An Aside: FMLA and Pregnancy Disability Leave — AKA: Why I quit my job (profanity)

A quick back-story here.  I moved to Seattle, to live with my now-husband, from Washington, D.C. where I had spent many years trying desperately to find a political job.  Capitol Hill is probably one of the most competitive job markets out there… right up there with acting in Hollywood.  So I move to Seattle, and have no idea what I want to be when I “grow up.”  After a string of unfulfilling temp jobs, I decided I needed to find something meaningful, or at least enjoyable, for employment.  Over an hour from the state’s capital, political jobs were probably not a viable option.

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Bringing out the big guns: IVF

IUI #3 was officially a bust.  This picture kind of sums up my feelings on that.

On Thursday we had a follow up appointment with the RE, a “what if?” appointment, to discuss our options if this IUI was unsuccessful.  With my low AMH, she doesn’t think it’s worthwhile to try more IUIs… so it’s time to move on to IVF.  A prospect which both excites me, and terrifies me.

I’m excited because it is, without a doubt, the procedure that will give us the highest possible chance of getting pregnant.  At our appointment, the RE said that fertility is the only area of medicine where they start with the least effective treatments first.

I’m also terrified because, despite being incredibly lucky and having some insurance coverage, it’s still going to be incredibly expensive.  And the emotional stakes are so high.  I knew, going into IUI, that if it didn’t work I was going to be more disappointed/upset than just trying on our own.  I know that going to such great lengths as IVF… I’ll be devastated if it doesn’t work.

We’re not quite jumping into IVF right away.  We’re taking one month off, to get ourselves more physically and emotionally ready.  Three IUIs, the meds, and disappointment, we’ve lost some ground on our weight loss journey… and just aren’t necessarily in the right emotional place for this procedure.

So, next up: we’re going to try the 30 day shred, and get back to our healthy eating.  And maybe look into a therapist who specializes in Infertility, because I think talking to someone about it would be beneficial for both of us.

Surgery, Drugs, and IUI

The beginning of April, we decided it was time to see a fertility specialist–a Reproductive Endocrinologist (RE).  We went with one recommended by my OBGYN.

Our appointment was the end of April.  We set up blood tests for me, a semen analysis (SA) for Andrew, and a Saline Infused Sonogram (SIS) for me to look at my uterus and make sure everything looked ok.  (SIS is also known at Sonohysterogram, or SHG)  They inject saline into the uterus to expand it, and get a good look at its’ status.

Well, Andrew’s SA showed mediocre numbers.  My blood tests were all normal, except AMH which was way lower than it should be for a 29 year old–apparently closer to that of a 39 year old… meaning I have a diminished ovarian reserve.  And my SIS revealed a septum in the middle of my uterus — blocking implantation in the most-likely-to-implant zone, and was likely the cause of my two losses.

All these factors combined were to blame for our difficulty getting pregnant.

I had surgery (a laparoscopy) to remove the septum.  During the surgery they also discovered and removed a fibroid, and “products of conception” that apparently had not passed naturally.  The latter of which was almost entirely blocking one of my tubes, thus cutting our already low chances effectively in half.

After the procedure, we had to abstain for a month while I healed.  We both agreed that we should move forward to IUI (Intrauterine Insemination, commonly thought of as “artificial insemination”), since we’d grown so frustrated with trying on our own.

The procedure goes like this: I take Femara, a fertility drug, to stimulate and hopefully strengthen ovulation.  They do an ultrasound to see when I am close to ovulation, and if close they give me a “trigger shot” of hCG (pregnancy hormone) to induce ovulation at a very specific time.  Then they do the insemination the next day.  Two weeks later, I take a pregnancy test, and find out if the procedure worked.

It wasn’t until the third, and latest, IUI that I realized that it was the trigger shot causing excessive hunger.  The hormone makes my body think it’s pregnant, and so I become incredibly hungry.  And can’t.stop.eating.

That coupled with the stress, and depression, of now three failed IUIs, a good chunk of our hard diet work has been undone.  But, I guess it would be 10x worse if we hadn’t lost the weight in the first place, and just gained even more.

Though, now, we have a new plan.  Both for diet/exercise, and TTC.

New Year and a new approach

We both firmly believed that 2012 simply had to be better than 2011, just by default.  We decided to start it off on the right foot, and finally lose that weight we’d been complaining about for months.

We started eating healthier, and exercising.  Our diet was our own sort of modified Atkins or South Beach, with a touch of a juice fast.  We cut out empty carbs–rice, pastas, breads, etc–while keeping the healthy ones, like beans and whatnot, and stayed away from sugars.  And we had juice instead of breakfast every morning.  With the caveat of a “cheat day” once a week, where we could eat whatever we wanted.

