Blew right out of the works-

Arrggghhh!!!!!!!

That's the kind of day I've been having. Baseline was clear, and we were all set to do 10mg Letrozole. Awesome, right? But then after an hour I found out that the first pharmacy was out of stock. Second pharmacy had me wait 25 minutes to tell me that my insurance denied the claim and wanted authorization and to talk to my doctor. Say what now? I checked online and it's a covered medication, not only that it didn't have a limit, and it didn't require authorization. I am pissed. Basically the way it's worded on the script sent up flags and they won't cover such a high daily dose. Go figure. Out of pocket it would be at least $300.

So, there went that plan! Instead, we're still doing 200mg Clomid ($32). We'll be adding estrogen during the follicular phase to combat my lining issues, but who knows how that'll work out. So, estradiol today until trigger (maybe beyond). Dexamethasone as well. And 5 days of 200mg Clomid, of course.

Fantastic.

I did make great follicles the last two cycles, it's just my lining was crap... which is, you know, kind of important. I was counting on Letrozole this cycle, so I feel a bit let down. I'm angry. I'm annoyed. It's been a long day and I've been up since 6am. Ugh.

I'm supposed to go back on CD11 for monitoring, but that was assuming we were doing Letrozole... I'll have to call and try to reschedule for CD12.

Baseline scheduled!

CD1 came bright and early. So I had to wake up around 8am to put in a call to the clinic, but everything is set for Monday.

The cat isn't doing well, and the antibiotics obviously haven't had a chance to kick in. He hasn't eaten, won't even sniff at wet food, and doesn't seem to have any interest in water. Hopefully he'll perk up by Monday, because otherwise it's back to the vet... and I don't know what we can do. So, we keep waiting and trying to get him to drink/eat.

We went out today to take in the weather, so that was a nice reprieve. I ate too much though. At least I got some exercise from walking?

Ugh. Back on the diet tomorrow.

The trouble with plans-

Oh, AF... where art thou? I'd really like for things to get moving already. 15dpo and waiting.... so much for being able to call in today to schedule that baseline on Monday! Maybe she'll show sometime tonight or early tomorrow... they're only in the office until noonish on the weekends though, so getting a hold of them is usually difficult. It figures this is the one time she doesn't show on schedule. I'm guessing my progesterone must have been really nice this cycle though, so there's that.

We had to make an emergency appointment for one of our cats today, the one that has FIV (our bedroom cat). He got really sick yesterday, and for cats with FIV when they get sick it gets bad fast. He's on antibiotics now, but the vet said that he has severe gingivitis and basically he needs all his teeth pulled. It's going to be expensive.

Because of that, we might have to downgrade the last cycle to an unmonitored cycle (with baseline only). I think it just depends on this coming cycle and finances. An unmonitored cycle would mean no trigger, and no ultrasound to make sure I'm responding... but it would save us about $250. We'll have to see how things play out. We might be able to swing it, but if I respond to the next cycle well enough it might not be a big deal to skip the trigger anyway. Eh. I don't know. We'll see how things go.

Tick. tock.

Waiting for a new day-

14dpo and still negative. No surprise there! *sigh*

I have another consolation mocha waiting for me in the morning. Hopefully we'll get this show on the road without issue, and the timing will line up so I can get in for a baseline on Monday. I'd much rather talk to my RE in person about what dose of Femara we'd do, than play phone tag with the nurses. I'm hoping for a quick turn around, no cysts, and 10mg this go around... she might only want to push 7.5mg. I don't trust my body though; it responded to that dose once, but the second time I didn't and we had to piggy back the dose. So, I don't know exactly what we're doing next cycle but hopefully we'll be moving forward with Femara.

Two more months before we go on break until October. Even then, after that we might do one unmonitored cycle but after that it would be... on our own. Which is often a joke, thanks to my stubborn endocrine system. Sooo... it's no wonder I have more hope pinned on next year than this year. But I'm getting ahead of myself, I mean you never know, maybe Femara will do the trick. One can hope?

Emotional baggage-

Sebastian's tree is in full bloom. I still remember the hollowness inside as we dug the whole, wiped the dirt from our hands, and let it be. It grew, with effort, and survived. It towers in the yard, white blossoms swaying in the rain reminding me that life is still beautiful.

