Friday, November 29, 2013

Book Review: Waiting for Daisy

Waiting For Daisy by Peggy Orenstein

I picked up this book because I knew of the author. I had read her other book, Flux, which examined the phenomena of super-women who try to have it all (the career and family 1-2 punch). You could tell that she valued her career and I felt that I could relate to her. Her story was very different from ours (so far) but the emotions and the questions to be considered were all the same. Honestly, I couldn't put it down. I was enthralled and really felt the disappointment right along with her in so many different points of the book. The writing was fantastic and sarcastic humor was seamlessly intwined with thought provoking internal debate and sequential narrative. Her story does have a happy ending, but it doesn't try to pretend that everything is roses after you do achieve a baby. The whole account was superbly realistic and thought provoking. I never re-read books, but this may be one that I am inclined to pick back up.

Some of my favorite excerpts that spoke to me especially:

How was it that despite my achievements, my education, my professed feminist politics, my self worth had been reduced to whether or not I could produce a child?

~

Clomid was my gateway drug: the one you take because, Why not - everyone's doing it. Just five tiny pills. They'll give you boost, maybe get you to where you need to go. It's true, some women stop there. For others, Clomid becomes infertility's version of Reefer Madness. First you smoke a little grass, then you're selling your body on the street corner for crack. First you pop a little Clomid, suddenly you're taking out a second mortgage for a another round of IVF. You've become hope's bitch, willing to destroy your career, your marriage, your self respect for another taste of its seductive high. Here are your eggs. Here are your eggs on Clomid. Get the picture?

~

The decent into the world of infertility is incremental. Those early steps seem innocuous, even quant; IUI was hardly more complex than using a turkey baster. You're not aware of how subtly alienated you become from your body, how inured to its medicalization. You don't notice your motivation distorting, how conception rather than parenthood becomes the goal, how invested you become in it's "achievement". 


Tuesday, November 26, 2013

Needle Phobia


I took my first Folistim shot this evening. Rather, C gave me my first Folistim shot. He's in nursing school so I figure I should support his education by providing additional practice opportunities ;)

At first, I was very excited by the gadgets and accessories. My pen came with a really cute carrying case in a lovely shade of green. I was just in the middle of plotting how I could re-use this as a cosmetics case when C got to work and I remembered that I had a fear of needles. As he re-read the instructions three times, my anxiety slowly climbed. I'll admit that I may have quickly questioned letting the student do this when my mom, the actual practicing nurse, was right down the hall. Then he poked me and it felt similar to any other shot I've ever been given in my life. No big deal. Immediately afterwards, the injection site felt a little uncomfortable, mild throbbing and tenderness. That's it. It was actually relatively anticlimactic. C asked if I could feel it working and I told him not to bother me because I was busy growing some eggs like a chicken. 

The slight irony of my anxiety, which C took delight in reminding me, is that I actually cured a teenager of needle phobia yesterday. She came to me initially getting herself in a panic at the mere mention of needles and blood draws. This was problematic because the physician needed blood work and her family wanted her to get the flu shot with the rest of them (two years ago she had to be held down by several people and last year they didn't bother trying). Well after a few treatment appointments with me alone, I coordinated an appointment with nursing and she got her flu shot last month without any difficulty. Yesterday she came in to get her blood drawn and let me just say, she was a champ. I was so proud of her. I was also proud of myself for helping her. Her treatment was textbook and went exactly as I had hoped and planned. Sometimes you just need a win and after last week, I deserved it. 

The most important factor in treating phobias, or any anxiety for that matter, is exposure to the feared stimulus. Avoiding the things that make us scared or anxious will actually serve to reinforce, or heighten, the anxiety. I give this example to my patients: Imagine that you're afraid of heights and I have you stand at the edge of the ledge 11 stories up (it's convenient that my office is on the 11th floor, overlooking a balcony). Initially, you're anxiety is going to be sky high, no pun intended. Your gut reaction will be to back away from the ledge and if/when you do, your anxiety will decrease, thereby telling your body that avoidance is a positive thing because it makes your anxiety decrease. So the next time you come in contact with heights, you will be primed to run. Now imagine that I don't let you back away. I make you continue standing at the edge of the ledge for 15, 30, 60 minutes even. At some point, usually much before 60 minutes, you anxiety will decrease. Partly due to exhaustion. Partly due to the fact that you haven't fallen yet and your body begins to realize that it's not so much the ledge that is scary, it's the falling to your death that is scary, and so far this hasn't happened. After both the shot and the blood draw, my teenage patient reported "That wasn't nearly as bad as I was afraid it was going to be," and this is the typical experience when people face their fears. 

