Monday, January 30, 2017

Monday Munchies...

With all the traveling I've been doing back and forth to NY, I've really lacked in the cooking department.  But with a quiet week and a half, I was able to get some cooking in and one thing I did cook was an awesome lasagna.  I have never been a big lasagna person, but for some reason, that's what I needed.  I also needed my lasagna to be loaded with veggies, and made with whole wheat noodles-not something I've ever done before! In fact, I have always thought it was quite rude to ruin pasta with whole wheat noodles, but I can now say I am a firm believer in whole wheat lasagna.  I hate to admit this, but this recipe was not a kid pleaser.  We were able to convince Dovy that all the vegetables would help his muscles grow, so he took a few bites, assessed his muscle growth, and then said he was done.  Dr. Husband and I enjoyed the leftovers though! 




Vegetable Lasagna (with my adaptations) 
1 box whole wheat lasagna noodles (about 12 noodles used)
2 tablespoons olive oil
1 medium onion
4 garlic cloves (I used frozen cubed garlic)
1 red bell pepper diced 
24 oz chopped white mushrooms (I could only fit 12 oz in my frying pan with all the other veggies)
2 yellow squash diced
2 green zucchini diced 
1 can (28oz) whole tomatoes 
1/2 cup white wine (I used white cooking wine)
1/4 cup parsley, chopped
1/2 teaspoon kosher salt 
freshly ground black pepper
1/2 teaspoon red pepper flakes 
30 oz ricotta cheese (I used whole milk ricotta)
2 eggs
1/2 cup grated Parmesan
1/4 teaspoon kosher salt 
fresh ground black pepper
1 lb thinly sliced mozzarella cheese (I used shredded)
extra Parmesan for sprinkling 

*I did not boil my noodles before: the vegetable sauce will add a lot of liquid to the pan, add some extra water until the pan appears to be full of liquid-there will not be room to add more! My noodles were not specifically no bake noodles either-just cover the lasagna, bake at 350 for about an hour and a half, or until easily cut, and then uncover to continue baking for 5-10 minutes.  Let it sit for about 10 minutes after removing from the oven.

Heat the olive oil in a large skillet-and when I say large, I mean large!  Like, special order on Amazon large! Add in the onions and garlic and cook for a minute, and then add in the red peppers for another minute.  Then add the squash, zucchini, and mushrooms and cook for a few minutes more.  Add the wine, salt, pepper and red pepper flakes and stir to combine.  

Pour in the liquid from the tomato can, and then gently squeeze each whole tomato releasing the liquid, and add in the smushed tomatoes.  

Combine the ricotta, eggs, Parmesan, salt and pepper.  

The vegetable sauce should go first into the bottom of the pan.  Then layer: four noodles, ricotta, mozzarella, veggies. Repeat this two more times for a total of three layers.  Finish the vegetables on the last layer and sprinkle with Parmesan.   

I definitely enjoyed this lasagna, although it can't take the place of the comfort lasagna, it definitely packed a good punch and I definitely plan on making this again! 



  

Wednesday, January 25, 2017

Facing infertility month after month...the mikvah and infertility

Infertility can often feel like a slap in the face.  Don't kid yourself; I do try to have a positive outlook on all of this, but there are plenty of times where I get angry: thinking about all the effort I have to put into just trying to have a baby-and hey, isn't that supposed to be the fun part?!?  I could have bought myself plenty of wonderful things...had I not had to pay for fertility treatment. Even with insurance coverage, treatment still costs us several thousands of dollars.  Watching people around you get pregnant, have babies, while you're left with empty arms.  But for those of us who follow the laws of family purity, we're faced with an even bigger reminder of how broken our bodies really are.  

One of my first posts highlighted a brief synopsis of the laws of family purity and if you want to read more information you can check out some good articles HERE  and HERE 
Upon completion of at least 12 days of separation, immersion in a ritual bath, the mikvah, occurs.  The mikvah is supposed to be a beautiful commandment marries couples keep, and conveniently, mikvah night, the night where the couple's physical relationship can begin again, coincides with ovulation in a typically working female.  
On a very simple and basic understanding, the practice of keeping the laws of family purity, and then immersing in a mikvah, ensures conception occurs
in typically working couples. 

It's not surprising that keeping the laws of family purity, and finally immersing in the ritual bath, are one of the most challenging and distressing times for practicing Jewish women who are facing infertility.  
Having your faith tested month, after month
failure after failure. 

