Today I went to a much-needed "Nurturing Woman Qigong" class, held at the Oregon College of Oriental Medicine campus in SE Portland. Eileen found the listing for it a month or so ago and asked me if I wanted to take it with her. She figured it would be good for us because it is a form of qigong that is calming and helps one turn inward for balance. It also supports and nurtures a woman's reproductive organs, and that is right up both our alleys.
It was a three-hour class (9a.m. to 1p.m.), and sitting here 3 and a half hours after it ended, I am still feeling relaxed and centered. I think what I liked most about the class was that it was mostly hands-on, with minimal lecture involved. The instructor, Julie Porter (who, by the way, has the most amazing, calming voice I think I have ever heard), gave us a brief lesson on qi and on the aspects of yin and yang so that we would be able to better understand the reasoning behind some of the qigong movements, hand positions, etc. For the most part, we just practiced the form, over and over, and eventually, Julie had us do it on our own, so that we would feel confident we remembered how to do it once the class was over.
We also got a spiral notebook on the history of the form and specific instructions on how to do each part of it. Eileen and I are both excited about having this tool that only takes about 20 minutes a day; it will be great to start using it and hopefully it will help us navigate some potentially emotionally and physically challenging times ahead in IVF Land.
Once again, I feel like I have come back to myself, back to my center. And I had a good reminder today when I was at the class. Julie told us that it will work best for us, in facilitating our healing (emotional, physical, mental, spiritual), if we can approach doing the form with the intention of getting centered--no goal other than that. I've been hearing the same message from a great fertility affirmations CD that my acupuncturist Jelena loaned me. Basically you set your intention, you invite what you would like to happen, and then you let go of your expectations of how and when it will happen: I release the need to know when. I release the need to know how.
It's certainly not easy, but I can understand how doing something with a sole purpose in mind (like getting pregnant) can lessen or completely negate any positive effects what we are doing may have, just because we are holding on so hard to the notion of what we want, hoping so hard, not letting ourselves open to what is the most right thing for us.
Anyway, I am grateful for this class today, for Julie and the wise, peaceful energy that just radiated from her, for Eileen who is beginning her IVF injections tonight, and for all women past, present and future; it sounds odd, but I feel like I connected with them all today just by coming back to myself and to my center.
Namaste.
Saturday, April 16, 2011
Wednesday, April 13, 2011
Changing Clinics
It's now the third day since I was SO angry with Oregon Reproductive Medicine, and now I am just mostly sad and disappointed. I still haven't called them yet, as it's been hard finding a good time and place to call from work, but I'm planning to call them this morning before I go in. Hopefully they will agree to transfer my test results to OHSU Fertility Consultants because we have an appointment scheduled for next Tuesday (!) with Dr. Phillip Patton.
Initially, I was hoping to schedule with Dr. David Lee because my friend Eileen sees and really likes him, but his first available appointment wasn't until May 10th and I'd rather not wait another month. Eileen said that she has a friend who saw Dr. Patton and liked him a lot, so we will give him a try. If we don't feel like we "click," it shouldn't be too hard to switch doctors since they are in the same clinic. But I am hoping that we really like him and feel comfortable under his care. I'll keep you posted!
Initially, I was hoping to schedule with Dr. David Lee because my friend Eileen sees and really likes him, but his first available appointment wasn't until May 10th and I'd rather not wait another month. Eileen said that she has a friend who saw Dr. Patton and liked him a lot, so we will give him a try. If we don't feel like we "click," it shouldn't be too hard to switch doctors since they are in the same clinic. But I am hoping that we really like him and feel comfortable under his care. I'll keep you posted!
Sunday, April 10, 2011
Clomiphene Challenge Part II: The Honeymoon is Definitely Over
The anticipation and sense of moving forward that I felt after our first meeting with Dr. Hesla at Oregon Reproductive Medicine wavered at our second meeting when he mentioned artificial insemination after we'd already established that invitrofertilization would be the best option for us, wobbled even more on Wednesday when I had my second blood draw and finally came crashing down around my ears today, on Day 10 of my cycle, the last day of the Clomiphene Challenge.
I am so very angry as I sit typing this blog post, and I know that a good part of what I am feeling is due to my jacked-up hormone level from the Clomid, but still I feel that we have not been treated well at ORM and I refuse to let it slide anymore. I'll back up a few days and blog about my experience there last Wednesday--which I initially decided not to blog about because I decided that perhaps it was just an honest mistake and that just maybe, I was jumping to conclusions and being overly judgmental (something I know is true about myself and which I am trying very hard to change).
