Soooo sleepy but still managed to dodge a few balls

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Today I started the letrozole. 2 teeny 2.5mg tablets a day for five days. This small prescription should result in ‘super ovulation’; hopefully this should stimulate development of multiple follicles and eggs being released, therefore increasing the chances of pregnancy. The nurse provided me with an info sheet and described some of the side effects. The only strange feeling I had today was sudden extreme tiredness, when I was driving!! That was very bizarre, so much so I almost skipped dodgeball this evening. I checked the pharmacists long list of side effects, tiredness was on there. But so was almost every other side effect known to man! Has anyone had this with letrozole too?

Although I was glad I got out the house, I wish I had skipped dodgeball. whilst playing I pulled a tendon in my thigh. It kills! Being on letrozole means that I can only really take Tylenol as a pain killer (which I have none of in the house! Doh!). So it’s going to be an uncomfortable nights sleep. Why can’t I be sleepy now???!!!

I wasn’t sure how much my prescription was going to cost, but the nurse showed me a good website www.goodrx.com that gives you coupons for prescriptions. She told me I should pay no more than $10 for the letrozole. So I printed the coupon and discovered my insurance covers it, and I payed just 0.26c for it. I’m so happy!!!

These ten pills can cost over $150 :-s but if you find a coupon they can be about $15

These ten pills can cost over $150 :-s but if you find a coupon they can be about $15

Mild Insurance Panic!

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This evening I was helping Chris with filing his taxes and was searching through our medical paperwork.  I pulled out our insurance policy booklet and flicked through it to read about infertility treatment coverage.  I already knew we were 100% covered, but what I caught sight of was that we needed prior approval for certain procedures – such as IUI! Whoops…!!

We are learning a lot about medical insurance, policies, bills, coverage, approval, pharmacies – the lot!  But there is so much to keep tabs of that I am not used to.  This was one of them.

After mildly panicking that I had screwed up, I called up my insurance company, and phew, I discovered that I did not need prior approval for this.  Panic over.  These insurance booklets can be very confusing.  Especially when our insurance is worldwide cover, so depending on which country you are in, depends on the process. Grrrrrrr.  However, I am entirely grateful that I do have amazing insurance.

I appreciate the NHS – I really do, particularly when it comes to the complicated billing system we have here.  However, if we were in the UK right now things would be different.  NHS guidelines used to be that IUI treatment was offered on the NHS if:

However, new guidelines released in 2013 state that IUI is no longer offered in these circumstances. Instead, we would probably have been advised to keep trying to conceive through regular unprotected sexual intercourse for a total of two years. Only after this time we may be offered in vitro fertilisation (IVF).  So if we were in the UK right now we would be 10 months and counting, then going straight to IVF.  That would be pretty scary.  I’m kind of glad we are where we are right now in the US!!

It can all get a little confusing sometimes

It can all get a little confusing sometimes

IUI beginnings & Chocolate Pudding

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Last night my period started, a day earlier than expected.  I cried with Chris.  He is so good at helping me see the brighter side of life.  But this only really meant one thing for us – we are going to start IUI.  Everything I have read about is now becoming real.  I had already picked up the Letrozole last week.  It didn’t seem real then because there was still a chance I wouldn’t need to take it. Now it is real.  I start the Letrozole on Thursday for five days.  I have scheduled in my first ultrasound for Friday 13th.  Talk about an ominous date.   I guess the rest will happen as it happens…

In the mean time, I’m going to chill out here with my chocolate pudding and try to forget about all of this.  Well until Thursday at least.

Sporting activities during the two week wait – stupid to do it or stupid to not do it?

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Day 12 of the two week wait – and on day 11 I did something which might be stupid.

Chris and I are both keep active and we like to try new sports.  Here is a list of sports we have done over the last few years or so…

  • Rock climbing
  • Hiking
  • Skiing & Snowboarding
  • Yoga
  • Insanity exercise programme
  • P90X3 exercise programme
  • Dodgeball
  • Volleyball
  • Softball

SAM_0997Our favourite sport is anything which involves being outdoors – particularly if it is quiet and remote (much to my mother’s horror!).  We have had discussions about whether or not putting myself at risk from a big fall on a climb was worth it, and we decided to give climbing a break and spend more of our free time travelling to cities and taking the opportunity to do some siteseeing around Virginia.

We have missed climbing a lot over the last year.  We also skipped a couple of ski trips last year too, similarly, not wanting to put myself into a risky situation with a big fall.  But after the last year we looked back and realised that you can’t put your life on hold just because you are trying to conceive.  Although I didn’t wrap myself in cotton wool during the two week wait, I was very conscious about doing something silly in case I was pregnant.

