That's our boy

That's our boy, originally uploaded by Kodamakitty.

Honestly, I thought I would have blogged more about this by now! So here's the lowdown - I am now 21 weeks along and our baby boy is starting to make himself very known to me. At first I thought it was gas, but now the sort of blips and flips are like nothing else. I can see why some moms report a sort of secret connection to their baby - no one else can feel the exact same thing you are, and the timing of the little kicks and turns can seem to be in response to what I am thinking or feeling.

For instance, on Wednesday morning, I hit the snooze button and thought, "Ok Benji, let's get a few more minutes" and I could swear I felt a small affirmative pat inside.

I do hope to go back and fill in all the details very soon, but for now, we are having a boy, his name will most likely be Benjamin Alexander (pending our first face to face meeting, of course) and things have been blessedly, thankfully, amazingly uneventful. With these flutters it has finally started to hit home that I am actually pregnant - it was such a happy accident that it felt like jinxing things to be too certain. I can't wait to meet him!

^_^

No longer a secret!

No longer a secret!, originally uploaded by Kodamakitty.

It's true - on November 4 I took a pregnancy test and found out that we are indeed expecting. It's been really difficult not to share the news with everyone and anyone, but since it was very much an off-chance, I needed to wait. More details when I can get around the fact that we're now "public" about the whole thing.

^_^

Contemplation

Lunartik in a cup of tea, originally uploaded by Kodamakitty.

I don't have a good photo to illustrate this post, but I am pretty pleased with this new toy, so there he is.

Ok, so since my last post I've finished my second round of 150 mgs of Clomid, which didn't do anything. It probably didn't help that I got a terrible head/chest cold right around the start of classes and was pretty much hopped up on Sudafed and Mucinex for the better part of a week. Still, sick or no, I kept my appointment for my day 12 ultrasound and we kept trying in case an egg decided to make a surprise entrance.

An ultrasound on day 12 and another on day 15 showed that nothing was really happening. My follicles were on the small side and a blood test showed that my estrogen and progesterone levels were not anywhere near what they would be if ovulation was imminent.

We met with Dr. Puschek on Thursday and we essentially have two options: Gonadotropic Injection Therapy or In Vitro Fertalization (IVF). Neither one is super cheap - I think the estimate for the injections are around $4000, and IVF is around $15,000. But, since I turn 35 next month, the odds of my having a viable pregnancy begin a very sharp decline.

So, if I do go with the injections, I would need to wait until I had a period at the end of October (we will be doing some extensive traveling and it just makes more sense to aim for November). Three days after my period begins Geoffrey or I give me a shot, usually in the abdomen. Starting on day seven, I would have to go in every day or every other day for a vaginal ultrasound and blood work to monitor my level of Estradiol, which measures egg maturity. Once it seems my follicles have matured and the Estradiol is at a specific level, I would then need an hCG shot to release the egg, followed by insemination. In order words, this is a lot like the Clomid regimen, but with injections, ultrasound and bloodwork every day for a week or so.

( source: http://www.ivf-indiana.com/gonadotropin-therapy.html)

According to the American Pregnancy Association, the steps for IVF as follows:
There are basically five steps in the IVF and embryo transfer process which include the following:

Monitor and stimulate the development of healthy egg(s) in the ovaries.
Collect the eggs.
Secure the sperm.
Combine the eggs and sperm together in the laboratory and provide the appropriate environment for fertilization and early embryo growth.
Transfer embryos into the uterus.

Step 1: Fertility medications are prescribed to control the timing of the egg ripening and to increase the chance of collecting multiple eggs during one of the woman's cycles. This is often referred to as ovulation induction. Multiple eggs are desired because some eggs will not develop or fertilize after retrieval. Egg development is monitored using ultrasound to examine the ovaries and urine or blood test samples to check hormone levels.

Step 2: Your eggs are retrieved through a minor surgical procedure which uses ultrasound imaging to guide a hollow needle through the pelvic cavity. Sedation and local anesthesia are provided to remove any discomfort that you might experience. The eggs are removed from the ovaries using the hollow needle, which is called follicular aspiration. Some women may experience cramping on the day of retrieval, which usually subsides the following day; however, a feeling of fullness or pressure may last for several weeks following the procedure.

Step 3: Sperm, usually obtained by ejaculation is prepared for combining with the eggs.

Step 4: In a process called insemination, the sperm and eggs are placed in incubators located in the laboratory which enables fertilization to occur. In some cases where fertilization is suspected to be low, intracytoplasmic sperm injection (ICSI) may be used. Through this procedure, a single sperm is injected directly into the egg in an attempt to achieve fertilization. The eggs are monitored to confirm that fertilization and cell division are taking place. Once this occurs, the fertilized eggs are considered embryos.

