Jekyll & Hyde

I know I joked the other day about the Clomid craziness starting but Holy. Crap. The ANGER, my god, the anger! I am not enjoying 150mg. I'm seriously like Jekyll and Hyde: I'll be completely fine one minute and then the next minute I want to scream at the top of my lungs, throw things and cry hysterically all at the same time for NO reason. I'm going nuts.

Hubs refers to it as me "hulking up".  It feels like I'm becoming freakishly strong and scary and losing control over my emotions and actions.  I want to rip my skin off of my body and run around flailing. It's crazy. I haven't quite figured out yet what to do to manage this when it happens...

Last night for example, it took longer than usual to fall asleep and I could feel myself hulking up. My blood started boiling, I starting huffing and tossing and turning and could not calm myself down. I was too hot so I ripped my PJ pants off and flung them on the floor; I got all pissed off because the sheets were too...ON me so I kicked and pulled at them; I was irrationally angry that my pillow felt too hard so I kept punching it and eventually got so frustrated I just chucked it as hard as possible across the room... You get the picture. Poor hubby just laid there like a little mouse and didn't make a sound. I don't think he even breathed out of fear that I might notice him there and turn my predator wrath from the inanimate bed to him.  Once I had finally calmed down he asked if I was okay and rubbed my back and I eventually fell asleep. I'm like a child throwing a temper tantrum.

This is not fun at all.

I have a lot of plans with people this weekend and need to figure out how to control this so that I can avoid killing one of them.

Don't make me angry. You wouldn't like me when I'm angry.

CD5 = Day 1 of Clomid...

...let the craziness commence!

Note to self while on 150mg Clomid:

Well, my tantrum is over.

Sorry about that folks. 

Overall I think I do a pretty good job dealing with IF and have been relatively even-keeled but every now and then it gets to me (as evidenced by the last mess of a post). Sometimes I feel like I have to let the emotions take over or I will just explode. That was Monday.

Hubby was wonderful and talked me down off the ledge the other night but I still had a tough IF day yesterday. I kept crying at the drop of a hat and scaring the dog (even had to choke back tears as I talked with the nurse at my RE's office about next steps - that was embarrassing), but I'm doing better today.

So the plan is the same for this cycle: Currently waiting for bloodwork results then more Provera to force a period. Clomid CD 5-9 (we're upping to 150mg this month) + Trigger (if I ever get that far) and TI. My RE said that 150mg would be the limit - he doesn't want to go up to 200mg even though I know other Drs will.  That's okay with me. I'm a little afraid of the side effects with 150mg as it is.  With my crazy hot flashes I'm probably going to constantly look like I just went running.

A tiny piece of me has died inside.

I realize I'm being a tad overly dramatic but in a way that's kind of how I feel...

Hubs and I finished the spare room last night.  We've lived in this house for 2.5 years and that room was always going to be the baby's room.  We knew when we moved in that it wasn't going to be long before we started TTC so we never really did much in that room, just stored a bunch of extra stuff in there and waited for the happy day we could turn it into a nursery.  Unfortunately, that day is taking way longer than it should and I've gotten fed up with the room looking like crap so we redid it into a bona fide guest room. It now looks beautiful and that makes me sad. 

Does moving on with my life mean that I'm slowly starting to give up hope? We've put a lot on hold because we thought I'd be pregnant last summer...and then in the fall...then winter...then spring...then THIS summer... When do you just say fuck it and continue to live your life without the thought of (hopefully) impending pregnancy factoring in? I'm beginning to think I've made a mistake by not doing that these past couple years.  

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On a different note, my hot flashes from the Clomid have been out of control lately. It's to the point where, if it was socially-appropriate to strip in public, I would do it without a second thought.  I'll be in at Target looking at shampoo or sitting in a meeting at work and all of a sudden I'll just turn bright red and start sweating profusely ALL over my body (seriously - sweat starts beading on my calves and forearms and shit).  Surely that's not normal.  I'm seriously considering bringing a change of clothes with me everywhere I go lately.

"I am serious... and don't call me Shirley."

(See what I did there?  Yeah, that's right - nailed it. Leslie Nielsen would be proud.)

Side effects of 100mg Clomid...

...have been almost non-existent! I am pretty surprised (and pleasantly surprised!).  It's CD9 so I'm taking my last dose tonight and so far I've had a couple hot flashes but that's it! No nausea, headaches or acting like a crazy person...Yet.  

