I'm Still Here! Except I'm Over There.

My recent blog silence stems from two things: 1) We've had family visiting constantly since June 19. 2) I've been in the process of moving and redesigning my blog.

You're all invited to visit the new Entrusted!

I'm very excited about the new site. I'll still be tinkering for a while, so please browse around and give me your feedback. If you didn't show up on the new blogroll and would like to be listed, send me an email; I'm sure I missed people inadvertently! Also, please update your own blogrolls with my new site address (http://entrusted.wordpress.com), and subscribe to the new feed (there's even a handy button in the new sidebar now!).

Thanks, friends!

Bad News, Good News

When I called Aaron last Thursday to report the heartbreaking news of our negative pregnancy test, he suggested that I take the rest of the afternoon off from work and spend some time crying out to God. He specifically encouraged me to read a few pertinent sections from A Gospel Primer. As I sat on our front porch and wept in weariness of getting bad news again and again, I read the following through my tears:

"[T]he gospel is the one great permanent circumstance in which I live and move; and every hardship in my life is allowed by God only because it serves His gospel purposes in me. When I view my circumstances in this light, I realize that the gospel is not just one piece of good news that fits into my life somewhere among all the bad. I realize instead that the gospel makes genuinely good news out of every other aspect of my life, including my severest trials. The good news about my trials is that God is forcing them to bow to His gospel purposes and do good unto me by improving my character and making me more conformed to the image of Christ" (p. 31-32, emphasis mine).

It's challenging to cling to the good news of the gospel when the bad news feels so very bad. I don't think I'll ever fully understand, in this life, how the trial of infertility is being made good in God's hands. But I trust, even as my eyes are dimmed by tears, that it is so. I trust that the precious news that my Savior has given me all of himself, that I am his and that he won't let me go - that good news will be my everlasting story and song.

Vignettes

I dreamt the same thing twice in one night last week. In my dream, I was thirty-some weeks pregnant and needed to be induced early for some medical reason. We were sure that I and the baby would be fine, and we were excited to meet our little one. Each time, I woke from the dream to remember: my belly was swollen not with child but with hyperstimulation post-transfer. Still, it was a nice dream, and I hoped it boded well for our embryos.

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Our house has a detached garage, with a disheveled, rusty basketball hoop mounted above the garage door. Birds have built their nest in the space between the hoop's backboard and the garage wall. This morning, as I stepped through the garage door to go to the car and leave for my beta appointment, I noticed something near my feet. The small, broken body of a baby bird. It's still there now. I'll ask Aaron to take care of it when he gets home from work; I don't think I could bear it.

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Words from a song I listened to as I drove to the clinic:

So I lay down what I cannot hold in my hands
Every sorrow and hope spinning out of control
And here I find sweet resolution comes in letting go
And we will find shelter here

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Results: Negative.

So very tired of bad news.

Psalm 66

In my Bible reading last week, I encountered Psalm 66 and decided to camp out there until we get the results from this IVF cycle. I've been re-reading it every day, and it's been helping me to maintain trust in God as I wait. Here are some excerpts and reflections:

Shout for joy to God, all the earth;
sing the glory of his name;
give to him glorious praise!
Say to God, "How awesome are your deeds!
So great is your power that your enemies come cringing to you.
All the earth worship you
and sings praises to you;
they sing praises to your name."

God is glorious, and all the earth praises his name. "All the earth" includes me, whether this IVF succeeds or not, and "all the earth" includes our embryos, tiny beings whose microscopic cells magnify their Creator. God's power is great. My enemies as I try to conceive are his enemies: sin, sickness, sorrow and death. His enemies cringe before his power. Sin, sickness, sorrow and death cannot ultimately triumph over me, even if these embryos don't survive.

Come and see what God has done:
he is awesome in his deeds toward the children of man.

I want, whatever the results this week brings, to call others to come and see what God has done for me. I'm praying that I would get to see his awesome deeds toward my children, in bestowing and sustaining life through this IVF. But if that's not how he chooses to work at this time, I can still draw attention to his work in my life, giving me contentment and peace even in the midst of suffering.

Bless our God, O peoples;
let the sound of his praise be heard,
who has kept our soul among the living
and has not let our feet slip.
For you, O God, have tested us;
you have tried us as silver is tried.
You brought us into the net;
you laid a crushing burden on our backs;
you let men ride over our heads;
we went through fire and through water;
yet you have brought us out to a place of abundance.

Throughout these four-and-a-half years of infertility, God's hand has been active. He sent the test, but he has not let me fall and he has sustained life in my soul. When I feel like infertility might crush me, like I might burn or drown in the hardship of it, it brings rest to know that God is in control of this trial and that he will preserve me. Not only will he preserve me, but he will bring me into abundance. I pray that this IVF would yield an abundance of blessing in a child or in children, that he will have seen fit to keep at least one of our embryos' souls among the living. But if I'm not pregnant, he has still brought me the abundant blessing of knowing my Savior better, of sharing in his sufferings.