Step 5: The embryos are usually transferred into the woman's uterus anywhere from one to six days later, but most commonly it occurs between two to three days following egg retrieval. At this point, the fertilized egg has divided to become a two-to-four cell embryo. The transfer process involves a speculum which is inserted into the vagina to expose the cervix. A predetermined number of embryos are suspended in fluid and gently placed through a catheter into the womb. This process is often guided by ultrasound. The procedure is usually painless, but some women experience mild cramping.

These steps are followed by rest and watching for early pregnancy symptoms. A blood test and potentially an ultrasound will be used to determine if implantation and pregnancy has occurred.

( Source: http://www.americanpregnancy.org/infertility/ivf.html)

If money weren't an issue (and my mom generously continues to support the cause), I'm still not sure which way to go. Neither is assured.

Much much thinking and soul searching....

Geoffrey has found that our insurance will not cover IVF. And, at this point, it would seem that adoption would cost the same as IVF. So, we are going to try the injections first and go from there.

At least I get October off and then we start again.

^_^

Think Happy Thoughts

IMG_5457, originally uploaded by Kodamakitty.

Today was a long day. Not for any specific reason, other than that work is piling up and classes are imminent and I don't have nearly as much done from the summer as would like, and the house is a mess, and I have a sore throat from a post-nasal drip most likely exacerbated by my freezing cold office and and and... So, the usual.

But today felt more wearying than usual. So, Geoffrey and I have agreed to blame it on the Clomid. I finished my fourth round last night and now it's a matter of waiting until Thursday to see how things go. Originally, my ob/gyn only wanted to do three rounds, given that Clomid can start to affect the quality of the uterine lining. However, based on the various tests and procedures, it looks as though my main issue is ovulation.

When I do ovulate, it seems to be a complete cycle most of the time, and my period begins on schedule, but whether or not I am releasing a viable egg and whether or not the sperm are getting to it seems to be another story. I'm not sure it's entirely logical to think that I would be more at peace with my current chaos if I were pregnant right now, so I'm going to blame the Clomid.

To counteract the sort of blue and down feelings, I'm posting this with a bright yellow flower - this was one of the bouquets from the Farmer's Market at WSU and they lasted a really long time, which was great.

And, in no particular order, here is an impromptu list of 10 happy things:

1) I love Geoffrey and he loves me
2) He's really been a trooper though all of this
3) We're living beyond our means, but it's temporary and we will sort all of this stuff soon
4) Bailey and Zookie (the dogs) love us, no matter what
5) We will soon have a new addition to the family, when Alex and Kara have their baby on September 22
6) I was able to take a walk outside, without discomfort or difficulty
7) Olga's is pretty good comfort food
8) This cooler weather is excellent sleeping weather
9) We live in interesting times
10) It could all be much, much worse

Be well, everyone! What's on your spontaneous list?

It's only natural

It's only natural, originally uploaded by Kodamakitty.

And yet, I was really hopeful this time.

As I mentioned in my previous post, there appeared to be a candidate egg and poor Geoffrey had to learn to give me the hormone shot to stimulate its release. The following Monday (so almost two weeks ago) we went through insemination. We also found out the happy news that IUI is covered by our insurance (yet another instance where male procedures are covered, but I am sure someone else is blogging about that), so we didn't have to pay and we have since received a refund from the IUI in May.

All we could do was wait, since a pregnancy test would only pick up on the hormone from the shot and not give a true result. But today, alas, my period has started, thus the shot of feminine hygiene products (and a pretty Dunny for levity) and a crying jag from me...

Geoffrey is disappointed too, of course, but his gentle strength and reassuring love are the best balm to my bruised soul, and I'll readily admit, ego. These are not the sort of tests you can pass on merit alone. There is chance involved and Lady Luck is fickle. We can joke all we want to about women who have babies when they don't want them and how we spend all our time trying NOT to get pregnant until we do, but at the end of the day, my chances of conceiving are really about 20%. This is only really our third attempt. We may be able to get lucky on our next two tries or in our next seven tries.

I guess the important thing is to keep trying.

I may need to call in for a mental health day tomorrow. I'm okay, for the most part, just sad and I'm not sure I can truly deal with trying to be efficient and cognizant tomorrow. I may just stay in bed and watch "Truly, Madly, Deeply" while eating a bunch of chocolate and browsing on eBay.

Then on Tuesday, we will begin again.

Thanks for reading.

Taking another shot

Taking another shot, originally uploaded by Kodamakitty.

