Adjusting to Change

Liliana loves to clean her pearly whites with her new "Dora the Explorer" electric toothbrush. This little item has transformed our brushing routine from "Do I have to?" to "May I please!" She absolutely loves the sensation...and it doesn't hurt to have Dora, Boots and Backpack on the handle. Once again, I shout, "Hooray for modern technology!"

My sweet girl has been having a rough time adjusting to Mommy's absences and diminished ability to play. Since Liliana has a difficult time identifying and labeling her feelings (as all 2-year-olds do), she has been acting out in dramatic fashion. As much as I adore my daughter, I was relieved when bedtime finally arrived last night. She gave all of us a run for our money yesterday.

It is clear that the past few days has been bittersweet for Liliana. On one hand, she has spent a great deal of time with her beloved Grammy and Grandfather. But on the other, her world has been turned upside down. For all of her life, Mommy has been there 24/7; and now, Mommy isn't available all of the time. She has been trying to make sense of it, and we've all suffered the consequences. Hopefully things will go right back to normal when I finish recuperating. I have a feeling she'll bounce right back.

As far as my recovery goes, I continue to experience sharp pain in the area of my ovaries. They are still in the process of healing from the egg retrieval. I had a few mild pains in my abdomen this morning, and I've been praying that they were due to embryo implantation. The implantation process may occur any time this week, usually around this point. Time to pray, pray, pray!

Here's to a warm, snugly place for my embryos! Enjoy your Wednesday, Ramona

Questions Answered

Two great questions have been posed in the comment section. First, Shannon basically asked if all 13 fertilized eggs could become embryos. The answer to this question is not a simple "yes" or "no."

To answer this question properly, allow me to back up a moment and tell you that Dr. Silber uses a procedure called Intra-Cytoplasmic Sperm Injection (ICSI) to fertilize each egg. ICSI involves the direct injection of a single sperm into each egg. This process ensures that every egg is penetrated; however, the nature of the sperm and egg (genetic make-up, quality, etc.)determines whether fertilization is successful and healthy growth will occur.

It is theoretically possible that all 13 would become viable embryos, but real life studies show that very few have the conditions necessary to thrive. In three days of incubation, 9 of our 13 fertilized eggs failed to develop properly. Therefore, we were blessed with only 4 embryos this morning. Two were transferred into my uterine lining, while the other two have been frozen for a future IVF.

Incidentally, when frozen embryos ("snowflakes") are used for IVF, the process is much simpler and the cost is significantly lower. We are thrilled that we have an opportunity for another pregnancy after this one. It was such a relief to hear the doctor tell us we had four embryos!

Here is a photo of the two embryos transferred during this morning's procedure. During the three days of incubation, the single cells divided several times and became healthy embryos.

As for the second question, Kate wondered if the embryos can split and divide into twins while in utero. The answer is YES. Although it is not typical, embryos sometimes split and become identical twins. So, if I were to be pregnant with the fraternal twins (pictured above) and one of them divided...I'd have both fraternal and identical twins. Triplets altogether!

Thanks for the question, girls. This is such a complicated process that I don't always include all of the details. If there's something you wish to know, feel free to ask! I'm practically a walking IVF encyclopedia.

Thanks for being here! I appreciate your interest and encouragement. Ramona

Answered Prayer

Today I am thrilled to share praise and answered prayer. Although the embryo transfer took place an hour & a half late, everything else went as smoothly as possible. We had four embryos--two for today and two to freeze for a later date. Yeah, baby! That's exactly what we prayed for and double what we produced during the last IVF. Praise God!

Now I am in resting mode. I am trying to lie down and relax for the next few days. Although it's not mandatory, there's peace of mind in knowing that I did everything I could to facilitate implantation. Hopefully as I write, two teeny little embryos are finding a warm, cozy place to settle in for the next nine months. My first pregnancy test will occur on Friday, April 11th (right before Mothers' Day). Wouldn't a positive pregnancy test be the most poetic Mothers' Day gift? I sure think so! And that's my prayer.

In the meantime, I continue to undergo nightly progesterone injections to support pregnancy. I also take my prenatal vitamins, Folgard supplements to correct my enzyme deficiency and low-dose aspirin to thin my blood. Hopefully this regimen will help create the perfect environment for a healthy pregnancy.

In my next post, I will answer the question posed in the comment section. I will also include a picture of our embryos as a visual aid (yes, we already have a photo of our would-be children). Advanced reproductive technology is such a complex science--it's mind blowing!

Thanks again for your support and encouragement through this process. I appreciate you. Praying for implantation and healthy growth, Ramona

Here We Go!

I'm leaving for the hospital in just a minute (literally). Please pray for many healthy embryos and a successful transfer. I'll post all of the details when I return home.

Thank you for your prayers and encouragement! Bless you all! Ramona

R & R

I'm spending this weekend resting, recovering and praying for healthy embryos in the hospital lab. The discomfort and lethargy have increased since yesterday, probably because I'm trying to do too much. We're so thankful that Grammy and Grandfather are here to help with Liliana and meals. They're such a blessing! I go back to St. Luke's for the embryo transfer on Monday morning. We'll know how our little ones are doing at that point.

Please pray for many healthy embryos. Hope you have a beautiful weekend! Ramona

A Baker's Dozen

All is well! This morning's procedure went smoothly, and the doctors retrieved 13 eggs. I was pleasantly surprised, especially since we only had 18 mature follicles. That's a much better ratio than my last IVF (26 follicles and 11 eggs). I'm very hopeful that we'll have good news Monday morning. The docs will provide us with a magnified picture of our embryos just before the transfer. We're praying for four or more.

Today has been very low key. The anesthesia has now worn off, but I'm still quite tired. I took a four hour nap this afternoon, and I could have slept through the night. Wade's softball season opener is tonight, and I'm missing it (doctor's orders). I have only missed a couple games in over four years of action. Thankfully, Wade's dad is there cheering him on. He may enjoy socializing with all of the wives even more than I do!

Cute note: Liliana just apologized for dropping something and said, "I'm sorry Miss Mama." She followed it by saying, "Don't worry. It's just me, E-ana." My darling!

Well, the embryo transfer is Monday morning at 9:30am. We have to be there at 7:30am to hurry up and wait. In the meantime, we'll be praying for our babies, who were conceived today in a warm, cozy laboratory.

Thank you so much for your prayers and sweet comments. We truly appreciate the support and encouragement. May the Lord bless you and yours! Ramona

Friday and Monday are the Big Days

Big news! My reproductive system has been responding so quickly to the treatment that my IVF dates have been moved up to Friday, May 27th and Monday, the 30th. The first procedure is just 36 hours away! I go into St. Luke's at 6:00am this Friday for the egg retrieval. Then bed rest before and after the embryo transfer on Monday.

As I was watching the ultrasound monitor this morning, I noticed that all of the follicle sizes had increased dramatically (even after the medication doses had been reduced). Since I knew enough about the treatment process to recognize what was happening, I called Wade and told him that the procedures would probably happen sooner than expected. Then I called his parents to let them know that a change of plans may be in order. As usual, they were both supportive and flexible. Sure enough, Dr. Silber's office confirmed my suspicions this afternoon and ordered my HCG injection for tonight (which means my eggs will be ready Friday morning).

Although I have fewer mature follicles than the December IVF, I am hopeful about the outcome. I have to be optimistic and hopeful...and relaxed. After Friday's procedure, I will know the exact number of eggs retrieved; however, we won't find out how many embryos survive until Monday morning, just before the transfer. We're praying for at least four, but I'll be relieved if three are viable. Last time, only two were available for implantation.

All in all, I'm happy about the way things have progressed. I definitely prefer action over waiting. Now I'm scrambling to complete all of the tasks on my "To do" list, so that I can put my mind at ease before a week of mandatory rest and recovery. One more load of laundry and a cart full of groceries ought to do it. The way I look at it, I've got a week's vacation coming up. What a blessing!

