Femara cycle 1

Today is a fuzzy socks, sweatshirt, and pony tail kind of day. Emotionally, I’m doing ok but I’ve felt a swirl of thoughts and confusion and felt the need to “bunker down” so to speak and have some quiet, introspective time. So I just sent Chad and the girls off to church while I stay cozy at home, smelling the new fall candle I lit this morning.

Pregnancy chances aren’t looking good this month. I am on day 14 of my cycle and my ovulation kits continue to record “low fertility.” I have been taking the kits since day 9. I experienced what I believed was ovulation pain on day 10, but the kit (that’s over 99% accurate) said I must have made that up. Or the pains I thought were ovulation pains were indeed some other pain? I go in for an ultrasound tomorrow to see what is going on and if I will ovulate or not.

This is a weird experience. For the first time in my life, I feel like I’m fighting my body. It feels like we aren’t on the same page and I’m trying to force something it is no longer willing to do. I mean, they gave me a fertility drug and I’m not ovulating! How stubborn can my body be?!

As I experience this, it’s easy to really quickly become hopeless. I know that hopeless feeling is premature. We’ve only really BEGUN the assisted fertility process, but it feels like a struggle and it feels overwhelming. I’ve started to wrap my head and heart around the idea that the family that we have right now is the family that we will have. I can start to identify myself as a mother who gets to dedicate her time and energy to raising two spirited daughters. And those two girls need my time and energy.

The life I have right now is not a bad life. Not at all. It’s a beautiful life. And a lot of the time I don’t want for it to be different (with the exception of wishing Charlie were here). But then I think of never getting the opportunity to give birth again. Of never nursing my own baby again. Breathing in the intoxicating perfume of a newborn. Of having that third child in our home that I always fantasized I’d have, and I feel persuaded to pursue this fertility journey.

It’s a weird, lonely journey. I feel, for the first time in my life, that I can relate to women with fertility struggles. People close to me in my life know what we are going through, but it’s strange to carry this experience, silently and invisibly. Whereas people saw, held and knew Charlie and his loss is an overt, visible, concrete loss. It’s something I can speak to, if I chose, and it’s something people quietly acknowledge. But this…it’s just a loud silence. It’s a loud QUESTION MARK. It’s a huge unknown and feels like limbo. I can’t move forward emotionally, because I don’t know what moving forward emotionally looks like. Does it look like grieving this ambiguous loss and the dreams I had for the children I would raise? Does it mean refocusing my emotional energy on the children I have now, and not on the child I don’t get to have? Or does it mean continuing to hope and believe that we will get another child? It all just feels really messy.

The good news is, whatever happens (or doesn’t happen), I feel and believe, I am going to be ok. We are all going to be ok. We will live our life meaningfully and it will continue to be GOOD.

 

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Femara

Our fertility journey continues. Three month of un-assisted trying has not yielded a pregnancy. So we take the next step up the fertility ladder: Femara and IUI.

Last night I felt pretty panicky about this. This feels like truly “leaning in” to this experience. Both Chad and I continue to feel somewhat ambivalent about it all. We feel at our capacity with our girls, and they aren’t easy. After a hard trip with them over Labor Day to California to visit the beach, Chad and I had a serious talk about whether we really should try for another child.

A week after that conversation, here we are starting medication and embarking on a $400 procedure to try to get pregnant! It feels like a big emotional step. Both Chad and I agree that we would regret not trying for another baby. I think we’d feel as complete as we can feel after our loss, if we got to have one more child. So we feel good about pursuing this. But we never imagined we’d be in a place where we’d need medical assistance to get pregnant.

That feels intense to me. If you know me, you know I don’t like medication. I don’t even drink caffeine anymore. I very rarely take pain medication unless I’m in a lot of discomfort. So coming from that place to putting myself on serious drugs, feels scary. And the drug they put me on, Femara, is technically a class D drug. It is known to cause birth defects in rats and so contra-indicated for pregnancy. The rationale, however, is that you don’t take it when you are pregnant. You only take it on days 3-7 of the cycle and it is supposed to promote my follicles to grow and mature better. By the time an embryo implants, the medication should be mostly out of my system so shouldn’t adversely affect the fetus. That’s the idea anyway. This medication hasn’t been approved for the use of fertility but it’s been used for almost 20 years “off label” for that purpose. But still, taking a medication that puts a fetus as higher risk for birth defects FREAKS ME OUT. This medication also increases the likelihood of having multiples. I think that would put us over the edge! We just want one more baby to round out our family. I’ve learned that life doesn’t listen to what I want though.

