Tag Archives: Clomid

What’s New?

I have been MIA lately on the blog. I keep oscillating between should I remove all the infertility obsession from my life (twitter, blogging, reading blogs, reading books on the topic, etc) to help me deal. Or is it healthy to accept and allow my obsessive ways. I think there is a happy medium between the two extremes that I need to find. So I am back… and here is a quick update on what has been going on in my life.

TODAY

I just sent back my final comments to my wedding photographer on our album proof… our TWO year Anniversary is Monday – haha! My photographer such an amazing job that I had the hardest time ever picking what photographs to use. Having the DVD of all the images didn’t help either as I could just flip through them anytime I wanted. I don’t like to think of myself as a procrastinator, but sometimes I am epic! Example 2 is the future nursery room that is essentially just a large catchall closet currently. Yes we purchased our home in the Winter of ’09 – we are coming up on three years. We talk about this room like the field of dreams… we need to clean it out and the baby will come. This thinking hasn’t yet produced action though =)

I added myself to the Stirrup Queen’s IComLeavWe (International Comment Week) October list. I’m hoping this will help me focus more on the blog – instead of just mentally outlining posts, but never writing them. More info here: http://www.stirrup-queens.com/2011/09/icomleavwe-october-2011/

It has been 3 months exactly since my endometriosis laproscopy – definitely thought I would be pregnant after three months… maybe fourth time is a charm?

THIS WEEK

Our little puppy Rosie got spayed on Tuesday (yes we got a puppy back in July – this is another whole blog entry). I joking told my husband this morning that she is like her Mommy now and can’t get pregnant! Normally she is crazy full of energy, but she is blissfully calm in her drugged up state. Sort of pathetic too in the cone head. The calmness is starting to wear off today already though, but that is good because it does not seem like she is in too much pain.

My husband went to dinner last night with his best friend, after he had noticed we were both so down on Friday night. I think that it was good for Joe to be able to talk to someone else besides me about what he is feeling. He also was able to share some of his feelings with me he hadn’t previously been able.

LAST WEEK

I officially started week 1 of the first cycle after a year of trying. I guess this technically makes me medically infertile now =(

I also found out that Charlotte, my friend who had the same endometriosis laproscopy procedure 6 days before me is pregnant. She had told me that she didn’t think she ovulated last month and was super down the last time I talked to her. So it was another one of the kick you in the gut pregnancy announcements because I had mentally put her in my safe, not pregnant box for another month. I know this should make me feel super hopeful that the surgery works. But I already knew the surgery works for a lot of people, but the reality is that everyone’s body is different. She was dealing with secondary infertility, so she already had answers to questions like, “maybe my eggs are just crappy?” My husband called at work and asked me to go somewhere private to call him and then he told me their news. I immediately just started crying. I spent probably 20 minutes on the phone with him, just sitting in front of my building at work crying. At times like that, I am sooooo tired of this journey and the reality is there could still be a very long road ahead of us. Charlotte was going to call me that night, but I had already been sort of weepy that day thanks to the Clomid and I just couldn’t handle it that day. The next day though, I mustered up my strength and happy voice and called her to wish them congrats. I realized why pregnancy announcements by close friends hurt the worst, because you would think you would be able to muster up the most happiness for those you care the most. It hurts because it feels so much like you are being left behind and excluded from a private club. It feels like a rift opens up a bit that separates the parents from the non-parents.

THIS PAST MONTH

I have added a few more layers of wellness to my get pregnant plan. I can’t stand to not change something from month to month. It just feels like Einstein’s definition of insanity… “doing the same thing over and over again and expecting different results.” So last month after I ovulated, I started acupuncture and seeing a chiropractor right after I ovulated (both of these deserve a whole post too). It didn’t result in a BFP, but I have been seeing some other great outcomes from the treatments. Maybe this month, it will all pay off?

This month, I added in removing alcohol from my diet. I am sure I will fall off the horse, but I figure reducing it 90% has to only be a benefit. We will see how I do at the wedding and all-inclusive vacation we have planned before Aunt Flo could make her dreaded appearance.