Why is this anniversary so hard? It's not even here yet, but I feel it hovering on the peripheral. Is it because five years has passed? Or because V's existence has eclipsed the lost ones in the eyes of everyone, except me? Because no one remembers, or cares, anymore. And that's seems so unfair. To pass from this life and have no one notice, no one remember, no one acknowledge that yes- you existed.

I fell off my diet this past week. I was doing so well too. I've kept jogging, kept walking, but I've kept eating and eating too. Brownies. Cookies. And yes, even soda. I always weave my emotions in with a hearty dose of calories.

I hate infertility. I hate how it makes me feel. I hate how, no matter how grounded I am, I still dive into hope. You know. Surely this cycle? It has to be this one. Except it's not. The odds aren't in my favor, but I end up hoping anyway.

I feel like a fool.

I was so laid back starting out, and I still am to an extent... but emotionally, it's starting to waver. Trying this time isn't like the first time, but I'm starting to feel that familiar despair kicking in. That desperation.

I don't think I can get my weight loss off this plateau until we go on our break from treatments. I don't have the willpower to fight two battles at once. Emotionally, I'm not equipped for this.

Depleted-

Yesterday's trip to the zoo was amazing, distracting, and good for my soul. The animals were super active, the kids had fun, my friend and I laughed a lot- we had a really good time. I was exhausted when we got home, but I felt better.

Then I got online and had an unexpected pregnancy announcement. I'm happy for her, even if our friendship is awkward and unresolved, but it was bad timing for myself- I should have just stayed offline until I felt up to it.

Then I got a call that my best friend was in the ER for chest pains again. They kept her overnight, and are still running tests. I worry about her, of course.

So, it was a long night. I was just depleted by the end of it. I passed out, and woke up ungodly early with morning insomnia.

A didn't hide the last test. Still BFN this morning.

I am downing a mocha. Screw it.

I fail-

I meant to hold off on testing until tomorrow, but A neglected to hide the tests from me. I have the worst willpower, and that man is such an enabler. Gah. Fail! So, of course it was negative. 11dpo, and while that's still early I feel a bit down. I was actually pretty hopeful for this cycle, I kept trying to keep myself grounded but I was really hoping.

I'll retest in a couple days, but I'm not very optimistic at this point. I know, I know: ra ra ra, it's still early! don't give up hope! I would rather start mentally preparing for the next cycle though. Sorry! If things change, well, AWESOME. I would love to have my pessimism thrown back in my face! As it is though, I'm going to prepare for the worst. I know it's still early, but with my history I know when I need to start preparing. It's 11dpo and I used a test with a sensitivity of 10... so, yeah, it doesn't look good. We can still cross our fingers for a late implantation, but I'd rather start the process towards acceptance. I'd rather have a happy surprise than a huge let down. any. day.
 
I'm going to the zoo today with my friend and our kids, so hopefully that will take my mind off things. It's a beautiful day; the sun is shining, it shouldn't be freezing, and some fresh air will do me good. Hopefully we don't have any unexpected issues. With the way my luck has been going, and those damn gremlins I seem to bring with me, you never know!

NIAW

It's National Infertility Awareness Week again. My husband and I, like many other couples, suffer from infertility. 1 in 8 couples do, or 7.3million in the U.S. alone. This week I won't be posting on here about NIAW, but I will be posting on my FB and continuing to try and educate my family and friends about this disease. Despite how long we've been down this road, many still don't get it. There is always this break in communications, or an uninterested ear, maybe a disconnect, I don't know. I do know that I'm going to keep talking though. I may not be talking about our current struggles, but I will be talking about all our struggles- what we as the community face everyday.

There are many issues about infertility that bother me. Like many of you, financially it is a major burden. This isn't the worst of it, but over and over it comes back up and gets in my face. When you're coughing up $500 a month, or $3k for one cycle, it's impossible for it not to get in your face. It's such a gamble, and I am not the gambling type. Yet here I am, throwing $500 down on the table for a 25% chance of winning big. If this year doesn't work, we'll have no choice but save and save, and then turn around and throw a whole months wages down on one cycle. An entire months wages... that isn't so easy to come by. And you know what? Some people have to risk more than that.

