Going to the Mattresses

Our new bed (renovated bedroom to come)

I can still vividly remember shopping for a mattress with my husband (then fiancé) just a few months before our wedding.  As we tested each one trying to make a decision all I could think about was that it was going to be our mattress.  We were going to be sleeping on it together.  We were going to fall asleep on our mattress and wake up together.  I must admit that on the day we were picking out our first mattress I was so full of love, excitement and anticipation any mattress would have been comfy.  Though I had spent a good amount of time preparing my heart for marriage, there would still be a lot to learn.

Nine years later it had become apparent that we had outgrown our first mattress.  It was not as comfy as it was during those blissful newlywed days.   It had become a bit too worn in and had lost the strength that our marriage continued to have.   It was time to get a new mattress.

Our mattress this time would reflect the learning and wisdom gained by nine years of marriage and bed sleeping.  We went to the store this time with specific questions in mind.  We knew exactly what we were looking for.  In the end we chose a Sleep Number mattress.  One where we could each adjust the comfort levels of our individual sides.  I like my side to be softer.  My husband has learned that I must be loved softly.  That sometimes I like to have dreams and ideas just to have them and when I have too much to do I get overwhelmed and I need a hug and a smile and maybe a helping hand.  My husband likes his mattress to be firmer and I’ve learned that as a wife I need to give him lots of respect and support with regards to who he is and what he does. It is an art that I continue to perfect.

      Thankfully our mattress can be adjusted at any time to meet unexpected needs.  My husband might need his side to be a little softer when ill or firmer after a long day of working on the house.  I have also learned when I need to be either softer or firmer with him depending on the circumstances that are going on in our lives.  Our new mattress is supposed to last for twenty years.  I hope we will come upon a day when we find that we have outgrown yet another mattress and I look forward to all we will learn between now and that day. 

        

To those who were curious and asked, Emma (the kitty) prefers a firm mattress we think since she now sleeps on my husband's side of the bed.

The Winter of my Discontent

It’s Saturday morning.  I roll out of bed and slide my feet into my fuzzy granny slippers (as my husband likes to call them).  I shuffle downstairs, make a mug of tea (in my favorite green mug) and curl up on the sofa under a cozy comforter.  I turn on HGTV and talk to myself as I enjoy long sips of tea.

   “See, isn’t this nice?  Isn’t this so cozy and peaceful?  It’s a lazy unhurried Saturday morning.”  I try, I really do but inevitably I sigh and admit that it is not as fun as my Saturday morning ritual May through November.  During those months I hop out of bed early and make my way to the Farmer’s Market where I stroll through sun drenched stalls admiring produce of varying shapes, sizes and colors.

 After making my purchases, which include homemade treats for kitty, I stop at the Tree House stand for a cup of iced coffee and then I stand in line at Tortilla Press for a yummy seasonal flavored quesadilla.  I then take pleasure in my spoils as I watch little girls in spaghetti strap dresses and floppy sun hats dance around to which ever band happens to be playing.  Yes that is my ideal of a perfect Saturday morning.

I didn’t always dislike winter so much.  I think the blizzard and ice storm of 1996 somehow broke my spirit. All of the women in the blogs I love to read have such romantic views of winter.  They speak poetically of knitting sweaters, snuggling beside fires with a good book and flannel clad children and cup after cup of steaming hot tea.  They encourage that winter is the time to slow down and spend more time quietly with God.  It always sounds so lovely and each year I do my best to make an effort to find the good things about cold weather, darker days and grey skies.  My feeble list…

-          Fires in the fire place (due to an ample supply of wood this year we have had a lot of them)

-          Cozy cups of tea

-          A kitty who is more eager to snuggle so she can suck up my warmth (sometimes my husband does too)

-          Chili (because that’s the kind of weather that makes it taste best)

-          A chance to wear my large collection of fuzzy socks

-          The crunching crackling sound that cars make as they drive over ice and snow past our house

  That’s all I can think of at the moment.  I’m sure there could be more but I must admit those things never quite compare to walks on the boardwalk, sandals, hands dirty from planting flowers and tall glasses of lemonade.   I’m doing my best though, learning to be content with and appreciate things even if they aren’t my favorite.

Finding my Hulk

This morning I got up excited about the day.  It was my birthday after all and in my mind the sun was shining (though it was not), flowers were singing, and birds were whistling a happy tune.  I was looking forward to coming home to new bedroom furniture and then having a fancy dinner at a restaurant I had yet to eat at.

