Goodbye, Hello

Friday , April 27^th – 10W, 2D

This has been a busy busy week in the life of our growing Puglet.  Monday morning we had our final appointment at Dr. K’s office; it was definitely bittersweet.  Over the past 9 months, we formed a bond with Dr. K, the nurses and the ultrasound technician in the office.  Knowing this was the last time we’d see them in a long time was wonderful but a little sad at the same time.  Through the process, they were awesome…patient, kind, caring, compassionate.  I truly believe they treated TeamPug the way they would want to be treated themselves and we couldn’t have asked for anything more.  During the appointment, Dr. K preformed our final transvaginal ultrasound…checking growth (still right on target) and heartbeat (160 BPM) one final time.  She answered a few questions and asked to see pictures or bring the baby to the office once he or she is born.

On Wednesday, we had our first appointment with the OB/GYN practice we’ll see throughout the pregnancy.  I didn’t choose them based on recommendation…I found the office closest to our home that also accepts our insurance and figured we’d start there.  The office and associated hospital I’ll likely deliver at are about 5 minutes away...convenience was obviously my driving force.

In one word, the visit was underwhelming.  The office was nice and the admin staff seemed friendly enough as they asked me to complete some paperwork and took my insurance.  The first person we saw was an ultrasound technician who seemed annoyed she had to wait an extra minute for JPug to sign in.  From there, she escorted us back into the ultrasound room where she logged our information into the computer and asked me to take a seat.  She asked that I pull my pants down to my hips and my shirt up just below my bra.  I’m so used to transvaginal ultrasounds I didn’t even think that I’d get to have the more traditional, top of the belly kind.  She squirted some jelly on my abdomen and went to work with her magic wand. 

The picture from this type of ultrasound is different…rather than seeing planes (body and hands/feet but maybe no arms/legs), we could see the whole baby.  She took some measurements, which continue to be right on target (10 weeks exactly) and the heartbeat was 153.  At one point, she found a clear, open picture of the baby and showed how it was moving around like crazy.  It was really amazing…little Puglet having a private dance party.  Although the ultrasound technician was never rude, she wasn’t friendly and seemed to rush through every step the process.  As we finished up, she asked us to wait in a different waiting area, but seemed annoyed we didn’t know where we were going.

A few minutes later, we were escorted to an exam room and waited for the nurse practitioner to arrive.  A care assistant asked some basic questions and the practitioner came in about 15 minutes later.  She went over my health history, discussed current medications, the lab tests they’d be running, whether we wanted to complete the recommended birth defect testing and talked a few minutes about the practice itself.  When she was finished, she answered our questions.  Just like the ultrasound technician…she seemed uninterested in us…like she’d rather be seeing her next patient.

Once we were finished, we moved back into the waiting area for my final stop of the day, the phlebotomist.  Of all the blood I’ve had drawn since we started with Dr. K…this lady was the worst drawer by far.  Considering it was only one needle, I have quite the bruise on my arm.  If my experience with the lab technician isn’t any better in the future, I’ll either have blood drawn through the hospital I work at or at a local Quest lab…neither of which have caused discomfort in the past.

I’m interested to see how our next appointment…on Wednesday, May 23^rd...will go.  We’ll see an actual doctor for the visit and I’m anxious to see if their bedside manner is any friendlier than our initial experience.  If not, we might forego convenience and look for another OBGYN practice that seems to be a better fit.  One note, I’m not looking for a best friend or someone to hold my hand and coddle me through the process.  But, I am looking for a physician or group of physicians who treat me the way I would treat them if the roles were reversed.

Friday the 13th

8 Weeks, 2 Days

Today is Friday, April 13^th…eek!  JPug and I went in for our 3^rd ultrasound this morning and I resisted the urge to come in a different day to avoid Friday the 13^th altogether.  Although the appointment date was the slightest bit unnerving, I had no signs that something might be wrong and figured I might as well face my “fears” head on.

We arrived to open office hours just before 7:30a and were first in to see the ultrasound technician, Sarah.  It didn’t take her any time to find our little baby…she took some measurements, thoroughly answered each of our questions and measured Puglet’s heartbeat.  It’s crazy to see the changes in our little white blob from our first ultrasound at 6+ weeks to today’s ultrasound at 8+ weeks.  Now, you can clearly see which end will eventually become the head, which end will be the butt and the slightest buds where arms and legs are beginning to form.  At one point Sarah joked that the baby resembles a gummy bear at this stage of development and proceeded to stick her hands up by her shoulders and wiggle around to simulate the tiny arms…haha!  Something new this week, this was the first time we could clearly see the umbilical cord on the screen.  We’ve been taking video of each of our appointments with our FlipCam…hopefully I can snap a picture from each ultrasound to show Puglet’s progression.

In my last few posts, I mentioned the gestational sac and yolk sac and I finally had a few minutes to research both.  Per Wikipedia (the most reliable source on the internet…wink wink), the gestational sac is “the only available intrauterine structure that can be used to determine if an intrauterine pregnancy exists, until the embryo is identified”.  During our ultrasound, Sarah explained that the yolk sac is where Puglet gets his/her nutrients until the placenta takes over around 10 weeks.  During today’s appointment, Puglet measured 1.7 centimeters/the equivalent of 8W, 1D development-wise (right on track) and his/her heartbeat was 164.

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Judy, Dr. K’s nurse, called in the afternoon to review the ultrasound findings; I wasn’t at my desk so she left a message.  I’m very glad to report that she said everything looked good and to keep doing whatever I have been because we’re on a great path.  Man, it’s like we might really have a real baby before the end of the year!

