Tuesday, July 31, 2007

8pm, 550 miles to go...

poor cl! his flight out of SC was delayed, the connection missed. the airline offered to put him on a later connection; an 1105p out of atlanta. it was a really tough call..but if that flight was cancelled, he'd be stuck in atlanta at 1105p with no way to dc before tomorrow am and we'd miss the IUI. the way our clinic works, all IUI's happen at 8a, but the male partner has to show up by 7a. so, the question was, fly to atlanta on the delayed flight and hope nothing happens with the 1105 dc connection? or drive 8+hrs and get in at 4a. we are people of little faith, so he decided to drive...he's driving now. poor guy.

(i just checked and his flight out of atlanta is on time for an 11:05 departure. of course, if he were on that flight, it would be cancelled i'm sure.)

Monday, July 30, 2007

you know you're alone in the world when...

...you give your own self a shot in the ass.

my blisters have blisters

just back from an ultimate tournament in wild.wood new.jersey. it's a beach tournament and fun as hell but HOLY CRAP am i sore today. the insides of each toe are swollen and blistered. the irony is i hobbled all around today at my orthopedic clincal. i didn't dare mention that i spent the weekend at the beach playing ultimate, because that would imply that: a) i had free time and b) i did not spend my "free" time studying. since i could not name the divisions of the ulnar nerve below the antecubital fossa, i certainly do NOT have time to be playing ultimate on the beach. anyway, wild.wood is crazy...it looks like a carnival threw up on the boardwalk. nevertheless it was a lovely tournament and i will put pictures up as soon as my lazy ass gets around to it.

speaking of lazy...on thurs i had a 13 and an 11 and a smattering of littles. you figure 1mm/day minimum, 2mm/day average and 3mm/day possible because of the clo.mid. today i had 1 18mm, a 15mm and a 14mm and some littles. so, either the 13mm did the minimum amound of growing acceptable, or it arrested and the 11 powered up to the plate. either way, on the strength of the 18mm i'm triggering tonight for a weds iui. hopefully that one will be mature enough but we can't wait much longer because quadruplets are not my thing. for some people, maybe. for me, definitly not.

Thursday, July 26, 2007

i'll take mine scrambled

i'd like to indicate, for the record, that i must have some anatomy in some very interesting places because no one can find anything they're supposed to on the first pass. so, to clarify for any of my health care providers that are reading:

1--where my my cervix?
i'll tell you straight up it's posterior. point the speculuum about 40 degrees south of where you think it should be, and you just might find it. i don't know why it keeps such bad company. usually i have this conversation after what seems like endless minutes in the stirrups, and great gnashing of teeth (mine, theirs). i think i should have it beforehand from now on.

2--where is my right ovary?
i know i have one, lets start with that. today it was located hanging out at dairy queen. who doesn't want a blizzard? best way to image it is to put the dildocam perpindicular to the hooha and set the phaser to 'stun.'

the news from the almighty divining rod was mixed. the best thing to see is one nice big follicle. i've got two mediums (a 13mm on the right and an 11mm on the left) as well as a smattering of littles. i'm going back on monday for another look-see, because the picture was too mixed to give me a definitive trigger date.

so, i have two problems (or slightly more than that). one is that monday is the next day i'm supposed to rotate with the orthopedic dr. of course. we are talking about someone who got thyroid cancer during her residency and took a grand total of 2 wks off. i lied about where i was today, because skipping clinical to get wanded is not acceptable. now i have to be late to the very next clincal with her for the very same reason. the nice thing is that the RE is going to see me at 720am so i can be out of there as soon as possible. the bad part is i'm still going to be about 1/2 hr late or more :(. my sis thinks i should tell her ahead of time that i'm going to be late, but that involves coming up with a plausible reason that i will be late, and there isn't any, really.

problem 2 is that i left the nov.arel powder in the trunk for 4 hrs today (HOT), because i'm not that bright. it isn't mixed or into solution anything but the box clearly says 'store at room temp' as does the package insert. so, odds that i turned a very expensive medicine into weak table salt? anyone?

you say it's your birthday?

Happy Birthday to Ms Jilly Sue!

