Level 3 Failed. Continue?

Friday's ultrasound and blood work were incredibly easy, I was in and out of the office in about ten minutes.  Feeling confident I spent the day slaving away at the big monthly spreadsheet report.  The nurse called around 4 with my results.  (Now, just as a refresher, on 50mg Clomid I had two follies on my right at 15mm and 12mm and one 12mm follie on my left with blood work showing I was already surging.)  On my right ovary I had two follies at 16mm and two more at 14mm.  On my left ovary there were two follies at 13mm and two at 11mm.  Eight measurable follicles from 25mg Clomid!  

The nurse told me to trigger the following day and IUI would be Monday afternoon.  We were able to go down to Baltimore as planned!  We packed the car up on Saturday, my Ovidrel shot sitting in the insulated packaging with an ice pack.  Everything was going great until it was trigger time.  It was about 1:30am, wanting trigger to happen as close to 36 hours before IUI as possible without staying up all night.  I was so incredibly nervous and I read the directions over and over again while waiting for the Ovidrel to come to room temperature.  Dave and our friends B and R were with me in the kitchen, giving their support.

It was go time.  I went to take off the cap, my hands shaking as the cap resisted.  There was a pop, but it wasn't the cap.  Somehow the plunger had pulled back and came completely out.  The medication spilled out all over the counter.  I stood there completely dumbfounded, wondering for a split second if I could just replace the plunger and suck the liquid back up into the syringe.  Once that stroke of desperate stupidity had passed I panicked and called the after hours service for Dr. S.  I was two states away with no chance of getting a second syringe.  The on call nurse put me through to Dr. S, it never ceases to amaze me how calm and collected that man is.  I would have to come in Monday morning for another ultrasound and blood work and see where we could go from there.

After getting off the phone we all went to bed.  I broke down and cried hysterically.  The cycle might be ruined and it would be all my fault.  Dave comforted me and got me to calm down, reassuring me that everything would be fine.  I didn't sleep well at all that night.  

The next morning as we got ready for Ren Faire I chatted with my NJ IDOB ladies and they helped me so much.  The cycle wasn't ruined, there was still plenty of hope.  Ren Faire was a lot of fun as always and really helped take my mind off the previous night's disaster.  We headed home later in the afternoon, got take out, and starting watching season 8 of How I Met Your Mother.  All in all a nice relaxing evening.

The ultrasound and blood work this morning went well and it seems I have not ovulated yet.  The tech said my blood work results would determine the course of action.  Best case scenario is trigger tonight with IUI tomorrow or Wednesday.  If I'm already surging then we'll be downgraded to TI.  Just waiting for the call now....        

Level 2 cleared

I am very grateful for this warmer than usual weather.  Yesterday morning we left the house at 6am and I didn't even need a jacket.  Not many cars were on the road yet and we made it to Dr. S's office relatively quickly.  While I am in no way a morning person, there is a serious perk to having the first appointment of the day.  The nurse took me back for blood work right after I signed in.  It hurt more than usual, but my troll veins relinquished blood quite easily.

The ultrasound was not pleasant.  My right ovary was way over to the side, almost impossible to see with the trans vaginal ultrasound.  She tried the usual technique of pushing down on my abdomen while searching with the vag wand, but no luck.   All it accomplished was giving me major cramps and discomfort.  Out came the regular wand and she was able to get a good view.  After what felt like an eternity she was done.  As usual she didn't give any results, but once again wished me luck.  This worked out well last time so my spirits were up.

Dave and I were working from home that day so we stopped at a little place to grab breakfast.  As usual when we work from home there was a large crisis at the office.  Luckily the outside tech company had a handle on it and we didn't have to rush in.  Good thing too since I didn't have my laptop and was wearing yoga pants, an old t-shirt, and a very worn hoodie.

Around 1pm the nurse called with my results.  She didn't give me the actual sizes, but I had two follies nearing maturity on my right ovary.  There are two smaller ones that may or may not catch up on my left.  I go back in tomorrow morning for another ultrasound and more blood work.  If things have progressed I could be triggering tomorrow night.  Not sure when IUI would be, but have a feeling it would be Sunday morning.

Of course we have plans to go down to Maryland for the weekend.  Our friends B and R live in Baltimore and plan a big group trip to the Maryland Ren Faire every fall.  The Faire trip is on Sunday, but we were going to head down Saturday afternoon to spend the day with them.  At this point it is what it is.  We'll know for sure what's up tomorrow.  Best case scenario is trigger on Saturday with IUI on Monday morning.  