Today, I'm so happy to have a guest blogger talking about her experience with the mikvah while facing infertility.  My former roommate, Estee, wrote here before, only then she was in the midst of her struggle and her post went live anonymously.  
Today, I'm happy to report that she is a mommy to two little boys


When we were undergoing fertility treatment, I experienced a very big challenge in my religious obligation of family purity. After menstruating each month, a Jewish woman immerses herself in the mikveh (Leviticus 15:24-27). The mikveh is a ritual bath that allows one to achieve both physical and spiritual purity. It’s a beautiful concept and there are many redeeming factors to it, but when you associate this ritual with failure to conceive, it can become a painful one.
The Torah tells women to count seven days of their cycle before immersing in the mikveh. (Nowadays, we count five days of our cycle followed by seven days of no bleeding.) Most observant women refrain from sex, and many refrain from any and all physical contact with their husbands (even non-sexual touching or sleeping in the same bed) during these days. Many relationships suffer during the stresses of fertility treatment. It was an added challenge for me to separate physically from my husband during such a vulnerable and emotionally exhausting experience. When we went through a fertility procedure in which I failed to become pregnant, it felt like I was being punished. I began to dread going to the mikveh, and saw it as a sign of my failure to conceive.
I learned to overcome these feelings through extensive research into mikveh in addition to individual and couples therapy. I read articles by women experiencing situations similar to mine, and was awed to see how one such woman learned to rephrase her experience of mikveh as an act of courage. “It takes courage to walk into the mikveh while dealing with infertility. It takes courage and strength to ask Hashem (God) the same question, month after month, and to keep believing that life is really possible.” 1 It had never occurred to me that enduring fertility treatment could be a testament to my strength of character. This perspective allowed me to feel proud about myself.
A second perspective that I read up on taught me to treat both myself and others more kindly. Being unsuccessful with fertility treatments made me feel like a failure, but I learned that G-d loves me even despite my imperfections. G-d relates to us in the way that we relate to others, and I began to work on being more forgiving towards others.2
Finally, I needed to learn that the good fortune of someone else did NOT take away from me. I so often felt that all of the requests for having a baby had been granted to others and that there was nothing left for me. I needed to reframe this way of thinking. God runs the world, and the same God that could grant children to my friends could also grant children to me.3
Going to therapy was the additional step needed in allowing me to reframe my mindset. Instead of looking at the mikveh as solely a means through which I could conceive, I began to look at it as I did when I first got married, a means through which I could reconnect with my husband. As much as I yearned for children, I appreciated the marriage that I had with my husband, and felt lucky that it was a positive one.
I have posted one other time on this blog, in July of 2013. At that time, I was an anonymous guest writer sharing my experiences with infertility and my hope that one day I would conceive and give birth to a child. I can genuinely say that the time before we had children was one of the most painful periods of my life. Aaryn built me up and gave me confidence even when I was completely ready to quit. Aaryn, thank you, and I wish you so much success and happiness as you continue your journey to expand your family.
A Journey to Parenthood is a series I began a few years ago as a way to highlight the many different paths to becoming parents may look like.  It is about solidarity, uniting through the common struggle of infertility.  I would love to make this a monthly feature on the blog again. If you, or anyone you know is willing to share their story and would like to be featured, please comment or e-mail me!
   

Tuesday, January 24, 2017

Makin' room in the freezer....

For NINE embryos!  

I wanted to do a whole post on the grading system of embryos except I found there are different standards and clinics can freeze differently, but I don't know what my clinic goes by.  I also don't have my personal report to offer any insight into the question of: there were 14, but now there are 9-what happened to the other 5?!?  However, it appears that it is very common for embryos to "arrest," or stop developing due to chromosomal abnormalities. So that probably explains the 1, as for the 4 grade Bs, right now, I don't have any insight.  

I should have more information on Monday and I will report back then! 
But, 9 is an awesome number to work with and hopefully we have some rainbow babies in there.  

Now, the real question is, how many do we transfer now: one, or two?!? 

Let me know which one you vote for!!!

You can check out information on embryo grading HERE ,HERE  and HERE
You can also check out embryo development HERE
*We did ICSI (Introcytoplasmic sperm injection) with all the eggs as a way to increase fertilization.  
*We decided not to do genetic testing on these current embryos due to cost-I will know on Monday how many embryos could be tested at a later date should we choose to. 

Monday, January 23, 2017

Monday Munchies...

Today I'm going to be sharing a hearty and comfort zucchini carrot bread.  This was fabulous straight out of the oven and it's so good, you won't be left with any leftovers, guaranteed! 



Zucchini Carrot Bread  (from an unknown Kosher cookbook! If you know, please let me know!)
3 cups flour 
2 teaspoons cinnamon
1 teaspoon baking soda
1/2 teaspoon salt 
1/2 teaspoon baking powder 
11/2 cups sugar 
2 medium carrots peeled and grated using the biggest holes on a box grater 
2 medium zucchini, unpeeled and grated using the biggest holes on a box grater 
1/2 cup canola oil
2 large eggs 

Streusel topping:
1/2 cup dark brown sugar 
1/2 cup rolled oats or old fashioned oats (not quick oats)
1/4 cup Grape Nuts-cereal
1/3 cup flour 
1/8 teaspoon salt 
1/4 cup margarine cut into four pieces at room temperature 

Preheat oven to 350 and grease either a 9x13 pan or 2 loaf pans.  

Combine the flour, cinnamon,baking soda, salt and baking powder in a medium bowl.  

In a new bowl, combine the sugar, carrots, zucchini, oils and eggs. Once mixed, add the flour mixture and combine.

Pour the batter into the prepared pan(s). Prepare the streusel topping and sprinkle on top of the batter and bake uncovered for an hour.  

I cannot wait to make this again, in fact, I think I will make it over the weekend to take with me on my next trip to NY.  
Check back tomorrow to hear the final embryology report! 

