what a day for a daydream

On Wednesday, December 30, per my monitoring appointment the previous day, I reduced my Lupron injections to 5 units each morning instead of 20 units. I also began taking Estrace (which is a tiny blue pill to be taken orally), once per morning with my prenatal vitamins. Everything was going along swimmingly until I started thinking to myself, based on what I remembered from my FET three years ago, "Hmm...I wonder when I'm supposed to increase my Estrace dose to two pills a day (one in the morning and one in the evening)?" The nurse didn't mention anything about it in my monitoring appointment on the 29th so I thought maybe I wasn't supposed to increase my dose until my next monitoring appointment on Tuesday, January 12. As busy as I was with getting our house ready to put on the market, making decisions for our new house that is being built, trying to keep up with my 2 1/2 year old twins, and fighting colds, I didn't check my FET booklet for a few days. The thought about the pills continued to nag me but not as much as the other chaos happening in my household.

But it finally nagged me enough the morning of Friday, January 5. I checked my medication and monitoring schedule in my FET booklet just before leaving for work. To my alarm, not only was I supposed to start taking my Estrace twice per day starting YESTERDAY (Thursday, January 4), I was also supposed to start taking 81 mg of baby aspirin once per day with my prenatal vitamin, morning Estrace dose, and morning Lupron shot way back on Wednesday, December 30! My nurse NEVER mentioned baby aspirin in my monitoring appointment on the 29th - only the Lupron reduction and Estrace once per day. If she had mentioned it, I definitely would have started taking it when I was supposed to! Although, to her credit, she did tell me to follow along in my FET booklet... She just didn't specifically mention the baby aspirin. ARGH!

So I took my morning dose of baby aspirin and another in the evening before I went to bed to "catch up" on at least one missed dose, which made it as though I had only missed five baby aspirins instead of six. Yikes. SIX.

And then I allowed myself to freak out: Panic. Anger. Thoughts of "I've totally ruined this cycle already!" And every other emotion in the spectrum. Except I didn't cry. I had too much anxiety for that.

I called my RE's office at 8:01 am (on January 5) - as soon as they opened. Naturally, I had to leave a voice mail, which, as usual, was very detailed. And, as usual, I specifically said it was ok to leave a voice message on my cell phone if I was unable to answer when they called. To recap, I basically told them I forgot to take my evening dose of Estrace the night before, which would have been my first day of taking it twice per day. I then asked if I should take an extra dose today (so three pills today) or just continue with my prescribed two pills today. I didn't mention anything about the baby aspirin because I figured it was less important and I had plenty of days yet before my actual transfer to get it built up in my system. (And I was embarrassed to admit I messed up two meds and didn't want them to think I was a complete idiot.)

So I waited.

And waited.

And waited some more.

NO ONE called me back before the office closed at 4:00 pm! I was beyond livid! I called them again at 4:22 pm and requested to speak with the on-call physician. I told the medical messenger person what happened, I heard her typing notes, she said she paged the doctor, and she told me if no one called me within 20 minutes to call back again. And what do you know...the on-call physician called me back within five - yes FIVE - minutes. Apparently, I should page the on-call physician more often instead of bothering with the unreliable nurse line.

But the doc obviously didn't read the notes from the medical messenger because I had to explain the whole situation all over again...with my toddlers shouting and pushing and screaming in the background. Fun times. I'm not even certain it was a doc who called me back...I think it may have been a nurse?? Anyway, she said it was too late to take the missed dose now (duh lady, even I knew that) and to just continue with my normal two doses as if I hadn't missed anything last night. She said it was early enough in my cycle that it wouldn't matter. I also expressed my anger regarding the message I left at 8:01 in the morning that was NEVER returned. She said she could say something to the nurses in the morning, to which I said, in a tone that indicated I was not to be messed with, "Yes, please do."

Then I thought to myself, "If this one missed dose doesn't matter, why prescribe so many Estrace pills?? I mean, those suckers are like five bucks (or more) each!" I was kicking myself for not asking that question when I was on the phone with the on-call doc.

The doc must have actually said something to the nurses the next day (January 6) because I received a call from my usual nurse (Theresa) at 11:49 am. I wasn't able to answer but she did leave a long rambling voice message and an attempt at an apology, along with instructions to not take the missed Estrace dose at this point. Seriously? Seriously. I don't know why I'm having so many issues with the staff this time around. Maybe because I'm not naively unaware of the process?? Maybe I'm less tolerant of "how it all works" with the whole nurse line messaging?? Maybe I'm more tired and stressed out with having twin toddlers this round?? I can't quite put my finger on it...