So . . .Wednesday I was scheduled at the Barnes road office for a 1p.m. blood draw. Since it is just a hop, skip and a jump down Hwy 26 from our office in Hillsboro, I figured I should certainly be able to make it there and back within my one hour lunch break. I was sadly mistaken. I walked in the office at 1p.m. and gave my name to the receptionist. I can't remember if I told her I was there for a blood draw, but did tell her the time of my appointment. She instructed me to have a seat and said that someone would be with me shortly. I was the only person in the waiting room, so I didn't think I would be there long. I closed my eyes and practiced breathing deeply. I opened them when the door opened and another couple walked in to the office.
The woman checked herself in with the receptionist and was taken back after only a few minutes of waiting. When the nurse came to get her, I noticed that it was the same nurse I had had the previous Sunday for my initial blood draw--as well as the nurse who'd taken my vitals during the initial consult two weeks earlier. She saw me and smiled and said, "I'll be back for you in just a minute." I thought, "Great! She obviously remembers me, and I'll be out of here in a jiffy."
Now it was just her husband / partner and me in the waiting room. We flipped through magazines and I continued trying to be patient. It couldn't be much longer, right? After all, I was only here for a blood draw. The door opened (finally!) and the nurse looked at me and gestured to come back (I was still the only woman in the office), so naturally, I assumed she meant me, still assuming, from our previous two experiences together, that she knew who I was. Can you see where this is going? I jumped up and asked her how she was.
As I passed through the doorway into the back office area, and she answered my question, I could have sworn she called me "Julianne." The next words out of her mouth confirmed my suspicion. "I'd like you to just empty your bladder before I show you into the examing room."
I raised my eyebrows. "For a blood draw?"
Then I saw recognition in her eyes and she became flustered. Now at this point I really wasn't angry about the mix-up (it came later, the more I thought about it). Mostly I felt embarrassed for her, and wondered if I had done something to lead her to believe I was the patient she thought I was--Julianne. I ended up going back out into the waiting room to wait again. Several more minutes passed and then a different nurse came for me and took me back to draw my blood. I was finished in about three minutes and headed for the car, still mostly bemused and thinking what I would say to Michael who was waiting for me.
We talked about it and thought it was definitely odd, especially since I had seen the nurse twice already and we'd had quite a conversation the last time. (She revealed that we share the same last name and was asking me if I have family in Minnesota. I do, but they are from my mom's side of the family, not Michael's.)
Anyway, Michael and I ended up getting back to work 70 minutes after we'd left and I was feeling more upset that the office clearly suffered from a lack of communication among their staff. The more I thought about it, the more I wondered. Was this an indication of future events? Did I really trust these folks with processes as complicated as 1) egg retrieval 2) injection of sperm into egg and 3) transfer of embryo into uterus? I mean, did I? My gut, which had begun whispering that maybe this was not the place for us when Dr. Hesla did not remember why we were there, started getting louder. I told Michael that I would give them one more shot, and if I still felt that they didn't know us or our specific situation, I would switch to OHSU.
Initially, he wondered why I would switch. "Aren't they the best?" he asked. I told him that while they have a very good track record with IVF, if I didn't feel comfortable with them, I would never be able to go through it there--not with something as rigorous both physically and emotionally as IVF. I figured that we could always get the results of the Clomiphene Challenge and take them elsewhere . . . we hadn't signed any papers yet with them or even really been taken on as candidates for IVF. That is what the Clomid test was supposed to determine.
So I went into today trying to have an open mind. I was sure that 10a.m. was my appointment time. I was wrong--it was an 8:15a.m. appointment. I got a call from ORM at 8:30a.m. asking where I was and if I was coming in today. Now this part I take responsibility for, since I didn't write down the time when the appointment was made. I also didn't get a reminder card or a reminder call Friday or yesterday, but I don't really hold that against them. What I hold against them is not taking the time to read my chart and refresh their memories as to why I am coming to their clinic and why I am paying them a whole lot of money to check my blood and my reproductive organs.
I had the blood draw and was told that I would get the results later today. Fine. I got a call from them at 11:00a.m. but let it go to voicemail because I wasn't ready to talk to them on the phone. Mostly I wasn't ready to find out what my Day 10 FSH level was. I wasn't ready until about 5:00p.m. When I listened to the message, I couldn't believe what I was hearing. I ended up going back and listening to it 2 more times, once with Michael.
