Wednesday, February 25, 2015

Epic 30th Birthday

I turned 30 yesterday.  Many months ago I told Sean that I wanted to do something "epic" for my 30th.  Kinda ironic that I said this because we're really not big into birthdays.  For us its just another day.  We dont buy birthday gifts and if we do they're usually pretty small or even gag gifts.  We make handmade cards.  But we do have cake.  Chocolate cake with 7 Minute Frosting is a MUST.  That's the only important thing for a birthday.  :)

So when I said I wanted to do something "epic" for my birthday that got the wheels rolling.  Sean suggested that I do something with girlfriends which made me think of going on a roommate cruise.  I called up 3 of my old roommates and said, do you want to go on a getaway cruise out of LA with me to celebrate our 30th?  Unfortunately it didn't work out for one of them but the other 2 were on board. 

These are my roommates from my Junior year at BYU.  We had SOOO much fun together.  Casey was my roommate since freshman year (we just hit it off so well), Liesel was my childhood friend who moved away and we reconnected when she came to BYU that year and Heidi was a random girl who lived below us freshman year who needed a new place to live so we thought, why not try it out?  We were the perfect dynamo.  We made silly music videos, we had LOTS of dance parties and spent hours sharing stories of awkward dates, boys we liked and everything else you experience in college.  

I really wanted the cruise to happen DURING my birthday but not everything can be perfect.  We left at the beginning of February.  Our getaway cruise spent a day at Catalina Island (which I had never been to), spent a day at sea and the last day was in Ensenada, Mexico.  This is our adventure....

Liesel and Heidi came from cold Utah and Montana so of course I had to take them to some good authentic Mexican.
They took every opportunity to soak up the warm California weather.

Getting on our boat was sort of a pain, it left from a different pier than it returned so we had to take a shuttle from the parking lot to our boat.

So excited to start our trip!

We had to wait in this long line to just check in.  It took us about 2 hours to get on to the boat.  Boo.

We took the obligatory muster drill in good stride.
Our comedian was racist and not funny.  Very disappointing.

We told them this was a birthday celebratory cruise so they obliged with balloons and a voucher for a treat.

This was my first time on Catalina.  There's a lot of stuff I wanted to do but was restricted because I was pregnant.  I'll have to go back later after the baby is born.

We rented beach cruisers to ride around Avalon.

We decided to go to the Botanical Gardens which was 2 miles up an slight inclined hill.  Not wanting to overdue myself, I ended up walking about half of it.

The Botanical Garden was small but a nice little escape.
The sun wasn't my friend but there is a deer in the trees.  It got pretty close to us.  I'm always surprised at how big they are.

On my to do list next time-take a tour of this historic building.

My friends obliged my museum attending desires.  This was actually a really well-done small museum about the cultural history of the island.  I also learned a bit of baseball trivia that Sean didnt know--the Cubs did Spring Training on the island which helped introduce baseball to the West.

We went to a show and it got crowded fast!  This was 20 minutes before the show even started!

One of the nights they had a 5 course meal.  It was . . . interesting.

We decided to play Jeopardy one night.  The questions were super duper hard.  We also did Karaoke one night which was . . . awkward!  They messed up our song and we didn't have the lyrics so we just danced around looking like drunk idiots.  Oh wait, we just fit in.

We went dancing on two of the nights.  We were so surprised to get into the night club to find that it was filled with geriatrics dancing to Pitbull and Lady Gaga. 
The beautiful port city of Ensenada Mexico.  I think I spent a grand total of 1 hour on land.

We asked an older gentleman to take our photo.  We told him his finger was covering the camera which he didn't believe us.

We took a photo with our old roommate Casey because she couldn't make it on our cruise.  We hung her picture in our room and thought of her often.  We wanted her to be a part of our cruise!  We missed you Casey! 

The one thing to do in Ensenada, the Cultural Center.  It used to be a Casino and Hotel in the Hollywood Days.  Now its has a small local history museum and banquet halls for receptions.