Why is it such a burden? Because insurance refuses to cover us. Because there are no government mandates here to protect us. Oh, yeah, my state has limited mandates... for diagnosis. But it's a joke. The moment I was diagnosed with PCOS, they left me hanging. No further diagnostics. And my insurance weaseled their way out of even covering that bill! The bottom line is that our insurance companies believe that our disease isn't worth it for them. That our ability to conceive and desire to have children is not their problem.

In my years trying to become a parent, I was forced to make decisions I didn't want to because of my coverage status. I had to take risks then, and even now, I don't like. I have to take treatment options that aren't as good, aren't as proven, or as successful. I have to take medications that aren't as helpful, or as strong. I have to take breaks in order to save money, and I've had to make the decision to walk away completely before.

Having coverage doesn't guarantee anything, and I get that. Even with coverage, there are co-pays and there are caps/limits. But that's why we need mandated coverage for everyone. Because most of us are getting screwed here. Insurance shouldn't be able to deny us coverage for a disease just because they don't feel like it.

There is so much more involved with infertility than just crappy insurance and financial burdens though. There is the emotional weight, the lead in your heart, the jealousy, the agony, the bitterness- constantly living in survival mode. I survived it once, and I have my son, but my heart still hurts. Not like it did before, but it still aches. I still find my heart catch in my throat, and tears spring up from nowhere at times. I still have a hard time when things happen so easily for others, because you know what? That wasn't me, and it won't ever be me. Yes, I get jealous. I get bitter. And I get sad. Something that was supposed to be so easy and natural was taken from me. It was unexpected, and yeah, it still hurts.

Infertility is cruel disease, and it's almost always unexpected. It's hard to talk about sometimes, and it's often closeted. I wish that we didn't have to do the things we do, but at some point this became the new norm. And while I hate that, this is the hand I was dealt. I can either keep gambling, or hold. I can keep educating and advocating, or remain silent. There is no right or wrong here, I can understand why some choose to stay silent. It is a hard road. But I will say that if we never speak up and out about this, then nothing will change. If we never take a risk, we won't get anywhere. If we don't tell our story, who will?

9dpo and holding-

I used a dollar store pregnancy test yesterday (8dpo) to confirm that the trigger was out of my system, since it usually is within 8-9 days. It was negative. It did have a bit of line with color later, but that was after the testing limits. For all intents and purposes, I'm going with negative. Even if there's residual left, it should be gone well before I start testing.

I'm going to hold off as long as I can. Ideally I would wait until 13dpo, but there are so many reasons I never manage to do that. For starters, I'm obsessive. I've always gotten positives pretty early. Then there's all my miscarriage factors and the need for immediate intervention. That's a big one. With V, I started spotting and bleeding at 11dpo. Originally, I was going to wait that out. It was our last cycle, and I was done wasting the money. But, then I started spotting and I knew something wasn't right. My body, for whatever reason, begins trying to abort immediately.

I am not a big fan of my body.

For me, I think in the end there is just too much going on. Would starting Lovenox a day or two later doom a pregnancy? Or upping my progesterone later? I don't know, but it's not a risk I'm willing to take either.

I'm going to try and hold off until 12dpo anyway, and hold off on buying any first responses until then too. But, we'll see how that goes.

Reminders-

We got the invite for our nephew's birthday party. Almost 5 years ago, on May 4th, I was getting ready to leave the house for his party, but we never made it. I still remember picking up his present, going to leave the bedroom, and falling down in pain. I remember the blood, my frantic phone call to A, waiting in the ER, and A calling to tell his family that we wouldn't make it. And no, there's no way we can even stop by for a minute. No, we have no reason to offer. They didn't hear me crying in the background. And to this day, we haven't told them why. They know about the miscarriages, but I doubt they put two and two together.

On April 26th 2008, I got a positive digital test, after thinking I was out. The odds were against us that cycle, I'd already had numerous negative tests. We almost completely missed our fertile window because A was out of town, and I didn't ovulate until cycle day 44 anyway. But somehow, miraculously, there is was. I felt so lucky, so fortunate that it only took a year.

How our dreams fell like water.

Ever since then, his birthday has been emotionally loaded for me. He was the first grandson on A's side of the family. We should have had the second grandchild. Instead we have the fourth. The fourth grandchild, from our fourth pregnancy, after four years. Due only a week before the first one we lost.