Praying for a successful IVF, Ramona

Sweet Smile

Here's the sweet smile I see every morning as Liliana enjoys her milk and Trader Joe O's while playing along with Blue's Clues. I think she has a crush on Mr. Steve, the host.

Corny Picture

Liliana enjoys an ol' fashioned BBQ dinner in our kitchen. This is her first time holding corn on the cob and learning to nibble off the pieces. She loved it!

Monitoring Results

Today's monitoring results were excellent. Praise the Lord! All of the hormone levels were right on track, and I have 18 steadily growing follicles. Things are going so well that Dr. Silber reduced two of my three medications to half the regular dose. Cutting the dosage will slow things down to maximize the number of eggs retrieved this weekend. After the retrieval, each egg is fertilized and provided an opportunity to grow and divide in an optimal lab environment for three days. On the third day, the surviving embryos are transferred into my uterine lining with the hope of implantation and development.

I'm feeling good about the process thus far. The egg count is good (although I would prefer it to be higher) and both the hormone levels and lining thickness are exceptional. Hooray for that! I'm hoping that the quality of these eggs is higher than the "batch" in December. Of eleven eggs, only 2 viable embryos resulted. That's not a great ratio. In fact, it's pretty poor. We'd really love to have four or more embryos this time, in which case we would freeze some for a future IVF. Ultimately, we know every little detail is in God's hands...and we wouldn't want it any other way.

This treatment process has been less physically grueling than the last (partly because I started out five pounds lighter & with a smaller tummy). My abdomen is pretty uncomfortable now, but nothing like before. I am still able to be active with Liliana, just not at my normal level. Last time I had trouble participating in any play activities. Even bending over, walking and sitting were painful. Maybe the tough stuff is yet to come, but right now I'm thankful for the ease of this process.

Wednesday morning is my next visit to St. Luke's for monitoring. I've been there so much that the lab techs know me by name. That tells you something.

I'm praying for smooth sailing and a successful IVF! May the Lord bless you! Ramona

Counting Down

Less than a week 'til my target date! In the meantime, I'm busy getting our life and home organized, since I'll be out of commission for about a week. Thankfully, Wade's parents are coming in to help with Liliana during my hospitalization and recovery. What a blessing!

At this point, my treatment is rolling along smoothly. My hormone levels have been good, and it appears that I have about 18 follicles in the running. We're waiting for the majority of follicles to reach a diameter of 1.8-2.1 mm. At that point, the egg retrieval will take place. I'll get the results from this morning's ultrasound and bloodwork sometime this afternoon. That will give me a better idea of the timeline.

I'll post the results this evening. Thanks for your continued support and encouragement!

Relax...it will happen!

I am in the process of preparing, both physically and emotionally, for the next week of treatment and the upcoming IVF procedures. My body will experience dramatic changes this week as my ovaries expand with a multitude of growing egg follicles. Sitting and walking will be very uncomfortable, while exercising and lifting a toddler will be out of the question. Once everything is good and swollen, the egg retrieval takes place. This procedure involves general anesthesia, an operating room and a short, but painful recovery. Three days later, the embryos are transferred into the uterine lining...and then I wait and pray for babies!

According to Dr. Silber, Dr. Pineda and all the well-intentioned friends who continually say, "relax...it will happen," relaxation truly is critical to a successful IVF. Stress hormones can sabotage embryo implantation by causing the reproductive organs to contract. They can also produce an unfavorable environment for healthy fetal development. And if I'm willing to cut out caffeine, you can bet I'm going to find a way to relax. So, for the previous IVF, I sprayed lavender fragrance all over the house and burned scented candles to set the stage. I listened to soothing music and practiced meditation to prepare for the big events. And after several weeks of my relaxation regimen, I trained myself to go from stressed mama to wet noodle in five minutes flat.

In an effort to kick-start the relaxation this time, I visited The Face and The Body in Chesterfield, where I experienced my first Swedish massage. Being a newcomer to the day spa scene, I had no idea what to expect. I'm the modest type, so I started to sweat when the massage therapist invited me to disrobe and lie nekked (as Mississippi Wade says it) on a table (under a sheet, of course). Then, she described the package and informed me that the "glutes" were included in the massage. My palpitating heart almost came to a screeching halt. Pardon me, but no one ever told me the Swedes gave tushy massages! Thankfully, Nicole set me at ease and allowed me to feel comfortable while she worked her magic. Even with an initial spike in my anxiety level, the hour of relaxation was heavenly. Thanks again to my Monday night Bible Study group for the best pampering ever!

Here's to Sweden, home of a divine massage! Blessings, Ramona

IVF and Insurance Coverage

Today I received my second prescription order via Fed Ex. The first was $1200, and this one was $1500. [I share the financial figures only to help readers more fully understand the process.] Our insurance does not cover fertility treatments--not even the medication. And we are not the exception to the rule. Most insurance companies do not pay for any fertility related expenses. They cover the diagnosis, but not the treatment. It's a shame. BCBS covers impotence treatments and Viagra, but they do not provide infertility coverage. It seems that the company values the function of the male sex organ, but does not care equally about the female reproductive organs. Candid, but true.

There are several states that have mandated fertility coverage by insurance companies. One of them is Illinois, which is just across the river. Wade and I have seriously considered a change of residence and/or employment in order to acquire the insurance benefits. In Illinois, three cycles of IVF are covered automatically. For us, that would translate into over $45,000. That's a huge amount of money!

Most European countries cover all costs related to infertility and advanced reproductive technologies. Many of them also provide several months of paid maternity and paternity leave! Other nations appear to understand the value of pregnancy and childbirth more than the U.S. Our country is so advanced in so many ways, but so primitive in others. It's astounding.

For couples who struggle with infertility in the U.S., treatment is considered a luxury. Every expense is out-of-pocket. When I began using fertility medication, I learned (the hard way) that various pharmacies charge different amounts for the same medication. As a result, I looked high and low for the best prices. During my 1st IVF cycle, I ordered from New York and London, which offered the lowest cost and reasonable shipping.

Thankfully, St. Louis also has one of the top pharmacies in the country (IVP Care), which is helpful when the doctor calls with a last minute orders and prescriptions that must be filled immediately. For this round of IVF, I actually used IVP Care for all of my meds, because they offer a substantial discount for 2nd and 3rd-time IVF patients. I think I saved about 15% overall...a sizeable amount of pocket change.

Anyway, I hope this information helps with gaining a better understanding of the financial challenges facing couples with infertility. I recognize that I am very fortunate to have a healthy child and this opportunity to undergo a 2nd IVF, and I hope that individuals and companies in the U.S. begin to place a higher value on the reproductive health of our nation. Fertility problems are difficult enough without the financial burden of treatment costs.

Here's to counting our blessings and improving our way of life. May God bess you and yours! Ramona

Liliana Longstocking

My girl finally has enough hair for ponytails! She was a hairless wonder for a year, and now she has entered the world of endless styles. Liliana couldn't get enough mirror time with this Pippi Longstocking look. She even watched her reflection in the glass fireplace doors for awhile. What a riot!

Yesterday I gave Liliana a piece of Hot Tamale candy, with the warning that it would be spicy. As soon as the flavor hit her taste buds, she took it out of her mouth and said, "I don't like a Hot Mama." I couldn't stop laughing.

Happy Days are Here Again

I feel like myself again! After five days of antibiotics, I am feeling better than I have in weeks. Thank the Lord for modern medicine! Apparently, the intensity of the infection wreaked havoc on my body, zapping my energy level and causing physical and emotional exhaustion. I'm sure some ups and downs are on the horizon due to daily doses of hormones...but right now I'm just thankful to be back to normal.