This museum had better English translations than famous museums in Europe.

We stopped to take some pictures with the locals.

Typical Ensenada street.

I used my huge vocabulary of Spanish to order Thrifty ice cream (special ice cream for those who know it). 

Liesel and Heidi wanted to get as much sun as possible so they went to a beach while I headed back to the ship.  A man asked if they wanted to ride horses and they said, why not?! 

Liesel bought some local wares for her kids in Montana.
Hard to see but there were a bunch of seals that kept swimming to this little embankment.  We figured they knew the ship would stir up food when we left.  They were very excited.

Blurry I know, but we decided to get mocktails on our last night. 

We spent some time chilling in our room reminiscing of the good ole days.
This was a great birthday celebration.  I did things on the cruise that I wouldn't have done with Sean (dancing, karaoke, acting silly again).  Even though it had been almost 10 years since we lived together it felt like we had just stepped back in time and were exactly the same.  As Liesel put it, we even have the exact same dance moves!  Thanks girls for creating a fun, epic memory for my 30th birthday!

My actual birthday ended up being fantastic too.  Sean happened to have the day off of work (how lucky that it happened to be my birthday).  We just spent the day together, sleeping in, eating lunch at a Japanese Restaurant, taking a stroll around a lake in a nearby neighborhood and of course eating cake and ice cream.  I loved just spending the day with my best friend!  Love you Sean!

Wednesday, February 18, 2015

Finally Pregnant

This is the second half of our story about getting pregnant (see first half here).   If you want the short version read just the bolded portions.

We got the news that we were pregnant.  I expected to get emotional and super excited but I wasn’t.  I remember sitting in the gardens at work and trying to make myself excited but I couldn’t.  Not because I wasn’t happy, it just didn’t seem real.  I told Sean during the entire process that I literally can’t even imagine myself pregnant.  Then I started to think about the twins that we would be having.  THEN I started to feel something.  Dread.

I was extremely nervous.  I started thinking about the money we would spend getting two of everything and then the biggest worry, C-Section.  Honestly, I wasn’t worried about breast-feeding or raising twins.  I was FLIPPED out over having to get a C-Section.  In the days/weeks that followed this is what brought tears to my eyes.  I barely could handle my shots and IV, how am I to survive (mentally, emotionally) a C-Section?

Weeks went by and during Thanksgiving while we were with Sean’s family, I started to bleed.  I immediately called the Dr who told me to go on strict bed rest and they would see me on Monday (it was Saturday).  I wasn’t worried, not because I didn’t think anything was wrong but because, as I have approached our entire infertility process, I approached it very matter of factly.  I’m cramping and bleeding and that’s that.

My appointment that Monday was Week 6.  They confirmed that I was pregnant with twins via the ultrasound but they saw that I had a blood clot.  The Dr told me to take it easy and lighten my load at work.  The truth is I wasn’t really taking it easy at work.  We were in the middle of this moving project and I felt guilty not jumping in with both feet.  I tried to take it easy over the next few days but on the following Thursday I started bleeding again.  I took Friday off from work and really took it easy until my appointment on Monday (Week 7). 

Clearly we were pregnant with twins.

At this appointment the Dr noticed that the blood clot got a little bigger.  He also noticed that Baby B looked like it had stopped growing.  When I asked him if its completely gone he said he wouldn’t make that call until 8 weeks.  He told me I needed to be on strict bed rest.  So I couldn’t go into work for the next two weeks at least.  He also told me the worst news.  I would have to get two shots in my butt every morning.  These shots were by far the biggest needles I've encountered.  I started to cry in the examination room.  Luckily it wasn't as bad as I was imagining but I was plenty sore with bruises to show for it. 

I think I figured it out that I got these shots 72 times.  Ugh.
So two weeks of bed rest went by.  I read a lot and just rested.  I didn’t watch much TV because it would give me headaches.  I was visited by a couple of friends who knew our situation and some people brought us meals.  That was the biggest help.  I couldn’t make Sean dinner and he wouldn’t come home until really late making it hard for him to make dinner.  We were really blessed with great friends.

