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Friday, April 26, 2013

What Is Infertility?

This is the second year I've known about Infertility Awareness Week. Last year is the first time I came out to our friends that we were going through infertility by posting a link about infertility on Facebook.

What I've found is that lots of people don't know what infertility is characterized as, or just how many are living with it.

The CDC defines infertility as not being able to get pregnant for a year or more while actively trying. If a woman is 35 years old older, that shrinks to 6 months. Women who can get pregnant, but cannot stay pregnant also fall into this category.

Infertility occurs in 10% of women (6.1 million in the US) ages 15-44.

One of the most overlooked facts about infertility is that it isn't just a female problem. Many men experience infertility as well. On the CDC's website, they say that 1/3 of problems are on the male side, 1/3 are the female, and the other 1/3 are from both partners. The urologist we saw gave different statistics, but basically what they're saying is that men are involved here too.

Male factor infertility can have as many different factors as female infertility. Men can be born with the issue, sustain an injury, or develop some other type of blockage. Lifestyle choices also impact fertility in men. Alcohol, drug, tobacco usage, along with environmental and age factors play a role in fertility health.

The most common factors that inhibit female fertility are PCOS, Endometriosis, Pelvic Inflammatory Disease, uterine fibroids, and ectopic pregnancy.

For women, the same lifestyle choices that limit men have an effect on female fertility. Age, tobacco, alcohol, stress, and weight all have effects on your fertility.

The testing to find out what the problem is, is emotionally exhausting. I feel fortunate to know what my diagnosis is, but some couples get an "unexplained" diagnosis. Finding out the problem in a woman calls for monitoring of temperature, cervical mucus, and ovulation test kits. The more invasive procedures are the HSG (X-ray of fallopian tubes and uterus in which a dye is injected), and laparoscopy (exploratory abdomen surgery).

Men take a semen analysis in which the count, shape, and movement are evaluated. Treatment options range from simple diet and supplement changes, to surgery (varicoceletomy).

There are numerous medications that both men and women can take to improve their fertility.

Other options that you may have heard of for a couple with infertility are procedures like IUI (intrauterine insemination) and ART (Assisted Reproductive Technology). ART includes a few different methods, one of which is the commonly known IVF. All have been proven to help infertile couples achieve successful pregnancies.

What the CDC doesn't really touch on is the emotional aspect of infertility. To be honest, I think this is the hardest part of it. The appointments and tests are just obstacles you have to get through, but the emotional pain lasts long after you've left the doctor's office - it never stops.

If you're still in the infertility closet, I would encourage you to talk to someone about it. I never knew how much love and support I could have until I started telling people. I'm not saying that you need to broadcast your problems, but make sure there is someone you can trust to talk about it with. Or write it down. Find some way to get it out of your head so you can process everything you're going through. I think many women instinctively keep the pain of infertility on the inside. For one reason or another, it's easier to not talk about, but it is so hard on us.

If you don't have anyone to talk to, please feel free to talk to me.

Tuesday, April 23, 2013

TTC #2

Now that we've adopted, I think we fall into the rather unique category of trying to conceive our second child while having not conceived our first.

Alright, it isn't that unique, but it sounds kind of funny.

While I'm no where near ready for another newborn, we have been talking a lot about our other kids. The ones who haven't been born yet, or we haven't met yet.

We feel strongly that in the future, I will get pregnant. We believe it is going to happen. We have faith.

Now that we have Isaiah and saw how everything was meant to happen, it's easier to go by faith. I wish I could have said that sooner, but now I know, without a doubt, that everything works out how it is supposed to.

At the same time we learned of Isaiah and his birth mom, we had decided to take a break on the infertility treatments. We were waiting until the beginning of the year to reassess our position and hopefully be in a better place financially to take on the more expensive medicines. All at the same time our well laid plans were tossed aside for the amazing life we're living now.

