Thursday, July 28, 2011

Exhausted

Quick update. . . .

  • The Zo.fran is helping.  I take a single dose around 7:30 each morning, and it gets me through until around 3:00 in the afternoon.  I still have lots of food and smell aversions and have to eat small, frequent meals, but no more waves of nausea, and I am once again able to get in 2 liters of water a day.  Whew.
  • Yeah, (TMI) the Zo.fran did cause the expected constipation.  A single dose of peri colace cleared things up.
  • My weight has stabilized, and I'm no longer losing weight.
  • On the down side, I think the Zo.fran is causing some mild headaches.  I hadn't had a headache in weeks and have now had one each afternoon the past two days since I started taking Zo.fran.  I can live with headaches more easily than I can with nausea, though; I'm used to them.
  • My extreme fatigue is getting worse.  I wake up tired--after nine hours of sleep--and am barely able to make it through the work day.  (My billable hours are suffering.)  In the evenings, I just lounge on the couch until I go to bed at 9:00, and the last two nights I've dozed off on the couch before 9:00.  I am hoping this will improve, at least for a while, when I reach the second trimester in a few weeks.
  • I've also started getting dizzy, especially if I stand up fast.  From what I've read, it's due to changes in blood volume and blood pressure.  Weird feeling.
  • MM continues to be really excited about the babies, and he is doing his best to be a supportive husband.  (Picking up whatever I can stomach for dinner, keeping up on all the household chores himself, walking and feeding the dog.)
  • He has also started reading a few of the twin pregnancy books I bought, which is very cute.  (He rarely reads books because he doesn't have the patience.)  He now shares with me facts like "Did you know newborns have to eat at least every three hours?"  and "This says that over half of twins are born prematurely."  Um, yes, I did know that.
  • Just taking one day at a time.  So far this has been harder than I realized it would be.

Monday, July 25, 2011

Second OB appointment

(Warning: another pregnancy-focused post here.  As ever, I won't be offended if you choose not to read it.)

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After writing pretty regularly while we were cycling, my posting here has dropped off the past few weeks.  In addition to having difficulty finding the time and energy to write, there are also times when I don't want to share my feelings here right now.  Most of the time my feelings are whining complaints about my exhaustion and nausea (and related symptoms), and who wants to read about that?

In no way do I want to seem ungrateful, and I know that there are women reading this blog who would gladly endure what I'm living through if it meant a baby at the end.  (And as a friend of mine pointed out, my symptoms are, in a way "self-inflicted.")  That doesn't mean it's enjoyable or easy as I'm going through it day by day, hour by hour.  Yes, I know it will be worth it at the end, but it's a little hard to see the forest for the trees when you feel like crap nearly all the time.

So forgive my less frequent posting and know that I continue to read all my regular blogs, even when I'm not always commenting.  (It's difficult to comment from my smart phone, and that's about the only way I read blogs these days.)  There are obviously also positive things happening for us, and I hope to get back to a better place physically and mentally where I feel up to writing about them some time soon.

For today, I did want to post an update on my second appointment with the OB this morning.  We saw the actual doctor (as opposed to her very nice and competent nurse practitioner), so that was nice.  She took a quick look at the Wonder Twins via ultrasound and told us she could see both heartbeats and that they are developing appropriately.  (We were in a different room, with a different, less sensitive ultrasound machine set at a different angle this visit, and I wasn't really able to see much.  MM was able to see them, though.)

I had lost a little over 6 pounds since my first visit two weeks ago.  The OB isn't concerned about my weight loss--it's normal for many women in the first trimester, and it's not like I was underweight to begin with--but she did write me a prescription for Zo.fran to help with my nausea.  I was originally reluctant to take ANY medications while pregnant, but she assured me that it's safe, and my nausea has gotten really, really bad, to the point where I am barely able to eat and am only able to drink sips of liquid at times during the day (and nowhere near the 2-3 liters they recommend for me).

