I have taught at the same school for the last four years.  I love my students and feel like I am in a position that allows me to make a significant difference in their lives.  I am also blessed with a great special education team to work with.  I work at a turn-around school with students with very intense needs.  I can think of many reasons to stay in my current position and few reasons to leave.   However, decisions can’t always be made by which side of  pro/con list is longer.  Some pros and cons simply outweigh other pros and cons.

An expectation of my job is that I put my students’ safety and well-being above my own.   When one of my student’s is having a crisis, I am called from whatever I am doing to diffuse the crisis.   Almost all of the time, I am able to diffuse the situation without anyone getting hurt, but there are always risks.  For example a couple weeks ago, I was called when one of my students had become upset to the point that he was holding a chair over his head and was about to throw it at the other students in the classroom.   It was my job to step in front of the other students in the moments it took to get the other students out of range of the chair.   If someone was going to get hit with the chair, it needed to be me, not one of the other students.   In this situation, I was able to get all of the other students safely away and was able to get the student to put the chair down by talking to him.   Unfortunately, it doesn’t always go as smoothly.  As I write this, I have large bruises on both of my legs from a student kicking me when I held him to prevent him from running into the street in front of the bus he had just got off of.   This happened almost three weeks ago and the bruises really only started to heal in the last week.  The bumps and bruises have taken a lot longer to heal this year since I started the aspirin and high dose folate.

At the end of the day, blood-thinners and my current job just don’t mix.   Because of this, I came to the conclusion that I need a different job.  I hope to get pregnant again, and if I do, I will be on lovenox.   I can’t  in good conscience put myself in a position where I am likely to be cut or bruised when I am on heavy-duty blood-thinners.   I also, know that there isn’t a way to stay in my current job and not be in situations with a significant risk of injury on an almost daily basis.   This was a difficult decision to come to, but I believe that me switching to a different job is the right thing to do for me and for my school.   I need to be in a school with a much lower risk of physical injury and my school needs someone who can and will run towards the crises instead of away from them.   If I get pregnant again, I will not take any chances and will run away from the crises.

After making my decision, I called my special education lead and told her that I need a transfer for next year and a little bit about why.  She was very supportive and said that she would make sure it got taken into consideration as they start to look at placements for next year.   I then talked to my principal.   She was incredibly supportive and I shared more than I had planned on.   In sharing, I learned that she and her partner are also part of the ALI community.  They went through 18 donor sperm cycles before conceiving their son and eventually decided to be a family of 3 after many more unsuccessful attempts at a 2nd child.  She agreed that it is the right decision for me personally and said she will put in a good word for me with the other principals.

I am very much at peace with my decision and hope that I get a great position.   I am guaranteed a transfer, but may or may not have any say in what job I get transferred to.   I do know of one teacher at a great school who is retiring and right now I am hoping to get her job.

It is weird to go to work knowing that I won’t be there next year.   Even though I know it is the right thing to do, it is going to be very difficult to leave.   I have worked with many of the same students for the last four years.  When I started there were no materials.  I literally walked into a classroom with nothing but a teacher desk, a table and four chairs.  I begged, borrowed, bought stuff and wrote a bunch of grants to get the necessary materials to teach my students.   I along with the social worker and speech pathologist built the program pretty much from scratch.   There are other members of the special education team, but we are the only ones that have been at the school for at least four years.  The year before we started, the district cleaned house of the special education team and the only person who survived was the speech pathologist.   We bonded a lot as we built up a functioning team and cleaned up the big messes left by the previous team.   We have been there for the students and for each other.   I don’t know how I would have made it through without them personally or professionally.   It will be a bittersweet change.

As part of my efforts to cut costs, I’ve tried several new things in the kitchen this past week:

I made bread for the first time last week using a copy of Health.y Brea.d in five minutes a day that I checked out from the library.    The first loaf which I made without refrigerating the dough was pretty much rock hard and inedible.  I made a second loaf in our dutch oven and it turned out much better.  However, it just didn’t taste good.   Yesterday I made a light wheat sandwich loaf using a recipe adapted from the Brea.d Baker.s Apprenti.ce and it turned out wonderfully.   I enjoyed kneading the bread and it really wasn’t much work.