If I had cherished iniquity in my heart,
the Lord would not have listened.
But truly God has listened;
he has attended to the voice of my prayer.
Blessed be God,
because he has not rejected my prayer
or removed his steadfast love from me!

God listens to my prayers. He listens to my prayers because of his Son. Because I trust in the death and resurrection of Jesus, God has given me a new heart - a heart where sin is still present but where sin has no final power. I can't earn the ear of God, but my justification in Christ ensures that God attends to my voice when I pray. He has heard all of my prayers for children over the past five years, and he has heard my prayers for these three embryos over the past few weeks. I so hope that I will get a positive pregnancy test this week as tangible evidence that he has not rejected my prayer. But whether the results are negative or positive, I have confidence that God will never remove his steadfast love from me, because of my security in Christ.

It's Hard to Type from a Horizontal Position

I've now got three embryos on board (graded as B, B- and C). The transfer went smoothly. However, the nurse said I'm dehydrated and that my ovaries are very enlarged, so I've been upgraded to a high risk of hyperstimulation. I've been put on bed rest for 3-4 days, and I have instructions to add two bottles of protein shake to the 40 oz of water and 60 oz of Gatorade I was already drinking each day.

So now my daily intake of fluids and medications goes something like this: a 5000 unit heparin shot, a large glass of Gatorade, and an antibiotic and breakfast; water and protein shake throughout the morning; baby aspirin, prenatal vitamin, and another large glass of Gatorade with lunch; more water and protein shake during the afternoon; antibiotic and a glass of Gatorade with dinner; a 5000 unit heparin shot and a 1 mL progesterone shot right before bed. And I'm supposed to add estrogen patches to all of that in a few days. Phew!

My three embryos, it's all for you! Please grow and stay awhile.

5-4-3... and let's just stop the countdown right there, please.

Yesterday, the clinic called to let me know that, out of the 28 eggs retrieved, 25 were mature. They froze 20 and attempted to fertilize five with ICSI. Of those five, only four actually did fertilize.

Today, the clinic called to say that one of the four embryos had arrested at one cell, two of them had progressed to two cells, and one had progressed to three cells. The three still-growing embryos all showed some signs of fragmentation and were graded at B-. We're going ahead with a day-3 transfer tomorrow morning, and we'll transfer all of the embryos that are still developing.

When I first heard today's news, I was discouraged by the fact that we seem to have such poor quality embryos from this cycle. But then I remembered what I read and meditated on from Psalm 62 this morning. My soul waits for God alone, not for embryo development or a successful IVF. God is my refuge; I can pour out my disappointment in our embryo growth to him, and he won't let me be shaken by cell numbers or embryo grades. I can trust in him at all times, even when faced with what seems like a sub-optimal transfer, because all power and steadfast love belongs to him. And as Aaron reminded me when I called to pass on the embryo report to him, this could be an opportunity for God to show how great his power is by bringing a pregnancy out of even low-quality embryos. I still find myself needing to fight discouragement, but I'm trying to shelter myself in the Lord.

Please join me in praying that all three of embryos will be thriving tomorrow morning at transfer time, and that at least one of them would implant and become a healthy baby. Thanks, friends!

With all this talk of eggs, Aaron asked if I feel like a hen.

Today didn't go quite as expected.

We showed up at the clinic at the requested 30 minutes before retrieval time. After a few minutes in the waiting room, they took me back to the prep room. Aaron was not allowed to come along. Once I had changed into the hospital gown, the IVF coordinator and the embryologist came in to confirm how many eggs we wanted to fertilize. I told them five and asked if the doctor had decided to go ahead with a transfer this cycle. The IVF coordinator had no idea what I was talking about.

While I've liked this clinic overall, my one concern is a sense that the left hand doesn't know what the right hand is doing; the personnel in different departments don't seem to communicate with each other very well. I've had to keep track of many of the details and advocate for my own care. Thankfully, I have enough experience under my belt to do so. But on egg retrieval day, it would have been nice if everyone was sharing information.

So the IVF coordinator scurried off the ask the doctor. Then she came back and brought me into the operating room. "What did the doctor say?" I asked. She replied, "Oh, he was interrupted by a phone call and couldn't talk." Um, this is kind of important stuff, determining whether we'd be fertilizing any embryos or freezing all the eggs. By now, I was on the operating table, getting an IV inserted and a blood pressure cuff and heart rate monitor put on, and having my legs tied into the stirrups. I desperately wanted my husband with me, but I comforted myself with the truth that God was with me.

