HSG & Bilirubin

I had the HSG test yesterday. Ridiculously, the office made me come in an hour early to take a pregnancy test. I assured them that there was no possible way that I was pregnant, and the woman at the desk looked at me pityingly. I guess she assumed I’m straight and haven’t had sex in a really long time.

The HSG test was uneventful. A nurse explained the whole process while I nodded along. She asked me how I know so much about the procedure, and I wanted to say “my blogging friends have told me about it,” but I just said “I’m a good researcher.”

The man (x-ray technician?) who inserted the catheter and dye seemed very skilled. There was really no pain with that part. I could feel the dye entering my uterus, and it felt like very mild period cramps. I watched the monitor as the dye leaked in. It quickly flowed through the right fallopian tube. He had me roll slightly to my left, and then it flowed out my left fallopian tube. He thankfully then removed the catheter and speculum. I sat up and let some of the dye drain out onto a puppy pad they had me sitting on. I asked if both tubes were clear, and he said “both tubes are clear!” After I changed and put on a diaper-like sanitary pad, they gave me a CD of the images for my RE. I think the whole thing took about 10 minutes. One interesting note is that later in the day I had TONS of EWCM. I almost never see any, so I was surprised. I guess the dye washed it down out of my cervix, where it must usually hide. It was CD9, so it seems a little early, but not completely off target.

I didn’t take any ibuprofen, though they recommended 800mg. I actually don’t think I’ve ever taken 800mg in one dosage. I might have taken one or two pills, but as I was on my way to the HSG test, the RE’s office called to give me more test results. They said everything looked great, except my bilirubin and liver enzymes were elevated. They want to re-test them. Those numbers are elevated by alcohol, obesity, diabetes, and over the counter pain medication. Well, they drew the blood on CD3, and I definitely had taken 2-3 aleve over the preceding two days for cramps/headache that accompany a period. The aleve would definitely elevate those numbers. I really wish they would have told me beforehand they were testing that and avoiding those things would give a more accurate measure. So, late next week I have to have another blood draw. Curiously, this time they are doing it through my own insurance/doctor, so it should be relatively cheap. It makes me very angry that they didn’t do the whole first round of tests through my own doctor/insurance, because I’m positive the tests would have cost less than through their own lab.

One other thing that caught my attention was that my AMH was 5.1. The nurse said it was “fantastic” and they want to see something higher than 1.5. She failed to mention that an AMH level that high could indicate PCOS. My slightly long cycles (up to 35 days) and a few other very minor signs (in addition to the fact that we haven’t successfully gotten pregnant) suggest to me that I might have mild PCOS. I’m okay with that, because I think it’s pretty manageable. It will be interesting to hear what the doctor says about all of these results. I know he’s going to push Clomid, and probably a trigger shot. We meet with him on the 10th to develop a “plan.” Meanwhile, I’ll be not drinking alcohol, not taking any NSAIDs, and scheduling another bilirubin test.

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Ultrasound, Test Results, and Bike Races

On CD3, I went in for my “baseline ultrasound” and testing at the fertility clinic. The ultrasound tech was really great, because she talked about everything she was seeing. Apparently, I have 21 resting follicles on one side and 23 on the other. The average for someone under 35 is 12 on each side, so she told me I am overachieving. She said the lining, shape, and size all looked good. The NP told me that my uterus tilts slightly forward, but didn’t talk much about what that means. She said that because my ovaries have so many resting follicles, they are large – almost twice the size of average ovaries. She didn’t say that was a problem, so I’m not going to worry about it.

The clinic did the CD3 hormone testing and called on Friday to let me know everything is great. My FSH is 5.1 (I think), and they want it to be under 10, so that’s fine. I won’t get AMH until tomorrow or Wednesday, because they only run the test twice a week. I was a little peeved to find out that I had to have communicable disease testing. First, I had it done in LA in January. Second, I have absolutely no exposure to communicable diseases. Third, it cost $750. Annoying. They also let me know that I need to have a psych evaluation, per FDA guidelines. False. They also let me know that they will ONLY accept the evaluation done through THEIR psychologist, and it costs $250. For under an hour. So that someone can tell me how to talk to my future child about being conceived through donor sperm. Complete bullsh*t.