Level 1 cleared

Just after lunch I got the call from the nurse with my results.  I was so nervous, trying to ready myself for bad news.  When she said I could start the Clomid that night I almost cried.  She said that Dr. S wanted me to start taking a baby aspirin everyday as well.  My follow up ultrasound and blood work is scheduled for next Wednesday morning.  I'm happy they are doing it on CD9 in case I respond quickly again.  A short while later I got the call from Mandell's pharmacy to set up my customer profile.  They would have to run everything through insurance first, but I can hopefully pick up my Ovidrel (trigger shot) tomorrow.

I felt a little silly cutting the Clomid pill in half last night.  It's such a small pill already.  At least it was very easy to swallow with a big gulp of water.  No disgusting taste was left behind either.  The baby aspirin are orange chewables and are actually quite tasty.  No side effects so far, hoping I can get away symptom free this time.

One thing I am most excited about is being able to go back the gym.  I gained a few pounds during my exercise restrictions last month and I'm sick of my pants being tight.  My new goal is to not have to buy any new clothes until I'm in need of maternity sizes.    

Make or break

Surprisingly my period started on it's own Tuesday evening.  It's the usual wonky post-anovulatory cycle bleeding and has pretty much disappeared by this morning.  I got the 6:40 slot this morning so Dave and I were out the door very early.  Of course the office was locked up when we got there at 6:30, when they are supposed to open, but the nurse let us in around 6:35.  

The ultrasound was fairly quick.  The tech had no problem finding my right ovary this time.  The techs don't give results, but she wished me luck as I was leaving.  I'm hoping that is a good sign.  Having blood taken was its usual adventure.  Luckily the nurse is very familiar with my troll veins at this point and was able to get enough.  I won't know the results until this afternoon.  Should everything come back okay I'll start my meds tonight.

For this cycle I'll be taking 25mg Clomid for five days.  Dr. S wants to give this a try first since I responded so well follicle wise to the 50mg.  Should I have problems with cysts again then we will be moving on, most likely to injects.  This will also be our first IUI cycle which I'm very excited for.  To time the IUI correctly I will take a trigger shot when my follicle(s) is/are ready to go.  

If this cycle gets cancelled I will be a wreck.  Getting pregnant before November seems like such a long shot already.  If we were to be cancelled again it becomes pretty much impossible.  Of course my hopeful side is trying to be encouraging.  My birthday is in about three weeks, possibly near the end of a two week wait if I respond quickly again.  That's what I want for my birthday universe, to find out I'm pregnant with our rainbow baby.  Please make it happen.  Pretty please?  With sugar on top?    

Coming storm

I find myself starting to crack.  When it became obvious that we were benched for the cycle, with the added insult of pelvic rest, I decided to make the best of it and throw myself into other activities.  Perhaps it was the high of finally being able to do treatments and having the great follicle response to Clomid that gave me confidence.  This benched cycle would be nothing, just a small bump in the road to our rainbow.  It's now CD24 and the downhill portion of the IF roller coaster has started.  The doubts and fears are creeping in again.  What if 2013 isn't our year?

Some important dates are coming up and I'm scared to face them.  October 15th, the day before my birthday, is Pregnancy and Infant Loss Remembrance day.  Last year it was too painful to do anything on that day.  I should have been 36 weeks pregnant and we were still in the closet about the miscarriage.  Still, I lit a candle in remembrance of our little bean and hoped our rainbow would be coming soon.  Then there is November 20th, my original due date.  This year our baby would have turned one.  It's hard to wrap my mind around the concept that in a different reality I would be planning a first birthday party instead of dreading hitting the two year mark since we started TTC with a still empty uterus.

I can't make time stand still or put off these painful days.  The world is moving forward at its usual pace and I need to move along with it.  Instead of laying down and succumbing to sadness it's time to stand up and face the day.  There will be sad times, times it feels like this was all for nothing, but as one of my favorite motivational quotes goes:

"Just because today is a terrible day doesn't mean tomorrow won't be the best day of your life.  You just have to get there."

Just keep swimming

Sorry I've been MIA for a bit.  Being benched this cycle really brought my spirits down.  I hate being on activity restrictions and have definitely done quite a bit of moping.

Last we left off I had been told by Dr. S that my ovaries were enormous and we needed to have a discussion on how to move forward.  Two ultrasounds later my left ovary is back to normal.  Righty is still enlarged, but only about 3 times the size it should be.  I am on pelvic rest for the remainder of this cycle and still need to be careful with strenuous activity.  My next ultrasound will be next CD3.

