Swabs, Syringes & Gonadotropins, Oh My!

This is what $3,200 worth of medications looks like.

My husband came home Wednesday to this sight  and joked, "Let's open a pharmacy!"

Almost looks like we could.

And don't worry, eagle-eyed IVFers, I only pulled half of my Cetrotide kits out of the fridge for two minutes to take this photo :)

It took a lot of back and forth — many phone calls and emails — with two different pharmacies to get this loot ordered. We applied to two discount programs and priced out the meds multiple ways (with insurance, without insurance, with discounts applied, etc.) in order to find the best price. Our fertility clinic estimated that the medications for one round of IVF would cost somewhere between $3,000-$6,000. The initial estimates we received were near the upper end of that range, about $5,500. I still can't believe how much we were able to get those first quotes down and I'm honestly thankful for my nagging annoying tenacious personality, that I continued to check every option and take copious notes. I actually asked the pharmacy rep to check the final total three times because I was in such a state of disbelief. Suddenly the more expensive pharmacy (by $300) was the cheaper pharmacy (by $400) and it was like I was at an auction; I didn't want to lose the bid! $3,200 going once, going twice, and SOLD to the surprised infertile woman on the phone! While we didn't plan to order the medications that day, Greg agreed we needed to get while the getting was good.

As I unpacked the huge box Wednesday morning and took an inventory of what I'd received, everything began to feel incredibly real. My stomach turned as the thought crossed my mind: All of this is going into me. Three different injections (well, four if you count the HCG trigger shot), a couple kinds of pills, and progesterone to insert, uh, vaginally. (Thrilling!)

I knew what IVF entailed, I'd attended the injection training workshop, I'd reviewed the prescription. But seeing it all sprawled out on a table in your living room is a whole different thing.

As nervous as I am, I'm trying to feel excited, too. At the very least, I feel more prepared to start our first round next month. And with all these boxes of medications and packages of syringes staring us in the face, we surely won't postpone again. Fingers crossed!

Not Alone

(via In Everything)

My current line of work as a bridal stylist has me meeting and connecting with women of varying backgrounds and experiences every day. And often, we bond in the most surprising of ways. (She’s in her skivvies, I’m measuring her bust and her booty… Suffice it to say, we get close fast and intimacy just can’t help but develop!) Wedding talk sometimes turns to real life talk and that’s exactly what happened a few nights ago.

Heidi was actually a walk-in appointment that we managed to squeeze in at the end of my shift when another bride didn’t show. An older bride (41, I later learned), she came by herself and was seemingly shy and soft-spoken for most of our hour together. Then, at the end of the appointment, when I went to get her waist and hip measurements, she noticed a big blue bruise on her belly.

“Oh no,” she said, grabbing at her stomach. “We must have hit a blood vessel.”

“Right now?” I asked quizzically.

“No, no,” she replied. “It’s from my injections.”

I caught my reflection in the mirror — my mouth gaped open in shock. I instantly knew what she meant. And yet, there was more to the story.

She went on to tell me that she was diagnosed with breast cancer; that she underwent a lumpectomy, and was then faced with deciding whether or not to undergo a mastectomy or radiation. Heidi decided on radiation but, somewhat against her doctor’s wishes, opted to retrieve some of her eggs first. That’s what the injections were for, in preparation for her egg retrieval.

As she shared her story, it took everything in me not to let the tears welling up in my eyes fall down my cheeks. Here was this woman, literally standing in a fitting room in her bra and underwear, confiding in a perfect stranger. One who is also struggling with infertility and yet, her situation is even more trying than mine. I kept thinking, she is so strong.

“Well, you know, my husband and I are actually starting IVF next month,” I offered.

My words opened up the conversation even further, and we traded more information: 

She only has one ovary and, despite how “young and healthy” I look (to Heidi, anyway), I actually don’t have “tons” of good eggs either. I told her I was a nervous about the injections and she advised that my husband treat the needle more like a dart — fast with a flick of the wrist. Inserting the needle slowly hurts more. (Heidi bought her fiancé clementines to practice.) The hormones make you gain weight, she also informed me; I laughed and said I’d heard that fun tidbit of information before and wasn’t looking forward to it. Heidi asked if my clinic is also RSC (the Reproductive Science Center of the San Francisco Bay Area) and I replied that, why yes, as a matter of fact, it is. 

The whole exchange left me stunned and, strangely enough, exhilarated. I couldn’t believe the connection I’d just made in 15 minutes in a dressing room. It felt a bit like kismet. We hugged goodbye and wished each other luck on our respective TTC journeys, and I spent the rest of the night marveling at the unexpected turn of events.

