Almost there...

yellow hibiscus blooming in our backyard

Today's HCG came back at 34!   We are soooo close... one more draw, next week, and we should be done with this!   That will be beta #16 if I counted correctly.  It has to be a record! 

This commences your update, as I am dealing with debilitating cramps all day today and just don't have the energy to post more.  But at least we are close!   The cramps probably signal the change in my chemistry ~ and that's a good thing, if I look at it that way.  Now where did I put that bottle of Advil...and wine?  With apologies to my liver.

Correction

Sorry i typed in the blog address wrong.  It should be:

http://thegargiulos.blogspot.com

Clearing up some stuff

Cross Eyed Logan kitteh

Apparently there is some major confusion going on about my situation, my blog, etc..  I'll try to clarify... to the best of my understanding!

One or more of the 4 embryos we transferred back in early January started to stick in my uterus, the way we had hoped.  This starts a series of chain reactions, one of which is the development of pre-placental tissue.  This tissue creates HCG, which is a hormone whose presence in the body typically means the person is pregnant.  The embryos do NOT create the HCG.  People test for HCG by using an over the counter urine pregnancy test, or by having a blood draw which is referred to as a beta (bay-tuh).  Betas are expected to double roughly every 48 hours.  If things develop normally, after around 6 weeks, you should be able to see a growing fetus in a sack inside the uterus, using an ultrasound. 

If a woman gets pregnant "normally" as in has sex and gets pregnant... they usually confirm the pregnancy with one blood test through their ob/gyn doctor, and often do not know the results of their beta because it's done qualitatively -- it is a yes or no type test.  A quantitative test tells you the exact number, or in a way, "how" pregnant you actually are.  Usually only infertile women going through some type of assisted reproductive therapy such as IUI or IVF will have more than 1 beta draw, and they are always quantitative tests. 

There are some cases where you might get a positive on a urine test or a blood test, but then not see anything on the early ultrasound.  One reason is what is called a chemical pregnancy.  It was a "real" pregnancy but it was very short lived - a couple days or so.  The embryo does not survive and the body eliminates the bundle of cells in a regular 'period'.  Usually the initial beta is very low, such as mine was, at a 7.5.  It's believed that chemical pregnancies happen fairly often but most women never know because they get their period on time or maybe just a couple days late. 

Another time you would get a positive but not have a viable pregnancy is in the case of a blighted ovum. This is where the embryo attaches and begins to grow, but then fails, and the sack on the ultrasound does not contain a visible embryo.  These may miscarry themselves or they may require an assisted miscarriage such as through drugs or a D&C.  They may seem like normal betas in the beginning, or maybe not follow a normal pattern of increasing, and can be devastating to discover as you can imagine. 

Another time you would get a positive but not have a viable pregnancy is in the case of an ectopic pregnancy.  This is a pregnancy where the embryo has attached somewhere outside the uterus.  In the vast majority of cases they occur in the fallopian tubes.  Beta numbers in the case of ectopics are often irregular - they may start very low and then jump up, but not double regularly in their expected time frames, etc.  Even though I do not have tubes, there was a concern that my pregnancy may be ectopic.  It is very rare, but has been documented, where a pregnancy tries to develop in what is left of the tube (usually a stump).  Ectopic pregnancies can be serious and even life threatening, because for example if it was in a tube, they can cause the tube to rupture and cause severe pain and heavy bleeding.  However after all of this time, with no real symptoms such as the pain or bleeding, plus nothing visible on the ultrasounds, it seems clear to the doctors that I did not have an ectopic pregnancy.

I guess in my case the closest we can say to the above scenarios is that I had an advanced chemical pregnancy.  The tissue which creates the HCG was persistent enough to soldier on just enough somewhere in my uterus that it was able to overcome the different treatments we have thrown at it.  (the misoprostol, modified endo biopsy, and MTX shots, all done for the intention of eliminating the pre-placental tissue that I still had).    There is not a baby in there, my life is not at risk, and there's no physical pain.  It just basically sucks and is something we have been dealing with for about 4 months.  There's no shock value left in it for me or for Mario.  We are just doing what the doctor's tell me to do, and living our lives as normally as possible in the meantime.  Emotionally we are taking it a day at a time, being grateful for our blessings, speaking with a therapist, etc.

