Wednesday, January 16, 2008

The Bitch is Back

Too much info here but hey - if I'm being open I mgiht as well be open, right?

I got my bleed today. I was shocked at how heavy this was and also shocked that it came so quickly since my progesterone has been so high. I didn't have any bleeding through the miscarriage though and I've been really sick - so I think my body just needed to "cleanse".

This brought a new wave of emotion. It felt a bit like the gavel slamming down with the verdict of my miscarriage. I keep looking at the clots to see if I can see "it". I know this entirely irrational - entirely - but I do it anyway. (I also know that sounds disgusting - but I'm being open, remember?) Of course - every clot is "it" and I cry for 5 minutes and then talk myself off of the ledge.

I do feel so terrible. The Bitch (I am fond of the word Bitch - it's my own personal pet name - silly bitch - but AF is The Bitch) was rearing her head last night and I totally didn't get it. I was plain wicked to my husband. And I do mean wicked - just ask him. Poor guy. He can't possibly understand how The Bitch possessed me without my knowledge and caused me to be evil. I defintely owe him some sweetness.

Of course - it's hard to conjure up sweetness when I've been in sweats sitting in the exact same spot on my couch for the past 3 days. I've done confernece calls, written pages and pages of worthless crap, argued with politicians and pundits and caused my dog to apparently have grave concern for me as she hasn't left my side - not even for my ritual bi-hourly trip to the potty.

I thought I might try to cook dinner tonight - but that can wait for tomorrow. My goal tomorrow - change into new sweats and actually make something for dinner - I can only feed my husband canned soup and sandwiches so many nights....

I know this will get better....

Our Czech Republic Experience

I have received numerous emails asking for details of how we chose the Czech Republic and about our experience with the Clinic. I’ve been hesitant to give my feedback prior to understanding our outcome. That’s not because it changes my feedback but I didn’t want to focus on those issues in the early part of a pregnancy – I just wanted to remain positive and stress-free. I thought it was important for me to be in a peaceful frame of mind and sharing my experience would definitely have moved me to a different place.

We used IVFVacation (owned and operated by Craig and Marcella Fite) and The Clinic of Reproductive Medicine and Gynecology in Zlin. In order to book with this clinic, unfortunately, you have to go through IVFVacation as they do not allow US patients to book directly. We researched many different countries and clinics and ultimately chose this one for the following: (1) the donor would have similar physical features (2) the medical practices in general in Czech Republic were much more advanced than some of the other countries we considered (3) cost (4) first-hand feedback from others that had used this clinic.

Rather than going into our full experience in this post since it would take way too much room I will be happy to send via e-mail - just shoot me an e-mail if you want the full story. There were a lot of things that happened that have caused us great concern.

The positives - (1) The clinic is just as clean as any clinic in the US (2) There are two nurses that speak English quite well which is not always the case at clinics abroad (3) Dr. Anna's English is very good, as well. He was able to clearly discuss issues and the treatment with us (4) I really loved the resting period allowed for most patients post-transfer. Rather than 10 minutes of rest I've gotten in the US they have you rest for a minimum of an hour with your legs elevated - this didn't happen for us but I believe I was the exception (5) Communication and service prior to our trip by Marcella was fantastic (6) Marcella called to check on us when we got to Zlin and did a great job of making sure we felt comfortable in Zlin.

I believe that when Craig and Marcella started IVFVacation things ran very smoothly. Their business has increased significantly and I don't think they have been able to manage this growth. The clinic is severely understaffed and IVFVacation seems to be in a little over their head. Schedules were communicated incorrectly, medication instructions were given incorrectly and worst of all - the treatment was 'One Size Fits All' for both donor and patient - which simply does not work effectively with infertility treatment.

We froze the boys while we were there but going back will be a very difficult call. I don't think that we will go back until we see things have changed with IVFVacation and with the clinic to ensure the mistakes that were made with us are not made again. Further, I would need to know that our treatment and schedule is dictated by our Donor's progress not the doctor's appointment book.

