Monday, March 30, 2009

just hanging around

So.  Now we wait.

The transfer went really well.  To be honest, it was like a show you watch on the Learning Channel - the whole science of the thing (although I'm hideously ignorant about much of that) is amazing.  Apart from the glaring display of my lady parts (nothing will get you over personal modesty faster than some kind of gynecological condition), I was totally absorbed by watching how it worked: our names clearly labeled on the petri dish; the close-up of the two great-looking embryos; the catheter gently coaxing each of them in; and then the ultrasound, which allowed us to see the catheter entering the uterus and releasing the embryos.  Can't see the embryos on that one.

It was surprisingly painless, apart from the famous full-bladder portion of the experience.  In order to get a good ultrasound of the uterus, since they're working from the outside this time, they want you to have a full bladder for the procedure.  Which means you need to drink 28-36 ounces of water one hour beforehand, finishing at least 30 minutes before the procedure is scheduled to start.  Thankfully, they weren't running behind.  For a girl who can barely make it a few hours on a road trip, this part caused me a lot of anxiety; though, honestly, it wasn't that bad.

So now, we wait.  And let me be clear: I suck at that.  As in, I could barely make it through the morning of Christmas Eve when I was a kid, anticipating the big family dinner at Grandma's and Package Opening Extravaganza to follow.  I've stayed off my feet yesterday and today, but I'll be glad to go back to work tomorrow: I need something else to think about.

For now, here they are: our two beautiful embryos.  One 8-cell, one 7-cell, both "looking great," according to the embryologist.  Send them some good settling-in prayers and karma, would you?  They have received their first maternal command: hang on, little ones.  We love you.

Sunday, March 29, 2009

transfer day

Well, here we are: transfer day.

It's a Sunday, the day I get up in front of a whole group of alternately joyful and brokenhearted people, and tell them week after week - in the face of plenty of evidence otherwise - that God's steadfast love surrounds them.

It's the last Sunday in Lent, the most somber season of the church year; it's the Sunday when we draw to a close this time of reflection, of sacrifice, of considering our mortality and the fragile nature of life.  Starting next Sunday, we enter the holiest week of the year.

Right in the middle of that week, I'll have a pregnancy test.

A day of steadfast love; a day of beginning to end a sad and serious season; a day which leads into the most monumental week of all.  

Yep.  Seems about right.

Friday, March 27, 2009

diary of a mad woman, waiting

Our heroine is waiting for the fertilization report on her five eggs.  She LOOKS like she's at work, going to the grocery store, reading the newspaper, watching television and preparing dinner all as normal.  But really, she's a crazy person.  Let's take a peek inside her head.

6:20am - Wake up.  Ooh, day of fert report!  Ummm, also PIO shot day.  But am unnaturally awake at this early time.  Surely this is a good sign?  Must be a good day.  Yes.

7:45am - Remembering feast of pregnancy and babies on television last night.  Premiere of in the Motherhood, which found not terribly funny but still a distraction.  Also, even Alex Karev on Grey's Anatomy made personal offering into cup, just like husband!  Must be good sign.  And THEN, on rerun of Friends last night, just happened to be episode with pregnant Rachel!  All good signs!  Surely!

8:45am through noon  - Phone is on vibrate at work so as not to disturb coworkers with ring and news from fertility clinic.  Surely will call soon?  They did say afternoon, however.  Must not be impatient.

11:30am - No, it is NOT strange to bring your phone into the bathroom.  But no point, as does not ring anyway.

1:oopm - Arrive home.  Early to leave work.  Nice.  Can now focus on other things.  Will read engrossing and work-related book.  Good use of time.

1:05pm - Hmm.  Have no ability to focus.  Okay, will make some decaf tea.  And have healthy lunch.  Good idea.

1:15pm - IS NOW AFTERNOON!  WHY HAVEN'T THEY CALLED?  WHY?  WHY?

1:20pm - Surely not calling is good sign.  Probably they call with bad news first.  Whereas I am a stellar case, so they are in no hurry.  Surely.  Yes.  This must be true.

1:30pm - Oh, shit, did I leave my phone on vibrate?  Will check.  No.  Okay.  Good.

2:00pm  - Wait, did I accidentally turn my phone to vibrate when I was checking to make sure it was NOT on vibrate?  Better check.  No.  Okay.  Good.

2:01pm - Will just read blogs for a little while.  Will try to comment as much as possible.

2:05pm - Uh-oh.  This blogger had more eggs than me.  Hmmm.  Will move to another blog.

2:08pm - Oh, crap.  This blogger says she had a failed cycle with six eggs, and she didn't know it at the time, but it was a really poor cycle.  Is that true?  Oh, shit.  WHY AREN'T THEY CALLING?  Will change to another blog.

