16dpo

Beta #1 - 14dpo: 319
Beta #2 - 16dpo: 732

Whew, it doubled. Plus about 100 bonus points for good measure. I think I feel good about this. Probably only need about 45 more minutes on google checking out other peoples' stats before I calm down. This journey has made me such an obsessive voyeuristic nutcase. I keep seeing numbers that triple and think man, if my 14dpo number was so strong, and then my 16dpo number was just an average doubling, maybe it's slowing down...disaster! Why must my mind always go there?

I have to admit that I kind of freaked out at the 319 at 14dpo. That seems high. I was freaked out because I've had a molar pregnancy and while, to most people a high beta # = strong! I could only think that it might be another mole. I am at increased risk for that to happen again. I also freaked out a little at the prospect of multiples. I even had a dream that my doctor was giving me brochures and articles on multiples and appropriate hcg levels (and I remember being touched that she now understood - I LIKE to have more information, not less, how nice of her to refer me to an article...but alas, it was a dream). Now, I would LOVE to have twins, but I don't know if I'd love to carry twins because it would escalate the fear I would feel at each stage so much that I'm not sure how I could cope. And anything more than twins would overwhelm me, I'm pretty sure. Though of course I'd be happy with anything. Anyway, the fact that the second beta isn't astronomically high has calmed me down a little with respect to that fear, but of course has stemmed new ones. It seems on track...I think. Though I'm open to all of your honest opinions, of course.


I don't think I'm going to do any more of these draws. My first appointment is Jan. 6 and I think I can just wait for that. I don't need the stress of getting to the lab at the same time, getting stuck, waiting for more numbers, interpreting more numbers, and spending more hours on google than I have time for. I think I will also stop temping. My triphasic pattern has sort of returned, had a nice high temp this morning. I need to quit while I'm ahead. I don't really worry that I'll let my greatest dreams run away with me if I stray too far from raw hard data. I'm too realistic for that. Instead I think I'll spend this time trying to forget about the whole thing. Just focus on the holidays, focus on family, after all the months I've spent waiting, a few more weeks isn't much, especially since there will be so much distraction in the meantime. Sure I'd like to have some idea of what to expect during that first appointment, but from my experience last year, I know that's pretty much impossible. My beta was nice and high, my symptoms were all there, not a spot of blood or a cramp, plenty of morning sickness, my uterus expanded on schedule...all of this and there was still no baby. So while I'm not looking forward to another shock this January, I've accepted that there's really no other way around this - I'll be shocked either way. And no amount of betas will spare me from the blunt disappointment of losing a pregnancy if that's what ends up happening. And this time around, I'll be 7w4d at the appointment instead of 11w so if things don't turn out well, I will have 'wasted' less time. I know that's crass, but it's how I feel. So I wouldn't want this appointment any later. I also wouldn't want it any earlier. If it was earlier with good results, I couldn't rely on them, anything could still happen. If it was earlier with bad results it could just be too early so I'd stew and stress for another week or so.
So I am good today. Scared s--- less and I wouldn't even say cautiously optimistic because I'm very pessimistic at this stage. I don't feel like I can trust my body, pee sticks, anything. I feel very out of control and that leads me to expect the worst. But today's news is good. It doubled. So I will just try to go with the flow.

My appointment is scheduled with the hateful-bitch OBG. It just sort of happened. One minute she was congratulating me and the next she was scheduling my appointment. I feel like I should wait for her to f-up one more time before I say something and back it up by leaving her. I don't really feel like there is any harm in letting her hold the wand at my next appointment. And as I've said before she's really smart. She's good at what she does. This is a personality and patient care issue. She blows at both of those. But maybe it won't be an issue...famous last words right?

For those of you who are following the V saga, she said something irritating again, no surprise there. This time it wasn't to me though, it was to C. I should preface this by saying that C is ultra conservative and very very private about her private life, including about her TTC plans. I have heard her say "I would neeeeever tell eeeeenyone if I was 'trying.'" It's a private subject for her. I understand that. It is for a lot of people, myself included. Now on the other hand, please understand that I don't knock people that talk about TTC at this level of detail, in fact sometimes i wish I trusted someone enough to share that kind of information with. But C makes no secret about the fact that she has NO intention of sharing this kind of information with anyone and I respect that too.

So V comes along yesterday and asks C if she's trying right now. C had her first baby 10 months ago and has said on many occasions that she'd like to have at least 5 kids. V thinks she's smart and asked in kind of a round-about way but it didn't work out for her - she's not as smart as she thinks she is: "So, C, are you like, on birth control now, or what's going on there?" ??!?? Poor C, she didn't know what to say. And after my last conversation with V, I totally understood how she felt. After hearing this story from C, I was left understanding V even less. I am starting to loathe her. She was a friend, a good one even, but little by little she's chipped away my resolve to give her the benefit of the doubt. Luckily I am also starting to think of it as a good thing when you lose friends if you lose them because they weren't really friends to begin with.

14 dpo

Beta is 319.

I'm shaking like a leaf (that can't be good for the...um....blastocyst). There is hope.

I had to open that calendar I was talking about before. My obg made me schedule my first u/s appointment. I wanted to wait - what's the use for an u/s appointment now? We don't really know anything yet except that there is still hope. She was afraid that if I waited for the second beta I wouldn't be able to get in early enough. We scheduled the u/s the same week as that fateful last prenatal appointment a year ago. Right after new year's. This time, if things go well until then, I will be in my 8th week. The appointment is for Jan 6. Luckily, 6 is my lucky number. Unluckily, I don't believe in luck.

Next beta is Wed. morning. The obg said I could do a third on friday if I wanted reassurance. I don't know if a third will be better or worse for me. I probably won't get it, given how stressed out I have been today. I can't keep doing this to myself. And my blastocyst.

I know there is this unanswered question hanging out there about my obg and why I haven't switched if she is such a hateful bitch. More on that later - suffice it to say that now I'm just 'using' her for getting my beta numbers. For now, after six hours of waiting for that result, I need to find a way to distract myself from this.

"HCG results day" or "V strikes again"

I ended up having to push my HCG draw up one more day, due to plans this evening.

Results: Less than 2. I feel SO much better. Almost have tears in my eyes (that's happening a lot lately).

Here's the bad news:

V, my new-mom co-worker who knows all the gory details of my babymaking story, was talking to me two days ago about how scared she is on nights when her husband is gone on work trips. She was saying how she calls him every 12 hours just so he knows she's alive and knows to get worried if she doesn't check in on schedule. "I know," I said, "I hate it when DH leaves, everything becomes a lot more scary. Like I get anxious walking the dogs by myself or taking out the trash. The dogs help a little of course but they're kinda small and probably not much of a deterrant."

"Oh," she responded blankly, condescendingly, "I didn't mind it so much before I had a kid. Now that I have a kid it's much worse." Like she couldn't understand what I would be worried about if I didn't have a kid to live for. Then she got more specific: "People out there can't have kids, no one is having kids, there's NO kids but everybody wants kids, so they steal them." I'm not sure what she was getting at but I have to think she was suggesting that infertiles are crazy baby-stealers. That anyone who can't get knocked up as easily as her (effectively her first month trying) is somehow irreparably damaged in the head and prone to felonious conduct. If this is what she meant I can't imagine a more offensive thing to say to someone who is having trouble. I absolutely can't imagine it. What is wrong with this person? Was she trying to make me feel better by saying "no one" is having kids? Like I'm part of a cast of thousands? And if so, then why would she imply that said cast was the psychologically disturbed, criminally inclined type?
I still can't quite get over the shock. She's acted on so many occasions like she's trying to be a friend and at times I've been totally convinced. I've trusted her, that's why she knows my story. She's smart, too, in a lot of ways. She has about three OBGs in her immediate family so I know she has probably heard some hard stories. In fact I know she has. Is it possible to be smart and friendly and then be a complete nutjob bitch when it comes to sensitivity and social grace? Is it possible that despite her experience in this area and sophistocation in general she can know so little about how very very difficult it can be to become a parent? And how very very emotional and sensitive that process is?

