Brace the mainsail

The thing about getting a fourth opinion is, that you might agree with the fourth opinion. And then you have to do something about it. And then, and then. Hope is painful. Medical treatments raise the stakes, and failed cycles drive those stakes into your back. It’s been two years, nearly, since I was last officially, look-I-have-two-lines pregnant. It’s been miserable, but, as Woody Allen said, life is divided into the miserable and the horrible. Be happy when you’re miserable, at least it isn’t horrible.

H is liaising (or, actually, playing telephone tennis) with Dr 4th Opinion’s secretary. We are seeing about scheduling an HSG, to check the endometriosis hasn’t glued the one-and-only fallopian tube shut (it’s been over a year since anyone last took a peek at it). And then we do LIT. And aspirin, and heparin, and Intralipids. If the tube is damaged, we go straight to IVF. If the tube is fine, perhaps we carry on trying au naturel for a few cycles, then retest to see if the LIT sensitisation is still holding, and then rethink the IVF option if there have been no two-lines. Dr 4th Opinion thinks IVIG, neupogen, clomid, steroids and progesterone support are all unnecessary, especially as the lining of my uterus is not infested with psychotic killer cells looking for embryos to slay.

I can go with this. H can go with this. So we are going with this.

I Just don’t expect any enthusiasm or positive thinking. They burnt out of me long, long ago.

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35 responses to “Brace the mainsail

  • Mina

    Having a plan is better than having none. Captain Obvious at your service, m’am.
    As for positive thinking, I am constantly wondering why would anyone consider life is a bed of thornless roses dripping honey, why not just accept that shit happens so often and randomly and let’s go with that and be realist, as in wishing for the best and being prepared for the worst? The positive thinking’s pitfall is that guilt piggybacks on its shoulder when things turn out not as one wanted them to, and we somehow make it our fault that we did not wish it bad enough, or we did not think proper positive thoughts enough. I do think we have got enough guilt-producing nonsense in our life, let’s prune this bu**sh**, why don’t we, eh? (like what I did there, with the asterisks?! Huh, huh?! :-) God, I’m hilarious today.)
    I hope the HSG brings forth the answer that puts the plan ‘bring home the bébé’ in motion. On paper, it all sounds favourable. I hope reality matches the expectations and desires.

  • Twangy

    With you all the way.. wishing you much luck.

  • korechronicles

    Well, I’m positive about this plan since I can actually understand almost all of what is proposed unlike the last lot of options. Turn into the wind and heave-ho!

  • Sheila

    I’m surprised that #4 says no to progesterone support or steroids – they’re both relativey common and cheap protocols that most IVF doctors use (esp progesterone support)….

    I believe some doctors are now suggesting doing only one of steroids / intralipids / IVIG (with steroids being the least expensive option and ILs having the least side effects) in order to prevent oversuppression. I think Dr Br in the US is the main proponent of latter theory. If I could be guaranteed they all had the same effect, I would probably go with ILs too as they have the least side effects. My personal experience though is that steroids were more effective for me but everyone’s different.

    I’m interested in #4’s logic for no progesterone support given your RPL history if you’re able to share?

    • The Comment That Broke the Camel's Back

      Maybe you have the best of intentions, but you know what? Nobody knows May’s history and May’s body better than May does. I am sorry that anyone has had to come to such a thorough acquaintance with infertility and related treatments; that still does not give you and your ilk license to run around the internet questioning the treatment plans of others. If you are trying to impress people with your knowledge, you have failed spectacularly: May knows how to operate Google, too.

      If you can be supportive, be supportive; if you cannot, zip it and move along. (I extend this all the way down the page to the longtime readers who are undoubtedly trying to help, but who really ought to know better.)

      @May: I am so glad you and H have a new plan and a doctor in whom you have confidence. Best of luck on your new path.

      • Chickenpig

        Also, all IVF cycles, no matter the patient, usually involve three stages: suppression, stimulation, and support. May didn’t go into what forms of suppression, stimulation, or support she would use. All the treatments she mentioned are ones reserved for difficult cases…above and beyond the usual. Progesterone support isn’t the panacea that some would think. I’ve had three miscarriages, even though for the second two I was on mega progesterone support.

        • Sheila

          I have been following May for a number of years and think she is a very talented writer. I did not mean to cause any offence by what I said and I apologise if that’s how it has been taken. I am genuinely trying to help by offering my own experience having lived in the bewildering world of infertility for a number of years (incl 5 IVF cycles with at least one of the doctors May has seen). The question at the end of my commet is a genuine question – I’m not saying I know the right answer as there may be advances I know nothing about and that May’s doctor does know something about. Hence my question. Again, I’m very sorry if I caused any offence – I promise that was not my intention.

          • Chickenpig

            It is a perfectly legitimate question. But your RE can push the progesterone until it is coming out your eyeballs and you can still miscarry,( unfortunately). I am also curious as to what May’s protocol will be, but it is just curiosity…and hope. Dr 4th Opinion has put some cards on the table that I’ve never heard of, and I’ve been at this rodeo since 2000. It doesn’t hurt, if/when you get pregnant to insist on frequent progesterone level checks and support if needed…but it is one of those ‘cross that bridge when you come to it’ sort of things.

