Post-MS Anyone?

I am thrilled that AF arrived, but I found myself in a bit of an emotional slump today. I wracked my brain to figure out what was wrong with me and then it dawned on me that I hadn't had many periods this year given all the IVF attempts we'd undergone. I'd forgotten, literally forgotten, that I'm one of those rare birds that doesn't get PMS (as in pre-menstrual syndrome), but I instead go through a bit of a Post-MS of sorts.

Many women find themselves feeling cranky, bitchy, desperate to eat chocolate *before* their periods. Not me. Mine screwed-up hormones kick in afterwards. In this case, CD3. I find myself depressed, sad, weepy, just plain miserable. I don't fly into rages, but find myself feeling more withdrawn and sullen. I don't understand why this is. One friend, a nurse, said that maybe I'm having a sort of negative feedback reaction to the increasing hormones at the start of AF. Hmm, maybe.

I haven't met anyone like this. Anyone else as whacked-out as me out there?

She's Heeeeeeeeeeeere!

As if nothing was wrong, AF showed up nice and bright this morning. I've never been so relieved to see her make her appearance. I still don't know what the delay was about but as Pamplemousse said, it's probably just my "bloody hormones" (dear girl, was that pun purposeful? heehee!).

Hmm, what else? Thursday night I took my first shot of enbrel of the 50mg variety (or is that 50mcg? Frightening how I didn't bother to really look this time). I haven't noticed any unusual symptoms. I've been extremely tired that last few days but that's probably all normal considering how little sleep I get, what with two frisky kittens who drop their toys on my sleeping head at 6:30 in the morning. I 'do' find myself looking at my scalp multiple times throughout the day scouting for a reduction in plaques in my quickly diminishing hairline. Yes, the hair is STILL falling out, but it seems to be slowing just a tiny bit.

Lastly, I just picked up a couple bottles of a predigested form of folic acid to help with the MTHFR issue (otherwise known as the "motherfucker gene") and am hoping to get my folic acid stores up in time for my next IVF cycle. Yeah, I know it might not happen ever again, but there's nothing wrong in "getting healthy". Anyways, with the MTHFR gene comes the increased risk of strokes and other issues if left untreated...so it's just one of those things that gets taken care of in the throes of trying to get pregnant.

There you have it. Nothing important save for my dear lost AF who finally made her way back today. Whew.

Real Late

Nearly 6 days late for AF and she's still nowhere in sight. This is odd, really odd. I guess at some point it would be prudent of me to phone my ob/gyn's office and advise this of this strange turn of events.

I need to make my appointment for my hysteroscopy on Monday so I guess I can mention to it at that time. I can already hear them saying, "Well it could be that you're starting menopause", to which I think I will burst a neuron. My mom didn't go through the change til her 50's so there's no reason to think I should start this soon.

Of course, my body has a mind of it's own. Something that is quite clear to me this week.

Late?

My last beta for IVF#4 was on 8/21 and my AF came the very same day in the afternoon. It was a typical heavy AF.

My AF is usually like clockwork: you can set your calendar by her. She comes every 28 days whether or not I want her to.

Except for this time.

Oddly I'm 4 days late.* Insanely, my mind started wondering, "Maybe the beta wasn't REALLY less than 2!?" and then "Maybe I'm getting early menopause?" (Mom didn't get hers till she was in her early to mid 50's so there's a small chance of that happening) and then I settled on, "Maybe my cycle is just totally whacked out after this last IVF?"

I've checked and double-checked my calendar. AF was most definitely due on Monday and today is Friday. This is a first. I'm rarely more than one day late even when it's the first real bleed after an IVF cycle. I've had minor cramps here and there that smack of AM coming on but I'll run to the bathroom only to find nothing. If she isn't here tomorrow I'm going to POAS just to set my crazy, hopeful mind to rest. (Now that I've said that I'm sure I've jinxed any chance of being pregnant!)

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*Before you get all excited, remember that I don't have any fallopian tubes. I can't get knocked up accidentally...oh how I wish.

