Green Smoothie, Anyone?

Pinterest has inspired me again! I have about two billion recipes that I plan for us to try at one time or another. We’ve tried a few that I’ve pinned – all but one were hits. Pretty good results to me! But recently I saw a pin for a green smoothie and started thinking that maybe I ought to try them again. I tried a couple when we were living in Minnesota, and I didn’t dislike them (well, one was gross) but I never stuck to drinking them. With all that is going on I feel like it can’t hurt me to be as nice to my body as possible. With us still staying in Wisconsin I’m not able to cook like I’d like. With a green smoothie I’ll be able to get tons of proteins, nutrients, and healthy goodness that I’m undoubtedly missing out on these days. I’ve also read that they help you lose weight (score) and….um…clean you out. So I’m kind of going to go into this as an experiment in addition to striving to provide healthiness to myself.

I found a Hamilton Beach personal blender at Target for $16.99 and went that route instead of buying a big ol’ whopper of a blender (though we do need a full-size one since our blender/food processor combo broke on us a while back). It is a 14 oz capacity, and the blender container part can be used as a cup. The lid has a slidey top to drink out of and it looks like the bottom would fit into a standard drink cup holder in your car. Pretty convenient! Oh, and it worked really well! I was wondering if it would be wimpy, but it wasn’t! You have to hold the “blend” button down the entire time, but that’s no big deal. Also, you can't blend warm/hot mixtures, but that's alright for me.

What did I put in my green smoothie? About a cup of fresh blueberries, half a peach, a medium-size banana, and about large handful of fresh baby spinach. Before when I tried this smoothie I used frozen fruit, but I think fresh fruit is the way I will go this time. Only thing about not using frozen fruit is that my smoothie today was warm…and that’s gross. Adding ice helped though, so I’m all good. If you haven’t tried a green smoothie and think that it would be nasty – and believe me I was prepared to be grossed out when I first tried them – you probably will be pleasantly surprised! You really don’t taste the spinach as the fruit makes it sweet tasting. I’m noticing an…earthy aftertaste as I sit here writing this, but it’s not bad at all. I’m planning on trying new fruits over time, and also adding increasing the greens ratio. I’ve read that any type of green will work in these types of smoothies, but spinach is sweeter so it might be a good starting point. I would recommend green smoothies! How can you go wrong with getting so many good things in one serving?! By the way, the ones I've made so far are NOT pretty. They've take on a really ugly color, but don't let that scare you!

Wasn't Expecting That One

Yesterday I got news that I never would have expected to hear. When I heard from the nurse on Tuesday she explained my results, told me what my immediate next step would be (Provera for ten days to start a period), and then said that Doctor wanted to have a phone meeting with me. I scheduled the meeting for Thursday (yesterday) and I slowly got more and more apprehensive about what Doctor wanted to discuss. I figured that it had to be pretty serious if he wanted to talk to me, otherwise why wouldn’t he have just had the nurse instruct me of the next step he thought was appropriate.  Okay, so I was way right.

My doctor is thinking that my egg reserve is decreasing prematurely. This typically doesn’t start to happen until a woman is around 51 years of age.  See but I’m only 31. The reason he thinks this is what’s going on is based on the fact that my body didn’t respond at all to the Letrozole I was recently on. Another indication that something is seriously wrong is that it took about twice as long to produce one follicle measuring 19mm back in April of last year when we had our first round of treatment. He said that I should have had 10-15 follicles of 20-25mm by that point. The fact that it had taken so long to just get one follicle to get to the appropriate size was not a good sign. When I say that this was the last thing that I ever expected to hear that it is a total understatement because the possibility of THIS happening wasn’t even in my mind. I thought he was going to say that we needed to move on to the injections or at the very worst that we just needed to move on to IVF. I was not expecting to hear that I wouldn’t be contributing anything on my part to this process.

