Tuesday, March 31, 2009

Randomness....and waiting sucks

It seems I semi-overdid it after feeling much better Saturday, one day post retrieval. I was off the Vicodin, feeling hungry, and had a small burst of energy. So I had a nice meal, did some light house work, made home-made cheese and a few other things. Wrong answer. I found myself back in bed Sunday with cramps, nauseousness, and severe constipation. So I spent a portion of Monday in bed too. And not to screw it up any further, I'm lying low today as well. Very low, as in flat.

I am not a TV fan. I lack the concentration now to read anything substantive. I have very little energy to do anything. So that leaves cat naps (cats included) and being a bore with another blog post. Today is mostly about my observations. A summary of stuff....and a way to pass the time.

1. Waiting sucks. I have not heard from the lab since Saturday. They did say they wouldn't call again until transfer day. OK, but I hope they would call if all was not well. On the other hand...there isn't a lot I could do about it anyway. I'm operating under the "no news is good news" plan.

2. The heating pad is my friend. So are stretchy clothes.

3. Despite being swollen from whomever sat on my stomach during the retrieval, I have lost 6 pounds since retrieval day. I like this.

4. Things I'm NOT eating: dairy, meat, citrus fruit, sugary food, anything cold.

5. Things I AM eating: chicken stock, pasta, egg whites, apples, applesauce, bread sticks, tea, mashed potatoes, lettuce (go figure).

6. Waiting sucks.

7. The PIO shots aren't horrible. They sting a bit a few minutes afterward and my rump is sore. Not big deals in the scope of things.

8. The prednisone is giving me grief. Super Doc hates this drug and has been bothered by the fact that I am taking it. I only have 2 more days of it though and the effects are not cumulative. Thankfully, I have not gone psychotic on it.

9. I am up peeing all night, so I'm not sleeping well. (See number 8). So I'm exhausted during the day.

10. I have the luxury of showing up to my office in my pajamas and going back to bed when I'm tired. I salute everyone who has to get dressed and make like a happy face at work.

11. Mr. W is able (and willing) to do absolutely everything around the house and build a pizza oven at the same time. I feel mostly worthless. Yesterday he asked me what I thought all 4 of our kids were doing. I realize he is absolutely smitten with the thought, and this fuels his fire.

12. Mr. W's parents have just returned from 3 months out of the country. He decides to tell his mother what's going on, at the risk she will not approve or understand the process. Nearing 80, Mr. W's parents have the Old Country values and religious convictions. Surprisingly, she is supportive and optimistic. I remind Mr. W it's only a matter of days now before relatives from near-by states and the old world start hounding us. It will be in the newspaper, tomorrow, I'm sure.

13. Did I mention waiting sucks?

14. I will never forget the first thing my RE said to me at our initial consult. "Stay off the internet." WTF? Are you kidding me? I have done a lot of research. I have some new ideas if this doesn't work.

15. Mr. W's BFF had a complete knee replacement 2 weeks ago. He has been laid up in bed and on pain killers ever since. He has been very supportive through this mess and sends me encouraging text messages every day. Some are funny. Some are laced with Oxycontin. Some are about his own constipation. It's good comic relief. And he's planning a recovery party for us all.

16. Reading the blogs of others, and reading the comments others have left me is inspiring. As many of you have said, it reminds us there is still good in the human race. Complete strangers have created powerful connections that transcend race, religion, politics, and socio-economics. Why then is our world always at war?

17. Mr. W and I were raised in homes where discussion of sex & bodily health (not to mention politics, religion, and money) were taboo. This is fundamentally wrong. Mr. W should not have had to go to medical school to learn what a varicocele was and that it could contribute to MFI. We should not have felt so ashamed to ask for help earlier on. We too, were guilty of the royal sweep under the carpet.

18. April 1st is my transfer day. No fooling.

19. For the past 10 years, Mr. W had not taken a sick day from work. In the past 5 months he's cancelled multiple days to be with me at the appointments. I offered to get a ride tomorrow for the transfer but Super Doc cancelled half a day's patients. He wants to at least be in the same room when I get knocked up.