Changes

Being that I am between cycles, I haven't had anything new and exciting to report on from my IF chair. I am still waiting for my shipment of Enbrel to arrive so that I can start the process of getting my immune system to calm down. Hopefully it will not only stop my psoriasis, but stop my hair from falling out (which has been going on since about CD10 or so of my last IVF cycle). My hair looks like shit. It's thin and dry. I used to have beautiful thick blond hair. Just last fall in fact. Some of my friends say they don't notice, but god, how can't they notice it? Why are they polite and afraid to say what they see? I saw Dr. G for my yearly two weeks ago and it was one of the first things she commented on. Perhaps, just perhaps, this enbrel will stop this hair falling out business in it's tracks and give me another lovely drop in my FSH as it turns things around, once again.

Last time I took humira, for somewhat similar reasons, I saw a great drop in my FSH. From about 9.5 or 10, all the way down to 5.6. It didn't help us get pregnant during FET#1, but it could have been crappy eggs from the previous IVF that was to blame. Dr. B used to think that women whose cytokines were extremely elevated were susceptible to ovarian and egg damage. He felt that patients such as that needed to take humira or enbrel on average of 17.4 weeks in order to get the maximum effects. My cytokines have never been in what he would call the danger zone, but because of my psoriasis outbreak, it's clear that my immune system is just whacked out and needs to be addressed.

I'm prepared to take it for that long for my psoriasis alone, so if it boosts my* chances with another IVF cycle all the better. Some studies show a slightly elevated risk of certain types of lymphomas for psoriasis patients that take enbrel and humira. I've also heard that they tend to disappear once the medication is ceased. I am not really sure what to believe but some days it just seems worth the risk. Some days, when I am feeling really down about this whole IF thing, I think that life would just not be the same without kids so I'll take the risk. Then my brain kicks in and straightens me out. So I'll ask my docs to monitor me as closely as they can for any indications of things going awry.

Otherwise, I have a tentative hysteroscopy scheduled for October 11th. I've been negligent in committing to the appointment but I really should have the good Dr. G take a look-see to ensure that all is fine inside. I've had sono-HSGs, chromopertubation tests, but never a hysteroscopy. Dr. G has explained that a sono-HSG should show any uterine abnormalities, but I really would like to know for sure that the 7 dwarfs haven't taken up residence in my uterus before shelling out another five figures for the next IVF.

I've managed to accumulate approximately 6.5 days of my IVF meds from online friends...thank you so much ladies. I can't tell you how much everything helps. :-) But I think you know.

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*J has decided he has had it with the whole IVF thing. Maybe even with being a parent. Our experience with IF been incredibly hard on us. Beyond words. I know that nothing really needs to be said for those of you that have, like us, endured multiple IVFs, failures, and what lupron can do to a couple. It's enough to destroy the best of couples. We've all heard tales of couples that separated or divorced after multiple IVFs yet the woman trudged on alone and was finally successful without her mate. Or wasn't.

I won't describe what has happened here out of respect for J, who was insane enough to give this URL out to friends, family, and coworkers. But, in a nut shell, it does not look as though he will sign on for another IVF whether or not I am hired onto a company that has benefits. I am assuming that I will be doing this next cycle alone and for myself. And that is fine by me. Yes, I am sad about it all, god, f*cking stunned is more like it, but I've had a few weeks to heal and I will keep trying because that is really all that I can do.

Expanding My Laboratory

Warning: TMI to follow

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Last Thursday I went in for my yearly p*p. It has actually been close to 2 years given that my nether regions have been, well, quite occupied with the multitude of IVF cycles that we've gone through.

Unbeknownst to me, my physician's office had lost a few of their staff and I was to see a new assistant. She came in and started off asking me the usual patient history questions, which in all honesty, felt a bit odd as I'm quite a regular in this office. My health history and that of my parents is pretty well documented.