The nurse gave me my FSH level (12.38, which is fine since it just has to be under 13), and then proceeded to tell me in a very cheery voice that my next step would be to go buy some ovulation kits (the kind with the smiley face) and begin checking my 2nd urine of the morning tomorrow (Day 11). As soon as I got the smiley face, the indicator of my LH surge, I was to call the office to schedule my insemination. Yes, that's right, folks, my insemination.
I was floored, flabbergasted and angrier than I ever remember being about much of anything. I said some choice words, and called my mom where I told her everything and gave her a preview of what I plan on telling someone at ORM tomorrow when I call them. Then I called my friend Eileen (who is also on track for IVF) and left her a message, and then I called my best friend Lindsey and left her a message. I was beyond steamed--firstly, because this was the second time the staff thought I was coming in for a treatment other than the treatment outlined during my initial consult, and secondly, that it was the third time in four visits that I felt like the staff did not know who we are.
So. Needless to say, we will not be pursuing the building of our family with Oregon Reproductive Medicine. Tomorrow I will call OHSU and see if we can get on the books for an initial consult. And I will call ORM and give them a piece of my flaming mind.
I am so very angry as I sit typing this blog post, and I know that a good part of what I am feeling is due to my jacked-up hormone level from the Clomid, but still I feel that we have not been treated well at ORM and I refuse to let it slide anymore. I'll back up a few days and blog about my experience there last Wednesday--which I initially decided not to blog about because I decided that perhaps it was just an honest mistake and that just maybe, I was jumping to conclusions and being overly judgmental (something I know is true about myself and which I am trying very hard to change).
So . . .Wednesday I was scheduled at the Barnes road office for a 1p.m. blood draw. Since it is just a hop, skip and a jump down Hwy 26 from our office in Hillsboro, I figured I should certainly be able to make it there and back within my one hour lunch break. I was sadly mistaken. I walked in the office at 1p.m. and gave my name to the receptionist. I can't remember if I told her I was there for a blood draw, but did tell her the time of my appointment. She instructed me to have a seat and said that someone would be with me shortly. I was the only person in the waiting room, so I didn't think I would be there long. I closed my eyes and practiced breathing deeply. I opened them when the door opened and another couple walked in to the office.
The woman checked herself in with the receptionist and was taken back after only a few minutes of waiting. When the nurse came to get her, I noticed that it was the same nurse I had had the previous Sunday for my initial blood draw--as well as the nurse who'd taken my vitals during the initial consult two weeks earlier. She saw me and smiled and said, "I'll be back for you in just a minute." I thought, "Great! She obviously remembers me, and I'll be out of here in a jiffy."
Now it was just her husband / partner and me in the waiting room. We flipped through magazines and I continued trying to be patient. It couldn't be much longer, right? After all, I was only here for a blood draw. The door opened (finally!) and the nurse looked at me and gestured to come back (I was still the only woman in the office), so naturally, I assumed she meant me, still assuming, from our previous two experiences together, that she knew who I was. Can you see where this is going? I jumped up and asked her how she was.
As I passed through the doorway into the back office area, and she answered my question, I could have sworn she called me "Julianne." The next words out of her mouth confirmed my suspicion. "I'd like you to just empty your bladder before I show you into the examing room."
I raised my eyebrows. "For a blood draw?"
Then I saw recognition in her eyes and she became flustered. Now at this point I really wasn't angry about the mix-up (it came later, the more I thought about it). Mostly I felt embarrassed for her, and wondered if I had done something to lead her to believe I was the patient she thought I was--Julianne. I ended up going back out into the waiting room to wait again. Several more minutes passed and then a different nurse came for me and took me back to draw my blood. I was finished in about three minutes and headed for the car, still mostly bemused and thinking what I would say to Michael who was waiting for me.
We talked about it and thought it was definitely odd, especially since I had seen the nurse twice already and we'd had quite a conversation the last time. (She revealed that we share the same last name and was asking me if I have family in Minnesota. I do, but they are from my mom's side of the family, not Michael's.)
Anyway, Michael and I ended up getting back to work 70 minutes after we'd left and I was feeling more upset that the office clearly suffered from a lack of communication among their staff. The more I thought about it, the more I wondered. Was this an indication of future events? Did I really trust these folks with processes as complicated as 1) egg retrieval 2) injection of sperm into egg and 3) transfer of embryo into uterus? I mean, did I? My gut, which had begun whispering that maybe this was not the place for us when Dr. Hesla did not remember why we were there, started getting louder. I told Michael that I would give them one more shot, and if I still felt that they didn't know us or our specific situation, I would switch to OHSU.