So far, I haven't noticed any major side effects from the Follistim, Repronex and Lupron rushing through my system. Just abdominal bloating and tenderness at the injection sites. Overall, I've been positive and upbeat all day, even without my afternoon siesta. I don't have much of an appetite, but I don't mind that one iota. I could use a few days of reduced caloric intake to whittle my waistline. I'm going to have ovaries the size of grapefruits in just a week...so I need room to grow. Elastic waistbands, here I come!

I'm feeling hopeful and excited about the possibility of having another child. Yesterday's bloodwork and ultrasound results were right on track, and I had 30 antral follicles (see "Let's Get this Party Started" from Dec. 2006 for more info on this subject). That's more than I had last time, so I'm hopeful for a higher number of eggs on the retrieval date. I go to St. Luke's for monitoring again on Friday morning. I'm praying that the Lord continues to bless this process and the ultimate outcome.

Thank you so much for your support and prayers. I really appreciate every encouraging word! Bless you! Ramona

Intense Phase of IVF Begins

Let the games begin...

First thing tomorrow morning, it's off to St. Luke's radiology for a baseline ultrasound and then to the lab for a blood draw. I will get the results from Silber's office between 4:00-5:00pm. If all is well, my follicle stimulation begins tomorrow night. My medication regimen will include two oral meds and three subcutaneous injections every day until April 27th or so. Monitoring (bloodwork and ultrasounds) will take place every other day at St. Luke's Hospital until the first procedure. My target dates for egg retrieval and embryo transfer are April 29th and May 2nd, respectively. Everything went right on schedule during the first IVF process, so I'm expecting a similar course this time.

Thankfully, I am continuing to recover from my crazy infection (which I am convinced was more than sinusitis). My throat still hurts, but the rest of my symptoms are steadily improving. Even my energy level has increased! Praise the Lord for decent health going into this intense phase of fertility treatment.

Here's to a terrific week for all! Blessings, Ramona

Answered Prayer

Last night, Wade and Liliana went grocery shopping while I stayed home on the sofa in my misery. Every single cell hurt. I felt so bad that I almost called an ambulance to come get me. This illness has been much worse than the typical sinus infection. While coming in and out of consciousness during the night, I prayed for an overnight recovery. And this morning, I awoke feeling 100 times better. I even felt well enough to attend an all-day seminar (which I was certain I would miss). That's an amazing turn-around, and it certainly wasn't due to chicken soup. Our God is an awesome God!

Here's to answered prayer, Ramona

A Diagnosis

I woke up feeling so bad today that I immediately made an appointment to go see my D.O., Dr. Chao. After examining me, he indicated that I have a serious sinus infection that was resistant to the round of Keflex I took two weeks ago. No wonder I feel worse than ever! He prescribed Omnicef and gave me a $20 coupon and four days in samples. Free stuff...that's one of the reasons Chao's been my doctor for 10 years.

And yes, JohnnyB, I did give up this season of 24 in my utter exhaustion. I wasn't kidding when I said it was serious! Wade and I decided to skip the rest of the season and watch it when it comes out on DVD. Knowing us, we'll probably knock it out one weekend.

TGIF! Enjoy your weekend, Ramona

A Siesta a Day Keeps Heart Disease Away

Not much has changed since my last entry. If I weren't in the midst of treatment, I would suspect that I have chronic fatigue syndrome. All day long, I pine for a nap...but my sleep doesn't result in rejuvenation. I feel lethargic, irritable and unmotivated, even after a full night's sleep. I haven't styled my hair or put on make-up for three days, if that tells you anything. I didn't even check to see who went home on AI last night. Seriously, it's getting bad.

I'm praying for some relief in this area. It's tough to really engage in activities with a toddler when your mind is foggy and your body is exhausted. And being a great mom is very important to me. Hopefully this will just be a short-lived side effect.

Today I mustered enough energy to take Liliana to the Lodge for water follies. She has only been to the pool four times, and she is already very comfortable in the water. Today she put her face in the water and blew bubbles quite a few times. She also swam with a noodle and used her legs to kick to every destination she desired. I was so proud of her! I "ran" laps around her while she practiced swimming. It was so nice to get a little exercise. Afterward, we both napped for three hours.

I am so thankful that Liliana has not given up her afternoon nap. She has always been a good sleeper, and it has been a huge blessing to me. Even science supports my afternoon siestas. A recent Greek study showed that napping is linked to heart health. People who nap three times a week for at least 30 minutes reduce their odds of dying from heart disease by 37%. What a wonderful benefit! I knew it was good for me!

Here's to sleep...restful and refreshing sleep. Blessings, Ramona

My Treatment Intensifies

Treatment Update: For the past eight days, I have been taking Lupron injections along with my typical regimen of Natelle prenatal vitamins and Folgard (for MTHFR enzyme deficiency). I finished the Desogen on April 5th, and my cycle began on Sunday. At this point, everything is right on track for the April 29th target date. The big stuff starts Monday, the 16th--bloodwork, ultrasound and three injections daily.

As for the emotional side of things, I have been experiencing pretty serious mood swings for the past few days. I feel irritable, tense and tired about 75% of the time...but I do have good moments, too. Unfortunately, today was especially rough. I felt as if I had been flattened by a steamroller. My neck and head have been aching like crazy...and all I want to do is lie down and sleep. That doesn't fly with a toddler.

I don't remember feeling this crummy with the first IVF protocol. Hopefully things will improve soon. If not, this will be very a long month.

Although I did not choose to struggle with infertility, I did prayerfully choose IVF. So, I will accept the side effects and hold tight to the hope of a successful outcome. I pray that I will be a blessing to others through this process, no matter what happens.

Have a wonderful day! Ramona

Easter Celebration

Here we are in all of our glory on Easter afternoon (notice the heavenly rays of light shining down on us). Liliana is obviously saying the "ch" part of "cheese" as Mama Joy snaps the photo.
Sunday morning, Wade and I attended the church where I was baptized as a teenager. So many faces looked familiar, but the place seemed much smaller now that I've "grown up."
We enjoyed spending time with my mom over the weekend. Liliana played with her Grammy's toys, colored pictures, bounced around on a big orange ball and played sweet sonatas on the out-of-tune piano all weekend long.
We also had lots of time with my brother and his beautiful family. Liliana and her cousin Luke had a ball together while cousin Clayton seemed happy as a lark cruising around the house. Watching the kiddos was such a joy!
As we pulled out of my mom's driveway, I felt such sadness. Although we see my family several times a year, I wish for more. I miss them dearly, and I would love for Liliana to have close relationships with them.
Here's to family, near and far. Blessings, Ramona

And they're off!

This poor pony got more than she bargained for as a birthday party attraction. After three laps with jockey Ramona, she had to take a long rest in the trailer.

I've got skills.

Giddyup Pony!

Liliana rides a pony at her cousin Luke's birthday party. Doesn't she look serious about her equestrian endeavors! During Easter weekend, we spent time with family and friends in my hometown. To celebrate the risen Lord, we hula hooped, hunted eggs, rode dirt bikes, learned balloon tricks and laughed til our cheeks hurt. On the way back to St. Louis, Liliana seemed a bit funky. Out of the blue, she hurled the contents of her tummy all over the car. After a roadside clean-up, we spent four stinky hours in the car on the road. Wade drove fast...very fast.