Stupified, I said "well there are plenty of things to be worried about EVEN if you don't have kids...like being raped or killed." I thought I was pointing out the obvious at this point. I really just wanted her to leave.

V: "Oh no one would rape me, there are plenty of better looking, younger girls out there. [V is beautiful and she knows this so this comment came off as a pathetic and fake attempt at self-deprication. Not to mention offensively naiive.] And death is just like sleeping, I kinda don't mind that. I'm not afraid of death. I'm just afraid of leaving my kid." I HATE how she says kid. Probably because, as I've mentioned before, it's every third word in her vocabulary now, as natural as blinking and breathing - she just spews this kind of shit out all the time in front of me.

Me: "Yeah, see, I don't really want to die. There are just too many things I still want to do. So I'm afraid of dying even though I don't have kids," I explained. I really wanted her to leave at this point. Never to return. Why was I trying to rationalize with this person? And what was her problem exactly? Then she seemed to try to backpedal, as if she understood that I was getting offended but wasn't exactly sure why. And get this gem - she said: "Well it's much worse when you have a kid, you'll understand this someday...in the near future."

O. M. G. Back the eff off, will you? That's what I should have said. Instead I think I raised my eyebrows in disbelief and started to ignore her until she left. I have snapped at her before. I thought maybe she had gotten the hint then. But she doesn't get it. She's one of those people I would really have to hurt emotionally in order for her to leave me alone - but I have to work with her. And the thing (or one of the seventeen thousand things) that kills me about this is that I wouldn't even have to deal with this mess if things had just gone the way they were supposed to last year. I'd have my child. The conversation would have gone differently - "Oh yes, I know what you mean, V, it's so scary when you have a kid, I mean imagine the possibilities." But now, even when and if I do have a kid, the conversation will always go the way that it did. Because I have been through my own struggle and I have heard the struggles of others. I have had the privilege of sharing in the intimate details of the daily lives of people who struggle, as I do, but for so many different reasons. And I am forever changed by that. I will never be able to understand people like V. Never. And not only will I never understand it, I will never condone it.

After this conversation with V, I happened to be talking to my other new-mom co-worker, C. She also knows my story and while she didn't know about the above conversation with V, she does know that I've been frustrated with V's insensitivity about this subject in the past. C mentioned that she had not asked V to a particular happy hour we're having tonight.

Me: "That's fine with me," I said, "I'm not a fan right now."

C asked what V had done and I told her. C then told me about her own recent conversation with V:

C: "I told V to knock it off. We were talking about kids in front of [X co-worker who is a guy, not married and not a parent] and afterwards I mentioned to V that people without kids probably don't like it that much when we talk about kids so much in front them, like X...and Astrid."

C told me that V had responded "Oh no, I think Astrid wants to hear about kids, 'cause she's like moments away from having them herself. I think of her in the "pregnant" category. I think she likes to know what it's like, etc. etc."

C told her that she was wrong and that I didn't like hearing so much about kids and about the stresses of parenthood - which is true, but probably not for the reasons C conveyed. It wasn't clear to me that (a) C was articulating my feelings properly or that (b) V was receiving the message, but if it gets V to stop talking to me, that would be fantastic.

See, the thing is, I like kids. I don't mind hearing about other peoples' kids. I find the stories funny and cute and interesting - sometimes. The worst that usually happens when people are talking about kids is that I get bored. I don't really get hurt anymore. It only hurts when some idiot like V says something downright offensive. Like "just be glad you don't have another mouth to feed," or like the conversation about why I wasn't invited to V's lunch. Or telling me that she is more entitled to be afraid when she's alone and that everyone is out to get her kid. Whatever it is, whatever stresses you have as a parent, V, they are not as bad as losing your child, and then getting cancer. They are not as bad as staring at that big 11w space in your uterus on an ultrasound screen and realizing that there are no signs of life inside, followed by 56 trips to the lab in six months and four doses of chemo. And I had it easy, relatively speaking. She would never wish away her child, no matter how bad it gets. She wouldn't wish a childless existence on anyone. If she stopped to think about it, she would understand that. What kills me is that she doesn't stop to think. I hate that people like that are not only walking around in our lives, but so very prevalent.

"HCG Results Day" or "We're go for launch!"

Results: less than 2.

The draw itself on Monday was painful. But the lab techs made me feel like an old friend which was nice:

Tech: "Where have you been? We were just talking about you the other day! We thought maybe you weren't coming in anymore 'cause you were....y'know. [dramatic shrug]" By [dramatic shrug] it was clear that she meant "pregnant."

Me: "Not yet, I'm only coming in once a month these days [I lowered my voice]...but if today's draw goes well, we can try again!" I felt like I was telling a secret or trying to get away with something. I can't shake the guilt at flying in the face of my hateful-bitch OBG. For those of you new to the blog, this post pretty much sums up her position on things as well as her colorful disposition and lack of trustworthiness.

I then explained to the tech that even if I were to get [dramatic shrug], I would definitely keep coming to the lab periodically - probably more often than I do now.

Tech: "Well, I'll be praying for you!"

That was nice.

It took me all day yesterday to get the results so of course that made me nervous. My OBG is on sabbatical so the on-call doctor called me to give me the good news. She asked "So how much longer are you coming in for?" I told her I was supposed to get tested until January but that the oncologist told me I could try again starting last month. It was like I couldn't stop telling people that I was planning to try again and that the oncologist said it was ok. Not because I'm excited about it (which I am, of course, though the excitement is edged out just a bit by fear still), but because I think I'm looking for approval from just about anyone I come across in the medical community. Even if it's just from the lab tech or the on-call doctor. I'm looking for a kind voice to tell me that it's not only "ok" to try again, but that it's great, anything to distance myself from what I've been hearing from my OBG. I'm looking for reassurance I guess. And on some level I'm hoping that the news gets back to my OBG that I'm trying again - I'd love to get that conversation over with. I'm expect it to be hostile and uncomfortable. I'll probably cry, as I usually do after a conversation with her. As an aside, I am still planning to switch OBGs if I fall pregnant again - but it seems premature to talk about so I'll leave that discussion for another post. Right now I have a standing order for HCG draws from her that I plan to take full advantage of.



The on-call doctor politely obliged, even though it was probably more information than she was asking for. She said "great so keep getting tested and keep trying and we'll hope to catch you somewhere in-between!" At first I thought that was an odd comment, what did she mean by that...somewhere in between? But really, that's exactly the word for it, isn't it? When you get a positive pee stick or HCG but before you see a heartbeat or before the end of the first tri (or the whole pregnancy for that matter). That is when you're somewhere in between.

"HCG Results Day" or "Then what the H is up with my BBT?"

Results: less than 2. The assistant keeps saying "less than zero." Which is lame and compromises her credibility. But as soon as I heard the assistant's voice on the phone I knew it must be good news. I think my OBG would call herself if it was not good.

I was also told that Dr. OBG will be on sabbatical next month and so I should call Dr. new OBG for next month's HCG results, which is good. Because if I get pg after my next HCG test, as I hope to do, it might be easier for me to "switch" to the new OBG going forward. For those new to the blog, my current OBG is a hateful bitch that I don't trust and can hardly stand to think about. She has lied to me, she has accused me of all manner of things and has said in no uncertain terms that the situation I find myself in is my fault. She is awful and I want to get rid of her asap. So this is a great opportunity. I should just start checking in regularly with Dr. new OBG instead of Dr. hateful bitch OBG. Then it will be only natural that I would go to the new OBG with a positive test. The only problem with this is that it would be such a seamless transition that my current OBG might not be sufficiently hurt that I 'dumped' her and moved on to the new one. She might actually get the impression that it was nothing she did...which it most definitely was. And, new readers, lest you think I am being irrational or spiteful, I can assure you, she has put me through so very much pain and anxiety, she deserves to know exactly how awful she is.

