Thursday, 31 March 2011

First Scan

My appointment was for 10.30 this morning, but I thought I would get there early. When I got to the ultrasound waiting room at 10.15 (yeah, my plan to get there early wasn't a very successful plan) there were about twenty other women waiting. Damn. It.

I got out my book and started reading, but actually I got called within ten minutes.

As I changed into my lovely checked ultrasound skirt, I thought about Chinadoll and the lack of privacy she gets in China for scans. At my clinic, even in the changing room there are little cubicles with curtains to put on your lovely check ultrasound skirt. Each little scan cubicle has a curtain and I feel quite secure. The ultrasound-tech was very good and it wasn't too uncomfortable this time. I don't think anyone would describe it as pleasant.

According to Dr K, my left ovary 'has not responded' as well as the right, but the right one has a 1.3cm follicle which it quite promising. I'm not sure whether to be pleased or not about the side. On the one hand, the right tube is probably has less adhesions than the left, as the left was the one I had the ectopic in. On the other hand, from the HSG, the open end of the right one is a little bit closed, though not completely.

At my last appointment the doctor warned me very seriously about the chances of another ectopic. I nodded, said yes-yes, but I wasn't really taking it in. Now it's getting closer to the time I'm getting more worried. But there's nothing I can do about it except wait and see, so that's what I'm going to do.

Next scan on Saturday, at 7.45am (gah!) as the doctor recommended coming in early before it gets too busy. He thinks we'll do the IUI the middle of next week. No more drugs so far.

Tuesday, 29 March 2011

Scatterbrain

Most of my early side effects have subsided, though I'm still finding it really difficult to get up in the morning. I don't have a headache any more, and I don't have any dizziness when I take the meds.

However, I am particularly scatterbrained at the moment. Concentrating at work is difficult, and I'm also yammering on more than usual. The bad thing about this is that I'm in an industry where TTT (teacher talk time) is a no-no. It's a strange situation, as students like you more if you talk to them and they know more about you, but as teachers we know it's better if we talk less and the students talk more.

However, my chattiness has seemed to get two classes who were both quite skeptical about me friendlier this week. The fact is that I'm almost glad about this particular side effect, as it seems to have improved my professional life for once.

Saturday, 26 March 2011

A laundry lesson.

Yesterday I washed my not-tight jeans. I knew I needed to wear them in the evening to meet my husband for the Korea-Honduras game, but I had to wash them because they *stank* of oil after going to a fish and chip restaurant earlier in the week.

I had to wear jeans, because it's still freezing here in Seoul, and we were going to be sitting outside for 2+ hours in the football stadium. There was no way I could wear anything else. I also had gloves and my ski-hat.

By the evening, my not-tight jeans weren't dry, so I pulled out my tight jeans, wondering if I could get into them. I could, but doing them up was a challenge. But they were on, they weren't too uncomfortable, I was ready to go. Fast forward a couple of hours and I was in so much pain. I had only taken one dose of clomid, but combined with the too-tight jeans... wow.

What can you do in this situation? I popped the top button open, and pulled my shirt down to cover, and just hoped that the zip didn't come too far open. I also put my bag on my lap, just in case. I felt much better.

So much better that I forgot I had done it, and only remembered as we were walking up the steps at the subway station near our house. By then from the walking and the steps the zip had come completely open. How my husband didn't notice I have no idea - I'd gone all across the city on the subway with my jeans undone.

Friday, 25 March 2011

Small side effects

Had night sweats last night. I woke up all sticky and cold, with my husband stealing all the covers. I was also dizzy about twenty minutes after taking the tablets, but only for a short time. Not so bad. I was awake at 5am, but that might have just been because I went to bed fairly early.

This morning I had really bad period pains. Sometimes I have strong pains, sometimes not. Today I definitely do. I don't know if it's related to the Clomid or whether I would have been in pain anyway. It seems to have reduced a little.

Sorry this post is less than fascinating...

Thursday, 24 March 2011

Clomid 100mg?

Nothing unusual to report at the appointment. Dr K was the same as ever, slightly vague seeming but clearly knowing his stuff. In-out, less than five minutes! This sounds bad, but I discussed our treatment plan with Dr H after the HSG, so all he really needed to do today was write a prescription.