Then the doctor came in. There I am, bound to a table by various tubes and tethers, feeling rather vulnerable. And Dr. Werthers starts questioning everything - saying we shouldn't fertilize more than 3 eggs, that maybe we shouldn't fertilize any, saying if we fertilized 5 eggs we might end up with 5 embryos which he absolutely could not transfer, and so on. I challenged him, asking what the odds were that we really would have all 5 eggs develop into viable embryos, bringing up our history. I asked him point blank for his recommendation, which he didn't want to give. I said, "We've been up front with you about our preferences from the start; why is this all coming up now?"

Finally, the doctor asked if I would like Aaron to come to the operating room so that we could make the final decision. When I said yes, he went off to the waiting room. In the meantime, the IVF coordinator started releasing me from the table so that I could sit up. As she did so, she kept rolling her eyes. "Are you rolling your eyes at me or at him?" I asked. "Don't let him pressure you," she said. "You go with your gut. You stick to your plan." Then the anaesthesiologist added a relaxer to my IV drip. "Your heart rate has gone up," he said. No kidding.

Dr. Werthers came back and said Aaron wasn't in the waiting room. (I had encouraged him to go get some lunch.) It was about 1:20 at this point, so time was becoming an issue. We needed to retrieve those eggs before the trigger shot induced ovulation. After a little back and forth and a couple phone calls to Aaron, we decided to go ahead and retrieve the eggs. When I woke up from the anaesthesia, Aaron and I would make the decision about fertilizing eggs.

The egg retrieval went smoothly. Remember how I said my follicles were immeasurable on the ultrasound? Well, they aspirated 40. From those 40 follicles, they got 28 eggs. No wonder I've felt so much more uncomfortable during this IVF!

Shortly after I woke up, Dr. Werthers came back and so did Aaron. Dr. Werthers seemed much calmer, and he said that fertilizing 5 eggs would probably result in 1-3 embryos, which he would feel comfortable transferring. We will go ahead with a transfer this cycle, Lord willing. My progesterone levels are borderline but not so elevated as to cause problems. With so many follicles, I am at some risk for hyperstimulation, but my estrogen levels are low enough that hyperstimulation is not too likely. At the IVF coordinator's urging, I'm drinking lots and lots of fluids to minimize the risk of hyperstimulation even further, trying to ensure that we will be able to transfer the embryos. I'm very achy and swollen, but glad to be through with the hardest part. I should get the first fertilization report tomorrow.

So all's well that ends well, I guess. I'm grateful for the presence and care of my good Shepherd today.

Egging Me On

Tomorrow (Wednesday) at 1 p.m., my ovaries will be relieved of their eggs. And I do mean relieved; I feel so tender and swollen that I can't wait for freedom from the twenty-plus follicles crowding around inside me. Granted, I probably won't feel better immediately, but I'll at least be on my way back to some sort of normalcy. (Oh Lord, please let it be a new normal of pregnancy!)

At yesterday's appointment, my largest follicle measured 21 mm, with many others in the 16-19 mm range. The nurse suspects that even the ones that measured under 15 mm are probably really larger and containing mature eggs, but they're too squashed together to show their true size.

I did get some disconcerting news. My progesterone levels are elevated, which means Dr. Werthers may not want to do a transfer during this cycle. He hasn't made that call yet. If he does want to postpone transfer, we'll proceed with egg retrieval and freeze all the eggs. Then, next month we would do the same process as a frozen embryo transfer, only we'd be thawing eggs and fertilizing them. At first I was pretty disappointed that we might not get to do the embryo transfer right away. But then I realized that I would much rather be patient for another month or so than send our embryos into a hostile uterine environment. We'll see what the doctor says tomorrow about my progesterone levels and the plans for transfer...

Scheduling the retrieval time for 1 p.m. meant I had to take the trigger shot at 1 a.m. last night (this morning?). I've always used subcutaneous trigger shots in the past, but this clinic prescribed an intramuscular (IM) injection of HCG. So we set the alarm for 12:45 a.m., I sat on an ice pack for 10 minutes while I mixed the medicine and prepped the syringe, and then Aaron gave me the shot. It's been two years since he last administered an IM injection, but he did a superb job, especially remarkable considering how bleary we were in the wee dark hours. It was painless!

We appreciate all your continued prayers, support, and encouragement. I'll try to post an update tomorrow evening, once the grogginess of the IV sedation has cleared.

Immeasurable

I had appointments yesterday and this morning, and I have another tomorrow morning. My largest follicle has reached 18mm, with a lot trailing close behind. I asked the nurse how many follicles I had, and she told me that the machine only allows her to record 11 measurements per ovary, and I have more than 11 follicles on each side. No wonder I'm feeling swollen and tender!

At this point, it's likely that the doctor will instruct me to trigger tomorrow night, with egg retrieval on Wednesday. But of course, I won't know with any certainty until after tomorrow morning's appointment.

