Resolve to Know More…

This week, in honor of National Infertility Awareness Week, I will be blogging about the facts of the disease of infertility.  That’s right, disease.  In fact, an article I read recently stated that it’s the 3rd most serious health condition after heart disease and cancer.  Infertility affects 1 in 8 couples of reproductive age.

We are 1 in 8.

We are 1 in 8.

 

According to RESOLVE,  infertility is a disease of the reproductive system.  Infertility is often diagnosed after a couple has had one year of unprotected, well-timed intercourse, or if the woman has suffered from multiple miscarriages and the woman is under 35 years of age.  If the woman is over 35 years old, it is diagnosed after 6 months of unprotected, well-timed intercourse.  One-third (30%) of infertility can be attributed to male factors, and about one-third (30%) can be attributed to female factors.  In about 20% of cases infertility is unexplained, and the remaining 10% of infertility is caused by a combination of problems in both partners.

My husband and I are in that small 10%.

There are many different risk factors that can contribute to infertility.

  • Weight
  • Age
  • Sexually Transmitted Diseases (STDs)
  • Tubal Disease
  • Endometriosis
  • DES Exposure
  • Smoking
  • Alcohol

I struggle with PCOS and him with MFI (male factor infertility).  We’ve been trying to get pregnant since we got married in November of 2011.  We had a miscarriage in August of 2012 and in March of 2013 my OB prescribed Clomid, which hyperstimulated my ovaries (OHSS).  I ended up needing emergency surgery to drain the cysts that had grown.  In June, July and August of 2013 we went through medicated IUI cycles (one pretty heavily medicated), which were all unsuccessful. We are currently saving money for IVF through an online fundraiser – www.youcaring.com/munchkin-mcnabb – which our RE feels is likely the only way we will get pregnant.

There are often no signs or symptoms that will indicate a problem with fertility.  But getting to know your body and understanding patterns it’s set will make that process easier.  If you feel there is a problem, seek help right away.

This week I’ll discuss family building options and the emotions that come with this journey!  I am so grateful for the awareness that is being raised and the opportunity that I have to take part in it!!

2014-niaw-image

http://www.resolve.org/infertility101  (Basic understanding of the disease of infertility.)

http://www.resolve.org/national-infertility-awareness-week/about.html (About NIAW)

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In One Word

infertility is

So many words.  I’ve felt every one of them at one moment or another.  Many at the same time.  I know that as a woman, we are known for feeling many things, but I was never fully aware that I could feel so many different things at once.  So many emotions that even conflict with each other.  Happy & sad.  Scared & excited.  Hopeful & devastated.  If I had to choose one word to describe all of my emotions, I would use the word “Insecure”.

When I first moved out here, I busted my tail and lost 80 lbs!  I know, right?!  That’s like a whole Vogue model!  I looked AMAZING, but even better, I FELT amazing!  I had more energy, self-esteem, confidence – all the things society would like us to believe that only being “skinny” will make you feel.  All the hormones I’ve had to take and the emotions I’ve felt have left me exhausted.  It’s a dialogue in my head just to get up and go to work every morning – “Come on, Dacina.  You guys need the money.”  “But I’m so sleeeeeeeepy.  I don’t want to.”  “It’s only 8 hours.”  “9 minus one for lunch.” – and then the voice of reason wins.

Of all the pain I’ve felt, and the things I’ve lost on this journey, I miss my confidence the most.  I look in the mirror and I do NOT like what I see.  I DESPISE the weight I’ve gained because of all the medications.  For some stupid reason, I’m the only one in my family with a tendency to carrying more weight than I should. And for some even more stupid reason, I think that weighing more than I want to, somehow determines the kind of person that I am.  But I know that’s not true!

My husband is the most amazing person.  I don’t know what I did to deserve him, but I’m glad I got him.  He tells me I’m beautiful – and I believe he ACTUALLY means it.  When he’s holding me and his hands drift towards my stomach, I always clench up and bat them away – embarrassed.  I’m so aware of the part of my body that is the most empty.  As little girls, we used basketballs or towels or pillows or whatever, just to see what it would look like when we got pregnant.  We never thought about THIS possibility.  And now – with my unfortunately expanding waistline – I’m reminded that my tummy is growing, but nothing is inside of it.

After this last IUI failed, I was devastated.  Big, huge, heaving, can’t-catch-my-breath sobs racked my body.  I had kind of known it was coming, but I didn’t realize how much hope I’d held until that red flag waved in my face.  I was going to wait a month to contact the Dr, but my husband reminded me – “That’s like people saying they are going to wait to have kids til they have money, we just have to spend money to try.”  Again – voice of reason.