She did tell me (in response to my question on the topic) that my pregnancy is considered "high risk" by virtue of the fact that I'm over 40, did IVF and am having twins.  However, she is experienced with caring for patients with all three circumstances and doesn't feel I need to be seeing a perinatologist until/unless problems arise down the road.

So that's where we are.  Looks like things are going fine so far.

Thursday, July 21, 2011

Advice on dealing with infertility

I enjoy reading Carolyn Hax's column in the Washington Post every day, but I really disagree with her advice to a letter writer today and wanted to share it here because I think it's a letter we can all relate to.

Dear Carolyn:

My husband and I have been trying to conceive for over two years. I feel like my life is in a holding pattern. We’ll be starting IVF soon. Already tried some other high-tech procedures. I can’t plan a vacation or commit to anything long-term outside of work because “soon I might be pregnant.”

After living my life like this for two years, I am getting really tired of it. We really want a child. I’m 35, so I don’t feel like we can take a break. Any advice? This stinks. Oh — also, almost all of my friends are currently expecting their second children. And my brother and sister-in-law gave their child the name we’d always wanted to name ours. How to move past this? Or through it? Or something?

Infertile Myrtle

Live your life, plan your vacations (refundably), set your priorities, make commitments. This is what people do when they’re not going through IVF, right? And women do get pregnant unexpectedly all the time — or, they suddenly become the parents of an orphaned relative, or they have other unforeseeables happen, like needing surgery. Trajectories change, and people adjust their calendars accordingly.

So please chuck your holding pattern, along with the defeatist, underdog thinking, and live fully as someone who doesn’t have a child. Like absolutely everyone else, you don’t until you do.

I feel that Carolyn's response to Infertile Myrtle completely ignores the financial and logistical realities of her situation.  Maybe Carolyn is unaware of the multiple daily injections and frequent doctors' visits required for IVF, not to mention the cost.  I think that, knowing that you are going to be facing several weeks of shooting up hormones (with various unpleasant side effects) and going to the doctor's office for monitoring multiple times per week, would be antithetical to planning vacations and making other commitments.

I think I get the gist of what she's trying to say--don't put life on hold, because you can't know what the future will bring--but I still think her advice fails to take into account what the letter writer actually has to deal with on a daily basis when she's going through an IVF cycle.

Your thoughts?

Wednesday, July 20, 2011

8 weeks

(This post will be all about pregnancy.  If you don't feel like reading about that right now, I completely understand.  I'll write about something else sometime.)

Total Weight Loss/Gain:  -4 lbs.  (I'm counting my "starting weight" as what I weighed the morning before our embryo transfer, which is only 0.4 lbs less than what I weighed the morning of my first OB appointment.)

Maternity Clothes:  No.  My regular clothes are actually fitting more loosely than they were a few weeks ago, due to the weight I've lost.

Stretch marks:  I've had stretch marks for years from growth spurts and weight gain.  I don't have any new ones related to pregnancy yet.

Sleep:  For the first time in my life, it takes me a little while to fall asleep, even though I go to bed EXHAUSTED every night.  Once I'm out, I sleep soundly for 8-9 hours.  (And I'd love an afternoon nap, too, but don't have time or opportunity for one most days.)

Movement:  Nope, much too early.

Cravings/Aversions:  No cravings, but I have many, many food aversions.  I usually eat a pretty varied diet, but most things I normally would eat gross me out now, and basically anything with a scent or spice to it is out of the question.  (Hot foods are worse, too, except some soups.)  I have been subsisting on cheeses and yogurt, wheat bread, soups and potato chips for the most part.  On a "good" day, I try to eat some lean meat and veggies or fruit.

Gender:  Don't know yet, too early.

Symptoms:  In addition to nausea which lasts most of the day (though no vomiting yet), I have heartburn after every (small) meal or snack and feel horribly bloated if I eat a normal-sized meal.  I am tired nearly all the time.  The only time of day I feel good is for the first half-hour or so after I wake up.  (I also have mild off-and-on uterine cramps and sore breasts, but I've had those since starting progesterone.)

What I miss: Having energy.  Being able to enjoy food.  Feeling good.

