Showing posts with label doctor. Show all posts
Showing posts with label doctor. Show all posts

Friday, January 14, 2011

The Inseminator

We did an IUI procedure this morning. No one told us that we had to abstain for 24-36 hours before, so D's semen volume was about half of what it should have been ("the other half wasn't wasted," the doctor said.) but the percentage of motile sperm was extraordinary (a fact that D is very proud of), so the doctor said that this made up for the lack of volume. We had to wait 45 minutes while they "washed" the sperm, so because I hadn't done that level of planning, D had to run off to work. I went to get a yogurt from Starbucks as a prophylactic against the impending yeast infection likely to follow the super-dose of doxycycline that I had to take the day before, the day of, and the day after the insemination.

The procedure itself was as uneventful and painless as all of the online information I read described it to be. The doctor used "the inseminator," (package pictured above) which was a syringe with a flexible catheter attached. She used a speculum, and then urged the catheter up through the cervix, which she said was "hiding." (They say that about my left ovary sometimes, too. Weird.) She told me as she was inserted the washed and concentrated sperm, and then she turned out the lights and told me to take a little nap for about 20 minutes. But my mind was racing and I started worrying about whether the seepage was D's sperm saying "oh, no you didn't!" and rushing back out because they didn't like the egg for some reason. I wanted to jump up from the table and ask someone, but I stayed still--if not calm. Then I started worrying about whether they'd forget me in there, and the fact that I had to get to a meeting by noon (it was already at least 1030 am). I spun the computer screen that was in reach towards me and it appeared to be 10:50, so I figured I would give them ten minutes to come and get me before I got up and got dressed. No one came to get me, so I just got myself ready and on my way out, I asked about the seepage and was assured that it was completely normal. (I didn't believe it, though, so googled it as soon as I could. It's fine.)

So, I don't want to jinx anything, but I have to say, if we're not successful this month, I have a list of things to remember from next:

1. Have sex 36 hours before the IUI so that the sperm is fresh, but abundant.

2. Build in enough time for the partner to be there.

3. Take your iPhone to the table so you can time how long you've been laying there, and have something to distract you with (maybe even update Facebook while laying on the table).

4. Take the day of the IUI off so you don't have to rush back to work.

5. If you do rush back to work, make sure you don't jump on the train going the wrong way, start reading, and not realize that you're in Queens until you're like, halfway into Queens half an hour before your meeting starts.

Thursday, January 13, 2011

Intrauterine Attempt #1

Tomorrow morning we're off to the doctor to give D's little guys some direction. When I went for my check-up yesterday, the doctor told me that I had one really good follicle that will absolutely produce one good egg. She said we'd be ready on Friday morning. D had to give me the trigger shot (obtaining the medication is a whole nother story that I'll deal with in a separate entry) at 9 pm on Wednesday.

My insurance company covers at least three intrauterine insemination attempts (IUIs). Tomorrow begins another two week wait. I should have sushi tomorrow night.

The latest worry: a friend telling me that the quality of a woman's eggs at this age can mean that if assisted fertilization and implantation actually does happen, a less-than-perfect egg can produce a child with flaws. I harbor no illusions that my possible future child will be perfect; no one is. But to intentionally create a less-than-perfect infant....gives me pause. I gotta find more information about that.

Wednesday, December 1, 2010

Processing my Blood

So now I wait. I went to the doctor's this morning for a blood test, and the phlegbotomist asked if I had done a home pregnancy test. I haven't. The blood test is the most accurate at this stage, so I don't want to get my hopes up with a false positive, or my hopes dashed with a false negative. I'd rather be on pins and needles until 2 pm when I am supposed to get a call from the doctor's office. Somehow I thought the news would be immediate; apparently they have to process my blood. When I called D from the lobby to tell him we'd get the news at 2 pm, he sounded terrified when he answered the phone. This is another one of those moments where I feel like I'm standing on a giant precipice waiting for the world to change.

Monday, November 29, 2010

False Alarm Every Ten Minutes

They call it the "TWW" or "two week wait" at the fertility clinic and on the online fertility sites. I'm not a very patient person, but this is really trying whatever patience I do have. Because of the progesterone vaginal inserts that I have to take, I'm a little oozy . . . that ooziness feels like I'm getting my period. So every ten minutes or so, I have the feeling that I've gotten my period, and so far, it's just been progesterone ooze.

