Short But Sweet

Monday was my big day – hysteroscopy with possible removal of adhesions.  I’ve mentioned before how much I heart my ob/gyn, but I have to say it again.  We got to the hospital, were settled in our room and she came to visit.  She talked about what would happen, how things would hopefully go and what to expect.  She was going to run back to her office across the street to grab an IUD in case there was scarring.  She’d use this to keep things open and then we’d be on estrogen for about a month to help the healing. 

She came back with the IUD, just as my anesthesiologist was getting ready to do her thing.  I tried to ask her a question and just started crying, “I’m so scared it’s going to be bad.”  She sat down at the side of my bed and she looked like she was going to cry.  “I know I’m not supposed to say this, but I’m scared, too.  I really want this for you and I’m really emotionally invested in this.  That’s why I brought Dr. J to help.  I just want another pair of eyes and guidance.”  It was the first I’d heard that she was bringing a wing man and it didn’t make me feel worried or scared that she was scared, it made me feel relieved.  I think being a little scared can help us be great, can help us do well, can keep us focused and it also means she’s human.  I like that about her.  So we went in, all the while talking about a New Yorker article I’d read at work about how teachers and doctors can benefit from coaches.  Timely.  It also helped that Brett brought up the Checklist – how doctors have become more efficient and successful when using checklists.  Looks like I brought my own wingman!

In and out.  I was knocked out by 11 am and was starting to come to by noon - such a surreal feeling coming out of surgery.  And there was Dr. Johnson, “Everything went great, no scarring, we got in. I didn’t use the IUD.  I’m going to talk to Brett.” That was about all I remember, that and being overjoyed that things were okay. 

When I finally got to recovery, Brett filled me in on the details I never would have remembered before.  At first, they couldn’t get the hysteroscope inside.  She actually had to use a device they use to dilate tear ducts – TEAR DUCTS!– to get inside.   Afterwards I had a chance to really think about this.  If all goes well, eventually, something akin to a Thanksgiving turkey is going to need to squeeze through a space that currently can only be accessed by a device made to get inside a TEAR DUCT!  But we will deal with that when we get to it.  She dilated my cervix is and hopeful that it will continue to stay open.  But other than that, everything looks fine.

I’ll admit, that sweet joy lasted a day and most of it I was still high on anesthesia.   The next day, she called to tell me that she wondered if perhaps the light periods were the result of low ovarian reserve.  In my mind, this was the worst diagnosis.  And it might not be because of my age, but due to the chemotherapy 8 years ago.  She thinks it might be good for me to go back to the RE (reproductive endocrinologist) and have him run some tests to see. If it is this, it means that having a baby will be really tough, if not completely unlikely.  Depends on how bad the ovarian reserve is.  It's hard to think about really and there is a part of me that just doesn't even believe this could be the case.  I know that Western medicine has it's limits, and I'm certainly more than willing to continue to explore other options.  But first, I need to make sure that we've done everything we possibly can within our limits - both emotionally and financially.  I'm trying not to focus on that later bit.  I am not sure how we will pay for the RE if he thinks we need to do serious fertility treatments.  Guess we'll cross or not cross that bridge when we get there.  Unfortunately, insurance doesn't cover any of it.

In the meantime, I’ve purchased the book “The Infertility Cure,” have made an appointment to see a Chinese Medicine doctor, continuing with acupuncture and started back at yoga.  I vacillate between feeling utterly defeated, exhausted and disconnected from Brett because I’m so damn focused on myself and feeling overly optimistic, like I’ll be damned if I went through all that cancer ‘stuff’ and have ‘this’ (whatever this is) get in my way.   

Maybe they call that bipolar?  Hope not!  That’d just be one more thing to fixate on – great!

So… not sure where this leaves us.  I guess we will just continue on this path, doing what we can until we can’t go any longer.  In the meantime, I need to create some space away from the worrying and fixating.  Not sure how to do that just yet, but I’m working on it.

Oh, and did I mention we got baby chicks?  Three of them.   Hopefully they will bring us some good luck.  

Monday it is...

Just returned from Dr. B's office, the reproductive endocrinologist that Johnson sent us to.  He managed to do the saline histogram with far less pain than she did, but with pretty much the same lack of result.  Yep, there is some sort of 'stricture' as he put it, a blockage, an adhesion that won't allow the catheter to actually go very far and thus, they can't see anything or know anything - except that I need to do the hysteroscopy surgery on Monday as scheduled.  

