A circuitous tale of waking up thinner, the scourge called IF, and feeling ticked about all of it

As 2009 approaches, I am thinner than when 2008 came knocking. Not by much, but I notice it and so does my scale.

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Quick tip for the wise: Scroll down to the large bold phrase near the end to get to the point sooooo much faster. You're welcome!
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I've been fine with Not Being Thinner ever since early 2007 when I gained 25–30 pounds in 2 staggeringly fast month-long periods: March, I think, and then again in July. At the time we were between REs (thinking we were done with REs, mind you) and I was effectively grieving the loss of my fertility, such that it never was. In March of that year I contracted a strange, made-up-sounding viral infection whose treatment was to fast for a few days and then slowly reintroduce food from the BRAT diet (bananas, rice, applesauce, and toast) before gradually returning to regular food. It took about 10 days for me to tolerate anything but BRAT food and at least another week after that to eat normally.

I consumed very little food, FAR less than my typical diet provided, yet I managed to gain 7 pounds during the BRAT-only phase. I thought it odd but assumed my system would normalize on its own now that I felt healthy again. A few weeks later—after setting aside yet another pair of shrunk-in-the-wash underwear—I caught a clue and gingerly stepped on the scale. Another 8 pounds up for a total of 15 (or, as I said, "fiffffteeeeeeeen?"). JUST LIKE THAT!

Now this did catch my attention. But I still believed it was a temporary thing and that my awareness alone would be enough to reverse the gain. I'd simply move more and eat less, and soon all would be fine. Thing is, I made good on my plan but nothing changed. This failure threw me for a loop because several years earlier I'd gained and lost what I can now grudgingly call my "first" package of stress weight—I had no trouble losing it once I cared enough to try, and for 4 years I'd kept it off with what I perceived as no effort. I'd actually come to the smug belief that I was in control of something.

This is just a chemical glitch, I thought. I'll bet the Clomid from the RE Who Shall Not Be Mentioned triggered something. Maybe that screwy infection screwed me up. Or was it the Fertility Bl.end? Whatever the reason, I can make it go away anytime I want to.

In the face of concluding we weren't done seeking help on our quest to conceive, the weight quickly became a nonissue to me. My concentration shifted to finding a new RE. I interviewed prospects during June and July (can you say "Discouraging"?) and—BAM!—next time I looked up 10 or 15 additional pounds had debuted in time for bathing-suit season. That gain happened, too, with such dizzying speed that I almost couldn't process it. But damn, there I was needing new pants again.

DH and I planned an IVF for October 2007. In September the RE did a pre-cycle hysteroscopy. She literally gasped upon seeing a large fibroid onscreen, brand-spanking new since the fairly recent ultrasound we had *just* reviewed. The tumor had originated outside my uterus and poked right on through the uterine wall into the cavity. That sucker had to come out.

Both my RE and OB say there is no way to prove my theory, but nobody will EVER persuade me away from the firm belief that the rapid-fire weight gains and fibroid growth went hand-in-hand and were directly tied to the stress of trying to "get over" my desire to conceive and move on before I was ready. No way could I ignore that an immediate need for a myomectomy had cropped up, with extra poundage, during all 3 of the hands-down worst times of my life. (Not that I don't understand that I must also have been eating and moving differently. Chronic stress changes the way you function, inside and out.) But my experience with all of it doesn't inform anyone but me.

No matter, though. As DH and I pursued the end of our ttc story, I put weight out of my mind. I couldn't spare the effort to care about it while dealing with the rigors of ARTfulness and consistently tenuous pregnancies. Although 7–10 pharmaceutically-induced pounds came and went with each IVF, my weight held steady overall. No true gains in 2008. A plus that, thankfully, was not. (Assuming you ignore the given that I would give anything to be waddling around with a weight gain of a different stripe.)

I didn't mention this before because I still plan to do a separate post about my recent D&C, but . . . the day after the procedure I felt lighter. I looked it, too. That day my scale said that all the extra IVF #3 weight had disappeared in a surreal sort of POOF.

Well today I woke up looking slightly thinner yet again—3 more pounds gone.

Honestly, I don't know how that could even be possible. I mean, 'tis still the holiday season at my house, and a less-than-jolly one at that. I'm regularly comforting myself with toffee and tea, egg nog and cookies, wine and something cheesy, and so on. Even as I work today, DH is out hunting and gathering a long list of ingredients for the New Year–appropriate appetizers, goodies, and cocktails we'll make and I'll help consume. Not really a weight-shedding setup.

I know. Those 3 pounds probably found their way back to me while I wrote this post. But whether they or their 10+ IVF siblings have left me for good is not the point today.

