Letrozole

I started Letrozole (brand name Femara) on December 27th. Finally a welcome side effect, super short periods. I took these meds on days 3-7 of my cycle.

This medication is commonly used in high doses in women who are fighting breast cancer. I often find myself wondering how they determine these "other uses" for medications. For example, the shots my mammaw gets in her eyes to treat wet macular degeneration is actually used in high doses to treat colon cancer... it baffles me... who thought "Oh we should inject this in that gimp eye just to see what happens"? Clearly this sector of science is above my pay grade... I never did care for chemistry. Anyways...

Some of the side effects were similar to what I felt with Clomid: headaches, hot flashes, some dizziness, fatigue, night sweats... but the worst thing? Muscle and joint pain. I have a fairly high tolerance for pain... after numerous run-ins with kidney stones... there isn't much pain that I can't deal with. This was intense. I found my OCD self laying on a heating pad with muscle relaxers instead of doing laundry and cleaning. The symptoms also lasted longer on the Letrozole, most likely due to the fact that it stays in your system longer than Clomid does.

These side effects would later come back to bite me when I had gotten more used to expecting the pain, and then confusing the pain for a side effect and trying to muscle through it when I was in actuality passing a kidney stone, however I could finally tell the difference when I started having the tell-tell bladder spasms of yet another stone being stuck at my bladder wall.

Despite all that I was very hopeful for this medication to work for us. I was excited to be on it... my sister-in-law conceived on her second month of taking this drug... and I just knew we would have the same experience!!

No baby round 1. Started round 2 January 23, 2013. No baby. Started round 3 February 22, 2013. I ovulated all three rounds!! Upon the start of our third round, we were informed that this would be the last treatment she could do with us. We would need to go on and make an appointment with Fertility Associates of Memphis, she suggested seeing Dr. Ke. I was encouraged to go on and call them because it can take weeks (and sometimes months) to get in with an initial appointment to see him. I like to be proactive sometimes, so I did as I was told. His first available when I called in February was April 1st. Wow. Guess they were right! And I could always cancel the appointment if I ended up pregnant... which I just knew after all this would happen and I could happily call and cancel, elated that we would begin a different journey.

During our last round, after I ovulated I was given the date to test for pregnancy if I had not yet started my period. March 19th. This was fate... that was our anniversary. What better gift to give my husband on our day of celebration of love than to show him that we were pregnant?! I fantasized about that day... how beautiful it would be to celebrate a pregnancy on the anniversary of our wedding day... I dreamed about it... I day dreamed about it. I tried, in vain, not to get my hopes up. But it felt right. It felt like it was finally going to happen. I prayed harder than ever.

But that didn't happen. Although I ovulated all three rounds, we still did not get pregnant. I was not one of those lucky people who get pregnant after their medications and HSG test... Our anniversary, as much as we tried not to be disappointed, was a hard emotional day for both of us.

Discouraging right?

After crying it out the morning of yet another negative pregnancy test... (I really should own stock in Clear blue easy) We chose to spend the day focused on one another instead of wallowing in our sadness, there was time for that later. All in all it was a good day. At work I received a beautiful delivery of red roses. Surprised and so happy (flowers are a straight shot to my heart)... I was not expecting the second delivery later... chocolate covered strawberries. He really went all out to make me feel special. I did feel that. I felt loved beyond measure. I felt so blessed that this man sees past all of my inadequacies and loves me whole heartedly. We went to our favorite date-night restaurant, splurged on dinner, crab cakes, prime rib, red wine and crème brulee. It was a good day. It was a day filled with love.

 

But during that three month period, something better... something amazing had happened during that time...

Read on...

Is This a Test or a Torture Device?!

December 2012- A Break from Meds and More Testing

A test was set up that I was not looking forward to, a hysterosalpingogram. I knew this would not be an enjoyable experience and I was NOT looking for to it. (As if any part of this is an enjoyable experience, but I digress.) I was ready to have this test done as soon as my doctor suggested it, because we could not move on with further treatment until it was done. The dilemma was this: it was December. Our insurance would not cover this test until our deductible was met. This one test would complete our deductible for the year and then they would pay the rest. I wanted to have it done then, as soon as the doctor set it up. We had this money, let's get this thing done. We could have put it off until January, and then our deductible would be met for this year... makes sense right? Not in my infertile brain. In my brain this would just delay our progress. If we waited until January it would make us "sit out" for two - three cycles. That could be three whole chances of the possibility of pregnancy just out the door... I may procrastinate on some things, but this would not be one of them. The doctor says I need a test... the doctor says she cannot treat me anymore until I have the test... so we did the test.

 

A hysterosalpingogram (or HSG) is a test done by a radiologist where a catheter is inserted through your cervix, a balloon is inflated to block your cervix and then x-ray dye is injected through your uterus and ideally fills your fallopian tubes and spills out into your pelvis. Sounds fun right? But what part of this hasn't been fun? Bring it on.

