My entire day revolves around food.  What will I eat?  When will I eat it?  I'm feeling hungry all of the time.  When a meeting pops on my calendar at work, I get annoyed if I think it will interrupt or delay my eating. When we took the kids to the park on Saturday, I spent the entire time thinking about food and how hungry I was, I wasn't much fun because I was so distracted by the thought of chicken nuggets and hot dogs.

Do all pregnant women feel like ravenous monsters?  

Today was my first official ultrasound.  I learned three things:

1. An egg has implanted in the wall of my uterus.
2. It's too early to see a heartbeat.
3. There is potentially going to be two babies - but we can't be sure yet, right now it could go either way.

The ultrasound looked like this:

           

Time has been going very slowly for me during the past few weeks.  So slowly, that it actually sometimes feels like it's going backwards.  I just feel like I've been doing so much waiting.

I had a positive home pregnancy test, and then a positive serum HCG. Tomorrow I find out if this is a legit pregnancy via ultrasound.

I'm hoping it's the real deal because I've already picked out names, baby carriers, and a couple of seven-seater vehicle options.  I told myself it was okay to be excited, because I'm never going to know exactly what the future holds, but I can at least enjoy the present. 

I have a container of sperm in my armpit people!  I can’t be late.  Today, of all days, I really need for there to not be traffic.  I prayed for everything to go smoothly – so why is this happening?  I hope, I hope that I can get there in time.

I call the clinic and tell them I’m running late.  I watch the minutes tick by on the clock, and try to urge the traffic forward with my mind.  Why do we do that?  Why do we think our “vibes,” or our angry curses will somehow change the traffic patterns.  It never actually works.

I’m twenty minutes late to my appointment – not ideal, but not too late either.  They’re ready to go when I get there.  I take the specimen cup out of its hiding place, gently unwrap the bag, and remove the container.  It’s wet.  The bag is wet.  Oh no!  It was leaking!?  How can this be?  I feel numb as I look at the lab tech who asks me to pass it over, and says that she’ll do her best to get as much sperm as possible.

I’m ushered back out to the waiting room, where I sit and try to come to terms with the fact that today will likely not be the day I get inseminated.  First the traffic, then a leaking cup… thing really aren’t going that well.  I open my book, and get lost in the words.

After about an hour I’m called back and ushered into a small exam room.  The nurse explains to me that we’re ready to go.  “So, “we’re doing everything today still?”  She nods.  “There’s enough sperm?”  She tells me that between 5-10 million is enough, and even with the spillage – there are still 8 million sperm ready to go.  And, in this moment I feel an odd sense of pride over my husband’s sperm. 

I have to take a minute to get used to the idea that this is happening today, I’d been working so hard to convince myself that it would be okay if they told me that I had to wait, that I wasn’t really considering that it might still work out.

I put my feet in the stirrups, they come in with a small syringe connected to a catheter and have me read off the patient identifiers to ensure that it’s the right sperm.  I ask the nurse practitioner if she’s 100% sure that it’s the right sperm, and she confirms that I’m the only person being inseminated this morning.  That’s super good news.  For some reason I was really worried, that that might get messed up – and that sounds like a giant legal nightmare to me – so I’m thankful that there’s not really a chance for a mistake.  I rest easy on the exam table, and the NP gets to work.

After about ten minutes, I ask, “Everything going okay?”

She says, “Yes, just threading the catheter.”  Then, a few minutes later, she adds, “I can’t get it through your inner os, your uterus is bent awkwardly.”

Well, count on my uterus to be awkward.

The nurse practitioner tries for a few more minutes, then the nurse tries, then they agree to get Dr. Yalcinkaya out of surgery so that he can do the insemination.  They give me two water bottles to chug, and inform me that a full bladder will likely help position things better.

I drink quickly, then I recline and read a book (that I am super glad I brought with me).

I'm super into my book, when the doctor come strolling into the room, he sits down on a stool, raises the bottom of the bed, and sticks the catheter straight in.  Easy peasy.  And there you have it folks, I’ve been artificially inseminated.  All I need is ten more minutes of reclining, and I can go back to my usual activities.

