Unexplained no more.

Last night I had my follow-up appointment with Dr. Sher. It was short and to the point, which is ok with me.

My Natural Killer cells are activated. Is that even the right way to say that? Also, my blood work was positive for antiphospholipid antibodies, including, but not limited to, the “bad ones”, a-PS, aPE, and aPC.

Dr. Sher says this is why I haven't gotten pregnant. His protocol for me would be Intralipid+Heparin+IVF.

After we hung up the phone, I cried. I cried tears of relief, tears of scared-shitlessness, tears of realizing that I will probably never be able to conceive the "normal way". The way that most people do it. The way crackheads and teenagers do. It's a tough pill to swallow, to be honest.

But it's not like I wasn't expecting it. I figured there would be *something*, ya know? And I've never been one for following the crowd. My body just decided to follow suit with how I live my life. That's what I'm telling myself, at least.

So having the night to think on my diagnosis and options, I came up with a list of questions for Dr. Sher and his office. He had mentioned to me that I am eligible for their Micro-IVF program, which is $6250 + meds. There is no difference between this and normal IVF, other than I won't require as much tender loving care. Couples who have severe male factor or ovulation disorders do not qualify for Micro-IVF, and neither do women over a certain age.

I called Dr. Sher's office when they opened to ask my questions. The only one I was able to get answered on the phone was the cost of the Intralipid treatment. It's usually around $300 per infusion, and I would require two, most likely. One prior to my IVF, and one after a positive beta.

The receptionist gave me Dr. Sher's email, and I emailed him the rest of my questions. She recommended making them short, otherwise he may want me to call back in for another consult instead of responding directly to email. Luckily, he responded to my email! And in less than an hour. How's that for service? I love this man more and more each time we communicate!

Here is the Q&A that transpired earlier through email:

Me: What level of NKa do I have? I have read there is low, borderline, normal, high, etc. 

Geoffrey Sher MD: Anything above 10% killing is abnormal. The range of abnormality is usually between 10% and 12%...so in your case, given that a reading was at 10.7% puts you firmly in a distinctly abnormal category.
Me: Are my NK cells activated because of the APA?  

Geoffrey Sher MD: Almost certainly, yes.
Me: Which type of APA did I test positive for? (I read there are 21 types, including Lupus)

 Geoffrey Sher MD: A wide range were abnormal, including (but not limited to the “bad ones”, a-PS, aPE, and aPC. The APA results were thus strongly +ve!
Me: This is an autoimmune disorder, correct? As opposed to Alloimmune?

 Geoffrey Sher MD: Almost certainly…yes! But to rule out alloimmune implantation dysfunction completely, we would need to test both you and your husband for DQalpha and HLA similarities.
Me: What about low-dose aspirin + Heparin to treat the APA? Or is the Intralipids for the NKa enough? 

Geoffrey Sher MD: We would add low molecular weight heparin (Lovenox or Clexane) but no aspirin should be used.
Me: Is it possible to do Intralipids + IUI prior to IVF?

Geoffrey Sher MD: Yes, but: a) the success rate is low (about 12-15%) b) with such a low success you would have to take steroids and IL each time and c) (most importantly) your prior poor response to stimulation suggests that your ovarian reserve could be diminishing and as such you simply cannot adfford to waste time on a lesser procedure such as IUI. 1 attempt at ET (with blastocysts) would improve success potential about 3-4 fold. 

Me: Any insight you could give me would be great! I didn't want to take up your time in a phone call, so if these could be answered via email, I would really appreciate it. 

Geoffrey Sher MD: If you want to talk again, call and set up another phone consultation. 

_______

I then sent a couple follow up emails with more questions. Here they are:

Me: Wow, thank you so much for your quick response! I really appreciate it. I'm doing my best to try to learn everything I can about this. I like being informed. Thank you again, and hope to meet you in person soon! 

Geoffrey Sher MD: Excellent!

However please be aware that out of “ignorance”, “arrogance” or both, many RE’s shun the concept of immunotherapy for IVF. Unfortunately this makes patients such as you potential victims. The truth is that the field of reproductive immunology is far more complex than IVF itself and most simply are not informed adequately. Even though the number of “believers” is growing by the day (simply go to Google to see) “Immunology in IVF” unfortunately has become a political football.

