Not much, what's new with you?

I cannot figure out how to write this.

I guess I will just do it chronologically.

There was Christina, standing in my living room, looking a little worried and telling me she had news. So I uncharitably guessed that an unmarried friend of ours was pregnant, and she said, No, I am. Which was a major things-you've-given-up-hoping-for-coming-true moment. And, oh, she'd been a little worried about how I would take it, but I was elated. Floated around for about a week with a smile on my face, my faith in the universe restored.

Until I remembered it wasn't over. I still had to somehow make the same happen for myself. Do what I'd been trying to do for years. Number one goal, unmet. Worse, really -- met, and snatched away, twice.

So I saw a new doctor, who scheduled a test, and almost all these tests involve me on my back, legs spread, and a couple strangers poking around in my lady bits. No exception here, where iodine was injected into my womb. The test said: normal.

I saw my cardiologist, who didn't have anything new to say other than to continue to be an annoying prick who I need to fire.

I started sleeping better after my husband, who should be sainted, resolved a snoring issue. Sleep is the great equalizer, no matter what anyone says.

I tried the Paleo diet and juiced vegetables and quit caffeine and started a baby aspirin regimen. I walked a lot. I half-heartedly attended cardio-kickboxing classes. I lost almost 20 pounds. 

I went to a dentist, which I'd been putting off for years. Two cavities, but other than that, nobody said The disease in your mouth has been affecting your fertility. Which I'd kind of hoped for, just so I'd have an answer.

I asked for progesterone. Doctors nowadays often won't say I think you should take this. They say We can try this if you want. So basically your health is in your hands, and this is the biggest lesson of the last three years. I asked for it and started taking it.

I started acupuncture and herbs, which I didn't know if I believed in. The effect I know it did most certainly have was to make me feel relaxed and positive -- I felt like I was doing something good for myself every week, working toward a goal. And as crazy as it sounds, there was the vision I had on my third visit in which I was standing in the sand, holding a male baby.

And what I didn't know at the time was that I was pregnant.

I always test too soon. I tested on Day 20, and nothing showed up in the first few minutes, so I threw it out. I tested on Day 21 and forgot about it for an hour or two, left it on the bathroom counter. I came back to find a faint, faint positive line. Burst into tears, started shaking. Dug through the trash for the Day 20 test. Even fainter positive line. Googled "false positive pregnancy tests" and "evap lines" with inconclusive results. For those wondering, I don't believe in false positives or evap lines. I've been testing for years, and the only positives I've ever gotten, no matter how long the stick sits there, have actually been positive.

 Days 20-26

And by the way, sorry for the fertility lingo if you're reading this and wondering about Day 20 and evap lines and all that. This has been my world for a while.

That was in March. Today is July 1 and I am 19 weeks pregnant with a boy and this whole thing feels very unreal, like I'm watching it happen to someone else. I mean, yes, that's me in the maternity pants, buying all the peanut butter chocolate ice cream while the clerk eyes my belly with an "is it burritos or a baby" expression, but I scarcely believe it.

It's thrilling and frightening and yes, I'm going to be someone's mother, and no, nobody made me prove I could do it first. It's terrifying but such a relief at the same time.

I'm posting this on both my personal blog and the Tired & Stuck blog, but I plan to update with baby-related stuff only on my personal blog. For those ladies out there who've followed along and been through similar struggles, thank you so much for every kind word. I wish the same miracle on you. 

the two faces of crinone

I realized last week (shortly after I ranted about how I had no way of knowing whether I'd ovulated due to the lack of temperature spike) that my temps were at least showing a rise in progesterone, however meager. So I started the crinone gel.

And hooo boy. That stuff isn't messing around.

First side effect I noticed: nausea. Then headaches, cramping, and major fatigue. Then, on my second full day of it, HOLY RAGE MONSTERS.

There's a bit of moodiness involved with the taking of this particular hormone, apparently. I will cry at anything. Anything. It's annoying. It can sneak up all surprise-like, which is extra annoying. It's frustrating because I know how I feel about things, and I don't feel like crying, but my body reacts involuntarily with grief, and then I'm in a puddle on the floor.

Yeah.

Anyway, the moodiness popped up after my last acupuncture appointment, which went well this time. I was so deliciously warm.

And.

Brace yourself for hippie madness.

I did not voluntarily imagine this, but it came into my mind like a vision. It is what it is. Hallucinations of a progesterone-addled mind, perhaps.

I saw a version of myself, nude, standing in the sand with a white-hot sun beating down on me. Icky creatures were crawling around my feet but I felt some sort of calm immunity from them. My hair was wild like it gets when you swim in the ocean and then dries all Medusa-like. I was holding an infant. A boy.