I still have a hard time imagining a successful outcome from this IVF; two previous failures have set my expectations low. But a friend reminded me last week that God is "able to do far more abundantly than all that we ask or think" (Eph. 3:20), and that has been coming back to my mind this weekend. I may not imagine a positive pregnancy test coming in a couple weeks when all of this is done, but the Lord's immeasurable power can do more than I can dream possible.

Closer

Trigger time is getting closer, and that means my appointments are getting closer together. After today's bloodwork (right arm didn't cooperate) and ultrasound (follicles ranging from 7 to 13mm), the nurse thought I would need to come in again on Sunday and might trigger on Monday. This afternoon, I got a phone call saying the doctor wants to keep a closer eye on me, so I'm going in tomorrow morning. I was instructed to drop my Follistim dose down to 175 units and to continue all other meds at the same dose.

I've been feeling kind of "been there, done that" about this IVF cycle, but I'm starting to get a little excited about the possibilities now that I've reached the point of daily monitoring. We still need to decide about how many eggs to have fertilized, so I'd appreciate prayers for that.

Have a great weekend, friends! I'll probably post little updates after my appointments, and I'll definitely let you know as soon as we know the trigger and retrieval days.

What I Did After Monday's RE Appointment

My friend from Texas, Amanda, visited last weekend; her husband surprised her for her birthday by sending her to Chicago. We had a wonderful time! Most of the time I forgot to take pictures, but I did take plenty on Monday, when Amanda and I drove into the city, walked around Millennium Park, and took a river cruise with the Chicago Architecture Foundation. Here are some of my favorite shots from the day.

Progressing

Today's ultrasound showed signs of progress. Not much had happened when I went in on Monday, which is normal as the follicles develop slowly at first. This morning, the scan showed three 6mm follicles, five 7mm, one 8mm, and two 9mm (as well as some too small to measure yet). I've continued on 225 units of Follistim, 10 units of Lupron, and 10,000 units of Heparin (two 5,000 unit injections a day). Stretching across my stomach, the semi-circle of bruises from the Heparin resemble a snowman's coal smile, with my bellybutton in place of the nose. I'm definitely wearing the most comfortable waistbands possible; thank goodness for working from home! I go back for bloodwork and ultrasound on Friday.

Let's Catch Up

So, a few things happened while I wasn't blogging.

I had another saline sonohysterogram, because Dr. Werthers thought he had seen a possible fibroid during the ultrasound at my initial consultation. Results: a free and clear uterus; no fibroids in sight.

The IVF coordinator called and said I could go ahead and start the month of suppression - a surprise to me, as I thought we would have to wait for more testing and further review of all my records. But I had no objections to beginning the whole IVF process sooner, so I started a prescription of BCP and we scrambled to get the rest of the blood work and testing done for me and Aaron. I also received the notorious big box of IVF medications, and I began the Lupron shots about two weeks ago.

I got more information about egg freezing (or oocyte cryopreservation, if you want to be technical). The out-of-pocket cost, while not insubstantial, seems worth it considering that it provides another option if the IVF doesn't work. Since we limit the number of eggs fertilized so as to avoid freezing embryos, oocyte cryopreservation means that the rest of the eggs I produce during an IVF cycle don't go to waste; we can save them for future fertilization, rather than having to go through the whole IVF process from scratch.

The clinic has recommended fertilizing 7 eggs; they say that should result, statistically, in 1-2 embryos to transfer but may leave some embryos to freeze, which is not acceptable to us. They also probably won't allow us to transfer more than 3 embryos. Ideally, we would like to stick with the guidelines of transferring 1-2 embryos, but we also want to know we will be able to give all of our embryos a chance to grow, if we happen to have an abnormally high percentage of viable embryos. We're leaning towards fertilizing 5 or 6 eggs. Fertilizing 4 in the past obviously resulted in nothing. Fertilizing 7 seems high, if we don't want to transfer a risky number of embryos. Fertilizing 5 or 6 should give us enough to aim for a blastocyst transfer of 1, 2, or 3. We're praying and will decide soon; we just need to let the embryologist know by retrieval day.

That all brings us up to today, when I went in for day 3 labs and a baseline scan. Everything looks good, so I decrease my Lupron and start Follistim tonight (10 units and 225 units respectively, for those who like those details). The doctor did decide to add Heparin to my protocol; it's a medication that increases blood flow and addresses any antibody issues, and it's common to use when a patient has a few failed IVF cycles. I had to get some extra bloodwork done for that, and then I had to track it down at a local pharmacy. I'll be on 5000 units twice a day. I go back to the clinic on Monday to see how everything's progressing.

IVF #3 is underway!

Yes, I really haven't posted since Easter. The blogging guilt is great, but I'm just going to pretend I haven't been gone.

Guess what? I was blessed by Mother's Day this year.

(No, I'm not pregnant.)

I went to church with the usual expectations: All the moms will be asked to stand, everyone will clap a lot, I will sit and feel a knot in my stomach and a desire to sink into the floor.

