Yo - What's the Haps?

It's a tale as old as blogs. I've been MIA. I've even started posts offline, only to never finish them. (Ok, technically it was only one - BUT I've thought of a bunch of others.) I've lurked. Not on purpose mind you, but the feeder app on my iPhone doesn't do a great job of posting comments and so neither do I of late.

Ya, ya, ya - so what's the haps? Current status: GREAT. All scary tests have come back normal. YAY!!!!!

We are at 21 weeks and 4 days and everything is lookin' good so far.

Surro is having major stress with other family stuff, but she is holding up like a champ. She's a GD saint and all I can say is that I wish a plague on the horrible person causing her pain - except that plague would hurt other people I love, so I guess I really don't. But maybe I do because that person always hurts other people and she's sure to hurt the people I love again. Shew. Life sure is complicated.

We manged to live through our announcements. First we told family and any close friends that weren't already in the know. Ok - that's a lot, but the response was generally good. Oddly enough I didn't really get much response from my Dad's side of the family that lives here in the US (Dad died when I was 3), but got great response from the ones in Sweden. All of hubbinez's family was super-duper-uber excited. So was my mom's side of the family - but most of them already knew.

Next we made the dreaded FB post. That actually went WAAAAYYYYYYYY better than expected.

At first I posted this video:

Mostly because I love Min Pins and this cracked me up as a baby announcement. Apparently no one viewed it or "got it" but that was ok because seconds later...

.... hubbinez was so excited about making the announcement (he had been telling people all week) that he made me do a joint word post, where we hit the POST button at exactly the same time. Because we are corny like that. It went something like this:

"On Mother's day it is fitting that we make our announcement that we are expecting twins. This would not have been possible if it wasn't for another wonderful mother, my SIL <insert name here> . Unable to carry our biological children myself, and after unsuccessful tries elsewhere, she selflessly offered to be our gestational carrier. Words can not express our gratitude over this incredible gift."

Hubbinez was as giddy as a school boy.

I haven't told my work yet, but that's because there has been a snafu with converting me from contractor status to employee status. Technically I am now an employee, but everything isn't final in all the systems, so it makes me nervous. I'm going to feel like an arse when I have to tell them about taking time off - which incidentally the due date is 1 day off from my boss' new wife. I'm sure he's going to freak, but because of my last disaster with getting fired when I told them about starting a family, I want to at least be protected by law this time.

In other haps - I am doing a sleep study next week. I've always had problems with not feeling like I get enough sleep (even when I do!), so no time like the present (ie., pre-twin birth) to try and figure this stuff out. We are off to a good start. Initial blood work from PCP showed that I have a big vitamin D deficiency.

That's a big one with sleep and immune problems, which makes sense since I've been sick so many times in the last year I lost count. With Vitamin D the doctor is looking for any number above a 29. Mine was 18. :-/  Apparently all that sun block wasn't so great for me. Except the whole wrinkle thing. I'm ok with the past trade off, but had to find another option for the future. Yay for supplements! 2000 IUIs a day! At least the past year has prepped me for that.

Srsly, I have to be the only girl whose doctor tells her to go get some sun WITHOUT sun block. Ok, maybe not, but it's not something I have ever heard before. And so I went out in the sun the other day without sunblock on anything except my face for the recommended 15 minutes. Then I slathered on the sunblock. The glare from my legs are still intact!

That's it for tonight. I need to post right away, sans editing, lest it fall by the wayside. Holy crap - it's 11:30pm. Gotta go take a bath and go to bed. Night all!

Amniocentesis and another 2WW.

From: http://www.webmd.com/baby/twin-pregnancy-types

Thursday we had our amniocentesis. What a nightmare. It was really important for us to have one, but holy crap that stuff is scary.

The doctor certainly didn't help. It was that same irritating douchey specialist from the other week.

I guess I should back up a bit since I've been MIA.

The cell-free DNA test ended up coming back inconclusive. That's right, the test that the doctor recommended and then we found out afterwards that the manufacturing company doesn't always recommend for multiples or donor eggs (and since this is surrogacy, my eggs are considered donor) - came back inconclusive. Shocking. They wanted my SIL (our surrogate) to come back in for another. She called me and gave me the update. The nurse was really pressuring my SIL to come back in for another try at this test that is only partially covered by insurance.

After thinking about it, I told my SIL not to get it. It didn't make sense. Why should she have to take extra time off from work for a test that was not going to tell us anything different than the amniocentesis that we had already decided we were doing. Why should we pay even MORE money for a test that didn't give us anything different? Why should we put her through an unnecessary poking that could very well end up being inaccurate or inconclusive. I told her to not worry about going back for the test.

And then she called back. The nurse was EXTREMELY insistent that she come back for this test. At this point I because very irritated (not at my SIL, but at this Dr.'s office.) It was clear that they wanted us to do this test to try and convince us against the amnio. I told my SIL not to stress about it and I would straighten everything out with the Dr.'s office.

Ready to rage war, I started making phone calls. First I called our old fertility clinic ACRM. Our nurse that took over our case when our original nurse was promoted was nothing short of awesome, and I wanted to ping her for her advice. Then I walked outside my office, took a deep breath, and called the specialist's office.