Monday, July 23, 2007

playing hooky to get dildo-cammed.

le sigh..

meh. today i'm in a meh kinda mood. i'm a student, so all of my time is owned by other people. except when i'm at work, when, actually, it is still owned by other people. thursday afternoon is the great and powerful wanding, but it is also a day i'm supposed to rotate in the afternoon with the orthopedic dr. i thought about trying to shift the appt, but it has to stay on thursday and no time on thurs would be better than any other, unless it was a morning appt, but the RE clinic doesn't have AM appt's on thursdays so blah blah blah. i guess i'm going to call in sick and deal with the repercussions (sp?) monday, which is the next time i rotate in orthopedics. i have a derm clinic rotation in the same building thurs AM, which i'm still planning to go to. the derm people and the ortho people don't hang out much, but watch, i'll get caught by the ortho dr in the hallway or something. SO very 7th grade. i remember when cutting school was fun, like to go shopping or veg or pretend to be bad asses, or to have something more fun than a dildo cam...well...i digress.

i think this sentiment from mel is really beautiful: I still love you / when you don't appear / and remain only a dream

today i had to ask myself the following really thought provoking question: can i possibly drop one more thing? i thought i'd outdone myself by dumping both my water and my ketchup (a vegetable! ask reagan) onto the floor in one fell swoop. but when i knocked the open container of yogurt out of the fridge and onto my pants and all over the floor when trying to replace my poorly squandered ketchup (a vegetable still), i was forced to conclude in the affirmative. i've since declared myself a walking disaster area and i'm sending myself straight to bed, still ketchup deprived, even though its not yet 9pm. le sigh!!!

Saturday, July 21, 2007

lazy much?

day two from the clo.mid fields, and i feel fine. the only thing i detect is a laziness that threatens to swallow me up into its soft fuzzy bliss. things i should do today: 1--assignment due monday that i will have to redo if it sucks; 2--pick up mail from UPS that will be returned to sender if i don't; 3--play ultimate with the team i paid good money to join 4--go shopping since i am down to eating stale cereal with rancid butter for breakfast. things i want to do: nap on the sofa in front of the tv. well, its hard to blame the laziness on the clomid, but i thought i'd try. on the good side, i slept 11 hours yesterday :). i dreamt i was with the hyannis port kennedy's, and one of them was born with a shortened arm, and died of complications from it at 2yrs of age. i'm not trying to read much into that one...probably not worth it.

Tuesday, July 17, 2007

greetings from my aunt

well, the old coot finally showed up and today is CD2. i don't know about YOU but for me, the auntie's visit is quite a production. i have a pharmacopia of products to enhance her visit. on the list generally: ad.vil (lots and lots and lots of ad.vil), Vi.Codin (not as much of this as the ad.vil, but as much as is necessary), Zan.tac (so i don't shred my stomach to bits with the ad.vil). Sometimes i have to fortify with Phen.ergan, when my aunt's visit cause me to lose my cookies. I also have my handy dandy alarm clock for when I have to take meds during the night. Woe is me if I forget, because my aunt will wake me out of a deep sleep and whip me until I cry for hours. The irony is, everyone but everyone from the Ob-Gyn to the RE to the NP to everyone in between says it will bet a lot better once i have children. Snort!

It occured to me the other day what an odd summer i'm having. this is the first summer i've really tried--balls out--to get knocked up, and i almost suceeded...twice. It's also the summer i'm surrounded by preglets. not just family, but friends too. many of them. and also, at clinial. at least two days a week i'm up to my armpits in pregnant 16yo's. it's very very odd. also today i had two women come in for what would be an infertility work up if they were well insured. my diagnosis was PCOS for both. anyway, the sort-of-insured one (25yo) we did the standard labs on. the barely insured one (34yo) i advised to make an appt with the gyn service at either of the two major hospitals in town. in maryland, access to a gyn for primary care is mandated. her chances of meeting with a specialist are still remote, but better if she starts primary care with one of them. i thought this rotation would be very hard this summer given my situation, and it is, but it is also tough in ways i didn't realize it would be.

Sunday, July 15, 2007

the divine issuance from my loins?

the ball is very near to getting started, so to speak. if my dear old auntie would ever show up, we could get started. my lp's vary much more than one would think. if it doesn't show up tomorrow i'm going to POAS, even though a + would mean that i'm carrying the fruit of the lord in my womb.

i'm in SC right now and my poor hubs and i have survived a 3 day visit from my dad and his wife. very stressful.

an online friend of mine delivered a healthy baby girl after an early induction (37wks) due to pre-eclampsia. she recieved pitocin and an epidural and had a vaginal delivery. the babe was discharged home with bililights due to jaundice. she is opting to formula feed and breastfeed at this time. i feel bad for her because i'm worried that our online community is not as supportive of her as they have been of other births (even a completely reckless homebirth that narrowly skirted abject disaster)...her birth was maybe everything they don't want for themselves or any birth: induction, pitocin, epidural, formula. so some people are writing supportive comments to her and others are writing 'i know it's hard, but don't give up on the breastfeeding.' i'm not sure that's supportive IMHO. i think we should all support one another's laboring, birthing, and childrearing choices even if they are different from our own or how we would want them to be. i've worked with many many children over my life and in the past few years in pediatrics. breastmilk vs bottle, cosleeping vs crib, pacifier vs thumb, none of it matters as much as people in it think it does. what really truly matters is an invested parent, better two invested parent. after that, the difference between one thing or another is subtle gradients that also depends on the temperament of the child and what works best for her. ANYWAY, i'm dissapointed that people wouldn't be more supportive of her when her outcome was so good, especially in comparison to homebirths that have less positive outcomes.

