Well I talked to Andy tonight about how I'm feeling about the Lexapro. I told him I was very uncomfortable with the idea of being on it while pregnant. At first he said "Well you just have to make a decision you can live with" and I was like "Uh, no. This is a WE thing. This is OUR baby so.. you're in this". I know what he meant was just that he knows I know more about how I'm feeling and about the risks, and he thinks I'm qualified to make the decision. I told him that I want to try the medication for as long as I can and see how I feel, but that unless I ABSOLUTELY CANNOT SURVIVE I want to come off of it when we start bcps. I will definitely stop taking it by week 20, because the risk of persistent pulmonary hypertension increases 6 times when the mother takes an SSRI during the last 20 weeks. I told my husband we might have to go back to dealing with high-anxiety me for 9 months, and he said "then we deal with it". And we'll know we have a medication to go back to as soon as we have the baby.

I feel good about this. I think the high risk OB will too. I'm not sure how the psychiatrist will but I'll discuss it with her in two weeks. I've definitely seen people taking it for short periods, so we'll see. But this is a decision that makes me feel good, so I'm going with it as long as it's ok to be on it for a short time. Who knows, it still may not work, but for now I'm feeling a little more hopeful. And I feel like I'm making the right choice for my baby. And... another point for IVF... total cycle control. I can be on the meds because I will know exactly when we're going forward. We'll still have to talk about that 1 cycle thing, but we can talk about that after we get my test results.

I had my appointment with the Psychiatrist today. I'm actually very relieved. I was nervous because you never know how you'll feel with a psychiatrist but I felt extremely comfortable with her. We really only had 2 options for medications for me: Prozac and Lexapro. The side effects are supposed to be very similar. Although prozac has been studied better in pregnancy, and I took it previously and it worked well, I chose the Lexapro. She was very clear that there are some risks, but she said that in my case, it was very clear that the benefits far outweigh the risks. She said that if it was her, she would take it. She said she's very honest about things like that, and if she were me she would do it. Says a lot about my mental state, right!? 

Anyway, I'm very unhappy about being on anything. I talked with my husband and he thinks this is the right thing to do, but it's just not sitting well with me. The high risk OB did call me back but I couldn't get to the phone, so I haven't talked to her yet. I definitely want to hear her take on which drug is better, and if she says Prozac is better, I'll call the psychiatrist and switch it. There's a reason I'm kind of happy about the Lexapro though. Apparently it has a much shorter half-life and works much faster. People often see some benefit within 1-2 weeks and full benefit at 4 weeks... the other side of that coin is that it gets out of your system very quickly. So here's the thing. I don't know if this medication will even work for me, and I also have no idea when the IVF is going to be. So one option we do have is to try it, see if it works, and if I don't like it I can come off of it, or I can stop it when we start the IVF cycle since it'll be out of my system right away. At minimum, I could get a few months of relief, find a drug that works that I could start on as soon as the baby was born, and work on behavioral therapy in the mean time. Also, from my own research, the main concern is lung issues when the drug is taken after 20 weeks, so there is the possibility of taking it until then and weaning off. So there are some things to think and talk about. I don't feel comfortable taking the drug my whole pregnancy, but I don't feel comfortable having this kind of anxiety right now when I'm NOT going through the IVF, and if I can be comfortable, even for a few months, I want to. For right now, I'm just excited at the prospect of actually being normal again in a few weeks. Even if it's short-lived, I'll know there's a drug that works for me... that I can go back to after we have our beautiful baby.

All of that said (and still clearly undecided about what to do when IVF time comes), I still don't have my period. I thought I did. I got bloody CM (I know you wanted to know that). But then nothing. Very weird. I guess it'll be here tomorrow... which still gives me a really short LP, but hey, what else has been normal about this cycle? We'll see what happens. And I have my RE appointment in a week and a half, and I'll be finding out the results of my 24 hour urine next week, so I'll at least have some idea of how the prednisone is working and when we might look at IVF. Progress is being made.. now I just have some decisions to face. I know I absolutely do not want to take an SSRI the last 20 weeks of my pregnancy. I guess we'll see about beforehand. I'll talk to the OB and see what she thinks before finalizing anything. This whole thing sucks, but if nothing else, a few months of SSRI & behavioral therapy before IVF is better than nothing!