Initially, he wondered why I would switch. "Aren't they the best?" he asked. I told him that while they have a very good track record with IVF, if I didn't feel comfortable with them, I would never be able to go through it there--not with something as rigorous both physically and emotionally as IVF. I figured that we could always get the results of the Clomiphene Challenge and take them elsewhere . . . we hadn't signed any papers yet with them or even really been taken on as candidates for IVF. That is what the Clomid test was supposed to determine.
So I went into today trying to have an open mind. I was sure that 10a.m. was my appointment time. I was wrong--it was an 8:15a.m. appointment. I got a call from ORM at 8:30a.m. asking where I was and if I was coming in today. Now this part I take responsibility for, since I didn't write down the time when the appointment was made. I also didn't get a reminder card or a reminder call Friday or yesterday, but I don't really hold that against them. What I hold against them is not taking the time to read my chart and refresh their memories as to why I am coming to their clinic and why I am paying them a whole lot of money to check my blood and my reproductive organs.
I had the blood draw and was told that I would get the results later today. Fine. I got a call from them at 11:00a.m. but let it go to voicemail because I wasn't ready to talk to them on the phone. Mostly I wasn't ready to find out what my Day 10 FSH level was. I wasn't ready until about 5:00p.m. When I listened to the message, I couldn't believe what I was hearing. I ended up going back and listening to it 2 more times, once with Michael.
The nurse gave me my FSH level (12.38, which is fine since it just has to be under 13), and then proceeded to tell me in a very cheery voice that my next step would be to go buy some ovulation kits (the kind with the smiley face) and begin checking my 2nd urine of the morning tomorrow (Day 11). As soon as I got the smiley face, the indicator of my LH surge, I was to call the office to schedule my insemination. Yes, that's right, folks, my insemination.
I was floored, flabbergasted and angrier than I ever remember being about much of anything. I said some choice words, and called my mom where I told her everything and gave her a preview of what I plan on telling someone at ORM tomorrow when I call them. Then I called my friend Eileen (who is also on track for IVF) and left her a message, and then I called my best friend Lindsey and left her a message. I was beyond steamed--firstly, because this was the second time the staff thought I was coming in for a treatment other than the treatment outlined during my initial consult, and secondly, that it was the third time in four visits that I felt like the staff did not know who we are.
So. Needless to say, we will not be pursuing the building of our family with Oregon Reproductive Medicine. Tomorrow I will call OHSU and see if we can get on the books for an initial consult. And I will call ORM and give them a piece of my flaming mind.
Tuesday, April 5, 2011
Clomiphene Challenge Part I
Last Sunday was the third day of my period, and the day that Dr. Hesla wanted me to come in to begin the Clomiphene Challenge. My appointment was bright and early at 8:00AM, and I am pretty sure that I was their first patient of the day. A nurse (the same one that took my vitals at my initial appointment a couple of weeks ago), drew my blood and then showed me into an examining room to get ready for the ultrasound. I assumed that a technician would be performing the ultrasound, and so was a bit surprised when Dr. Hesla walked in and said that he would be doing it. It makes sense though, to have him do the ultrasound so that he knows exactly what we are dealing with. He described everything he was seeing, both for my benefit as well as for an accurate record. A staff member stood nearby taking down information on a clipboard. He looked at my uterus first, and as usual, it was just fine (go, uterus!). The right ovary was next, and this time, I figured out that the large gray image on the screen was not supposed to be there. It was the biggest cyst he found and although I don't remember the exact measurements, the first number he said was 40mm, which Michael says is about 2 inches. The left ovary had several smaller cysts associated with it, and Dr. Hesla measured them all. Next he said he was going to see how many follicles he could find and count them. I hoped he would find a lot as that would indicate that I still have functioning ovaries, despite the cysts. Dr. Hesla found 6 follicles in the right ovary and 2 follicles in the left. And while I have no idea what the average number of follicles that develop each month might be, I think 8 is not too shabby for a girl with cysts. :) The only thing that really took me aback during the visit was Dr. Hesla saying that with my level of endometriosis, he wouldn't normally recommend IUI (artificial insemination). I was pretty sure we had gone over that during our initial consult and that everyone had agreed IUI was out and Michael and I would go straight to IVF if we seemed like good candidates. I'd like to give him the benefit of the doubt that he brings IUI up with every couple, as an option when taking the Clomiphene Challenge, but a part of me felt like he didn't remember us or hadn't taken the time to refresh his memory by looking through our file before the appointment. I am probably more than a little spoiled by eastern medicine and other natural health care modalities. I think I just have to come to