We also did a full on juice fast for 10 days.  It was really difficult to consume nothing but juice, but all the micro nutrients in the juices actually kept us feeling really good.

Overall, we each got close to the 25 pound mark.  We felt better, looked better, and were happy with our accomplishment in the weight loss department.

But the stress and disappointment of continued failure in the TTC department was taking its toll, and we finally decided to see a fertility specialist.

Another loss: Over before it started

After the miscarriage in September, we took a month off at the doctor’s recommendation.

I joined Andrew on the Atkins diet–lost a few pounds, plateaued, and then got frustrated.  Why was I depriving myself of certain foods if it wasn’t actually accomplishing anything?

Late Oct/early Nov we were cleared to TTC again.  I was shocked to get pregnant again right away.  I’d told myself I wasn’t going to test so early, but I noticed a few symptoms I’d only ever had during my previous pregnancy.  The next day, my positive tests were lighter, and after another two or three days, gone entirely.  The technical term for such an early loss is “chemical pregnancy.”  And, if I hadn’t been so attuned to my body, I probably wouldn’t even have known I was pregnant in the first place.

So another loss meant more heartbreak and disappointment.  Being so brief, I don’t think that it necessarily had as drastic an impact on either of us as the miscarriage.  But it still sucked.  A lot.

Loss and Heartbreak: Miscarriage

August 2011 was our eight month of TTC.  At the end of the month, we went on a weekend getaway to Portland (only 3 hours from Seattle).  The Friday we left, I was convinced we’d had another month of failure, but I was determined not to let that ruin our trip.  On the drive home, we discussed how unhappy we were with the weight we’d both put on the past 2+ years, and how we’d have enjoyed the trip to Portland much more if we were both 20 or so pounds lighter.  We resolved to start a diet the next day.  Specifically, Atkins, since Andrew had been successful with it in the past.

By the time we got home on Sunday night, I suspected that maybe I’d been too quick to judge.  I took a pregnancy test, and was surprised to see a Big Fat Positive! (BFP)  So surprised that I used another one, which had the same two pink lines!  So I used a digital test, and that magical word appeared, “Pregnant!”

I come downstairs, in shock, and tell Andrew “So, I don’t think we’re starting Atkins tomorrow.  I’m pregnant!”  Needless to say, we didn’t get much sleep that night.

Sadly, that excitement only lasted a few weeks.  At our first appointment with my new OBGYN, I had an ultrasound done.  After what felt like an eternity of silence from the ultrasound tech, I grew concerned, and finally asked, “is everything ok?”  I was supposed to be just over 8 weeks pregnant, and the ultrasound showed the baby measuring around 5 1/2 weeks.

Despite my meticulous tracking, which meant I knew exactly when I ovulated, and where I should be in my pregnancy, my blood test results were so high that my OB said she was “cautiously optimistic” that everything would turn out ok.  This was a Wednesday.  And we spent a few days in denial, and a sort of hellish limbo, not knowing how things would turn out.

Until that Sunday, when I started bleeding heavily, then we knew it was over for sure.  September 25th, 2011, was arguably one of the worst days of my life.

How did we get here?

Andrew and I met in January of 2005.  After a somewhat convoluted story of a long-distance, on-and-off again relationship, we got together for keeps in 2008.  At our little get back together rendezvous, Andrew admitted that he wasn’t sure whether or not he even wanted children.  I told him, no, that was a deal-breaker, I absolutely wanted to have children.  To which he agreed, and as time went on, he grew to realize that he also really wanted to have children.

Our rendezvous was in March 2008, and I then moved to Seattle to live with Andrew July 1st.  Three days later, Andrew proposed while we watched the fireworks from our new apartment.  It was very romantic!  We were married at the courthouse on March 20th, 2009, and had the big wedding celebration on our one year anniversary, in Baltimore, MD.

I knew from a very early age that I wanted to have children.  I was 12 years old when I started babysitting, and that experience is what made me realize I wanted to have my own children some day.  However, my early-20s were fraught with uncertainty — employment, student loans, poor financial decisions typical of that age group, and of course love.  So I knew I was in no position to even consider having a child.

So, as soon as Andrew and I got engaged, I got bitten with the baby bug something fierce.  I could feel my biological clock ticking.  Andrew, however, took a little more time to be comfortable with the idea.  Let’s get married first.  Ok.  Let’s have the big wedding first.  Ok, ok!  Let’s buy a house first.  Oh, come on!  Fine.

We did all that.  We closed on our (five bedroom!) house in November 2010, and started trying to conceive (TTC) shortly after, in January 2011.

Eighteen months later, and here we are.  Waiting….