The dreaded 2WW and being away from home

April 14, 2015April 14, 20156 Comments

Beautiful Bavaria

I’m almost halfway through my 2 Week Wait (2WW). I am currently in another country across the other side of the pond for a work trip. Despite the beautiful location in deep Bavaria and being kept busy with work all week, I am finding this a very different type of 2WW to any of the others. Being away from home and the 6 hour time difference has made it hard – on both of us I think – just to talk about things and how each of us is doing. A break from talking about Trying to Conceive, IUI and other baby making related stuff has been refreshing I will admit. BUT as I continue to have random pains, and thoughts of what is to be this time next week, I really miss Chris. Yes, of course, I miss him whenever I go away for work trips, but this time is harder. This time it is make or break.

With this being our third IUI, this time next week we will either be preparing to be proud parents (and not knowing if it is twins yet!!!) or preparing for a long journey on some other new path that we haven’t talked much about yet. Woah – scary stuff whatever happens.

As I am currently teaching 36 international students (mostly male, of varying age and backgrounds!) it is very difficult to hide any of the side effects I am having whilst I am ‘up on stage’ in front of everyone. Mostly trying to hide behind the lectern from the sharp pains I am experiencing!! Ordinarily after my day at work I would talk to Chris about these kinds of things. So I am talking to you all instead, sorry about that 😉

These pains suck, and I think that they may potentially be getting worse that I am going to have to ask the doctor about it next time. I really hope I don’t get what happened in my last cycle where I was doubled over in the supermarket, people watching and wondering if I was OK, debating whether I should go to an emergency doctor or not! I know that if anyone here sees me do that they would make a big fuss instantly, then I would have to explain it. Fingers crossed that cycle was just a one off.

Count down to make or break T-8 days……scary.

Irritable Bowel Syndrome and Trying to Conceive

April 12, 2015April 12, 20156 Comments

I have Irritable Bowel Syndrome (IBS). It is a relatively common disorder of the gut. The weird thing about IBS is that no one really quite knows what causes it exactly. Symptoms are variable depending on the nature of the IBS. For me, I suffer from abdominal pain and diarrheoa. I’ve had it since I was a late teen. But I don’t really remember when it truly started, but it got worse at university. There is no cure for IBS, only treatment of the symptoms. Approximately 1 in 5 people will suffer from IBS in their lives, some may never realise they have it. Symptoms vary on scale and nature and is slightly more common in women than men.

I am writing about IBS because last night as I boarded the plane for my transatlantic flight and experienced an awkward situation. As I sat down the family next to me asked if I could switch seats with their son (about 13yrs old) so they could all sit next to each other. Sure I said, no problem, I don’t mind moving a row back! But then they pointed to the dreaded in centre seat. I had specifically booked an aisle seat because I go to the toilet a lot. And as this was a red eye flight I would not do well sitting here, I would have asked the person next to me to move at least 10 times so I could go to the toilet. I looked at the boy, realised he was 13 and thought he would be perfectly fine there, plus one of his parents could always sit on their own if they were worried about him. So I politely declined to switch seats and told them of my predicament to be near the toilet. But then the mother told me she couldn’t swap because she had a fear of flying. Yes I felt guilty, but I was very willing to swap with anyone in an aisle seat. Eventually a nice lady the other side of the plane volunteered to sit in the boys seat so I could sit in her aisle seat. But it just reminded me of the hidden side of IBS, even though I told the family my reasoning, they seemed pretty pissed at me. They didn’t understand. I know of people with IBS who have disabled toilet keys because when it is bad, it is very bad!! I don’t have this extreme requirement, but IBS is a hidden disability.

I self manage my symptoms. I know that stress makes it worse, and eating certain foods such as potatoes and pineapple can give me killer cramps and half a night on the toilet. I have simply learned to avoid certain foods or when I have a craving, give in and just expect it and manage it when it happens, I prefer it that way rather than take drugs. I tried a lot of things at university to relieve the symptoms, but ultimately cutting out the stress seemed to work the best.

In order to diagnose IBS the doctor will put you through a series of tests to rule out something more serious, like Chron’s disease, cancer of the ovaries or coeliac disease. These are tested usually with blood and stool tests. For me, the doctor said that there was a possibility of having endometriosis, which can only be detected through a laporoscopy. But before doing this invasive procedure she wanted me to try an exclusion diet to see if there were certain foods that increased the symptoms. After several weeks of hunger, cravings and a very large shopping bill, we figured that IBS was likely. So I never had a laporoscopy to rule out endometriosis. My current Reproductive Endocrinologist has suggested there is a chance I do have endo, but a laporoscopy can do more harm than good to my fertility if it is just a little bit of endo. I find it strange that I have no definite diagnosis whether I have one, the other or both conditions.

