4 out of 4 doctors agree

Well, I guess that settles it.

I had an appointment yesterday with my regular, internal medicine doctor as a followup to see how I’m adjusting to some anti-depressants. Yeah, I went there. Things haven’t been so great lately and in the last months of last year, it was almost like I felt this shift where things were getting worse. And then looking ahead and anticipating that things would most definitely get worse, I decided it was time.

So yesterday was simply for her to see how I was doing and decide if the dose and particular med is working for me. My initial thought was, yes it’s helping but I think upping the dose to twice a day would be better. She agreed to that and said that’s the typical dose anyway.

While I had her attention and time, I decided to ask her stance on hysterectomy for endometriosis purposes and that I’ve been gathering opinions and doing research before agreeing to this life-changing surgery. She looked over my history while I told her that I’ve been in the ER twice in the past six months. She said, “you’re 41?” and I nodded and realized just how ridiculous and desperate I must have looked. She asked if we’ve ever been successful at conceiving and I told her we were not. I guess I sort of put her on the spot.

She ultimately agreed that a hysterectomy was probably best for someone like me, whose endo is severe. I’m sure she wanted to deliver those words about as much as I wanted to hear them, but I figured they were coming. We discussed a little bit about some concerns with adjusting post-op, like bone density, hormones, etc. and the importance of having a thorough list of questions ready for the surgeon.

And here’s the funny thing. I haven’t even discussed this with him yet. He was the first doctor to suggest this and we haven’t even talked to the man. I guess I was hoping for a differing opinion, even if just one. So our consult is still planned for March 10, one month from right now. We’ll hear what the good doctor has to say and I’ll be armed with my list. I’m thinking end of year for surgery. I just started working on myself again, working out, hoping to train for a marathon again, and giving some serious thought to career goals. I really don’t want to stop now and be sidelined for two months.

Time to keep up the strength, in so many ways.

Second and third first opinions

It seems like I’m working backwards here but since I already know the direction my RE/surgeon is suggesting I head, I figured I’d use the next month before my consult with him to get a second and even third opinion on a hysterectomy, before technically hearing the first.

And within 24 hours, I’ve received opinions from both and it’s unanimous. I guess I’m scheduling a hysterectomy. I still can’t even wrap my brain around it yet and I’m trying not to let it get to me, while looking for the positives. But there aren’t many right now. Maybe in due time, but not now.

The first doctor I went to for a second opinion, before actually talking with my RE, was an OBGyn who came highly recommended by a friend of a friend who’s been dealing with endometriosis most of her life. While she was never successful with having children, she’s become her own advocate on finding a doctor who will actually listen and have some compassion. So I decided why not start there, with a doctor who could be completely unbiased. I will say, it was a little weird to feel like, “you don’t know me but do you think I should have a hysterectomy?”

But he asked a lot of questions and listened to what I had to say and while I’m no doctor, just hearing myself out loud made me feel like this is a no-brainer. His first question was how bad is your pain on a daily basis? Surprisingly, I told him that I’m fine most of the cycle. It’s just during ovulation and my period that I have issues. And actually, I can expect and deal with the period pains, it’s the mid-cycle surprises that really get me, which prompted two ER visits in 6-months.

He basically said I’m between a rock and a hard place. Based on what I explained, and without seeing all my previous surgeries, it sounded like I have a pretty aggressive case of endometriosis and while there are a few options that I could try to avoid surgery, they would only be temporary. The pill would slow things down but not ideal for me to ride out the next ten years on it while waiting for menopause to kick in. By then, I might still require surgery and it would be far worse and more difficult the longer I put it off. The thought of a colostomy or worse didn’t sound all that appealing.

He also didn’t sugar-coat the surgery and recovery and said that it’s pretty brutal, especially for endometriosis patients because they won’t allow estrogen for a good six months to ensure that any speck of microscopic missed endo would continue to grow. With that, comes a host of other issues until hormones can be balanced again. It sounded terrible and something I really don’t want to go through, but I may not have much choice.

Then he said something that really struck a chord. He said my doctor is in the business of helping women conceive. He wouldn’t suggest a hysterectomy if he didn’t feel it was best. So I guess that helped me realize that I’d be going to the right surgeon for this.

