Friday, July 30, 2010

All Our Eggs in One Basket

Pre -Frog and egg retrieval we thought that was just what we were going to have to do.  The slow way my follicles were growing was getting us kind of down on how many eggs we might get and thinking best case scenario would be that we would have maybe only one or two eggs to implant with none to freeze.  We had prepared ourselves for a one shot deal in regards to this whole cycle and were already trying to figure out how to pay for another.  But after Thursday's egg retrieval things are looking up, in fact after this morning's call from the Embryologist I think I might need more baskets.

Tuesday night at exactly 10:15 per the Magic Man's specific instructions, Brady triggered my ovulation with an intramuscular HCG shot.  The reason for this is that the eggs kind of attach themselves to the inside of the ovaries and only release when ready to ovulate, so the docs have to trigger this so they can actually go in and get them, but it's kind of a narrow window.  Too early and they won't be able to grab them, too late and we lose them to my body.  There is a whole part of the power point presentation in class 1 about this and our instructions list our time for the shot with a disclaimer at the bottom stating any deviance from this schedule could jeopardize the success of our procedure. This was our first intramuscular shot and earlier in the day we had gone over it with the RN at the clinic, she even helpfully drew nice round targets on my upper hips with a sharpie so Brady would know exactly where to inject (they are still there two days later I might add).  This shot was similar to the Menapour in that you have to inject a diluent into the vial with the powdered medicine and mix it before injecting it, unlike the Menapour this med didn't dissolve as quickly.   Brady was nervous enough about this shot because of the larger needle, so he was trying to take his time and do it right but then the medicine took longer to dissolve and I am there at 10:12 with my face buried in a blanket leaning against the counter with my jammie pants pulled down to expose the target telling him to hurry up! We were going to be late! We were going to miss the window! We can't deviate from the schedule!!!  Finally with the shot ready (and his annoyance with me at an all time high) he went in at the perfect 90 degree angle and drew back on the plunger (to make sure he didn't hit a vein) and administered the dose.  It didn't hurt as badly as I had anticipated, I was glad for this and we headed to bed where we once again repeated our frog routine and hoped for the best.  Wednesday I am told to lay low and relax, this is normally quite difficult for me, but the fact that we have no injections today helps immensely.

Fast forward to Thursday morning, we head into the clinic bright and early, which is good because due to the anesthesia I cannot eat or drink anything, even water.  We are a little nervous and excited and ready for this part to be done.  The literature states that I will be administered intravenous anesthesia, the good stuff they say so that I won't feel anything when they go in through my vaginal wall to retrieve the eggs.  We have a super cool nurse that assures me that not only will I be allowed to bring the frog with me into the egg retrieval room, but I can hold on to him the whole time.  I think this is pretty rad of her and we get a consensus amongst the nurses and the doctor going in for the eggs that whatever good energy we can get is good.  They wheel me in and take Brady away to "the sample room" and I remember talking about the frog and my blog and then that's it, nothing.  I wake up in recovery and am wickedly groggy.  I hear the doc come in and tell Brady we got eggs, that we actually got 9 eggs.  9 EGGS!  We knew after Tuesday's appointment we had 5 large follicles on the left and 2 on the right, we were thinking of a best case scenario of maybe 7 eggs, with not all of those being mature but 9? We were stoked and I remember thinking, finally something was going our way.  It took about an hour for me to fully wake up from the drugs, I really had to use the bathroom due to the large amounts of fluids the nurses had pumped into me via the IV and I asked if I could get up and hit the little girls room.  I was told no, I could not.  My blood pressure was super low and they were afraid I was going to faint but not to worry because they had a bed pan I could use.  Yeah, no thanks.  I opted to wait a few more minutes while they administered something through the IV to get my heart pumping faster to get the blood pressure up.  I was finally able to sit up and from there, I just wanted to go home.  I was given post-op instructions and Brady packed me up and took me home.  I immediately passed out on the couch and slept for about 3 hours.  I wasn't in any real pain, mostly just tired and groggy but still pretty stoked that we got 9 eggs.  Climbing into bed we praised the frog once again, convinced now more than ever that he is in fact our fertility good luck charm.

