A sigh of relief

In late July I had my annual womanly appointment. Everything went quite well. In late August we completed our near train wreck of a retrieval cycle.

A few weeks later I found a lump - a lump in my breast.

Of course, I started scouring the Internet trying to learn about the connection between fertility medication and breast cancer. I was freaked out, but was trying to maintain my cool.

I emailed my OB/GYN and she agreed to see me right away. She confirmed the lump and sent me for a mammogram and ultrasound. When I got to radiology to schedule the appointments, they scheduled the ultrasound but denied me the mammogram because their radiology department makes it a policy not to do them on women under 35 - due to breast tissue density.

Anybody see the recent Oprah where Christina Applegate discussed her breast cancer and double mastectomy? Yeah, this was all coming down for me right about then.

I had had a fertility cycle where they super ovulated me and they only got 1 lousy egg ... and now because of the need for these treatments - I might have cancer? It was a rough patch, but these days I'm used to a little drama.

I finally got to do the ultrasound and as I'm putting my clothes back on the tech barged in and handed me a green slip with the word "normal" on it ... she said, "see you again when you're 40," and that was it.

Luckily, I have a friend who is a general surgeon (I know, sounds like I hob nob, doesn't it? I don't.) He suggested that when you find a lump you should have three forms of confirmation that things are ok, and that it wasn't alright that the radiology department did not follow through on doctor's orders for the mammogram. He said that if I was still concerned, it would be best to request a referral to a breast surgeon and so I did.

This morning I had the consultation with the breast surgeon and she was so comforting and caring, she was very interested in our entire history and I'll tell you it was quite reassuring that on the questionnaire they make you fill out for a lump consult ... that it doesn't ask you about your fertility medication usage (which would imply that they believe it's a risk factor - a topic for a whole other post!) though it did ask about miscarriages and age of menarche and a whole slew of reproductive questions that kind of surprised me (but I guess not, when you consider that infertiles, or women that choose not to have babies, have a higher risk of reproductive cancers).

Ok, anyhow ... she did another exam, she affirmed what I had found. She reviewed the ultrasound with me and explained why it looked "normal". She affirmed that I took the right steps to being cautious, and she scheduled a follow up in 6-8w just to ease my comfort. She says she sees many women each week who are in the middle of fertility cycles who come in with complaints of breast lumps - she said the meds can temporarily cause them. I was reassured and yet I wasn't. She said that the lump is in a critical breast feeding location and *when* I get to breastfeed, I will need that section of my breast; doing a lumpectomy on that area would remove an entire quadrant of my breast!! She indicated that it should go away on it's own as my breasts change through pregnancy and life.

Before she left she let me know that it would be ok to have the 6-8w follow up if I was pregnant, and she told me how encouraged she is that this will be successful for us - the pregnancy I mean. She really didn't see how it couldn't work if we were testing eggs and since I get pregnant so easily ... little does she know that we've also got the greater part of the Bay Area praying for us!

I left this morning's appointment with a sigh of relief and now I'll make peace with my lump ... until it goes away.

A word about the tickers

I remember when Amy from Maybe Baby was gearing up for her fresh IVF in February 08. In late December or early January her site was filled with tickers and I LOVED it!! I’m a numbers person, I like the data.

Whenever I visit a blog (especially if I’m relatively new to the story) I like to know where we’re at so I’m not surprised with a “well, my surgery went well today” … you see, having a marker in the form of tickers, for where we are in the process, helps me help you support me. So really, it’s all about me.

My husband thought it was a little extreme and then he realized that this is what’s going on in my head, so better to have it out there for him to keep at the forefront of his mind. Helps him to stay in touch with what this must be like for me.