The nurse that spoke to my SIL was not available, but another person in the office was able to call me back fairly quick. That conversation did not go as expected. Actually - it went quite well. The nurse (I think she was a nurse - but we will call her one anyway) was awesome. She is similar in age to me and she confided that she would consider the amnio if she was in the same situation. She explained why the other test was inconclusive and agreed that if we were going with the amnio, then it was not necessary to get the cell-free DNA test - especially so close together. We talked for quite awhile and she restored my faith in this part of the process.

Hubby and I decided that maybe it would be better to have the amnio done at an office closer to us. Maybe staff at a Decatur/Atlanta office would be more professional that some of our previous encounters at the Fayetteville office (like the bad nurse my SIL talked to). Heck, I'll bet the Fayetteville office, even though quite modern and large, has never even seen a mixed Indian/Caucasian couple, much less one using surrogacy. It would be the same doctor (groan), but hopefully no sight of other staff members with similar issues. (Atlanta is completely different than most of the rest of GA.) We would still do the regular appointments closer to where my SIL lives, but we felt safer with the amnio in a more diverse setting.

Fast forward to Thursday: amnio test day. Meep.

We knew that my hubby would be about 15 minutes late due to work constraints, but we really wanted the time to be more convenient for our SIL and let her set it. So when the doctor came in after the initial ultrasound, hubby had not arrived yet. The doctor started off with "are you sure you still want to do this?" and I had to resist the urge of having a fit. Both SIL and I answered in the affirmative.

The doctor then explained that since there were twins, the first injection would have an add-on of dye. The barrel part of the syringe is interchangeable and thus one needle can be used to insert dye, screwed off, and another barrel placed on to gather the amniotic fluid. This insures that you are hitting the same place and that you don't have to puncture multiple times. The purpose of the dye is when they go to do the second amnio on twin B, they make sure they get the fluid from twin b and not twin a again. Apparently the sacs can be all over the place.

Guess what happened? 

Removing fluid for the second amnio showed blue dye. The doctor stopped and asked us if we wanted to continue. By now my husband has arrived and we have to explain what the blue dye is and what it means. It also, all of a sudden, occurs to me that 2 punctures to the same sac means we have just doubled that baby's chance of miscarriage. And the doctor says that if he hits it a third time it will triple it. And if one miscarries, then it can make the second one miscarry.

I sat shaking. Oh - and I haven't even MENTIONED how horrible this looked for my SIL. The first one didn't look painful until they removed the needle, but the second one definitely looked painful. What to do what to do? I felt paralyzed. Secretly I wished my husband would make the decision for us, but I knew that wasn't fair. My SIL turned to us and said she was fine if we wanted to continue. She continuously amazes me.

While the doctor started rambling on about some of our other options, I quietly thought to myself. There was a pause and I explained to my husband again, because I felt it had been glossed over, that the second puncture had increased the chances of miscarriage and a third would triple it. I stated it again to make sure my understanding was correct. The doctor said it was and my husband started asking more questions. Again I reach internally and quietly thought to myself.

What I realized was that my initial fears of chromosomal abnormality had not changed. I still couldn't deal with certain outcomes, but now I was increasing the chance of making a good outcome bad. And I didn't have my comforting statistics on hand to let me know what was optimal. Ultimately I internally decided that I felt we should continue. And to nut punch the doctor if he pierced the wrong sac again. My SIL reiterated she was fine to continue today.

I overheard the doctor saying we could try again in a week or two. This made ZERO sense because then you would definitely be piercing the twin A 3x (because you would have to do the dye again) and the timing would be off if we had to make other decisions. My husband turned stonecold at this point and told him "Just do it now." Hubby looked at me and I nodded my head yes.

The doctor found another area that he sounded more confident with injecting. Complete opposite side that had not been available (baby moved) previously. My husband asked him "between 0 and 100% what it your confidence rate that you won't hit Twin A a third time?" The doctor replied "Oh you can never be 100%" and didn't answer the question. Hubby repeated the question again and doctor replied "I'm very confident". Which of course we followed up with "how much is VERY???" His reply: "At LEAST 50%." Facepalm.

The doctor had to get into a weird hand position to access the third location. The dye check occurred and this time it was clear. We all breathed a big sigh, but the room was still incredibly tense. I could tell it was painful for our SIL. I watched as the doctor withdrew the amniotic fluid and saw his hands visibly shake the entire time. I have no idea if it was because he was old, nervous, or just because his hands were in a really awkward position. I decided that it would make the situation worse to announce "WTF is wrong with your hands?!?" mid-withdraw, so I stayed silent. (I did tell hubby, mommy, and SIL later.)

It was over. We were done. We asked SIL if she was ok. She said she was. Hubby ran downstairs to pharmacy because the doctors office didn't provide any after pain medicine and we didn't want her hurting on the long drive home. Tylenol was fine the staff said. SIL said she was fine, but hubby ran to get some Tylenol anyway.

My mother was waiting in the lobby when we were done. She had graciously volunteered to drive my SIL when we realized the night before that she shouldn't drive herself. Doctor's office failed to mention this. Hubby ran back downstairs and got drinks and Reese's peanut butter cups for everyone. We talked for about an hour to make sure SIL was feeling ok, before the long drive home.