This morning I was eagerly awaiting the call from our embryologist to let us know how many of the 9 eggs were mature and had fertilized.  I was hoping for 6 and Brady had said he would be happy with 4.  We were both hoping for enough to make it to day 5 (transfer day) with at least 2 embryos to implant, and a bonus if we had one or two to freeze.  The call came around 9 and I was super nervous, my nervousness turned to elation when I heard that 8 of our 9 eggs had fertilized.  I was going between tears of joy and shouts of woo hoo and I think I probably scared the nice lady on the phone.  8 out of 9, that means that after 5 days (some will not make it past day 3) even if half our eggs don't make it we will still have 4. Two to implant and two to freeze and potentially more (or less but I am trying to think positive).  This means so many things for us.  It means that if our first implantation doesn't take (we know this is a possibility) that instead of starting all over from scratch with a whole new cycle we can hopefully do just the implantation part again with frozen embryos.  You know what that means? NO MORE SHOTS PEOPLE! Well ok, that isn't entirely true, I still have one shot a day and it's a doozie.  The progesterone shots start tomorrow and go all the way through the 10th week of pregnancy (if we are fortunate and the transfer works) and is a large intramuscular shot that takes an entire minute to administer.  I can totally handle this, it hurts allot the next day since it's in the muscle and I'll probably be limping around and whining like a wimp but one shot over three I will take any day.  It also means that my eggs and Brady's sperm like each other, in fact they like each other allot. I hope they fall in love and make a baby.

Wednesday, July 28, 2010

Superstition and The Frog

So I know I will probably induce the ridicule and skepticism of anyone reading this blog but I am going to let everyone in on a little secret.  My follicles are growing, in fact they are growing well and I give complete credit not to the vials of drugs I am injecting into my body on a daily basis but instead to a small painted ceramic frog and piece of rock. Our appointment last Saturday to check our stimulation progress was a little depressing, the doc on for the weekend (not MY doctor) left a little to be desired in his bedside manner (not to mention wardrobe choices, he wore socks with sandals, how can I trust a man who thinks this is ok?) and we left feeling like my follicles were never going to grow. That night I climbed into bed feeling down and frustrated and there, on my nightstand like a beacon in the night was the frog.

The frog came to us from my dads awesome girlfriend a couple of months ago.  She had recently traveled to Honduras and while there visited the Los Sapos (the frogs) ruins in Copan.  The ruins here have carvings on a small outcropping of rock of a large frog and one depicting a woman with her legs spread as though giving birth.  Studies suggest this area is where ancient copanecan women came to give birth to their offspring.  Apparently it's also a tourist spot because in addition to lovely views of the Copan valley they also have trinkets.  Small ceramic frogs to be more specific.  Knowing (as all our family does) about our stuggles to conceive she picked up one of these little guys in addition to a small stone from the ruin site itself.  I have no idea if this is bad mojo, the whole taking a piece of the ruin thing but it's a pretty small piece so I am going to go ahead and think it's ok.  She presented me with the frog and stone and assured me of it's potent fertility inducing powers and I'm not gonna lie here, I thought it a slightly crazy though tremendously kind gesture.  I put the frog on my nightstand with the stone in the little hole in its belly and kind of forgot about it.  Until Saturday night.  After the depressing doctors visit, I climbed into bed that night, took my litany of prescribed pills and laid down and looked over and saw the frog.  A light bulb went off.  I turned to my darling and very science and fact driven husband with the frog in hand and a come hither look.  I will let it be known that he thinks I am pretty crazy most of the time anyway, so he wasn't entirely shocked at the prospect of some frog time.  I put the frog on my puncture marked belly and looked up at him, I swear people I have the kindest and most tolerant husband ever.  He kind of moved the frog around on my belly and hopped it here and there along with the piece of stone to humor me and then we turned off the lights and went to sleep.  The next night I grabbed the frog after climbing in bed and he sighed and did the little belly hop routine again.  Fast forward to Monday's stimulation check, I was nervous and completely convinced that my little runt follicles hadn't grown and was preparing for the worst kind of news.  Low and behold, they were growing!  In fact, they had grown leaps and bounds and my hormone levels indicated that we might even get a couple more days worth of growth out of them before triggering ovulation.  I immediately called Brady and told him the good news, extolling the virtues of the frog.  Another appointment on Tuesday showed even better growth and we got the go ahead from the magic man to trigger last night for egg retrieval on Thursday.

