How long will the good stuff last?

This question is something I’ve been asking myself over the last few weeks, but don’t quite have an answer for. Before May and my appointment with Dr. TAD, I was struggling in my work and in my life as an infertile. I was still trying to come to terms with the idea that I would unlikely have biological children and trying to shift my focus of trying to get pregnant with my eggs to trying to build a family by whatever means would provide a good chance of success. I was struggling with the fact my work was not going well and had been stagnant for over two years and questioning the choice I had made to get a PhD after having worked a “real” job for 6 years. Infertile and hating my career choice was not where I had imagined myself in year 2006. The faith I had that most things in life would work themselves out was almost nonexistent. I wasn’t sure if I could ever be truly happy again and even if I could, how I would get myself there.

Then, came the surprising new test results and the possibility that I may have a better chance at conceiving than we thought. Still, I was cautious. I had lost my trust in doctors and my own research into high FSH and DOR told me to be cautious of fluctuating numbers. Then, came breakthroughs in my work and I could feel my general self-confidence starting to grow again. There were setbacks and scares in starting the cycle and decisions not to try to do too much at one time (do Clomid/IUI and have a committee meeting). Decisions made based in part because I was afraid it was all going to turn out to be bad news and I didn’t think I could handle the crush of emotions that would follow. But, slowly, slowly, things seemed to be falling together. All my tests kept coming back negative and in preparing for my pre-defense meeting it dawned on me that some of the work I had put into my research these last few years were not for nothing, that I may have made some contribution to basic scientific knowledge after all.

Part of me knows that just because things are going well (and sometimes better than I expect) doesn’t mean it will continue to go that way. Life has ups and downs, period. I’ve had the downs, now I’m just having some ups. But, I know another part of me, a part of me I’m afraid to feed but not too afraid to invite out to play, has other ideas. That other part of me secretly hopes that the wave of things-going-well will last and imagines life six months from now as I am defending my thesis, on the edge of impending motherhood. And that scares me a bit. It scares me that I can have these thoughts again so easily. At the same time, I don’t want them to go away because they are such nice thoughts. Like the feeling you get when you are gently waking from a beautiful dream. I’m even able to talk for short lengths of time with my co-worker who is in the middle of her second trimester. A few weeks ago, I couldn’t even look at her in passing.

And it doesn’t help that Mr. Worrier is excited, too. I feel like we’re both being too optimistic and forgetting the months and months of disappointment we have gone through. I have this sense that things are too good right now and it just can’t last. I must have used up all my good karma points with the biopsy and culture. No? Well, then, I can’t be lucky with the Clomid and not have any side effects. A pimple? That’s it? Surely, that’s the end of the good news. No response from Clomid for me, right? Oh, three mature follicles. Well, this has got to be the end of the road for the good ship lollipop, right? Things can’t keep going well for me. Bad news must be imminent for the earth to remain balanced and not spin off it’s axis, right?

Worrier gone bad

Things Mr. Worrier has been doing differently lately:

1. Asking me every morning before work and every night after work how I’m feeling. If I tell him I feel normal, he gets all quiet. If I tell him I was cramping or feeling bloated (yesterday), he gets all quiet but with an excited look in his eye.
2. Asking me where my fertility/infertility books are so he can read up on what may be happening at this point. He was reading this morning about implantation and suddenly called to me, “Do you realize that they do? They burrow into you!” (Pause) “We’re about 5 days after ovulation, right?”
3. Offering me pineapple in all sorts of different forms after I mentioned to him some people believe eating pineapple will help in implantation.
4. Poking my boobs. His logic is that if I shrink away in pain, then I could be pregnant. If I just give him a dirty look (my usual response so far), then I’m not. I guess it’s cheaper than a pee stick. Though I think this test runs an unusually high risk of false positive since my boobs normally get sore before my period anyway. Somehow explaining this to him has not stopped him from poking.