As I get further into my two week wait and I get pains even a couple of days after IUI, I wonder are they IBS pains? Or are they related to the IUI and the progesterone? What has IBS got to do with infertility? Well I didn’t think there was much of a linkage, but as always google shows you something interesting. There were two interesting conclusions that came out of my, albeit brief, search, in general the research is pretty thin on the ground.

There is no evidence to suggest IBS causes infertility. A couple of sites discuss this and conclude that there is no evidence of a linkage.

IBS increases risk of miscarriage and ectopic pregnancy. A research study* looked at 100 000 women who became pregnant during the period 1990 to 2008. Of these 100 000 women 6% suffered a miscarriage, which is considered to be the ‘normal’ statistic. Of these 100 000 women, 26 000 women were diagnosed with IBS. Of these women diagnosed with IBS, 7.5% lost their babies. That is a significant difference, increasing the risk of miscarriage for women with IBS by 30%. It should be noted that IBS is linked with other disorders which are also potentially linked to miscarriage, for example chronic fatigue syndrome and fibromyalgia, therefore it is not wholly conclusive evidence. The authors wanted to stress that the chance of miscarriage was still small, and that they wanted to highlight the need for more research into IBS and fertility. I have not been able to find anything more up to date than this report from 2012. Maybe they are still researching it…maybe no one carried it forward. But I think it definitely deserves some more attention.

*Increased Risk of Miscarriage and Ectopic Pregnancy Among Women With Irritable Bowel Syndrome, Khashan, Ali S. et al. Clinical Gastroenterology and Hepatology , Volume 10 , Issue 8 , 902 – 909

Injecting in the car park…not your average day!

April 11, 201512 Comments

I never finished my story of ‘Don’t panic Mr Mainwaring‘. Not long after I wrote my blog post, Chris called me back. He could not make it home to give me my injection because he had a meeting in less than an hour. Rather begrudgingly I agreed to meet him at his work for him to administer the Ovidrel I needed. Just as I was leaving,Chris called me again. He had read my blog post and felt guilty, so was going to come home. But I missed his call as I got in the car, so at his work it was to be! Unfortunately, his work place does not have any ‘private’ meeting rooms we could use, they are all glass walled, so we decided to just do it in the car park (AKA parking lot for my American friends).

Yup, this is where it was going to go down! I got out of the car and handed him the equipment. He could tell I was in a grump; I said I didn’t want to talk about it, rather to just get it over and done with. I held up my shirt so he could wipe my belly down with an antiseptic wipe, he got the air bubbles out of the pre-filled needle, took the cap off, and whilst I squeezed my belly, he injected the needle into me subcutaneously. He didn’t even count this time, I just held my breathe, closed my eyes and didn’t move until he told me it was over. He threw away the needle in the mini bio-hazard bin that the pharmacy had provided me with. And that was it….within seconds I felt dizzy, as usual. I sat back down in my car, I didn’t think driving to work would be a good idea for a little while. Chris went back to work, and so I sat there in my car eating the sour jelly beans I had brought along as a treat to myself. These were the only things holding back the tears. I think it is actually impossible to cry whilst stuffing your face with jelly beans.

I was upset at myself for being so pathetic! Why couldn’t I have just done the injection myself? I was psychologically torturing myself. I hope that is the last time I ever have to do it, otherwise next time I am going to have to get the nurse to coach me through it. All you ladies that have managed to inject yourself – kudos to you. Kudos.

IUI round 3-AKA third time lucky

April 8, 201516 Comments

Today we went for IUI round 3. It’s Cycle Day 12 and I’m feeling the ovulation pains. My body basal temperature jumped almost a whole degree and my Ovulation Predictor dip stick was dark, verging on positive.

I’m pretty confident today is the day my eggs will release.

Chris’s sperm stats were excellent again. 61.2 million motile sperm. Good job Mr F!

We had another new doctor do the Insemination procedure today I’ve seen a total of 5 different doctors so far, if we were playing doctor bingo I’d be doing quite well to date!

