Adventures in "Family Planning"

As promised, here is a post about our TTC (that's trying to conceive ;) story for those of you who are interested. It's a long one...

In the fall of 2006 we decided it was about time to start trying to get pregnant. At that point we were in line with my working goals and our financial goals (as much as you can be…). So, as a happily married couple with over 4 years under our belt, we never expected that trying to get pregnant would be so hard.

As a youth, I can vividly remember being told it just takes “1 time” and you could get pregnant. That gets implanted into your brain somewhere and when you first get married; you take every precaution to try to NOT get pregnant. Then, years later the time finally comes and the 2 of you decide you’re ready to have a baby, and to your dismay, you find out it’s not so easy. In reality, you have a 20% chance of getting pregnant each month IF, and only IF, everything is right. Wow, was that disappointing!

We are lucky though. We have always trusted that the Lord has a plan for us and for our family, and we believe that his timing is far more perfect that ours. While yes I had never thought we’d make it to 31 without having a baby, we can rest in Him and trust his plan. Even through the emotional roller coaster of trying month after month is hard, we knew that he had a child in our future, and that we had to wait until his timing is perfect before he will give him/her to us. I’m not saying there wasn’t disappointment and frustration…there was (and lots of it!). I’m not saying this wasn’t been a painful and heartbreaking time…it was. I’m not saying that we haven’t learned to cleave to the Lord and not be so controlling of our own lives…we have. As a matter of fact, I think the whole time was just preparation for the frustration and challenges of parenthood. As we watch our nieces and nephews, and our friends’ children, (as well as frightfully looking back on our own childhoods) we know that our kids will give us a run for our money. I quickly learned (and gratefully so) that I am not in control, and that my “Franklin Covey” means nothing in the grand scheme of things. So, here’s our “Adventures in Family Planning” story...

As the months went by and we were not getting pregnant, we struggled. I have practiced FAM for almost the duration of our marriage, so I have a pretty good grasp on my cycles. Still after several months of trying with no success, we both felt that we should do some investigation and preliminary testing, and the Doctor agreed. David was tested, everything was a-ok. I had blood work done and an HSG. All ok, as a matter of fact the technician told us that for the next 4 months I would be extremely fertile…we were excited! Well, those 4 months came and went and still no baby. So, I made another appointment with the Doctor.

I was still concerned that my progesterone levels weren’t right, and this time I wanted David to be with me. Dr. Hudson was great, very informative and encouraging. She agreed that there were most likely some progesterone issues as my level in the February blood work was a 4 and it should be 10 or above (I decided not to get frustrated about the fact that we could have done something about this 4 months prior…), so she gave me a prescription that will help my body to produce the appropriate levels to help facilitate a positive environment in my uterus to allow implantation to occur.

After reviewing my charts, knowing that we have been trying for 9 cycles on FAM and seeing that my ovulation dates range from cycle day 12-18, she also suggested that we “take it to the next level” and start on Clomid with my next cycle. In addition, she said that I would have ultrasounds each cycle on or about CD 13 or 14 to see how the eggs are developing and that they would give me an HCG trigger shot to force ovulation. All of this to help us time with even more accuracy than with FAM alone.

Needless to say, David and I were a little nervous she would suggest Clomid (I had spent some time looking online researching the next step and I thought she may suggest it), but after she explained it in great detail – and told us that the risk of multiples is only about 4-5% greater than normal - I felt much more comfortable. After alot of talk and prayer, we decided this was the right thing for us and that we would continue to pray and let the Lord guide our decisions. He’d been so faithful so far, and we felt confident that he was guiding us in that decision.

So, on August 8th I started Clomid. Thankfully, I didn’t have any reactions or side effects to the medicine, as I was scared I would. Unfortunately, the first 2 cycles on Clomid were a series of unfortunate events. I ovulated early the first cycle, and on the second cycle there was miscommunication between the hospital where I had the U/S and the Drs office so I again missed my window for the shot.