I woke up today to a high temp. We're talking post-O level temp. But I'm only on CD8. And it was the second day in a row of this same temp, so I can't chalk it up to a fluke. Of course my mind went straight to the fear that my HCG had gone up again. So that's what I've worried about for two days. Obviously not, according to the results today. THANK GOD. But I wonder what the deal is? Maybe I'm fighting off some bug? DH had a stomach thing this weekend...but I feel fine. Maybe it's the heat wave? But really there is nothing out of the ordinary so far as I can tell...this has never happened with my chart. Very mysterious. And of course scary. Cause everything is scary these days. I'm starting to wonder if I'll ever be ready to try again.

It could be stress I suppose. I'm not sure why that would cause a 2-day high temp but stress seems to be an answer for everything. And I have plenty of it lately. The situation with our neighbors vs. our barking furbaby is worse than we originally thought which I found out when I finally worked up the guts to go over and talk to the neighbor who we suspect filed the complaint. Turns out, it's not just the retired guy next door who's miffed, there's someone else who's complained. In our defense, there is another dog on our street that's a barking mess - I just hope these complainants can tell the difference. I also hope all the mechanisms we're putting in place are working. So far we have the citronella bark collar and THREE (count 'em) ultrasonic devices that will get set off if the furbabies bark (hopefully not all at once, they're spaced out around our yard). It turns out that our neighbor had already purchased one for his yard to stop our furbabies from barking and he was bummed 'cause it didn't work through the fence. I started to feel a little bad for him when he told me that. It must be pretty bad. So I told him all the steps we were taking, asked him if I could come by in a few days to ask if it's working, and I mentioned some backup plans if the first measures don't work (like keeping the furbabies in the garage during the day - which I would be loathe to do but it would be better than having them taken away obviously). I hate how upset I have become over this. Upset by the fear of losing the dog, upset by the guilt, upset by the anxiety of not knowing if things are working and of losing time at work and at home having to deal with all of this. Upset about what it's costing. Upset that our neighbors didn't confront us directly before going to the authorities. It's really rocked me.

Also, I got a cavity filled yesterday. I thought after my last trip to the dentist, the whole fact that I used to be pregnant would disappear silently into the past as far as my dental care was concerned but the first thing the hygenist said this time was: "So...you had a baby?!?" She was a different hygenist than last time. It must be engraved in gold on my chart: "Pregnant girl was here 11/17/08." "No." I said flatly, "I didn't." She understood instantly. She put her hand on my shoulder and said in a very quiet voice, "I'm sorry." And that was the last I heard about it that day. The visit did not get any better. I went in for a simple filling and after an hour and a half of numbing and digging and drilling the dentist finally ended the procedure by saying "we'll keep our fingers crossed that we won't need a root canal!" Indeed. "We" will.

Other than this though, life is good. Because my HCG is still at zero! I can't believe how close I am to this wait potentially being over. Somehow it makes me feel like I don't really deserve for it to be over. Or like it would be smarter to keep waiting. Somehow I still think my oncologist's advice (he thinks its fine to start trying again right away) is too good to be true. Like if I dare hope for it to be true I will be punished with cancer. I still have a month to get comfortable with it though and believe me, there are days I'm tempted to try even earlier. How did I get here? When trying for a baby has become the stuff of nightmares? When trying too early can mean a deadly disease? When even waiting the recommended time is no guarantee that you won't get cancer again? When I'm scared to trust my doctors? When I find myself rationalizing the choice to start to TTC 4.5 months after my HCG hit zero instead of 6 months after it hits zero by saying - if by month six post HCG normalization we determine that the GTD is back and I am two months pregnant, I can terminate (for purposes of undergoing cancer treatment) without as much heartache as if I was 5 months pregnant. What kind of consolation is that? I hate this. And I hate it even more when I think about how blissful the new moms in my life are. And how easy the rest of the family obviously expects it to be for us. It is not getting easier. It's getting harder.

"HCG Results Day" or "Cutting to the chase"

UPDATED...twice

Results: "Zero" (woot) which usually means less than two. Since I was once told "five is basically zero" by my OBG, I am forever suspicious when I hear the word "zero" and usually press for whether that means "less than two" because five only means zero when you're trying to get pregnant. Not when you're trying to monitor GTD. For the latter, zero means zero. Automaton nurse called me to leave the message and threw in there "the doctor wants you to try to hang in there." Undoubtedly this little add-on was inspired by the angst I expressed during The Conversation but coming from my hateful b--- OBG, it juts came across as condescending and pathetic.

I am thrilled that the number is zero. But after the conversation I had with my oncologist, described here, I am actually being sensitized to expect a zero. If he doesn't think it will come back up, why would it? If he thinks we can TTC again tomorrow, doesn't that mean it's over? Resolved? That it can't come back up? Let's hope.

Relatedly, I'm feeling braver lately. Braver about trying again. Maybe it's the EWCM on schedule, the regular periods, how very very long August has seemed. I feel ready.

Part of my inspiration came from some news I heard at work yesterday. I think I've mentioned before that out of the four girls in my group of 20 people, I am the only one without kids. The other three are around my age and all have toddlers. Every single person senior to me, even if it's only by a year, has kids, except one. There is one guy who is in the younger crowd and he and I were the last to be married without kids. I have noticed that we spend more time hanging out at work functions lately because we're the only ones left not talking about spit-up and babysitters. He's 39, his wife is 36 and he had talked before about maybe wanting kids but was worried that he and his wife are getting older. The girls in the group are often bringing up pregnancy and babies and make not-so-subtle hints, asking this guy when he's going to take the plunge (they used to ask me too, this is part of why I told a couple of them what's happened - so they would back off). He had told us not to ask him about it anymore because he knows people have trouble, things can happen, so even if they did get pg he wouldn't want people bugging him about it to find out early. I can understand why he said this so bluntly, "stop asking;" there are some pretty nosy girls in my office.

I found out yesterday that his wife is pregnant. He told me. He has no idea about the problems that me and DH have had. And I'm glad. Because it allowed me to be happy for him. I didn't feel stilted - like he did this in spite of the fact that I couldn't. His wife is five months along already. And when I mentioned that he'd been keeping this a secret for a long time he said two interesting things. One was that he didn't want to say anything earlier because he was worried that bad things could happen. They did an amnio and everything and he was saying how many risks there are. I told him he didn't need to explain. That I knew. Hopefully I didn't reveal too much. The second thing he said was that he had actually told some of our coworkers a while ago. Including two of my very close new-mom friends. Normally that kind of news would spread like wildfire amongst us. I would have known the same day my friend V (who has a 1 yo) found out, for example. We are a very tight group. But this time I didn't have to wonder why I hadn't heard. I knew it was because neither of my friends wanted to be the one to tell me that I am now truly the only one left out of the club. It was easy for them to keep this secret. That stung a little.

I impressed myself with how happy I was at my friend's news. I think it's partly because I will hopefully be back on the bandwagon soon and partly because I knew they didn't have much time left in their reproductive years and partly because I really like the guy - he's been putting off family in lieu of the partnership track and he's apparently decided to reorder his priorities. And I think that's good.

Anyway, my point in all of this is to say that I felt a little sad, and more urgently interested in getting back into the swing of things. So I did something a little crazy, actually katery suggested it in the comments to this post. I called my oncologist, and reinstated a question similar to one that I had withdrawn previously. A few weeks ago I had asked whether there was any kind of test to see if MTX is still in my tissue and whether the oncologist is worried about any MTX that may still be in my system. Then I canceled the question because I thought he had pretty well covered the issue and I didn't want to annoy my doctor or come across as crazy. If that's possible to prevent at this point. You see, I regard my oncologist as kind of a deity, ever since our last meeting. I had resolved to wait until late Oct. to try again - well past the normal recommended wash out period for MTX but not quite as long as the conservative recommendation of 6 months. Eagerness got the better of me today and I called back. I left the following message: "we talked at our last meeting about TTC in Oct/Nov and my question is whether late September would be too early given my dosage of MTX, the last dose of which was May 8." "Early September?" The receptionist asked? "EFFF. No. Please don't mess this up, it's risky for me to even ask since I think I already have the answer I wanted (that my oncologist is ok with us trying again right away), I'm just trying to clarify at this point. I don't want to invite a bad answer by persisting...please handle with care." I didn't really say any of that. I just said "no, late september. Is that too early?"