I do not like needles, but perhaps by the end of this experience I will have exposed myself enough that it will be as easy as taking a multivitamin. I certainly don't seem to be avoiding them these days! I also don't like flying, but I don't let that get in the way of traveling to cool new places and visiting with friends. And what is fertility treatments overall if not facing your fears head on? We are all brave souls. 

Monday, November 25, 2013

Early Holiday Emotions

Today I am thankful for the pharmacy, or my insurance, or some computer glitch... Actually, I'm not sure where to direct the thanks, but I am definitely appreciative. I had my baseline monitoring appointment this morning and will begin the Follistim tomorrow. They told me that everything was "boring, in a good way." No cysts. Nothing else that would contraindicate a "Go!".

This afternoon, I picked up the Follistim prescription along with the prescription of the Ovidril, and the progesterone suppositories (oh joy!). As the pharmacy tech rang up my order, I prepared for the worst. I had mentioned earlier that I was hopeful my insurance would be covering the prescriptions until the end of the year, but I never imagined this... the whole bill ran me $24! All of the injectable medications cost $0.00 and the only thing I was actually charged for was the progesterone. I made the tech double-check because I couldn't believe this. Even on covered meds, I'm still supposed to be paying a percentage. The tech told me not to question it, which I think is a good advice. I'm just so used to having everything possible go wrong (especially related to insurance coverage), that it doesn't make sense when something good happens.

So this injectible thing is confusing to me. First, I forgot to get the cartridge this morning from the doctor's office and then the pharmacist told me they didn't carry the cartridges and that I would have to get it from the doctor. So now I have to go back to the doctor's office but they close before I'm done with work so this means getting there bright and early tomorrow before work. I also realized, after leaving the pharmacy of course, that I need to get some alcohol swabs. I'll just plan on "borrowing" these from my floor at work. Do I need band-aids also? I noticed that the Follistim pack comes with 4 or 5 needles, but what happens when I run out and need more? Does it really not matter if I inject my abdomen vs my thigh or was the nurse just saying that to make me less anxious? And when when she told me inject around the same time each evening, are we talkin' within an hour, two-hours, or five minutes?

Aside from the confusion, I actually feel like a kid on Christmas eve. I'm super excited to open up my new package and play with what's inside. I get to put things together and measure stuff and read instructions. Sounds like great fun. Until we get to the part of the needle and actually having my nursing-student/husband give me a shot. I'm sure that part is going to get old real quick. Until then, I'm going to remain thankfused and exciteful. (Sorry, this mixture of emotions makes me really corny apparhently)

Sunday, November 24, 2013

Shopping is the pits


On this latest round of Provera, I'm up another few pounds and my fat clothes are starting to feel uncomfortable. I'm really anxious about the injectables adding on even more weight/bloat so in anticipation for this possibility, I decided to go shopping today for some new bottoms that might be more forgiving. I am into the whole skirt/tights/boots look and that this might be a good strategy so that was my mission of the day. Plus I didn't want to spend a lot of money because I'm still convinced that this will not be a permanent situation.

I may have had a small melt-down in the fitting room of Old Navy. 

In the grand scheme of infertility, complaining about my weight and body image issues seems petty and self-absorbed. But I can't help how I feel. Here are the issues:

1. I don't feel comfortable in my body. I definitely don't feel comfortable being naked, which I know has affected my desire for intimacy with C. Frankly, I feel disgusting much of the time and today I looked in the full-length mirror with the florescent lighted-fitting-rooms and could hardly recognize my body. This is not me. 

2. I am terrified of being asked if I am pregnant. In the past 6 months, this has already happened on three different occasions. A colleague. A family friend at church. A patient's mother. Each time, I froze and then responded awkwardly that I wasn't and proceeded to feel humiliated and horrible the rest of the day. 