During the singing time at the beginning of our church meeting, I tried to prepare my heart. We sang songs with a focus on the spread of God’s kingdom and glory, asking him to “use us as You want, whatever the test.” That reminded me that my trials are about something bigger than myself. In ways I can’t always see, he is using the troubles in my life to spread the gospel. As we sang, God brought to my mind these words from 2 Cor. 4:

For God, who said, “Let light shine out of darkness,” has shone in our hearts to give the light of the knowledge of the glory of God in the face of Jesus Christ. But we have this treasure in jars of clay, to show that the surpassing power belongs to God and not to us. We are afflicted in every way, but not crushed; perplexed, but not driven to despair; persecuted, but not forsaken; struck down, but not destroyed; always carrying in the body the death of Jesus, so that the life of Jesus may also be manifested in our bodies.

What a precious reminder that while I am afflicted, perplexed and struck down by infertility, I am not crushed, driven to despair, forsaken, or destroyed. Not even on Mother's Day. I was encouraged to think of that moment of sitting down while mothers were honored as a small way of dying to self and sharing in Christ’s sufferings, and as a way to show the life of Christ in me by sitting in peace rather than in shame or self-pity.

But God still had more encouragement in store for me.

Our church is in the middle of a series on Proverbs, and that morning we skipped ahead to Proverbs 31. Tab (our senior pastor) shared some words of praise for various moms in our church that their husbands had sent in at his request. But then he highlighted three single ladies (one with a teenager, one with grown children, and one who has never married or had kids) and how they have been fruitful women. My heart lifted to know that those of us ladies who are in the demographic minority among the women in church were remembered and honored. Then, at the end of his message, Tab asked ALL the ladies – young, old, single, married, moms or not – to stand and be honored and prayed for. I started crying happy tears. For the first time in five years, rather than battling for faith during the entire Sunday morning of Mother’s Day and feeling isolated by the lack of children that I so desire, I experienced a Mother’s Day at church where I felt uplifted and encouraged and joyful.

I'm so grateful for such a tangible reminder of God's favor for me, secured to me by his Son!

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For another, better post on Mother's Day, please read Molly Piper's "Do you want to die this Mother's Day?" If you've lost a child or experienced infertility, you'll identify and be spurred on. If you haven't experienced either of those things, it will help you understand a little bit more of what goes on in the hearts of your friends who have.

Happy Easter!

There in the ground his body lay,
Light of the world, by darkness slain.
Then bursting forth in glorious day,
Up from the grave he rose again!
And as he stands in victory,
Sin's curse has lost its grip on me;
For I am his, and he is mine,
Bought with the precious blood of Christ.

(from "In Christ Alone")

What Have I Done?

(After reading the crucifixion accounts in Matthew, Mark, Luke and John this morning, I thought I'd try meditating in a poetic form. Here's a second-ish draft of what I wrote. May your Good Friday be full of time to reflect on the Savior's cross with horrified sorrow and grateful awe.)

When he tried Jesus
Pilate asked,

What evil has he done?
I covet,
a toddler bully
biting kids with toys.

What evil has he done?
I indulge,
a lazy teen
refusing to leave bed or do chores.

What evil has he done?
I judge,
a college co-ed
knowing just enough to think
I know more than everyone.

What evil has he done?
I dictate,
an arrogant executive
demanding my plans fulfilled.

What evil has he done?
I resent,
a bitter old lady;
nursing home, nursing grudges.

What evil has he done?
None
but mine.

I – mocking – cry
Crucify him!
I – penitent – weep
Have mercy!
Crucify him.

HI Day 2: Just Beachy

We started the morning on Sunday with gobbled greetings from our new turkey neighbors.


Then we spent several hours at Hapuna Beach (where my mom and I read, my dad hid from the sun, and Mark and Aaron played Frisbee).


After we cleaned up, my parents treated us to a gourmet dinner at Merriman's.

The End (of day two, at least)

HI Day 1: To Market, To Market

My parents and brother had their travel to Hawaii delayed by one day, so Aaron and I were on our own for most of Saturday. Our condo in Waikoloa Village overlooked a golf course, the foothills of mountains, and the ocean.


The property was also home to wild turkeys.


After taking a few pictures, the first order of the day was to find food. We visited two local farmers' markets (a tiny one in Waikoloa Village and a bigger one in Keauhou), which were full of exotic produce.


After lunch, we explored Holualoa, a little town full of art galleries and boutiques. A highlight was the ukelele shop, housed in the town's old post office.


We finished the day by picking up my family from the airport, celebrating their arrival by giving my mom a lei.

Humor Me and Pretend It's March 12

Here's what I intended to post that Thursday, before silly things like packing for our trip got in the way.


