Dreams

I'm not one to think too much into dreams, but I know that some of you out there are. I'd love to hear your opinions on these.

Yesterday, H told me that the night before I had been having night terrors. H said that I woke up twice sat straight up and reached for the ceiling with both arms saying "don't drop it" or "don't do it". I have no recollection of this. However, I know I had them as a child too and used to wake up screaming in the middle of the night and my mom would rush in only to find that I was still sleeping. I also used to sleepwalk. I do remember as a child waking up sitting at the top of the stairs peaking at the TV after I was told to go to bed but not remembering how I got there. I even remember sitting at the counter eating cookies and milk also not remembering how I got there, just sort of "coming to" while doing it. Also, a few months after I first moved in with H, I woke up in the middle of the night screaming at him that "it's under the bed catch it" after dreaming that I had been pet sitting my friend's guinea pig and it had gotten out of it's cage and was running around under the bed. We never pet sat their guinea pig.

So the point is that I do have vivid dreams sometimes, but not very often and it can and does translate into real life in my mind. I sometimes have to ask people if things really happened or if I just dreamed it.

Anyway, I had a dream last night that I was pregnant...with ravioli...lots of it...in my uterus, not in my stomach. I could see it on the ultrasound. I looked a the ultrasound tech and asked..."is that ravioli"? She smiled and said "yup, congratulations!" Even in the dream I thought WTF?!?!?!

I think that one was brought on by the new Chef Boy-ar-dee commercials where he pronounces his name Boy-AR-dee instead of BOY-ar-dee as I always thought it was.

That dream was immediately followed by a dream where H called me over to look in the turtle tank where we found our beagle Mattie sleeping under the water. Not drowned, just snoozing like the turtles do with their nostrils at the edge of the water so that they can breathe but the rest of their bodies completely submerged and eyes closed. I pulled her out and took her to the tub to give her a bath. She smelled like shit and was covered in green goop. I couldn't figure out how she got out of the laundry room where they sleep at night and up into the turtle tank the lip of which is at least 4 and a half feet off the ground. It is big enough that she could lay down in it.

This one was probably brought on by the fact that I cleaned the turtle tank filter last night in the bathtub and thought I should clean the tub right away so that I don't accidentally give the dog a bath in the dirty tub as it did look pretty clean, but had just been covered with turtle goop.

I know that people do have vivid dreams during pregnancy, but since I have them occasionally I'm not sure they mean anything.

Waiting and waiting and waiting

7 dpIUI

I had a nice distraction this weekend. We went up to Colorado Springs for the weekend. We were supposed to go to a wedding in Minnesota but the trip got cancelled when plane tickets were found to be so expensive.  Because I had the weekend plus Thursday and Friday off work already, we went to the Springs instead.

We hung out with friends and family. We took a hike at 7 falls which was really climbing tons of stairs up the side of a cliff next to the falls. My calves and butt may never forgive me for that one. I got a bracelet I've always wanted from Tiffany's on a short trip we made up to Denver to have lunch with some friends. In general, we had a great relaxing time. We are going up again for Labor day this weekend. I took Friday off and we already have Monday off. 

But I'm still waiting and waiting to find out the results of this IUI. I feel nothing, no symptoms whatsoever (granted I'm only 7dpo). I'm already ready for the next one as H has agreed to make some changes. A friend that reads my blog let it slip out that I bagged on him a little in the last post, if he read it he would realize that it wasn't that bad, but after an argument, he agreed to make some changes. He took it easy on the alcohol this weekend, although we were with friends that we hardly ever see, and I know it was hard for him. He agreed to quit taking the workout supplements because he agreed that neither of us knew their effects on fertility. I didn't realize it, but he already quit taking pain medication. Also, he, on his own, went out and purchased the fertility vitamins that Lulu recommended. We're hoping for significantly better results next time. But ultimately we are still hoping that there won't need to be a next time.

Particularly Horrible...

That's just not what you want to hear when going into any medical procedure.

After preparing H's semen/sperm yesterday, Lulu and Monica came in to do the IUI. They said that H's volume/count/motility were "particularly horrible" and that his previous SAs were "deceivingly optimistic". My brain shut down after that.... I didn't catch any numbers but I did hear "might be sufficient".

However, She still went ahead with the IUI and let me tell you, the internet and you guys lie!!!! It was painful!!! She said it was so bad because I had a little stenosis (narrowing) of the cervix. Which Dr. Google tells me can be a result of the cryosurgery. She said that she had to push the catheter to get it past this point, but that it should open it up a bit.