I think it would be “normal” for someone to have a countdown to the activities and even the pregnancy test … but the second trimester ticker? Well, that’s because if we are blessed with a positive pregnancy test – that does little to set the fear at ease. In the past, getting pregnant has been “easy” … so many times we’ve seen the positive pregnancy test and so many times our hearts have been broken just weeks later. If we are blessed with a positive test – there will be celebration, but hopefully we can give a sigh of relief when we’ve made it to the second trimester … and even then, I know I will be anxious about making it to the 50% shot at life mark – 24w and then viability at 28w and then I’ll be concerned that the baby will strangle themselves on the cord. (Delightful pick me up for your Tuesday morning, no?) Man, how I wish my heart wasn’t soured with multiple losses – I really do have a lot of hope for motherhood, it’s just that this whole successful pregnancy thing seems like an unattainable goal.

I wonder how many women who have had easy pregnancies can understand what I’m going through.

And lastly the tickers are there to generate excitement. Mostly, I feel hope and fear, the hope is a choice and the fear is overwhelming. So I’d like to look at these things as exciting upcoming events – as I anticipated Christmas when I was a girl, so I want to anticipate this with the same enthusiasm.

And I loved mapping out the events for you. I know how important it is when we pray specifically for things. I know that so many people can get lost in all the complex procedures and tests that we’ve gone through, so my list makes for a good reference for those who feel lacking in the right words and phrases.

I can’t believe it’s just over three weeks away … we’ve been waiting well, since our last cycle in August for this. Wait, or was it after our first cycle in April. No, I think it was in February of 2008 when we first signed up with this clinic to pursue this technology … nope, it was more like January after our fourth miscarriage. Ok, perhaps it was Sept 07 after our third miscarriage? Or maybe February 07 after our second miscarriage? Ok, it had to have been in Sept 06 after our first miscarriage.

Let’s be honest, ever since I saw that positive pregnancy test in July 06, although I was surprised, shocked, and a little upset about being pregnant, I wanted that baby. My heart has been longing and breaking for a very long time. That ticker countdown started over two and a half years ago and now we’re 3 weeks away - three weeks away from the beginning of a successful pregnancy or three weeks away from heartache and reevaluation – and to be honest, I’m not sure how much more of this I can take, I was ready to get off of this merry-go-round years ago. Lord, I am broken and exhausted - please bless us with a child.

When you see those tickers, don’t think of the few days left remaining on them. Think of the perseverance, faithfulness, fight-against-the-enemy’s-lies, and hope that they really represent.

Ok people ... here we go!

I got my calendar this morning for the January transfer (note: this is not an "implantation" it's a transfer. If I get pregnant, then the embryo will have implanted, but a doctor can't implant the embryo, she can only transfer it). In finally receiving my calendar, I was quite disappointed to see that I was supposed to start my shots YESTERDAY ... but my meds haven't been ordered, so of course they haven't arrived yet ... hmmmm, and I'm supposed to remain low stress through this process? Luckily, my fridge is a regular fertility apothecary.

So now, the dates are solid - 1/5 is baseline ultrasound and further instruction, if those buggers thaw safely we will conceive on 1/7 ... is that a little too much information?

For those that are curious about protocol: today I started Lupron shots, I will continue those until transfer (sometime between 1/10-1/13). I am on .75mg of Dexamethazone until then as well. Starting on Christmas Eve eve (12/23) I start twice weekly IM shots of Delestrogen. I guess I will continue those until 10 weeks of pregnancy (here's hoping). I will begin Progesterone sometime after the 5th of Jan, though I'm not sure the exact date. I will also be on Lovenox or Heparin for this attempt, though I don't know when I will start.

For those that don't understand what all that stuff above said: I'm taking 1-2 shots per day, mostly the easy kind, but some are the kind that hurt like a punk. I will do this until it's time to lock and load the babies. These meds have been known to cause SEVERE grouchiness and have even rocked a few solid marriages, I'm sure. So if I'm even less pleasant than normal ... live with it! (Yes, I started the shots 30 minutes ago, so that behavior is excused - ha!)

We are planning on thawing all three oocytes, fertilizing them, and transferring the two surviving embryos on day 3 (and if all 3 survive, we will transfer only the two derived from CGH normal oocytes), we will freeze the third embie on day 3 ... but don't go tellin' my RE all this info - he still thinks we're considering a day 5 or day 6 transfer - which we aren't.