I guess I could cut down on this false alarm phenomenon by taking the progesterone at night like I'm supposed to, but I find it unappealing to have sex with the progesterone insert in for an hour (precisely because of ooziness), which is what the blogsters out there suggest. My doctor said to insert the progesterone pill AFTER having sex -- this was his answer, after receiving an anxious text from me asking if we could have sex at all for the 21 days I am using the inserts -- but I like to fall blissfully asleep after sex, so the idea of having to go in and put the insert in after sex was not appealing.

At any rate, my period should have come yesterday, today, or tomorrow (depending on what online calendar you use). I have a doctor's appointment Wednesday morning for a pregnancy test, so all I can do until then is try to resist running to the bathroom every ten minutes to check.

My heart sinks, and then it's happy . . . but no matter, I have to keep reminding myself that this was the first month of this type of intervention and it isn't necessarily going to be successful.

What's funny is how similar this "false alarm" feeling is to a "false alarm" feeling when you DON'T want to be pregnant . . . the waiting for the period to come.

New York Magazine had a really interesting story this month called "Waking Up From the Pill: Fifty years ago, birth-control pills gave women control of their bodies, while making it easy to forget their basic biology—until in some cases, it’s too late." I found the article to be perfectly relevant to what I'm dealing with now. Like this passage:

Now many New York women have shifted their attempts at conception back about ten years. And the experience of trying to get pregnant at that age amounts to a new stage in women’s lives, a kind of second adolescence. For many, this passage into childbearing—a Gail Sheehy–esque one, with its own secrets and rituals—is as fraught a time as the one before was carefree.

Suddenly, one anxiety—Am I pregnant?—is replaced by another: Can I get pregnant? The days of gobbling down the Pill and running out to CVS at 3 a.m. for a pregnancy test recede in the distance, replaced by a new set of obsessions. The Pill didn’t create the field of infertility medicine, but it turned it into an enormous industry. Inadvertently, indirectly, infertility has become the Pill’s primary side effect.
One of my colleagues in the women's rights/reproductive rights field thought that the article blamed the pill too much for women postponing childbearing, but I don't think that was the point of the article at all. What the pill did, I think the article argues, is relieve women of having to think so much about their reproductive capabilities. Like the author explains:

. . . [W]omen are half-consciously rebelling against the artificiality of the Pill’s regime. Removal from one’s true biological processes was more appealing in the Mad Men era, when machines were going to save the world and pills could fix everything, even the ennui of housewives. But for the wheatgrass-and-yoga generation, there’s something about taking a pill every day that’s insulting to one’s sense of self, as an accomplished, adult woman. “I feel like I’ve gotten a message over the years that the less I have to do with the nitty-gritty biological stuff of being a woman, the better, and that’s a weird message,” says Sophia, 35, who was on the Pill for fourteen years. “In my ninth-grade health class, I remember the teacher saying, ‘You can get pregnant any day of the month, so always use protection,’ and I kind of knew that wasn’t true, but because I was on the Pill, I never really cared about finding out the right answer. The Pill takes a certain knowledge away from you, and that knowledge is empowering.”

And, in fact, what I think the article argues for, although I think it could have done so more thoughtfully, is that women should be made aware of ALL of the risks and implications of taking the pill. I am constantly surprised at how much I don't know about my own body: blame it on inadequate sex education in school or at home, whatever. The fact is, before taking a drug that prevents conception, we should really understand conception altogether, and at least for me, I know I didn't. Of course I knew that waiting too long would make it more difficult to get pregnant, but I like the fact that the author talks about how easy it is to hit the "off switch" on fertility for a while with the pill, and not have to think about your body so much.

To arrive at the stage when one stops taking the Pill and starts timing one’s ovulations is to enter a new and anxious universe. After that, if you’re unlucky, you may enter a kind of medical and bureaucratic purgatory of doctors’ waiting rooms and insurance companies and worries that’s very far indeed from the freedom you enjoyed before.

On the Pill, it’s easy to forget the truths about biology. Specifically, that as much as athleticism or taut cheekbones are, fertility is a gift of youth. The body that you wake up with after fifteen or more years on the Pill is, in significant ways, not the one you started out with.

