Lab Results Finally In

Hey you!
Over here!
Yes, you!
Look at me!

Me: Hello Nurse J.  Would you please schedule me for ....?
<Now that I've got your attention I'd like something done.  No don't argue with me.>

Nurse J:  who is this?  Oh sorry I thought you'd recognized my voice by now.  It's Rebecca. < I've only been going to your clinic for 4 years!>

It was one of those mornings on the phone.  Again Nurse J.  Loves to argue with me.  Had to explain in detail what I wanted.  She said they gave me all the lab results the other day.  No they didn't.

<Again, please listen.>

Me: I need the vitamin D3 levels.

Nurse J: 26.1

Me: that low?
I'd like the doctor to put me on the prescription strength D3 again.

Nurse J:Your PCM will have to do that.

Me:No he won't. My cardiologist did it last time.  Can you at least ask Dr.C?

Nurse J:No you need to see your PCM.

Me:But it affects fertility.  Shouldn't Dr. C. be told my levels are too low?

Nurse J:Fine!  I'll let him know and call you back.

Me:<won't hold my breath waiting>  Thank you.

With the D3 levels this low I now have an explanation why the fibro has been flaring so often.  Also why I haven't been able to lose weight without starving myself.  Yesterday I had two really lean meals.  Maybe a total of 600 calories for the day and I managed to lose 0.8 pounds.

I'm tired of everything.  I'm getting depressed.  Oh and btw, I do take D3 daily and I told the nurse that too.  I just forgot to mention it above.  600 IUI daily.  It obviously isn't enough.

CD1 I'll be doing another natural cycle with an IUI towards the end of the month.  Hoping the vitD3 issue won't cause more problems with the eggs.

I Just Don't Get It

Most of you know what is going on with my reproductive health.  I had a 0900 hrs appointment this morning.  Lt.Col. B. was unavailable and I was told I was going to get stuck with Dr.B.   As it turned out I got stuck with Dr.C.  Dr.C. was the one that did my IVFs.  Sure he is good for that but it seems like only that. 


Dr.C.  said he didn't think surgery was necessary.
He said I could now have sex.
He said he still wants me on bed rest for at least another 3-4 weeks.

WTF?

The cyst is still there.  A tad bit smaller in one direction but still 6.7 cm in the other direction.

Dr.C. then tells me after saying I can have sex that he is concerned about ovarian torsion.  Well duh!

I asked for a second opinion when the numbnut said the above.  He told me he was willing to page Lt.Col.B. to the office to take a look at me.  I said having him call me with the lab results will be sufficient.

Dr.C. said he wouldn't have to see me until several more weeks have passed.  Oh yeah I want the second opinion!

Need I say I'm pissed?

Dr.C. also then tells me that there isn't much more that the clinic can do for me after stating that he realizes that I can get pregnant.  Huh?  Seriously someone make him go back to med school now.  Maybe he didn't have enough caffeine this morning?

I say get the cyst out of me this week and get my period going.  I want  a cycle.  Its something like CD40 now and I'm sick to death of this bed rest.  My eggs aren't getting any younger.  If I need to do donor eggs I want to have all the endometriosis cleaned out so that I can have a better chance at having the embryo stick this time.  Is that too much to ask for?

Poke, Prod, Pain

So I got up early this morning and gave myself the shot of Ganirelix.  Two more days of that shot.  I didn't eat.  I wasn't allowed to eat. 

Next off to the lab for the blood draw.  I wore a black t-shirt I bought in Forks, WA.  Its a happy face with vampire teeth.  Yes, the lab techs loved it!

Off to ultrasound for an abdominal ultrasound.  I'll find out what my asinine PCM has to say about the results. Marla, a really nice ultrasound tech, told me my gall bladder and pancreas were fine. She took a look at the area of pain on the left where the kidney sits and told me I need to follow up with the PCM.  That is where she wouldn't tell me what is wrong.  I asked her what is over there and she said spleen and left kidney.  Okay now what the hell is wrong with me?  I swear if its not one thing its another.  I need more chewing gum and glue to hole me together because the duct tape is obviously peeling off.