Anyway, on Friday, January 8, I increased my Estrace dose, per my FET booklet, to 3 mg (three pills) per day...one dose in the morning, one at noon, and one in the evening. By this time, I was also still taking one baby aspirin per day, one prenatal vitamin per day, and one 5U dose of Lupron per day.

And I continued taking my meds as noted in my FET booklet - or so I thought - until my second monitoring appointment on Tuesday, January 12 at 8:15 am. This next part is where my memory is a little foggy: I can't remember if I checked my booklet the morning of the 12th and discovered my next medication slip-up or if the nurse talked to me in my appointment about my med schedule and that was how it was discovered. Either way...I took my morning 5 units of Lupron FOUR days too long! I should have taken my last dose the morning of January 8. I mean, who does that?!?!

Me. That's who. %*&#@!

At least I had good results from my transvaginal u/s at my appointment on the 12th: my ovaries were quiet and my uterine lining was super thick at a 10B. I asked my nurse what they look for in a lining, and while she didn't give a specific answer, she did say my lining for my last successful FET was at a 9 so I was looking really good this round. (I should ask for copies of my records just to have all that info from last time that I neglected to document. But I'm afraid they will charge me for it...)

Then the nurse said to start my progesterone in oil (PIO) shots on Thursday, January 14 (1 mL once per evening in my rear end...with a 1 1/2 inch intramuscular needle), Doxycycline (an antibiotic) on Saturday, January 16 (one 100 mg oral pill twice per day - once in the morning and once in the evening), and that she would let my doc (Dr. C.) know what happened with my Lupron. She said someone would call me if there was any change to my med schedule or transfer date, and indicated my doc may push my transfer date out a few days (which was tentatively set for Tuesday, January 19). It was a bit of a relief to hear these options because I was afraid my cycle was going to be canceled altogether and get re-dated for March. Then I told her the problems I'd been having with the nurse line so she said someone would call me either way, which was a big relief.

I made a stern mental note to myself to not screw up the PIO shots or the Doxycycline.

At 1:49 pm on January 12, I received the call. And the news was better than I expected: continue my meds as outlined in my FET booklet except increase my Estrace dose to 4 mg (four pills) per day instead of 3 mg (three pills). I was to skip my noon dose and take two pills in the morning and two pills in the evening. Aside from the added cost of extra pills, that sounded like a better plan anyway...it's so hard for me to take the noon dose at the same time every day because I don't eat lunch at the same time every day. And it's usually a late lunch...like 1:00 or 1:30 or sometimes even 2:00. Pretty much whenever I feel hungry.

And there were no changes to my FET date...it was still a go for Tuesday, January 19! It did seem a bit odd, though, that they didn't want me to come back again for any more blood work before my FET just to make sure my E2 levels were on track after my Lupron screw-up. But I guess they know what they're doing! I can't imagine I'm the only one who has ever messed up their meds...

***

Edited to add: I forgot to note that I did have my blood drawn at my second monitoring appointment on January 12. Nothing out of the ordinary there...I had the same paperwork to give to the receptionist as with my first monitoring appointment. And the receptionist then handed it off to the same technician to do my blood draw. Queue painful stab, etc, etc. When I received the call from my nurse later in the afternoon instructing me to up my Estrace dose, she didn't mention any specifics about my blood work and E2 levels and I didn't ask. I figured it didn't matter anyway since I messed up my meds so much the past few days.

After completing my 23 BCPs in the month of December, CD 1 started just three days later on Saturday, December 26. And per my FET instruction booklet, I started giving myself 20 units of Lupron (actually, Leuprolide, which is the generic version) on Sunday, December 20 once per day for 10 days between the hours of 6:00 am and 9:00 am using small insulin syringes. I chose 7:15 am as a good time for the shots because I didn't want to get up at 6:00 am on the weekends if I didn't have to (re: if my daughter actually let me sleep in). Plus, during the week, we usually leave for daycare drop-off around 7:30 am so if I did anything later than that, I'd likely have to give myself my shots at work. No. Thank. You.