terms with the fact that western medicine is not bad--just different, and that even though I might not get the same personalized attention from my fertility doctor as I do from my Chinese medicine doctor, that doesn't mean one is better than the other. I have to remember that both people are working in my best interest. After the ultrasound, I was free to go. I headed over to a Starbucks for breakfast and to write down my thoughts about the morning's appointment. By the time I left, about 10:30AM, I had already gotten a call back from the doctor's office with my blood test results. My FSH (follicle stimulating hormone) level was 9.79, which was fine. It just has to be less than 13 to be considered "good." My Estradiol (type of estrogen) level was fine too at 49. My TSH level was slightly elevated at 3.82. The nurse explained that if I looked it up online, I would likely find that it's a "normal" level, but that Dr. Hesla likes it to be 2.5 0r less before pregnancy occurs. He wants me to take 25mcg of Levothyroxine a day, which I was not all that happy about at first. I told the nurse that I used to take Naturthroid, a natural thyroid supplement which was prescribed by my naturopath, but she let me know in no uncertain terms that their office does not endorse the use of supplements. So . . . I will play by the rules and take the pills. If it brings me closer to my child(ren), then I am happy to do it. I can always make other choices later. I started taking the Clomid today and will take it through Saturday. Then I'll go back in on Sunday for another blood test to determine my FSH level once again. After the results are in, Dr. Hesla will give us his opinion on where we should go from here. I am excited to find out. P. S. Tomorrow I have yet another blood test to measure my level of AMH (Anti-Mullerian hormone), which will be another indicator of how well my ovaries are working.
Sunday, March 20, 2011
Initial ORM Consult
Michael and I went to our first appointment with Dr. Hesla at Oregon Reproductive Medicine last Wednesday. During the three weeks since scheduling the appointment, I had been thinking that it would be at their clinic near St. Vincent Hospital. My confirmation email said it would be at their westside location, but didn't give an address. I even checked their website before we left work for the appointment, but somehow missed seeing the Barnes road address where we were supposed to go. Instead we drove downtown to their office at Good Samaritan Hospital where the receptionist informed us that we were at the wrong place. My heart sank because we had waited so long for the appointment and I figured we would have to reschedule and wait a few more weeks before we'd be able to get back in. Luckily, we were Dr. Hesla's last appointment of the day and he very kindly agreed to wait for us. We hopped back in the car and made it to the right clinic at 4pm, so we were only 30 minutes late. Still, I felt silly for getting the locations mixed up!
Needless to say we didn't have long to wait once we arrived. A staff member (whether nurse or medical assistant I don't know), led us to a small room that just fit a table, 4 chairs and a sink. She took my vitals (pulse, blood pressure & weight) and took a picture of the two of us for our file. Michael and I thought that was kind of cool--it showed that they care about putting our faces to the information in our file. Well, I guess you would call it "my" file because at a fertility clinic, it seems like only the woman undergoing treatment is considered to be the patient--even if she has a male partner who will be donating his sperm. Michael had to fill out health history paperwork like I did, but his was only about 3 pages whereas mine was probably twice that, and his forms will be kept in my patient chart instead of having his own file.
Michael definitely noticed the focus on me because after the lady finished taking my vital signs and left the room, he said, "They're not really interested in me, are they?" I explained that it was because if we chose to work with them to get pregnant, I would be the one whose body would have to be healthy enough not only to conceive but to maintain a pregnancy. Still, I think he felt left out, so I teased him by asking, "Do you want me to take your blood pressure?" He did consent to hopping on the digital scale that was in the room and we were both happy to discover that neither of us weighed as much as we had feared. :)
The lady was soon back to collect us and take us to Dr. Hesla's office. He was a tall, soft-spoken man with silver hair at his temples. We thanked him for agreeing to see us late, and then he got right down to business discussing our forms. There was quite a stack of paperwork on his desk which included our health history forms as well as the results of the 3 ultrasounds I had over the course of last year, the HSG and blood test. He had to do some shuffling of papers to find what he wanted, but as I had feared, the first thing he wanted to discuss were the cysts on my ovaries.
I didn't make a blog post about the results of the December ultrasound (mostly because I didn't hear from the doctor until FEBRUARY . . . when I did it was just a voice mail message glossing over the fact that she had never gotten back to me with the results and telling me to feel free to call her if I wanted to discuss them. It shows the level of communication among her office staff because I had called her office several weeks earlier and requested that I be sent a copy of the results since I was tired of waiting around for her to get back to me.)