Finally my appointment time for REI arrives.  I get in there and get stuck with Nurse J.  Lt.Col. B. is out of town for the day so I'm stuck with none to gentle with the probe Dr. B.  (he is a major).

E2 is down from 500 to the 160's he said.  He won't give me exact numbers on anything nor show me the screen.  He printed out the picture of the cyst and I demanded to see it.  I saw the numbers.  Its not shrinking.  But the good news is that the E2 is down. So the shots are sort of working.

Dr. B. said another 2-3 weeks of bed rest.  Ugh!

He also said that it could still twist at that size or even grow more and I'm to go to the ER if I'm in bad pain.

He also informed me and my spouse if it doesn't start to shrink soon that they are going to have to go in and surgically remove the cyst.  Oh and he didn't think that Monday's follow up plan with Lt.Col.B. was necessary.  I beg to differ.  I told him I was keeping that appointment as I was told it was necessary.

Dr.B. is on my crap list today.  He didn't have to hurt me with the probe. 

Oh on June 6th I'll be running a contest to give away a prize.  Look for the post on that day and sign up for a chance to win.

Feeling Unwanted

This is not about my spouse or other family members.  No, I feel wanted by them.  This is a venting of my feelings about my doctors right this minute.  Specifically the staff at the Reproductive Endocrinology and Infertility clinic (REI  clinic); well actually about a particular nurse, Nurse J.

I was in terrible pain last night.  I was bent over in pain.  I was bent over and limping trying to walk as the pain radiated from my pelvis down to my right knee. Then the left ovary decided to compete with the right ovary and caused my left thigh to ache down to the knee.  No I didn't want to go to the ER and get poked by doctors that had no clue especially with the speculum insertion as I try to tell them my uterus is retroverted and they ignore me.  Why they feel that is necessary after I tell them that its my cysts I don't know.  But they don't listen so I'm not going to ER unless its absolutely necessary.

I called my REI clinic this morning and actually got to speak to a live person after only pushing one button for the extension.  Amazing.  I could hear Nurse J eating.  I was a tad sarcastic I have to admit when I said, "oh wow I got a live person!".  I was laughing and she wasn't.  Personality absent any one?  I guess she's never had to wait and wait and wait and only talk to an automated system before in her life.

Well Nurse J and I talked about my pain last night. 

She said, "I don't know who is there today."

I said, "I'm willing to wait until this afternoon.". 

She says, "Dr. C. will be here in the afternoon." 

Funny how she had no clue who would be on today.  Okay, um little peeved at that lie.

She says, "Dr. C. will be in an IVF class all afternoon."

  B.S.  I'm thinking. 

I said, "I've taken the IVF classes before and I do remember how long they take.".

 ( Its only 30 minutes tops with the doctor in the room after the nurse gives her lecture of which the doctor isn't even present for.  So with the 8 couples he'll be counseling afterward maybe another 80 minutes tops for all of them. I figure about 2 hours of his time.)  I didn't state this so I'm questioning why he can't still see me for just the 10 minutes  he normally spends with me.  Oh and where the hell are the other three RE doctors? I'm thinking all this and not stating it.

I can understand one or two of them not being there but that is such B.S. from Nurse J's mouth.  When they are doing the IVF classes they always have another RE doctor covering the appointments and emergency call in appointments.  I'm not that stupid.

So here I sit and wait in major pain.  Oh and I've gained another 0.4 lbs making it an even 15 I've now gained since January's IVF, almost 5 lbs of which I've gained alone in the past three weeks from bloat in my pelvis. Its CD20, 16DPO.  But really I guess I'm okay to them.  If only I could make them feel what I feel.

There is my vent/rant/anger spewing.  Thanks for reading this far down.

I Can Tell Its Monday

I'm fatter than last week by two pounds and I'm totally exhausted.  It seems that not enough sleep on Saturday night caused my metabolism to crash.  I went into fat storage mode.