Whose Hands

A basketball in my hands is worth about $19.
A basketball in Michael Jordan's hands is worth about $33 million.
A golf club is useless in my hands.
A golf club in Tiger Wood's hands is twelve major golf championships
It depends on whose hands it's in...
A rod in my hands will keep away a wild animal.
A rod in Moses' hands will part the mighty sea.
A sling shot in my hands is a toy.
A slingshot in David's hands is a mighty weapon.
It depends on whose hands it's in...
Two fish and five loaves in my hands is a couple of fish sandwiches.
Two fish and five loaves in Jesus' hands will feed thousands.
Nails in my hands might produce a bird house.
Nails in Christ Jesus' hands will produce salvation for the entire world.
It depends on whose hands they're in...
As you see now it depends on whose hands it's in.
So put your concerns, worries, fears, hopes, dreams,
families and relationships in God's Hands.
Because it really does depend whose hands they're in.

Adapted from "It All Depends on Whose Hands It's In" By Paul Ciniraj

One of Those Weeks

I'm having one of those weeks where it seems like everyone around me in pregnant or giving birth or planning with the full expectation of success. Sometimes I feel completely alone in this infertility struggle. I know it's not true, but I sure feel isolated sometimes. It's so crazy that there are women like me who consider every child to be a miracle and then other women (some of them my previous clients) have several unwanted children all with different daddies. This is just one of those things that is beyond my comprehension.

At the same time life seems so unfair, I also know that God works in all of these situations for good. Romans 8:28 "And we know that in all things God works for the good of those who love him, who have been called according to his purpose." Therefore, even the toughest things in life benefit the Lord's kingdom in some way.

Maybe it's just my mood swing making me sentimental and somewhat negative (yes, the rollercoaster has begun). Either way, I'm having a "down" week. I'll bounce back, not to worry.

Time for my shot. More to come...

Sick again!

Well, Wade and I are both sick with some sort of upper respiratory infection. Wade never recovered from his bronchitis & walking pneumonia, and now he's suffering from this cold. Poor baby. We're praying that Liliana does not come down with it. So far, she seems to be healthy. PTL! St. Louis weather is not helping the situation much. All of the sudden, it's 50 degrees and we need to wear winter coats again. Boy, I sure was loving that gorgeous spring weather!

On Your Mark, Get Set...

Tonight was my first in a series of dozens of injections. It really was no big deal. I'm what you'd call an old dog in the world of infertility, and giving shots is not a new trick. Even though I've done this before, we're still required to participate in a "refresher course" on administering injections. That will be our exciting family outing tomorrow morning. After that appointment, we'll traipse upstairs to Dr. Silber's office and tearfully part with a large sum of money.

So far, this has been a slow process. Think of cold, thick molasses. I'm trying to keep my thoughts occupied with other things so that I am not consumed by the IVF process. Right now I'm pretty ill with some sort of upper respiratory infection, so my mind is actively solving the dilemma of how to rest when neither nostril is functioning. When I'm not focused on treating my list of symptoms, I'm currently dealing with important neighborhood issues (Wade and I are trustees of our subdivision). I'm also gearing up for an exciting trip to see family in Indiana. And, as always, taking care of my husband and daughter is number one.

I have a feeling that the next month is going to feel like a year. The most difficult aspects are dealing with the unknown variables and waiting to see if the IVF was a success. We will do our best to rest in God and put all of the details in His hands.

May you be richly blessed during this holy week, Ramona

Treatment, Triplets and Tomfoolery

My treatment intensifies tomorrow whith the start of Lupron shots. I have to administer them myself every evening at the same time. We are hoping for more embryos this IVF cycle. We have decided to increase the number we transfer. Last time, we transferred two (which is all we produced). This time, we have requested that the medical team implant up to three embryos (God willing, we have that many). If we are fortunate enough to have four, we will transfer two and freeze two for the next IVF cycle. If there are five, we'll implant three and freeze two. And so on.

Yes, our chance of having multiples goes up, but considering that I've had three miscarriages, there is little chance that all three would develop healthily. A few nights ago, I had a dream that I was pregnant with triplets (wild dreams are a side effect of the Desogen). Sure, triplets are a possibility--but it's unlikely with my history.

It's fun for me to think about potential names, but I try not to dwell on it too long. I don't want to count my embryos before they hatch (embryos really do hatch, did you know that). If we have twin boys, we'll probably name them Lenny and Squiggy, but I'm not sure about triplets. Maybe Larry, Moe and Curly? Okay, simmer down!--I'm only kidding! A little April Fool's Day humor. Of course those names are not on our list!

Hope you played a little prank on someone you love today! Even more, I hope you enjoyed Palm Sunday and all of it's meaning.

Bless you! Ramona

Climbing Through the Creek

Our recent adventures took us to a local park, where we hiked along a creek, skipped stones, looked for wildlife and played on a jungle gym. Liliana was especially thrilled when she spotted a turtle on the bank of the creek. Her favorite activity was throwing stones in the water and watching the resulting effect. She absolutely loves the outdoors, just like her mommy! I come by it honestly. Back in the good ol' days, my mom took us on hikes along a creek in Madison, where we caught many mudpuppies and crawdaddies along the way. Fun for the whole family!

Love and Longing

I've always felt that parenthood gets sweeter with each passing day. Today is no exception. Liliana and I have been experiencing a closer bond than ever. She is communicating so well and her little personality is blossoming in technicolor. She is so imaginative, humorous and innovative--and I am enjoying this stage in her development more than any other.

As I observe these amazing changes in my daughter, my longing for another child continues to grow. I so desire to love and encourage another little one, and I pray that God grants me the opportunity to do so.

I am beginning to experience anxiety about our upcoming IVF...fear that we will go through all of the physical, emotional and financial sacrifice for nothing. Just when I feel like I've put complete trust in the Lord, nervous feelings creep in and take hold. Obviously I need to work on resting in the Lord. Please pray that I would have peace and total faith during this process.

In His hands, Ramona

St. Louis City Museum

Liliana is pictured at the St. Louis City Museum, where she enjoys the ball pit, slides and fun things to climb. I love the creative exhibits, random relics and works of art embedded throughout the attractions. It is truly one of a kind! As much as we love this St. Louie hot spot, though, it is not for everyone. Parents of toddlers must be 100% on their game, because there are plenty of opportunities to lose a child. And if you want to experience all of the fabulous nooks and crannies, be prepared for climbing and wriggling through tight spaces. We call it a crazy kind of fun!

Springtime in St. Louis

This is such a beautiful time of year. I love to feel the warm sunshine and see the budding plants peek through the soil and push their way skyward. Liliana and I tour the yard daily, just marveling at the amazing growth (Liliana really enjoys looking for worms and roly poly bugs). Springtime is the epitome of rebirth and growth in the world. What a perfect time of year for us to set new goals, start new projects and forge new relationships.

With Easter just around the corner, let us each remember the true meaning of the holiday and our personal rebirth in Christ. May you be richly blessed this Spring! Ramona

Treatment Update

IVF update: Today I begin my 2nd round of Desogen (birth control pills) to prepare for IVF. It's a short course that ends on April 5th. My Lupron injections start Monday, April 2nd, which is the same day most of our $$$ is due. Yikes! I will be giving myself shots every night until the egg retrieval (tentatively April 29th). First, Lupron, which puts my hormones in limbo so that the medications can dictate what happens. Then two follicle stimulating medications are added in mid-April. Finally, there's one HCG injection just before the egg extraction. Then after the embryos are transferred (May 2nd-ish), it's Wade's turn to give me progesterone injections in the hip every night. Yep, things are getting more complicated and exciting!

Even though this is our 2nd IVF process, it still takes a great deal of organization and planning. Dr. Silber's office provides a huge packet of instructions, medical orders and authorizations; and it's the patient's responsibility to review it, understand it and carry out the plans. The patient orders medications, attends injection training, schedules multiple MD appointments, takes oral meds & administers daily injections, keeps track of paperwork and goes to the hospital for ultrasounds and blood tests every other morning. It's crazy!

As we get closer to the target dates, I'll continue to explain the daily ins and outs of the process. It's quite fascinating, whether you're a medical genius or novice. And if you've been following this journal, you know that there's always drama involved. Hopefully this process will be uneventful, except for the final outcome!