It just is what it is. I take it how I want to, which is as a transmission of hope.

Then I felt a surge of a need for action. A number of issues in my life rose to mind. I sensed I was stagnating on several fronts and needed to begin working much harder to move forward. K says my yang is stuck, and maybe it's stuck in more ways than one. In any case, I was inspired.

K said my pulse was stronger, which is a good sign. She advised me to continue to avoiding carbs, which I mostly failed at over the weekend but have revitalized my efforts this week. And she advised staying hydrated due to certain intestinal side effects of the progesterone.

I'm officially out of "gather vitality" herbs and still taking "jade moon phase 4," or worcestershire sauce as I like to call it.

And, in very good news, my temperatures look much better than they have in several cycles. They are actually above the cover line in the second half of my cycle. This is likely due to the crinone gel, which is why I'm happy to continue taking it, crazy-making though it is.

the perils of temping

Funny story.

My temperatures were looking really stupid. Here's my chart so far this cycle.

I mean, seriously. 97.7 five days in a row? A bit suspicious, even if I was temping at different times (which I was). But then the numbers started going up a bit so I was like, OK, I guess my thermometer's not broken. But then I realized, Hey. It's Day 18 and according to my chart, I haven't ovulated, even though my most fertile days were Day 15 and 16, according to my opk machine. And I'd been waiting to ovulate so I could take the crinone gel.

(Not to mention that I'd been waiting to ovulate so I could put my stud horse out to pasture, if you know what I'm saying. My poor husband is exhausted.)

So I ordered a new thermometer, got it yesterday, tested it against the old one, and my temperature on the new one was a full .6 degrees higher. Which in the world of basal body temperature charting is the difference between ovulating and not ovulating. It's huge. So obviously there is something amiss with the old thermometer.

Lesson learned: Change the batteries in the thermometer every month.

The problem now is I have no idea if/when I ovulated, and I'm uncertain about whether I should just start using the crinone gel. If I haven't ovulated yet, excess progesterone can block the release of the egg. My number this morning was less than helpful: 97.7. Some past charts show delayed ovulation on Day 20, so perhaps I'll wait to see what tomorrow's number is and then start using the gel.

Anyway, yes, I did decide to start using crinone gel after I visited K the acupuncturist last week. She was as kind as ever, but I'm afraid she had zero insight after I showed her my charts and labs. I shouldn't have set my expectations so high -- I mean, at this point I already know what's going on. Or at least, I think I do; my wonky thermometer may have been leading me astray.

Another lesson -- last week's session was much less relaxing because my hands were freezing. Why didn't I just tell her my hands were freezing? I'm dumb. I will tell her next time.

She prescribed another herbal concoction. This one is in liquid form. You mix it with water and it is nasty. It's possible it's not herbs at all, and just worcestershire sauce. Ick. I'm still taking "gather vitality" as well -- 3 pills, 3 times a day.

On my way out I asked K basically if she thought she could fix me. And she said the same thing she told me the first time; we'll nourish the egg and my hormones will respond properly to that strong egg. I officially no longer believe this, but that's ok because I still think herbs and acupuncture are potentially beneficial. She advised me to go ahead and use the crinone gel, so I figured I should.

Meanwhile I'm on Week 3 of Paleo. It's significantly easier than it was mid-week in Week 2, when I was depressed and had begun thinking there is no way this diet is sustainable and I'm going to have to give it up and eat bread again and I'll be fat forever, etc. I was having the worst cravings. This week I feel much better (although the idea of pizza ... is a little heartbreaking). That said, the weight loss has slowed WAY down. I'm sure if I was sticking to it really well, literally eating only meat and vegetables, I'd still see a big difference. But I can't do a no-fruit diet. It's just unreasonable at this point.

What's baffling to me is that I really have cut out all grains and dairy and legumes and this weight loss-stall is still happening. Pretty interesting. I guess I need to really watch my fruit and up the exercise.

tcm

I don't know why it took me this long to try acupuncture. I mean, I've been studying Making Babies as though it were a holy screed for the last two and a half years, and the book clearly says acupuncture and Chinese herbs would be beneficial for me.

Timeliness is not my strong suit, I guess.

Anyway, I decided on Friday to just go ahead and do it. I called the office to make an appointment and they were like: Would you like to come in today? And I was like: Sure.

So I went in and met my acupuncturist, K. She asked a lot of questions about my medical history. She is officially the first person I've sought fertility help from who's asked me how I have dealt with my miscarriages emotionally. Just her caring enough to ask made me a little teary. She confirmed that Paleo is the best diet I can be on right now in order to minimize insulin surges.