Sex-a-thon begins tomorrow!  Hubs better start stretching now.

Sad and Annoyed

As you probably deduced by my blog post title, I am sad and annoyed.

This was my first medicated cycle (50mg Clomid + timed intercourse) and it appears it was a bust. Today is CD21 and I have not O'd.  I am sad.

The reason I am annoyed is because of my stupid RE not monitoring this cycle. And I'm annoyed with myself too since I knew better because of everything I've learned on TB. I should have pushed my RE to monitor even though he finds it to be "completely unnecessary during the first Clomid cycle since it will either work or it won't".  Well, apparently it won't, and since there was no monitoring I don't know if I had zero response or if it almost worked but couldn't quite get there so maybe (due to the cumulative effect of Clomid) another 50mg next cycle will be all I need to O and 100mg would be overkill. I would think this would be important info that the RE would want to have, no? Frustrating. I feel like I wasted a chance for more info and that was stupid of me and stupid of him IMO.

Here's the other annoyance: I'm pretty sure I have a cyst on my right ovary. However, since there was no mid-cycle u/s, I wouldn't know.  I've had ovary pain & cramping since CD10 (day after last pill) and it hasn't stopped. I can actually FEEL my right ovary.  Me thinks that is not good. The pain is pretty dull so I haven't been worried yet but it hasn't gone away or lessened over the last 2 weeks so that bums me out because I'm worried I'm going to be benched next cycle and have to take BCPs until the cyst goes down.

I'm supposed to call the RE's office on CD24 since I haven't O'd (confirmed by neg OPKs and low temps) so I'm interested to hear the plan for next steps. I know I definitely need an u/s to check out righty and that better be the first thing out of his mouth or I might have to think about whether this is the right RE for me.  Thankfully, he did say during our last appt that he does do full monitoring for every clomid cycle after the first so I'll definitely be ensuring that that happens (CD3 b/w & u/s, mid-cycle u/s to check follies, and b/w to check progesterone 7DPO assuming I O sometime in this century).

Whew - I feel better now that I got that off my chest. I've been avoiding TB check-ins over the past couple weeks and even my own BLOG! (ridiculous!) because I knew it would be obvious I was not being properly monitored and I didn't want to hear it from any of you helpful ladies who know better because I'm apparently a child.  I'm mad at myself for not pushing the RE and advocating for myself. I was worried that if I did that I'd be viewed as a high maintenance or pushy patient and didn't want the RE or nurses to be frustrated/annoyed with me. Dumb.

So with this waste of a cycle, it brings me full 'round to close out the first craptastic year of TTC: A year in which I did not O even ONCE and had exactly zero % chance of making a baby despite all our efforts.

Hmm, this is not a very good mindframe to start my day. So instead, I leave you with this:

So close! Haha

Waterworks

DAMN, I've been crying a lot lately.  I would say my face has been blotchy and puffed up more often than not over the majority of the last 4 days.   

Overwhelmed and/or frustrated with work?  Cry.  
National Anthem being sung at the start of the Bruins game? Cry. 
Hubby says something unexpectedly sweet and thoughtful? Cry. 
Reading another bumpie's IF blog? Serious waterworks. 
News coverage of the tornado in Oklahoma?  SOBBING. 

Hubs has started to just ignore me now and I can't say I blame him. Every time he turns around I'm crying again - and usually for NO reason. Today I made a special out-of-the-way trip to Wendy's because I was totally craving a chicken apple pecan salad and when they told me they were out of salads I damn near lost it again.  This is getting ridiculous. I'm kind of worried to go back into the office again this week for fear of making a huge ass of myself.

It wouldn't be so bad if I looked like this when I cry:

Unfortunately, I'm like the Claire Danes of crying:

Claire Danes: Ugliest crier on TV (Homeland rocks though)

Clomid side effects

So far, so good with the Clomid side effects. My last dose is today and I'm thankful that so far things have been pretty good. A couple headaches and a handful of hot flashes is nothing compared to what I thought I'd be experiencing this week. However, during the rest of this cycle and when (if!) I have to take more Clomid/a higher dose of it, I should probably repeat the following to myself like a mantra:

There is no reason for me to get irrationally angry or overly emotional and break into tears because;

• I couldn't remember where I left my book
• Bugs exist
• A commercial was loud
• The elastic on my underwear folded over and felt uncomfortable
• My computer took a while to load  
• The dog barks sometimes

Okay, so maybe I'm having a few side effects. 