On Saturday I made homemade yogurt in our crock pot.   It was really easy and the yogurt is yummy.   I love plain greek yogurt so I strained the yogurt once it was done and then found a recipe to use the leftover whey.  I will experiment some more with this, but I think yogurt making will become a fairly regular weekend activity.  I probably won’t strain the next batch in order to get more yogurt for our money.

I decided to try and make ricotta cheese from the leftover whey for dinner last night.   My ricotta making was an epic fail.  I followed the directions I found online, but did not get any cheese out of it–all I ended up with was the same liquid whey I had started with.

Today I am making a whole turkey for the first time.  Even though we usually host Thanksgiving, I always give my mom the job of making the turkey and I do everything else.  We had a coupon for a free turkey that expires at the end of this month so I picked up a turkey at the grocery store yesterday.   This turkey is HUGE (a little over 21 lbs).   I should have dug around more to find a smaller turkey–it doesn’t really fit into the largest pan we have, but I’m making it work.  I hope it turns out well.   Do you have a favorite recipe for leftover turkey?  We are going to have a LOT of leftover turkey.

-I started blogging and discovered this wonderful community.   You all have helped me through some really rough time this year and I am so incredibly grateful to each one of you.

-My husband was able to go home to Kenya last January for the first time since he came to the states 9 years previously.   While there he was able to spend lots of quality time with his dad and took many pictures and videos of his dad that the family will treasure for a long time.

-The lump in my breast was benign

-While the circumstances were far from desirable, I’m glad that I was finally able to meet all of my husband’s family when we went in March for his dad’s funeral.

-I got to spend lots of quality time with our nieces and nephews, especially the niece that lives in the same metro area we live in.

-My uncle made it home safe and is now posted in the states after finishing his 2 years in Afghanistan.

-My husband learned how to swim this summer in my aunt and uncle’s neighborhood pool.

-I got to spend a lot of time with my aunt, uncle, cousin and her two kids while staying at my aunt and uncle’s house during our ivf cycle.

-I got to see my best friend who lives in the same area as my aunt and uncle several times.

-We got new dishes for Christmas (our old dishes had cracks all over that were big enough by December that liquids seeped through them).

-We got to put up our new nativity set for the first time this year and also purchased it earlier this year in Kenya.

-My husband got a new job in July and even though he is now laid off from the job, we both still think it was a good career move for him.

-I discovered Teeccino and it is awesome.  It’s an herbal coffee–it tastes like coffee but doesn’t have any caffeine or any actual coffee.   I gave up caffeine almost three years ago and stopped drinking decaf coffee a year and a half ago.

-I got a Kin.dle for my birthday and while I was initially skeptical about it, I love it now.   It has been so nice to be able to throw it in my purse and have books with me for the many hours I have spent waiting in Dr.’s offices this year.

-I found a good therapist and have found it to be really helpful (more on this soon).

-My eye is almost completely back to normal after the visit to the retinal specialist.

-I became tenured.

-In addition to getting a full-size classroom with windows, I now get to share said classroom with a good friend who’s allocation got increased from .5 to full time at the beginning of December.

-We got to spend Thanksgiving with my whole family.

-I’m glad that I had the rpl panel done and that I have found a treatment for the mthfr that doesn’t make me lose feeling in my legs.

-I found a new primary care Dr. who is very close to our house and is fabulous.

-I finally switched all of my banking to our local credit union.  We’ve had our savings there for years but I had always just left my checking account in my home state despite the fact that I haven’t lived there in over a decade.  And no, I have no real justification for waiting so long.   It is so much more convenient to have my checking account in the place where I live.

-We were able to refinance our house at a much better interest rate without and appraisal or  out of pocket closing costs.

-My husband and I have both become more open about our infertility and pregnancy loss.

-Finally I am very grateful that I got to spend another year married to my best friend.

I hope you also are able to find at least some good things to remember about 2011.   Here’s to a new year filled with hope, love, and possibilities.

Happy New Year!