So this weekend we headed west on a ski trip with a few friends.  I decided to ski the easier runs and not put myself in potential danger on the black runs this time round.  This was so much fun, I was in my element, enjoying being outside on the mountain.  The second day, Chris and I decided we would keep going with our lessons to learn each other’s sport.  I took a snow board lesson (my third one) and Chris took a ski lesson.

As I am a beginner on a board I knew I would be sticking to the bunny slopes – little chance of big falls here!  Perhaps a few bruises and bit of hurt pride, but other than that – safe as houses.  This was all until the very last run of the day.  I had two lessons that day, and suddenly snow boarding began to click (hooray! at last!!!!).  Well…..so I thought!  I felt comfortable picking up some speed (but not quite as fast as I ski, so I know what stupidly fast is), and as I came into the flat, I caught an edge and landed heavily on my backside – I was winded.  When Chris hurried over to me, I could barely breathe.  I cried.  I cried because it was such a stupid thing for me to do.  Also, my stomach and back was writhing with pain.  I can deal with bruises – but my abdomen just throbbed like hell, as if I had been punched in the stomach.

I know it is highly unlikely that this fall could cause a failed pregnancy this time – but why would I risk it for my selfish desire to do these dangerous sports??!!  When you try to look at other people’s experiences with these sports, I have not found consistent guidance on whether they should be avoided completely.  The only common guidance I found was to seek advice from your doctor, I suppose because each individual is different.  And this is exactly what I shall do next time I see her.  But I have read that after IUI, strenuous exercise should be avoided, so this could be a mute point if this month is a failure and we proceed with IUI next month.

When I am pregnant then I want to keep doing as much as is thought to be reasonable.  But what is reasonable?  I like this lady’s story about rock climbing when she was pregnant: Anonymous mom – I was a pregnant rock climber (www.mommyish.com) She talks about how she felt during her pregnancy and how people made hurtful comments (unintentionally sometimes).  You have to be a strong person to do this.  I’m not sure I can.

I found two books which I have seen a good few reviews about, these are going on my to read list:

Exercising Through Pregnancy by Dr James Clapp

Fit & Healthy Pregnancy: How to stay strong and in shape for you and your baby by Kristina Pinto

Into the two week wait with a little help

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I am on cycle day 19 and 5 days past ovulation.  I think.  I think, because this month I decided not to do any tracking.  I am now regretting this!!

Today has been particularly hard.  This morning after I went to the toilet, I discovered a spot of blood.  I came out of the bathroom beaming at Chris.  I think I might have been a bit optimistic that this was bleeding from implantation.  The rest of the day I have had abdominal pains, and I am now sat here with a hot water bottle, still in pain.  I’ll see how tomorrow goes.

But today got me thinking about the two week wait.  At first they were exciting, and nerve wracking, but recently I have been so busy that I hardly noticed them except for a couple of days before my period was ‘due’.  Today I found this article, which I will attempt to critique from my personal perspective:

9 ways to make the two week wait a little more bearable By Catherine Pearson.

Here’s what Catherine suggests:

1.  Step away from the computer.  Yup, this is what I talked about in my blog post yesterday.  Today I certainly felt a little bit of heightened anxiety looking at some other blogs and articles about implantation bleeding.  When I am done with the blog I will do just that!

2.  Distract, distract, distract (and plan for it).  Usually I do have a distraction – my study for an online course, but I skipped this month’s module because of Christmas holidays.  We have started watching a new TV series – The Americans (love this!), so this has been a great distraction.  However tonight Chris is out doing some photography, and I can’t watch the next episode without him!!! With nothing good on TV, I have failed at distracting myself this evening.  I must be more proactive about distractions next time from cycle day 1.

3.  Write it down.  I’m doing that write now!!! Do I get bonus points for writing about writing it down??!

4.  Name your feelings.  I’ve never tried this.  So today, my feeling is ‘Anxiety’. I want to learn more about meditation techniques.  A few months ago I downloaded an app called ‘Breathe‘ to help me learn some guided techniques.  It has been brilliant at helping me to get to sleep when I have had work going around and around in my mind.

Defining my feeling - I am anxious

Naming  my feelings – I am anxious

5.  Stroll.  Sleep.  Take care of yourself.  Chris and I have started doing more p90x3 in the mornings, getting up earlier, but going to bed much earlier.  So I think this is another tick in the box.  But as of tomorrow, I will make myself go out for a walk at lunch times whilst at work.  I have been bad at this because it has been so cold recently.

6.  Give yourself sad days.  I have done this and treated myself to a monthly glass of wine.  I only recently started to do this because I had given up alcohol almost completely for about 9 months.  A little glass on the first day of my period can’t hurt as a treat.  Chris is also great to talk to, but actually he gets more sad than I do sometimes.  Our partners need these sad days too.

7.  Try an intention.  I do this at yoga classes when I go.  I haven’t been for a while, so I might try and schedule in a few more classes during this time.