I sat on the bed, just staring at the syringe in my hand.  I sat there for like an hour.  Hoping, wondering, praying.

The syringe contained one-hundred and seven dollars worth of hCG, and is commonly referred to as a trigger shot.  It was prescribed by a fertility specialist.

I finally just told myself to breathe and have a little courage.  I gave myself the injection like I would any other patient, I was deft and swift.  It wasn't the injection itself that was making me nervous, but my inability to see a glimpse of the future, and what this needle might bring - maybe happiness, maybe not...

I've been in to the fertility clinic twice recently.

On Feb 15th I went in for a hysterosalpingogram (HSG), where they were unable to confirm whether or not my fallopian tubes were already open, or whether the contrast dye had just pushed them open right then and there. I felt like they should be able to tell them if my tubes were okay or not before this super expensive intervention, but they couldn't.  I also felt like they should've been able to tell me how long my tubes are likely to stay open... hours, days, weeks, months... but they couldn't tell me that either.  What they did tell me is that my left fallopian tube is three times longer than my right.

Weird.  

They printed off a picture so that I can keep it forever.  

I attribute this anomaly to the fact that my mom used some kind of herbicide to kill weeds in our backyard while she was pregnant with me.

Apparently it may or may not effect my ability to get pregnant.

Maybe if the fertility clinic was able to answer some of these questions they would have a higher success rate - but you can't really point that out to them, because you need their help, and you don't want them to inseminate you with the wrong sperm as retaliation.  That would be bad.

My second time at the fertility clinic was this week. This time it was to measure my follicles.   I had like nine of them that measured 14-20 mm.  Apparently that's pretty good because they told me I could go ahead and take my hCG trigger shot, and they will plan on inseminating me at the end of the week... this definitive announcement is what started making me so nervous though, and my brain started swimming with questions.  What is a good size for a follicle?  How many should there be?  If I normally ovulate on the 14th day of my cycle is it really best for me to take the trigger shot on Thursday? I ended up calling the clinic fifteen minutes after driving out of the parking lot.  I had to start the conversation by apologizing for my weirdness.  They were very kind and answered all of my questions, and thought maybe it would be better if we did the trigger shot today.

This made me more nervous.  I mean, it's a whole day different - they should know the exact timing of these things, shouldn't they?

Apparently nervous Bonnie is someone who spends a great deal of time reading information on the internet.  This is what I've gathered in the past hour:

Follicles grow 2 mm per day toward the end of your cycle

Follicles should be 18-20 mm (or larger) before taking your trigger shot

IUI should take place 24-48 hours after the trigger shot

5-10 million (or more) motile sperm are needed for IUI to work

STUDY 1: Eight percent of patients (n = 87) were excluded because their leading follicle was less than 18 mm by days 11 to 13. Pregnancy was recorded as clinical pregnancy with fetal heart activity seen at 6- to 7-week transvaginal ultrasound. For both CC and letrozole, higher pregnancy rates were achieved when the leading follicles were in the 23 to 28 mm range. The optimal size of the leading follicle was not statistically significantly different between cycles using CC or letrozole. However, for each endometrial thickness, the optimal follicular size of the leading follicle was different. Each additional millimeter of endometrial thickness increased the optimal follicular size by 0.5 mm. Thicker endometrial lining led to a higher probability of pregnancy.

STUDY 2: In this study, intrauterine insemination timing did not affect the cycle outcomes whether the procedure has been performed 24 or 36 h later following ovulation trigger with exogenous hCG utilization. The longer period of treatment cycle during ovulation induction with clomiphene citrate resulted with higher clinical pregnancy rate. Intrauterine insemination can be done successfully at either 24 or 36 h after hCG in clomiphene citrate stimulated cycles. This will allow more flexibility and convenience for both physicians and patients, especially during weekends.

