Fuck you world.... just fuck right on off.

My temp tanked this morning.  It's too damn early too if you ask me but at least my body is giving me time to rebound before I have to pretend that I'm not trying to tape my soul back together after this latest in a very long string of disappointments.  Last LP was 15 days... this one is looking like 10.  Whatever.  I'll blame it on the Clomid.

My natural defense mechanism is to turn pain into anger and I'm really fucking pissed off right now.  I can't begin to tell you how much I hate this shit.  All this shit.  I hate temping, I hate worrying about what meds I can take, I hate that my poor vag seems just fucking pissed off all the time because of the shit I put it through, I hate that I can't just make love to my husband without doing some crazy unromantic shit afterward, I hate taking extra pills every day.  I hate it all and I'm not sure how much longer I can do it.

I've been slowly getting myself used to the fact that I will live a childless life.  Honestly, given everything that's happened, maybe it won't be the worst thing in the world.  Anything has to be better than this.  I've gone through a wider gamut of emotion than I thought I was capable of.  When I was 18, married and suddenly being harassed by my biological clock, I was so full of hope.  Even though I had previously lived my life thinking I would never have kids, I thought "surely that's all in my head" and "I'll be pregnant by the end of the month!"  Oh what a series of failures that was.  I was shocked at each negative pregnancy test as I still thought back then that anyone could get pregnant at any time during their cycle... all I had to do was stop taking the pill and I'd be set.  I was so naive, as most women are when they first start trying.  After a year of disappointments, I think most of me gave up.  My marriage was already starting to suck and I was slowly realizing that bringing a baby into that would have been a very bad idea, so I never really tried.  I never went back on the pill and we didn't prevent but it was never something I really strove for.  After 5 years, we divorced and my baby dreams were put aside while I fixed myself.

By the time I started trying the second time, I knew it wasn't going to be easy.  I started educating myself and began charting.  We only managed to try for 6 months before that relationship imploded so I wasn't shocked that I wasn't successful.  At least I made leaps and bounds in my own growth and would be completely prepared when I finally found the right man.

Adam and I weren't married yet by the time we started trying.  My bass-ackwards logic said that "I like you enough to be tethered to you for the rest of my life by a child" fell somewhere between "I could be friends with you forever" and "I want to spend the rest of my life sharing the same tiny space with you" in the stages of standard relationships.  Yeah, that's fucked up but I'm being honest here.  In my defense, I was already a bit desperate for a child.  That "trying #2" business up there was when I knew I'd be a single mom and I was okay with that.  I was temping, charting, taking OPK's and monitoring ferning, the whole fucking nine my very first cycle... not that it did any good.  18 cycles later, I was ready to see a RE.  Of course, that was about the time that I got sick and had to go on birth control for 6 months.

After I got better, I hit the ground running yet again and joined a support forum this time.  I was full-on-fucking obsessed with it this go.  I was constantly googling all things TTC, pregnancy and baby related.  I'd look up my hopeful estimated due date every fucking cycle after ovulation and just torturing myself daily.  I think I needed the renewal of hope and knew that would be the only way to get it back.  After three months or so, I got the HSG and thought I cleared up a tube and fixed my problem.  After three failed cycles after that, I saw a RE.  Now I sit, in what I imagine is the final few hours of this cycle, after two failed IUI's.  I'm starting to think that enough is way fucking enough.

Sure, I could get a laparoscopy for possibly no reason other than piece of mind.  I could see if we'd get approved for financing a few rounds of IVF just to say I tried but I have no shred of confidence that it will work.  I've seen too many fail already.  I've experienced too many failures.  I just don't want to do it anymore.  I don't want to find another reason to get my hopes up, just to have them crushed and feel stupid for even thinking it was possible.  I'm tired... fucking exhausted... sick of pretending that I'm okay when I'm not.  Sick of stoic.  So close to fucking done.

Maybe this is why a person shouldn't blog while upset.  This is the blogging equivalent to drunk dialing I think and I'm sure I'm going to regret posting this after a good sleep (and perhaps a good drunk) but for now, I'm sticking to it.  I really do mean, from the bottom of my broken heart, fuck you world!  I hope you get punched in the junk.

It's been too damn long...