20. Waiting sucks. And I'm sure the 2ww will be worse.

Saturday, March 28, 2009

Fert Report

Yay! I have 4 fertilized with ICSI and am on deck for a day 5 transfer for Wednesday. The embryologist says they would typically expect 2 to make it to blast. Typical has clearly not been my M.O. but I am happy to go with that. My regular acupuncturist has recommended someone special for a pre and post transfer session so I've got her all lined up. Fortunately my clinic is proactive in allowing the acupuncturist to complete the treatments in the room with me. Gotta like the easy button!

Retrieve Me Then Revive Me

Well, hats off to all of you who have blogged the afternoon of your retrieval. You all are animals! I, on the other hand, am a complete wimp. But alas, I found myself unable to sleep (and finally able to manage the stairs) at 3 am this Saturday morning. So here I am.

My retrieval was a little eventful, probably more eventful than I'll even ever know. Mr. W and I bailed out of the house at 6:30am yesterday. I saw Mr. W had some reading material in tow, so I think perhaps he's bringing a little special treat for himself on production day. Turns out, it's the latest issue of Forbes. (OK.....everyone is different.)

Despite the fact that 4 retrievals are planned for my morning (I am second in line), I get a nice toasty private suite with a view and a cool convertible bed. The OR is conveniently adjacent to my room. IVF nurse comes in to start my IV....or try anyway....twice (both misses). She has my hands heat packed and spends a few minutes flicking the veins. She finally gets one in but it won't drip. Super Doc is standing there patiently not even saying a word. His eyes just tell me he is incredibly sorry. IVF nurse gives up and gets the anesthesiologist who says those attempts clearly will not work. She takes a look and Super Doc points to the protruding vein on top of my wrist. ....I can get that one, she says. ....I'm just going to go right for it, no messing around, no local...... And she does and it's all good. I'm whisked away to the OR and I'm out the minute we hit the door.

Twenty minutes later, I hear an announcement that they're done, followed by... Six, we got six..... Six? Six is more than three? Yay, six! It occurred to me that I had been dreaming I was harvesting grapes, while under. Hmmm, more symbolism. But not time to analyze that, oh shit, OW! OW? Holy crap. Mr. W and the IVF nurse quickly appear in my recovery room. ......You are in pain I can tell....she says.....I'm giving you a shot of Fetanyl...... Nice. She comes back a few minutes later, I'm giving you another bump on the painkiller and sending you home with Vicodin. The OR nurse is there explaining they had to "mash" on my abdomen quite aggressively to move the ovaries (apparently because they were holding hands against my back) in order to get them to move into position. I will likely be in more pain than normal. But I got six!! I point out to the nurse that RE's partner (doing my retrieval because RE is on vacation) was such the face of doom and gloom at my last u/s. She smiles and politely says....All of the RE's have very different personalities......

Super Doc grabs my chart and takes a glance then asks the nurse while pointing at the chart what was up? He has the slightest almost undetectable calm concern on his face. Apparently I had an 80/50 blood pressure while under with no explanation. OK, so six is great news, and I'm still here too!

The nurse insists I get up to use the restroom before I can leave which turns out to be a good idea. Walking back from the bathroom they notice I am pale, cold-sweating profusely, and am unable to stand. WTF? The nurses determine my blood sugar is extremely low and cram a Sprite down me. (I detest that stuff.) I can't believe after 20 years of insulin reactions with Mr. W that I can sniff out from a mile away, I have missed this sign in myself! Worse yet, Super Doc has missed it too! At this point, I am nauseous, exhausted, and just want to go home. They finally load me up in a wheel chair and whisk me out the back door. Yeah, if anyone else saw me, they'd likely not go through with this gig.

I spent the entire rest of the day in bed, mostly asleep and on Vicodin. I am swollen from the abdominal compressions and I feel like the Eurostar has derailed in my Chunnel. I will not have a lab report until sometime later today.