GS

P.S. Please read my 2 very recent blogs at www.IVFauthority.com on immune issues.

________

Me: How many embryos would you transfer for my IVF? 

Geoffrey Sher MD: I would suggest two!


Me: So because my blood work was + for Antiphospholipid Antibodies, does this mean I have Antiphospholipid Antibody Syndrome? 

Geoffrey Sher MD: No! 

 ________

So that's that! I have been pricing out hotels and plane tickets. Buster is officially ON BOARD for Vegas IVF!! He loves Dr. Sher as much as I do. I think it's because Dr. Sher called him a stud when I asked about the sperm DNA testing we had done.

I've found pretty affordable flights and hotels, so my only real issue is getting the time off from work. I've googled "FMLA for IVF" and found that many people were able to use FMLA. I think I would just need Dr. Sher to write something saying that I would be unable to work for 3 days. I will not have any vacation or sick leave to use, so my choices are:

• FMLA (unpaid time off)
• Regular unpaid time off, if they would grant it
• I could plead my case for working from the hotel. I have a powerful laptop that would allow me to do the work I need to do.
• Don't go to the beach in July with my family, and use that time for Vegas. I know, this seems like it would make the most sense, right? But I just can't agree to this option right now. I am sooooo looking forward to the beach. We didn't go last year, and I need it. But, if this was my only choice, I'd do it.

_______

Any advice/info/opinions on what you've read up there would be BEYOND appreciated, especially if you have had a similar diagnosis.

OK weather....

Please keep my great friend Aub in your thoughts and/or prayers. She and her family are heading to a tornado shelter, as a wedge tornado is headed their way.

Catch up.

TTC has been far from my mind recently. And I'm actually enjoying it.

If you would have told me two months ago that I'd enjoy taking a break from needles in the belly, being wanded by oafs (among other total strangers), and the up and down of testing out a trigger, I would never have believed you. But here I am today, smack in the middle of my second month of a TTC "break".

I'm pretty sure I ovulated very recently, or will today. We've BD'd once in the past couple of days, and that might be it for this fertile period. We have been so busy recently, it's hard to fit "us" time in.

________________

I spent 4 hours yesterday planting my very first garden! Buster built me a raised bed, and yesterday I filled it with top soil, manure and MiracleGro! I planted sweet peppers, basil, thyme, oregano, parsley, rosemary, onions, and sage. We have some squash to plant as well, but I'm going to need another raised bed from Buster before that gets done!

I think I must have burned lots of calories, plus I got some sun, so it was a great day!

________________

Tomorrow night is my follow-up consultation with Dr. Sher. I'm nervous, anxious and excited to hear the results of all of my bloodwork. Part of me is really expecting the bloodwork to reveal nothing, and for me to remain "unexplained" forever. The other part of me is hoping that there is something wrong, so at least we know what path to take next.

________________

So, this past Thursday I went for a walk/jog after work. After I got home and I was taking my headphones off, I brushed my neck with my hand and it hurt. I felt what appeared to be the beginnings of one of those really painful under-the-skin zits that never fully emerges (I hope you know what I'm talking about here, lol). I didn't think much of it, jumped in the shower, made dinner, went on with my life.

That night I could not get comfortable because the damn "zit" was swollen and hurt so bad! It's on the back of my neck, kind of below my ear and towards my spine. Friday morning it was still going strong. I quelled my urges to poke, pop, squeeze and prod it.

Saturday morning, still there. Still huge. Still hurting. Still red and swollen.

Sunday morning, still there. Still huge. Still hurting. Still red and swollen.

I started freaking myself out that it was some kind of poisonous spider bite, and googled things like, "Is this a spider bite or zit" and got lots of, well, helpful(??) photos to accompany descriptions of the disgusting creatures that left the pictured bite.

At this point I decided to go to our local urgent care place. I figured that the embarrassment of going in for what appears to just be a zit would be overshadowed by my peace of mind.

The first diagnosis I get from the doctor is that it feels like a lymph node, but looks like an abscess. The doctor then had to call a second doctor in to come and take a look at it, and he agreed with her. He suggested she numb the area, cut into it and see what comes out.