Our new doctors had a med student in tow. We are at a clinic based at a medical college so this is to be expected and is the second time I’ve had one observing. Chris grilled the med student about what his dreams and aspirations were as an OBGYN and pointed out how lucky he was to be part of this moment of creating a baby. I kept telling Chris to stop making me laugh because I thought the speculum might pop out and ruin the procedure! It was funny though, the poor student didn’t know what he was letting himself in for sitting in on our appointment!

So another positive looking IUI procedure done, fingers crossed this one does what it’s meant to do.

Don’t panic Mr Mainwaring!

April 7, 2015April 7, 20151 Comment

You know how I said third time round means I must be expert on IUI and I felt at ease with this round of treatment? Well today is Cycle Day 11, everything had been going to plan so far…..But this morning I had my CD11 Ultrasound to check how my follicles are doing. (By the way, you know you are in serious business when they send my actual doctor to do the ultrasound – they were obviously sending in the big guns for round 3! It was good to see her.) Back to my follicles, they are looking good. I have two maturing, one in the left ovary and other in the right. Both are 22mm – perfectly sized! My doctor commented on how good my uterine lining was – 7mm. She pondered on why the eggs hadn’t wanted to make a home in this nice uterus already! She knows all the right things to say 🙂 I told her that I thought I was about to ovulate in the next 24hrs because this morning I had a 0.53 degree drop in my body basal temperature and my Ovulation Predictor Kit came up with an almost positive line. She thinks I will probably surge on my own, but I should take the Ovidrel shot, just in case. But this would mean I would have to take the shot now for an IUI procedure tomorrow pm (Weds). OK….sounded good! Just one problem – I’ve got to go home, get the shot out of the fridge to bring back to room temperature – and I’m going to have to do this thing alone! Oh and I’m supposed to be back at work too. Cue panic attack.

I furiously attempt to call Chris to see if he can come home to give the shot, because I really don’t want to have to give myself a shot for the first time under pressure. Chris must be busy. So here I am, sat here with my Ovidrel shot warming up next to me, whilst I wait for Chris to call me back. I’m freaking now because it’s either do it myself or nothing. And nothing is not a valid option. You’d have thought stabbing myself with a needle is a very small price to pay to have this chance of having a baby and my logic would take over my fear. But no logic does not dictate in this case. Come on Chris! Call me back!!!!!

For those of you who have not heard of the ‘saying/quote’ “Don’t Panic Mr Mainwaring”, here is a little video excerpt….

Infertility Awareness: Sharing our Journey

April 4, 2015April 4, 20158 Comments

It’s national infertility awareness week soon, 19-25 April 2015. The theme is “You’re not alone”. There is a blogging challenge under this theme which I have been thinking about writing. I asked Chris if he thought it would be a good idea for us to write a joint blog post under this theme and post it onto our personal facebook pages. After all, it is the making people aware of infertility week – how better to make people aware than to share our journey so far? But Chris quickly pointed out that this would be too much to share. We would get more questions like, “Any news?”, we would be asked about our troubles at times when we just don’t feel like talking about it, we would also get the unintentional insensitive thoughts, ideas and suggestions (a great post about this “Pardon me whilst I burst into flame” I re-blogged here).

This all makes me so sad. Sad because I feel like we should make people more aware of the statistics (how common it is), the hidden suffering, the variety, complexity of infertility problems and the many options/choices of treatment.

Our journey is getting a bit rocky

The infertility journey is a rocky wild path, that will throw all types of extreme weather at us, it’s physically exhausting and mentally draining. We know the peak is high, we may come across false summits. Some of us may fall down, some of us may find shortcuts (we always hope to find shortcuts!) and sometimes the path simply becomes longer and windier than we ever imagined. We can ask directions from the experts along the way, they help us to see the path as a gentle winding pleasant route, but they can rarely help when nature creates that avalanche and cuts you off. If we have our friends with us, they can help us round and scale the new challenges that pop up…they don’t need to be there all the time, they can relay it up the mountain with us, but surely we are better off not going it alone?

In some ways this journey reminds me of the play we saw last year, K2. This is a story of two climbers who scale K2 but come across difficulties in their climb, death is near as they fight for survival together. The two contemplate the meaning of life, family, friends, God and our existential existence. Ultimately, if there had been at least one other person with them, they all may have survived. Is our infertility journey like this? If there were more than the two of us, if we fall, will it be easier to get up and keep going? Movies often portray climbers that find themselves like the K2 scenario as egotistical and selfish. But climbers are misunderstood, climbing is more than adrenaline or ego, big climbs are often an exercise of self examination, a chance to get away from the daily grind. I am not saying that in this case infertility sufferers are like climbers. But what I do wonder, is that we similarly are misunderstood. We are misunderstood because no one knows we are out here on our journeys. Should we make more people aware? How can we do this?

