And right on target with all that I've written today is the personality test at http://similarminds.com/global-adv.html that said:
Stability results were moderately high which suggests you are relaxed, calm, secure, and optimistic.
Orderliness results were moderately low which suggests you are, at times, overly flexible, improvised, and fun seeking at the expense of reliability, work ethic, and long term accomplishment.
Extraversion results were moderately high which suggests you are, at times, overly talkative, outgoing, sociable and interacting at the expense of developing your own individual interests and internally based identity.
Woo-hoo. Exciting night in this house, I tell you. I'm going to quit now, upon the advice of a couple of bloggers, as the... wait, let me get the bottle... Morgenhof Natural Sweet (sort of an ice wine made with botrytis-affected grapes) that we brought back from South Africa ummm... over two years ago is going very quickly to my head.
In Germany, people wish each other "einen guten Rutsch ins neue Jahr" -- a good slide into the new year -- and so I shall for you all.
May 2007 be a year of happiness and of dreams fulfilled!
... to get back my body of a decade ago.
So Who Am I? I’m a 38-year-old Canadian-born German married to another Canadian-born German (our dads grew up relatively close to one another in Germany, so we did a bit of research before becoming too vested in this relationship), living in western Canada. We have an amazing son born in April 2005 who daily awes me anew, another son and daughter born in October 2007 who remind me how quickly babyhood passes, and baby number last, born on her big brother's birthday in 2009.
posted by Tinker at 21:21
So let's try that again without the wallowing....
So what did I accomplish this year? Well, I did make seven more serious attempts to get pregnant (and did get pregnant for a little while). I participated in a variety of activities with our son (baby massage, kindermusik, playgroup, swimming lessons, library storytime, baby signing classes) that hopefully provided him with some enrichment. He has grown pretty good too, so I must've fed him okay. I have been taking more photography courses as well as architectural design classes. I did more volunteer work for the zoo and for a community association. I built a deck on the back of my house (me! by myself!). And we had a lovely visit and holiday with relatives from Europe who still can't stop talking about the marvellous time they had in Canada.
It's not the overachieving year that I always expect from myself, but apart from the not still pregnant bit... passable.
So what did I accomplish this year? Well, I did make seven more serious attempts to get pregnant (and did get pregnant for a little while). I participated in a variety of activities with our son (baby massage, kindermusik, playgroup, swimming lessons, library storytime, baby signing classes) that hopefully provided him with some enrichment. He has grown pretty good too, so I must've fed him okay. I have been taking more photography courses as well as architectural design classes. I did more volunteer work for the zoo and for a community association. I built a deck on the back of my house (me! by myself!). And we had a lovely visit and holiday with relatives from Europe who still can't stop talking about the marvellous time they had in Canada.
It's not the overachieving year that I always expect from myself, but apart from the not still pregnant bit... passable.
Labels: Little R, Rants and Shoot-Em-Up Stories
posted by Tinker at 21:03
There's a day each year that makes me sadder than my birthday. New Year's Eve. It's the end of another year and a time to reflect upon the accomplishments of the preceeding 12 months, but by the time I get to this day, I can't think of much of significance that I've done.
Usually I've gotten a year older and still haven't had another baby. That's particularly depressing, but there are other projects on my 'to do' list that never ever seem to make it off. In grade school I was always ahead of my classmates. I was the third youngest in my graduating class, an honours student (while barely cracking a textbook I'd like to add). I took a full month out of my senior year to volunteer and my grades even went up during that time. Can you see the horrible precedent I set for myself? As I've gotten older and watched increasingly younger people achieve and surpass what I've done it becomes ever more depressing.
So what are these 'to do' items? Well, there are big ones like having 4 children, born before I hit 40. I'd like to publish a book too (a photo book -- we can all see I can't actually write). Shorter-term goals are to start selling some of my stock photography, which means I've got to finally get all my slides scanned and build a website for it all. And to lose a chunk of this weight. I miss taking real holidays -- the kinds of places where they don't usually allow kids under 8 (not that I wouldn't love to take our son, but most outfitters simply wouldn't permit him to be there) -- and have had seriously itchy feet to go somewhere for a couple of years already. More immediate plans are to create a landscape design for our yard so that I can hand it off to a landscaper to implement in the spring (because I'm going to be pregnant and not able to do it on my own -- ha!), and to create a family recipie box.
On a significantly smaller scale, the night itself is depressing. All my life I've wanted to go to a fancy New Year's Eve party. I've even picked the event most years, but for one reason or another I've not been able to go. My husband and I stay home -- not because I don't want to go out, but because he would rather stay in (always falling asleep well before midnight). Going to a New Year's party stag while your husband is at home... is out of the question I guess.
Usually I've gotten a year older and still haven't had another baby. That's particularly depressing, but there are other projects on my 'to do' list that never ever seem to make it off. In grade school I was always ahead of my classmates. I was the third youngest in my graduating class, an honours student (while barely cracking a textbook I'd like to add). I took a full month out of my senior year to volunteer and my grades even went up during that time. Can you see the horrible precedent I set for myself? As I've gotten older and watched increasingly younger people achieve and surpass what I've done it becomes ever more depressing.
So what are these 'to do' items? Well, there are big ones like having 4 children, born before I hit 40. I'd like to publish a book too (a photo book -- we can all see I can't actually write). Shorter-term goals are to start selling some of my stock photography, which means I've got to finally get all my slides scanned and build a website for it all. And to lose a chunk of this weight. I miss taking real holidays -- the kinds of places where they don't usually allow kids under 8 (not that I wouldn't love to take our son, but most outfitters simply wouldn't permit him to be there) -- and have had seriously itchy feet to go somewhere for a couple of years already. More immediate plans are to create a landscape design for our yard so that I can hand it off to a landscaper to implement in the spring (because I'm going to be pregnant and not able to do it on my own -- ha!), and to create a family recipie box.