Moments like these remind me how important community and connecting is, especially when going through a trial, of any kind. Knowing that there are others who understand and are walking a similar path can give you the strength to continue on — not to mention valuable perspective. 

You are not alone. We are not alone.

A Delay of Plans

A pair of hopeful Christmas ornaments, symbolizing my wish for 2017.

We were supposed to start our first IVF cycle this week. The skin below my belly button should be tender from needle pricks, and I should be even more hormonal and emotional than usual.

We should be on our way to finally, hopefully, maybe making our dream come true.

BUT.

Lest we forget the hallmark of infertility: Waiting. Always more waiting.

For the past two months, since the beginning of November, I have worked feverishly to get everything checked off our pre-IVF to-do list, with the ultimate goal of starting our first round in January. My nurse case manager said that wasn't an unreasonable goal, if I was motivated. And I was.

Aside from the usual blood draws and physical evaluations, the list included watching nearly 2 hours of online education modules to learn about mixing and administering my medication (definitely some cringe-worthy moments there!), attending an in-person injection workshop, reading and signing a stack of consent forms, obtaining price quotes and applying to available discount programs for my medications, and applying for a loan to help fund the whole crazy-expensive process called IVF.

Yet, as we inched closer to our anticipated start date of Jan. 14, it felt like we were racing against a clock that was precariously dangling above my ever-faster graying head. (Those suckers just keep taking up residency in new roots day after day.) I had outstanding questions for my nurses and doctors and responses were not coming in their usual lightning-speed fashion. (Isn't that always the way when you're in a serious time crunch?) And suddenly we were faced with the reality of paying a loan "security deposit," of sorts, on top of loan documentation fees, on top of thousands in medications — all at the same time.

I could feel it but didn't want to admit it; the timing just wasn't working out. We were going to have to postpone. It was a week into January and we were finally taking down our Christmas tree when I spontaneously burst into tears and cried out to Greg: "Is this really going to happen? Are we going to do IVF or not? I just need to know."

I was worried for my fragile emotional state. Preparing to launch into something so huge, so costly, slightly painful, and potentially unsuccessful in the end is enough of a burden without being unsure if you really are going to take the leap... and when. I needed us to be steadfast. Committed. Unwavering in our decision and undeterred. Not to mention I had this nagging feeing of "what will people think?" since I had confided in a few work friends as well as told my managers about our plans.

The straw that broke the camel's back was a phone call from our RE. A bit perplexed by a discrepancy in two test results, she wants us to try something for a few weeks that could, if successful, save us from spending an additional $1,800. This news shook me out of my denial and forced me to concede. We'd have to wait until February.

There are still a few loose ends to tie up and it's not going to be easy, but for the moment I am trying to find the positives in being afforded this extra time (like that optimistic spin?) and I'm looking forward to a productive month of LOVE.

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Our TTC Story

My husband Greg and I knew we wanted to have children right away. In fact, when my birth control pills ran out a couple weeks before our wedding in May 2014, I didn’t even bother to refill the prescription. When the topic of having kids came up, we had already told a few close friends and family members we hoped to be pregnant by the end of that year.

Of course, life doesn’t always go as planned, and we were flexible. When my best friend got engaged two months before our wedding, I decided we should hold off on the baby-making. I didn’t necessarily want to be a pregnant maid of honor and, more importantly, I wanted to be able to fully participate in all of my friend’s pre-wedding celebrations just as she had been able to for mine. Feeing a tiny bit impatient, we only casually started trying (read: not preventing) in December 2014, about three months before my bestie’s big day, and then slowly began ramping up our efforts in February 2015.

If you’re doing the math, that’s two years now that we’ve been TTC — trying to conceive. Two years since I entered the land of “alphabet soup,” as my dad would call it. By June 2015, I was fully immersed: From checking and charting my BBT (basal body temperature) the moment I woke up to paying attention to the status of my CM (ahem, cervical mucus)… I tried OPKs (ovulation predictor kits) a few times to further help with timing BD (baby dancing!) but they mostly left me frustrated and confused. 

Oh, and I can’t forget the dreaded 2WW (two week wait) before taking an at-home pregnancy test, only to ever receive a BFN (big fat negative) and then, usually the next day, AF (Aunt Flo). The amount of acronyms swimming around in this skull is, well, mind boggling. 

I read Taking Charge of Your Fertility — what is akin to the fertility bible — cover to cover in a day, and ordered several more books that seemed to promise answers. I’m not typically such a voracious reader but I was thirsty for information, for a solution. 

It’s hard to explain but I just knew in my bones that something wasn’t right. And no amount of “just relax, it will happen” or “get drunk, that’s what we did!” was going to fix it. But we needed to wait the requisite one-year of trying unsuccessfully before reaching out to a reproductive endocrinologist (RE).