Yes... it's December... I know, I'm a wretched slug (more so to try and bring back the Tombstone quotes).  Anyway, a lot has happened and yet nothing has happened.  If that makes no sense, fear not! I shall explain.

I lived in a post-HSG haze for three cycles before seeing a reproductive endocrinologist (RE).  I told myself I'd give it six but I've waited long enough, I think.  Finding a decent RE is one of the most important decisions you can make if you're infertile.  You want someone who has a great track-record and high success rate but also someone that will take your ideas into consideration without copping an I-am-God-and-you-know-nothing 'tude either.  Pricing is also very important if you're paying out of pocket for all this business.  Go over all the costs with them.  Clomid v/s injectables, IUI, IVF, ultrasounds, office visits, everything.  Ask if they have itemized breakdowns of major treatments (IUI and IVF) so you'll know what you're up against ahead of time.  I actually got lucky here.  A BBC friend of mine went to this RE so I piggy-backed her research and have so far been happy with the result.  (Thanks Nic!)

The first cycle was a bust, but I knew it would be, as it was filled with testing; not only fertility testing but also I was back to the cardiologist, rheumatologist and pulmonologist to get the green-light for treatment.  They also made me see a perinatologist, as if I need another fucking 'ologist.  Anyway, I got the "all clear" from the Sarc docs and the fertility tests came back within normal ranges.  In case you're not aware, you'll get an ultrasound to evaluate uterine lining and ovarian health.  They're looking for follicle production, cysts, fibroids and other things that might pose a problem.  You'll also have CD3 blood-work done to determine ovarian reserve and quality and possibly a progesterone test to figure out whether or not you have a deficiency.

Other than a fibroid that they're not terribly concerned with, all things are normal.  All things except for the fact that I still can't get pregnant.  Anyway, I'm officially lumped into the "unexplained infertility" group and they scheduled my IUI for last cycle.  We're doing a medicated IUI cycle with clomid to amp up ovarian production and estradiol to make sure that the uterine lining doesn't thin from the clomid.  They picked a time based on my previous cycles that I might be likely to ovulate and scheduled an ultrasound for a few days before.  They wanted to make sure that the lining didn't thin too badly but also that my ovaries didn't overstimulate and produce too many follicles (which would mean a wasted cycle because they won't proceed with the possibility of too many multiples) but that they produced more than they normally do.  Unfortunately, I did not produce more follicles than usual.  I had one at 17 mm and another at 11 mm.  These were both in my left ovary, as my right was shriveled and useless.  It seems that I only have the use of the one though the doctor still won't fully confirm that after only one cycle.  Regardless, my follicles weren't large enough to trigger me so they sent me home to use OPKs until O day.  When I finally got my +OPK, I called them back and we scheduled the IUI for the next day.

Adam's appointment was scheduled for an hour before mine in order to give them time to wash the sample.  Washing is when they take your significant other's sperm sample and remove the dead sperm and the seminal fluid.  After regular intercourse, the sperm shed the fluid before entering the cervix anyway and getting any of it into the uterus would cause severe infection.  So, about an hour after Adam made his deposit, we got to business.  The room was set up like a normal exam, sans all the normal equipment.  I'm not sure why I hoped for some candles, maybe a nice water feature, but for something so intimate, it was certainly clinical.  Once you get to this point, I highly suggest that you take all delusions of romance and "the natural order of things" and throw them out the window.  I promise it will make your life easier.

So... feet in the stirrups, the nurse practitioner came in and had me verify the sample.  I thought this was odd at first but I'm fairly happy they did it.  She told me that his count was around 193 million, which is apparently awesome-sauce, and then she showed me the catheter and made sure I was cool with what was about to happen.  Long and short of it is, they insert the catheter through your cervix and into your uterus so they can deposit your man's swimmers right next to the tubes.  This bypasses the vagina and cervix, which is where most of the sperm are killed enroute.  She set up like any other exam and like a Pap, it was a smidge uncomfortable but nothing too painful.  I bled a bit more than I expected but she said that happened sometimes.  They had me lay there for ten minutes or so and then I paid the bill and showed myself out.  The whole thing was pretty impersonal considering I was making a baby but we do what we have to do.