She too noticed my EWCM and said that it looked great and that H and I should have sex for the next two days to improve our odds. That was not about to happen last night though. I bled and bled on the ride home. I was only given a pantyliner and bled through it onto my underwear, pants and carseat. It was really as heavy as a period flow. Since I was driving through the desert, there was nowhere to stop. The procedure was done around 4:00 PM and the bleeding slowed around 8-9 PM and the cramping stopped at about 10:00. This morning it is about gone.

Even though she said that we still had a small chance of being successful with this cycle, yesterday was the first time I really got upset about the whole thing and I blew up at H when he got home last night. I really just freaked out on him out of frustration. I have to monitor my cycle, get jabbed with needles and go through a painful procedure because of him. Yet he does nothing to improve things.

I'd like for him to:
1. Lay off the painkillers, he's had multiple joint surgeries including both shoulders and total ankle reconstruction and I understand that he's in pain but he just uses them occassionally, I think he could quit altogether
2. He needs to back off on the exercise. He exercises too much which I think aggrivates the problems with his joints and that much running can't be good for the boys especially because of the vericocele. Also, because of exercising, he takes multiple workout supplements and I'm not sure that some of the side effects of those supplements couldn't be contributing to the problems.
3. Quit drinking altogether. Apparently, H missed his college phase because he was in the military, but still being in the military turned him into quite the drinker. He doesn't drink often, but when he does, he is incapable of having just one or two beers.

He has yet to really change his lifestyle since finding out his numbers were low, I think we were both hopeful that with a little assistance things would be ok and that he wouldn't need to.

I'm hoping that H's numbers were low because of the amount of alcohol he consumed last night and not for any other reason. He told me that our neighbor's kidnapped him and forced him to drink...12 beers...that's right, I said 12! It's not exactly his fault because neither he nor I thought about the effects that it could have had on today's procedure. He says he's kicking the habit for the next month as well as doing a few other things to improve our odds. He said that he feels like he has to live someone else's life to be able to get me pregnant, and though I don't think this will kill him, he sure acts like it will.

Sorry this turned out to be a bit of a rambling post. Needless to say, I'm not feeling real positive about this cycle.

What to do today...

 ...I think I'll go have an IUI.

So yesterday's appointment went great. I had my first experience with the transvaginal wand for my US and folicle count. I told wandy that all you guys said "hi".

I think my numbers were good, but what do you think? Let me remind you that this was a natural cycle.

CD14
Lining was at 8mm
Lefty-12 measurable folicles, largest one at 22mm, no others above 18mm, most others around 10-14mm
Righty-6 measurable folicles, largest one at 18mm, no others above 18mm, most others around 7-10mm

Lulu decided to go ahead with the HCG shot (yes I got it in time, last minute and took it with me) For those inquiring minds, I don't think the brand name was specifically chosen for me, I asked for Nova.rel because I knew that that was the one that they had. Monica administered the shot and I think she was getting back at me for rescheduling my last appointment so many times because it hurt like a bitch! One shot in each butt cheek of 5000 units HCG. Made the hour drive back home fantastic.

Assuming things go well, Lulu said that odds are good for twins with those size follicles on a natural cycle. Really I'd just be ok with one but a two-fer would be ok too, really anything at this point. And if all else fails, at least we learned a few things.

1. That I for sure ovulate on my own and I ovulate hardcore!
2. HCG is impossible to find in southern New Mexico.
3. Don't make someone who will eventually have to stick you with a needle angry.

Side note: Some of you guys mentioned a 36 hour delay between HCG trigger shot and IUI, but I asked about it and was told that their clinic's policy is to do it at 24 hours and recommend intercourse the evening after the IUI and the next day. I think if I pushed, they would do it at 36 hours. Maybe next time, but hopefully we won't need a next time.

Second side note: I have EWCM for the first time since cryosurgery, obviously this means next to nothing this cycle but perhaps it will help in case our IUI timing is off.

Everything is working against me

I'm supposed to have the ultrasound and HCG trigger shot today for tomorrow's IUI.

But...I'm lazy and forgetful. I didn't put in the prescription for my HCG prior to today and now I may not be able to get it in time to take to my appointment today.

I think I was secretly hoping I'd surge over the weekend and not need it, but I made it to today without an LH surge. So...ooops, turns out I need to take the HCG to my appointment this afternoon. 

The pharmacy that was "sure to have it" in Las Cruces has it on backorder until October. (Per H, as he was to drop it off this morning on his way to class). H called the local pharmacies with no luck.