Today, I decided to send my current OBGyn a message, letting her know the latest and to get her opinion as well. And, it was more of the same. She said that my RE is an amazingly talented surgeon and if she walked into his office and he told her it was the time when she needed a hysterectomy, she wouldn’t think twice. She also has like four kids. It seems so easy for doctors who didn’t deal with infertility of their own, or mothers, or other well-meaning family members to all agree that this is the way to go. It’s not them. And even if they had a hysterectomy, they still managed to have children before letting go.

If I could have had one child. Just one. This would all be so much easier. But, part of me feels like just get this over with. End the what-ifs. And if it helps with the pain and the issues and I can live a good life, then I guess that’s what I have to do. So my consult is in March, ironically the month that marks our 6-year milestone of TTC.

 

The H-word

Sorry to have set this blog to private for a bit. It creeps me out when some of the photos of my home/paint colors (because at one point this was more of an interior design/life blog before it turned ugly with infertility) show up on pinterest. I don’t like the idea of some big pinners in my life finding me and some of my harsh but very real posts.

So on that note…

Last week I took myself to the ER again. I was at work with what started as the usual mid-cycle “I better let hubs know to pencil me in later wink-wink” ovary twinge. When it progressed to serious bloat and increasing pain, I started to worry. Last time this happened I ended up with a kidney infection and a cyst to boot. That cyst hung around for three more cycles.

This time around, it got so bad that I was afraid to drive the 35 miles to the hospital near home so I went to the big main hospital in the city. Plus my husband works there so he could join me while I waited. What a mistake. We waited for three hours and then spent another four hours being “seen.”

I’ll cut to the chase.

Endometrioma-cysts on both ovaries, one of which was leaking, causing me all the pain, bloat, and discomfort I was experiencing. Figures, right? My integrative medicine doctor had just determined that I had a progesterone issue and I started taking some drops in the hopes that it would do the trick. I don’t think there’s any magic drops to take when big, fat cysts keep popping up.

So I went home and read over the discharge papers which included something new for me. Hydrosalpinx. I’ve seen that word before in all my years of TTC research but never really looked into it. But from the sound of it, there’s fluid building up in my tubes which can be toxic and even if by some miracle an egg squeezed by and fertilized, it probably wouldn’t stick due to the toxic sludge environment the fluid is creating.

I sent a message to the fertility chair, who did my surgery back in June, so that he was up to speed on the second ER visit in 6-months time and his nurse said she’d pass the info along and call me back with his thoughts. I already knew deep in my heart what he would suggest.

The H-word.

Hysterectomy.

Game over.

When the nurse said the word today, it literally took my breath away, even though I was expecting it. So I guess that’s it. We’ve made an appointment for a consult to discuss the options. I could have gone next month but pushed it out to March so that my husband could get the day off and go with me. It also gives me more time to get a second and maybe even third opinion. It’s not that I’m grasping at straws because I know our ship has sailed, but it’s about making absolutely certain it’s the right decision before having all my lady parts scooped out.

12 days of Christmas

Work event wrapped up and then I had to wrap up a ton at work before taking some much needed time off.

Find out that I did not have an acupuncture appointment scheduled for the week but miraculously was able to get one. Soon as I try to relax, I start having a tickle cough that just won’t quit. I laid there with tears streaming down trying to suppress my cough. What a waste of an appointment.

Next morning, yep, now I’m sick.

Spend time with family while trying to finally shop for Christmas with less than a week to go. Did I mention I was sick? So annoying trying focus when feeling like shit.

Next day, yep, husband is now sick.

Now we’re even closer to the holiday yet there’s still so much to do and we both feel like shit.

Find out that the sizable reimbursement check I was supposed to get from work wasn’t submitted properly, money we definitely needed for the holidays. Should have received it Christmas eve. Didn’t.

Couple days later I have a doctors appointment that I set over a month ago to discuss depression and anxiety and the possibility of going on antidepressants because I just can’t take it anymore. When discussing my bouts of heart palpitations,  she orders an EKG. Detects an abnormality.

Next night, the lights on the top third of our Christmas tree go out. Worked fine all month.

Christmas eve morning I’m out having an echocardiogram,  because doesn’t everyone on that day? No results given due to holiday so I’ll likely have to wait until Monday.

Christmas eve mass is held at the high school, but we get shut out of the auditorium so we get to sit in the cafeteria overflow section. Can’t see the projection screen, can’t hear the priest, can’t even focus to pray and enjoy the hymns.

Come home to find our outdoor lights stopped working. Just bought those less than a month ago.