In Oct 5th I started my third round of Clomid. The U/S gave great results and I got my first HCG trigger shot on the 15th - what a literal pain in the ass! It's a shot they give you in the hip muscle, and while it doesn't hurt when they do it, or even right afterwards, but it hurts so bad for the next 2 days. Moving, bending, sitting, laying - it all hurts. When I got my period, I was almost as upset that I was going to have to go through the process and have that shot again as I was that we weren't pregnant...well maybe not, but I definitely thought about it alot! I'm not sure if it's better to know what's coming so you can be prepared, or to not know so you don't dread it. =)

Anyway, in late January 2008, I talked to the Dr. Hudson and she said you are only supposed to be on Clomid for 6 cycles, and this was our 7th, so we hoped we'd get pregnant and not have to worry about the next step. Unfortunately, that didn't happen. We had many stressful days over the course of that last month on Clomid. We were frustrated that this was taking so long, frustrated by the uncertainty of what the Lord has in store for us and not understanding his plan, but mostly fear I think...fear about what came next. David continually told me that he believes we will conceive. He believes that God would have shown us if we weren't going to get pregnant by putting a roadblock in our path. When my period started, we finally decided to go ahead and set an appointment with the specialist. At this point it had been a year and half into this adventure and while we had no intentions of moving on to the next step for a while, we wanted to meet with them and see if perhaps there was something that Dr. Hudson missed - something that was wrong that needed to be fixed. If everything was a-ok, then we would stay the course and just enjoy the time God continued to give us without children as much as possible. If there was something wrong and it was simple we would seek a remedy, but if it was something more complex, we would wait to make a decision after much prayer.

On March 18 we went to meet with Dr. Dorothy Michell-Leef, our fertility specialist at Reproductive Biology Associates (RBA). She was very matter of fact in our 15 minute consult and we were both a little put off by her. She took one look at me, saw that I was overweight and starting making assumptions. First she said that she thought I had endometriosis and that I was insulin resistant (pre-diabetic). She said I would need medicine and laproscopic surgery to confirm & remove endometriosis. To further deflate my esteem…she told me to go home, lose 50lbs and come back and see her. Her exact words were: “Lose 50lbs and I’ll get you a baby”. I left there feeling hopeless and very frustrated. I struggled with the “is this my fault?”, “has this been the reason?”, “Could I have done something about the fertility issues months/years ago?”… It took a while before the Lord brought me out of the self doubt and detrimental behavior. She wanted us to go on the South Beach diet because she was also convinced that I was insulin resistant (although blood work done the following week confirmed that I was not).

By the time our follow up appointment with Dr. Mitchell rolled around on June 9th, I was down a total of 24lbs. She was very pleased with our progress (David was down 32lbs at that point!) and told us to keep on keeping on. That visit was far less stressful and much more encouraging than the initial visit. David & I just assumed that she sees a lot of people looking for the quick fix and not being willing to work for it. By us showing her our commitment to the plan, I think we proved that we really want a baby and we’re willing to do whatever it takes to make that happen.

On November 20th I found out I was losing my job. On November 30th (despite the thanksgiving holiday!) I’d reached the 50lb mark so I set up our next consult with Dr. Mitchell for December 9. It had been a long 8 months and I was excited to get in to see her before we headed home for the holidays. I thought we’d have our plan in place and it would be easier to make it through all the baby talk that always happens at family functions. So here I was, unemployed, stress free and excited for the next step.

We got in to see her and she said she’d ideally like to see me lose another 45lbs and then come back. I asked if we could try during that time, but she still thought I had endometriosis and said she didn’t think we’d get pregnant on our own but she wouldn’t tell us not to try. I asked about the progesterone, and she said that when I got down 40lbs to call and they’d test me on my next cycle. I pasted my smile on and made it, barely, to the car before completely loosing it. I was basically in shock and spend the next 3 days in tears crying every available tear my body could muster. It was so devastating. I couldn’t believe it. I wished that she had just said loose 95 or 100lbs then come back and see me. I was so hung up on the “Loose 50lbs and I’ll get you a baby” that I just couldn’t handle it...

David & I had many, many lengthy conversations on this and he did his best to comfort and console me, but we were on different pages. He was hopeful because he saw this as the next step. I however was left with lots of questions and was feeling pretty hopeless and wanted to set another appointment to go back and ask her all the things I couldn’t because of how emotional I was while we were there. Plus, I was dealing with the despair of now knowing how long it would take for me to get another 45lbs off and seeing our children drift even farther into the future. I was within 15lbs of where I was when we got married and that was my lowest weight since I started high school. This number was completely overwhelming to me. I was frustrated, angry, sad, disappointed...you name it. I just started to pray that the Lord would bring us to the same place. After some time to think about what I was saying, David started to pray with me that the Lord would guide us on this path and unite us into one place, whatever that place was, and that he’d give us patience.