So here’s what we do: We need to confirm that this IS what is going on. On day three of my cycle I’ll go in for bloodwork and an u/s. He’s going to do check my FSH and estrogen levels and also my Anti –Mullerian Hormone (AMH) levels.  From the little research I have done and to state it very basically, AMH levels help to show the remaining size of the egg pool, or “ovarian reserve”.  As a woman gets older, the AMH levels decrease as does her egg pool. I’ll also have a u/s done to check my antral follicle count. What are “antral follicles”, you ask? They are the small follicles that can be seen, measured and counted during a vaginal u/s.  Basically the number of antral follicles they can see indicates what is left in the ovarian reserve/egg pool. As women age the antral follicles decrease along with the eggs in the reserve.

So what does this mean? If this in fact is what is going on with me then our options at this point are adoption or donor eggs. The donors are selected by Doctor’s office and are put through a thorough screening process to look at family medical history, lifestyle, their general health, etc. Only the most promising and healthy donors are approved for donation. They would look for donors who share similar physical characteristics as me/us. We wouldn’t meet the donor – this is all anonymous, which I would prefer. So she won’t know who is receiving the eggs and we won’t know who is donating them. How does it work? The donor would go on the FSH injections that I would have been scheduled to take. This will allow Doctor to control the growth and status of her follicles. When the time was right she would give herself the trigger shot to initiate ovulation. She would then go into their office and the egg retrieval would take place. At that point, or by then, Steven would have dropped of his sample. The two would be combined, and then after five days I would go in and an IUI would take place, except rather than injecting sperm into my uterus they would be injecting an embryo. At that point we would hope and pray that it attached.

How do I feel about this? I mean, assuming this IS what is going on, I guess I feel relief that there is still an option for us before adoption. I’m not against adoption in any shape or form, but I think that it is understandable that we would want to eliminate all possibility of conceiving our own biological child before moving onto that option. While this child won’t be mine biologically it would be Steven’s, and I would still be carrying it and delivering it. I can’t ever see a time when I would look at the baby and think, “You’re not mine.”, you know? So while I’m appreciative that there is still another step for us, I am saddened by the thought of not seeing myself in my child physically. You know, in the end though, that is not important and wouldn’t stop me from wanting to go through with this. If we are interested in adoption, should that be our only option in the end, then I’m certainly open to using donor eggs. In the end all that is important is that we have a healthy baby. Hopefully this will work for us. Let me tell you that it is really strange to discuss my hair and eye color with the coordinator who finds and matches donors with recipients. I never thought I’d be having conversations like the ones I had yesterday. But I guess this is the hand that we’ve been dealt. I’m grateful for my husband for his continuous positive outlook. We knew before we got married that we would need help having kids, but we never anticipated that it would come to this. At the very beginning of our journey we just thought that I would need help. Then it turned into him also needing help. Then it turned out that IVF would probably be our only option. Now I can’t even contribute a single follicle to create an egg and we are discussing donor eggs. Throughout this whole process he has only been positive and has remained upbeat. Up until recently, we were told that we’d only be able to do IVF, I was also positive and certain that this would work out. Since the IVF day I’ve had a hard time staying positive. I do continue to think that things could definitely be worse and that what is supposed to happen will happen, but I’ll just say that it is good that he has and will continue to remain optimistic when I’m not feeling it.

It’ll be a little while before I go back in for testing. I’m anxious to find out what the results show, obviously. In a way I’m alright confirming that this is what’s going on with me. That way we won’t be talking about follicle growth and hoping that I can grow follicles. Instead we’ll be talking about when we’re going in for the procedure, which is very positive to me. We’ll see….

Bitch Ass Ovaries

Friday I went in for bloodwork to check my estradiol levels and to have an u/s to see how things were looking after a week on Letrozole (5mg). Results were not what I wanted to hear: the lone follicle that was found during my baseline u/s was still hanging out but it hadn’t grown at all. This, from what I understand, made it a non-functioning follicle. Doctor decided to have me take my final round of Letrozole the following morning and then come back the next Tuesday (today…I’m behind) for an u/s to see what’s what. Here was my thinking: If nothing had happened after a week on the Letrozole it was pretty unlikely that I would suddenly pop up with several follicles on my own over those three days without the drug. That brings us to today, Tuesday….