I also fell asleep in the tub last night.  That just isn't good.  I would jerk awake because I was afraid of drowning only to fall asleep again.  I put my book outside of the tub and just decided to soak.  That was stupid as I slid down more in the tub and well you can see where it could lead to.  I got out before my normal time of a 30 minute soak.

I'm still cranky.  I did test this morning and it was negative.  I'm just fat and getting ready to cycle again.  Its only CD20 but still I don't feel like this natural cycle with two of my own eggs was a success.  I know the odds were against me anyway to begin with.  So from here on out I'm going to attribute the symptoms to PMS.

I called Tricare and scheduled my re-entry appointment into the gastroenterologist office.  I have to bring my driver's schedule with me and a complete list of my medicines too.  Fun part is going to be trying to figure out who will be my driver.  I don't even know if J will still be here for my scoping let alone the initial interview which is late next month.

I also called the Respite Care EFMP ACS coordinator and left her a message explaining that I just got my summary sheet on Friday so that there is no way that they could have denied me without the application being properly supported with the data.  I'll probably get a call from her by the end of the week.

Next call was to the REI clinic.  Nurse N called me back just now and asked why I wanted the CD 21 test.  She is going to ask Dr.C. if he feels its necessary since Dr. B. is out today.  They were all quite surprised that I ovulated on my own and two eggs at that.  Nurse N did ask if I had a reason why I wanted the test and I explained to her that Maj D (an RE doctor of my past) said that the reason why I miscarried the twins in 1996 was due to low progesterone and poorly functioning corpus luteul cysts.  Back then I had ovulated two eggs,one from each ovary.  So Nurse N will get back to me.  She knows that I still have endometrium and PIO here at home and said I would be put back on it if the test showed anything.   However, she said that they didn't believe that the tests were all that definitive for showing that a possible pregnancy might need support.  I told her that I realize that its still too early to have a valid home test here, negative or positive.

So this is where I sit.  I'm in limbo on all grounds.  I wish I had a set of orders with a deployment date rather than just the fact that J knows he is on the list.  He could leave in a week or 2 months.  I just wish I knew when!  I'm guessing though that he is going to get screwed out of his block leave, which means no vacation together for us.

Second load of laundry is in the washer and I'd better go check it because it got way too quiet.  Old machine from 1995.

2nd Day Of This Weirdness

I made it through a single day with about 15 more to go until my WTF appointment.  But I made it through the night with the aid of Gas-x and peppermints.  Oh and they didn't fix the stomach pain entirely either.  Nor did it stop the puking.

Just think this was only the beginning I thought to myself.  I had only made bleached flour bread or as the recipe calls it, Amish White Bread.  If anything this particular bread should be the easiest for me to digest.

Today I'm making Wheat Bran Dinner rolls.  Today I hit the hard stuff.

My weight is still the same, thankfully.  I don't like what all this bloating is doing to my body already.  This morning I woke up with a double chin.  I had just gotten rid of the double chin in January too!

Thanks for all your support yesterday.  I'm not going to hold my breath waiting for the REI office to call me back.  They haven't yet and I do understand that I am no longer a priority to them.  Its just rather hurtful to be given the brush off so soon.

I need answers.  I'm willing to do another colonoscopy and endoscopy if the blood work shows positive.  I've had both 11-15 years ago.  Intestinal problems run in the family too.  I've had an ulcer and GERD.  I was on prilosec for most of 10 years before going off of it almost two years ago for these infertility treatments.  Before J came home from Iraq I was slated for a procedure to have another endoscopy done because of my problems. I had to cancel the procedure because he was due home when I would be having it.   The doctors knew they'd have to go in with a balloon and reinflate the area that seem to have collapsed a bit.  At one point my closure was a stage 4.  Something was aggravating my inners and I'm guessing it was the foods that I ate.  Its not too often that I now suffer with the feeling of trying swallow a golf ball when I'm only trying to drink water.  I'm thankful for that bit of reprieve.  However, as of this morning its back.  I think I might have a slight allergy to something.

