Ultrasounds; next steps

I got a call from one of my RE's practice partners last Wednesday (my usual RE is out of town). He suggested I come in this past Friday to get an ultrasound to see where things stand for me. They were able to fit me in at 8am, which is great since I have to be at work a little ways away from the doctor's office. I went in (was late because I messed up getting there, another story, I was nervous etc.), got the bloodwork and ultrasound. It was fortunately a female doctor who did the wanding (I hadn't had one done in 4 years), which made it slightly less awkward.

She basically told me I had "stereotypically cystic PCOS ovaries with no dominant follicle" and that "there is no question you would benefit from medication, no question at all." Again, not anything that surprises me, but it's still not fun to hear. But, later that afternoon, she called me back and said my estradiol was a bit elevated, so there was some chance I could develop a dominant follicle sometime in the following week - neither she nor I expected that. (Although I wonder if she looked at the full blood profile closely enough - what if my estradiol is just elevated this cycle? My temps seem lower than in the previous cycle? Don't know for sure if there is a connection.)

So, I'm going in for another ultrasound on Thursday to see if by some chance I've developed a dominant follicle. I'm not holding my breath, but I guess we'll see.

My tentative plan is to ask them about Provera to start an AF very soon; do the HSG before we go away for a week (command performance with in-laws); then do the birth control pill for that month to calm down the cysts; then the Clomid. We'll see what the doctors say when I ask them what they think of my tentative plan! I want to maximize the chances that the Clomid will work (or at least not quickly cause large non-functional cyst issues that would lead to some time on the pill anyway), so this seems to make sense to me. Make sure my tube are open with the HSG, and calm down the "millions of little cysts" currently on my ovaries.

And in the meantime, I've decided (pretty much) what I'm going to do work-wise. My DH and I have drafted a letter to my boss, giving her far more detail about what I've been dealing with than I'd wanted to share... but I feel like I have no choice but to share more than I'm comfortable with to lay all my cards out, so to speak. I basically said that I didn't expect to be at the point of having to choose fertility treatments only 6 months after starting the job (I'd hoped to ovulate at least 2-3 times by now, but instead I last O'ed back in January); that emotionally this is especially difficult for me because of the loss of my late husband and the loss of having a family with my LH, and now I'm having "fertility challenges" with my new husband; that I have no choice but to have some of these appointments at times that will eat into standard work time, and with what she's said about how I would be allowed to make up some time, it would be extremely difficult to make up enough time if I start having a lot of appointments. And that the choices are either for us to work out SOMETHING in the way of time flexibility for me to have my appointments (unlikely for a variety of reasons); for her to help me find a job that is part time with benefits there and with some flexibility in the hours so I won't have to worry about that when I have appointments; or... I would have to quit (and find a part-time job somewhere else). I am not thrilled with the last option. The best choice would be the part-time gig somewhere at the company. But I don't know if it'll happen.

Nonetheless, I have decided I will make it work as long as I can (probably until shortly before I start Clomid, whenever it winds up being), and then give her the letter and see what happens. Although I am NOT looking forward to having to actually give it to her and have the inevitable super-awkward conversation, I've made some peace with knowing that this is the deal, and I have gone as far as I can with this.

Another week is starting... we'll see how this one is.

Infertility and Work

As I hinted at in my last post, I feel like I can't really do what I need to do fertility-treatment-wise given work. (I work at a company that does education stuff, enough on that.)

I haven't been there that long (several months, but less than a year). I have already had several false starts work-wise since my LH's death, so I don't want to quit outright, even if I had something else I could do part-time that would still somehow have benefits and more than $5 a paycheck. This job was mostly a foot-in-the-door type thing (but the benefits and an okay paycheck considering the position are really good too), so I don't want to burn any bridges, either. The vacation/sick policy is not horrible, but I have effectively used up all my days on a big trip that had to be negotiated into my starting paperwork already. So I basically have no time off that is not already a company holiday until after the New Year.

While there is some flexibility in my department in being able to take the occasional (and I do stress OCCASIONAL) couple of hours for a doctor's appointment and not be docked for it, I had several appointments in a row in late May-early June. I had put them off for a while already (checkups, follow-ups for stuff I'm supposed to get checked every so often, etc.). My boss was understanding at first, but then I could tell that she was annoyed by the number of appointments (despite the fact that I had given her ample warning that these were coming up, and had been making up the lost time). I finally had to print something out for her to let her know that I was dealing with fertility issues, and she was cool about it (I think she may have dealt with some of this herself when she was younger).

But, I just don't know if I will be able to keep up with sufficiently focusing on the job (which had already been getting increasingly difficult as I've begun to realize that I really am not ovulating, and thus will have to enter the realm of fertility treatments), in addition to trying to somehow work it out with my boss to do whatever appointments I'll need to do if I go on Metformin or Clomid. Not to mention the likely side effects of abdominal cramping and probably having to live in the bathroom for the first few weeks of Met, and/or the potential mood issues if we go straight to the Clomid.

