No good news

So yes, the endometrioma is back, possibly gotten a push from Letrozole, and is just slightly smaller than it was before the surgery in February. Not only that, but my CA-125 is higher than it was before the surgery. I am not back to square one, I am back to ground zero. I just cannot win. Such a neat double whammy: no pregnancy, but a bunch of potentially dangerous cysts, that threaten the whole possibility of me ever getting pregnant again.

I realize that all this time, I've been waiting for a miracle. Like you know, deus ex machina, light saving the darkest hour, this kind of thing. But apparently the miracles do not apply to us anymore. We had our miracle 6 years ago, only we did not understand just how great and singular it was.

And of course I am angry. At the surgeon - did she do her job well? At Dr who prescribed Letrozole - how could he not take into account my history, being told about it repeatedly? He said "you're in a good place right now", and then proceeded to put me in a much shittier place. At myself - if I wasn't so impatient, I would not have taken Letrozole, and maybe I'd have had another shot at miracle. At my body, which is failing me again and again.

Feeling so down

I've been feeling incredibly down for the last few days. I've been testing every morning over the weekend, and the test line was getting paler and paler - until, on Monday, it wasn't visible anymore. I went for betas and spent an hour in a crowded lab waiting for my turn, thinking that I really didn't need to be there, since I already knew the answer. I haven't had breakfast, and might have been looking so miserable, that the technician offered me juice. This never ever happened before. Then she took a needle out too early and had to reinsert it, and I couldn't contain my tears.
The result was 2. My bitch RE didn't even say "I am sorry" (my OB/GYN, on the other hand, emailed me specifically to offer her sympathy). The other Dr. was uncharacteristically grim when I emailed him the news, and suggested we come and see him "sometime". His stupid office scheduled this "sometime" for August, and marked it as a "new infertility appointment". I am going to call to yell at them one of these days.
So, here's what I am dealing with now:
- I am feeling hopeless and helpless and desperate, because, once again, my chance to have a second child has evaporated. The bleeding came on Wednesday, and brought a new wave of grief and frustration.
- I am feeling sad re: death of my MIL, and having thoughts about the inevitability of this horrible end for people I love... everyone of us was someone's beloved baby, kissed and caressed and carried in arms, being read to and cooked for, and then fast forward - and there's no one to do this anymore; and then, this horror, and pain, and suffering, and then a cremation and a void.
- I am feeling alternately the immense comfort of my parents being here with me during this difficult time, and the poignancy of them getting older, frailer, and sadder. I am feeling guilty for not being able to cheer them up, and my heart breaks when I think that they would be leaving soon, and I don't know when I am going to see them again.
- My husband would be out of town for another week, and I miss him. Part of this time we would be alone with a kid, and this is going to be the hardest time - with all my grief and all bottled up tears.
- I am feeling like time just seeps through; my kid is having a graduation party this week, and this wonderfully safe cocoon her preschool provided would not be available anymore. With everything we've been going through the last two years she attended this place, it slowly became, in my mind, the embodiment of safety, the only constant place in her life. More constant than even her home, and safe from its pervasive sadness.
- I am feeling a horrible anxiety due to some health concerns; in the next couple of weeks I will have to face them and schedule some appointments. I am just so scared. I think somewhere in my heart of hearts I have this crazy idea that being pregnant is a miracle shield that keeps all the health issues at bay. I know it's not the case, of course, I am not stupid. It's just that I don't want to be thinking about tests and doctors if they are not related to be being pregnant - but I have to, and this makes me cry.
...And then I was folding the small girl clothes, new with tags, that someone in our household didn't get around to wearing. I was folding them to send to her younger cousin, and my heart was breaking again. It wasn't supposed to happen this way.

* * *

This is truly a horrible time for another chemical pregnancy to happen, especially with the implications that go with it - i.e. we are hitting the wall and not getting anywhere, and we are too freaking old to have another baby. I mean, 2 chemicals in a row is one thing; 3 chemicals in a row - bringing the total to five miscarriages - sound like a final sentence. And the thing is, my MIL died last night. My husband is beside himself with grief, and he is dealing with it and with all the rituals and bureaucracy surrounding death - and he is dealing with it alone, across the state. I am at home with a kid, and I am powerless. I did not tell him about the test, because I did not want to put extra pressure on him, and I did not want to put him through another round of beta hell. But the thing is, he remembers. He even remembered to ask me today, if I'd checked already - and I did not tell him the truth. I wanted my news to be a ray of light in an all-around bleak time, but now I fear it might as well be the breaking point.

This is truly hell. I couldn't help but Google happy endings for low HSG, but there were not much. Also, from my experience, if something doesn't look right and requires some elaborate mental scheming, calculations, and explanations like "sometimes it could still be normal", it probably is not right at all.

And yes, I've already thought about the name. Stupid old me.

Letrozole scan

Went for Letrozole scan. The Dr. on call who performed it gave me the impression of being quite pissed off because she had to be at the office on Sunday, and on Mother's Day, no less. She was professional, but brisk and unfriendly (and she refused to look for semen analysis kit, so my husband would have to drive there again to pick it up). She did not tell me the size of follicles, and I did not do my homework - so I did not ask. My impression was, they are not quite as big as she would want them to be, and there are only two of them. She outlined the protocol: few more days of Letrozole, trigger shot on Wednesday, BD on Thursday, estrogen and progesterone few days afterwards. I flat out refused estrogen. I questioned the idea of more Letrozole. I basically got very confused, since none of this was discussed as a possibility at my last week appointment, and decided I will have to think it over and talk to my Dr about all of it. As for my continuing spotting - she dismissed since my lining "looks good". 