Sunday, January 22, 2017

Embryology Report & Recovery

If you ask most people who have undergone a retrieval, most will tell you it's a piece of cake.  The two people ahead of me walked right out.  
Of course there's always one...
I was at risk for OHSS because of how stimulated I was and because of my estrogen levels.  So it was no surprise that things got difficult.  My abdomen became so distended I looked about 5 months pregnant by the day after retrieval.  I'm on medication specifically for this, and I'm supposed to eat salty food to draw the fluid so I can pee it out, as well as drink Gatorade so I get electrolytes which will help keep me hydrated because all the fluid was going to my abdomen through the "leaky vessels."


While I didn't take a specific follow up picture, which I totally should have-I was doing some recording for an upcoming video! I did take a shower and put on makeup.
All so I could feel human for a bit. 

 
#greyhairsforthewin 

On Friday, I was down a couple pounds by mid day-I had finally started peeing more and I was definitely losing the fluid that was being retained in my abdomen.  
The thing is though, even once the distention goes down, your abdomen is still sore from being distended for so long.  

On Saturday I was still looking pretty bloated, and had started to feel like I was overdoing it-dizzy and slow walking.  
Sunday, today, I also woke up feeling dizzy, but after laying around for a few hours and eating something, I felt better.  I will also say here that I am no longer sure if how I look is bloat, or just fat?!? 
My morning began with me feeling decent, however, by around 2pm, I had almost a constant uterine dull tender feeling and have spent the rest of the day laying low.  I am back to work tomorrow, but plan on taking it relatively easy this week.  While I no longer specifically feel the bloating/distention due to OHSS, I am still eating salty foods and drinking gatorade just as a way to ensure I continue to be on the up and up.  

Now, for the most important part, what makes this all worth it!
As of Saturday, we still had 14 embryos: 10 grade 1: perfect, and 4 grade 2: average.  
So, no longer do we have a straggler!!! 
Freezing takes place Monday and Tuesday at Day 5 and 6, and I'll hear from the embryologist then!

I also begin 10 units of Lupron tomorrow. 

Friday, January 20, 2017

Retrieval UPDATED

Wednesday afternoon, was our second egg retrieval!


We were to report around 10am, but arrived early, around 9:45.  I'm not sure why they have you arrive so early, as nothing started until around 10:35.  At that time I was called back to get my gown on, sign consents, and speak with the anesthesiologist.  At this point, there was one person ahead of me.  



When it was my turn, Dr. B came in and went over the risks with us.  He of course listed all the minor risks, and when he was done, I added in, "death." 
"That's very rare," he said.  "Ok, but it can still happen!" 
"God forbid!"  
He told me after, he repeated this story in the OR while I was asleep, and when he was done, I pointed to my ear, as if I can hear you!!!



Dr Husband and I said our goodbyes and I was taken into the OR when they had me position against the foot of the operating table, and lean back so I was laying down in the proper position.  I was fitted with my blood pressure cuff, oxygen and IV.  The room was freezing and I couldn't stop shaking.  Apparently it's kept cool so the patients don't overheat.  
Dr. B came in the room once we were ready and the anesthesiologist eventually said, "here we go." I saw her begin to inject the white sedation, and I promptly closed my eyes, determined not to fight going to sleep.  I did feel a burning sensation through my oxygen, I mentioned it, was told it was ok, and that's all I remember.  
I know I wasn't off on my weight when I told the anesthesiologist, so I know I wasn't dosed wrong, but I woke up twice during the retrieval-which is all of about 15-20 minutes.  My eyes were closed, and I couldn't talk, so all I could do was point to my IV as a way to motion to them that I needed more meds. 
Eventually, I woke up for good, and I heard him report how many eggs were retrieved and I blew him a kiss, or at least I thought I blew him a kiss, he says I gave him a thumbs up.  

I was asked to move to another bed so I could be wheeled into recovery, and there I continued sleeping for 45 minutes.  Standard recovery is 30 minutes, but I needed extra meds, so I took longer to wake up.  And even though I was "awake" I was not at all ready to get up.  At some point, maybe an hour into it, I began having a lot of pain in my abdomen and right leg.  The nurse went up to check with Dr. B that leg pain was normal, and he said it was.  About an hour and a half into it, Dr. B came down and we talked about my pain, and he suggested I eat something, drink something and take Tylenol.  Two hours into recovery, he insisted on sending Dr. Husband to go get percocet from the local pharmacy.  I was adamant I wasn't taking it, but I was almost in tears about the pain. I just couldn't move without pain, so I wasn't sure how I was going to get up and go home. But eventually I just was getting all worked up about it.  Afraid of the pain, afraid of why I was dizzy (I wasn't wearing my contacts) afraid I was going to have a severe case of hyperstimulation, afraid every sensation I felt was blood...and I realized I needed to just get up and go home.  They saved the best for last ;) as I was the last retrieval of the day, so they let Dr. Husband back and he gave me my contacts, and helped me get to the bathroom where once I confirmed I definitely was not bleeding, I felt much better.  


 "Document the journey" 

We headed home, stopping at DD along the way-it was almost 3pm, and I hadn't eating since dinner the night before!  My pain was bearable, but not great and I was kind of groggy.  We got back to Baltimore around 7pm that night.  