So I went in for a day 12 ultrasound on Thursday (another $150, plus $100 for tests run the time before - yikes!) and my ovaries weren't ready yet. Which is kinda disappointing when you've taken a triple dose of a supposedly powerful and effective drug. Thankfully, this is the week I decided to use up some of my vacation time because I immediately went into sulking mode. Geoffrey was slammed at work, so he wasn't able to help me put things into better perspective until he got home. Which, of course, he did. My reaction to the Clomid could have been so much worse, I've lost a decent amount of weight, and I'm generally eating healthier (though my sleep hygiene does leave a bit of something to be desired).

I had to go back in on Saturday (you guessed it, another $150) and this time, it looks as though there is one "perfectly round... beautiful" follicle of the correct size to merit the shot to stimulate ovulation. Now, when we did this in May, we had to make a decision - inseminate before the shot so the sperm would be waiting, or inseminate after the shot so that the sperm would chase the egg. We decided to do the shot first. This led to a crazy race against the clock to get the injection, go home, have sex (because there shouldn't have been more than three days between ejaculations), come back 24 hours later, have Geoffrey, erm, produce, and then get inseminated two hours later. To say it was exhausting and chaotic was a bit of an understatement, followed by the disappointment of the egg and sperm not meeting up.

This time, the nurse suggested that if Geoffrey was comfortable giving me the shot in the evening at home, ovulation would occur within 36 - 48 hours, meaning that the insemination on Monday morning would have a better chance of coinciding with the release of the egg. My wonderful husband gamely walked through the procedure with the nurse, was handed everything in the photo above plus a square of gauze "in case she bleeds," and then we were ushered out the door with a reminder to have sex that day, none on Sunday and be ready to produce on Monday.

Flashback: when I was in high school, my dad became ill with non-Hodgkin's Disease lymphoma and so he couldn't control his type II Diabetes and his hypertension just with diet and exercise. For a short while, my aunts would come by and administer the insulin he needed. But one night, no one could come, so it fell to me. Why my dad hadn't learned to inject himself is a mystery to me now, but I got my first lesson on giving a shot over the telephone. Up until my junior year, I had thought I would become a nurse, like my mom and most of her family, so I suppose it seem like as good a time as any to learn how to use a hypodermic needle. Thing is, I hate needles. Totally freaked out and scared of them.

This meant that my hands and presence of mind were not too steady giving this shot to my dad. It was not pleasant, and I botched it terribly (the insulin formed a bubble beneath his skin, so it didn't get delivered into the muscle). I cried my eyes out, because my dad was also expressing how much I was hurting him at the same time (I did eventually get proficient at administering insulin and using lancets to check blood sugar - in fact, most nights I would have to be home by 11 in order to help with that). Did I mention I hate, hate, hate needles? Definitely one of the major factors in deciding to major in Psychology instead of Nursing.

So, my brave, brave husband and I discussed the fact that he had never given a shot before. Thankfully, my mom was off this weekend and agreed to supervise. Thankfully, too, the shot is administered to the top outside quandrant of the buttock (either side) and so I cannot see it and it doesn't hurt as much as you might think, especially when my mom, the uber-nurse, looked at it and said, "wow, that's a long one - they really mean for it to be IM" (intra-muscular), and starts measuring it with her thumb. Not reassuring, except that I knew it wasn't that bad once the needle was in.

I am happy to report that Geoffrey did just fine and the shot was administered successfully. My mom talked him through it (I can see why she's a good teacher on the unit) and also had extra alcohol wipes in the house since the nurse only gave us one pad (I mean, really - you have to wipe the bottles AND my butt. One is not enough. But I digress).

Tomorrow we go in for another "deposit" - insemination (another $350). Keep your fingers crossed!

Reflections

Me Then: October 23, 2008 (which was my birthday)


Me Now: August 2, 2009


I was using the "Faces" feature in iPhoto and suddenly wanted to see photographic evidence that I was actually managing to lose weight. I know my clothes have been fitting better and I am enjoying smaller portions of things, but I really think these two shots hammer home that I am making progress and that I need to keep going. Sooner or later, I'm sure I'll be taken off of the metformin and I need to be ready.

In other news, I finished a triple dose round of Clomid (150 mgs per day) last week so tomorrow morning I go in for yet another ultrasound. If all goes well, we'll attempt insemination again on Friday. It's been frustrating, especially as I start to sort through all of the stuff in the house and begin to realize just how mortgaged to the hilt we really are. But I am sure that we would be able to handle a baby, right? We'd just have to make do and cut back on stuff and sell stuff and borrow stuff and make it work :)

Thanks as always to everyone for their loving support - especially Geoffrey.