Here are my major concerns:

1) Treatment schedules should be dictated by the donor – not the doctor’s schedule. It is very clear that Dr. Anna is simply far too busy to handle the volume of patients they have right now. I truly believe the extra day of stim pushed my donor too far and in turn gave us poor quality eggs. It is absolutely critical in IVF that the eggs be retrieved at the ideal time. There were 6 of us there at the same time on the exact same schedule. All 6 of our donors needed an extra day of stim, all of our retrievals were on the same day and all of our transfers were on the same day. Almost all of us even had the same results - 2 grade 1 and 1 grade 2. We knew my donor had 10 follicles one full week out. that she would have needed an extra day of stim made no sense. Of course - we were all charged $500 for the extra day of stim, as well.
2) Medication and instructions should only be given by medical professionals at the clinic. There should have been a written treatment plan to avoid any confusion.
3) It is illegal to give medical advice and manage or dispense prescriptions in the US if you are not a medical professional. All medication instructions and medical questions should be answered by an English-speaking nurse with the clinic. This type of information should not be mediated - things can get lost in translation. It is so important to think of IVFVacation as more of a Travel Coordinator - they are definitely not IVF experts, counselors or medical professionals. This is how we used IVFVacation but I've seen many women with different expectations.
(4) Medical Records should be sent directly to the clinic - not to someone in the US that is not bound by Healthcare Information Privacy Laws.

I really hope that Craig and Marcella and The Clinic can address these issues. The service the Clinic provides opens up a door to so many women that can no longer pursue the treatments in the US. - and that is very important. However, I can not refer anyone or have confidence in this service or the Clinic until these things are addressed. I would love to go back to Zlin for treatment and I hope to see many other women from the US go to Zlin for successful treatment but for sustained success growth must be managed wisely.

Tuesday, January 15, 2008

Miscarriage

First - thank you all so much for your very sweet comments. It's great to know that there are people I've never met praying and hoping for us.

We are defintley miscarrying. I stopped all drugs yesterday. It does not look to be ectopic because my hcg levels are falling so quickly but I am having some very odd pains so I go back Thursday for another check.

I'm pretty numb right now. But - after meeting with my obgyn yesterday I felt encouraged. He said that it's great that I actually got pregnant. My body was receptive. He also reminded me that this was my first attempt with DE so I can't look at it as my 4th cycle. We talked for a long time and reviewed everything very closely. He believes this is a matter of poor egg quality. He was stunned when I told him our stats - 25 eggs retrieved, 19 fertilized and only 2 grade ones and 1 grade 2 fragmented in the end.

My husband is so wise - and I am trying so hard to listen to him. He believes that I just need to take some time off - grieve and let my body rest. That sounds natural but it's so difficult. My mind immediatley jumps to planning the next step. Adoption, DE again or Embryo Adoption. I think he's right though. I just need to breathe for a few months and not be preparing for anything. We'll see how well I do with this.....

Sunday, January 13, 2008

Hard Times

I'm going to try and journal my way through this on my blog. If you knew me "in real life" you'd be shocked at how ultra private I am. I don't share much about myself with others. I put on a happy face and do what I have to do. The thought of faking my way through this pain seems unbearable and impossible but I know that I will do it perfectly, as always. I know this forced stoicism makes me come off as cold to people that barely know me but that's the best I can do lately.

That's one of the issues that makes infertility so painful. It's private pain. There may be select people in our lives that know but most of us don't walk around with the infertility badge on our arm. We cry to sleep at night - we excuse ourselves to the restroom when something hits us publicly to gather our composure and we come back out with the pain tucked away in it's place until we're alone again.

This is a private pain because others simply can not understand. They give terrible unsolicited advice. They judge our actions. They don't understand why we can't find the bright side and move on.