The notion of "choice" and "sexual freedom" in this discussion of the pill was also fascinating. The author talks about how NARAL and Planned Parenthood and other "choice" groups don't want there to be any public discussion about the relationship between the pill and infertility. It may be true that, as my colleague suggests, that the article overdoes it by actually insinuating that a "side effect" of the Pill is infertility ("Inadvertently, indirectly, infertility has become the Pill’s primary side effect."), I do believe that choice groups don't want to talk about how these issues intersect. As the author explains:

[I]ronically, this most basic of women’s issues is one that traditional feminism has a very hard time processing—the notion that this freedom might have a cost is thought to be so dangerous it shouldn’t be mentioned.

. . .

Sexual freedom is a fantastic thing, worth paying a lot for. But it’s not anti-feminist to want to be clearer about exactly what is being paid. Anger, regret, repeated miscarriages, the financial strain of assisted reproductive technologies, and the inevitable damage to careers and relationships in one’s thirties and forties that all this involve deserve to be weighed and discussed. The next stage in feminism, in fact, may be to come to terms, without guilt trips or defensiveness, with issues like this.

Choice is a more accurate word when the chooser—us—is aware of all the possible consequences of taking different possible paths. But reality has a hard time getting into these areas, let alone the Brave New World of infertility medicine.

Wednesday, November 17, 2010

Drugs

A few weeks ago, I started getting a series of calls from Cigna saying that I had ordered some drugs and where did I want them delivered. I'm like: "what drugs? I didn't order drugs! Put me on your 'do not call' list." Then I find out that the drugs my doctor prescribed were supposed to be delivered to me, and Cigna was calling me to confirm delivery address and get my credit card number for the copay. Fed Ex next day delivery to my office the next day allowed me to start this course of treatment this month. Thank you Fed Ex. Except one more problem: they didn't send the pre-filled syringe of hCG that they were going to--the shot that releases the eggs. Apparently it's a controlled substance and they only fill it upon a written scrip. So I call the doctor back, and they say that Cigna is notorious for this kind of screw-up; of course they mailed the scrip. Cigna just always loses them. So I ask to speak to the doctor to see if I can figure out whether the rest of the drugs (the clomid, the ones pictured here) will boost my chances enough so that I can risk maybe not doing the shot this month, or whether the hCG shot works in tandem with the rest of the drugs such that I should fork over the $90 out-of-pocket expense. The doctor's assistant got back on the phone after about 15 minutes and said that the doctor just happened to have an extra shot in the office and they'd administer it for free. Bingo. So, off to the doctor I go again, shot in the butt, and I'm off. Doctor advised us to make love that night, and then again Friday morning. (The math is just crazy: shot releases the eggs in 40 hours; sperm lives for 72 hours; egg lives for 12-24 hours unfertilized; sperm takes 30 minutes to reach an existing egg...) Unfortunately, I was so exhausted from work and running around all week that I just could not muster the energy for seduction. Thankfully, D knew what he had to do, and while it didn't work out that night, he dutifully performed the next morning. We were prescribed one more try on Friday morning (several hours after the eggs are supposed to have been released), and I've already arranged to go into work a little late, so we're cool. Pregnancy test on December 1, and if we're not successful, we try again in December. It's super exhausting to deal with all of this, but I feel like we're taking the right steps.

Thursday, November 4, 2010

Offbeat Mama

I just read an amazing blogpost on Offbeat Mama. The founder of Offbeat Bride, the book and accompanying social networking site that helped me keep my sanity during our year-long wedding planning process, started Offbeat Mama, right around the time of our wedding last May. I check back every now and then to see if she creates a feature, like the Waiting Room on the Offbeat Bride Tribe website, for women who are trying to get pregnant. I don't think she did (yet), but I did find this post, by Ariel, the founder herself. She introduces her own story of problems conceiving with a video by a woman who poses a series of "what if" questions...questions that have been swirling around in my mind about infertility for the past year. I have been searching for something to read, something that I could identify with, around all of this for the longest time. My husband is so certain that it will all work out in the end, he insists on speaking in terms of "whens" as opposed to "ifs." Ariel's story was poignant, and scary . . . I hope I only have to go partway through the course of action she had to take in order to become pregnant. But I've already gone farther than I thought I would in order to conceive.

Two parts of Ariel's post particularly resonated with me:

the weight of the trying and failing got heavier and heavier. After a year of trying to conceive, it's not so much fun. It's depressing. It starts to mess with your head. I started feeling like a core part of my body had become an untrustworthy stranger. A breech of trust with your own body is emotionally brutal.