I have my HSG test coming up on Wednesday. I’m looking forward to knowing if the tubes are clear. If they’re not, our course will change quite a bit, but if they are, I feel confident one of the next few IUI’s will work. N let me know that she has a good feeling, and has been dreaming, that the first attempt is going to work. Let’s hope she is right!

This weekend we went up to Fort Collins to watch the end of Stage 6 of the USA Pro Challenge (big cycling race). It was really fun, but it happens very fast. We saw the men fly past early in their stage. It was a really tight pack of about 100 racers going 35+ miles an hour. I was leaning in to the road to watch them coming, and we all practically had to jump backward as they flew past, because they come at you so fast and take every inch of pavement. We then went downtown to try to watch the finish. I was lucky and snapped one decent photo of the leaders as they approached the finish line.mms_img1608487817We were really disappointed to just miss the women by about 10 minutes. We did get to see the men finish, and again, they flew by in seconds while we cheered really hard, and then we headed home.

mms_img1250247909A selfie while we waited for the cyclists to approach the finish line. I need a haircut.

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Patience is Virtue

Well, either posting on wp got my uterus cranking or I just need to be a little more patient. My period showed up about an hour after I wrote a whiney post yesterday. A 30 day cycle is not abnormal for me, so I cannot complain. I promptly scheduled CD3 bloodwork at the clinic for Thursday. I had previously scheduled a dentist appointment later in the afternoon that day, so I’ll have to miss a lot of work, but that’s okay. I also called and scheduled the HSG for next week on Wednesday (CD9). My insurance company assured me that it will cost $100 out of pocket, so I’m thrilled about that news. My last insurance, while good, did not cover any fertility diagnostics or treatment, so it would have cost around $800 out of pocket.

Small forward steps feel good, even if there is nothing really exciting on the horizon this cycle. I’m also grateful to my body for having a relatively short cycle, even though it wasn’t the 28-day clockwork I strive for.

As for other bloggers, I’m loving hearing about the flurry of babies that have just been born. Post more pics of those little squishes!

Typical

Well, I’ve enjoyed nearly six months of very regular cycles while we waited for the opportunity to try again. And of course, now that we are approaching the next attempt, my period is nowhere to be seen. I’m on CD 31, and I don’t feel anything coming. I have been enjoying cycles of 28 days, but historically they have stretched up to about 35 days. I guess this is one of the long ones. I have no idea why some are longer than others.

Most importantly, I don’t want it to start Thursday or Friday, because I need to have the CD3 bloodwork done again. If CD3 falls on a weekend, I have to drive over an hour to another clinic location, because the nearby clinic won’t be open. Now that I write that, I wonder what is going to happen if I ovulate on a weekend, and the sperms are shipped to the nearby clinic. I’ll have to ask about that…

Least importantly, I just want to get this show on the road. Am I starting to sound like a broken record? Shoot.

In other news, we had a very busy weekend. We went to a music festival on Friday and Sunday. It’s an annual tradition that we share with one of my closest friends and his wife. We couldn’t attend Saturday because we went to a wedding. I’ll write more about that later – it was really beautiful.

The artists at the festival were very diverse, and really entertaining. I learned from Peter Yarrow (of Peter, Paul and Mary) that he actually had not yet encountered marijuana when he wrote Puff the Magic Dragon. So the rumors are false. We also learned that Sufjan Steven’s parents were failed hippie cult members, and they later apologized to him for his esoteric first name. And we were absolutely inspired by Shane Koyczan. Shane is a spoken word poet, and while that is not usually my favorite genre, he was truly amazing. Google him. And my absolute favorites were the Wood Brothers. I cannot get enough of them.

Regrettably, this is the only picture I took:

mms_img1122809737What are your favorite music festivals? Do you attend with family, friends, or spouses? Do you camp? Any annual traditions?

Luke Potter

That is the fictitious name we gave potential donor #3. This is the first donor we have considered whose name we don’t actually know. The first two were known to us, having met for the express purpose of arranging donation. The first donor was a quiet slightly heavy, but overall healthy fellow who was approaching 35, if I remember correctly. We tried using his sperm at home 6 or 7 times. Never had any luck. The second donor was a tall, adventurous entertainment exec of about 26. He very generously donated at the clinic in LA to stock up vials for future use. We got to try one IUI with his swimmers, which obviously didn’t take. The rest of the crop are stuck in LA, though we are still researching options to circumvent the RE’s office and have them sent directly to us.