I was also feeling excited about seeing a new GI doctor; someone who might be able to put a fresh perspective on my complex issues. As soon as he sat down he asked me why I left Cooper and I explained that I just had a hard time making appointments and getting ahold of people when I had emergent issues and he said, "You made a huge mistake. I don't know you, I don't know your history or your issues or what tests and diagnoses you've had. They do. You should have stayed with Cooper. You shouldn't be a doctor hopper." Then he wrote a script for blood work and said "Well we can run some blood work, but for all I know you've probably had all of these tests before." He then said if I really wanted to stay with their practice he wasn't going to cast me out. I'm not someone who cries easily but once I left the appointment I started crying because I was hoping to find someone who was going to be concerned about the issues I was having and help to figure out what was going on, but I felt like a little kid getting scolded for doing something bad.

    Since I have chronic health issues I feel like I just want to assemble the best team possible.  Is that so much to ask?  I feel like I’m Nick Fury assembling my team of Avengers.  My infertility doctor can be Iron Man and my rheumatologist can be Black Widow.  My primary doctor practice as a whole can be Captain America. Since my GI issues are probably my biggest problem I need a Hulk for that I think. Is it too much to ask that I find the best Hulk that I can?

So it looks like I’m going to have to move on to yet another GI doctor.  I have someone who comes highly recommended so I’m going to have to wait and see how that works out. 

I did get my Lupron shot yesterday (it will hopefully suppress my endometriosis) and so far so good with not having any terrible side effects (unless that is where the crying spell really came from).  I can’t say enough about how wonderfully nice and sweet the nurse at my infertility office is.  She made getting the unpleasant shot quick and simple.  I’m apparently the first person in six years of her being there that has received the Lupron shot.

And the day wasn’t all bad.  My bedroom furniture is beautiful and my fancy birthday dinner was greatly enjoyed and while writing this I’m watching Jean Luc Picard.  Maybe the second half of being 34 will be struggle free.

On the Eve of my 34th Birthday

Tomorrow is my 34^th birthday.  Since my birthday occurs only two weeks after January 1^st, I count January 13^th as my official fresh start of a new year.

       I’m not someone who laments getting older.  This may partly be due to the fact that most people tell me that I look younger than my chronological age. I strongly believe that age does or at least should mean that one has grown wiser so the only thing that I would lament is if the past year had been one void of growth and learning, but grow I did and I have learned quite a bit.

I learned

-          That God does answer prayers (giving me a new less stressful job) He just may not answer all of them at the same time.

-          I am not as patient as I thought I was.

-          People who take pictures of their cats and post them on facebook are perfectly sane people.

-          If you don’t like a doctor look for another one.  There are some really great doctors you just have to find them.

-          Psalms really is a great book of the Bible to read when you feel troubled.  Ezekiel, not so much.

-          Having a wise, calm and supportive husband is better than all of the riches in the world.

-          Having a sleeping kitty in your lap is often the best medicine.

-          How to handle disappointment gracefully, though I still have a lot more learning to do.

-          How to be thankful for the things that I view as not being so great (again I have a lot more learning to do)

-          Though it’s not easy, you can survive a year filled with struggles and still feel hopeful about what the new year will bring.

The Department of Mysteries

It all started the day after I got our bad news.  I had a routine appointment with my rheumatologist.  She ordered routine blood work that I have done once or twice a year.  I went the very next day and had the multiple viles of blood drawn, no big deal.

The following week the rheumatologist’s office called and asked for the name and number of my fertility doctor.  On Wednesday we met for our already scheduled meeting with my fertility doctor.  My routine blood work showed that my liver enzymes were extremely elevated.

AST (normal 10-30) 102

ALT (normal 6-40) 73

Alkaline Phosphatase (normal 33-115) 140 

Not quite liver failure, the doctor assured, but still it looked pretty bad.  The main question is…why.

In 2009 I spent several days in the hospital because I had an inflamed liver and pancreas.  At the time it was considered a fluke.  In the spring, after my embryo transfer  I had routine blood work completed and my liver enzymes were high then.  I went to my GI doctor who ordered more blood work.  By the time it came back to her the enzymes had decreased.  She also sent me for a liver ultrasound which came back fine.  She said she wasn’t too concerned.  This time the enzymes were much higher than that time in the spring and again…why.

-          Do I have a yet to be diagnosed liver disorder?