2:10pm - Oooh, pregnant-from-IVF blog!  Yay!  Love to read good news.  So happy for her.

2:10pm and 30 seconds - And also a little jealous.  But is natural reaction.  No problem.

3:00pm - Should I call my nurse?  No, would be annoying.  They will call.  They will.  They promised.  Wait is no big deal to them, because they are busy encouraging my little eggs to grow like champs.  Yes.  Do not want to bother busy egg people.  Will be fine.

3:01pm - IF SHE DOES NOT CALL IN THIS HOUR WILL CALL HER.  I SWEAR.

4:00pm - No, that would be clingy.  Will check my blog again.  Surely someone will have left personal story about wild success with five eggs?  Definitely.

4:01pm - No.  Humph.  Well, clearly Wild Success people are now Busy Moms with no time to comment on blogs, so this must be why.  Will go look at beautiful orchid again.

4:02pm - Aaack!  Orchid has six flowers!  Could be bad sign.  Perhaps should pinch one off?  Good Lord, am becoming crazy person.  Step away from the orchid.

4:10pm - Just one more check on cell phone.  Perhaps has magically chosen to put itself on vibrate?  No.  Humph.

4:11pm - I know!  Will go upstairs and start laundry.  This always makes phone ring.  And then will also actually accomplish one thing today.  Good.

4:13pm - Laundry in.  Surely phone will ring.

4:15pm - HATE my nurse right now.  Does she not understand the pain of this waiting?  Is she not thinking about me all day, wondering how I am?  What, does she have other patients?  

4:20pm  - Will start watching basketball tournament.  Will be distracting.  Oooh, look!  I forgot - five players on a team!  Whoo hoo!  We have basketball team in our petri dish!  Is good news!  Surely!

5:03pm - PHONE IS RINGING!  Oh, crap - where is phone?  Stupid cordless bastard, where ARE YOU?  WHERE...oh.  Here.

Excuse me for a moment.

5:15pm - Within span of six minutes, received three calls from fertility clinic.  First was doctor, reporting: five eggs, four fertilized, two are developing normally.  Yay!  Two!  That's all we wanted, so - good!  Was, naturally, hoping for off-chance possibility of FET cycle with frozen embabies, but two is great!  Then received two more rapid-fire calls from nurses, calling to schedule transfer.  Which will be Sunday, at 1:3opm.  (Pacific Time, in case you need to know.)

Hurrah!  Can now go back to normal life.  Will have festive glass of chardonnay to celebrate!  Perhaps will be last glass of wine for next ten months!  

If I am this nuts about fertilization report, what does it bode for the two-week-wait?  Hmmm.  Will not think about this.  Enjoying wine instead.

what comes next

I'm up extra early this morning because it's Day One of the dreaded progesterone-in-oil shots.  The husband has to do these.  As a wife, it's sweet to see how worried he is about causing me pain; as the recipient of the shot, it's a little worrying to know that the person administering it is pretty freaked out about what he's doing.  But he does well.  To my surprise, the Big Ass needle that comes with that shot doesn't hurt at all.  My left bum cheek isn't too happy this morning -  no part of my body is happy about being up at 6:20am, much less getting speared with a needle shortly afterward - but we did some massage of the spot and then heating pad time following, which I hear is important to help the medication spread well.

So, now we wait for the big call: this afternoon's fertilization report.  Because we're doing ICSI (meaning that the sperm will be individually injected into each egg), each will technically fertilize, but may or may not grow well.  I'm nervous.  It's odd: although I was excited for the retrieval and to continue the process, part of me wanted to keep the eggs inside where they were safe, and where there was the eternal possibility that everything would work out.  I don't think of these eggs as 'life,' in the strictest sense, but they are the possibility of life, and once they were removed, I feel terribly vulnerable.  Someone else has them.  Someone else is now in charge of their welfare.  What if they don't do a good job?  

And yet, once they're back with me, I imagine the vulnerability feelings will increase exponentially.  For now, they're safe in the lab.  Once they're back, it's my own body's chance to take care of them, and I will have almost no control over this.

It's possible that the IVF process is the perfect combination of fierce protectiveness and sheer powerlessness that prepares one for parenthood.

Anyway, here's the plan:
  • Today: fertilization report
  • Tomorrow: additional report
  • Sunday: very probable 3 day transfer
  • Then...we wait.  (And continue the festival of shots in the bum.)
I've never liked flying.  To be precise: I hate flying.  After years of considering why, I've come to the conclusion that it's my total lack of control (and comparative lack of knowledge) to blame.  I like being in control: on a plane, I'm nowhere near it.  I don't know how to fly a plane.  I don't know how this huge pile of metal heaves itself into the sky.  I'm afraid it will fall out.