I'm totally thinking baby spiders. Baby spiders are going to emerge from my neck.

(Ok, if you are creeped out by spiders, like yours truly, NEVER google "baby spiders". Seriously, that is some golden advice right there. Take it. Also, make sure the word "abscess" isn't in your google search bar when you click on "images". Abscess images are almost as fucking disgusting as baby spider images.)

The doc numbed me and cut into it, and based on what found it's way out, her diagnosis is that of an infected hair follicle. Geez. All of that for an infected hair follicle? It sounds so... not painful. And small. She did say it's a good thing I came in, because it was slightly infected. If I would have waited it out, there's a good chance it would have just gotten worse.

So I'm on an antibiotic 3 times a day for 5 days. It feels better today, but is still big. And still there. I'm so ready for it to be gone!

Sorry if that was TMI! ;)

Stagnation, 10 for 30 update, and swimsuits.

And no, not a nation full of male deer. Although that would be interesting.

Stagnation: Stuck in an established routine; mired in monotony; caught in a stultifying sameness.

Tell me that's not the best definition ever! "Mired in monotony" and "Stultifying sameness" are awesome potential blog post titles.

But anyway...I am so boring as of late. This TTC "break" (of sorts) leaves me feeling further and further away from my end goal. But the testing I'm doing, although not necessary, will end up proving helpful in the end. I hope.

I had another blood draw yesterday. This was to replace the unusable blood. So, in the past two weeks I've had my blood drawn 3 times. OVER IT!

My follow-up consultation with Dr. Sher is Tuesday, May 24th. I'm really excited to hear the results of my tests, and to see what he recommends as far as a plan of attack. I also rescheduled my consultation with the clinic in Pittsburgh. I wanted to be sure I had my appointment with Dr. Sher first. So the Pittsburgh consult is Saturday, June 11. Basically forever away.

__________________

10 for 30 update!

I am now on day 3 of the 17 Day Diet. Yesterday was also my weekly Weight Watchers meeting. I was down a pound and a half, which brings my total weight loss to 12.5 lbs. I like the sound of that! 12.5 just sounds so much better than 11. I'm hoping to get close to 15 lbs down by next week!

The 17 Day Diet seems to be going ok. The biggest struggle for me is not eating something sweet before bed. Last night I cracked and had a fudgsicle. Hey, it was only 100 calories! I figure if having a delicious 100-calorie fudgsicle in the evening keeps me going with the diet, it is well worth it!

I also joined myfitnesspal.com, and I like it a lot so far! Great online nutrition tracker.

__________________

My friends and I were talking about swimsuits for the upcoming summer. Last year, I bought this suit from ModCloth:

ModCloth suit!

It is a great suit! Fits wonderfully, feels good, looks good. I think it will still fit me, even if I lose more weight, although it might be too big in the boobage (unfortunately those seem to be the first to go when I lose weight!).

I'm also excited to get back in to this suit:

Juicy Couture suit!

It's a Juicy Couture suit that I bought 2 years ago at TJ Maxx for $40! What a steal. It is really comfortable and cute, but I was getting a bit big for it, unfortunately. I'm hoping it fits better this summer. Also, that pic up there really makes me want to grow my bangs out and go back to a middle part. Hmm...


I think I'm going to need to hit up TJ Maxx again and check out suits. Perhaps I will do that today at lunch...

:)

My new goal: 10 for 30

This year I am turning 30.

 Yes, that's me up there. Crying. Ok, my hair is longer, but you get the idea.

My 18-year-old self made the decision that I would be done having children by the age of 30, because I didn't want to be an old mom (obviously my 18-year-old-self was a freaking idiot!).

I don't want to turn 30, but I'm really relishing moving on to a new chapter in my life. I'm ok with leaving the twenties behind me. I'm sad about my fleeting youth, but hopeful for a new beginning.

As I've blogged previously, I am still doing Weight Watchers. It's been 16 weeks, and I haven't been the most diligent dieter. Sure, I do great most of the time. I've also cut out a TON of my snacking. And I've lost 11 pounds. But after 16 weeks, I really had hoped to have lost more weight. Or to have been down a size.

