Almost a Daddy or How Dr. Smith Broke My Heart

Friday, my husband and I went back to the doctor to have follow-up blood work completed after three weeks on the estrogen treatments. I have learned not to get my hopes up too much before we head to Dr. Smith’s downtown Houston office. His office has become menacing. It is a large, skyscraper-esque building, complete with lots of traffic and a large parking garage. The building has changed for me. I used to see a bright building full of hope, but each visit the building has grown darker and darker. It is no longer a place of hope. It is a place of fleeting dreams. A place of heartbreak. A place of hurt. And, I feel all of these things before we have even had a chance to try a single fertility treatment. So far, Dr. Smith has been focusing on my “crazy hormone levels”, because at this point my body will not respond to treatment. I respect and support this treatment approach, but he doesn’t always exhibit the best bedside manner. He is a man of jokes, and I am a fragile girl who cannot handle them. Since this visit was to be short, only long enough to discuss that I have not had any side effects on the estrogen, I didn’t expect much in the way of a new treatment plan. There can be no plan until he has read my test results sometime this week. I didn’t even want to ask him what was next. But, I ended by saying what I usually do, “I’m really praying this works, because I really want to be a mommy.” Dr. Smith laughed and said, “With testosterone levels like yours, you’re almost a daddy.” My mouth fell open, and my heart sank. I held it together enough not to cry at that moment. My husband wrapped his arms around my and whispered in my ear, “I love you.” This is always his answer when things get me down. It used to feel like it was a copout, but lately it’s the only thing that gets me through. He loves me enough to hold me when the world falls apart, which is something that happens more frequently than not with fertility treatment.

But, Dr. Smith’s one sentence sent me into a downward spiral of despair the entire weekend, not a good thing considering we had company from out of state, and I was appearing in a Christmas play. Who would not have been hurt by those words? If you read my blog regularly, you know that the high testosterone levels have begun to make me feel like less of a woman. I questioned everything about my life. Am I not a girly girl, because I have too many boy hormones? Can people tell that I have high testosterone? Will my hips ever pear-shape like a woman’s should? Will I have less of a sex-drive when the testosterone levels come down? This weekend, it took everything in me to hide how I was really feeling in order to perform in a play, and be a good host to my friend. It was exhausting. And, I didn’t do a very good job at it. For someone that has ridiculously high testosterone levels, I am pretty damn emotional. The worst part is that since there was so much happening over the weekend, my husband and I really haven’t had a chance to process the new information, however little there was.

The current plan, as I understand it is to wait and see how my test results come out. If it looks as though there is some balance, we will probably start Clomid after taking Provera to induce a period. If there isn’t… there is no current plan in place. I am a planner, and the waiting, not knowing, uncertainty is killing me. I wonder if it would be a good idea for us to begin the process to adopt. My husband says that he isn’t ready to give up on my body yet. And, that isn’t because he doesn’t believe in adoption. In fact, we both believe adoption saves lives. He doesn’t want to give up on my body, because he knows that I selfishly want to carry a child. I have two friends who were adopted, and I believe their lives were better because of it. I know I’m being selfish by wanting to exhaust all our options for treatments first. I know we run the risk of extreme stress on our marriage as sex becomes a chore prescribed by a doctor, and as doctor’s bills go unpaid by our government issued insurance. I know that there is a better way to spend the kind of money we could be paying out in the end, but I am selfish enough to not care about any of it. At least my husband is supportive, and I am very appreciative. But, I wonder if his role will become passive as mine becomes pregnant by any means necessary. Will he resent me? Will he resent our child?

On a related note, my life has been consumed with fertility talk. I enjoy writing this blog, because it is free therapy for me, cathartic. But, people ask me about it a lot in my personal life, and I can’t seem to not bring it up in relatively every conversation. I am a woman obsessed. I fear it will become a draining burden on everyone around me. I am a Debbie Downer. And, I really don’t want to be. So, I am hereby granting permission to change the subject. Just because my life is consumed by fertility overload, doesn’t mean the lives of all my friends has to be too.