Anyway, basically the results were about the same. I have 3 cysts in my left ovary and one of them keeps getting bigger, little by little. The right ovary also has at least one cyst and possibly more, which brings the number and quality of my eggs into question.
Dr. Hesla said (twice!) that I have severe disease (indicated by the presence of the endometriomas, which are cysts filled with old blood caused by endometriosis), and that in some cases, women in my situation make fewer eggs--but not always. He said he recently had a patient who also had severe endometriosis affecting her ovaries and she was able to produce a good number of eggs when she went through IVF.
He wasn't too concerned about Michael's low sperm numbers . . . although he did say that the problems we both have don't make us good candidates for IUI (the much less invasive, less expensive procedure), which he said isn't actually much better than just having plain old sex. He does not think we would ever get pregnant naturally. :( He did say that they have great success with IVF when the difficulty is male infertility. But before he can determine if we are both good candidates for IVF, he needs to take a closer look at my ovaries.
So the next step will be calling the clinic when I begin my next period (in about 12 days), to get an appointment on either Day 2 or 3 of my cycle and to make a second appointment for Day 10 of my cycle. I'll have to take the "Clomid Challenge Test" which incorporates two blood tests and an ultrasound to determine the quality of my ovarian reserve.
The first part of the test will be a transvaginal ultrasound. I have to say that I am not looking forward to that since I will be having my period. I guess they can kind of tell where the cysts are in relation to my ovaries (the endometriomas look gray and the ovaries more white, I think), and so can help determine how many eggs may be in there.
At the same time as the ultrasound, I'll have a blood test to determine my FSH and estradiol levels. FSH is a hormone produced by the pituitary gland that stimulates the ovaries to develop follicles, which are the small cysts that contain eggs. As follicles develop, they produce hormones (estradiol and inhibin-B) that flow back to the pituitary gland via the blood and tell it how much FSH to produce. Both my FSH and estradiol numbers should be low (FSH less than 13 m1U/ml, estradiol < 100pg/ml) at either Day 2 or 3 and also at Day 10.
At the same time that I have the ultrasound and the first blood test, I will start taking Clomid, which is a fertility drug that will stimulate my ovaries to produce follicles. If I understand the test correctly, I should have a lower FSH level on day 2 or 3 of my period since my pituitary gland won't yet be sending the signal to my ovaries to develop follicles for that month's cycle. As I take the Clomid, I'll get a peak in my FSH and estradiol levels as my ovaries are stimulated to develop follicles, but by Day 10 of my cycle I should have a low FSH number indicating that my ovaries are working to send the "turn off" message to my pituitary gland.
I told Dr. Hesla that everyone was surprised that my fallopian tubes were both open when I had the HSG test (because of my history of endometriosis), and that until proven otherwise, I consider myself to have an abundance of eggs. :)
I had a lot of emotions after the appointment: sadness, anger (that again my ability to get pregnant hinges on having the endo), regret that I didn't begin fertility treatments several years ago, regret that I wasn't consistent with the abdominal massage or the castor oil pack treatments--wondering if I would still have the same problems I do now or if those things could have helped. There's no way to know . . . and I tell myself that I did the best I could, but I still feel guilty.
So now we wait until it's time for me to go in for the testing. If my ovarian reserve is good, we will most likely prepare to begin the process of IVF. If it isn't, we will have more decisions to make. My best friend, Lindsey, has offered us her eggs, but I don't know if Michael is altogether comfortable with that arrangement. We may decide to go the adoption route instead. I guess we'll just have to keep taking it one step at a time and go from there.
It's funny because at this time last year, I was still not ready for IVF . . . in fact I was just about to book my trip to North Carolina to attend the Fertile Soul retreat. I still thought we could get pregnant naturally--if only I did everything right, followed every suggestion, was mentally strong enough. Now I admit that we need more advanced help. The one thing that makes me feel better is the fact that I have spent nearly a full year being pretty consistent with the special diet and with taking the chinese herbs and other supplements. Eileen (who has also been taking herbs and doing other alternative treatments), reminds me that that must count for something--that our bodies must be in better shape than they were before, and that that will work in our favor as we both begin the road to IVF.