This cycle is much more aggressive.  Hormone pills and hormone injections.  Even more trips to Cincinnati for unltrasounds, blood work and monitoring.  And now, there is more pressure.  After arguing with the specialty pharmacy about getting everything prior authorized and cleared, and spending more money than expected – I received a phone call from them.  For some reason, someone hadn’t noticed that it had already cleared, we’d already paid and I’d already received the medicine and was trying to run it through again.  But they were getting an error message that we’d reached our “maximum lifetime limit” on the medications.  Meaning that, if this fails, we pay for EVERYTHING.  Out of pocket.  We haven’t decided EXACTLY what that means just yet, but for now it means – if it fails, we wait.  We’ll take it day-by-day.  And on the days I feel like giving up, my husband will remind me what it is we are fighting for…

change the plan

“Hurting with Hope”

Not many people know this tidbit of information but my husband is a PK.  Yes, that’s right, a Preacher’s Kid. I’ve heard about the stereotypes for years.  And while there may be some evidence of a slight rebellion, my husband does NOT fit those stereotypes.  I am continually thankful to my Father and Mother in Law for raising my husband into the man he’s become.  To be clear – he has his moments where I’d like to make it a rule that he not be able to pester me for an entire day.  But I have no doubts that he loves me more than he may have ever thought it could be possible (as I’m sure he has the same thoughts about me!).  Last Sunday, as we sat in his father’s congregation, a meditation was given, and one of the phrases stood out so strongly.  The gentleman spoke of how Jesus “hurt with hope” when he was crucified.  Such powerful words.

My mantra these days is “I’m not getting my hopes up.”  So much easier said than done.  After all the hormones I had taken for the IUI that we were unable to have done, I secretly hoped that just MAYBE they’d jiggled something loose and we’d get pregnant naturally.  I woke up on a Sunday morning with a visitor that I DREAD & DESPISE.  I cancelled plans and told friends I wasn’t feeling good.  I remember having the thought “I’m done!  I can’t do this again!  It hurts too bad!”  But we went through the motions.  When you want something you’ve never had, you have to do things you’ve never done.

Our Specialist had given the order that if a good sample was given, it was to be cryogenically frozen so that we would have no surprises come time for our next IUI.  In an attempt to save us some money on gas to get to the lab in Cincinnati again,  we called the lab that the first couple analyses had been done at, only to be told that they don’t freeze at their lab – they referred me to the University of Louisville Embryology Lab.  I called there and spoke with a woman who told me that they would indeed freeze it, were it a good sample, but there were quite a few requirements that would need to be met first.  He would need 4 different blood tests ($$), to sign a consent form and have it witnessed ($) and a referral from our Specialist for cryo & banking.  After that, there was a HEFTY fee for simply freezing it($$$$), and then another for storing it($$$).  On top of that, once it came time to get the sample from UofL to the Institute of Reproductive Health (Dr’s office) in Cincinnati, we would be responsible for the fees incurred from a carrier and having to maintain it at a certain temperature during shipping($$$$$).  SO. MUCH.  WORK.  We soon realized, it would be cheaper to simply spend the gas money and drive to the lab.

piggy bank

 

 

Oftentimes I feel bad for the people at IRH.  I ask a lot of questions.  I can’t help it… inquiring minds want to know!  I plied the woman at the counter with multiple questions!  I learned that it would be MUCH cheaper for them to freeze a sample, were they able to.  I learned that it doesn’t, in fact, take 5 days to get the results of an analysis.  I learned that if I called the Lab about 2 hours after we left that they would be able to give us SOME information – while they couldn’t tell us what the results were, they would be able to tell me how many vials they’d frozen.  My next question was “So, if there are none frozen, will they tell me that?”  She told me the person would probably “not feel comfortable” giving those results and would refer me to contact our physician.  So, I called about one hour and 57 minutes later.  After being on hold for a 5-minute eternity, she came back on the line and said that the Lab was able to freeze 2 vials and that they looked “really good.”  FINALLY!!!  The first piece of good news in this whole thing!  She told me to wait a couple days and contact IRH, make sure the Dr had seen the results and find out where to go from there.  I thanked her, hung up and immediately called the Dr’s office.  (Patience is NOT one of my virtues! Plus, I was less than a week away from starting my cycle and I didn’t want to wait a whole month!)  I left a message and the nurse called me back about a half hour later and I explained that I was close to my cycle and didn’t want to miss it and was there someway the Dr could get the results quickly so I could know what to do?  Somewhat irritated she said they’d received the results, but Dr Scheiber hadn’t seen them yet and we could expect a call within the next couple of days.  We actually received a phone call not even an hour later from the same (somewhat sheepish) nurse saying that Dr Scheiber had reviewed the results and wanted me to start the hormone pills again on my next cycle so we didn’t have to wait.  Thank goodness we seemed to be on the same page as far as urgency!