On a significantly smaller scale, the night itself is depressing. All my life I've wanted to go to a fancy New Year's Eve party. I've even picked the event most years, but for one reason or another I've not been able to go. My husband and I stay home -- not because I don't want to go out, but because he would rather stay in (always falling asleep well before midnight). Going to a New Year's party stag while your husband is at home... is out of the question I guess.
Labels: Rants and Shoot-Em-Up Stories
Saturday, December 30, 2006
posted by Tinker at 22:02
We went to a birthday party today, for my niece. She's one, growing well and becoming an independent little person. I was quite excited to go.
Then we got there.
I did expect to see a number of other kids in the same age range, as my sister-in-law and youngest brother have hung in with their cohorts in most respects. What I didn't expect were the many pregnant bellies, most gestating baby number two, particularly the one with a baby I guessed to be only about 9 or 10 months on her arm. Through all the holiday celebrations I had managed to not think about our struggles to conceive or our recent loss, but I had to make a u-turn to leave that room. I could hardly make eye contact with these women and focused on taking photos of the kids instead.
On the way home I did the math -- I would have been nearly 17 weeks today and probably just starting to feel the little one move. My belly should have been among those motherly pouches with number two tucked snugly inside.
Who knows when (or if) I'll ever get there again.
Then we got there.
I did expect to see a number of other kids in the same age range, as my sister-in-law and youngest brother have hung in with their cohorts in most respects. What I didn't expect were the many pregnant bellies, most gestating baby number two, particularly the one with a baby I guessed to be only about 9 or 10 months on her arm. Through all the holiday celebrations I had managed to not think about our struggles to conceive or our recent loss, but I had to make a u-turn to leave that room. I could hardly make eye contact with these women and focused on taking photos of the kids instead.
On the way home I did the math -- I would have been nearly 17 weeks today and probably just starting to feel the little one move. My belly should have been among those motherly pouches with number two tucked snugly inside.
Who knows when (or if) I'll ever get there again.
Labels: Rants and Shoot-Em-Up Stories
Thursday, December 28, 2006
posted by Tinker at 11:21
Right at the beginning of the 90's when I was attending college, the internet was still just getting started and people were exchanging ideas via newsgroups (usenet). I got loosely hooked in (didn't have my own computer at the time -- had to battle my dad for time on his machine), read lots and made a few posts. Curiously, one of those posts was about (in)fertility. I had a suspicion (for no good reason at all) that I might be infertile and asked about tests I could do to find out. I don't recall getting a response. I didn't press it either, because I was barely 20 and not intending to marry for a few years let alone have kids right away. Fast forward 10 years and I'm living with the man who will become my husband, contemplating quitting contraception to start a family, certainly not thinking back to that strangely intuitive post, and not knowing the challenging path ahead.
So now that I know what tests can be done, and have done a lot of them, I truly know no more than I did all those years ago. The most recent tests -- additional thrombophilia panel items that my RE ordered as my GP had missed them -- have come back normal. For all the blood that has been taken, all the tests that have been done, the results are normal, normal, normal. There's no reason the doctors can find that we shouldn't be able to conceive on our own.
And how I knew at 20 that I would be here is beyond my comprehension.
So now that I know what tests can be done, and have done a lot of them, I truly know no more than I did all those years ago. The most recent tests -- additional thrombophilia panel items that my RE ordered as my GP had missed them -- have come back normal. For all the blood that has been taken, all the tests that have been done, the results are normal, normal, normal. There's no reason the doctors can find that we shouldn't be able to conceive on our own.
And how I knew at 20 that I would be here is beyond my comprehension.
Tuesday, December 26, 2006
posted by Tinker at 23:15
A couple of years ago, another blogger posted about being 'in or out the closet' with regard to infertility. When we started, my husband and I were both firmly 'in'. Nobody needed to know how our son was conceived. We even decided that he himself would never need to know, as it would have no bearing on him as a person.
It has been over a year and a half since his birth, and my opinion is changing -- not about telling him, but simply about being 'in the closet'. Having some sympathy and understanding from a few people who know about our recent miscarriage has bolstered this opinion.
I'm spending much more time reading other blogs and posting on a bulletin board. The more infertility stories I read, combined with the ever-increasing length of time it's taking to build our family, the more I want to be 'out'. Posting and blogging have become my way of peeking out of that closet; maybe even sticking out a limb. It's reassuring to be able to converse with women in the same situation or discover the points of view of women who have made other decisions.
I dislike not being able to tell my brothers or sisters-in-law that we're not pregnant yet because another cycle failed. It has become very difficult for me to ask my mother-in-law to babysit when I have to attend doctor's appointments (even surgeries) for reasons about which I'm circumspect (though curiously, I don't want to tell her either). I've decided to try accupuncture with this next cycle and that's going to mean more cryptic appointments for which I need someone to look after our little man.
I did come out to a cousin of mine just a couple of weeks ago; she's the first family member to know and I've sworn her to secrecy for the time being. She lives more than 2600km away, so the odds of her dropping it casually to anyone are pretty slim. The reason was that she emailed me at the beginning of December and mentioned that she is due with her second baby in February. She volunteered that she went through IUI to get pregnant -- I had suspected that she might be headed that way because she had an HSG while we were visiting in November a year ago -- so I just had to tell her our story.
My husband would still rather nobody know, and that leaves me feeling like I'm doing this all by myself. As if infertility isn't lonely enough. I'll probably continue to creep out of the closet, my poor reluctant husband getting dragged behind.
It has been over a year and a half since his birth, and my opinion is changing -- not about telling him, but simply about being 'in the closet'. Having some sympathy and understanding from a few people who know about our recent miscarriage has bolstered this opinion.
I'm spending much more time reading other blogs and posting on a bulletin board. The more infertility stories I read, combined with the ever-increasing length of time it's taking to build our family, the more I want to be 'out'. Posting and blogging have become my way of peeking out of that closet; maybe even sticking out a limb. It's reassuring to be able to converse with women in the same situation or discover the points of view of women who have made other decisions.