I'm on Clomid (well, Clomiphene citrate) for 5 days, then back in a week for a follicle scan to see how I have responded, then go from there. I'm a little worried about the Clomid as I've heard the side effects can be a bit difficult, but I'll just have to see how it goes. The doctor recommended that I take them before bed on an empty stomach.

I've been given ten 50mg tablets to take for five days, so I take it my dose is 100mg. I can't find anything in my paperwork that tells me that, but the prescription bag says 2 tablets 1 time a day at bedtime (in Korean of course, my google translate app got a workout.) I then confirmed with a friend who speaks good Korean. I didn't ask any of the Koreans in the office as the clinic is quite 'famous' so they would know what it was for.

I'm not sure whether this is a 'normal' dose or not for a first cycle. I was also wondering whether it was 'normal' to start it on day 3 of the cycle. I trust my doctor and he has explained the procedure to me, but here in Korea they don't seem to take a 'softly softly' approach to medication. It's more 'get it done as quickly as possible.'

I was a little surprised that he didn't order an ultrasound to check for cysts, but I guess they check that out at the scan next week.

Back in on the 31st for an ultrasound. I suppose all I can do from now 'til then is post about my weird dreams and hopefully mild side effects.

Wednesday, 23 March 2011

The Wicked Witch

Yesterday was a really rubbish day. First of all, I had my usual pre-period spotting, and now this morning it is pretty clear. The witch got me again. So I turned into the wicked witch at work yesterday (though one little boy was particularly challenging in his behaviour) and was really sarcastic with my students. I don't like this kind of behaviour in myself.

Like everyone, I really hoped that I would avoid treatment. That this last cycle would be the one. But it wasn't, so we now move on...

Once I'm sure the witch has really kicked in, I'll call the clinic to go in tomorrow or Friday.

Tuesday, 22 March 2011

Happy ICLW!

Hi if you're visiting from ICLW!

If you want to click on Timelines you can learn more about our IF journey, but just a brief run down:

After thinking for a year we would need IVF, we discovered that the initial test results were wrong. Our doc is happy for us to try IUI for a couple of cycles before pulling out the big guns. We start that next cycle, which will probably start in a few days. Right now I'm still holding out a small hope that this cycle may have been 'the one' and we won't have to have that IUI. It's not a big hope, but I'll know in the next couple of days.

Oh, and I live in South Korea.

Monday, 21 March 2011

Two lines... OK! One line... NO!



So, as I used all my internet cheapies, I decided to go buy a pregnancy test (yeah, I can't get over my addiction at all) for use later this week. It's called 'Homestick' 홈스틱 which is not Korean language, but Korean-English, or Konglish.

The old couple who run our local pharmacy are really sweet. The old guy never gets out of his chair, he just leans around and picks things up. I've never dealt with the old lady before. I asked in my best Korean, imshin-testuh-issoyo? It was 5000won (convert here) which is a bit too cheap for my liking (my addiction might cause me to buy too many.)

My experience of hpts means that I know how they work, but I thought I would double check. I asked in my broken Korean, but she replied in English. She said 'Two lines...OK! One line... NO!' She sounded equally excited by both possibilities, which I thought was great as she had no idea what outcome I was looking for.



However, after I looked at the box it was actually pretty clear. T is test. C is control.

I wanted to see the sensitivity of the test, as my cheapies were 10mIU. However I got distracted by the the 'Mouse anti hCG'


I thought it might be a mistranslation, but the Korean says 마우스 (mouse) also. I consulted Google, and found this very instructive animation about how this test uses mouse something to detect hCG. I understood it at the time, but now I can't remember.

I've just noticed that the test is 25mIU. I can't use it 'til closer to CD32 (it's CD28 today) which is probably the exact thing I need so I don't test all the time and drive myself crazy.

Sunday, 20 March 2011

More dreams...

Uh-oh, you groan, and to be honest I groaned when I woke up from this one this morning:

I dreamed about positive pregnancy tests again. I don't know if this is my subconscious picking up on something my body is doing, or sadly more likely, I'm so completely obsessed with this cycle that I'm now dreaming about it.