When I went back in on Tuesday for my 2nd round of MTX shots (which is a low dose chemo drug, given in a shot, which blocks folic acid uptake in rapidly reproducing cells such as those creating the HCG), Dr. Sunshine did an ultrasound just to check again if he could see anything going on.  He found 3 large cysts on my right ovary, and one very large one on my left ovary.  It explains the sharp twinges and pangs I had been having the last week or so (felt like ovulation pain but obviously not that!).  He said that they are caused by the excess hormones in my system, and would go away when the HCG has returned to zero.  He said he is not concerned about them, but did say that I probably felt "quite full".  Err -- yes!  My favorite description is that it feels like I have bags of change hanging from my ovaries.  :-P  He and the nurse assured me that my weight AND boobs would return to normal once this was resolved.  I can't wait!!!  :)  Especially the weight and boobs and normal part.  ha ha

So after the ultrasound I got the 2 MTX shots (again, one in each cheek).  I have felt pretty shitty the last few days as a result.  It just makes me feel very drained as though I am fighting something.  But I've been trimming and doing my thing and sometimes I feel totally normal too.  I haven't been back on my bike or horse, but I think in a day or two I will be.  I will go back in about a week for another beta test to see where the number has gone to.  I am praying that this will really truly be IT.  If it isn't, Dr. Sunshine has said that he will perform a D&C to scrape things out and be done with it.  But I don't think we will need to do that!  I don't think he really does either, but I know we are all reluctant to say anything in absolutes anymore, since I am the odds maker and all.  ;-)

OK -- as for my blog... there are a few of you that get my blog in your email.  If you get my blog in email, and reply to it, it only goes to my AOL address.  No one else sees it but me.  Only a few people read my blog and none of them are clients.  It is not listed in any listings on the internet.  It's just basically an on-line diary where I post about what is going on in my life.  Please don't feel you need to reply to it, and please don't feel you aren't allowed to reply to it.  It's totally up to you!  If it is emailed to you and you don't want it to be because it is upsetting you, as I've been told is the case for some, then just let me know and I can remove your email address from the list.  It's EASY and I don't mind.  Then you can just go to the blog site (which is http://blogspot.thegargiulos.com - it is basically a website that you can click on the link or type in the address and view) and read it IF you want to and feel up for it. 

OK I think I covered all the bases there?!

In OTHER news, here's some random fun info...

My fancy new client in San Diego area is wonderful.  I still can't believe she's "real", I love the way she thinks and she's just so nice.  I have manifested my ideal client (except perhaps she could live a bit closer, but Del Mar is beautiful and so far the drive has been very manageable).  :)  She let me meet the Olympic horse that her husband rides (and is going to the Olympics in London on this summer!)  I was giddy and silly and made it difficult for Mario to get a good picture.  The horse, on the other hand, was regal and businesslike, a professional.  ;-)  There is some exciting stuff happening on that front that I need to keep on the down low, but it's just amazingly exciting.  The last time down there she added another 1/2 a horse to our schedule (hinds only right now) and took us to lunch.  Very fun. :)

I will be going to northern CA in early june for the PHCP board of directors meeting and a clinic relating to equine body work, laterality, balance, etc.  I'll be flying up with my friend Jennifer who is also on the board (we've lost track of all the clinics we've attended together!  I would say around 20, no joke) and staying in wine country. It should be a fun, although busy and tightly packed, getaway.

Mario and I are talking about going to Hawaii for our 15 year anniversary this year.  We went for our 10th to Maui and I think it would be wonderful to go again...we are considering Kuai this time?   We are thinking of going in early fall, around Sept, to get good rates and avoid the crush. 

Lily the turtle, sunning herself on the large rock in the water

And finally, news on the fountain front!   Mario has added to the Gargiulo clan by 5 fish (4 small koi and one fancy tail goldfish) and one red slider turtle!   I was against this idea, mainly due to bad flashbacks of our ultimately failed and expensive attempt at a salt water reef tank.  But I have to admit so far everything is surviving (even, dare I say, flourishing??).  The fancy tail has a weird habit of swimming upside down (seriously!) and even lets Mario pet it.  That fish ain't right!  But it is very pretty and kind of funny.  The turtle is a female that Mario named Lillian (Lily for short, because she loves the lily pads) and she's started venturing out of the water and sunning herself on the rocks. 

The fancy tail (name still undecided - any ideas?) is to the left, Lily the turtle is near the rocks in the top middle of the photo.

Guess that's it for now ~ !   Hope all is well with you all...

Another backslide

Rainclouds moving in over the ranch

I ended up going in for bloodwork today instead of tomorrow because I was in the area and they had said the 12th or 13th would be fine.  Hours later, Dr. Sunshine called me from his vacation to tell me how "highly unusual" my pattern has been...

