Due to work commitments, I had to reschedule my doctor’s appointment. It is now set for February 20. There is nothing to report. I do not have a newsworthy post to write. Instead, dear readers, I will entertain you with some photos from my garden. Look! Plants!
We have a scheduled appointment for a follow-up with Dr New later this week. However, Dr New actually given up her practice and left town. We have been transferred to someone else. Dr Someone Else seems perfectly reasonable from her online biography. It’s just that starting over at this point with yet another doctor just seems unbearable. It was hard enough with Dr New.
You see, I didn’t actually want to see Dr New. I did not want to have to tell the whole story over again, endure all the invasive questions, and end up with the same set of limited options. I am completely aware of what those options are, at this point. All I wanted was my beloved Dr C. But with Dr C far, far away, and old age rapidly approaching, we decided to give it one last shot. There really wasn’t any option other than to consult a local doctor.
I am hesitant about going to this appointment. D had to drag me to the one with Dr New. He will probably have to do the same again. I will consider this a go-see, just in case there is some new perspective that can be shed on our situation (something I highly doubt).
It seems that the troubles we’ve experienced all these years have finally taken their toll on my husband. He continues to be surprisingly optimistic. Enthusiastic, even. Poor dear. He’s clearly become delusional.
Buon viaggio, dear readers, for today we leave for five weeks in bella Italia and France. Oh!
There is nothing of interest to mention regarding the ttc situation. We had a follow up appointment with Dr New last week. I am not sure what the point of this appointment was, other than to deliver more thyroid test results, because there is little left to say at this point.
Dr New re-iterated that she thinks our best chance is to do IVF, not because it will overcome RPL, but because we need to look at the embryos as the great unknown. I accept the logic of this argument but I am still ambivalent. All I heard was blah blah, IVF, blah blah, embryo, blah blah, no time to waste, blah blah.
My response to all this was that as we are going overseas, we aren’t doing anything right now. Then it will be mid-November, and then it will be Christmas. At this stage we plan to do another tracking cycle when we return and then we are to have another appointment with Dr New in January if we decide to attempt IVF.
Surprisingly, my husband seems to be leaning towards IVF. Which is fine for him to say, given that his part is…well, I am sure that I don’t have to explain it to you. He wants to talk about it while on holidays. I prefer to ignore the whole thing in the hope it will go away.
Italy is not meant for such things. Italy is for the greater experiences of art, history, wine, love, and eating one’s body weight in gelato.
Today was our appointment with Dr New.
I was not looking foward to it. Overwhelming Dread. Unspeakable Horror. Nausea. I only went through with it because D made me. And because he promised me vodka.
In actual fact, Dr New was great. She was sharp, she was savvy, she was to the point. She seemed to understand us. We are old timers. We know our stuff. We didn’t want any wishy-washy newbie nonsense and we didn’t get any. Thanks mainly to my wonderful husband, everything went smoothly. We ran through the history, she asked us a few questions. No-one cried.
First of all, she definititively answered one of our burning questions by confirming that over-stimulation could in fact compromise egg quality during IVF. When IVF#1 failed because we didn’t make it to transfer, Dr Famous wouldn’t accept this argument. He preferred to insinuate that the cycle failure was entirely the fault of me and my lousy eggs; therefore I should spend more money on his quality enhancing drugs, take more stims, and do more cycles that were doomed to failure. This incident was followed promptly by my break up with Dr Famous.
In Dr New’s opinion, we have an implantation issue and an embryo issue. That probably seems like stating the obvious, but we can’t be sure if it is one of these things in isolation or a combination of both that are causing the problem. What Dr New thinks is absolutely essential is getting a look at the embryos in the best possible environment. I actually do agree. Of course, this means doing IVF and preferably with genetic screening, because we still simply don’t know whether:
If we were to undertake IVF, Dr New promised me a conservative stim with a focus on quality eggs, as opposed to quantity of eggs. She would use all the new-fangled techinques to select the best swimmers, and do genetic screening. We would also have the standard immune support of prednisone, clexane, and progesterone. If we aren’t ready to do that, then she recommends simple tracking, but also with immune support. And and and and. Here comes the good part. My TSH level is 3 out of 5, and she recommends a level of 2 or less for conception. This combined with the antibody problem = thyroid medication. I’ve always wondered whether this would help, but I could never get a doctor to agree, and so am very happy about this idea. I am starting Thyroxine tomorrow. Thyroid meds will stay with either tracking or IVF.