We are out here on this journey because the top is going to be beautiful, it will be worth it in the end, worth the financial burden, the mental exhaustion, the physical pain. I’ve heard it is amazing up there. I just don’t want to be alone. But I’m not sure we are ready to invite everyone to join us on our journey just yet.

Top of the world

Work in Progress…ARTApp

April 3, 2015April 3, 20154 Comments

I successfully completed another module in my Data Science course! Woohoo!! Eight modules down, one to go. Now I have one week off of study, then onto the home straight. I can’t wait to finish it.

Part of my final project was to develop an online web App; I decided to develop an App that uses the data provided by the CDC on Assisted Reproductive Technology and presents the data in more user friendly way. I bit off more than I could chew for this project because the data the CDC provides is a bit messy and required some cleaning up in order that I could manipulate it easily. Now I have ‘cleaned’ the data, I need to spend a bit more time making the visualisation useful. I got 100% for my project so I passed with flying colours, but I have a lot more to do before I share it with a wider online community. You can have a sneak preview!

You can see my ARTapp here. It was supposed to look a bit more like this…

Screen shot of my ARTApp so far

My idea is that someone can select a state they are interested in, it shows all the fertility clinics in that given state, then the user can select a fertility statistic they are interested in comparing their clinic against the state wide average. There is also a map of the states that shows the statistic average for each state. This is just a prototype for now, I will keep working at it and include all data available from CDC, not just data for fresh embryos. Also add in some more interactive charts for looking at ART data over time.

Now, wouldn’t it be good to know what the IUI stats are like too?

Third time’s a……

March 31, 2015April 1, 20151 Comment

Three Times a Charm

I think I am getting the hang of this IUI thing now. I understand exactly what is going to happen each day, what drugs to take, what side effect will happen and when, who to speak to on the phone, who NOT to speak to on phone, how to ask for what I want, how to make myself understood, how to refill my various prescriptions, what bills to expect, even what emotions I am probably going to feel on this roller coaster of a cycle. For example, I am on Cycle Day 4, and having taken two 2.5mg of Letrozole last night at 7pm, I knew at approximately 4pm Today I was going to be mega sleepy. And I was! Where I work, if you have done something more than twice you are considered an expert, so I’m going to declare myself “IUI Subject Matter Expert” on my “CV of life”. I’m feeling quite chilled out about it all, that is except for one, teeny, tiny, annoying thing.

INSURANCE.

The thorn in my side right now. Needles have nothing compared to this pain in the….

You may recall before we started IUI that my insurance company wrongly stated that I did not need pre-approval for IUI treatment. It was only after I started my first cycle all became apparent that we needed pre-approval before any fertility treatment. Since then, we have been trying to get things straight with our insurance company. I am not entirely blaming the insurance company here. I am blaming ‘the system’.

It seemed so simple, our insurance company required copies of our medical records to determine pre-approval for our IUI treatment. Well that’s easy! No? Fertility clinic – please provide our insurance company with our medical records. “No problem, we will get the nurse right on that” they said. Well each week we chased them, they claimed no knowledge of this request, but wait, what is this? …oh there is a note in our records to do this. Hmmmmmm. At our last appointment 2.5 weeks ago, the nurse promised us the request to send the medical files was with their business team and they were going to action it that day. Well it turned out that was all bull. No medical records were ever sent because we had to fill out a release ‘form’. And after the number of people we spoke to try to make this happen, not one person mentioned a form. Things also got complicated when the fertility clinic realised that our insurance’s medical office is located in Belgium. This would be impossible! Sending medical records abroad – there are different laws for this. They were not quite sure how they are going to do it, come on, surely there is a form for that too! How about I google it, I bet google knows the answer.

So after we hit this road block, Chris tried a different approach. He has given the half completed ‘pre-approval’ forms to our insurance company to chase up with our fertility clinic. When my insurance company emailed me this morning to say could I please provide them with a contact number for my doctor, oh, by the way we would need approval for each round of IVF….I flipped! As you can imagine we had dutifully and carefully provided a contact number and address, but most importantly, it clearly stated on the form the treatment was IUI. I even provided them with a breakdown of all the costs for each procedure and medication. Aghhhhhhhhh!