I just want to say that I have so much respect for those of you who don't normally ovulate in a regular fashion. I am currently on day 40 (the longest of my cycles since I started charting in 2008!) and I got bad cramps today so I think my period is coming over the next few days. I feel like it has been years rather than just over a month. I simply can't imagine having the stess of "Will I ovulate?" and "Will I ever get my period?" on top of "Am I ever going to get pregnant?". It's a horrible feeling having no idea what's going on in there... and I know some people who get 60+ day cycles, or need meds to start a period. You are all very strong women for enduring this sort of anxiety on a regular basis.

On another note, I've lost 6.2 pounds in the last two weeks according to our Biggest Loser at work challenge. That's 2.17% of my body weight, and I'm psyched. I have exactly 8.8 pounds to lost to my IVF weight, and I did weigh with clothes (and shoes!) on this morning. It still weighs 3.8 pounds heavier than home, but my clothes and shoes probably weigh close to that.

I called the high risk OB about medications for my OCD. I think she'll be the most knowledgeable and with information from her I can formulate a plan. I have to do something. I had a panic attack this morning with shortness of breath and everything. That's bad for baby too, so I guess we'll see what she says. The good thing about monitoring my cycles (I'm continuing to do so right now) is that I know exactly what's going on when, so there will be no "Oops! I'm pregnant, but still on this medication!" things happening. Andy wants to try one more natural cycle before the IVF, so I'm trying to figure that out. I can't make any decisions until after I talk to the OB, but we'll formulate a plan then. He came up to me and said "Can we have one more 'honey we need to do it RIGHT NOW' month before the IVF?". I'd like to accomodate if we can, 'cause I'd like to have one more natural cycle out of the way too. Just for peace of mind. I've been doing more research and I really don't want to take an SSRI, so I'm thinking about the whole Xanax as needed plan. It's category D, but because I know where I am in my cycle all the time, I can know when not to take it. At the same time, the SSRI would provide more long term benefit, and allow me to be less anxious, which is better for baby's cognitive and emotional development. I think if I wasn't so severely impacted (I almost couldn't work because of this morning's panic attack) I wouldn't even be considering it. I HATE MAKING THESE CHOICES. Chances are my baby would be fine.. but what if my baby is the 1 in 100 that has a problem from it or something? Then I have to live with that.

I just don't know what to do.. so instead of worrying I'm going to try to relax. I think tonight that might mean alcohol. Ahh, the (few/one) joys of NOT being pregnant.

Fear and Loathing in Eldersburg

I went to the nephrologist this morning. It was just a sort of "How are the meds working" visit, and it was OK. He mentioned the IVF a few times and said if he gets good numbers next week he's going to tell the high risk OB he thinks we should go for it. He's honestly concerned about me and my future in all aspects and that's a really cool thing for a doctor. He wants me to stay on the prednisone as well, which I was sort of nervous about because of all the side effects. My family seems to think the chest issues (palpitations, feeling my heart beating a lot) are from anxiety, and this wouldn't surprise me at all. He also mentioned that prednisone ups anxiety. I have an appointment on Friday to see about getting on medication. I've been researching the various drugs a lot, and I know what I absolutely will not take. I'm hesitant to take anything, but at the same time, I'm thinking "If I'm having panic attacks and irregular heartbeat and chest pain due to anxiety... what would that do to my baby?". My OCD has been classified as moderate to severe, and I don't know that it wouldn't be worse for my baby to deal with the constant anxiety. We're not talking some normal nervousness, but real panic... almost every day.