While D and I agree that the IVF idea has merit, we simply aren’t ready for that right now. We’ve decided to make another few attempts with cycle tracking. Cycle tracking with Dr New involves blood tests starting at Day 8, plus the usual ultrasounds, trigger and HCG test at the end, with all of the above mentioned immune and thyroid support. D has to take anti-oxidants and – how to describe in polite company – keep his swimmers fresh. This, apparently, will provide us with the optimum conditions for a “natural” conception.
In a stunning co-incidence, today is Day 1. So, here we go.
I was flipping through my diary at work recently and I realised that our visit to Dr New is just three weeks away. I must confess that the thought of starting over with another doctor at this point fills me with dread.
***
I wrote the above lines at least two weeks ago. I was going to say that due to this overwhelming Dread,* I had done nothing about preparing for this appointment. Things like obtaining a referral from a GP and ordering my medical records. Sensible, useful, things.
Fast forward to yesterday when I finally got my sorry butt to the GP. I was dreading that almost as much as Dr New. It was a mixed experience.
Firstly, he didn’t recall this conversation that we had when I first consulted him. He hadn’t recorded any of the details about my reproductive tale of woe, and therefore I had to go through the whole thing again. Which I proceeded to do, in a rather perfunctory and perhaps abrupt fashion. Fortunately, the wobbly voice was masked by the congested head and barky vocal tones caused by a severe head cold. Dignity restored, then.
The GP stated that although he was not an expert, he was not optimistic about our chances. Well, neither am I. And what of it? I don’t really care what he thinks. I was not there for his opinion, I was there to get a piece of paper entitling me to pay $270 for someone else’s opinion. Just give me my $70 piece of paper already.
The good part about this appointment is that GP actually is a good and thorough GP. As such, he thought we should run some basic blood tests just to see what the old hormones are doing. To which I heartily agreed. GP ordered anti-thyroid antibodies, all the other thyroid hormones, and fasting glucose. So this morning I dutifully went and gave another two vials of blood to add to the other eight thousand vials I have already given.
And now, for some genuine infertility humour. I swear that what I am about to say is the absolute truth.
After we’d had our nice talk, GP gave me the lab slip and the referral. As he was handing it over, he said, “you know, what happens a lot of the time, I refer people to infertility specialists, and then they get pregnant. Just like that. You never know!”
See? I told you it was funny.
*I will try to write more about the Dread later. Now that there is something to say, I want to say it before time escapes from me once again.
Wonder of wonders! Much to my great surprise, I have discovered a doctor right here in Small City who specialises in the treatment of, well, problems like mine, and who has in fact treated patients with intralipids. Shock!
We have an appointment on August 9.
Yes, I know. August 9. When I delivered this news, the husband responded with “ouch”. For me though, it was more or less as I was expecting. So now we wait. Again.
1.Cycle update
Unsurprisingly, my last cycle ended as predictably as ever. My period arrived on 11dpo. The only surprising thing about this is that apparently my capacity for self-delusion knows no bounds. Allowing myself to believe that this is going to happen for us is clearly misguided at best and lunacy at worst.
2.The Talk
Surprisingly, the crushing disappointment of failure led us to actually have The Talk.
What we agree on:
So. Where does this leave us? Intralipids are still a rarity in Australia.
For a long time I have known of only one doctor in the whole country who was prepared to do IVIG/intralipids. Let’s call him Dr Last Resort. He is not part of a fertility clinic and is not an RE per se. He is an ob/gyn with an interest in reproductive immunology who will give you a protocol whilst your pursue your treatment cycle elsewhere. He is located in Sydney, which is accessible from Small City. I know that he has had success with difficult cases. Win all round.