I've learned enough along the way to mitigate my flying fear quite a bit.  I know a relatively considerable amount about IVF.  And yet, today I feel like we're sitting on the runway, enduring my least favorite part of the flying experience: it's about take-off time, and once again, I can't imagine at this moment how any of it is going to work.

It does, every time.  But I'm just as nervous, every time.  Wild blue yonder, here we come.

Thursday, March 26, 2009

retrieval update

Well, I'm home and recovering pretty well; some cramps, but that's about it.  I'm far less woozy than I anticipated.

The doctor reports that they got 5 eggs, which he said was 1 or 2 less than he really wanted, but that we were "still in good shape."  I feel a little disappointed about the number; I was hoping for at least 6-8 myself, given the 10 good sized follicles we had.  But hey - five good quality ones would be better than 10 mediocre ones, so let's hope these are all over-achievers.  

And now I get to spend the rest of the day on the couch watching movies.  Not too bad.

Wednesday, March 25, 2009

and now for something completely different.

Proof positive that I'm trying to keep my mind busy with non-fertility related distractions...

Think you can find the states on a map?

Try this.

Tonight's lesson: I have NO idea where Ohio is. Otherwise, I scored a decent 86%.

And now, back to enjoying my injection-free evening.

statistically speaking

At my acupuncture appointment on Monday, I asked about the next stages of the process: namely, when it would be best to do acupuncture again. The therapist told me I could schedule one for retrieval day, but, in her words, "that's really best for women who have a difficult retrieval, and it doesn't look like you'll have to deal with that." So, she said, it would be great to schedule acupuncture on the day of transfer. Apparently, the common practice is to do one session immediately before and one immediately following the transfer. "Statistics show that there is an increased chance of success with acupuncture on the day of transfer," said the therapist, and then we went on talking about other things, but that little phrase got stuck in my head.

"Statistics show."

Here's my initial reaction to that phrase: "oh, yeah? Well statistics show that I should have been pregnant three years ago, so f&#k statistics. " (Note that I did not say this out loud to my acupuncturist.)

For someone who studiously avoided taking statistics in college, I've become familiar with an awful lot of them over the past three and half years. You have, at most, about a 25% chance of getting pregnant every month. By the time you're in your 30's, it can go down to 10%. 90% of women get pregnant within a year. Of those who didn't get pregnant in a year, 80% get pregnant in the second year.

30-40% of infertility problems are male; the same are female; the remaining are either unknown, or both partners.

At my age (36), there are widely varying statistics on the success of IVF procedures. At my clinic, with our diagnoses, we're looking at a 50-60% chance of success.

And the statistics I've been reading (fearfully) lately: between 10-25% of known pregnancies end in miscarriage. 80% of those happen in the first trimester. After the first trimester, the miscarriage rate is about 3%. Only 1 in 200 pregnancies ends in a stillbirth or neonatal loss (after 20 weeks).

So. At the front end of this game - the conception part - we're starting off on the wrong end of the statistics. Male (a bit controversial, but probably mild) problems and female (pretty damn serious) problems. That places us someplace in the 20% of the 5-10% who didn't get pregnant in the first year OR the second year and then have problems detected in both partners.

See? F&*k statistics.

How am I supposed to trust these numbers? Statistics show that we are now in the better range. Our problems (morphology and endometriosis) can be very effectively dealt with through IVF. Statistics show that this procedure will probably work, and the thing is, I have no idea how to believe that. Part of me does; part of me looks at the impersonal things like side effects and follicle size and number of follicles and rampant family history of getting knocked up in one's late thirties and says, "hey! We've made it past the shit part of the statistical mountain, and now we're on the way down! We're dealing with our problems, we've finally gotten aggressive about it, we're no longer in denial, and everything we're doing now is designed to deal exactly with what's wrong with us. Why be pessimistic? Why not believe that this will work?"

And the other part of me says, "I'll tell you why. Because statistics have been hitting us over the head for three and a half years, and I'll be damned if I fall for that line again."

On the whole, I do feel remarkably hopeful about this process. But every once in awhile, like late at night when the moon is bright and I can hear the rain, I lay in bed and think about statistics, and I worry. It's awfully hard to trust the same thing that's brought you down so many times.

I remember something my mom says - and whoever she's quoting, it's been a mantra for me for a long time - "everything will be okay in the end. If it's not okay, then it's not the end."

I'm trying to trust my mom on this one. Statistics definitely show that she's right on a very regular basis.

Tuesday, March 24, 2009

on your mark, get set...

...go!