Now I know there are probably a lot of reasons for my super fantastic follicle growth, the drugs, timing and all that stuff, but part of me really thinks it's the frog.  My ovaries are starting to look like big egg sacks and hopefully, come Thursday, that's the exactly the case.  In the meantime I am trying to figure out how to sneak the frog into the surgery room tomorrow because something tells me the magic man probably won't let him sit bed side, but he is part of the protocol now, bad paint job and all.

Saturday, July 24, 2010

Late Bloomers

At least that is what I am hoping my follicles are.  I have had two stimulation phase checkups in the last four days and I'm having a hard time staying upbeat.  My first check was Thursday of last week, I am at the point in the game where I am seeing the Magic Man every other day now for ultrasounds and blood draws to check on the status of my follicles and hormone levels.  Surprisingly enough my left ovary, the one that had the cyst, is the one responding best follicle wise.  Clearly it felt bad for the setback and is attempting to overcompensate, I have about four good sized follicles growing on that side.  My right side is my problem child at the moment, while I have an ok number of follicles in this ovary (about 5 or 6) they are not growing very well (around 6-8mm).  On Thursday's apt the magic man thought maybe we would be looking at egg retrieval on Wednesday of this week, but after today's apt it is looking like that probably won't be the case.  My left side follies are doing ok but still too small (around 12-15mm) for retrieval, the lead follicles need to be around 18-22mm for that to happen.  I left the office feeling a little down after this information this morning.  It just seems like we keep hitting these road blocks at every step, I know it doesn't mean the end for this cycle and that we are still hanging in there, but I was hoping for like, big huge follicles and maybe even a gold star on my chart or something. 

We have also reached the point where we have maxed out our insurance for the IVF.  We are incredibly fortunate to have had insurance cover any of the process, most don't and we are extremely thankful to have had the first 10k covered.  I have had to make my first trip to the pharmacy for refills on the meds sans insurance.  Our Follistim shot, which I get every night @ 300 IUs is $520 per vial, we get two shots per vial so that's $260 a shot, and that is only one of the three I get daily.  I am again reminded how lucky we are to even be able to go through this process and try to think of that every time I get sticker shock on a prescription or lab test.  We have some friends who have gone through IVF to have children and they joke that their cars are paid off but their kids aren't.  I have a whole new appreciation for this. 

This week also marked the first time I've broken down in tears because of the shots.  It's getting harder and harder to find spots on my tummy that aren't sore from previous shots and though Brady has now perfected his technique on the big ones I still cringe and close my eyes.  One night this week I was attempting to give myself the Lupron shot (small insulin needle) while Brady prepped the Follistim shot.  I have given myself a few shots, it's not terrible and I thought I kind of had it down, not this time.  My first attempt didn't go in, and my second (on a now duller needle) failed as well and all of a sudden I just lost it.  I know I am on the hormone roller coaster, I know that and yet I was still surprised that I was crying in frustration at my inability to get the damn shot to go in. It was more than just the physical part that got to me, it was the psychosomatic part as well, I was holding the needle and pinching my tummy and I was just thinking of how it was going to feel and I just couldn't bring myself to do it. I was annoyed at my hesitation and overall lack of resolve.  It's just a shot, a momentary little prick of pain and it's over, I've been repeating this mantra daily for weeks now and all of a sudden it just wasn't cutting it.  Brady had to eventually give me the shot and it hurt quite a bit more than usual, of course it could just be my inner 5 year old thinking that.  Speaking of my inner 5 year old, I've completely reverted to the days when I used to go to the doctor and look forward to the lollipop or treat post shot.  These days it's ice cream bars covered in chocolate and almonds that is my consolation prize.  Every night at 9 I lay down on the couch and cover my face with a blanket and try to hold still for the injections and when Brady is done he gives me a kiss on the forehead and brings me one.  It turns my frown upside down. 

Hopefully Monday's check-up brings some more positive news, in the meantime I'm going to give my ovaries nightly pep talks and maybe even promise them some ice cream when it's all over.