Maybe I should have more faith

Had my appointment to see Dr. No Face and Dr. SIL this morning. They started with the u/s and saw 2 mature follicles on the right and 1 on the left. The two on the right were about 17mm and 20mm, they didn’t say how large the left one was, but Mr. Warrior said it looked as big as the 20mm if not bigger. So, let’s just say it was at least 17mm. So, there’s our answers. I responded well to the FSH, no ovulation yet and the IUI will not be too late. Dr. SIL performed the IUI and had some trouble getting the catheter in. Almost had to have Dr. No Face do it, but she was able to in the end. I can tell she is gaining more confidence in what she is doing, because she was much more aggressive with the wanding this time.

I can’t believe I made it this far. I can’t believe there were three mature follicles. I was so doubtful there would even be one. So, now I just keep myself distracted for the next 16 days (the Drs said 14 of course, but I typically have a 16 day LP). Should be easy, right?

The best laid plans

My OPK turned positive early this morning. Called twice to have Dr. No Face paged. No response. Thought maybe he was busy with patients since that is usually the case when he doesn’t get back to me within half an hour. We were getting ready to go out for brunch with my in laws, then to an IMAX film to get out of the afternoon heat, so I figured he would call me back after lunch. By 2:30pm, still no call, so I called in to have him paged again. It turns out there was no record of my first two pages! I couldn’t believe it. All that time, he was never paged! Dr. No Face got back to me almost immediately the third time I called in (and when he was ACTUALLY paged) and said we would do the IUI tomorrow morning and probably do an ultrasound beforehand. I know the cycles before when I check for my LH surge, my temperature always gets higher the next day which tells me I usually ovulate the day of my LH surge. Does this mean the IUI will come too late? Should we even go ahead with the IUI? I almost feel like we’d be wasting the frozen samples we have.

I don’t know what to feel, but I know I don’t feel happy. I had told Dr. No Face repeatedly that I ovulate early. I really wanted to get some idea of whether my follicles were responding to the Clomid and get some idea if my eggs were maturing enough before ovulation. I guess we could still know the answers to some of these questions, but I’m feeling doubtful about everything right now.

Quick update

Last day of taking Clomid today and my first scan (unless my OPK turns positive) is Monday. I still don’t have any side effects and am still very grateful for that.

My committee meeting went great! This was my pre-defense meeting, which in some ways is the most important one in your grad school career because this is the meeting they decide if you are worthy of a PhD and you set a timeline for graduation. The actual defense is really just for show (and to present your completed work) because really, your committee has already decided to pass you at the pre-defense meeting. I still have a couple of experiments to tackle, but whenever I am done with those and done writing my thesis, I will be able to graduate (probably by December). I was on cloud nine, of course, after the meeting. It was a feeling I hadn’t had in a long time. After living with uncertainty for so long in regards to IF and in my research, it is a wonderful feeling to have some certainty in my life.

The in-laws are coming in Thursday and will be staying through Monday or Tuesday, so we’ll be busy entertaining them. I’m going to try to spend some time this weekend to post something more extensive.

We interrupt our regular programming

Growing up bicultural, I often felt like I didn’t belong. Not completely American because I didn’t have the blond hair and blue eyes. Not completely Chinese because I was so Americanized. There were very few minorities in the town I grew up in and this added to the isolation. There were times (years?) I would feel compelled to reject most things Chinese, in hopes that would make me belong.

As I’ve grown older, I’ve started to embrace my bicultural identity instead of choosing one or the other. These last ten years or so I have come across more and more personal experiences, especially in mainstream media, about the bicultural experience, some from Asian-Americans, some from immigrants from other parts of the world, some from international adoptees. I slowly started to learn that my experience was actually part of a larger collective. This morning I came across this article about a woman’s journey to find her roots in China. The author’s story, in the details, is nothing like my own. But she captures many of the nuances to Chinese culture, especially when it comes to family, and the balancing act in trying to deal with Chinese manners and traditions while trying to be true to your own.

If you’d like to see some of the things described in the article, see also the pictures associated with the story. She also has a blog where she writes more about her Shanghai experience.

Clomid Watch, Day 1

Hours since taking first dose of Clomid: 14

Mood: Good; I got confirmation from my professor that my upcoming committee meeting (in 3 days!) will likely be my pre-defense. Which means that once my committee members all sign my evaluation form, countdown to graduation will begin.