That’s the other part of this that feels so vulnerable. Four miscarriages later, I am struggling with feeling hopeless that we’ll have another baby. There are moments when I feel more than fine with the girls we have here with us now, and moments when I feel like our family, as it is, is all we can handle. But then there are times when I ache for another baby. It feels cruel that after all we’ve gone through, we don’t really get a choice if we get to have another baby. We might not be able to and that’s the reality. How many miscarriages am I willing to go through to reconcile myself to that fact?

That’s all my rambling for today. I took Femara, the first dose, today, so here we go. Deep breaths and honest prayers.

 

Almost cancer

Today was a scary day. This summer my amazing mom discovered she had breast cancer and quickly got a bilateral mastectomy. She is recovering well and we don’t yet know if she will need chemo.

About the same time she went through all this, I noticed a lump in my own breast. I hadn’t paid much attention to it because a lot has happened to my breasts with three pregnancies and miscarriages this last year. I figured my breast was just settling after another miscarriage. But the lump didn’t go away. And then while we were on our Alaskan cruise, it actually started to hurt and bother me.

I decided it was time to take action and get it checked out. So this week I called my OB to schedule an appointment. I was pretty surprised that they got me in to see him THE NEXT DAY. I guess, “I have a lump in my breast” are the magic words to say when you want an appointment STAT! I’ve never seen my OB that fast except for a miscarriage!

When I went to my appointment, I was hoping that my OB would reassure me that nothing was wrong and that I was exaggerating what I felt to be a lump. Instead, he felt it and immediately confirmed that it was a lump. He also recommended I get a mammogram…like immediately. The nurse, who I also consider a friend, after all the years I’ve known her, immediately got to work on getting me an imaging appointment. Meanwhile, as a result of their reactions, I found my own adrenaline pumping and my anxiety beginning to throb. My blood pressure registered at 147/90, which is quite high for me (I’m usually a balmy 110/75).

20 minutes later I was sitting in the imaging department, wondering to myself, “Can this be real? Am I really getting a diagnostic screening for breast cancer?” It felt surreal and also pretty scary. I began to realize what my mom must have felt when they found her lump.

The nurses and ultrasound technicians were SUPER nice. They were so caring as they showed me to a locker room that makes you feel like you should be changing into robes for a relaxing massage, instead of getting your breasts compressed like pancakes in an imaging machine!

Due to the location of my lump (close to my right armpit) and my age (still 34 years young people!) the radiologist wanted to do an ultrasound first and then decide whether a mammogram was necessary.

The ultrasound did indeed show “spots” where I felt my lump. In fact, there were several spots. But the ultrasound technician was quick to reassure me that my lumps were actually cysts, NOT tumors. She said, “I shouldn’t tell you this, the doctor should be the one to tell you this, but I’ll tell you first, those are cysts!” And when the radiologist saw the images, he also confirmed that I simply have a “cluster of cysts” and nothing to really worry about. The cysts look HUGE on the ultrasound machine and the technician wrote down 4 cm on one of the images and I freaked out. She reassured me and said the 4 cm was about location of the cyst, not 4 cm big! It’s only 1.5cm big. But cysts…as cysts do…can change size, which is probably why I’ve noticed them lately.

The only thing that they want to do is follow up with me in 6 months to keep an eye on the cysts. As the technician put it, “We need to make sure the cysts keep acting like cysts and aren’t a tumor in disguise.” But beyond cautioning me to continue to monitor for lumps, they gave me a green light to simply move on with my life and not worry about it.

Phew!!! That was a pretty nerve wracking afternoon.

I am waiting to hear if my mom has the BRCA gene that causes cancer. If she does, then I need to get tested for that too. But besides that, I am very happy to just move on with my life!