Wednesday, March 25, 2009

All....or Nothing

I'm cutting to the chase, my news is not good. Somehow, I am down to only 3 contending follicles. I don't know where the other ones went, or what happened. The ones I have are huge (27 and 26, and I stopped listening after he said I only have 3.) My E2 is 1430, so all other things look good. RE's partner has done the u/s today and said my chances of success hover around 10%. They normally cancel cycles where fewer than 4 viable follicles are present, but said it was our call. He said converting to an IUI would be another option. Hardly! After all of this, and the thinking that this was a MFI issue, he officially labeled me as having poor ovarian reserve, despite my normal FSH levels, and all other normal hormones. I am completely blown away and numb. The nurse asks me "if I have any thoughts". It's not like I have a lot of options here......I say. What's the question.....? Do you want to proceed.....she asks? Do most people quit at this point? She tells me if money is no object then we should try....it only takes one. Duh! A really f***ing good one! She said to take the HcG tonight for a Friday 7:30am retrieval. I said F.I.N.E. ......I'm all in. Let's pull the trigger.

Monday, March 23, 2009

Wake Me Up When It's Over

A total stranger has just asked me if I'm feeling all right. Nice....thought I was doing a better job of compensating. She thinks I look pale and exhausted. .....Ha....that's nothing ....wanna see my ovaries?.....I am thinking to myself, but instead I smile and say I'm not the best. She feels bad and apologizes for saying so. Maybe I looked like I was going to pass out and she thought she would catch me? Right.

This morning NP #2 waved the magic wand around and found some of what NP#1 missed two days ago. There are still eleven follies in the picture with possibly some smaller ones hiding, however I'm looking at only 6 over 10mm . Clearly I will not be a candidate for OHSS - the silver lining in this cloud. No med changes, 3 stim days to go, an E2 of 805, and a partridge in a pear tree.

I am waiting in my car for a meeting with some clients and have conveniently pirated someone's nearby unsecured wireless network. Multi-tasking now (and getting this blog done) will allow me to focus on all I really care about when this freaking day is over.... slipping into a pair of sweats and joining my kitties for a cat nap!

Sunday, March 22, 2009

A Bun in HIS oven

RE is on vacation this week, so the NP is wielding the magic wand at my second check yesterday. NP is nice but lacks the authority with the wand and struggles to find what we're all looking for. Super Doc is watching patiently and biting his tongue. I can tell he wants to jerk the wand out of her hand and do it himself. After cramming the probe up through my throat she sees 4 and 4 on each side (from 14.5 to 7, with 4 over 10) and a few more bringing up the rear. Super Doc is certain she missed a big follie right off the bat. So it's anybody's guess as to what I've got now, except things are still moving forward and my e2 is 541. Today I start the Ganirelix shots (remember I am sans Lupron and BCPS due to a total body shutdown on IVF#1). Tomorrow NP will poke around a little more and I'm still T -3 days and counting until trigger. RE will not be present for the planned retrieval Friday, so this could get really interesting.

Meanwhile I'm recently slammed at work and am trying to navigate my week, clients & friends who know nothing, and Mr. W who has grandiose ideas about all of the things we need to do before Friday (and next weekend if I'm "up for it."). Stress shuts me down, so I prefer to nap it off. Stress has the opposite affect on Mr. W so he decides to start building a pizza oven in our backyard. (I think there is some weird female-envy induced symbolism here....or not.) In any case, Mr. W has made serious progress on the oven and has even documented construction with the video camera. I soon realize the oven project has impeccable timing for Mr. W, who will be banished to the caves of celibacy for the remainder of the week and now has an acceptable diversion!

Thursday, March 19, 2009

Today Is Today

I am happy to finally be current on my blog dates. Today is really March 19th and I am 4 days into my new stim cycle. Already things feel different. I still have great headaches and hot flashes but I'm also starting to see signs of the sta-puff marshmallow man. The wedding rings are off and I have a little bloating around one calf. Oh, and I'm starving. All the time.

I am also noticeably more "checked out". Focusing on anything is virtually impossible, especially things like work and oh..... driving. Yesterday I managed to blow past a school bus stopped with its red lights on and when I realized what I did, I only half cared. Fortunately, I'm able to work from my home office quite a bit. However, this morning the headache that started at 4 am was still beating me in the face when I tried to get up, so I stayed in bed with my laptop and phone, pretending to talk to clients while simultaneously contemplating my navel.

The kinda cool thing is, I got so involved in reading some other blogs that I almost missed my first u/s and e2 check this morning! Fortunately RE was running a bit late, so my tardiness wasn't noticed.