At the end, we scheduled our appointment for the next ultrasound. We decided that Fridays would work best for everyone, rather than Thursdays. The front desk lady informed us that we would have a different doctor if we went on Fridays. Without getting mad, or causing a scene, I simply replied "GOOD" and she made the appointment. 

Cupid's Gift

Artwork by Setsiri Silapasuwanchai

Purchase here

Today could have been the best or worst Valentine's: this morning we had our ultrasound. Originally it was supposed to be on Saturday, but we realized that there was a miscommunication and that they don't do non-required-cycle ultrasounds on Saturday. That's a story in itself that at this point bores even me, so I will spare you the details.

I think I may have held my breath as the ultrasound began. My husband has never seen an ultrasound, which seems incredulous now that I think about it, so it was a completely new experience for him. (I've lost count on how many I've had in the last year alone!) After what seemed like forever (really just a few seconds), the big black circle came into focus. With a little white circle (yolk sack) inside. And a blinky heartbeat that measured at 129 beats per second. The doctor said it was perfect.

And then she showed us #2... Equally perfect.

Cycle Limbo Part 2: Return of the Cycle

UPDATE

Nurse called. As long as my SIL can come in tomorrow and get an ultrasound - then we are proceeding as planned. Whoooooooooooooooooshhhhhhhhhh.

When the nurse initially called, she kind of presented it as my option with the knowledge that if my SIL's lining isn't thick enough upon transfer day, than the transfer won't take. Normally they want 11-14 days of the estrace to insure a thick lining, but they don't want to start the estrace until a untrasound and blood work on her confirms everything is a go (eg, no cysts, hormone levels good, etc..) My last cycle gave me only 12 days before transfer. She asked me if I wanted to go forth.

At first I asked questions about how would we avoid this next time if we waited. She said that normal protocol was to control the GC's cycle with BCP/Lupron overlap. Then I asked the follow up question that surprisingly, I think was a bit unexpected: why did we not do it this time? This was a little harder to answer, but the short of it was - they/she didn't want to start medications (including BCP) until all the initial testing had been completed. Of course my logical reply was: Does BCP effect the testing. Answer: No.

So getting past all that, I realized she expected an answer from me about whether I wanted to start or not. Here is where I lost it. Crying the cry only someone that is mildly dehydrated and still slightly sick can manage. My guess is that over the phone it sounded somewhat like a choking horse.

Normally when I get really upset, my sensibilities leave me, but they did not this time. I put the question back to her: "What you are telling me is that I have to choose between my chances lowering further from waiting a month, or take a chance that the lining won't be thick enough." She said she would speak to the doctor and call me back.

I laid the options out like that for a couple of reasons, but the main one was that I really didn't know which is riskier. One would think that a month wouldn't make a world of difference, but women in my age bracket know differently. My AMH dropped drastically in a very short period this year. Conversely, I don't recall our surrogates getting estrate (or similar) that long in India prior to the transfer, so I'm not sure if it is a booster/fail-safe thing or what.* From a medical perspective, since my GC and I started menses within 24 hours of each other, one would think at 29 years of age, her lining would be reasonably thick for ovulation at the proper time anyway.

After speaking with the doctor and both reviewing my records, the nurse called back. She stated that as long as my GC could come in for ultrasound tomorrow (she can), then we would continue the cycle as planned. We nailed down a few of the other details (like when I would start my big gun meds) and now I feel a crapload better than I was feeling. Earlier I was trying not to let panic surge, but I was having a hard time. I would have waited another month if I had to, but honestly, I am ready for this to be over and done with. The emotional and physical, even things you don't let anyone else see, is astronomically draining.

*Originally I thought the Indian surrogates did take meds from the beginning (from my own research of surrogacy), but I had my husband ask the Indian lady directly and she said that she only been told to start medication a few days prior to the transfer. My husband and I now debate if this was a protocol thing, problem with the surrogate, or other. 

Running and Running

Yesterday was a day that started with me waking up in the middle of the night - running to the bathroom. Several times. I couldn't even see what time it was because the clock was slightly obscured and I was afraid any movement would have me running back to the cold tile.

Course that's the kind of thing that makes you afraid to sleep. So there I was, wide awake, trying my best not to do that little gaggy-thing you do before you throw-up, in fear that the muscle contraction would make me poo in my PJs. I had my Hello Kitty's on after all. Fortunately nothing like that happened and I was able to keep running when needed. By 7:30am, I was exhausted. 

During this time I was wondering to myself (and to my husband, whom had much pity on me), how this could have happened. My son had a violent bout of stomach problems for most of the day 3 days prior (and of course I was with him on Christmas), but my husband didn't seem to think that sort of thing was contagious. I remembered differently, but I wasn't exactly in a state to argue or even think straight. More than likely, he mused, it was the Thai food I brought home the night before. 