Here's to smooth sailing!
Blessings, Ramona

Faust Park Follies

Our dear friends, Jim, Katie, Lou and Nick, are visiting this weekend. So far we've toured the St. Louis Zoo, Pepper Tree Village, Covenant Church, Chevy's Fresh Mex, Fortel's Pizza Den and Faust Park (pictured left). Tomorrow we go to the City Museum and Arch for the grand finale. It's been a terrific weekend, and we'll be sad to see them go back to Cincy.

The kids are having a ball together. Lou & Nick have been so brotherly to Liliana. Thanks for a wonderful weekend, Walros!

Liliana's First Easter Egg Hunt

Liliana participated in her first Easter egg hunt last week. The St. Louis Mills mall is now forever embedded in our memories thanks to its opportunity to meet the Easter bunny and hunt for eggs. Although Liliana is rarely frightened of anything, she wasn't thrilled to shake hands with the bunny. Instead, she wrapped her arms and legs around Mommy and refused to make eye contact. Not sure what that was all about, because she talked about the rabbit for the next three days. Toddlers...you gotta love 'em. Happy two weeks 'til Easter!

Spring Cleaning and Old Friends

Isn't Spring cleaning one of the best feelings? After several days of organizing, cleaning, discarding and giving away, our home seems almost brand new. My house is no longer a force to be reckoned with, but instead a soothing place to relax. My cleaning was partially inspired having visitors this weekend. My best pal from HS and his family are here through Monday.

It's been so much fun to have Jim, Katie, Lou and Nick in town. The kids have spent lots of time outside, and we went to the zoo this morning. Thank goodness it's sunny skies all weekend! Wade and I have enjoyed catching up with our dear friends after a long hiatus.

Here's to old friends and good times! Blessings, Ramona

The Life Aquatic

Liliana learned to swim today at the Des Peres Lodge. She is fearless! Not only did she explore every inch of the pool, but she swam without holding on to Mommy! What a big girl. She was so exhausted that she snoozed for three hours this afternoon. Mommy was pretty worn out, too.

Summertime is just around the corner, and we plan to do lots of swimming. Hopefully Liliana will be ready for slides and diving boards by then. She has learned that the water is her friend, despite swallowing quite a bit today. The aquatic life runs in my family, so she'll surely be a little mermaid.

St. Louis is above 70 degrees this week. Here's to warm weather, spring flowers and playing outdoors!

Blessings, Ramona

My Legacy

After months of teaching Liliana good old fashioned Southern manners, we are finally seeing the result. Not only does she say "please," "thank you," "I'm sorry," "Sir" and "Ma'am" appropriately, but she also starts her requests with "May I..." It is so rewarding to hear her little voice utter such politeness, and it has also been quite entertaining.

Yesterday morning, she awoke, stood up and asked me, "Mommy, may I wake up?" I replied, "Of course, honey, you're already awake." After playing outside in the sand box, she said, "May I have dirty feet?" As we were walking through a yard filled with doggy land mines, she inquired, "May I step in dog poop?" Oh, how I love that little charmer!

On a different note, here is an excerpt of a song that inspires me. I sing these powerful lyrics throughout the day as a reminder that I am here not for myself, but for Christ.

I want to leave a legacy.
How will they remember me?
Did I choose to love?
Did I point to You enough
to make a mark on things?

I want to leave an offering;
A child of mercy and grace
who blessed Your name unapologetically;
And leave that kind of legacy.

Not well traveled, not well read,
Not well-to-do or well bred;
Just want to hear instead,
"Well done good and faithful one."

Legacy by Nichole Nordeman

A New Definition of Family

We just returned from Michigan. Amazingly, Gramcracker pulled through and is doing much better. Praise the Lord! She had all of us so concerned. Even her doctor thought she may have been in her last days. Although Gram isn't thrilled about her new residence at a nursing home, it seems to be the best option for her. Her injuries require months of physical therapy; her leg is severely broken AND neither of her arms is fully functional at this point (she had a stroke in one & the other is dislocated at the shoulder). She needs around-the-clock care to help recover to the point that she can return home.

It was difficult to see my Gram suffer so much. She has always been a pillar of grace and strength to me...and now she cannot even care for her basic needs. This independent woman is now completely dependent upon perfect strangers for every aspect of her care. It is my prayer that she will overcome her disappointment about being in a nursing home, muster up a strong will to survive and rise to the challenge that lies ahead of her.

As for our time with family, I couldn't have asked for more. I had wonderful opportunities to get to know family members on a personal level. Because I always lived relatively far away from my family (seven aunts & uncles and many cousins, most of whom grew up in Michigan), I always felt like somewhat of an outsider. Throughout my childhood, I saw my relatives once a year during Christmas--a situation that didn't exactly foster close relationships.

Over the past few days, I learned more about my family than in all of my 34 years, combined. I had real, honest conversations with aunts and cousins...and I gained great insight into the hearts and minds of people I've always longed to know. I now feel like I have meaningful relationships rather than distant relatives. And I have a true sense of belonging within my extended family. What an unexpected blessing!

As usual, Liliana was a terrific traveler and Wade was helpful beyond words. They had lots of daddy-daughter time, while I spent quality time with Gram and family. I appreciated Wade's willingness to take care of things behind the scenes so that I could have the time to do what I felt I needed to do. He is so thoughtful and generous. Thanks, honey!

Now it's back to life in St. Louie. I have lots of catching up to do, but I wouldn't trade a moment of my time in Michigan for an easier road here.

Here's to staying up 'til the wee hours of the night, talking about real issues and creating real relationships! Blessings, Ramona

My Gramcracker in the ICU

My mom called Friday, and the tone of her voice suggested that bad news was on its way. Sure enough, she informed me that my grandma was in the hospital. According to Mom, Gram broke her femur on Wednesday, and the injury required surgery and multiple pins to connect her frail bone. As if that weren't enough, Gram suffered a stroke while she was recovering in the hospital. Since then, she's been coming in and out of consciousness. At this point, the full extent of her condition is not clear. Things looked grim yesterday, so I packed my bags and headed for Michigan.

As of today, Gramcracker is in the ICU. I spent some time with her this morning, and the first thing she asked was, "How's that little darling?" Even in her fog, she though to ask about sweet Liliana. During my time with her, Gram appeared to be more alert and responsive. She's doing better today, but doctors are concerned about the possibility of blood clots. Her heartbeat has also shown irregularities, so the medical staff is also treating and monitoring her heart.

Please pray for my Gram--that she will heal quickly, regain full consciousness and cope well with the news of her impending nursing home stay. There is fear that she will lose hope and “let go” once she realizes she won’t be returning home. We are also praying for my mom and her siblings as they watch my grandma battle through these medical conditions. Yes, my mom quite the strong and independent woman, but it's not easy for anyone to see their parent in distress. Most of all, please pray that this crisis would strengthen family ties and lead my family members to a personal relationship with the Lord.

Here's to family--precious and dear. In Him, Ramona

God's Will Be Done!

Thank you so much to all of you who visit and share in this journey with me. I truly appreciate your time and relish your expressions of encouragement and concern. My husband and I are especially grateful for those who pray on our behalf. May God bless each and every one of you!

A recent anonymous comment has prompted me to provide further explanation regarding our choice to pursue in vitro fertilization. I enjoyed the candid and challenging nature of the comment; however, I found it to be a bit insensitive, especially considering all the sorrow we've experienced. It was also apparent that the writer made several incorrect assumptions. So, please allow me to expound on my personal beliefs and the process that led to our current medical treatment.