My periods were still incredibly irregular so I went back on birth control. I was on BCP for ten years and when I went off of it when we started TTC I realized that it was just a bandaid for PCOS, not a treatment at all. I didn't want to go back on it, but had noticed my PCOS symptoms had dramatically increased while I was off. I wasn't watching my diet as well as I had been, but the weight gain was still there. I tried to take it off and had the hardest time. I don't think it's unfair to say that in order to lose weight women with PCOS have to diet and exercise a lot harder than others. By diet I mean healthy eating, nothing extreme. I tried low carb diets that are recommended for people with PCOS, and I found out that I really hate low carb eating.

So anyway, I went back on BCP with hopes of losing weight by regulating my hormones again to where they were when I lost weight so easily in 2007. The goal is to lose enough weight to start ovulating on my own, and hopefully get pregnant without a doctor.

You know what is hard? Losing weight with a newborn. It's hard to make myself get out of the house and exercise. Eating right is hard because meal times are not what I'm used to. I eat when Isaiah decides I can, and sometimes I'm past the point of hungry and straight into starving by then.

But that's the plan. Lose weight. Ovulate. Get pregnant.

We're absolutely open to adopting another child, and we both agree that we will be happy even if we cannot conceive a biological child. We have our child. Any others that come along will be equal and additional blessings.

So I think we're officially TTC #2. We're used to waiting. 

Wednesday, April 17, 2013


I avoid writing posts about current events. I don't like to do it because everyone else is already talking about it. I have to turn off the news because I get overwhelmed by everything reported.

I prefer to find a short article that summarizes the events rather than watching hours of news coverage that replays a short clip over and over. I only want to read it once, and I usually don't go back for updates. My coworkers discuss the news enough that I really haven't had a need to watch or read it for three years.

I guess what I'm getting at, is that Boston is different.

Whether it be that I'm a new mother and I'm extremely sensitive, or that we know someone who was there and I heard the worry in Josh's voice when he asked me to call to check on them, I'm not sure. But for me, this was hard.

On September 11, 2001, I was 15 years old. It sounds like an age where something as tragic as 9/11 would be understood, but to be honest, it wasn't. I didn't know what was going on, I wasn't clear on what had happened, and I didn't comprehend the big picture. I knew lots of people died, but all that occurred to me was that they died. Not that their families lost them. Not that thousands of families would never be the same. Not that I should be grateful for the ability to live and breathe.

Boston is no September 11. But for me, Boston is different.

I had just sat down to feed Isaiah when the alert came through on my phone that there were two explosions, and my heart sank. I got goosebumps and without even knowing any more detail than I just gave, I began to cry. Without knowing what happened, I knew it was bad. I knew with all of the people in attendance, someone wasn't going home to their family.

This is the part I didn't get when I was 15. Those people won't be home. And those who have lost limbs can, but may never run again.

Knowing that families have been torn apart, and lives have been forever changed, makes my heart break.

I went on a long walk with Isaiah this morning. I feel like I'm a fairly grateful and positive person (besides by sarcasm, but I'm still sincere), but I found myself, for the first time, thanking the Lord for my legs and feet. For the ability to walk with my son, and if I ever choose to, run.

When something tragic happens like this, I often take a leave of absence from the internet and social media. I stop posting, not because it isn't important, but because my issues, and all of my thoughts I put on Twitter are not important. When something like this happens, I realize how selfish my thoughts are. I realize that I need to be more present in my life and in my relationship with God.

Events like this don't make me realize how much I love my son, this makes me realize how much I have to lose. I have an incredibly blessed life, and the fact that I'm a mom now changes everything.

Monday, April 15, 2013

Letter To My Future Self

Isaiah is six weeks old and so many things have happened lately that I don't want you to ever forget.

I want you to always remember the amazing circumstances in which he came into your family. I want you to remember that against all odds, you became a mother. You agonized over infertility for years and you began to believe your family would only contain two people and sixteen dogs. You wanted this baby so bad, so when he begins to irritate you, and do things he shouldn't, please think back to how much you wanted him. Think of how much you loved him before you ever met him. Think of everything you went through to become his mom.