• Right now we are still on a break from trying to conceive.
• I found a really good therapist and have been seeing her since the end of October.   I’m glad I started and think it will be really helpful in the long run.
• I have been having weird problems with my left eye for the past few weeks.  At first I thought it was just that I needed a different prescription, but it is more complicated than that.   I can still see 20/20 with my glasses on out of both eyes, but it is noticeably more difficult to see out of my left eye–things are darker, blurrier, it can be hard to focus my vision and my left eye hurts.   The eye dr. is not sure what is wrong, but has narrowed it down to some sort of a retina problem or a neurological problem.   He thinks the retina is probably more likely so I will be seeing a retina specialist soon.   I hope that they are able to find the problem and fix it.
•  All of my work trying to figure out our health insurance may have been for naught.   My husband’s business unit is doing major restructuring and laying off quite a few people.  He is supposed to find out tomorrow for sure, but it looks almost certain that he will be laid off.
• We started the process of refinancing our mortgage and I hope we are able to finish the process as mortgage rates have gone down significantly since we first bought our house.
• I have not been spending anywhere near as much time as I needed to have been on my master’s thesis.  It is looking less and less likely that I will be able to graduate at the end of December.
• On the positive side of things we had a lovely Thanksgiving with my family at my aunt and uncle’s house.   It was the first time in six years that we didn’t host Thanksgiving.  It was kind of a nice change to just pack a bag, hop on a plane and not worry at all about food or where people would sleep.

I will try to write again much sooner this time.   I’m also working on catching up on reading and responding to blogs.

I try to make the most informed decision possible and try to pick the best combination of options that we can afford.   We are extremely lucky to have more than usual to consider this year.   The health insurance my husband’s new company offers will cover infertility services including IVF up to a lifetime per person maximum of $10,000 and an additional $10,000 lifetime max for infertility prescriptions.   Additionally, there are significantly fewer in-network mental health providers under my insurance than under his.   I want to be able to see someone who is very good and I want to be able to see them for as long as I need to rather than just as long as I can afford to pay out of pocket.   This has left us with questions about whether we should add me onto my husband’s insurance or not.   I am required by my employer to cover at least myself under one of the insurance plans they offer.  So adding me onto my husband’s insurance means that I will be covered under two health insurance plans.  Each of our employers offer three different plans.  This past weekend I looked at everything and narrowed it down to what I thought would be the three best options:

1.  Stick with what we have now (I have a traditional insurance plan with co-pays, high premiums and low out of pocket max and he has a high-deductible HRA plan)

2.  Stick with the plans we each have now and add me onto his plans

3.  Both switch to HSAs

After spending thirty minutes with a very helpful insurance rep at an open enrollment meeting on Monday evening, I think we will go with option 2.   The insurance rep was very kind in answering my questions about how having primary and secondary insurance works with each of the plans as well as a bunch of HSA questions.   If we end up doing IVF, this option will save us a LOT of money.  If we don’t do IVF this next year, we will have paid for me to be double insured with very little benefit, but it is a risk we are willing to take at this time.

This decision was further confirmed for me by the information from my husbands urology appointment yesterday.   My husband’s latest semen analysis didn’t show any improvement from the last, but also didn’t show any significant decreases.   The urologist recommended that he consider taking clomid.   We are still deciding what to do with that recommendation.  If you have advice or experience, we would love to hear about it.  The urologist also mentioned that in his opinion and only considering the male-factor side of things IUI is a possibility, but IVF would be the much better option.

My coworker’s situation today further confirmed my decision.  E., one of the people that I wrote about in this post, found out today at almost 12 weeks pregnant that the baby died at about 6 weeks.   I was very frustrated by being lapped when I wrote the previous post and I really meant it when I said that I was genuinely happy for my co-workers.   There is a room inside the classroom I had last year that among other uses was used for pumping.  E. pumped in there each day during my prep time and I opened up to her about some of our struggles after she walked past me crying on her way to pump one too many times.   For someone who hasn’t experienced infertility and had never experienced a loss she has been incredibly supportive.   She told me about this pregnancy right after she found out and I know she has had some concerns for a while.  In order to afford to cover her husband and daughter, she is on the cheapest plan our employer offers with the highest deductible.  She went in for her initial appointment last week and they pretty much just talked with her and told her to come back in a month.   They were not planning to give her an ultrasound until 20 weeks or so (I had a really hard time wrapping my infertile, rpl mind around that).   She began to spot today and when she called her clinic she had to beg them to see her.  They eventually found her an appointment at noon and then made her wait until 4pm for an ultrasound.    From talking to her it sounds like she would prefer to have a D&C, but may not be able to afford to.   Unfortunately while prenatal services are covered at 100% under our plan a D&C doesn’t fall under that which means she would have to pay for it out of pocket.   Having to pay a significant amount of money to have your dead baby surgically removed feels like such a slap in the face.   I’m sorry that she is going through this and has to deal with an unhelpful clinic and insurance mess on top of it.   This has also really solidified my decision to not switch to the HSA , I’m sticking with the insurance plan that wouldn’t require $1000′s of dollars of out of pocket expenses in a situation like this.