The plan for next cycle, as long as my ovaries are okay, is to do 25mg Clomid with trigger and IUI.  Follicle-wise I responded beautifully to Clomid.  Dr. S believes that the Clomid just stays in my system for a longer time than normal which caused the cysts.  Hopefully going down to the half dose will correct that problem.  Due to my UU he's not ready to move onto injects yet, being very concerned about the risk of multiples.  He doesn't usually use Femara, but will keep it on the table should the Clomid fail.

So for now we are just waiting for my period to show up.  If my body decides to ovulate on its own this cycle then that should be happening any day now.  If not I will call on CD30 for Provera.

Being able to do more activity now, I've been motivated to get stuff done around the house. Since I can't obsess about TTC for a couple weeks, might as well put that crazy to good use.  This past weekend Dave and I scrubbed the floors in the guest bathroom, swept and cleaned the hardwood floors, got all the laundry into appropriate bins, vacuumed the area rugs, and hung the new wine rack/glass holder over the bar.

My project for next weekend is to fix up the front foyer.  My hope is to replace the old shelf unit, clean the tile, and maybe even paint.  I went to Lowes on Saturday to pick up some supplies (drywall anchors and a level) and spent a good twenty minutes in the paint swatch section.  Came home with about 30 swatches and picked out a new color scheme.  Our walls are a bright teal color at the moment, but I feel it's time to dull it down a bit.

Our foyer

 The only rooms we have painted since we moved in are the foyer, hallways, living room, dining room, and our bedroom.  All of the above are the same bright teal color except for our bedroom, that is a dark teal.  Our home has a somewhat open floor plan so it flows nicely to have all one color on those walls.    Since we'll be redoing the kitchen at some point this fall I'm taking it as initiative to fine tune our home color palette.  Below are the swatches that we've decided on for the moment.  The living/dining room color would extend to the front hallway.  We will not be repainting the master bedroom, but I included a close match to the color for reference.

The main color probably won't happen for a while or will happen a wall or two at a time.  The foyer will be very easy and the kitchen will be done during renovation.  The guest bathroom will be quick and I want to replace the old medicine and wall cabinets as well.  We're considering renovating the master bath as well so I'll hold off on painting that for now.

I'm very excited to have some new projects ready to go.  Keeping my mind occupied with tasks like this are helping me keep my sanity while on the bench.  Wine helps too.

Weighing the options

I saw Dr. S yesterday for an ultrasound.  He wanted to personally look at my ovaries and check my heart.  My heart rate was perfectly normal and I was not having any pains or trouble breathing.  During the ultrasound he pointed everything out on the screen.  My ovaries were enormous and he could not tell where one ended and the other began.  He did not find any fluid in the cavity so it could not be labeled OHSS (Ovarian Hyper Stimulation Syndrome).  There was a small victory in that my lining was down to 8mm.

After the scan he gave me a sheet of strict instructions to follow.  It is basically slightly modified OHSS precautions.  Absolutely no intercourse/tampons/anything up the hoohah for at least a week, possibly two.  I'm not quite on bed rest, but need to stay off my feet as much as possible.  I cannot do any lifting, strenuous activity like exercising or dancing, or heavy housework.  If I have any abdominal pain, trouble breathing, problems urinating, or gain more than 3 pounds in 48 hours then I need to call in immediately.        

I go in tomorrow afternoon for another ultrasound and afterwards we'll discuss our plan moving forward.  We have the day off from work so Dave will be able to come as well.  Our options at this point are to try Clomid again at half the dosage or move on to injects.  Both plans have their risks.  With Clomid I could have the same response and my ovaries blow up.  With injects the risk of multiples increases greatly, which is something we want to avoid.

Clomid

Dave and I went out to dinner last night and talked about these possible plans.  I explained the risks each plan would entail.  After much discussion we decided to lean towards injects.  My body just does not react as it should and it seems foolish to try Clomid again.  Injects, while increasing the risk for multiples, usually do not have any side effects and is easier on the body overall.  There is also a lot more monitoring involved in case my ovaries go crazy again.

For now I am taking it easy and trying not to overdo it.  Hopefully my ovaries are shrinking and we'll get some good news tomorrow afternoon.  We're going out shopping tonight since I need a dress for a wedding on Sunday.  I'm so bloated that everything I own makes me look and feel like a whale.  Hopefully I'll find something nice and comfortable that doesn't make me look enormous.