I remember my first 2WW (two-week wait). Oh, how sweet and innocent I was. I was on cloud nine pretty much the whole time. I was constantly praising God for everything, especially opening DH's heart to TTC. I had so much hope—a hope that fully expected to be fulfilled. (Having a 76% chance* of conceiving in the first cycle seemed like pretty good odds to me.) About halfway into the 2WW, I started spotting. I had never ever been so excited to see spotting. "Implantation bleeding," I thought, "right on time." I diligently kept track of other early pregnancy symptoms. Toward the end it took a lot of willpower not to take a pregnancy test. (But I was bound and determined not to test until P+17...no false negatives for me.) I never quite made it to P+17. I was crushed.
The second cycle I had 2WW amnesia, I think. I let my hopes get just about as high as they were the previous cycle, not remembering how much the disappointment hurt when AF came. Lots of people don't conceive on the first try, I told myself. If 90% of couples* conceive by the third cycle, there's no need to worry. Yet I still cried when AF showed up.
Since then my attitude during the 2WW has gradually shifted towards self-preservation: "I'd love to be surprised by pregnancy this cycle, but I'm not really expecting it to happen now." Change in expectations means less disappointment, right? Of course, there is always a tiny voice in the back of my mind thinking, "This could be the cycle!" (This is followed by, "God, could this be the cycle?") I try not to dwell on it until the end of the 2WW. I actually look forward to the first week after ovulation. No more pressure to use certain days. Either I'm pregnant or I'm not—there is no way to tell, and nothing more can be done at that point (aside from trying to boost progesterone). It's a nice little emotional break...provided PMS stays away.
But then there's the second week of the 2WW. Just as I'm starting to mentally relax, I notice what could be an early sign of pregnancy. Let the mind games begin. Here's a little peek inside my head:
Fatigue: Wow, I can barely keep my eyes open. I really need a nap. Ooooh, could I be pregnant? Or might it have something to do with not getting enough sleep the last three nights? Or perhaps it was that lunch I had an hour or two ago full of carbs—my blood glucose probably just took a nose-dive...I suppose that's it. Doesn't everyone feel tired mid-afternoon? But I didn't feel this tired yesterday...hmmm...
Breast tenderness: I think they're a bit sore. Am I imagining it? Hard to tell. Maybe I'm checking too often so that's why they're sore. Oh, it's just another PMS symptom. But taking HCG has eliminated my other PMS symptoms...and I never noticed it before TTC, so maybe I'm pregnant? Well, I guess I really never paid attention to it before TTC...
Urinary frequency: I have to go to the bathroom again? Really? It's only been an hour since the last time. (grumble) Maybe this is pregnancy! No, it's just those ten glasses of water I had today—I did drink more than usual. Well, at least my kidneys are working. But I've had that much water before and never had to go this often...
Nausea: My stomach hurts. It's not heartburn. Ooooh, it's really nausea. This is unusual for me. It must be that I'm pregnant. Or could it be related to eating way too much homemade ice cream approximately an hour ago? I wonder. But this really feels different from the past when I've eaten too much at once...
Vomiting (only twice since TTC): I threw up. First thing in the morning. It's morning sickness! Wait, maybe I'm just super nervous about that big meeting at work today. Or it's because I am up much earlier than normal and haven't eaten yet...but, it's not THAT early, really...
Toilet paper status: Is that spot red? (after scrutinizing the TP very closely for two minutes...) No. Great! Is it brown? Wellllllll....maybe? Oh, it's just not the best lighting in here. That's why I can't tell. I should check again to be sure. It's not really brown. Maybe the urine is dark because it's concentrated, and it just sort of appears brown. Or almost brown. Does that count? But even if it is brown, it could be implantation spotting. (five minutes later...) Oh, I felt something—is that my period starting? I better go check again... God, your will be done. (Are infertiles the only ones to pray before going into the bathroom?)
ETA of AF: Today is peak + ___ (insert number 13 or higher). AF could possibly start today. I should wear a pad just in case. Oh, but this cycle could be the one. Yeah, but it would be really bad if AF came today and I weren't prepared. Fine, I'll wear a pad. And I'll put three tampons in my purse. But that doesn't mean AF WILL start...maybe I'll get to the end of the day and find out I didn't need one after all. That would be nice.
