Thursday, July 25, 2013

What to do when your baby dies

I seem to be wanting to go back in time to the days after I lost Adrian.  It was January 2, 2009.  I have saved my therapy sessions on tape and was listening to them today.  I don't know what has triggered this wanting to go back in time, but I suspect it was related to a recent EMDR session. The session was not even related to my pregnancy or baby loss history, it was about something totally unrelated, but every time my psychologist let me travel in my head to some time in the past, I ended up thinking about Adrian, and what was, and what could have been, and particularly what was not to be.

If I were to go back in time and talk to myself as I was in January 2009, this is what I would be saying, more or less:

You have just lost your baby, whom you loved so much.  It is very, very hard.   You are suffering not just from the physical loss, but also from a huge, raw, dark grief, on top of the trauma of the delivery, and it is all excruciatingly painful.  Take your time, don't rush the process.  The first week is very hard. You will want to isolate yourself, to keep apart from society, and that is ok.  You will have a lot of periods of numbness, and then raw grief.  The numbness is normal, and it is an adaptive response, don't worry about it.  It will help you get up in the morning and maybe brush your teeth.  The grief is what is lying underneath that numbness, and it will bubble up to the surface sometimes.  Let it all happen.  Just take very good care of yourself, as best as you can, by keeping warm, trying to eat something, connecting with someone you trust who was with you through this whole thing (for me, my husband).  Notice when you feel more still and peaceful, and try to do more of whatever brought that feeling on (for me, it was looking at pictures of birds on Flickr, knitting hats, and going for a walk in the snow).

Don't take personally the things that your loved ones say out of grief, it is their grief speaking and not their wisest self.

Two weeks later, perhaps things will be a bit better.  Perhaps you will be better able to think about what you will do next, about trying again, about going back to work, about life after death.  For now, however, and in particular today, at this very moment, you don't have to think about it.  Just focus on healing and being kind to yourself.

I deliberately wrote this in the second person because I am thinking that it might come in handy to someone going through this difficult trial now or in the future.  It might even come in handy to me sometime in the future, when another grief-ladden moment awaits, as they do for all of us.

I feel a bit better able to look through the past up to now, and appreciate how much time heals.  I am, however, still amazed by how much grief I am still carrying and am not aware of, almost ever.  Therapy or suppression, what is the answer to this one?

Sunday, July 21, 2013

3 great iPhotos







Wednesday, July 17, 2013

going forward

I have phoned the new IVF clinic yesteday, and spoke to my old fertility doctor, the one that got me pregnant with Adrian and with Emma.  He said that there was better data to support the synarel/estrogen/progesterone protocol rather than the natural cycle for the frozen embryo transfers.  That is not what the doctor who just did my recent FET said.  She said the data is better for the natural cycles. 

Crazy, I know.  I am trusting my old doctor through hell and high water though, so I decided to move my one remaining embryo in his hands at the new clinic that just opened.  This is somewhat exciting, in particular because he said that the one remaining embryo is "not that bad".  I am also having an antral follicle count and bloodwork to prepare for a pending fresh cycle if the one remaining embryo does not stick.

I am moving forward.  We have decided to have another baby, and honestly, that is what I think will happen.  I am optimistic overall, but just drained to the bone by the process. 

I have gained a total of 6 lb in this frozen cycle, and did not end up taking any drugs.  It is all probably due to stress and emotional eating.  Eating mindlessly.  Not paying attention when I am full because I am thinking of pregnancies.  Whenever I eat this way, I gain weight very quickly.  I am starting to (hopefully) reverse the trend.

I went back to exercising, both running and swimming.  Before this FET, I could run 5 km daily (3miles), now I need to stop somewhere after 3.5 km (2 miles) and take a short break, then go on to complete the 5 km (and then collapse :).  My speed is not as good either, and I cannot fathom running 8 km like I did the day before the transfer.  I am tired and frankly not as motivated, but I am making myself go on as I don't want to lose the fitness that I fought tooth and nail to gain, in between surgeries, IVF treatments, pregnancies, etc.

As far as the swimming, somewhat bad results as well:  I am about 10 -15 sec slower for each 200 m sprint, which in swimming is a fair bit of time.  However, from my previous experience, I tend to improve quite quickly if I swim three times a week or so.  To make things worse, I have developped an otitis externa as well, and am reluctant to go back to the pool until it heals.