Have a nice Christmas eve with family. Finally something nice.

Christmas morning husband and I exchange gifts and Santa was good to both of us this year. I decide to go for a run, something I haven’t done much lately.

I picked out a Christmas themed shirt and even wore a Santa hat. I wanted to get in a good place, have a positive outlook for the day. It was Christmas, after all.

As I ran, I noticed a penny on the ground and thought about those old sayings, like “pennies from heaven” or picking up a “lucky penny.” I left it, thinking how I need a lot more than just luck. I continued on and thought about the future.  I thought about how I need to get to a place where I’ll be ok. I’ll need to move on. I’ll need to be happy. If that means antidepressants, so be it.

I started feeling a little better and actually enjoying my run when I noticed something else on the ground, in the street, near the curb.

A pregnancy test. Really. A pregnancy test in the road. Our trash day was the day before, so maybe it fell out?  I’m out trying to clear my head, on a run, on Christmas day, and I get to see a fucking pregnancy test at my feet. I’m not kidding. I can’t even make this shit up. If my phone wasn’t so firmly strapped to my arm, I just might have taken a picture.

Why. Why? WHY???  Seriously. It’s just a big “FUCK YOU” slap in the face via the universe and who cares that it’s Christmas.

Then we celebrate with my family. Everything is good. We eat, we laugh, we open presents. My mom and step-dad just finished opening the gifts from us, gifts I was pretty happy with for them. Then they open a gift from my step brother and his wife. It was like I was caught in the line of fire.

There it was, their “Announcement.”  Mugs printed for Papa and Nana. My mom will be a grandma again. MY mom. Only it’s not because of us.

So there you have it. There it is. Christmas of 2015.

December 26, 2015 I will start my antidepressants. How timely. And maybe Monday I’ll hear back regarding my heart, but I don’t need any tests or doctors telling me what I already know.

That it’s broken.

Two of three

I had written a little while back, after learning of a pregnancy on our team at work, that there were three who were of reproducing age and it would only be a matter of time. 

I’d put money down that there are now two expecting.  

But here’s the part I hate. When you sense what’s going on and you also sense that everyone else already knows what’s going on, but no one wants to tell the infertile one. Everyone tiptoes around. Then, when it can no longer be helped, it comes out in a group setting where I’ll exhibit poor control over the reaction face I’m making or the uncomfortable smile I’ll try and muster. It’s so awkward. 

People have no idea how incredibly difficult this scenario is, yet it plays out over and over. At work, with a group of friends, with neighbors. And the real kicker, if the infertile one is visibly awkward, it only reinforces to the group that breaking the news is a task no one wants to take on. 

I’ll always find happiness for others and all they have to do is spill it, that’s it. Like ripping off a band aid. It might seem difficult, and if over the phone or in an email or text is what they feel most comfortable with, so be it. Totally fine. But please, I ask on behalf of all infertiles struggling, just tell them one on one. Don’t wait until there’s an audience or an outing that might be a special occasion. They will appreciate not having to give their best deer caught in the headlights look, and they might not go home and cry later, either. 

And with that, here’s to  another season of holiday parties…

Why, December?

I started not wanting it anymore. Maybe it was a coping mechanism or maybe I’m closer to being done. I stopped counting. I stopped searching for symptoms. I actually made a conscious effort not to hate the holidays. There have been zero tears and I might even bake this year.

And then I went to my acupuncture appointment before Thanksgiving. As I was wrapping up my session, he told me not to lose hope. It caught me off guard because I think I must have given up on hope a while ago. In the back of my mind I already began to tell myself I wouldn’t resume these sessions much past this year. I’m nearing the end.

Then, all I could think about was hope, which then turned to panic because I didn’t have an appointment with the acupuncturist during Thanksgiving week and there were no openings. Would missing a week mess things up? Did he know something I didn’t?

Thanksgiving was great this year. We had family from both sides and for a moment I even thought what if we had kids? There’d be no room for anyone else at the table. Maybe this is how it’s supposed to be. But, deep down, I thought about how wonderful having something to announce would have been during a time like this.

Then, the whirlwind of Christmas took over. I immediately took down all the fall and Thanksgiving decorations and pulled out all the Christmas gear. The lights, the trees, the garlands, the wreaths. All of it. I didn’t feel the pain of another Christmas, yet. For the first time in years, I really got into it. It didn’t feel like going through the motions.