The point of the photo is not to preserve our packing list for posterity, but to say, "Look, I can take frivolous pictures now and publish them on the Internet with ease, because I have a digital camera!" Just before our Hawaii vacation, we used a slew of horded gift cards to purchase a Nikon D40, along with an 18-55mm lens and a 55-200mm lens. We love it!

So even though the packing list post is outdated now, I thought it would still serve as a good introduction to the Hawaii vacation photoblogging about to come.

Unfulfilled

We sang the hymn "Praise to the Lord, the Almighty" at church this past Sunday. The lyrics flooded me with memories and emotions. Five years ago, I wanted desperately to start trying to conceive, but Aaron thought (and I agreed logically) we should wait one more year. During that year, I listened to "Praise to the Lord, the Almighty" many times. The words encouraged my faith in God's plans and gave me hope.

Hast thou not seen
How thy desires e'er have been
Granted in what He ordaineth?

"Surely," I thought, "the Lord will grant my desire for children. I can be patient for a year until we can start trying to get pregnant." So I waited, and I hoped. We finally started trying to conceive in January of 2005. We were still trying in 2006. 2007. 2008. Now in 2009, I sang the same hymn, and tears rolled down my cheeks.

Hast thou not seen
How thy desires e'er have been
Granted in what He ordaineth?

"No," I thought, "I haven't seen that. I've seen my desires denied again and again. I haven't been healed. I don't have children. God hasn't granted my desires; He has deferred my hope indefinitely." The words of praise that had previously offered such a balm now brought a surge of grief and weariness over how long this trial of infertility has lasted. So much longer than I ever expected. No clear end in sight. As we kept singing, I was reminded that the proof of God's goodness lies not in my circumstances but in the cross, not in giving me everything I want but in giving me Himself. But still, I ache with the unfulfilled yearning for children.

Roaming

Thanks again to all who are praying for Aaron's dad. We had a good visit in West Virginia. John ended up staying in the hospital through Sunday, and now he's recovering at home. I'm sure he and Carolyn (Aaron's mom) would appreciate ongoing prayers for endurance during the long recovery (6-8 weeks). We're grateful!

On an entirely different note...

We leave a week from today for a vacation with my family - in Hawaii! None of us has ever been to Hawaii, so we're very excited. We're staying on the big island, in Waikoloa. After browsing through a travel guide, we have some good ideas of what we want to do (besides relax on the beach, of course!). But I'd like to throw it out to you, Internet: does anyone have recommendations for things to see and do on the big island? Suggest places to eat, too; we love food! We planned this vacation almost two years ago; I can't believe we fly out next week!

Going to WV

We're heading out to West Virginia to spend the weekend with Aaron's family. John seems to be recovering quite well; it looks like he'll be dismissed from the hospital tomorrow, several days earlier than we were told. Thank you for all of your prayers for him and for the family. Please pray that we would have safe travel this weekend and that we would be able to serve Aaron's parents during our time with them. Thanks!

Pray for Aaron's Dad *updated*

I'd like to ask you all to pray for my father-in-law, John. He is currently having emergency open-heart surgery to bypass five blocked arteries (the blockages were just discovered this morning and the doctors needed to operate immediately). They began the operation earlier this afternoon and don't expect to be done until late tonight. It has caught the entire family by surprise and shaken everyone. Please pray that John will be sustained through the surgery and that the procedure would be a success. Please also pray for Aaron's mom, Carolyn, and for the whole family to have peace. We're grateful that God has preserved John's life and allowed these blockages to be found before any sort of heart attack occurred, but we're also all tempted to be anxious. I will update here as soon as we hear more news. Thanks for praying; I feel privileged that I can marshal so many people to pray all at once on this dear man's behalf!

*UPDATE*
We just got the call that Aaron's dad is out of surgery, much sooner than expected. He ended up "only" having quadruple bypass surgery (instead of bypassing five arteries as doctors originally thought was needed). Carolyn will get to see him in recovery soon. John will have a four to five day stay at the hospital, and then a long recovery at home. We'd appreciate your prayers for his continued health!

Fifth Doc's a Charm (Bullet Style)

Positive

• RE #5 is an affable, grandfatherly man; henceforth, he shall be known as Dr. Werthers.
• Dr. Werthers called our religious convictions about not freezing or discarding embryos "laudable."
• Dr. Werthers also seems to have a subtle, sarcastic sense of humor. I never knew for certain if he was joking or not, but he peppered his remarks with little asides (with his nurse as straight man). For example, while running through my history of doctors, he said something to his nurse about how many women like Dr. [Ego], how Dr. [Ego] is very handsome and knows it.
• Speaking of the nurse, she also seems caring and personable.
• The intake questionnaire, consultation, and exam were far more thorough than the other two clincics' were; my appointment lasted at least an hour and a half (not including time in the waiting room before the appointment even started).
• Dr. Werthers actually engaged in dialogue and took my opinions and preferences seriously.
• The doctor and nurse are hopeful that we can do egg freezing in conjunction with IVF and will do all they can to get insurance approval.
  