I swear I didn't mean for it to feel like this, like every inch of me is bruised.

It seems as though every time my husband and I have a glimmer of hope, we get knocked down so low that it is hard to remember that our doctor hasn’t given up on us yet.

I was so excited as I started this week. Monday was the last day I was taking Provera, which meant a period later this week, and the start of our first round of Clomid. On Monday afternoon, Dr. Smith’s nurse called me to deliver my test results. I had completely forgotten that he had ordered blood work before I left his office two weeks ago. Since I was told not to wait for the results, the tests seemed meaningless. I didn’t even remember what he ordered, and I assumed it was just the standard routine that I have drawn nearly every visit. The results were not good, to say the least. You see, my biggest complication with PCOS is that I have unusually high testosterone levels, which is a major symptom of the disorder. However, mine are the highest my doctor has EVER seen. And, despite the fact that they were in normal range a month ago, they have once again skyrocketed to levels that prevent Clomid (or really anything else) from working. Basically, he wanted to see us the next day (yesterday) in his office to discuss a new plan.

            After I hung up the phone, I cried. Mostly, I felt defeated in a battle that I didn’t even get the chance to suit up for. But, it also hurt my heart to hear that my testosterone levels were high again, because the very idea of it makes me feel like less of a woman. I consider myself to be an intelligent person, and my mind KNOWS that this is not my fault. I even KNOW that I am actually pretty lucky that I don’t take more after my Hungarian roots, because the symptoms would be more visual. But, my heart… my heart feels pain, hurt, anguish that I am defective. It makes me feel like I am not a woman. Sure, I have breast and a vagina, but my ovaries make more testosterone than they should, and my brain doesn’t know how to turn it off. Essentially, my body appears female, but behaves male. It is a major identity crisis. I feel like my husband married a woman, but didn’t get one. I irrationally worry that my body will somehow find a way to change shape and grow a penis. I KNOW these things can’t happen, but I cannot change how I feel. I feel manly, and no woman ever wants to feel that way. We are conditioned from birth to grow up as beautiful woman. We wear make-up, color our hair, bat our eyes, and sway our hips. And, I feel like my body has forgotten those things, choosing instead to spit, scratch, and grunt. I am defective. If I were an electronic, I would have been traded in under factory warranty. I am broken.

            After stewing in these thoughts for a full day, my husband and I made the long trek to Dr. Smith’s office. I wanted to believe I had prepared myself for the worst, but if I were really honest with myself, I hadn’t. Dr. Smith had a plan, though, which was a little reassuring. My cycles, the way my body will respond to treatment, it’s all a guessing game at this point. While Dr. Smith couldn’t answer all of our questions with more than, “I don’t know yet”, he did explain in detail what he would like to try in order to get my body in gear. Since my testosterone went down with birth control, we know I do not have a tumor, and we know that there is a window of opportunity that could produce ovulation. So, I will now be taking three weeks of estrogen treatments once I finish my period sometime next week. These treatments are the same ones given to women who are going through menopause, which I am not. Dr. Smith is certain I am not going through early menopause, because my levels would be more than double what they are, which I guess was supposed to make me feel better, but really didn’t. After I have taken three weeks of estrogen, I will be given another blood test and then “smacked” with Clomid. Basically, I will be on the highest dose of Clomid Dr. Smith is comfortable with. Though, that doesn’t mean I will ovulate. Like I said before, it’s all a guessing game now.

            Maybe I am crazy for putting my body through this. Maybe it will work too well, and we’ll end up with a litter instead of just one healthy baby. Maybe it won’t work at all. But, I have to try. I think the worst part about the uncertainty of infertility is the guessing, waiting, praying for a positive result. Being that I am what Dr. Smith calls a “toughy”, it makes it even worse. I can no longer rely on the statistics that surround the medication, because I do not fit the mold of the women who usually take them. I am thankful that Dr. Smith is still willing to try pills before exploring other options, because our insurance won’t cover anything beyond that, and the other procedures can be painful and invasive. But, I wish it were all over. I have dreamt of holding a baby my whole life. Since I have known my husband that baby has a face; features similar to his crooked smile and brown/ green eyes. I want to hold OUR child. I believe in adoption, and I would never love an adopted child less than I would love one I carried for nine months, but I want the chance to be pregnant. I want to help God grow a miracle. I want to feel that baby grow, kick, move. I want to feel the pains of birth, and hear our child cry for the first time. And, I don’t think these things are selfish. I am not motivated by greed, hate, destruction; I am motivated by love. What can be more pure than that? 