My brother got married! I wore the size 14 bridesmaid dress (ordered when I thought for sure I would be pregnant) that was “altered” back down to a size 10. It still looked huge! The wedding was so much fun and they are so happy. I have a new love of weddings currently. They are events filled with so much hope for the future – how can you not help but love them?

That pretty much covers the big stuff. Until next time!

HUGS to all, Kelly

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Peak +7 Bloodwork

I just scheduled my lab appointment for Wednesday to get my peak +7 bloodwork drawn. Last month, I never took the time to look up what exactly the doctor was testing. All I knew was that his office called with the results and told me, “the numbers are okay, but next month Dr. G would like you to raise your Clomid dosage.” It was a little discouraging to hear the doctor talk about next month when I hadn’t even had my period yet. Could he tell from my progesterone and estradiol levels seven days after ovulation that I would not be pregnant? Anyone know? I’d love to hear what you other IF ladies have come to know about these two hormones in your journeys – I hope you’ll leave comments!

Last month, I had been taking half a Clomid pill for a dosage of 25mg. This month I was instructed to take 3/4 of a pill for a dosage of 37.5mg. I have troubles with diminishing mucus and a side effect of Clomid is mucus reduction. So the doctor is trying to find the balance of just enough Clomid with the least effect to my mucus. To help the mucus, I’ve been taking 1200mg of Mucinex 2x a day and have been using Preseed lubricant.

My peak +7 numbers last cycle were:
Progesterone – 11.8 ng/ml
Estradiol – 224 pg/ml

I’ve spent a little google time checking out what functions these two hormones play since I had never even heard of Estradiol before seeing the lab order.

PROGESTERONE
(info from http://en.wikipedia.org/wiki/Progesterone)

Progesterone is sometimes called the “hormone of pregnancy”, and it has many roles relating to the development of the fetus:
-Progesterone converts the endometrium to its secretory stage to prepare the uterus for implantation. At the same time progesterone affects the vaginal epithelium and cervical mucus, making it thick and impenetrable to sperm. If pregnancy does not occur, progesterone levels will decrease, leading, in the human, to menstruation. Normal menstrual bleeding is progesterone-withdrawal bleeding. If ovulation does not occur and the corpus luteum does not develop, levels of progesterone may be low, leading to anovulatory dysfunctional uterine bleeding.
-During implantation and gestation, progesterone appears to decrease the maternal immune response to allow for the acceptance of the pregnancy.
-Progesterone decreases contractility of the uterine smooth muscle.

In women, progesterone levels are relatively low during the preovulatory phase of the menstrual cycle, rise after ovulation, and are elevated during the luteal phase. Progesterone levels tend to be 5 ng/ml after ovulation. If pregnancy occurs, progesterone levels are initially maintained at luteal levels. With the onset of the luteal-placental shift in progesterone support of the pregnancy, levels start to rise further and may reach 100-200 ng/ml at term

ESTRADIOL
(info from http://en.wikipedia.org/wiki/Estradiol)

In the female, estradiol acts as a growth hormone for tissue of the reproductive organs, supporting the lining of the vagina, the cervical glands, the endometrium, and the lining of the fallopian tubes. It enhances growth of the myometrium. Estradiol appears necessary to maintain oocytes in the ovary. During the menstrual cycle, estradiol produced by the growing follicle triggers, via a positive feedback system, the hypothalamic-pituitary events that lead to the luteinizing hormone surge, inducing ovulation. In the luteal phase, estradiol, in conjunction with progesterone, prepares the endometrium for implantation. During pregnancy, estradiol increases due to placental production. In baboons, blocking of estrogen production leads to pregnancy loss, suggesting estradiol has a role in the maintenance of pregnancy. Actions of estradiol are required before prior exposure of progesterone in the luteal phase.

