-upper, I’d check for it before doing my middle of the night business.  You may be thinking why I didn’t notice the seat was up in the first place and my answer is because I don’t turn on the bathroom light in the middle of the night…does anyone?  This sort of thing is a once every couple of months occurrence so it’s like a sneak attack that comes out of nowhere.

In the grand scheme of things, this event is totally inconsequential but I just had to share.  Ladies, if this has happened to you, you’re not alone!  And guys, please don’t forget to put that seat down in the future!

Thursday, December 1, 2011

Quick & Delish: Mushroom Soup

A few years ago, I made a conscious decision to begin cooking meals from scratch, using fresh ingredients whenever possible. Besides tomatoes for sauces (when I’ve run out of our fresh/frozen pureed garden tomatoes) and beans for chili, I can honestly say that I don’t remember the last time I bought a canned vegetable. Two years ago, I was on the hunt to find a made-from-scratch green bean casserole recipe for Thanksgiving and this one from Food Network’s Alton Brown doesn’t disappoint. The homemade mushroom soup baked with blanched, fresh green beans and topped with French’s onions (yes canned…but I can never get the fresh ones just right) is a total hit.

This little back story brings me to today’s recipe. With Thanksgiving over, omit the green beans and French’s onions and enjoy a delicious pot of mushroom soup as winter rages on.

Ingredients

  • 4T unsalted butter
  • 16 - 24oz. mushrooms, trimmed and cut into ½ inch pieces (depending on how mushroom-y you like your soup)
    • Suggest chopping about 1/3 and leaving the remaining 2/3 as slices
  • 1t freshly ground black pepper
  • 4 cloves garlic, minced
  • ½t freshly ground nutmeg
    • Who has freshly ground nutmeg in their kitchen? Just use the stuff from your spice rack.
  • ¼c all-purpose flour
  • 2c chicken broth
  • 2c half & half

Directions
  1. Melt the butter in a large skillet over medium-high heat.
  2. Add the mushrooms, 1t salt & pepper and cook, stirring occasionally, until the mushrooms begin to give up some of their liquid, approximately 4 to 5 minutes. Don’t be afraid to let the mushrooms cook a little longer if you feel they need to.
  3. Add the garlic and nutmeg and continue to cook for another 1 to 2 minutes.
  4. Sprinkle four over the mixture and stir to combine…cook for 1 minute.
  5. Add the broth and simmer for 1 minute.
  6. Decrease the heat to medium-low and add the half & half.
  7. Cook until the mixture thickens, stirring occasionally, approximately 6 to 8 minutes. My soup never seems to thicken in 6 to 8 minutes. If you’ve stirred for a while beyond the recipe directions with no thickening in sight, make a roux of chicken stock and corn starch (2 - 3 parts stock to 1 part starch in a small dish) and add a little at a time until the soup thickens to desired consistency.
    • A couple notes regarding the use of corn starch...
      • It usually thickens better if your soup is simmering. Be careful if you raise the heat with this recipe as the half and half could scorch…just keep stirring constantly.
      • Make sure you add the starch in as a roux…if you just dump it in, your soup will be lumpy.
      • Corn starch can over-thicken in the blink of an eye. Like I said earlier, add a little at a time and mix thoroughly before adding more. It’s better for your soup to be on the thin side rather than over-thickened.
      • If you do over-thicken, add some chicken broth to the mixture until the soup reaches desired consistency.
  8. I didn’t say this recipe was healthy but it’s definitely delicious…serve with crusty bread and enjoy!