UltraSOUND

Friday, April 6^th – 7w2d

Happy Friday everyone!  Or…whatever day this post ends up being published, happy that day.  This morning, JPug and I went in for our second prenatal ultrasound.  We arrived before 7:30a and were the first patients in the office…yes!  Dr. K’s office has open hours from 7:30a – 8:30a for labs and ultrasounds which means first come, first served.  First in means first out and we can get on with our day.

Hit the breaks…Sarah, the sonographer, called in sick and Dr. K was on vacation so the nurse asked if we could come back at 8:30a to have the other Dr. K (our Dr. K’s partner) perform our ultrasound.  It was only a minor hiccup in our day so JPug and I headed to breakfast and returned about an hour later.

Dr. K came into the office, introduced himself and got down to business.  Let’s just say that the fastest I’ve ever moved with a gentleman…luckily, it was for good great reason!  He performed a transvaginal ultrasound…big wand in the hooha...and after a few wiggles of the stick, you could see the big black circle, smaller hollow circle and a little white blob.  This time, I remembered to ask what each of the circles is…the big black circle is the gestational sac, the smaller, hollow circle is the yolk sac and the white blob is the baby (I didn’t have to be reminded of that part).  At this point, I'm not exactly sure what each of those sacs is or does...stay tuned...hopefully I'll figure that out soon.

Thanks to the wonders of the internet, here's an idea of what today's ultrasound looked like.  Big black circle (or kidney bean) is the gestational sac.  White ring with hollow center (on the right) is the yolk sac and the white blob to the left of the yolk sac is the baby.

  

I had some trouble seeing the little flash/heartbeat on the machine but JPug seemed to see it without issue…it was probably just the awkward angle of trying to look at the monitor while laying on my back, head tilted to the side.  At one point, Dr. K asked if we wanted to hear the heartbeat and before we got a chance to respond, he clicked a button on the machine and you could hear our little baby’s heart pumping clear as day.  The ultrasound picture reduced in size and a cardiac monitor filled the bottom of the screen…you could see our baby’s heartbeat…constant and strong…it was truly amazing!

This morning I measured at 7w1d which is right on target given the first day of my last cycle.  Technically today is 7w2d but the ultrasound was in the morning so 1 day difference is totally ok.  The baby’s heartbeat was 145…28 beats per minute more than last week’s measurement.  We’re by no means in the clear but today’s appointment was definitely a step (or maybe a giant leap) in the right direction.  Next up is our 8 week ultrasound next Friday…the 13^th.  I’m typically superstitious but I’ve decided to face Friday the 13^th head on…BRING.IT.ON!

A Whole New Journey

Day 35 - Wednesday, March 21st


TeamPug has officially known we're expecting for 1 full week...I'm exactly 5 weeks pregnant today.  Although 5 weeks probably isn't a milestone for most, it is for us.  Back in December, 5 weeks is when my body started cycling naturally and our first baby was gone in the blink of an eye.  This time around, I've had 3 really good blood tests and am hopeful we'll make it to the next big benchmark...12 weeks.

Although I'm only 5 weeks along, I have noticed some changes in my body.  I started dropping weight almost immediately and have lost a total of 5 lbs.  I don't have much of an appetite/fill up quickly and don't have the sweet tooth I usually do.  I'm trying to eat more regularly and am enjoying healthy snacks between meals.  I haven't experienced any sensitivity to tastes or smells which I'm very thankful for.  I get up at least once a night to go to the bathroom and have had some trouble sleeping through the night which is very uncharacteristic for me.  My breasts have become tender and I've noticed some changes in my nipples (Probably TMI but I've been open and honest throughout the process so why stop now?  I'm trying to stick with the facts here folks!).  I've also had spotting on and off for the last week which is really unnerving.  I read online about 30% of women experience spotting...sometimes during implantation and sometimes it lingers throughout the entire pregnancy.  I haven't had any other symptoms that would signal a problem and my blood tests last week were good even though I was spotting...I'm trying not to get myself worked up over nothing.

Yesterday, Dr. K increased my synthetic thyroid supplement to 75mcg/day (which should reduce my TSH) and I had my 4th blood test in a week...this one checked Free T4.  From what I read on www.labtestsonline.org, providers typically check Free T4 as a follow-up to a TSH test that was abnormal.  The Free T4 test allows providers to see a more complete picture regarding thyroid function.  Dr. K's office should have my results later this week...hopefully the nurse will call with good news.

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Dr. K's nurse Jamie just called this afternoon with my Free T4 results...the normal reference range is between 0.7 and 2.0.  My result was at 1.1 which is totally normal.  I'll stick with the increased thyroid supplement dose which will hopefully lower my TSH and they'll probably test me again in about a month.  Last but not least, I asked about my spotting and Jamie said although it's not common, it is normal.  As long as i don't experience cramping or blood that's bright red in color, I should assume things are progressing nicely.

Next up is our 6 week ultrasound next Friday!

You Never Forget Your First

Friday, March 30th - 6W, 2D

Today was a big day...the first ultrasound to see our little Puglet.   When I say ultrasound, it's the transvaginal kind (a big wand they stick up your hooha) which gives the technician the ability to see more detail south of the border.  At this point, seeing our tiny bean on a more traditional ultrasound...through layers of skin, muscle and organs just wouldn't happen.  Today's was the same type of ultrasound I've been having for months.  From August 2011 to February 2012, the technician used the machine to check my uterine lining and ovaries as each monthly cycle progressed.  Today, we saw the makings of a baby.