Here is a bit more about my family medical history.  Mom has the Celiac Disease, mild but she ignores.  She has always been allergic to wheat and oatmeal and breaks out in a rash when she eats it besides the gastric issues.  Mom also had to have a foot of large intestine removed when she was just 19. She was vomiting her own feces it was that bad.  My dad's side has colon cancer.  Most likely unrelated to the Celiac Disease but still its a concern.   Dad has always had issues, well as long as I have known him, with his digestive system too, perhaps he inherited it from his father.

But anyway my experiment continues today.  In a little bit I'll be getting the dry yeast out again to make bran dinner rolls.  Only 15 days to go.

As for the endo pain.  Oh baby its there.  When I barely touch my pelvic area it hurts.  I'm trying to ignore that pain to better focus on the other symptoms right now.  I did say trying.

Excuse me I just belched again.  Oh this is going to be a fun day.

I also lost one of my followers today.  I guess that they got sick of me?

Waiting For The Call

Oh I had some fun this morning.  I get over to Madigan hospital lab and I pull a number.  Its 0630 hrs.  I'm there early.  I'm #2 in line.

0700 hrs they start calling my numbers.  I get to the counter and present my ID card and tell the clerk its for a Beta HCG.  She doesn't even pay attention to me.  She prints out the lab request and hands it to me.  Next person is called up.

I look at my lab request sheet.  Its for an E2 level!  WTF?

My number for the lab gets called and I tell the tech that I have the wrong lab request in hand.  We go back up to the front desk and tell them what is wrong.  The clerk is oblivious to me and looks to the computer, the HCG beta was NEVER put in.

That's right!  My REI forgot to put in the system the test.  Now folks this isn't the first time they have done this with labs.  They've also done it with my medicines too.  I'm not sure who is lazy over there or forgetful but they need to work on this part of their paperwork.  Its find and dandy to do the procedure to transfer the embryo but if you hand the patient a sheet saying when the lab is to be drawn but then forget to put it into the system what good is the paper to the patient?

So J and I walked over to my clinic.  The lights were on but the door was locked.  We waited and waited and waited.  It seemed like forever.  I wanted to get my blood drawn and get home.  I wanted to get some breakfast before the marriage counseling session later this morning.

I ask J to go check on the door again.  Its still locked and he said he would head around back to the back entrance.  That door was unanswered.  He said he could here them moving about in there.  The door was unlocked so he waltzed in and back to the doctor's office.  Nurse Nasty see's J and she gets pissy.  He cuts her off and tells her about the situation.  She says she'll fix it right away.

Back to the lab I go.  I go to the head of the line.  I've been waiting long enough and there is no one really before me anyway.  I get a new number and wait.

Finally I get called up again.  This time its in the system.  Yay!  But the E2 is still on the draw too.  Oh well who cares now how much they take its all just one vial.

I still haven't tested at home.  Why bother.  If the numbers aren't high enough we all know its a chemical.  If they are high enough I'll find out later today when they decide to call me.  I swear they only call in the afternoon when its bad news.  They don't like giving out bad news.  Maybe I should call them?

Delay, Dilemma, or Doom

I can feel a storm approaching in my ovaries.  I know that sounds a bit odd but those that have suffered through IVF will understand.

One of the RE doctors called me yesterday about my E2 day 3 lab results.   I knew it couldn't be good since the clinic was closed due to the snow so they would only call if it was bad news.   It wasn't good.  I can find no one that would cheer about a count of 1064 on only day 3.

I'm taking a deep breath in right now and trying to blow away the stress.  I might end up with a cancelled cycle.  I might end up with OHSS if the number continues to climb.

Dr. B. told me the Gonal-F will have to be reduced from the 525 to 375.  The Lupron and Menopur will both stay where they are right now.

I should have known this was going to happen.  Tuesday I started producing the egg white fertile cervical mucus that we infertiles always seem to look for each month.  I had it and I'm like wtf?  Seriously why now?  Something isn't right.

I should have known when yesterday my pelvic region is so puffy that my 16's are snug from only a 0.6 lb weight gain in two days.  Forget wearing my l4's which were still lose on me only three days ago.   It looks like I've gained 10 pounds.  Today I stepped on the scale only to see another 0.6 added to my weight in just one day.  That makes 1.2 pounds in three days.  Will the weight gain stop?  Its not my eating for sure, I'm closely monitoring what I eat and how much exercise I get.