 

I knew what I was in for. I knew the process of this procedure from ultrasound school. I knew it from the experience of friends. I knew it from my own research. I knew that when my doctor said it would be "rather uncomfortable" translated to *this is going to hurt*. For once I would suck it up and tell my husband that "Yes, I do need you to take off work to take me to this appointment, please." Even though I know that he hates hospitals. I was not offended when he declined the offer to come back with me when the test was being done. If there is anything he hates more than hospitals, it is seeing his beloved in pain. Hospitals don't phase me... watching procedures doesn't phase me. I was thrilled when they fixed the screen so I could watch the x-ray images as they were being taken. The thing that does phase me? Needles... and that catheter was close enough to a needle to get my heart racing. I was so nervous. Okay let's be real here.. I was downright scared.

 

I had taken a light painkiller about 30 minutes before my procedure at my doctor's suggestion. Boy was I glad that I did, I actually wished I had taken a whole one instead of just the half that I took... but the other half would have to wait until afterwards. The catheter was uncomfortable... the balloon however? Holy cow. That was intense. Luckily the "radiologist" doing the procedure and the x-ray tech that was assisting were well aware of this fact and did not try to downplay it. They also knew my medical background, so I assume that they knew pretending that things weren't how they truly were wouldn't work on me... just as that process doesn't work on most people that have ever worked in a hospital or in the medical field.

 

The procedure was rough... it took longer than I anticipated. They had trouble getting the catheter placed exactly right in what the "radiologist" referred to as a small uterus. They had to move me around... a lot... with all the equipment still in place, if you know what I mean. The dye being pushed through was fairly uncomfortable in itself. Let's just say I would be hesitant to want to have this procedure done again, although I am happy they went on and suggested having it done at this point in our journey.

 

I watched the screen. I watched the dye. I saw it spilling out into my pelvis. Good right? Until the "radiologist" says, I think your tubes are narrowed, that can cause fertility issues... and so on and so on... My heart dropped. "What can they do about that?" I asked... he suggested that was a question for my gynecologist. So I left... hurting and feeling so defeated. I was so upset at the idea that there was even more wrong with me than we anticipated. I actually cramped for several days and felt pretty sore after this procedure, although for some people this feeling only lasts for several hours.

 

Soon after I had the follow up appointment with my doctor. "Did you have your test?" "Yes, they said..." and I relayed everything this so-called "radiologist" had told me. She looked concerned and then said, okay let me go pull the report. In a few minutes she came back looking confused. "Who did your test and told you this information?" I told her... describing the "radiologist"... Then she said something that stunned me. "This report says that your test was completely normal. This is no stenosis in either tube, they were completely normal." I'm pretty sure my response was... "Wait... what?" Turns out this "radiologist" was actually a resident and I was his practice case. Now, I know all about such residents... I don't mind my test being done by a resident... but for the Love of God... TELL ME YOU ARE A RESIDENT!! And don't make assumptions about a test before consulting the real radiologist. And don't tell patients there is something wrong with them unless you are 100% certain and have a radiologist to back you up!!! Seriously!! Part of me was so mad that this guy had me so upset and worked up and never once revealed that he was NOT in fact a radiologist yet... but then the reality of what she was saying sank in. After she apologized that I even had to deal with that... My tubes were open! They were open! Hallelujah! All that anxiety over what this guy had told me was wrong with me was gone.

 

Then we received the next part of the plan. A new medication. It was too late in my cycle to take it at that time (because the HSG has to be done between days 7-10 of your cycle), but we were told to keep trying that month, because in lots of cases just the hysterosalpingiogram can actually BOOST your fertility for up to two months! If my body decided to spontaneously ovulate there would still be hope for our Christmas baby being conceived after all!! And if not, I would be given Femara (Letrozole), a medication that works similarly to Clomid but with a different chemical makeup and can have less side effects... in some people.

 

So we tried.... we prayed... we were happy and hopeful.

 

We spent Christmas Eve with my family. I prepared my first big Christmas dinner for the people I loved. I felt so accomplished to have everything decorated and creating a delicious successful meal... my first from-scratch yeast rolls... my from-scratch everything really. Cooking had become my therapy. We oohed and awed over my little nephew playing in the paper during his first Christmas... we laughed together... I looked at the angel wings on my tree we purchased in remembrance of our little one in Heaven. My husband and I talked about how much fun it must be to celebrate Christmas in Heaven... I cried in the bathtub missing my child, wondering how much fun he would have had playing in the wrapping paper with his cousin and the puppy dogs on his first Christmas... after I cried I felt okay but weary from the journey thus far... I went to bed, thankful for the blessings that I was fortunate enough to have.  

 

I started my next period on Christmas day. So much for the thought of a Christmas miracle. We celebrated Christmas together as a couple, just the two of us (well, the two of us and our three pups)... we went to see Les Mis, in our sweats... each of us somewhat melancholy at yet another disappointing failed cycle. At least we had each other. That is what we focused on.

 

Time for the new medicine. New year and a new start right?