It is all so cliche

They went back for one more ...

Both measuring exactly on schedule.

I think our RE is young and naive but she gave us a 90% chance of success.

We are all a little stressed around here.  Very excited (IF) things work out, also tired. 

Next check in 2 weeks.

Thank you for all of your support.

the worst blogger in the world

pops back in to say hi.  And um, ultrasound tomorrow. 

I think that my deep skepticism of this cycle (it was a long and slow start) and a number of early negative hpts just prepped me to call it a failure.  But in fact betas doubled and here we are.  The ultrasound is tomorrow morning, and JD has already declared his intention to skip it.

I feel like this has been one 6 week long 2 week wait because I have been basically symptom free (or maybe the symptoms were just masked by my untreated strep throat.  I did not notice the strep until I got a classic strep throat rash.  Thankfully no fever but I basically either coughed or slept for 3 weeks).

I have what can only be described as zero symptoms.  Except sleeping all the time.  But no smell aversions, food aversions, nauseau, tenderness.  Nada.

Wish me luck, and I will post an update.  On one hand I know that we are incredibly fortunate.  If this cycle worked, I will have ovulated 4 times in my life and conceived 3 times.  If it failed we at least know that calorie restriction and injectables do work as long as my medical team listens to me and quadruples the dose they would like to start with.  So we'll see what happens tomorrow.

Day 15 or so of stims ...

I am not sure why I have quite so little to say about this cycle.  I think that it's just a tad dreary to realize that despite the only intervention I can control (my weight) and all sorts of wishful thinking, my body is as ever ... slow, at best.  We're on Day 15 of stims with no distinct end in sight.  Down to daily monitoring from every 48 hours, which does give me hope. 

My morning dashes to the clinic are nothing but annoying, brusk, interaction-less interludes except for the occasional conversation with my doctor.  It is astounding how the men and women in such a packed waiting room can studiously avoid eye contact but I have yet to witness so much as a hint at small talk in the waiting room.  The clinic conveniently has you write down the reason for visit so I don't even have to say hi to the receptionist, and the shuffle from phlebotomist to ultrasound tech (no repeats yet.  A different tech every time.  Whee!) makes this entire endeavor seem even more clinical and surreal.

Oddly we have now told many of our local acquaintances, in part because I expect to need a good deal of help making the 9 am lab cut-off if JD ever goes back to work (thank you GOP for being ever so family friendly as to take away our only paycheck).  We have not, and will not, tell either the kids or our immediate families until there is some news to share.  I also haven't really bothered to tell my long-term friends since it tends to be an awkward conversation.  It's hard to strike the right note of optimism when talking about someone else's fertility treatments over e-mail, and most of our close friends have yet to even consider starting their families.  And there is just the absurdity of being so lucky as to jump back in to all of this for Project 3.0.

So yeah, chugging along but not much to report.

Chugging along, very sleepy

Well here we are at CD 6 with not all that much to report.  I fall asleep everyone night at 7:15 with the small peoples because I am so low energy.  I also fall asleep every time I sit down to read to them mid-afternoon.  Also, flu-like muscle aches.  Just plodding along.

The thing is that last night I read my usual 50 or so blog posts (by no means all IF related)and I saw only a single mention of the government shutdown, and that a passing concern about an agency's money running out soon.  I know that we live within a weird little warped zone around the nation's capitol where small incidents are writ large (needless to say there was yet again a very high police presence in our neighborhood this afternoon and our afternoon ice cream playdate was delayed because of police presence.  Fun times), but it is hard for me to separate those external factors from all the anxiety of cycling again.  Needless to say JD has not been to work since Tuesday, and while it is lovely to have some help at home and we dutifully spent his first morning off scrubbing the basement and cleaning our back "yard," it also adds another layer of uncertainty to all of this.  And of course makes my trivial complaints about a self-induced period of hunger even more slightly obnoxious.  And yet, despite my concern I am not really in a position to take much action.

Of course this afternoon I went to visit a friend with a new baby.  And while baby was lovely and my jealousy of the baby was running at a reasonable rate, it was everything else that set me off (and does of course help me stay the course on 800 calories a day).  The lovely grandmother who graciously served lunch to visitors.  The new mother (and I do mean very new) who accidentally let her nursing top ride up and stood there comfortably in front of a room of visitors exposing her bikini-read body.  And of course the off-hand comment about how hard it was to manage all of the visitors and the month of food delivery.  I am of course skipping over things - the bed rest, etc. but it was a bit hard not to wonder what I've been doing wrong on the way home? 