Let's recap, shall we?  My betas, in order:

7.5 --- 71 --- 540 --- 3,000 --- miscarriage with Misoprostol --- 2,000 --- 1,300 --- 1,700 --- modified endo biopsy (to try to move things along) ---1,500 --- 1,267 --- 1,670 --- MTX (2 shots) --- 600 --- 386 --- 401 (today). WTF!!

He assured me that while it was highly unusual, and the whole office sounds baffled and frustrated for me, that it is not "ominous".  He explained that with the low-ish numbers (i.e. not in the multiple thousands) and in the face of my lack of bad symptoms like alot of pain or bleeding, that it is not at risk for being any kind of weird crazy growing placental tissue such as what is called gestational trophoblastic tumors.  He said we could probably not do anything, and the number might plateau for awhile and eventually drop, but he wasn't comfortable doing that and had no idea how long it might take.  He said he would like me to go back in and get another MTX shot. 

Yayyy.  :-[

In other news, I get my bike back tomorrow in time for a whole lotta rain!   We are getting periodic swaths of heavy rain tonight and it is kind of cool... tomorrow is going to be cold, rainy, thundery and windy though.  I am so happy to have the day off, but Mario has to work. 

One of my clients gave me a great pep talk today about my prices (currently $55) and self worth and all this stuff, it was funny and well said... mimicing what Mario and my therapist have said as well, and made me feel good.  :)   When we got back to the car after she had left, I saw that she had left me a check for $65 and in the notes section she wrote, "You are worth it!!!!"  :) 
I told her I was going to frame it and save it.  ;) 

What happens in Vegas...

...doesn't stay in Vegas, when you were there for a hoof conference! I haven't been to Vegas since fall of 1994, when Mario and I stayed there on our way due west to our new home in Ventura... We had driven all day from Colorado, and I still remember the amazement as I crested a small hill in the pitch dark, not a single car around, and there lying in the desert was a city of lights. It happened to be a Friday night, and Vegas was hoppin'. We stayed in a La Quinta. ;) The next morning after breakfast we went into the MGM lion, which was one of the coolest things around at that time! We gambled - Mario lost about $20 at blackjack, and I made $1.05 in slots. I think the extra 5 cents was a mistake, but it was fun to see my plastic cup filled with nickles!

This time into Vegas I flew in on a Monday, and back out on a Friday, and I didn't do a single Vegas-y thing. But I was ok with that! It just wasn't the focus of the trip, and I wasn't in a that-kind-of-Vegas frame of mind. I stayed with my friend and fellow trimmer, Leslie, off the strip at a swanky (NOT!) place called AZ Charlies. We attended a full day of meetings and conference related stuff the first day, and had dinner at the meeting site that night. The next day we went to the Shiloh horse rescue, where all of us trimmers along with 2 like minded vets took radiographs and trimmed horses and discussed the trims and situations ad naseous. -er - naseum.

The place was amazing, they had tons of interesting (and some very sad) situations to learn from and try to help out. They have huge paddocks of horses, then smaller ones for, say, the blind horses... or very senior citizens, etc., and then they have a variety of donkeys and mini horses which wander the property on a free rein. They have a saying at the rescue that if you adopt a horse from them, you have to take a donkey too. ;) We worked on a foundered pony named Trigger, a severely injured mare named Yep that was found let loose and starving in the desert, a horse with a flexural deformity and a yearling with a different deformity. I personally trimmed a horse with subsolar abscessing on both feet and a pretty amazingly long toe. We also got to radiograph a healthy hooved (and beautiful!!) enormous Friesian. The American Hoof Association (and I) made a donation to the rescue to hopefully help them continue to do their much needed work.

The day after that, we learned the finer points of doing fecal worm analysis. So seriously, those 3 words should really never be used in the same sentence together. Gross!! Also got to put together a Renegade hoof boot from the ground up and did alot of great case study sharing. That night I had a very delicious dinner at the hotel with lots of trimmer friends. I had a super yummy merlot, salmon, amazing potatos au gratin in a little crock, delicious salad, crazy yummy crusty raisin bread with a honey butter, and raspberry cheesecake!! Oh yeah, forgot to mention that I had decided that this was my last hurrah trip before going on a diet. For real. No, seriously!! I have gained 30 lbs over my favorite weight, and 20 lbs of it in the last year. I've had to buy new jeans to work in and new bras because the ta-tas still think I am pregnant. They are *ridiculous*. So anyway, I did indulge quite a bit on the dinner in Vegas, but I did have salad every day for lunch except mustang day.