It's been about 24 hours since I left the message. I don't know what to make of that. He's a busy guy and in his own words, my case is resolved and he has patients that are dying of their disease. So any answer I get I would consider a blessing that he even took the time to review my message. You might be thinking I should be a little more assertive with him (and you would be right), but you have to understand how much our last conversation affected me. I really don't think I'd have felt any luckier if, instead of shortening The Wait, he'd said "you won the 10 million dollar jackpot."

So I wait for his word. If I don't hear from him I'll probably leave my ticker where it is. Time really is passing, however slowly. Oh, and I had my first eye exam today in about 20 years. I have astigmatism in my left eye apparently. Bummer, but I suspected it when I could barely read the letters on the eye exam at my driver license renewal appointment. On the bright side, there are some cute frames out there!

UPDATE #1: This isn't much of an update. And it's discouraging more than anything. The receptionist at my oncologist's office called me back and the answer to my question of whether MTX was still in my system was "most likely not."

Really? Thanks. My confidence in my oncologist shrank just a little. He was telling me to jump back in the sack Aug 10 and now he's telling me it may not be out of my system? And more perturbing was that he didn't say anything else. Come. on. Does he really consider that an answer? Most likely not? Now I know he can't say for sure, and that he wants to avoid a lawsuit, but there are some obvious follow up points he could have expanded on, seeing as how he wasn't going to call me directly and that this would be a one-way exchange. So I asked the obvious follow ups - "is there any way to tell? Does he think it's safe to TTC or not...because if I get pregnant and have MTX in my system, that might be dangerous, right?" I'll update again if and when I hear back. As happy as I am about being at zero and potentially getting to TTC again in about two months, I still get frustrated about not being able to really communicate with my doctors. I know I am so lucky and that I'm "most likely" 100% back to normal and that I should just be glad I have health insurance and all the blessings in my life, but this bureaucracy stuff still gets to me.

UPDATE #2: Another call from the receptionist this morning. Another answer of "very unlikely." This time I had picked up the phone so I pushed a little - "does that mean he's not worried about it?" Receptionist: "He can't say absolutely but no chance of MTX still being there, but he's not worried about it." This I already knew. I was hoping for a little more specificity like that he'd reconsidered the MTX issue and had declared that it would not be dangerous to TTC right now, just like he'd said at our meeting. Or maybe something about the half-life of MTX or the logic behind the 1 or 3 or 6 month recommendations. Instead I just got a very strong message that he refuses to say for sure whether there will be a problem. This makes sense. He knows that I know what that means. No one has a crystal ball. No one wants to invite a lawsuit.

I then asked whether there's any way to test - he had said no. There's no test. Maybe I'll ask Dr. OBG to add a folic acid test to next month's beta to see if at least that has been replenished.

Interestingly, on the way back from picking up DH at the airport, he told me about a movie he'd watched during his trip about a woman who had complications during her pregnancy and was told it was her life or the baby's. She chose to risk her own life and continue the pregnancy. The baby survived. She didn't.

I have actually made a concerted effort to make sure we avoid movies casting pregnancy or kids in a bad light, knowing of the delicacy of DH's position on kids. Predictably, DH's response to the movie is that he wants to wait as long as we had to to make sure there is absolutely no doubt that I won't be jeopardizing my health by getting pg. This is very sweet but of course there is no point at which there will be no doubt. I told him this. And I've told him what my oncologist said. But, barring DH getting over his fear or getting tired of the particular type of birth control we're using in the meantime, I think my ticker is going to stay where it is. I.e. two more cycles instead of this being the last one before TTC. We're getting there.

"HCG Results Day" or "1 step forward and 2 steps back"

UPDATED BELOW x3

Results: Less than 2. Actually the automaton nurse said "Less than zero" but we all know that's not right. Lies, lies, lies is all I get from that office.

The step forward is that I've graduated to monthly testing! No more weekly stab-fests. With any luck, my veins might regenerate a bit. Yesterday they had to put a warming pad on my arm to get anything out. And there was only one unimpeded vein available so we weren't taking no for an answer. This is good because as arbitrary as my doctors are, if - in all their anal wisdom - they're not worried about waiting a month to test, neither am I.

The two steps back is that she said "Now test once a month for SIX MORE MONTHS!" Friends, this is the second time the story has been changed. And frankly I've had enough. I had had enough about a month ago when the story was first changed. So that would make what I have had now more than enough.

As I've mentioned, I have an appointment to talk to Dr. GO in 10 days. I feel like I'm approaching a negotiation. Like my lawyering skills might come in handy in persuading a doctor to let me do something other than what they've suggested. But I also am convinced that the plan Dr. OBG is following is completely arbitrary and probably unnecessary and that Dr. GO knows that he will have to acknowledge that if he wants to retain any semblance of credibility. And while he may be hesitant to disagree w/ Dr. OBG, I'm not going to ask him to do that. This meeting is not about her. In fact, I've decided to not even bring her up. If he wants to bring her up, fine, I'll deal with it then. But this is a meeting about me and my life. I'm going to go in there and ask to talk about how long I need to wait before we can safely TTC again. As if no plan had ever been suggested. As if we were starting from scratch. If he brings up old sh!t, then I will try to calmly and deferentially explain that the plan has been changed a couple times and that I just want to understand exactly what the recommendation is. And I want to understand the statistics and science behind it. I'm taking time off work, cancelled my second opinion appointment, and am going ALL the way in there so I plan to get out of it what I damn well need out of it! Thankyouverymuch.

UPDATE: So instead of sitting here stewing in my frustration ALL DAY LONG, I decided to call Dr. OBG back and leave a question for her: Can we count the six months from my last MTX injection? I've seen journal articles that substantiate this, and while she may have no interest in my internet research, if she asks where I'm getting this idea from I can say "I might ask you the same question," and then launch into all the inconsistencies in her prescribed waiting period. I don't think my suggestion sounds unreasonable.

The best case scenario is that she at least thinks about it seriously enough to call Dr. GO and see what he thinks. If they "ok" the plan I can cancel my appointment with Dr. GO (huge relief).

Worst case is that she says no and that would be pretty bad because then when I go talk to Dr. GO about it, I will be officially going behind Dr. OBG's back. In fact, I might still have to cancel Dr.GO's appointment since if she does talk to Dr. GO, then I'll have re-conditioned him to agree with her just before the appointment. He surely won't be happy to see me in that case. But even in the worst case scenario, she may feel compelled to explain why she's asking me to do the wait that she's prescribed. Which is all I really wanted in the first place.

I think asking is worth the risk. I'm not being totally reckless, hopefully she respects that. And the payoff is huge. I could get excited about waiting until November and about skipping the trip to Dr. GO's office.

I feel a little like I'm bidding for a house or something. She says 7.5 months. I come back with 4.5. Maybe we'll meet in the middle. Or maybe I'll get the smack down again and just continue feeling miserable about how awful my doctors are.

UPDATE II: The automaton nurse called back. No counting back she said, "the six months are subsequent to the weekly quant." "What textbook are you reading that out of?" I wanted to ask, "cause mine is different."

No explanation of why my idea isn't a good one, no suggestion that we could re-visit the issue after more tests and regular cycles. She didn't say anything like, 'go ahead but here are the risks.' She wouldn't call me back herself. She didn't ask Dr. GO, I'm pretty sure of that. Otherwise she would've mentioned that she had talked to him and it would have taken her much longer to get back to me.

I can barely breathe I am so upset. I am still going to the appointment with Dr. GO on the 10th. He wasn't consulted so I still need to hear for myself what he has to say about all of this.

UPDATE III: So I can't concentrate on work because I'm upset. And angry. So I called back with a new message. WHY? Why does the six month period start now and not when HCG hit the zero range? Simple enough, right? The receptionist asked if I had already called with that message. I said my prior message was related but that I hadn't gotten the whole answer so I was calling back. Am I crazy? Or am I just finally being appropriately assertive?