I dislike not being able to tell my brothers or sisters-in-law that we're not pregnant yet because another cycle failed. It has become very difficult for me to ask my mother-in-law to babysit when I have to attend doctor's appointments (even surgeries) for reasons about which I'm circumspect (though curiously, I don't want to tell her either). I've decided to try accupuncture with this next cycle and that's going to mean more cryptic appointments for which I need someone to look after our little man.
I did come out to a cousin of mine just a couple of weeks ago; she's the first family member to know and I've sworn her to secrecy for the time being. She lives more than 2600km away, so the odds of her dropping it casually to anyone are pretty slim. The reason was that she emailed me at the beginning of December and mentioned that she is due with her second baby in February. She volunteered that she went through IUI to get pregnant -- I had suspected that she might be headed that way because she had an HSG while we were visiting in November a year ago -- so I just had to tell her our story.
My husband would still rather nobody know, and that leaves me feeling like I'm doing this all by myself. As if infertility isn't lonely enough. I'll probably continue to creep out of the closet, my poor reluctant husband getting dragged behind.
Labels: IVF 1, Little R, Trying to Conceive
Wednesday, December 20, 2006
posted by Tinker at 14:06
In the German Christmas calendar, today is Thomasnacht (the eve of St. Thomas' Day), falling usually on or near the day of the winter solstice. Very traditional families will bake a kind of fruitcake called Kletzenbrot. Another Thomasnacht tradition is running outside and hugging a tree trunk to bring fertility and a good harvest in the coming year.
I wonder if the local tree nursery will be open tonight?
I wonder if the local tree nursery will be open tonight?
Labels: A Head Full of Trivia, Trying to Conceive
Monday, December 18, 2006
posted by Tinker at 21:15
I'm having trouble tracking down some information. I have a vague recollection that a long protocol results in fewer eggs but better quality, while a flare protocol will produce more, but not necessarily all of good quality. Is this right? Is it the other way around perhaps? Or am I out to lunch altogether? I don't even know why I'm trying to find this stuff because it's not even the info I need.
What I really want to know is if it's better to start stims at a high(er) dose then drop the dose if the response is too good, or if it's better to start at a moderate dose and have to boost the meds later. How are quantity and quality affected?
Dr. Google is being very evasive on this one.
What I really want to know is if it's better to start stims at a high(er) dose then drop the dose if the response is too good, or if it's better to start at a moderate dose and have to boost the meds later. How are quantity and quality affected?
Dr. Google is being very evasive on this one.
Labels: IVF 1, Trying to Conceive
Sunday, December 17, 2006
posted by Tinker at 19:04
When my HCG hit zero 12 days post D&C, and I noticed EWCM (with a correspondingly positive OPK) at 19 days, I estimated my next cycle to start December 18. Maybe estimated is too precise... guessed and hoped is really more accurate. After all, 33 days post D&C is pretty quick, especially considering my cycle is normally around 31 days anyhow.
I just can't believe how excited I got this afternoon when I started spotting. I had convinced myself that my estimate would be wrong and that I probably wouldn't start until a week later -- when the clinic was closed for the holiday. Having said that, I don't yet know if tomorrow will actually turn into CD1. I don't normally get more than half a day of spotting, so I don't really expect anything else, but I guess we'll see.
I just can't believe how excited I got this afternoon when I started spotting. I had convinced myself that my estimate would be wrong and that I probably wouldn't start until a week later -- when the clinic was closed for the holiday. Having said that, I don't yet know if tomorrow will actually turn into CD1. I don't normally get more than half a day of spotting, so I don't really expect anything else, but I guess we'll see.
Labels: IVF 1
Wednesday, December 13, 2006
posted by Tinker at 15:18
I spent yesterday evening in the company of Dr. Google, conferring about some of the pros and cons of Preimplantation Genetic Diagnosis (PGD).
Here's what I've come up with:
CONS
- unskilled lab tech could damage embryo during biopsy
- potential damage to developing intercellular communication networks (among other critical functions)
- biopsied embryos don't survive freezing as well as intact ones
- embryos that survive biopsy are not as good at implanting
- limits to what can be tested
- aneuploidy for only 12 chromosomes
- monogenic disorders (autosomal recessive/dominant, X-linked)
- balanced translocations
- ICSI usually required if monogenic (& translocation?) testing is to be done to avoid contamination by residual sperm
- possible misdiagnosis of embryo due to high incidence (50% in some studies) of mosaicism
- blastocyst transfer means embryos could be lost to the environment of the petri dish
- high cost
- reduced chance of miscarriage/decision to terminate due to disorder
- transfer of only 'normal' embryos increases the likelihood of a healthy take-home baby
Health Canada makes a very discouraging statement on issues associated with PGD, specifically that PGD may result in a decreased pregnancy rate. The link is to an issues paper on which they are requesting comments, and I can't see that they've given any references for the statements that they've made.
What is surprising is simply the number of crummy embryos we all make regardless of the reason for our IF. For my age group (35-39) I read that 64% of all embryos would be abnormal in some way, regardless of other factors. That means that if you get 10 embryos from a fresh cycle, only 3 or 4 are even potentially good. Yikes!
So in spite of all the cons, I still feel like the knowledge that you're transferring only the best embryos seems to trump them all.
I've got some specific questions for my clinic, but I've asked to be put on the PGD waiting list just the same.
Labels: Trying to Conceive
Monday, December 11, 2006
posted by Tinker at 14:44
I've just come back from my appointment with my RE and I'm soooo pumped! We've got a very definite go-ahead as soon as my next cycle starts (in a week or so, I figure). I was so afraid that he'd put me off for additional rest cycles because of this miscarriage. My poor husband doesn't understand my excitement and why he is having to watch me bounce off the walls, but I can't help it!
My RE reassured me that the embryonic material from this last miscarriage was probably untestable due to the length of time the embryo had been dead.
We talked about some of the bloodwork results my GP ordered (normal, normal, normal, ad nauseam) and he requested a few more thrombophilia panel items that had been overlooked. I asked about karyotyping and was referred to a geneticist who will take blood from both me and my husband (who really hates needles -- good thing he's not the one having to shoot up, or we'd have no babies) tomorrow and let us know once the results come back from the US (umpteen weeks from now).