We made it through the trip to WV, which was taxing and enjoyable at the same time, and of course the 25+ hours we spent in the car. We talked a lot, a lot, a lot. We came to several conclusions, but still had a ways to go. One thing we decided was that I needed to pray for the Lord to help me die to my timeline. That means not only when we have kids, but how many, how far apart and how old I am when they come along. That’s a big step for me and I’m still working through that process, but the Lord is good and I know he’s working. Another thing we decided was to tell David’s sisters what was going on and get them & their husbands praying for us. It was hard for me, and very emotional, but I made it through and I’ve been so grateful to have their support and wisdom.

On New Years Day, David said that he was thinking that we should go see Dr. Mitchell again and ask more questions…that it didn’t make sense at the very least for us to not have the progesterone addressed and if she is still so convinced that we have endometriosis, then we should go ahead and schedule the laparoscopy and find out for sure. That way we’d know what we’re dealing with. We both felt that we weren’t ready to move onto the next step (injectable fertility drugs) so if the results show that the only way we’ll get pregnant is to move into that area or up to IVF, then we have some serious praying to do. Do we move into that phase, or do we pursue adoption? And if there isn’t anything wrong, then we wait.

So, on January 15, 2009 we went back again to talk to her in more detail about our concerns. She conceded to do the laparoscopy now with a Hysteroscopy (in replace of redoing the HSG), remove any cysts, polyps, growths, etc. as well as remove any & all endometriosis and do a D&C if needed. Then, we’d retest David since it’s been 2 years and check my progesterone & other labs as well as.

My surgery was scheduled for February 3rd @ 1pm. Throughout the next few days I worked diligently to get all the laundry done, the house cleaned, and meals prepared so we wouldn’t have to worry about all of that during my recovery and so that David would have things to eat for lunch & dinner every day. It was challenging to get ahead like that, but I made it happen, thank God. I was still worried, but thankfully Deborah had a laparoscopy in 2005 and she was able to tell me what to expect which made me feel a little more comfortable.

At 11am on Tuesday, February 3rd we headed to RBA for my surgery. They called me back just after noon and I got dressed up in my surgery digs, a stylish gown and blue hairnet and of course tan footy socks for my walk to the OR - aren't I cute?I almost passed out when I had the IV put in, but once I recovered from that I did well until it was time to go under. David wasn’t able to come back with me until my blood pressure stabilized after the IV, but once he did I rested easier. Everyone was great. Jim, our pastor, came up to join us and I was so glad to have him there to pray for me before I went under. He was there when the anesthesiologist came in who proceeded to tell me I had 4 out of the 4 factors that increase nausea after surgery (which is NO fun after abdominal surgery!!). Everyone got a kick out of that - he was funny and very friendly – he put me at ease.

The walk to the OR was quick and it was amazing how cold it was in there!! They have these heated blankets which are great but it had to be at least 20 degrees colder in the OR than it was in the pre-op rooms (and they weren’t warm!). So apart from freezing, before I even laid down on the table a slew of people came in. The anesthesiologist was at my head loading me with different probes and monitors all over my top half while the nurse got me situated on the bed and several other people came in and did all kinds of things I can’t remember. In less than 3 minutes he had put the meds in my IV and had me on oxygen and I was out. I remember him saying go to your paradise, your happy place (and I thought of Happy Gilmore) before drifting off so fast!

While I was in recovery, Dr. Mitchell went out to talk to David and tell him what happened. There was NO endometriosis! Woohoo! She did find 2 small cysts, one on my Right ovary and one on my right fallopian tube. She said that the cyst on the tube could have affected things in that it was weighing down the tube. So she removed both cysts, 2 small polyps that were in my uterus (but she didn’t have to do a complete D&C – again Woohoo!) and there were several other tiny cysts on my ovaries that she removed while she was in there. Summary - nothing major which is wonderful. She also said that they did the Hysteroscopy and that everything was clear and beautiful with that.

I woke up having a really hard time breathing and feeling overwhelmed by the pain and nausea. They put me back on the oxygen and gave me lots of meds through the IV. I kept saying “Where’s David”, “It hurts” and “I feel sick” over and over again. At one point I do recall Dr. Mitchell coming back and telling me I did great and that there was no endometriosis. I don’t remember seeing her though… Finally David came back (of course I have no idea how long it was between when I started to wake up and David came in) and I was so relieved to see him even though I was in and out of it. After they took out my IV, they gave me an additional pain/anti-nausea shot in my thigh and that was painful, but no more painful than my HCG Triggers. Unfortunately the shot left a band of numbness at the injection site that is still there today. It was quite painful, but either its getting better, or I'm tolerating it well because there are days when it doesn't bother me except when it's touched.