And this one, which describes so many things in my life about which I've harbored fear and loathing:

IVF was this terrible awful procedure that I'd invested a lot of fear in. It just didn't fit with my identity — who's heard of offbeat infertility? Offbeat IVF? Pshaw. It was the expensive invasive terror that desperate people indulged themselves in. It was like gambling: this thing that you keep tossing money at hoping that this time you'll win but ultimately the house always wins and you always lose. Of course you lose. It makes you crazy, and worst part? It doesn't even work most of the time.

. . .

What I want to say is this: I was wrong. I invested years of my life living in fear, seeing something (in this case Western fertility treatments and especially IVF) as the awful boogey man in my hippie closet, the terrible admission of defeat that would forever turn me into a person I hated myself for being. Ultimately, I was wrong. This makes me wonder ... what other massive fears of mine are completely unfounded? What other things that I see as the worst WORST case scenario could actually lead me to a place of profound happiness? What other paralyzing grief and fear could I release?

Wednesday, August 11, 2010

WTF.

So I had the HSG test on July 28, where they shot radiation goo through my innards to see what was goin on all up in there (everything was all clear!) and I leaked for like a day and a half. I did ovulation tests every day since then (19 days now) and no freakin' LH surge. WTF. They say that this HSG test has a chance of resulting a smoother journey for the sperm, so there are some women who get pregnant after the HSG test. Well, we didn't take advantage of this extra boost this month, unfortunately. We should be doing it like bunnies right now, but instead, I waited for a positive LH test, and heat, exhaustion, and other diversions kept us from the job at hand and the LH surge never came. I totally don't understand it, and I am getting very frustrated with how little I know about reproduction, and how little it actually out there in a coherent, public way about conception. July-August was a bust. My doctor says not to worry, try again next month, but I feel really stupid. Not only did I waste a huge amount of money on these ovulation tests which were all negative, we also kept getting ready for the right moment to have sex, which never came. I am going to have to try to plan for less stress this coming month and just get myself ready for sex 24-7.

Friday, July 23, 2010

"No Sex Allowed"

I had an appointment with my OB/GYN today who did an ultrasound to check my innards and see if there was anything to be concerned about. He also wrote out a "prescription" for my husband to get his semen analyzed, and a referral to a radiology diagnostic center for me to get that HSG test next Wednesday.

Things I Didn't Know Before Today
1. That I wouldn't be able to have sex between now and when they shoot the dye up into my body
2. That there would be some "dye leakage" and bleeding after the HSG
3. That they would recommend a mild pain reliever before the procedure
4. That I have a small, tiny 2 cm cyst on my left ovary (doctor says not to be concerned about it at all)

Things I Still Don't Know
1. How they're going to go about getting semen from my husband (will a nurse named Vanka or some such be "assisting"? Will pornography be involved?)
2. How badly will the HSG hurt during and aftewards?
3. What color is the dye they'll use? Will I be leaking neon green all day?

Kitten update: Two nights ago at a dinner with friends, my husband said for the first time affirmatively that we are getting a kitten! We've made plans to go and pick her up next Tuesday. Yay!

UPDATE:
1. My husband was able to "produce" at home and bring the sample in.
2. The HSG didn't hurt even a speck. I felt like I had metal in my mouth all day, though.
3. The dye was clear; lots of leakage, but it was all invisible.

Monday, July 19, 2010

Hysterosalping-o-what??

Hysteria After a tumultuous weekend, I feel like a stereotypical woman who, at the turn of the century, was diagnosed with hysteria. I got my period early Sunday morning and completely freaked out. My reaction to finding out our July attempt was not successful was very different from last month--I was totally sad, blamed my partner for not trying hard enough and being not as concerned as me, and I was angry about everything: I was angry that he was on the conputer playing video games, angry that he wasn't helping me around the house, and angry at everything he did. I should have been put down with a horse anesthetic.

Dictionary.com defines hysterical this way:

hys·ter·i·cal

   [hi-ster-i-kuhl] Show IPA
–adjective
1. of, pertaining to, or characterized by hysteria.
2. uncontrollably emotional.
3. irrational from fear, emotion, or an emotional shock.
4. causing hysteria.
5. suffering from or subject to hysteria.
6. causing unrestrained laughter; very funny: Oh, that joke is hysterical!


Origin:
1605–15; < L hysteric ( us ) hysteric + -al1

1610s, from L. hystericus "of the womb," from Gk. hysterikos "of the womb, suffering in the womb," from hystera "womb" (see uterus). Originally defined as a neurotic condition peculiar to women and thought to be caused by a dysfunction of the uterus.