A little voice inside me feared it was a reaction to my Ganirelix. I've never had it before and wouldn't that be a disaster if we had to figure out a change of meds at the last minute? While I've never had quite the exploding reaction to any other meds (unless you count the time my mom made me take cough syrup and I instantly barfed), I still have a weird history of medicine reactions. Can't take anything from the Cipro class of antibiotics. Well, I guess I COULD in an emergency, but I would be freaking out and asking my husband repeatedly why he was looking at me funny (paranoia is only one of the lovely reactions it causes.) 

Turns out I just had my son's stomach flu. Spent most of the day in the bed (and bathroom), but by 5pm (and a forced dose of  1-2 mg of Melatonin to make me sleep), I was able to come downstairs and eat. (BTW: Melatonin is supposed to help us infertiles, but golly it sure does pack a wallop with me.) Was weak as all get out, but I feared shot #2 less than I thought I would. Perspective I suppose. Now a day later, EXCEPT FOR MY STUPID PERSISTENT COLD, I'm all better. 

Kinda makes me wish I had these:

Photographer and story behind pic here:
http://www.flickr.com/photos/mararie/2137142469/

P.S. If you are a regular reader of my blog and are wondering about the answers to the questions I asked my nurse the other day, I updated the post to reflect the answers. Here it is: Day 1.5. I thought that would be better than to write an entire response post that are a few short sentences. 

A job, a surrogate, and possibly the flu

http://liannetaimenlore.blogspot.com/2012/08/edbp-movie-review-lion-witch-and.html

“All shall be done, but it may be harder than you think.” 
― C.S. Lewis, The Lion, the Witch, and the Wardrobe

Two weeks ago my husband and I decided that I needed to go back to work. Our funds are greatly depleted and the time had come. This made me more than a little nervous on several counts.

1. I'm rusty in my job field. Not only because I took off 7 months for IVF treatments, but also because my last position had me doing a different area in my expertise. While that's all great and fine, the problem becomes two-fold in that I could either continue in that subcategory (with only 2 years experience) or go back to my old subcategory with well over a decade experience. Going back to the old actually means I have 2 years worth of catch-up to do as you have to constantly stay updated. 
2. Interviewing terrifies me. I don't know why, very few positions have I ever interviewed for did I not get a job offer, but they still terrify me. Like make me want to vomit type of terrify. Like my voice shakes and my mind can go blank type of terrify. Now that I think about it, maybe I have such a good success rate at job offers because I usually go with the one of the first couple. That gets me out of other interviews. Add on #1, and I simply did not feel ready to interview. 
3. Wasn't sure how this would fall inline with our IVF treatments. What if our surrogate here doesn't work out? Then we are back to looking at India. Can't exactly take time off to go there for 3 weeks when I'm brand new at a company. We don't save any money by doing IVF in India, only surrogacy, but I don't have confidence that my embryos will make it to freeze. Need to look at things to increase our chances, not decrease.

As my grandfather used to famously say "Oh well, what the hell" and thus I dived into job search mode. Went on a interview last week, felt like puking (before and after!), thought I bombed part of it, and lo-and-behold, they loved me. Took an online technical test and scored high. Job was offered immediately (like within 5 minutes of me completing the test!)  So here I am getting ready to start my contract-to-perm position next Monday. Have a shit load of studying to do before then. 

In other news, we met with our friends (husband and wife) that are considering surrogacy for us. We have to meet with our clinic here in Atlanta to find out some more answers, but I felt really good talking with them. Made me realize that they had thought it through (at least with the information they had) and wanted to think it through some more after we laid all the heavy duty stuff on them. That's actually a really good sign to me. 

The next day my friend emailed me and said she went through the forms and wanted me to check with the doctor about a medical issue she had years ago. We have an appointment with my clinic on the 30th, so I will have my list of compiled questions then. Meanwhile, I also have a phone consultation this week with another clinic via Skype. 

The only big concern my friends really had was insurance. They've had problems with theirs in the past. If we have to buy insurance, pay for a ton of new medical tests for all 4 of us, plus attorney fees, then that may be too cost prohibitive. Won't really know until we speak with some clinics. Don't even know if they will still take me. 

And if this all seems a bit lacking in the segue arena - it's because I fairly certain I have the flu. Sigh. 

Still in Limbo

We were suppose to get the update today. We didn't. Which is not surprising, because sometimes that's just how it is. 72 hours will give a better picture of where we are at anyway.

Woke up a 4:38am and started checking email. Realized around 11am it wasn't going to come. Hopefully I will wake at a normal time tomorrow morning.

Rather than write out a long post (and rather than reread what I wrote yesterday), I will just recap what I sent to my mom this morning.

yea, I know she is looking for the hcg value to double every 48-72 hours, so she may have not been able to do the test today, knowing that tomorrow is just as good (if not better.)

Just as an FYI,

At 14 days

any value over 25 is considered pregnant. 

any value under 5 is not preg

5-25 is indeterminate

Ours was 27.44

The average for 14 days is around 100. The value doubles every 48-72 hours (for many many weeks.) If you do not see the value doubling, then it is cause for concern that the growth may have stopped. This can be from ectopic pregnancy or that the embryo has just stopped growing and the body will usually miscarry it naturally. Happens all the time and of course at my age the chances of miscarriage is higher.