I should have known when the cramping started and the back pain became almost unbearable.  Usually that pain only hits when I'm close to the retrieval time or ovulation itself.  The pain was radiating down my legs and up my back.

So yes, I'm a bit worried.  Hopefully I'll keep my blood pressure down.  Hopefully the Circle + Bloom will work its magic and I'll just have extra recruits. I had only 5 antral follicles.  I'd love to have 10 so that I might be able to freeze an embie or two.

But I'm being a realist here.  I'm quite aware that this cycle might be cancelled.  I've prepared my husband for the worst.  Now I'm going to hope for the best.

If you are the praying sort would you keep me in your thoughts and prayers that this cycle will still give me that take home baby?  I know its a lot to ask for, but I'd do the same for you.

Finally I Get An Appointment

At 1400 hrs today I'll finally get in to see a doctor.  Or I hope its a doctor that I'll be seeing at my clinic.  It could very well be a physicians assistant or nurse practitioner.  Our clinic doesn't have that many doctors on staff as its too costly to have them there and it would mean that we would receive the best medical care available and we can't be having that now can we.

As I'm typing this my vision is a little messed up.  Its as though the screen is farther away than it should be.  Just another wonderful symptom is my guess.

Last night the sinus headache enveloped the whole left side of my head.  I just want this looked at and some medicine thrown at it before the next IVF is in full swing.

I called my REI nurse and she assured me that if I'm put on antibiotics it won't affect the drugs I'll be taking for IVF.  I was wondering about that since antibiotics affect birth control effectiveness I figured it was sane to ask her for advise on the matter.

So with any luck I'll get something to fix the congestion, I'm no longer producing green with the use of my neti pot, now its just blood I'm so congested.  I need something for the pain in the head too.  Something stronger than tylenol though I doubt they'll give me anything stronger.  Breathing is becoming complicated.  I can eat or breathe but not both.  Taking a deep breath is painful so I'm sticking with shallower breathing for now.  My lips and fingernails have been staying a lavender color, I'm guessing its because my oxygen supply isn't the best.

Remember though, my guesses don't count as I'm not a doctor and they will know better than me.  But my guess is that the sinus congestion is now moved towards my lungs and might be giving me a touch of bronchitis. 

Wish me luck on getting the proper treatment.

My WTF Appointment

0920 hrs I was seen at my REI clinic at Madigan with my spouse.  We sat down with Dr. C. to discuss what went wrong with the last IVF cycle.  J was really tired from his CQ duty last night so I wonder just how much he comprehended from the meeting.

Dr. C. explained everything to us but I still don't know the reason why it failed.

On day 3 we had a 8 cell, 0 fragment, Good quality egg, Perfect embryo.  The abbreviations and number were explained to us from the chart.  So if it was a perfect embryo why did it chose to not stick around?  I know I was pregnant because of the two home pregnancy tests.  I told Dr.C. at this appointment that I took them.  I guess it changed the picture a bit.

Now the focus is on the fact that my eggs are my age and not so much what could possibly be wrong with me but with the eggs themselves.  If we used donor eggs he said we'd have a 65% success rate.  I have only 40% with my own eggs.  But it was perfect I'm yelling in my head.  I must have done something wrong.

I asked about the hypertension issue since I'm always on medications.  Its not that.  I asked about being put on restricted weight limit for lifting  he said even if I moved furniture it wouldn't be the problem.

So why?

He said it could look perfect at day 3 but there are sometimes issues with implantation, yes even with the Assisted Hatching we had done on the embryo.

I then asked if it was the endometriosis. He said that could be a factor but that most likely it was still with the age of my egg.  Dr. C. said one of the larger follicles he drained in his egg quest was filled with blood so he knows that I have issues with endometriosis.

To be quite franks he was genuinely surprised to get the 8 cell with zero fragmentation and a perfect embryo considering I'm 42.  He said its rare.  So we still don't know the exact reason why it didn't chose to stick around.