In the normal menstrual cycle, estradiol levels measure typically <50 pg/ml at menstruation, rise with follicular development (peak: 200 pg/ml), drop briefly at ovulation, and rise again during the luteal phase for a second peak. At the end of the luteal phase, estradiol levels drop to their menstrual levels unless there is a pregnancy.
During pregnancy, estrogen levels, including estradiol, rise steadily toward term. The source of these estrogens is the placenta, which aromatizes prohormones produced in the fetal adrenal gland.

Serum estradiol measurement in women reflects primarily the activity of the ovaries.

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Birthday Blues

Today is my birthday and I can’t help but feel a little glum today. It is depressing to know that my eggs are now a year older. I know that I am still young-ish for this IF game, but I worry about how even more difficult conceiving a second and third child will be in the future. My DH and I have always wanted a larger family of 3-4, but now we just need to worry about conceiving the first one. I feel like not only am I disappointed we are still trying to conceive, but that I am grieving the loss of the family we had always pictured. I know I am getting ahead of myself a bit, but it feels true. In my head I thought that if we could easily get pregnant post-lap that there was a chance that we could have easy conceptions in the future. But every month that goes by could mean there are other issues at work too. I really do need to cut myself a break and breathe and give it some more time.

This last cycle, I had so much hope. It was my first full cycle after the endo laproscopy and using Clomid. I had been religious about taking all my pills. Plus we had discovered Preseed to help with my mucus issues. It felt like so much was different than past tries and surely these changes would tip the scale in our favor. It also seemed so perfect that we could get a BFP for our birthdays. My DH’s 30th birthday was on Friday and my 29th today. Plus the baby would have been due on April 24th, AFTER tax season. This is a big deal to us as my husband works in public accounting. It just felt like the stars were aligning.

Early BFNs were followed by the arrival of my period on Wednesday. I cried all the way to work two days in a row. Recently, my car has become my crying safe place. I must have too much time to think in there, because I know I am always at a higher risk of becoming a blabbering mess when driving alone.

So today I am blue about not being pregnant. Instead of going to the pool or doing anything social, fun and distracting, I’ve been moping around the house. The DH has been napping for the last few hours as he had a 24 visit to Chicago for a bachelor party yesterday. So he hasn’t had a chance to curb the pity party taking place on the couch.

Anyone else notice today, that despite the heat it is starting to feel like Indian Summer? I love summer and I am annoyed at myself for wasting one of the last good pool weekends. It is time to peel myself off the couch and get moving. Laying here is not going to make ANYTHING better. Today I took my first Clomid dose for the month, so it is time to look forward again and stop dwelling in what hasn’t happened!

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Hopeful Avoidance

You may have noticed that it has been pretty quiet on my blog since surgery. I hoped and almost certainly believed I would definitely get pregnant right away. Therefore, there was no need to blog about infertility, but now I feel my hope wavering a bit. I also still feel new to the infertility communtiy and wonder what right I have to complain when I haven’t had to fight the emotional and physical battles of miscarriages, IUIs and IVFs? What if I did become pregnant “naturally” (with a just a little help from Clomid) and there are all these other deserving women who have been through so much more and may have to continue waiting for their nugget? I always imagine that more veteran IFers are sometimes thinking, ‘oh honey – you haven’t seen bad yet!’

Recently though, I have been making peace with the reality that everyones TTC story is different. My situation may turn out to be easier than lots but it is also more difficult than the typical TTC experience for those lucky 5 out of 6 couples who don’t have to struggle.

So I have decided it is time to reclaim my blog to share my journey and work through the sometimes complicated and messy emotions that infertility stirs up! I hope that you’ll comment and share your experiences too in the comments. I am looking forward to reconnecting with everyone!!!

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Surgery Recap

The surgery is now officially over!!! I am so glad that to be done with it and to leave behind all the anticipation and anxiety! It took me a while to write these posts, first because the pain medication had me very high and I was unable to easily compose paragraphs that were coherent. Then I was glad to have the experience behind me and didn’t feel like revisiting it – not that it was really that bad at all. I had just spent so much time thinking about it prior that I was glad to have some carefree space back in my mind again! I want to capture my experience though for other woman who are preparing for a laproscopic surgery for endometriosis. I hope reading my experience can ease their minds by helping them know what to expect. The unknown is always so much more scary than it has to be.