In summary, I have a plan, but I am very anxious about everything related to IVF.  As for my fittness, I have lost some, but will likely gain it back quickly if I keep up with the running and the swimming.  At this point in time, I have a feeling that it is the most important thing in keeping me sane.  The exercise, and my beautiful family.

Monday, July 15, 2013

post IVF depression

I was not expecting that I feel so depressed after this cycle.  I went into the FET transfers thinking that they probably won't work, and so was not prepared for this dissapointment.  I think that the brief positive was a huge surge of happiness and then losing it was a big blow.

I don't know if it is the rollercoaster of emotions or if it is the fact that doing IVF again I feel taken back in time to the pre-Emma days, but I am envelopped by the same darkness that I was in back then.  The only difference is that now it does not last long, and that I can easily still get out of it and enjoy my days.  However, if there is nothing to do and I am bored, I revert to my worried, anxious, hypercalculating and hyperruminating mind. 

I don't know what my subconscious is plotting and scheming, but I am amazed by how easily I can be thrown off into depression again.  I knew that my mind was not the sturdy elephant that I was hoping it would be, but I was not expecting that I be so down, disoriented and worried again about life, the future, what to do, my next move, etc.

I am going to have the next transfer of the 4BC embryo (i.e. pretty crap) during this cycle coming up.  I am now CD 3.  Because my prior cycle was only 25 days long, I have requested some luteal support with progesterone this time.  I feel that I should have requested it with the prior cycle as well, but now it is too late to dwell on this. 

I miss my old fertility doctor, the one that got me pregnant so many times.  He has moved to a new fertility centre, and I am going to be moving there as well.  I just wanted to finish off the frozen transfers at the old centre where the embryos were, because to move the embryos is a bit of a logistic nightmare and costs 500$. 

During my visit to Vancouver for this upcoming transfer, I have booked an appointment for an antral follicle count.  I have just done the bloodwork for CD 3 that is required to see my FSH.  My hysteroscopy is pretty up to date.  If the frozen cycle in August does not work, I should be good to start a fresh cycle in September.  I am worried about that as well, but I am happy about a fresh cycle, as they did give me the best results so far.  Not to mention that the frozen embryos from nowadays are much better preserved than they were three years ago when I last had a fresh cycle.

Anyway, that's where I am at.  Caught between two clinics, a frozen cycle going on and a fresh cycle pending, anxious and worried, but still infinitely better and stronger than I have ever been going through fertility treatments before.  Secondary infertility is nowhere near the heart wrenching pain of primary infertility, for me and for now anyway.

Thursday, July 11, 2013

Line is gone

So sad :(

I don't know if it is because I have eaten too much watermelon yesterday, or if it is that the implantation did not happen properly, but the line is gone today.  I am living on pins and needles.
The only thing that helps me stay in a good mood (relatively speaking) is my work, my husband and particularly my baby, who is so beautiful and so sweet.

Even if I never have another baby again, I am still so happy and fullfilled.  And that is what I am going to focus on.

Wednesday, July 10, 2013

IVF recommendations

Did you guys see this study?

I am one of those women.  I drink coffee once a day, IVF or not.  I gave it up for the first seven transfers or so, then decided I had enough and started drinking it again, and guess what, I had Emma.   And I drank coffee up to my delivery day.  I also exercise within reason with all of my IVF cycles, but avoid running during the stim cycles.  For this cycle I ran up to the day before embryo transfer, when I did an 8 km run, the longest of the week.  I was told not to swim for two weeks, but the truth is I believe in my heart of hearts that this is bogus and that I should be allowed to swim already, I mean it's not like I get a vagina full of water every time I get into the pool.  The doctor said to me she also thought it was overkill, and we both agreed that 2 days is likely enough, but as she told me, in IVF, the tradition is to ask patients to abstain from swimming and baths for two weeks, so there we go.

I never did any bed rest with the transfers, although I did take it easy on those days.  I don't believe in bed rest. 

It seems harmless enough to ask women to refrain from x, y and z during IVF cycles, thinking that it cannot harm and it might help, but without research to back it up, or even without sound scientific thinking behind these requirements, I get a bit skeptical.  I mean, did they research this swimming topic?  Why don't we tell women no baths for two weeks after insertion of an IUD, a much more invasive procedure than an embryo transfer?  None of my friends who had IUDs inserted were given any kind of restrictions for more than two days after the procedure.