To further complicate things, L and I are in the process of buying a new condo. While my pay is not a lot, it's still something, so I really kind of would have to continue in the position until we have a locked-in mortgage. I'm not sure how soon that will really have to be (officially we only have 45 days, but given that the place won't be done until late fall-early winter...?). And as I said, the benefits are good and COBRA is expensive on top of copays etc., so I feel like I shouldn't quit or go down to part-time without benefits (even if there were a position like that that I could take). So I just don't know what to do!!!

I figure, for the summer, I'll try to make whatever appointments on Friday afternoons (although that's tough, obviously, since doctors may be closing early on Fridays too), since we get summer Friday flex-time, and hope that somehow we get lucky in the next couple of months. But it kills me to continue to do the wait-and-see but not really do anything productive, because I don't know if I can take the side effects of the Met, or the additional appointments required of the Clomid. (What I've heard about the Met side effects sound in part much like how my stomach felt for about 2 years surrounding my LH's death... I never want to go back to feeling like that again!)

Am I just a wuss about the job stuff, and about being afraid of the side effects if I can't just take a sick day here or there? Am I just stalling? Am I afraid we'll actually get pregnant, paradoxical though that is?! I just don't know...

Oh, and this morning, we're meeting friends for brunch. I love brunch, big fan. But a friend in this group who normally doesn't show up to these things is coming... she got PG by semi-accident before she and her husband married, and now is pregnant with the second one. You think she's super-fertile?! (The kids will be only 18 months apart.) She only met her husband a couple of months before L and I met, and we didn't dilly-dally about getting engaged and married. To make it worse, it doesn't really occur to M that there can be other perspectives on life - she decides she wants to do or say something, and nothing will deter her. (But she seems very sweet and cute and harmless before you get to know that side of her.) Some of the same friends who saw me break down the other night (my husband gave them the topline summary while I went to the bathroom to wash off the Tammy Faye streaks on my face after crying) have been really nice asking how I was doing etc. At L's request, they have promised to help keep the pregnant one from making the whole conversation about her, her kid, and her pregnancy, which I REALLY appreciate. L said he'll also make sure I don't have to sit next to M., so I will hopefully not have to talk with her much at all.

I am not looking forward to seeing M, especially after the last few days I've had relative to other people's pregnancy news etc., and given that she is the not-so-empathic type. At the same time, I'm schizo about the kid thing - I went to a BBQ on the 4th for a couple of hours, and those friends have a baby. I wound up holding the baby for a while, talking to her, etc. But my pleasure in holding her was precariously close to my heart breaking again over the fertility issues we're facing...

Anyway, here is some of the issue as far as work/life expectations. To mangle a quote from Charlotte on "Sex & the City", "It's tradition! We will not behave like a typical barren couple! We have to LIVE!!!" I feel like that's what's expected of me/us. I'm not supposed to quit my job/shift to part-time to give myself the time and mental/emotional space to try to conceive, because I'm not supposed to put ANYTHING in my life on hold in the quest for a baby. I'm not supposed to mind hearing about other people's pregnancies, babies, toddlers, etc., since of course they have the right to get pregnant by looking at their husbands, and it's not their fault I can't do the same. I'm not supposed to be anything other than happy for my good friend who just got pregnant after only 2 cycles of not-preventing, instead of feeling guilty for not being happier for her and angry that I'm not right there with her. (I would be the logical person to offer to hold a small shower for her in the area when she is here around the holidays, but I don't know if I could do that without having to serve up a voodoo version of my heart on a platter for everyone to ritually stab, just to give physical representation to how I would probably feel if I did follow through with giving her a baby shower.) I'm not supposed to really resent the woman in the next department over at work who just came back to work after having her baby back in February, who has a bunch of baby pics plastered all over her office door that I have to walk by all the time.

There is a lot of "I'm not supposed to feel/act that way" in this infertility thing, and the choices in every way are not easy - work, treatments, friends, etc. I'm still trying to even begin to get a grip on them.

Okay, I'm going to try to get to sleep now, really.

Tonight - or why I started blogging now

I've been thinking of starting a blog for a little while (likely topics: the TTC thing, PCOS, young widowhood, young adult cancer, remarried young widows, work stuff, etc.). So, I finally did it. (BTW, "LH" in my world is "Late Husband" - it will be a somewhat frequent reference, so there you go.) This will be a bit long, since I'm trying to give you guys some background.

As I alluded to in my first post, issues of pregnancy/babies/etc. were HORRIFICALLY painful for me while my LH was slowly dying of cancer and for 2+ years after he died. I literally couldn't deal with most things related to those topics. It was like the proverbial "Why don't you give me a nice paper cut and pour lemon juice on it? We're CLOSED!" Only, times about 100. At least.