Needless to say we didn't have long to wait once we arrived. A staff member (whether nurse or medical assistant I don't know), led us to a small room that just fit a table, 4 chairs and a sink. She took my vitals (pulse, blood pressure & weight) and took a picture of the two of us for our file. Michael and I thought that was kind of cool--it showed that they care about putting our faces to the information in our file. Well, I guess you would call it "my" file because at a fertility clinic, it seems like only the woman undergoing treatment is considered to be the patient--even if she has a male partner who will be donating his sperm. Michael had to fill out health history paperwork like I did, but his was only about 3 pages whereas mine was probably twice that, and his forms will be kept in my patient chart instead of having his own file.
Michael definitely noticed the focus on me because after the lady finished taking my vital signs and left the room, he said, "They're not really interested in me, are they?" I explained that it was because if we chose to work with them to get pregnant, I would be the one whose body would have to be healthy enough not only to conceive but to maintain a pregnancy. Still, I think he felt left out, so I teased him by asking, "Do you want me to take your blood pressure?" He did consent to hopping on the digital scale that was in the room and we were both happy to discover that neither of us weighed as much as we had feared. :)
The lady was soon back to collect us and take us to Dr. Hesla's office. He was a tall, soft-spoken man with silver hair at his temples. We thanked him for agreeing to see us late, and then he got right down to business discussing our forms. There was quite a stack of paperwork on his desk which included our health history forms as well as the results of the 3 ultrasounds I had over the course of last year, the HSG and blood test. He had to do some shuffling of papers to find what he wanted, but as I had feared, the first thing he wanted to discuss were the cysts on my ovaries.
I didn't make a blog post about the results of the December ultrasound (mostly because I didn't hear from the doctor until FEBRUARY . . . when I did it was just a voice mail message glossing over the fact that she had never gotten back to me with the results and telling me to feel free to call her if I wanted to discuss them. It shows the level of communication among her office staff because I had called her office several weeks earlier and requested that I be sent a copy of the results since I was tired of waiting around for her to get back to me.)
Anyway, basically the results were about the same. I have 3 cysts in my left ovary and one of them keeps getting bigger, little by little. The right ovary also has at least one cyst and possibly more, which brings the number and quality of my eggs into question.
Dr. Hesla said (twice!) that I have severe disease (indicated by the presence of the endometriomas, which are cysts filled with old blood caused by endometriosis), and that in some cases, women in my situation make fewer eggs--but not always. He said he recently had a patient who also had severe endometriosis affecting her ovaries and she was able to produce a good number of eggs when she went through IVF.
He wasn't too concerned about Michael's low sperm numbers . . . although he did say that the problems we both have don't make us good candidates for IUI (the much less invasive, less expensive procedure), which he said isn't actually much better than just having plain old sex. He does not think we would ever get pregnant naturally. :( He did say that they have great success with IVF when the difficulty is male infertility. But before he can determine if we are both good candidates for IVF, he needs to take a closer look at my ovaries.
So the next step will be calling the clinic when I begin my next period (in about 12 days), to get an appointment on either Day 2 or 3 of my cycle and to make a second appointment for Day 10 of my cycle. I'll have to take the "Clomid Challenge Test" which incorporates two blood tests and an ultrasound to determine the quality of my ovarian reserve.
The first part of the test will be a transvaginal ultrasound. I have to say that I am not looking forward to that since I will be having my period. I guess they can kind of tell where the cysts are in relation to my ovaries (the endometriomas look gray and the ovaries more white, I think), and so can help determine how many eggs may be in there.
At the same time as the ultrasound, I'll have a blood test to determine my FSH and estradiol levels. FSH is a hormone produced by the pituitary gland that stimulates the ovaries to develop follicles, which are the small cysts that contain eggs. As follicles develop, they produce hormones (estradiol and inhibin-B) that flow back to the pituitary gland via the blood and tell it how much FSH to produce. Both my FSH and estradiol numbers should be low (FSH less than 13 m1U/ml, estradiol < 100pg/ml) at either Day 2 or 3 and also at Day 10.
At the same time that I have the ultrasound and the first blood test, I will start taking Clomid, which is a fertility drug that will stimulate my ovaries to produce follicles. If I understand the test correctly, I should have a lower FSH level on day 2 or 3 of my period since my pituitary gland won't yet be sending the signal to my ovaries to develop follicles for that month's cycle. As I take the Clomid, I'll get a peak in my FSH and estradiol levels as my ovaries are stimulated to develop follicles, but by Day 10 of my cycle I should have a low FSH number indicating that my ovaries are working to send the "turn off" message to my pituitary gland.