So that's it, I know my part from here on out ... unless things change. I am excited to finally get my calendar and get off to the races.

I want to provide a little education for those not versed in IVF speak:

1/5: Baseline Ultrasound - I will have an appointment with the doctor where they will evaluate my endometrial lining and make sure it's baby safe, they will make med adjustments if it's not.
1/7: Thaw/fertilization (Day 0): They will thaw all three oocytes (eggs!) and catch a couple of the cutest sperm Berilac can provide. They will hunt those soldiers down, capture them, and FORCE one sperm into one ever-so-eager egg. We will get a report of how many eggs get fertilized and how many embryos we have growing.
1/10: Fertilization report/Embryo Transfer (Day 3): We will get a report on how many embryos are still surviving (hopefully all 3!!) They will get graded with a letter and number score as well as with an overall score (more to come on that later). We hope that we have 2-3 good embryos. If we have 2 or more good ones, we will only transfer 2, and freeze the other. If we have 3 poor ones, we will transfer all 3.
1/11-1/12: Serious bedrest to allow for the nestling embryos to ... well, nestle!
1/17: I obsessively start taking home pregnancy tests. I will refrain from this unless I feel pregnant. The bad news of a negative test is crushing.
1/20: Blood test to determine pregnancy, and if so HCG level.

So if you couldn't tell, there are a lot of hurdles that we have to clear before we can start getting excited about this. Here is my promised list of prayer requests.

1. That my lining will be prepared in time for my 1/5 appointment.
2. That the eggs survive thaw on 1/7.
3. That the sperm fertilize the eggs on 1/7 - that all 3 turn into healthy, chromosomally normal embryos.
4. That the embryos develop and perform cellular division properly.
5. That we have 3 amazingly healthy embryos come 1/10.
6. That once the embryos get transferred they nestle on in to the nutrient rich endometrial lining for a long gestational hibernation of sorts.
7. That we become healthfully and successfully pregnant with normal blood and ultrasound results to help alleviate the already copious amounts of stress and fear we'll be facing.
8. That this struggle will soon be over.

People, you're done reading ... now, get to prayin!

Putting my heart on the line

The AMH results came back from both the California clinic and CCRM, the results are consistent with a high follicular count and NOT early menopause.

I.am.floored.

I mean, for 2 and a half years, I've been coping with this struggle and for the past year and half I've been trying to cope with the ever growing diagnosis of early menopause. And now, now we are being told we are not in early menopause; that there may be explainable reasons for the "proof" we found previously that pointed towards early menopause - who wouldn't be astounded?

So we're laying it all out on the line. We paid for 3 retrievals with our current clinic and instead of making good on the third retrieval (or heading out to CCRM for a closure cycle) we will be attempting pregnancy next month.

I started my protocol on Wednesday, and it's inches away from being confirmed that the actual date of thaw/fertilization (conception!!) will be Wednesday January 7th, we are aiming for a 5 day transfer on January 12th, and we are STOKED!!

So we are trying to ignore the fear of historically poor test results, poor egg retrieval results, and the loss of 4 babies and instead focusing on the hope that God is in control, that we have two "normal" oocytes, and the fact that in the past - we have gotten pregnant easily ... so this time maybe we won't miscarry?

We are choosing the risky and courageous route, instead of the easy and safe route ... it would be so much easier to just keep doing egg retrievals ... when we don't actually attempt to fertilize eggs and transfer embryos, we protect ourselves from the procedure not working or even another loss. I'm so afraid of taking the next step, only to be let down again. But I must face this fear if I want children ... I can only claim God's strength to face this giant.

We are 31 days away from thaw and 36 days away from transfer ... and hopefully, we are 45 days away from a positive pregnancy test that results in a healthy, take home baby come the end of September.

My prayer requests will be coming soon ...

Ahem, ahem ... is this thing on?