In the course of my research, I have now found out there are at least two other doctors, both attached to fertility clinics, who are using intralipids.* (Compare with two years ago, when I could not find anyone except Dr Last Resort). One of them sounds great, the other not so great. Both are very far away. I am considering them as back up options. I am also looking into whether there are any available doctors in Small City who will consider treatment with intralipids.
You may wonder why we are going to all this trouble. After six years, we have tried it all. I have tried aspirin, clexane, progesterone, prednisone, vitamins and minerals of all types at one time or another, often lots of these together. We have almost reached the end. Intralipids is the only thing we haven’t tried. I have read so many success stories. We feel that this is what we have to do before we give up for good.
3. Other people
I am fed up with people in the workplace asking me whether I have children. No, I do NOT have children. Have I ever spoken about any children? No. Do I know when the school holidays start and end? I do not. Do I ever talk about childcare or the school run? Certainly not. Do I dissect in excruciating detail the wonders of Mother’s Day? Do I even MENTION Mother’s Day? I would rather stick a fork in my eye. So, dear colleagues, I ask you to draw your own conclusions based on common sense and leave me the hell alone.
* If you are in Australia and need to know who these doctors are, please e-mail me. I would be more than happy to share this information with you.
Well, dear readers, it certainly has been a long time. There has been nothing to say. Progress has not been made in the “what the hell do we do now” department. We have been avoiding The Talk. Hell, even watching a story about embryo donation on a lightweight television current affairs program last week couldn’t induce us to have The Talk.
I think it is partly because I don’t want the Husband to say Things That I Don’t Want to Hear. I think we are also both well aware of what the options are at this point, and none of them are palatable. The chances of success this late in the game appear extremely remote, regardless of any options we decide to pursue.
Nonetheless, this month we both felt like it would be a good time to give it a shot. I have no idea why. We pulled off a perfectly timed cycle and now I find myself back in the middle of the perpetual “am I/aren’t I/could it be/it couldn’t be/well it might be/who are you kidding/get a grip/stop being a psycho/this is never going to work” psychological horror show that is the two week wait.
There’s at least five days to go.
Send cake.
I would like to bid a fond farewell to 2011, and offer a hearty welcome to 2012. 2011, I have nothing more to say to you. 2012, you may take a seat by the hearth and make yourself comfortable.
There are a lot of good things on the horizon in 2012. Sadly, I do not think having a baby will be one of them. But let’s not be maudlin, shall we, dear readers? I offer you the forthcoming celebratory highlights of 2012:
As you can see, there is a great deal to look forward to this coming year.
Now for the not so good. The best way to express the way I am feeling about the whole baby situation at the moment is to say that I just don’t know. I don’t know what to do. I don’t know what the answer is. Although we both feel the need to do something, we just aren’t sure what that something is.
We’re taking some time to think about it. I hope that by giving ourselves this space our path might become clearer.
I feel compelled to say something, although I’m not exactly sure what.
I don’t think there is anything I can say that would accurately describe all that I (and my husband) have experienced during the past few months. Suffice to say that losing a parent is a very difficult thing. I would like to take this opportunity to thank every one for their very kind comments.
*****
And so, to return to the topic at hand. This month was supposed to be the big return to action. You know, in our grand plan to try and take home an actual baby. It’s the first time in months that my husband and I were in the same place at the same time and both feeling like we were ready to go ahead. We agree that now that I have reached the ripe old age of thirty-eight, it’s the business end of this whole deal. It’s time to get serious, y’all! I mean, what on earth have we been doing all these years?
In the event, it turned out to be a rather half-baked attempt. But lo, an attempt was made, and now we wait. How will we pass the time during yet another infernal two week wait? How will we ever withstand the excruciating suspense of inevitable disappointment?
There is one point upon which you can rest assured, dear readers. Passing the time during the next two weeks most certainly won’t involve wild nights filled with rampant and spontaneous non-duty sex. Of that I am quite sure.
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