I have no idea what is going on right now, but it is all now in the hands of the insurance company and our fertility clinic to figure our laws, methods of handling medical records, procedures, money and what not. Why couldn’t we have got to this stage two months ago? At this rate we will probably get our “pre-approval” for IUI after we have finished all three rounds of IUI!

Without pre-approval we have paid for our first round of IUI out of our pockets and hoping we will be able to claim some money back. Soon the bills will be coming in for the second round of treatment. It would be nice if they figured it out before then. My worst nightmare is that they deny the claim because there was a small test we had to do or form we had to complete before we started with the IUI. There is little advice the insurance company can provide us on whether we are covered or not until they have our medical records. Similarly, they can’t answer if we are covered for IVF until they see our medical records. This makes financial planning for the future a little challenging. But we are planning for the worst, just to be safe.

I should point out that we do have a rather strange insurance arrangement – because my organisation is international, Allianz, our insurance company, provides coverage for all staff across the various countries. Allianz uses United Healthcare as their service provider in the US to purely deal with admin for claims made in the USA and negotiate in network deals with providers. This makes things complicated for medical providers here in the US when we try to explain that they have to provide medical records to Allianz, not United Healthcare. I hope I didn’t lose you there!

Third time…

So to sum up today’s post – Insurance sucks and starting IUI cycle 3 is going to be a breeze. As the saying goes….third time lucky! Or….third time a charm! Let’s hope it’s not like the other google search term on the list above – third time out :-s

The big question – What if we can’t have children?

March 30, 20158 Comments

As we were about to head to bed for the evening, Chris quietly asked “What if we can’t have children?”. This is a question we have discussed before – several years ago in fact. It’s the kind of question you ask just after your boyfriend/fiancee asks you to marry him. It’s one of those BIG questions. And we had much time to talk about it back then. Chris proposed to me just 1/2 hr into our 4 day hike in the remote Italian mountains, the Dolomites. Of course I said yes when he asked me to marry him (If I had said no it would have been a rather awkward four days in the mountains 😉 ), but this left four days of ‘just us’ to talk about ‘the big things in life’, to double check that we were in fact right for each other. Well probably more of me doing the double checking, after all, he had been planning to propose to me for months, he had all that time to think about it. We concluded that love conquers all, you couldn’t really argue with that logic. Oh so naive?

This time around, Chris asked the question with a genuine sadness in his eye. With a little bit of wine in me, my eyes welled up instantly and hit some kind of nerve. Because yes, love does conquer all, but it hurts to think that this could be a reality in the not so distant future. I have thought about it a bit, but I haven’t really looked into it in depth. We discussed potential future options of donor eggs. donor sperm, gestational surrogacy, adoption and being ‘child free’. These discussions were brief and emotionally fuelled, with neither of us having much understanding about any of them. We concluded that we do not both agree on each of these options, we have our differences of opinions, however we recognised that these feelings are likely to change dependent on our situation and once we have done more research together. We did agree on one thing – that we would use all of our savings if we had to, but we would not get into debt.

The discussion was brief, we were tired and emotional, it was not the best time to ask this BIG question. But it is a question we need to be prepared to think about more if round 3 of IUI does not work. This doesn’t mean we are not hopeful about round 3, far from it, it’s just something we might want to start smarting up about. Education certainly never hurt anyone.

Lost: one unopened clear blue digital pregnancy test

March 28, 2015March 29, 20158 Comments

Today was meant to be the day that I unwrapped the ‘highly Gyn/Ob recommended’ Clear Blue Digital pregnancy test. But it’s currently ‘Missing In Action’, I couldn’t find it…I know it’s in the house somewhere, I just can’t remember where I hid it from myself. Incidentally, I bought it about 7 months ago. Do these things go out of date? Oh well…it doesn’t matter because Aunt Flo arrived anyway.

I would like to thank Aunt Flo for the big glass of Wine I shall enjoy this evening and the trip to Busch Gardens now planned for tomorrow – and I am going to go on ALL the rides, many times over, probably until I am sick and dizzy.

Infertility, you sure do suck, but today I am not pregnant and I am going to enjoy this short time of drug free freedom (except the good good Ibuprofen to help alleviate my period pains). Yes I cried with Chris early this morning, but now I am more determined than ever – whatever is stopping us from getting pregnant – we will overcome it, together. Round 3 – Ding Ding!

TTFN X

(TaTah For Now)