It wasn’t until just a few days ago that I realized how late in my cycle I was and without spotting, except for one strange moment of pale pink. It was also on this day that I was ridiculously, uncharacteristically tired. Like fall asleep on couch at 5pm tired.

Then it was day 28 and nothing. I’m usually spotting for a few days by now. Of course all sorts of thoughts start racing through my brain but I didn’t want to test because I just couldn’t take the deception. So I waited another day and there was one tiny moment of spotting but that was it. I still couldn’t do it. I couldn’t help but think about how wonderful the timing could be since it’s now December. I couldn’t help but dream about finally having great news for our families this Christmas.

Yesterday was day 30. I can probably count on one hand the times my cycles ever topped 30 days. I thought about buying a test on the way to my acupuncture appointment, but just couldn’t bring myself to do it. When I got there and explained my cycle, he spent extra time on my pulse. Took several pulses on both my wrists, both sides of my neck and then started doing this strength test with my fingers. What is he checking? Then he put a couple little pads that looked like band-aids with a tiny battery cell on my ring finger of my left hand and told me to leave it there for 10-12 hours.

As I tried to quiet my mind for the regular acupuncture session, I couldn’t stop thinking about what the heck might be going on. I couldn’t help but hope. But the realist in me kept fighting back, telling me to just wait it out, give it another day. I went home and relaxed on the couch with my weird battery bandaged finger and fell asleep.

And this morning, just as the 76 previous cycles. It was all over. I pulled off my silly band-aid feeling like a sucker. I knew what the cramps meant. I knew I’d be sitting on the toilet with poo-cramping issues for the better part of the morning. I knew I’d be taking ibuprofen around the clock today.

CD31. Cycle day thirty-fricking-one. Why? Why now? Why in December? Why does Mother Nature have to F with me in December? Ruining my zen. Ruining my holiday. Crushing my dream. I realize my dream gets crushed every single cycle, but never in this fashion. Never.

Only in December. Making it extra special. Extra awesome.

Well, I still love you

Yesterday I received a call from my RE/surgeon’s office about the ultrasound I had for my ovary. It was originally ordered by another doctor but I just felt he needed to be aware of the three consecutive cycles of pain that I’ve been experiencing, not long after having surgery to fix everything up. The good news is, the cyst first discovered on accident during my emergency room visit for a kidney infection has shrunk. It was over 4cm in the ER down to 2ish cm during last month’s scan. He said it’s likely resolving on its own and not considered endometriosis-related.

The bad news is the adhesions are returning. I’m a little over four months post-op and they are returning. We knew this was inevitable yet I didn’t think it would be this soon. We were working on our original suggested plan of TTC on our own for 6-9 months and not only were we thwarted for three cycles by this stupid cyst but now there’s a jungle of rubber band like adhesions returning to the scene. It’s like we can’t catch a break. I get kinda good news about my AMH being better and then this.

For the rest of the day all I could think about was the discussion with the nurse who basically said if we are planning another IVF, it needs to be soon. There’s not much time to sit and think about it anymore, between my age, my endo, the adhesions, and who knows what else. I knew this day would come. I wanted to see it through to the end of the year and revisit things in January. Now I’m not so sure we have that luxury anymore.

It’s so final. I mean, that’s it. I go on the pill or some other suppressive treatment and that’s it. Game over. It boils down to we try something invasive soon or we don’t try at all.  It’s TTC or my health. No one should ever be faced with these decisions. It absolutely sucks. I had class after work yesterday and didn’t feel like bringing it up to my husband right before bed so I waited until this morning before we left for work. When I explained everything to him he paused and asked if that meant the pill and I told him probably so.

Then he paused again and said, “Well, I still love you.”

I thought good. That’s all that’s left. It’s a good thing.

I really don’t know where to go from here, short of a miracle. I’ll finish out the year working on my overall health, my added supplements for the deficiencies we’ve discovered, and I’ll choke down a few more herbal teas and maybe have a few more acupuncture sessions.

And then I guess that’s it.

2016 we close up shop.

It’s just that simple…

The night before we left for a little anniversary getaway I met with friends for dinner. I hadn’t seen them in a while and my radar was in high gear. Within the first 20 minutes my hunch was correct. One of them is expecting baby #2. I know I sound like a broken record here with, “I’m truly happy for them because they are my friend,” but Jesus when will this get easier? And by easier, I mean for me, not them. It’s already “easy” for a lot of couples. They decide they want to have children and boom, success! They go away on vacation or have a fun night out at a party and bam! Or they have the luxury of selecting a month, taking Clomid and ding! Done! Just like that. And when they want to give their child a sibling it pretty much happens the same way. So, yes, I’m happy. Happy as I can muster and then I pick up the pieces and move on to the next announcement.