Got the okay to do the trigger shot tonight, so the husband is nervously awaiting his first (but not his last) opportunity to enter the joy of injection land.  Tis more blessed to give than receive, they say, but in this case I think it's the opposite: as hard as it is to get an injection, it's a lot worse to be the one giving it, worrying about inflicting pain.  As for me, I'm delighted to be done with the belly shots - especially that menopurevil one, which burned worse every night.  I'll take a poke in the buttock over that any day.

It remains to be seen how I feel about that if 8 weeks of progesterone shots are needed...

Retrieval will be Thursday morning, 8:00am.  

Yesterday I bought an orchid.  I have never had any success at growing those things, or even keeping them alive.  I figure this is the time.  I'm ready to take on two of the things I haven't succeeded at yet - pregnancy and orchids.  If nothing else, it's a gorgeous sign of hope sitting in my living room.  I plan to fertilize it a bit on Thursday.  Just for fun.

Monday, March 23, 2009

getting closer...

Yet another bloodwork and hoo-ha wanding appointment this morning showed good progress - and now eight little follicles on the left side.  Go, liberal left ovary!!  YES YOU CAN!  One more check tomorrow morning, but all indications are that retrieval will be Thursday.

Coincidentally, I noticed last night that Thursday is the premiere of ABC's new show, In the Motherhood.  Not a show I plan to watch, really, but a fun happenstance.  Hopefully it's a premiere day of sorts for me, too.

Saturday, March 21, 2009

small black blobs update #2

Nothing says "yay, weekend, Saturday morning!" like having a wand up your hoo-ha at 8:45 am.  Ah, the joys of fertility treatment.

Still lagging behind is the right ovary, which only shows 2 follicles.  Not sure where the other two or three went...

But Left Ovary is humming along nicely, with 7 decently sizes blobs visible in there.  One more appointment on Monday will confirm our retrieval date, which looks to be mid-next week.  

My husband came along to this appointment; his first experience with the internal ultrasound.  Ah, romance.  Poor guy: I should have asked Super Cheerful Ultrasound Lady to explain what she was doing, because he was completely lost.  ("Did you see them?" I asked happily afterward.  "Well, no," he said, looking confused, "but it was cool!"  And then - "What IS that thing?" pointing at the wand.)

My bruised belly is happy to hear that this injection phase is, indeed, coming to a close.  Still very few side effects, except for an increased awareness of the presence of my reproductive organs.  

Must go; our accountant will be calling soon to finish off our taxes.  Taxes AND a hoo-ha wanding?  What a weekend.

Wednesday, March 18, 2009

small black blobs update #1

So, an update on the follicles.

Where we started: 4-5 on one side, 6 on the other side. (I couldn't remember at the time, but the higher number is the left ovary.)

At Monday's day 3 bloodwork: estradiol level 50, which the nurse said was "just fine." Some minor Googling of this number agreed with the nurse. (Google: the world's greatest blessing, and worst curse, to the infertile. And to everyone else, for that matter.)

At today's ultrasound: 7 good follicles on the left side (yippee!) but only 2 visible on the right side (huh. Am obviously Democrat, so perhaps that explains high success rate on left side). Estradiol level is 129. Am trying to resist Googling this. Doc says to stay on the same dosage of meds, so I assume the number is fine. Super Cheerful Ultrasound Lady says that more may well show up on the right side at Saturday's ultrasound, since we're only at day 5.

So: all is well. Lots of little ovary-area twinges going on, but that's about it.

The right ovary and I will be having a little discussion tonight about kicking it up a notch. No doubt that will work like a charm.

Tuesday, March 17, 2009

wilderness

So, among the other things happening in my life right now (which do consist of more than shooting myself subcutaneously in the belly every night), it's Lent. I've never been big on giving things up for Lent, although it's not a bad idea. What I have tried to do is think more intentionally about my life and my faith during this season. It's a particularly good time to think about the potential meaning of any suffering in your life - in fact, if you go to worship during Lent, it's fairly hard to get away from that theme since most of the bible readings have something to do with that.

[Also, for the sake of honesty, and before you say, 'well, just don't go to church during Lent,' I should mention the fact that I am a pastor. So, not going to church is not really an option. And although I had intended NOT to talk about my profession in this blog - only because it comes with a lot of baggage that I get tired of - I find that I just can't write this particular entry without being truthful about such a huge part of my life. Okay. Confession over.]

I'm preaching this week on two stories about wandering around in the wilderness, and I'm finding that this is a particularly apt metaphor for my life at the moment. While rooting around on the internet searching for helpful preaching ideas (i.e., alternating between textual studies available online and reading the People magazine website because you never know when the love life of Tom Brady and That Giant Model Lady, or some new Lohan chaos, might be helpful to mention in a sermon), I came across an article which talked about the idea of an "involuntary Lent." The author, the Archbishop of Los Angeles, put it this way:

In prior years when our life and financial security were far more predictable, Lent meant we could choose which special sacrifices we wanted to undertake - but just for six weeks, until Easter Sunday. And then back to normal.