I asked for her thoughts on the crinone gel I'd recently been prescribed and she said it can certainly help, but that her take on my condition is that my eggs need to be nourished and built up so they'll be strong. When I produce a strong egg, my body will react in accordance with the proper hormones. I'm not totally sure I agree, but I do agree that I'd like strong, nourished eggs.

For the treatment portion of my visit, she felt my pulse, palpated my stomach, and felt my cold hands and feet, at which point she declared that my yang is stuck. Although she pronounced it "yong." My qi is deficient and needs to get ... efficient. This information totally jibes with what Making Babies has told me.

She popped some needles in my forehead, lower abdomen, legs, and feet. Then she did this moxibustion thing I'd never heard of, where they heat some kind of dried Chinese plant and touch it to the needles. I think the theory is that it stimulates circulation. She placed a heat lamp over my belly and a heating pad at my feet. I was instructed to let my heart grow with unconditional love and send that love down my right arm, into my hand (which was resting on my lower stomach), and into my ovaries. I began to picture my ovaries as purple mirror balls. It was involuntary, what can I say.

I was left to relax for ... I don't know. Half an hour? I laid there and listened to the hippie music and got nice and deliciously toasty, and once I got bored of sending love to my glittering ovaries, I let my mind wander wherever it wanted to. I didn't fall asleep -- I'm simply not that chill of a person. Perhaps on a future visit I'll be able to relax that deeply.

When the session was over, K asked if I'm familiar with basal body temperature charting. Um. YES. She wants to see my charts. She is the first person I've sought fertility help from who's expressed the slightest interest in my charts. My personal belief on this subject is that most doctors have no clue what the temperatures mean.

K also wants to see my most recent blood work, so I got that for her as well. She prescribed some herbs and gave me a moxibustion stick to light and hold over my stomach. I told her I will try anything. Why not?

When I got home, there was an email waiting for me with my treatment plan inside. I'm to go for weekly sessions for one full cycle, and then reevaluate. She also strongly suggested I buy a certain book ... you guessed it! Making Babies! I believe I've stumbled upon the holy grail of acupuncture practices.

Because I had such a positive experience, I'm seriously considering not taking the crinone gel when I ovulate this cycle. Is that insane? I just kind of want to see how my body responds to acupuncture first ... maybe give it a couple cycles. We'll see how I feel after the next session on Friday.

To top it all off, I got a card in the mail today from K, just welcoming me to the practice and wishing me a happy weekend. Which is way more than I can say for the multitude of doctors I've seen and paid wayyyy more money to. Now, if it works? I'll be completely sold.

a new drug

So I asked my doctor for progesterone and ... she prescribed it! Wonders will never cease when it comes to Dr. C. Why in the world I couldn't get a fertility specialist to test me for progesterone, I will never understand. Oh wait, I do: it's all about the money.

I'll be taking crinone gel. Please tell me you've heard wonderful things about this stuff and any tips/tricks you know when it comes to using it.

Meanwhile the battle of the bulge continues and I've embarked on the Paleo Diet. I know -- so obnoxious. It's one of the most restrictive diets I've been on, since it doesn't allow most dairy, legumes, or any grains. But after a lot of reading, I believe there is actually a significant amount of scientific evidence that backs up this way of eating.

And, there's also a butt-ton of evidence that the American government can't be trusted when it comes to what we should eat. Their food recommendations are always going to be tainted by the whispers of food lobbyists, who need us to keep eating corn syrup and getting cancer so they can make a lot of money.

Aside from all that, I'm just trying to relax. As the infertiles are constantly commanded to do. I should probably stop reading blogs, in that case. Today I read a blog written by an apparently fertile woman who was telling the quaint and adorable story of how she found out she was pregnant. This happens frequently. I read a blogger when she's single. Then I read about her wedding plans. And then I know it's coming ... she gets pregnant. Life keeps chugging along for some and stalls for others.

And then I read another blog by an infertile who finally had a kid after three IVFs, and her message of the day was basically: Don't sit on your hands. Make this happen for yourself. It's not how you imagined it was going to be, but you're going to have to accept that and start getting pushy with your doctors if you want this to happen.

It really rang true with me, since I do feel like I've sat on my hands quite a bit, waiting for a miracle. Thankfully, I started facing reality after the last miscarriage. Hence the battery of tests, and now the progesterone. I really only plan to give progesterone one or two cycles before I move on to something with a little more oomph. Time only moves forward and it's time to un-stall this process.

some thoughts about the luteal phase

... or as it is known by those in the know: The Two Week Wait.