Anyway, I continued with the 20 units of Lupron and managed to give myself the shots every day between 7:00 am and 7:15 am. Per my nurse consult back on Monday, December 14, it was ok to administer the shots within one hour of my preferred time...so I was safe with the 15 minute interval. With my first shot, it was almost like visiting an old friend. The familiarity of it all came rushing back. Along with the sting of the injection. Like a rookie doing it for the first time, I forgot to release my fingers from the pinch on my stomach before taking the needle out so the medication didn't drip out of my body when I removed the syringe. By the next morning, though, I had much improved my technique.

Everything was going well until my first monitoring appointment - the day 10 Lupron and estradiol check, and ultrasound. My appointment was Tuesday, December 29 at 7:45 am, and I forgot to take my Lupron shot beforehand at the normal time. Ugh. Usually when I forget something in my morning routine, it's because there has been a change to the routine - like today when I had an appointment at my RE's office instead of just heading straight to work. I contemplated turning around and driving back home as soon as I realized I forgot my shot but I knew if I did, I was going to be seriously late for my appointment. So I continued on the road, freaking out, and praying everything was going to be ok.

And it was! I told my nurse what happened and she said as long as I could still take my shot this morning within a reasonable time (i.e. within the 6 - 9 am preferred time period), I would be ok. Even if it was slightly out of the normal time frame, one time wasn't going to hurt anything. So we proceeded with my appointment and I received good results. My u/s showed quiet ovaries and a thickening uterine lining (measuring at 4A). Then the nurse said to drop my Lupron to 5 units the next morning, start taking my Estrace pills once per day, continue following along in my FET booklet, and schedule my day 14 u/s and estradiol check on my way out. She also handed me my paperwork to take to the front desk for my blood draw.

When I had no more questions, the nurse left so I could get cleaned up and dressed. Then I checked in at the front desk again, scheduled my day 14 checkup (Tuesday, January 12 at 8:15 am, which was the earliest available), and handed them my paperwork. The paperwork provided my patient information (name, DOB, etc) and indicated what blood test I needed (estradiol, or E2). They then handed off my paperwork to the blood draw technician (very technical term), and I was shocked and upset to see it was the very same tech I dealt with back in 2012. I had hoped enough time had passed that she was able to draw blood for another clinic or hospital. {sigh...} So I mentally prepared for the worst and hoped for the best (maybe she had improved her technique over the past three years??). And the worst happened...the same familiar stab in my arm. I even looked at the bend in my arm the next day where the needle was inserted and noticed a line on my skin leading up to the puncture, like a scratch mark. So yeah, I wasn't imagining it. She scratched me with the needle before it actually went in my arm. But at least I didn't bleed all over this time.

Then I headed home again to take my shot, which I managed to do by about 9:30 am...not too bad! It just made me super late for work, which no one even noticed. Whew!

The nurse who was in the room with me for my u/s said if all was normal with my blood work, I would not receive a followup call. I anxiously waited all day but everything must have been good because no one called me. Another successful milestone checked off on this new journey. :)

***

Side note #1: As I waited to be called back for my blood draw, I let the receptionist know I had another question for my nurse that I forgot to ask during my appointment. She checked my nurse's availability and let her know I was in the waiting room and to come see me when she was done with her next appointment. A few minutes later, my nurse called my name and I asked my question right there in the waiting room. If my question had been more personal, I would have requested a private room or something but all I wanted to do was confirm I was supposed to be taking prenatal vitamins. I said I assumed I was supposed to but no one said anything about it at my nurse consult on December 14. And she confirmed yes, I was indeed supposed to be taking them. Everything with IVF is so specific, I didn't want to take something, even prenatal vitamins, that wasn't recommended yet so I thought it was better to check.

***

Side note #2: Per our financial consultation also on December 14, we were to pay our FET fees today (December 29) since we didn't send a check in the mail before my first monitoring appointment. No one at the receptionist desk asked for payment when I checked in today, and I didn't remind them, so I made it through without having to fork over $4,335. That is until they called me at 2:04 in the afternoon and asked for it. Humpf. At least the lady was nice that I talked to; she blamed the staff rather than me for the oversight. She said I could send a check in the mail or pay over the phone with a credit card. Credit card?! This was new information! I gave her my card number so I could rack up a few thousand reward points. I pay my card off every month anyway so the reward points are like a sweet bonus for all my typical (and atypical) spending. I'd just end up reimbursing myself with my HSA (Health Savings Account) anyway.

