Wednesday, June 30, 2010

An Education

Thank god for required classes!  I will be the first to admit I thought the notion of "IVF Class" was both ridiculous and boring and I am happy to report that I was completely wrong.  Our program requires two classes, IVF 1 & 2.  Each class is available only once a month, and due to some scheduling issues we are taking our classes backwards.  IVF Class 2 was the Injection Class, and as it turned out, it couldn't have come at a better time.

The first and most important thing we learned in class is that WE DON'T HAVE TO USE THE 18 GAUGE NEEDLES!  I typed that all in caps because the moment I found that out I wanted to shout it from the rooftops.  When we got our meds the 18 gauge came included with the intramuscular shots and they were pretty much terrifying to both Brady and I.  We have done two subcontaneous (in the belly) shots before but those use little tiny insulin needles, the big needles were seriously frightening.  In class we learned those are for drawing the injection only, then we switch to a 21 gauge for the actual intramuscular shot itself.  I was so relieved I almost cried.

The second thing we learned in class was really more of a dissapointment.  We were kind of excited at the prospect of meeting people like us!  That is people going through IVF, and maybe even make some friends that we could go through the process with.  Unfortunately that wasn't the case.  Most of the couples were older and very serious.  I know that it's a class and that the subject matter is a little intense, but seriously, I think we were the only ones who smiled or laughed at all.  I know it's a hard process, I am going through it too, but if I can't laugh about it sometimes I think I'll go crazy and these people? They were not the laughing kind.  Hopefully we will meet some more lighthearted folks in the next class.


We also learned that we are starting to get a grip on this stuff, that it isn't as scary as we thought and that we are actually going to rock this shit.  I'm no genius but I think that means we get an A+ for our first class.

Tuesday, June 22, 2010

3...2....1...disco

So technically our ride on the IVF roller coaster began weeks ago, with the onset of the testing to move forward, but after this weeks trip to the pharmacy it actually feels real.  We knew it was coming, we had read the information and power point presentations and heard the stories from friends and even family members who have gone through IVF, but nothing really prepared me for the drugs.

I will start by saying that I am already taking birth control, I know right? Birth control to get pregnant?  The pharmacist that handed them over to Brady was confused too (normal pharmacy).  I am in the initial drug phase of the process, this is the supression stage.  The idea here is to stop my body from functioning in it's normal hormonal capacity so that the Magic Man and his assistants can call the shots from here on out.  But so far this is the only drug I've had to take for this process.

So the docs originally fax my drug order to some mail order pharmacy, I have no idea why this is the norm for this kind of stuff.  There is one local pharmacy whose niche is fertility drugs, thankfully it is both close to my office and my the Magic Man's office.  I call ahead to make sure my order is ready and I head up on my lunch break to pick up the goods.  Now I've seen the drug order, I've familiarized myself with where they fit on my IVF calendar so I know there are several.  I know there are needles and pills, vials and swabs but nothing prepares me for the moment when the pharmacist steps forth with a SHOPPING BAG full of stuff. 

 I stare in disbelief and try to catch my breath and make sense of what the pharmacist is telling me.  There are inections with two parts, injections that need to be refriderated and there are even injections that have a special 007 type pen with it's own carrying case. There are so many boxes and colors and labels spread out before me its insane.  For some reason what I focus on are the needles, oh my god the needles.  I am not actually scared of needles, quite the contrary, I have given blood and am friendly with my phlebotomist but the sheer volume of them has me starting to breathe funny.  It cannot be possible that I will need this many needles, clearly this is wasteful and meant as an intimidation tactic. The pharmacist senses my complete loss of rational thought.  She stops for a second, she asks if I am ok, clearly this isn't her first rodeo. We start again and I try to take mental notes.  It's impossible to keep it all straight without lists, I tell myself as soon as I get home with my stash of drugs I am making lists. I will pile them on the coffee table and organize them and it will all make sense.  I leave the pharmacy feeling dazed and head back to the office where I start looking through the littany of info sheets full of reactions and side affects, I decide maybe I don't want to know all this stuff  after all, I will leave this for Brady to read.