Also, two of my best friends got married (to each other) last night and let me just say it was a good thing I was wearing waterproof eye makeup.  Glad I thought of that one in advance.

I've got a plan! (It's name is Clomid)

Hubby and I met with the RE today for a follow up appt since I have now finished all my diagnostic testing. He said everything looks great, we just need to get me ovulating!
He gave me a Rx for more Provera (10mg for 5 days instead of the 5mg for 10 days like I'd been taking every other cycle), I took a HPT to confirm what I already knew (NOT pregnant), and I'll start the Rx tonight. I should expect my period sometime between next Thursday and the following Monday (5/13) and then I'll be starting 50 mg Clomid days 5-9 of the new cycle! I am praying I respond to the 50mg.

When we left the RE's today, my hubby gave me a big hug and was so pumped. I wasn't. I don't really know why though. Those exclamation points I wrote up there in the first paragraph are total lies. I should probably be happy and relieved that the only problem we seem to have (fingers crossed)  is that I don't O....right? Then why do I feel so numb about it? Why do I sort of feel like crying?

Maybe it's that I can't lie to myself anymore. Maybe it's that the whole infertility thing is real now.  I now have a medication sitting on my counter with paperwork that says it's use is "to treat infertility in women".  I guess I'm finally admitting to myself that I am dealing with infertility. For almost a year now I've just told myself that my hormones need to be regulated - that's all! Or, that we were just going through "testing" - Testing is easy!  But now I'm officially in the treatment phase. 
I don't know, it seems sort of stupid typing it all out. I guess it's just something I have to wrap my head around...

Rationally, I know it isn't a big deal - I'm just taking some pills and going to some monitoring appointments. There's no injections, no IUI or IVF, we're just doing timed intercourse.  There are so many women who are so much further along in this journey who would probably equate Clomid + TI to taking a break! It's not the action of actually taking the meds that is getting to me, it's what it signifies;

Brutal honesty? I'm scared. I am really scared that it isn't going to work - not this 1st round of Clomid specifically, but trying to treat my infertility in general. I am scared that I am now about to take the first official step that is going to lead me down a path that could end in NEVER being able to get pregnant.  I've seen it before - with BOTH of my sisters (one is CFNBC, one with SIF).  I am scared to death that it's going to happen to me too.  

However, there is no reason to think that way. I've already passed many of the hurdles my sisters faced that took them out of the running and I'm still going. Like some of the ladies on TB have said; "another woman's fertility has no effect on your own."  That's true. Granted, in this case we share genes, but that still doesn't mean that because they can't get pregnant (/get PG again) that I won't be able to have children.  Only time will tell, I guess.  In the meantime I will focus on the fact that I have had almost all good news so far. 
I have a plan, and I'm moving forward.  Wish me luck!

First RE Appt Today

I had my first RE appt today!  It went well and was...enlightening. It also totally gave me the sense that with this appt, I just voluntarily hopped aboard a fast-moving train and there will really be no slowing down until I'm pregnant or if we happen to hit some sort of unavoidable roadblock. I guess I'm just gonna hang on and hope for the best.

Warning: This is probably going to be a SUPER long post because A) I want to write things down before I forget in case I want to review it and B) I want to provide details in the off-chance that someone reading this who is in a similar situation might actually get something from it!

So here's what happened today:
Hubby & I had a good discussion with the RE and I got to ask all my questions (more about that in a minute). They drew blood to make sure I'm not a carrier for cystic fibrosis and SMA (? I can't remember what that is).  They also tested something with my liver to make sure my body can handle Metformin. As long as the b/w results are good I will be starting Metformin (extended release) tomorrow night. The plan is to start with one 750mg pill every night before bed and once my body is used to that dose (he said it would likely take a few weeks) I'll add a 2nd pill each night so it'll be 1500mg/day every day, through (at the VERY least) 10 weeks into my pregnancy since he said it cuts down the chances of early miscarriage. I also will be having my HSG next week on either Tues or Wed so that we can make sure my tubes are clear and my uterus is shaped correctly. (It ended up being a very good thing that I timed the most recent dose of Provera to make sure I was only a couple days into my cycle at this point so that we can get the HSG done now instead of wasting another 2+ months until I can be at the beginning of my cycle again.)  I'll also have a pelvic exam and ultrasound to determine just how cystfull (totally a word) my ovaries are.  I think that's all that's scheduled for now. Once it's all done I will be going in to meet with him again in another 4-6 weeks and I will be starting Clomid shortly after that (more about that below).