Eating my lovely salad on bed rest.
At my Week 8 appointment he saw that the blood clot was still there and Baby B was no longer viable.  I think he was worried I would freak out because he talked to me about “what is positive about this situation.”  But little did he know, I was actually very relieved.   This was not a sad occasion for us.  I knew that we shouldn’t have done 2 embryos and this was God’s natural way of letting us get to the size of family we were suppose to have at this time.

The blood clot was there because the body was terminating baby B.  We just needed to make sure that it wouldn’t affect Baby A, hence the continued bed-rest.  The Dr also told me to expect the blood clot to come out soon.  I waited for the next week and when nothing happened I started to get pretty lax on my “bed rest”.  I just felt like everything was fine. 

Baby starting to take on form during Week 8.

At 10 weeks I saw my regular OB (I would be graduating from Dr. Naj soon).  He was really good and spent the time talking with us about all my medications that I was on and we talked about the blood clot.  He seemed less concerned about it because my placenta was getting stronger and wouldn’t be affected by it.  He confirmed my own feelings.

My graduation appointment with Dr. Naj was Week 12 and he also confirmed that the blood clot was no longer a concern.  He also ordered me off my meds immediately (YEAH!!!!).  They gave me a DVD of our last ultrasound with all my medical records and I was on my way.
Saw a lot during this appointment including the well developed spine.  Baby even sucked its thumb.  How cute!

So we are pregnant, due July 27th.  Crazy!  It’s been a four-year process and a time that I couldn’t even fathom (yet knew would happen).  There were ups and downs but for the most part we were very ok with our situation.  We approached this situation very matter of factly.  We never got angry and wondered why it was happening to us.  It was just the fact of life.  Yes it took longer for us to have a family, we are older parents than what we would like to be but throughout this whole process I have come to realize that this was the right timing for us.  I am so grateful for the 6 years I’ve had to be just Sean and I.  We honestly have the best of relationships and get a long so well which I think will really be helpful when we are raising our family.  In the beginning I would get a little emotional when I would think about the fact that I wasn’t going to be as young of a mom as I would like (for our subsequent kids) but as time passed I became really ok and at peace with the timing of it all.  The toughest part of this whole process was actually the stress of dealing with people asking awkward and unwanted questions or the insensitive things people would say.  That’s a post in itself.

From Infertility to Conception

I always wanted to share our story of infertility.  I've heard a lot of percentages out there from 1 in 10 to 1 in 8 couples face infertility issues.  I don't know if this number also includes those who have to face secondary infertility but its a real issue that affects probably a lot more people than you realize.  There are a lot of "closet" infertility couples.  We were one of those.  It was a couple of years before we told our family members and it was only in recent months did we tell other people.  Our reason for being a "closet" infertility couple was simple, it wasn't anyone's business (this is where I will give you simple advice that I wish I could go on a HUGE tangent: never, ever, never NEVER, never ever even-if-you-are-besties never ever ask someone when they are having kids (or more kids).  Just dont.  Ever.  NEVER. Got it?!)  

I've read TONS of stories of people with infertility problems and really no one had a story just like ours.  That was a little disappointing because it would be nice to know there is someone out there who experienced the exact same problems.  But it was also comforting because a lot of couples have had to wait a lot longer, spend a lot more money and had a lot more invasive problems then we did.  How grateful that made us for our own situation.  One reason why I wanted to share our story was for those closet infertility couples out there to give them another story and another set of problems that they can either identify with or get perspective from. 

Our story's kinda long, we've had a lot of hiccups.  If you're just wanting to know the gist of our experience you can read just the bolded sections below. 

About four years ago we decided to start our family. I knew we needed help in getting pregnant.  I have always had highly irregular periods which makes it near impossible to plan to get pregnant.