There are so many associations with our miscarriages though. Our second was conceived on my birthday, and due the same week as two of our nieces/nephews were born. My brother's new baby is due the day after our third one was due. It took me awhile to realize that, because I rarely think about the due date with that one, I've always focused on how hard it was to miscarry days before Thanksgiving. But ours was due July 29th, and his baby is due July 30th.

I don't know why the nephew's birthday party hit me so hard this year. Maybe it's because, wow, it's been 5 years now. At V's party I took a moment to reflect on how that week we should have been holding a 4th birthday party, and not a 1st. But this hit me harder, for some reason.

Maybe it's because I'm running a parallel cycle right now. If this cycle works, I would be due on the exact same day at 5 years ago. I'm reliving everything, and yet I'm not. This cycle is so different than the one 5 years ago, but I'm reliving other cycles in unison with it. I've been here before, and yet I haven't. It's like reality has shifted and I have bad deja-vu.

Passing thoughts-

I spent most of yesterday keeping busy. I made cushion covers for my glider (finally) and mellowed out with The Beatles. After what happened in Boston the other day, I was in a Beatles mood. I have no personal ties to Boston. I've never been there, or wanted to visit. But the senseless violence has a way of shaking you to your core.

There have been so many headlines this year that have made me feel that way. I don't write about them, because what is there to say? It's terrible. It doesn't make sense. I cried. I always cry. I donate, when I can. I wish these things didn't happen, and that the world was the place I imagined it was as a child. There is a media over-share, a constant barrage of video and updates... and it can be too much. When these things happen, I step back and process. I wonder what makes a person do these terrible things. It's a useless question though- you can't apply logic to the illogical.

My heart goes out to those affected by such tragedies, those who have lost loved ones or friends. Those that are injured, those that life will never be quite the same for. I'm not just talking about Boston, although they are at the forefront today. I'm talking about all the headlines that make me wonder why? Why this family? Why this child? Why this city? Why this time?

I'll leave you with that, because I really don't know what else there is to say. May those affected find strength and peace to get through this.

April 2013 weigh-in-

I haven't lost anything off my waist or hips really. I keep fluctuating a half inch on my waist, last month it was up and this month it was down. I've been very bloated off and on too, probably no thanks to fertility treatments.... so I don't know. I did lose 2lbs this month though, so there's that at least.

My biggest challenge remains my diet. I really struggle with staying within my allotted calories, I still struggle with the emotional eating that comes with my depression, plus the increased calorie needs that come with my workout. This past week I had been doing really great on my calories, but then I got sick... and whenever I'm sick, I just eat and eat. Hopefully I'll be on the mend soon.

In an attempt to get back on track I have ditched Sparkpeople (SP) and decided to try MyFitnessPal (MFP). So far, I like the change. SP was great to lose that first 75lbs, but it was doing nothing to help me lose the last 25. The biggest limitation their software has is that  it doesn't take into account your workout, and MFP does. I burn roughly 500-532 calories each jog/yoga session, but SP had no way of taking that into account. It wanted me to eat 1,600 every day... and when burning as many calories a session as I do, that isn't enough to function. I never stayed under my calories on those days, so the program was no longer working for me. I think the change has been good. I can eat more on the days I workout, while staying within the limits, and I don't feel like I'm starving. And hey, the scale finally started going back down too. Even if my body hasn't reflected these changes, it's a start.

I still jog 3x a week, for 40 minutes with a 15 minute cool down walk. I do yoga after, to work the muscles so they don't lock up (huge difference on the days I skip it). I try to walk on the other days, but it's hit or miss there. Not a big deal though. I'm hoping that now it's starting to warm up we'll be able to start taking walks outside... the fresh air would be nice.

Having returned to fertility treatments, it has made staying focused on my weight loss even more difficult. I'm more emotional, I've had to post-pone workouts here and there, and a lot of the old feelings have resurfaced. We're only doing this for a short amount of time though, so I'm trying to weather it well. My weight loss isn't my main focus right now, but it is a focus and I do not want to backslide. I've worked too hard for this.

Even though I haven't made any real progress,  I took a photo anyway for comparisons sake.