It was for sure a done deal now. We were all paid and ready to go! :)

As previously mentioned, and per my FET booklet instructions, I started my BCPs on Wednesday, December 2 and continued taking them until Wednesday, December 23. However, on December 22 I noticed I was going to be taking my last pill so I checked and rechecked my FET booklet, manually counted the days on the calendar (more than once), and eventually gave a call to my RE's office at 2:37 in the afternoon. Naturally, I had to leave a voice message. In my message I gave specific details about my discovery and that it was ok to leave a message on my phone if I missed their return call. I asked if there had been a mistake since a pack of contraceptives only contains 21 active pills, or if I needed to take one additional pill for a total of 22 this month.

And, naturally, I missed their return call at 3:51 pm. As I anxiously checked my voice mail, I was irritated to hear the nurse did not provide any answers whatsoever to any of my questions. She just said something about how the office was closing in nine minutes and to give a call back when I was able. ARGH!!! So I called them again bright and early the next morning at 7:40...they weren't open yet and weren't accepting voice messages. Of course. I called back again at 9:24 in the morning - at my desk at work, mind you - and someone actually answered! So I had to explain the whole situation all over again. At work. Yay.

The nurse said my booklet was correct; I did indeed need to take 22 BCPs this month in order for the timing to match up for our transfer date. She even counted the days out loud on her calendar while on the phone with me just to be sure herself. After all that, plus some more explaining on my part, it still took her a moment to realize I needed another prescription of pills ASAP. Luckily, I mentioned I had a pack on hand at home from about two months ago when I thought I was going to be starting my FET cycle but didn't. I asked if the brand of pills mattered (because my brand at home was different from the brand my RE originally prescribed - things are very specific in the IVF / FET world) and she said no. She breathed an audible sigh of relief - I'm pretty sure I did too - then she went on to explain I may see some spotting or get my period after my pills were done. Spotting - ha! I almost laughed at that; I knew I would not be so lucky. I thanked her and we hung up. Whew! Crisis averted!

Our combination nurse consult / financial consult was Monday, December 14 at 1:15 pm. Hubby had a meeting downtown with his clients that wasn't scheduled to end until 1:00 pm, but didn't actually end until 1:15 pm. So we had to drive separately this time and meet at the clinic. To top things off, we had freezing rain / sleet off and on all day, which made the commute to our appointment especially fun. At least my normal route was construction-free this time.

I arrived at the clinic a little early and let the front desk know Hubby was going to be late. The very nice receptionist said she'd let the nurses know, and a few minutes later, two nurses (one in training, who looked the same age, if not slightly older than the other nurse) came to talk to me. The main nurse (the one not in training) said it was no problem Hubby was going to be late and that we could go ahead and get started or wait for him. I asked if we could wait until 1:30, and the same nurse reiterated it was no problem at all and there was no rush; she was so nice. (Thank goodness!)

I knew 1:30 would be a stretch and Hubby likely wouldn't make it by then, but I hoped it wasn't going to be much later than that. 1:30 came and went. Around 1:40, I just happened to look outside through the window of the 4th floor waiting room and saw him pull into the parking ramp entrance. What timing! I immediately let the receptionist know Hubby had arrived, and I stood near the desk to welcome him and let him know it was ok he was late. Plus, I thought the nurses were going to come out and get us right away. Yeah, that didn't happen. We waited maybe another 15 minutes before they finally called our names. I wondered if they decided to take a lunch break while they had a few extra minutes?? Either way, the only thing that mattered was we could now start our appointment.

The nurse consult was no big deal - that's probably why my memory of the details are a little foggy already. It was all fairly familiar to me anyway from three years prior. We talked about meds and a tentative timeline of everything, we went over my booklet of information that came in the mail a few weeks before, and suggestions for where to order my prescriptions. I remember asking a few questions and being proud of myself for speaking up when I was unsure about something or wanted clarification, particularly when it came to remembering how to administer the medication. Historically, I'm not one to say anything additional in my doc appointments because...well, I'm not entirely sure why...maybe I feel like my Dr. has already brought up all the important topics so the other stuff doesn't really matter?? Anyway, the nurses didn't volunteer a demonstration of how to give myself the medication (like I remembered them doing last time) so I asked for a refresher. And it all came rushing back..."oh, yeah, I remember how to do this!" I thought to myself. I was also amazed that I ever forgot.