I was slightly shaking when I arrived to the imaging department, overwhelmed by nerves and the possibility of what I would find out. I found myself also shaking afterwards and realized how worked up I must have been about the whole situation. While I felt very relieved after that appointment, I also felt sympathy for the women who attend those appointments and don’t get to feel relief. It so easily could NOT have been cysts and I would be facing a very big and different life challenge. I’m grateful that for now, that’s not the challenge I need to face in my life. My heart goes out to the women who are facing it. My respect for my mom’s bravery through all of this has also increased as a result of today.

When I came home, I fell into Chad’s arms and said, “I almost had cancer today.” I hope a day like today doesn’t repeat itself any day soon!

(In)fertility update

We finished fertility testing. If you don’t want to read the details about my reproductive system, feel free to stop reading here. 🙂 The results are both not hopeful and hopeful. They found three things about me that are “worthy of note” but only one of those things seems it could explain my recurrent miscarriages.

1. I have a genetic mutation that makes me prone to clots. This clotting gene may have explained my subchorionic hemorrhage I had at 11 weeks gestation with Cami when I almost miscarried her. However, our fertility specialist said that there is no evidence that this gene increases the risk of miscarriages. In fact, apparently 70% of Mexicans have this gene but they don’t have higher incidence of miscarriage in their population. The potential treatment for this concern is to go on heparin shots while pregnant, but as the specialist pointed out, if I had started bleeding, I wouldn’t have stopped bleeding due to the heparin and probably would’ve miscarried Cami for sure. He says heparin shots are not indicated given that I am a “heterozygote carrier” of the gene and not a “homozygote carrier.”
2. I have an underactive thyroid. My numbers fall within “normal” range but it’s not a range they want to see for someone trying to get pregnant. So they initiated me on thyroid medication and want to monitor my numbers and will give us the “green light” to try to get pregnant after my numbers are in a healthy range. So even though they want to make my thyroid more active, apparently hypothyroidism isn’t associated with miscarriages either. It’s just dangerous for the baby if I don’t have a good functioning thyroid. Although my internet searching does say there is a link between hypothyroidism and miscarriage…who to believe? The omniscient internet or our sub-specialist? Either way, treatment for my hypothyroidism is helpful and puts my mind more at ease about trying to get pregnant again, knowing my thyroid levels are in a better range.
3. Now to the reason our specialist thinks I keep miscarrying: my egg quality. Doctors can’t directly measure egg quality. They can only measure egg quantity but they know that egg quantity is correlated with quality. As our doctor said, “When you get to the bottom of the barrel, the apples aren’t the greatest.” There are four categories of egg quality: excellent, good, fair, and reduced. I am in the “fair” category. Our doctor thinks that my miscarriages might be a result of “bad eggs” or as he puts it, “You might have flipped tails three times in a row.” He thinks it’s possible for us to get a good pregnancy from trying naturally, and sustain the pregnancy because maybe some of my eggs that are left are decent eggs. But he says, given my age (approaching “advanced maternal age”) and the quality of my eggs, we need to “be aggressive.” The doctor recommends that if we don’t get a sustainable pregnancy ourselves in three months, we need to start “moving up the ladder” of more aggressive interventions, ending potentially with at least one round of IVF.

How do I feel about all this? There needs to be a word that articulates: between hopeful and not hopeful. I feel both hopeful and not hopeful. I feel like we got some answers and that there is reason to hope, but I also feel that we didn’t get a complete picture of what is going on. For example, does my egg quality explain why I miscarry at exactly six weeks gestation? (I didn’t tell our doctor that I actually had a fourth chemical pregnancy that miscarried at 6 weeks at the end of April…so is it possible to flip tails four times in a row?). And these results don’t explain the autoimmune response I have when I get pregnant (swelling fingers that resembles rheumatoid arthritis). I asked our doctor about that and he said that in pregnancy the immune system if extremely suppressed, so if I have an early stage autoimmune disorder, symptoms could be manifest at that time because the immune system isn’t up to speed to hold the symptoms at bay. That does make sense to me and while it seems to me  that a weird autoimmune response is  related to my miscarriages, the doctor doesn’t necessarily think so. It’s hard when I’ve been tested for a couple autoimmune disorders and they all come back as negative. I’m not complaining, I don’t want a diagnosis of an autoimmune disorder. But I would like to know what is going on with my body in that regard and know if there is something that can be done.  The biggest suspect for an autoimmune disorder that I could have is Hashimoto’s disease. When they were looking at my thyroid nodule, my ENT said that my thyroid looks like it has Hashimotos but the test came back negative. My swelling fingers and “lower register” voice, as well as fatigue and low thyroid numbers all fit that profile. Ugh, I’m getting bugged writing about all these medical concerns, let alone imagining how your eyes must be glazing over to read all this! Anyway, it’s a mystery yet to be solved. Maybe one day we’ll figure it out. The fertility doctor said that Hashimotos complicates pregnancy in that the thyroid needs to be monitored more closely as thyroid levels can change more rapidly and inconsistently, but I still wouldn’t need to be monitored more than once a month.