-          Could it be my lupus/immune system attacking my liver and if so is it somehow being triggered by IVF or is it completely unrelated?

-          Is my liver reacting to one or more of the medications used during the IVF and if so why would my system be so sensitive?

-          Do I have endometriosis on my liver?

My doctor said something akin to…I’m puzzled. I’ve never seen anyone who is so young and not obese have a liver that reacts this way.  My husband and I started to laugh.  The doctor was aghast and told us this was extremely serious and worrisome.  We tried to explain that if he knew how many times I’ve heard doctors express their puzzlement over my body he’d find it funny too.  I don’t think he really found the humor.  I am officially grounded from any fertility anything until the mystery of the liver is figured out.  For now the plan is to

-          Talk to my GI doctor when she gets back from having off for the holidays

-          Repeat the blood work in one month to see if my enzymes have gone down

-          Stop taking birth control immediately.  My fertility doctor’s biggest theory is that the birth control pill could be damaging my liver.  They had put me back on it after the IVF failed to suppress my endometriosis while we waited for my Lupron shot to get approved by my insurance.  I’m still waiting for the shot to come in but I had to stop the pill which I had just started taking so my period hadn’t even ended before it restarted again so I have spent weeks with an inflamed intestine.  It has not been fun. 

I’m praying very hard that the enzymes go back down like they did the last time and that it is drug related and that I do not have a mysterious yet to be diagnosed liver disorder.

A Change of Heart

 I feel like the post unsuccessful IVF cycle often feels like cleaning up after a war.  I seem to be having a tougher time recovering each time.  You spend weeks pumping your body full of drugs and then in one day you stop abruptly.  It shocks your system a bit.  I’ve had terrible insomnia and horrible mood swings and feel slightly crazy at the moment.

My doctor has decided to place me on a three month break.  During that time they are going to give me a high dose of Lupron.  One shot per month that will put me in a chemically induced state of menopause.  It is the best cure aside from a full hysterectomy to treat severe endometriosis.  We are going to talk more about our options at a meeting on the 28^th.  When he called me this week he suspected that the embryos that they implanted ended up fizzling out around day five since that was what happened to the embryo that they were watching to potentially freeze.  Before the third cycle he did suggest that if it didn’t work that we should consider using an egg donor for our last and final round since the quality of my eggs has been continuously in question.  At first I was very open to this suggestion and so was my husband.  We even had friends who stepped forward and offered to donate.  I knew I would be more comfortable using someone I knew.  After more consideration however I’ve had a change of heart.

I believe that the best tool that can be used in making major decisions is The Bible.  Because my name is Sarah I’ve always felt very connected to Sarah in the Bible.  I read through Genesis 16 and although the situation is a bit different I found the thought of egg donation to be similar as the situation between Abraham, Haggar and Sarah, just with better technology.  Sarah always seemed to be a mature, wise and dignified woman but I didn’t like who she was during that time in her life and things didn’t turn out well when it appeared that she allowed her desperation for a child to cloud her wisdom.  I just feel that using an egg donor is possibly forcing something to happen that may not be meant to happen.

Going back to the Bible as a reference for decision making, James 1:27 states

“Religion that God our Father accepts as pure and faultless is this: to look after orphans and widows in their distress and to keep oneself from being polluted by the world.”

There are a lot of verses in The Bible that refer to caring for orphans or the fatherless which leads me to believe that if we have the resources to do so (and we do) adoption would be the more Godly decision over egg donation.  Since we have one more round of IVF left we may just take a shot and try the last round using my faulty eggs just to see what will happen.  If it doesn’t work it will at least confirm that one door has been closed and I look forward to seeing what the new open door will bring.

Little baby oblong

I didn’t have the easiest day yesterday. I went in for my transfer. The worst part of the transfer by far is the fact that you have to do it with a full bladder and I’m not good at having a full bladder. You are supposed to drink your water an hour before the transfer so I finished my water at 2pm in preparation for a 3pm transfer. When I got to the office they drew blood, checked my blood pressure and recorded my weight….and then I waited. The Doctor (not the one who travels in TARDIS but that would be really cool wouldn’t it?) was coming from the Vineland office and he hit some bad traffic so he was running late. I was starting to get flushed, sweaty and pretty worried when at 3:20pm he still wasn’t there and I still needed to go through the briefing and then all of the transfer prep. When the doctor walked through the door seconds later, he apologized a lot and they let me empty out a little bit so I wasn’t so uncomfortable.