Given the latest hurdles, we decided it would be best to prepare for the possibility that the frozen batch may never make it out of California. We started researching banks and donors, making the infamous spreadsheet showing costs, family limits, availability of photos, etc. My favorite clinic (because they will ship directly to the recipient without doctor’s approval) is in the northwest. However, their supplies are low, and it seems that most donors won’t be available for 2-5 months. Our second choice clinic brought us to donor #3. If we have to go this route, we have chosen him to be the “open identity” donor. We named him “Luke”, because that is what his baby pictures look like to us, and “Potter” because he is of British descent and loves the Harry Potter series. From what we can tell, he is smart, funny, has good values, and was a cute baby/little kid. Of course we have glamorized him in our minds, and are picturing someone with the facial features of a model and the brains of a mensa member.

Is it weird to name a donor? We wanted something to call him, other than “the donor” so it seemed appropriate. I guess it may not be any more strange than naming an unborn child. And really, who wants to say “oh! the fetus just kicked.” Obviously, it will be a surprise when we one day learn his real name, but for now, we will call him Luke Potter and believe all good things about him. We will NOT likely tell any future kids about his fake name in order to avoid confusion, at least until they are old enough to understand.

So, we press forward with Luke Potter and wait for the next cycle to begin…

Mount Democrat

On Sunday, we hiked Mount Democrat, elevation 14,148. I think the hike was about five miles round trip, but N’s fit bit claims it was seven. It took us about four hours, and it was a very vertical hike. We arrived the night beforehand with a plan to camp, but the parking area was actually already full. We were pretty surprised by how many other people had come to do the same thing. We decided that the best option was to fold down the seats of the car and sleep in the back. Our sleeping pads and bags fit perfectly, so we could each stretch out head to toe. We were amazed at how comfortable it was. The dogs, thankfully, slept in the front seats with their own nests made of blankets.

mms_img-1873301301 mms_img-1517193028We woke up to the sound of other hikers preparing to depart. The sun was just starting to rise, and it was hard to leave the warm car to use the restroom and start packing the backpack. We were lucky, though, that the weather was perfect. It was sunny, but not hot. There were very few clouds in the sky, so we didn’t need to worry about lightning storms. The wildflowers were amazing. These photos don’t quite capture the huge variety of colors, but it was impressive.

mms_img1271962028 mms_img-1555541091 mms_img-341439174This was our puppy’s first big hike, and she has boundless energy. I made her stay on the leash for the first part, just to make sure she wouldn’t take off like a wild banshee. Her (much) older brother is a very experienced hiker, very trustworthy, and cautiously waits for each person in his pack at each turn. He sweetly runs back to check on the last hiker if he hasn’t seen them in awhile, and then runs back up to the front to lead the way. I worried a little bit about whether he would have the stamina to summit another fourteener, since he is ten years old, but he did a fantastic job. He did pass out hard in the car on the way home, unsurprisingly.

mms_img-1736154228 mms_img1095936817 mms_img-838746186The views from the summit were beautiful, but we were sharing them with many other hikers, which detracted from the experience. It was also quite windy at the top, which is to be expected. We sat and ate PB&J, even though it was only 9:00 a.m., gave the dogs cookies and water, and then headed back down. There are three other summits nearby, and initially I planned to do all three, but the trail was pretty crowded, and I did not want to push our luck with our older dog, so we returned to the trailhead. The descent was really lovely, because most of the hikers continued on the loop. We were mostly on our own, though we ran into several people who had gotten a late start. Our plan is to return in early September or maybe next summer to do the other portion of the loop and reach the other summits. I’m hopeful that once school is in session, less people will be up hiking on the weekends.

Overall, it was a fun experience. We had dinner in Breckenridge on the way up. We used Yelp to choose a place and even though it looked like a hole-in-the-wall bar, the food was terrific. I’m hopeful that once we have some kids, we are able to continue taking adventures like this.

The Best Laid Plans…

We met with the new RE last night. He is the only doctor at the closest location of this practice, and this practice is the only contractor my insurance (which covers 50% of most things) uses. So, we don’t really have the option of shopping around unless we want to pay out of pocket.