You can read a recap of our TTC journey thus far here (you’ll see the prevailing theme is lots of tests and lots of waiting). But to summarize, following several blood tests and procedures, including a diagnostic laparoscopy, we learned:

• I have endometriosis. I guessed as much based on my symptoms, but only a surgical procedure called a laparoscopy can officially diagnosis the disease. My doctor classified my endo as stage II or III.

• I have low AMH, or anti-Mullerian hormone, and a low antral follicle count, both of which are indicators of ovarian reserve. Essentially, my remaining egg supply is very low (about that of a 40-something woman) but, because I am just 31, the assumption is that the eggs I do have are of good quality. Related, my FSH (follicle stimulating hormone) is elevated, which means my body has to work harder to grow a follicle each month.

• A blood test also revealed that my TSH (thyroid stimulating hormone) was higher than doctors would like it to be for someone trying to get pregnant. I’ve been on a low-dose thyroid medication for almost two months and my TSH has been brought down into the ideal range. I just have to keep taking the pill every day :)

Those are the main issues at play, and while it will be an uphill battle, I feel somewhat fortunate to at least know why I am struggling to get pregnant since there are others who are simply diagnosed with “unexplained” infertility. (I can only imagine the additional frustration that brings to the infertility journey!) Knowing what we are up against makes me feel ready to fight and, hopefully, beat the odds.

Recently, our current RE, Dr. Willman, called us with some test results and it was not exactly good news. Greg expressed to our doctor how difficult and defeating it is to constantly be presented with new roadblocks as we attempt to move forward. Now, what I appreciate most about Dr. Willman is that she’s typically very direct and matter-of-fact. She doesn’t have the warmest bedside manner — she’s not one to spout off encouraging words to make you feel better — and yet, in that moment, she said just what my wounded heart needed to hear:

“I believe that one day, I will be calling you with good news.”

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Hello from the girl with a dream

For as long as I can remember, I’ve wanted to be a mom. It was an inner desire that I always felt and never questioned, and the longing has only become palpably stronger — truly, an aching feeling in my heart and gut — in recent years. (Baby fever is real, ya’ll.) I had friends who weren’t so sure. Who even at times said they did not want kids. And I had friends who waited… Who waited a long time. But those friends now have those babies they weren’t so sure they wanted, or were in no rush to conceive. For many it happened on the first try — they pulled the goalie and scored! — or before they were really ready. (“We wish it had taken us longer,” one said.)

My story — and, by consequence, that of my husband’s — is different. My journey to motherhood has not been smooth, quick or easy, despite knowing my intended, hopeful destination from the very beginning.

I am infertile. 

Wow, that’s a hard thing to type, let alone say out loud. Even when talking with friends and family, I usually soften the blow. The “I” word just seems to put a painful exclamation point on the whole situation. But it is the simplest way to express the truth that has consumed our lives for the past two years:

I am infertile.

And since we’re being honest… Truth be told, I have wanted to share about my infertility experience for months. “Write blog post” has been on my to-do list and scribbled in my calendar — alongside bullet points for blood tests, doctor’s visits and everyday life stuff — countless times. And yet, I could never cross it off the list. Every free moment, fear stopped me.

Fear of opening up about a private battle with the world, and what people — strangers or acquaintances — might think or say. Fear that I could never adequately or accurately express the crazy swirl of emotions inside my head, and do it as well as others have already done in the infertility-blogging community. Fear that putting those thoughts and feelings on (figurative) paper would just leave me sadder in the end. And fear that somehow the act of publicly sharing this struggle would jinx me, as if I need any more bad luck.

But it’s a new year and it’s time to push past the fear. 2016 was a hard twelve months, for many reasons beyond infertility, but the “I” word was definitely the gray storm cloud that hovered and thundered above my and my husband’s heads — dominating our thoughts and conversations, influencing our actions and emotions — the most.

I’m hopeful that 2017 will be better. That it will be “our” year. But whatever the outcome, I can no longer deny that other inner leading to document the journey. Not only to help myself (a cathartic release, I hope) but to perhaps help others feel more understood and less alone. I agree with those who have touted the importance of speaking out about infertility, miscarriage and pregnancy loss. We women, and our spouses, shouldn’t have to suffer in silence; it shouldn’t be taboo. Infertility is a disease, one that affects 1 in 8 couples and ravages the heart and the mind as much as if not more so than the body. We need all the support we can get, and to spread around that “baby dust,” which really just is LOVE, as far and as wide as possible.

Dreaming of Lullabies will be my place to do just that.

Until next time, my fellow dreamers and infertility warriors,

xo Carissa

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