So as we planned for our mini-vacay here’s a stark contrast to how our “planning” goes:

Squeeze in acupuncture beforehand. Drink nasty Chinese herbal teas. Get a new tea prescribed that won’t arrive in time to take on trip. Expedite shipment of said tea and pay almost as much in shipping as the cost of the damn tea. Try my first cup of it before we leave and almost barf. It is by far the worst of the three formulas I’ve tried. Oh yes, I’ve been on three now. Doesn’t everyone when TTC? Pack other tea to mix with this tea in the hopes that I can somehow choke it down. Oh yeah, and I need to consume it 3x a day, while in a metropolitan area meeting with friends, watching a marathon, and visiting museums, I’m supposed to carry around this container with little plastic measuring spoon, whip up this nasty concoction and drink it. I did it once and gave up. No one should have to work this hard.

Oh and then, THEN, I have to pack my saliva testing kit and spit into tubes two out of the four days we are away. And, keep them frozen, and then transport them home, keeping them frozen. Do couples do this while TTC? No? We do!

And then it’s all the supplements and vitamins that I take around the clock, while spacing them out with my nasty tea. And all the time I cut into the work day to run to pincushion appointments, then make up the time I missed. It’s the robot TTC sessions and the fights, ruining our anniversary and making us question if we’ll ever survive this.

It’s the cheese that I ate that makes me feel guilty because my casein-defective body can’t make babies when it’s too busy fighting dairy crime. Or it’s the donuts we had. Twice. Because I just don’t care anymore about the candida that’s wreaking havoc on me and covering all my organs with sludge.

Maybe it’s the cyst that’s been hanging around on my left ovary for the past three cycles that for whatever reason decides to show up after having extensive surgery, cutting into our 6-month window of TTC before giving up. Good luck with all that when you have a giant cyst messing up hormones and throbbing for a week each month. Hubs thinks I should just get the ovary removed. Part of me agrees but yeah, let’s just make it even more challenging with one remaining ovary.

And this is just the here and now, this doesn’t even begin to cover the years of temping, testing, procedures, shots, medicines, thousands of dollars and tears. Some days I wake up, sit on the toilet and try to remember, am I supposed to pee on anything today, spit into something, take my temperature, or mix up some tea? Now which is it?

I just don’t know how much more of this I can handle. I kinda wish my RE took everything out, leaving us no more hope and making it without a doubt obvious that this chapter is over. It’s just that simple.

Closure test

So I’ve been bouncing around between appointments lately – acupuncture, herbal followups, integrative med followups, consuming a certain kind of tea mixture for 7 days thru CD3, then starting a different mixture for 10 more days. I’m still getting poked and my pulse checked and am asked to stick out my tongue at each appointment. I keep going along through the motions until I’m ready to say “enough.”  But then some interesting things have been happening.

My Vitamin D is so much better now and so is my Magnesium. My doctor wants me to retake a few other tests to see how things are going. One of which is the candida test which I’m pretty sure will still show up as being an issue, but I’ll be curious to see if there’s even a slight improvement. I also explained what had happened last month where I went to the ER to find out I had a kidney infection but discovering I also had a fairly sizable cyst on my left ovary. My doctor thought it was too soon to have this after surgery but wanted to determine the type of cyst as it could interfere with my hormones and everything we are trying to do. So I scheduled an ultrasound.

She then suggested I try a month-long saliva test to see what my hormone levels are doing throughout the entire cycle. I figured why not. What else do we have to lose at this point? So every few days I have to spit into a tube and freeze it. This should be interesting when hubs and I are traveling later this month and two of the four days I need to produce a sample and keep it frozen until they can be reunited with the collection in my freezer at home. So there’s that.

And then, it was suggested I retake the AMH test, or what I now refer to as the “closure test”. I really dreaded the idea of this. My RE/surgeon had suggested this before I even had surgery. His thought was since my results were really low four years ago (0.39), if they are even lower now it might not be worth having the extensive surgery and we’d go right to suppressing my system, which meant no more trying. I just couldn’t bring myself to find out things could be worse. I knew they’d be worse. So I resisted and elected for surgery anyway. It’s what my gut told me to do, quite literally.

