One Year

I just realized that it has been a little over a year ago that I began this blog. Time sure does fly, even when you're in the midst of an unwanted struggle. I have continued to grow over this past year and continue to see God's goodness in allowing this struggle in our lives. Maybe I'll take some time later this week to write more about this, but I am finally getting to the point where this journey with infertility has become so vital and indispensable to my spiritual growth that I thank God for it. Am I still heartbroken each empty month? Of course. But am I recognizing that God's goodness is seen in how he is changing us through these trials? Absolutely.

I can and will make it through this week. I will, I will!

Distractions please!

Last Saturday was my IUI, so one week down, one week to go before we get to see if it was successful or not. We felt really good about the procedure, especially the timing. We were so glad that the office was open on Saturday, as waiting until Monday just didn't seem to be an option.

I spent the last week visiting Kelly, which proved to be a wonderful and fun distraction. However, all good distractions must come to an end, so on my way home, the pain game began. Many people have told me not to stress too much when I feel cramping, but it is really hard not to do that. If there is any positive thing that has come from going through this infertility struggle, it is that I have learned about my body very well. I know every twinge, cramp, and bloat. I know the difference between ovulation pain and pms, regular cramps and progesterone-induced cramps. As much as I want to believe that this pain could be related to a pregnancy and not a menstrual cycle, I can't. The only thing I can do is distract myself from the cramps, so I can get through this week without melting down prematurely.

It seems the word "distraction" always connotes something negative, but sometimes, distractions can be positive. Distractions can force us to stop thinking about ourselves and our situations for a moment and focus on someone or something else. This week, then, I'm welcoming the distractions! I want to sew and think about the person for whom I'm sewing, play piano and sing, spend time with family and friends, get out of the house, read a good book, and do anything else that happens to come my way. As long as I allow God to be some of my distraction, I'm pretty sure He is all right with it this week :)

Thank you so much for keeping us in your prayers. I know many of you are right there with us, waiting impatiently to find out if this month is the month. The burden of this struggle has been lightened because of you and your love for us.

#4 or more accurately #1

We are on our way to having our fourth IUI done. Just a recap: last week I went to my doctor to see how my first month since the surgery was looking. Overall, things were positive except for an unwanted cyst on my left ovary. Because it was just a normal cyst and not an endometrioma, my doctor said we could go ahead and do the medicine.

I took 50 mg of Clomid on Days 3 through 7 on my cycle, which would help with follicle development. Sure enough, I found out at today's appointment that I had a few follicles, five total, though only two of them were big enough to mention. Both are on my left ovary, which is good since that is the ovary that didn't have the giant endometrioma removed, and overall my left ovary looks a bit healthier. The two follicles were right around 18 mm which is not ideal but decent. Also, even though that cyst isn't gone, it is far enough from the follicles that my doctor said it wouldn't impede ovulation. The next step is to wait another day to give my little tiny follicles time to grow, do the Ovidrel injection tomorrow night, and then head to the doctor Saturday morning for my IUI.

I am very excited about all of this, and I am just getting more and more excited as the day goes on. At first everything just felt like it always does. Just another doctor's visit. Just another IUI. Then I realized this isn't "just another" anything. This is the first time I've ever had a healthy and happy body! For all I know, this is the first real chance I've ever had at conceiving. So, this IUI is not just another one. It could be the one. So exciting.

Here we go again!

It's been nearly five weeks since the surgery. Amazing! I am on Day 3 on my new cycle, so this morning we headed to the doctor to find out how things look and if/when I can start treatment. Besides feeling like a guinea pig for the new ultrasound machine at the office (along with Robby and me, there were three other people in a tiny closet sized room learning how to use the machine), things went pretty normal. There was one cyst on my left ovary that my doctor was a bit concerned about, mostly because it's larger than what he would like to see. The good news is it doesn't appear to be an endometrioma, but just a regular fluid-filled cyst. This does mean that this cycle of treatment is going to be less aggressive, which is fine by me. Instead of taking 100 or 150 mg of Clomid a day for five days, I am only taking 50 (one pill). I'll go in next Wednesday for another look. If things appear to have gone well and I produce good follicles, I should be able to do the Ovidrel injection that night and have the IUI within the next couple days.

Thanks for your prayer and concern today!

A Lesson in Hope

This morning, we are headed to my doctor to have my first ultrasound since the surgery and discuss our next course of treatment. We don't have to leave until 9:30, so my hub is catching up on his sleep, and I'm getting a few moments to pray and read.