do we care about people or the path? is 'natural' so important that we cant find love and support for those who take a different path? :(

Monday, July 9, 2007

if you don't laugh, you'll cry

look at that belly! my sis, pregnant with twins. one of the onsies says 'i love my auntie' (but, of course!)and the second one says 'spring chicken'. LOL! this is 16wks in to her 1st pregnancy.

women's health care in baltimore city has an edge of the macabre. to wit:

--last week i told a 50 something year old woman that her pap smear had come back postive for trich, an easily treated STD. i thought this was sort of good news; hey, you have an STD but we caught it early and can treat it easily. no long term sequelae. except that she was married. for 21 yrs. eeeaugh, not such good news after all.

--last week a 17yo came in with a last menstrual period of sometime in late may. dutifully i wheeled her out to be about 7wks pregnant, and talked about getting her set up for prenatal care etc. my preceptor came in to do the bimanual exam and was like...not so much with the 7wks. i'm going to call you about 5 months (!) pregnant. and sure enough, the top of her uterus was above her belly button. not 7 wks at all, unless she's gestating, ten-tuplets.

it's sort of funny, in a what-can-you-do sort of way. countdown is on for next cycle. i should know more by the end of the week.

Thursday, July 5, 2007

just a quickie

i wanted to give a superfast update. i feel like the count is ON finally for the next cycle we can try. i'm 3 days into my 2ww, so the iui is less than a month away. i'll be picking up the clo.mid this weekend, so i feel like the ball is rolling.

cl doesn't know what he'll do when he gets back from the army. he gets back in november, which is a tough time for a teacher to return. i just want him to do something. if we pretend that i might possibly (ptu! ptu! ptu!) be preg at that time, having him home and underemployed means he can make me food and keep the apt clean :). somehow i don't think he'll find that plan very exciting. and, to be honest, i'm not sure i'd like him home all the time either.

OH, i just remembered i wanted to make a confession to the blog world, because it's just too embarrasing to confess this IRL. anyway, i was doing prenatals today and there was this 34wks preg lady with prob a 5yo girl and a 3yo girl. i asked if she knew what she was having, and she said 'a girl' in a dissapointed affect, so i thought maybe she was upset because she wanted a boy. so i went on for a while about how cute they'd all be, and how she'd have clothes already etc. etc. kind of on a 3 girls isn't all bad type of tangent. she kept looking at me all cockeyed and strange. so then my preceptor enters the room and asks if she's getting counseling and how she's holding up emotionally, and it became clear to me that the woman had made an adoption plan for her baby. i felt, just, 40 different kinds of stupid. none of our patients that i've worked with at the clinic so far have made an adoption plan to date (and many are in very difficult situations), so i just assumed, i guess. after we were done that prenatal i set up a code phrase with my preceptor so that if she ever hears me shoving my foot down my throat or my head up my a$$ i have the potential to stop before i dig in even deeper.

Monday, July 2, 2007

and you call yourself a mental health professional?

i was down in charleston today so cl and i went to see what i think is a lcsw regarding the mc's and the struggles getting back to baseline emotionally, especially poor cl. i've had some experience with counselors, but this guy hit a new low, and it only took him 30 mins to do it! i kid you not: within the first 1/2 hr he managed to get in not just one, but all, of the following:
--the 'adopt and you'll concieve' mantra
--relax, how important it is just to relax,
--how all his kids were 'pop-ups' they just kinda happened!

he rounded out the trifecta with some advice about how i maybe need to gain a little bit of weight and then i can get pregnant with no problem. seeing as how my RE's never mentioned my weight as an issue, i think i'm going to let that one slide along with the rest of it. i think couples going thru probs following a m/c was just NOT his forte. i guess he's alot better with soldiers coming back from deployment going through ptsd issues. god i hope so, or they are in significant trouble. the only good i could see from it is at least we didn't have to pay for it (not directly, anyway). i've had bad counseling sessions that i've had to pay for, so i guess there's that.

i want to give a tremendously joyous shout out to ultimate journey who after a long and hard road found two pink lines on her pee stick this morning. woo hoo!!! so exciting.

i also read this very interesting article from newsweek about the state of birth in the world today. not too shocking i guess, where health care is better overall, women tend to fare better too. but an interesting read nonetheless.