Remember his first smile at four weeks old. Remember how you felt when he flashed that big goofy gummy smile up at his mama. Remember how even at four weeks old he could show you he loved you. Remember that even though you are not his birth mama, you are the only mama he knows. Remember that no matter what, he loves you, even if he doesn't like you.

I want you to remember what a wonderful baby he was those first six weeks. Remember how he let you sleep and how he loved to listen to music with you. Remember his giant yawns that made your heart melt. Remember how he furrowed his brow as if to ask if you're being serious.

Remember how much change you went though. You were 27 years old and scared to death. You had no idea how to be a mom, and within six weeks you were catching spit-up in your hands on purpose. You were an expert booger picker and you finally got Isaiah to not cry during a diaper change. You learned how to get his clothes over his giant head, and you know all the right places he liked to snuggle.

Remember how hard it was to leave him with anyone besides Josh. It was even hard to leave him at your parents house. Leaving him at child watch at the Y was out of the question. You wanted him to use his crib in his own room from day one, but you couldn't stand to be away from him, so he slept next to your bed.

Lastly, please remember how you questioned if you were a good parent. Remember how you wondered if you were doing the right thing by not encouraging his birth mother to keep him. Remember how you questioned if he could love you because you hadn't carried him. Also, remember the day when you realized that was all ridiculous. Remember the day you knew, without a doubt, that Isaiah knew you were his mom, and you knew that he was meant for you.

Thursday, April 11, 2013

Reproductive Endocrinologist

As I said last time, I was very hesitant to admit that there was something wrong with me, and couldn't figure out why my regular doctor couldn't help me get pregnant.

I knew seeing a RE would be expensive. Very few states offer infertility insurance coverage, and our state isn't one of them. I knew my HSA would be quickly wiped out and we would be left to pay out of pocket.

When I was finally ready to admit that I needed the RE, I made the appointment, and to much disappointment, we weren't able to get in to see him for months. We don't live in an especially rural area, but we also aren't a buzzing metropolis. There are a few doctors in our area, but this one is the best we have. He has an office where we live and another in Indianapolis, so he isn't always available. However, we are very fortunate in that his office is only five minutes from home. I've heard of lots of couples who have to travel pretty far to see their doctor.

For our first appointment we met with the doctor and discussed what we had going on. He looked over my medical records and the results of Josh's semen analysis and gave us his recommendations.

I was to start Metformin, Provera, and Femara.

I've said before that I have PCOS with absent periods. Two weeks before we were to see the RE my period decided to make an appearance. And in true form, didn't want to leave. The flip side (for me) of PCOS is a never-ending period. I'm all or nothing, people. By the time we got to this appointment I was on day 18 of (sorry, not sorry for this next part) extremely heavy bleeding. For example, Mr. P and I went to a movie after our appointment and I had to get up to go to the bathroom three or more times. It was horrible, and even though I knew the horrible side effects I get from Provera, I couldn't wait to take it.

The Metformin was prescribed to control my metabolic syndrome. I'm not saying it isn't possible, because I have lost weight before (hello, white wedding dress) but it is hard for women with my type of PCOS to take weight off and keep it off. The extra body weight adds to the hormone imbalances that make up PCOS and it becomes one of the most vicious cycles ever. Many women are prescribed Metformin as a way to lose some weight. I'm convinced that this only happens through the diarrhea it causes (again, sorry, not sorry).

Josh's only instructions were to not smoke his weekly cigar and to cut back on his nightcaps (and basically to not do anything at all he might enjoy), and to standby.

The RE wanted to use Femara because of the side effects I felt with Clomid. He was willing to start our first cycle right away and prepare for our first IUI. I was pumped. I just knew I was going to get pregnant. I even had my BFF on standby for a celebration recipe of cheesecake stuffed strawberries dipped in chocolate, because, you know, yum.