Provera, Period, and Clomid! Oh, My!

This week started off with another disappointment, but today Dr. Smith turned it around. Monday, I called the doctor after unsuccessfully having my period on my own again. I faxed the doc my temperature chart, and he asked me to take a home pregnancy test. Despite the fact that my blood work did not show signs of ovulation four weeks ago, my temperature chart looked like I may have been pregnant. Although it was disappointing to take another negative pregnancy test, it wasn't as heartbreaking as others I've taken. I wasn't letting myself get too excited about anything, because I know my body well enough to know I was not pregnant. Because it was negative, the doctor requested my husband and I come in today for a follow-up. I made my husband promise he would help me be tough and press the issue that enough was enough, and it was time to try an actual treatment. I was prepared to put on my big girl pants and threaten to seek another doctor. But, all of that was unnecessary. Dr. Smith began by saying that, while he had hoped I would ovulate on my own, it wasn't looking like my body would. And, that he wanted me to take Provera (a period-inducing pill) for 10 days to shed the lining in the uterus and have a period. After I actually start my period, I am to fax my temperature chart, and he will tell me when to start Clomid. I think my heart literally skipped a beat when he said the word! Clomid is often the first step in infertility treatment, but Dr. Smith is an advocate for balancing the body's natural hormones before trying any ovulation stimulators. I actually agree with him. He has given my body the best chance at not only conceiving, but staying pregnant, and delivering a healthy baby. The side-effects, besides the possible lack of cervical mucus I mentioned before, are hot flashes and night sweats. Provera makes me crazy hormonal, and I imagine Clomid will as well, so I have pre-apologized to my husband for my possibly crazy, hormonal behavior. Also, Clomid increases the chance of twins. I wouldn't mind twins actually. Since we don't have any kids now, it's not like we'd know the difference in the lack of sleep from one baby versus two babies. Besides, built-in playmates sounds pretty good to me. I think my husband is less sold on the idea of twins, but he is super excited to be taking another step forward toward making a baby. I feel conflicted about starting Clomid. On the one hand, this is exactly what I want. On the other, I worry that I will get crushed if it doesn't work. But, I will NEVER give up. I believe that I will be a mother. I believe I will carry a child. And, this is just step-one in making my body cooperate. There will not be much to report over the next three weeks as I will be taking Provera and having a period. But, I am asking that my readers will keep my husband and I in their prayers for the road ahead. I am guessing we will start Clomid in the middle of November. During that time, the husband and I will be on a strict sex schedule (I doubt he'll complain), and wait to see if it worked. Speaking of the sex schedule, after Dr. Smith once again gave us the best doctors orders of sex every other day, I thought of a very important question: Are there any positions that help with fertility? Dr. Smith said, "don't believe any of that." Fertility is different for each person, and each egg is different each ovulation cycle. But, one thing remains the same, if the sperm can get to the egg, pregnancy will occur. There isn't a position that can help that, just our bodies doing what it does naturally, or in our case with the help of Clomid.