- Is it just me, or are you always starving during the 2WW, too? I find dieting so much easier during the first two weeks of my cycles. But as soon as I ovulate, it's like I need all the food, NOW.

- my temperatures are still really low, with no thermal shift. This would seem to indicate my body is not responding to the increase in progesterone. As I mentioned a couple weeks ago, my progesterone numbers are considered normal. Perhaps on the low end of normal, but normal enough to indicate I am ovulating. Should I just ask for progesterone?

- I asked Dr. Google how I could naturally bump up my BBT numbers, thereby hopefully increasing progesterone, and wow. Talk about mixed messages. Never trust Dr. Google.

- For example, there's one dude who says you should eat more sugar, and eat lots of whole foods, to the point that you are overeating, and you shouldn't exercise. I'm like: Hey. I am a living example of why that particular "method" doesn't work. Also, it's a little scary when people who aren't doctors dispense medical advice on the internet.

- The rest of the internet thinks I have a thyroid problem. Multiple tests have shown that, clinically, I do not.

- Plenty of internet geniuses think I should cut out gluten. I don't even know, you guys.

- Making Babies is not helping me the way I want to be helped right now. It alludes to a possible luteal phase defect. And the book and my doctor seem to disagree about what adequate levels of progesterone are ... I'm leaning toward simply asking for the progesterone supplement once this cycle is over.

- Mostly I just want to stop thinking about this forever.

Ow, and ick

Well, good news. My uterus is normal. No polyps or fibroids or whatever. My right ovary has a promising looking follicular cyst that should pop out a nice little egg later this cycle, so I need you to send your most fertile vibes to my vagina, please. Thanks!

The procedure -- the sonohysterogram -- was ok. Mine was performed by a doctor who, if I had to guess, is about 150 years old. Imagine all the vaginas that dude has seen in his lifetime. Anyway, he shoves in the speculum and realizes my cervix is too high (I'm really beginning to wonder if my high cervix/tilted uterus is what's really behind my fertility issues, although I don't suppose that would explain the miscarriages). So his little helper nurse runs off to find a longer one. Oh, joy.

The longer one works fine. I feel some discomfort akin to menstrual cramps, in addition to the mental discomfort of two people staring at my vagina under fluorescent lights. He swabs my cervix with iodine, puts a catheter through it, and then helper nurse pumps saline solution into my uterus while he does a vaginal ultrasound. If there is any sort of prize for most use of the word vagina in a blog post, this one might win it.

So yeah. Kind of a relief, but still kind of a mystery. I'm gonna give this cycle a shot before I run off for karyotype (chromosome) testing and subject my husband to another sperm analysis. I'm just wondering if all this infertility crap is my dumb, shitty luck. It just would not surprise me.

Meanwhile I'm continuing to have my heart checked out and went this morning for my holter monitor, which is strangely more painful than an old man digging around in my vagina. That's because for the monitor they've got to scratch the points of contact on your chest and other areas on the torso. It really burns for like half an hour. After that it's just annoying because you feel like a robot. Going to the bathroom is especially fun.

My echocardiogram is Saturday, and that's just an ultrasound of the heart. I fully expect these results to come back "normal," as in normal for me, slightly abnormal for others. I just want the doctor to say I should be fine to carry a pregnancy, which I expect he will. Not that I really care what he says; I'm still trying regardless, at least for the moment.

de blood

Well, it's been a couple weeks and a few doctor's visits, so here's my update:

Nothing.

My blood was tested for everything under the sun, and they came back with everything looking perfectly normal. Even progesterone (although on the low end of normal). While being good news, I was extremely disappointed. I wanted her to say, Oh! Your progesterone sucks. Here's a pill! All better now.

No such luck.

Next moves are:

- karyotype testing. This tells you if your chromosomes are jacked.
- another semen analysis.
- sonohysterogram. They inject saline into your lady parts and do an ultrasound. Sounds joyous.

Meanwhile I'm simultaneously having my heart re-checked and will also be having to wear a holter monitor for 24 hours (if you've never done this it is one of the most annoying things on the planet) and undergo an echocardiogram (an ultrasound of the heart) to establish that my heart is healthy enough for me to get pregnant in the first place. It is. We're just double checking.

If all that other shit comes back normal, and I have a sneaking feeling that it will ... the next move is probably something like Clomid and/or IUI. Ah, and I really need to try acupuncture. Been meaning to but just haven't gotten around to it yet.

I'm reaaallly hoping I can make something happen before that, but we'll see. I'm still taking my new "job" of losing weight seriously and have embarked on another juice cleanse -- I got pregnant shortly after I did this the first time. I do think weight loss will be the key for me, so I'm really not messing around right now. It's not easy, never has been and never will be. But it's so important, I can't ignore it anymore.

new job

I've given myself a new full-time job.