After work last Tuesday, I came home and began to get ready for the big day. Unfortunately, I had a throbbing headache behind my right eye from stress, eating small meals all day (in fear of the enema), and not being able to take any pain killers. I think there was one type of pain killer I could take pre-surgery, but I couldn’t remember and didn’t want to risk taking anything that would thin my blood. Because of the headache, I was very crabby towards my husband, but he was very sweet at dealing with my very grouchy self. All I wanted to do was crawl into bed and pull the covers over my head, but we had to go through the pre-surgery checklist. Wash the sheets, wash the towels, clean the bathroom, wash the clothes I’d be wearing pre and post surgery, wash myself – everything had to be very very clean to minimize infection risks. I really wish that the nurse had warned me that the special soap they sent home with me to wash pre-surgery was bright red before I poured it on my new white washcloths, but in the end the pink color washed out. I was convinced it was ruined, which only enhanced my already pissy mood.

That evening, a pregnant friend stopped by to drop off a pan of lasagna for us to eat while I was recovering. It was incredibly sweet of her, but all I could do was stare with envy at her tiny baby bump and think about how my head felt like it was splitting in half. After she left, there was no escaping the enema! I definitely built it up in my head to be a much bigger deal than it was in reality. I can almost see how people do them just to find relief from constipation – ALMOST see! Eventually all the tasks on the list were done, I curled up in bed and amazingly fell right asleep. I slept the entire night without waking up once. I was so grateful to not have to deal with anxious tossing and turning.

We had a very relaxed morning, picking up the house and packing my bag, as we had until 10am to arrive at the hospital for the noon surgery. I showered again with the red hospital soap that morning. My mom arrived at our house exactly on time and with plenty of time to spare we all arrived at the hospital early – let me assure you, that neither my mom nor I EVER get anywhere early! After checking-in, we took a seat in the waiting area. By this point, I hadn’t eaten since 8pm the night before and was starving! All I could do was talk about how I would kill for a pizza!

After waiting about 15 minutes, a nurse came to lead us back to a patient room in the outpatient surgery wing, meanwhile I was still obsessing over pizza. Once back in the patient room, I went over my basic info with the nurse, I peed in a cup for a pregnancy test (BFN – not exactly a shocker) and was handed my surgical “outfit.” There were the ever so sexy, thigh high, white compression stockings, extra large surgical gown (but with good coverage when tied), and purple slippers. My husband teased that he wanted a photo to remember how hot I looked. After getting dressed, the main nurse came back with nurse number two. She again asked me the basics – I was asked four times my name , my birthday and what procedure I would be having done. They really do not want to do the wrong operation on the wrong person!

Nurse number two had me lay in the bed and put on these leg warmer, floaty looking things which connect to a machine that compresses and decompresses them to help reduce the risk of blood clots. Then she hooked my hospital gown up to a vacuum looking tube that pumped in air controlled by a personal thermostat remote. This was probably the best part of the whole experience!

I’m not sure why but I was expecting the IV to be inserted in the crux of my elbow where they draw blood, so I was a little taken a back when the IV nurse (nurse #3) started preparing my hand. While she was inserting the IV, nurse #1 was asking me some more questions, including if I had any open wounds. I responded that I had a paper cut from the other day still flapping about. Immediately I realized the ridiculousness of my response and started laughing at the exact moment she inserting the IV. Knowing that I should not be laughing, caused me to laugh even more – vibrating my entire body. The nurse was the IV pro though, so it hardly hurt.

During all this prep, my husband was asking questions about why and how things work. He is very analytical and likes to understand things like me. The IV nurse asked him if he was an engineer, which I found humorous as I work with engineers all the time and he is sooooo not the engineering personality.