So, I dreamed that I had two positive tests, but I wasn't sure, so I dipped the two tests again and the positive lines kept sliding about. Incredibly weird.

I've felt nauseous all afternoon (hopefully not from radiation from Japan!) but I suspect that's just because I ate my lunch too quickly. I also have abdominal tenderness, though I can't remember if that's normal for my cycle or not (I'm the least self-aware infertile ever, it seems).

I just took a hpt when I got in (I know it's the wrong time of day, but I couldn't wait as I had been dwelling on it all day.) BFN of course. It's CD27 and 9dpo, so I can tell myself its still too early, but at least now I've used up the cheapies, so I won't be tempted again.

Friday, 18 March 2011

Gloomy Friday

Today has barely started and I feel really down. I hate this stupid IF roller coaster. Last night I felt fine, my husband and I went out for dinner and didn't talk about babies or infertility at all (sometimes it feel like its all we talk about) but this morning I feel so down its ridiculous.

Today is my day off this week (I don't work M-F like normal people!) and I was really looking forward to the day and just having some time to maybe go shopping. I've been wanting to buy a sewing machine for months, and I worked loads of overtime so far this year so I have money, but now it comes to it I don't feel like it.

I'd forgotten how stressful trying to conceive is. Since the ectopic last year we've been on a break, and to be honest our sex life has been close to non-existent, as I've been feeling 'what's the point' and my husband I think has been terrified that we'd have another ectopic. But after getting possibly good news at the HSG we thought we'd give it a try this month.

I'm now 7dpo, which I know is still several days too early to test, but I have already tested yesterday and today. Both BFN of course. I really shouldn't have hpts in the house (internet cheapies, and I only have 1 left).

The money side of things is stressing me a little as well. So far things have been manageable, but now we're heading into IUI/IVF territory I'm getting more worried.

I'm also symptom spotting like crazy - which is also completely stupid as there would be none showing up at this point anyway. But I'm not sleeping because of the stress so I'm tired all the time, and I have to keep telling myself that the tiredness is not pregnancy.

Also, last night I ate a giant steak, buffalo riblets, a chocolate brownie ice cream thing and a few glasses of wine. I feel like a pig and I look fat this morning.

Wednesday, 16 March 2011

Opinions Wanted

At my work, in August, a nearly year-long training course starts. It would be an important step for me professionally and I would need it to move into any kind of management role at my company. If I get a place it is paid for by the company and I would have some time off my normal work every week to do it.

So the problem, of course, is what happens if the BFP happens? Over the next six months we're going to be undergoing treatment.

My husband thinks I should apply for a place and see what happens - it might be that I don't get in this year anyway. The thing is, I don't want to get a place, start the course, and then withdraw, as I would have taken a place from someone else who wants it. On the other hand, if I don't get pregnant then I will have put everything on hold for a baby that still hasn't come (which I did the year before last).

I recently said to Elphaba over at Yolk that she should go for a work opportunity she has, but for some reason I can't make up my mind when it comes to me.

What do you think?

Tuesday, 15 March 2011

Paranoia

After staying pretty calm so far this cycle, I'm afraid paranoia has kicked in this morning. I have an ache, occasionally I would classify it as a twinge, on the left side, where the scar from my ectopic surgery is. It's not too painful, but it's there.

Intellectually, I know this could be a number of factors; in fact I get random twinges often on that side since the surgery. I usually consider it proof that the tube can still move. The pain starts around ovulation, and continues until my period starts.

However today I'm paranoid, and something in my brain is whispering ectopic.

I thought of taking an hpt this morning, but this would be a complete waste of a test as I am only 4 dpo, so a normal pregnancy wouldn't be showing yet, and an ectopic pregnancy definitely wouldn't be. I'm not sure if a normal pregnancy would have implanted yet but an ectopic one might have whispers that little voice.

When I had the HSG earlier this month, I was really surprised at how small the uterus and tubes are compared to the surrounding space. I guess because the only time I'm really aware of them is when they hurt in some way, and then the pain fills the whole abdomen. Knowing this, I know that the pain could be coming from my fallopian tube, but could also be coming from the ovary, or the uterus as well, as they are all so close together.