So I guess we are waiting to see if it is still growing properly. From what I understand, a low value could have been caused by the embryo implanting itself a little late, or it could be the embryo that fertilized late (1 out of the 3 did.) .  Healthy babies have been born with initial low hcg values, but it significantly lowers our chances. A statistic I saw said that <35% will be successful when the value is between 25-50 at the 16 day mark. Low hcg has no bearing on the baby's health after it is born.  If it is growing slowly, then there could still be chance and they will just monitor every 2-3 days until the 5-6 week mark when an ultrasound would show if there is a gestational sack and if it is empty. At least this is how it is done in the US. I haven't asked her yet. 

Literally in limbo and I guess it could go either way.

What a week... wait, it's only Tuesday

Photographer: Jill Greenburg
http://abcnews.go.com/Health/popup?id=2242810

Yesterday morning, I was reading my son's facebook status and out of nowhere I burst out crying. Not a small cry, but one of those full-on crys that makes you think "thank goodness I'm alone" when it's all over.

What was the status you ask? That's the problem. I couldn't read it.

I have ADD (Attention Deficit Disorder). The correct term is actually ADHD (the DSM-IV combined the terms years ago) and now ADD is listed as a subtype. Why do I call it by the sub-type name? ADHD is a controversial topic, thus the last thing I want is for people to say to me "that's baloney - you aren't even hyper", which means I have already lost the argument before I even have begun to explain the difference.

It's an argument I've grown weary of. Fortunately I've known doctors and people that know the reality of how hard it can be to deal with this problem; it can be soul-crushing to be honest with you. In addition to dealing with the multitude of issues it causes, I'll often run into people that will make a snarky comment or worse, self-diagnose it. Do I think it's possible that it's over-diagnosed or over-medicated? Yes, but not nearly as much as you see in the media. For every lame brain, non-researched excuse of why it's not real I can give you solid facts of why it is. It's as maddening as someone telling you that infertility is "all in your head". My absolute favorite is when a doctor (who has never studied it) jumps on the fashionable bandwagon. Thank GOD those are few and far between. Anyone that goes through the torture of not being able to process a conversation IN THE MIDDLE OF a conversation, knows the personal hell that can be ADD.

In addition to using the technically incorrect term "ADD", I also avoid calling it "Adult ADD". I've had it since I was a kid, they just didn't even know what it was back then. Mostly I was called scatterbrained, day-dreamer, or my personal favorite "not reaching her potential". I had no idea what was wrong with me and often just thought I was somehow broken. As a child it was depressing to constantly think I was crazy, lazy, you-name-it, and as an adult it is exhausting. Especially on days/weeks that I am particularly bad. I haven't taken medicine for years as the side effects far outweighed the slight benefits that it gave me, and so I have learned coping mechanisms that effectively make help me make it as a normal, bright, individual. Most of the time (unless I'm in a reading block), I manage quite well. You will never see me use it as an excuse, except on the rare occasion I have a private meltdown in a rush of frustration and insecurity.

If you are a regular reader of my blogs, you will see that I occasionally veer off topic, like I seem to be doing right here and apparently right now. Sigh. That's part of the problem.

Back to my story. 

I couldn't read my son's status. There are times I can't read. I try and it's just jumbled up and my brain won't process what I have read. Even if I read it 5x. Even if I read it 10x. It really sucks. Conversations can be the same. At work I write everything down, record meetings, and make sure anything that is important gets sent to email and immediately put on my calendar.

Having taken time off from work (after getting fired in February when asking about infertility benefits), I've gotten behind and now need to majorly study to get back in the job market. My job is one that I have to constantly stay updated. Not being able to read anything more than 3 sentences long is a MAJOR PROBLEM. Thus the realization of this yesterday morning made me have a meltdown.

This happened just when I have resolved to NOT let the EEOC decision to not pursue my case get me down (they issued me a "right to sue" document if I ever want to deal with that nightmare.) Friday I received that lovely letter, but after I read the letter more closely, I realized that my old company denied that I ever told them about infertility. Point blank said I never came to them. Stated that they had no idea I was going through infertility and denied that they had asked me directly if I had had a miscarriage when I made a statement about stress of some bullying that was causing me medical issues. (Note: I actually have proof that my boss gave me her infertility doctor's information to contact, but again, I don't know if sueing will cause me more grief than it's worth.)

In the back of my head, I think I half wondered if something had happened with my ADD that I just didn't realize. The letter let me know that it really wasn't me. My company stated it was for performance reasons, yet had not ever said there was any problem with my performance. I've won awards for stellar performances at companies before. The very week I was  fired (4 days after our 2 guys returned from paternity leave no-less), our toughest client had given me huge praises - something they never did. It wasn't me. I could be furious at my company, but it at least I receive confirmation that it wasn't me.

But that didn't help yesterday morning. I still had my meltdown. Then I noticed my period had started. Well that figures (and explains the meltdowns better). The day saw me have 2 more meltdowns. The second one  with a doctors office when I was late for an appointment, got lost (ended up being a tornado warning weather), and they cancelled me. Afterwards I had to rush to the DOL and wait hours to reschedule a missed appointment from when I was in India. (They scheduled it for me a few days prior and sent an email when I was halfway across the world.)