The hormones affected me MUCH stronger this round.  I was woken abruptly at 1am the first night of hormones with a headache that felt like a brass drum section was practicing in my head.  I went to work that day and the hot flashes DRENCHED me.  Eating?  FUGEHDABODIT!  I was so nauseous that even thinking about food just about made me wretch!  About the third day, I got a big dose of the “mood swings”.  I still remember my husband making a comment to me while I was cooking dinner about an insignificant amount we needed to pay on something and I had a complete meltdown.  Throwing pot holders, yelling, tears – Code 5 Meltdown.  His response?  A hug in the middle of the kitchen.  Perfection.

As the days got closer to when I was supposed to go for the ultrasound, my body was telling me that something was INDEED going on in my ovaries.  While I’d had a small amount of cramping with the last dose, I was having significantly more with this and was almost completely sure I was ovulating.  I called IRH on my way to work that morning and left a message.  I was a nervous wreck.  If I was indeed ovulating, there was such a small window of time that the egg stays alive, I didn’t want to miss it!  I called again as soon as I knew they were open and explained to the girl on the phone what was going on and that our appointment wasn’t until 3:45pm.  She told me that the day looked booked solid, but she would transfer me to the nurses and see what they could do.  When the nurse came on the phone she said “We have an opening at 10:45, but it’s not in Florence, you’ll have to come all the way to Cincinnati. Can you be here?”  It was almost 9am and I still hadn’t told my husband or even made it home yet. That could still take almost a half hour in itself.  “We’ll be there!”  Thankfully, the dr was able to confirm that I wasn’t actually ovulating but the 2 follicles I had produced this time were significantly larger than last time and that was where the cramping was coming from.  He instructed us to give the trigger injection that evening and then be back at 9am on Saturday, July 28th for insemination at 10:30am.  The actual insemination hurt more than I was expecting it to!  I cramped for 5 days afterwards.  But during that time I kept reminding myself that if it worked, it would be worth it, while that little voice in my head reminded me that if it didn’t, the discomfort would pale in comparison.

As of today, we are on day 12 of the Two Week Wait.  It has been the longest two weeks of my LIFE.  My mind has played many tricks on me, even convincing my body of some things.  I never realized I was capable of feeling so many emotions all at once – all conflicting.  As the hours tick by, that feeling that a woman gets a couple days before she starts a cycle has grown stronger and the emotions have gotten closer and closer to the surface.  I feel this IUI cycle has failed and it hurts.  It hurts DEEP.  But those words – they keep resonating.  If Jesus can “hurt with hope” than so can we.  We have to……

hurts

What am I gonna do?

faith quotes

Faith is such a tricky word.  Merriam-Webster dictionary defines faith as a “firm belief in something for which there is no proof.”  A Bible verse that I remember learning as a child was Hebrews 11:1 – “Now faith is the substance of things hoped for. The evidence of things not seen.”  That verse has been niggling at the back of my brain for awhile now.  When I looked it up on my handy-dandy Bible app on my phone, I read it in the New International Version and this is what it reads – “Now faith is confidence in what we hope for and assurance about what we do not see.”  Wow.

When I hear stories about people who’ve had these big “ah-ha” moments about their faith, I find myself wondering if I’m doing something wrong.  Should I have had my “ah-ha” moment by now?  Will I ever?  Things have happened in my life that have made me SO angry with God.  I’ve questioned Him, yelled at Him, blamed it on Him, asked Him why.  I’ve never had a neon sign light up in front of my face that says “Here I am. I’m real. I not only know what you’re going through, but I planned it this way. I’m sorry it hurts, but TRUST ME.”  But there HAVE been days what I’ll get a random text from a friend asking how I am.  Or a phone call from someone I haven’t heard from in awhile just to check in.  Or a breeze on a hot day when I feel like there’s no relief in sight.  I know what that is.  Max Lucado says ” Faith is not the belief that God will do what you want.  It is the belief that God will do what is right.”  Man, that’s a hard pill to swallow sometimes!