Post-retrieval has been hard.  Many people have no complications from the retrieval and walk away just fine-I did my first time.  This time, I almost set a clinic record for recovery time, and I definitely have mild OHSS.  I didn't know what to expect, but my abdomen is retaining a lot of fluid.



It is very uncomfortable-not in a painful way, but just being so bloated hurts!  Yesterday I didn't pee much, but since I did pee, I don't have to panic.  Today I'm peeing a lot of fluid-less bloated, but still the same uncomfortable, if not more.  So far I don't have to be concerned because I'm not gaining a ton of weight (I'm up 5-8lbs) and I can breathe easily.  I'm definitely not moving well, and I'm so glad I cancelled work for Thursday and Friday; this was definitely not an easy recovery.  

I also want to mention, in case anyone is reading this who is going through a retrieval, I had almost no bleeding post retrieval. The pain in the recovery was uterine and in my right leg, however once that subsided a few hours later, it is just uncomfortable distended abdomen feeling.  

I think you've waited long enough to find out how many eggs were retrieved.

Image result for 23 image

"I aspirated every single one of those follicles!" 

Yesterday was the day the eggs were fertilized and I knew I would get a call with my embryology report.  It turns out I missed their call, twice, and by the time I saw, the office was closed; they close early on Thursdays.  I called the answering service, who tried convincing me I didn't really need to talk to anyone.  I really don't love texting Dr. B during work hours, but I did and he wrote me back with my fertilization report:
23 retrieved, 18 mature, 13 fertilized 
In 2009 our fertilization report:
18 retrieved, 16 mature, 15 fertilized

Considering I'll be 30 next month, and our initial guess was 12 at retrieval, we did pretty damn good.  This roller coaster was well worth it for this outcome and I'll find out Monday the final report as we'll know then what developed long enough to be frozen for next month's transfer.  

Until then, don't forget 

I wasn't expecting a call from embryology, but he just called and left me a message that in the end, 14 fertilized and currently 10 are a grade 1: perfect, 3 are a grade 2: average, and 1 is a grade 3: not so good.  He will call me tomorrow with an updated report!

And one more story for the books: Moshe was asking Dr. H why he has to go to NY.  He told Moshe, "because mommy is having a surgery." To which Dovy responded, "No, you also have to go because you have part of the baby inside you that also has to come out!"
Dr. B thought that was "amazing!"

Tuesday, January 17, 2017

Stims: Day 11 and 12 and UPDATE

The past few days have just been a blur!!! So here I sit, on the eve of the retrieval, to fill you in on all of the last nitty gritty details.  

Stims
Friday, Satirday and Sunday I was taking 4 vials of menopur, 75 gonal-f, .4 hcg and 1 cetrotide, and a baby aspirin.  I was instructed to take the letrozol Saturday night only. 
 I ran into a bit of an issue Saturday night because I went out with friends and forgot that I had been taking the cetrotide (to prevent ovulation) around 8pm.  I just figured I'd take it between 10pm-12pm with my stims-except I missed that window by an hour!  It wasn't until Sunday morning that I realized I was 5 hours delayed with the shot that I panicked that was enough of a lapse to allow ovulation to take place.  So, having the wonderful doctor I have, I texted him.  He told me it was probably fine, but I should take the shot at 4pm that day.  Blood work on Monday would be the true determining answer.  

Monday
Monday I had another monitoring appointment with blood and ultrasound.  
"You're ready to go!"  
It seemed surreal, and the details didn't seem to matter anymore because once your in the moment you tend to stop focusing on things that can no longer be controlled or influenced.  So I have no idea what my lining was, what my estrogen levels were, or how many follicles he saw.  We reiterate that my estrogen was too high and the transfer was most definitely canceled.  We talked about what after the retrieval will look like and what prepping for an upcoming FET will entail.  All those details are still to be worked out, but he thinks I'll start lupron 5 days fater the retrieval.  

I left his office knowing retrieval would be Wednesday. but no idea what time or what my instructions for the trigger would be.  I did some questioning today about what exactly the trigger is for, so I want to explain that here as it comes into play later.  In a natural cycle, the final step is a surge of luteinizing hormone.  This step is the final push in egg maturation and begins ovulation of allowing them to be released.  Because an entire cycle is manipulated and re-created, so does this last step-the trigger shot.  At 1am, I took hcg and lupron as my trigger in anticipation of an 11am retrieval tomorrow (Wednesday) morning.  I was determined not to fall asleep before the shot, and it went off without a hitch, thanks to my awesome friend.  