I don't know if this makes me feel reassured or worse.

Monday, 14 March 2011

Keep Calm and Carry On

Saturday was my husband's birthday, and we had quite a large party at which I drank both wine and champagne. I didn't overdo it because I had work the next day. Similarly last night I had a glass of wine with dinner.

I'm trying to conceive. We're trying naturally this cycle (as there's a tiny chance it might work) and right now I'm between ovulation and period. (I don't want to use the phrase two week wait as it suggests a medicated cycle and I don't want you to think that I would be drinking then.)

I think there are two possible reasons why I'm carrying on regardless. First I don't believe this month is the month. We tried for two years with no results, and so I don't connect sex with the possibility of pregnancy anymore. Second, I guess I'm hoping that if I ignore it, it might happen!

For those of you who are horrified at the thought of alcohol and pregnancy, remember that not all countries take such a hard line when it comes to drinking a little during pregnancy. The British medical community do not recommend heavy drinking, but allow that one or two units a week are alright. The same goes for other European nations. Also, remember that chances are I'm not actually pregnant.

When that does happen, I will stop drinking, but while I'm in this seemingly never-ending ttc limbo, I refuse to act as if I am. To be honest with you, it's too depressing when it comes to nothing.

Friday, 11 March 2011

Makeover!

As you can see I have a new look blog, created by fantastic Aly at Bridge Work Blog Designs, all ready for spring. I love it so much! We're still tinkering a little with the layout, but its so cool and fun.

Wednesday, 9 March 2011

Smart apps!

I got an iphone last week - I know many people living in the UK or US or wherever have iPhones, but here in Korea they have only recently made it easy for foreigners to get one. I love it, it's awesome, and one of the things I love is the apps.

When we realised last week that we might be able to have a baby 'the old fashioned way' I immediately went to the app store and looked for an app to tell me about my cycle. I have an admission, that the two years that we were trying, I never charted. I knew how long my cycle was, and we worked with that. In fact, the month that I finally bought the basal body thermometer, was the month the ectopic pregnancy occurred.

So, I have my app, which is pretty cool, and by putting the dates it it has told me that since my ectopic, I have shifted to a 30-31 day cycle. I am aware I could have calculated this myself, but as we weren't ttc the last year while waiting for enough money for treatments, I never really bothered. It also tells me that this week is the week, and that I ovulate on Friday. I know I should back this up with charting but I'm really not very good at remembering to take my temperature. I have managed it three times over the last week and forgot to write it down once, as I tend to take it half asleep when the cat first jumps on me, then check it later when I feel more awake. I suck at charting.

As we have no idea whether we can conceive 'naturally,' and we have been strongly advised not to wait long at all before pursuing treatment, I don't feel too bad about my lack of initiative. If it's going to happen this way, it will happen. Charting only really works if you do it over a longer period so you can see patterns. By that point, we will be undergoing treatments.

I love my smartphone app.


Sunday, 6 March 2011

A Year Ago...

The following is from an email I wrote to my best friend in Australia last year, a couple of days after having surgery to remove my ectopic pregnancy. I was planning to post it in a few days on the anniversary, but as that anniversary is also my husband's 30th birthday, I decided against it. This year I want to celebrate.


However I also feel the need to post this as a way of drawing a line. I will never forget what happened, especially as it will be impossible to forget the date, but I feel like I have mourned the loss, and the consequences, and that it is time to move forward. It may read as overly dramatic, but I was still in a lot of pain and emotionally raw at the time.


Just a note, I was living in Spain at the time.


I was pregnant. But I knew something was wrong when I started bleeding at the wrong time. I go to the clinic. They can see nothing. Follow up in two weeks. The bleeding is normal. Indulgent smiles say: Go away you stupid English girl.

Nearly two weeks later, on Friday, I am walking down the stairs at Dominicas school when I feel the blood start flowing. Then the pain and dizziness. In a taxi with a colleague who tells me how his wife lost twins at five months.

This time at the clinic there are no indulgent smiles. The blood and the pain put paid to that. I cry and squirm as they try and see what’s wrong. I’m wheeled around on a drip from room to room. The other women hold their pregnant bellies, thanking God it’s not them as they follow my progress around the clinic.