Energy: Average; It’s miserable hot so I don’t want to move around much and, frankly, don’t want to move at all away from the fan.

Emotional State: Happy; I can’t believe the end of grad school is near and putting together my presentation for this meeting has made me realize that the last six years has not all been for nothing. It also made me realize that I was probably more depressed than I knew these last two years dealing with infertility and the lack of progress in my research. I’m grateful to be feeling the way I am now.

Hormones: Nothing topsy turvy or too weird. A zit appeared on my chin a few hours ago and I don’t usually get them this early in my cycle. I don’t usually get them at all these last few years. So, I can’t be sure if it’s due to Clomid or not, but if it is and that’s the extent of the side effects, I’m just going to count myself lucky, for once, and leave it at that.

For all the angst I had about whether or not to do Clomid this cycle along with trying to deal with the stress of preparing and giving a talk on my work, so far, it is working out pretty well. In fact, one is acting as a distraction for the other and I’m feeling less stressed than usual before a committee meeting and less obsessive than usual when dealing with the steps involved in this cycle. I hope day 2 will be more of the same.

Cleared for Clomid

Yesterday was CD1 and I called for a baseline u/s for Thursday. Turns out they were having a slow day and asked if I could come in that morning. I had the time so I went in. Dr. No Face was indeed training the doctor who will be taking over all the IUI cases from him. She reminds me of my SIL, so I will call her Dr. SIL. I’m so glad we made the decision to go ahead with this cycle. Dr. SIL seems competent but as suspected, needed practice. I’m glad Dr. No Face will be around to guide her.

They saw what they thought was a cyst and measure it. It was 11.5 (mm?) and Dr. No Face mentioned that if it was under 15 it was fine. Later when they were giving me instructions (Clomid day 5 to 9, next u/s scheduled for the 24^th, monitor with OPK’s in case I ovulate early, as I tend to do), they decided that since the “cyst” was not there last month, it probably was not a cyst. I didn’t really understand that reasoning and was more worried about the timing of the Clomid (day 9 will be the day of my committee meeting), that I didn’t ask any more. I was counting on starting Clomid on day 3 so I can be off the drugs by next Tuesday in case I get awful side effects, but I guess that isn't going to happen. I asked it they saw a typical number of antral follicles and they thought I had a good number, so that is possibly good news.

Saturday will be the first Clomid day. Ok, say it with me, now…no bad side effects, no bad side effects…

All Clear

My culture came back negative, so no infection.

Wow.

I’m starting to think that maybe every visit to the doctor’s office or call about a test result may NOT always entail bad news.

We are 85% sure we will go ahead with the Clomid/IUI this cycle instead of waiting for my next cycle. Last weekend we were 85% sure we would wait because I decided I didn’t want the extra stress of preparing for my committee meeting and worrying about coping with a cycle at the same time. I’ve never been on Clomid and I hear some women get horrendous side effects from it. But when I went in for the culture Monday, Dr. No Face was training the new RE fellow who would replace him in a month. Which means I would be one of the first patients the new doctor would practice on. Now, I’m sure she is competent, but I would rather have the experience of a doctor who has been doing IUI cycles for the past three years than be the experience for a new doctor still learning the trade. (Most of the fertility doctors I usually see at my clinic are fellows overseen by RE’s. Dr. No Face has been the only fellow who does IUI’s and his fellowship is ending. If I want to do IVF, I would go to their affiliated IVF clinic where the IF RE mainly spends his time. Dr. TAD is the other RE and head of the department on campus.) Plus, the main issue I am interested in for this cycle is whether or not my ovaries will respond. I think I would benefit more from someone who has seen a lot of ovarian responses (or non responses) if my ovaries do something weird and unusual, which seems to be my track record so far.

My period should start Monday and then maybe Clomid on Wednesday. My committee meeting is the week after that, so I’m working on my annual write-up and preparing my slides for my presentation. I want to get the bulk of it done in the next few days so if it’s a no go on the cycle or the Clomid treats me harshly, then I can have time to deal with whatever is in store for me without stressing too much on what I still have to do.

I don’t know how much I’ll be posting the next couple of weeks. I will post updates, but they will likely be short and sweet.