Tuesday
I went for blood work this morning so they could determine the trigger had indeed worked.  I was told that I can't eat or drink after midnight, and I'm supposed to report at 10am for an 11am retrieval.  I also start my antibiotic tonight and then tomorrow after retrieval as instructed.  
You'll only get a call from us if something doesn't look right.
12:15 pm-my phone rings: it's Dr. B.  He just wanted to ask me if I was sure I took the right dose of medicine last night, because my LH was low!  Let me tell you, I have never been more sure than last night that the dosage was correct.  But, I will tell you about my premonition:  one of my friends, and I don't know if she reads this blog or not, but I will use this opportunity to publicly thank her for her endless support and love-and when I say that, I mean her 1am-texts, emotionally-supportive, hand-holding, babysitter-filler stuff.  I wouldn't have made it this far without you, thank you for being such a blessing in my life.  
After she checked in on the 1am shot, I told her I was so worried I messed up the dosage, even though I knew I hadn't.  
I called that one I texted her this afternoon.  
As I said above. the LH is needed for that final push in maturation but to also allow them to be retrieved.  Mine is low, but he thinks my hcg level will compensate for it, and no additional medication can be given at this time.  
I'm not surprised, but we will move forward as planned.  

Insurance
On Monday at my appointment, the financial lady said we were still awaiting approval.  So, we decided to tag team insurance.  We spent about an hour on a conference call in an attempt to determine why authorization was taking so long, and how to move it along.  It was an extremely frustrating experience, and I'm so appreciative of her time and efforts to resolve this issue.  Somehow, when I arrived this morning, she informed me that between a conference call between herself, the secretary who initially requested the approval, and insurance-I had been granted approval.  No one on either side, in any department knows exactly what was happening! 

Side effects 
I had been feeling some bloating, some uncomfortable, dull pain.  My friend had warned me that with the trigger, and impending "ovulation" you feel a shift in the follicles.  It's as if you can feel your body moving the process along.  I woke up much more sore and crampy.  Even tonight, riding home after picking up Doctor Husband, who has made his way to NY, the bumps on the road were painful!  

Retrieval
I am to arrive at 10am tomorrow, for an expected 11am retrieval.  I will be put to sleep using propofol and the entire procedure is an estimated 15 minutes.  An ultrasound is used to guide a needle into the ovaries where the eggs are suctioned out.  You can watch a video HERE about the retrieval process. 

I will update as I can.  You can follow my Instagram and Facebook page for faster updates.  
Let's do this!

Saturday, January 14, 2017

Stims: Day 9 and 10

I'm trying to remain super zen throughout all of this.  It's especially important to remain emotionally detached because this is anything but simple.  
Tonight will be night ELEVEN of stims and I'm not sure how much more my ovaries can take; I now have a constant dull pressure and my tummy is quite sore from all the needles.  
However, monitoring on Friday revealed almost no growth in my follicles since Wednesday.  
Cue: PANIC. 
Apparently ovaries with PCOS can misbehave sometimes and this is normal.  My menopur was increased to 4 vials a night, my hcg was increased to .4 and my gonal-f was lowered to 75, cetrotide remains on board to prevent premature ovulation and letrozol is to be taken as instructed.  
Phew...
Retrieval is still TBD.  

On Wednesday my estrogen was 1,000 and of course on Friday, although we didn't know levels when we sat down to discuss the results, we did know it would be higher.
Officially cancelling my transfer.  
I forgot to ask what that means for a period, and prepping for a FET. I do know that we specifically stimmed how we did in case I would need lupron to prep the following cycle.  

Although I'm ok with this outcome, I'm sad because it's a reminder that things are not going to work out how I thought they would, or that I have control over any of this whatsoever.  
I won't have gotten pregnant shy of one year of TTC, or even 12 months of TTC.  
I'm not sure I shared this with you before.  But my goal is to just be pregnant in a year from now.  And in my heart of hearts, I believe we have a lot longer left in this journey.  

It's interesting how things work out.  On Monday I was told I had not received insurance authorization for the retrieval.  I was instructed to look for a letter from the insurance, since they usually send a letter to the patients before informing the doctor's office.  
No letter.
On Wednesday, I reported to the financial lady at the office that I did not have a letter.  She confirmed that the request for authorization was sent in December 13.  We decided we would both call insurance.  Insurance told me they never received a request for authorization.  The financial lady later informed me that she had proof of insurance correspondence from December 15-yet no approval!  
On Friday, insurance approval still had not been granted.  
I see God's hand here, had my follicles developed as we thought they would, my retrieval very well could have been Monday-leaving me potentially financially responsible for the retrieval.  
But the best part is how rockin' my doctor is.  When I told him I hadn't received insurance approval he looked at me...that's BULLSHIT! I'm not canceling this cycle! I WILL go and get those eggs. 

Well then, the retrieval will go on.


Thursday, January 12, 2017

Stims: Day 7 and 8

Deep breath. 
Wednesday was a loaded day.  
I honestly can say, I don't know how I've made it to this point.  I don't know how I'm so blessed to have Moshe, Dovy, and especially Hannah. 
She's a miracle 
Moshe says.  

Over the past 11 months, we've faced more questions, uncertainty, and heartbreak than ever before.  
I just don't know how I got so lucky to have not experienced any real uncertainty and heartbreak before all of this. 
Let me clarify one thing: yes, we had several failed cycles before Moshe was born, however when you work according to a hierarchy, it's easy to just brush off the failures as due to needing to progress up the ladder so to speak.  And that's what we did, we finally reached the top, IVF, and got pregnant.  
I really thought, a fresh cycle would be the simple answer to the past cycles.  
I thought that statistically, all my good embryos were used first and I just need to replenish to get the "statistical good ones." 
It was easy then, it'll be easy now.