Last month, we began the actual IUI process.  Simply put, it’s a 2 week process that involves stimulation hormones, ultrasounds, an at-home injection & the actual insemination.  The hormones weren’t as much of a nightmare as I’d heard (thank God for that!), but I did have some headaches, dizziness and hot flashes.  When we went up for the ultrasound that would tell us how my body was responding to the stimulation hormones, it revealed that I had 3 follicles that were mature & ready for the trigger injection that would make me ovulate. Our Dr also gently told us that some results of my blood tests he’d ordered weren’t good.  My AMH levels were pretty low.  (Remember, you can click on those little blue words and there’s secrets behind them!)  He said that he’d been expecting many more follicles, but that was likely contributed to my AMH levels.  Our chances of getting pregnant naturally were pretty much gone.  And if this IUI didn’t work, he would have to get much more aggresive with the treatments.  The next round of IUI would consist of at-home injections instead of oral hormones.  Then if that didn’t work, we would have to consider IVF.

We travelled to Cincinnati the night before our IUI, since we had to be there early the next morning and neither of us really wanted to drive.  In addition to that, there was a NASCAR race that weekend and our trip there took us right past the speedway – and we didn’t want to take ANY chances missing our appointment!   We made it to the lab that morning at 9am & they collected the sample from my husband.  My appointment wasn’t until 10:30am, to give the lab the time to “wash” the sample – separate the bad from the good & concentrate it.  After a wait in the lobby, we were led to the room where all the equipment for the insemination was laying out.  We knew that our Dr wasn’t working that weekend so we weren’t surprised when one of the partners from the institute came in the room.  What we were surprised by was what he said next.  “Mr & Mrs McNabb, unfortunately, we are not going to be able to perform the procedure today.”  I remember hearing the rest of his words, I just don’t recall how.  He told us that he would let our Dr know and that he was sorry.

hurting again

As we left the office and I crumbled against the wall in tears, Jon put his arm around me and led me out of the building.  I don’t really remember much of the walk to the car, or the ride home.  I do remember trying to call my mother in law and having to hand the phone to him so he could explain because I couldn’t talk.  I didn’t really talk to anyone for close to 2 days after we received that news.  I knew that all hope wasn’t gone, but it sure felt like it in that moment.  Our Doctor called us – personally – on Monday night.  After answering he asked, “How are you?” and then he did something I’ve never really experienced with a Doctor…  Aside from the fact that he sounded like he really MEANT it, he waited to hear my answer.  “Upset. Annoyed. Confused. Devastated.”  He went on to say that he was confused also, but that we would get to the bottom of this and he would ensure it.  He then ordered some other analyses and testing to be done.  I feel so blessed that we have the Dr that we do taking care of us.

I’ve always loved music.  It picks me up, soothes my soul, gives me energy.  Kerrie Roberts has a song called “No Matter What” that has spoken to me many times.  It says “Before a heartache can ever touch my life, it has to go through your hands… I know you can find a way to keep me from the pain but if not, I’ll trust you. No matter what.”  When I heard this song the other morning on my way to work, I remember thinking “What am I going to do? ”  Not in the “woe is me” kind of way but in the “Am I going to trust Him – no matter what?” kind of way?  You bet I am!

Know what I wonder?

I wonder how a woman that used to light up around babies can hardly even glance in an infant seat when she’s in public? I wonder how a woman that used to get butterflies in her stomach when she saw a pregnant woman has to turn her head when one comes in view? I wonder how a woman that used to wander through the baby section in a department store for fun now has to find the route that keeps her the furthest from it? And then I remember… The woman that used to light up around babies, now feels how heavy her empty arms are. The woman that used to get butterflies in her stomach when seeing a pregnant woman, now only sees a reminder of her barren womb. The woman that used to wander through the baby section, now only sees painful reminders of what age their child would have been. And I only know that because that woman – is me.

dream

Sometimes I feel so dramatic about the situation God has given to my husband and I. I remember that there are women that have been travelling this path far longer than I have. There are women that have felt far worse pain than I’ve felt. But saying someone can’t be sad because someone else may have it worse, is just like saying someone can’t be happy because someone else might have it better. And just because it could be worse doesn’t mean my pain is any less real. It’s been really hard for me to see so many friends get pregnant. I’m overcome by feelings of bitterness and jealousy when I see the announcements. You see… it’s a fine line. That line between being happy for you and being sad for me. I haven’t learned how to walk it just yet. But I’m trying.