3. At the hospital I work for, our health insurance cost is based on the state of our health and healthy behaviors. If you're considered healthy, you need to show that you're physically active to maintain the lowest premiums. If you have one of several chronic health conditions (including being overweight/obese), you have other specific requirements (e.g. for diabetes, maintaining good blood sugar levels; for overweight, losing a set amount of weight). I am now officially 5 pounds over their cutoff of the overweight category (it's a BMI of 27, I assume to give people a little extra leeway). If I am still over the cutoff by the end of the year, then I'll be in the overweight category and then, in order to keep the lowest premiums, I'll be required to lose weight. Which would be great, if I wasn't trying to get pregnant and therefore gain weight. Normally, I fully support this policy, but in the current situation it seems utterly unfair. Truthfully, I haven't fully looked into this to see if there is a pregnancy clause or if I can get a letter from my Doctor explaining my situation. My hope is that I won't have to. In the meanwhile, this is one other aspect that stresses me out. 

4. Having PCOS puts me at greater risk for miscarriage and gestational diabetes. Starting off a pregnancy in the most healthy state possible is really important to me but the longer I am infertile, the worse my health seems to be getting. 

Saturday, November 23, 2013

Two Truths and a Lie: Revealed


I need a break from the stress of being an infertile psychologist with a crazy cat. Plus, I'm impatient. So without further delay, here's the answers to this post:

1. I spent three years of my childhood living in St. Petersburg, Russia.

Unfortunately, this is not true. I only wish it were. The truth is that I spent two weeks in Russia after studying the language and culture throughout high school. I loved it and briefly considered changing my career choices so that I could have a summer home in Russia and visit it yearly. Also, my mother is Czech and we practice Russian Orthodox as our religion so I do feel very connected to this culture.

2. I used to work as a janitor at my old high school.

For three summers, this was true. I was the one who scraped off the gum from under the chairs and desks that you all put there throughout the year! I actually loved this job. I also worked at an ice cream store for about ten years before moving on to more psychologically-minded professional activities.

3. I have a half sister that is 15 years younger than me, despite the fact that my parents have been happily married for nearly 40 years.

How is this possible, you ask? One day, while in high school, my mom came home from work, sat us all down, and asked us what we would think if she chose to have a baby for another family. She knew of a colleague at work who could not have children of their own (due to female factors that I was not completely knowledgable of) and she wanted to offer to be a surrogate. She provided the eggs and uterus, he provided the sperm, and I have a sort-of-half-sister. My mom was in her early 40s at the time. Yes, she was that fertile, that she had another baby after her own family was complete. Little did she/we know that her own daughters would not be so lucky.

We used to visit with the other family yearly, around her birthday, but lately it has been less frequent. Their family now consists of three girls; my half-sister and then two other girls from a second surrogate. In high school, I just thought it was a cool party trick ("my mom is having another man's baby and she's still married to my dad!") and really didn't think too much about it. Only now can I fully appreciate the magnitude of this gift.


Friday, November 22, 2013

Professional Hazards

I was doing a fairly good job of keeping my emotions in check this week. Managing the hormones at work and suppressing the urge to cry over relatively trivial things. Until today. Today I lost it. I lost it several times in fact. Once in the break room trying to make myself a cup of tea in hopes of calming myself. Once on the treadmill in the employee gym that I went for a walk on trying to clear my head. Several times in the confines of my office. And final time when I got home, in my husband's arms.

Today I received a phone call from a mother of a patient informing me that my patient was in the Intensive Care Unit after attempting suicide. They are still running tests to determine the amount of damage that was done to her nervous system and what recovery will look like, but she will survive. I talked with her mother several times throughout the day. I'm not sure if she could hear my voice cracking over the medical machine noises in the background, but it was.

My heart goes out her parents whom I can't even imagine the amount of terror and sadness that they've endured over the past 24 hours. It goes out to her younger siblings who are still trying to process the events that have unfolded. It goes out to her, who can't see past her current despair and was so engulfed in hopelessness that ending her life seemed like the only viable option.

I feel angry towards the other medical providers that I believe dropped the ball. I feel helpless to do anything. I feel a crushing sense of defeat in my past efforts to help her. Most of all, I feel so much sadness for her and her family that my chest feels about to implode.


Thursday, November 21, 2013

Two Truths and Lie


In honor of the start of ICLW, I thought I'd participate in something a bit more interactive. Jenny at Dogs Aren't Kids posted this initial prompt and I was just talking about this game to my parents today! I was telling them about one of the truths that you might never think of as a truth and how I need to remember this for the next time I use this as an ice-breaker with one of my patients. So here's the gist:

Tell us 3 things about you and make 1 of them a lie. Try to think about what other bloggers already know about you, what might shock them and what they don’t know and would simply not being able to guess which one is a lie.


1. I spent three years of my childhood living in St. Petersburg, Russia.

2. I used to a work as a janitor at my old high school. 

3. I have a half sister that is 15 years younger than me, despite the fact that my parents have been happily married for nearly 40 years.