          • Hairy Farmer Family

            Chill, lovey. You & your ilk seem ok to me!

          • Chickenpig

            I don’t find any question offensive. I’m certainly not offended. I doubt if May is offended. I just wouldn’t want anyone to hang their hopes on Progesterone. Hope is a Mink killer! ;)

  • Womb For Improvement

    A plan is a plan and that is good. I, too, wonder what the rational for not throwing more stuff in as a belts and braces approach – but if you are happy that then it is better to be trying something than nothing. Good luck.

  • a

    I think you’re pretty well-versed in your options by now, and if you happen to find a doctor who mostly agrees with you, then you’ve found a good fit. I’m with everyone else on the progesterone, but I don’t know what your bloodwork looks like. :) (Why don’t I know what your bloodwork looks like? Are you being reticent with information?)

    I do think it’s a good idea to take a look at that tube. I just wish you could do with ultrasound or something easier.

    I will hope for you. Much luck.

  • Moira

    Hi … How do I email you? My phone won’t let me seArch your blog for contact details.

    I’m not a nutter or anything (I think!) promise

    Thanks

    M

  • Valery Valentina

    Oh, hope and the unlearning thereof. and then to try again.. (but to me it felt so good to have a plan, with tests and dates and medication schedules, to do something (different) again, to have double digit chances)
    But even with double digits kicking me in the ribs it is still hard to trust that ‘everything will be all right’
    I’ll start hoping for you now already, so you can take your time, ok?

  • Wendy

    Good you have a plan, something to look forward too, at least to do, go for it and good luck.

  • Chickenpig

    The good thing about IVF is that it works, or doesn’t work, no matter how you feel about it. It is wonderful to have a plan, though, even if Hope is a mink-killer. (Herbert says it’s Fear, but it’s hope). I wish you all the luck in the world.

  • manapan

    Good luck! I will be thinking the positive thoughts that you can’t manage right now. Consider me your very own morbidly obese cheerleader. :)

  • korechronicles

    To the usually gentlepeople of May’s blog commentary team, others of our ilk, and to Sheila in particular, I offer you the Urban Dictionary definition of Concern Troll for your delectation:

    “A person who lurks, then posts, on a site or blog, expressing concern for policies, comments, attitudes of others on the site. It is viewed as insincere, manipulative, condescending.”

    Thank you. As you were.

  • Anonymous

    Bugger positive thinking. I have a half memory of recently reading that being stressed/relaxed/miserable as sin/skipping merrily through meadows matters not a jot to one’s chances of getting pregnant. Either the ducks line up or they don’t, and no amount of twinkly happy thoughts/gloomy Eeorye-ish brooding makes a blind bit of difference. So here’s to well-ordered ducks!

  • Dr Spouse

    Something to go with! Hooray! A Plan! Frabulous!
    The blogosphere seems full of plans. It is good.

  • Betty M

    Hesitating in case I incur anyone’s displeasure to say anything other than I’m glad No 4 came through with something that you and H can be content with trying. As it has been so long since I was in the midst of the whole IVF process I have a ton of questions on the new to me aspects of No 4s protocol but I expect you’ll get to them when and if you are good and ready. And I totally agree with positive thinking making squat all difference.

  • thalya

    HFF thanks for the shoutout, I had forgotten that post. I do tend to get pretty indignant sometimes.

    I am not sure I completely follow the indignant thread up stream from here. I thought Sheila’s comment was entirely well meant. Most of us have had a hand in creating our own protocols, or at least asking the questions that get our docs thinking about what they are recommending to us. Certainly I would never have been given clexane without all the online research and discussion I had had about my MTHFR mutation (nor would I ever have known to ask for the relevant blood tests). Of course none of us is a doctor, and none of us knows the full story, but I am at a loss as to why a thoughtful post is seen as a bad or thoughtless thing. May can decide if she wants to pay even a blind bit of notice, but the comment itself and the poster who wrote it are not inherently evil.

    On that note, dear may, my entirely un-medically qualified opinion is that you should be going to IVF, stat. You have been too long with partial bits of treatment and miserable tries and treatments and losses. IVF may not be the magic bullet, but it does increase your chances on any one cycle of sperm meeting egg and developing appopriately. If the LIT etc treatment (about which you know I am sceptical but I totally support you in your trust in your doc, because, what do i know) is the right answer for the immune issues then why wait to try naturally when IVF will increase the chance of getting you pregnant that cycle? I am fed up with docs, esp NHS docs, saying ‘everything’s fine, dear’ when clearly if you aren’t pregnant IT’S NOT FINE.

    Hmm. indignant again. Must centre.

    • Chickenpig

      I hope I didn’t come across as bashing Sheila because it wasn’t my intention. As I said, I thought her question was a legitimate one, but May hasn’t gone into details here about her protocol yet, so the question may be premature. I too am curious as to what Option # 4 entails in more detail, if/when May chooses to share it.

  • Whoa Nellie « Nuts in May

    [...] of some duration, and who has dealt with some of the same doctors I have, and therefore I take her comment as coming from a place of friendly interest, affectionate concern, and natural curiosity. And [...]

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