Brady is an engineer, he likes to understand things, he likes to examine and read and make sense of things that I grow frustrated with in a moments time.  He is big and strong and he also doesn't like needles.  I arrive home and he is waiting to examine my cache of drugs.  I empty the bag out and he is blown away.  He cannot beleive the variety and ammount of stuff.  He starts sorting through things, we match up what we have with what is on the order and pull out our calendar to see what drugs we inject when.  We come across the 18 gauge needles.  Brady has to sit down.  He is breathing fast and looking pale.  The needles we have used thus far have not been this big.  Brady is wondering if he can in fact, give me these injections.  The big needles are for the intramuscular shots that I cannot give myself.  I am wondering in my head who both loves me and gets annoyed with me enough to be willing to give me this massive shot every day if Brady cannot.  Brady assures me that he can do it.  I am thinking of how I can make it easier for him and then I remember, it's me getting the shot. 

Thankfully we have a week before we start the shots, and before we do we have our first class, we are hoping we will learn that we can do this.  We are hoping that it isn't really as intimidating as we think and that it is actually easier than it looks, because right now all we see is a big pile of scary.

Thursday, June 17, 2010

Who Me? Blog?

Ok so I'll be honest, I never saw myself as someone to have a blog, I enjoy reading the intimate life details of others but consider myself a somewhat private person. Around those I love and whom I am lucky enough to have love me, I am not known for being private (something quite opposite), but to the general population I try to keep as much of my life my own as possible.

That being said, a woman I both admire and respect sugessted a blog as a way to document, vent, and reflect on the new journey that Brady and I begin today, our venture into IVF. For those of you not versed in medical terms that stands for In Vitro Fertilization. I'm not gonna lie, this blog will more than likely push the boundaries of TMI, because let's face it, the details of reproduction, In Vitro or otherwise generally will be.

We started our foray into the wonderful world of medical reproduction almost two years ago. The short version goes something like this:
We get married (yay) we decide after a year to try to have a baby (easy right?) after 6 months we see my regular OBGYN (we'll call her McAwesome) she runs a littany of super fun tests (catheters and blood tests are fun right?). The tests come back normal so she thinks we might just need a little help (pharmacutical help that is), three months of crazy pills and a trip to Maui later and we are prego (again yay!). We are thrilled, assume nothing can go wrong and proceede with life filled with glee and joy. At 8 weeks we see and hear the heartbeat of baby Herder, we are now more than cautiously optimistic, we believe we are out of the woods and are elated beyond words, we post ultasound pictures on the fridge. We clear out a room for the baby, we accept gifts from excited soon to be grandmas and buy books to prepare us for the joys of parenthood. Around week 10 I begin to spot slightly, McAwesome assures us this is normal, I am advised to rest up, lay low and do nothing strenuous (day at home on the couch yo) things clear up and we brush it off, we schedule early fetal testing and start considering baby names. At 11 weeks and 4 days, just three shy of the magical "safe" second trimester phase I begin spotting again, this time more seriously. I call McAwesome, she is concerned and we schedule an apt for the following day for an ultrasound to check on the baby. Brady is a rock, he is strong and kind and attempts to assuage my debilitating fear that something is wrong. I don't know what to do, so I cry (and I am so not a crier) I lay in bed and watch law and order with my feet up, and I even pray. The next morning (and throughout the night) the spotting has gotten worse, we go see the ultrasound tech and hear the wost news of my thus far sheltered and relatively blissful life, "I'm so sorry". We stare at the ultrasound screen in disbelief. There was a heartbeat there a mere three weeks ago (165 bpm no less). McAwesome comes in and lives up to her name. We are told that growth has stopped somewhere around 10 weeks and given our options. We schedule surgery for the next morning, we go home with prescription painkillers in hand, because now my uterus is contracting in an effort to rid my body of the baby. I go home, I take the pills more for the emotional pain than the physical, I crawl in bed and cry uncontrollably. I speak with my mother and then my sister and ask her to spare me the agony of telling loved ones. Brady is sweet and sad, making sure I have my medications and attempts to fill his time with distractions. The following morning we report to the hospital, the nurses are nice, the pain is growing increasingly strong, they give me drugs, I am nauseaus, I am cold, I am ready for this part to be over. McAwesome meets me in surgery and I see Brady again in Post-Op. He looks sad, and I feel groggy. We clean me up and head home. My amazing mom and wonderful sister arrive an hour later bearing Vodka (for brady) Champange (for us girls) and chocolate covered strawberries. We are not celebrating, we are trying to keep my mind off my now empty womb. They lay on the bed with me and we watch Almost Famous. Brady and his father are downstairs, drinking marinis and watching golf. We order pizza, we ladies lay on my bed and eat pizza and strawberries and drink champange and cry. Eventually everyone leaves and I am again reminded of what has transpired and I begin receiving Happy Birthday texts on my phone, tomorrow is my 33rd Birthday.