All I have to do all day, every day, is work toward losing weight. If nothing else happens, whatever. I just need this weight gone.

It's easy enough to "forget" or simply push aside all of the evidence out there that points toward weight being a major impediment to not only getting pregnant, but maintaining pregnancy, and producing a healthy child. I've been re-reading Origins in an effort to psyche myself up for pregnancy since I'm hell bent on making it happen ASAP. Early on in the book, what do you think the author mentions?

Weight. Specifically that kids born to pregnant women with weight issues have a higher incidence of birth defects, and then to add insult to injury, they also often inherit their moms' weight problems. In a study of women who had one kid, then weight loss surgery, then another kid, the second kid was shown not to have inherited their mothers' weight issues. Insane stuff.

I've read it so many times and listened to a heartfelt 20-minute lecture from a fertility specialist about it. And as a result, I've lost 15 pounds. But I need to do that, oh, at least a couple more times.

It's amazing that even with such a massive motivation, I haven't been able to shed all the weight yet. I'm not punishing myself for it, but simply marveling at it. Losing weight is extremely difficult. Everything in my body wants to stay at the weight it is now. Working against that and various other roadblocks (holidays, family meals, eating out with friends, PMS, cravings) is a full-time job that requires vigilance.

Old Faithful

I needn't have worried about Day 3 falling on Christmas, because my trusty old vagina waited until Christmas Day for Day 1. This has happened several years in a row, so I ought to have suspected this year would be no different.

Normally this would be beyond irksome, but this year, of course, it's pretty good news because it means I get to go for Day 3 testing tomorrow. Day 3 testing is nothing new for me and I don't expect it to reveal anything interesting, but I do wonder about the many other tests they're going to run at the same time.

No one wants anything to be wrong with themselves, but I hope there's something wrong with me just so I can have an answer, finally. Of course, I want it to be something extremely fixable, too. I'm particular that way.

There will be more tests later in my cycle, so I won't have the full story until near the end of January, but, oh ... I wait with bated breath.

getting the ball rolling

What's that saying? The one about how if you have a problem with everyone, maybe you're the problem? After all, the common denominator is you.

I don't have a problem with everyone, but I do have a problem with most doctors. I've only ever had one doctor who helped me out. This was probably six years ago now, when I thought I was having panic attacks. She ran every test under the sun, and the results were super helpful. Turns out I wasn't having panic attacks; my heart is just a little jacked. Unfortunately, that doctor closed her practice.

I just saw a new doctor, and ... I am afraid to get my hopes up, you guys. I went in with my 7-page infertility questionnaire, told her it'd been over two years and two miscarriages, and said I wasn't interested in hearing about how I needed to have a third miscarriage in order for her to be concerned. She told me she wouldn't have said that, anyway. This may have to do with me being 34 years old now.

She is running 19 tests. Many of them are specifically for the repeated miscarriages. 

And she's running the progesterone test, guys. Why has it taken me this long to find a doctor who would run a series of progesterone tests? I've always suspected progesterone was the issue.

I'll also get a heart check-up to make sure I'm OK to actually carry a child since it puts stress on the heart.

Of course, I need to wait for the start of the next cycle before I can do any of these tests. Many of them need to be taken on Day 3 of my cycle. And when do you suppose Day 3 is projected to fall for me, since my cycle has been spot-on for the last several months? That's right. Christmas Day. This Murphy's Law shit is the story of my life. I've just called and confirmed that yes, all of the labs will be closed on Christmas. As they should be. So I will probably have to wait until the following cycle.

It's ok, really. I do feel very rushed to get my results, but it's been over two years already. Another month won't hurt.

one word of advice

If you happen to be home alone and want to watch something funny, and you also happen to be infertile, may I suggest you refrain from watching "What to Expect When You're Expecting"?

Sweet Baby Jesus.

I admit it was a dumb move on my part, ordering that movie from Netflix in the first place. But I honestly thought it was going to be a funny ha-ha "look how much pregnancy sucks but being a mom is cool" movie. And it was some of that but it was also a lot of oh my god miscarriage and trying-for-two-years and IVF and bad eggs and adoption and ... I sobbed. It was really ugly. I should have turned it off and I didn't because I'm a glutton for punishment.


Lesson learned. No movies about pregnancy/adoption/infertility/babies. Not yet.

please hold

Hurry up and wait is the order of the hour. It's a good news/weird news week.

For starters, my OB (the bitch with a capital C) is leaving the medical group I go to so she can be a full time mommy. How nice for her. That sentence wasn't dripping with acidic sarcasm. In opposite land.