I think that many more people should have the option of having infertility treatments covered under their health insurance plan.   I signed on to RESOLVE’s petition to have infertility treatment included as an Essential Health Benefit under the Affordable Care Act and you can too.   They are looking for 7,300 people to sign the petition which will be sent along with a letter to Secretary Sebelius at the US Department of Health and Human Services.   The hyperlink should take you to the petition sign-up on the Resolve website.

With everything that I am going through right now, trying to conceive would be a bad idea.   To be honest, I’m having a hard time even cuddling with my husband.   I am not in a good place for trying naturally or doing an IUI.  Though I would consider pushing through it and trying things if I thought it wouldn’t harm a potential baby, the risk for potential harm is too high for me.  The research I have read this week indicates that pregnancy during active PTSD is a bad idea and significantly increases the risk of pregnancy complications and if a live birth is achieved increases the child’s risk of PTSD later in life.

As hard as it is to take a break given my diminished ovarian reserve, I’ve come to the conclusion that it is what I need to do.  Even though taking a break may mean that I never get to have a living biological child, it is still what I need to do for my potential children and for myself.   We are also not going to start the adoption process right now.   We will continue to work on saving money for adoption and/or treatments, but mostly I am going to be focusing on myself.  I need to finally take the time to deal with the rape.  I am angry with myself for not dealing with things earlier and wonder how things would be different if I had done that.  However, I can’t change that so I am going to focus on healing now for myself, our marriage and our future children.

I am also taking a break from IMT until I find and have been working with a therapist for a little while.   W. and I talked and agreed that doing further IMT work right now will make things worse for me.   He thinks that this is having a significant impact on why I can’t get/stay pregnant and the research does seem to support this assertion.  Speaking of research, at the end of this post are excerpts from some of the research/information I have looked at to help make this decision.  I have bolded the most pertinent statements and included the links and/or citations.  They are all direct quotes.

I hope that this break is short and we are able to get back to working on building our family quickly.  I do still plan to post during this break and hope you will hang in here with me.

“Post-traumatic stress disorder is common during pregnancy. One study found that almost 8 percent of pregnant women are affected (9). Women with PTSD may be at increased risk for a number of pregnancy complications, including miscarriage, hyperemesis gravidarum (a severe form of pregnancy-related vomiting) and preterm labor(9).”  from http://www.marchofdimes.com/lifechanges_indepth.html they are citing from this study: Cook, C.A.L., et al. Posttraumatic Stress Disorder in Pregnancy: Prevalence, Risk Factors, and Treatment. Obstetrics and Gynecology, volume 103, 2004, pages 710-717.

“Babies who are born to mothers who suffer from this illness during pregnancy are more likely to experience a change in at least one chemical in their body that makes it more likely (predisposes) the baby to develop PTSD later in life.“ http://www.medicinenet.com/posttraumatic_stress_disorder/page7.htm

“PTSD symptoms can cause adverse effects on both the mother and infant child, making the identification of risk for PTSD in pregnancy of critical importance. In a large epidemio- logical study by Seng and colleagues (2001), women with PTSD were more likely to experience ectopic pregnancy, spontaneous abortion, hyperemesis, preterm contractions, and excessive fetal growth after controlling for relevant demographic and psychoso- cial factors.” from: Rauch, S. A. M., Defever, E., Oetting, S., Graham-Bermann, S. A., & Seng, J. S. (2011, April 4). Optimism, Coping, and Posttraumatic Stress Severity in Women in the Childbearing Year. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication.