The point is what ticked me off:

Here's a case where I have not been trying to do something I'd very much like to do. Namely, to start losing my "no baby" weight that so callously attached itself to me 2 years ago. I've done nothing whatsoever to advance the cause and practically everything one might think of to achieve the opposite effect. Yet quite a few pounds have gone missing anyway. I was "relaxing" about the whole deal, if you will, and suddenly I ended up with a desirable outcome. Thinking about it that way really burned me up for a minute.

You see, it's just one more item on life's infinite list that, ultimately, I will never control, even when I think I know for sure that I can and will.

October's path

Today in relevant history:

• 1987 — Knew my October AF was everything but normal. Couldn't begin to fathom that the things that do/don't grow inside my uterus would so profoundly affect not just that year, but the next 20+.
• 1995 — Married my sweetheart.
• 2000 — Knew I needed a second myomectomy.
• 2003 — Started TTC for our 8th anniversary.
• 2007 — "Skipped" our 12th anniversary because I was in the hospital for surgery that would allow us to try IVF.
• 2008 (that's today) — Hugged DH extra hard at 5:58 am when he whispered "Happy anniversary," then teared up when he added a soft "thank you."
  

Cycle status:

• Day 4 of stims.
• Feeling strong and not too stressed.
• Bloating is trying to start.
• Headache pops up about an hour before my shots each evening. (Can you say, "Hormone dip"?)
  
• Day 5 monitoring tomorrow.

Things I'm doing to help myself stay calm and focused:

• Staying ahead of my work.
• Listening to meditation CDs and music.
• Reading books.
  
• Watching movies.
• Flipping through magazines.
• Using the "good" lotions and potions.
  
• Going to twice-weekly acupuncture sessions.
• Soaking my feet nightly in warm water. (Gotta get that blood and good Qi moving!)
  
• Taking fistfuls of vitamins and supplements.
• Consuming IVF-/fertility-friendly foods.
• Drinking plenty of water.
• Getting enough sleep.
  
• Walking the dog (see photo for today's path).
  
• Cooking and baking.
• Consciously choosing positivity.
  
• Planning for an "IVF #3 failed" future.
• Trusting that an "IVF #3 worked" future is possible.
  

Time is gonna fly

It's here, the cycle that officially starts the madness of IVF #3!

I'll do a suppression check at 6 or 7 DPO (around 3 weeks from now), and if all looks good I'll shoot up with Cetrotide that night. Stims will begin about week after that. My clinic calls this a Natural Luteal Phase Antagonist Protocol — it's the same one we used for IVF #2.

I had a hysteroscopy 2 weeks ago, just to make sure everything looked normal after the D&C and that no new fibroids had sprouted. I still have one by my cervix that they didn't feel comfortable taking during my October 2007 myomectomy, but it hasn't grown and isn't making anyone (with an M.D.) nervous. Everything looks peachy. Make that pink-y — I saw my insides on a color monitor!

DH and I are flying out early Saturday to visit 5 different family units, with an (equal!) emphasis on both sets of parents. I want to go a little bit, really I do, but mostly I don't want to go in the least.

We haven't seen any family since well before we canceled last year's visit in the wake of finding out I needed surgery and needed it fast before proceeding to IVF #1 (followed by IVF #2, followed by miscarriage, followed by IVF #3 . . .).

I kind of wanted to see everyone under different circumstances: either with our baby in tow, or after we're totally done pursuing ART and I've had a chance to return to a more typical mindset and, I won't lie, body weight. Some of the clothes I'm packing are 2 sizes bigger than the ones I took on our last trip in 2007. It kinda stinks to anticipate the double-takes I know I'll get, but I know it will be fine and I'll enjoy seeing people I love.

All I'm really thinking about right now, though, is flying back home October 4 and getting this third dog-and-pony show on the road.

Baggage: What dreams are made of

So, I've been pestering the clinic for a detailed accounting of where our up-front IVF cycle money went, and most important, EXACTLY HOW MUCH WE GET BACK. The money is an issue and does affect our next steps. Because we went no further than ER, we should at least get money back for things like ICSI, AH, embryo coddling/fertilization reports, transfer, and the beta finale. That's my position, anyway. Nobody did any of that stuff. The clinic is happy to help but is taking its time getting me the info.

Yesterday's mail brought a note from the finance department, so we thought "Finally, here it is." Wrong-o, it's a BILL. For $20. Due upon receipt. It's strange because it's listed as a copay x 2 for a date neither of us went in. It looks like they successfully submitted a charge to insurance after the fact, though. We'll see, more money back for us, perhaps. I expect to know where we stand early this week.