Wednesday, July 21, 2010

I Call Shenanigans

I've been duped.  Our first week of shots during the suppression stage of this process seriously had me thinking this wasn't so bad and that I wasn't going to feel like a human pincushion.  I was wrong.  We started the second round of drugs this week, the stimulation phase after we got the all clear from the post cyst blood tests.  This means instead of just one little shot in the evenings I now have one in the morning and two at night.  During the suppression stage I was taking oral birth control and 10 units of Lupron.  The Lupron is given in the evenings with this little tiny insulin needle, it's so small and easy I've even given them to myself.  I was starting to feel like a pro with this shot and even started to get a little cavalier about the upcoming injections.  My attitude changed drastically with my first Menopur shot Saturday morning.  Brady has to give me these shots because, well that is what we decided at the beginning, he was the one who was paying attention in class on both how to draw and administer all the injections and the Menopour is a little complicated. This shot includes two vials of medicine that needs to be mixed with diluent, because we need things to be more confusing.   Saturday morning arrives and Brady gets the shot ready, I have this thing where I don't like to look when getting shots (or blood draws) so I lay down and expose my tummy and put a pillow over my eyes.  I know, I'm a huge baby, I've accepted this fact and am ok with it.  Brady finds a good spot (this will become harder in the coming days due to injection site sensitivity) and goes in with the "dart like" motion he was trained to use and I kind of come unglued.  This is not a tiny little insulin needle, this is a whole new rodeo.  This is also more than 10 units, so in addition to a much larger needle, the shot takes much longer to administer.  I am tensing up and squeezing Brady's arm and whimpering.  I know this isn't helping Brady at all but I can't help it.  When the shot is done I sit up and look at Brady, he looks as miserable as my now punctured tummy feels.  We both feel relived that it's done and take a deep breath.  I look down and see that I'm bleeding.  This hasn't happened with any other injections thus far and I'm a little freaked out if this is a sign of things to come.  I put a compress on my injection site and have a cup of coffee, which happens to be another point of contention with this whole process (the doc wants me to have no more than one 8 oz cup per day) and try to enjoy the fact that I have 12 hours before my next injections.  I get up and head to the shower where I discover another fun fact about the shots.  In addition to the injections the docs have me taking an oral steroid and baby aspirin.  The aspirin thins the blood and helps with blood flow to the uterus and also makes me bruise like a peach.  Awesome.  Brady's dart skills have left me with a nice little bruised spot just to the left of my belly button.  I look down at my legs and discover that my omnipresent clumsiness has wrecked havoc on my legs and arms, I am covered in bruises and dark spots.  I reach for my lotion with self tanner and hope to camouflage the map of splotches on my body and tell myself that I'm going to have to be more conscientious of my surroundings if I am going to make it through this with people not thinking Brady is beating me.  The evening shot goes a little smoother, the downside to this injection is that it is administered with this wanna be high tech pen like apparatus, the needle is slightly smaller than the Menopur injection but the Follistim pen takes just as long to inject and it actually feels longer because the pen makes this little click click noise as the plunger is depressed, marking in time each unit injected. 

Three days later and the injections are getting a little easier to take, I still get this little frown look when Brady tells me it's shot time.  Shot time used to mean tequila, now it means egg growing drugs and considerably less headaches.  My stomach is a virtual astrological map of puncture marks and bruises and is tender to the touch.  Each morning and night we have to find a spot that isn't too sore for the new injection.  Leaning against counters or carrying grocery bags hurts and I find myself holding my tummy allot, as if to protect it. Tuesday morning I went in to see the Magic Man for my first stimulation check and things are looking great.  I have five nice size follicles in each ovary and my progesterone and estrogen are at great levels.  The doc is pleased, he smiles and shakes my hand and I tell him that I am on to their little game of starting off with the small needles.  He laughs and tells me "just wait, you haven't seen anything yet". He is trying to be funny but I know what lies ahead.  I know about the 21 gauge needles waiting for me at home, the intramuscular shots that take ONE WHOLE MINUTE to inject because the progesterone is in oil, and I decide that maybe these shots aren't so bad after all.   Maybe that was his intention because while he is a great RE a comedian he isn't. 