But now we have a new reality: we aren't choosing our sacrifices this year, they have chosen us. And they aren't just for six weeks: they have been our burden for over 75 weeks now, with no end in sight.


Obviously, he's addressing the economic turmoil which affects all of us to one degree or another. I admit that said turmoil is affecting me to a very slight degree, for which I am thankful, and about which I also feel a little guilty. But it is deeply affecting people I love, and that is grief enough.

One of the great struggles of this infertility journey has been the questions it raises for me about faith, and about why things happen, and about my relationship with God. I've done some serious thinking about why shit happens in the world, and my highly theological and astute reflections can be summed up as follows: it just does. God did not smite me with infertility to teach me something. It is not the will of God that I not have children. God is not trying to tell me to adopt. After serious theological and philosophical consideration, I have made some peace with the fact that shit happens, and it's happening to me, and that's just how it goes sometimes. As with any darkness in life, this one has pointed out some of the bright spots: I have a loving and supportive husband; I have some great friends and coworkers; I have damn good insurance, all things considered; I am basically healthy and able to handle the difficulties of this treatment cycle. All good stuff.

And I am finding a lot of meaning in these wilderness-wandering stories lately. The truth is (as far as I can tell), there is not a lot of helpful Christian thinking out there about infertility. A lot of it seems to be along the "pray harder, have faith, God is working for good, what doesn't kill you makes you stronger" kind of line, which doesn't do much for me. You know how many people in the bible "just had faith and it all worked out"? Pretty much none. Nobody. The people of the bible screw up, get mad at God, make HUGE mistakes, doubt everything they are supposed to know about God, complain on a regular basis, turn their backs on suffering, and, in general, completely f&ck everything up. I realize that this helpful Biblical Summary is unlikely to make it into the Christian bookstore, but that's the point: the bible is a lot more likely to commiserate with our struggles than it is to tell us to shape up, have faith, and put a smile on your face.

So, back to the 'involuntary Lent' - that seems about right. The wilderness wanderings of Israel were, in every way, involuntary. This wilderness of mine is, in every way, involuntary. I do not want to be here - I want the promised land, the child, the late nights and the crying jags and the dirty diapers and the sweet smell of baby powder. And yet what I think I need, as much as I believe I need that promised land, is some way to find meaning in this particular wilderness. Without resorting to cliches like, "God works in mysterious ways." (Which is probably true. But not all that helpful.)

This 'sacrifice,' this particular stage of my life, is not of my own choosing - it chose me, for some unknown and probably unknowable reason. Even now, even in the midst of it, I can see some of the ways in which I am becoming a better person, someone with more compassion, a bit more patience, someone who realizes now, more than before, that each person we encounter may be fighting a battle, walking through a wilderness, which may not show on the outside, but which is worth empathy and understanding. Could I have learned these lessons any other way? Probably. Did God make me infertile so that I would learn this stuff? Hell, no. But here's the thing I struggle with most: if I don't at least try to learn something from this involuntary Lent, then it is worth nothing. I don't know how this story will end. I believe I will make it to the promised land. I believe strongly that our child is on the way. But I cannot know that. And I can try to make choices which redeem this struggle in some way, which transform its darkness now into some light, later. Maybe much, much later.

Things do grow in the wilderness. Slowly, usually. And they need to be hardy to survive. But it does happen. May it be the case for me, and for you, if you're in this wilderness too.

Sunday, March 15, 2009

Stimming: A Play in Three Acts

Act One: Lupron, I Thought I Knew Ye

Enter our heroine, who is about to start her first night of stimulation medications for IVF.  She is slightly overconfident, having sailed through the suppression phase without a single drop of blood or even one bruise.  Let's be perfectly clear: she is VASTLY overconfident.  And also, she is very tired.  Not the best combination.  Our heroine has just finished watching the oh-so-helpful drug injection videos online, as provided by her RE's office.  She enters the bathroom.

Heroine: Okay.  Three shots tonight.  No problem.  I'll start with lupron - I've been doing it all week, no big deal, I'll get that one out of the way.  Oops - must wash hands.

Heroine washes her hands.  She gets out the lupron box and inserts the needle into the vial of medication.  She draws it up, as she has every night.  She prepares to take the vial off the needle.  For no apparent reason, the vial drips medication, which throws her off.

Heroine: CRAP!  Oops - dripped more.  Hold on - oh, no, wait, I can't put this needle down.  Um...now there's an air bubble in there.  That can't be good.  I'll just slowly push up the...AACK!

Lupron shoots out of the needle onto the bathroom ceiling.

Heroine: CRAP!  Shoot.  I'll just inject the damn thing before I lose more of it.  Right here.  I haven't had any problems on the left side, so I...ouch!