First, let me make it perfectly clear that I am a Christian, and I believe that the Bible is God's infallible word. My faith is strong--but not blind; it is supported by personal conviction and over two thousand years of evidence. I continually seek to know the character and the will of God, and I pray daily for the strength and wisdom to follow His will [For instance, last year I waited 6 months without transportation for God to make his will known to us about repairing our car]. I seek the Lord in every aspect of my life. I do not compartmentalize my faith; I live it every moment of every day.

Second, I love and cherish my family beyond words...and I believe that my adoration is quite evident in the pages of this journal. I am so very thankful for what the Lord has given me.

As parents, Wade and I know that our precious daughter is a gift from God. We have been so richly blessed, and it is our hearts desire to have many children. As mental health professionals and strong believers in Christ, we know that it is important to examine our hearts and our motives. We have spent many months doing exactly that, and we know our desire for children is pure and from above.

"May he give you the desire of your heart and make all your plans succeed." Psalm 20:4
"Delight yourself in the LORD and he will give you the desires of your heart." Psalm 37:4

Although we long for a large family, we suffer from unexplained infertility. All of the medical tests suggest that Wade is perfectly healthy in the reproductive realm. However, I have several medical issues that prevent natural conception. Consequently, we have been unable to conceive a child without advanced reproductive technology. Because part of my problem is related to hormone levels, I also require medication to sustain pregnancy. We know the reality of the situation, and we look to the Lord for wisdom and patience regarding our fertility.

During our emotional struggle with this issue, Wade and I researched all of the options available to us (e.g., waiting for a miraculous conception, hormone treatments, intrauterine insemination (IUI), in vitro fertilization (IVF), adoption) and prayed that God would show His divine will to us. We also asked Him to put obstacles in the way of paths that stood outside of His will. For many months we waited on the Lord, and He eventually gave us a great peace regarding medical treatments...and, ultimately, the pursuit of IVF.

It seems that the aforementioned blogger comment makes the assumption that IVF is not God's will. In the course of our research, we never encountered evidence that IVF is either unethical or immoral. Controversy sometimes arises when fertilized embryos go unused. However, we fertilize every egg and transfer every embryo that God supplies. So, it is our belief that IVF is a perfectly viable treatment option...and it is the method that God chose for us.

"We can make our plans, but the Lord determines our steps." Proverbs 16:9

The simplest explanation I can provide is that it is because God is sovereign that we are pursuing IVF. All of truth, life and breath is created by God. He has also provided advancements through human invention and intervention. Should none of us take antibiotics when we are ill, but rather expect that enough faith, patience and endurance will heal us? Those who practice this philosophy may indeed find healing, but they are even more likely to die. Either way, God is sovereign and He gives us the will to choose.

God is ultimately in control and thus "determines our steps" by regulating our situations and the information we base our choices upon. Since we will generally choose the option that our mind finds most preferable in light of the situation, God can simply make the circumstances such that the option we find most preferable is the choice He ordained us to make. Our choice is free and truly ours since it is a result of our own reasoning and thought processes ("we can make our plans"), but God still controls it because He orders and directs the information our thought processes were based on to ensure that the choice we make is what He wills ("the Lord determines our steps"). Personal responsibility lies with the individual while fate and judgment remain in God's hands. For an elaboration on God's sovereignty, visit www.geocities.com/mattperman/sov.html

At this point, let me also clarify my view on adoption. Even though it is not what is best for our family at this time, I support and respect both internation and domestic adoption. Throughout the world, there are so many children who desire a loving family to call their own. I fervently pray for children in need, and we personally support a child in Tanzania. God willing, we may adopt a child into our family in the future.

Right now, God has given us personal assurance of our decision to proceed with IVF. He reassures us daily through His Word and by miraculously providing the means for this treatment. Further, the Lord provides encouragement through fellow members of the body of Christ. Funny as it may seem, the seemingly quarrelsome comment has led us to a deeper conviction in God directing us toward IVF. And so we will rest in God's assurance and put the outcome of this treatment in His hands.

And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus. Philippians 4:7

Praise God that we are able to know God in a personal way. How wonderful that we may communicate with Him through prayer, worship and fellowship. Praise God that He reveals His will to us so uniquely through His living Word. And thank God for trials that both refine us and remind us of His unfailing grace, love and power. We humbly give God the glory for our successes (e.g., our daughter, increasing wisdom, strengthened faith, close friendships) and through our disappointments (e.g., miscarriages, financial strain, grief)...all of which display God's sovereignty and remind us of our complete dependence on Him.

"We ask God to give you complete knowledge of his will and to give you spiritual wisdom and understanding. Then the way you live will always honor and please the Lord, and your lives will produce every kind of good fruit. All the while, you will grow as you learn to know God better and better. We also pray that you will be strengthened with all his glorious power so you will have all the endurance and patience you need. May you be filled with joy, always thanking the Father. Colossians 1:8-10"

May God richly bless you and yours, Ramona

Grieving Over One Year Later

Today would have been my father's birthday. As you may have read earlier in the journal, he died in December 2005 from complications due to lung cancer. The day he died, we were packing to visit him in Texas. Unfortunately, I did not have an opportunity to say good-bye in person. And since our relationship was quite complicated, finding closure has been a difficult and ongoing process. I have been surprised how many waves of grief accompany the death of a loved one. It isn't something you can prepare for, and you never know what to expect. Such is the way of loss, I have learned.

Please pray that I will exude grace and comfort to my father's wife as I support her during this difficult day. Pray that I would put her needs before my own.

In His grip, Ramona

The Great Healer

We met with Dr. Silber this afternoon. He offered his condolences for our miscarriage and informed us that he believes the results of the embryonic genetic testing to be erroneous. In his opinion, the lab inadvertently tested my tissue instead of that of the fetus. Consequently, the testing showed normal female chromosomes when the fetus was, indeed, chromosomally abnormal (hence, the miscarriage). Although Dr. Silber had no hard evidence of this, he seemed convinced that the baby had a genetic issue that kept it from developing correctly. And, he said the lab's error was not uncommon. Scary.

As for our current situation, Dr. Silber recommended that we allow each embryo to undergo genetic testing prior to IVF. According to doc, he would use the process to identify embryos with genetic abnormalities and exclude them from being transferred during IVF. Our chances of pregnancy would naturally decrease (with fewer embryos available), but our odds of having another miscarriage would be much fewer. It may come as a surprise to some, but I felt strongly that we should not do the testing.

Here's why: 1) I believe that God is sovereign over all. That includes our IVF...and, as far as I know, He does not listen to statistics or lab results. 2) By Dr. Silber's admission, the lab makes mistakes and may accidentally omit a perfectly viable embryo from the process. 3) The testing is at least $4500, in addition to the $16K. That's no pocket change. To me, there are three compelling reasons to forgo the pre-IVF genetic testing. I'd rather put my future children in the hands of the Almighty than a room full of scientists. Can I get a witness?!

In God's hands, Ramona

Chromosome Analysis Results

We finally received the results of the fetal chromosome analysis. Our baby was a female with normal chromosomal characteristics. What does this mean? Basically, we have no idea why the miscarriage occurred. With all of the modern technology available to the medical team, no abnormalities have been discovered. The only thing we understand is that--of the hundreds of factors that must be exactly right for during conception and development-- something seems to go wrong for us almost every time.

This news is both frustrating and encouraging for me. On one hand, there is no explanation for our infertility and my chronic miscarriages. It's difficult to continue trying, knowing that we may not have any success. It's also painful to know that we lost a little girl. Knowing the gender makes the whole thing more real and personal. I think that's the hardest part for me.

On the other hand, however, I am relieved and encouraged that no abnormalities were found. At least there is nothing genetic causing our problems. Now we need to see what Drs. Silber and Pineda plan to do in order to increase our chances for success.

We meet with Silber at 1:30pm. I'll share the information from our appointment later today.

Hope you have a wonderful Wednesday! Ramona

Hello, McFly!?