After we all agreed there were no more questions, the nurses let the financial consultant know we were ready for her. And this is where it all went down hill... After she entered the tiny conference room, one of the first things the consultant said to us, aside from the typical greetings and pleasantries, was NONE of our cycle was covered by insurance. I kept telling her I believed her but I was still surprised that even the u/s monitoring appointments weren't covered. And she kept saying something to me like, "unless you know something I don't, your insurance doesn't cover anything related to fertility treatments. Aside from IUI." I mean seriously. I just told you I believed you and that I was sure you were right, just that the information was still surprising. And no, I don't know anything you don't know. So quit asking me if I know something you don't. All I wanted to do was express my surprise...no, shock. I don't need you digging at my wounds any further, lady. She was actually very nice, I just found it irritating that she kept repeating herself when all I wanted to do was express my surprise.

She went on to explain we could pay her today for our FET cycle (a mere $4,300.00, not counting meds), send two checks in the mail (because one agency / clinic covers the monitoring and another covers...I'm not sure what...the embryo transfer, maybe?), or remit payment at my first u/s appointment. She left the room to give Hubby and I a few minutes to talk it over, during which I reiterated to him I couldn't believe NOTHING was covered. I mean, I know nothing was covered three years ago, but I hadn't met my out of pocket max expenses for the year at that time so going into this appointment, I thought (hoped) more was going to be covered. Anyway, Hubby and I weren't sure what we were going to do so I just told the consultant we'd mail it to her. She wrote down who to make the checks out to, and we were on our way.

I was crushed. I truly didn't know if we were going to be able to proceed. We no longer had extra cash around since having our twins. My heart ached. My soul sank to the bottom of my feet. My uterus shriveled up and hid behind other organs in my body. And to top it off, Hubby and I had to drive - separately - back to work. I couldn't even talk to him properly about what I was feeling because he left first while I scheduled my next appointments (not knowing if I was actually going to be able to keep them).

I tried to keep myself collected while at the front desk booking my ultrasounds, but as soon as I got into the miserably slow elevator, the hurt and the tears and the anger began to release. It wasn't until I reached the parking ramp that I didn't care anymore who saw me or what they thought. I was full-on sobbing. I debated whether to just have a good cry and move on or call Hubby via cell phone to talk about it. What the heck. I called him. And managed to choke out some coherent sentences like "It's not fair! Why can't we have it all...with building a new home and building our family?? Why did this have to happen to us?? There are all these people out there in the world who have no problems having kids who don't deserve them! Why does it have to cost us $35,000 and counting to have our family?? I really don't know if we can do this." And so on.

Hubby didn't have much to say back to his hysterical, sad, sobbing wife but he did get out a few encouraging words, like "You know you will always regret it if we don't at least try. We will make it work. This is all you've been talking about for the past, what, year?" And I remember saying "Just because we can make it work, doesn't mean we should. We just don't have that kind of money anymore. And I don't know if we actually can make it work this time."

Basically, I gave him an out, a realistic, logical, unplanned out, and he didn't cave. I couldn't believe it. He was there for me and knew my heart. He knew what I really wanted and didn't take advantage of my weakness for an opportunity to go the other route and remain a family of four. And I love him for it. I was scared and so unsure of how we could possibly make it work, but we were going to give it a shot. Somehow.

I've always - ALWAYS - said to myself and others in my life, I would never wish infertility on anyone. Not anyone. But on this day, I had a moment of realization. Clarity. I do wish infertility on some. I wish it on politicians who vote against IVF as a covered medical expense. I'm certain if they walked a mile in my shoes on this journey, we would have policy changes over night. I wish it on those who keep having more and more children and can't (or don't) take care of them. The ones who don't know what a blessing it is to have a child. The ones who take it for granted. The ones who hurt and abuse their children. The ones who don't protect those little hearts. And, most importantly, the ones who don't love them. To not love a child is completely unfathomable to me.

This may be the most selfish admission I've ever made. But this cold, dreary December day changed me. Tears fill my eyes even as I write this. To those mothers, those parents, those so-called families who think their beautiful, unique, special, wonderful children are burdens, and to those politicians, I say to you: you deserve infertility.