Wednesday showed me once again, I'm fighting an uphill battle.  
 Dr. B's response, upon looking at my chart, was to take off his glasses and cover his face.
The only question I could ask was, "am I in trouble?"
Yes, a little. 

I'll start with the good news.  The good news is there were 16 visible follicles, and I still had another 5-7 day left.  So, the goal of this cycle was to harvest embryos.  We are definitely still on the right track for that, and I'm so grateful. I have seen so many times where women struggle to produce eggs, so I'm so thankful that is not an issue I'm facing.  Obviously egg production doesn't mean anything-they still have to be retrieved, and be mature, and fertilize and grow to day 5.  But at least it seems very, very positive that I'll have a good retrieval.  

However, my estrogen is just so high, and it's only going to get higher as more follicles are produced and grow-which is the priority.  We won't curb the egg production to lower the estrogen-that defeats the current purpose.  So, most likely, I won't be having a transfer this cycle. Everything will get frozen and I'll prep for an FET in February.  I'm also starting letrozol, which is similar to clomid, but I'm not using it for ovulation purposes obviously, I'm using it as a way to help lower the estrogen effect.  Because of my estrogen levels, I'm at risk for ovarian hyper stimulation syndrome which is essentially (at least my understanding) is a hormone imbalance/reaction that leads to a fluid retention.  You can develop OHSS from the stimulation alone, but if a transfer would take place and I would get pregnant and start releasing HCG (the pregnancy hormone) that also adds to the risk of getting OHSS. Dr. B said that my current estrogen levels, combined with a pregnancy, would land me in the hospital.  

The other concern, is that my lining "looks like mush."  It's not receptive for implantation at this point.  This issue is what concerns me the most.  At some point in every cycle we've questioned my uterine lining.  For this reason alone, I'd be willing to push off the transfer. I thought I saw the light at the end of the tunnel, but I think it was just a mirage.  But while I might feel as if I'm surrounded by darkness, I really have a light, a light that shines so brightly, and it's Dr. B.
"We're going to figure it out."

We'll know a lot more tomorrow-when the retrieval is, what my levels look like, and how we'll proceed.  At this point, I'm prepared for us to spend a couple months leveling my hormones and investigated my lining.  

When I first started fertility treatment in 2008, Dr. B told me the first cycle of every "new" step, was always done according to textbook-and then after that cycle, personalized.  
My body has not responded in a textbook fashion this time, "you're definitely not simple." 
This might be a set back, but we're going to work on figuring out my issues, to personalize my care so I can, one day, God willing, welcome our rainbow baby.  

Medication for Day 7: 3 vials of menopur with .5 saline, 100 gonal-f, .3 low dose hcg, cetrotide, and low dose aspirin 
Medication for day 8: 3 vials of menopur, 100 gonal-f, .3 low dose hcg, cetrotide, low dose aspirin, and 1 pill of letrozole

My general bloating has continued, sometimes I feel more uncomfortable than others.  Emotionally, I feel relatively stable.  I've also lost about 5-7 lbs since starting my thyroid medication so that's a big positive!  

Tomorrow, will be another monitoring appointment, and the next steps will be decided!

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Tuesday, January 10, 2017

Stims: Day 6

I first want to say that I truly did mean to double post yesterday!  My goal is not to make this blog solely infertility while I'm in it, but rather maintain somewhat of a normal blog posting schedule as well.  I sat down at my computer with a nice large chunk of time yesterday, and lo and behold, when I was finally going to bed last night I remembered I forgot to post a Monday Munchies.  So, I'll hold onto that yummy recipe until next week. 

Yesterday I reported that I was relatively symptom-less, but later that evening, I began to feel uncomfortably bloated, and that carried on into the night.  I had to prop my pelvis up with a pillow to alleviate the pressure on the area.  Overall, I just feel rather crampy at times. Otherwise, my emotions have been kept in check and I told someone yesterday I'm feeling rather zen about everything.  

Tonight I started my cetrotide to prevent premature ovulation of the follicles I'm developing, and I also have to add a baby aspirin to increase blood flow to my uterus.  I am still on three menopur vials, 100 gonal-f, and .3 low dose hcg.  

I report back tomorrow for more blood and ultrasound, an update will follow of course!  

For those of you that have been around for awhile, I posted during Hannah's pregnancy that I associated a song with her pregnancy.  That song sparked feelings about her, and the pregnancy and how it came out of no where, took us by surprise, but stuck around.  Now, a song has made it's way into my heart that signifies my journey to this point and moving forward.  

Sometimes the world seems against you
The journey may leave a scar
But scars can heal and reveal just
Where you are
The people you love will change you
The things you have learned will guide you
And nothing on earth can silence
The quiet voice still inside you
And when that voice starts to whisper
Moana, you've come so far
Moana, listen
Do you know who you are?


Sometimes the world seems against you
The journey may leave a scar 
Yesterday marked 11 complete months of actively trying to have baby #4.  There has been a lot more negative than positive, and at times I've questioned the whole plan.  

But scars can heal and reveal just where you are
This journey has forced me to dig deep, and face challenges I never dreamed of.  Challenges I wasn't sure I could face, but I did.  