The other big thing is that I will now be very focused on trying to lose weight since he said that my chances of becoming pregnant would increase dramatically with weight loss and that I should focus on getting my BMI into a healthy range.  I asked if the Metformin could help with that and he said if it does it would really just be because of appetite suppression and since the Met will almost undoubtedly give me diarrhea, I likely won't feel like eating as much or the same kinds of foods I have been. So that will be tough but I am motivated.

So here's some not great news: (And let me first preface this by saying that I really do trust that he knows his shit, understands the cutting edge research, and has proven success regarding his patients' pregnancy rates. He has stellar credentials and works at one of the top hospitals in the COUNTRY. His bedside manner is somewhat lacking but I don't mind if it means I am receiving great care. In spite of all that, I WAS surprised at some things he said and asked him many questions, and do not plan to just blindly follow exactly what he says without first doing some more research on my own.) Okay, so:

1. Apparently with PCOS, not only is it harder to get pregnant but my chances of miscarriage are greater as well. Direct quote: "The problem won't be GETTING you pregnant, it will be KEEPING you pregnant." Silly me, and I thought this was the hard part. Now I have something else to worry about.

2. He doesn't think depression and PCOS are really linked and that I should ask my PCP about it if I'm having a problem. He doesn't know if it's connected to my hormones and said if it IS, it would be due to increased progesterone but based on my charts, that doesn't really make sense when I look at my most depressive days (it looks to me like increased estrogen and/or LH and/or FSH cause it). So I don't know what's up there.  Hopefully eating better/exercising/losing weight will help. If is doesn't, I guess I'll go back to my incompetent PCP.

3. He puts zero stock in charting BBT, etc. and seems to think it is outdated.  I brought copies of my charts for him and he was completely uninterested. Charting over the past 10 mos was helpful in that I was able to confirm that I do NOT ovulate but other than that, now that I've 'graduated' to fertility medications, it seems like he thinks there is no need. (I plan to still chart while on meds even though my temps may be elevated, in order to see if I can still capture a temp shift to confirm O.)

4. He told me that he does not prescribe Metformin without also prescribing Clomid (except he did make the distinction that I need to take the Met alone for 6 weeks to get it fully into my system before starting the Clomid), because he says there is not much point and we'd just be wasting more time. He says it's proven time and again that the two work very well in conjunction with one another so that is the path he follows. I take it to mean that he takes a more aggressive approach to infertility than some other drs might. I guess that is not a problem for me.

5. The thing that MAY be a problem for me is that he does not think monitoring on the first dose of Clomid (i.e. CD3 & CD10 b/w and u/s) is necessary. (Note that he DOES monitor each dose after the first) The reason why he said he never does it is because the risks are SO rare that it's not necessary and in his thousands of patients, not ONE has ever had a problem. When I mentioned the risk of large and/or ruptured cysts he said that if I have a problem I will have pain so we will know something is not right and that the monitoring would not head that off. When I mentioned the risk of overstimulated follicles (i.e. too many follies and increased risk of multiples) he said having a lot of follies is what we WANT because I would have a higher chance of getting pregnant and that the risk of actually getting pregnant with multiples (esp. 3+) is very low anyway.  And when I mentioned uterine lining thinning he said that is really only a concern if you take about 12 rounds of Clomid which he would NEVER let happen, and that the generally accepted "limit" of 6 cycles among medical professionals is not truly a limit but just the consensus they came to based on the hard "limit" of 12.

So this was very surprising to me since I've been on The Bump for almost a year now and have seen it repeated time and time again that you "MUST BE MONITORED EACH AND EVERY TIME!!!".  After a year, that kind of got drilled into my head.  So I'm not sure what to think now.  Is this dr just extremely headstrong, has seen what works, has never had a patient with serious issues and so he is convinced that this is the best/right way to do it? He IS the professional... is he right and the women on TB are just overly afraid? I don't know. He DID say that if I really want to have the monitoring done (even though he made a point to restate that he finds it completely unnecessary) then we can do that. So that's good I guess.  I haven't made up my mind about it. He told me about some studies regarding this that I can take a look at and I will be doing some more researching on my own as well.  Thankfully, it's just the first dose that he finds no need to monitor so if it is taking a chance, it is only ONE chance, not every month. We'll see.

Okay, I think those are the main points.  HSG early next week, and I should be starting the Metformin tomorrow night! Let the diarrhea commence!