I told Dr. Hesla that everyone was surprised that my fallopian tubes were both open when I had the HSG test (because of my history of endometriosis), and that until proven otherwise, I consider myself to have an abundance of eggs. :)
I had a lot of emotions after the appointment: sadness, anger (that again my ability to get pregnant hinges on having the endo), regret that I didn't begin fertility treatments several years ago, regret that I wasn't consistent with the abdominal massage or the castor oil pack treatments--wondering if I would still have the same problems I do now or if those things could have helped. There's no way to know . . . and I tell myself that I did the best I could, but I still feel guilty.
So now we wait until it's time for me to go in for the testing. If my ovarian reserve is good, we will most likely prepare to begin the process of IVF. If it isn't, we will have more decisions to make. My best friend, Lindsey, has offered us her eggs, but I don't know if Michael is altogether comfortable with that arrangement. We may decide to go the adoption route instead. I guess we'll just have to keep taking it one step at a time and go from there.
It's funny because at this time last year, I was still not ready for IVF . . . in fact I was just about to book my trip to North Carolina to attend the Fertile Soul retreat. I still thought we could get pregnant naturally--if only I did everything right, followed every suggestion, was mentally strong enough. Now I admit that we need more advanced help. The one thing that makes me feel better is the fact that I have spent nearly a full year being pretty consistent with the special diet and with taking the chinese herbs and other supplements. Eileen (who has also been taking herbs and doing other alternative treatments), reminds me that that must count for something--that our bodies must be in better shape than they were before, and that that will work in our favor as we both begin the road to IVF.
Wednesday, February 23, 2011
ORM Appointment Made
I made our appointment with Dr. Hesla at Oregon Reproductive Medicine yesterday . . . it will be March 16 at 3:30PM. Will you all please think of us that day and send us some extra good energy/thoughts/prayers?
Thank you. <3
Thank you. <3
Sunday, February 20, 2011
For My Friend
"Even When You're Sad"
Sing hard. Act out that part you have,
by singing when it comes. Invited,
plunge. Places there are where you'll never
be unless the sound is your sound.
Here's a way, for the kind of world
this is, to take before it ends:
Discover a talisman
hold it; find a road; run.
--William Stafford
It's so hard going through infertility. It's hard going through it and it's hard watching a friend struggle with it because you know exactly how she feels.
Tonight I am thinking of my friend, Eileen, and of myself and I am wondering how much longer we will have to wait to become moms.
When I feel sad, I surround myself with words. They make me feel better and help me keep going. Groovy, soulful, passionate music helps too--and sometimes chocolate. Tonight, it's "Sydney (I'll Come Running)" by Brett Dennen and Crosby, Stills and Nash's "Southern Cross" playing over and over that are helping keep me from wallowing too much. Also helping are words from a couple of women writers who also walked the long road I'm on and who, following different paths, came out the other side holding the hands of their children.
One lady and her husband adopted a baby that another couple had decided they couldn't provide properly for. The baby didn't belong to the author and her husband biologically, but when she was born, they knew at once that she was theirs.
The other lady and her husband wanted to have babies that would be genetic siblings. They found an egg donor, used the husband's sperm and found 2 surrogates to carry the babies for them. The babies were born 5 days apart.
What I like about these stories is that these women found a way to get what they wanted. They were sad for awhile, they wallowed, they despaired, but then they pulled themselves up and out and decided upon a plan.
When I look back on all of the posts I have made since beginning this blog, I get discouraged. It feels like so much time (so many months) have flown by and I still don't feel much farther along. I feel something building though--something is coming to a head. I am ready now to make the call (tomorrow!) to Oregon Reproductive Medicine and consult with a doctor there. Then it will be decision time . . . do we try one or two IUIs or do we take a gamble and go for IVF? Or do we look into adoption instead?
IVF will most likely depend upon whether or not we qualify for ORM's "Our Promise" plan which promises a partial or total refund of money invested if, after 3 IVF tries, there is still no live birth.
Adoption is scary too . . . birth moms can change their minds even after the baby is born. And even if a birth mom didn't change her mind, even if she freely gave us her baby and signed all the papers, I wonder how giving up that child might damage her spirit. I would worry for her.
Michael and I talk about it and it feels surreal . . . thousands of dollars placed (not unlike a bet in a casino) on what comes down to about a 50/50 chance of success, or thousands of dollars spent on a child that someone else, somewhere, will have to give up having in their lives so that we can have a family. Both options tug at my heart in different ways.
But for now, there is music and there are words, and I thank God for them. And I hope my friend is feeling some peace tonight too.
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