Losing Smoosh

     Saturday evening, my husband and I returned home to discover that our dogs, a beagle named Bella and a pug named Smoosh, had dug their way out under our fence. They were so determined that they actually dug around chicken wire. We searched everywhere for them. It was dark and late. My husband searched until 3:30am. He hung signs and walked until his legs literally hurt. I drove our neighborhood and two others following the creek behind our house until midnight. I finally convinced my husband to get some sleep around 4:30. We woke up to my phone ringing at 8am. A woman had found Bella in her yard howling loudly at 3:30am. She didn't have Smoosh.
     I had a bad feeling about it, because they NEVER go anywhere without each other. The one time Smoosh went on a car ride with daddy without Bella, Bella cried the entire time. When we go to the woman's house, a house so in the country she didn't even have an address, I saw a black animal lying under a tree. I knew it was Smoosh. I got out of the car, and called her, certain she would come running with that big smile on her face. But, she didn't come. She was gone. My husband believes she was hit by a car, but we'll never know for sure. The evil, Texas fire ants had already begun to do significant damage to her body.
     Bella was not hurt at all, at least not physically. She has a few scratches on her tummy that are probably from the chicken wire. But, she is heartbroken. I believe she was howling to try to get Smoosh help. She knew her sister was hurt, but she was unable to communicate it properly. And, since the woman didn’t want to be rude and wake us up in the middle of the night, we couldn’t do anything to save her. So, we wrapped her body in a towel the woman gave us, and took her home. We buried her in our yard in a shoebox from the pair of boots we were busy buying while she was escaping to her death.
     Losing Smoosh is absolutely devastating. She was our baby. We got her from a breeder when she was eight weeks old, four pounds, and didn’t know how to bark yet. She was beautiful. We fell in love with her when we first saw her. We wanted a fawn pug, and we wanted a female. The only fawn left with this breeder was a male. But, it didn’t matter; we fell for Smoosh as if she were ours all along.
     Part of the reason we purchased Smoosh, not a small fee for a purebred, was because I wanted a pug. I love pugs. They’re funny, happy, and loving dogs. The other reason we got Smoosh was to fill the void of my empty womb. We knew at that time that we were going to have difficulty conceiving and this way we would have a baby until we could have one we made. It may sound silly to some of you, but she really was my child. I taught her everything. She went through the same developmental stages a human baby goes through. And though I didn’t carry her and she wasn’t technically human, she was mine. Don’t get me wrong, I know I will love my own child more, if not differently, than Smoosh, but she is the only child I know now.
     I’m heartbroken. I’m angry. I’m hurt. I’m sad. I’m regretful. She did not deserve to die that way. She deserved to grow old, and die peacefully. Not like this. She was the happiest dog I have ever met. She loved life. She loved her sister. She loved us. And, we failed her. We failed to keep her safe. I hate that I cannot stop thinking about other sceneries that end with her sitting in my lap when I get home from work today. We had several people tell us they saw our dogs out, and one even checked their tags. But, no one called us. I suggested we lock them in, but we decided they would be fine roaming our fenced-in yard. If I would have stayed up longer, and driven further. If the woman who found Bella would have called us sooner. None of these things can change, but I can’t stop wishing they could.
     I feel cheated. I have been unable to get pregnant on my own, and now I lose the one child I had. I feel cursed. And, I feel like God hates me. He has many reasons to. I know these are not realistic feelings, but they feel normal right now. Grieving the loss of a pet feels no different than when I was grieving the death of my grandma last December, a loss I still have not been able to fully get over. I feel empty. I am empty. Smoosh was ours. One of the first things that was ours. And, now she’s gone forever. Nothing can replace her. But, I do think we will eventually get a new dog. Maybe another pug, because that’s the breed I prefer. But, no new dog will ever be Smoosh. I miss her more than I knew I could.