Last night was hard. It was a night unlike any my husband and I have had before. We lay in bed and I sobbed. Part physical pain and part heart pain. He held me and for the first time - with a deep sense of sadness and desperation in his voice said "We can't do this again. We can't do this to you again." That's a great husband - because - inside his heart is breaking, too. His dream has been shattered as well. He has shed tears and every one cuts my soul like a knife - I just want to be able to make him happy.

My husband is still holding out hope though. He hasn't said it but I can see it in his eyes. He's still hoping that Monday there will be a miracle and the ultrasound will show a sac with a heartbeat. I know this can not happen. After all that we've been through - the one thing I know for sure is that I am not on God's Miracle List.

Saturday, January 12, 2008

There's No Happy Ending for Me

Yesterday I had my first ultrasound and the tech could not find a sac. A couple of things are possible - either it arrested a week ago or I have an ectopic - though an ectopic seems most likely. I go back Monday for another appointment and we will likely stop the drugs.

I'm just so broken right now. Absolutley broken. All I can do is cry. Why can this not just happen for me? I can't imagine doing this again at this point. I'm so very exhausted from all of this.

There was a point before we decided on donor egg that I knew I would be ok without bearing children. I've always wanted to adopt and I would have been satisfied with that. But now - after knowing there was a life growing inside of me I don't know how to reconcile this. I was ok before. This is just so cruel.

I believe there is a loving God that will one day help me understand all of this but right now I have to wonder where he is. Why I can't be blessed with a child - when it's the only desire in my heart. I've always said that I know I can't be the person God wants me to be without having gone through this - but I'm afraid I won't be much of anything but a broken, sad, bitter woman when all of this is said and done.

I just don't know how to be ok this time......

Thursday, January 3, 2008

Tonight My Heart is Sad

My heart is breaking tonight. It's amazing this bond we women have who share this terrible commonality of infertility.

Today - several women from a board that I participate on are in pain and facing the greatest disappointment. Three of the women that were in Zlin with me have gotten negative results. One thought she was pregnant but it turned out to be a chemical - her progesterone has steadily been decreasing. Another - was pregnant with twins and one has arrested at 10 1/2 weeks.

I feel their pain. Truly - I feel it in my soul. I've been the one so many times watching everyone else get the good news. The pain of more hope lost. The pain of another dream crushed. The pain of the fear it wil never work for you.

For me - there is certainly a deep sense of guilt. Why did it work for me and not for them? Have I been sensitive enough to quietly and meekly share my good news.

And then there's fear - will the same thing happen to me? Who am I to think that I should be the one to dodge this pain? How do I balance hope and belief and fear and anxiety without my body registering all of this and affecting the bun?

When you read this post - please say a prayer for these women. Pray their hearts will recover from this recent loss. Pray they will find hope again. Pray they are surrounded by people who love them and can carry them through this. Pray they know they are beautiful, strong, admirable women regardless of the outcome of their pregnancy tests. May they know they are held up by strangers - by sisters who may or may not have had a similar experience but grieve with them regardless.

I have never met anyone I admire more than the women that brave this pain over and over and over again for the hope of a dream realized. That, in and of itself, is the very essence of motherhood.

Wednesday, January 2, 2008

Bun Is Still Baking

I got the call this morning as I was driving to work that our bun is still progressing. My numbers exceeded what they were looking for so everything is looking very strong right now.
Our first ultrasound is scheduled for Friday, January 11.

I always thought I was just looking for the double line. For a positive - that all would be well - I just had to get in this condition (still avoiding the "p" word...). But that's just not the case. I got the double line but then we had to worry if it was a chemical and be sure that it was a viable condition. Now - we will be nervous until the first ultrasound to hear that the bun actually has a heartbeat.

It's also interesting - and I can't wait to write about this and see how this evolves - but though we are baking - there's a bun - I still feel like I'm pretending. I would imagine that it is going to be more difficult than I ever imagined to move from Infertile to Baker to acknowledging the "P" word...