when did when, turn into if?

yesterday my husband and i watched the movie, switch, with jennifer anniston.

it was an okay movie.  the quick and dirty plot is that jennifer anniston wants a baby but isn't married.  she hires a sperm donor to have a baby but her best friend switches his sperm for it instead.  years later he meets the son and realizes it's his especially after seeing some of his own mannerisms in the boy. it got my husband and i talking about how weird/cool it is that kids have similar mannerisms to their parents even when they don't know them or get a chance to meet them. 

almost 6 years ago, one of my family friends, my bff's older sister who was like an older sister to me, passed away at the age of 31 after battling breast cancer.  she was diagnosed in october and died in may.  no family history of breast cancer.  she walked into her doctor's office complaining of back pain.  they ended up doing an xray and found lytic lesions.  she was diagnosed with stage 4 metastatic breast cancer.  her daughter was 6 months old.  she died the month after her first birthday.  her daughter is now almost 7 years old and i see so much of her in her mannerisms and actions.  she has the same broad beautiful smile, the same dainty way of running, the same fully belly laugh.  its amazing!

my husband and i were discussing this and he asked, which of my mannerisms do you think our son would have?  an innocent enough question.  i heard myself saying, if we have kids, our son would probably have your smile.

when the hell did when turn into if?!? 

i swear i'm trying to be positive, to be hopeful.  to have faith.  i guess my sub-conscience has a different point of view.  its so difficult to want to be hopeful because of the fear of recurrent disappointment. 

last night, my husband confessed that he's worried about me.  that i'm too stressed out about this whole ttc thing.  and i have to admit that i am.  i feel like its all consuming.  i can't help but think about it every day, several times a day.  don't get me wrong, i'm not sitting around in my room, curtains drawn, brooding about ttc everyday.  it may seem like it because its really all i write about in this blog. but really i have a very full and busy life.  its just when i'm alone getting ready in the morning before my husband's gotten up or at night when i'm trying to get fall asleep, a million obsessions swirl around in my head.  i use this blog as an outlet for my obsessions.  and i think it helps.  it helps to get them out of my head and see them in black and white.  it helps me to process it, and also helps me to have some perceptive.

yes, we're still young.  yes, we haven't been trying as long as some other couples.  yes, there's nothing medically wrong with us.  yes, there's still time.  yes, i should be more hopeful. 

i need to turn my if back to when.

where do all my comments go?

i know how much i really appreciate little comments that are sometimes left on my blog. it makes my heart smile. :)

so i do make an effort to leave comments on other people's blogs, especially when i start following them. most of the time, i've been finding that my comment will show up briefly for a second and then it disappears. i'm not sure if there is something wrong with my blogger setting, if the blogger chooses not to publish them or if the comment gets thrown into the internet black-hole never to be seen again. i hope that the owners of the blog actually get to read my comment. i really don't care if it gets published or not but i just know how nice it is to get that email that someone else out there is going through a similar situation and can relate to how crazy/upset/sad you're feeling that day. so if i haven't gotten a chance to comment on your blog or it has somehow disappeared, i'm hear routing for you!

2 posts in one day?!? i must be drunk!

and i think i am. i'm finishing up my 3rd glass of wine. my husband has left to go have some drinks with one of his friends. which is fine, really because now i can spend time lurking on thebump.com or researching "unexplained infertility" via google.

today we bought a bottle of wine celebrated our tests being "normal". normal hsg. normal CD3 blood work. normal SA. normal, normal, normal. but where does that leave us? really with a whole lot of questions and no answers. where do we go from here?!?

i think i'm kind of in a state of denial. not quite ready to use the "i" word, infertility. sometimes i write it on comments on the bump or will google it online but i have yet to accept the fact that technically, we are infertile. over 1 year of unprotected sex that does not result in a pregnancy. that's us. not one double pink line. not even a hint of a little pink shadow. all i have see in a stark white space where my beautiful little pink line should be.

if you've been reading my blog, you'll know that i've been of bcp since 05.09. that's almost 2 freakin' years! we started using opks in 06.10. every month its the same story, +opks, good timing sex-wise, and a stark white space next to the pink control line. its just so frustrating!

so here we are with unexplained infertility. idiopathic is what it would be called in medical terms. where do we go from here?

because my main coping mechanism is intellectulalization, i google what our next steps could possible be. what i found was essentially clomid + IUI. naturally i did a pubmed search using the key words "unexplained infertility" + "clomid" to find studies/review articles in the medical literature regarding this treatment. what i found basically reinforced what i thought initially. that if a woman is ovulating, clomid, with its anti-estrogenic properties, basically fools the body into developing more than one follicle and increases the likelihood of multiple gestations - twins, triplets, ect. now, i am not knocking anyone for being on clomid or trying it for unexplained infertility - to each his own really. but for me, personally, being a neonatology fellow and see what complications can come from multiple gestations, preterm birth, ect, right now for us, it's not a risk i'm willing to take.

