NFP... When There's No Chance of Conceiving "Naturally"

With it being NFP Awareness week, tons of Catholic writers are discussing NFP, from explaining why newlyweds are afraid of the wrong thing, to when is it licit to use NFP to avoid, to what NFP actually is. It reminded me of this discussion that Amy started, about what might persuade more people to try NFP/NaPro. Many of the commenters focused on emphasizing the "natural" aspect, how it doesn't involve putting "chemicals" that could be carcinogenic into your body. (As a chemist, I take issue with how those words are sometimes misused, but that's an entirely different post.) Kat raised the issue of how NaPro uses many of the same medications that a reproductive endocrinologist would use to treat infertility, which doesn't fit the "natural" aspect being emphasized. Someone may have asked something to the effect of "does it really matter if it's a NaPro doc or an RE who puts you on Clomid?" I know someone else in the discussion said that women struggling to conceive just want a baby and don't necessarily care about treating the source of the problem.

Maybe I'm weird.... hold that thought, I know I'm weird. However, I also don't think I'm the only woman who was diagnosed with "unexplained infertility" and was frustrated by the lack of answers. (I've talked about this with a friend who saw a different RE in the same practice and was also labeled unexplained.) Maybe it's all those years of scientific training, or maybe it's just my personality, but I knew something was wrong, and I wanted to know what it was. Contrary to some of the comments in that discussion, I don't think RE's are skeevy or only out to make money; there are good and bad doctors of every stripe, just as there are good and bad lawyers, auto mechanics, etc. (There are probably even some really good people that are used car salesmen, despite all the jokes.) We had a really great RE, who we worked with for about a year and a half. Before we started seeing her, I was convinced that something would show up in the tests (probably my thyroid), and we'd be pregnant in no time. Getting hit with the diagnosis of unexplained infertility was a major blow, but we trusted our doctor. After 9 rounds of Clomid, we were given the option of switching to Femara, which might or might not improve our chances, or moving to injectables, which she thought would improve our chances, but would cost about $5,000 per cycle. Femara was described as more of a lateral move, whereas the injectables would be stronger medicine. That was the point where we decided to switch to NaPro. We were both fed up with the lack of answers, side effects, and "just push harder" mentality. (Our RE was interested when we gave her some information on NaPro and wished us well; there was never any hard sell or strong push to do IVF. She asked us to send baby pictures; I'm still hoping that some day we will have pictures to send.)

Here I am, approaching a year after our first NaPro visit, and I'm on more medications and supplements than I was with our RE. I'm even back on the same dose of Clomid as I was with our RE. Is there a difference? Does it matter who put me on 50 mg of Clomid CD3 - 7? I would say yes. In our RE's words, her approach was about "pushing the reproductive system harder." I can, and do, grumble about my growing list of diagnoses, but NaPro has truly focused on identifying the problems that I have and specifically treating them, not just pushing my body harder. If it weren't for the extended hormone profile that NaPro does, I would be at a much greater risk for an early miscarriage (or implantation problems). There are times I wonder whether my estrogen and progesterone levels dropping prematurely contributed to our early loss; I feel confident that if it did, the post-peak HCG that I am on will provide the necessary support for the beginnings of pregnancy if we conceive again. 

With my long list of diagnoses and medications, there may not be much "natural" about our NFP-coupled attempts to get pregnant, but it has made me much more aware of my fertility and health. (I think there's a lot to be said for re-branding NFP as Fertility Awareness.) I can't say that I am super hung-ho about NFP and plan to chart forever; if/when we stop trying, I may stop charting, but I would certainly recommend NFP to both couples of normal fertility and infertility. 

Simcha's week of giveaways continues, here and here. And that's another reason to be happy for NFP! (Who doesn't love free stuff?)

Little Happies (1)

Apologies to all my gluten-free friends, but this week's Little Happies features quite a few gluten containing foods (feel free to skip this post!). Since I have returned to eating gluten, Husbandido has been eager to treat me to many of the foods I missed.