The good news is my e2 is 272 and I've got one side going to town with follies at 8,9,10, & 12. The other side is a little slower, but still has opportunity. RE is happy with these results and wants me back in 2 days. If all goes as planned, I will trigger on the 25th and retrieve on the 27th. I am cautiously optimistic, but a little concerned about the bloating this early on.

Wednesday, March 18, 2009

Always Bet on the Yo

To my amazement (or not), AF visits early.....the third time in 6 weeks to be exact, and I have beat feet into the clinic this morning for the suppression check.....or normalcy check....or whatever it is this time. (It's Monday the 16th of March......yeah, I'm a bloggin fool now and almost caught up to myself.)

RE appears in the room with a puzzled look on his face. (Nothing new there.....) I just saw you, he says. Yeah...... You're early. Yeah...... Silence. Puzzlement. More silence. Chart flipping. Puzzlement. (....Let me help you out.....I'm here for the magic wand.....I need a count and some sizes, and maybe a side of BW with an e2?) When did you want to start, he says? ......Well golly gee......how about next year?!?!? Uh...today? Tomorrow? What do you think? (Is he seriously asking me this???)

Well let's see what we've got, he says. I am watching the u/s as he counts. There are 6 follies on the left and 5 on the right. They all look much happier to me than they did during my first cycle. They actually look like they might be awake, or ready to wake up! OK, he says. Do you have a calendar? Yes.... Do you have your meds? Yes....(I'm raiding your sample closet on the way out the door). Ok, start the stim shots today, as in now, he says. Conveniently my e2 is 43, naturally double what I was on stim day 4 last time. The nurse appears with a GWP shot of Menopur on the spot. Nice!

At home that night I tell Mr. W there are 11 follies! Eleven....? he says a little giddy. Eleven, I say with a silly "knowing" smile. (Mr. W's favorite bet at the craps table is 11. ) And so I wait for his punchline ...Always bet on the "yo"..... he says!

Friday the 13th, Part 2

It's like the movie Groundhog Day, where Bill Murray wakes up every day and it's February 2nd over and over again, except I'm waking up on Friday the 13th, (only this time it's March) and I'm off to see the wizard again....the one with the magic wand. Just one Friday the 13th ago my IVF #1 was canceled. This time I get another mock transfer (yep, the third). Mr. W has his boxing gloves on when we enter the ring with RE this time. (I begged Mr. W to use restraint....remember RE will have foreign objects crammed in my hoo-hoo....?)

RE is pleasantly surprised. This mock was easy (oh really....? I had no idea.....) and I am good to go for the next cycle. No suppression this time, just a plain ganirelix protocol with Menopur and Follistim. I'm to high-tail it into the clinic the next time AF visits for a u/s. RE is unusally cheery today and has made extensive small talk with Super Doc about his practice. Warm and fuzzy have appeared for the first time in this place.

Apparently HIPAA lives here now too. RE's nurse invites us back to a conference room to discuss my next cycle in private. (Hmmm...guess we've outgrown the chair next to the check out line.) She reviews the protocol and drugs and asks about my supplies. Since I had to toss the leftover Follistim juice and I took a Menopur the morning of my last cancel, I'm going to need refills if this gig goes anywhere. She offers some clinic samples (they have samples of this stuff?????) to get me started when I'm cleared after the next u/s.

Mr. W and I are once again speechless. Walking out to the car he says....Wow, we visited a totally different clinic today. I agree, but I'm not totally sold. He is suspicious Top Doc's office may have called and had a chat and now there is threat of another rooster in the hen house. I rather doubt that......I just think tomorrow will be Saturday the 14th.

The Politics of IVF

Crazy as it sounds, I feel like I'm actually responding to the drugs I quit taking a few weeks ago. I am swelling up like a balloon, my clothes are tight, I can't get my wedding rings on, and I have gained 10 pounds in less than a week. RE's nurse is hounding me on the phone to get in ASAP for another mock transfer. I'm working on some schedule changes, I say (true).... can you fax me a copy of the proposed calendar? (Our conference call with Top Doc is in a few hours and I want to have the protocol in front of me.)