Not-So-Positive

• During the ultrasound exam, Dr. Werthers saw what could be a fibroid in my uterus. He'll look into it further once he has seen my X-ray films from last year's HSG.
• Every doctor I've seen now has offered a different explanation for our infertility. Dr. Peppy attributed it to a luteal phase defect. Dr. Owlish called it unexplained, possibly caused by mild endometriosis. The possibilities Dr. Werthers threw out: PCOS (!?... I have none of the normal indications for that), elevated male hormones (!? again... not exactly what a girl wants to hear), this potential fibroid, poor egg quality, etc. Now I know he's just brainstorming and wouldn't actually diagnose any of those things without further testing; but still, it doesn't inspire confidence that no doctor has agreed about the reason we can't conceive.
• Dr. Werthers still recommends transferring no more than two embryos for a woman my age, even with our history of failed IVF. He'll study our previous embryology reports, but his initial recommendation is to fertilize 3-5 eggs and then make a decision about how many to transfer based on embryo quality. We'll have to keep negotiating to find the right balance between being cautious (no, I don't want octuplets) and aggressive (I don't want to squander our remaining 2 IVF cycles, so I want to fertilize more eggs, but we are firm about transferring all living embryos).
  

What's Next

• Track down remaining records to fax to Dr. Werther (embryology lab reports, HSG X-ray films, most recent semen analysis).
• After they review those records, the nurse will call about any further testing needed.
• Figure out if egg cryopreservation is a viable option (will insurance cover the IVF cycle that yields the eggs? how much would we have to pay for cryopreservation and subsequent fertilization and transfer?).
• Do IVF, possibly adding heparin as a can't-hurt-might-help medication.
  

Chicken Roulades with Sage and Bacon

I haven't posted any recipes in a while, so here's one for your weekend enjoyment! I adapted this from a recipe in The Silver Spoon.

Chicken Roulades with Sage and Bacon

4 boneless, skinless chicken breasts
1/2 tsp dried rubbed sage*
8 strips bacon
2 tbsp olive oil
salt & pepper

Cut each chicken breast in half, then pound to about 1/2" thick (place the chicken inside a plastic bag or between two sheets of wax paper to keep from splattering). Lightly sprinkle sage on one side of each chicken breast half; season with salt and pepper. Roll up each piece of chicken, and wrap one slice of bacon around each roll. Heat the oil in a skillet over medium heat. Place the roulades in the skillet so that the ends of the bacon are on the bottom. Cook, turning every 2 minutes, until browned all over. Cover and cook over medium-low heat for about 20 minutes, adding 1 tbsp hot water if skillet gets too dry.

*The sage has a strong taste; sprinkle sparsely, as you need less than you think. You might need slightly less or more than 1/2 tsp.

Houston, We Have a Plan!

My sidebars are woefully out-of-date (new blogs and links need added, the reading list needs updating), but you might notice a change in the "Next Step" feature over there on the left. That's right, I've scheduled a consultation with my fifth RE for February 9. Back when we first started trying to get pregnant, I certainly never thought we'd be sitting here four years, seven IUIs, two IVFs, and five reproductive endocrinologists later...

Over the past few months, we've been weighing our options and being weighed down by them. IVF, donor embryos, adoption in some form, stepping away from active family building for a while - if you spin out all the variables, we had about six or seven possibilities on the table. When people have asked us how to pray, we solicited prayer for discernment among all the choices and unity in whatever decision we made.

A little over a week ago, those prayers were answered. During a dinner date, we talked over the options and felt no closer to decision or action. We left to go home; I got into the car while Aaron brushed snow and scraped ice off of all the windows. As I sat in the passenger seating waiting, a sudden shift in thinking made the way clear. You see, we had essentially sorted the possibilities into two categories: the medical category (containing procedures covered by our insurance) and the adoption category (containing domestic or international adoption). Oh, and there was also a do-nothing category. Anyway, we have two more cycles covered by insurance, and we had been debating between doing fresh IVF or using donor embryos for a frozen embryo transfer (FET). The revelation on that date night was this: the donor embryo option really belonged in the adoption category, not the medical category. If the Lord leads us to adopt, then we can consider whether to adopt at the 100-cell stage, the newborn stage, or the todler stage. If we want to exhaust our insurance coverage, we ought to use it for IVF, our last realistic chance at biological children and a procedure that we could never afford without the insurance coverage. (FET costs quite a bit less than IVF, and if we choose to adopt, we'd be fund-raising for that regardless.) Looking at the options in that new light, Aaron and I both feel confident that our next step is to try IVF again.