Next up to visit was the anesthesiologist, who thank goodness was not the man I had met with during my pre-op appointment. He was very handsome and a little dismissive during our conversation. So first off, I was afraid I would declare him to be handsome once under the drugs, making a fool of myself. Second, his bed side manner did not conjure up great feelings of trust regarding my life. I felt a wave of relief wash over me as his partner, a woman doctor walked in who had a very pleasant way of speaking. It is irrational, but I just instinctively trusted her to do a good job.

Then my OBGYN came in the room. I wanted to clarify before surgery what he would do if he got in there and saw that ovaries and tubes were damaged by endometriosis. My biggest fear was to wake up and be told that both ovaries or tubes had been removed. He assured me that he would not be taking anything out unless it was something extreme like cancer (which was so highly unlikely). If by chance my appendix looked bad (I have a family history of bursting appendixes), he would call in a general surgeon to remove it. After our chat, I felt confident that I knew the limits to the surgery scope. I could see the crowd of people congregating outside the door at this point and knew it was about time.

After a quick prayer, the crowd of people swooped into the little room. It felt like I was completely surrounded on all sides of the bed by people. It was a little overwhelming. The new OR nurses quickly introduced themselves, and all I could respond was, “so many people.” This was the only time where I started to tear up, because it was surreal to be the center of all this medical attention. My husband gave me a quick kiss and I said bye to him and my mom. Later, My husband told me it was really hard for him, because I looked so scared and he could only sit there and watch me roll away.

It was literally only within a minute of their descent upon my room, I was being pushed down the hall. Leading up to surgery, I thought the journey from the room to the operating room might be the hardest part emotionally. I was thankfully wrong, because before leaving the room, the anesthesiologist gave me a shot of ‘happy meds’ in my IV to relax me and begin the sedation process. By the end of the first short corridor, I felt completly drunk! When we got to the operating room, I remember moving myself from the bed to the table. It was a very small table and the nurses asked me to make sure I was centered. That was the last thing I remember…

I woke up in a large room where there were patients recovering in beds all around the perimeter. I was only half awake but asked for nausea medication the first time the nurse (yet another new person) asked me how I felt. Nurse #1 had given me a pep talk before surgery to not be shy about saying I was nauseous or in pain. I was a squeaky wheel and was given the big gun anti-nausea medicine. I told the nurse that the pain was a 5 after surgery and after some meds it was down to a 3. I was very groggy in the room and I could hear them discussing my blood pressure. I normally have very low blood pressure – sometimes as low as 90/60. It dipped even lower than that after surgery, so I spent some extra time in recovery until it raised to a pressure they liked.

Around 3:30, I was rolled back into the patient room. I was so happy to see my husband and my mom! Nurse #1 brought me a tray with a jello and a sprite. I inhaled both, so she brought me more which also quickly disappeared. She then said I could try some solid food and brought me a bag of pretzels, which never tasted so good. The last step before getting released was that I had to pee. I was very relieved when it worked (2 bags of IV fluids and 2 sprites and I didn’t feel the urge at all!). Walking back to the bed, I was hit with a rush of nausea from moving around. The nurse called my OB and got me a nausea pill prescription. She kept saying that the pills would make me very drowsy. I did not understand why she kept saying it like that was a bad thing. Sleeping and waking up when I felt better, sounded fantastic! Before surgery the nurse had stressed that most patients get sick from the anesthesia and having their insides manipulated. I am so grateful that the meds were able to protect me from that added bonus!

While I was stuffing my face, my husband and mom told me what the doctor found. He removed endometriosis from my right ovary and cervix. The unexpected finding was a golfball sized cyst on my left Fallopian tube that was drained. The fluid drained was clear and not infected, which was good. The dye test run on my tubes flowed well on both sides and everything else looked good. The overall message from the doctor was that nothing he did would be a magic bullet fix, but everything that was done would help our chances of getting pregnant. My husband seemed to think the doctor was saying that the tubular cyst would not have been effecting my fertility, but I really can’t believe that when I see the pictures! He felt the cyst was probably causing most of my pain. He feels that the MTHFR blood clotting disorder might be playing a larger role and that we’d discuss that more at my post-op appointment. Overall it felt like mildly good news. He gave us the go ahead to try this month and mentioned trying Clomid again next month. So we’ll just have to wait and see if the proof is in the pudding as they say!