Also, she told me there's a possible small cyst on my right ovary - the one that I had a surgery on. "Or maybe it's just the way your ovary looks after the surgery," she said, but I am so not convinced. She doesn't think this cyst appeared during the last 10 days. Does this mean they missed it while doing an ultrasound to rule out any cysts before starting me on Letrozole? Or is it a Letrozole sife effect? Too many questions, and no answers. 

There was a poignant moment today, while we were waiting for the Dr. to come and for the office to open. All three of us had to come to the appointment - the kid had a birthday party nearby to attend later, and we were going there as soon as the ultrasound was over. Another woman came to the door to wait. She was alone. She complimented my kid, we exchanged some platitudes about bilingual childhood. She mentioned that her husband was of different ethnicity. She mentioned her nephew. I just knew she was there for the same reason as me, but she had it much worse. And my heart was breaking for her, too.

It was also breaking for us. Two years. Two years, and we are visiting the same parties, same shows, same places. And I am still checking my freaking pantiliners and pads, peeing on sticks, and having nothing to show for it but few gray hairs. 

The merry month of May

May is not an easy month.
Two years ago, on Mother's Day, May 12, I did a test and found out I was pregnant. I was happy, I was naive, I thought that positive test equals a baby in 9 months or so. It didn't happen. I had my first miscarriage on Father's Day, later in June.
My second miscarriage in the fall of 2013 had a due date somewhere around May 20th (I did not really look at the due dates at that point).
And then there was my third miscarriage, on May 9th last year.
I am writing all this down, and again I cannot believe this happened to me. How did all of this happen? How did all this happen to me? How did I survive all this, in one piece, at least physically? Would I ever be able to pick up pieces of myself and put them back together?
...And I cannot even drink anymore. 

Introduction

It feels a bit like throwing a bottle into the ocean, but anyway.

I am 39. I am a mother to a wonderful girl who just turned four. Last year, we decided our kid needs a sibling - to help her deal with parents when they get old and crazy, and anyway, we always wanted at least two kids and a loud, crazy, chaotic house. And that's where it all started.

May 2013: Got pregnant on our first try, went for an ultrasound, and there was an empty sack, too small for 6th week. Missed miscarriage. I was shocked beyond belief. I didn't think things like this could happen to me. I carried an ultrasound picture, the one with an empty sack, with me for months. I don't know why they gave it to me.

September 2013: Got pregnant on our second try, while on vacation. I always wanted to conceive on vacation. I was so hopeful that I even took a picture of the house where it happened, just in case. I was pregnant long enough to get to prenatal appointment, where a well-meaning but inept nurse practitioner told us there was a heartbeat. I wasn't convinced. I remembered how it looked during my first and only successful pregnancy - so much more pronounced and clear. But I made myself believe her, and I received yet another ultrasound picture.

Then I had spotting and came for another ultrasound. The baby was no more.

This miscarriage was longer, two and a half month of hell. This time it wasn't shock, it was despair: I thought before that my first miscarriage was a glitch. Not anymore.

February 2014: Went to see RE, who ran a panel of tests and concluded that I need to take thyroid medications and receive progesterone when get pregnant. Have to say - I hated thyroid medications. I used to be a reasonably healthy person and never before had to take pills every day.

April 2014: Pregnant again, for the whole of two weeks. Endometrin (hated it) and regular beta checks, all the way trying not to get too attached. (I failed). HCG started going down pretty soon, and I never got to even have an ultrasound. RE's explanation of what happened, basically: you are old and your eggs are crap.

June 2014: Went for a second opinion to a well-respected Dr. His conclusion: the reason for what had happened is immune, we need to fight inflammation in my uterus (translation: it's not my eggs, it's my uterus that's crap). He prescribed a ton of anti-inflammatory supplements and Doxycycline for three month, and then try to get pregnant again. These were long three month. I struggled with drugs schedule for a while, but got a hand of it eventually.

October 2014: Got green light to start trying, and progesterone after ovulation. Got implantation bleeding, had positive pregnancy test and betas of 24 - just to discover in two days that it's another no-go and HCG is not rising properly. My personal record two-day pregnancy. I told myself quite firmly that it's better that way, cut your losses early and all that.

Yeah, right.

I was incredibly angry.

I soon found myself crying hysterically in a shower and yelling "I can't do this anymore!"

I do realize we are so incredibly lucky. We have a child, who makes every day a better day. But still.

Every time my kid talks to me about how she wants "a real sibling".

Every time she plays with a doll and calls it her sister.

Every time I see a pregnant woman with a kid.

Every time I think how we always wanted two kids.

It hurts so much, but I cannot stop trying yet.

November 2014: We went to our docs again. RE is pushing for IVF with genetic screening (remember, crappy eggs). I don't want to do this. It's invasive, expensive, may endanger my health (I have a bit of a history) and the success percentages are about the same as my chances to successfully conceive and carry to term on my own.

The other Dr. insists my eggs are not the issue (remember, crappy uterus). He thinks we have to deal with inflammation, and suggests we send a few tests to a lab in Chicago and go from there - either continue with current protocol, or have more serious drugs, or have a surgery for endometriosis. Our current insurance covers my RE (though it wouldn't cover IVF) and doesn't cover the other Dr. and any of his suggested options - and since the RE is, to put it mildly, not very keen on the whole "inflammation" theory, we are on our own.