He didn't deserve my ire; and I shouldn't have let myself go off the deep end either.

Take steps; take charge. That's what I did on Monday morning.

I made my annual OB/GYN appointment and asked about a procedure called a
hysterosalpingogram that a friend recently told me about. Dye is inserted into the uterus and fallopian tubes to determine if the passages are clear; and apparently, there is a slight increase in fertility after the procedure. I want it. My doctor called me back and told me that since we'd only been trying really on the right schedule for two months that he wouldn't immediately advise me to do it. He suggested waiting for two more months, sending D off for sperm analysis, and being persistent. And patience. He didn't recommend patience, but I think patience is in order. Even though I feel the clock is ticking.....

On the kitten front: D's friend brought over our one-eyed kitten to see if she got along with our existing cat. Things seemed to go well. Kitty Coco (the one-eyed one) will have her sutures taken out next week, and then, if I can get D to agree, we will bring her home.

Tuesday, July 14, 2009

Preconception Planning

So today D and I went for a "preconception planning" appointment with an OB/GYN. I visited this doctor in a pinch two years ago (he's right downstairs from my primary care physician), and as I was thinking about this whole project, I remembered how good natured and gentle he was. I was a little nervous about asking D to go with me--he sounded so scared when I called him to tell him about the appointment! He's a good egg, though: agreed to go to the appointment and was good natured and supportive the whole time. The big surprise was how nervous *I* was. It was like: oh my god, we're actually thinking about doing this!

Initially, I didn't remember the doctor's name, so I just googled "OB/GYN" and my PCP's address and voila! When I found his name, I also found that he had a website: http://www.drovitsh.com/biography.php After I got my hopes up about how great it would be to have this doctor provide my prenatal care, I was certain that he wouldn't be in my insurance network. I called my insurance company and the rep put me on hold while he searched to see if Dr. Ovitsch was in my network of providers, and my head began to spin. I thought about how hard it is to find a doctor you like, and had my first experience of feeling tied to a decision and tensing up realizing that I need to let stuff go or I'll drive myself crazy. My elation was palpable when they told me he was" in network" and there would be no problem. After a huge sigh of relief, I took a moment to remind myself how lucky I am to have health insurance. When I called and was easily able to get an appointment within two weeks, I reminded myself how incredibly lucky I am that the one doctor I went to and liked is so easily accessible and in my insurance network.

I made the appointment because we both had some questions that were making us nervous--I asked about how difficult he thought it might be for us to conceive at this age (I'm 41) and about whether he anticipated any problems because I am overweight. Neither thing seemed to concern him too much, he said he had plenty of patients who are my age or older and had no trouble conceiving or having an uncomplicated pregnancy. And as for my weight, he asked if I was active (I am) and told us that I should keep that up throughout the pregnancy. He started to suggest a nutritionist, but then D and I explained how healthy we eat (see my other blog: http://mysticgypsypickles.blogspot.com) and he seemed impressed. He said that I could gain between 15-30 pounds during pregnancy, but that I should realize that I shouldn't worry about nutrients getting to the baby if I eat healthy. In other words, I don't have to "eat for two" as they say! The most reassuring thing he said was that I wasn't carrying enough extra weight for him to be concerned; and that breastfeeding might help with losing the extra weight I will gain if I become pregnant.

Of course he asked if I was taking folic acid, and I told him about my multivitamin which has 100% folic acid. He said that was fine. He suggested that I might want to buy a home ovulation meter or something, but I think I can read my body pretty well. Plus, it's not like we're only going to have sex when I'm ovulating for god's sake! He told me to go get a panel of blood tests on the third day of my next menstrual cycle to test for estrogen levels and some other things that will tell him how easily I might be able to conceive. He also suggested trying for three cycles (fun!) and if there's no luck, I should come back and he can talk with me about hormones and some other tricks to boost the chances of conception. I'm not sure about all that--I've always thought that if it doesn't happen, it's not meant to be...don't fool around with nature. But I'll cross that bridge when I get to it.

All in all, it was a good appointment. I think we both left feeling a little bit more comfortable with this decision. I didn't raise one big question that I had: whether he would be supportive of us planning a home birth. That's another bridge we'll cross when we get to it--and another blog post altogether!

Uh oh, though--in keeping with the title of the blog, this visit cost me a $5 copay. The first expense of the project. I gotta start a spreadsheet.