Here is the citation and abstract pubmed of the study cited above:

Seng, J. S., Oakley, D. J., Sampselle, C. M., Killion, C., Graham-Bermann, S., & Liberzon, I. (2001). Posttraumatic stress disorder and pregnancy complications. Obstetrics & Gynecology, 97(1), 17–22.

Abstract

OBJECTIVE: To assess the associations between specific pregnancy complications and posttraumatic stress disorder based on neurobiologic and behavioral characteristics, using Michigan Medicaid claims data from 1994-1996.

METHODS:Two thousand, two hundred nineteen female recipients of Michigan Medicaid who were of childbearing age had posttraumatic stress disorder on the basis of International Classification of Diseases, 9th Revision (ICD-9) codes. Twenty percent (n = 455) of those recipients and 30% of randomly selected comparison women with no mental health diagnostic codes (n = 638; P <.001) had ICD-9 diagnostic codes for pregnancy complications. We used multiple logistic regression to investigate associations between specific pregnancy complications and posttraumatic stress disorder, controlling for demographic and psychosocial variables. Obstetric complications were hypothesized based on high-risk behaviors and neurobiologic alterations in stress axis function in posttraumatic stress disorder.

RESULTS:After controlling for demographic and psychosocial factors, women with posttraumatic stress disorder had higher odds ratios (ORs) for ectopic pregnancy (OR 1.7, 95% confidence interval [CI] 1.1, 2.8), spontaneous abortion (OR 1.9, 95% CI 1.3, 2.9), hyperemesis (OR 3.9, 95% CI 2.0, 7.4), preterm contractions (OR 1.4, 95% CI 1.1, 1.9), and excessive fetal growth (OR 1.5, 95% CI 1.0, 2.2). Hypothesized labor differences were not confirmed and no differences were found for complications not thought to be related to traumatic stress.

CONCLUSIONS: Pregnant women with posttraumatic stress disorder might be at higher risk for certain conditions, and assessment and treatment for undiagnosed posttraumatic stress might be warranted for women with those obstetric complications. Prospective studies are needed to confirm present findings and to determine potential biologic mechanisms. Treatment of traumatic stress symptoms might improve pregnancy morbidity and maternal mental health.http://www.ncbi.nlm.nih.gov/pubmed/11152900

“If your mind and body are constantly on edge because of excessive stress in your life, you may face serious health problems. That’s because your body’s “fight-or-flight reaction” — its natural alarm system — is constantly on.

When you encounter perceived threats — a large dog barks at you during your morning walk, for instance — your hypothalamus, a tiny region at the base of your brain, sets off an alarm system in your body. Through a combination of nerve and hormonal signals, this system prompts your adrenal glands, located atop your kidneys, to release a surge of hormones, including adrenaline and cortisol.

Adrenaline increases your heart rate, elevates your blood pressure and boosts energy supplies. Cortisol, the primary stress hormone, increases sugars (glucose) in the bloodstream, enhances your brain’s use of glucose and increases the availability of substances that repair tissues.

Cortisol also curbs functions that would be nonessential or detrimental in a fight-or-flight situation. It alters immune system responses and suppresses the digestive system, the reproductive system and growth processes. This complex natural alarm system also communicates with regions of your brain that control mood, motivation and fear.” http://www.mayoclinic.com/health/stress/SR00001

I was raped March 6, 2003 and subsequently stalked.  I was 19 years old.  I tried to minimize it, ignore it and just move on with my life.  One of my college majors was psychology and thus I was familiar with the DSM and knew that I met full diagnostic criteria for PTSD for at least two years.  However, I chose not to seek help because I didn’t want my parents to know (I was under their health insurance), was ashamed, felt guilty, felt like it was my fault, and more than anything had decided that I should be able to handle it alone and not have it affect me significantly.   While I no longer believe that I made the right decision then, it is nonetheless the decision that I made.

Eventually the nightmares, flashbacks and panic attacks decreased and I no longer thought about it on a daily basis.  I thought that I had moved on and healed because I was able to sleep, didn’t have regular flashbacks and didn’t think about it on a daily basis.  I knew all along that I still had a very exaggerated startle response and was constantly hyper-vigilant but they didn’t interfere with my life.   Being intimate with my husband and pelvic exams have always been and continue to be difficult for me, but did get significantly easier with time.   I thought that things were about as good as they were going to get.