What I look forward to:  Our next ultrasound on July 25.  Since the bleeding episode I had on July 13, two days after my last u/s, we've been a little worried about how Zan and Jayna (the Wonder Twins) are doing.  It will be nice to get some reassurance.

Moods:  I have been more emotional and irritable at times but mostly the same as usual, just EXHAUSTED.

Milestones: Hmm.  None yet.

Medical concerns:  Spotting/bleeding I had last week.

Sex?:  Um, we've only "done the deed" once since our embryo transfer.  MM is afraid to harm the pregnancy.  ;-)

Thursday, July 14, 2011

7 weeks, 1 day

Just a quick note to let you know I'm still alive.

I am struggling with most-of-the-day nausea, many food aversions, and heartburn, in addition to feeling exhausted much of the time, no matter how much I sleep.  Our nurse practitioner told us this is par for the course with a twin pregnancy, and I am by no means complaining. . . . I knew this would/could be part of the deal.

It is a little hard to find time and energy to write here, though, when I have all I can do just to make it through each work day.  (Actually, I am behind on a few things and will have to work most of Saturday to catch up.)

Had a little scare yesterday.  In addition to the brown spotting that I've had off and on since Saturday, I was sitting at my desk mid-morning yesterday when I felt a "gush" of fluid.  A quick trip to the ladies' room to check my panty liner revealed that this "gush" was bright red.  Yikes.  The nurse practitioner had told me to expect to continue to spot, but the amount and color freaked me out.

I called my OB's office and headed home to rest (and change my stained clothing).  By the time the OB's nurse called me back about an hour after I called, I had had no more red bleeding and haven't had any more since, thank goodness.  I didn't have any cramps either, which I guess is the other thing they look for if miscarriage is suspected.  I spent most of yesterday on the couch and even took a 3-hour nap.

So MM and I are hoping that the Wonder Twins (as we have dubbed them) are doing OK in there.  We are hopeful that yesterday's gush wasn't a sign of miscarriage but was just more bleeding from the same area the NP showed us on Monday's ultrasound.  We have been told that bleeding is more common with twins, more common after IVF, and more common with DE.

My next OB appointment and ultrasound are on Monday, July 25, so we won't know for sure until then.  However, considering that I've had no more bleeding or cramping and my pregnancy symptoms continue unabated, we are feeling mostly positive.

(By the way, in this instance, I'm not interested in hearing from readers who had similar symptoms and then miscarried.  So if that was your experience, I'm sorry, and please don't leave that in the comments section.  Thanks.)

That's me in a nutshell.

Monday, July 11, 2011

Ultrasound update

This morning's ultrasound confirmed that I am pregnant. . . . with twins!  We were able to see both embryos, their yolk sacs and their heartbeats.  Twin A measured 6.6 mm, and Twin B measured 7.0 mm.  We were also able to see the small area between the sacs where my spotting has been coming from.  The nurse practitioner said it is a normal side effect of the development of the placentas and to expect to see more spotting before it stops entirely.

I am 6 weeks, 5 days pregnant today, and the embryos measured 6w4d and 6w5d respectively.  The NP said that measurement by ultrasound is never exact and may be off by as many as 3-4 days at this stage and deemed their measurements "perfect."

So this explains why I have been so nauseated and exhausted--I have much higher hormone levels than I would with a singleton.

I am going to go back every two weeks for the next six weeks to ensure that things continue to progress normally.  The NP said today's exam was very good, no indicators of any problems.

MM was thrilled, as are our parents.  I am happy and excited and also a little freaked out.  ;-)

Big day

Thank you for all your comments and support on my last post.  The spotting I wrote about had stopped by midday and hasn't returned.  I called St. Mungo's at MM's request, and the on-call nurse said over three-fourths of their IVF patients have some kind of spotting in the first trimester and that they would not be concerned unless it was bright red bleeding saturating a pad an hour. 

I continue to "feel pregnant": unusually tired, most-of-the-day nausea, food aversions.  So I am hoping that all is well.