For no reason, Lupron shot hurts like a motherf*&*er this time.  And also leaves a drop of blood.

Heroine: Of course.  OF COURSE.  Okay.  This is fine.  No problem.  The nurse said we were bound to bruise, no matter how hard we tried otherwise.  So this is fine.  I'll just move to the other one.  I'll do the Menopur.  That one looks harder.  We'll get it over with.

End scene.

Act Two: Menopurevildamnthatstuffhurtswhatdotheyputacidinthere?

Our heroine, summarily humbled by her experience with lupron, now prepares to inject Menopur.  She has been warned that this stuff burns.  So she is ready.  She has, however, forgotten the relative complication of this particular injection.  This does not bode well.

Heroine: Okay.  Menopur.  No problem.  First, I'll open the box.  Or, wait.  Boxes?  Is that right?  Wait...was I supposed to refrigerate this?  Oh, shit.  No - oh.  No.  That's Gonal-F.  Okay.  Menopur.  First, I pop the tops off.  Can do.

Heroine pops the tops off the powder vial and the liquid vial.  

Heroine: Okay.  Now, the q-cap.  That's...this one.  Right.  Twist on.  Done.  Now, I stick this into the liquid vial and draw up...wait.  There's 2 ml in here.  Wasn't I supposed to draw up the whole vial?  That's what the video lady did.  But I thought it was only 1 ml.  Shit.  Where are you now, stupid video lady? HUH?  What do I do?  Okay.  Read instructions again.

Instructions say to draw up 1 ml.  Heroine breathes sigh of relief.

Heroine: Okay.  1 ml.  Draw this up....oh, I forgot.  This is the one that doesn't stay put.  The liquid just wants to shoot out of there.  And my ceiling has been medicated enough for the evening.  So, I'll just hold this like this, upside down, with my right hand, while I try to twist off the q-cap with my left hand, which does not...really...work.  At all.  Video lady said this would twist right off, and I believe video lady was WRONG.  Oops..okay. Off.  So I'll throw this in the safety container.  Because I am all about safety!  I am the queen of safety!  Woo hoo!  Now I have my syringe full of sterile water, which I need to inject into the...CRAP!  I was supposed to leave the q-cap ON so I could put this water in the powder vial.  And I can't let go of this damn syringe, because all the liquid will shoot out.  But I only have 10 q-caps, so what should I do?  Good Lord, they gave me three hundred stupid alcohol swabs, which I have not screwed up once, and now the one time I need something extra, I don't have it.  So.  Be smart.  Think like a spy.  Think like Harriet the Spy.  What would Harriet the Spy do?  First off, she would probably be unlikely to be in this situation, given that she is a 10 year old girl.  And therefore not so prone to be doing in-vitro fertilization.  So.  I will just take the q-cap out of the sharps container and swab it with one of the five hundred extra alcohol pads I have.  And I will do this with my left hand while trying frantically to hold this syringe with the 1ml water in it, and also not poke myself.  This will be no problem.  

Heroine, in manner of frantic drug addict, shakes out various syringes and finally gets to the q-cap, which she then cleans off as best as possible with one hand.

Heroine: Okay.  Better.  Now...q-cap back off, into sharps container, needle on, ready to inject.  One...two...three...poke!  Okay.  I know this is probably going to burn.  Inject s-l-o-w-l-y...this isn't so bad!  Who said it would burn?  Big wimps.  I think people totally overestimate the effect of these HOLY MOTHER OF GOD WHAT THE HELL IS IN THERE?  ACID?  

Heroine removes needle and puts it in sharps container (because she is all about safety!) and reads ingredients of Menopur package.  Listed last: phosphoric acid.

Heroine: Well, that explains it.

End scene.

Act Three: Gonal-F-You

Heroine, now bleeding from both injections, prepares cautiously for the third.  She tells herself that every shot is one less she will have to do.  Very logical.

Heroine: Okay.  Gonal-F.  This should be easy.  Cute pen.  Turn to dosage, pull out...okay.  Done.  Now, remove cap, twist on needle.  Ooh!  Tiny needle.  Good.  Okay.  Ready.

Heroine injects Gonal-F pen.  Good so far.

Heroine:  See?  No problem.  In like Flynn.  Now, I just push the end of this...thing...why is this so hard?  Good Lord.  Do I push...CRAP!  Now I'm pushing this damn thing past the needle into my skin.  Somebody warned me about that.  Who was it?  It wasn't that stupid video lady with her soothing voice and her TOTAL DISREGARD FOR THE FACT THAT THIS STUFF IS HARD.  Keep pushing...but not that hard...but hard enough for the meds to go in...oops, too hard again...how many clicks can there be on this thing?...oooh...okay.  Done.  And not bleeding!  Oh.  No.  Spoke too soon.  Crap.  Three for three.