I spent all morning calling around until it finally occurred to me that one pharmacy in a chain should have access to what the other ones may or may not have. The very nice pharmacist at a Wal.greenes in El Paso (an hour and a half away where I was willing to drive to) found a location in Las Cruces that had it as well as a location in...and you never would have guessed...Alamogordo! (This was after I had to look the brand name up on the internet to find choices...there are three.) I called the one store here in town (that H had called earlier and they told him they didn't have it) referred to it by a brand name and guess what???? They have 4 vials of it...no kidding! 

Maybe I should have been a pharmacist. On that note, maybe I should do the IUI myself. Geesh!!!!! 

Something is telling me that this isn't going to happen. That this is some type of bad omen.  Why do we have to jump hurdle after hurdle? Why do I have to work so hard at this? I mean COME ON!!!!

If you pray, please pray for a good appointment today and tomorrow for me. If you do not pray, please just keep us in your thoughts.

The squeaky wheel gets the FREAKIN' GREASE!!!

With you guys backing me up, I called the clinic back with a "question" as to what I should do if I should happen to detect my LH surge prior to our scheduled appointment and I got a real answer after a day of waiting for them to call back.

When I first called yesterday, Monica, the not so lovely MA, gave me the following information:

Should I surge on Friday, I am to call the clinic and they will let Lulu know she has to come in Saturday to do an IUI for me, there will likely be no one else there so I will not have to wait.

Should I surge Sunday, I am to wait until Monday and call first thing in the morning to come in in the afternoon and because I already have an appointment with Lulu that day to administer the HCG shot post ultrasound (if I haven't surged already),  as they already have a time for me.

So I asked, "what do I do if I surge on Saturday?" Which was obviously the reason for my calling...(duh). And she told me she would have to call me back. Monica called back today to tell me that should I surge on Saturday, I could call Lulu's PERSONAL cell phone to ask her to come in Sunday to do an IUI for me. Bonus is that there will for sure be no one else there that day!

I'm so excited that this now looks like this will happen! I can't believe I had to go through all of this to get here though, they act like no one has ever ovulated on the weekend before!

If they think they can fuck with me again though...they're wrong. If they do, I will strongly consider putting her personal cell phone number up on the internet! (just kidding...sort of)

This isn't going to work, I'm sure of it

I did get a call back yesterday after leaving many, MANY messages. At least Monica wasn't rude when I did finally hear from her. My aggravation with the whole situation may have been exacerbated by AF hormones (I hope they understand, I bet they get it a lot). However, I'm still pretty certain that this cycle will be a bust.

According to fertility friend my ovulation averages day 16, but for the last few cycles and since getting my TSH under control, it's been day 14, day 12 and day 13. They have scheduled me for a day 14 ultrasound with HCG shot to be administered by Lulu after the ultrasound and an IUI on day 15. Apparently this was done this way because there are no sonographers there on the weekend and Saturday is day 12 and Sunday is day 13, therefore Lulu just wants to see me on day 14. If she sees me then, will she just do an IUI after (H will be with me just in case)? Will they inseminate me the day after ovulation? Will they do nothing if we've missed ovulation altogether? This practice just seems like a joke to me.

I think I have decided what to do, but any opinions are welcome.

I have decided to do OPKs and then call the office if I surge prior to their scheduled timeline. However, if it is on the weekend (as it will likely be), I'm not sure what to do, will anyone even answer the phone? Will they have an answering service who will call and let Lulu know? She did say she did inseminations on Sundays and she did give us the option of calling when I surge on my own instead of the HCG shot.

I'm calling the results of this cycle in advance, it's going to be a bust! I've created a poll over in the right hand column, vote on how you thing IUI #1 will turn out for me!

I could not be more PISSED OFF!!!

I was told to call the clinic when my period started. That way we could schedule my IUI and the preceding ultrasound.

Said period showed up yesterday before lunch.

I called the clinic (just after AF came) and spoke to the receptionist who said she'd leave a message with Monica, who is Lulu's medical assistant who does the scheduling. When I didn't hear back from her by 3:30, I called again. I spoke to the same receptionist who told me that Monica calls patients back between patient's and at the end of the day. They close at 4:00. I waited to hear from her and didn't hear back at all yesterday. Sooooooo, I called back today and left a message (for the receptionist to let Monica know I need an appointment) on their voicemail at 11:30.

My question is, how often am I supposed to call? I'm tempted to call every hour on the hour.

Also, Lulu gave me her personal e-mail so that H could send her the info on the vitamins. She I send a message to her personal e-mail and how long should I wait to do so?