We were living in Glendale at the time so I went to a OB/GYN in Burbank.  When I told her I wanted to get pregnant and it was problematic because I had highly irregular periods she pulled a paper towel out of the dispenser on the wall and wrote down instructions for using Clomid on it.  Wow, she was really invested in my case.  She sent me on my way with an afterthought of getting some blood work done.  Otherwise she told me to start Clomid.

When I was almost down with my first cycle of Clomid I got a call saying my thyroid was flagged and I needed to make an appointment with an endocrinologist.  At my appointment I told her I was at the end of my Clomid cycle.  She told me to stop immediately because I didn’t want to have a thyroid problem while pregnant.  I actually felt devastated after that appointment.  I remember calling Sean, crying, tell him we’ll have to put off getting pregnant for a couple of months.  It felt like a huge set back.  Little did I know it would be LOTS of months before we would make any headway.

Over the next couple of months I took lots of pills, had an ultrasound done on my neck, went on an iodine free diet (extremely difficult especially because I wanted my salted popcorn!) and ingested radioactive iodine to take some thorough scans of my thyroid.  In the end they found nothing and sent me on my way, diagnosing me with Graves Disease (hyperthyroidism) which basically meant, you-don’t-show-any-signs-of-thyroid-disease-so-we’ll-slap-you-with-a-catch-all-disorder.   

We could have resumed but since I did not like my OB/GYN (really, writing my instructions on a paper towel?!  Geez, show some concern for your patient) and we were moving to Valencia, we decided to wait till I found a new doctor in our new area. 

This time around my Dr. ordered lots of tests on BOTH Sean and I before she would start us on Clomid (why didn’t my other OB/GYN do that?!).  She ordered a semen analysis for Sean and tons of blood work for me.  A couple of weeks later we got the call letting us know that Sean’s analysis came back with not the best news.  He had low morphology which meant he had a high percentage of misshapen sperm leaving few to be healthy enough to fertilize an egg.  With my anovulation problem compounded with this, we really needed help to get pregnant.

The Dr said the morphology could be affected by a condition called varicocele (which about 10% of all men have) and she referred him to a urologist who then referred him to a radiological urologist at UCLA.  He confirmed that it was varicocele and that Sean would need surgery.  They would insert a catheter in his vein to help with the flow of blood (apparently if the testes get too hot from back flow of blood it can affect the morphology of the sperm).  He was so nervous for the surgery but was such a trooper.  It was enjoyable to be there when he was still recovering from his anesthetics. 

Yes they went in at his neck to get to the vein around his testes, doesnt make sense but there you go.

We had to wait a while to see if the surgery worked.  About 10% of men who have the surgery don’t see any improvement and Sean fell into that percentage.  His morphology levels still put him in the infertile range. 

In the mean time my blood results came back with great news.  Other than the fact that I don’t have periods, I was great on the fertility chart- excellent quality and quantity of eggs.  My hysterosalphingogram or HSG also came back normal (they basically shoot dye in your uterus and then take X Rays to make sure there isn’t damage-it feels like you’re being blown up from the inside out in case you’re wondering).  

All those squiggly lines mean I dont have damaged tubes.  My fertility Dr. joked that I should frame this as artwork and not tell people that its my uterus, weirdo.

With all our test results in, our Dr. allowed us to go on Clomid.  This is the cheapest and easiest technique for those trying to get pregnant.  The pills help ovulation so it’s easier to time everything.   Looking back it was a waste of several months because our problems combined meant we needed more help than just a pill.  Three failed cycles later, we were on our way to a fertility doctor.

Dr. Najmabadi was the best thing that happened to us.  At the time he had a small office in Valencia where I was able to go to many appointments.  His main office was in Beverly Hills but his hours were early and he was open on Saturdays so that meant it wasn’t too much of a disruption to my work schedule to go in for appointments.  And you have A LOT of appointments.  I felt really good after my first appointment.  I knew that it would work.  I just didn’t know how long it would take but I knew we would get there. 