She asked if I was having hot flashes or vaginal dryness yet. "Goodness no", I told her. Furthermore, we were actually still trying to get pregnant and had done quite a few IVF cycles, one of which ended just a few weeks prior. I forget what her comment was but it was pretty clear that she hadn't prepared for my exam by rummaging through my records when she made some suggestion to me that was predicated upon my actually HAVING fallopian tubes. To which I pointed to the keloided 4" scan on my abdomen and said, "Dr. G removed them last summer!" She had this pained quizzical look on her face, and asked yet another question which further reinforced my notion that she hadn't so much as glanced at my file before walking in. I had to explain how Dr. Moustache and Dr. G conferred and decided that with the massive amounts of endo that I had that it was likely that I had hydrosalpinxed and an exploratory laparotomy was in order. I explained that my tubes were found to be utterly destroyed and were removed with all due haste. It was clear from the look on her face that this was all new news to her.

But then she said the thing that makes many of us IF cringe. "Have you considered adoption?" It's a fair question, but it's a question that feels so dismissive of what we're aiming for: a genetic child of our own. I told her: "It's not for me. Of course I could always change my mind, but being that I was adopted and had a terrible experience with it, I don't think that I could be an adoptive parent myself. Besides, there are so many people who want to adopt and don't have the baggage that I have about it. Let them adopt."

I think that stifled her for a bit. I really do think that many (most?) people think that to undergo IVF means that you merely want a child. Any child. While that is certainly true for some people, it's certainly not true for me or for many people. Men, more than women, seem to have a greater difficulty accepting the idea of not having a biological child of their own and rejecting adoption out of hand. Perhaps it's a biological imperative thing? Who knows. It's true for "J" and I've heard it echoed by the DH's of many of my friends.

After this she swabbed my cervix and proceeded with the most vigorous pelvic exam I think I have even endured. She asked if anything hurt. No, nothing hurt, but wow did it feel as if she rearranged a few things. Mayan massage anyone? Geez!

Everything seemed in order and I left for home where I worked from home the rest of the day. By Friday night something was not quite right. It felt as though a UTI was coming on. I started to drink loads of water and although the typical UTI pain hadn't yet set it, I could feel that it was close.

Saturday morning a dear friend stopped by to bring me the latest H*rry P*tter book and when she left at 1pm I truly felt ill. I spent the entire day on the couch reading and heating up. By nightfall my temperature was up to 100.9 and I had intense body aches and something wasn't quite right down there. Mind you, this is a 3 day holiday weekend and not only are the physicians all out of town, save for the on call physician, but the pharmacies won't be able to fill prescriptions very easily.

By Sunday morning the fever had passed and I was back to a normal 97.7 (yes that's normal for me, so 100.9 is more like 102 for me) but still things weren't back to normal down there. A quick self exam showed opaque EWCM but things were a bit reddened and there was a mild sensation of burning. I've never been prone to yeast outbreaks but I figured that the high fever might have been enough to throw things askew. I read everything that Dr. Google could point me to about yeast and anything else that produced similar symptoms and, well, it could be quite a number of things.

I thought to myself: "If only I have a microscope here at home." You see, I have a veritible pharmacy of drugs here at the house and it's just a matter of knows what I have and then consulting Dr. Google for dosaging. Or Dr. Hungarian. It would be so easy to identify yeast. A smear on a slide with a drop of 10% KOH would make the candida cells quite clear. If that was the issue. Or a slide prepared with some of the EWCM would clearly show flagellated trich*m*nas if they were swimming around in there (they are easiest to identify in EWCM when they are literally pushed out of the cervix en masse). I would have to dig out the old microbiology books to find the methods for isolation and identification of the other microorganisms, but even E. coli is rather easy to identify, although the staining process is a bit of a pain in the arse even if you do have the requisite bunsen burners and stains on hand.

So being that I'm lacking a microscope and my physicians are all out of touch this weekend I opted to take the following:

1. For a potential UTI: 100mg of Macrobid, 3 times a day for maybe a week
   
2. For a potential yeast infection: A 3 day course of monistat
   
3. For any other BV related critters: 1g flagyl, twice a day for 5 to 7 days

It's a bit much, but I really do need to knock out whatever this is and fast.