1) Sarris Chocolate Covered Pretzels

Before going gf, chocolate covered pretzels were my absolute favorite candy; they have the perfect mix of salty and sweet, and Sarris chocolate is wonderful. (They do make a gf version, but the pretzels were just a hair too crispy and not salty enough. Plus, they're $17.)

2) Pizza Hut Stuffed Crust Pizza

This picture isn't actually of the pizza Husbandido surprised me with last Tuesday; ours was pepperoni and sausage. Beside making a yummy dinner, I had leftover pizza for lunch most of the week! (Husbandido had tried repeatedly to make me a stuffed crust pizza, but the cheese usually leaked out a little. The best pizza crust recipe or mixture we found that was gluten-free was Cup 4 Cup, which is pricey, but worth it for a special treat.)

3) Saturday morning I woke up to breakfast in bed... of Chik-Fil-A Spicy Chicken Biscuit and Hash Browns. Husbandido thought I might be super hungry, so he got me two. The second one reheated really well, and we split it for a fast breakfast on Sunday. Previously he had tried to make a gluten-free version, but the problem was getting the chicken right. 

4) I don't remember exactly which day it was (might have been the weekend before the one just past), we went out to eat at Red Lobster. We hadn't been there since I went gluten-free. Those biscuits are so good! (And again, I had plenty of leftovers to make lunch for both of us the next day. Yay for easy meals!)

I will now cease taunting you all with gluten containing foods that you can't have. (And I'll get my final GF product review post up soon!)

5) Synthroid - I know there are some people who think that Armour is the only way to treat hypothyroidism, but Synthroid has been a miracle drug for me. I have the energy to do things again (including deal with a downed tree), and I've lost 5 pounds in the approximately 2 weeks I've been taking it. I'm keeping a close eye on the weight loss, especially since losing too much too fast is problematic. I also have a definite idea of how much is too much to lose, though it is fun seeing my Wii Fit Mii shrink.

6) Free stuff! Who doesn't love a good giveaway? In honor of NFP awareness week, Simcha Fisher is hosting major giveaways, including a copy of her book. Here's the post for today's giveaways. (I know, I know... we may all be a lift too aware of our fertility or lack thereof, but not all of the items are fertility related.)

Accepting a Gift as Given

The phone rang; I didn't recognize the name or number on the caller ID, so I handed the phone to Husbandido. (I intensely dislike talking to strangers on the phone. I have no problem happily chattering away to friends and family on the phone or talking to strangers in person. Just one of my many quirks, I guess.) I went back to doing whatever it was that I had been doing; washing and putting away dishes, I think. He seemed to be on the phone a while, though, so I quietly asked him who it was. It was that older couple from church; they had seen us at Mass the previous Sunday but hadn't had a chance to come over and see how we were doing, so they called. It could have seemed nosy (or nebby, as Pittsburghers would say), but it didn't. Their compassion and willingness to support us and suffer with us leaves us feeling more like we have a third set of parents. They are truly living out a spirit of adoption, which is a tremendous gift to us. Especially knowing how many others suffer from a lack of support, we acknowledged how fortunate we are to have generally supportive family and friends.

It got me thinking about some of the other gifts we have been given by family and friends. A while ago I was chatting online with an old friend. We've known each other since high school; there have been times that we were very close and times we haven't been as close, but we have managed to maintain our friendship despite very different directions our lives have taken. I was telling her about our IF struggles and some of the side effects I've been going through. In the middle of our discussion, she volunteered to serve as a surrogate for us (I think her words were "As far as I know, I have a perfectly good womb that I'm not using."). My response was a simple "thank you." While we wouldn't use a surrogate, what she was really saying is "You're my friend; you're hurting, and I want to help however I can." To her, this was something she could do to help. My friend isn't Catholic, and it wasn't the right time to get into the reasons why we wouldn't use a surrogate. It was the right time to acknowledge and appreciate the gift she was offering. 