AWESOME...nothing else I can say besides awesome!

We saw all sorts of things on the screen...the grainy black/white you think of with any ultrasound, a big black hole in the middle, a smaller black bubble in the middle of the black hole and just below the bubble was a bright white spot.  The technician was patient and explained all the different things we saw but of course, now I can't seem to remember.  What I do know...the bright white spot is our little baby.  If you stared at the spot for any length of time, you'd see a tiny flicker...the heartbeat.

The technician spent the next few minutes taking measurements and let us see the baby one last time so JPug could capture our first ultrasound on our FlipCam.  At this point, our parents have no idea we're expecting but we're looking forward to sharing video from each appointment with them when the time is right.  Before we left, the technician said Puglet is measuring perfectly...at 6 weeks, 1 day and the heartbeat was 117 (anything above 100 is good news).  I should hear from Dr. K's nurse sometime this afternoon and I'll likely go in for my second ultrasound next Friday.

Oh, and I have my official due date...November 22nd, 2012.  I honestly can't think of a better day...11 days after my birthday, one of my best friend's birthdays and Thanksgiving.  Pretty perfect...and a heck of a lot to be thankful for!

Big Money, No Whammies!

Day 33 - Monday, March 19th

This morning I traveled to Dr. K's office for my 3rd and final blood test of the initial series.  Other than being a little late (open office hours and I wasn't motivated to arrive right when they opened on a Monday), the draw itself was uneventful.  Once again, the orders were STAT so they should have my results before the end of the day.  Since this draw was technically 3 days after the second, the office will be looking for my betaHCG to be more than double Friday's number (which was 782) and Progesterone should be about the same (which was 38.9).  I should also get the results of Friday's TSH test back today.  As JPug says, we're hoping for Big Money, No Whammies!

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Just heard from Dr. K's office a few minutes ago.  They called at 3:51p...sure to like to make a girl wait!  Today, my HCG level was 2,698 which was more than 3x Friday's number.  My progesterone was 30 and my TSH was 5.0.  Because the TSH is higher than they'd like, they're going to increase my synthetic thyroid supplement to bring the level down and ensure no unnecessary harm comes to our growing Puglet.  I'll have one more blood test later this week to test free T4 (don't know what that is at the moment...will need to do some research to explain) and our next step w/ Dr. K is our 6 week ultrasound on Friday, March 30th.

Number Two

Day 30 – Friday, March 16th

This morning I went to Dr. K’s office for my second of 3 blood tests.  They’ll be measuring betaHCG, progesterone and TSH. 

HCG, human chorionic gonadotropin, is a hormone produced during pregnancy.  According to AmericanPregnancy.org, it’s made by the cells that form the placenta which nourishes the egg after it’s been fertilized and becomes attached to the uterine wall.  In the majority of normal pregnancies, HCG will double every 48 – 72 hours so it’s a good indicator (although not fail-safe) that the pregnancy will be viable long-term. 

Progesterone is measured to ensure the uterine lining is thick…a key component in a successful pregnancy as it helps to create a nutrient-rich environment.  I’ve discussed TSH in detail previously but the quick and dirty is that studies have shown developmental delays in children carried by mothers with a TSH level above 4.0.  I’ve continued my 50mcg dose of Levothyroxine since Dr. K increased my dose in October and feel pretty good. 

There’s no real target for betaHCG on the initial test but Dr. K looks for it to double every 48 hours.  My reading on Wednesday was 345 so today should be about 690 (maybe slightly less as my Wednesday test was over lunch).  Dr. K looks for Progesterone to be above 10 (some doctors look for a number above 20) and should remain pretty constant…hopefully it remains close to or higher than Wednesday’s reading of 28.2.

For now, I’m waiting for Dr. K’s office to call with this morning’s results and hope they’re better than the results of our 2^nd blood test in December.

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It’s 3:40p on Friday and I’m starting to convince myself that Dr. K’s office won’t be calling today.  I’m going through a thousand different scenarios in my mind and am probably getting worked up over nothing…but I just can’t help myself!  Dr. K’s nurse Judy finally called at 3:46p…I ran into a work conference room to have some privacy and she began.  My betaHCG from this morning was 782 (more than double Wednesday’s number) and my progesterone increased to 38.9…both really good signs.  I still haven’t breathed a sigh of relief but I’m very happy that I’m farther along with this pregnancy than I made it in December.  Next up is my third and final blood test on Monday.  Baby steps…literally!

An Unexpected Hiccup

Day 29 – Thursday, March 15th

On my way to work this morning, I was rear-ended on the highway.  I had just crossed over the Bond Bridge going south on I-35 (main North to South highway in KC).  Traffic in front of me slowed…as did I.  I didn’t make one of those super-quick, look in the rear-view mirror to be sure the people behind you stopped too kind of stops…so you can imagine my surprise when swerving cars caught my eye in the rear-view mirror…and I felt an impact.  I knew it wasn’t too bad and I wasn’t hurt so I moved my car to the left shoulder, grabbed my phone to call the police and got out to make sure the other drivers were ok. 

Behind me were two cars…a 10-ish year old cranberry minivan with a male driver who was injured and a newer mint green Honda Element with a crunched front end…but the driver was out of his car and seemed to be fine.  After a couple of attempts, I called the police, checked on the driver of the minivan and gave a status update to the paramedic dispatcher.  We worked with the injured driver to move his car from the center lane to the shoulder and before I was off the phone, the police had already arrived…go KCMO!