My SIS was scheduled for Tuesday, December 8 at 11:45 am. I called my RE's office a few days prior to get a prescription for Valium to take before my appointment. I think I called December 4; I have a record in my cell phone from that day but I can't remember what, specifically, it was for so that's my best guess...I had to get my prescription somehow so this seems like the most logical option. Anyway, the day of my appointment, I had a meeting with my boss immediately before I needed to leave so I wasn't able to take my Valium one hour before my as instructed. The best I could do was 30 minutes, or risk being high during my meeting. ;) And because of the Valium, I needed my hubby to drive me to and from my appointment, which was fine because we work in the same building.

We left at 11:15 am only to discover our normal route was closed due to construction. I was pretty confident I knew an alternate way to get to the clinic but I pulled up Google maps just in case. We had no more issues and arrived with a few minutes to spare.

Soon one of the nurses called me (and hubby) back to a room, gave me instructions to undress from the waist down, leave socks on, and wait for my doc on the table. I briefly reminded her I have a history of difficult SIS tests and that I wasn't looking forward to this one. At all. We had a quick discussion about it, which made me feel better, and before she left the room, she read in my chart my last FET was successful with B/G twins. We had a small moment of bonding as she informed us she also had B/G twins (maybe 5 years old??) with "J" names. So fun hearing other moms of multiples talk about their twins, especially the names. I love hearing what others name their kids. And I love it when the names start with the same letter, like ours (even though we didn't plan it that way). She said she felt like age 5 was a big milestone to reach where her kids became so much more independent. I'm both excited and terrified for that day to come.

Then the nurse exited (I must make a mental note of her name next time...Theresa, maybe??), gave me a few minutes to get situated, and returned with my doc - Doctor C. He asked me a few questions - to which I should have reiterated the nausea caused by my BCPs but I didn't think of it in time - including if I was in my happy place from the Valium. I told him I didn't feel any differently but maybe it was working and I didn't realize it. He thought that was likely. Then we got started.

First, the nurse inserted the vaginal ultrasound wand to get measurements of the thickness of my uterus and any follicles. My uterus was good (I forget the measurement but it was thin) and I had one follicle (on the left, I think) measuring 24 mm. No one told me directly what the measurements were; they just read them off to each other and recorded them in my file. So I asked, specifically about the second one (which, as I mentioned, turned out to be a follicle...I mean, I had an idea based on what I remember from my IVF and FET in 2012 but I wanted to be sure). Dr. C said it was probably a cyst on a follicle that didn't fully develop because I was on my first week of BCPs. I assumed if I had been instructed to start my BCPs earlier in my cycle, there likely wouldn't have been anything to measure; i.e. my one lonely follicle wouldn't have grown at all, or at least not a measurable amount.

Then we moved onto the fun painful part - the SIS and trial transfer. I'm not going to sugar coat it. It hurt like an SOB but not nearly as badly as my last failed SIS in my OB/GYN's office over the summer. As the procedure began, I took several deep breaths, especially when the catheter was threaded past my cervix and into my uterus (the trial transfer part). Then deeper breaths as they inflated the balloon and pushed water through it to get a look at the inside of my uterus, specifically checking for any abnormalities such as polyps, fibroids, or septums. Dr. C said everything looked good, and the cramping became almost unbearable as they captured the last couple ultrasound photos. Relief came as my doc removed the catheter and balloon. Not a huge amount of relief, but some was better than none. I was actually surprised how long the cramping lasted.

And my hubby was there with me the whole time. I told him before the procedure started, he could go to the waiting room if he wanted but he elected to stay with me. I was pleasantly surprised and appreciated the support through something I knew was going to be very painful. Afterwards, though, I insisted he leave the room to give me a few minutes alone to catch my breath and clean myself up. I thought for sure the cramping would have been gone by the time I was dressed but it wasn't. I even needed hubby's help walking to the car after my appointment. I eventually fell asleep on the way home and woke up as we were pulling into the driveway (about a 25 minute ride), and was mostly pain free at that point. But the Valium was in full effect so I slept most of the rest of the afternoon...until the kids came home. It was good, and I was so relieved they didn't find any more polyps or fibroids.

Side note: I'm so disappointed in myself for not blogging about this part of my treatment when I went through IVF the first time around in 2012. It's amazing how much of this process that I thought was so ingrained in my mind - like a tattoo - has been erased or is just plain foggy. Then again, I didn't start my blog until after all this stuff had already happened. Ugh! Note to self: be better at documenting things this time around!