We talked about how aggressive we need to be in order to have 3 more kids in the next 4 years, and while I'm a decent responder to the meds, he agreed we could step it up a notch.
Because I'm nearly 36 and seem to be very up on what's going on, we also talked about the possibility of PGD. While it won't happen this cycle, I've asked to go on the waitlist to do it next time.
And the resident that was with him paid me a very nice compliment. She was impressed with how much I knew about not only my own history but about research that has been done in the field (she said she didn't even know about everything the doc and I discussed). Very sweet of her.
I just can't wait for this next cycle to start!
My RE reassured me that the embryonic material from this last miscarriage was probably untestable due to the length of time the embryo had been dead.
We talked about some of the bloodwork results my GP ordered (normal, normal, normal, ad nauseam) and he requested a few more thrombophilia panel items that had been overlooked. I asked about karyotyping and was referred to a geneticist who will take blood from both me and my husband (who really hates needles -- good thing he's not the one having to shoot up, or we'd have no babies) tomorrow and let us know once the results come back from the US (umpteen weeks from now).
We talked about how aggressive we need to be in order to have 3 more kids in the next 4 years, and while I'm a decent responder to the meds, he agreed we could step it up a notch.
Because I'm nearly 36 and seem to be very up on what's going on, we also talked about the possibility of PGD. While it won't happen this cycle, I've asked to go on the waitlist to do it next time.
And the resident that was with him paid me a very nice compliment. She was impressed with how much I knew about not only my own history but about research that has been done in the field (she said she didn't even know about everything the doc and I discussed). Very sweet of her.
I just can't wait for this next cycle to start!
Labels: IVF 1
Sunday, December 10, 2006
posted by Tinker at 21:27
"So if this is an infertility blog," you're thinking, "where are the rants and shoot-em-up stories?"
Well, I've been having a little break. My most recent battle with the medical world was more frustrating than I could ever have fathomed, and I've been reveling in the peace I've managed to achieve in spite of it. Want a taste of what I went through? Here are some of my notes; I've added the pregnancy dates to make the timeline easier to follow.
October 3 (15dpiui or 4w1d)
I feel like I've been dumped. My pee-in-a-cup test was positive and I got a call from the clinic that basically said "Congratulations, you are now released to see your GP, but make sure to call us with your ultrasound results." Apparently their responsibility ends the instant you get a second pink line. I'm nervous though; that second line was still pretty faint this morning and I know that low HCGs are correlated with early miscarriage....
October 13 (5w4d)
Our first ultrasound today saw one gestational sac measuring 5w1d (within range), which makes sense given the faint HPTs. A late implanter probably.
November 7 (9w1d)
Today was the soonest appointment I could get for a 7-week scan. Not good news. There's no heartbeat and the embryo measures only 6w2d. I called the GP's office to let them know, and left a message with RE that I'd like to get in for IVF as soon as he'll let me. I did have a lovely phone call from my GP late this evening. I've been seeing him since I was a teen and he was a new doctor, and when I was pregnant with R he was always so excited when I came for a checkup. He was very sorry to hear that I had lost the baby and offered to help support me in moving ahead. He's going to help me order some recurrent miscarriage tests because I can't get in to see my RE until the second week of December. He has also said that he'll help push my RE into letting me do an IVF sooner than he might otherwise (I've heard from girls at my clinic that it could be 2-3 cycles wait!) if I ask him to. The best healing for me is to jump into the next cycle as soon as I can -- it means the possibility of a new baby; waiting is just frustrating.
November 8 (9w2d)
My RE's office called me today to confirm that they wouldn't make me wait longer to start IVF after a D&C than a natural miscarriage, so I called my GP's office right away and left a message confirming that I want to book a D&C as soon as possible. I wasn't sure that the girl taking the message understood clearly, so I sent an email and got a call later from my GP's assistant to clarify. She'll make the booking right away.
November 9 (9w3d)
I quit my Prometrium as soon as the u/s was over and even though I know better, expected to wake up the next morning gushing blood. Well, two days later and I still feel as pregnant as before. My GP is supposed to be arranging a D&C, but the hospital hasn't yet called me with a time. I sent my GP's assistant another email reminder. It's particularly frustrating because I want to move on as soon as I can and waiting to be able to start waiting again (does that make sense?) makes me feel helpless and hopeless.
November 10 (9w4d)
I still haven't heard from the hospital about an appointment for a D&C, and when I tried to call my GP's office after lunch to get the story (or a phone number I can call myself), I discovered they're closed for the day! Grrr.
November 12 (9w6d)
I called the public health nurse this morning out of sheer frustration. I had thought that I could get a D&C within a couple of days and here it is five days later with no word. I had hoped that she might be able to give me a contact number at the hospital, but all she can do is make a note on my chart for my GP's office to see tomorrow morning.
November 13 (10w)
Well, I'm no further ahead today than I was a week ago, and I'm frustrated to the nth degree about it! Shaking with anger even. My GP's office just called to say they got the note from the public health nurse and were wondering if I want to go ahead with the D&C. Do I want to go ahead!? Did my phone calls and emails not make that clear!? I just can't believe that they haven't done anything yet! Aaaaargh!
~~~~~~~~~~
I called back about 45 minutes later and asked to talk to my GP directly. All they could do was give me his voicemail and tell me he checks it throughout the day. I recounted the entire last week's series of calls and emails and told him (well, his voicemail anyhow) directly that I'm exceedingly angry. I was mad last November when it took 5 weeks to get a re-referral letter out of his office to get back in to the RE, but I'm beyond mad now. This is unacceptable. Grrrr.