The saying “the things you take for granted are the things someone else is praying for” became very real and personal to me earlier this year. On a day that was challenging enough in it’s own respect, I received the news that someone that was once very close to me – who has basically thrown their life away for that “fix” – was expecting a baby. I know where I was, what I was doing, who I was with, what I was wearing. I will never forget hearing the news that had just “slipped accidentally”. The words “I’m sorry! We weren’t going to tell you because of the miscarriage!” swirled around through the fog of emotion I had been enveloped in. I couldn’t think about anything but getting off the phone as quickly as I possibly could – to save the person on the other end from hearing whatever it was that was playing tug-of-war with my tongue to be uttered. As I hung up, I don’t remember saying goodbye, and I can’t quite put words to the feelings that completely overcame me, but I do remember hitting my knees & trying to catch my breath. I can only liken the feeling to what I’d imagine it’d be like being hit dead-center by a MACK truck. Not fun. AT ALL. I remember it finally hitting me and thinking, “Wait? You mean you KNEW and you didn’t TELL me??” I hastily composed a text to someone very close to me, a text that toed the line between accusation & sheer amazement that they’d actually kept the secret from me. The response was simple… “I didn’t tell you because I didn’t want to hurt you.” I felt that now, not only was I dealing with the gut-wrenching fact that someone was getting the gift I’d been begging praying for, but also with the fact that I’d been lied to. My head could grasp the concept of protection, however getting my heart on the same page has not been so easy.

When women that have been diagnosed infertile are trying to get pregnant, there is a long list of methods that are tested, through trial and error, to obtain the outcome desired. Although sometimes those methods have side effects that are unexpected. In March 2013, my (new) OB-GYN decided that it was time to try Clomid. Clomid is the given name for a medication that makes most women have mood swings that would make even the most pleasant woman go from 0 – BI*$% in 3 seconds flat. Thankfully, I didn’t have much of the mood swings. Hot flashes? Check. Headaches? Check. But then, about a week and a half after taking them, I went to the Emergency Room for severe abdominal pain. At first, the dr’s in the ER were completely puzzled. My symptoms manifested themselves as a classic case of Appendicitis – pain, nausea, loss of appetite. They did all the testing and everything came back mostly clear. The only thing that showed up on Contrast CAT Scans were the large mass of cysts that had developed on my left ovary – measuring 4.4cm. They weren’t convinced that there wasn’t something deeper going on and with the evident amount of uncontrollable pain I was in (even after large doses of morphine & dilaudid), they admitted me to the hospital and told me that the Internal Medicine Doctor would be in to see me in the morning. After a fairly brief discussion, he told me that he would give his recommendation to the Surgeon and I’d hear back shortly. The next I heard was a few hours later when the nurse came in the room and told me that I was to be prepped for Emergency Surgery. When the surgeon came in to talk to me in Pre-Op, he told me that they were going to go in laparascopically (three small incisions) and take my appendix. He also said that the cysts they saw on the CT Scan were large enough that he felt they would probably need to be drained. So, while he was in there he took my appendix, drained the mass of cysts and also ended up removing blood from cysts that had ruptured. Unfortunately, that wasn’t the end of the pain. My hubby had to take me back to the ER only 9 days after surgery, to which it was discovered that the mass of cysts had not only came back, but were now measuring 5.6cm. Know what that meant? No more of that fertility medicine for this girl. The medication that has been used for YEARS to help women get pregnant was now on the list of “Things Dacina Can’t Take To Get Pregnant.” And to add insult to injury – the person so close to me that had gotten pregnant? She had her baby 3 weeks to the day before we would have been due. Hard to not let that little tidbit of information mess with your mind.

After everything kind of settled down with that, the OB decided that the next course of action would be to have my husband get an analysis done. The results of that first test were devastating, to say the very least. We were CERTAIN that the results were wrong. She wanted us to have a second one done, just in case something had actually gone wrong. (Gentlemen, there are SO many things that can affect your swimmers that you don’t even CONSIDER!) But in the meantime, she had referred us to… [insert ominous movie music here] an Infertility Specialist. As if it hadn’t been real before, now we had to see a SPECIALIST. We booked the appointment for the Specialist and the second analysis all very quickly. Thankfully, the results from the second came back completely normal.

I knew, through some research, that Kentucky is #48 on the list of “Fertility Friendly States” so when my OB told us that the best specialist around was in Cincinnati, we were okay with it. It’s only about 1 1/2 hours from where we live, but still… it’s 1 1/2 hours from where we live! Thankfully they had a satellite office in Florence, which is only about an hour. On our first visit, I remember the triage nurse asking me how far we’d driven to get there and when I’d told her just an hour, she said they’d just had someone there that had driven 3 hours! SHEW! I feel like he was totally worth it now! Then we met him and I KNEW he was totally worth it. The consultation and ultrasound actually took less time than the drive up there. It was so much information so quickly and I think my hubby and I both just felt completely overwhelmed by it all… but, now we had a gameplan!! We were on the road to getting pregnant!!

Of course one of the looming obstacles now is, the exorbitant cost of the infertility treatments themselves… But, we are taking it one day, one step, one breath and often days, one tear at a time….

please

Post Script: Resolve has since updated & Kentucky is now #50.