I walked back to my car to assess the damage and grab my insurance card and license.  Considering the crash occurred on the highway, I was incredibly lucky.  The rear passenger bumper of my SUV had only minor scrapes and dings which can hopefully be buffed out and repainted.  Once the medics arrived, their standard protocol is to assess the driver of each vehicle to ensure they can be released without going to the hospital.  As they finished my assessment, I asked about the pregnancy.  Because the impact was so minor, it’s unlikely I would experience any negative side-effects…very comforting words to hear.

My car had the least amount of damage and was drivable so the officers took my statement first and allowed me to leave the scene right away…I still made it to work in time for my 8:30am team meeting!  Before the day ended, I had already given my statement to our insurance company and their estimator came to assess the damage and provide a quote…go Travelers!  I’d be lying if I said it wasn’t an inconvenience but all-in-all, I’m probably the happiest person you’ve ever encountered post-crash…I’m ok, the car is ok and hopefully TeamPug’s newest addition continues to grow.

Third Time’s a Charm?

IUI Cycle 3, Day 28 – Wednesday, March 14^th (Pi Day for you math lovers!)

This morning I woke up just after 1am.  Nature called so I made my way into the bathroom and took the test.  The package states the result will be ready in about 3 minutes so I finished up my business and moved from the water closet to the main area of our bathroom to wait.  Before I had even gotten into the main area (officially the fastest 3 minutes of my life), the result was visible…“Pregnant”.  Wowzers. 

Although a positive result should bring a rush of joy and excitement, I have to admit…it didn’t.  I’ve had a positive test before…the feeling of ‘Wow, the road to get here was difficult but you finally made it’.  I ran out to purchase ‘What to Expect When You’re Expecting’, signed up for a growing baby notification website and calculated my due date…but not this time around.  This time I’m thinking with my head instead of my heart.  We have three crucial blood tests to get through over the next week before we can even begin to breathe the slightest sigh of relief.  Pretty deep thoughts for 1am, huh?!

After the positive result sank in, I climbed back in bed and did my best not to disturb JPug.  It took me a couple of hours to fall back asleep and I accidentally woke JPug up in the mean-time.  I told him about the test...and the result...and we're hoping things will go better than they did in December. 

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I went to Dr. K’s office over lunch to have the first of my 3 lab draws…they’ll be checking betaHCG, progesterone and possibly TSH.  The office ordered the results STAT so hopefully they’ll get back to me before the end of the day...

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Just heard from Judy, Dr. K's nurse...my betaHCG is 345 and my progesterone is 28.5.  In December, the initial reading for my betaHCG was 72 so the fact that today's number was nearly 5x December's brings the slightest bit of comfort.  Now Dr. K's office will look for the number to double by Friday (my second blood draw) and double again by Monday (my third and final draw of the initial series).  No expectations at this point...just a lot of hope and positive thoughts that this process has a different outcome.

The Next Go 'Round

Day 27 – Tuesday, March 13^th

I haven’t blogged about TeamPug’s 3^rd round of IUI...until today.  We’re nearly 4 weeks into the process and the path we took was virtually the same as the ones we followed in November/December and January/February.  The main, albeit minor, difference between the two previous processes was that I took Estroidl before insemination to enhance my uterine lining during round 1 but it wasn’t necessary during round 2.  This month Dr. K put me back to Estroidl to ensure my lining was as thick as possible before insemination. 

Just to recap the process…baseline transvaginal ultrasound on day 2, Clomid on days 3 – 7, second transvaginal ultrasound on day 11 and self-administered ovidrel injection on day 12.  Day 14, we headed to Dr. K’s office for insemination and we’re happy to report that JPug’s count improved once again.  The two weeks between insemination and the big test have gone pretty well.  I started volunteering on Monday and Wednesday nights which keeps me busy and work has picked up so my mind doesn’t have much time to wander during the day.  Last weekend was jam-packed full of my cousin’s pre-wedding festivities so our process barely crossed my mind…thank goodness!

Although it’s hard to believe given my two-shakes-from-crazy state of mind last time around, I’ve felt strangely calm about this month’s process.  JPug and I have almost always been successful in life…especially if we put our mind to something.  If xyz didn’t work out the first time, we tried harder and things went our way the second time around.  Infertility is different…no matter how hard you try month after month, it’s a very real possibility that you won’t get the outcome you hope for.  For overachieving TeamPug, that’s a really hard pill to swallow.  I think my state of mind during round 3 can be attributed to the fact that I’m beginning to realize that we’re putting ourselves in the very best possible situation to be successful and we honestly can’t do anything more.  At this point, the outcome is out of our hands.

I say I’ve been calm about the process and I absolutely have…until this afternoon.  After lunch, I noticed some spotting when I used the restroom.  About 1/3 of women who become pregnant experience implantation spotting or implantation bleeding; implantation typically occurs 8 – 10 days after ovulation.  Because the timing of my cycle is well managed as we go through the process, I know that I’m right at 13 days after ovulation, not 10.  Also, the color of the spotting can be an indicator for implantation…typically implantation spotting is pinkish or brownish in color but mine is bright red.  These new developments have crushed any semblance of hope I had for this month’s process working.  In the blink of an eye (or a couple trips to the restroom), it’s become hard to concentrate at work and all I can think about is skipping my post-work meeting and going home. 