The conference call reveals that both clinics (with slight variations and timing changes) have come up with virtually the same protocol so Mr. W and I are left to make a decision. All protocols considered equal, staying in town and avoiding additional travel expenses seems most logical. However, Mr. W is still waiving his wallet around on a soap box as a matter of principle. Think how much better and more comfortable you felt at Top Doc's clinic, he says. He's right. But think how much stress the additional travel could add, I respond. (I'm right, he admits.) I remind him this is not about political agendas and we need to do what's best for the big picture. We agree to do one more cycle in town. I phone RE's nurse back. I can't believe I'm having another mock transfer.

Top Doc

It is March 4th now. Mr. W had semi-surprised me with a 10-day road trip to my favorite place on earth. I am only semi-surprised because I made the call to see Top Doc in the clinic 600 miles away and my appointment is this day. I am surprised because Mr. W turned this one day appointment I was planning on catching a plane for, into this fabulous 10-day event (that started February 26th) and my favorite place on earth is a mere 50 miles from Top Doc's clinic.

This is a fact-finding mission, or at least an inquiry to a second opinion. Top Doc's clinic is in one of the greatest cities in the world. Mr. W and I lived there for three years and arriving in her office is a bit like coming home. I am calm and comfortable, although the office is swanky and hip. Despite the fact that Top Doc is running almost an hour behind, I am enjoying one of the best views I've ever seen from the sofa in the waiting lounge. The staff is gracious. The place is quiet and there is ample privacy. We are not sitting on top of others and it's actually possible to check in and pay your bill without announcing to everyone else what baggage you bring to IF.

I have booked a one-hour consult with Top Doc and have sent our charts and tests ahead of time. Mr. W and I step into her office. She is bright, warm, and prepared. She is flattered that I have found her article online and thinks they can help. She also knows my RE and thinks he has an equal chance at success. Mr. W instantly likes her professionalism and candor. It helps that she is giving Super Doc some ego hits along the way too.

She reviews some protocol options but says she would like to do an u/s. I have explained the difficulty in the mock transfer, the laminaria, and the suspect hyper suppression and she is perplexed by it all. Her u/s reveals I am already PO again despite having just seen AF after my canceled cycle 19 days ago. Blood work confirms this and my progresterone is 5.2. She offers to do a mock transfer while I am there. Sure.... let everyone try at this point. She explains she has not done a laminaria in 10 years, and her preference is to dilate the cervix on retrieval day (if necessary) while under anesthetic. I am liking this alternative to special seaweed a whole lot better, but just then Top Doc announces she is done with the mock. There is no problem. She would like to review my case with her colleagues and phone conference with us the following week for options, which we think is fine.

Coincidentally, RE's nurse is leaving me a voicemail at the same time I am having the appointment with Top Doc. They have a new protocol & calendar ready and would like me to come in ASAP for another mock transfer. Uhm.......yeah, ok. As soon as I get back in town and decide what I'm doing.

In the car on the way back to my favorite place, Mr. W is optimistic and says we should seriously consider moving this show to Top Doc's clinic. I suggest we take a more analytical approach and let each clinic present their own protocol and then we will make a decision. Mr. W agrees to temporarily cast his pocketbook vote aside.

In Memory

February 22nd was my original scheduled embryo transfer day. Of course, I had nothing to transfer, so it was just another day, a Sunday. But it was also my late Grandmother's birthday. I had so wanted to honor her with this special event that would have coincidentally occurred on her birthday. But it was not meant to be. Instead, I bought 2 bouquets of flowers. One for her, and one for me. They smell wonderful and look beautiful in the kitchen (the heart of our house). They make me smile and cry at the same time. I was not prepared for how hard this would be.

D Day (D is for Decision)

It's Friday the 13th (of February, I promise I'm catching up) and RE has asked if I think anything is going on inside of me? Well gee whiz doc....you've got the magic wand, let's find out! (Truth is, I'm pretty sure the lights are out.) And sure enough, they are. I've got one follie at 9, maybe one at 7, and the rest (maybe 10 or so) hit the snooze button. I also have an e2 of 107 and I'm at stim day 8.

RE huffs a big sigh and sifts through my chart. And then he says......wait for it......Are you sure you're taking the meds? I thought Mr. W, who has never hit another human being in his life, was going to lunge over the table & u/s machine and stab the RE with the magic wand! I'm thinking, RE can't be serious but then he says, it looks like I haven't taken a single drug and am having a natural cycle. I must be overly suppressed from the BCPS and the Lupron. Duh.......like shut down completely. RE advises we cancel, there is no point in using the remaining drugs or going through the process for possibly one follie.