Here's the stats-

Since March 17, 2012:
Weight lost: 54.6 lbs
Inches off hips: 11.5
Inches off waist: 11.5

Since January 2011:
Total Weight Lost: 77.6 lbs

Tender-

When I woke up at 5am Thursday, I was fine. When I woke back up at 9am, I was starting to get uncomfortable. By 10am... yup, definitely ovulated. I've been pretty sore all day. Yay ovulation! I decided to post-pone my jog until tomorrow, and opted to walk a little instead. I think that was a good call. Ouch.

So, we'll see where this goes. If I get pregnant this cycle, my EDD would be the exactly the same as with the first miscarriage. Just something to note. Yeah, I looked that up. Because I'm a masochist. Maybe I'm trying to be hopeful? But let's be honest... it's hard when you've been through this before. I doubt I'll get pregnant, but there's always the damn IF.

Progesterone tomorrow. Estrogen in the meantime, as well as my other miscellaneous handful of pills I choke down every day.

In other unrelated news, I finally got my appointment set up with the back specialist. If you recall, I have scoliosis and a lovely humpback (it's not extremely noticeable, but it's there.) Anyway, I'm still getting tingling/numbness in my humpback; it's just when I hunch/bend, but it's annoying. It doesn't hurt, but I find it concerning. I won't be able to get x-rays or anything done right now, but at least I can consult the doctor and go from there. So, I should see him Tuesday. I expect it to be a huge waste of money, but maybe I'll be surprised? I'm really jaded when it comes to doctors, I'm just so used to getting blown off at this point. Ugh.

Okay, so-

We triggered last night.

Then I fretted about my lining. A lot.

I talked to some friends of mine and they suggest calling and trying to get put on estrogen. Now, I'd never heard of being on estrogen during the luteal phase- I've always heard it helps with lining before ovulation. They said it can help after too. I'm no expert, but I'm willing to try anything. So I called my clinic, and although my RE doesn't think it will make much difference (and the nurse assured me that women get pregnant with linings as thin as mine) she's still calling it in for me anyway, since I asked. Score one for persistence.

Now, will it help? I don't know, but at least it'll give me some peace of mind. So, I start it tonight.

I usually ovulate 24-36 hours after the trigger, so far nothing is happening (that I can tell, and I can always tell). I'll probably start feeling it later though. My temperature hasn't risen, so I'm going to wait until either a) it does, or b) 3 days past trigger to start my progesterone.

Yesterday I woke up feeling great. By noon I felt congested. With the weather change, I hoped it was just allergies. No dice. I seem to have a cold, or the flu, or some other random bug. Ugh. Second time being sick this year. Second luteal phase (out of three) getting sick too. I hope this isn't a trend. So, my sinuses are congested and I have a headache, my throat is sore, and I feel like crap. So...yeah.

Well, that was good and bad?

I had my monitoring ultrasound today. First the good news: I responded! I have 2 follicles on each ovary- 2 20's, a 18, and a 15.5 (which probably won't catch up, but it's there). Now for the bad news: my lining is super thin. I'm talking 6mm. I never had this problem with Clomid in the past, my lining has always been around a steady 11mm. So for it to be 6mm, that's pretty bad! Hopefully the progesterone supplements can counteract that somewhat, but I just don't know.

I do know that next month (assuming this month is a bust) I'm definitely doing Femara.

If it's not one thing, it's another. That's just the way it goes.

I'm supposed to trigger today, so then we'll see how things go. I still have to call in for my progesterone supplements.

Anyway, here's to hoping regardless. I have follicles, so it's not all doom and gloom. Things just could have been better, that's all.

Deflection-

We went out to lunch with my mother the other day, and she causally asked if we'd given anymore thought as to whether/when we'd try again.

I deflected as best I could, since I really don't want to deal with that can of worms. I told her that we changed our plan from waiting 5 years, and she tried to tell me 2-3 years is good spacing (as if some of us have that choice?). I left her with how I didn't want to wait until 35 to move on to adoption, if that's what we needed to do. I didn't leave her with a definite date or anything.