Anyway, it's fine, because as I say, she's a total cuntwozzle and I am just gonna pick a different OB in the same practice. Probably.

Probably, because yesterday my husband's old company acquired his new company, and our insurance is going to change. Things can only get better in that department -- nothing can be worse than "We're sorry your vagina doesn't work, now here is zero dollars to help with that."

So in anticipation of better coverage, I canceled a physical I'd scheduled at the fertility clinic on Tuesday, along with a round of blood tests that would have cost a couple grand. I'm OK with waiting another month or so.

In other fertility clinic news, they keep having this ignoramous call me and tell me things, when she clearly has no idea what she's talking about. It's becoming grating. She called Monday to tell me one of the doctors says two miscarriages in a row does not equal "a pattern of miscarriages." In their world, perhaps. Anyway, because of that, they do not feel any additional testing is warranted. I didn't argue with her because as I said, she knows nothing. I'd planned to attack the NP doing my physical for information yesterday, but that'll have to wait.

Finally, I pored over Making Babies and upped my vitamin intake to the level the book recommends. I will probably ovulate this cycle, despite the miscarriage, if the CM I'm seeing is any indication. I'm seeing more than normal, and I can only attribute this to the vitamins. I'm taking a lot more folic acid, and I've added vitamin C, NAC, and coQ10 to the mix.

The ignoramous on the phone says they don't generally recommend trying to conceive again directly following a miscarriage blah blah I've heard it all before. I wonder if three miscarriages equals a pattern? Hm. I'm not interested in finding out but I also wonder if it's possible two miscarriages in a row really isn't a pattern and there's maybe nothing wrong with me. I can clearly get pregnant; staying pregnant is the trick. I'm still losing tiny bits of weight at a time and am down about ten pounds, so hopefully that helps whatever might be jacking me up.

In any case, that's what's up right now. There probably won't be much to report until we get the insurance thing worked out. Til then!

(insert curse word)

Since what Making Babies calls my "early pregnancy loss" and what others may term "chemical pregnancy" or the charming "disintegration":

• I ordered an ass-ton of new vitamins. Because what if vitamins are the problem? Sure.

• I rescheduled a physical with the fertility clinic. Blah blah I hate everything. 

• A woman from the clinic told me "we don't test for progesterone" when I suggested that might be the problem. She is dead now because I killed her. 

• I composed a list of tests I want done, including progesterone testing. I am bringing it to my next appointment. If they won't order them, I am blowing the place up. Which I think is perfectly reasonable. 

•  My dominating emotion this go-round has been anger, if that's not readily apparent. I'm a true joy to be around. 

• I'm still not talking about it. I don't want to talk about it. After the first miscarriage I talked the fuck out of it and now if I have to talk about it I might hurt someone. 

Yep.

Second verse, same as the first

I may have just had a beer, which is not on the Dr. A diet plan, but allow me to explain.

Last Tuesday, I was scheduled to have a physical with a nurse at the fertility clinic I've recently begun using. I woke up and took a pregnancy test, just in case. And it was positive.

This moment in time -- this two-pink-lines moment -- was such a sweet plink on my timeline. Good god, second pink line. You could not have arrived at a more fortuitous moment in time. You are saving me thousands of dollars in doctor's bills. You are the indicator of the son or daughter I fully expect to come tearing out of my vagina in nine months.

I woke up my husband. He was astounded. I went to the drug store and bought various different types of pregnancy tests. I tested a total of five times and got a positive result each time. So I bought a baby name book. We discussed plans for the nursery.

And, of course, I canceled my physical. The doctor's office wanted me to have a blood test to confirm the pregnancy, so I blithely headed to a lab for a draw that afternoon.

This is where the sequence of events becomes droll and irritating and grey and possibly even infuriating.

The doctor's office called me back. Yes, you are pregnant, they said. But your HCG level is only 28.

HCG levels are supposed to double or triple every 48 to 72 hours.

I tested again on Friday. They called on Saturday. Your HCG level is only 32.

I tested again on Monday. I started bleeding Monday afternoon. I took a home test and it was negative. The doctor's office called Tuesday and the HCG level was 8. I informed them that I already knew I was miscarrying.

What a fertility clinic will never call this (because they want to keep you as a client) is a chemical pregnancy. Christina says: I hate that phrase. I hate it, too. It's demeaning. It's a real pregnancy but the difference is it's never seen on an ultrasound. It's an early miscarriage. It's a blessing in one way; I won't have to spend any number of hours hunched over on a toilet this time. But it's absolutely still a miscarriage.