Once I arrived home, I wanted to talk about the process and wanted to ignore it completely…all at the same time.  JPug was wonderful and had dinner ready but I didn’t appreciate it.  At some point I finally broke down in tears…the thought of another month gone and the uncertainty of what’s to come are totally overwhelming.  After dinner, I headed to bed and watched some TV before falling asleep…emotionally exhausted…at 8:30p.

Good Idea, Questionable Decision

Almost a year ago, some close friends were looking to hold a garage sale to raise money for their pending adoption.  They live in a townhouse not too far from JPug and me but it wasn’t a great place to hold the type of grand-scale garage sale they were hoping for.  Our subdivision holds a neighborhood garage sale each spring that gets a decent amount of traffic and we weren’t looking to sell many (if any) items ourselves so we offered up our garage and driveway for their cause.

They collected items from friends, family members and complete strangers both near and far…enough that the collection completely consumed our entire three-car garage, except for the two spaces where we park our cars.  As JPug and I perused the house to find items to donate, we settled on a couch and armoire (among other things) from one of our extra bedrooms.  Our line of thinking was pretty simple, the couch and armoire which turned the extra bedroom into an ever-ready Wii room would eventually be a nursery.  The opportunity presented itself to help our friends sell bigger-ticket items while getting the items out of the house without having to load them a truck and drive somewhere to donate.  As long as our friends could get the items out of the room and down the stairs…they were free to sell them to the highest bidder.  The items did sell that day along with many others that provided a huge boost to the couple's adoption fund.  JPug and I truly couldn't have been happier for our friends.

Fast forward nearly a year and the once ever-ready Wii room is a heartbreaking shell on the 2^nd floor of our home.  Completely empty…it's a constant reminder of our unsuccessful process.  I’ve had the door closed for months and rarely go in the room unless I have to.  Hopefully one day it will be filled with fresh paint, a crib and a growing baby but for now it’s out of sight and more often than not, out of mind.  At the time of the sale, I had no idea what the process had in store for us and didn't think twice about donating the items.  Looking back, I can't say I would do anything differently but I'd be lying if I said the emotions tied to the room weren't painful.

Moving Forward

At the beginning of March, JPug and I booked a vacation to Washington DC for early fall.  He had some Southwest frequent flyer points that were set to expire and I got tired of planning our lives around if or when something might happen with our process.

We chose DC for a couple of reasons…neither of us have been there and combined, we know 5 different people who live in or near the DC metro…some childhood friends, some relatives.  The opportunity to reunite with so many folks and see a new place made our decision easy.  We’re taking a weeklong trip…flying from KC to Pittsburgh, PA to visit one of my best friends from high school (and her family) for a few days before taking the train to our nation’s capital.

We’re looking forward to the trip while simultaneously continuing treatments for infertility.  Stupid idea?  Maybe so...but I’d much rather plan the trip and have to cancel because something wonderful happens than sit around KC come fall twiddling my thumbs regretting the decision not to book if something doesn’t.

Is it possible we’ll be in a situation where we lose some money or airline points?  Absolutely…but it’s a risk we’re willing to take.  Plus, from my point of view, any money or points we might lose are well worth being lost of the process actually does work.

For now, the flights are booked and we’re leaving the other details for later.  If anyone has suggestions for places to stay, things to see or where to eat in DC…please share!

Thanks to Google Images for this sweet DC pic!

The Test

The morning of Day 28, I woke up at 3:15a and took a test…no dice.  I wasn’t shocked as I hadn’t felt any of the symptoms I experienced in December but I was definitely disappointed.  The two weeks between insemination and testing are filled with such a barrage of emotions…hope, anxiety and everything in between.  Everything leads up to the big test on day 28 and when it’s not positive, I'm thrust back into an unfortunately familiar situation.

To make matters worse, my body began to cycle naturally on Day 28.  Rather than having a few days to absorb the process and its result, I was calling Dr. K’s office to let them know about cycle Day 1 once again.  I’ll go back in for a baseline ultrasound and start this month’s dose of Clomid (if everything looks good) in just a few days.

This month’s process will be a good benchmark for Dr. K’s office.  This is IUI #3 so they’ll evaluate my body’s reaction to the medications and the process thus far…and make a recommendation for the future.  The next step could be stronger medications or different procedures…at this point we just hold tight and keep hope alive.

Speaking of hope, I have to admit that the process is beginning to lose its luster.  On one hand, that’s a good thing because maybe that means I’ll be more relaxed next time around but on the other hand, it’s hard to continue believing the process will work eventually.  In time, I’m sure everything will get easier…things always do.

The Waiting Game

This post was originally written on Monday, February 13th...

The second time around, the two-week waiting period between insemination and the big test is different.  It may not be different for everyone but it has been for me. 

First and foremost, my expectations are higher.  The process worked once before so I’m hopeful (almost overly so) that it will be again.  Trust me, I know this line of thinking is totally unrealistic.  I believe Dr. K said about 1 in 3 IUI treatments is successful (maybe even less as my memory re: this specific statistic is kind of foggy).  We’ve already had our 1 so it wouldn’t be surprising for the next two to fall short…but, my mind immediately goes back to the fact that the process has worked before.

I found myself thinking about the looming test more during week 1 than I did last time around.  I’ve been in the situation before so I’m even more mindful of my body and signs that could signal a pregnancy.  Self-stalker…party of 1…that’s me!