When failure repeats

     This week has been depressing. There is no other way to describe the emotional roller coaster of happily anticipating good news only to receive another heartbreaking blow of disappointment. I am not trying to sound as though I am whining, or seeking sympathy; but, I cannot shake this feeling that I am in a major funk.
     Monday, my husband and I went back to the doctor to have him look over my temperature chart, and run some blood work to check for ovulation. A few weeks ago, I had a drop in temperature, which is usually the sign that ovulation has begun. Dr. Smith took one look at my chart and said, "Well, April, I think you've ovulated!" The rest of the appointment went on with discussion of when we would know we were pregnant, and for how long he would monitor me after confirming pregnancy. He had me so excited, anxious, joyful, and scared... everything a first-time mom feels. My husband was also pretty excited, because he has been telling me for a week that I was pregnant based on the "symptoms" I was experiencing (nausea, fatigue, swollen and sore breasts). So, I had my blood drawn, and left awaiting the phone call Tuesday that would confirm that this was the "first chance we truly had at getting pregnant" (Dr. Smith's words).
     Tuesday morning I woke up with a fear of bad news. I couldn't shake the feeling that the temperature drop was a fluke. I was right. In the midst of pure chaos after realizing our dogs had literally broken out of the fence (seriously they broke boards, and the biggest one is only 32 pounds), I got the phone call from  the doc's nurse. The blood work showed that I had not ovulated (again). The doctor's new orders are to call when/ if I get my period. If I do not get it by the time I am due (which is supposed to be 10-2), then I am to call in three weeks. THREE MORE WEEKS!
     I feel like I am fighting with myself. Half of me wants to begin treatment immediately, because I would like to pregnant before the end of the year. The other half of me thinks that we have to start right away, because this is going to take a while. I didn't ovulate this month, so I will not likely have a period. I know that I have to have a period before I can begin Clomid, because of the nature of the medication, so why not just give me a period inducing med (like Provera), and get a jump start on things. Provera usually takes 10 days to induce a period; Clomid induces ovulation in the typical 28-day cycle. So, we are now looking at Thanksgiving before we could even get pregnant.
     My husband told me it is difficult for him to understand my need for a "time table". I want to be pregnant before the end of the year (I turn 30 in December), but not because it is some need to meet some biological clock as much as it is a need to set a goal. Sorry to brag, but I have accomplished a lot in 29 years. The reason is because I have always set goals for myself. I know that fertility treatment is at best a guessing game, which scares me to death. I am not fully able to set a goal in this case. Dr. Smith shared the statistic that, with a couple with no fertility issues, there is only a 1 and 5 chance of conceiving. Now that my hormones are balanced, we have a better chance than what we did, but still not 1 and 5. With Clomid, there is only a 35% of conceiving. Other treatments are even lower. We could be undergoing fertility treatments for years before we conceive, or we could get pregnant in a few weeks. The fear of the unknown is killing me.
     My husband says, that he is not giving up on my bum ovaries. And, he believes that he will be a father, and I will be a mother. I believe that too, but I wonder when. It breaks my heart every time we go to the doctor, and hear that it didn't happen again. It breaks my heart every time I have another month go by without ovulating. It breaks my heart that I cannot make my husband a father. I blame myself every time, because it is my body that has failed.

A Most Useless Place... The Waiting Place

     Wednesday, we went back to the doctor to work out our pregnancy plan. I prepared my heart for two possible outcomes: 1-we wait a month to see what my body will do on its own; 2-we start treatments (most likely Clomid) this month and see how my body reacts. Dr. Smith chose the wait and see method, which isn't that bad, because it gives my body a chance to get pregnant naturally. But, I worry what will happen this month with my hormones. Since we already know that my hormones are unbalanced when I am off the birth control, I wonder if, in one month off the pill, they will revert back to their abnormal levels. If that happens, what will that mean for us moving forward with treatments. Dr. Smith did make one thing pretty clear: the likelihood of me actually ovulating on my own is minuscule, because I haven't had a "spontaneous period" since 2009. I believe in prayer, and I believe in God-created miracles, so I KNOW it is possible for me to have a period this month, but I am also prepared for that not to happen. In three weeks, we are to go back to the doctor to repeat some blood work to see what actually did happen to my body this month. We have to wait the three weeks, so that the birth control can work its way out of my system. At that time, we will create our real pregnancy plan.
     I asked the doc about Clomid as a starting point next month. And, I learned of one pretty intense side effect that I had not read about in my research. WARNING THIS IS A LITTLE GRAPHIC SKIP AHEAD IF YOU DON'T WANT TO READ IT! Clomid does cause women to ovulate, but it can cause the body to stop creating cervical mucus, which would mean that the sperm would not be able to get to the egg anyway. This essentially defeats the purpose, so it doesn't work with every women's body. I have read that if a woman doesn't get pregnant in three tries on Clomid, she never will. This is the reason why.
     In the meantime, while we await for the next three weeks, we have received the best doctors orders anyone get get: have sex every other day. If you are reading this blog, and you already have planned children, you know the importance of timing. All the best literature on the baby making subject says sex everyday will cause the sperm to not be mature enough, and abstaining from sex for longer than five days will cause more dead sperm than living. Most (s)experts recommend every other day for the most viable sperm and optimal opportunity for conceiving. Some may say that this is a lot of work, but it is also a lot of intimacy. I love my husband. Why wouldn't I want to be intimate with him? I think it also helps that we are still technically newlyweds.
     Anyway, stay tuned for more info in three weeks. And, please keep praying for us. God has already begun to create a miracle in my body through balancing my hormones in only two months. I cannot wait until I can help God grow a miracle in my body.