Ok, fine. I can't say I was surprised by this, but it still f -ing hurts. The nurse says at least I'll have some meds left over. Ok, yeah, and can I take the remaining stuff out of the Follistim pen vials with a regular needle and use that too? Sure, she says.......oh, but it will be expired before your next cycle start date if you've punctured the vials already with the pen. You'll have to throw them out. WTF? Uh, who missed passing that memo on? I have 7 punctured vials with juice left that I am to toss? Everyone vacates the room. Mr. W and I stand there looking at each other speechless. Make the call, he says.


Determined to learn everything I could in ten minutes following RE's spectacular news, I googled IVF poor responders and came up with an interesting article published by a Top Doc from a clinic out of my area. The article listed several alternative protocols for poor stim responders. I also learned (ignorant me) that clinics such as mine, with high success rates, will often cancel cycles to avoid lowering their statistics. I was intrigued by the info and passed it along to Mr. W for review, who agreed it was interesting. Although Top Doc's clinic was 600 miles away, it's an easy flight (or day's drive) and presented an alternative option or at least a second opinion if Friday the 13th proved catastrophic to this cycle.

Mr. W, frequently in control of his emotions, has now taken a business approach to this process and wants to vote with his pocketbook. He has grown disgusted with the cattle call (my clinic claims to do 40 IVF transfer per month, and yes, we are stacked and racked frequently in the waiting room, at the blood draw, and at checkout) and wants to take his cash somewhere else.

Tuesday, March 17, 2009

I'm Not an Idiot, I'm Just Asleep!

So far I am a happy camper. Aside from some wacko headaches, hot flashes, and super night sweats, I am feeling pretty great 4 days into the stim shots (cd6). Uh....and apparently that would be the problem. Judging from the rest of ya, I should be pissy, miserable, and complaining about pants that don't fit. Unfortunately, on my first post-stim u/s, RE confirms this. Lights are on, but no body's home. I've got an undetermined number (because they're so fricking small) of follies and a whopping 21 on the e2-Richter scale. I had better results on my natural cylce with only clomiphene for IUI. And clearly, I'm far more pissy on my natural cycle than I am with these injections.

RE explains that it's possible I'm just a late stimmer and need a few more days to kick it up a notch, but by Friday the 13th (nice, and yeah that's still February) we better have a move on. RE is puzzled, looking through my chart, and can't find a reason why I wouldn't respond. Are you giving the shots right?.....he asks. I can have the nurse review it with you......did you watch the video?

For starters, I AM NOT AN IDIOT. Yes, I watched the video, and I DO know how to give shots. Needles don't bother me, nor do they hurt. I have administered insulin to Mr. W (as well as emergency glucagon kits) frequently for the past 20 years. And although my degree is NOT in medicine, Mr. W's is!! So I happen to believe I have adequate supervision, in case I truly am a moron. RE advises us to give it three more days and then be prepared to make a decision. Mr. W is bordering on obscene again, and appears done with what he thinks has become a three-ring circus in our clinic.

For my part, I am angry and depressed, but delve into the internet searching for answers upon our return home. I am not optimistic and contemplate opening all the vials and pouring them down the toilet, to get the same results (nothing). Mr. W. with his unusual sense of humor, says I should look at it like this......we could have taken the $3500 we spent on the drugs to Vegas and put it on black and come up with nothing too. Yeah, but it might have been more fun.

Monday, March 16, 2009


It's the morning of cd1 for the beginning of a Lupron Flare protocol. (Remember, I am a slacker and this is really 2/4/09). The BC pills and doxycycline have ended. Here is what my first 2 days looked like:

Lupron microdose injections 20 units - am/pm
Dexamethasone - pm
Aspirin 81mg

Cd3 I add to above:
150 units of Menopur injection - am
300 IU of Follistim injection - pm

I organized everything into plastic bins (each drug with its respective needle) with printed labels, taped my calendar & checklist to the counter, and lined up all the bottles.