This two week wait was in-fucking-sane!  Despite my better judgement, I could not contain my new-found excitement.  I was researching, and googling and pinning baby shit left and right!  I started thinking like I did when I was 19 and newly married... thinking like it might actually happen.  Thinking like a fucking idiot.

Then, it happened.  I was 11 DPO, typically the day before AF would show, and my temp jumps through the roof.  I was giddy!  Laughing and crying a bit at 6 AM, trying to contain myself so as not to wake Adam that early on a weekend.  I wasn't supposed to test until the next day and managed to wait a few hours until I lost all willpower and tested with a cheap pregnancy test from Amazon.  Much to my dismay, like it always has been, the test was negative.  I thought maybe it was too early and the test wasn't sensitive enough.  I continued to think this for a few more days, even after several more BFN's, because AF hadn't started yet.  I was around 3 days "late" before my temp tanked.  It was another two days until I'd get my period.  You see, for me at least, one of the dirty little secrets of clomid is that it can lengthen your LP.  This is information that would have been fantastic while I was thinking "I'm not out till she shows" so I'm letting you know now.  Before starting a medicated cycle, take everything you know about your body and forget it.  You can ovulate later (or not) and you can have a longer LP (or not), you never know how it will affect you until you're on it.

So, after all that, the end of this story is that my first IUI failed.  I'm supposed to accept this, do exactly what my doctor says and move forward knowing that most IUI's fail the first time.  I realize this.  However, what I've been doing is losing any ounce of hope I might have gained with the IUI and all of what I had before that.  At this point, I'm fairly positive that I will never get pregnant.  Don't get me wrong, I haven't given up, but I have no hope left.  No delusions.  No fantasies.  I'll go ahead with this IUI (I'm on CD4) and I'll run through the motions but I do not think it will work.  After AF arrives this cycle, I'll go ahead with the next IUI but I doubt I'll think that one will work either.  Once both IUI's fail, we will take a deep breath and toss in the towel.  IVF is an option if we finance but I don't care.  Kudo's to all the women who have the energy to go through all this shit and more, only to do an IVF round and a few transfers as well but I don't.  I waited too long.  I should have seen a RE more than a year ago.  I'm glad I didn't have a child with my first husband but that time didn't help either.  I've always known I wouldn't be able to have kids.  I've always known I'd never know what it felt like to bring life to something other than myself.  It's been a long decade and have no fight left in me.  Childlessness can't be too bad right?  I have a feeling I'll be finding out.

The HSG

This... is not my uterus.

If your OB or RE has suggested this test as your next step, punch them in the face... then sign yourself up!  It is an invaluable tool to helping you along your TTC journey but, as it hurts like the dickens, it also sucks ass.

The HSG (or HysteroSalpingoGraphy) is a procedure used to determine whether or not your uterus and/or fallopian tubes are blocked and, therefore, preventing pregnancy.  A catheter is inserted through your cervix, into your uterus and dye is injected, while under x-ray, to see if it flows freely through your lady-bits.  Well fuck all that noise!  It should have been called a HellishSucktasticoGraphy because if all that sounds like torture, you're fuckin-A right!  That being said, you may have to have one done at some point and you're trying to get pregnant anyway, so this seems like a lovely introduction into the world of pain.  It's also a great trainer in the ways of throwing your modesty out the window.

I arrived at the imaging center sans my OB because she doesn't perform them.  After consulting several people in the back, the receptionist finally figured out how to process a cash payment (insurance companies are staffed with evil bitches).  I brought my sister along, God love her, and suggest you find someone equally capable to accompany you.  Doctors, especially those you've just met, sometimes fail to convey the facts of the matter and you may need a second eye on the monitor.

We were ushered to the back, where I was introduced to the torture chamber that was my procedure room and told to undress from the waist down in a tiny little bathroom.  I came out, gown open in the back, and she gave me a bit of information about the test.  It seems that protocol at this hospital deems a disposable catheter be used when their doctors perform the test instead of your OB or RE.  This sucks because the disposable catheters are plastic and, because plastic is slippery, they employ an inflatable balloon to remain in place.  This does not feel pleasant and should be avoided if possible.  Then, she had me hop up onto the x-ray table (which is damn near impossible to do gracefully without flashing your ass about the room) and prop my feet up on the table's edge.  As my sister had not previously been introduced to my cervix, I had her move to my side at this point. 