He suggested that we do some genetic testing to rule out anything that would cause miscarriages.  At the time it seemed like such an expense with little benefit but compared to the overall cost of the entire experience it was a drop in the bucket and I am glad we did it.  A lot of people will try to get pregnant and cant or have miscarriages then they do genetic testing and they find something that was causing those problems.  If you do the testing first, you nip it in the bud. 

I found out I only had two problems.  One was minor (as far as getting pregnant), I’m a carrier for a deaf gene.  The second was a bit more serious but not much.  I was a heterozygote carrier for MTHFR.  Bottom line, I couldn’t process folic acid like everyone else so I would need special folate and at a higher dosage.  Folic acid is important for the growth and development of your baby and it reduces miscarriages.  So I had to switch to a new (and expensive) prenatal vitamin and to start taking baby aspirin (to help reduce miscarriage).   During this time we also learned that my thyroid blood tests put me in the hypothyroidism spectrum (why the switch, I dont know).  But all I had to do was go on a pill.  Now we could finally get started.

Dr. Naj told us that his recommendation would be to go straight to IVF because of Sean’s low morphology.  We didn’t want to make that jump because it would be much costlier.  So we decided to try IUI first.

IUI is when they stimulate ovulation in the female and then place the sperm directly in the uterus.  The idea is to help the sperm on their long journey to fertilize the egg. I went on injection shots to stimulate my ovaries.  I had major problems with this. Like A LOT of people, I have an aversion to needles, but lately I’ve realized I have full blown anxiety towards needles.  Not only do I feel the needle going in but I can feel the needle in me and if it’s in me too long I start to laugh (yes weird reaction but there you go) and go extremely weak.  How on earth was I to survive shots in my leg?!

Luckily for me the first round was only Follistim, a very small micro needle in a cartridge that reminded me of an Epi-pen, which would go in my leg.  Sean was my nurse and he did great.  Although one time I forgot my medicine at work (long story) and I knew I had to give it to myself.  Sean was completely convinced that he would have to come to my work to give me the shot but I (thankfully!) was able to do it on my own (albeit I did mess up a little I was so nervous).

My easiest shot.  Small needle and in the leg.

Remember when I said there were lots of appointments with the doctor?  Well, you basically went in every 2-3 days to do ultrasounds to see if follicles were growing on your ovaries.  We discovered that the drugs weren’t working fast enough so they upped the dosage.  The follicles finally grew to a good size and then I had to inject the HCG or “trigger” shot which was time sensitive.  It triggers ovulation.  The timing is important because then you go in for the actually IUI 36 hours later (the time it takes for the egg to be released).  They had washed and cleaned Sean’s sperm and they used a catheter to put it in my uterus.  I laid on the bed for 30 minutes and then they sent me on my merry way.

It didn’t work.  AND we learned some information that would push us back a little more.  The follicles that didn’t burst forth the egg were very large still.  They hadn’t subsided.  This is a sign of Ovarian Hyperstimulation Syndrome or OHSS.  We couldn’t go immediately into another cycle because the drugs that I would be on to increase follicles would increase the already large ones and they could burst and cause other problems and ultimately I could be hospitalized.  To fix this the Dr. told me I needed to go on birth control for a month to “quiet” my body.  Another waiting period.

Finally I was able to start again.  Knowing I needed extra help from drugs, the Dr increased my Follistim dosage and put me on an additional drug, Menopur.  This was going to be a bigger shot and it had to go in my STOMACH.  Oh boy, I was flipping out.  I knew that I was just too weirded out to have Sean give me that shot so I did it myself but he was right there holding me every time.  He was such a support.  I only cried once.  

I had to mix my own medication with this one, it was fun acting like a scientist.  But not fun shooting it in my stomach.  :(

SIDE NOTE: I cried because I didn’t want to give myself any more shots.  It was mentally challenging.  Sean told me how brave I was and I immediately dismissed the thought.  Brave was fighting a huge fire-breathing dragon with only a sword.  And I definitely was NOT that kind of brave.  But then I started thinking about why fighting a dragon was brave.  It was brave because you did NOT want to be doing that, you wanted to be tucked up safe in your cozy bed.  Did I WANT to be giving myself shots?  No!  I was having mini therapy lessons right before each shot.  I realized that I was indeed brave.  I straight up faced my anxiety towards needles and ended up being shot around 120 times (some of those with my own hand).  It didn’t get easier, I just dealt with it better.  Bravery took on a whole new meaning doing those insufferable days. 