~~~~~~~~~~
My GP hasn't called me back. I called his office at 2pm (4 hours after talking to his voicemail) and ended up with a very concerned staff member who called me back less than 10 minutes later assuring me that she would make things happen and that I would get a call from my GPs assistant before the end of the day. His assistant called later to tell me that she couldn't book the D&C because the results of the ultrasound (from almost a week ago) hadn't arrived (why didn't anyone look into it on Wednesday when I asked twice via telephone and once via email to book it?). Hospital protocol won't allow her to make the appointment without the ultrasound. Of course the radiologists are closed today so she can't do anything until tomorrow morning. I try to remind people that this embryo has been dead for nearly four weeks now, but because I'm not showing any indication of sepsis they don't seem to be in any hurry. You know, if we had found out at 7 weeks that the pregnancy wasn't viable, I'd likely be within a week or two of having a normal period right now and starting IVF. Instead, I may not get an appointment for another week putting me into late December/early January for a normal cycle -- a full month of delay!
~~~~~~~~~~
I wrote a 3-page letter to my GP this afternoon. When my husband came home, he made me edit out the sarcastic/angry parts before mailing it. I still need my GP to do a bunch of tests, and I've asked him to confer with my RE before my December consult to ensure that I can start an IVF cycle as soon as I start another normal cycle. I can't believe that I have to spell things out like that. And more frustratingly, I can't believe that I've gotten lost in the shuffle in spite of my email and phone reminders. So maybe tomorrow, one full week after the ultrasound, I'll finally have a booking for a D&C. I just hope that that isn't another week away. What really sucks is that the embryonic tissue is probably well beyond testable, so we won't have any information about what might have happened. I'm so miserable right now. I spent the day on the phone and computer completely neglecting my sweet little boy and I'm no further ahead than I was a week ago.
~~~~~~~~~~
I just faxed the radiology clinic where I had my ultrasound, with an unedited angry letter (only one page though). I know that the Dr. in charge can't comprehend that his carelessness and inaction (he offered to call my doctor that same day, but my GP's office says there was no call) have caused me such stress, but I figured he ought to know how pissed I am with him, and that he still needs to get that report to my GP!
~~~~~~~~~~
It's now 9:30pm and I've just started spotting -- the onslaught is to come shortly. At the very least, this means that the pregnancy hormones are diminishing and I'm on my way to a normal cycle to finally start IVF.
November 14 (10w1d)
So this morning, finally (a full week after my u/s), my GP's office calls to say they've gotten my u/s results which say exactly what I told them (duh!), and have contacted the hospital. I should get a call sometime today to book a D&C. So I sit at home all day waiting because nobody can give me the number to call for myself. I call the GPs office at 4:00 because I still haven't heard anything, and get a call from the hospital 15 minutes later. It's the Early Pregnancy Loss Clinic and they want to schedule a consult to talk about my options. I almost exploded. I told the poor woman I know what my options are and I want to book the surgery asap. I've been waiting a week to even have this conversation so can she please get me in right away. She can't do anything because she doesn't do the scheduling for the OR; that's another department. Aaaaargh! The one consolation is that she gave me the number for that department and I should call tomorrow morning. They have 4 slots blocked for emergencies but it looks like I'm #3 on the regular waitlist. This means maybe in two or three days, she can't say for sure. I can't stand it! I still don't have a firm appointment! So here's my plan: I'm going to be one of tomorrow's emergencies. I'll not eat/drink tonight or tomorrow morning (per usual pre-surgery protocol), and I'll call in early with a fever (my temp has been elevated the last two days, but that could be from my adrenal response to this aggravation as much as anything) and bleeding (the light spotting is continuing). They may be only half-truths, but I've been given nothing but complete untruths this past week.
~~~~~~~~~~
Well, with all the reading I've been doing tonight I have found a couple of recommendations that D&C or vacuum aspiration be performed after 28 days in a missed miscarriage (hello! that's me!) because "coagulation defects may result". What I can't find is what is meant by 'coagulation defects' or 'maternal coagulation abnormalities'. The little bit of spotting I've got is dark brown and very clotty. Is it related? And how serious are these coagulation abnormalities and what are the long-term implications? And why do I even have to be asking these questions?
November 16 (10w3d)
Well, I couldn't bring myself to not tell the hospital the whole truth, but I did have a bit of a change of circumstances too. A few hours after my last note I started getting red blood. I left a message on the OR answering machine (about 11pm that night) and called back the following morning (yesterday). I explained to two different nurses my concern about losing the embryonic material and having nothing to test. They consulted with the on-call physician doing the procedures that day who insisted that he wouldn't test anything after two miscarriages anyhow. The nurses relayed this to me and told me they might be able to squeeze me in the next day. I told them that not testing wasn't the OR doctor's decision to make, as my own doctor had ordered the testing. They needed written proof, so I had to get in touch with my GPs office and ask them to fax something to the OR. In the meantime, the charge nurse called back and said that I could come in at 11:30, but my status was such that it could be 6 hours before I could be seen. That was fine by me, as it meant the wait would at least be down to only 6 hours. So I had a consult with the OR doc when I arrived and insisted that I wanted the embryonic tissue tested. He gave me his reasons why he wouldn't do it and I told him that my doctor had ordered it. I don't think we actually came to a firm conclusion and I have a suspicion that I shouldn't be waiting for any test results -- that he just overrode my own physician (who has known me for 20 years) and didn't send anything for testing. So I'm annoyed that there won't be test results; irritated that people do what they want in spite of evidence that something else needs to be done; but relieved that the vacuum aspiration is behind me and that I can get on with trying for a new baby. The next challenge is convincing my RE that I'm in a position to start a fresh cycle on a long protocol as soon as I get my next period. This means a transfer probably late January. I don't think that that's too soon. We'll see how it goes....
To not leave you in suspense, I went for a pelvic ultrasound (requested by my RE because he wants it pre-IVF, but requisitioned by my GP) 6 days post-procedure. Nothing had been left behind, my lining was at 4mm, and I had a decent number of antral follicles, the largest at 7mm. My HCG hit zero within 12 days of the procedure. Nineteen days post-procedure I noticed EWCM after a lunchtime pee and decided to do an OPK ('cause I've got these things just sitting around, you know) that showed a strong surge line. So it looks like my hormones are settling into their old routine pretty quickly.