I also went and saw my acupuncturist on Tuesday, because clearly I haven't had enough needles in my body.  She is freaking awesome and we work out a schedule so that she can see me immediately before egg retrieval and both before and after the implantation.  My days are a filled with apts lately, this whole process is like a full time job.  When I stopped working I was looking forward to not having to commute from Forest Grove into downtown and yet I am still driving into NW every other day for ultrasounds and blood draws, and now into NE for the needle lady, how did I ever think I was going to be able to work full time and do this?  I am reminded that everything happens for a reason and I try to just take each day as it comes and face each shot one at a time.  This is hard for me, I'm always trying to think one day ahead and whats next, so I guess I will be grateful that I can walk away from this whole process with a new found appreciation for living in the now.

Sunday, July 18, 2010

A Bump In The Road and Needles In Scary Places

So this week we had our suppression check.  This is the appointment where we go in and the magic man does an ultrasound and checks out my ovaries to see if the Lupron and the Birth Control have done their job.  I had this weird feeling all week that something was off.  I happen to be a big believer in intuition (it's never failed me before) and I somehow sensed the appointment wasn't going to go well.  I was really emotional pretty much from the moment I woke up, which was weird but not completely unexpected considering my body is no longer in control of it's own hormone cycles.  I met Brady at the Magic Man's office and he did his best to reassure me.  We headed in to the ultra sound and the doc is telling us what they are looking for, that they want to see how many follicles we have in my ovaries and hopefully no cysts.  Right off the bat I hear the uh-oh before he even says it.  There it is, a large cyst in my left ovary.  This is like my millionth ultrasound in the last month so I've become accustomed to the weird shapes and shadows that make up my body on the ultrasound screen, and there it is.  I start to cry.  The Magic Man tries to sound positive as he measures the cyst and moves on to my right ovary where everything looks as it should.  He sits up and the lights come up and I'm trying to not be completely obvious in my crying.  The doc is trying to not notice my being upset and starts discussing the game plan.  I sit up and do my best to cover myself with the super awesome paper blanket that is provided to cover my previously spelunked female parts and wipe the now mascara laden tears running down my face.  I am aware that I am over reacting.  I know this and yet I cannot seem to get a handle on the crying.  The Magic Man tells us that the cyst was probably caused by the Lupron, and things can go one of two ways.  Best case scenario is that though large, the cyst is emitting relatively low levels of estrogen, that we can therefore go in and eviscerate it and continue skipping down the IVF path.  Worst case scenario is that it's producing lots of estrogen and  will throw a wrench into our IVF plans by removing our ability to control hormone levels and we will have to scratch all the work we've done thus far and wipe our hands of this whole cycle.  That means a month and a half worth of ultrasounds and blood work and shots will be worthless and another month will pass before we can even start thinking of getting on this ride again.  Brady and the Magic Man are talking and discussing options and all I can do is think, really? Seriously, can I please just get one fucking break please!?!?!   Brady and the doc give me a sympathetic look and I'm instructed to get dressed and come out for my blood draw.  I start ranting to Brady as soon as the doctor leaves the room, my poor darling husband is so completely sweet and tolerant of my insane lack of emotional control it makes me cry even more.  I get my blood drawn and the nurse on duty takes pity on me (or doesn't want me to frighten the other patients) and takes me into a back office to "talk" which is code for "please regain your composure before re-entering the waiting room".   She reiterates that we don't ever really have complete control over this process and some times our body just does what it wants.  She briefly goes over what will happen if my estrogen levels are low enough to go in and drain the cyst.  I am not paying attention.  I am trying to not look at her or Brady and desperately trying to stop sobbing and feeling sorry for myself.  I leave the office and head to a friends house.  We are supposed to have lunch and I am feeling like the worst sort of company I could be and she hugs me and assures me it is ok to be upset and frustrated and convinces me that we should go get lunch.  Another friend arrives and we decide when in the dumps, only toasted cheese sandwiches will do and we head over to a big school bus on Alberta that serves only that.  We lunch in the sun and I am feeling better.  I get a call from the docs office and am shocked to hear that I have caught a break.  My cyst is not producing copious amounts of estrogen and can be drained and they will see me the following day.  Great! Wait, what?  How exactly do you drain a cyst inside the ovary?  I call Brady, he is happy that we can move forward and promises to be there to hold my hand.  I am now trying to remember that conversation with the nurse that I wasn't really paying attention to and recall something about local anesthetic.  I think it's probably just a shot or something and enjoy the good news. 