Unfortunately I was informed that Dr. OBG won't be in again until Monday. I can wait. I'm getting good at it.

"HCG Results Day" or "Could that snail move any slower?"

Results: still less than two. Awesome.



Instructions: test again in one week. HELL NO. This has gone on long enough. So I protested this time. I told automaton nurse lady that I had a question for Dr. OBG: Why are we still testing weekly if, almost TEN weeks ago now, Dr. OBG said we would test weekly for four more weeks and then go monthly? The answer was that Dr. OBG changed the plan. Simple as that. No explanation, no call back from Dr. OBG. Not even an acknowledgement that the plan had changed. I. am. done. with. her.

Friends, this weekly testing thing isn't just annoying anymore, it's actually getting difficult for the lab to draw my blood. My veins can't take this weekly shit anymore. Even perfect shot guy had to jab me twice yesterday. He actually said "I can feel the needle snagging on the scar tissue." This was his grotesque explanation of why no blood was coming out of what was formerly my best vein.

Enough, I say. This is getting ridiculous. So I've decided to make an appointment with Dr. GO. To discuss dates and facts and come up with a plan I can live with. None of this "changing our minds" crap. I am worried that he'll be predisposed to agree with and defend Dr. OBG and I know that that is a very good reason to get a second opinion outside the group, but I also feel like we are so knee deep in this quagmire that jumping ship right now would be more trouble than its worth. Plus, I trust Dr. GO (as opposed to Dr. OBG who I emphatically do NOT trust). So if I can get him to understand my concerns, I think he will be straight with me. He's reasonable. I like him. I think I will feel better after I talk with him, whatever the outcome. Here are the questions I plan to ask (after I lead with the story about Dr. OBG arbitrarily changing her mind about how long to do weekly testing - just to develop the historical background for him, lest he's forgotten)



1. What is the science behind these numbers? Why 7.5 months from when my HCG levels hit zero? Why not 12 months from zero? Why not six months from the last MTX shot (my first choice, btw). I think I can leverage this question into a shorter wait.



2. What, exactly, are we worried about here. I mean I get that we're concerned about an uptick in HCG. But the most they ever went up by themselves is SIX lousy points. Are we worried that they'll go back up by six points on their own? Is that why I can't start trying again until over a year past my miscarriage?!? Does that seem extreme to you Dr. GO?

Dr. GO will inevitably defer to Dr. OBG. I'm expecting that and I'm prepared for it. I will say something like "well, she's told me that she's deferring to you. She's told me on several occasions that she doesn't have experience with this, she's never seen it before, and she's moved the target around without explanation. I made this appointment because I really want to hear your opinion as to what I should do. And why."

I am going in there armed with all my dates and values and conversations I've documented. I am bound and determined to make this a productive meeting because I think it is taking the place of my second opinion appointment. I just don't have the hours between now and the end of the billable year to be spending my days waiting in waiting rooms for oncologists to come out of surgery. I want the visit to be an investment. And if I can get one of my doctors to be on my side - meaning: to talk to me, to understand and address my concerns - it will have been worth it. And I want to clarify, by wanting a doctor "on my side" I don't mean that I'll only be satisfied if I get The Wait shortened. I really just want some honest answers. If it turns out that Dr. GO has a litany of anecdotal or statistical evidence that I really should wait another year, so be it. My goal is not to get a certain plan out of him (though I will of course be thrilled if its a shorter plan), my goal is to stop feeling so angry and mistrustful and alone in this process. My goal is to invest the time in making sure my doctor knows me and my case well enough to make an informed decision on my treatment. I'm almost a year from when we started TTC and I still don't have that. So this is me, trying harder. And when this is all over and I don't need an oncologist's supervision anymore, I plan to switch to a different OBG. Maybe even a different group, like Ka!ser.

Anyone had any experience with IF or OBG at Ka!ser?

Finally, I wanted to note that when I called Dr. GO's office to make the appointment the receptionist said "Oh hi, Astrid. Is this your three month follow-up?" Huh? "No," I said, "Dr. GO didn't ask me to come in. I just want to talk about my treatment plan. But I guess that's a fair way to classify it." She said that sounded good.

It made me feel better to know that follow-ups are the norm here. I just wonder why no one mentioned it before. Whatever.

UPDATE:

The day just keeps getting better by the moment. I have this FB acquaintance who has gotten into the habit of using the status updates to write how her pregnancy is going. Every time. EVERY UPDATE is pregnancy-related. It's like, her "thing." Sometimes it's a complaint which I find particularly offensive, sometimes it's cutsey, sometimes its u/s pics. There are weekly updates and milestones, etc. With no regard whatsoever to how this might come accross to someone who is having trouble. It's like the thought of 'having trouble' has never entered her mind. Like she thinks she's somehow earned the attention by getting pregnant (again). And if I were a betting person, I'd bet a LOT judging by the size of her friend pool and the age of her friends that I am NOT the only one having trouble.

Today, the most obnoxious of all. "18 weeks, time for in-vitro education! Bet you're all glad I'm working from home today!" Through comments to this post I come to find out that she's trying to teach her babies (oh she's having twins, did I mention that?) pattern recognition. By playing patterns of sounds. Really?

I otherwise quite like(d) this person but I'm starting to want to ask her: have you ever heard of infertility? Could you not be a little more sensitive and a little less ignorant? Could you please refrain from turning the home pages of all of your FB friends into a shrine to your pregnancy? It's not her first one, she's pregnant with twins after having two prior healthy pregnancies. One of her updates lamented that her youngest was turning two and finished "thank goodness there are two more on the way!" Blech. Not happy for her. Not one iota. She is not the person I thought she was and that's disappointing. This IF/loss journey certainly is one of those experiences that teaches you who your friends are and casts peoples' intelligence (or lack thereof) in a whole different light.

HCG Results Day

Results: zero

Instructions: test again in one week.

Really? I was so hoping I would graduate to the once-a-month testing schedule today. I've been testing at least once a week since about April. My levels have been in the zero range for over a month. Less than two for one month.

Again it was Dr. OBG's automaton assistant giving me the news so I couldn't break through the protective force Dr. OBG has artfully constructed around herself against anyone who's actually interested in getting any information as to their treatment or prognosis.

There are two reasons I dislike HCG Results Day. One is that as soon as I get up in the morning I'm apprehensive about getting "the call." When is it going to come? Should I wait by the phone? Will I get to talk to Dr. OBG? And most importantly by far, what will the news be? I get really worried, every single time, that the news will be bad.

The second reason I dislike HCG Results Day is that 99% of the time, the call itself leaves me feeling angry, whether or not the news is good. I get angry at not hearing from Dr. OBG after I've registered some very reasonable questions with her staff and with Dr. GO's staff. I get angry that she continues down the road of this ridiculous testing schedule that has no logic behind it, given my unique situation. I get angry that whatever I'm told on the phone, whether it's the Dr. or her assistant, all I hear is a hyper defensive voice saying "you can't sue me, I've covered all my bases." And whatever they're actually saying to me is about as helpful as that.

I am glad I got tested though because now, if AF is late (which would be understandable, I don't think I should expect my cycles to be 'regular' immediately after the ordeal I've had ) I won't worry so much that my HCG has come back up. And now I'm even tempted to get another draw next week, as I was told to do, even though I know it's unnecessary because I really do want to get Dr. OBG's blessing to test only once a month. And the sooner I go in for my next test, the sooner I might get that blessing. Why her blessing is important to me, given my opinion of her, is beyond me. I think it's 'cause I don't have anyone else's opinion to go on - my second opinion Dr's office hasn't gotten back to me. Also, I know that she's being conservative which tells me that if I follow her advice, I should be fine at the very least, even if the process is a bit protracted.

I think there's also a part of me who will feel a little scared of only checking in once a month. Once a week seems ridiculously over-frequent for my situation...but once a month seems like an eternity. And one day, I know, I will not have to go in at all..... Weird to think about now. But after six months of this, I'm sure I'll be ready to leave it all behind.