So here we are a few cycles later and the herbalist wanted me to retake this test and so did the integrative med doctor. It’s a puzzle piece in the plan so they know how to treat me and so I complied. Last night I was out with friends at dinner and then a work-related event when I noticed I had missed a call. It looked like one of the many numbers I see when getting a call from the hospital and 99.9% of the time they are a recording telling me about my next appointment. I usually play the message for a second and delete but this time it was my favorite nurse calling with the AMH results. Part of me wanted to stop playing the message. My brain kept saying Hang up! Play it later! Don’t ruin your evening! But I couldn’t help myself. And then I couldn’t believe what I was hearing.

My AMH level went…up. More than doubled.

0.93

Wait. What?!

In her message she sounded pleasantly surprised but did mention that the Dr. would probably say “your fertility is only as good as your lowest test.” But she said they didn’t go down, which really seems strange. I’m 41 years old now. I thought I’d be into the “undetectable range” by now.

So now the questions begin. How does that even happen? Was it the damn Vitamin D that was never tested prior to IVF? Is it all this crazy acupuncture – Chinese medicine – nasty tea – cutting out gluten and dairy and limiting sugar? I’m not running much anymore, is that it? Is it a fluke?  An error? Transposed numbers for either test? The fact that I’ve nearly given up on this whole thing?

I realize this number is still low but if this were the number I would have had four years ago and while doing IVF, I can’t help but wonder if the outcomes would have been different. But I can’t go there. I put in a call this morning to the nurse to ask her all these questions of which she may not have answers for. So I guess we’ll see and maybe I just might be on to something with all this crazy stuff.

An herbal verbal warning

I had a follow-up appointment with the lead herbalist yesterday. It’s really confusing how this whole group operates. When my integrative medicine doctor recommended acupuncture and herbal therapy, I thought they were two different people. To my surprise, when I walked into my first herbal consult, it was with the acupuncturist I had just seen the night before. Why couldn’t we just double up and book a longer appointment, then? I was put on some stinky tea concoction that I choked down for two weeks. I continued my weekly acupuncture sessions and then went on vacation, and then had to miss another week due to a conference conflict on his end. Even if I’m not entirely sure if it’s doing anything, I’m actually looking forward to my session next week.

So anyway, back to yesterday. My acupuncturist/herbalist had recommended I follow up with this lead herbal lady. Not sure why we didn’t just refill my tea script, but this is all new to me. Another copay later and another discussion about my history, and this is getting exhausting. And at some point, there almost was a hint of a mini-lecture about how women need to start sooner. I wanted to say “So I should have just gotten knocked up in my 20s by someone who wouldn’t have married me, then tell my now husband ‘well, at least I got the kid thing out of the way, in case we can’t have any of our own.’?”

I almost wanted to give my own lecture about how not all women are career women and not all women find Mr. Right in their 20s. I almost felt like I had to defend myself and my “choices” even though they were beyond my control and not really choices. I didn’t know I’d have endometriosis from like, birth. I didn’t know that 20+ years ago perhaps the doctors didn’t treat it in the ways they know to be better now. I trusted my doctors whole-heartedly. I didn’t know I’d have to stay on the pill until my early 30s because that’s when Mr. Right finally came along. I never had a career path. My God, I’ve been an admin my entire career so that I could someday easily step away to be a mom without regrets. I certainly didn’t know any of this at the time of my first period at age 11. None of this.

Oh how I’d love to have done this differently. There’s a lot of things that maybe I couldn’t control, but dammit if I only had pushed my doctor’s during the 4+ years we spent in the fertility offices. If only I went with my gut that the endo would be an issue and not bypassed via IVF. If only I had stopped waiting for them to advise me poorly. If only I had pushed for surgery sooner, instead of wasting two whole years post IVF to discover how messed up my insides were. There isn’t anything this herbalist or anyone else is telling me, that I’m not already beating myself up over.

I am 41 years old. I really don’t know how much more of this I can put myself through. I’ve been asked to retake my AMH test, the test that absolutely shattered me four years ago, telling me just how low my reserve was. I can only imagine what it is now. I’m also going to do one last fertility panel to check the proper hormone levels on the proper days of my cycle. This will also help to determine the course of action with acupuncture, herbals, etc. Or it might just determine we are done. Totally done. And in some ways, maybe that’s best.