Spots of Endometriosis on right ovary

Tubular cyst on left fallopian tube

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Deja Vu

This is a completely repeat of last month with the negative pregnancy test after pregnancy test, then the light brown spotting, the achy boobs, and the bloated abdomen.  But still, I am holding out the smallest amount of hope that maybe I could still be pregnant!  That maybe the spotting was implantation bleeding and that the pregnancy tests were just too early.  Tomorrow is 14 days past ovulation and the day I predicted on my chart for my period.  Luckily I am out of pregnancy tests, but there can always be that last kick in the gut of the basal body temperature shift down in the morning.  Soon I will know and will need to start fully accepting that the Clomid didn’t work and the surgery will really be happening in 9 days.

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Surgery Update

As the original date for my surgery passed by on June 1st, I realized that I had 100% made the right decision!  Not only was a frazzled mess from being out of town just prior, I have no idea how my project at work would have been completed!  As a result of traveling and pushing myself too hard and not getting enough sleep, I also picked up a killer cold the day we got back from NY.  I was a full on gross mess on June 1st – Non-stop runny nose, colored snot, sore throat and body ache!  So let’s say they had gone through with the surgery – I can’t even imagine how miserable the recovery would have been with a cold on top of it!  I am still coughing away today as I write this!

Previously, my husband and I had decided when I canceled the surgery to reschedule for the next.  When I called to reschedule, I asked the nurse what would have happened with the surgery if I had been sick.  She assured me that with an active infection, the surgery most likely would have been canceled anyways.  I could not have been rescheduled for the next week because I had a peak ovulation day early that week.  I’m not sure if this is common practice, but my doctor will only perform the surgery from the last day of your period till you ovulate so as to not disrupt the embryo if one has formed.  So even if I hadn’t canceled, I would probably still be having the surgery this month anyways!

It feels great to know that I listened to my gut instinct that the timing of the surgery was wrong and to reschedule and give myself a stress break!

The extra time to prepare mentally has been great too!  I have been able to read up more on it and feel 100% sure that this is the next step.  I didn’t really even understand what endometriosis really was or how it worked.  I now know that every month that goes by it could be getting worse and causing damage.  I know that the surgery will reduce the amount of endometriosis and thereby the inflammation and toxins in my abdomen, making it a more hospitable place to grow a baby.

As my pain is not severe, I see it as an added benefit if the surgery helped abdominal bloating, discomfort and intercourse pain.  Only occasionally will I go home from work on the most extreme day of my period from intense lower back pain or nausea, but otherwise it is just a constant dull pain/cramping/nauseous feeling on most days.  I find the discomfort to be mostly in section of abdomen under my belly button but above where my pelvic bones jut out and in that area but around by my back.

My bloating is out of control during  my period.  This past period while I was in NY, I swear it looked like I had put on 10 pounds in that area.  It was to the point I would describe it as distended.  It is so uncomfortable and obviously not good for the self image.  I am only hard on myself about my tummy area and maybe it isn’t even anything I could fix with diet!  In between the end of my period and ovulating this month, I had a few days where I felt that my tummy looked normal and not sorta pregnant.  Luckily, I’ve never been asked by anyone if I am during these bouts of bloating!

I am now sort of looking forward to getting the surgery over.  Especially if I don’t get pregnant again this month, I will feel even more that the surgery is not overkill for the situation but the necessary next step.  It is scheduled on June 29th – so only 19 more days.  Another benefit is that because it will not be coded as an infertility issue, my insurance will pay for most of it.  I will only be responsible for my $1K copay.  That is a much easier bill to swallow than other infertility treatments.

This time I feel much more prepared to know what to expect.  I need to not have too high of expectations of bouncing back as quickly as I might hope and I definitely need to go out and get myself some more comfy sweatpants and dresses for the recovery!  Maybe a little retail therapy is required for my surgery pre-op!

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