That leads us to the consulation with RE #5, whom I'm hoping will work within our convictions and desires to fertilize a limited number of eggs (maybe six?) and transfer all the resulting viable embryos. This clinic (which I had called way back when we originally left the care of Dr. Peppy) seems more familiar with couples in our situation. They even have an egg-freezing program, which may not be a workable option for us but which at least indicates a degree of flexibility that I haven't seen with the last two doctors. Still, we won't know for sure until I've actually met with this doctor, so please pray that he will actually be amenable to our preferences. We're grateful for the prayers that brought us to this point and excited to have a plan of action again!

2009 minus 1980 equals

Today I turn 29. Aaron jokingly called it the age I'll be for the rest of my life. Truly, I hope that I'm never abashed by my age, that I never wail about getting old, that I never wistfully long to be in a different decade of my life. I want to live every year to its fullest, with joy and grace. But, I would really like to be a mom by 30. Please, God?




Aaron took me out to celebrate on Saturday. We went to a cozy French restaurant for lunch (tea, souffle, and crepes; yum!). Then he took me to pick out a Dutch oven; I've wanted one for ages, and we found a great deal on this one. I can't wait to cook with it!

I'm settling in for a quiet, low-key day now. Aaron, sadly, is out of town on an unavoidable business trip. It's my regular day off of work, but I do have some lesson-planning and grading to do for the homeschool co-op where I teach once a week. I slept in a little, then I made a tasty breakfast of steel-cut oatmeal with honey, cranberries, and pecans. I think I'll treat myself to a bath at some point, and I have a couple of presents from my parents to open. Aaron kept urging me to set up a lunch date with girlfriends or something, but a restful day at home appeals to me.

This morning, I read and meditated on Mark 8:34-36. I pray that this last year of my twenties would be one in which I learn to embrace my cross with greater faith, to deny myself and find the immeasurable gain of Christ and the gospel.

Lost in Translation

When Aaron and I started dating, I had fun discovering some of his unique, West Virginia style pronunciations. We laughed most together about the way he said, "color." He pronounced it the way most Americans say, "collar." We joked about the difficulties of being "collar-blind," as in, "I can't tell if you're wearing a turtleneck or a polo; I'm collar-blind." Though almost a decade in the Midwest has standardized Aaron's pronunciation of "color," we still giggle when we think about collar-blindness.

Aaron's mom, Carolyn, has lived all but a couple years of her life in West Virginia. She has an endearing accent, and I enjoy listening to catch all the variations. One of my favorites is any word ending in the letters, "ush," which she pronounces, "oosh." So "push" is "poosh," and "bush" is "boosh." That last particularly tickles me when Carolyn has talked politics over the last several years; I get a kick out of hearing her say the name of President "Boosh."

During our Christmas visit to West Virginia, I helped Carolyn do some last-minute shopping for one of Aaron's three sisters, Laurie. Aaron's younger sister, Rachel, was with us, too. Laurie had requested V-neck shirts in jewel tones, so Carolyn, Rachel and I browsed through a department store in search of the right kind of tops. I pointed out some bright button-up blouses to Rachel, thinking that leaving the top few buttons undone would create a V neckline. Rachel commented that she didn't think Laurie liked collared tops, since she had advised Aaron's oldest sister, Esther, not to wear polo shirts. I made a mental note and wandered over to see if Carolyn had found anything. When I reached her, she gestured towards a rack of vibrant blouses.

"What do you think of these?" she asked.

"Well," I replied, "they are pretty, but Rachel told me that Laurie doesn't like collars."

Carolyn turned and spoke vehemently. "Yes, she does! She asked for jewel tones!"

I blinked, startled at the non sequitur. Then it clicked. Gesturing with my hands as if grabbing imaginary lapels, I said, "No, collars. She doesn't like collars."

What Veronica's Brother-in-Law Said

Here's some recommended reading for you. Over at Toddled Dredge, Veronica's brother-in-law wrote a moving post about how suffering binds us to God. And when you're done, take time to read the entire Toddled Dredge Twelve Days of Christmas series; it's become an annual favorite for me. Rich stuff.

New Year

Welcome, day one of the new year. Welcome, day one of a new cycle. Welcome, day one of our fifth year of trying to conceive. Sigh.

During the Christmas season, I found myself mulling over this verse from "Joy to the World":

No more let sins or sorrows grow,
Nor thorns infest the ground.
He comes to make His blessings flow
Far as the curse is found,
Far as the curse is found,
Far as, far as the curse is found.

The curse is found right here in this broken body of mine, this frail flesh that can't create and carry life like it's intended to do. I've had four years of growing sorrow, four years of the stinging, prickly thorn of infertility. How I would dearly love for His blessings to flow in a reversal of my barrenness, for the Lord to say, "No more!" to this trial. I don't know if that will happen in 2009. But he has said, "No more!" to my sin, has turned my soul into a fruitful garden, and has given me every spiritual blessing in Christ. That's more than enough for a very happy day and happy new year.