It's the same type of gift we receive whenever someone offers to pray for us. Regardless of whether they're Catholic, or even Christian, their offers of prayers are a gift; they are trying to intercede on our behalf with the divine, however they see it. Months ago, when talking to an old friend (and former fiancé, but that's an entirely different story), we were comparing notes on our fertility problems. He and his wife have tried twice, gotten positive pregnancy tests twice, and twice had the pregnancy be a anembreyonic (a blighted ovum). He would like children, but his wife is reluctant to try again. It got to the point where they were living more like roommates than spouses, to the point where he considered divorce. They managed to improve their relationship, and he concluded that he wouldn't find someone else who suited him as well as his wife and that a disparity in their desire for children wasn't reason for divorce. Though he was obviously hurting from their situation, he listened and offered compassion for what we have been willing to do in our attempts to have children. He asked if I was okay with him praying to his deity for us (he is now pagan, was formerly Catholic). It wasn't the time or place for a theological discussion, especially not one of whether Catholicism considers pagan gods demons. Prayer was one of the few things he felt he could offer. (That doesn't mean I can't hope and pray that he will someday return to Christ, which is, again, an entirely separate issue.) Saying "Can I pray for you?" is really a way of saying "I care and want to help."

We finally received the results of the re-test of my thyroid. Back in September my anti-thyroid antibodies were 288.8, where normal is 9.0 or less. Because of those levels, consistent with Hashimoto's thyroiditis (a diagnosis I had been given previously), our doctor recommended I go gluten-free, which he expected would bring that value down. Upon re-test, after 9 months of being gluten-free, my anti-thyroid antibodies were 287.6, which isn't an appreciable difference. To say that I had mixed emotions at that result would be an understatement. I hadn't felt any different after going gluten-free; while I had lost a few pounds, the results had generally been underwhelming, compared to the results others have had. After some debate, we decided that I should go back to consuming gluten, since removing it had not had much effect. In some ways being gluten-free worsened my eating habits, as it became the focus of what I could and couldn't eat. I had expected being gluten-free to help, but I am trying to see the lack of effects from it as a gift. I am now much more focused on portion control and generally eating better than I was before. I could be upset about the lack of results - I wasn't the biggest fan of going gluten-free; instead I am choosing to take it as a gift, of again being able to eat food that I missed. 

Blerg...

I got my P+7 blood work results yesterday. Of course our doctor is on vacation this week, so I have yet to hear his interpretation, but I can't say that I'm thrilled. For my own reference, I decided to compare them to the last couple of months, where he has been happy with the results. If anyone has any wisdom to share, I'm eager to hear it (for reference, this was on 25 mg Clomid and 2,000 IU HCG P+3,5,7 and 9). I was told to do the blood work on P+6 if P+7 is a Saturday and Monday if P+7 is a Sunday. I'm suspecting that there will be messing around with dosages either for next cycle or after surgery. Granted, I was a bit of a stressed out mess this past cycle, but that estradiol level looks low to my untrained eyes. 

                             5/1             5/30        6/30
Estradiol            15.20         21.03       9.52
Progesterone     37.9          23.1           20.8
Actual CD           P+7          P+6           P+8

Adopt-a-Blogger: July

First of all, if this is your first visit, courtesy of Amy's Adopt-a-Blogger program, welcome and thank you! I cannot begin to describe how much this means to me, and it could not come at a better time (but I'm getting ahead of myself here). If you're curious about the name and heading picture, I explain in my Welcome to Chateau d'If post.