I totally had a McFly moment last week and forgot to include the results of my bloodwork and ultrasound. Unbelievable!

My hormone levels (beta HCG, progesterone, follicle stimulating hormone, luteinizing hormone and estradiol) were exactly where we want them to be going into IVF. Dr. Pineda's nurses seemed excited to tell me about the results--so that's definitely a good sign. As for my ultrasound results, the sonogram showed 21 antral follicles on the right and 22 on the left. Knowing that antral follicles are an indication of the potential number of eggs that may be produced, this is incredible news!

During my previous IVF, 26 stimulated follicles yielded 11 eggs. Ultimately, only 2 viable embryos were available for transfer. For that reason, I am very interested in increasing the numbers so that more embryos may be produced. According to Dr. Silber's nurse, we may be able to enhance the process with some changes in the medication regimen and timing; however, we'll need to be careful not to overstimulate the ovaries (which can be very dangerous). It's a balancing act, but Sherman Silber is world renowned for a reason.

Tomorrow is our meeting with the great doctor. We hope to leave his office feeling more confident about investing $16K on this process (for the 2nd time). Fortunately, we know this is our only option for conceiving a child and it's ultimately in God's hands. Thank goodness for that!

Here's to many months of good news! Blessings, Ramona

Like a Good Neighbor...

Meet some of our wild and wacky neighbors! Wade and I feel so blessed to have such great friends as neighbors. It's rare that you find yourself in a community where people take care of each other and truly love one another. We couldn't imagine living anywhere else! Saturday night we celebrated Michael and Jen's nuptials. What a terrific evening--tasty morsels, refreshing beverages, creative nicknames, hilarious charades and laughter that makes your face hurt!

Here's to neighbor friends! Blessings, Ramona (a.k.a. Muffin Lamplighter)

Grandparents and Upcoming IVF

Wade's parents just left after a lovely weekend visit. We always enjoy having them here, and Liliana was especially sad to see them go. It's been wonderful for Liliana to have so much time with her grandparents (Grammy Joy, too) during the early stages of life. Even though all of her grandparents live far away, she sees them regularly enough to know them and love them! A huge thanks to Grammy and Grandfather for Liliana's new turtle sandbox. She loves playing in it!

This Wednesday is our appointment with Dr. Silber. I'm anxious to hear what changes he'll make to the medication regimen during the upcoming IVF process. I'm really hoping he has big ideas for improving my number of eggs (which potentially increases the number of viable embryos). I'm experiencing more anxiety as the target date approaches. Hopefully this meeting will put some of it to rest.

Here's to sunny days. Enjoy this beautiful weather, St. Louisans!

In My Daughter's Eyes

This song encapsulates what I see when I look at my precious daughter, Liliana. She is such a blessing in my life, and I thank God for her every single day.

In My Daughter's Eyes

Performed by Martina McBride

Written by James Slater

In my daughter's eyes, I am a hero;
I am strong and wise, and I know no fear.
But the truth is plain to see-
She was sent to rescue me;
I see who I wanna be...
In my daughter's eyes.

In my daughter's eyes, everyone is equal;
Darkness turns to light, and the world is at peace.
This miracle God gave to me
Gives me strength when I am weak;
I find reason to believe--in my daughter's eyes.

And when she wraps her hand around my finger;
Oh, it puts a smile in my heart.
Everything becomes a little clearer;
I realize what life is all about.
It's hangin' on when your heart has had enough;
It's giving more when you feel like giving up;
I've seen the light--it's in my daughter's eyes.

In my daughter's eyes, I can see the future,
A reflection of who I am and what will be;
Though she'll grow and someday leave--maybe raise a family--
When I'm gone, I hope you see how happy she made me;
For I'll be there...in my daughter's eyes.

Sacrifice

When you are going through fertility treatments, things are often more complicated than expected. There are also a great deal of sacrifices that come with the territory. Being a fertility patient means a change in lifestyle, from multiple MD visits and ultrasounds to daily blood draws, oral meds and injections. And the waiting...it's often the hardest part!

One of the most difficult adjustments (for me, at least) with advanced reproductive technologies is that there are limited opportunities for exercise. When my treatment involves injectible drugs, I have just a few days during the month to be physically active. Follicle stimulating hormones create multiple egg-producing follicles--sometimes a dozen or more. As a result, the ovaries become enlarged (often the size of grapefruits), and something as seemingly harmless as vacuuming can cause them to twist and rupture. Not a good thing. If an ovary ruptures, it is useless. Even carrying more than 20 pounds can cause problems. Hello, 36 lb. toddler!

As a person who has always exercised regularly, this has been a difficult aspect. I long to jump on the elliptical machine or go rollerblading in Forest Park. Most days I can't even take a brisk walk through the neighborhood. But here's the way I look at it: this is just a temporary phase of life during which family must come first. Yes, staying in shape is important (and much tougher with my sweet tooth and the hormonal cravings), but it will be worth it when I hold another precious child in my arms.

So, that being said, I will continue to press on! Yesterday birth control pills were added to the regimen of prenatal vitamins and Folgard (for my MTHFR enzyme deficiency). I got the bloodwork out of the way yesterday, and I have an ultrasound tomorrow (Friday) morning. I'm praying that the results of both will be normal so that we may proceed as planned. And, most importantly, I pray that the Lord will bless us with another baby.

Here's to life's sacrifices and its sweet rewards.
Bless you! Ramona

The Long Road

Over the past few years, friends have asked me exactly how infertility is defined. If you're like me, you hear the term and have a vague idea...but you don't consult WebMD or Dr. Koop until it becomes personal.

Here's what Webster says: in·fer·til·i·ty (ĭn'fər-tĭl'ĭ-tē) n. Absent or diminished fertility; the persistent inability to conceive a child. Although that's a pretty good start, the medical diagnosis is more precise. According to medical professionals, infertility is the failure of a couple to naturally conceive a pregnancy after trying to do so for at least one full year.

If you're wondering what the journey looks like, here are some numbers that may be helpful. Although everyone's road is different, our statistics look like this:

Months actively trying to conceive: 39
Natural cycles (no meds): 12
Cycles on Clomid: 12
Months on Clomid and injectibles: 2
Cycles on serious injectible medications: 6
IUI Cycles with injectible follicle stimulation meds: 4
IVF treatments: 1, going on 2
Months on post-ovulatory progesterone treatments: 29
Pregnancies: 4
Miscarriages: 3
Children at home: 1
Dollars invested in fertility treatments: A mind-blowing number.
Tears shed during infertility struggles: Countless.
Being a parent: Priceless.

Date Night

Wade and I had a date night in Wisconsin over the weekend. What a rare and special occasion! We actually have another date planned for Saturday evening, when we get together with our neighbor friends for a celebration. This may be some sort of record for us! Here's to love, laughter and dates with your sweetie. Bless you, Ramona

Wisconsin Wedding Photo

Photo from our recent trip to Wisconsin. The bride is my college pal, Greta. We really enjoyed ourselves at Lakelawn Resort, even though it was icy weather.

Funny Face

Liliana enjoys making me laugh. Here's her funny face in front of the wooden boat at the Museum of Transportation. What a nut!

Let the Fun Begin!

Our IVF target dates are almost two months away. Yet, the fun begins this week! If you want to know the "ins and outs" of IVF...stay tuned, my friend. In the coming weeks, you will get the low down on what it's really like to go through the process. No hold barred!

My cycle began today (which may be TMI, but you have to know that to understand how the whole thing works). On the third day of the cycle, Dr. Silber's patients begin birth control pills. I know it seems counter-intuitive to ingest something that inhibits pregnancy when you're yearning for a child, but that's how the doctor controls the timeline from here on out. My cycle has to be exactly on target for both the egg retrieval and embryo transfer. That's why the medical team takes control this early. More opportunity to work out any glitches, I suppose.