Here’s my Catch-22.  As much as I want to feel the same symptoms I felt last time around, I also don’t want to feel those things because the process worked but quickly fell apart.  If I’m not feeling them, does that mean the process didn’t work at all?  Man, how is it that I haven’t completely fallen off the deep-end of crazy yet?

Today is Day 25 and I can honestly say I haven’t felt anything like I did in December.  The main thing I noticed last time around was breast tenderness but this time I haven’t noticed that at all…and believe me, it’s not because I haven’t tried!  This time around my complexion has turned into the equivalent of a teenage girl but that could very well be a result of the hormones I take during the process or the fact that it’s finally winter in KC and the seasons are changing.  I’ve also noticed some constipation but that could be the result of a number of things.  No nausea, sensitivity to smells, tiredness…nothing.

I’m resisting the urge to test tomorrow (Day 26…which is also Valentine’s Day) because a positive result isn’t guaranteed 2 days early...I found that out the hard way in December.  The surprise would make this ridiculous, consumer-driven holiday special but I just can’t put myself through an emotional roller coaster unnecessarily.

For now, we wait…I’ll keep myself busy, try to keep my mind clear for the next two and a half days and keep hope alive.

Take 2

This post was originally written in early February...

I haven’t blogged about our actual process in a while so I thought I’d provide an update.  In January (one cycle after we experienced our first loss), my hormone levels returned to pre-pregnancy normal and we were able to begin the IUI process once again.  For JPug and me, beginning the process again immediately was almost a no-brainer.  Dr. K advised that we should wait until we were both physically and emotionally ready and for us, one cycle was enough.

The process was the same with a few, minor changes…if you didn’t read the series I published regarding our first IUI but would like to, scroll to the bottom of this post and click “IUI” under Labels.  The link will take you to all IUI posts I’ve published…scroll to the bottom once the screen refreshes and read up.

I started the cycle with 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)…everything looked good.  Next was 50mg of Clomid during cycle days 3 – 7.  If you remember from my previous posts, Clomid is the drug that has a tendency to make women emotional.  Ironically JPug was travelling for work cycle days 3 – 7 so I wept…in bed…by myself…for 5 days straight.  Just kidding folks…once again, Clomid didn’t seem to cause any issues. 

Day 11, I went in to Dr. K’s office for my second transvaginal ultrasound.  This is the ultrasound where they check to see how my follicles (which contain an egg) are maturing.  Given that it’s the dead of winter and colds and the flu are running rampant in KC, Dr. K had a few folks out of the office.  Instead of the ultrasound tech performing my exam, Judy, Dr. K’s nurse did the honors.  I much prefer Judy to the technician because she doesn’t hesitate to comment on how things are progressing during the exam.  At one point, she said that my body was reacting “beautifully” to the Clomid so I took that as a good sign.   

Day 12, it was time for my Ovidrel shot which I administered myself (immediately after, I flexed my muscles because I felt pretty tough).  One difference between our first process and this one is that I didn’t have to take Estradiol to enhance my uterine lining before the insemination…less drugs + the fact that my body made a sufficient lining by itself = happy me!

Day 14, INSEMINATION DAY.  JPug did his thing and we returned an hour later for the insemination.  Before she started, Jamie reviewed the results of JPug’s sample with us.  He’s continued taking the medical food prescribed by Dr. N and it continues to work…his count increased once again.  About 5 minutes later, insemination was complete and I laid on the elevated table for 15 minutes.  Once the procedure was complete, we left the office and returned to work.

KC Infertility Awareness

A few weeks ago, my friend Jayme, brought this blog/website to my attention.  She’s an avid blogger/blog follower herself (check out her blog here) and came across the site through a midwifery service she likes on Facebook.  Although it’s only been a few weeks, this site has become an important part of TeamPug’s journey.  To understand the significance, let’s take a couple of steps back.

February brought Round 2 of IUI for Team Pug…I blogged about the process (in less detail than Round 1) but haven’t published the posts quite yet.  I honestly don’t know why…I guess I’m just waiting for the right time.  The first two months of the year also brought a mix of emotions because the two ladies I’m closest to in the process found out they were both expecting…their processes weren’t exactly the same as ours…they experienced their own, unique hardships...but they longed to be pregnant and deliver healthy, full term babies just like me.  While I’m overjoyed their processes have finally worked, I can’t help but be sad that TeamPug’s journey of infertility continues.  Now, I find myself feeling that the dynamic of our relationships has changed and although they remain some of my most supportive friends and cheerleaders…at times, I can’t help but feel all alone.  

This loneliness is hard to describe…feeling alone on the journey and alone without the child we long to have.  At some of my saddest times, I turned to the Kansas City Infertility Awareness blog and felt I had somewhere to belong.  Learning more about infertility from local professionals and hearing stories of women who have been through similar journeys brought me comfort.  To set the record straight, the site definitely isn’t a boo-hoo, bitch session, message board because I have no interest in that sort of thing.

Thanks to the site, I found a start-up support group led by a local infertility counselor and also learned about an infertility conference taking place in April.  This is the second year for the conference which focuses on infertility awareness and family building.  They offer breakfast, a speaker, multiple breakout sessions and a success story panel.  The conference and support group will give us the opportunity to meet other families with similar experiences and learn more about potential next steps in TeamPug’s process.

If you or someone you know is experiencing infertility, I encourage you to point them toward the Kansas City Infertility Awareness website.  The journey of infertility is just that…a journey that’s constantly changing and evolving.  You may not be ready for a support group or a conference just yet but if you are interested now, the information is available. 