RULES: Comment below with which one you think is a lie. Make a new post on your blog and do the same. After you get a bunch of guesses (or whenever you feel like), make a new post with the right/wrong answers and explain them if you want. If you’re lazy, you can comment and not play along. Party pooper.

Wednesday, November 20, 2013

Random Musings

Sometimes I get really emotional and forget that I'm swallowing hormones on a daily basis. I'm not usually an emotional person, so when the sudden urge to cry rushes over me, it feels very uncomfortable (although now that I type this, I'm sure this wouldn't be a comforting feeling for anyone). I need to remind myself that it's not the situation that's upsetting me, that it's just my messed up body.

In the beginning, I had a lot of anger towards my body. I've gotten around to being more accepting, flaws and all, but some days I still feel like I'm very much at odds with myself. It often feels like my body is trying to F*ck with me, teasing and taunting me and then snatching away any hope at the last minute. Or it just enjoys confusing the crap out of me. Today I am almost done with taking Progesterone to induce my period and I know that it is the drop in progesterone that stimulates the period, so theoretically this should occur after you're taking the medicine. And yet today I noticed about 4 drops of bright red blood on the toilet paper. WTF!?!? Of course this couldn't be re-created later, so now I'm just trying to forget it ever happened and continue with the plan.

I am at odds with both of my sisters now, who are also at odd with each other, and I'm beginning to get stressed/emotional about Thanksgiving (although this may the hormones). Why can't we just have a drama-free holiday for once? It's really so cliche.

I'm fairly certain that my insurance plan is going cover a large proportion of the injectable medications! The catch is that I'm also fairly certain that the insurance is changing next year and they won't be covered. This means that I can get one cycle for sure and possibly two if everything works out exactly as scheduled (but let's not fool ourselves here). I am only fairly certain because insurance companies suck and are nearly impossible to navigate and get a straight answer.

In order to help ensure that I stay on schedule, I've officially jumped off the deep end as far as fertility Googling goes and have found a few natural remedies to induce menstration. Last time the progesterone didn't work so I wanted a backup plan. I learned that possibly Vitamin C and/or Parsley could help in inducing a period so then I promptly drove to Whole Foods and picked up some supplements to begin taking after I complete the progesterone. My thought is that it likely can't hurt and it will really just be to supplement the actual medicine and not replace or go against any prescribed protocol.

I rearranged my work schedule to allow for many more frequent monitoring visits in preparation for this medication cycle. It was a big pain, but I'm glad I figured it all out. I told the secretaries that I was having health issues and now I'm paranoid that they think I'm lying because I certainly look healthy enough when they see me. Oh well.

I did tell two more colleagues this week. Lo and behold, it didn't kill me and really wasn't nearly as awkward as I was afraid of. I'm glad I told them and I think it will make it a little easier in future interactions.

I had a dream last night that I slept until Friday and thus missed two full days of medication and screwed up the cycle. I woke up in a confused panic until I realized what day it was. This may have been precursor to the rest of the day when I became so exhausted after lunch that I put my head down on my desk and actually passed out for ~40 minutes!

My cat is driving me nuts because she's back to peeing on various furniture items. She was out of this habit for about 5 months and we thought we were in the clear, but now it's starting up again and I really am out of ideas of what to do with this (likely more on this later after I can form a more coherent thought).

This was a complete random mess that's been floating in my head all day and I needed to get out so that I sleep tonight. Any one of these paragraphs could likely be expanded into a full post, and just might be when I get around to it. Feel free to take a vote! In the meanwhile, thanks for tolerating my lack of cohesive thoughts.


Sunday, November 17, 2013

This May Be My Migraine Talking

I've decided that medicine is chauvinistic and annoying.

You're prescribed these drugs to regulate and/or distort your hormones, with the ultimate goal of getting and keeping you pregnant. As required, the Drs talk with you about the possible side effects or complications of these drugs. This information is also reviewed by the pharmacist, in the medication information handouts, and online when searching for the medicine. 

I've read a lot of "official" information and talked with a lot medical professionals and I find it increasingly annoying. All they talk about are the "serious complications" related to the higher rate of multiple pregnancies and the possibility for hyper-stimulation syndrome. I get that these are not good and I would not like either. However, could anyone please acknowledge the other, less-serious-but-more-common-and-frustrating-on-a-daily basis, side effects?!?!? 