This morning is my first OB appointment and ultrasound.  Despite my annoyance with my doctor's office, after I calmed down and regained my perspective, I concluded that I'd be likely to run into the same types of scheduling mistakes at any clinic, so I'm not going to find a new doctor.  My two closest friends who've been pregnant in the past few years both used this practice and were very satisfied (and one of those friends had a lot of complications and got to know every doctor in the group).

I will post later today about the results of the ultrasound.  I am mentally prepared for everything from an empty uterus or no heartbeats to two yolk sacs, fetal poles and heartbeats.  We shall see.

Saturday, July 9, 2011

Uh Oh

I woke up this morning to some brown spotting. Apart from this new development, I'd have no concerns about my pregnancy. I still have the same mild, on-and-off cramping I've had since shortly after transfer. My nausea arrived within an hour of waking up, just as it has the last three mornings.

This spotting is pretty similar to what I had with my chemical pregnancy in August 2009. I know that there is nothing that can be done; what will be, will be.

I am 6 weeks, 3 days pregnant today. I hope this isn't another miscarriage. I guess I won't know until Monday.

Friday, July 8, 2011

Monday's ultrasound

I am so upset right now.  Being the type of person I am, I called my OB/GYN's office this morning to confirm my initial appointment for my ultrasound on Monday morning. . . . and learned that, for reasons which are a mystery, the appointment had been booked in the practice's satellite office which is over an hour from my house (in light traffic), rather than at the main office, which is 20 minutes from my house and less than 10 minutes from my office.

I cannot imagine why this happened.  I have been a patient of the practice for nearly three years, and the only appointments I have ever had have been in the main office location.  I know that I specified the main office, but even if I had not. . . . why would anyone book me an appointment in a satellite office I have never visited?  It just doesn't make any sense.

Because it was their screw-up, the office moved some other appointments at the main office to "squeeze" me in at 9:30, instead of the 8:30 appointment I had scheduled.  But I am so angry with them right now that I am considering finding another practice.  Seriously, I cannot be dealing with this sh1t for the next several months. 

I have a call in to the nurses' line at Local RE's office to see if they can do my first ultrasound there early next week instead.  (St. Mungo's was kind enough to fax orders for the u/s to Local RE.)

Ugh, I hate dealing with doctors' offices!

Thursday, July 7, 2011

Twin dream

(By the way, I'm enjoying following the results of the "Is it twins?" poll I posted.  If you follow me through a feed reader, stop by the blog to vote.  So far the votes are running 2 to 1 in favor of twins.  Yowza!)

I had a dream last night that I had twin girls.  As with most dreams, several things about the dream were weird.  First, I delivered at home in my living room with my father assisting.  (Weird, since my father is not a doctor, knows practically nothing about childbirth, and I'm sure would not want to be in the room with me for any reason when I'm naked from the waist down!)  MM wasn't even there!

Second, my delivery was painless (ha ha ha) and very quick.  Each twin was delivered vaginally, one right after the other, and I never delivered a placenta for either of them.  I also managed not to get any blood on our bone-colored sectional. . . yeah, right.

Third, apparently we had bought nothing in preparation for our babies' arrival.  So I had no crib or bassinet to place the babies in, no diapers, no clothes.  Part of the dream involved a convoluted trip to Bab.ies R Us (which included my secretary) to obtain these items.

Finally, our baby girls were weird looking.  Not deformed, just. . . . unattractive.  They did not look alike, and neither of them looked like MM or the donor.  S-looking-into-the-dream could see that these babies were not cute, but dream-S thought they were adorable.

Isn't the subconscious mind interesting?

I have woken up the past two days feeling queasy, and that feeling has continued until at least mid-morning.  I haven't puked yet, and it hasn't kept me from eating, but I feel icky.  Well, on the plus side, MM is reassured by my nausea. . . . so I guess that's a good thing.

Tuesday, July 5, 2011

Moving forward

Thanks so much to all of you who expressed your sympathy and support on my last post.  I am still feeling pretty sad about losing Sebastian.  I always knew I would take his death hard because he was an exceptional dog and I loved him so much.  I had just hoped I would have more time with him and it would be a few more years before I would have to face it.