Once upon a time I kept track of (i.e., wrote down) each and every symptom I observed during the 2WW. (I wanted to be able to answer the CrMS pregnancy evaluation questions accurately.) At some point a few months ago it became too difficult to constantly focus on them, so I stopped. Now, if they happen, they happen. No big deal, right?. Except I still have those little dialogues in my head whenever I notice one or more of the symptoms. I guess that hope is still there. I hope it doesn't drive me crazy.
*couples with normal fertility using CrMS to conceive
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Saturday, August 28, 2010
Wednesday, August 4, 2010
The other side
I've worked with couples with infertility or repetitive miscarriages for several years now. I probably told every engaged couple I met during their CrMS introductory session, "I hope you never need NaPro, but just in case, it's reassuring to know that it's there." I've even taught engaged couples who started TTC on their wedding night and went on to need NaPro. It was heartbreaking to watch cycle after cycle pass without a pregnancy...and to see their excitement and hope turn into disappointment and (sometimes) despair. My heart broke for them...but I never imagined I would one day be in their shoes.
My CrMS chart wasn't textbook perfect, but it didn't have the "major" signs pointing to increased risk of infertility that we're taught to look for on charts. My mucus was great...really great. (Seriously, if there was a contest of whose mucus stretched the most, I would win.) My post-peak phase was well within the normal range. I averaged very close to the "typical" 28-day cycle. I didn't have painful cramps during my periods. I even had a client with an almost identical-looking chart to mine who was super-fertile. I had pretty much convinced myself we had good fertility. I really wanted that to be true. But in the back of my mind, I knew I had too much bleeding. My periods seemed to go on forever and would be followed a few days later by more spotting. I tried to rationalize that the mid-cycle spotting was probably just estrogen-breakthrough bleeding, so nothing to worry about. But I could not explain away the long periods. Regardless, I still clung to the (naive) hope that we had normal fertility.
While I was in Omaha for practitioner training (before I was married), I showed my chart to Dr. H, the founder of NaPro. He studied it briefly, handed it back to me, and said, "You need a hysteroscopy." I was not expecting that, but I figured with 30 years of experience, he knew what he was talking about. :) There wasn't a NaPro ob/gyn anywhere near where I lived, so I had to find someone else. I found a local ob/gyn covered by my insurance who specialized in hysteroscopy and was also pro-life—a nice bonus. Unfortunately, he did not agree I needed a hysteroscopy. He ordered an ultrasound and said that the results explained my unusual bleeding but needed no further intervention. "Come back to see me when you're pregnant," he said. I was relieved not to need hysteroscopy and didn't pursue it further.
We started TTC last summer. Six cycles came and went without pregnancy. (Note: When charting with CrMS, if you begin TTC and have not conceived after 6 cycles of fertility-focused intercourse, you can be referred to a medical consultant—you don't have to wait the full 12 months like most non-NaPro doctors require.) It was a little strange to refer myself to the local NaPro doctor (Dr. A), but I wrote the referral letter just like all the rest I had written for clients. The only difference was the number of charted cycles I sent to him. Normally if a couple learns CrMS after they have experienced infertility, they only need two cycles charted to send to the medical consultant. I sent Dr. A more than 40 cycles. Overachiever, I know. :) (I charted long before we were married.) Dr. A ordered the standard targeted hormone profile, a series of blood tests to measure different hormones throughout the cycle. He also had me go back to my non-NaPro ob/gyn to see if he would do a hysteroscopy now. The ob/gyn still didn't want to do it, but he did order a pelvic MRI to check out the anatomy of my uterus. The MRI showed the same thing as the ultrasound so still no hysteroscopy.