The people you love will change you
I wouldn't be where I am if it weren't for the unwavering support of a couple key people.  
Their love, their hand holding.

The things you have learned will guide you
And all the negatives of the past are being used as positive information to get us to where we need to ultimately get.  

And nothing on earth will silence
The quiet voice still inside you
I have contemplated quitting so many times over the last 11 months; didn't think I could face anymore disappointment.  But I can't silence that voice inside, telling me to push forward. 

And when that voice starts to whisper 
Moana, you've come so far
I'm a completely different person than I was 11 months ago, and despite all the heartbreak, I wouldn't change any of it.  

Moana, listen
Do you know who you are?
I know more who I am now, than I ever have before.  



Monday, January 9, 2017

Stims: Day 3-5

Today is day 5 of stims!
I am so happy to report that I really have been feeling so much better physically since my extra lining was removed on Friday.  No cramping and no weird pains!
I also want to add that the weekend was a nice reprieve from my usual and I found myself having no emotional side effects. I do think many of these emotional reactions are due to any particular situation, so if you're reading this and looking for advice: assess your personal situation and try to see where you might need help, or put a safety in place to prevent an emotional reaction that could otherwise be thwarted.  

Today I went in for a monitoring appointment, and "you have a nice crop growing!"
10 follicles ranging in size from 3-11.5, and since this is just the beginning, we should still see some more pop up.  Although I've said realistically I'm going for two good embryos to transfer, I would really really love to see a similar retrieval response of 18 like last time.  It's not realistic, but it will be interesting to see what happens.  

For the first two nights I was injecting: two menopur vials dissolved in .5 saline, 150 gonal-f, and .3 of the low dose hcg.  Friday-Sunday night I increased to three menopur vials and everything else remained the same.  Tonight I am supposed to take three menopur vials, drop to 100 gonal-f and .3 low dose hcg. Tomorrow night that stays the same, but I add in a cetrotide injection.  That medicine is used to prevent premature ovulation.  I will probably be on that until retrieval.  I want to add that because I outgrew my last chart, and it's not medically relevant since I'm nine years older and the protocols have changed, but I'd love to compare last cycle to this cycle.  Maybe one day I'll ask them nicely to drag it out.  

Right now, the ultrasound showed an almost non-existent uterine lining.  Even though I was cleaned out Friday, it should have still shown some development since then.  Also, because my estrogen was on the high side when the cycle began, he is not able to give me estrogen to stimulate the lining production.  If my lining remains "crappy," then we'll freeze whatever we get from this cycle and I can either do a frozen embryo transfer the next cycle, February, or I can wait however long I want!  He does think it's either a bad image, or with the time we have left, the lining will naturally develop.  However we both agree that our focus right now is just growing follicles and creating good embryos, we'll worry about the rest later.  

I go back for blood work and ultrasound on Wednesday.  

    

Friday, January 6, 2017

Stims: Day 2

I left Baltimore at 5:15 this morning in anticipation of bad traffic due to the night's weather.  However, the roads were just fine, and I hit almost no traffic and arrived the earliest yet!
I had given him the heads up that I would need to have the procedure as planned, so we were able to move quickly.  

The suctioning went well and was over in about a minute, and I was on my way back.
I definitely feel less crampy now, so I wonder if that extra lining had something to do with how I was feeling yesterday.  However, I am still emotional today #stupidhormones 

I am increasing my menopur to three vials, everything else remains the same.  
I go back on Monday for a blood test and ultrasound.


Thursday, January 5, 2017

Stims: Day 1

These next couple of weeks' updates will surely be somewhat repetitive.  And while that doesn't make for the best blog content, it will serve as a journal for me, but also for anyone else now or in the future.  When you're in something, you think you'll forever, but as time goes on, you soon forget.  

Today was my first day post the first stimming injection.  Last time I was on stimms, in 2008, I really do not remember any side effects. I did not gain weight, I was not overly hormonal, I was not uncomfortable...although I'm sure the fact that life was really boring then probably helped keep my emotions at bay.  Now, with three kids, thank God, and a crazy always on the go lifestyle, things get hectic.  
Today, I had a full on meltdown after I dropped my kids off at school. There were just too many tantrums to count by 8:30 this morning.  
Coincidence this happened the day after my first injection?
Maybe...maybe not.

I have also been feeling rather crampy and uncomfortable today.  I never did get my overdue period, so tomorrow it'll be suctioned out.  So, maybe my cramps are from an overdue period? Maybe the hormones made it react? Who knows, but I'm so excited to see what tomorrow's ultrasound shows!  

It is supposed to snow here and in NY tonight, so I'm hoping to get out of here a little earlier than normal so I can get back in time, as Fridays make for a rushed afternoon.  

I'll update when I can!

Wednesday, January 4, 2017

And We're Off!

After weeks of anticipation, stimming for IVF #2 begins tonight!  



Yesterday was my baseline, and I was given my instructions for tonight.  
Of course nothing is ever easy, so here's where we stand now.  