Absurdity, Round 3

I was going to write a long, whiny post about the absurdity of putting a busy woman on an 800-1000 calorie a day diet.  I wake up a little before 7 every day, hit the ground running at 7:25 with a little jog to the bus stop for the fusspot, come home to feed the dumpling breakfast before walking/driving/jogging him to any of his 3 preschool options, try to get in a little work, collect child #2 for nap, drive to pick up child #1 through an hour of traffic, chase them to the playground or assorted activities, cook dinner, bedtime, work some more ...

Let's just put it succinctly: it's miserable to do all of that with absolutely no energy.  It is not even that I am hungry because oddly I have not been particularly hungry the past few weeks (although I am sure that will change as my body loses some of its fat stores), but I have been extraordinarily low energy.  And really just pissed.  To start with the obvious, plenty of women plumper than I not only conceive naturally on their own, but they cheerfully slog through fertility treatments.  Or someone sets them up with insulin and they carry on.  But since magic struck twice the very exact two months when I had dropped 30 lbs, we decided to try extreme dieting.  The diet is simple: calorie restriction.  Some basic carb-limitations (no pasta, no bread, no sugar) but nothing too strict.  Just don't eat.

And ... in predictably dramatic fashion I started bleeding this morning.  17 days after I re-committed to extreme dieting, a good 10 lbs lighter (from about 157 to 147) and I may be approaching a cycle.  I ran home, got some equipment, carried on my day ... and found myself hunched over in the car by mid-afternoon bleeding through 2 plastic changing pads and one Ergo as I desperately texted JD to collect screaming children and rendez-vous in the parking lot.  It was gory.  So now I am exhausted, terrified of leaving the apartment, and bordering on developing a sudden onset eating disorder.  It feels like every snack, every meal I need to ask myself whether I'd rather have a baby than that hard boiled egg (70 calories for a large, 90 for an extra-large ...) or tasteless slice of hard cheese.  I am not sure how long I can do this diet without more childcare (let's just not even talk about how I have not exactly made any attempt to wean the dumpling.  The diet was supposed to be 1000 calories, some days I up it to 1200 to accommodate him, some days I feel like speed is of the essence and I cut much lower).

But then again, progress.  And hopefully this will be a very, very short-lived catastrophe.  And of course worth it even if it just cuts down on the amount of medication I need.  And of course the weight loss is good for my body, just perhaps not this fast.  Also worth noting, libido has been nil since day 2 of the diet.  Nil.  That should make all of this even more fun.

And now for a technical question for my IF friends.  I am slightly less impressed with Shiny New Clinic since they called in meds for me but did not e-mail me a protocol.  Since our pharmacy is reliably unreliable, I e-mailed my cycle coordinator to ask what the meds would be: follistim, progesterone, HCG.

???????????????????

Has anyone ever heard of an IUI-style cycle which did not start with clomid or femara?  Can this whole thing be done with just follistim?  And is baby aspirin entirely out of vogue nowadays?  Of course I am rather dubious of the need for progesterone having never used it in the past (baby #1 cycle worked when I was working in Europe and there was no way to get progesterone, baby #2 I hadn't weaned the fusspot so we kept putting it off and checking my levels) but it doesn't seem like a big deal either way.  But is this a real protocol?  Just injectables started on some entirely random day (protocol was written pre-cycle-breakthrough and apparently bcp for a month is also very much no longer a la mode). 

Thoughts?

Heaps of trash

We had a lot of trash to set out this week.  Far more than usual.  No, the soon-to-be-averted at the last minute government shutdown did not kick in early (although apparently our trash collection will end if the gov does shut down.  Who knew?).  It's just the normal banality of guns.  You may have read about a shooting last week ... non-stop news, endless rumors about someone loose in the neighborhood, 100 cops and ambulances descending on the scene with sirens blaring, the President gently consoling a crying child at a hastily scheduled photo op.  And then it's over.  And everyone has already moved on to the horrors abroad and the absurdity of our government and all the usual concerns.  But the truth is we live 5 blocks away and even having spent the better part of the last decade in NYC, a day of sirens blaring and text alerts warning you that your children's preschool is on "lock-down" and alerts to lock your doors can make the usual complaints of life seem trivial.  Twelve people went to work in the normal way, snapped at their kids about being late, left the dishes on the table, snuck a coffee onto the subway, and then were shot to death by a mentally unstable but legally armed assailant.  And the only lasting result on our quiet little street was a missed trash collection (we were close enough to the cordoned off security zone that the garbage men were not allowed in).

And if you are wondering what radical changes we made to live our life better in the face of evil?  Well, one rather bitchy e-mail to the dumpling's preschool listserve about the stupidity of locking the door during pick-up when the building is shared and has about 10 unlocked doors, a permanent community of homeless men who live outside (and 99% of this particular population has mental or addiction issues, I do know that is not at all true of all homeless populations.  I spent years volunteering at a family homeless shelter for perfectly ordinary people who had bad luck and no support networks), and the truth is that neither locked doors nor background checks are effective against easy access to guns.  And then I took my kids and fled to Costco to wait until the sirens slowed down a bit.  Costco, land of bright fluorescent lights and free tasters and cheap pizza.  That's it.