June 14th marks our 3rd wedding anniversary. August 21st is my 30th birthday. It's a big summer! Which leads me to my newest goal...

I will be a size 10 by my 30th birthday.

I've always been embarrassed about what size pants I wear. Always. I'm slightly bigger boned, and even when I've been so skinny that my hip bones have been pointy and a danger to those passing me on the street, I've never been smaller than a size 8. When I was a size 8, I looked anorexic.

On our wedding day, I was a size 10. It worked for me. I felt great at that size, even though I was still ashamed to admit my double-digit size. What is up with that? I hate feeling like I'm fat just because I can't (and will never be able to) fit into a size 6. I guess this is the effect that media's fixation on women's weight has on us. Sad, right?

Anyway.

Here are some photos taken around the time of my wedding, in June of 2008:

Me bossing my sister around, as usual! :)

Bridal shoot

Buster and I

That was then.

And a bit more recent:
Nov 2010:

No, that's not Carnie Wilson. It's me.

Dec 2010:

So yeah. You can tell by my face that I've chunked up a bit. I don't even have any full body shots to post because I've been avoiding cameras like the plague! Now I have lost 11 pounds since those pics, but I'm nowhere near where I want to be quite yet. I'm currently in a size 14 (sometimes a 12...).

I bought the 17-Day Diet book last night at Walmart. Not really worth the money, imo, but I'm still going to do it. It works ok with Weight Watchers, and then after the 17 days I might just go back to my normal Weight Watchers (which will feel like a treat, I'm sure!). The 17-Day Diet is basically South Beach or Atkins, but a little more lenient on the fruit. Oh, they want you to eat yogurt twice a day as well.

Along with the new diet (which will start after I properly hit up the grocery store), I'm am going to walk or hula-hoop every day. Yes, I said hula-hoop. I bought one of those weighted hoops. Fancy, right? I have yet to use it, but I'm sure it will be TONS of fun... (sarcasm!).

If you read this far, congratulations! Now you will know what I'm talking about when I mention 10 for 30!

The universe hates me; or the story of how hope infested me

My ticker up above this post is correct. CD34. My longest cycle to date has been 32 days. I've had two 31-day cycles. But all my others are 28 or 29 days.

So what's up with this month?

Yesterday, I somehow managed to talk myself into thinking that I could be pregnant. On a break cycle. When we only BD'd one time during fertile season (yes, season!). I haven't been temping or charting or anything. I actually had a pretty decent month, aside from Easter.

So why? Why would I let hope permeate my I'm-on-a-break-cycle shell?

I'm weak. That's the answer. I'm weak. I'm never late! AF shows up freaking early when I'm doing injects, ffs. She doesn't show up late.

After work I went to the grocery store, and picked up a 2-pack of Kroger brand pink dye tests (they look just like the Equate pink dye tests). When I got home I peed. And nothing. BFN. Like usual.

It's not enough, is it? It's not enough, month after month enduring expensive fertility treatments and jabbing needles into my stomach, letting strangers dildo me, going on hormonal rages, crying when it doesn't work (and it never works), nothing works. It's not enough that I cannot get pregnant. The universe, or my body, or some being who controls the day-to-day lives of peons like me thinks it would be amusing to make my period late.

"That will show her! Moron thinks she could actually get pregnant on her own... on a break cycle! Muahahahaha"

I hope someone's getting a good laugh. It sure as hell isn't me.

_________________________


In more WTF news, I got a call yesterday from the lab that 5 vials of my blood was shipped to. Something happened to my blood, and it is no longer usable for testing.

Um, what?

Hemoglobin something or other. I can't remember what she said. Definitely had "hemo" and "globin" in the sentence, though.

So I have to schedule a redraw.

It's not like I'm in a hurry at this point, so I guess it doesn't really matter. It's just annoying, is all.

I have my next appointment with Dr. Sher on May 24th, and he will go over my results then. That's assuming that my blood is testable. WTF am I, an alien or some shit?? Maybe that's the answer! I can't get pregnant with a HUMAN baby because I'm an alien!!!!!!!!!

Who needs doctors? I just solved my own mystery.