Thoughts on Adoption

If you’ve spent more than a year and a half trying to conceive naturally with no success, why not move on to adoption?  Simple question, right?  Yes…very simple question on the surface.  Simple answer?  Not even close.

Most people who know me also know that I’m an only child.  If you know JPug, you probably know that he’s an only child as well.  How the heck two only children met, fell in love and married is beyond us but it happened and here we are.  I actually can’t think of any other two-only child couples…I’m sure they exist but are rare…if you’re reading this blog…woot woot…here’s a shout out just for you. 

When TeamPug first started talking about a family, we joked that we’d send our son or daughter to kindergarten with a picture of their Family Twig rather than their Family Tree.  Ahhh…gotta love only child humor.  I digress.

Something maybe no one…outside of my parents and JPug…knows is that for three-quarters of my direct lineage, I am the only hope for future generations.  My paternal grandparents had two sons…my father and his brother.  His brother had no children and my father had 1…me.  My maternal grandparents had one child…my mother who had 1 child…me.  My maternal grandmother and her first husband had a son, my uncle and my mother’s half-brother.  For my paternal grandfather, paternal grandmother and maternal grandfather, I am the only person who can continue that blood line in our family.  JPug's family is a bit different in that both of his parents have siblings who have continued their respective blood lines.

I was talking to a friend the other day and mentioned that I look at the potential end as an extinction.  Not on a grand scale, save the pandas sort of way but hopefully you get what I mean.  My family blood line, which can be traced back hundreds of years (thanks to terrific research by my uncle/dad's brother), would be no more.  Would the line continue down the branches of my grandparents siblings…yes…but our direct line would come to an end.

This isn’t something that weighs on my mind constantly but it’s absolutely a consideration in our process.  Having children means so many things to me…one of which is paying homage to those who worked so hard during their lifetime to provide a better life for future generations.  I feel we owe it to ourselves and our ancestors to exhaust all options when it comes to having natural children.  If we’ve done everything in our power to have natural children and the process doesn’t work, then we’ll know we did our absolute best and can move on and consider other options.

Is this line of thinking or the process we’re following right for everyone?  Absolutely not.  As I’ve said before…everyone has their own unique process.  Hopefully this post shed some light on a burning question (just kidding folks)…or at least provided you with another piece of TeamPug’s seemingly enormous puzzle.  

Perception vs. Reality

The process of infertility and the impact it’s had on my relationships with various friends is an interesting topic.  TeamPug has received an overwhelming amount of support from so many different people…friends I haven’t talked to since high school, family members near and far, even complete strangers who received our blog link from a friend.  The love, kind words, prayers and overall positivity have been truly amazing.  I’d be lying if I said everything has been sunshine and rainbows but so much good definitely outweighs the bad.

Throughout the process, I’ve found myself gravitating to those friends who are…as I say…in the same ocean making their way to the same destination, just on a different boat.  But, what’s a girl to do as those friends begin to reach their destination while TeamPug continues to paddle?  Is the closeness that’s developed over the months for real or simply a product of shared circumstance?  What happens when the friends who have provided so much love and support say something that’s perceived as insensitive although that was not the intent?

As I continue to mature in the process, I’ve found myself letting go of insensitive comments rather than allowing them to simmer until they boil over.  Why?  For a multitude of reasons.  First and foremost (as I’ve stated in previous posts), it’s not good for my health during the process, long-term health or the strength of my relationship with JPug and our friends.  I’m beginning to understand that friends who make insensitive comments…the level of insensitivity is strictly my perception.  The vast majority of comments are made in an encouraging fashion but miss the mark.  I can’t hold that against those whose ultimate end goal is support and love for TeamPug and our journey.  Now, please don’t mistake insensitive with downright rude…in my mind, there’s a pretty clear line between the two.  To this point, we’ve been fortunate that no close friends or family members have been rude...although some acquaintances have.

Bottom line, I can’t hold someone’s ignorance against them…unless you’ve been in our shoes and through our process (which is impossible), I can’t expect you to know something you don’t or identify with something you can’t.  In the same breath, I'm sure I've said things that have been perceived by friends as insensitive when that was not the intent because I haven't been in their shoes (it's a two way street, right?).  Do comments that were perceived as insensitive sting a bit more when they come from friends who have been in similar situations?  You betcha.  But, I can’t hold those friends to a higher (maybe even unattainable) standard just because their journey can be likened to that of TeamPug.  Different people...different journeys...different emotions.  Even if the journey is similar on the surface, the rooted emotions may be very different.

In the end, every journey and every struggle is unique…whether it’s TeamPug’s infertility, someone who loses a family member suddenly or one of a million other obstacles we encounter on the road of life.  As outsiders, the best we can do is lend support, love and encouragement with the best of intentions and trust those intentions will be accepted for what they are rather than misconstrued.  If you find your gut telling you a comment may have been insensitive...face the issue head on and apologize...a simple "I'm sorry" can go a long way whether you're on the giving or the receiving end.   

A Change…In Thinking

In case you’re keeping count (which I honestly hope you’re not), this is month 18 of Team Pug’s process.  In gestational terms, that’s two full-term babies but we’re still at a big, fat, goose egg…0.  Is it what we planned?  No.  Does it break my heart? A little.  Is it ok?  Yes.