By my calculations, my Dec. cycle will fall six months after my HCG hit zero. So right now, that's the date I'm targeting for TTC (although my ticker is counting down to a conservative January 1, 2010). I keep reading journal articles that recommend a six month wait so I don't know why I would wait 7.5 as Dr. OBG has suggested. Whether or not I'll get Dr. OBG's blessing on a December start, and whether I'll be brave enough to go for it without her blessing remains to be seen. It also remains to be seen whether my HCG will stay at zero between now and then so I think I'll focus on that for now. And be grateful.

"HCG Results Day" or "I need a vacation"

Results: <2


Instructions: test again in one week.


No way Jose. Testing again in two weeks. I've only been testing once every 10 days so far anyway. There is no medical need to test every week. My Dr. OBG is crazy. And she of course didn't call me back herself so I had no way to discuss this or anything else with her. You'd think, notwithstanding the financial incentives she has to make me come in instead of advising me on the phone, that she'd have some sensitivity to what I've been through and my cries for help last week. But evidently not. Her receptionist called and said my levels were zero. "Does that mean less than two?" I asked. I'm not taking this "five is the same as zero" crap anymore. (Especially after my nightmare last night that the level was 3). And she said yes. So I'm glad.


I've been working like crazy. Nights, weekends. DH is about to leave for a month and I'm pretty depressed that this is how I'm spending the time leading up to his departure. Imprisoned at work. But I need the hours. It's endlessly frustrating. I'm supposed to go to a function with some of his friends this weekend. And I don't think I'm going to make it. But until I'm sure I will agonize over whether I can make it work, whether I should work instead, whether that will insult DH and his friends, it's a lose lose situation. If I don't go, this will be the second time in a month that I've flaked on his plans. And I'm sure it's not lost on him that I've somehow been available for my family, although I did have to blow off a (pregnant) friend for lunch last weekend when DH and I both had to work. Hmm...I'm noticing a pattern of selective busy-ness. It's like I'm prioritizing work above things that maybe I shouldn't. Like spending the weekends with friends. Or at least with each other.

So I'm under a lot of pressure (some admittedly self-inflicted, this is one of many things I'd like to work on about myself) and my stress level is through the roof. And it bothers me that this affects not only my marriage and relationships, but also my fertility. When I was getting my blood drawn yesterday the phlebotomist was telling me how important it is to relax when trying to make a baby. She has seven girls. She said it will happen, I just need to relax. Any stress at all can disrupt your cycles, she said. Really? Any stress at all? It's a wonder the world is so populated. At least I have a few 'freebie' cycles before we start trying again. I better get all my stress out now.

"HCG Results Day" or "I've had it up to here"

I got my blood drawn last Friday. Morning. So W(hy)TF haven't I gotten my results yet? Every time I call in for my results the nurse says something patronizing like "the doctor will call you back when they're ready, like she always does." And yet....here I sit....almost time for my next weekly draw and I still don't have them. I'm going to call - under the guise that I'm also trying to find out what Dr. GO says about wait time. Dr. OBG said she was going to check with him as to whether the testing/waiting process needed to be 'tweaked' at all. Let us pray.

UPDATE: The nurse called me back. My levels are "still at zero." Which could mean anything coming from Dr. OBG - recall a couple weeks ago when she said "your levels are FIVE! Which is basically zero!" even though the previous week they had been two. So the levels had gone up and she tried to convince me that five was still a good result. I was almost in tears. And recall that the first time my levels were two she said that was basically zero too. And I said "isn't there a lower number, like 'less than 2?'" and she said, and I quote, "not really." Which is obviously crap. Because the next week I did get "less than two" and it was pretty damn monumental, according to Dr. OBG. And recall that she said five weeks ago that "now that your levels are negative we'll do weekly testing for four weeks and then go to monthly." But now that they're at a true zero we're doing six more weeks of weekly testing?? So results that were 5 or 2 weren't really negative enough after all? Basically I draw from all this that 'zero' means whatever the eff she wants it to mean. She thinks she's protecting me by telling me what she thinks I want to hear and assumes that what I want to hear is the best case scenario, but the lack of honesty just makes me so angry. And the nurse said that Dr. OBG wanted me to know that Dr. GO said to go ahead with the 7.5 month plan.

Feeling a bit of rage coming on over all of this (I am really thinking more seriously than ever about getting a new OBG) I called Dr. GO immediately for an explanation. Dr. OBG is clearly uninterested in talking to me. The receptionist at gynecologic oncology told me I'd have to make an appointment for this kind of conversation. I called BS...as politely as possible. I told them I'd been talking to him about my case over the phone for months and had already come in once and that I was pretty sure he'd be ok with a phone conversation. I am pretty sure. And I have SO had it with this cryptic arbitrary treatment and testing schedule and lack of honest communication. I HAVE HAD IT. Goddamnit, I want some answers - I've gone six months without any and now I want some. Real ones, not sugar coated, not overly conservative, I don't want textbook answers if I'm not a textbook case. I want customized treatment. Or at the very least, the facts. Plain and simple. I want someone to explain to me the logic behind a 7 month wait. It would be nice if Dr. OBG could justify changing her mind from four weekly tests to TEN but I'm sure that's asking too much. Call me demanding but this is my fucking life they're messing with. Good lord, if AF hadn't just ended I'd swear I was PMSing.

I also wish someone would say - "it really is up to you, these are just our recommendations" and then explain their recommendations. If they don't want me going to the internet, then perhaps they should provide some reasoning. Curiosity is human nature. So when they tell me to wait 7 months and don't tell me why, of course I'm going to second guess and do research on my own. I'd like them to at least acknowledge that I have some understanding of and control over my own situation, even though their recommendations are (arguably) more medically sound than anything I could come up with. It would be nice if they could just be a little more respectful of what I'm going through. Maybe then I'd respect their opinions more. And even if they don't say it, I'm hereby changing the protocol and doing bi-weekly blood tests instead of weekly. I'm going on with my bad self. Don't try to stop me.

UPDATE II: Dr. GO's office called back. A receptionist. She said "Dr. GO COMPLETELY agrees with Dr. OBG" and that if I have any other questions I need to make an appointment. I asked if I could make an appointment to talk to him on the phone. "No, you'd need to come in." I said I didn't understand, I only need a five minute conversation with him and coming in would take an hour and a half and I just don't have the time with my job in this economy. I actually said the words "in this economy." And I wasn't bluffing, I actually don't have the time. This is part of the reason I'm changing to bi-weekly testing. I have a lot going on at work and a great deal of pressure and the added risk of getting a pay cut if I don't put in enough hours in the next few months.

Am I being unreasonable? Will someone please tell me if I should tone it down (or up - maybe i just need to grow a couple)? I wouldn't take no for an answer - I just kept telling the receptionist yes, I understand what the plan is, I just need a rationale. No one has told me why they've agreed on this treatment plan. I need to know if Dr. GO thinks I have GTD, is that why the long wait? I feel like crying, I just don't understand this. Are they afraid to give me an explanation? Afraid they'll get sued? Afraid to tell me too much? Afraid it might cause "patient anxiety?" Was he lying when he said "feel free to call with any questions?" Fuckers. I feel trapped. And helpless. As if having something like this happen to me isn't traumatic enough. Now my own doctors won't even talk to me.

"HCG Results Day" or "All Hail the Arrival of AF"

No joke. That's what it feels like. Like the arrival of a sacred diety. Or Hayley's commet. Today is a day exactly 5.5 months from my D&C and exactly 8 (count 'em) months since my LMP. And now, today is my new LMP. CD 1. I am almost crying. I wondered if this day would ever come. And how it would come, and what I would do and how I would feel. I imagined how happy I would be. And oh how happy I am. I am sleep deprived, I am frustrated by work, I am all tore up after wrestling with chicken wire for 4 hours yesterday in the interest of protecting my precious fur babies, DH is leaving for a few days. But I could not be more gleeful. AF is here.