I went in for my u/s and heard back fairly quickly from the nurse. The verdict: Doctor had decided to cancel this round because there were no follicles to be found, only a couple of cysts. So I’m to start Provera today and take that for ten days. This will “calm my (bitch ass) ovaries down and start a bleed” according to the nurse. I’m also scheduled for a phone meeting with my doctor this Thursday.

I saw this coming. Not from the start, but after Friday when the lone follicle hadn’t grown at all. I knew in my heart that there would be no good news to find this morning. That doesn’t mean I’m pessimistic but, rather, realistic. I understand enough of what’s going on based on previous experience to just know when something isn’t going to work. But knowing it and expecting it doesn’t make it easier to take. There were tears, but I’m alright now. Frustrated and disappointed, yes, but I’m alright. I struggle with how disappointed I should be throughout this process. Even though we’ve been WANTING and have technically been on this road for several years, it isn’t like we’ve actually been TRYING. I understand that there are women and couples trying month after month on meds, some of them even losing babies, so I know that we haven’t exactly been through the wringer just yet. But, as my best friend (shout out, MLR) helped me to understand, we still have been on this road with or without results. I think for the longest time I just wanted to be doing SOMETHING with this process. And now we are and I should be relieved because we are making process. Not the progress that I’d like, but we are making progress. I understand that, while it sucks that my body didn’t respond to 5mg of Letrozole that maybe it will respond to double that. Doctor can’t slam my body with a high dose of medicine. That would be dangerous and we’d still end up in the same spot – with nothing…except maybe really bad effects from over-stimulation. So I get it. I do, but it still sucks. I’m trying really hard to have a positive outlook, but I’m struggling. I’m not down in the dumps and wah-wah. But I think I just need a smidgeon of good news. Just a bit. I really don’t know what to expect Doctor to say Thursday. Like Steven keeps saying, the worst case scenario right now is that we end up back where we were a year ago with the injections. We know THAT worked. So we wait until Thursday…..

Okay, and as a sidenote, I would like to address my ovaries. If you don't want to function properly (I know, there's more to it than that), can you at least NOT HIDE DURING THE U/S's? IT'S NOT FUNNY.

A New Start

I haven’t really felt much like sitting down to gather my thoughts on what’s been going on with us fertility-wise in quite a while. Up until the past couple of weeks it’s kind of been up and down and all over the place for me. I’m not sure how many people will even read this, but I’ve decided to get back on with it and write for myself also. It feels helpful to get my thoughts out and write it all down. And who knows, maybe one day soon I’ll be able to reflect back on our journey in a positive light.

So here’s what’s going on. The last time I posted we basically didn’t have any idea of what was causing Steven to have a low sperm count. He had been tested, examined, poked and prodded as thoroughly as was possible and there was still no explanation. His urologist wasn’t offering the option of putting him on meds to try to boost his numbers (which he had been one for a short time last year). According to their ratings he was at the low end of normal. The very low end. To me that was very frustrating – why not at least see if some medicine would work to help us out a little bit. But no, that wasn’t an option with this guy.  He felt that Steven was too young and I guess he was worred about long-term effects. Which to us didn't make a whole lot of sense because it's not like Steven would have to be on anything for the rest of his life or anything . But then again we are wanting something pretty badly. And also we aren't doctors and stuff. After reviewing both of our most recent results my doctor handed down the ruling that our only option would be IVF. Now. Here’s the thing. When we first started seeing fertility doctors years ago we always said that if we ended up having to do IVF we definitely would. Of course we would! We want a baby! We’ll do whatever it takes! But see, when it came down to it, even seeing it coming for a few months, the ruling hit me like a ton of bricks. It wiped me out. Having to make that decision, when it came down to it, was massive for me. It was the most heavy decision I have ever faced in my life so far. I have faith in modern medicine…it’s not the medical aspect of it that scares me. It’s the fact that it is so expensive and there is no guarantee that it will work. It is more invasive. It is draining physically, mentally, and emotionally. I ended up going to visit my parents that same day and I swiftly morphed into an emotional mess. I mean, I wasn’t traumatized, but whenever even thinking about THINKING about making the IVF decision crossed my mind I would start to cry. What if it didn’t work? What if it did work? The money. If it doesn’t work it’s like lighting $15K on fire and watching it burn. It’s like paying for a new car up front and not knowing if it’s going to run. But what if it did work? It’s not like we have oodles of money lying around, so it wasn’t like we could just turn around and start another round of IVF if the first one didn’t work. So we’d have to wait for some time to try again. But what if it did work? I started thinking that maybe we should start the adoption process. My thought was that even though adoption is costly and can take quite a long time, at least in the end we’d have a baby or child in our home, you know? Steven wanted us to try a round of IVF and then if it didn’t work we would start the adoption process.  I was stuck on the issue of time. As with starting another round of IVFI, I knew we would be able to financially start the adoption process immediately. Time going down the drain. Keep in mind that I was in an extremely emotional state at that point and so everything was doom and gloom. I still have anxiety over the decision and what it involves, but I'm feeling considerably better. I don't cry when I think of THINKING of the decision now, so that's good. Basically we were stuck in a horrible place where neither or us would budge from what we thought we should do. This might seem really overly dramatic to some people, but when you are faced with such a heavy decision that has no guaranteed outcome it can be as bad as I'm describing. BUT WHAT IF IT WORKED?