Tomorrow: the RE's take on things.
Well, I've been having a little break. My most recent battle with the medical world was more frustrating than I could ever have fathomed, and I've been reveling in the peace I've managed to achieve in spite of it. Want a taste of what I went through? Here are some of my notes; I've added the pregnancy dates to make the timeline easier to follow.
October 3 (15dpiui or 4w1d)
I feel like I've been dumped. My pee-in-a-cup test was positive and I got a call from the clinic that basically said "Congratulations, you are now released to see your GP, but make sure to call us with your ultrasound results." Apparently their responsibility ends the instant you get a second pink line. I'm nervous though; that second line was still pretty faint this morning and I know that low HCGs are correlated with early miscarriage....
October 13 (5w4d)
Our first ultrasound today saw one gestational sac measuring 5w1d (within range), which makes sense given the faint HPTs. A late implanter probably.
November 7 (9w1d)
Today was the soonest appointment I could get for a 7-week scan. Not good news. There's no heartbeat and the embryo measures only 6w2d. I called the GP's office to let them know, and left a message with RE that I'd like to get in for IVF as soon as he'll let me. I did have a lovely phone call from my GP late this evening. I've been seeing him since I was a teen and he was a new doctor, and when I was pregnant with R he was always so excited when I came for a checkup. He was very sorry to hear that I had lost the baby and offered to help support me in moving ahead. He's going to help me order some recurrent miscarriage tests because I can't get in to see my RE until the second week of December. He has also said that he'll help push my RE into letting me do an IVF sooner than he might otherwise (I've heard from girls at my clinic that it could be 2-3 cycles wait!) if I ask him to. The best healing for me is to jump into the next cycle as soon as I can -- it means the possibility of a new baby; waiting is just frustrating.
November 8 (9w2d)
My RE's office called me today to confirm that they wouldn't make me wait longer to start IVF after a D&C than a natural miscarriage, so I called my GP's office right away and left a message confirming that I want to book a D&C as soon as possible. I wasn't sure that the girl taking the message understood clearly, so I sent an email and got a call later from my GP's assistant to clarify. She'll make the booking right away.
November 9 (9w3d)
I quit my Prometrium as soon as the u/s was over and even though I know better, expected to wake up the next morning gushing blood. Well, two days later and I still feel as pregnant as before. My GP is supposed to be arranging a D&C, but the hospital hasn't yet called me with a time. I sent my GP's assistant another email reminder. It's particularly frustrating because I want to move on as soon as I can and waiting to be able to start waiting again (does that make sense?) makes me feel helpless and hopeless.
November 10 (9w4d)
I still haven't heard from the hospital about an appointment for a D&C, and when I tried to call my GP's office after lunch to get the story (or a phone number I can call myself), I discovered they're closed for the day! Grrr.
November 12 (9w6d)
I called the public health nurse this morning out of sheer frustration. I had thought that I could get a D&C within a couple of days and here it is five days later with no word. I had hoped that she might be able to give me a contact number at the hospital, but all she can do is make a note on my chart for my GP's office to see tomorrow morning.
November 13 (10w)
Well, I'm no further ahead today than I was a week ago, and I'm frustrated to the nth degree about it! Shaking with anger even. My GP's office just called to say they got the note from the public health nurse and were wondering if I want to go ahead with the D&C. Do I want to go ahead!? Did my phone calls and emails not make that clear!? I just can't believe that they haven't done anything yet! Aaaaargh!
~~~~~~~~~~
I called back about 45 minutes later and asked to talk to my GP directly. All they could do was give me his voicemail and tell me he checks it throughout the day. I recounted the entire last week's series of calls and emails and told him (well, his voicemail anyhow) directly that I'm exceedingly angry. I was mad last November when it took 5 weeks to get a re-referral letter out of his office to get back in to the RE, but I'm beyond mad now. This is unacceptable. Grrrr.
~~~~~~~~~~
My GP hasn't called me back. I called his office at 2pm (4 hours after talking to his voicemail) and ended up with a very concerned staff member who called me back less than 10 minutes later assuring me that she would make things happen and that I would get a call from my GPs assistant before the end of the day. His assistant called later to tell me that she couldn't book the D&C because the results of the ultrasound (from almost a week ago) hadn't arrived (why didn't anyone look into it on Wednesday when I asked twice via telephone and once via email to book it?). Hospital protocol won't allow her to make the appointment without the ultrasound. Of course the radiologists are closed today so she can't do anything until tomorrow morning. I try to remind people that this embryo has been dead for nearly four weeks now, but because I'm not showing any indication of sepsis they don't seem to be in any hurry. You know, if we had found out at 7 weeks that the pregnancy wasn't viable, I'd likely be within a week or two of having a normal period right now and starting IVF. Instead, I may not get an appointment for another week putting me into late December/early January for a normal cycle -- a full month of delay!
~~~~~~~~~~
I wrote a 3-page letter to my GP this afternoon. When my husband came home, he made me edit out the sarcastic/angry parts before mailing it. I still need my GP to do a bunch of tests, and I've asked him to confer with my RE before my December consult to ensure that I can start an IVF cycle as soon as I start another normal cycle. I can't believe that I have to spell things out like that. And more frustratingly, I can't believe that I've gotten lost in the shuffle in spite of my email and phone reminders. So maybe tomorrow, one full week after the ultrasound, I'll finally have a booking for a D&C. I just hope that that isn't another week away. What really sucks is that the embryonic tissue is probably well beyond testable, so we won't have any information about what might have happened. I'm so miserable right now. I spent the day on the phone and computer completely neglecting my sweet little boy and I'm no further ahead than I was a week ago.
~~~~~~~~~~
I just faxed the radiology clinic where I had my ultrasound, with an unedited angry letter (only one page though). I know that the Dr. in charge can't comprehend that his carelessness and inaction (he offered to call my doctor that same day, but my GP's office says there was no call) have caused me such stress, but I figured he ought to know how pissed I am with him, and that he still needs to get that report to my GP!