The hope is that Johnson will be able to visualize what at this point can only be faintly seen and felt through an ultrasound.  The other hope is that the blockage or adhesion is a small area that she can simply cut through, opening up the rest of my uterus and that all will be back to normal after that.  Well, semi-normal.  Even if all of that goes smoothly and the adhesions are minor, it will require me to be on estrogen for at least a month - which translates into another month or two until we would even be able to try to conceive.  

It's a bummer. But more than that, I'm just pissed that I didn't insist on the histogram sooner.  I knew at the end of November that something wasn't right, that my period felt like it should have come but didn't.  If we had started this process then, well, who knows.  Instead, we are now 5 months down the road and only hoping that 6-7 months down the road, well...that we can actually even be on the road!  Right now, we're just going to have to spend a few months at this pitiful truck stop they call infertility and hope that we actually move forward some time soon.  

I hope it goes well. I hope it's not a worse case scenario.  I hope my doctor knows what she's doing.  I hope that new adhesions don't form.  I hope we are able to try again soon.  I hope we are successful.  

Small Celebrations

Dr. Johnson is awesome.  Yesterday after work, I noticed three calls from a blocked number.  I didn’t give it too much thought since how the hell could I call ‘blocked’ back?  As I pulled up into the driveway, ‘blocked’ called again.  It was Johnson. 

“Hey, how you feeling?” 

“Aahhh, you know, frustrated. I just wish we knew what was going on.”

“I know; I’m frustrated, too.  Not as much as you probably, but I am for sure.”

The thing about Dr. Johnson is that I believe her.  That’s part of why she is awesome, but also because even though I didn’t specifically ask her to, she decided to call a good friend of hers who is a reproductive endocrinologist.  She told him all about me and what has led us up to now.  He has agreed to see me on Thursday before the hysteroscopy the following Monday.  Hallelujah!  I don’t know why this makes me so excited.  I guess it’s just the feeling that an expert in fertility (or infertility, depending on if your glass is half empty) will be giving me some advice and know-how.  He came from Johns Hopkins – he must be a rock star, right?

When I spoke with his nurse this morning, she said that he would attempt the do the saline histogram that Johnson tried to do but was unable to do, along with an ultrasound.  I’m so hopeful that he will be able to do the histogram.  Even that will give us a great deal of information.  If he is able to see the uterine lining, he will be able to tell if there is scarring or any number of other possible physical issues that are the problem.  If there are, then we will go ahead with the hysteroscopy on Monday, but at least with an idea of what to expect once Johnson gets in there. 

And if there aren’t, then we know that it might have to do with hormones, ovaries, or something else.  And then, we can work that route.  Brett says it’s like “House.”  Right…just like it.  I just want to be optimistic that we will get some answers on Thursday.  I really, really hope so.

So now, it’s on to celebrate this blasted birthday.  Brett says I’m being a little Don Draperish about the whole thing. 

Zou Bisou Bisou. 

(And sorry if you don’t get the reference, but you really should be watching Mad Men!)

Not out of the woods...yet

It has been a little over 29 days and the joy and elation I felt when my period finally returned has seriously dissipated.  Our trip to Mexico was a wonderful reprieve from worrying about this ever-elusive baby and from waking every morning to take my temperature.  Instead, I tried to sleep in (despite the loud neighbors and roosters) and take it easy.  I felt optimistic that things were now ‘back on track’ and that we simply needed to get back on the horse.

Oh…how naïve.  This week has been tough.  When we returned from Mexico, I started temping again.  It appeared that I had just ovulated and I watched each day as my temperatures seemed to soar higher and higher.  In fact, the highest I have seen them since my whole adventure into BBT (basal body temperature) began.  I even noticed that my temps went triphasic, which can often be a predictor of implantation and consequently a positive pregnancy test.  However, I kept getting negative tests.  I realized, the morning my temperature dropped from 98.2 to 97.6 that we were definitely out of the game this month. 

  

But oddly, that wasn’t where things turned bad.  It was in the days following.  I had told myself that regardless of the outcome – pregnant or not pregnant this month – I would be content that things were progressing in a positive way.  My cycle had returned, my body was getting back into the swing, and in time, we would get that positive test and we’d be on our way to building this family.  When my ‘period’ did arrive this month it lacked all gusto.  I am only calling it a period because it arrived when it should have.  It’s punctual; I’ll give it that.  But what it said loud and clear to me was that things are still not right. 