I could have just told her that's not her business, but she would have taken it as a personal affront. Besides that, I was really open the first time with everyone (after the first miscarriage anyway), so she probably expects me to be this time. I was fine with that the first time. I was glad to educate and reach for support. But the bottom line is, it's not really anyone's business. I don't want people to start asking, prying, getting in our business, watching our failures go down. This time, I just want some space. I don't want my life consumed by if we're pregnant or if we're not. I want the focus to be on our son, on our life, not the what if. I want to live. Actually live- not just exist in survival mode. And I don't know if I can do that with people breathing down my neck, asking questions, invading my space.

There's already enough of me messing with my head space as it is. There's already enough medical issues and expenses eating at us.

I'm hoping she doesn't bring it back up. Heck, I'm hoping no one else brings it up for a long time. In the meantime, deflection and vague answers are my friend.

Life-

The power steering in our car went out this morning. Turns out the serpentine belt, uh, fell apart. Yay. And the belt tensioner was to blame.

A took it in and got it fixed earlier, but that's another unexpected expense. I'm just glad it's not anywhere near as expensive as it could be. My car is 15 years old now; so, she's getting on a bit.

I found the HCG $2 cheaper at another pharmacy. I know, I know- what fantastic savings. I'll take what I can get though. If I can get my clinic to fax it in properly... I may end up just sticking with what's familiar to save myself the headache.

I did check in with my insurance and Letrozole (generic Femara) should be covered. If I read it right it should just be $10. Which would be fantastic. So, we'll probably see about that next go around if this cycle is a bust. Unless there was some fine print I missed or crap... which is entirely possible with this new insurance.

It's was such a long weekend. There just wasn't a break in there anywhere, and it's shaping up to be an even longer week. Hopefully things will run smoother this coming weekend.

And something completely random: 2 years ago yesterday we had our last IUI, and conceived V. Not that I went around telling anyone, but it's something I'm not likely to forget, you know? My April Fool's trigger baby... I feel like that about set the tone for my entire pregnancy with him.

We are in such a different place than 2 years ago. If you had asked me then to describe my future, I wouldn't have said this. I couldn't even imagine this anymore. Going in that day, knowing it was our last cycle, our last IUI, our last try... well, it was a lot to process. And, of all the ways I saw that cycle going? A viable pregnancy wasn't one of them. I thought that we'd move on to adoption eventually. We'd live childfree, if that's what we needed. But become parents before that year was out? No. Not even remotely.

I've never been so happy to be proven wrong.

Cycle 3 and random stuff-

My baseline was clear, and I've already taken the first dose of Clomid today. If this month doesn't work, I'll probably give Femara a whirl next month for the hell of it. 7.5mg wasn't the best for me, but my new RE said she sometimes goes as high as 10mg (implied: hint hint). I'll have to check into pricing though. I think my stubbornness over Clomid stims from two things- more follicles, and I did get pregnant from it once. Or I could just be old and set in my ways?

Either way, 200mg worked great last time around so hopefully it will again. I'm on Dexamethasone still, and will be even if we switch to Femara. And by worked great, I mean I responded, even if I didn't get pregnant. Yay for ovulating at least; sometimes that is such a HUGE battle.

I'm trying to call around and find out about pricing of the HCG trigger. Walmart told me they don't carry it and it's not in their system, and they couldn't find out the price. I don't think the girl even knew what she was doing, and I've heard from others that they've got theirs there... maybe my Walmart is just that off the radar though? So, more calling around. One of the nurses came up while I was talking to nurse L about calling around, and she told me that I'm not going to find it any cheaper. Personally, I'd rather be the one to decide that. No harm shopping around, it's not like I'll need the damn thing tomorrow. So she stood and argued with me, and I said that's fine, but I still want to shop around. God forbid I stray from the herd.

Other than that, I've spent the say calling and paying bills, straightening things out with my insurance. Ah yes, my new insurance. How I loathe them. They've denied every claim that's went through them, even my son's recent lab work, citing that we have other insurance. Which we don't. So, that's cleared up and hopefully they'll finally issue out payments. But, GAH. Seriously? I really don't like this new insurance. I am so glad we have coverage, because we've done without, but this has been such a headache.

I finally got a call back about setting up an appointment with the back specialist. I'm still getting tingling in my hump on my back. I should probably call the back and schedule that.

Oh, and the weekend was crazy. CRAZY. I am so exhausted. But it was good, and we had fun. The carrot cake was divine. DIVINE I tell you! I need a break now though, because good gracious the work involved to get through this weekend.