And no, it is not just-for-one-month-so-suck-it-up kind of thing either.  For me, who has had nine transfers so far, we are talking about nine months, i.e. almost one year, of limitations.  Plus the months of IUI related madness (12 of those), in which no running was allowed either.  That is almost two years of my life in which I was to behave as an old lady with a broken hip.

There was one study about exercise in the five years prior to IVF leading to decreased success, but how exactly does that translate into decreased success if I exercise the days before a FET cycle?  A blanket statement such as "take it easy, just to be sure" is a bit irritating.  Why not state the facts, which include the "we have no idea" element?

Need the macro lens


A second line.  4dp5dt. 

May the games begin. 

Tuesday, July 9, 2013

waiting, waiting, 3dp5dt

I am not very normal and am continuing to pee on expensive sticks every day.  Today, I have actually wasted two of them.  The one in the morning really had nothing.  The one in the afternoon also had nothing but I was starting to imagine a pink line that came and went as the sun's light got stronger, however when I looked at it a few hours later there was nothing, so I am calling it a negative.

For some reason I am so certain that this embryo will stick that I am looking at the tests expecting to see a line, not waiting to see if one appears.  I am wondering why the line is not there already, although with my mind I know that 3dp5dt is too early, I have convinced myself that I am pregnant so I am looking for the second line as if it should be there.

I don't believe that optimism or pessimism bring on a certain result when it comes to getting pregnant.  I also don't believe in the law of attraction in this case either (or in any other case).  I am a realist at heart, and hence tend to see things in a mostly worried and negative light.  So for me to be so positive this time is a funny thing.

Monday, July 8, 2013

did I just do that?

Did I just pee on a stick two days after transfer?  Yes, it looks like it.  Was it me or someone else taking over my brain again?  I don't think the embryo has even had time to hatch out of its shell by now, but I just have a hard time not doing the thing that I am most compulsive about during the two week wait:  peeing on very expensive little sticks. (It does look like I was able to hold off a bit longer than last time though...

Don't even ask what the result was.  Even after looking at the window for a FULL HOUR afterwards and studying every little imperfection, imagining lines all over the place, turning it 180 degrees and then 90 more degrees, varying the amount and intensity and colour of light, trying one eye, then the other eye, then my grandmother's glasses, then opening the test and taking out the window strip and scratching it with my nail vertically I cannot say that I saw anything worthy of notice.

Who thinks I am going to make it through tomorrow without peeing on another one?

Transfer day July 6

On Saturday I woke up for the transfer and decided that I should try to get some acupuncture done to help things along.  The transfer was scheduled for 9:15 am.  I woke up at 8 and drank some water for the full bladder requirement, then called the acupuncture place listed on the website for my clinic, and got the on call person that agreed to have a session before and after.  It was very tight timing, but it went well, and I enjoyed the before session, but especially the after session, which helped a lot with my uterine cramping.

The clinic had me change and the embryologist showed me a picture of the embryo to be transferred, a 4AA expanding blastocyst that had been frozen, and had shrunk a little bit as a result, but looked amazing.  Emma's transfer was a 4AB and a 4CC.  I am guessing that Emma was the 4AB.  So, aside from the fact that this cycle was a "natural cycle", hence counting on my own hormones entirely to do their job, this cycle is remarkably similar to my previous one.  Aside from the fact that the transfer was very worried me how much cramping I had.  I don't know if it is because of the cerclage being different in feel from the previous cerclage, or if it has to do with the doctor's skill.  Anyway, I am hoping that it will go well.  I drove to the acupuncturist right afterwards and he did some laser treatment of a point just below my right knee, and the cramping stopped right away.  It was quite amazing.  I am probably going to have acupuncture in the future if I ever need to have another IVF, and will probably chose the same place, as they seemed professional and specialized in IVF related acupuncture.

In the meantime, I have (and still do) worried a lot whether I made the right choices all along: having this embryo transfer at the old clinic, when my old doctor had transferred to another clinic (but their lab is not open yet, and I was in a hurry), and having this cycle go "natural" instead of medicated.  Can I trust my body not to screw up this luteal phase?  (Because the truth is, although my body and I, we coped well through a lot of crap and are best buddies now, we still have our moments of mistrust).

This morning I woke up to a bit of cramping and worried that I would start bleeding any moment now. I did not.  It was probably my irritable bowel giving me mixed messages.  Throughout the day today I have been having the feeling of a "busy pelvis" as alittlepregnant calls it.  Let's hope for the best.