I need to figure this out because as we get closer to that day I am getting scheduled with my own patient's to see and will have to reschedule tons of them because I have to take like a half day off work to go to these appointments. My assistants are starting to get pissed off because I can't tell them whether or not they can schedule patients to see me.

Side Note: in many of the reviews of this clinic that I found online, I found this to be the main complaint, being able to schedule an appointment and getting anyone to return your calls.

And we finally have a plan!

So I finally had the follow up appointment with Lulu over in "the big city".

She had reviewed all of the testing she had requested and declared me officially normal!!! Well at least fertility-wise.

She believes I ovulate regularly, in fact, very regularly since getting my thyroid figured out. I have had a 28-29 day cycle with ovulation on day 13-14 since April. I was finally able to get a little excited that this might actually happen for us.

But her analysis of H's SA results was the same as my novice evaluation of the results. Not good...not bad, but not good. He is borderline on every single thing. The two tests he has had done look very similar. She was apparently unaware (although I know it is in my file and that I brought it up last time) that he has a diagnosis of Vericocele. She said his numbers were actually great given that diagnosis.

H was there with me at the appointment and got involved in a discussion with her about whether there was anything he could do to improve his numbers to help things. She suggested some vitamins. He told her that he was already on an assortment of vitamins (he is a personal trainer and is a distributor for his own supplement company) and she believes his numbers might already be as high as they can be without surgery due to the vitamins he is already on. Because of his high numbers, she wanted more information on the vitamins he takes and if they seem comparable to the ones she typically recommends she will refer patients to him for his vitamins. His are whole food vitamins instead of synthetic and because of this, the results of taking the supplements are superior. Seems odd to be getting business from the fertility specialist, but hey, if it pans out it will help us pay for her services.

Regardless of if his nubers change or not, she said that IUI was the way to go for us right now.

Given that my cycle is regular she gave us two options for IUI.

1. Track ovulation and LH surge with OPKs at home and then call to schedule an IUI within 24 hours

2. Come in on CD 13, do a dominant follicle study (read as: fun with the dildocam) if I've already ovulated that day, do an IUI that day, if not (hopefully not) she will administer a shot of HCG, that I am to pick up at the pharmacy and bring with me, and do an IUI the next day.

We chose #2 as that way I can schedule my patients around my own doctors appointments and not have to reschedule my patients last minute.

She did forewarn me that typically success is low on IUI #1 (boo), but that our odds are pretty good because there are enough sperm and I am ovulating regularly (Yay!). She also told me that because I am not really going to be on meds, we can do IUI's repeatedly cycle after cycle until I am pregnant without skipping cycles. This might be hard emotionally, so I am preparing myself mentally in advance for doing this every cycle through December before taking a break.

I am ecstatic over the outcome of this appointment and finally feel that we will be actually doing something to get pregnant instead of just waiting to see if it happens! I don't really get that upset over each BFN, but do feel that overall my mood has been a little depressed and after this appointment I feel much better!

So we are just waiting on AF who should arrive today or tomorrow. If she comes on time, things will be starting on August 22! I'm so excited! I know I've seen other people say how excited they are for AF to show so that they can move ahead with other procedures and all I have to say is ditto!

Pediatric hearing loss

Research estimates of newborn incidence of hearing loss are between 1 and 6 children per 1000 live births.

I don't think that I ever told you guys that I'm the pediatric audiologist at my practice. Also, I'm contracted out to work for the public schools. I see mostly adults because it's a small town and there just aren't that many kids with hearing loss. But I see all the kids that need hearing aids. I have maybe 50 kids (at any given time, because you know...they get older) birth to age 18 with permanent hearing loss under my care and probably another 25 that are awaiting some other treatment be it surgery or a cochlear implant or just further evaluation.  I'm very proactive about these children wearing hearing aids even with mild degrees of hearing loss as hearing aids can help prevent other delays such as language, speech, and comprehension delays.

If you can't hear...you can't learn to speak, at least not without a lot of therapy.
 
The youngest child I have fit was 12 weeks old (born 8 weeks early this was 4 weeks age adjusted).

Many parents with infants with permanent hearing loss are just happy their children are alive as they typically have had many other problems often due to prematurity. Often it is the medications they were given for these other problems that were ototoxic (toxic to the ears causing hearing loss). Sometimes it's tons of ear infections that have lead to permanent hearing loss due to scarring on the eardrum. Sometimes it's genetic and the loss is somewhat expected.