The third meltdown came from explaining the whole day to my husband and then simultaneously thinking about how I could be passing off this ADD to our child. I guess I'm carrying a larger load than I wanted to admit to myself. We get our 2ww results either Saturday or Monday and everything hit like a ton of bricks at once.

Today was a better day. My period makes me CRAZY and unable to handle stress for usually around 24 hours. Today seem to pass the 24 hour mark and I went to my volunteer place and was unexpectedly asked to manage 25+ volunteers. That not only helped me feel better about myself, but gave me a warm and fuzzy about helping others. I was profusely thanked by the top people at the end of the day.

2ww. Yea, I thought I was totally beating you this time. Not so much.

On a brighter note: my boobies no longer hurt. 

A Carrier's Perspective (possible tissue alert)

This is a hard one for me to write. Because even with my veil of anonymity, it reveals something so personal and secretive, that few people in my life actually know about it. Many of my closest friends do not know about it and it was even hard to admit to my husband, but I realized recently how very relevant it is to my journey. And how much it will make me cry to write about it. 

Some recent stories I arrived at via Stirrup Queens showed me the importance of sharing my story. I apologize in advance for any grammar mistakes, for I don't plan on check editing like I normally do for long posts. Feel free to comment, but if you ever meet me in person let's agree not to bring it  up - ok? Alright, here it goes:

When I was barely 16, I gave up a child for adoption. 

There. I said it. Or at least wrote it. 

Surrogacy is not an easy option for me. Wait, I need to rephrase that because surrogacy and infertility are not easy options for ANYONE on any side of the fence, as blog after blog can attest. Let me try again... Like many cases in infertility land, our path to use surrogacy was an extremely difficult one.

For you see, I know the pain of carrying a child in your womb for 9 months and then giving it to someone else. I can pretend that my pain was "more" because the child was genetically linked, but I really have no way of knowing that. The best I can hope for is that the verbal evidence I am given from those "in the know" is what my surrogate will experience: that it's not easy, especially that day in the delivery room, but that the surrogate knows from the beginning that the child is not hers. Knowing that her GIFT will enable her to help her own children - something HUGE that I think most articles on the subject seem to miss, but mothers pick up on right away - helps to ease the worry. At least a little. 

My main nurse in Anand is twice a surrogate. She is always happy with a smile and her recent deliveries occurred when she was about 39 and 41, the last one being only a year earlier. She has worked at the clinic for approximately 9 years. She's not the only nurse that is a former surrogate and I dare say that they would certainly have inside information on what the women go through before making those decisinos for themselves. 

The life and emotional well-being of my nurse is a strong contrast of how my life was a year after giving up my child for adoption. Maybe emotionally she's an exception, but I don't think so. Speaking and reviewing empirical information on former surrogates lets me see how their lives are changed for the better, but I still don't fool myself into believing that the initial period after births are easy-breezy for them.¹

When I was pregnant and 15, I listened to people tell me that, "if I loved my baby, I would give it up for adoption." No one told me how the pain would rip me apart. The pain didn't even fully settle till months after, when it was far too late by legal standards to do anything about it, (even though I did try). Having been ostracized by any "good girls", combined with an already deep ability have depression (even before my pregnancy), it's no surprise that I continued making bad choices for awhile. I have no doubt that post-partum equally contributed it's ugly head during those times. 

And then I stopped making bad choices, (at least for awhile). At 19 I was engaged to a man 5 years my senior and became pregnant. While I certainly had not (I promise) PLANNED on being pregnant, after I got over the initial shock, there was a sense that a huge hole in me was in some way going to be repaired. I had to clean up my act for my baby. My marriage lasted for a very brief period, as my husband did not share my epiphany, but my second son helped me heal. Tremendously. 

I won't pretend that I haven't had other ups and downs in my life, many of my own doing on both accounts, but to say that giving up my first-born for adoption didn't have a huge impact on my life would be a lie. My first-born is now old enough to have tried to seek me out and even though I put in the initial papers that he could, he never has. Something that both grieves me and relieves me. It's probably been over 20 years since I dared even open the box containing all of the documentation and correspondence I had during those difficult times, but I still have the box. And it's a big box. It has been a long time since I grieved on his birthday, but there were many, many years that I did. Now, most birthdays go by without even remembering. Not because I don't love him, quite the opposite, but I guess my mind finally kicked in it's defense mechanism that we humans are so famous for. 

Invariably when I see surrogacy articles, I get enraged when I see all the comments about "they are selfish and should just adopt!" Do people think the mothers of adopted children didn't equally grieve? Some maybe less, but many possibly more. (There are more reasons that these comments enrage me, but I will save those for another day.) Do people not know that the amount an Indian  surrogate makes, even though small by western standards, can effectively change her and her families life? The surrogate can start a store or buy a rickshaw for her family to earn more. Things that were never even remotely possible for her prior.

Surrogate mothers choose their paths for a variety of reasons, but as long as it is their choice and they are fully informed, we should not take away that right or even judge it. Not even if the woman is poor and does it simply for the money. A poor woman wanting a better future for her family should not be held to a lower standard than other women. Knowing a little bit about Indian culture, I know that these women don't do it for pure altruistic reasons as I sometimes see touted, but that doesn't make their GIFT any less. 