The hormone profile ended up being 11 blood draws over 3 weeks—I felt like a human pincushion. I really don't like needles, so DH came with me to all but one of the draws. (I was so proud that I did one by myself!) The phlebotomists at the lab started to recognize me after I kept showing up and said, "We love our regulars." The good news is that I think I'm over my fear of needles. :) Everything came back normal except for low progesterone at the end of the cycle—a late luteal phase defect. The treatment was post-peak HCG injections on certain days of the cycle. Dr. A said the HCG should give us a pretty good chance of pregnancy, but if it didn't work after three cycles, we'd try something else. So far we've tried two cycles with HCG without success. We are disappointed, of course, but I think more than usual because Dr. A was rather optimistic about the HGC working. This cycle he wants some blood tests done post-peak to see how my progesterone is doing. The next step will probably be antibiotics. After that, I refer myself to another medical consultant who does surgery...maybe I'll finally get that hysteroscopy. Is it unreasonable to ask God to let me get pregnant before I would need surgery? Surgery was not in my original plan. ;)
My CrMS chart wasn't textbook perfect, but it didn't have the "major" signs pointing to increased risk of infertility that we're taught to look for on charts. My mucus was great...really great. (Seriously, if there was a contest of whose mucus stretched the most, I would win.) My post-peak phase was well within the normal range. I averaged very close to the "typical" 28-day cycle. I didn't have painful cramps during my periods. I even had a client with an almost identical-looking chart to mine who was super-fertile. I had pretty much convinced myself we had good fertility. I really wanted that to be true. But in the back of my mind, I knew I had too much bleeding. My periods seemed to go on forever and would be followed a few days later by more spotting. I tried to rationalize that the mid-cycle spotting was probably just estrogen-breakthrough bleeding, so nothing to worry about. But I could not explain away the long periods. Regardless, I still clung to the (naive) hope that we had normal fertility.
While I was in Omaha for practitioner training (before I was married), I showed my chart to Dr. H, the founder of NaPro. He studied it briefly, handed it back to me, and said, "You need a hysteroscopy." I was not expecting that, but I figured with 30 years of experience, he knew what he was talking about. :) There wasn't a NaPro ob/gyn anywhere near where I lived, so I had to find someone else. I found a local ob/gyn covered by my insurance who specialized in hysteroscopy and was also pro-life—a nice bonus. Unfortunately, he did not agree I needed a hysteroscopy. He ordered an ultrasound and said that the results explained my unusual bleeding but needed no further intervention. "Come back to see me when you're pregnant," he said. I was relieved not to need hysteroscopy and didn't pursue it further.
We started TTC last summer. Six cycles came and went without pregnancy. (Note: When charting with CrMS, if you begin TTC and have not conceived after 6 cycles of fertility-focused intercourse, you can be referred to a medical consultant—you don't have to wait the full 12 months like most non-NaPro doctors require.) It was a little strange to refer myself to the local NaPro doctor (Dr. A), but I wrote the referral letter just like all the rest I had written for clients. The only difference was the number of charted cycles I sent to him. Normally if a couple learns CrMS after they have experienced infertility, they only need two cycles charted to send to the medical consultant. I sent Dr. A more than 40 cycles. Overachiever, I know. :) (I charted long before we were married.) Dr. A ordered the standard targeted hormone profile, a series of blood tests to measure different hormones throughout the cycle. He also had me go back to my non-NaPro ob/gyn to see if he would do a hysteroscopy now. The ob/gyn still didn't want to do it, but he did order a pelvic MRI to check out the anatomy of my uterus. The MRI showed the same thing as the ultrasound so still no hysteroscopy.
The hormone profile ended up being 11 blood draws over 3 weeks—I felt like a human pincushion. I really don't like needles, so DH came with me to all but one of the draws. (I was so proud that I did one by myself!) The phlebotomists at the lab started to recognize me after I kept showing up and said, "We love our regulars." The good news is that I think I'm over my fear of needles. :) Everything came back normal except for low progesterone at the end of the cycle—a late luteal phase defect. The treatment was post-peak HCG injections on certain days of the cycle. Dr. A said the HCG should give us a pretty good chance of pregnancy, but if it didn't work after three cycles, we'd try something else. So far we've tried two cycles with HCG without success. We are disappointed, of course, but I think more than usual because Dr. A was rather optimistic about the HGC working. This cycle he wants some blood tests done post-peak to see how my progesterone is doing. The next step will probably be antibiotics. After that, I refer myself to another medical consultant who does surgery...maybe I'll finally get that hysteroscopy. Is it unreasonable to ask God to let me get pregnant before I would need surgery? Surgery was not in my original plan. ;)
Sunday, August 1, 2010
Disclaimer about TMI
I'm a CrMS practitioner. Mucus is a common household word. It has been for years—even long before I met DH or became a FCP. So consider yourself warned ahead of time. Some bloggers write TMI (too much information) on a individual post when talking about personal physiology. I probably won't do that. I'll just start talking about mucus or bleeding and assume everyone's comfortable with it. Just wanted to be clear upfront. :)
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