STUDY 3: Study showed a statistically significant increase in pregnancy rate up to 22.6% in patients performing IUI 48 h after hCG trigger, compared to the 10.6% in the patients having the procedure done 12 h earlier.

STUDY COMPARISON: They reported a 2.3% pregnancy rate per IUI cycle when fewer than 10 million total motile sperm were initially available, compared to 8.4% for 10 to 30 million total motile sperm and 9.9% for ≥30 million total motile sperm. We reported an 8.4% pregnancy rate when 5 to 10 million total motile sperm were initially available, 8.7% pregnancy rate for 10 to 40 million total motile sperm, and 12.8% for ≥40 million total motile sperm, compared to 2.3% pregnancy rate when there were fewer than 5 million total motile sperm.

I love these sweet faces, and the funny, adventurous little personalities behind them.

List 10 Hobbies and Activities That Bring You Joy...

1. Hiking - I think that anyone who knows me, knows that I love to hike.  To be outside.  To get to the top of a mountain.  To go a distance that's a little farther than I thought I could.
2. Seeing new places - I love a good adventure. And actually, sometimes I like to see old places again, in a different light.
3. Taking pictures - I can't really say photography, because I just snap what I see, with my phone - but I love taking pictures - capturing beauty, memories, moments. And, lately I enjoy a good home video recording too.
4. Tucking the kids into bed - I love this time with them, because I feel like it's a time to really connect, to talk to them about important things, and see into their little souls, and understand what really makes them unique and special.
5. Organizing - having things in order feels so, so good to me.
6. Art - these days most of my painting, coloring, drawing is done in the company of three crazy kiddos - who are funny creative, and focused on doing a good job.  I love to see what they make.  I also love to see what Trevor will come up with.  And, for me, it's nice to be creative for a time (even though my skills never really progressed past the 4th grade 😊)
7. Talking - to family and friends, connecting on a deeper level, laughing, learning something new, finding solutions to problems, discovering what feels good and true.
8. Reading - I haven't done as much as reading as I would like lately - but I love to read.  I love the way the pages of a book smell.  I like learning something knew, or being sucked into a world that is different from my own.
9. Sleeping - When ever I'm having a bad day - a little sleep can make it a lot better.
10. Writing - enough said.

It's this girl's birthday today.  

I met her in 1989.  She was too cool to be friends with me then - but eventually I won her over, and we became the best of friends.

We would listen to 50's music and dance in the basement, go for walks up mountain sides and look out at ocean vistas, skip school and ride in logging trucks, drive back and forth in car washes, eat yummy food, watch the Rosie O'Donnell Show, take ballet classes, sit next to each other at lunch, sing next to each other in choir, go sledding down steep snow covered mountain roads, hide candied valentine hearts so we could eat them all by ourselves, watch movies and eat popcorn, run and slide to safety from charging cows, dance ourselves silly at school dances, camp on beaches with friends, and canoe away from angry sea lions in the dark.

But most importantly she was there.

We could talk for hours, we would laugh so hard our sides would ache and tears would come streaming out of our eyes

I loved her then, and I love her still.

Happy Birthday Roberta!

Well, I had a super rough day at work today.  So, in an effort to stay positive, I'm going to list what I like about my job:

• I have an office with a window and a bathroom.
• I work with some pretty amazing people.
• My commute is only 20 minutes.
• The work I do helps keep people safe.
• I have two computer screens.
• My boss will let me work from home if the plumber is coming to my house.
• I get paid.
• I cover two hospitals, but they're right across the street from each other so that makes it easy.
• The department has made some positive changes in the past year.
• The Friday HAI meeting.
• Did I mention the people?  The people are great.
• The photocopier.
• I have some flexibility and autonomy.

I'm resurrecting my blog.  I think it's about time.  And, this time I'm going to be writing with a purpose.

I want to start a gratitude journal.  I'm not sure that I'll be able to put my sarcastic, pessimistic self completely to rest, but at least I'll be making an attempt to become a little more positive and emotionally resilient.

Wish me luck!