I am trying to move on.  I know Sebastian would never want me to be sad; he was happy every single day of his life.  Even though I feel his absence keenly, I do still have so many good things in my life to be happy about.  I need to focus on those things and not on what I have lost.

My father and stepmother visited us this weekend.  Having them here was a good distraction (though I still thought about Sebastian a lot).  MM and I told them about my pregnancy on Friday night when they arrived, and they were thrilled.  They didn't ask any questions about how we got pregnant, just said they had both been praying for this for a long time.  They have already offered to come for the birth and to help us out in whatever way we need or want.

Speaking of my pregnancy. . . . despite knowing it intellectually, sometimes it's a little hard for me to believe I am actually pregnant.  I still have basically no pregnancy symptoms.  Occasional cramping in my lower abdomen, but (TMI) I have been really constipated lately (probably due to the PIO, I'm told), so I can't even be sure whether it's coming from my uterus.  I have had no more nausea, and my energy level has been as normal.  My breasts continue to be sore, but I've had that symptom since the morning after starting PIO.

On the one hand, I am happy to be feeling so good and relatively normal.  (Honestly, the biggest problem I have at the moment is managing the occasional headache I get.  I'm not permitted to take anything but Ty.len.ol, and it does little to nothing for my headaches, so a mild headache which Ad.vil would knock out in one dose lasts all day now.)  On the other hand, I think I would be more reassured if I "felt pregnant."

We are counting the days until my first ultrasound next Monday.  Maybe this will feel more real to me, despite my lack of symptoms, once I see something growing in there.  ;-)

By the way, two bloggers I read regularly have recently had their babies.  If you're in a frame of mind to read about such things, stop by and congratulate Kelly and Lisa.

Thanks, also, for all your input about how to handle MM's, um, over-solicitousness, and whether I should continue to write here.  I think I am going to continue writing here for the time being.

Friday, July 1, 2011

Awful day

Yesterday was one of the hardest days I've lived through in a long time.  We lost my beloved golden retriever Sebastian.

Those of you who have been reading this blog long enough may remember the problems we had with our two golden retrievers two summers ago.  (I wrote about them here, in case you don't remember or weren't reading then.)   Happily, after an initial difficult adjustment period of a few months, Hunter and Sebastian became good friends.  They happily played and wrestled together every day.

What happened with Sebastian was very sudden.  On Wednesday night, he was his usual self.  When we woke up yesterday morning, he was lethargic and refused his food for the first time in his life.  Luckily, I had stayed home sick with a migraine (which awakened me at 2:20 a.m.), so I was able to take him to the vet promptly.

As Sebastian's condition deteriorated before my eyes--he went from seeming a little sluggish to being unable to get in and out of the car in a couple of hours--visits to two vets finally yielded a diagnosis.  Sebastian had a fast-growing tumor called a hemangiosarcoma in one of the chambers of his heart which had burst and caused a cardiac tamponade.

We were told that the immediate problem of the fluid in the sac around his heart could be treated but that the tumor would continue to grow and that the fluid would eventually come back.  It could happen in hours or days, and there was no way to know for sure how long the procedure would buy him.  There was no treatment which would cure him, though, and get him back to normal.

So we made the difficult decision to let Sebastian go.  MM and I were both with him at the end, and he seemed very peaceful.  Two vets told us that they didn't think he was in pain; he just had a hard time breathing.  So he didn't suffer very much or for very long.

MM and I are both so sad that he's gone.  At home, there are constant reminders of him.  I woke up early this morning to use the bathroom and then couldn't stop crying because Sebastian wasn't there next to my bed or coming into the bathroom to get petting.

Mine is obviously not an unbiased opinion, but I think Sebastian was an exceptional dog.  He was smart, mellow, friendly and fun, all the things a golden retriever should be.  I loved him very much and miss him terribly.








Sebastian  10/23/02 - 6/30/11

Goodbye, my loving and faithful friend.