Since starting on this medication journey, I've gained 20 pounds. I used to be a level-headed person but now I'm overrun with emotions and the irritability often wins out. I feel nauseous many days of the month. I have many more frequent migraines than I used to. I pull out clumps of hair from my head on a daily basis. 

The only time I hear about these other side effects are on blogs, discussion boards, and other informal information sites. It's as though the medical professionals have decided that the ends justify the means and, therefore, the means aren't even worth mentioning. As if I should be so grateful to get pregnant that I should shut-up and quit complaining about these less significant side effects. As if these side effects don't matter because we'll all take the drugs regardless in hope that they give us what we've all been hoping for. 

And we will. I haven't heard of anyone stop taking a drug because they were bloated or crampy or irritable or constipated. I don't plan to either. It would just be nice if these other effects were at least acknowledged as another real factor of crap that we have to go through. 


Friday, November 15, 2013

Two Week Envy

I have a confession. When I read about and hear about the stress and agony of others enduring their "two-week-waits," I get jealous. I know this is ridiculous. I am sure it stressful. I am sure the disappointment at the end must be excruciating. I wouldn't really know. I haven't experienced it. I haven't had a confirmed ovulation since we began trying.

My story has been something like this: take medicine, wait for the ultrasound, get told you're not responding to medicine, wait until you're able to take progesterone, then wait for the period to begin the next round. My two+ weeks consists of waiting for a period, without the hope or expectation that anything else is even remotely possible. Maybe this is easier is some way. My let-down comes at day 12 rather than day 28.

As icing on the cake, without ovulating I don't usually get a period without medicine (and sometimes even this doesn't work) and so my cycles are usually longer than 40 days. My two weeks are usually more along the lines of 3-4 weeks.

My mom keeps asking for updates, wanting to stay abreast, as her way of being supportive. Often I get snippy and agitated because my usual response is that we're "waiting". Never waiting in excitement or waiting with hope. Just waiting.

This is a very whinny and self-absorbed post. Logically, I know that others have had it much harder. But this is how I feel. And this will likely be my only fertility update for the next two weeks or so. I am within the process of waiting and mentally preparing for the next step.

Tuesday, November 12, 2013

Another One Bites the Dust

My ultrasound monitoring appointment was yesterday to see how I was responding to 7.5mg Letrozole. The short answer is - I'm not.

The Dr called me later in the afternoon and spent a lot of time discussing options, which I really appreciated. In fact, my first thought when hanging up wasn't "WTF Ovaries?!?!" but rather "I really am glad I switched Drs. I really like him." Even now, I feel content knowing that I do actually have several options, that I'm being cared for by someone who knows his shit, and that he trusts me and C to have a say in my medical decision making.

Option A: Give my body a little more time and come in for another monitoring appointment on Friday to be absolutely sure. He said he wouldn't put money on this, although unfortunately we actually would be putting money on it in the form of more hospital bills.

Option B: Wait until Friday anyway to give my body a minute to adjust, take medicine to induce my period, and then begin a round of injectibles. The big risk we talked a lot about is a very high risk of multiples, especially given that I have a whole bunch of tiny follicles that could potentially develop, or also hyper stimulation syndrome.

Option C: I am actually a "great candidate" for IVF because I have so many damn follicles and am relatively young. This would also help to protect again multiples because they'd have more control of how many embryos were implanted. Too bad the insurance or the bank account don't see it this way.

C and I had a good talk this evening and decided that Option B is the right choice for us now. We've officially jumped into the higher cost, increased monitoring/appointments, and much more invasive world of infertility treatments. This isn't about taking a pill for 5 days anymore. This is serious.

Saturday, November 9, 2013

Spiraling Downward

In an effort to keeping myself accountable to being as healthy as possible (read more about it here), I will say that this update has some very big highs and then lows.

It started out so well. I had written out all the recommendations for the dietician and posted them in the kitchen. I did some math and realized there were 32 days until Thanksgiving so I decided to have a 30 day commitment (giving myself two days off) of healthy eating before the holiday. I gave myself a sticker on a chart for every day that I followed my commitment of healthy eating, drinking enough fluids, and exercising.

After six days I was down about a pound and feeling pretty good. I felt motivated. I felt like I could conquer anything.

Then the fight with my sister happened. Then I developed a cold, starting with a horrible sore throat and morphing into to a coughing, snotty, congested mess. Since last Friday, I have been entirely eating for comfort not for health. I have not been paying attention to drinking and haven't exercised once.