~~~~~~~~~~
It's now 9:30pm and I've just started spotting -- the onslaught is to come shortly. At the very least, this means that the pregnancy hormones are diminishing and I'm on my way to a normal cycle to finally start IVF.
November 14 (10w1d)
So this morning, finally (a full week after my u/s), my GP's office calls to say they've gotten my u/s results which say exactly what I told them (duh!), and have contacted the hospital. I should get a call sometime today to book a D&C. So I sit at home all day waiting because nobody can give me the number to call for myself. I call the GPs office at 4:00 because I still haven't heard anything, and get a call from the hospital 15 minutes later. It's the Early Pregnancy Loss Clinic and they want to schedule a consult to talk about my options. I almost exploded. I told the poor woman I know what my options are and I want to book the surgery asap. I've been waiting a week to even have this conversation so can she please get me in right away. She can't do anything because she doesn't do the scheduling for the OR; that's another department. Aaaaargh! The one consolation is that she gave me the number for that department and I should call tomorrow morning. They have 4 slots blocked for emergencies but it looks like I'm #3 on the regular waitlist. This means maybe in two or three days, she can't say for sure. I can't stand it! I still don't have a firm appointment! So here's my plan: I'm going to be one of tomorrow's emergencies. I'll not eat/drink tonight or tomorrow morning (per usual pre-surgery protocol), and I'll call in early with a fever (my temp has been elevated the last two days, but that could be from my adrenal response to this aggravation as much as anything) and bleeding (the light spotting is continuing). They may be only half-truths, but I've been given nothing but complete untruths this past week.
~~~~~~~~~~
Well, with all the reading I've been doing tonight I have found a couple of recommendations that D&C or vacuum aspiration be performed after 28 days in a missed miscarriage (hello! that's me!) because "coagulation defects may result". What I can't find is what is meant by 'coagulation defects' or 'maternal coagulation abnormalities'. The little bit of spotting I've got is dark brown and very clotty. Is it related? And how serious are these coagulation abnormalities and what are the long-term implications? And why do I even have to be asking these questions?
November 16 (10w3d)
Well, I couldn't bring myself to not tell the hospital the whole truth, but I did have a bit of a change of circumstances too. A few hours after my last note I started getting red blood. I left a message on the OR answering machine (about 11pm that night) and called back the following morning (yesterday). I explained to two different nurses my concern about losing the embryonic material and having nothing to test. They consulted with the on-call physician doing the procedures that day who insisted that he wouldn't test anything after two miscarriages anyhow. The nurses relayed this to me and told me they might be able to squeeze me in the next day. I told them that not testing wasn't the OR doctor's decision to make, as my own doctor had ordered the testing. They needed written proof, so I had to get in touch with my GPs office and ask them to fax something to the OR. In the meantime, the charge nurse called back and said that I could come in at 11:30, but my status was such that it could be 6 hours before I could be seen. That was fine by me, as it meant the wait would at least be down to only 6 hours. So I had a consult with the OR doc when I arrived and insisted that I wanted the embryonic tissue tested. He gave me his reasons why he wouldn't do it and I told him that my doctor had ordered it. I don't think we actually came to a firm conclusion and I have a suspicion that I shouldn't be waiting for any test results -- that he just overrode my own physician (who has known me for 20 years) and didn't send anything for testing. So I'm annoyed that there won't be test results; irritated that people do what they want in spite of evidence that something else needs to be done; but relieved that the vacuum aspiration is behind me and that I can get on with trying for a new baby. The next challenge is convincing my RE that I'm in a position to start a fresh cycle on a long protocol as soon as I get my next period. This means a transfer probably late January. I don't think that that's too soon. We'll see how it goes....
To not leave you in suspense, I went for a pelvic ultrasound (requested by my RE because he wants it pre-IVF, but requisitioned by my GP) 6 days post-procedure. Nothing had been left behind, my lining was at 4mm, and I had a decent number of antral follicles, the largest at 7mm. My HCG hit zero within 12 days of the procedure. Nineteen days post-procedure I noticed EWCM after a lunchtime pee and decided to do an OPK ('cause I've got these things just sitting around, you know) that showed a strong surge line. So it looks like my hormones are settling into their old routine pretty quickly.
Tomorrow: the RE's take on things.
Labels: Rants and Shoot-Em-Up Stories
Wednesday, December 6, 2006
posted by Tinker at 00:05
And not to leave those of us TTC out from the fun stuff:
Wine-drinking women are more fertile - report
Sapa-AFP September 18, 2003
Copenhagen - Women who drink moderate quantities of wine become pregnant more easily than their teetotal or beer-supping sisters, a Danish medical review reported Thursday.
According to Dagens Medecin a study of 30,000 women showed that those who chose a glass of wine over beer or spirits were most likely to conceive. The least likely to become pregnant were those who drank no alcohol at all.
The research was carried out by a team headed by Mette Juhl of the state serology institute, Statens Serum Institut. They could not explain the reasons for their findings.
"We know that wine-drinkers eat more healthily and are of a higher social status than beer drinkers. But ability to become pregnant does not vary according to social class," Juhl commented.
"So we cannot rule out the possibility that wine contains substances that are beneficial for fertility."
Labels: In the News, Trying to Conceive
Monday, December 4, 2006
posted by Tinker at 10:30
Eating chocolate (but not dark chocolate) lowers the risk of miscarriage. Good news for my pregnant friends! Oh, except that morning sickness seems to do the same. Hmmm. Here's the story from this morning's paper.
Sickness, chocolate improve pregnancy odds: study
Sharon Kirkey, CanWest News Service
In a finding that should come as comfort to pregnant women who can barely manage a cracker without being sick, new research shows morning sickness lowers the risk of miscarriage by almost 70 per cent.The worse the nausea, the better, according to a study published today in the International Journal of Obstetrics and Gynecology.
Eating chocolate daily also appears to lower the risk of miscarriage. So, too, did ''feeling well enough to fly or to have sex,'' according to researchers from the London School of Hygiene and Tropical Medicine.