Background: Husbandido and I first met in the summer of 1999, though we didn't start dating until 2007, partly because he looked really young (like 12, though I assumed he was an undergrad) and partly because he was trying to get his life in order. Having known each other for so long before we started dating (and the fact that we covered religion, politics, and children on our first date probably helped, too), we went from starting to date to married in 13 months. I turned 31 on our honeymoon. Four months after our wedding Husbandido lost his job; in addition to losing his income, we were also suddenly faced with bills for COBRA and his tuition (which had previously been covered by his employer). I was working in a temp position, and we didn't know how we were going to get by. It wasn't until March 2011, almost three years after we married, that we started TTC. Though Husbandido had not yet found a job, he had completed his degree in computer science, and we had both felt nudges from the Holy Spirit that it was time. We had learned sympto-thermal NFP shortly after we were married, so I started to get concerned after about 6 months of TTC. (The fact that 35 was starting to loom didn't help.) We started working with a reproductive endocrinologist (RE) in November 2011. We had a positive pregnancy test my third cycle on Clomid, October 2012; unfortunately the pregnancy proved nonviable.

Diagnoses: According to our RE, we were "unexplained," which frustrated me to no end. On the other end of the spectrum is our NaPro doctor; it seems like every time we talk to him, I gain at least one more diagnosis. The current list includes vitamin D deficiency, iron deficiency, poor quality ovulation, type 3 luteal phase deficiency, and, as of our last appointment, probable endometriosis. 

Plan: Now that you're all caught up on our background, the reason that this couldn't come at a better time is that our NaPro doctor thinks that the next step is surgery, which is scheduled for August 6.  Today is my final HCG shot of this cycle (P+9); based on my last few cycles, I expect CD1 to be around July 6. Based on that assumption, we may have one more cycle left before surgery. I'll be on 25 mg Clomid (CD3-7), Biaxin (CD7-20), low dose naltrexone, and HCG post peak (P+3,5,7, and 9) for the fifth time. Barring a miracle positive this cycle or the next, August 6 will have me in Columbus for a laparascopy and selective hysterosalpingogram. I'm not enthusiastic about having surgery, but at this point, it is our best chance at success. As much as I would love to be one of the stories of women who end up pregnant right before surgery is scheduled, I'm certainly not counting on it. As we prepare for my surgery, please pray that I may find peace in the decision and that we may have the grace to accept whatever may come. 

My Blisters Have Blisters (And Other Unhappy Moments)

It's been a rough (checks calendar) almost three weeks. This stretch started June 8, when a 2 ww ended, reaffirming my infertility on the day I was having Mass said for all couples suffering from infertility and miscarriage. (Was it ironic or just appropriate? I have yet to decide.) On top of that, a family with five children, where the wife/mother looked almost a decade younger than me, came in late and sat in the pew right in front of us. At the end of Mass as they were filing out, the mother left first with the first couple of children, then the dad and the other two older children; it almost looked like they were leaving the baby behind. (Of course they didn't.) Normally I prefer not to bawl in public, but there was no stopping it. I just turned and buried my head in Husbandido's chest, sobbing. It wasn't pretty, and boy did I need to clean myself up afterwards. The one semi-redeeming moment came as we were leaving; an older couple that we had met during the Seven Deadly Sins, Seven Lively Virtues program during Lent came up to talk to us. To have them truly grieving with us, offering comfort, made a world of difference on a difficult day. As the young family that had sat in front of us walked out, this older couple approached them, let them know that we had requested the Mass, explained that them sitting in front of us was difficult, and asked them to pray for us. It's certainly not something I would have done; they did absolutely wrong (in fact, Husbandido later commented on how good of a job they are doing; the kids were following along, mostly paying attention [no snacks, toys, etc]), but it felt so good in that moment to not be invisible, to have someone acknowledge and recognize our suffering. And it never hurts to have more people praying. (How many people bother to read the bulletin for the Mass intentions, I do not know.)