For old time's sake last night I dreamed about the doctor who wanted to treat me to a hysterectomy for the "leaky faucet" he so expertly diagnosed 22+ years ago. I said no to the uterus removal and got a godsend of a second opinion (chronic hemorhagging clearly due to removable fibroids), but not before I'd let him spend a year pursuing myriad ineffective procedures while my life, health, college career, and relationships suffered. I was young and desperately trying to make everything work, and I just kept taking that doctor's "medicine" for too long.

The dream started with me sitting in my home office. My phone rang: Dr. Leaky calling. He wanted me to stop into his office, which was — conveniently enough — suddenly located in my laundry room. I trotted right on over to talk $$$. Oh no, sorry, no refunds for the IVF, he quickly explained. He then handed me a plain white envelope (clearly from my own stash). He encouraged me to put the $20 right on in there; he figured that was easiest since I had the cash in my purse. I said, "What exactly is this charge for?" And he told me it was for the extra unplanned hour he'd recently spent thinking about my case and concluding that he'd been right all those years ago . . .

Turns out I have money issues, lingering emotional baggage, AND the subconscious of a simpleton. Nice!

I happen to know that Dr. Leaky is long dead. I woke up rolling my eyes at him for taking time out of his afterlife to rattle some of my rusty old chains.

"My, what a beautiful lining you have"

Too bad everything else sucks eggs.

I pulled the plug on my IVF cycle this morning. Twenty minutes later I'm sitting in a coffee shop with my laptop and a subpar full-fat, all-caf latte. Actually, I finished that while waiting for the computer to boot; it wasn't very hot—or maybe my pain receptors are numb.

I meant to go straight home from my appointment, but I took the northbound freeway ramp when I wanted the southbound one. So I said "Frick it" and pointed my car toward a spot DH and I frequented when we first moved to town almost 10 years ago. Man, we were young(er) then.

At Day 5, my cyst has grown by 75%, and my follicle count is in the dumps: 1 decent one on the right, 2 small ones and 1 disappearing one on the left. Other follicles viewed at my suppression check have vanished.

I'll get my b/w results from my RE this afternoon and will confirm then that we're done for now. I wish I had talked with her after my second suppression check. Not that we wouldn't have proceeded just as we did. It's all a big what if, I know. Yet I wasn't totally satisfied with Dr. L's judgment on that day and now I am completely kicking myself for following it without giving more credence to that little piece of my gut that wasn't on board.

Now here's where I provide evidence that I had reason to second-guess Dr. L's judgment and that I was an idiot for waving off my instinct:

It was obvious that Dr. L hadn't given my chart more than a cursory glance. For four things: he was surprised to learn my age; he had no idea that his partner had recently performed a myomectomy on me (never mind that it was my third in 20 years of living a life of fabulous fibroidosity — and that I didn't need him to define subserosal, convert mm to cm, or question the veracity of my knowledge that I do not have endometriosis); he assumed I was doing a different protocol and gave incorrect "start injections tonight" advice based on that (which I didn't follow); and he was, I felt, more focused on putting on a getting-to-know-you floor show than paying close attention to my actual situation.

I don't know about you, but I prefer that my doctor save both playfully joking with me about my cyst/fibroids/clinic bill and patronizing the nurse ("You're wrong, as usual! But I still love you") till after he's done probing me. "Probing" was Dr. L's word; most at least use the term "wand" — without turning it into a verb.

You know how some guys, some gals too, will grandstand for you the first time you meet? They present an exaggeratedly charming/clever/funny self to seal the deal on that spectacular first impression. They are full of themselves (because they truly are talented, smart, charming, funny, or something good) and insecure with a capital I. They need that immediate feedback that you think they are the greatest, so they hit you with all they've got within your first 2 minutes of acquaintanceship. By the second time you've met, they feel comfortable enough to settle down into a normal personality presentation. And you do like them. Usually a lot. That was my take on Dr. L.

I don't blame him for my cyst growing or my follicles withering. And I don't blame him for answering my questions about oversuppression and why we wouldn't expect the cyst to grow with "In my experience, these shouldn't pose any problems." He gave me the advice he would have given to anyone else. And that's the kicker. Was he framing that advice within the context of my history, my age, anything about my case? I feared not then. And my incredible superpower of laser-like hindsight tells me NO now.

I do blame myself for not calling my RE directly to talk it through a little more. Had I done that, I may have gone ahead as I did. But I wouldn't be so freshly irritated by my visit with Dr. L and soooo mad at myself.

Looking forward to Dr. K calling later. We will figure out next steps.

Listen, Dr. K and I discussed the possibility of a poor response several times before DH and I signed up. I absolutely knew it could happen. I thought maybe it was even likely to. So this really is not a big surprise. In fact, I need to start thinking about it as good news. I had REALLY hoped, that if my meds protocol was wrong for me or I was just not going to do well, we'd get good indication of that early on. Before proceeding to retrieval. And so that wish has been fulfilled.

Yay.