8.  Practice a relaxation technique.  I learned breathing techniques at yoga class, and strangely enough, at a presentation skills course.  Thinking about your happy place and connecting it to a sensory point has helped me stay calm before big presentations.  Combining that with deep breathing is an awesome feeling.

9.  Try defensive pessimism.  This is a new one for me as I am usually a glass half full kind of girl, but a little less so recently.  I will try to work on the defensive perspective.

Thank you Catherine Pearson for your article, some great ideas I will put some into practice starting tomorrow.

Infertility Tests – wands, needles & fishy dye

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I scheduled my initial round of infertility tests as soon as I could, but due to work commitments and travel back to the UK for Christmas the tests ran over two more cycles.  Over December 14 and January 15 I had a vaginal ultrasound, cycle day 3 blood work and HSG.  Chris booked his sperm analysis in January.

Vaginal Ultrasound. An ultrasound wand was placed in my vagina to check if I had follicles in my ovaries.  And I had many!  The ultrasound also showed that I was just about to ovulate from my left ovary (which is the ovulation pain I had been feeling earlier that day – it’s nice to know that I can tell which ovary I am ovulating from!!).  The doctor confirmed everything looked healthy and normal. Woohoooo!

Cycle Day 3 blood work.  I was horrified at the amount of boxes that had been ticked on the blood paper work….I calculated at least 4 vials of blood.  I am not good with needles.  I cannot bear to look at them without feeling faint.  Just before I deployed to Iraq I had to ensure all my vaccinations were up to date (all four million of them).  The army nurse asked me how I wasDani thought with needles.  I replied ‘not particularly good’.  He said ‘well now is the time to overcome your fear, I’ll tell you when you can look away’, and then immediately proceeded to jab me four times, after he just laughed, ‘see?  I told you would overcome your fear!’.  I walked away dizzy and attempted to find the toilet to be sick.  I also have donated blood once, and passed out after giving 1/2 a pint.  Apparently even when I voluntarily want to give my blood away my body won’t let me!  This time, for these particular blood tests, the nurse was lovely (despite him coming to the conclusion that I ultimately kill people for a living), he put me at ease straight away.

A big difference between the UK and the US, is that here in the US it is possible to get your blood test results online before your doctor sees them and discusses what they actually mean.  I am not a doctor and I can barely pronounce the name of the tests, so using the internet to help me decipher the results was a TERRIBLE idea!  In the UK you call up your doctor and then a receptionist will tell you if the results were normal or you need to book an appointment.  I am not sure which way round I prefer!!  Anyway, my results were normal.

Hysterosalpingogram also known as a HSG.  I’m not sure any human being would want to have this test performed out of choice. This procedure is where dye is injected through the vagina into the uterus and by using x-rays to see if the fallopian tubes are blocked. I was given an information sheet about the procedure, I felt prepared, and took the 800mg of Ibuprofen as prescribed an hour before.  My friend accompanied me as it recommended that you have someone drive you home afterwards. I am very pleased she was there with me, I couldn’t have gone it alone.

I was a bit nervous, naturally, but it wasn’t until the nurse asked me ‘Are you familiar with the procedure?’, I said, ‘yes, I read up’.  The nurse looked a little worried ‘uhoh you haven’t been reading the internet have you?’.  Now that part made me nervous!  I had not thought to look up the procedure online because the info sheet given to me was sufficiently detailed.

The procedure was very uncomfortable, and painful at parts, it felt like my insides were on fire and I had immediate cramping.  I could just about see the screen with the x-rays on it and could make out that my tubes were flowing freely.  Great news!!!! But the doctor asked me ‘did you know you have a retroverted uterus‘? Nope, no I did not know that.  Well everyday is a school day after all.   The only question I had on my mind at that point, was  what does all of these results really mean?  What will Chris’s results be?  I felt sad and guilty that Chris would be feeling more pressure about his sperm analysis.

Google – Jekyll & Hyde?  After my final test, I went home intrigued, and googled “HSG”.  I am so glad I did not read any forums before going for this procedure, there are some sad and terrifying stories out there.  The nurse was right to look so worried.  A lesson was certainly learned here – I’m going to  keep trusting in the people I am paying lots of money for to look after me.  Maybe I’m being naive, but google isn’t always your friend.

Diagnosis – Taking The First Steps

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When do we seek help?

The typical time to see a doctor when you are concerned about infertility is after a year of TTC (Trying To Conceive) if you are under the age of 36.  Both Chris and I are 32, we had discussed when we would seek advice, which was of course as per the guidelines suggests.  But ten months in, Chris had a new doctor’s routine physical where he explained our dream of becoming parents.  The doctor recommended a routine blood work up; this is when we found out that Chris’s testosterone levels were very low.  And so as our doctor provided a suggested specialist fertility clinic.

In the UK, things may have gone a little differently.  We probably would have had to wait a year and at least one minute to be able to get any tests unless we had symptoms.