Around that same time, my aunt caused a whole bunch of drama by announcing (less than two weeks in advance) that the Saturday picnic at the family reunion would be potluck. And by the time I got the e-mails (we had been at a dance class), there were already more than 10 e-mails, claiming all the easy stuff. I was pissed off to no end because attending this family reunion was already costing us a lot, and I had to bring my own food for much of it. Now, I was being asked to also bring food for 24 that somehow would not spoil or melt despite the fact that we were traveling 10 hours, spread out over 2 days. It would probably be accurate to say that I threw a gigantic hissy fit. To be honest, I was not enthusiastic about going in the first place. At a previous gathering my grandmother had explicitly commented on how seeing the little ones was the most important part. (Mmmmkay, so I'm traveling 10 hours and spending hundreds of dollars why? Yeah, yeah, yeah... good old guilt. My grandmother turned 89 this year, so there is not guarantee that she will be around much longer; I would feel horrible if she died, and we hadn't seen her in over a year.)

Somewhere in there, Husbandido's sister caused a stir on that side of the family by suggesting, a week before Father's Day, that there should be a fishing trip for Father's Day and that her husband was out of town for work, so somebody else should organize it. Oh and that there should be going out to eat, never mind that we had previously arranged with Husbandido's parents that we were making enchiladas. Yeah... Eventually that got scaled back to bowling, but all the last minute decision making was driving me bonkers.

In the midst of all that, I managed to get royally mixed up about when our follow-up with our FCP was, missing the appointment and effectively doubling the cost. (No, I didn't have anything else I might have wanted to do with that money, really.) It didn't help that my phone and computer weren't playing well together with my calendar, which still haven't completely fixed.

Father's Day itself seemed like it might not be too bad, except I wasn't feeling very well. Queasy just doesn't do good things to my patience levels. And of course that would be the day Husbandido's oldest brother's wife (one of these days I really will put together a cast of characters post, to better keep track of who is who) brought up politics and then tried to bait our MIL about the Pope changing everything, especially with regards to gays. Needless to say, my patience for such things was nonexistent. I kind of injured Husbandido digging my nails into his hand about the political discussion, but totally erupted over the whole "the Pope is changing everything" thing. Yes, the Pope did say "Who am I to judge?" but that was in the context of someone who is genuinely seeking God and trying to live a holy life. (I get really sick of people playing gotcha games with what the Pope has said, speaking off the cuff.)

Last Wednesday we were scheduled to have someone come in and fix our bay window, which  keeps fogging up; of course the only time he could come was the first time in 5 months that I was scheduled to have my hair done. I initially canceled the appointment, then got into an argument with Husbandido because he didn't want me to cancel the appointment. He ended up calling the salon back to see if I could have my appointment back; I felt bad for the poor receptionist. He took a half day, and I had my hair lopped off (and colored). I do mean lopped off; it was past my shoulder blades, and now it's short. Not chin-length, not a bob, but short short. It's taken me a little while to get used to it, but Husbandido and everyone else has liked it. (And really, why does it take longer to style short hair than long hair?) 

Thursday I got up horribly early to drop Husbandido off at work, then come home and finish packing. An accident on I-79 meant I was late for picking him up from work and thus late for our rescheduled follow up. Fortunately our FCP didn't mind too much. Then our journey took us to Columbus, in anticipation of an 8:50 doctor's appointment. After not much sleep, we got up and headed to the doctor's office, only to find out that he was tied up with a delivery. Our appointment was moved to 10:00; I made sure that they now had my cell phone number, and we went for a walk. While we were walking around I got a call saying that the appointment would have to be moved back to noon. I wouldn't have minded quite so much except we had stayed overnight to be able to make the appointment (traveling for 3 hours before a 9:00 am appointment was not going to happen) and we had 7 hours drive to get to the family reunion afterwards. I think I ended up getting a bit sunburned as well as developing blisters in our three hours of walking around. Graeter's Ice Cream was wonderful, as always. Somehow it seems like every appointment we have with our doctor there is a bombshell dropped. This time he announced that he thinks there is a 60 to 70% chance that I have endometriosis, and it's time to schedule surgery. Part of me is resistant to the idea that have endometriosis; I have no family history of it, and I don't really have any of the symptoms (except infertility and possibly long periods). This will be my fifth surgery total, and I'm not particularly enthusiastic about getting cut open again. It doesn't help that I tend not to do well with anesthesia or strong pain meds. (It would be an understatement to say that I dislike throwing up.) 