I’ve talked before about how this process can make a girl downright crazy.  I’ve found myself turning into my own stalker…stalking my cycle start and number of days, stalking my own feelings as the cycle progresses…do I feel different?  do I have any tell-tale signs of pregnancy?  I’ve gotten a sinking, heartbreaking, here-we-go-again feeling as friends shared their good news of a baby on the way, sent a shower invitation or texted a picture of momma’s growing belly.  I hope you haven’t had to experience these feelings but I have…and I know others who have as they struggled with their own infertility process. 

These emotions and about 1,000 more that I won’t write about…so much to write and so little time…can be crippling.  Not crippling in a physical sense but crippling from an emotional standpoint.  Such an internal conflict...how can you be happy for friends but at the same time sad for yourself?  How can you be strong for those two weeks each month where the magic of conception might be happening right under your nose while fighting off the worry, fear and inner turmoil that accompanies those same weeks?  How can 18 months of a cyclical, emotional process be good for your long-term health and strength of a marriage?  Sometimes I feel like a tornado of 1…spinning completely out of control.

Month 18 is where this all ends.  I’m not sure if I’m emotionally exhausted, maturing to a new level in the process or maybe a combination of both.  I’ve decided to take all of my eggs out of the “Everything will be ok…someday you’ll have your own, biological children” basket and move a few into the “Maybe not biological children but adopted children who become your own” basket.  Adoption is an interesting topic for Team Pug and I’ll definitely address it in a future post but at least a window (or maybe the back door) of my heart is open and I’m letting those feelings make their way in. 

Am I giving up hope?  Absolutely not.  Am I setting realistic expectations for myself, my husband and our process?  Yes.  What if I kept all my eggs (no pun intended) in the biological children basket and we find out a year from now…30 months into the process…that biological kids just won’t happen?  The news would be heartbreaking.  But, if some of our eggs are in other baskets, our journey doesn’t come to a screeching halt…it simply detours onto a new highway.  Plus, I can’t keep going the way I have been…those sour thoughts and emotions…my head has to be in a better place to lead a happier, healthier life.

My change in thinking won’t take place over night…it’s definitely not a light switch I can choose to turn off immediately.  I can honestly say that I’m more at peace with the process than I have ever been before and I’m truly pleased with how far we’ve already come.  If I feel myself feeling sad or getting overwhelmed, I’m going to step back and take a deep breath and remember all the wonderful in life I have to be thankful for.  Although I wouldn’t wish this process on anyone, I am truly glad for the experience (bleh…though I’d NEVER say that) and believe it’s made Team Pug better, stronger, more thankful and compassionate people.

What Happens Next?

This post was originally written on Thursday, December 29th...

Today, nearly two weeks after receiving the news, we met with Dr. K for our follow-up appointment.  She started by saying that she was sorry for our loss and continued with what happened and potential reasons why.

What Happened & Why?

In its simplest form, conception occurred…sperm met egg…which is further than we’ve ever gotten before.  Dr. K can be sure conception occurred because the only way an HCG level can be detected in a woman’s blood is from the result of conception.  Somewhere during the process of cell division (growing) and implantation (attaching to the uterine lining to pull nutrients from the mother's body), something went wrong.  What exactly went wrong remains a mystery.  The clinical term for an early loss, like the one we experienced, is chemical pregnancy...conception occurred but the pregnancy was never detected by an ultrasound.  Chemical pregnancies are fairly common...most women don't even know they occur because their bodies will cycle normally just a week or so late.

During my blood work-up after the positive home tests, my hormone levels (outside of HCG) looked good so that’s a positive sign.  It’s likely the miscarriage occurred due to a genetic abnormality and losing the baby was my body and nature’s way of saying…hey, this baby won’t be healthy so we need to start over and give this process another try.  Some promising news…Dr. K said 70% of women who lose their first pregnancy go on to deliver healthy babies the second time around.  I can’t help but look at 70% in school terms...a C- which is unacceptable for my personal, high standards.  Instead, I’ll look at 70% with a new perspective…pretty decent odds.

Moving Forward

Because the process worked (although the outcome wasn’t what we intended), we’ll follow the same course the next time around.  I’ll be on the same drugs at the same doses and visit Dr. K’s office for the same number of appointments.  Between now and then, Dr. K’s office will ensure my cycle re-regulates and my HCG level drops back to 0 (technically less than 3 which is considered negative).  I had blood drawn again today…it’s possible my HCG level has already dropped but it could also linger just above 3 for a couple of months which means my body isn’t quite ready to start the process again.  

Before talking to Dr. K, I consulted two friends who experienced losses of their own…it’s nice to know you’re not alone and I wanted to make sure we were asking the right questions.  They both suggested consulting Dr. K about starting a baby aspirin regimen.  She didn’t bring the topic up during the appointment so I did.  She said she typically doesn’t recommend baby aspirin until a patient experiences recurrent miscarriages but it wouldn’t hurt to start now if I was comfortable with taking the medication.  She went on to explain that baby aspirin increases blood flow to a maturing embryo so it definitely couldn’t hurt.  We also discussed vitamin supplements that might make a difference.  She suggested taking an over-the-counter Vitamin E supplement which has shown to help patients increase/maintain the thickness of their uterine lining.  I'm typically not a fan of taking meds but if a baby aspirin and a Vitamin E supplement prevent future losses and give us a better chance next time around, take them I will.

December is considered a missed month…skipping the process will allow my body to heal physically and our minds to heal emotionally.  If everything checks out, we could potentially start the process again in January or…it may take longer.  For now, we wait and keep hope alive.