Whatever caused the hearing loss has typically been diagnosed by the time the child sees me. The parents are prepared for what I have to tell them, but it's a lot of information at once. I let them know that I'm aware that the diagnosis of hearing loss sucks, but I try to convince them that their child will be ok, they will grow up, go to school and get a job and likely (but as we all know so well is not for sure) have a family. But...it will be a lot of hard work on their part.

This part is what gets me a little bit, but only because I live in the infertile world. I know I would, and I'm sure any one of you reading this would, do anything in the world for your child, that is if we could just have one. It's the slacker parents, the ones who don't take notes or follow through with instructions just get to me. I want to shake them and yell at them "Don't you get it! This is a big deal! You need to do this NOW!" Hearing loss will affect their child's intelligence and success in school, it will affect their social interactions and ability to make friends, it will affect them now and as adults, yet it's a perfectly treatable diagnosis!

The parents that do follow through with my instructions really deserve a medal though with an awards ceremony and all. Again, hearing loss is often not the only problem their child has, but rather is one of many and for sure is not the easiest to deal with. They learn sign language to assist in speech development. They take their children to countless appointment and let strangers into their homes to do therapy. Sometimes it's not just one of their children that has hearing loss. I have one family where 3 out of 7 of their children wear hearing aids and a fourth child has a dead ear, they never miss an appointment and all wear their hearing aids consistently. I have another family who has 2 out of 4 children with progressive hearing loss (they will likely go deaf before they are 18) and although it sort of embarrasses the kids now, she signs to them all the time, even in public so that they don't miss out on anything.

The reason I decided to write about all this is because of a baby I just saw the other day. The mom, who is young (although this isn't always a factor as I have a set 17 and 18 year old parents who are great about following through), brought in her 7 month old son (who was born at 31 weeks gestation) in due to permanent hearing loss. We do not have an official diagnosis as they are still undergoing genetic testing and a few other tests, but it is for sure a permanent hearing loss. She wanted to wait for the official diagnosis before getting hearing aids which could take months if it even has an official diagnosis that can be found.  After an hour and a half of counseling I got her to agree to a loaner program that will loan hearing aids out 3 months at a time for kids birth to age 3 who are awaiting a diagnosis, surgery or insurance payment. I also got her to agree to have someone from the state school for the deaf come to her house for therapy.

This is the type of child I work for, one who's parents need a lot of help, who's parents will benefit from my education, experience and counseling. For an instant though I wanted to take that baby from her (crazy infertile thought I know).

What if...?

 I ask H all the time, "what if...?" and then fill in the blank.

During the 2ww "What if I'm pregnant?" "What if I'm not pregnant?'

When I'm feeling particularly positive "What if we have twins? triplets?"

When I'm feeling particularly negative "What if we can't have a biological child?"

When I feel like starting an argument "What if we have to adopt?"

I can pretty much predict the answer to the last one, although the answer to the others sometimes varies.

If I spoke this way I'd say "It isn't in his heart to adopt." But the reality is that he doesn't want to and sort of feels like it is like raising someone else's child. It's more complicated than that but that's the basic premise.

I, however, have known for years that I wanted to adopt. There was a family whose children all when to the same school as me through junior high and high school. Their dad was a local doctor and mom was a homemaker. Their parents and my parents became friends so they brought them over to our house when we first moved to town. I found it unusual that their younger brother didn't really look like them or their parents (he was asian and they were white), but I knew it would be inappropriate to ask more about it (I was 12 and old enough to know better). So I just let it go and thought it was a fluke that he didn't look like them. They then went on to adopt 3 more little girls. When I figured it out over the years, I just thought it was the coolest thing. I thought, "if I become a doctor I can adopt too." I must have known even then that IF was expensive.

Over the years, that idea sort of stuck with me. Then when I didn't really date that much in high school, college or graduate school, I thought that it might be the way it actually worked out, that I would be a single parent who adopted a child (or children). This especially seemed to be the case when I earned my doctorate as many of the professors at my university had done just this.

H and I probably should have talked about adoption more when we first got together, but then when we did get married, I never really thought it would come to that. H rolled his eyes when he asked why I became a doctor and I gave possible adoption to him as an answer. Granted we are still a long way from that right now, but I wish it were something that he would be willing to at least consider, or at the very least talk about.

Side note: this might all be coming from the side of me that is starting to panic a little about our upcoming appointment.

Second Side note: the fire in the mountains near town it now out, it burned for just under 24 hours and spread over about 75 acres. You can see more here. It burned the breast of the sleeping lady (if you follow the link, you can see her profile just to the left of where the fire is).