So, who knows what the future holds for us? We are going to go ahead and keep trying. If I miscarry again, the doctor wants me to get a D&C so they can collect the tissue and see if there are chromosomal abnormalities present that explain the miscarriages. He doesn’t think that’s likely though, since we’ve had three healthy babies.

What a guessing game this all is! Who knew that at 34 (I still feel young), I’d be looking at the edge of my fertility? I never thought I’d be in this place, considering significant medical interventions to help us have another baby, while also not knowing if those interventions will even help! As our doctor said, “We’ve gotten good at getting people pregnant, we aren’t nearly as good at keeping people pregnant.”

Taking deep breaths and continuing into the journey…wherever it leads us!

PS Chad’s swimmers passed with flying colors!

Cami is 3!

Despite my efforts to continue to pretend she’s a baby, Cami has completely grown into a little girl. It’s bittersweet to see her grow up! I miss my little squishy baby, but I also delight in the little person she is today.

Last night I read the post I wrote for her two-year old birthday. A lot has changed in a year. The biggest change, I think, has been Cami’s vocabulary! Last year we were a little worried she was verbally delayed. We aren’t worried at all anymore. She is speaking in complete sentences now. Some of my favorite things that she says, that I don’t want to forget include:

Cami is very independent: “My do it.”

She tells us the same story over and over again”Pon a time, big horsey by us. Big horsey eat an apple. Horsey got hurt.”

She sings I am a child of God a LOT but only these words, “Child of God, Child of God, Child of God, Child of God” in a very tone deaf, but cute way.

She’s incredibly loving, “I love you too much!”

She can count to three…and anything higher will just be a repeat of 1-2-3. For example, if she’s counting the stairs she’s climbing, “1, 2, 3, 1, 2, 3, 1, 2, 3!”

She’s the Defender in the family. If an argument is going on between anyone, she’ll advocate for the one she perceives is being picked on. “Mom, you be nice to my sister!” Or sometimes, she is the one being picked on, “Hailee, you be nice to me!”

Sometimes Cami just screams…at the top of her lungs, to express her frustration. We’re still working on teaching her to use her words.

Cami is friendly and loves to make friends, “She’s my friend” “Mimi my best friend” “Oey my best friend” “Hailee my best friend” but beware if you take something she is playing with! A serious fit will ensue!  A fit that sometimes includes hitting, but she is getting a lot better at this as she knows hitting is NOT ok, and will now mostly just angrily swat the air.

Developmentally we feel Cami is right on track. She isn’t potty trained yet, but that isn’t her fault. We have tried two separate times to potty train her and with some success. The problem has been that each time she has quickly developed a UTI in the process. This last potty training attempt was very scary for us because she got a fever of 104+ and doctors were beginning to wonder if she had a kidney infection. Our pediatrician sent us to get images of her kidneys with ultrasound. Overall her kidneys look fine. There is a tiny bit of fluid in one of her kidneys but it is so minimal that our doctor said the “fluid is not exciting” and he’s not worried about it. Her urine has “debris” in it, and we don’t know what that is about, but right now our doctor isn’t worried about that either. In a few weeks we will try potty training again. We feel some urgency about this as we hope to get Cami into preschool this year but most preschools require that kids be potty trained. The start of the school year is rapidly approaching! What is different with Cami than Hailee regarding potty training is that while Cami is developmentally and intellectually ready to be potty trained, she just doesn’t WANT to. I don’t blame her though because each time she starts using the toilet, her “bum is hurting” from a UTI. So, we’ll see how this goes. If it wasn’t for the approaching school year, I wouldn’t worry about it for awhile. Maybe we can find somewhere she can attend school and not be 100% potty trained. We’ll figure it out.