The doctor came in and seemed nice enough while running through the procedure again.  This, ladies, is the time to ask questions.  Tell them exactly what's been going on and how important it is for you to have this fixed.  My main goal was to find that there was a blockage but also have it cleared by the HSG (yes that can and does happen).  Most would think I'd rather have my tubes be completely clear to begin with but I needed some explanation as to why I've been having so much trouble with this.  After we hashed all that out, the procedure began.

He started by slathering an iodine cleaning solution all over my hooha.  This is not painful, but is cold and wet and generally uncomfortable.  Then came the speculum... fun times... and more iodine on my cervix.  That felt fucking weird.  I've got no better explanation.  A good doctor will warn you when they're about to insert the catheter, which he did, and I'd advise you to remember to breathe at this point (just not too fast).  It hurt but it was not unmanageable.  It feels like fairly determined cramps and if you've had a hard menstrual life, you get this already.  At this point, I was told to scooch (her words) myself up the table so my uterus was over the x-ray zone.  Let me tell you, with a speculum and catheter making your life a little more interesting, that table is a long motherfucker.  I was pretty sure I was about to "scooch" myself right off the damn thing when she finally told me to stop.  Then she lowered the camera to me and stepped back. 

When the doctor announced that he would be inserting the dye, he wasn't fucking kidding.  This took my cramps up to about a 9.5 and I started thanking the universe that this was a short procedure.  He told me to roll to one side, hold and then roll to the other.  Once I was flat again, I had hoped that I was nearing the end.  My breathing must have made my discomfort obvious because he let me know that he was just about finished.  About that time, a hellish wave of pain hit me and I wanted very much to kick the good doctor in the teeth.  Then the pain abruptly ended.  He retracted his torture devices and pushed the monitor up so that I could see what was going on.

The images they show you will be choppy as they are pictures, not a video.  It started with dye in the uterus (which looks very much like a caved in triangle).  The next frame showed dye in the right tube.  The frame after that did NOT show dye in the left tube.  At this point, I began to panic.  Likely sensing my horror, he flipped to the next frame and explained that he had some issues with the left tube but the dye finally went through.  I nearly started bawling.  That is exactly what I had hoped to hear.  My sister would later explain that she thought he was about to give up as the dye refused to go through the left tube.  Apparently, that last wave of pain was him pushing past the blockage.  For this, I am very thankful.  For this... I may just get pregnant this cycle.  Too soon to jump there though.  Your tubes are not short and thickish as biology and anatomy drawings have led us to believe, but instead they are long and stringy, extending upward (or so they were that day) into your abdomen.  So don't freak out if it looks like you're harboring a body-snatcher in your belly because that's just the way it looks.

Getting off the table was fun.  I don't like leaving a mess behind for someone but it's unavoidable considering the amount of dye and blood that will be leaking from your unmentionables.  Don't worry, they've seen it all before.  They advised that I would have a bit of spotting throughout the day and provided a pad for this reason.  After the initial clean-up and around an hour afterward, there wasn't nearly as much mess as I was expecting.  Overall, I'd do this again fifty times if it gave me the same result.

So, a few things you should remember when you have this done:

1. Talk to your OB a lot... especially if they aren't performing the procedure.  I set this up myself by calling imaging centers in the area because my OB didn't do it.  She left me in the dark for the most part so I hope you have more information than I did.

2. Make sure you have a scrip for antibiotics especially if you're showing the slightest signs of infection.  The dye goes out into your body and pushes anything that might be in your uterus and tubes with it so you NEED to take them.  My scrip was for prior to the procedure but others have been different so pay attention to the dosage.

3. TAKE 800 MG OF ADVIL WITH FOOD ABOUT AN HOUR BEFORE YOUR HSG!  I'm not even fucking joking about that amount either.  That's what I took and it still hurt.  This is an important step... do not forget it!

4. You should bring a pad with you for the reasons stated above.  The nurses will likely give you one if you don't stock them but if you have a preference, bring one along.  No tampons!

5. You should make sure and schedule this test right after AF leaves for the month.  They won't let you do it if you've ovulated and they make you take a beta (blood pregnancy test) at least 24 hours before.  Then no sex till after the procedure, though I doubt you'll want to until the next day.