There was no evidence that working full time had a worse effect on the risk of miscarriage than part-time work or staying at home, even if the job involved standing for more than six hours day or heavy lifting.
But women who said their jobs were stressful or demanding were significantly more likely to miscarry in the first three months of pregnancy.
They were also more likely to lose the pregnancy if the baby's father was older than 45.
And women who were underweight when they conceived meaning they had a body mass index of less than 18.5 were 72 per cent more likely to miscarry in the first 12 weeks of pregnancy, according to the study.
An estimated one in five pregnancies ends in miscarriage. Some studies have said it may be as high as one in three.
''It can be a very distressing experience for women, and any advice on how they can improve their chances of achieving a full-term pregnancy is likely to be welcome,'' lead author Noreen Maconochie said in a statement.
According to Maconochie, the causes for the majority of miscarriages ''are not wholly understood'' and many suspected risk factors remain controversial or unproven.
''This study found no evidence for the commonly held beliefs that risk of early miscarriage varies by social class, employment status or strenuous exercise,'' the London team reports today in BJOG: An International Journal of Obstetrics and Gynaecology.
Neither did it show that caffeine or smoking increased the risk of early fetal loss.
The researchers questioned 603 women, aged 18 to 55, whose more recent pregnancy ended in a first-trimester miscarriage, and 6,116 women whose pregnancy continued beyond three months.
In addition to confirming the widely held belief morning sickness is a sign pregnancy is progressing well, and that women over 35 are more likely to miscarry, there were several new findings. Being happy, relaxed or in control were associated with a 60 per cent reduction in risk. Conversely, women who reported feeling stressed, anxious, depressed, out of control or overwhelmed had much higher odds of miscarriage.
''When you're stressed, your body's reaction is to produce adrenaline and stress hormones'' such as cortisol, said Dr. Gerald Marquette, site head of obstetrics and gynecology at B.C. Women's Hospital in Vancouver. Those hormones trigger the ''fight or flight response.'' But cortisol can also increase the risk of pre-term delivery by kick-starting labour, Marquette said.
Eating fresh fruits and vegetables daily, or most days, halved the odds of miscarriage, as did taking vitamin supplements, particularly folic acid, iron or multi-vitamins, including pregnancy preparations. Eating white meat and fish twice weekly also may lower the risk, they said.
Previous studies have shown dark chocolate lowers blood pressure, which can cause women to miscarry.
Labels: Trying to Conceive
posted by Tinker at 05:00
Okay... Here comes a riveting post...
Our reproductive history to date:
I'm 35 (but only for another 6 weeks); he is 39.
Our diagnosis: Unexplained
2001 (late): we start ttc (though not earnestly)
2002 November: miscarriage at 10 weeks
2003 (late): finally get in to see an RE
2004 February: HSG (Yuck!) all clear
2004 Jun-Jul: first cycle with clinic; Clomid-IUI = BFP
2005 April: DS born (c-section)
2005 December: back at clinic for more
2006 Dec-May: 3x Clomid-IUI = BFN, 2x unmedicated-IUI = BFN
2006 May: Laparoscopy/Hysteroscopy = "Nice Uterus."
2006 Jun-Jul: 1x injectable-IUI = BFN
2006 Aug-Sep: 1x injectable-IUI = BFP
2006 November: miscarriage; D&C at 10 weeks
2006 December: waiting on blood test results ordered by GP
I have an appointment with my RE in a week. All the background work is done to start IVF; we're just waiting for the go-ahead. I actually can't wait to see how well (or poorly) our eggs and sperm tango when the lights are on!
Our reproductive history to date:
I'm 35 (but only for another 6 weeks); he is 39.
Our diagnosis: Unexplained
2001 (late): we start ttc (though not earnestly)
2002 November: miscarriage at 10 weeks
2003 (late): finally get in to see an RE
2004 February: HSG (Yuck!) all clear
2004 Jun-Jul: first cycle with clinic; Clomid-IUI = BFP
2005 April: DS born (c-section)
2005 December: back at clinic for more
2006 Dec-May: 3x Clomid-IUI = BFN, 2x unmedicated-IUI = BFN
2006 May: Laparoscopy/Hysteroscopy = "Nice Uterus."
2006 Jun-Jul: 1x injectable-IUI = BFN
2006 Aug-Sep: 1x injectable-IUI = BFP
2006 November: miscarriage; D&C at 10 weeks
2006 December: waiting on blood test results ordered by GP
I have an appointment with my RE in a week. All the background work is done to start IVF; we're just waiting for the go-ahead. I actually can't wait to see how well (or poorly) our eggs and sperm tango when the lights are on!
Labels: IVF 1, Trying to Conceive
Friday, December 1, 2006
posted by Tinker at 14:40
November is becoming a pretty crappy month for me. Both of my miscarriages have happened in November, and my mom died in November too. An intimidating thought is that if we can go ahead with IVF as I hope, that baby would be due in November. But I'm not going to wait just to have a baby due in December -- I think that's a crummy month for a kid to have a birthday (I have an inkling having been born in mid-January).
You see, I'm running out of time.
We've been trying to conceive for nearly five years at this point. Granted it was pretty casual at first, but we've been seeing an RE for three years and have had only marginally better success. The high point, certainly, was the birth of our son almost 20 months ago, but his arrival only cemented our resolve to have four kids. Until then we had been waffling between wanting two or four (not three -- we're each one of three and I know that I hated the dynamic). Given that I'm on the cusp of 36, we've really got to get moving before we (well, mostly my eggs) get too old.
You see, I'm running out of time.
We've been trying to conceive for nearly five years at this point. Granted it was pretty casual at first, but we've been seeing an RE for three years and have had only marginally better success. The high point, certainly, was the birth of our son almost 20 months ago, but his arrival only cemented our resolve to have four kids. Until then we had been waffling between wanting two or four (not three -- we're each one of three and I know that I hated the dynamic). Given that I'm on the cusp of 36, we've really got to get moving before we (well, mostly my eggs) get too old.
Labels: IVF 1, More About Me