Miscarriages are what happens to other women. Two miscarriages in a row is what happens to other women who have shitty fucking luck; not you. God, or the universe, or whoever it is you think is looking out for you out there: He or She would never let this happen to you. You don't deserve it, certainly. It's not fair, at all. You'd be a good mom, your deity knows.

But there it is, draining out of you. Draining out of me, a bright red river. Again.

I'm not sure what I should feel, and I'm not sure what I do feel. I feel a swarm of things that are buzzing around my head, really, and when I pluck one out of the air it's often something like: Rage, self pity, helplessness, seething anger.

Whether I am allowed to feel strong emotion about an early miscarriage, I'm not sure. I do, though. I did. I will. I don't know, really. I am confused. They said You miscarry once, then you get pregnant again and it's fine, and it wasn't fine. No.

I told my family and a few close friends, but most friends I didn't tell. If you are one of them, I'm sorry. Maybe you are one of them but you'll never read this, and that's OK, too. I can't discuss this over and over and over with everyone. I know you get it, or hope you do. I wanted to be pregnant at the same time as my other friends who were pregnant and I can't talk to them about it. They'll read it here: Hi, girls.

The only option is keep going, keep going, keep going. The woman from the clinic on the phone talks of next steps and tests and appointments and money and I answer with a voice that's small in my chest and I know it's the only option. 

Things I needed to hear

We had our consultation with the fertility specialist, Dr. A, and we really liked him. I went in to the meeting feeling irritable and left feeling hopeful. So that's definitely something.

And that's despite the fact that he spent at least 20 minutes talking about how I need to lose weight. He said it in the nicest way possible, really. And it's not like it was surprising news. I'd been planning to ask Dr. A about how my weight might be affecting my fertility, in case he was one of these docs who's too embarrassed to discuss it. Turns out, he's not.

He pointed out that weighing too much can result in higher miscarriage rates and make it much more difficult to become pregnant in the first place. He said losing weight would double my chances of conception. So really, I have no excuse now. None.

Other highlights:

- I'll be having a number of tests run. They include: a physical, a heart check-up (I have an arrhythmia and enlarged heart valve), a bunch of blood tests to check hormone levels and for STDs, at least one ultrasound to check endometrial thickness, and probably a hysterosalpingogram and a hysterosonogram (which: yikes).

- My husband will donate more sperm to the cause even though we finally found out his motility and count are way above normal -- information my gynecologist mysteriously refused to tell us.

- Dr. A suspects PCOS. He says treatment would likely be metformin and clomiphene.

- Dr. A emphasizes eating of whole foods (not packaged), getting plenty of sleep, exercise, keeping caffeine and alcohol consumption fairly low, and limiting toxic exposure to stuff like pesticides, solvents, beauty salon crap, etc.

- Dr. A has freed me from lying around in bed, waiting for sperm to magically swim to the right place. For that matter, he's freed me from the missionary position. BAM!

-  Sex should be happening every 1.5 to 2.5 days mid-cycle. He says every day is fine, but he refrains from telling people that because he's worried they'll get divorced. Ha!

Finally, Dr. A says my "chances are excellent." I know we haven't run any tests yet, but I feel relieved and hopeful, nonetheless.

A few pre-appointment thoughts

My consultation is next Tuesday. I'm still nervous, but possibly more annoyed than anything else. The whole "it's not fair" thing. Nope, life isn't fair, is it sweetheart?

So here are the thoughts I'll just bullet-point for today, since they're a bit jumbled for now.

• I hope that whatever treatment and tests I need don't exceed what's in our health savings account. Although we will pay whatever we need to, if we exceed the HSA funds, we are on the hook for all costs since infertility treatments aren't covered. Well, of course they're not! Why would they be?! Don't get me started. 

• I still need to get my records from my OB sent over. In speaking with the fertility clinic's rep, she asked if I had copies of previous test results or if I knew the numbers on the results. Which made me hate my OB just that much more. She basically refused to tell me the results of our tests a number of times, despite me repeatedly asking her. Just another instance of doctors believing they know better than their patients, and that patients are on a need-to-know basis. What a bitch. 

• I feel like I'm being dragged into this by my ankles, while I clutch desperately for a handhold. 

• I could have been born a boy. Sometimes I think about that when I'm fed up with being a woman.

• I stopped taking my temperatures, even though I know it's valuable information for the doctor. I think I'm just pissed off about the whole thing. I give up. Fuck taking temperatures. It's never helped me before. Fuck laying around for half an hour after sex. I have a friend who got pregnant after having sex, then drinking fourteen pina coladas while sitting in a hot tub. But I have to lie in bed with my legs in the air? Fuck that. 