And now, L and I are having trouble getting pregnant. I ovulated once right off the pill back in January - and then nothing since then. I'm doing the whole temping/charting THING, so I KNOW I haven't O'ed. I have freaking pretty charts and statistics (those of you doing this too will totally get what I mean). Lots of pretty pictures showing why I'm not pregnant, why I could have two martinis tonight (I was not a happy camper, so sue me). And I'm doing occasional ovulation predictor kits, not that they're overly useful for many of us with PCOS anyway, but whatever, just for sh**s and giggles.

The cause of my not being a happy camper tonight? Within about an hour of each other, I found out that two friends are pregnant - one, an old friend of my LH's (who I also knew going way back) whose wife is due any day now, and the other, a close friend who had been not really hardcore TTC but kind of not NOT trying for only a couple of months... and bingo, two lines. The first set already has a 2+ year old daughter, and this friend had already accidentally put his foot in it. When his wife was pregnant the first time, he sent an e-mail to me about how overjoyed he was to feel his baby move inside his wife - to his friend's widow who had already told him that pregnancy stuff was incredibly painful to her - hello?!?!?! The second friend and I had wanted to be pregnant together. Oh well.

I feel absolutely awful - almost dirty - about not being able to be happier for both of these friends. And I'd suspected it, too. I've developed a hyper-sensitive radar for pregnancies in the last 5 years. But at the same time, I am ANGRY and HURT that I can't be there with them. I hate - loathe - that my LH's friend has become one of these obliviously happy parents who just don't get (and worse, don't really respect) the fact that no everyone's lives revolve around children (even if they ARE parents!), and thus I pretty much have nothing to talk to him about anymore. And clearly they have had absolutely no problem getting pregnant either time (I know they got pregnant pretty much immediately the first time, and I can do the math with the fact that there is not much time between kids). I had even told him that my new husband and I were having trouble in the TTC area, and he barely even acknowledged it much less offered any kind of empathy when he wrote back to tell me that they were pregnant again. Um, thanks for even trying to be empathetic!

I also absolutely hate that my other friend and I will not be able to somehow have the stars align and both be pregnant together. And now I am afraid I will lose her as a friend, as has happened with so many others, especially given how hard pregnancy/kid stuff has been for me in the last few years. Not that she would purposely leave me out of her life, but kids have a way of doing that to so many friendships. Especially if you don't live really near each other, and my friend and I don't. And so of course, I am really upset that I can't be more supportive of her, happier for her pregnancy, etc. She was very sweet on the phone, saying that she knew this may be hard for me, that she wanted us to be friends but she would understand if I needed to take little breaks from her pregnancy news as long as they weren't permanent breaks, etc. Of course, that only makes me feel worse.

After all this, I walked into the bar where I was meeting my husband and some friends for drinks to kick off the holiday weekend... and promptly burst into tears. My heart felt like it was breaking in a way it hasn't - well, pretty much ever - about anything other than my late husband's death and related issues. My husband steered me back outside to the curb, and I sobbed into his chest in front of all the people at the outdoor tables. Yeehaw! How classy. Good thing I had lots of training in getting over crying in public during the intensive young cancer spouse/young widow period. It felt like something was coming open in my chest, and such painful, deep sadness was pouring out. I hadn't cried like that in a while.

Anyway, as far as our TTC, I more or less knew I probably had PCOS (Polycystic Ovarian Syndrome) even before going to the reproductive endocrinologist a few weeks ago. I went off the pill last December, ovulated once, and then nothing since then. I guess I never figured I wouldn't have ovulated at least 2-3 times by now. (Ah, to believe that again...) To make things even more fun, since we went on a big trip this spring (for which I had to get extra unpaid days worked into my contract) and have another "command performance" family trip next month, I have basically absolutely NO vacation/sick days left at work. So, I feel like I can't even really start medical intervention to TTC - even Metformin, a diabetes drug that helps some women with PCOS to ovulate more regularly - because I really can't take much time at all for the doctors' appointments. Not to mention possible sick days due to potential drug side effects. Ugh.

So I feel like I'm really between a rock and a hard place. Especially after news from two friends who are PG and how I felt tonight, I want to jump on either the Met or Clomid freaking tomorrow. But I feel like I'm barely holding on at work as it is (my job isn't that hard, but it's been really annoying and rather stressful for the last 6 weeks or so, and will probably not get any better in the next 2 weeks). So how would I be able to deal with all the feelings about getting treatment, how the drugs may make me feel, etc. - and still function even halfway decently at work? But I am pretty much over acting like there is "plenty of time", like it's not a big deal if I don't start treatments until more like late fall or so, etc.

So anyway... that gives you an idea of some Stuff I'm dealing with, may be writing about, etc. Thanks for "listening".