I started the cycle and was disappointed to find out that nothing happened. Not only did nothing happen, even less happened than would have if I had taken Clomid. Literally, nothing happened. I was down $1,000 and all it bought me was an extremely uncomfortable baseline ultrasound (you know they do those WHILE you're bleeding, right? Awkward.) and an extremely overpriced blood draw.

But, I needed to get pregnant, so we went for it again. I had a higher dose of Femara and just knew it was going to happen.

To make a long story short, it didn't happen that time, or the next. Or the next.

By the time my Femara chances were maxed out, I was desperate to try Clomid again. The headaches weren't that bad. I could handle it.

After our last failed attempt at oral medication, the nurse called me and suggested we consider IVF, and I lost my mind. I was mad, I was sad, and I was heart broken. I felt ripped off, and taken advantage of. I felt like my doctor was just trying to make money instead of doing what I needed. I was mad that I hadn't seen my RE once since our initial consult. I felt abandoned.

IVF is an amazing option, and an incredible opportunity for those who choose to use it. I don't have any religious reasons to not try IVF, but I've always known that it just isn't for me. I have lots of blogging friends who have had healthy and successful pregnancies through the beauty of IVF, but when I was told that I was at that point, I broke down.

In my mind I knew I wouldn't ever go that route, so it felt like the end to me.

I called the office back and told them that I couldn't do IVF. I asked the nurse to speak with the doctor about other less expensive options.

When she called back she said the doctor wanted to move to IUI with injectables. When she told me the cost, I knew we couldn't do it.

It wasn't so much the cost, because we could have made it happen, but it was the point. We have a lot of student debt already, and I began to consider what kind of life we would be welcoming our child into if we created even more debt for ourselves with fertility costs.

I asked the nurse to talk to the doctor about another Clomid cycle, and Josh and I decided if it didn't work we were going to take a break for a few months to reevaluate and gather funds.

That Clomid cycle didn't work, and I haven't been back to the RE. I don't think I have officially quit using his office, but (read this next part like Ross Gellar) we're on a break.

What is your relationship like with your RE?

Friday, April 5, 2013

TTC Sucks

TTC is draining.

It starts with "It has been three months and I'm still not pregnant", but then three turns to six, and six turns to however many months you're at right now.

For us, our bump in the road (not in my abdomen) came six months in. I stopped taking the pill and we decided to let things happen naturally. Naturally, nothing happened.

My OB/GYN told me that if we didn't have any results within six months to come in to talk to her. I went in, but figured it wasn't a big deal, it was only six months. I was diagnosed very young with PCOS, so I kind of knew, even if I didn't fully understand, that it wasn't going to be as easy for us as it would be for some people. At the same time, I felt the extreme disappointment of every failed pregnancy test. And when I started ovulation tests, those negatives hurt too.

The thing about trouble TTC is that it is all negative. The test results, your feelings, your attitude. All negative. Your plus one is really a minus one. The dream of eating for two is really eating for yourself and in my case, my feelings (ice cream works wonders). If someone gets pregnant, it's hard to be happy. Which in turn, makes you feel negatively about yourself for feeling negatively about them.

I don't know that there is a standard protocol for the time limit between TTC with no issues, and trouble TTC. We went nearly two years before we saw our RE for the first time, and I think that is rather excessive.

My OB/GYN wanted to try to make me lose weight, and was reluctant to let me try some of the oral medications that help many women get pregnant. She has an extremely natural approach to medicine (I don't think she is even with the practice any more because she went somewhere to do holistic things). She said that I have anovulatory cycles which is the absence of a cycle at all. I don't ovulate on my own, and while Clomid is the most commonly used treatment to this, she wanted to try a natural way. Being uninformed about my options, I went with it. She was my doctor, she would know what was best, right?

I'm not an all natural kind of person. Don't get me wrong, my boobs are real. I don't buy organic (no offense intended if you do) and in my eyes, "all natural" reads as "higher cost". I don't really care to eat tons of chemicals, but I think organic ketchup is a joke. Organic canned food? Really? It's canned. But I digress. When it comes to wanting a baby, I didn't feel that all natural was the way to go.