Many thanks to Wendy from Our Story: A Blog about Adoption, IVF, and Infertility. I love this girl! She has had to endure so much pain and loss in her continuing battle to have children and yet she still shows up to work everyday and loves on other people's children - she's a teacher! And a great artist, I might add! I have been following her story closely for awhile now and I can say that I am so excited for her most recent step in family building - adoption. She has yet to be shy about the whole process ;-) and she has shared with the infertile community so much wisdom and support - I'm sure that is why she was given this award, and it is with honor that I accept it from her. Big hugs to you Wendy.

So it looks like there is an award going out for those who are speaking out and speaking up about infertility and I am truly honored to receive the award. I really feel like going through this struggle is an opportunity to be purposeful in pain, bringing this battle to the light - so I was excited to be recognized in something I have been trying so diligently to accomplish.

My family, my friends, most of my colleagues, my church, my neighbors, and even my dog has heard some truth about infertility from these lips (and from these finger tips!) I am adamant about getting the word out that infertility happens and it is painful; it shouldn't be taboo nor should the fertile continue to think that they "know best" when it comes to resolving infertility - no, relaxing will not cure menopause - yeah, hey it's a good idea, but it's been tried already, what else have you got? I risk my heart and my emotions as I wait to hear what someone might say in response to my telling them the truth of our situation ... in an effort to pave if even just a pothole on the road for many of the infertiles who will follow in our footsteps. (Sadly, there will be more).

I think the one thing that scares me, is so heavily identifying with being an infertile that I forget how to be normal. Seriously, I have gotten into character, I'm poised and ready to pounce at any insensitive movie line and I'd love to put one of those stick figure families on the back window of my SUV that depicts me, my husband, and our little dog all lined up in a row ... and in place of the typical title "Mommy's Taxi" I simply want to say "Infertility hurts" ... but DH isn't willing (who knows why??). So I think of that day, someway, someday ... when I will have children on earth to hold and I'm hoping that I can shake a lot of the bitterness and triggers and just enjoy my life once again. I may recover from being an "infertile" but I will never stop standing up for them. To me, that's why I got the award - I'm one sicko die hard.

On that note, I am proud to nominate my own crew of proud infertiles, regardless of whether or not they share this information in person or on their blog ... these ladies speak up and speak out:

Andrea at Bella and Her Fella

Elmojessi at One Small Wish

Tiffany at Our Slow Journey to Parenthood

Tara at Divine Secrets of the Infertility Sisterhood

Much love ladies and keep on sharing!!

The kindness of strangers

Yesterday was my semi-annual teeth cleaning appointment with my hygienist at the dentist's office. I take good care of my teeth, so I'm one of those sick-o's that enjoy these kinds of appointments - really it's just one more thing I can control in my out of control life.

I had a new hygienist, she was in her early to mid 40's and totally adorable. She was quirky and witty and very talkative (I guess you have to be when you spend hours on end with people who can't talk back!) among the many things she said during my appointment: (now mind you she doesn't know me from atom and had no idea about our struggles)

You poor thing, you don't have a car? How do you do it? You must be very green. (Yes, let's start by pointing out the sweeping generalizations!)

Are you pregnant? We're going to do some x-rays and we want to make sure you're not pregnant before we do those.

Not pregnant ... now that I can do for you.

Are you looking forward to the holidays? (My answer, with tools in mouth, was "Eh, I gwess;") she then responded with "Well that was positively underwhelming!"

Now, you'd think, based on my play-by-play that she's an irritating character, but she really wasn't. It will get more infertility frightening soon ... but this woman has a way of being endearing somehow.

So you're married? Do you have any kids? No, of course not, who would want to schlep kids around without having a car? What are you going to do, drag them around on a train?

I have three kids. Two are exiting college and the other one is very young. I'm looking forward to the holidays because the older ones will do much of the work and the little one really gets to enjoy the time ... holidays are so much better with kids around to appreciate them.

Now, somehow I was in a wonderful frame of mind yesterday. She whipped out a camera at some point during the appointment and somehow I sported a genuine smile in .23 seconds ... like I said, I enjoy these types of appointments - I always get a good report card with these doctors, so I always leave there proud.

Ok, now you have some unprovoked bleeding with this molar, this means that you've got some sort of mouth/tooth infection that you're fighting, here's a tool to help with that.