that leaves me wondering, do i want this bad enough? i mean, if others are willing to risk multiple gestation pregnancies and right now i'm not, does that mean i don't want it as much or as bad as they do? for now, i'm reassuring myself that no, that's not what it means. i have a very different perspective than most people. i take care of the 24-25 week twin gestation babies and see how difficult the course is not only for the babies, but for the families. i see them when they are 2-3 years old and see how far behind some of them are developmentally from their peers. i see moms and dads hearts break when we have to withdraw care on their babies because they just can't fight the fight anymore. it's so heartbreaking. i'm not sure my husband and i would be able to stand it.

so for now, the plan is nothing. which is a very tough thing for me, being a planaholic. we will continue to hump like rabbits and pray that one day we will make a baby. at least that's where we're at right now. ask me the next CD1 and it could be a totally different story. i might be ready to put my feet in the stirup and be injected with my husband's sperm! but for today, we wait.

meanwhile, tonight, i get drunk. :)

normal

i got a call from my ob/gyn today.  my husbands swimmers are good!  :)  so that means so far everything is normal.  all we have left is my progesterone level to check on april 1st.  after that...who knows...

my husband and i talked about it and if everything does come back normal, we'll probably just keep trying or maybe even take a break for a little bit.  i'm really not sure.  i don't think we're quite ready to move onto more invasive measures.  what those would be, i'm really not sure.  for unexplained infertility, i'm really not sure what the next step is/could be.  i guess i'll find out when/if i make a follow up appointment with her. 

at this point i'm just happy that so far, things so far are normal.

i was so excited about our results that i skipped going into the lab to work and instead treated myself to a mani-pedi today.  its finally flip-flops weather where i live & i'm lovin' it!

hysterosalpingogram. try saying that 3x fast!

today i had my hsg. i won't leave you in suspense. it was normal.

my appointment was at 1:00pm. of course being a natural planner, i pre-printed my new patient registration sheet off their website and arrived with it filled out. my husband went with me to this appointment. at first i wasn't sure i wanted him there. i wasn't sure that he'd even be able to go back with me. but after doing some research (aka lurking on trouble trying to get pregnant on thebump.com), a lot of girls said that they thought it was nice/would be nice if you didn't go alone. my husband's job allows him a flexible schedule so i asked him to go.

we arrived 20 minutes early, starving from not having eaten lunch yet. i checked in at the counter and asked the lady how much my copay would be. (i called my insurance last week to see how much i'd be paying. i was told either a $35 copay for an office visit or 20/80 split for the procedure.) the lady at the desk tells me that she doesn't know how much my insurance would cover. she says the test costs $450 if you go through insurance, and i would be responsible for whatever they didn't pay. needless to say, i was on the phone with my insurance company in 5 minutes. apparently they don't cover an hsg unless you are checking to see if your tubal ligation is working or if you have a foreign object in you uterus (like an iud) that can't be found. i argued with the insurance guy for awhile but quickly saw that the conversation was going no where. long story short, we ended up pay $160 out-of-pocket for the hsg. we haven't met any of our deductible yet this year so either way, we were going to pay. whatev.

30 minutes later we were called back to another room where a very sweet tech asked if we had any questions and explained to me what they were going to do. then we waited for the exam room to be ready. 15 minutes passed and we go into the room. i change into a gown, bottoms off. the table looked like a ct scanner bed. there were no stirups. a few folded sheets were in place for me to prop by butt on.

i met the radiologist. he would be the first male to put a speculum in me. weird. i called ahead and knew that the radiologist would be doing the procedure, not a tech. i've always gone to female ob/gyn but looking on the website all of the radiologist were male so basically i was shit out of luck. he was more personable than most radiologist (no offense any radiologist out there). he left to wash up, meanwhile the sweet tech kept talking my ear off.

he gowned up and started the procedure. i informed him that my cervix was situated to the left so he wouldn't have a hard time finding it. the speculum was as uncomfortable as any speculum exam would be. he found my cervix and did 3 betadine swabs of it then he placed the catheter through it. it hurt. not just a little uncomfortable, but actual pain. on a scale of 1-10, i'd say it was around a 4/10. then he inflated the balloon. that was the part i think that hurt the most. i'd say around 5-6/10. (during this time, my poor husband is just sitting in the back of the room with a lead apron to protect his swimmers. i can't see him because he's directly behind me.) i turn my attention to the screen that is displaying my lady parts. it shows a catheter inside me.

he injects dye into my uterus. it feels like pressure, not really pain but i'm still in a pretty decent amount of pain from the catheter balloon. the radiologist and i are both watching the real time screen of the dye in my uterus. it was actually pretty interesting. here's the first picture we saw.

the catheter is in too deep on the right side. he deflates the balloon some and now the pain isn't really too bad, maybe a 2-3/10. most of the discomfort comes from the speculum. this is my next picture.