Starting Wednesday, I take the Desogen for 16 days (to create a "short cycle"). I will also have my blood drawn at St. Luke's to get a baseline reading on my Day 3 hormone levels. My progesterone, HCG and estrogen should be within normal ranges at this point. Friday, I will undergo an ultrasound at Dr. Pineda's office. (Normally IVF patients have the ultrasound completed at the hospital, but my insurance does cover "diagnostic" ultrasounds...so do it this way to avoid unnecessary out-of-pocket expenses. Trust me, there will be no shortage of expenses.) Both the bloodwork and the ultrasound are standard procedures before IVF.

We meet with Dr. Silber on March 14th for a consultation. I plan to ask him how this IVF process will differ from that in December. I'd also like to know how he plans to alter the medication regimen to help produce more high quality eggs. It seemed to me that we should have produced more than two viable embryos when I began with 26 antral follicles. We were hoping to have at least four embryos (two for transfer/implantation and two to freeze for a later date). I'd really like Dr. Silber to make adjustments to enhance the process now that we know how my body responds to the medication.

So that's the medical aspect. The emotional side of this is more difficult for me (and most IVF patients). We're getting ready to undergo a process that has an extremely high cost with about a 50% success rate. That's a bitter pill to swallow. But then again, you can't put a price tag on the life of a child. And we did get pregnant with our first IVF attempt, which is a fact I'll definitely hold onto during the coming weeks. Being positive and relaxed is crucial to success.

This is where you have to have faith. The wondering and worrying can drive you crazy! I read an article today, and I just have to share it. Here's an excerpt from "When Everyone's Pregnant...Except You" by Deborah Bohn on BabyZone:

Dr. Madeline Licker Feingold, PhD, a reproductive medicine psychologist and fertility counselor based in Berkeley, California says, "The level of depression and anxiety in the infertility population is the same as in cancer, heart disease, and HIV-positive patients. Infertility is much more difficult than people may think."

Let's be honest, baby showers, like weddings, can be tedious affairs—it's enough to drive an older mom nuts, so imagine how it feels to someone who's struggling to have a baby of their own. Imagine putting a starving person in a room full of food they're not allowed to eat. It's simply torturous.

I wish I had a dollar for every time someone told me about the friend of their cousin's back in Wichita who tried desperately to have a child, went on to adopt three children, then miraculously got pregnant on her own a few years later. Somehow this miracle baby myth was supposed to give me hope that it could happen for me, too. Well, it didn't give me hope. It made me angry.

And so did all the unsolicited medical advice. I was instructed by people with no medical training whatsoever to prop my legs up after intercourse or make sure my husband wore boxer shorts. But the best one by far . . . the one every childless woman hears is this, "Just relax!" Basically it's implied that we're sexually frigid and that loosening up a little will result in a positive pregnancy test.

"They'd never say something so crazy to a cancer patient!" Dr. Feingold says. She recommends either explaining to the pseudo-physician that you or your husband has a medical condition that no amount of prickly-pear juice or Pilates will cure. Or you can end the conversation on the spot with, "That's fascinating, but I'm working with doctors and considering all the options available to me."

And that's what I'm doing, folks....state-of-the-art in vitro fertilization and old fashioned prayer. I've got a world-renowned IVF specialist overseeing my medical care, and I've got the Lord overseeing my doctor and me! What more could I ask for? So my prayer today is that I will glorify God through this process, and that He will bless us with a child (or two)!

Here's to a healthy pregnancy in May! Bless you, Ramona

Wisconsin Wedding & Water Baby

Last night we returned from a weekend whirlwind in Wisconsin. We left Saturday morning and drove home Sunday afternoon, giving us less than 24 hours at Lakelawn Resort--but the moments we had together were priceless.

We were privileged to attend the wedding of my collegiate best friend and her fiance. What a treat! Wade and I enjoyed spending time with the bride and groom while a babysitter sat in the room with our sleeping daughter. We also had the opportunity to catch up with old friends, slow dance and laugh, laugh, laugh! Now that's what I call a great date!

Although the drive was long and the weather was freezing, we made the very best of the weekend. We even had a champagne brunch (my first ever) with the wedding party on Sunday morning. Fancy!

Before we left, Liliana and I took a swim together in the hotel pool. What a joy it was to hold my slippery little toddler in the water as she learned to kick and float. When we finished splashing around and got out of the pool, Liliana exclaimed, "Mom, am pruny and shibbering!" Sure enough, her little feet & hands were shriveled up and her whole body was quivering. Even her teeth were chattering. What an observant child. I always suspected she was a genius!

After that terrific experience, I've decided that I will take Liliana to an indoor pool once a week until summertime. I want her to be totally comfortable in the water when the swimming months arrive. If she's anything like my side of the family, she'll grow fins and a gill!

Here's to family memories. Ramona

God's Good Gifts

After attending a Missions Conference at our church this week, I am reminded of how very blessed we are. We get so accustomed to luxuries like hot meals, dishwashers, cars, computers and comfortable homes that we sometimes take them for granted. I am so thankful for the freedoms we enjoy in the U.S. and the good gifts we've been given by God. And I believe it is important that we show our gratitude by giving generously to those in need. Wade and I support several charity organizations, but I know I can do so much more.

Today my prayer is for guidance in giving. I pray that the Lord will place the needs of others in front of me and show me how I can make a unique and lasting contribution.

Here's to a selfless heart and countless acts of kindness!

Bless you, Ramona

Brands I Live By

When I find something wonderful, I just have to pass it along. Here are a few the trusted products and websites enhance my duties as a wife and mother:

Consumer Reports-evaluates and ranks consumer goods (from diapers to dishwashers to digital cameras). We look to CR for their input before making major purchases, and we rely on them for identifying trusted brands. CR is available by subscription and online at http://www.consumerreports.org/

Grocery Game-for significant savings on brands you already use with this helpful site. It pairs up current sales at supermarkets and drugstore with available coupons. The web address is http://www.grocerygame.com/ and you can sign up for a $1.00/week trial. To get the most savings, collect the coupon sections of the Sunday paper for at least four (preferably 10) prior to starting the trial. If you register, please use my email address as a referral: earthangelmona@aol.com (Who can't use a free week of service!)

Ergo Baby Carrier-a soft, durable, ergonomic backpack for carrying your baby or toddler. Even with my back problems, I can carry 36-pound Liliana on my back for several miles. No joke! It is comfortable for me and ergonomically designed for the growing bodies of our little ones. I have traveled hundreds of miles with Liliana happily secured in the carrier. Find it at www.ergobabycarrier.com

Magic Eraser by Mr. Clean-If you have a tough stain on any hard surface, this sponge will get it out. You have to see it to believe it--it really works! Available at most retailers.

Children's Place Socks-they are available in a variety of colors, and they're the only socks that stay on Liliana's feet. Bonus: they have grippers and the sock size on the bottoms. Worth every penny!

Boz DVDs-Boz, the big green bear will provide educational entertainment for your child while reinforcing godly principles. Liliana loves the series so much that it's her first choice when offered the opportunity to watch a video. Boz can be purchased online or in Christian bookstores.

Shout out and tell me what you love! Ramona

Attack of the Killer Zzzzz's

Sleep is no longer my friend. I used to love my slumber (and sometimes covet it, I must admit). But after so many months of nightmares and difficulty falling/staying asleep, I'm ending the friendship! I feel like I've exhausted the resources--lavender, warm showers, milk, melatonin, Tylenol nighttime, Lorazepam, a comfy specialty mattress. Maybe I should use them all at once! Kidding.

Please pray that I would sleep well. My desire is to always be a blessing to others. When I am well-rested, I am my very best self. And when I'm sleep deprived...watch out!

Here's to a good night's rest. Ramona