Finally they see it: a ‘bruise’ in my fallopian tube. A bruise. This is how they describe my poor embryo which because of scarring in my tubes which I wasn’t aware of, instead of going to the uterus and growing into a child, got stuck in the wrong place. Ectopic. From greek: out of place, I’m told the next day.

I’m admitted. Then the waiting. Waiting for hours in a dark room, the shutters down against the afternoon sun as the middle-aged woman by the window sleeps off her hysterectomy. Her husband glares at us. At our not-quite-hushed-enough voices. At our speaking English. He pulls the partition across, blocking her from my view. I’m glad.

I lie on the bed for hours. Our boss waits with us, wanting to help, to translate, but the doctor doesn’t come. The nurses take blood and temperatures. My husband goes home and comes back, both hoping and not hoping that I will be in surgery by the time he returns.

Hours pass. Our boss leaves, with promises to check in. She had to pick up her thirteen-month-old, go home and feed him and thank her lucky stars that her horrendous pattern of miscarriages is over, finished with the laughing infant in his highchair.

We wait. I’m hungry and thirsty. Nil by mouth. Finally the gynaecologist comes. She is older than she looks, I think. She asks efficient questions in reasonably English, but I note that she is using the past simple rather than the present perfect. I wonder of my husband is making the same judgements, while he listens to my medical history.

There is another woman with an ectopic pregnancy on the ward. They will assess her case and then decide which of us is more urgent. Don’t worry, she says, your tests are normal. We take that to mean the other woman will be operated on that night, me in the morning. My husband decides to run home to grab all the things he forgot the first time - toothbrushes, my glasses. He turns off the light - it is now eight o’clock and dark.

I turn on my left side, the side I’ve been practising sleeping on since I knew I was pregnant, and cry. I cannot quite describe the tears. Like a child who has lost a beloved teddy bear, knows that crying won’t bring it back, and grieves for it’s loss. This is the closest I can come to describing it.

Then, suddenly, the doctor is back. They’re taking me in in the next ten minutes. I call my husband, he hasn’t yet reached the apartment. He turns and runs back and is back before they take me away, but only just.

It’s not like in the movies. My husband doesn’t walk by my side, holding my hand. The orderly pushes me away with such speed that he has to jog to keep up, trailing behind. At the waiting room he gives us no chance to say goodbye. I call ‘I love you’ but I don’t know if he hears. In the corridor, the nurses try to comfort me. ‘Tengo mierdo,’ I say. I’m scared.

Friday, 4 March 2011

An Urban Myth?

Since Wednesday I have been trying to put it all together. I've been off work this week and so I have time to think about it and try to figure out what on earth has been happening the last year. The trouble is, I'm not a doctor, and the doctor I have has no real idea what could have happened. As a non-doctor I see one or a combination of the following as possibilities.

1. The surgeon's in Spain made a mistake and could not see the dye passing through. This is what my doctor here has said, but the Spanish doctors were pretty adamant that the tubes were closed and referred us to the fertility specialist. If the test is that fallible it must be quite expensive for the Spanish health service.

2. The trauma from the ectopic/surgery had made both tubes swell up and so the dye did not pass through. After the trauma passed, the tubes opened again.

3. The chlamydia I had at the time of the ectopic and was only discovered/treated after the event had made both tubes swell up and so the dye did not pass through. After the infection was treated, the tubes opened again.

4. The Spanish surgeons tried to open the tubes during the surgery. I find this unlikely, as I think they would have told us, but my doctor here suggested it as a possibility. However the fertility doc in Spain did not mention anything about this (though maybe he just didn't want to give false hope?)

5. After the surgery, while stuck at home, I read The Secret and was visualising my tubes healing - the theory being that as all your cells renew themselves all the time, why shouldn't we be able to affect the way they renew. I both do/don't believe in this kind of thing, so I do/don't want to leave it off the list.

So, does anyone else have any ideas? At the moment I risk become being an urban infertility myth to give people false hope.

The Hysterosalpingography


My HSG experience was probably no different from anyone else's; I have been describing it as a really aggressive smear test mixed with excessively bad period pains. I'm not going to go into the details except to say that it hurt and I was really, really happy it was over.