Around this time Steven started working in Wisconsin, filling in as a GM for the sites there.  I’m going to skip a bunch of stuff and just say that I became friendly with one of the girls who worked at the hotel we're staying at. I’m a talker. I’m my mom’s daughter. I’ll talk to strangers. I’ll talk to the wall. So she and I ended up talking about what's going on with me and it turns out that she too had to see a fertility specialist for help getting pregnant. While our situations aren't exactly the same, they were similar enough to make me wonder if I shouldn’t make an appointment to at least meet with her doctor for a second opinion. Y’all, it was the best decision we have made. This guy is awesome. He took the time to thoroughly detail what my body and Steven’s body SHOULD be doing and what our options were. I mean, he drew diagrams. Might not seem like a big deal, but to me the fact that he took the time to so thoughtfully talk us through what’s going on, what can be done, what our options were, etc, meant the world to both of us. We didn’t feel like customers, instead it felt like he WANTED to help us. Like he cared. One thing he threw out there as a possible explanation was that I might have PCOS, Polycystic Ovary Syndrome, which is where there is an imbalance of hormones, possible cysts involved, lots of other stuff that could be causing my infertility. I haven’t researched it enough to speak more on it so I’ll leave it at that. I knew right away that I didn’t have that. I've never had any other symptoms and plus I’ve been to several doctors and have had so many u/s done that someone would have noticed something if there were any cysts. Or they would have made the connection based on other could-be symptoms and looked into it further. After reviewing my records he determined that I in fact do not have PCOS. Which kind of sucked because then at least we could have worked on “fixing me” to some degree.  So anyway, that leads me to what’s going on right now.  Today…

So I started taking a drug called Letrozole last Thursday afternoon. From what I understand, Letrozole is similar to Clomid, but stronger and it doesn’t affect the uterine lining as negatively as Clomid does. It is in 2.5mg pill form so no getting stuck. Another bonus – a big bonus – is that insurance covers it. Talking way cheap. So I’ve been on Letrozole since last Thursday afternoon after I went in for my estrodial testing and baseline u/s. The findings on the u/s were that I had a cyst  on my left ovary and a lone follicle (<10mm) on the right. Doctor decided to put me on 5mm of Letrozole daily. The cyst was small enough in size that he wasn’t concerned about it. Our hope was that the drug would make my follicle grow and/or produce more follicles by the following Friday morning (yesterday). My experience so far on Letrozole has not been very eventful. The possible side effects listed on the prescription bottle are drowsiness and dizziness, but I haven't experienced anything at all. No nausea or anything either. The only thing I have experienced was random cramping in my ovaries. Nothing bad, just slight and random.  The nurse I spoke to who gave me my instructions for the week told me keep up with my normal activities and just to stay as stress-free as possible. I have to say that staying relaxed and stress-free is sometimes easier said than done. I remind myself to stay calm often and also remind myself that what will be will be. More than anything this first cycle is a trial run anyway just to see what my body is doing on its own and at this first level of medicine. I was  mainly just anxious to see if there was any growth or change whatsoever….