Thanks for being such a sweetheart getting your teeth cleaned, you were so pleasant, now I have a couple of follow up questions for you, if you don't mind ... have you had any medical changes since we've seen you last? Like any diagnoses or treatments?

I froze. I have never shared my struggle with my dentist's office, I'm kind of new there and I always have funny conversations with the staff I didn't want to kill their Polly buzz. I could answer this question in many ways ... but did I want to share this delicate part of my life with this near-stranger? (You know I do that way too much) or do I let her enjoy her holidays and not tell her my sad story?

The suspense is killing you, isn't it?

So, of course I opted to ruin her Thanksgiving.

No really, I just wanted to make sure they had the information on my chart because I know hormones affect so much in your body. I responded to her "was there a medical change" question by letting her know that they recently changed my diagnosis from diminished ovarian reserve to potentially PCOS! And how do you think she fielded that?

So do you have high FSH?

Score one for the cougar!! (Sorry any older ladies out there reading this, but she really was a cougar) *Roar* ... and her question prompted the telling of my story. I tried to keep it mellow and uneventful (it's kind of hard though with a story as wild as mine).

So have you been having troubles conceiving?

I told her that we do not have trouble getting pregnant, we have trouble staying pregnant, that we've had some miscarriages. I told her that we have many diagnoses that are not in my charts that she might want to include: Rh Negative, Hashimoto's Hypothyroidism, +AntiOvarian Antibodies, Diminished Ovarian Reserve, and of course Habitual Aborter. When I took a breathe from spewing my laundry list of items, I looked up to a crying woman. She was literally crying.

I am so sorry. That is so painful. I can't believe you've had to endure all of that. It always seems like the ones that deserve to have a family - end up struggling with it. I just can't imagine all the pain you've experienced.

I leaned over and rubbed her arm and said, "it's going to be ok". Yes, this is a major complaint from women who share their stories, that they end up consoling people more than people console them - but it was strangely healing. I think it's because I know God is going to do something good in all of this - someway, someday.

Ok, but score one for the seriously compassionate and loving fertile. She never mentioned anything about her own struggles - who knows if she's ever had any. She just completely blew my socks off in her empathy and heartache ... and I'd known her for 40 minutes. If there are any fertiles out there wondering "how do I respond to a woman who's been down this road?" Well, first off God bless you for reading this and secondly God bless you for even asking the question and pondering it and thirdly ... this is how you do it. With heartache and compassion ... it definitely filled my love bucket. I felt like God reached right out to me and wrapped his arms around my hurting heart.

I had no idea you were dealing with all of this, you seem so cheery and pleasant and sweet.

If my real friends were to read her above comment they would laugh, we all know I'm not considered a "nice" person. It must be a God thing :-) She then proceeded to load up my goody bag with many toothbrushes (in pastel colors, mind you, purposefully ... what? in hopes of eliciting the fertility gods? Who knows!) floss, and instruments.

I look forward to seeing you in 6 months ... hopefully with a big belly.

Yeah, she's very sweet, but I thought that on my way out of the last cleaning. Well, see. God only knows, God only knows ... literally! Ha! (I crack myself up!)

Holiday apprehensions - like everybody else

As many infertiles know the holidays are rough. This will be my third Christmas without any of my four babies. That's hard to type, let alone hard to think about.

Let's be honest, I white knuckle it through Thanksgiving and Christmas. I enjoy and look forward to time off work, that's the one thing I've got going for me. I get two weeks off at Christmas and everybody else at the company is also forced to take the time off, so I don't come back to a pile of work - ah Christmas! Ok, and I won't be so crass as to not mention the celebration of the birth of Jesus - hello, my Savior?! I'm very grateful for that (but sadly that too can be skewed in my heart, on a bad day ... because it's a baby's birth and removing the fact that He's God incarnate ... it's a bit taunting to think of another baby's birth.)

Oooh, I know I'm going to get knocked for that one. Moving right along ...

But I am overwhelmingly scared when I think about Christmas. I am fearful of ...