Heroine removes pen and uses third alcohol swab of the night to wipe away third bloody spot from injections.  Heroine glances at the pharmaceutical convention on her bathroom counter and suddenly feels a bit lightheaded.  She goes to lay down on the bed, where she indulges in a rare moment of self-pity.

Heroine: Okay, this is it.  I have been patient and hopeful and I am still those things, but why do I have to do all this to have a baby?  Why can some people just have sex and be all warm and cuddly and then pee on a stick two weeks later and poof! pregnancy, when I have to squirt meds on my ceiling and bleed three times and then do this over and over again?  THIS IS NOT FAIR.  I need a girl scout cookie.

Our heroine, for whom all things are made better by a Samoa Girl Scout cookie, finds the strength to crack open a package and eat three of them in twenty seconds.  After which, she does feel considerably better.  Tomorrow, she tells herself, this will be easier.  Every day it will be easier than the one before.  And, if not, there are more packages of Girl Scout cookies in the freezer.

End scene


Friday, March 13, 2009

suppression? check.

Yet another glorious pants-dropping appointment in the Festival of Pants-Dropping Appointments known as IVF. But a good one, so no complaining here. (Although the day when I no longer have any planned opportunities for someone to put an ultrasound cam up my hoo-ha will be a very, very good day.)

It looks like we have 6 follicles on one side and at least 4 on the other - she thought there were very probably more, but it was a bit tricky to see. I think she saw 5 or 6 the first time around, so I'm feeling good.

Another acupuncture appointment today too: love it. It's hard to peel myself off the table and go to work afterward, but if that's the biggest complaint in my day then all is well.

Tonight the husband and I are going out for dinner and then tomorrow we're working on a mini-facelift for the downstairs powder room. Such a nice, normal weekend.

And then in the evening, I will begin injecting myself with Super Stimulation Hormones. So, not so normal. But at least the bathroom will look snazzy.

Thursday, March 12, 2009

march madness

So, that whole previous post about sailing wound-lessly through the lupron injections, tossing my hair at the idea of side effects, coasting into the stimulation phase with nary a bruise?

Yeah. Might have spoken too soon.

It's still not bad. No bloating, no headaches. My period started after I stopped taking birth control pills, which is a weird sensation: the first time that "I got my period" has not been followed immediately by, "which means I'm not pregnant, AGAIN, damn it."

What I have noticed in the past two days is a significant escalation in my crankiness level. I think we are approaching CRANKINESS WARNING LEVEL: ORANGE, which is pretty bad for me, because I'm normally not a snippy person. Here's how I would break down the Cranky Levels, Homeland Security Style:

Cranky Level: Green
Characterized by internal eye-rolling, wondering at the stupidity and/or thoughtlessness of other people. Highly passive-aggressive. Think Brangelina-fleeing-from-Ryan-Seacrest-at-the-Oscars: not a lot of actual face-to-face conflicts. Just exiting situations quickly.

Cranky Level: Blue
Eye-rolling externalized. Under-breath-mumbling begins. Make eye contact with grocery store clerk about idiocy of woman who takes out her checkbook only after entire, very large, grocery order has been completely scanned. Sigh loudly in public. Head-shaking increases dramatically.

Cranky Level: Yellow
Under-breath mumbling moves out of 'whisper' into 'low but audible sounds' stage. Lots of "come ON, lady," said quietly at grocery store or other shopping alternatives. For the infertile, this stage also increases slightly evil looks at pregnant women in public. Significant increase in yelling at other drivers, though always from safety of own car.

Cranky Level: Orange
Think might actually yell at stupid person who asked, "so, what do you think about the Octo Mom?" yesterday. Feel that, if were celebrity, would be likely to completely destroy hotel room (if could drink, which would also be nice at this stage). Absolutely no patience with stupid drivers. Honk. A LOT. Get super pissed at husband for eating last piece of banana bread BECAUSE I MADE IT THREE DAYS AGO AND I ONLY ATE TWO PIECES OF THE WHOLE DAMN THING, DON'T YOU REALIZE THERE'S ANOTHER PERSON IN THIS HOUSE, YOU ARROGANT BASTARD? Wish for punching bag. Big one. Have to stop self from answering phone with, "WHAT? WHAT ON EARTH DO YOU WANT?" Notice huge increase in all-caps spelling. Definite problem.

Cranky Level: Red.
I don't even want to know what this looks like. Glad we do not own any guns or other weapons (except for good kitchen knives, which should probably be cleared from house at this stage).