We went in again for our second IUI.  We were pros by now. 

It didn’t work.

We knew if it didn’t work that we wanted to go straight to IVF (of course with hindsight we should have done it first).  I still had OHSS so I had to wait a while before we started.  I knew what to expect from our IVF cycle because I was on almost the same medication during my second IUI.  I still took Follistim and Menopur but I had two more shots that would be added, Omnitrope (a human growth hormone and what Sean informed me is the drug of choice for athletic steroid users) and Ganirelx.  I still took my trigger shot but the next step was different. 

My counter wasn't free of drugs for several months.

Do you see that needle?!  Much bigger!

Red, white, blue and yellow pills, very patriotic.

IVF is when they retrieve the eggs during an operation and then they fertilize them with the sperm.  After they grow in a petri dish for 3-5 days they implant them back into the uterus.  We decided that because of my OHSS I would freeze my embryos and wait for a month then thaw the embryo and implant. 

I was really nervous for my egg retrieval because it was a legit operation.  I wore an operation gown with booties for my feet and a hair net.  I had to get an IV for the anesthetics which I DID NOT enjoy.  My defensive mechanism is to laugh (remember?) so I think I weirded out the anesthesiologist.  The operation was short and I recovered extremely well.  We also got great news that they were able to retrieve 41 eggs!  That is pretty much unheard of.  They immediately fertilized them and the Dr. called me every day after that to tell me how many fertilized and how many were dividing.  By day 5 we had 13 (yes a big drop but still a VERY good number) and on day 6 they were able to freeze 2 more.  I had 15 little embryos waiting on ice for us.

During our waiting period we had a huge decision to make.  How many embryos were we going to implant?  Most IVF patients start with a fresh cycle and they put in 1-2 embryos.  If it doesn’t work they can try a frozen cycle and usually they put in 2-3.  These numbers are based on what infertility problems the couple are facing and how well they think the body is going to accept the embryos.  Since we didn’t do a fresh cycle we had no idea how well my body would accept the embryos.  I knew for sure we didn’t want to do 3 embryos but did we want to do 2?  It was a huge debate that we kept going back and forth on (good thing we had such a long waiting period).  Ultimately we decided on 2 embryos because as Sean put it, we didn’t have the money to do it again immediately and what would we rather have, two kids or no kids?  I was nervous about it, but 2 it was. 

After our waiting period we went in for the transfer.  Our embryos thawed perfectly and it was a go.  It was similar to the IUI but the placement was different.  They had to use a special catheter and ultrasound to guide the embryos to the magic spot. It was a bit painful because my cervix was not in the best position for the procedure so the placement of the catheter caused moderate cramping.  But it was really cool to see the two embryos squirt out of the catheter into the uterus via the ultrasound.
One of the two blastocysts that we implanted.
The two white spots are the embryos.  You can see the tip of the catheter touching the bottom one.

Now it was the waiting game again.  It wasn’t hard at first to wait.  We had to wait a full two weeks to come back for a blood test.  Around day 8 I started to get nervous.  I was getting anxious and wanted to know.  By day 10, I made a decision.  Day 10 was when we were tested when we did IUI so I didn’t see why we couldn’t do home pregnancy tests now.  Sean was opposed to it at first because he didn’t want it to be not accurate.  I knew whatever the result would be that I would take it with a grain of salt.  We did three tests over the next three days (I found some old ones under the counter) and they all came out positive.  I wasn’t feeling any symptoms so it was hard to believe.  I went in to get my blood drawn and they gave me a call later and told me not only was it positive but the numbers indicated that both took.

We were having twins.

Continue to the next blog post to finish our story or click here.