I called Dr. Johnson yesterday after the one-day period and our plans for the hysteroscopy on April 30^th are back on.  Yesterday was hard.   I think it is all compounded by the fact that I turn 37 next week and it makes me wonder if I will have a baby while I’m 37.  Will it take longer than this year? Will it never happen?  Then what?  For the first time in decades, I don’t feel like celebrating my birthday.  I don’t feel celebratory at all – about anything.  I just want this birthday to pass, for the months to pass until we actually have good news.  Right now, nothing feels very good at all.

When I got off the phone with Johnson’s office, I did what anyone with half a brain will tell you not to do.  I searched the Internet to find any information about pregnancy after hysteroscopy with removal of adhesions, which, in my completely untrained opinion, is the diagnosis.  For once, the first link listed was a woman my age, asking the same question.  And unlike what you usually find when you play this sort of World Wide Web roulette, the responses were so positive.  Women saying that yes, the cycle right after their procedure, they were pregnant.  And it wasn’t just one woman saying that, it was many.   And although I finished reading and felt optimistic and hopeful, it still left me feeling overwhelmed with sadness. 

I know I keep saying it, and I keep telling myself, our time will come – it will.  It’s just getting harder to believe it when any time it seems we get close to our dream, it keeps moving further away. 

In the same boat

In a few days we are headed to the sunny shores of Sayulita, Mexico for some much needed and much deserved relaxation.  The weather in Portland has been unseasonably cold.  Yesterday, we had a 2-hour late start at school due to overnight snow.  It’s March 22^nd for crying out loud!

It has been months since I actually started writing this blog and about a month since it actually has gone live.  Being an English teacher, I thought it would be good to start writing for myself again and seeing as to the emotional state I was in last fall, I needed to get stuff out. It’s funny though because I could have just kept a journal.  But for some reason, I needed to get it out of my head and even, my house.  When I began to tell the story to friends, I learned that so many of the women in my current circle had similar experiences and in most cases, I’d never known!  It is reassuring to know that I am not the only woman on the planet who had a miscarriage and whose body was acting kooky. 

I knew that writing the story would be healing for me, but what I didn’t expect was the degree to which other’s stories have impacted me.  So many of you, some from my present, some from my past and some from my distant past (a special shout to those of you I’ve know since high school, even elementary school!) have contacted me and your stories have meant so much to me.  It is helpful and heartbreaking all at once to read your emails.  It seems we have kept our stories guarded and close to our hearts.  I find that interesting and it has made me wonder why.

Yes, it’s painful.  That’s one reason I didn’t or couldn’t talk about it.  But for me, and I’m not sure how universal this next part is, there is something to it about feeling less than, feeling inadequate.  I mean, for heaven’s sake it is within our biology to make babies – our bodies are supposed to do it without us having to think about it.  Even the act of is based on instinct.  No one really has to teach us!  And yet, here I am and my body has failed at the most basic level.  And in turn, it feels like I failed.

For the last few months, whenever I would hear about or see pregnant women, and yes, it seems like they are everywhere right now – like a zombie infestation – it has been hard not to feel envy, anxiety, sadness and longing.  My acupuncturist, Jo, went through similar fertility issues and she reminded me of changing the message that inner voice keeps playing.  Instead of “Why not me?” it is, “One day, that will be me.”  It isn’t easy though; cynicism comes way too easy for me.  But it is a good practice for me and I find that it is getting easier with time.   I think that is where all of your stories come in.  It helps to imagine, to remember how common the stories of lost pregnancies are and to think that perhaps that newly pregnant mom has waited months or years for her moment.  It is quite possible that she and her husband struggled and waited, cried and loss, before finally getting their moment in the sun.  When I think of it that way, it is easy for me to replace the envy, the anxiety, with joy and excitement.  To share in what must be the joy they feel, knowing that one day, it really will be me.  And for those of you in the same boat, it will be you, too.

She's here!

Oh happy day!  O happy day!  Yes, that is the chant I was singing this morning.  I woke a bit earlier than normal, took my temp and noticed a drop from 97.7 to 97.3.  Dramatic, seriously.  And then, there she was that elusive period!  Sorry if this is too much information, but I honestly am so excited and relieved.  

I'll admit it, I cried. 

Since the miscarriage and the waiting, I did assume the worst. My mind quickly and easily went to that place.  I imagined the worst.  In many ways, it is easier to imagine the worst so when you get the good news, you truly are relieved.  Certainly it must be better than assuming the best to find out the worst?  Brett, in many ways, is a quiet optimist.  He just doesn’t let his mind go to those dark places that mine can go.  Maybe it is because I have quite literally already been there.  I’ve seen the landscape, know the terrain.  