Surrogacy is hard for me, but the adoption option would be even harder. My baby may have been unplanned, but he was definitely not unwanted. Not any more than my second child. I can not imagine reliving my 15 and 16 year old life from the other side of the fence. Adoption is not even on the table for us for us for many reasons, including simple ones like wondering if we would even be allowed AND our desire to have a genetic child. It was not until my most recent trip to India that I even acknowledged to myself about how my teenage years affected some of my angst of our current journey. 

Does the 40 year old me regret giving up my child for adoption? Surprisingly - no. I don't think the 20-ish one did either. I knew that the 16 year old me could not give a life to a child that even a 20 year old me could give. Even the 20 year old me had difficulties, but I think my second son turned out pretty awesome,. My first son would have had less of a chance and there is a high likelihood that if I had kept him, my second son would not have been born. 

I don't doubt that most surrogates go through pain when giving a child they have carried for 9 months to the intended parents, but I don't believe that most would want to keep the child either. The financial burden compiled with the stigma would be something that we westerners could not even begin to understand. At 16, I may not have understood all the pain that would occur with my decision to give my baby up for adoption, but it was the right decision. For me, my future self, and both of my sons. 

¹  I can ONLY speak from my experiences with my clinic, there are tons of nefarious ones out there that I hope are regulated out of business soon.

Days are flying by: Day 6

I've met the most interesting people this time from all over the world. Couples from Africa (including Casablanca!), Europe, Japan, China, USA, and of course many from other parts of India. My husband and I  are not even the only mixed couple this time. There is a Chinese lady married to a Norwegian, a lady from South Africa married to an Indian (they just had twin boys!), and a Irish guy married to an India lady (who graciously invited me to dine with them at lunch yesterday.)  Everyone is super friendly and I feel much more relaxed.

Well, except for today. Today I get my AMH results back and a sonogram to see how I am progressing. I'm  very scared. I've had flash thoughts of having to tell my husband "don't bother coming". Fortunately I'm not obsessing over those thoughts, but this morning they are definitely there.

Have had several mini-adventures that involve me trying not to get lost while still exploring new places. Managed to find the Anand version of Target on foot, something that I am extremely proud of given my propensity to get lost. Doubly exciting as my flip-flops broke on my walk to the clinic that morning. The road was a slushy mix of mud, trash and probably poo (lots of cows here!), thus barefooting it was not really an appealing idea. Was able to pull a temporary McIver move with a safety pin as you can see below. It held till I was able to find Target - yay!

Also managed to find the baby Mart (called 7-eleven), but that was a little more hectic as I ran into a couple of hustlers along the way (more on that later.) This almost never happens with my husband around and it's interesting to notice the difference. Often I tease my husband for walking around with such a stern look on his face, but now I see why.

Well that's it for now. Have to get ready to go to the clinic.

Spot check

I started bleeding tonight. Not good. It's only very light, barely spotting, but then again that's how my periods start.

Have no idea if my cyst burst or if my period is starting early. Will a burst cyst cause problems that will cause an infection? What if I missed a pill? Or was late? Is my whole cycle for India screwed now? My head is spinning and it is taking everything not to freak out. 

Simple Cyst

When I woke up this morning, I wondered if I should just stay in bed. Was trying to get 8 CONTINUOUS hours of sleep, which is nearly impossible in my house due to the fact that I stay up too late and my husband gets up early. A bad dream woke me up after 6 1/2 hours. I tried to go back to sleep until my husband's 7am alarm, but I never really did.

I should have just stayed in bed the rest of the day. Already I felt weepy.

At 9:20 am I had a followup appointment at my OB/GYN's office (Dr. I) to check for cysts. I didn't even have to ask this time, the big black space on the monitor told me everything. Then I met with the doctor, where he informed me that I have a minor "simple cyst" and not to worry. Except I do worry. And then I asked the size... 5 x 4.1 cm. Look, I may not be a doctor, but that's not small. I think the one that threw off my cycle last time was smaller than that and that we had to aspirate before proceeding.

I reminded Dr. I that I was starting IVF in September and that a cyst was a problem last time. He said we could check in a few weeks, that it would probably burst on it's own. Without losing my shit, I explained I would be on a plane next Thursday. He still seemed mighty casual about it all and said that if we wanted to PUSH to remove it, then I would have to undergo GENERAL anesthesia. Still keeping my cool (I'm not sure how), I informed him that I had to have general anesthesia in India to have it aspirated anyway and that I would much prefer doing it here, then letting it mess up my cycle. He was nice about it and all, but hellz balls I'm frustrated.

Initially I thought I would ask my doctor in India (Dr. P) what to do (which I did), but I also wanted to go ahead and schedule my appointment here. In India they immediately gave me anesthesia and aspirated, in the USA you have to have appointments way ahead of time. After returning home, it occurred to me that he had really been saying laparoscopy removal when he was talking about general anesthesia. I have NO IDEA why he didn't just suggest aspirating it as that is what I told him we had to do last time.