Related good news is that the uptick in my BBT roughly two weeks ago that sent me into a cycle of despair and caused me to put away the thermometer was probably ovulation. I feel like a kid at the best Christmas of their life.

Wasn't I just posting yesterday about how I didn't have any AF symptoms? Isn't that weird? Well they all seem to have set in at once. Woke up with cramps, had a backache last night but assumed it was from building a freaking fence - which would make sense, right? I'm feeling heavy and bloated and a little nauseous. My boobs are not sore. Which makes me think...why were they sore the month before I got my BFP. I thought it was an AF symptom since I got it both during the month I got my BFP and the month before. When I saw only a faint line and assumed it was an evap line. The next day there had been no line. I'm starting to wonder if I had a chemical pregnancy before my BFP. Which would be good and bad. Bad 'cause it means my m/c was a second m/c. Good because it means my body is capable of flushing out HCG in a timely manner and the past 5 months were a fluke. You see, I am PETRIFIED of getting pregnant again so any sign that I will not have to go through this again, however attenuated, I will latch on to. I don't know that I could handle another year-long ordeal. I don't know if I could cope with another m/c that turns into a months-long waiting game. I don't know if I could cope with spending my child-bearing years going through year-long attempts and disappointments. I could handle more m/c's. I don't know if I can handle another possibly-cancer diagnosis resulting from a m/c. So I am scared that my body doesn't metabolize HCG effectively but am hoping it was just a fluke.

This certainly helps me to set my sights on trying again. I can't try again anytime soon because of the recent MTX injections and because my folic acid is likely still depleted and because my HCG could come back up if my so-called gestational trophoblastic disease shows itself again. But I can now focus on BBT charting, pinpointing the day of O so when we do try again we'll have some focus, FEELING NORMAL (which is vastly underrated, just like AF and getting a trim, among other things), getting healthier (read: drink less), training the dog, working on my relationships, working on work, and a myriad of other things I need to catch up on both practically and emotionally. Who knew AF could be such a motivator?

UPDATE: Beta results are in.

LESS. THAN. TWO!!!!

Speaking of things I thought would never happen. I got a message from Dr. not-my-usual-OBG saying 'congratulations, I know this has been a long wait to get this good news.' I listened to the message twice. She rehashed what the office usually does for molar or GTD pregnancies: I would need to get negative (less than two) tests for three weeks in a row, then monthly tests all negative for three months in a row, then test negative every three months for, and get this, she said "for three months" in a row. Which puts me at roughly six or seven months from TTC again. But if what she really meant was test every three months for "three negative tests in a row" then they're talking more like a year away from TTC. Hell's to the no. I think I can swing a six month wait but since there was no confirmed molar tissue and since my levels, while slow, pretty much came down on their own, I don't know if I can wait a year. Fortunately, the dr. qualified what she said by mentioning that since I'm far from a usual case (I never thought that might be a good thing) I may have worked out another plan w/ Dr. OBG and I should follow her advice. Dr. OBG, before she went on vaycay alluded that it would be more like a three month wait. Dr. GO seems to think I can wait three days and be fine. So I'm still holding out hope for the 6 month wait from the last MTX shot which would mean around December/Jan. I will talk to Dr. OBG when she gets back. The last thing I want to do is doom myself to another experience like the one that is hopefully drawing to a close.

This seems like too much good news for one post. Or even for one day. After discovering AF this morning I asked myself, what good thing have I done to deserve this? It must have been wonderful. And then I realized - I think I've been through enough. So much that I can confidently say - I deserve this. Good or bad behavior, it's time for me to get some good news. It's enough that I am me, weathering my experiences, to afford me a little peace of mind once in a while. I don't have to do anything to deserve it. Other than survive.

"HCG Results Day" or "Has it been a week already?"

The quality of having time both fly faster than you ever thought or wanted to be possible and simultaneously crawl by at an unbearable wretchedly slow pace may be one of those unique characteristics of the IF world. This has certainly been a theme in my life lately.



The Big Fight between me and DH got worse before it got better. But I think it's dissipating now. I am just gauging by the unsolicited kiss goodbye I got this morning. And the fact that he slept in the same room as me last night. This has been a real doozy and I hope never to repeat it. It's been crunchy and ugly and sad, not one of those 'productive' fights where you both learn something and are closer or better off for having gone through it. This was just based on a misunderstanding and a direct difference of opinion and stubbornness (and DH's inability to be logical or sensitive about anything! oh, sorry, and I was trying so hard to be civil about this). I had a dream in the midst of The Big Fight that I had lost my wedding rings. Just plain they were gone. I couldn't find them and I was kind of frantic about it. Definitely a stress dream. I'm not much for interpreting dreams or signs or believing in the paranormal or being superstitious...and if I'm being really honest with myself the dream probably had more to do with vanity and insecurity than anything else (oh no, i broke up with my husband, which means no more wedding ring...but it was so pretty, and i felt so legitimate with it on). But I do wonder if it could have meant something else... Like was it a directive? Was it foretelling of what's to come? I'm not going down that path.



My beta stick yesterday was a bummer. It was my old friend 'perfect shot' guy. I forgot my squeezy stress-ball duck that i usually bring to grip on to ('cause they don't always provide stress-balls in this lab - sometimes you're left just squeezing your hand around itself as tight as you can and I swear I find that so uncomfortable) because I had left it in my 'other' purse. So perfect shot guy (who is aware that I carry my own stress ball around with me for the purpose of these draws and thus asked where the duck was) and I talked about purse fetishes and how his wife has two louis vuitton's and a gucci and some burberries. I usually stick to coach, I said. $450 is pretty much my very highest limit on what I'm willing to spend on a purse and I really try not to do it more than once a year. We also talked about where his wife and I go shopping - there are some nice (and dangerous) high-end malls around this area. I'm going to one of them this weekend to get my hair cut and a father's day present. DH is going on a weekend trip with the boys this weekend, so I will be alone. At the (high-end) mall. This is going to be trouble, I just know it. I might mention here that DH and I have separate bank accounts still.



Anyway, perfect shot guy had to stick me twice. Despite being a perfect shot. The first time, my vein just plain ran out of blood. It was going really slowly and then, all of the sudden, there just wasn't anymore - like when you suck the last part of your drink through a straw and you're left with just bubbles and air going up the straw instead. "I guess that's it," I thought, "you bastards have taken ALL of my blood....There is NO more." That's one way to get my beta HCG to zero.



But of course there was another vein. Because I have two that are available for blood draws. Thank god it's not just the one. The first one, we concluded, is too scarred up and consequently shrunken to get any blood from anymore. It's really taken a beating this year. Poor thing. The second one, which originally was smaller than the first, is now our best bet. You might say it's our only hope since no phlebotomist has ever successfully gotten blood from any vein other than these two. And #2 worked but now I look like a heroine addict. Again.



Dr. OBG is out of town this week and next. So all rules I know about how long it takes for the office to respond and what that says about my levels are meaningless today - this is somewhat relaxing. Maybe I'll get some work done.


UPDATE: Dr. not-my-usual-OBG called me back as soon as she got in this morning. This was very much appreciated by me. The level is back to 2. This has caused me to take a giant sigh of relief but I am still not rejoicing in the halls because she says they really should get to "less than 2" before they can proclaim that I have reached my goal.

"HCG results day" or "I wish I had a Xanax"

I got another HCG beta yesterday. I called this morning and the receptionist said the Dr. would call me back. This means the results are in. If they had not been in, the receptionist would have said "the results are still pending, please call back later." I then got a (kind of rude) message back from Dr. OBG's assistant saying "Dr. OBG will call you back when all the results are in - as she usually does." Like, pipe down and quit calling us. We'll call you. First off, they don't usually call me. They forget all. the. time. I really have had to keep on that office to get my results. And still I've missed at least one that I know of. It's been incredibly frustrating, actually, so imagine my disgust at being talked down to like this after all this micro management I've had to do. Secondly, if the results are now in and Dr. OBG has taken the time to talk to the receptionist about how to respond to me, why didn't she leave the HCG number in the message? It would have taken half a second to check the computer screen and relay the number. Why didn't she? Was she away from the computer and just hasn't gotten back to it in the last three hours?....