I won't be testing until the weekend.  This time I am much more at peace with the outcome.  I am more at peace because my little strawberry baby girl is sleeping right next to me as I type this, and being her mommy is enough reason for me to live a full life.  I would love another baby just as much, and I am so excited when I allow myself to think of a pregnancy, and a delivery, and a name for...

Better get a grip on it before it gets out of hand.

Monday, July 1, 2013

LH surge, finally

This morning I woke up bright and early and went to have my ultrasound.  The lining is 9.3 mm thick and no longer trilaminar, which usually indicates that the LH surge has happened.  There was no corpus luteum visible, and the doctor thought that it probably collapsed.  I used one of the OPK kits on the second morning urine and it was an unmistakable positive.  Hence, my transfer is scheduled for this Saturday morning.

There was, however, some scar tissue on the ultrasound, visible along the lower third of the uterine body.  I don't think that it will be a problem, at least that is what the OB said when he did my last hysteroscopy in March.  I was nervous that the transfer would be difficult, so I asked for a mock transfer, and I got one done today with no problems.  I am such a control freak!

Let us hope for the best.  I am continuing to swim and will probably run a bit tomorrow, up to the time of embryo transfer, then I might only swim and not run until the pregnancy test.  Or I might do nothing.  The doctor does not think that the exercise that I do currently (3 mile run three or so times a week, and 1 km swim three times a week) is too much, or that it will interfere with anything.  However, just to play it safe, I am probably going to give up the running, which is a bit of a bummer, since I am training for a 10 km run in mid September.  Hehe, I guess if I get pregnant then I can skip it and not feel bad...

ovulation frustration kits

I think this is a good moment to express just how I feel about the ovulation predictor kits out there in the pharmacy.  I am doing a natural cycle, ie. I get to track the LH surge with ovulation kits, and then have one ultrasound to check the lining (tomorrow morning) followed by transfer six days after the LH surge.

Sounds simple, on paper.

I went to buy an OPK at the pharmacy, and got a digital Clear Blue.  I am not a big fan of digital anything, but they did not have the analog ones, so digital it was.  I used the first one on cycle day 10, and I will spare you the details of how exactly I have urinated on it for five seconds, but for some reason, instead of a smiley face or a blank circle, I got an error message.  Having wasted my preciously held urine (did you know you have to hold your bladder for four hours prior to peeing on one, and no fluids for the last 2 hours allowed either, in the middle of freakin' summer), I was back to square one.

I held it again for three more hours (the waterworks, that is) and, feeling smarter by the minute, decided to collect the urine in a cup and use the second method of "dip it in for 15 seconds" as outlined in the pamphlet.  Ditto.  Got another error message.  Dumped the urine and did it again, four hours later.  By now it was night, I got a negative (finally) and practically collapsed in exhaustion after not drinking and holding my urine for so long.

The next day, I got a smiley face (positive) on the first morning urine.  Deciding that, although the test pamphlet does not forbid using the first morning urine, it was probably a bad idea to use, I thought I should double check it by using another test kit from some other place.  Hopefully not a digital one.

I went to the first pharmacy available in Salt Spring Island, where I was at the moment.  It is a hippy type of island, and the first pharmacy was an integrative healing pharmacy.  They had all sorts of herbal and "natural" remedies, but alas no OPK's.  The second pharmacy did, and they were the old style First Response where you get to look at two lines and decide whether yours was darker than the control line.  Love those.  Peed on one at first sight, in the pharmacy's washroom, and got a big fat negative.  Huh?  Am I or am I not ovulating?  that is the question.  Not to mention that now I was comparing two different brands, introducing another element of instability in the madness.

Two out of three tests seems always best, so I did another test three hours later, from the First Response batch as well.  (Have I mentioned that they cost 16$ each?).  The last one DID NOT WORK!  I got no control line, no test line, nothing.  It was blank like a piece of cardboard.  So I had to do a fourth one ($$$$) and got another negative.

My conclusions at the end of cycle day 11 are as follows:
1.  Out of six opk sticks, three gave me an error. Two of the ClearBlue, one of the First Response.
2.  Out of the three that did give me a result, one said yes, two said no.  On the same day, within four hours of each other.  Which one is wrong? Who knows...

Tomorrow I am going for my ultrasound for lining thickness, and I am going to ask for a blood test to detect the LH surge.  Blood is thicker than urine.  And that concludes cycle day 11.