The first night at home was a little rough. When David was helping me inside, the front door didn’t get latched and both cats got outside. When Scotty jumped off the porch, David came up to tell me and ask what he should do. I decided to head downstairs and call to him and see if he would come to me. Neither of us believed that I was out on the deck and porch screaming for Scotty when I could barely walk. Of course, he did come home several hours later, but it wasn't exactly how we thought my first night of recovery would go but alas…

For the first 2 days, I needed David to help me do everything. I couldn’t get up by myself, go to the bathroom by myself, or even sit up without his help. It was really painful. I had to take my pain meds every 3 hours so they didn’t wear off. David was in charge of setting the alarm clock and helping me sit up, eat something and take the drugs. He had planned to take a personal day on Wednesday and thank God he did. I certainly wouldn’t have made it without him. As we got closer and closer to Wed evening, I did figure out how I could get out of bed by myself using a stool and the headboard to help me leverage myself without too much stress on my muscles (and with David there just in case). He went back to work on Thursday and I did pretty well on my own. I downgraded myself to the lower level narcotic and tried to stretch out the time in between doses. I don’t like taking lots of medication, so I was happy to be on the road to recovery.

We went in for the post op appointment on Friday Feb 13, and she explained everything from the surgery to us, took off the sterile strips over both incisions (which hurt, but I made it) and answered questions about the numbness in my leg. The recap form the surgery was everything Dr. Mitchell had already told David, but it was good for me to hear it firsthand and ask my questions. She said that we didn’t have to wait to start trying and that once again our changes were good due to the Hysteroscopy cleaning everything out. All in All good news!

So on February 25th we went back to see Dr. Mitchell for our consult. We had our labs re-run the week before and David had another analysis completed so she was going to address all of that as well as give us any recommendations on the next step in her eyes. She said that my blood work looked beautiful. My insulin was down from a 12 to a 3 – amazing! And that all my numbers were ideal. She did say she wanted to try me on the Glucophage anyway to see if that did anything. Since I had talked to Dr. Denton (my primary care) about it a year ago and she said it was fine, I agreed. We said we’d do that for 6 weeks and see how things go.

Who knew that just 3 weeks later I'd be in there for my Beta test! I knew this cycle was different, but didn't want to get my hopes up. David had no idea it was testing day (I had stopped telling him a LONG time ago) so at 4:45am on Marh 16th, I woke up and snuck into the bathroom where I had laid everything out the night before. I took the first test and it was positive, then the second, also positive. I couldn't believe it. I wasn't planning on waking David, but Scotty was crying at the bathroom door, so when I came out he asked if I was ok. I said, "yes, I think you're gonna be a Daddy!" and collapsed into his arms crying. We both were just giddy and held each other until it was time for him to get up to go to work. It was a moment I don't think either of us will ever forget. We held our breaths for the next seveal hours until the results of my beta were in to confirm the test, it was certainly one of the longest days of my life. Over the next 24 hours I took 2 more tests, faint but positive!I’m sure some of you are saying – we didn’t even know you were trying! Well, there’s a reason for that. We decided long before we ever started trying that we didn’t want to “announce it”. The main reason was that so many friends and family announced they were trying, and then it took years to conceive. Most said that they wished they hadn’t said anything. Of course, there are pros and cons to each side. The pros are nobody knows and you don’t have to publicly grieve each month. Also, you don’t have to field the “are you pregnant yet” questions. On the other side, you don’t have support that you could have had, both in prayer and in encouragement. And you have to field the “when are you going to start trying” questions. The hardest part is when friends get pregnant, they don’t know how hard it is for you and to be sensitive about how much they talk about it – even though you are thrilled and excited for them.

David and I did decide that we’d each a few people that we could talk to about it and seek prayer and encouragement from. That helped us both tremendously and we are grateful for our dear friends who rode this ride with us (and will continue to do so!). Thank you, thank you, we love you!! ;)

So that’s our story! I can’t believe we could have had a child several times over in the amount of time it took us to conceive, but it is all in His perfect plan and we wouldn’t want it any other way. We have learned so much through this process about ourselves, our relationships with each other, and most importantly, our relationships with the Lord. We are so grateful that there is a little one on the way and I can’t even begin to convey our excitement!!