I was on birth control for a cycle; I took my last pill December 30, and I was supposed to get a period. However, in typical fashion, I was actually bleeding for a week while on the pill.  Now that I've stopped the pill, I'm not bleeding. #inserteyeroll #nicejob #mybodyisawesomeandfollowsdirections 
Ok ok, enough with the hashtags.  My body is awesome, of course, and is going to do wonderful things this month!!!  

It was possible for the bleeding episode of last week to have been enough lining that I would be ok without a period this week, but, the ultrasound revealed my uterine lining is 6mm, where it needs to be 3mm.  I was threatened, but I don't think my body really cares, that if I don't start bleeding by Friday, when I return for monitoring, "I'm going in and getting it!" 
I was a little concerned with what that entailed exactly, but when he told me he would go in, just like he does for the biopsies, and suction it out, I actually thought about it and decided that sounded pretty dang awesome.  Who wouldn't want their monthly suctioned out?!? I mean, I would totally pay money for that on a regular basis! No bleeding, no cramping, no tampons, no pads...hello side business? Not for me of course.  
As of now, there's no period in sight, so I'm just anticipating some Friday suctioning.  

Tonight, I take two vials of menopur, 150 of gonal f, and .3 of low dose hcg.  Thankfully, it can all be mixed into one syringe and given as one injection.  
It all seems a little overwhelming, but it's slowly coming back to me. I actually enjoy mixing all the medications, it's kind of fun to feel like a chemist. I've also gotten over my fear of the injections, and as of a few months ago, I give them to myself. 
It's quite liberating.  

Last week, I was having second thoughts about going through with a fresh cycle. Mainly because of the potential to fail.  If this fails now, I don't know what our next step will be and it feels like a lot of pressure is riding on this and that's not a good feeling. I want to go through this month without having expectations for what the result will be, but also what it needs to be.  Although it is possible to walk away from any IVF cycle with no embryos to transfer, that's not a likely option for several reasons: my age, my history, and my husband's history.
I have no reason to think we won't end up with one embryo to transfer.  

And, anticipation is always worse then actually going through the actual anticipated event.  Now that I'm officially in it, there's no backing out now and it feels fine.  I presently don't feel emotionally attached, I don't have any expectations, and I'm just taking it all in.  

And so tonight, it begins.

You can tune in LIVE on Facebook to watch my nightly shots.  Unfortunately, I haven't found a better platform for nightly documentation that allows viewers to watch once recording is finished.  Another unfortunately is I can't Facebook LIVE from the blog Facebook page.  I do plan on recording on a camera as well in hopes of being able to create a documentary of this months journey.  




Monday, January 2, 2017

Monday Munchies...

Is anyone else as confused as I am about what day of the week it is?  Is it Sunday, Monday, Friday? I can't keep track anymore!  But, tomorrow, my kids return to school, and we hope this bug that has been floating around all break long is kicked to the curb! So far there are two people left standing who have not fell victim to this winter crud, so we shall see! Fingers crossed I don't have to take anyone with me to New York tomorrow!  
I'm going to interject that I have been Instagraming LIVE my nightly injections. I think I will switch to the Facebook LIVE because it can be watched as a recorded video, where Instagram cannot.  Feel free to follow my blog Facebook page.  You can also reach out to me with any questions you may have and I'll answer them during the video.  

I know many of us start out 2017 with a food or diet goal, but who can ever forego a classic like pizza?  Although, I have been meaning, for years actually, to try the cauliflower pizza crust-maybe 2017 will be the year!  

Dovy has become a picky eater recently, and on his will not touch list, is sauce.  That makes pizza day challenging at school.  So, I promised him white pizza.  The first time was a huge fail, since I tried to be resourceful and use up leftover cottage cheese, but this recipe has turned into a huge family win.  And to be honest, I have never been a fan of homemade pizza.  It just never quite compares to the real thing, so I don't enjoy it.  I would do make your own pizzas for the kids, but not for me.  This, however, is a true winning recipe and I have, for better or worse, ended up devouring the kids' leftovers.  



White Pizza
1 store bought dough, or individual doughs 
Olive oil
2 cups ricotta-whole or part skim
2 cloves garlic, finely chopped
Handful of flat-leaf parsely, finely chopped 
2 cups shredded mozzarella or provolone 
10 fresh basil leaves, 1/2 cup shredded 

Preaheat your oven to 425 as well as the pizza stone if you plan on using one.  I use the package of three individual pizza crusts, that makes it more kid friendly.  You can find these at your local grocery store.  It also eliminates the hassle of having to work with dough.  But, if you do want to make your own dough, or buy fresh dough, stretch it to size onto your tray or stone.  Use a fork to pierce the dough all over.  

Drizzle olive oil around the crust and then use either the back of a spoon or a pastry brush to spread it around the entire crust.  

Mix the ricotta cheese, garlic and parsley and season with salt and pepper.  If you know me, you know I do not do fresh garlic or herbs.  I'm sure it will add to the taste, but this is delicous enough, and it cuts down on the prep time and the amount of dishes! 

Spread the ricotta mixture across the dough. This can sometimes be challenging because of the oil, which prevents it sometimes from spreading, but just play around with it.  Top with mozzarella or provolone-I use mozzarella.  

Bake for 20 minutes, or until the cheese is browned and top with shredded (or dried) basil.   




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