I read Psalms 4-6, and once again I am amazed by the mystery of Scripture. How does Scripture speak so appropriately to each of us in the very moment we need? I am sure I've read these Psalms before, but I have never noticed the emphasis on hope.

Psalm 4 begins with David saying, "When I called upon Thee, O God of my righteousness, Thou didst hearken unto me." David recognizes in these first verses that God has heard Him and God has saved Him. Later he then says, "Sacrifice a sacrifice of righteousness, and hope in the Lord. Many say: Who will show unto us good things? The light of Thy countenance, O Lord, hath been signed upon us; Thou hast given gladness to my heart." He ends the Psalm with this: "For Thou, O Lord, alone hast made me to dwell in hope."

Psalm 5 continues in the theme of trusting and hoping in the Lord. David contrasts the man who is hated by the Lord with the man who is shown mercy by the Lord. David says, "And let all them be glad that hope in Thee; they shall ever rejoice, and Thou shalt dwell among them. And all shall glory in Thee that love Thy Name, for Thou shalt bless the righteous."

Psalm 6 seems to begin with a different emphasis, but really it is simply David in his weakness crying out for the Lord to save Him. Again. By the end of the Psalm, he again knows God has saved him and heard him: "The Lord hath heard the voice of my weeping. The Lord hath heard my supplication, the Lord hath received my prayer. Let all mine enemies be greatly put to shame and be troubled, let them be turned back, and speedily be greatly put to shame."

I said these psalms were mysteriously appropriate to me this morning, and this is why: I have been thinking a lot about hope. I've been asking God how I am supposed to do this thing called "hope" - how do I have hope about a baby when I know that there is the possibility that it may not happen? How do I live in hope of a future when plenty of women have remained infertile after these treatments?

These verses reminded me of something. I hope in the Lord. My hope is not in a baby or in an outcome. We are unlike the world because our hope is unlike the world's. We hope only in one thing -- the Lord. And about the Lord we know this: He is good. He makes us righteous. He never leads us to evil. He never troubles us. He never leads us to shame.

When I begin to hope in an outcome, I begin to temper my hope because I don't want to be let down. Hoping in an outcome always has the possibility that we will be disappointed. The beautiful thing about hoping in the Lord is it doesn't have to be tempered with reality or lessened with caution. God will never let me down. He will only lead me to good. He will only lead me to righteousness.

And so I hope in the Lord and only in the Lord. I know He has brought me to the place I am today. I know He has guided each of my steps and has loved me and refined me as I've walked in them. I know He is with me this morning, will be with me at the office, and will continue to be with me every day of my life. And I know He only has plans for good, not evil, and never shame.

For thou, O Lord, alone hast made me to dwell in hope.

Results!

Today was my post-op appointment, so here is a quick summary of what my doctor shared with me. Some of it's review from what he told Robby, and some of it's new. Although he did have pictures to show me, I didn't push to have copies made because, to be honest, even I didn't really know what I was looking at. It was just a big gross pink mess.

• There was Stage 3 endometriosis around my ovaries, and my right ovary had a large endometrioma, which is a fluid-filled cyst. He explained again that my ovaries were immobile because they were stuck to my abdominal wall.
• Because the endometrioma on my right ovary was so large, the ovary looked pretty beat up after the cyst was removed. He said they had to remove the whole cyst, including its lining, so there is always a risk that a few eggs are taken with it. (Sad, right?) If they didn't completely get the cyst out, though, it would return in a month or two. Because removing of the cyst causes bleeding, he had to cauterize the outside of the ovary, so it looked black and misshapen. However, the amazing thing is that the ovary will heal itself between 2 and 4 weeks, so there's a good chance at this moment it's looking fine.
• There was a little bit of endometriosis on my bladder wall which would be at a stage 1. It was interesting to see the difference between the two: my ovaries were covered with endometriosis, but my bladder had only tiny dark dots here and there.
• My uterus was healthy, and both of my fallopian tubes were clear, as well. They did the same HSG test that I had done in 2009, which at that time had come back with the results that one tube was clear but one seemed slightly blocked. This was good news to hear that both looked great.
• Some other interesting things: progesterone can control the spread of endometriosis, so that is why a pregnancy will at least stall the endo from coming back. This could also explain why birth control is used as a controller for endometriosis and often helps make severe menstrual cramps milder. The monthly period itself is a contributor to the problems of endometriosis since not all of the blood leaves the body. Another weird thing: apparently, the "make-up" of blood that a woman with endometriosis has during her period is different than another woman. Crazy, huh?
• I also asked him if the treatments could have made the endometriosis worse, and he said, theoretically, that would be the case. The endometriosis thrives on estrogen, and the treatments increase the levels of estrogen a person has. However, he wasn't too concerned about this since the treatments are done rarely and for only a short period of time. I do wonder, though, if that visit to the ER two summers ago was the beginning of that cyst. Just speculation, of course...