As I stared at the assortment, neatly displayed on the wet bar in my bedroom with the Follistim and Lupron snug in the Sub-Z underneath, it occurred to me how grateful I am to have this opportunity. We have good insurance, but it doesn't cover any of the medications or treatment. I have shelled out close to $15,000 in the past couple of weeks alone for this one chance. I feel fortunate Mr. Wonderful is willing and able to provide for this chance. I am grateful that Mr. W is by my side. And I am thankful that if this doesn't work out, I will still have my best friend to share my life with. And then, an amazing sense of calm swelled inside of me and I took the first shot.

Just Tell Me Already

It is T-1 and counting to cd1 and I'm waiting for the phone to ring. The BP was on the upper end of normal for the morning. I can't imagine why, it's not that I'm a stress ball or anything. I wait patiently all morning for the green light. Finally, in the afternoon, I phone the nurse with the magic BP cuff and ask for an update. No word yet, RE had not had a chance to review. In my polite-but-irritated voice I explain that I live an hour from the pharmacy and need to get there TODAY (like now) before they close if I am to start this gig tomorrow like the calendar says! Of course, and they will have an answer shortly. And, miraculously....they do.....and I am off to the pharmacy to collect the new toys.


It's February 2nd (yes, I'm still behind on my blogs) and I am T -2 days from cd-1 with a Laminaria in tow. I have not gone to the pharmacy to pick up my meds as was the plan for this day. Instead, I manage to drive myself home in complete hysteria.

For the past three months, I have weaned myself off caffeine and chocolate. I have reduced my red meat intake and increased the number of encounters with my treadmill. I've tried to sleep better, eat better, avoid toxins, fumes, sick people, and anything else I can think of. I have even (gasp) eliminated wine consumption - not an easy task with a 4000 bottle wine cellar and a fledgling new wine business on the back burner.

And despite following all of the rules, my first IVF cycle is "on hold" because of post-laminaria blood pressure. Are they kidding? I am angry and near devastation. I arrived home sobbing and in pain and the best I can do is take a painkiller and go to bed. The nurse instructs me to have my blood pressure taken elsewhere in the morning and Mr. W (aka Super Doc) cannot be the taker. RE will make a decision after that. I get moderate relief in the fact that I have not picked up the $3500 worth of drugs.

Special Seaweed

Had I known what the hell a Laminaria really was, I would have had a few cocktails with some oxycodone ahead of time and called a cab. Apparently I missed the memo and showed up pre-cd1 for IVF #1 thinking I was getting a sushi roll with a side of miso soup. Instead, after doing the baseline u/s, RE tried injecting my cervix with 3 "numbing" shots which amounted to holy hell in a hand basket, followed by the insertion (more like cramming) of a seaweed stick the size of Texas into it. The instructions were to remove it later that evening before I went to bed......uh yeah, if I could walk myself to the car and drive my 30 miles home first.

As I lie on the table, grasping for any part of it I can, sweating profusely from the pain, it occurs to one of the nurses that she should take my blood pressure. I think she is joking but she insists I should meet her in the hall as soon as I'm ready (which at this point is like never).

This is where it gets really good. My clinic has been under remodel construction for the past 2 months - basically since I started the pre-IVF testing. There has been carnage everywhere....charts, patients, office equipment, not to mention construction workers, boxes, and a total lack of privacy. I have tolerated this (though not very well) and Mr. W. (a super doc himself) has been borderline obscene about the chaos. After this special seaweed treatment I am invited to sit at the blood pressure cuff chair in the middle of the hallway with my shirt hanging off while the nurse gets vitals and boy does she get 'em! I am 170/110 post seaweed experiment, followed by 140/100 while Joe the plumber and the rest of the building pass by. My BP is suddenly cause for alarm and now there is discussion of cancelling my whole cycle. I am speechless. The nurse wants to get a blood draw and send me home to wait for a phone call pending the RE's review of my BP.........what......? And could you make your $10,000 deposit on your way out?