"You can get so confused that you'll start in to race down long wiggled roads at a break-necking pace and grind on for miles cross weirdish wild space, headed, I fear, toward a most useless place. The Waiting Place..." Dr. Seuss Oh, the Places You'll Go

Back Home

Last week, my husband and I went to Ohio to spend time with my family. The trip was eventful, fun, and filled with lots of babies. Friends' babies, brothers' babies, twin babies, plane babies, lots of babies. Don't get me wrong, I love babies, but while I was awaiting the test results that would determine how well my body was responding to the birth control, every time I finished holding a baby I felt scared, sad, and conflicted. In many ways, I guess, I have thought these particular test results seemed so much bigger than any of the others we have had. To recap, the doctor put me back on birth control in hopes that it would raise my estrogen levels and lower my testosterone levels. When we went back to the doctor last week, he did some blood work to check the progress. He determined before the blood tests that he really wanted me to stay on the birth control for another month. Fast forward to two days ago... I hadn't heard from the Dr. Smith, which is really unusual considering we have literally driven 45 mins to his office to sit for five minutes while he asks, "So, how are you doing?" So, I made a phone call to his office. When, the nurse called me back, I received news that I actually think is worse than the "one more month on the pill": "Dr. Smith said your test results were satisfactory; you should continue treatment for the next three months; and follow-up after that." I was devastated! Three months! That is NOT what my husband and I had talked to him about.  Nearly every time we go to him, I cannot stop myself from asking when he thinks we'll be able to move forward with actual fertility treatments, not just balancing my hormones. Each and every time he says that he is not prepared to make that call yet. Not to mention, if the results were satisfactory, why were we not going to go off birth control and try to get pregnant again. So, I stood up for our fertility, and said that this was not acceptable, and that we did not want to wait another three months on birth control to restart trying to get pregnant. The nurse was sort of rude and sarcastic as she told me, "Well then, I'll just tell the doctor that you don't want to wait three months and see what he says." She didn't need to be like that. I get that she deals with anxious mothers-to-be daily, but this was about me, and my treatments. When she called me back, she said that Dr. Smith wants to see us next Wednesday, and that we should discontinue taking the birth control until we develop our "pregnancy plan". PREGNANCY PLAN!!! We finally are getting to the big meeting with the doctor. The one that will determine how we will move forward, and what we will do (besides the obvious) to get pregnant. Now, I feel nervous, excited, and scared. I know that it could be this month, next month, next year, several years until we actually get pregnant, but I guess I feel the same as any first-time potential mother. With the added pressure that comes with already knowing there are problems with the plumbing, and there is a potential for sex to become more about the mechanics and less about the love-making. It's obviously too early to be concerned that my husband and I will get to that super frustrated place that many couples with fertility problems get. But, I'm a worrier. Mostly, right now, we need some prayer. Prayer that this pregnancy plan works, isn't overly expensive, and that it doesn't put pressure on our marriage. I will fill you all in next week when I have more details about the pregnancy plan.