I wonder what is really going on here though. The order of symptoms is just odd. On Wednesday I spent the day with my friend's two children at the beach. They had just gotten over a virus of some sort. Or did they? They're 20 months and 3 and a half. Maybe they're still sick and their parents just don't have a clue? I could have gotten their virus which popped up on Saturday in the form of a 24 hour fever. The vigorous p*p test could have, on it's own, had led to the UTI. And the fever and UTI, together or individually, could have caused my flora to get out of what and lead to the yeast imbalance or BV issue.

I hope I've covered all the potential bugs here, but if not, I've got a consult with my ob/gyn, the same one whose assistant gave me the free Mayan massage with my p*p. I can ask her to do another swabbing and see if anything remains on Friday. If I can wait that long.

So this morning I bid on a box of premium microscope slides with frosted edges and cover slips. I am committed to buying a microscope so that when things like this happen, again, I can quickly figure out if it's yeast, a UTI, or what, that I'm dealing with, walk over to my armoire and pull out the appropriate treatment, should I have it "in stock".

You might ask, "A microscope for a UTI?" Yes! With my trusty centrifuge(s) I can spin down my own urine and identify WBCs, RBCs, and microorganisms. Lovely, eh? I don't want to perpetually self treat, as I have done this weekend, for I am sure to miss something or do something wrong. But in the future, I would like to be able to treat myself in the case of an emergency and I would also like to be able to direct my doctor's assistants, who I am not confident of, as to the most probable cause for my discomfort so that I can get treated faster.

Maybe I can do sperm counts for friends to offset the cost of all this damned equipment?

The lab is now open.

Newbies

As one that has literally been through the IVF mill a few times, and considers myself a fairly active blogger and reader of IF blogs, I find myself trying to limit myself to only reading the blogs infertile who have been through at least 2 IVF cycles. I do read one newbie blog, religiously, but for the most part I find it incredibly difficult to read the blogs of the "new to IVF".

My heart really does go out to the newbies. I read of their hope, their angst over whether they'll get pregnant this first cycle. They write about how often they'll do acupuncture, how they think their REs walk on water, how they are "doing everything" right so that this first time will work. I read how they have switched from drinking 5 colas a day to diet soda and I cringe at the amount of aspartame that they're ingesting. Or the girls that stop binge drinking the day before they start taking stims. I have to wonder, sometimes, how serious some of these women are. I know that when this first one doesn't work for some of them that the shock will be unexpected. The pain deep. They'll look for reasons as to why this cycle didn't work. Many will analyze each step they took. Each meal. Each supplement. Whether that pitcher of margaritas the day before transfer had anything to do with it. They'll drive themselves batty with self blame.

When I follow the blog of a newbie and they aren't successful that first time, I feel their pain so intensely because I was there once. (Hell, I still fret over the silly shit!) The pain is so familiar that I dare not venture to their blogs too often. When I read of what their REs are or are not doing in their cycles I want to butt in with my SWAG (ie, scientific wild assed guess), or perhaps you'd call it my assvice. Whatever.

I want to write to them and tell them what I think of their REs, their protocols, their diets, their BMIs, their binge drinking, and to ask if they did "this test" or "that test" before they considered IVF or their RE. "Didn't your RE tell you to stay away from Ginkgo Biloba, Echinacea, and St. John's Wort????" I want to butt in. Sometimes I do, and I always fear the "thanks for stopping by but please back off" note. I haven't received one, yet, but I'm sure it's just around the corner. But for the most part, I try to read and move on, and better yet, I try to read the blogs of my fellow veteran sisters...those who have had repeated failures and have had their newbie blinders removed from their eyes.

I hear many women say that when they become pregnant that they move on and stop reading the blogs of the IF world. I'm not sure that I could ever do that if I were to become pregnant. I think I would still continue to follow my cycle sistahs and check in on them from time to time and offer up my SWAG whenever I felt so moved.