First up, he is super nerdy and comes across a little bit hard to relate to. We typically love nerdy. And awkward. He must have received feedback that he does not relate well to patients, because he spent about 15 minutes very deliberately trying to “get to know us.” He asked about our work, told a few funny stories from his, and made a solid effort at chit chat. I cannot imagine that he does well at cocktail parties. I do appreciate his effort to personalize his service, but it felt very … forced?

Next he asked for all of our family medical history and lifestyle practices (smoking, exercise, etc.). Then he asked for those of our donor, and that’s when things got a little weird. We have met the donor, we trust him and his intentions, and we have asked him all relevant questions about his health, family history, etc. The fertility clinic in LA did screening, testing, blah, blah, blah. When we told the new RE (let’s name him Beaker…he looks a little like that muppet) that we don’t know if the donor has a current partner, we started getting the side-eye. Why would it matter if he has a current partner, or 7? He donated the samples six months ago. He also asked about the legal agreement, which, frankly, is none of his business. What Beaker needs to know is that it exists, not what terms are included.

To make a long story short, Beaker told us that the FDA has extremely strict guidelines about donor sperm (duh) and it is extremely unlikely that this clinic satisfied all of the requirements, meaning there is about a 1 in 1,000 chance that we can transport our stock of 13 vials from LA to the new clinic. Beaker asked about the donor’s psych evaluation, drinking habits, family history, etc. Beaker wanted to know how we met him, which network specifically, and then proceeded to tell us that people offering their sperm often lie about their own health. To be honest, that kind of pissed me off. I appreciate Beaker’s caution, but we have already made a decision about this person, attempted an IUI with his sperm, and have a really good working relationship with him. Don’t sit across the desk and question my judgment about my body and my family.

The next part of the meeting was about the next steps. First he explained to us CD 3 bloodwork, which I have had done before, and which he can see in the file. Then he said we needed an HSG. I quickly told him that I had convinced my HMO to give me a referral for an HSG, even though the nurse practitioner didn’t fully grasp what it was. Beaker then proceeded to explain to me what an HSG test was, like I hadn’t just told him that I was very familiar. Then he jumped immediately to Clomid. What I find perplexing is that the LA RE poopoo’d Clomid immediately and said I was ovulating fine with big healthy follicles, so there was no reason to use medication. Beaker started pushing it immediately. I told him that we had concerns about multiples, but that our jury was out on Clomid. It left a bad taste in my mouth that he had my charts, everything looks super, including FSH, and he’s already pushing interventions.

Finally, he told me what I need to be doing now. As if I’m not fully aware. He already knows the vitamins I take, but he told me again to take them. He knows I sometimes drink 1 cup of tea or 1 cup of coffee once or twice a week, and he said to completely eliminate caffeine as if it was going to be this herculean effort. Like, Beaker, did you forget that about 20 minutes ago you asked me how much coffee I drink and I said a cup or two a week? Your script is showing. He also said to take fish oil, which I had already told him I do, and to drink no more than 4 alcoholic beverages a week, but only before ovulation. Whatever, bro. I’ve already told you I drink 4-5 beers or glasses of wine per week, and I’m pretty sure a glass of wine after ovulation and before implantation isn’t going to hurt anyone or anything.

The underlying issue was the paternalistic approach he took. This isn’t our first time to the rodeo, and he acted like we thought he had a zoo full of storks in the basement ready to start delivering bundles of joy to worthy parents.

Regardless, we left feeling frustrated and like this endless journey is continuing on. One of the more disappointing points is that no matter what happens with the sperm, he won’t try an IUI next month. I’ll start a new cycle around August 16th, have CD bloodwork (again), the HSG between 5 and 12, and then presumably wait for the NEXT cycle. When I asked if we ordered donor sperm from a bank whether we could try next month, he said that he doesn’t try an IUI the same month as an HSG, because it could have introduced bacteria into the uterus. What?? Why have I never heard that before? Anyone have insight?