On Saturday when W, touched where my nose meets my forehead (it’s a connection to the limbic system) all of these emotions and memories came flooding back and my whole body began to tremble.   It was really overwhelming and terrifying.  W. and I talked a little bit then and I told him I had been raped (I hadn’t mentioned anything about it previously).    He was supportive, but I think I covered things up enough that he did not realize how much it was impacting me.   My parents were in town for the weekend and I expected them to return from shopping with my husband soon.   I still don’t want my parents to know so I was doing everything I could to maintain my outward composure.

Things have been really rough since Saturday.   I have been experiencing almost constant flashbacks throughout the day and night.   It has been taking almost every ounce of my strength to keep myself together and get everything done that needs to get done at work and home.   Thank goodness my school is closed tomorrow and Friday, because I don’t think I could have made it through a full week of work this week.

When things weren’t getting any better by Monday, I began to think that it might be time to reach out for some professional help.  I called W to see if he had any suggestions and if he knew of any good therapists.   W. and I spoke last night and he suggested that I go to therapy and said he would check on some possible referrals and get back to me.  I talked about it with my husband after speaking to W and he also thinks that I should go to therapy.   I feel bad because I know that seeing me like this is hard on him and he also wasn’t expecting any of this to resurface.   I am still ashamed about the whole thing and feel like I should be able to cope by myself, and should be over it, but I am starting to come to terms with the fact that I should get help.   I hope that it isn’t a rational fear, but I am also afraid that going to therapy will be looked at unfavorably if we choose to pursue adoption by an agency and/or birth parent.   At this point, I think I have convinced myself that this is something I need to do regardless of any negative ramifications it may have.    My goals for tomorrow are to identify a possible therapist and contact them before I chicken out of this and also to finally catch up on my blog reading and commenting.

Anyhow, on to the topic of this post.  My cousin W (his wife S is my mom’s first cousin, so I’m not actually sure what our technical relationship is) lives in the same metro area and is a physical therapist who specializes in integrative manual therapy.   Back in June, we hosted a mini family reunion dinner at our house because family that lives in another state was traveling through.   I hadn’t shared anything with them about our struggles, but mostly because we had both been really busy and hadn’t seen each other in quite a while.  This was about a week before I was scheduled to leave for our IVF cycle.   I shared with W and S some of our struggles and learned that S had several miscarriages before they conceived their first child.  W mentioned that he has worked with several women with infertility and he would be happy to treat me.  We finally got things scheduled a few weeks ago and he came over to our house for the first treatment last Saturday (a week ago-not yesterday).

Here is a little bit of information on what IMT is.   It is a direct quote from the institute of IMT website and the link is at the end of the quote.

“IMT treatment techniques are based on the premise that the body has the potential to self-correct or heal itself under the right circumstances. Tissue repair at the cellular level is a normal process that occurs within the body. The healing of a cut or wound on the skin, or a broken bone that heals itself once it has been immobilized, are two examples of this mechanism at work. Pain and dysfunction, on the other hand, are an indication that there is too much cell or tissue dysfunction for the body to restore health on its own. Under these circumstances, in order to improve the body’s self-correction mechanisms, intervention is required.

IMT treatment techniques are manual (hands-on), and generally involve gentle manipulative techniques to promote tissue repair, normalize structure and restore function. Unique to IMT is the integration of manual therapy techniques for all systems in the body (ie. bone, nerve, fascia, muscle, organ, lymph and circulatory systems). As each tissue type in the body has unique requirements for healing, tissue specific techniques are used to yield optimal results. Often, multiple systems are addressed to facilitate recovery, as a dysfunction in one system may influence or be influenced by a problem in another system.”    (http://www.instituteofimt.com/index.php?mod=show&id_pag=2)

I don’t fully understand it, but I have seen that it can work for some things.   For example, shortly after I started walking again after breaking my leg we were at their house and my leg, ankle, and foot were SUPER swollen.   W put his hands over a specific spot on my hip and I watched in amazement as the swelling went down significantly immediately.   The first session last week was part evaluation and part treatment and now he is going to come over every other Saturday for the treatment.   It won’t help with anything related to MTHFR, but may help with my progesterone levels as well as possible immune problems and should increase blood flow to the pelvic area.  I figure it falls into the can’t hurt, might help category of things and am hopeful that it may help.   I am very grateful to W for so generously offering of his time and expertise.