So that's the explanation of what he found. Of course, we were concerned with one main question: How will this affect our ability to conceive??

• Because the endometriosis was as advanced it was, it will return. It could return in six months or a year, but there is no doubt that it will come back. Another laparoscopy really isn't an option because multiple laparoscopies will have negative effects on my ovaries and the quality and production of eggs.
• He has found that with women like me, there is about a 40% chance (or 1 in 3) that they get pregnant without treatments within the year.
• He would recommend that we consider a few cycles of treatments and IUIs because women with endometriosis typically have lower quality eggs. The clomid and ovidrel I have taken help produce more follicles (so more chances that my left ovary will produce an egg, which would be the better option) and higher quality eggs and ovulation. The only downside with the treatments and IUI is the cost and a slightly increased chance of multiples.

Overall, the appointment was positive. Of course, it was a bit disheartening to hear that the endometriosis will come back, and that there's no way to really "cure" it. And I don't like this whole "race against the clock" thing, but I guess all women have some clock they're having to think about. Nevertheless, it seems my chances of having a baby have just sky-rocketed! Our main prayer concern right now is if and when to do the treatments. My doctor wants to make sure I have one normal cycle, but after my period comes next month, we can begin an IUI cycle or can choose to wait. Neither of us has any idea of what we want to do right now. The one plus is that our new insurance does have a small amount covered towards infertility, so there may be a chance one or two IUI cycles could be covered.

It feels great to have the surgery done and to have met with the doctor and talked about Robby's and my immediate future. What an exciting beginning to 2011!

Recovery Update

I can't believe it has already been four days since my surgery. Physically, I am recovering well. The first three days I stayed on the pain medication prescribed to me. Not only did this remove my pain, but it also made me pretty out of it most of the day, which (I'll be honest) was kind of nice. (Maybe that's why the days have gone by so quickly??) Today is my first day just using tylenol, and although I don't feel quite as good as I did, I'm still relatively comfortable. I experienced shoulder pain the first couple of days, a side effect of the gas they put in my abdomen to help them see better, but that has subsided. I'm struggling through the annoying aftermath of anesthesia, the dreaded constipation (sorry if that's TMI), but besides that, I can't be happier with my body's response to both the anesthesia and pain killer. Neither of them made me nauseous, which is fortunate indeed! The biggest thing I faced today was fatigue. Just moving from one room to the next is exhausting. I also am running a low fever, which I don't think I need to be concerned about, since I was advised to call if a fever reached 101 degrees.

I've had a lot of help, and this has truly been amazing. Robby has been super-husband and spends his day preparing meals, cleaning, monitoring my meds, and overall keeping me as comfortable as possible. My mom has been over almost every night with meals, my dad and sister have stopped by, and my cousin Kara came by with a pot of soup, as well. Everyone has been so good to check on me and offer help. I feel blessed by all of my support.

For the most part, I think I had accurate expectations of the surgery and recovery. What I wasn't prepared for and what is most surprising to me is how emotional I am. I cried a lot today and became frustrated with things that wouldn't normally bother me. I am just feeling down, and I wasn't expecting that at all. It brought me some comfort, then, when I found this helpful article on endometriosis.org, "Laparoscopy: Before and After Tips." This little article, by the way, is the best thing I've found concerning laparoscopy. It really does cover every major thing related to the surgery and gives good tips for recovery.

I'm very pleased with my recovery, but I am ready and anxious to get back to normal as soon as possible. Thanks everyone, for your continued concern and prayers!

Post-op blues, from "Laparoscopy: Before and After Tips"

Most of us experience a period of emotional ups and downs following surgery. For some, the blues remain for several weeks. It's not unusual to cry easily or become anxious, agitated, frightened, or suspicious. Some of us have also experienced nightmares following surgery. All of this will pass in time and you will begin to feel in control again. Be gentle and patient with yourself during your physical and emotional recovery