Looks like I'll be doing a late January embryo transfer if all goes well.  If I don't have enough follicles we'll commute to an IUI and hope for the best.

J's morphology issue is no longer an issue and that is good to know.  Now if only his sperm will stay that good for the next round.  We are still going with the ICSI for the January IVF.  We have to.  Dr.C. says it will again increase our odds of a better embryo.

This time I hope we get four follicles for retrieval day, we had four the first day but Dr.C. wanted to wait leaving it at only 2 follicles left by retrieval day.  Dr.C. just didn't want us to do too early of an egg retrieval.  But now that he knows my ovary reserve is declining we might end up doing an early retrieval in January.

I'm also hoping for two perfect embryos to transfer this time around.  I can hope right?

I can also hope that I'm pregnant now, right?  I mean I am in the two week wait right now after ovulating on my own.  But yes, I know that at my age its rare.  My maternal grandmother had my mom at 42 so there is always a chance. 

All My Ducks In A Row

As of this morning I made the final two appointments that I was required to make in order to possibly secure that letter recommending that my spouse be allowed to stay with me during part of the hopeful pregnancy.  I had to make a few extra calls this morning but it was worth it.

I called my REI clinic to ask why the MFM (maternal fetal medicine) folks had yet to call me back.  I was supposed to be called back within 24 hours of Thursday.  Its Monday here.  After chatting with Cpt. S-D. I explained the situation about the prior MI I had in March 2009, the beta blockers and water pills I've gone off in order to prepare my body for pregnancy and the fact that I have to see my cardiologist biannually.  She seemed quite concerned all of a sudden about me.  Its not like I didn't tell her the other day about the issues.  Whatever.

I called MFM directly after getting the number from Cpt. S-D.  They asked if I was already pregnant, I wish, and I told them that no I'm not but we are going through an IVF cycle.  I'm now scheduled for the 23rd of September.  At last we might get somewhere with that letter if they choose to listen to me and actually pay attention to my chart.

I was able to get my walk-in appointment scheduled with Cardiology for October.  Yes, a walk-in has to be scheduled, this is Tri-Care we are talking about.  I won't be seeing Dr.K. as he is retiring.  I will be seeing Dr. V. instead.  Never met the chap but I do hope he will at least take a few minutes before seeing me to familiarize himself with my file and Dr.K's notes.

So if I seem like a bit of a pessimist today its because I'm in pain again today.  Bear with me folks.  Most of the time the doctors I see I rarely will see again.  They aren't interested in my feelings, nor the fact that my spouse will deploy or any other conditions that I have other than the reason that I'm being seen in their specialty clinic.  If they took the time to actually look through my computer chart it would mean they wouldn't be able to see as many patients as they do now.  It means that I will take time away from someone else.  Its sad but true.  I get shoved aside because they are understaffed.  I've been given medicines that I can't take and refuse to take that the doctors think will cure my ailment without realizing that they conflict with the other medicines I'm currently taking or might cause another one of my medical problems to flare back up.

I'm not a hypochondriac, I do have real medical issues.  Its not all in my head unless you are referring to the neurological problems from the fibromyalgia.

So I'm hoping that with the four new doctor appointments, all specialists, maybe one will be able to help me out.  Remember I'm not asking the Army to go to war understaffed, they have plenty in my spouse's job for help.  I am, however, asking that they consider letting him stay home for the entire IVF cycle and part of the pregnancy.  If I miscarry REI has told me they'd be able to get me into another cycle right off.  I can't do this if he is gone, well at least I can't do it without banking his sperm and who's to say I'll even think of doing that if I say miscarry at week 12?  He'd be gone by week 12!

So I'm still frustrated.  I'm hoping for some good news soon.  Meanwhile I can't take pain meds for the cyst pain as the acetaminophen isn't working on the pain nor percocet for that matter.  I'm not going to suck it up either, I'm going to write about it, talk about it with my spouse, and in general just moan from the pain.  I'm coping the best way I can without pain killers.