To be honest, I have a hard time trusting that my body can do what it's supposed to do.  I blame that on cancer.  When I was 29, I was diagnosed with breast cancer and in hindsight, I had never felt so betrayed by the universe and my body.   When I came out, not unscathed (a mastectomy, 6 months of chemotherapy, and 5 weeks of radiation) but at least free and clear of cancer, I did not know how to feel about my body.  I still don’t.  It is truly a mystery and despite what most doctors would have us believe, it is a mystery to them, too.   I haven’t called my doctor to give her the good news yet, but I know she will be relieved and excited.  She was my 2^nd opinion when I thought that perhaps there was something going on before I had cancer.  She had pushed me to have a biopsy.  She has said, it is her mission to get me knocked up and I believe her.  She and I have been through a lot together, as far as patients and doctors go.

When I was diagnosed with cancer, my friend and colleague Barb gave me a Saint Peregrine coin.  I carry it with me to this day.  When I was married and moved to China, she gave me a Saint Christopher painting.  When I posted this blog for the first time, she told me about St. Gerard, patron saint of Motherhood.  I’m not a religious person, but most of my family is Catholic.  I didn’t grow up in the religion, but I do feel a connection to it in the sense that it is part of my family’s story.  And with that, comes a fascination with saints.  I find comfort thinking that there is someone looking out for us, willing to advocate for us, helping to see our dreams come true.  People who lived good lives, devoted themselves to others and even in the ‘afterlife’ still have duties.  There is something sweet and selfless in that and it is comforting, especially when we find ourselves in dark places.  I have thought about St. Gerard since Barb mentioned him. 

Today, I finally feel a sense of closure and for the first time in a long while, hope and joy about where we go from here. 

Where are you spring?

Spring is attempting to break through the last few weeks, as winter desperately hangs on.  The daffodils are in full bloom, the crocus are out, and yet the past few mornings snow showers were falling.  Temperatures remain in the 30s at night, rising nearly 20 degrees during the day.  But still, it is chilly. It is nice to know that in less than a week, we will be warming our bodies on the sands of Mexico.  A much needed relief.  

I am a weather junky, so it comes as no surprise to me (or those who know me) that when I heard about charting your own temperatures to keep track of your monthly cycle - I was all over it.  It is the aspiring forecaster in me.

I have become an expert on temperatures.  I take mine every morning at 6 a.m.  I purchased a special Basal temperature months ago and went through many phases of diligence.  However, since February, I have been a die-hard temperature taker.  In some ways, it helps me feel like I have a little insight into my body.  I took my temperature chart with me to my latest acupuncture appointments to seek a 2^nd opinion.  It appears that I might have ovulated this month.  And for the first time since December, my chart looks ‘normal.’  

Things you learn…Apparently, your basal body temperature is your lowest temperature of the day.  Women can actually chart their monthly cycle by looking at their waking temperature.  The temp readings are to the tenth degree, so it is quite subtle, but noticeable when you are desperate for some glimmer into your body’s inner workings.  Because I don't have a previous cycle to base my temperatures on, it is a bit difficult.  The only point I can go with is ovulation.  The short dip in temp and rise right after.  That is there.  Then, you hope the temps stay up for at least 10 days.  If you see this you know that 1) you have indeed ovulated, which means your body is producing enough estrogen to produce a follicle and 2) when the temperature rises right after, your body has released the egg and the follicle continues to produce enough progesterone to keep the uterus in prime condition to support a fertilized egg.  These are all things you want your body to do naturally and can see through your temperature - it's amazing to me.

Like the past 4 months, I am waiting to see what happens.  If all is well in my body, based on my temperature readings (another drop after the progesterone high), I should start my period any day.  What will be confirmed if I don’t is that there is most likely scarring.  I have heard it diagnosed as Asherman’s syndrome on the web and it looks like the hysteroscopy I will have in April is the procedure that will both diagnosis and treat it.  The odds are good that it will be successful and we will be successful in our hopes. 

I am hopeful and optimistic that this blasted period will come this month, but I am also trying to prepare myself for nothing.  I have the appointment scheduled; I know that if not this month, then in the coming months, blah, blah, blah.  But it would be so, so, so very nice if it did.   It would all at once give us a sense of closure and beginnings.  

I will continue to chant my affirmation - I am healthy.