I want to say that I am more than happy with my clinic, and that I am not complaining about their English not always being perfect. In fact, the fault lays with me not knowing enough Korean.

The note above is the directions they gave me on where to go before the procedure.

Below are the instructions they gave me about the procedure:


I didn't post the whole info note, but underneath is says 'Contrast media that remain in your uterus will be expelled due to gravity.'

Afterward the doctor asked me how I tolerated it. Fine I said, probably because I took a painkiller before hand. The woman who went in before me was still lying on the sofa in the radiology waiting room when I left, poor thing.

Thursday, 3 March 2011

Options

After the news yesterday, I found myself breaking in giggles as I walked down the street to the bus stop, as if I had received a stay of execution or something. However, just because my tubes are somehow now clear does not mean that it will be easy sailing to conceive.

However, just to be presented with options is amazing. For a year I have thought I only had two: childlessness or IVF. Suddenly we actually have a choice to make; even if we come back to IVF in a few months time at least I will feel that I have taken my chances elsewhere first.

Given my history, there is no way of knowing whether my tubes will actually function properly, even though they are not blocked. Dr H (who was lovely in every way - very beautiful woman!) says that if there is scarring on the outside, which on the left there definitely will be from the surgery, they may not move as they should, and scarring from the chlamydia/surgery on the inside makes my risk of ectopic higher.

I asked her what she thought we should do, and she said immediately, IVF, but she also said that if we wanted to we could try one of the following for a couple of cycles:

1. Timed intercourse
The ultimate test of whether things are working properly.
Pros Free. More enjoyable. Completely non-invasive (so to speak).
Cons Low rate of success. Risk of ectopic

2. IUI with/without fertility meds
Pros Less drugs, easier to take than IVF. Cheaper. Less invasive than IVF
Cons Lower rate of success than IVF (10% says Dr H). Risk of ectopic

Unfortunately, the risk of ectopic is always there even with IVF, especially as I have already had one, but she was very reassuring and pointed out that I would be so carefully monitored that we would know very quickly if there was a problem.

I'm leaning towards a medicated cycle of IUI, which is what I said to Dr H yesterday. She stressed very strongly that we should only try a couple of cycles before moving forward to IVF (got to keep the clinic stats high!) but at least we have the choice.

Wednesday, 2 March 2011

I. Don't. Understand.

Were my words to the doctor. I am in shock right now.

So, last year I was told that my fallopian tubes were severely blocked on both sides and that the only way that we could conceive was through IVF. We were told this 3 times by two different doctors.

Today I had the HSG, and things are 'normal' more or less. There is a slight dilation on the right side which suggests an adhesion, but the contrast dye passed through completely. On both sides.

I guess the lesson here is always get a second opinion.

The doctor says that perhaps because this test is more sensitive than the lap and dye they might have made a mistake. She also said that given my history she double checked that they were my scans.




Can't believe it. Tubes clear. More later.

Today's the day

Today I go in for the HyCoSy or whatever test it is they do here that involves dye and fallopian tubes. If I sound vague it's because I am. I have been advised by ladies who have gone through it not to look up too much about it in advance. So I haven't. I am mentally telling myself that it can't be worse than the pain of the ectopic pregnancy nearly rupturing my fallopian tube, nor the recovery from surgery for that. It can't possibly be, can it? True, they gave me some pretty strong drugs for that, but it still hurt.

I'm staying in bed as long as possible today in an attempt to stay relaxed. Not sure if it will work. I have to go on my own which I'm not thrilled about, but my my husband can't get time off work and I don't want to drag my friend to this on her day off.

But, at least after today the doctor will know what the situation is and we'll hopefully be able to move forward one way or other. Also, the lap and dye I had was a year ago now, and I have been wondering if there could have been any changes. I don't expect positive changes, by the way, I know I won't have magically healed myself. If only. Even if the left tube, which had the ectopic in, has miraculously healed in an 'open' way (if such a thing is possible) I still don't think I would feel that confident about trying 'naturally' after having had an ectopic.

Also, I'll get the results of my Day 3 bloods that were taken last week today I think. Not sure how long that takes actually.