Cami finally likes being read to, which I love! We will read two to three books before naptime and bedtime.

Cami still sleeps with us every night. That was a battle we gave up on this last year…but also no longer wanted to fight. We love snuggling her! Even if it means poorer sleep for all of us. We did solve the problem of her falling asleep in her own bed. She falls asleep in her own bed just fine. It’s just VERY predictable that every night between 10:30pm and 2:30am, she will wake up and wander into our room. We will pull her into bed with us for the rest of the night at that point…and we kind of love it. In fact, many nights we end up with both girls in bed with us as Hailee has been having nightmares lately. It gets a bit crowded when that happens but we are a snuggly family and we love it!

Overall Cami is just doing great. She is growing big! She is happy, playful, loving and feisty. We love our rainbow and are so grateful that we have had her in our home and arms these last three years!

Here is an interview I had with Cami about herself for her birthday:

Favorite toy: Barbie and my little ponies

Favorite fruit: mangoes, strawberries, peaches, and watermelon

Favorite TV show: Sofia the First

Favorite thing to eat for lunch: Pizza

Favorite outfit: Lularoe dresses

Favorite game: hide and seek and tea party and potions

Favorite snack: carrots and dippy

Favorite animal: piggy and camel (that’s what she said!)

Favorite song: Child of God

Favorite book: Where’s baby’s belly button

Best friend: Mom, Dad, Mimi and Baba, and Hailee, and “Oey”

Favorite thing to do outside: ride scooter, tea parties, and pool

Favorite drink: milk

Take to bed with you: Sippy, garmy, binky and books

Favorite thing to eat for breakfast: “paincakes”

What do you want to be when you grow up: Want to go have a tea party

 

 

 

Goodbye to BYU

As I mentioned before, my personal theme for the year is “bravery.” This week, I made another brave move by quitting the job I’ve had for the last four years at BYU’s Counseling and Psychological Services. This is a decision I’d been ruminating about for over a year and was a very difficult one to make.

BYU holds such a special place in my heart. In so many ways, it is home to me. According to my math, I’ve spent 13 years of my life at BYU (undergrad, grad school, internship, and working)!

The counseling center was a haven to me after we lost Charlie. I knew then that I wasn’t emotionally equipped to return to work at Center for Change where I had worked with an eating disorder inpatient population, but I also knew I needed to return to work as I was going into a really dark, unhealthy place and needed to get out of my head.

BYU reached out to me as they were looking for someone part-time and it was a perfect fit. It felt so great to be somewhere where I didn’t have to feel so broken, and felt like I was contributing in meaningful ways. The BYU students were great to work with and I became good friends with many of my colleagues.

As the years passed by, I was also able to develop professionally. I created and co-led an experiential eating disorder group; I trained my colleagues in how to run this type of group and now there are three of these groups running throughout the year; I started a mindful eating group with a colleague and a dietitian; I led training on how to work with clients struggling with eating disorders, and I got to teach some new classes I’ve never taught before.

Over time however, my professional development slowed and there were frustrating circumstances about our workplace that were unresolvable. The main frustration was that for eight months of the year, I could only meet with my clients about once a month. This obviously wasn’t conducive to effective therapy or helping my clients overcome eating disorder and body image concerns! Given that it is my passion to be a competent therapist for treating eating disorders, it no longer felt like a good fit. Plus, I have recovered significantly in terms of my emotional reserves and feel ready to work more in depth with the eating disorder population again.

Over a year ago, my really good friend started a private practice in Pleasant Grove and asked me to join her. Like I said, I took over a year to consider this move as I love BYU and also felt loyal to them for all they have done for me. But after much thought and consideration, Chad and I decided leaving was the best move for me.

(PS, regarding the professor position I interviewed for in March…I didn’t get it. I was a bit bummed to not have that opportunity, but that interview and exploration process confirmed and solidified thoughts that it was time to change jobs).