I keep thinking to myself how much better it would be if we could just take 6 months and use some medication and try to get my anxiety under control first, but... from talking to the Dr. today, it's just not an option. He actually wants me to get pregnant as early into my prednisone treatment as possible to ensure the prednisone is still helping my kidneys for as much of a pregnancy as possible. Like he's really unconvinced that it will help long term. And am I willing to completely give up my dreams of a baby because of an anxiety disorder? No, I'm not. It's taking so much else of my life away from me that I'm putting an end to it. If I have to use a low-mid dose of a medication, then I think that's what I have to do. If it was mdoerate anxiety I think I would avoid it, but as severe as it is, I honestly believe it would be worse for the baby to just leave it. So I hope everyone isn't thinking "wow, what a horrible mother you're going to be" because I'm not willing to risk not having a baby at all because of a maybe 1% increased risk of something. and the evidence is so conflicting. Does that make me a bad person? I dunno. But I don't think anyone should judge me until they've been faced with the decision themselves... because it's horrible. My life is one horrible decision after another and I'm not letting go of this one.. of trying to have a biological baby, until someone says "Erika, I'm sorry, you just can't". I've also tossed the thought around of seeing if they'll give me Xanax on super bad days, so that I can continue using behavior therapy, and just have the meds for if it gets REALLY bad.. so I don't have to miss work. It's short-acting, so I could just.. not use it.. when I'm pregnant but it would still help me get through the horrible days while allowing me to practice the cognitive behavioral therapy for a few months and hopefully start benefitting more from that before pregnancy.

In other news, I have lost weight. I was not even 10 pounds from the weight limit for IVF on the doctor's scale this morning. He said he could tell I've lost weight and that given that I'm on prednisone in such a high dose, he's amazed. He was clearly impressed. Me too. He actually said he was going to talk to Dr. Neale about the weight limit since I'm so close and under extraordinary circumstances. I had very little water retention which is also cool. I do, however, have to get an ultrasound of my kidneys on Friday. They're not expecting to find anything but he wants to see if there's anything visible causing the pain I've been in.

I guess I'm just stressed out today, but what else is new? I want the OCD to go away, and I want to chill out! I feel like I don't enjoy anything anymore because I'm falsely anxious (OCD anxiety is so weird. I'd rather have a real problem any day. I've never felt anxious about anything that was a real issue [OCD anxiety feels like dread. Literal dread though, not like "I'm dreading work tomorrow"]. Nervous, down, upset, sure.. but not anxious like this. I HATE OCD.), and when I'm not falsely anxious I'm worried about my kidneys, and when I'm not thinking about my kidneys I'm thinking about baby struggles. Well, next Sunday is my 24 hour urine so I should know next week if the prednisone is working. AHHHHHHHH!!!! I want my results right now!

Infertility At Work

Infertility is a touchy subject all the time, but especially at work. Today we had a baby shower where I found out a co-worker was pregnant with baby #2. She got pregnant exactly 1 year after #1 was born, so I'm pretty sure it was the first month trying. she was pregnant within 3 months of her wedding, so.. no problems there. Two other girls there were pregnant as well. Both on their first month trying. Two others who had just had babies.. 1 first month, 1 wasn't even trying. What a time that was. When I returned to my desk I started discussing one of the girls' upcoming showers with the 2 new moms. Neither one of them really knew I was trying but I kind of mentioned that we'd been having some issues. Just in a joking, "So which waterfountain have y'all been using?" kind of way. They were discussing their infants and both said "Oh, we can change the subject if it makes you uncomfortable!". *sigh* We all know how that one feels... I know they're trying to be nice but I feel like a bit of a freak. So I said "NO! I love it! Seriously. It’s not always easy but babies are amazing and everyone should be psyched to talk about their kids. Me having trouble doesn’t make it any less awesome that your babies are doing cool stuff. I just know a lot of people don’t talk about it but I think it’s cool because if you ever run into anyone else that has trouble they can see “Hey, there are options.” So I think I handled it pretty tactfully without sounding insincere. Now they're making jokes about how I need to have twin boys to fill the world up with more since everyone else is having girls.