Hope you are doing well.  I will try to be a more active blogger and commenter this week.

Now, on to my embarrassing story from this past week.  After stopping the Folbic, most of my side effects went away, but I continued to experience weird pain in my left leg.  The pain was below my knee on the left side, radiated up through my thigh at times and got worse when standing/walking/running.    Had the pain occurred in my right leg I would have ignored it because my right leg does lots of funny things.   About seven years ago I spiral fractured my right fibula and tibia and tore all of the tendons and ligaments below my knee.   Plates, screws, three surgeries and a bunch of physical therapy later, my leg is as healed as it is ever going to get.   As a result of the injury I experience pain and swelling in my right leg sometimes and I don’t think anything about it.  However this wasn’t my messed up right leg and getting the MTHFR diagnosis has made me paranoid about the possibility of blood clots.  I checked my symptoms with Dr. Go.ogle and convinced myself that the pain in my left leg could be a dvt.

I called my Dr.’s office last Monday to schedule an appointment to get the pain checked out and also follow up on the Folbic incident.   When I told the scheduler why I wanted an appointment, she said that I needed to speak with a triage nurse before they could schedule an appointment.   The triage nurse asked me a bunch of questions and wanted me to go to the after hours clinic that night, but I convinced her to let me make an appointment with my regular Dr. for the next day.

I had called in to the nurse line regarding the Folbic, but hadn’t seen my Dr. since before the MTHFR diagnosis.  When I had called in to the nurse line, the nurse had never heard of MTHFR and wanted the full name rather than the abbreviation.   So, at the appointment as I was explaining what had been going on, I began to rattle off the full methylenetetrahydrofolate reducatase rather than the abbreviation.  My Dr. stopped me part way through my pronunciation and said oh, MTHFR.  She went on to comment about what the abbreviation reminds her of and I agreed that I think of the same thing every time I see the abbreviation.

I explained the symptoms and told her I thought I might just be being paranoid, but that I was concerned anyways.  My Dr. asked me some questions, examined my leg and then said that it was highly unlikely that it was a clot.  She reassured me about being concerned about it and that having an MTHFR mutation does put me at a much higher risk.   She explained that it was unlikely largely because of the location of the pain and that dvt pain would be in the back or on the right side because of where the veins are (apparently I didn’t pay close enough attention in my anatomy and physiology classes).   She said that while she thought it was highly unlikely that it was a clot, but that if I was still concerned about it she would send me to get an ultrasound done on the leg.

I told her that if it was that unlikely, I didn’t think an ultrasound would be necessary and as I said it, my eyes started to tear up.   Being an observant Dr., she noticed this right away and said something about it (I don’t remember exactly what she said).   I told her everything was ok, and she said no it’s not, I’m making you cry and that’s not ok.  At this point tears began to run down my face instead of just having watery eyes.   She gave me kleenex and sat there and talked to me for close to ten minutes.   She talked about how she has seen other patients with MTHFR have success and about how hard infertility and rpl are and that I might want to consider going to a support group.  I answered her questions, but mostly I just sat there as she talked continuing to cry.   As I was crying I was feeling like the patient that cried wolf, I was embarrassed and I was trying to figure out why I was crying for no reason.  She ended her pep talk and talked me into going ahead and getting my flu shot.   I had managed to momentarily stop the tears by this point and got my flu shot and left.

When my Dr. asked me why I was crying, I had no answer for her, because I really didn’t know why.  It wasn’t until after I left the office and was sobbing in my car that I connected the fact that it was probably due to my hormones being out of whack having stopped taking progesterone a couple days earlier.  Am I the only one that has ridiculous incidents of crying for no reason when stopping progesterone?    I wish I would have connected the dots to the progesterone while still at the office to help me explain to her why I was crying.   I mean seriously this was the second time I had ever seen this woman and here I was in her exam room crying for no apparent reason.    Here’s hoping that next week is much better than this one was and that I don’t have any more embarrassing infertile moments to write about for a while.