I wake up bright and early and head into the city to get my cyst drained, Brady is there waiting and we head in and see my doc.  I am in a jovial mood and I think this is a relief to the Magic Man.  He mentions that he felt bad for me the day before and I tell him that it's only because the drugs he is prescribing are really tear serum and I won't hold it against him.  Then he tells me all about exactly how he is going to drain the cyst and I almost reconsider that.  I am told that they are going to go into the ovary through the vaginal wall with a needle.  But it's ok because first they are going to take a different needle and inject some Novocaine to numb it first.  "like the dentist" he tells me.  Really?  You're comparing my vagina to my gum line?   Will my vagina drool afterwards like when I get a cavity filled? The good news, he assures me is that the pain will last only a second.  I lay back and Brady comes over and holds my hand.  They flip on the ultrasound machine and the wand goes in, I choose to not look at the needles and though the doc warns me it's coming the pain catches me off guard.  This is the Novocaine shot and we wait about 5 min before he goes back in to drain the cyst.  Brady is watching the screen along with the doc and I am looking at Brady, it weirds me out to see everything happening inside me.  The doc tells me that I need to be very still, and I do my best to go zen and not move, there is a sharp pain and Brady tells me it's in.  Then it's over.  I am relived.  I'm told I took it like a champ, advised to put on one of the circa 1976 maxi pads for spotting and continue on my drug regimen as advised.  I feel better.  I feel like I caught a break and I'm grateful I can continue on this cycle.  It's frustrating to me that there are so many things that can go wrong.  It seems so grossly unfair that anyone going through all of this should face so many potential obstacles.  I am reminded in a way that I shouldn't take any of this for granted, that every day we get to move forward with this process is a gift and I am one of the lucky ones in so many ways.  Some days it's hard to remember that, especially when you have needles in your vajayjay, but I'm going to try.

Wednesday, July 14, 2010

First Week

And I made it.  The first week of our IVF drug protocol is over and surpisingly it wasn't that bad.  Brady has been rocking the injections with the magic touch and managed to not pass out even once.  We have now gone to both of our classes and are heading into the docs this week for our "supression" check. It feels like forever ago that I was scared and nervous.  It's also been forever since I thought about all of this producing an actual baby. Since we started this whole process we have been so focused on the ins and outs of the shots and pills and appointments that I kind of lost sight of what it's all for.  We have been distracted by the details.

In our second class (actually the first in the series that we had to take backwards) they discussed the outcome possibilities and the mere mention of the phone call where they potentially tell you that it didn't work made me cry.  I've done two IUI's now and each phone call telling me it didn't work reduced me to a mess of tears and dispair.  I know it's inevitable that I become attached to the possibility of a pregnancy, but it is hard knowing that after all of this that I might still be on the other end of that "I'm sorry" phone call.  Class got me thinking about that alot.  They tell you that after the supression and then the stimulation when they go in you might have 20 follicles to retrieve eggs from.  Out of those 20 follicles you might get 15 eggs, of those 15 maybe 12 will be mature enough to be fertilized.  Of the 12 that you can fertilize maybe 10 will actually fertizile and of those 10 you might get 6 good quality embryos after three days.  From those 6 you may get 4 that make it after 5 days.  That means if you're lucky, out of 20 follicles you will get 4 embryos. 4. Two of which the magic man will implant and the others we would freeze.  Just looking at those numbers kind of depresses me. 

When we first started this whole thing I was so anxious and confused and nervous I didn't really think about the possiblity that it wouldn't work.  I mean all the money and drugs (woah that sounds bad) and the fact that an actual fertilized embryo is being implanted into my uterus and it still might not work?  It's a pretty devastating thought.  I don't want to really think about what I will do if it doesn't work.  I don't know how I will function if I get that phone call.  I've been thinking I will have the docs office call Brady, because I've convinced my self that I can tell the answer from the tone of the nurses voice when I answer the call.  I'm in a little bit of a weird place right now with all of this and I'm not sure how much of that has to do with the fact that I am pumped full of so many syntetic hormones that I cry when the grocery store is out of my favorite salad drressing, but I'm trying to think good thoughts because if I don't have that, I might as well give up now.  I have to remember that we are good people, that we will be great parents and that this is going to happen for us. I know it.