When we sat down with the doctor he said, “All I want for Christmas this year is a Miduski baby.” He then told us his plans to transfer 3 embryos instead of the usual 2. He said that given my history there is still a greater chance that I won’t be pregnant at all and he wasn’t worried about triplets or more. He then went over our results. I ended up with 7 eggs, they performed ICSI (injecting the sperm directly into the eggs) and we ended up with 4 embryos. He explained that in the past my embryos were loose, which means that the cells didn’t fill out to the edge/zona. Though nothing with infertility is absolutely positive the thought is that loose embryos have a lesser chance of surviving. This time around our embryos had filled out nicely. One was a 5, which is the best grade and the others were 4. Two looked hopeful, one hadn’t quite filled out to the edges and the other was our little oblong.

Above is the actual picture of the three embryos they were preparing to transfer. The top two look pretty good. They are nice and round and filled out to the edge. The bottom one if filled out to the edges but instead of being round it is oblong shaped. The doctor and the embryologist differed in their opinions a bit. The doctor thought that oblong embryos aren’t super great and have less of a chance of surviving. The embryologist thought that there wasn’t enough evidence that that is the case and thought that they could survive and implant just as well as any other embryo. The doctor joked and assured us that no matter the outcome our baby wouldn’t be born with a head like Stewie from Family Guy.

I laughed that there is actually a cartoon called The Oblongs and our little oblong embryo made me think of them. I must admit that I fell in love with our little underdog unusual embryo.

They had me walk to the same top security area where I had the retrieval and I changed into the same attire. My husband then changed into scrubs complete with cap, booties and a face mask. They want to be sure that nothing compromises the embryos. I then climbed up on the table and they prepped me a bit.

Due to my endometriosis and the adhesions that come with it my uterus has been pushed and pulled to the right side of my body instead of being in the center. My right ovary was still quite enlarged and was also pushing on my uterus obstructing the view. This was making getting a good picture of my uterus impossible. When completing the transfer you have to place the embryos in an exact spot at the top of the uterus but it was hard to see where the top was. The doctor decided that retro-filling my bladder may help to push my uterus into a better position. This involved inserting a catheter into my bladder and then pouring liquid through it so that my bladder could expand more and more. It wasn’t as bad as I thought it was going to be, but it also wasn’t fun. There was then a lot of pushing on my tummy and jiggling of this and that desperately trying to get a good picture. At this point I wasn’t feeling a ton of pain but there was a lot of uncomfortable pressure. Then my cervix was being stubborn as usual and didn’t want to let the uterine catheter through. I was doing my best to relax so that my cervix would be more relaxed but being in an awkward position with all sorts of things already inserted and a bladder that felt like it was going to burst it was challenging. The catheter was finally able to be inserted and at this point I was feeling really uncomfortable. There was a lot more pushing and jiggling as the doctor and nurse did their best to find the catheter in my uterus as it was still difficult to get a clear picture. They were finally able to get things in place as best as they could and the doctor promised they were going to try to move quickly. The good thing about all of this extra time was that the embryologist was able to examine our fourth embryo and found that since looking at it the day before it had filled out nicely so she switched it out with the oblong one (I know that this was to give us the best possible chance but I have to admit that I was a little sad since I liked little oblong. They will let us know in a few days if it becomes freeze worthy. The embryos were finally transferred through the catheter. The catheter was given to the embryologist to give the all clear that all the embryos were inserted. After that the doctor used the bladder catheter to completely drain my bladder, which was actually the positive part of having had that inserted because after the transfer is complete you have to lay flat on your back for an hour and that is pretty unpleasant when your bladder is full. Feeling much more comfortable, I was transferred to a bed and wheeled to the recovery area where I chilled for an hour. My husband sat with me so we chatted and I admired how handsome he looked wearing scrubs. I was finally able to get up, change and then leave.

Our food tradition for the transfer has been chicken croquettes. So we stopped at Palace Diner (because they have yummy croquettes) and my husband ran in and got two dinners to go since I am not supposed to exert myself. I enjoyed my dinner and we spent the night watching Star Trek episodes. I was feeling pretty beat up and exhausted. I’m still sore and feeling beat up this morning and the same instructions apply today. I am supposed to laze about all day and not walk or exert myself. I have to continue the progesterone oil shots and I have two oral medications that must be taken three times a day. Now comes the worst part of the process, which is having to wait for weeks for the blood test to find out if the process worked. I do a lot of praying and try not to think too much so as not to drive myself crazy.