everything looks fine. normal shaped uterus. both tubes are patent. you can't see the bottom of my uterus because of the catheter balloon. then he had me uncomfortably try to lay on my right side, the my left side to take some pictures of the posterior of the uterus. i won't bore you with those pictures. everything looked normal. catheter and speculum are removed. i wash up and get dressed. i feel crampy pain but nothing too terrible. my husband and i wait in the waiting room to get a copy of my film. (yes, they still use actual film in this office. hello, it's 2011! go digital!! i had to use my scanner light box thing and take a picture with my camera to get these on my blog.) after our appointment my husband and i grabbed lunched and talked.

we were both relieved that it was normal. his first question was, "what now?" i told him i guess we wait for his semen analysis results (which we should get by next week the latest) and my progesterone level on april 1st. i think i forgot to mention that my CD3 blood work (FSH, estrogen, TSH, prolactin) were normal. they were. yay! so i guess now is just a waiting game.

during the ride home i was thinking...

how did we get to this point? why do we have to do tests and blood work while it seems like everyone else is just popping out babies left and right?

i hope everything else is normal too but what if its not? what would we do? how far are we willing to go to have a baby? would we just try a little longer? how aggressive do we want to be?

so many thoughts going through my mind. its like a whirlwind up there...

when do you want to have a baby?

this is the question my mom asked me over the phone yesterday. we have this agreement, my mom and i, that i call her every sunday. she really looks forward to my call and gets pretty upset with me when i forget or don't make time to call. i know some people talk to their moms everyday. first of all, i'm not much of a phone person to begin with. secondly, i don't have any idea what i would talk to my mom about every day. i love her but my life isn't really that exciting. there's not much to say. i get up, go to work and come home most days. anyways, so sundays i try to remember to call her. most of the time our conversation is brief but it is nice to hear updates from her about what's going on back home. last night for some reason, she asked me about having a baby, more specifically WHEN did i want to have this said baby, as if it were up to me! i gave her my generic answer,"whenever God wants me to have one." but she kept persisting, "so, are you ready now? do you want one now?" i again said, "i don't know mom. we'll have one whenever God wants us to have one." she said, "well, if you're ready now, i'm going to start praying that you get pregnant." and we left it at that.

it's kind of weird sometimes how moms know what you want/need without you saying so. when i abruptly decided to pursue a neonatology fellowship during my third year of residency, i told my mom after i had already lined up 2 interviews. she surprised me by saying, "oh good! i've been praying that you'd want to do neonatal ever since i met this lady on our vacation a few months back what was a neonatal. i'm so happy!" (fyi, my mom is non-medical & speaks with an accent, thus the use of the word "neonatal".) i had not once talked about doing a fellowship, let alone neonatology, with my mom but all this time before i even knew i wanted it, she was praying.

weird, huh?

during our sunday conversation, my mom was at my aunt's house so i didn't tell her how long we've been trying, that we are now on to blood work, tests and more tests. my husband and i decided that we would only tell her about the tests if something were wrong. there's really no point in burdening her with it now. it feels good to know that my mom is praying for us to have a baby. i just hope it doesn't turn into a weekly, "so are you pregnant yet?" question. we'll see.

on another note, below are a couple of pictures of the baby in our lives right now. how could you not love his ugly face?!?

happy tuesday everyone!!

at least we have a plan...

so i went to my ob/gyn this am with my husband to discuss our fertility issues. overall it went fine. i knew exactly what she was going to say we needed to do. it was just a little frustrating that we are actually to the point where we need testing. so here's a run down of what we've got planned this month written out by my doctor. btw, today is cd 1 for me. freakin' awesome.

1. semen analysis - my husband will do this some time next week
2. CD3 (scheduled for fri 3/11) blood work - FSH, prolactin, TSH
3. CD 22 or greater (scheduled for fri 4/1)- progesterone 
4. HSG some time during CD7-10 (scheduled for 3/16)

she coded my visit as "irregular periods" so we could bill the insurance for the lab work but the HSG and semen analysis will be out of pocket expenses for us.  i think the semen analysis is around $120 and the HSG is a steal at $200 or so.  Most places I think charge several hundred up to $1,000 for it so I guess that's a good thing.

i like my ob/gyn. she knows i'm a doctor so she doesn't sugar coat things which i like. she's very matter-of-fact with me but at the same time, she took the time to explain to my husband in layman's terms what she was looking for in his semen analysis. so overall it went well i guess. at least we have a plan for now.

oh, i also asked her about getting a digital fertility monitor & she didn't think it was necessary for me. we are both pretty sure i'm ovulating and my lab work this month will provide more information than it would. so for now, i'm holding off on that.

so after that appointment, i had to go back to work. right now is a research month for me, meaning i spend most of my time in the lab unless its the weekend or i'm on call. i decided to spruce my little corner of the lab up a little bit. i LOVE office supplies! so here's my little office supply corner. i haven't filled out my "this week" pad yet but will start using it next week.

and because i'm feeling pretty infertile, i brought some plants to bring some life into this place.

i picked a cactus and a succulent because they're pretty hard to kill. i won't always be here in the lab when i'm on service so hopefully they'll hold up!

here's the view from my "office" in the lab. :) its a cloudy day today but at least the sun is trying to make its way out.

so that's the update from me! hope your wednesday is going well!