6. You should only spot a little after.  My doc said if I notice more than a few teaspoons of blood or any signs of infection that I should call my OB immediately.

7. If your insurance doesn't cover infertility, call different labs.  There can be a huge difference between costs here so shop around.  Also, some billing offices give discounts for cash customers so pay in full up front if you can.  My HSG was a little over $400 and that was after a 40% discount.  They went as high as $1200 though so do your homework.  It may be cheaper for you to have it done at an outside lab even if your doctor does perform them.  All they really have to do is write the orders up and fax them to the imaging center.

8. Know that all women and hospitals are different.  Your procedure may not be exactly like this and you may have less (or more) pain than I did.  Just remember, this may be worth every penny and wince so keep an open mind, try to relax and pray it's over quickly.  My procedure lasted less than 10 minutes and once I left, minus some very mild cramping, I felt nothing.

So... all that being said, I hope you've enjoyed this episode of why HSGs are both horrible and fantastic!  Join me again next time as we discuss some more weird and squidgy facts of TTC.

And so... it begins.

I'm eating cake.  Why is a woman hell bent on losing shit-tons of weight eating cake you ask... because it has chocolate on it.  Why is that relevant... because Aunt Flo arrived today and not only am I aware that my body metabolizes faster while I'm knee deep in menstrual cycle but also because Flo demands chocolate and what she demands, she gets.  That being said, welcome to the first of many blogs bound to contain a whole lotta TMI (and quite possibly foul language).

I mention this because I'm quite happy Aunt Flo showed up bright and early this morning.  It means that this is Day 1.  Cycle day 1 (CD1) to be exact and this will be the first day of what will hopefully be the successful stint of my TTC (trying to conceive) journey.  You see, I've been at this a while already... over a decade to generalize it.  It began when I was about a year into my first marriage.  As a teenager, I had always vowed to never have kids but somewhere after walking the long mile, I lost all track of my good senses and caught baby fever.  We tried, obviously unsuccessfully, for the latter 4 of our 5-year marriage.  Considering that marriage ended in divorce, the fact that we were unable to conceive ended up being a good thing.  I also don't generally think of this period as part of my TTC journey.  I didn't know what I was doing back then and, knowing what I know now, I didn't try nearly as hard as I should have.  Regardless, as most divorcees do, I spent a few years after that picking up the emotional pieces, as well as what was left of my self-esteem, and scotch taping it all back together until I felt comfortable with the "me" I had left to work with.  Then I started dating. 

Eventually, I suppose we'll call it after I met my husband and realized that it was not my lot to live pining and alone forever, my biological clock woke back up.  And when it did, it was thoroughly pissed off that I had ignored it for so long.  It felt like someone grabbed my Grandma's huge brass bell alarm clock and started beating my upper extremities with it.  I had an itch that would not be ignored under any circumstances.  Since then, the itch has turned into a longing that, most of the time, just makes me sad.  Eighteen cycles came and went without so much as an implantation tickle.  I suppose there was the one chemical pregnancy I'm fairly certain I had, but I try not to think about that one.  Needless to say, I was devastated when my doctors (yes doctorS, I'll get into that later) strongly suggested that I go back on birth control for a while.  I won't go into the medical stuff now other than to say they mentioned something about lymph nodes, arterial constriction and death and thought it was best that I try to avoid those things.  I agreed, though not without serious consideration, and proceeded to take a break from TTC to enjoy the worst drug ever created by man or beast.

So, after the shrinking of various organs, countless fevers, intense screaming fits of rage, mania, four prednisone tapers, fatigue and 40 or so unavoidable pounds later... here we are.  My doctors (one of them at least) has given me the AokieDokie to start trying again for our dream!  Well... my dream his "starting to really want".  And today, Day 1, is the first day of my cycle off birth control.  I'll likely be getting back into the swing of things on this cycle (frankly if it's effective I'll fall off the fucking throne I swear it) and letting my body rid of the birth control but at least they've given me hope.  Hope and a whole lotta renewed obsession.  So, please feel free to stop by on occasion and walk with me for a while on my journey.  As the blog title states, it's gonna be a barefoot sprint up a mountain but damn I can't wait to see the view!