On the way home we started discussing sperm options. We are anticipating that the supply in LA is lost at this point, but of course we would be thrilled to learn otherwise. We will spend some time in the next few days looking at online catalogs. If that’s the case, then we wasted 4-5 months waiting for the stupid 6-month FDA quarantine. And as an aside, we called this clinic BEFORE we started waiting, and they acted like if 6 months passed and donor was all clear, then we were aces. Nothing about KNOWN DONOR SPERM HAVE NEVER SUCCESSFULLY BEEN TRANSFERRED HERE BEFORE!! We could have gotten back to it in March, if we knew we had to go straight to the sperm banks.

Okay, I’m done grumbling, and I’m deliberately not thinking about how much money we spent to have the donor make deposits and get tested. We now just sit and wait for CD3 testing, and start picking Donor Plan C…

swim, bike, run

I am happy to let you know that the wife finished 5th in her age group in her triathlon this weekend. There were over fifty women in her age group, and she finished 273/2900 overall. She was pleased with the result, especially because it was her first ironman-distance race.

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Sunrise over port-a-potties. I think I’m funny.

Our day began at 3:00 a.m., when she got up to start eating. She had to consume 1200 calories before the race began at 6:30 a.m. and allow herself enough time to digest it before the starting gun. From there we made it to the swim start at about 4:45, when it was still plenty dark, and I found myself wondering why I hadn’t brought a sleeping bag to snooze on the beach while she applied sunscreen, body glide, junk jam, and her skin suit. It was exciting when the athletes finally got started, because all ~3000 of them rushed into the water at once. It looked like a chaotic mess of flying elbows and brightly colored swim caps all splashing about, but somehow they all made it out into the water to start their 2.4 mile swim.

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Finishing the swim, grabbing her bike bag.

I puttered around until she made it out of the water, approximately the 15th woman. She quickly stripped her skin suit and hopped on the bike. I managed to take my only worthwhile photo of the day of her leaving on the bike. For five hours and 45 minutes she pedaled around the county. I zigzagged with the car, catching her at a few locations before heading to the marathon course. There, I met up with my bestie David and his parents where we volunteered at a water station, handing out water, gatorade, coke, and general cheering. It was really fun seeing the first racers come through at breathtaking paces.

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The only good photo I got all day.

N came running by surprisingly early, which meant she had a strong bike ride. She was on pace with her goals, and in seemingly good spirits as she flew past our water station the first time. Because of where we were positioned, we saw her two more times over the next 90 minutes. It was clear that she was losing steam, but she was more than halfway done with the marathon. At mile 18, I was slightly concerned that she couldn’t hold her position without getting passed. She was wilting fast and had a lot of uncomfortable aches, pains, and hot spots. Plus, it had been about 10 hours since she had eaten anything solid, other than a few energy bars. These triathletes train their systems to thrive on powders, gels, and chewy bits, but frankly, I would just want a pb&j. David and I departed our water station after our shift and headed to the finish line. It is always so painful waiting for her to re-appear. I can calculate, based on pace and tracking points along the course, when she should arrive at the next location, and I also recognize the racers who have been near her all day, so it’s excruciating when I am waiting for her to appear and fearing that she has suffered injury, illness, or just stopped running. However, she did eventually round the corner and head down the finish chute amidst much cheering and high fives from random children. As we caught up to her in the finish area, she was surprisingly upbeat, although her eyes were only about halfway open. She finished just under her goal of 11 hours and 30 minutes, so the day was a success.

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A helpful sign I made her, which she did not see. Fail.

She was three places away from qualifying for a spot at the Ironman World Championships in Kona. And frankly, I’m happy she didn’t qualify this year. That race is in two months, and although we would have gone, I would rather spend money and energy on making a baby this year. Her finish also made it clear that she definitely has the capability to qualify, and we’re both pretty confident she will do it next year.

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At the finish line. I’m rocking bed head at 6:00 p.m. and my tag hanging out my shirt. Cool.

I was EXHAUSTED at the end of the day, and I (embarassingly) think I am more sore and stiff than she is today. She took the day off work, so she has enjoyed a leisurely day of sitting in the spa, drinking coffee, hanging out with the dogs, and over-analyzing race statistics. I’m hopeful that when I get home she’ll tell me we are done with triathlon for the season, but part of me thinks she’ll squeeze another half-ironman into the fall or early winter. Regardless, I’m super proud of her results this weekend and excited to see what next race season beings.