Family Engagements: and feeling like a failure. I know that with every birthday, holiday, anniversary, or seasonal change I experience the loss of not being able to enjoy the time with children that should have been. Because I am so open about my struggle I know that others are aware of how long it's been and I think that they must wonder how it feels to experience this pain ... that still hasn't ended. I think that makes them sad, and I carry that. I feel responsible for a piece of their sadness, like I cannot make it go away. Not only do I feel like a failure to myself and my husband, but I feel like I've let my family down as well. I have been and continue to be very open and honest about our struggle (for better or for worse) just about every person I know (some colleagues excluded) knows about our situation and that makes things very tricky. I don't regret telling people, I know that God has given me a gift of "revealing" being transparent in my struggles, and although the pain is great, the connection (when found) and the hope that someday because of my big mouth someone won't feel alienated or judged because of their infertility and miscarriages - that is what keeps me going, knowing that God is using me. But I won't say it isn't hard.

Quite Moments: You know, the down time between conversations that comes with family when you've spent too much time together. Berilac and I will likely visit a few sets of family this season. Like most families, you can count on most of the conversation being relatively superficial and lighthearted but when the conversationalists have exhausted all of the "interesting" topics, there's silence and an opportunity to 'check on the turkey', 'set the table', 'light a cousin's hair on fire' (whatever the case may be) and that's when I mentally and emotionally step back from the situation and take inventory. I seperate from the person who was just so funny and even transparent (if we'd been talking about the infertility) and I am left with myself. You know, like when you're in bed late at night or early in the morning and it's just you and God. You can't escape your situation, or hope that it's any better than it really is. It's a scary place and somehow these places pop up everywhere at family functions!

Receiving Children Filled Christmas Cards: Ok, let me start off by saying that anyone who reads this, who happen to send us Christmas cards, who happen to have children ... please know that I WANT YOUR CHRISTMAS CARDS, I repeat: I WANT YOUR CHRISTMAS CARDS AND ANNUAL FAMILY LETTERS! The thing that I do not want to be ... is handled. And I do not want to cry in a puddle when I'm having a bad day as a beautiful smiling (Christmas decor laden) family is staring back at me when I go to collect the mail. I love children. I love them. If you didn't already gather, the reason this blog exists, is because I have such a heart's desire for children - so don't misunderstand me. Somedays, when I see a certain card or picture or letter, it doesn't matter if it's aunt betty's step child that I've never met and her hubby, their two kids, and the mutt ... something triggers me and I can't predict it. When I do have those crying bouts the reason behind them is usually because I can't imagine sending a letter of my own (until God-willing we have a child someday) because the card, picture, letter if truthful would really be sad, like heartbreaking ... and I don't want my card to be pinned up with pity, I'd rather it not be there, and that makes me sad. In the past couple of years, some friends have suggested that we send out an update like "Berilac started his MBA this year!" or "We've moved!" which is true ... but my heart would break if I sent those because I would know that I'm lying. The only thing I know is being too honest and too direct - people either love me or hate me for it, but it is what it is. (Ok, so, try as I might ... I'm not convinced that those reading this blog who ordinarily send me family Christmas cards, in years past, will do so this year ... people, please send them! I really do want them!! I really don't want the enemy to win.)

Most of all, this year, I'm a little scared to decorate the Christmas tree: Sounds strange doesn't it? Well it's not. You see, this year Berilac and I decided to memorialize our four beautiful unborn babies with Christmas ornaments from Miscarriage Memories, we found them at the beginning of this year, we had them engraved, they (like our babies) are perfect.

This will be our first official outward symbol of grieving the losses. Of course, I want to memorialize my babies and I want to honor them each year remembering them at Christmas, I'm just sure that it's going to be a painful tree trimming at the Gamwich house this year. It will be sweet, bittersweet.

For me this Christmas is a time to remember what I have lost. I really am hopeful that this battle will come to a happy ending - someway, someday. This year I'm really thinking about my little ones. I'm not really focused on what 'might not ever be,' rather on what ... just isn't.

August 2006
February 2007
September 2007
January 2008