***

I meant to write this post earlier but I had two sick toddlers on my hands around the time this cycle officially started. It was a really rough seven days. Then there was work and (trying) to catch up on sleep. And just life in general. So here I am. Finally.

CD1 started Saturday, December 28 - even earlier than any of my "normal" early periods - which meant my cycle was only 26 days in November. Out of all the years of tracking my cycles, I had never recorded anything less than 27 days before. Cue freak out and Google search, re: premature menopause. Results: inconclusive. As you would expect from Google. Note to self: Discuss with doctor - my mom went through menopause around age 40. Although, now that I think about it, I don't remember (I was only 10 after all) if she went through menopause before or after her hysterectomy. I'm sure my dad would know but that's not exactly something I'm excited to bring up to him.

Anyway, I missed the window of calling my RE's office on Saturday to report CD1 and discuss next steps, and they are always closed Sundays except for important and unavoidable appointments. So I gave them a call Monday morning, and of course I had to leave a voice message. Less than two hours later, I received a call-back from a nurse with instructions: start BCPs Wednesday, December 2 and continue taking them through Wednesday, December 23.

I didn't have time to fill my prescription until Wednesday after work, and even then, I nearly forgot...I'm easily distracted these days. So I rushed to my local Target pharmacy during E&E's bedtime routine (I hate missing putting them to bed) and came home with more than just my Rx, because who goes to Target and makes it out alive with only one or two things in their cart? And I took my pill around 8:30 pm.

Fast forward to Thursday morning: me with a horribly upset stomach, sitting on the toilet crying, and trying not to vomit at the same time. I managed to squeak out "I can't do this!" to myself between sobs and nightmarish flashbacks to the all-day "morning" sickness I had with my twins for 17 weeks. Then I was finally forced to "finish up" before I was ready because I knew it was coming: the wretched vomit from the pit of my stomach caused by my BCPs. Oh how I hate those things! Only, this time, it didn't come. I knelt there for at least a good 10 minutes dry heaving and hoping and praying for some relief. Then, all of a sudden, just as quickly as it came on, the pain and nausea vanished (mostly). And I felt like a real person again. I whispered to myself "maybe I can do this."

Don't get me wrong, I had mild nausea the entire rest of the day, but nothing as bad as what I was hit with early in the morning. I've had this strong reaction before but I've always just powered through it. ...Not this time. This time, I called my RE's office. At 7:59 in the morning. And left a message.

A nurse actually called me back before 9:00 am but I just missed her call by a few seconds. So I called back again right away, even before giving my phone a chance to register a voice mail, and guess what! Someone actually answered! Miracle of miracles, I didn't have to leave another message. The nurse who returned my call in the first place was routed to my call by another nurse; I was glad to be able to speak with her rather than try to explain what had happened to someone else while I was at work.

She gave me a few options: 1 - Stop taking the BCPs and get re-dated for a "natural" cycle but this would push our transfer out to March. Curious as I am about how a natural cycle works, I passed. I had no desire to push our transfer out FOUR more months. 2 - Continue taking the pills normally and put up with the nausea, which she said would improve over time as my body got used to the new hormone levels, and continue with this cycle as planned. She also recommended taking the pills at night (which I was already doing) and taking them with food (which I did as well). 3 - She could call in a new prescription to my pharmacy for a low-hormone BCP.

I opted for the last one, which was actually my suggestion to her. I went through this same experience in college (except I did actually throw up in a campus restroom between classes and my student job) and ended up on a low-hormone pill at that time, which, it turned out, I didn't need to be on in the first place because there is no getting this woman pregnant naturally. No way. No how.

But I never ended up picking up that new prescription because I didn't think my insurance would cover two sets of BCPs in one month. I never called to check on this to be 100% sure, but it's par for the course; I've run into this with other prescriptions. So I've just been putting up with the nausea and lack of appetite for almost two weeks now. I haven't felt like I've needed to throw up since that awful Thursday morning, but I've definitely been nauseated every day and feeling like I don't want to eat (or like I just want unhealthy junk food). So basically, I already feel like I'm pregnant without actually being pregnant. Yay. (Not.)