...or was the result bad and she's checking with the oncologist about what to tell me? I've said before that a late answer means a bad answer. It always has.

Recall also that it's not possible that the results just aren't in yet, since I would have been told if that was the case. So it's probably a bad result.

I guess that makes sense. I had such a fantastic day yesterday, I'm due for some major disappointment and additional traumatic stress. Well that's not true about yesterday. Yesterday was sleep-deprived and stressful at work and full of angst over some issues with the new puppy. But I got a gentle leader which solved most of my puppy issues and we had the best walk since getting her yesterday evening. (PS Get one of these gentle leader deals if you have a dog that pulls or gets aggressive or anxious on the leash. It will change your life. I'm not kidding. In so many ways. Not the least of which is that you will be more popular in your neighborhood because you will be a more sane, humane, and effective dog parent. And your dog will stop being a terrorist. Which is good for you and your dog. And your neighbors.) So I had such a fantastic hour yesterday. So it makes sense that shit should rain down upon me today. So here I sit. And wait for it.

UPDATE: Level went up three points. It's now 5. It "more than doubled." What an awful outcome. Dr. OBG said she wanted more than anyone to tell me today that it was a true zero! She was so disappointed that it was 5. Not as disappointed as me. But she tried to stay upbeat saying thankfully, no change in treatment - meaning no chemo...yet. Just keep waiting it out is the plan. She was trying to be optimistic 'cause she could hear the disappointment in my voice and my words. The first thing she said was "it's five...which is essentially zero!" Which is BS. It's not zero when you've been waiting for five months for it to be zero and numbers go from two to five. Don't BS me. I asked what the levels have to be for me to start cycling again. She said "less than five," not realizing probably the gravity of that remark. She probably said that 'cause she wanted me to think I'm in the range. But what I heard was that now I'm one point above the 'cycling normally maximum'? I HATE this. On one hand, given the trend in my levels, three points up is no big deal and I'm not super worried. On the other, that little mini AF is behind me, there's no indication that I'll shed any more tissue in the next week, I'm now even farther from my last MTX injection, so if something is still growing it will have every opportunity to thrive in the next few weeks. Let's hope not. I'm getting so tired of this.

It's about damn time.

HCG is TWO! Which means negative!..........!!! AAAAAAGGGGGGGGGGGGGHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH

I mean Dr. OBG said it means negative. I protested, "isn't there a lower increment, like 'less than 2?'" She said "not really. Two is negative" I'll take it. I can't really believe it. In fact, I don't dare believe it. It could still come back up. But that seems less likely by the week thanks to this very-light-but-still-respectable AF I'm having and the fact that I haven't had a MTX shot in weeks and that I've been religious about prenatals! I know that people have an upsurge in HCG sometimes years after a molar pregnancy or choriocarcinoma (more typical is an upsurge within the first 6 months of a negative result), so I am not making any rash assumptions here. Just very greatful that I'm on the track towards normalcy.

I just keep thinking about it and smiling. What a change from the last six months.

Dr. OBG herself called to deliver the news, after talking to Dr. GO. They agreed I should get weekly tests over the next 6 weeks and evaluate as we go. I am hoping with every fiber of my being for the best. It's funny - because there is a risk that the levels could go back up, this is really just one more step on the path, just like any other drop in the numbers. But it feels more momentous to have your doctor say your HCG is negative. And that I should expect wonderful AF more regularly now. Wonderful wonderful AF. Let's hope!

Good news and bad news

Good news:

Beta HCG is FIVE! Despite having started prenatals and stopped MTX.

Bad news:

Maybe that means we shouldn't have stopped the MTX so soon...will ask Dr. GO about this asap.

Potentially counterveiling good news:

I'm done with my course of Provera, so something could happen to help things along any day now. Zero symptoms though. Does anyone know if it's normal to have NO symptoms (no cramps, no discharge, no sore bbs, none of that "impending AF" feeling, etc.) the day following 10 days of 10mg of Provera? Or would I be feeling it by now if it was going to bring on AF?

Another wait with a side of obsessive deductive reasoning

I ended up being ordered by Dr. GO to get my beta HCG drawn last night. Lame. Really, what is the point? The day 4 result is historically meaningless. So I went and the 'bad boy' of the lab techs (same one who gave me an unauthorized standing order to get HCG draws - I know, scandalous) tried to set me up to get my results faxed to me. However, that process seems to have been derailed. Apparently lab results are super top extra secret and it is a pain in the ass to get ahold of them. So I called Dr. GO to get my lab results this morning. The receptionist said that while she had access to the results, she couldn't disclose them until the doctor has had a chance to review them and she wasn't sure whether he had.

However, she also said she had tried to contact me earlier today to answer my question about how often to get tested from here on out. Now, my question wasn't really how often to get tested, I know that depends on what the results are and whether treatment continues. My question was whether to get tested yesterday and I had tried to explain that I shouldn't need to get tested until Thursday. But in true form, the receptionist had totally misinterpreted what I was saying and made up her own question. Anyway, she said she had asked Dr. GO about my non-question and he had said that I should get tested once a week.

Giveaway?

Does this mean Dr. GO did review my results this morning and determined they're not low enough that another MTX injection is in order? Weekly draws were going to be the outcome if the MTX had not gone to zero. So does this mean a non zero result? If the labs were near zero the answer would have been, "it's working! test friday and get a MTX injection," right?

Or was he confused by the question, knowing that I know that the real answer is "it depends," and just gave a safe answer that doesn't really mean anything.

Or the third option: I am, characteristically, overthinking the issue.

Before this phone call with the receptionist I wasn't sure whether I preferred 1) a close to zero number + more MTX or 2) a higher HCG number and no more MTX right now. After the phone call, I realize I would prefer option 1, the low HCG + MTX. But I guess not by a lot. A non-zero means I can stop taking MTX, drink with abandon, test once a week, see what happens with the provera, maybe start the clock on the 6 to 12 month wait before TTC again, and possibly conclude that what I have might not be cancerous. But it could also mean more lethal chemo along the way if it does turn out to be cancerous. It's really a lose-lose. I just can't get my head around how long this is taking to resolve itself. It's become a mind-blowingly huge chunk of my life.

Dr. GO will get back to me, the receptionist said...

UPDATE: Dr. GO didn't get back to me, but Dr. OBG's assistant did. Beta is 8. Again. Will this never end? No seriously, will it never? This is so disturbing. Its 4.5 months past my D&C with FOUR MTX shots, which, admittedly, may have had no effect (but then, how to explain the precipitous drop just following the first injection...). How is this possible? And what does it mean when the gynecologic oncology receptionist says "this certainly is an interesting case." It's oncology, is this really an 'interesting' case, relatively speaking? Am I a freak of nature in some kind of alternate universe? Should I just accept that my HCG will never get to zero during my reproductive years and I have no hope of having a baby? Is this a sign that my hormonal system is so jacked up that even if I get pregnant again, my body won't function properly and it too will fail? Or is it part of the choromosomal fluke and not likely to happen again?

Actually, having talked myself up about possibly not having to do another MTX in the first part of the post, I'm kind of ok that it's still at 8. But not totally, but I could use a break. And really, I have no basis upon which to declare myself free of MTX this week since I still can't get either of my doctors to call me back. Eff.

In other news, I'm taking a trip to the dog shelter this afternoon to take my mind off 'things' and possibly add to our family. But this adds it's own kind of stress. DH wants a big dog. I want a small one. DH always does what I want so I want to to it his way this time and get him a big dog. But it's SO impractical for us. And there aren't any big dogs at the shelter that fit our criteria. So we may end up doing things my way once again. And I will have to somehow deal with the guilt that will inevitably ensue.

Work is busy, that helps get my mind of this too. So I will carry on. Still hopeful. Still thankful the numbers didn't go up.