This is a really brave step for me as I have never quit a job before! And BYU was comfortable and pretty easy (high functioning students make great clients). But I want to feel passionate and competent and I know moving to an environment where I can see my clients more regularly is the right move. Plus, I am so excited to work with one of my favorite people and build a practice with a great reputation! I also feel like there are so many cool adventures we can create together in this practice (body image and self-compassion retreat in the mountains, for example!) I am thrilled to work with one of my best friends who also happens to be one of the most competent therapists I know.

I also am exploring picking up groups for Center for Change in addition to working in private practice, but this is up in the air right now. Groups are my biggest passion and I must lead them! If I can’t work it out with CFC to run groups, I’ll be recruiting clients for a private practice group!

Another thing that feels good about this move is the flexibility and lifestyle. I am looking forward to not working Fridays anymore and possibly only working two days a week! Since we’ve been struggling with so many miscarriages, I have re-recognized how precious my time is with my kids! Cami starts preschool this year! I want to suck up as much time with them as possible and private practice will allow me to do that!

I was super sad to say goodbye to some of my favorite clients this week, but I mostly feel happy and excited to start this new adventure! So farewell BYU! God be with you until we meet again! 🙂

Spy birthday party!

Hailee, our sunshine, turned 7 last week! She is such a fun age! Usually planning a birthday party feels a bit overwhelming and the last two years we’ve had destination birthday parties after I learned the stress of home birthday parties with Hailee’s fourth birthday party. But I think, like the pain of childbirth, you forget after a couple years and it seems like a good idea to plan a home birthday party again.

I worked really hard to pull off an intricate and awesome birthday party for Hailee this week! When I first talked to Hailee about what she wanted for her birthday party, she identified that her favorite things to do are obstacle courses, scavenger hunts, and basically anything active. After ruminating about a variety of themes: adventure party, or cowgirl theme, or camping theme, I finally came up with the SPY THEME! It was perfect and Hailee loved the idea!

I absolutely must give a shout out to my partner in crime: the social media website, Pintrest. I am so glad I live in the age of Pintrest! I got 95% of the ideas for this party from this site!

We started the party with a “cadet check-in” station. Check-in was where the only hiccups of the party occurred. It was during check-ins that some random, older boy, showed up to the party with his little sister. He wasn’t invited and the mom didn’t ask me if he could stay…he just walked right in and joined the party. I was bit miffed but it actually worked out ok and the kid ended up being decently nice. But seriously people?! Invites have names on them for a reason! As part of check-ins, the kids had to choose spy agent names from a list of adjectives and nouns (like stealthy marshmallow and dark unicorn) and make a name tag for themselves. I had a “lie detector” hand scanner ap on our ipad that I used to scan about half of the kids to make sure they were all honest and qualified for spy training. I didn’t scan all the kids as chaos quickly threatened to ensue with the already-scanned-kids starting to running amok and we quickly needed to get the kids onto the next part of the adventure: spy school.

Spy school included an obstacle course, target shooting, and a grenade toss challenge. The grenade toss was a great way to cool the kids down on this hot summer day!

After all the kids graduated spy school and got their graduation certificates, they went on a “mission” to find stolen treasure and the bad guy who stole it!  In the process of this mission they had to navigate a lazer maze, find and deactivate some bombs, and solve a puzzle to know who the bad guys was!

Once they knew who the bad guy was, they had to find him and capture him! I then gave the kids “interrogation tools” to get him to reveal where he had hidden their goody bags. The kids loved dousing Chad in silly string and Chad was a great sport. After he told them where they could find the goody bags and the kids released the prisoner, we celebrated Hailee’s birthday with cake and presents.

While we waited for parents to pick up the guests, a lively water fight ensued with water guns the kids found in their goody bags. Hailee said the water fight was her favorite part! Oh the irony that her favorite part of the party was the impromptu, unplanned part! But oh well, I think the party was an absolute success!

I totally gave myself a pat on the back for this well-planned and executed party! It was stressful and barely controlled chaos, but everyone had a great time and it’s a party for the books! We had important help from our nanny, Zoe and her husband, Ryan. Zoe decorated Hailee’s cake in an awesome spy theme! And Zoe and Ryan helped set up and facilitate the different activities so that everything ran smoothly! That evening we were all happily exhausted! I’m not sure this party can be topped!