Mustang day was the highlight of the trip for me! We went to see the Cold Creek mustangs, which are about an hour north of Las Vegas... only 12 miles from Indian Springs, for those of you that know where that is!! (I was so excited to see that sign) We drove straight up to the snow line and then we all hiked around the desert in search of wild mustangs! It was great! I kept wishing Mario was there to share in that experience. He was home holding down the fort - working 2 jobs (trimming and Auto Magic) and taking care of the canines, felines and equines.

The Cold Creek mustangs are friendly overall, not nearly as wild as most mustangs in terms of fear of humans. They will allow you to get very close to them and several even let us pet them -- I even got to give nose-wigglin' whither scritchies to a couple of them! :) But they are truly wild - no one owns them, feeds them or does their feet -- and they have thousands upon thousands of acres to roam! They are the model by which my entire trim style was originally based... a naturally worn hoof, a herd lifestyle, low sugar/high fiber diet. It was great! Didn't want to leave at the end of the day.

Usually returning from AHA conferences fills me with a newfound motivation to trim and for what I do. Interestingly, this time was different. I felt MORE sure of what I do and why, but I felt less motivated to deal with all the BS that comes with it when it comes to - well, the owners. I for the most part have great clients, but there are always difficult and challenging situations coming up. I feel that interacting with my clients, my attempts at sharing what I've learned, answering questions and dealing with vets and trainers who completely oppose my suggestions... that it all challenges me on a really regular basis. My therapist (whom I seriously LOVE!) told me that I care more than the owners sometimes, and that is always going to be hard, and I need to learn to know when to step back. It's effing hard to be honest with ya. But I was also told that I am going through a transitionary phase in my life, and I totally agree, and it feels better just to *say* that. To know it is a phase is something I have struggled with always, I forget that things won't always be this way (or that way) and get a little tunnel visioned. So I am relying on this knowledge of it being a phase to help me work through it as sanely as I can.

So I feel this general dissatisfaction with my life in many areas -- but I know that only I can change that. So I am making those steps. I am raising my trimming prices, and going to be extremely selective about any new clients we take on. I want quality, not quantity. I am one week and a 1/2 a lb into my diet. My 15 year old bike was taken out of mothballs so to speak, and is going in the shop for a tune up tomorrow. I have a friend who lost almost 100 lbs partially by riding her bike - so I want to add that into my routine. I can ride it the 2 miles to the 1-mile park, and then ride it around that 10 or so times, or around the neighborhood. We are still members at the gym, even though all that has meant in the last year was that we probably paid some of their electric bill. So we are planning on going back to the gym also. And of course I am trying to ride more. I had a really fun ride the other day where I trotted Jordan around the trail around the property - I think he liked it as much as I did. I am hoping to find someone to teach me how to pony better, so I can pony Faith alongside sometimes. (ponying is where you ride one horse and lead the other alongside. I am afraid my ponying skills would have all 3 of us tied up like mummies)

Bailey at the vet!

Today is a day off - woot! And I took the pugs to the 1 mile park. About 1/2 mile in, Bailey freaked me right out by peeing bright red blood!! I was on the phone with the vet and in their office within I think 10 minutes! Turns out she has a bladder infection, the poor thing! I feel soooo bad for her, I can't imagine how that must hurt to have been bleeding. :-[ She never even showed any symptoms and was wagging her tail at everyone in the office. She got a shot and some antibiotics for at home, hoping she feels better right away!

In case anyone is wondering, yes, I am still "pregnant". My last beta (when I got back from Vegas) was 386. So much for it falling at the same rate after the mtx shots. The nurse has asked that I come back in on the 13th for another beta. I have zero belief at this point that it will actually be at 0. I guess I am just happy that it is going down at all still. Farking maddening!

For Easter yesterday we went to our friends Stephanie and Nick. They just had their baby boy, Dominick, about a month ago. He was premature and had to spend time in the NICU, but is home and gaining weight and doing well now. We had a delicious dinner (I tried not to eat much of anything during the day to make up for the dinner!!) and champagne punch, and hung out with them and Stephanie's mom, Ann. I got to play with their toddler, Melina, aka The Tornado. ;-) We had a nice relaxing visit, and also got to see the apartment that Ann is renting right across from the beach. Even at night you could feel the airiness and closeness to the ocean.

Guess that's it for my update - there was some rambling but actually there's a lot more of that in my head right now!!