So, orange. I'm pretty much at orange. The problem is, I've also been working a lot lately, and a lot of evenings. And that always makes me cranky. It's the time of year in my profession when this is just normal: I do this every year, and I get cranky about it every year, and it passes. So I can't entirely tell if this year's Orange Level is due to the drugs, or is just a normal "I'm glad to have a job and all, but still - I need to GO HOME NOW" reaction. I'm sure it's a combination of both. The good news there: my crazy hours come to a head next week (when the stim drugs start, so that's not so good), and then they go down quite a bit. By the last week of March, work will be much more under control. And that happens to be the week when the transfer is likely to happen, so I'm thankful for that confluence of events.

For now, however, I'm trying hard to breathe deeply, stay out of traffic, avoid making more banana bread, and not answer the phone unless necessary.

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Tuesday, March 10, 2009

update

I've been hesitant to write this update because I'm afraid that even writing this down will make it stop happening.

So, imagine this is a whisper.  Don't tell my body, but here's the thing: I've been on lupron for a week, and I have had absolutely no side effects.  Nada.  Zip.  I'm simultaneously thrilled and a little bit nervous that the stuff might not be working.  Mostly, I'm really thankful.  But don't say this out loud.

There's the update.  Shots are going fine; acupuncture is fantastic.  Suppression check this Friday.  Yes, the 13th.  I have no fear.

Saturday, March 7, 2009

daylight savings confusion

So, yet another question I never anticipated needing to ask.

I do my lupron shot at 9pm every night.  The nurse said to pick a time between 7-9pm, and be consistent with it; I could choose anytime within that 2 hour range, but then stick with it.

Okay.  Not a problem.  I pick 9pm, because sometimes I don't get home from work until 8:30 or so.

So...tomorrow, when the clock says 9:00pm, my body thinks it's 10:00pm.  If I obey the clock, I'm adding an hour between shots.  If I obey my body, I have to move the shots to 8pm, which doesn't really work the rest of the week.  What should I do?

Yet another reason why this is my least favorite Sunday of the year....

(Early Sunday morning edit:  Wait a second.  I would need to do the shot at 10pm, not 8pm, right?  Because right now, at 6am, my body thinks it's 5am.  That I know for sure.  So at 10pm, it will feel like 9pm.  Which all begs the same question: is any of this worrying even necessary?)

Wednesday, March 4, 2009

poked, episode 1

One shot down; lots to go. But still, it's a relief to be here.

It went completely fine last night. I got home fairly late from work, so headed straight to the computer to review the "how to inject yourself" video. Had some flashbacks about last-minute-cramming before a test in high school and college. This, however, seemed a bigger deal, not least because failing this one could actually result in pain and bleeding. I mean, the chances of that are infitessimally small, but still; it's not like that was a real possibility if I failed my quiz on medieval English literature.

Anyway. I opened the box of Lupron (huge box which contained a billion syringes - or, you know, 20 - and one very, very small bottle of actual medicine). I popped off the top, and, as if I were an injection pro, I measured out the space I needed in the syringe, inserted the air into the bottle, drew out the liquid, rubbed my belly with an alcohol pad, took a deep breath, pinched the skin, and, pow! Shot myself.

I felt like there should be fireworks afterward, or something. It was kind of anticlimactic, really. But I did it, and it wasn't bad at all, and so far, no problems. The fish oil pills I'm taking have more impact on me than anything else. (Note to self: take one pill in morning, one in evening. This wards off little fishy burps in significantly helpful manner. Two in morning gives self impression of having digested whole can of cat food. Ick.)

I'm sure the side effects are well on their way. But for now, we're off and running.

Monday, March 2, 2009

just shoot me, part two

Yippee!  Drugs!

The box arrived this morning.  It wasn't quite as big as I thought it would be, actually, though when you consider that most drugs I've taken have come in a box the size of a cough syrup bottle, this is a pretty damn big box.  It looked like this:


I've been warned that it's a rather overwhelming experience to open it and lay all the drugs out on the counter, and I think the warning helped.  The only slightly frightening bit was the long, long, long row of syringes...but they're small.  I keep telling myself this.  In some kind of freakish miracle, my insurance actually paid for these drugs.  I HAVE NO IDEA HOW THIS HAPPENED.  Nor do I care to ask.  I suspect the amount was taken out of my assisted-reproductive-technology benefit, and we'll just have to pay a little more for the cycle itself, but that's fine with me.  Here it all is:

About a week ago, I planted some sunflower seeds and put them in our kitchen window.  The seeds were a housewarming gift, and I completely forgot about them - I left them outside all winter, and when I finally put them in the soil, I figured it was probably a lost cause.  Too old, too weather-beaten.  Yesterday, there they were - a whole group of tiny green shoots poking out of the soil, growing as if there had been no winter at all.

I'm going to take this as a good sign.