•  It's funny who in my life cares (or seems to care) about this stuff and who doesn't.

• These pre-appointment moments are filled with "what extremes would I go to" hypothetical scenarios. Surrogacy, egg donation, sperm donation, adoption, IVF. You begin to wonder. 

•  This was never in the plan for me or my friends. Don't ask me what was; I just know infertility was not. I resent its presence. 

•  On the other hand, I'm brilliantly lucky to be able to seek treatment for this. I am grateful for that.

• I'm tired. 

Scheduling

For those (most, if not all) commenters who suggested I make the appointment with a fertility specialist immediately, I must explain something. We have probably not met, or else you perhaps do not know me well because if you did, you would know I live in 1) a perpetual state of denial and 2) a perpetual state of procrastination. So making the appointment before my period started was simply impossible. I'm not saying I did the right thing; I'm just explaining my neuroses.

So what happened was I started my period late Thursday night. Friday I went on a camping trip (which: what could be better? Camping while on your period? Obviously good times). Saturday I came home. Sunday I recovered from not sleeping on the camping trip. Monday I sorted out my insurance questions. Tuesday I scheduled a "new patient consultation" at a local clinic. The appointment is two weeks out, on the 26th.

Which leaves us at today: Wednesday.

I think we should play a game called "What's Your Damage?" We should guess what my problem is (if we are so inclined). For those who are familiar with symptoms/temperatures/fertility monitors, it might be fun. So here's my list of "ailments."

- been trying 2 years, with 1 miscarriage.
- 33 years old
- overweight
- fertility monitor says I ovulate
- basal temps suggest I do not ovulate, and there's no rise in temp in the second half of the cycle.
- cycles range from 24 to 32 days
- periods are not debilitating -- crampy first two days, then fine.
- no family history of infertility
- husband's sperm has been checked and is fine

So, whatcha think? I think high possibilities are progesterone deficiency and/or PCOS. Worst-case nightmare material = I am out of eggs/eggs are not viable.

Questions? Thoughts?

Get on it

There are no changes since last week.

Temps are still too low. Ovulation is unlikely to have occurred. Aunt Flo should arrive shortly.

And my plan to wait until July has been booted out the window.

Because I'm making an appointment with a fertility specialist as soon as I get my period.

And I'm nervous as hell about it. 

Ovulation ... ?

Because my life follows Murphy's Law, I became rather ill during what The Machine told me were my most fertile days. We managed to get some good "work" done before I turned into the walking dead, and then I waited for ovulation.

And waited. And waited.

And then my temperature spiked on a morning after I'd slept fitfully. This was three days after my last peak fertile day, according to the fertility monitor. The previous night I'd slept two hours. I can't be sure if the temperature spike can be attributed to illness, or actual ovulation.

The next day the temperature dropped back down to pre-ovulation numbers. In case you're not familiar with how tracking basal temps works: Your temperature is supposed to spike when you ovulate, and then basically stay high for the rest of that cycle. If the temperatures drop back down, that's usually an indication of low progesterone, according to Making Babies. That's something I've suspected for a while.

But I gotta say, I am suspicious of that temperature spike. I don't think it's genuine. Next cycle's temperature chart will be more telling, as long as I don't come down with The Crud again. But honestly, I don't think I ovulated.

MB says the most common anovulatory condition is PCOS, and that 10 percent of women have it. I've never been diagnosed. Post-miscarriage the ultrasound showed only one unruptured cyst, but that's been seven months now. Who knows what my ovaries have been up to since then.

Most women with PCOS have weight issues (yes), hair in unwanted places (hello mustache), and insulin resistance. I've been tested for insulin issues a number of times -- my sister has Type 1 diabetes and I'm overweight, so doctors probably assume I'm a ticking time bomb. But the results have always come back normal.

However, there are actually two faces of PCOS; one that involves insulin resistance, and another that involves hyperandrogenism -- elevated androgen levels result from unruptured cysts. I don't know if I've ever been tested for that, but you can bet I'll be asking for it. 

MB says the best at-home remedies for PCOS are eating well and exercising. Unfortunately, "eating well" for PCOS means something close to the Atkins diet. The disease responds well to it. And the book says, encouragingly, that the majority of women with PCOS can get pregnant naturally. 

So, as usual, I'm basically self-diagnosing. Something else entirely could be causing my temperatures to be off. In any case, I'm still planning to give it one more cycle, and then it's off to the doctor. I'll reluctantly give low-carb eating a shot for the next month and keep trying to knock off the pounds. Diet, exercise, and The Crud helped me lose another few pounds since last week, so I'm on the right track.