{note: this post will continue next time with my SIS / trial transfer appointment and our nurse consult / financial consult appointment. and lots of tears.}

After E&E went to bed last night - which, let me tell you, was like WW III - I hesitantly brought up the idea to my hubby of postponing our FET. And surprise, surprise! He didn't have a strong feeling one way or the other about it. I don't know why, but I actually was a little surprised he didn't have a preference. Looking back, I should have known better. ;)

Now I feel like this is yet one more thing I just need to decide on my own and basically tell my hubby what I want to do. As I've mentioned before, this is both good and bad...good that I can do things my way but bad that we aren't actually making the decision together. Because isn't that a big part of what marriage is? Making decisions together as a unified front?

So here is a list of some of the pros and cons of postponing from my perspective (please feel free to let me know your thoughts in the comments):

(-) We will be even older...I will be well into my 38th year and my husband will be halfway through his 47th year (as opposed to if we move forward in January when I would give birth about a month before I turn 38 and just a couple weeks after my hubby turns 47).

(-) It will affect how much I am able to participate in my 20 year class reunion in 2017. I know it sounds silly to include this but it's been on my mind since my last class reunion (which was the most fun EVER) because as an infertile, I knew timing would be questionable if I was still growing my family in my later 30s. I graduated from high school in a tiny town with a tiny class of 43. We're all very close and I really want to have a good time at our next reunion and not be - for lack of a better phrase - tied down (and exhausted) with a newborn. Oh, and I currently live in a different state so it's not like it would be just an evening out. It would be at least a long weekend away. And it takes 8 - 10 hours to drive there.

(-) I'm afraid if we postpone, we will postpone permanently because we will have become comfortable or we will have come to a deeper understanding that we just can't afford it. Or that I will be ready to move forward in a few months and my hubby won't. So then we will end up going through the whole argument again.

(-) 99% of my girlfriends are already done having kids and are on their way to freedom and flexibility. Don't get me wrong, I love the infant and toddler stages and all the snuggles, and I know I will mourn it one day when it is over for good, but when I am still tied to naps and feedings, my girlfriends will have their big kids making their own big-kid decisions. And they won't have to wipe anyone's butt but their own.

(-) I really want to go on a 40th birthday trip with my girlfriends the year we all - or most of us - turn 40. And I want to not have to worry so much about my kids when I'm gone. I have trust issues with caretakers other than myself and my hubby when my kids are less than 18 months old. (I have big-kid fears too but I'm not there yet with my twins so it's less of a worry right now.) So it would be ideal for my next child to be a bit older by the time I turn 40. (I have similar thoughts for the year my hubby turns 50...which is the year after I turn 40.)

(-) If waiting until next year, it will likely be more expensive because we've already met our out of pocket deductible for this year. That is, if some of the FET monitoring is covered by insurance like I think it is. (I expect to find this out for sure at one of our appointments in December.)

(+) Then again, if postponing until next year, it will help us reach next year's out-of-pocket limit faster.

(-/+) We will inevitably get the "you're too old to be parents" comments, which I'm already dreading, especially from my hubby's family. But I suppose we will get these comments whether we postpone our FET or not. So maybe this is a more neutral point.

(+) We will (hopefully) be more financially stable by only having about a year left of daycare payments for our twins (instead of a year and a half - which doesn't sound like a big difference but when we're talking literally thousands of dollars every month on childcare, it makes a bigger impact). Plus, my hubby will be up for a promotion sometime in March...adding to our financial security (if all goes as planned...although that may be more of an argument not to postpone).

(+) I won't be pregnant, and thus huge and sick and uncomfortable and limited, when we move into our new house late next spring. It will be easier for me to help pack and move big boxes and rely less on others for help, which, let's face it, no one likes helping other people move. No one even likes helping themselves move.

(+) E&E will be bigger and easier and more helpful with a newborn around. Because they will be out of their terrible twos - fingers crossed - and closer to four years old. (FOUR YEARS OLD. I just can't imagine it.)

(+) I will have the baby of the group for my friends and family to ooh and ahh over (until the next one comes along, anyway). Who doesn't love that! ;) Although six months isn't that big of a difference when it comes to this.

(+) Our new baby could have a due date closer to E&E's birthday and my mom's birthday. Having my child's birthday on or near my mom's birthday has been a dream of mine since losing her 10 years ago to breast cancer.

At this very moment in time, I am leaning toward not postponing because I know things will be hard either way. So, really, why delay the inevitable?

But we'll see how I feel in the next five minutes...

***

In other news, we signed the paperwork last night to start building our new house! If all goes as planned, our builders should break ground in about three weeks. So. Exciting. :D (I'm trying not to think about the stressful stuff and just enjoy the process.)