We didn't get to my grandmother's in western central Illinois until late in the evening. I will say that I ended up making something of a dramatic entrance; my mother asked if I had had my doctor's appointment (she hadn't listened to any of the 5 voice mails I had left), and I promptly announced that I was having surgery in early August. I'd call that an entrance. Plus there was the whole lack of hair thing, too. Saturday was the picnic, which went well despite the heat and humidity. We had brought charcoal and bought sausages at the local grocery store. I had been volunteered to run the gag gift exchange, which most people enjoyed. It wasn't until Saturday dinner that I ran into problems. It started with my aunt mishearing something my oldest cousin's wife had said. My aunt then asked for clarification, wondering if she had missed that my oldest cousin's daughter was getting married. His wife answered not with a "no," but with "She has all the time in the world." Having just been told that my age was a risk factor for endo, as well as freely acknowledging the decline in fertility that comes with age, I took issue with that. Sure, if she doesn't want children, she has all the time in the world. But if she wants children, she would do well to be aware of the strong correlation between age and infertility. I got a bit heated about the topic, especially since my cousin's wife seemed to have sympathy for our plight (and yes, I got into the doctors, costs, surgery, that insurance covers next to nothing). Now granted, some of that may be related to the fact that cousin and his wife wanted to borrow money from my parents; my parents would have lent it to them, but they would have had to learn about managing money and get better at it. Said cousin and his wife have been pissed off at my parents ever since, and that happened several years ago. Walking around after dinner Saturday was when my blisters grew baby blisters. Sunday lunch was the final event of the family reunion, and the focus was clearly on the great grands. It's getting a little easier for me as they grow and develop more distinct personalities. The drive back was long, but spending roughly 22 hours in the car between Thursday and Sunday will do that to you. (And of course, in the midst of all this, Sunday was peak day.)

Oh, and to top things off Husbandido's family has a huge family and friends cookout on the Fourth of July, and of course, the little ones are always the center of attention.

Thank you for putting up with my whining for so long! I'll try not to complain so much next time.

Sacrifice

I was 17; it was my first trip outside of the U.S. I was with a group from my high school, partnered with students from two other American schools. Of course we saw Paris, Versailles, the Loire Valley, the Bayeux Tapestry, Mont St. Michel, Monmartre, and Notre Dame de Paris. As much as I loved the churches and castles, full of history and intrigues, what struck me the most was the American Cemetery at Normandy. Words cannot begin to describe the sight of row after row of white crosses, almost as far as the eye can see. An occasional Star of David interrupts the rows of white crosses. Even pictures struggle to capture the enormity of the cemetery. According to the American Battle Monuments Commission, 9,386 Americans are buried in the Normandy cemetery; 14,000 others were originally buried in the area, but their bodies were returned home at the request of their families. At the base of the monument there was a slip of paper encased in plastic listing the names and ages of young men who lied about their ages in order to be able to enlist; the youngest was 12. It was just two weeks after the 50th anniversary of D-Day; the welcome the people of Normandy gave to even American students was humbling. As we visited the D-Day beaches, museum, and cemetery, we encountered a few veterans, their memories and pride clear on their faces. 

Twenty years have passed, and I am still very much in awe of those young men, most them younger than I am now. Though they were scared, they followed orders, did what needed to be done. How can we not be humbled by their sacrifice?

Would You Be A Grandfather Today?

Fifty years ago you took these beaches,
From the Nazi Germans who had taken France,
You died here, in Normandy, so very far from home.
My grandfathers fought this war, too,
But they survived, returned home, raised families.
Would you have done this, too?
Standing here, looking at your marble crosses, 
I realize that had they not survived, I would not be here today.
If you had survived the D-Day beaches,
Would you be a grandfather today?                        
                                                                            6/20/1994