Months ago I had asked my Indian Dr if I should get a laparoscopy to check for endometriosis or just get some sonograms to check for cysts. She only wanted me to do the sonogram and distinctly said no to the laparoscopy. When I called Dr. I to schedule it (had to calm my mind down and go home first), I asked to have it aspirated. If Dr. P wants me to wait till I get there, then I can always cancel. I don't even know if it will be covered on insurance here.

When I come back from India, I will be having a laparoscopy to test for endometriosis. After today, I may want to try to find a different OB/GYN. I miss my old one (had him since I was 15!) and his small practice ways. There is something to be said about a doctor and his staff knowing you every time you walk through the door and remembering everything you tell them.

Waiting for the flood gates to open. If I cry now, then I may be ok when I see hubby later.

I guess the myo-inositol didn't work. 

I'm scared

As I read the joys and sorrows of other couples' journey with surrogacy I begin to realize something: I'm scared. We've told some family and friends, and everyone is super supportive so far, but I wonder how big of an expectation we are setting ourselves up for regarding our trip to India. It's almost as if there is some unspoken word of "we go to India, we have baby". Logically speaking, the chances are better we WON'T.

After discussing IVF with my boss, I lost my job. While I really don't want to get into the details of that at the moment (too stressful), my hubby and I agreed that it is really important for me to keep my stress down. Looking for a new job with a pre-planned trip to India in June would be too difficult/stressful, not to mention starting a new job, so we decided that I needed to take a break and de-stress. Not to worry about a job until we get back (unless some small or low-stress contract one comes my way).

I think that's a good idea to help insure our success, but what happens if we don't succeed on our first trip? I'm not sure I've heard of anyone that did. My income is significant enough that it is a HUGE hit not to have it. We can't keep it up AND afford repeated tries at having a baby. And the more times we try, the more time that passes, and the less chance we have of success. Plus, my husband certainly doesn't need the stress of having everything on his shoulders. That lowers our chances too!

I'm scared.

Stats! need stats, stat!

Where we are right now: we knew from the beginning that we would have to go the IVF/surrogacy route (more on that later), but late last year we were given some hope that I may be able to carry a baby. Several tests and renewed hope/worries, we were told a few weeks ago "that ain't gonna happen". Ok fine. Back to square one. What we were not prepared for was the cost... After much research I had to inform my husband that the possibility this could easily go over 6 figures, was very real. Not to mention costs if something medically went wrong with the gestational carrier (new code word for surrogate) and she doesn't have insurance. I'm guessing most won't.  (All of this lead to my idea of surrogacy in India, but I will save that post for a later day.)

Here is a tiny shred of info about us: 
My stats - 40 years old, Caucasian, good BMI of around 22, generally a healthy eater, exercise semi-regular, semi-weird health issues over the years with nothing serious.
DH - 40 years old, Indian, mid-range BMI for male, generally a healthy eater, exercise semi-regular, no known health issues.

Current state of basic tests:
His tests showed good count, with a little slowness.
My tests showed an AMH of 1.7 (normal range), FSH of 12.4 (GAH!), and 16 follicles (yay). (Stay tuned for my rant on confusing AMH numbers...)

I honestly expected a much lower FSH and the news hit me hard. The news of 16 follicles earlier that day was probably the one thing that didn't make me crumble in a pile of tears. Just kinda stone-faced for a few hours. I'm hoping that the HUGE amount of stress I have been dealing with lately (tremendous stress at job, followed by loss of job, car accident, worrying about money, worrying about this whole IVF/Surrogacy thing, blah blah blah) may have had some affect and that with proper stress reducers, followed by a few lifestyle changes (no alcohol, cut way back on caffeine, muti-vitamins, baby aspirin, avoid toxins, etc) that this will help.

The logical side of me worries because I saw a blurb on the interwebs that some doctors believe your highest FSH is where you are at no matter if it fluctuates later, but the hopeful side of me reminds me that all of this is not known yet and thus doctors can not have an absolute certainty of what may or may not help. Besides, the article very vaguely stated "some doctors believe..." with no facts or numbers to back it up. Plus, I tend to be the girl that doctors say how unique my situation is. With everything. Want proof?  My normal AMH combined with my FSH puts me at less than 5% of cases of a study that was about AMH and FSH numbers combined. When looking at SART reasons for infertility, my medical issue of why I can't carry a baby has me at less 2% of the population that goes to infertility clinics. Essentially, it means I really don't have a lot of stats I can lean on at the moment to gauge what our success will be.

Our US doctor will be calling me later to either "discuss the results from last week" or "schedule an appointment to discuss the results from last week". Not sure which since the lady on the phone (when I was driving no less), gave me the info and I honestly did not hear much after "FSH 12.4" and "doctor team will discuss internally at their meeting on Monday". We are in the process of talking with several clinics in India as well and will see how that goes. On SART, our clinic had an over 30% success rate with women my age last reporting period (2010). This statistically significant enough that it will make them stand-out, but it also makes me wonder if they skew what they advise. As in "you really need to use donor eggs" instead of what might be a perfectly normal range of odds for my age.

Sigh. I told you I over-think things.