Sunday, March 15, 2009

Three Big Letters

Hearing the letters IVF was like having the scarlet letter A stamped on my forehead. A branding, a forever labeling of inadequacy. I couldn't believe it was happening and I had no idea what to do next. So I avoided it, and conveniently Mr. Wonderful did too. For almost two more years. There were a million excuses why we "needed" to wait. We were in the middle of 16 projects, we had extensive travel plans, there was a pending court date for another matter, it was sunny, it was raining. Truth is, I was scared and in denial and feeling like I/we were tampering with things not meant to be. I was on the verge of giving up and ignoring it permanently until one day last fall Mr. Wonderful announced he had picked up the phone and made the appointment for an IVF consultation. Timing would never get better, he said. We would always need to change our lifestyle, cancel a vacation, or otherwise, and there was no better time than present. I was stunned, but relieved. And mortified all over again.

At the consult, our RE advised us we'd better get a move on and produced a list of pre-IVF testing requirements. We needed all kinds of blood work, another Clomiphene challenge test (because my previous one was too old), and another semen analysis for Mr. W. I'd also get to have an HSG (hysterosalpingogram) - a really special experience where a radiologist injected dye into my uterus while I rolled around on a table and a special camera took photos of the dye travelling through the fallopian tubes, into the ovaries, and out the abdominal cavity. I also learned that blood flowing through the uterus makes sounds which I got to hear on a Doppler Ultrasound - kind of like watching a weather forecast for storms, but not so much. For his part, Mr. Wonderful got away with a mere genetic karyotype blood test and a coke and a smile.

After six weeks of poking and prodding, my final test was a mock embryo transfer. A special type of catheter is used to transfer the embryos into the uterus and my RE wanted to be sure it would fit effortlessly through my cervix when the time came. Unfortunately I am one of ten percent of women who have a cervix wound tighter than a clock. (Mr. W would say it's just because I'm always uptight.) RE said I would need to come back for a Laminaria before the IVF cycle started.

Tuesday, March 10, 2009

So here's the deal

I'm not one to lay my open book on the table. Truth is, I'm a private kinda person, who likes to keep personal decisions away from public comment, judgement, or interpretation. I'm not really sure why, but that's the way it is.

So why am I plastering this info on the Internet? For starters, I'm going to reach a point where I'm tired of talking about it and this way you can fill yourself in. I've also found that going through this process surrounded by people who don't understand, don't know, (and possibly don't care) is painful and frustrating. Desperate for information and down-home truths, I turned to the Internet and the blogs of others for support. I'm hopeful someone else in need of this support will read mine too. I'm starting this mid-process, so I've got some catching up to do but will try to keep it short.

I'm 38, nearing my 17th year of marriage to a wonderful guy with his share of faults, least of which is the fact that his "boys" don't swim. We have been TTC for 6 years. At first, it seemed like no big deal. But one morning nearly 2 years or so into the process it dawned on us, that something was strange. (Really, a brick should have hit us in the head). But life just kept happening and we couldn't get a grip on how this would all fit in. After some personal mis-steps and a thorough review of our priorities, we decided to get some answers.

Mr. Wonderful (now 41) who has had Type I diabetes for over 20 years, acknowledged that he thought he had a varicocele but hadn't done anything about it. (Look this one up on the Internet boys and girls, I'm not going to explain it.) A consult with a urologist confirmed this and a surgery was scheduled to attempt correction, after which we were advised to look for an improvement in the "boys" within 6 months. To no avail, low and slow was still the norm.

After further research we opted to consult with a reproductive endocrinologist (RE). This is a doctor who has (usually) completed residencies in both OB/GYN and Endocrinology, as well as a fellowship in reproductive endocrinology. Further tests confirmed that Mr. Wonderful's boys were having a hard time playing the game, though there appeared to be no obvious issues with me, other than my age (36 at the time). The RE suggested a few rounds of IUI.

I thought cutting back on work would be a good idea to minimize stress and improve our chances of conception during IUI, so I took it easy for awhile. I scaled down my work, we quit travelling, and instead spent every waking minute dwelling on what was going on inside my body. IUI amounted to a round of Clomiphene Citrate to stimulate the ovaries and a turkey baster to inject the boys into the uterus where they'd have a better chance of hooking up with an egg. (OK, it wasn't a turkey baster, it was a small flexible catheter inserted through the cervix.)

Four rounds (months) of IUI later, I was exhausted by the side effects of the Clomiphene and the stress of it not working so we stopped. The RE had advised us that additional attempts would be a waste of money at that point and IVF was our only option.