Research….research….research

So after a serious amount of research, including finance checking, we made an appointment with the Jones Institute for Reproductive Medicine – this organisation was the pioneers of IVF.  We took the first appointment we could get, and so after 11 months of TTC we were taking the first steps towards a diagnosis.  This was pretty scary.  I was in denial, I really did not want to go to the appointment.  Chris was eager, with his testosterone levels being so low, I understood why it was important for him.  Within the last eleven months we had experienced twelve of the dreaded two week waits.   (Those two week waits deserve a whole blog on their own, so I won’t talk about them right now.)  I can have a very short cycle of 22 days so we were able to pack a few extra chances in 🙂

A bad history with doctors

Why was I so nervous?  Well my history with the doctors in the UK is not a great one.  I spent several years in my early twenties making numerous trips to the doctors to diagnose the cause of my sharp, random, abdominal pains, painfully heavy periods and diarrhea.  After many tests ruling out anything serious, my doctor concluded that my pain was either IBS (Irritable Bowel Syndrome) or Endometriosis.  To diagnose Endometriosis I would require a laparoscopy – the last resort – and not a favoured diagnosis method for someone so young.  Therefore, she recommended I first try an exclusion diet to rule out foods that might cause the pain.  After four weeks of experimenting with my diet I discovered a notable correlation between my pain and eating potatoes, wheat and acidic type fruits such as pineapple.  The pain also got worse with stress a notable IBS symptom.  There is no test you can take to diagnose whether you have IBS or not.  But it fitted my symptoms and so I tried many treatments.  My IBS was very bad at university – I had spent two days out the field training with the Army, eating the Army freeze dried ration packs (packed with potatoes and wheat!!!), this plus a particularly stressful moment tipped me over the edge, the pain was so excruciating I passed out and woke up in hospital.  When I told the hospital I had IBS, they discharged me immediately with no further questions.  And since then I have managed my IBS through diet (and recognise that stress is likely to be a bad day for me!!).

So why do I not like the doctors?  My experience with doctors in the UK has always been one of a feeling that I am wasting their time.  I have yet had the opportunity to experience them here in the US as I have in the UK.  So far so good…..the major difference is that I am paying a lot of money for the doctor here in the US and I have a choice, but in the UK it was ‘free’, and beggars can’t be choosers (although much has changed in the NHS over the recent years, there is more choice available now)!

Our first appointment with the Fertility Clinic

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I can tell you that I felt sick to the stomach about going to our first appointment together, I must have gone to the toilet at least three times in the hour before.  I knew it was a ridiculous feeling to be having, but this time I had Chris to hold my hand with me, and after discussing the first steps with our new doctor, it wasn’t all so bad.  In fact, I left with a feeling of huge relief.

The beginning? Or the beginning of the end?

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Is this pPathost the beginning of my hunt?  No.  But it feels a little bit like the start. This is my first blog post, and the first time I am sharing with the world that we are on the hunt for the pudding club.  But this is by no means the true beginning of our journey.

Our journey began a long time ago.  It started in 2011 with a trip to the Dolomites, Italy, where Chris romantically  proposed to me at the top of a mountain.  He proposed 2 hours into the start of our four day hike into the remote mountains.  A very risky proposal considering I had been giving him signals that I was not interested in getting married (mis-read signals, I will add!).  It could have been an awkward four days if I had turned his proposal down.  But it was after accepting his proposal on this four day trip, that we spent quality time discussing our future together.  As you can imagine over four days in the wilderness, it was many hours of discussion.  But it was clear that we had similar dreams, goals and desires in life.  Including having children.  I think this was the true start of our journey, our hunt.

We married in 2012 and moved to Virginia USA in 2013.  I had my birth control IUD removed in 2012, but the real deciding moment to make our family bigger was in December 2013.  This was the defining moment when we realised we were on the right path, and this was our greatest dream.  Life since then, for us both, has been amazing, and blessed in many ways.  Our journey has been beautiful, but it is getting tiring.  I am a glass half full type of girl, and recently my glass has been looking a little half empty.

Last week our doctor diagnosed us with ‘unexplained infertility’.  This was a huge relief to both of us.  We have no serious ailments preventing a natural conception.   However, this is a diagnosis given to almost 30% of infertility cases and often all this means is that there is some other unknown cause of infertility.  Pinpointing exactly the cause is very difficult for medical professionals.  The art of conception is an amazing feat of nature.  So the doctor recommended that we focus on treatment rather than causes.  Chris jumped straight in – when can we start?  The answer, was right away.

So is this the real beginning of our journey? Actually, this blog post is the beginning of our journey, for what I hope is the start of my glass returning to being half full.  Maybe the hunt will be over next month, and this is actually the beginning of the end.  But the turns keep coming at us, and so our journey continues for now….