I see McAwesome again in two weeks, my levels have returned to normal and I am relived. We are advised to wait two months before we begin trying again and it is agony. Month three arrives are we are excited, we start back on the crazy pills and schedule our sex life. A month goes by with no success, the start of my cycle is like a knife to the chest, but we don't lose hope. The following month we up the dosage on the crazy pills (brady is tolerant beyond belief and I chop my hair off) and again, no success. McAwesome sugessts that perhaps it's time to take the next step. We make an appointment at Oregon Reproductive Medicine, the inital consultation is $350, paid up front and there is a severe cancelation fee. We are nervous and excited, as though the consultation alone will get us pregnant. We go in for our apt, they take some blood and my vitals, my pulse is over 90, Brady thinks this is unusual, it is, I am nervous. We meet our doc, he is nice. I am not sure what I expected, he draws alot when talking, making notes that we can't read and sketches lopsided graphs. Basically he tells us that women in their 30's, while not old, are not in prime childbearing years (so much for waiting until I was ready), we discuss a plan of attack, we acknowlege the insane costs, we decide three rounds of IUI with IVF testing in the third round. I leave the apt with a sense of purpose and dread, I cry on my way home, I am attempting to accept that this is what it is going to take for us to have a child.

Our first cycle of IUI (Intra Uterine Insemination) requires a basline ultrasound (guys skip the next line) for you ladies, that means an intravaginal ultrasound on day one of my period. This is not fun. They look at my ovaries and check on the status of any follicles, I start the crazy pills on day three of my cycle. I see the Magic Man (thats what I call him now) again for a mid cycle ultrasound to check the status of my follicles, unfortunately I have over-responded to the drugs. If we move forward with IUI this cycle I could potentially have 7 babies, the magic mans states that it would be "medically irresponsible of us" to proceede this cycle. I cry in his office, he seems suprised by this (really doc?). The next cycle starts another round, more ultrasounds and this time things look good, Brady has to go to the office on Insemination day 2 hours ahead of me. He is shown a sterile room with the sports illustrated swimsuit issue and an outdated playboy and handed a cup, you can use your imagination (he had to) for the rest. We go in for insemination, the nurse brings in Brady's sample (25 million little swimmers) and the doc goes in with his catheter while the nurse lights the way with the ultrasound wand on my stomach. They place Brady's sperm up near the entrance to the fallopian tubes, hoping that they will make it the rest of the way on their own. It takes a while (damn tilted cervix) and is mildly uncomfortable. We wait 10 min post procedure in the office then I go home and lay low (another day on the couch yo). 11 days later I go in for a beta blood test (basically an early and expensive prenancy test) I go back to my office and wait anxiously. 25 million sperm and I only needed one! It had to work! I get the call, the nurse is nice but I can tell right away the news isn't what I hoped for, I can't speak, I squeak into the phone and she interprets, this is clearly not her first time at this. Friends at the office in the know see me, they can tell by the look on my face, I escape to the ladies room where I rant and dry my eyes with rough paper towels. A kind co-worker takes pity and covers me for the day, I head home to a bottle of whiskey and some Bob Dylan. Cycle two starts the same, and unfortunately ends the same, although this time I am more prepared. I am functioning on the assumption that the IUI will not take, we move forward with IVF testing. We sign documents saying we understand the next step, we sign up for classes (hopefully no homework?) and get the rundown on all the drugs (no wonder the pharmacutical companies are rich) and we wait. Today at 1:37 I got the call that our second IUI has been unsuccessful. I pull out the IVF folder, I try to make sense of the calendar of appointments and drugs and I get dizzy. I sit down and pour a glass of wine. I am glad there is a plan B, but right now I am confused and frustrated and a little scared. We know we want this, we know we are meant for this, we aren't sure why it's this hard (or expensive) but we know that it will happen, one way or the other. We are ready for round two.