I think it makes people uncomfortable, but I do like to be open about it. When I finally put baby stuff on Facebook, I plan to mention that our baby was conceived with fertility treatments (unless we have a miracle before then). I don't want to make people feel weird, but I know that there are other people out there struggling that don't have anyone to talk to and don't know about all of their options and things, so if someone needs to talk to someone, I want them to feel like they can talk to me. I think it's amazing how much people DON'T know about infertility. Things that are so normal to me, like talking about IVF and IUI and temping and OPKs, are so... unheard of to people who are fertile, or who aren't, but don't have any idea where to begin.


I'm not as convinced about ovulation anymore from my temp this morning, but I think I did. and if I didn't, I'd like my period please. I just want to be on to a new cycle. I got my IVF paperwork in the mail!!! Our initial deposit is going to be like 3600, plus it'll be around 1200 for cryopreservation and storage for a year. I'm incredibly thankful that my parents are paying for these things. I'm sure we'll have to pay them back for freezing but that's OK. I don't think we could come up with the deposit in time without them so I'm eternally grateful for this gift. We just have to get insurance approval and then be on our way. I'm so excited!

Well, I'm pretty sure I actually ovulated yesterday. Woo-hoo! It's only day 33! I did have a lot happen this month that could have delayed ovulation, though. Especially starting the new meds a few days before. But yesterday I had the tell-tale horrible pain in my right side and then I was crampy all night. I've been taking my temperature, though not really tracking, and it was finaly above 97.5, and I got up an hour earlier than usual, so it would've been at least in the 97.6s. It's just good to know that things are still working in there on some level. I started tracking in December 2008, and I've only had 2 cycles over 35 days, so that's pretty OK. I wonder about people with totally normal cycles lol. Nothing else to report.

I don't know why I feel the need to post about this, but... I do, so I'm going to. Erinn just came over to my desk to chat. We were talking about the crib she got last night and stuff. Before she got up to leave, she told me to put my hand on her belly, so I did, and I could feel the baby moving!! It was so cool. I was kind of surprised because she's only 24 weeks but I couldn't definitely feel it! I yelled "Oh my God that's so cool!" really loud lol. I dunno... I like it when I have real, honest-to-God happiness about this stuff. Despite my troubles, pregnancy and birth is really amazing and just the realization that there's really a little baby girl in there moving around is so cool.

I feel good about things today. I mean I'm still terrified about my kidneys, but I'm doing the best I can, and I just have to be positive and hopeful and confident that it will work. It did before, and I definitely feel like the prednisone is doing more. I know I was on a short-term higher dose previously, but I feel constantly the effects of a triple oral dose. I'm hoping that my kidneys are feeling the constant effects as well. I'm pretty sure I will be getting a slip for a 24 hour urine for the first week of November. I'm VERY nervous and curious to see how it goes. My last 24 hour urine was up 2000mg to 8000 total, but it was a very blatant overcollection of 2 hours, so I am going to set my alarm to make sure it's a perfect 24 this time. I'll be happy with ANY improvement because last time it took about 3 months to see better numbers. Ideally, it will be down to 2000-2500 in January-February. That's my goal anyway. It was 1700 last January, but I was on Ace Inhibitors so that may have helped. I mean we'll see what happens. I'm nervous but just so hopeful that we're able to get this started and that it works. I think we'll do a fresh cycle and if it works, awesome, but if not we'll head right into another or a FET. I'm hoping we can get insurance straightened out over the next few months. I'm sure I'll need letters from doctors, but I'm hopeful. If not, Andy and I will take out a loan for half, but I'm really hoping it doesn't come to that. I just want to get started!!! Come on, kidneys... heal, guys!!