Right now I mostly just feel miserable because I still can't breath. I struggle between the strong desire to get back on track and physical misery that just wants to make my body happy. The latter is still winning out. I am also beginning to worry that I won't be feeling better by my u/s monitoring appointment on Monday and then all my hopes for a successful response to medication could turn into a snotty disgusting awkward mess of us trying to make a baby. As if the romance hasn't been removed from sex enough already! Fun, fun.

Perspective Taking

As a pediatric psychologist, I have the daily privilege of being let into people's lives and entrusted with some of their most challenging moments and struggles. I have been asked on many occasions, "How do you do it?" as in, how do I not take these struggles home with me at night and I how do I keep sane in spite of taking on everyone else's stress?

The answer has always been easy. Hearing about [and hopefully being able to help] the struggles of others is such a privilege and gives me such a huge perspective on my own struggles.

Today I had to admit a teenager into the inpatient psychiatry unit because she was suicidal. Yesterday a mother called me in panic because her daughter ran away after an argument. Earlier this week I helped a young child who will literally vomit from anxiety every time she is separated from her parents. Last week I worked with a family that is composed of three autistic children all under the age of 10.

Life is hard. Everyone has a cross to bear and there are so many days that I wouldn't trade in my cross for anything. While work can definitely be stressful at times, I am really so glad that I have this job and truly feel honored and humbled on a daily basis.

Thursday, November 7, 2013

Forgiveness, Trust, and Re-victimization


Last week my sister said some very hurtful things related to my fertility. More hurtful was actually what she didn’t say or didn’t acknowledge. Maybe it was just bad timing on her part, but the hurtful conversation happened the day I got the results that I was not responding to the medication. She knew this. She didn’t acknowledge this. Instead, she focused on her own issues and accused me of being insensitive and demanding and overbearing. I’d like to say this was the first time something like this happened with her, but it isn’t the first…or the second…or even the third…

I want to forgive her. Mostly for my own self, because I know that holding on to anger and hurt likely does more harm to me than it does to her or anyone else.

To forgive is to set a prisoner free and discover that the prisoner was you.
~Lewis. B. Smedes

The challenge is how to go about forgiving her without allowing myself to be re-victimized, because that also is not good for my emotional health. In the past, I forgive her and then let me guard down, eventually open up again, and then the whole process repeats itself.

People who know her and the situation all tell me that she is basically incapable of empathy at this time in her life. This sounds harsh, but it’s not just my opinion, its reality. She is far too wrapped up in her own life and stresses to consider the impact that her words and actions have on other people’s lives and stresses. To expect this is to live in a fantasy, which I was told by a few people and am increasingly beginning to believe. A fellow psychologist commented that empathy, or taking the perspective of someone else, is a developmental task that a) not everyone always achieves and b) not everyone can consistently implement.

My new goal is let go of anger and accept that she cannot be a part of my support system. Secondarily, I would like to keep some semblance of family peace as we head into the holiday season. My concern is that these two goals are not simultaneously possible.

Those who cannot remember the past are condemned to repeat it.
~George Santayana

Saturday, November 2, 2013

Unimpressive Ovaries

On Thursday I found out that I'm not responding to the Letrozole. Specifically, the nurse was "not impressed" with my ovaries. Frankly, I haven't been impressed with them for a while.

My estrogen level was actual lower than during my baseline, so the RE wants to bump me up right away to 7.5mg. That's the good news. I remind myself that if I was still with my old RE, I would be taking only 2.5mg now and would likely be forced to wait until my period shows up to do 5 and then wait again to get to 7.5, so it's definitely nice that we get to cut out all the bullshit and go straight into a higher dose. Simultaneously, I am nervous because I know that this is the last stop before injectibles...before I have subject myself to daily shots and a lot more monitoring appointments...before I need to break down and tell my boss that I need to rearrange my schedule to be able to make all these appointments...before we seriously up-the-financial-ante.

I know I shouldn't focus on this. I need to focus on positive thoughts of 7.5mg being "my dose".

Thursday I also got in a fight with my sister. She said some really selfish things and was generally unsupportive of the news I received. This actually made me feel worse then the actual news.

I struggled to finish my day. I went to bed early. I struggled to go through an equally trying work-day on Friday. Then I went out with some friends for a drink and dinner and had a genuinely good time. Today I have the weekend to re-group, relax, and pull myself up. I'll get there. I always do. This is a just another bump in the road.