In other news, our insurance cleared us for treatments this morning and I am plodding along through a lovely 1000 calorie a day diet (makes me a tad grumpy) and we are all systems go any day now.

Feeling a tad like a fraud

I left the new clinic on rather a nice high.  Not only is it entirely subway accessible, but it seems like you get what you pay for (and it is pricey).  A well-organized, polished baby mill complete with full waiting room of women studiously examining months old tabloids in order not to make eye contact, on time appointments, nurses who use e-mail (hooray!!!!), a follow-up with the exact costs of everything involved, the works.  And I really liked the doctor.  She was young, sympathetic and reasonably thorough.  More than that she asked me whether my preference was for old-fashioned clomid or jumping right into injectables.  Honestly it hadn't even crossed my mind that we might just get sent home with a prescription for clomid (see: entire blog, if only it was quite that easy) but I like that she asked.  And when she casually wondered if I remember my dosing on injectables from 2007-2008 and I whipped out the shot schedule she was duly impressed that perhaps despite my age my body is not quite as healthy as one could hope for and we really ought to jump right in with some follistim.

Since our insurance coverage has not yet cleared (working on that since June), our plan of action for the time being is ... drumroll please ... work on some rapid weight loss, a la the egg diet of 2008 or the great gas baby of 2010 (long-time readers may recall that I have only gotten pregnant after rather absurdly sudden weight loss (the great gas baby was a case of gi.ar.dia left untreated for 30 days which both made me look 6 months pregnant and helped me to lose 30 lbs)) and hope the insurance clears in the next 30 days.  And then she referred me to her favorite PCOs weight-loss specialist.  And I spent the afternoon on the phone only to discover that there is no way my insurance will pay a single penny for it because they have "nutritionists on staff to help with lifestyle changes."  Lifestyle changes. 

And when I finally got off the phone with the depressing news that all I needed was some lifestyle change to cure my insulin resistance (diagnosed when I was 11 and weighed all of 90 lbs), the fusspot walked through the door with a 102 fever.   Wednesday is the one day of the week that I don't have to make the hour plus trek across the city to pick her up so there's nothing better than having your child walk through the door with a high fever and knowing that not a single adult who interacted with her thought to ask if she was feeling okay.  Not the teacher, not the gym teacher, not the neighbor's au pair who drives her home on Wednesdays.  And then I got one of those awful guilt-inducing e-mails from another mom that the fusspot had been sitting on the ground crying at pick up.  Because she had a 102 fever and no one noticed.  Awesome.

And since the day was fairly well-ruined by a miserable lump of preschooler on the couch moaning in agony (she suffers illness far more like her father than me), I decided to make it a day and run out and have a final blood draw done once the kids were asleep.  The 24 hour lab is one of those enticing tidbits that can lure you in to the trap of awful insurance, but my experience is that late night techs are even less competent than daytime ones.  Thankfully I've already twice had blood draws for the wrong tests so I thought to ask how many scripts she had, etc. and what do you know, despite printed e-mail in hand saying that the labwork I needed was in the system the burly late night tech was about to draw my blood for a blood type reading ... needless to say looking forward to another late night run to hell next week.

Also up next week: a meeting about lifestyle change, a meeting with the PCOs specialist, and a dear-lord-let-me-stay-polite meeting with my OB/Gyn about what exactly is holding up our referral. 

Whoops, and back to the title post.  As I was leaving Sh.ady Grove, the receptionist explained that I would get a "new patient appointment evaluation" in the mail.  Just as she was emphasizing the importance of my feedback to the clinic, a cute young couple came through to say their goodbyes to the staff.  It was clear from the discussion that they'd been around for quite a while and there were some sweet, fond farewells including the exchange of a thank you card with the receptionists.  And then the woman turned to me and wished me good luck.  I know she was not being patronizing, that she was just trying to acknowledge the awkwardness of graduating from the infertility clinic while some poor sod was just handing over her Amex to reception for her intake appointment.  But rather than feeling sad or jealous at her teeny tiny belly I just wanted to shout I have 2 babies at home!  I am running back to pick my 2 year old up from babysitting coop.  But you can't.  So I just said thanks and bolted for an up elevator to avoid any more conversation.  But I think it will be different this time.  I no longer associate fertility treatments with snuggly newborns.  It's just an unfortunate obstacle I have to get through, followed by months of total denial that anything good is going to come of it (if if if), followed by a sudden dive into washing newborn diapers and folding clothes (if if if).  I was in fact genuinely excited to get in to the clinic; one more hurdle down.