When I went off of the pill I stopped having periods at all. It was amazing. No cramps, no bleeding, but also, no baby. For the first time in my life I wanted a period. It was so weird. My doctor started me on Prometrium to induce a period. Thinking this was my only option (surely my doctor would give me something cheaper if it were available, right?) I took it. And I took it. And I took it. And nothing happened. My doctor didn't have me doing anything besides having a period every month. Fabulous. Once it was apparent that I wasn't going to start ovulating on my own, she switched me to a progesterone cream that I had to order from a special pharmacy that would make and mail it to me. I had to rotate the locations that I applied the cream twice a day (wrists, shoulders, neck, or knee pit). This allowed me to have a cycle, but it was only 20 days long. And we were still doing nothing to encourage ovulation.

To be honest, I should have taken a stand for my own health long before I did, but that is neither here nor there. When I finally had enough, I switched doctors. The new doctor listened to my wishes, and immediately got me prepared to start the medications my other doctor had been holding back on.

I did four cycles of Clomid at 100mg before my OB/GYN decided to send me to the RE. I was having headaches on the Clomid (but I also ovulated once) and she was concerned of my risk of stroke. Honestly, and maybe carelessly, I wasn't concerned about stroke. I was concerned about being pregnant. I was pissed that she gave up so easily. I didn't want to see the RE because nothing was wrong with me. I wasn't infertile and she was a quitter.

Several weeks and many breakdowns later, I made the appointment with our RE. That post is coming up soon.

How long did you wait to move on to the next step?

Monday, April 1, 2013

The Adoption That Wasn't

This is a post I wrote for Hellobee.com when I first started writing there earlier this year. I never posted it on this blog because most of the information is already here, just jumbled around in different posts. 

Mr. Polish and I waiting on our Mini Polish to arrive and change our lives forever, but just so you know, this isn't our first manicure. (I wanted to say rodeo, but I feel like that is Mrs. Cowgirl's territory more than mine).

In the summer of 2012 we first entertained the idea of adopting. I don't know if you all have ''the grapevine'' where you live like we do, but it is a major form of communication here. We heard about our first birth family through the grapevine. We discussed it with each other, with our parents, and most importantly I discussed it with my BFF. Everything was a go. I contacted an adoption attorney to gather information about how to proceed. Our attorney directed us to a local social services agency to begin our home study.

Suddenly, without even knowing it, I fell in love with a baby I had never met, or even knew the sex of. I had all these ideas of how I wanted things to be, how I wanted birth announcements to look, who I wanted to watch our baby, getting our baby onto our Y membership, and almost every other thing you can imagine. I had all of our ducks in a row. I knew the attorney we were to use. I had all the paperwork from social services. I was getting ready to tell my boss that if everything went well I would be taking a leave of absence. I started pinning adoption links. Picking out clothes. Losing my mind.

And then the birth mom changed her mind.

I was so upset, to say the least. I was crushed, and at the same time I felt like I was being selfish for being upset. I felt like I should have been happy because the birth mom stepped up to take responsibility.  It was so hard because I felt like she stole our baby. The baby that was hers all along.

And I thought that was it for us. I thought we were done. I couldn't get pregnant, and I couldn't successfully adopt. I began to get used to the idea of just the two of us. We decided to not continue with the home study, and just take every day one at a time, when suddenly the grapevine fired up again, and months later we found ourselves in our current situation.

Our first birth mom's story got around to our current birth mom. Before our current birth mom reached out to us, she found herself confiding in a woman in her church about her pregnancy and the decision she had made. The woman she confided in is related to our first birth mom and she knew what we went through the first time.

What I'm getting at here is that if we hadn't known about the first birth family, we wouldn't know about our current birth family, and we wouldn't be anxiously awaiting the arrival of our first child.

It's kind of funny how life works out.


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