Tuesday, April 29, 2008

2 Heart Attacks

I received a phone call from the clinic at 10:30 this morning. My heart jumped into my throat. They aren't supposed to call the morning of the transfer unless the transfer has been cancelled because the embryos have arrested.

Me: Hello?!!!
Clinic: Is this Denise?
Me: Yes! Is something wrong, you're making me VERY nervous!
Clinic: No, everything's fine. Are you on your way? You are signed up for acupuncture at 10:00am!
Me: Uh, no. My transfer isn't until 2.
Clinic: Really. Well, we had to move some patients around and so the schedule got changed.
Me: But my transfer isn't until 2.
Clinic: Hang on one second...well, sorry about that. Obviously no one told you that they moved you up.
Me: Uh, no.
Clinic: Are you on your way?
Me: No, we weren't going to leave for another hour.
Clinic: Okay, no big deal. That's okay.
Me: We can leave now if you want us to.
Clinic: Sure. Go ahead and come in now.

Heart attack number 1 averted.

We got to the clinic and were told to go directly up to the surgery center and they would do the ultrasound and blood draw up there. We were called back almost immediately by the acupuncturist. She was all ready to get started and I had to tell her that I needed an ultrasound first. What's the point of paying $225 for acupuncture if they cancel the transfer? Luckily, the nurse had already given me the valium, so I got the benefit of that no matter what.

Two ultrasound techs came in to do an abdominal ultrasound to check for fluid. And there it was. My friend the fluid. Still hangin around. They thought it was slightly less than Saturday's level, but didn't sound too positive. I couldn't get a good read from them as to whether or not it was too much. One tried to calm my fears by saying that it really depended on how I was feeling and since I'm feeling pretty good today, we'll see. They left us alone for a bit and my mind was racing. All I kept thinking was "I'm NOT going to cry. NOT going to cry."

Next thing I know, the acupuncturist came back in to say the doctor had given us the go ahead. Phew!!! Second heart attack averted.

Dr. G was working today and did my transfer. Jen is right, he is awesome. He came in to go over the status of the lucky 13. We are amazed by our embryos. Out of the 13, 11 of them were graded 4AA, the highest grade our clinic gives. Dr. G said the embryologist who did the grading is quite conservative, so for 11 to be graded this high says a lot and he has never seen anyone have this many with the highest grade. He said he even double checked with the embryologist. How cool is that?

We talked about transferring 1 or 2 and decided on 2. Dr. G said our chances of success if we transfer 2 would be 75% versus 50% if we only transfer 1. Chances of twins for transferring 2 would be about 30%, so we were willing to risk those odds. Of course, these are just statistics and I don't think they really take into account my lining, our prior failures, or the quality of the embryos.

B asked if he was concerned about the fluid and Dr. G said he wasn't, that it was really just a sliver of fluid. That made me feel much better. He did tell me to keep up the fluid intake through the pregnancy test. Enough that I'm peeing every hour. He also encouraged me to continue with the sodium intake for another couple of days. Then we got down to business.

The embryologist came in and showed us our 2 embies on the screen. First time I ever got to see any of our embryos, so it was really cool! She said one was compacting and one was "pulsing." I asked her what pulsing meant and she said something like "first they compact and then they start expanding. I assume that's a good thing? Dr. G had a bit of trouble getting the catheter in and had to switch to a different one. I really don't understand why this stuff isn't in my chart. I mean I had multiple IUI's there where they had to switch catheters and two transfers, the first one being difficult as well. The last transfer went pretty smoothly and I think it is probably because it was the second one that Dr. S did and so he knew which catheter to use and how to thread it through my roller coaster of a cervix. Oh well. Dr. G managed after a bit and the embryos were transferred in. The embryologist checked the catheter and gave us the "all clear."

Another session of acupuncture and I had to remind them that they were supposed to draw blood. Things were pretty disorganized today. After the blood draw, we were on our way home.

The embryologist told us that they were freezing the other 9 4AA embryos today and they would check the other two tomorrow. One had already arrested and the other was about 24 hours behind where it should be, so it doesn't seem likely those two will make it freeze. But that's alright. We know we'll have at least 9 more buns in the freezer again! And this time we know they are really high quality.

Monday, April 28, 2008

Fluid Ramblings

Just getting ready for what I hope will be the big day tomorrow. I say "hope" because all of the sudden this afternoon I started panicking about the fluid build-up. Today at work was rough. Not having moved off the couch except to pee and move to the bed for 4 days straight, it was a bit of a shock to my system to be moving around all day and sitting upright in a chair. My abdomen was NOT happy. I felt even more bloated and started worrying that the fluid had returned with a vengeance. Of course now that I'm home relaxing on the couch, I don't think it is any different from yesterday.

It is just so hard to tell. Saturday when I thought it was getting worse, it was actually better. Therefore, because I feel better than I did Saturday, I now worry that it is actually worse. Faulty logic, I'm sure, but still.

I really, really hope we get to transfer tomorrow.

Sunday, April 27, 2008

Lucky 13 Update

The Lucky 13 are still going strong! All 13 are still growing, which just amazes me. They like them to be 6-10 cells at this point. Eleven of them were 8 cells this morning (ten graded 4- and one graded 3+), and two were 7 cells (one graded 4- and one graded 3+). I'm not sure if 4+ is the top grade or just 4, but we're very pleased with the report. So we are definitely moving forward with a Day 5 transfer on Tuesday.

I'm very relieved. Although I feel much better today than I did a couple of days ago, I'm still not 100% and I'm grateful for 2 extra days to hopefully keep feeling better before the transfer. I'm still having some abdominal pain and my digestive system is NOT functioning at 100%. And although I'm still really bloated, I think the fluid has probably gone down quite a bit. I'm still waiting for a call from a nurse today with my instructions for Tuesday, but they will do an ultrasound before the transfer to check for fluid. I hope that by Tuesday, there is none left.

I am going to work tomorrow and I'm trying to figure out what the heck I can wear. None of my pants fit right now and everything is really uncomfortable except for very loose happy pants that have either elastic or a drawstring waste. I don't actually own any skirts or dresses-I just never wear them. Too bad I can't just work from home, but I really need to get some face time in, even if it is just one day. I'll be off Tuesday through Thursday and then back to work on Friday.

The snow disappeared pretty quickly yesterday and it was sunny by the afternoon. Today is sunny, but still a bit cool. It is supposed to be back in the 70's by tomorrow. Pretty typical spring weather in this part of the world.

Saturday, April 26, 2008

Fluid Movement

Just got back from yet another ultrasound and there is actually less fluid than yesterday. Yay!!! I am relieved, but left wondering why I feel worse than I did yesterday morning. Rhonda's comment on my last post made me think that maybe there is some truth in feeling funky from eating a weird diet. I mean, how often if life are you told to eat as much sodium as possible? It can't be all that good for the digestive tract. The nurse encouraged me to just keep up the fluids and to rest, lay low and watch movies all day. And to call if I notice any changes.

For today's diet, I'm adding chicken bullion cubes. One cube dissolved in one cup of water has a whopping 1,100mg of sodium. That was my breakfast this morning on the way to the clinic. B is going to a basketball game today, so mom and dad are coming over to keep me company and deal with the dogs. Mom is going to make some yummy, salty potato latkes for dinner that we were supposed to have for passover, but had to skip because she had a cold and didn't want to give it to any of us. I'm also adding benefiber to my diet today in hopes that it will keep me more regular. If this stuff works, it will be pretty amazing. It is a tasteless fiber powder that you can dissolve in any liquid or soft food and you don't taste it. At all. The pharmacist assured me it works well.

On the way home from the clinic, it started snowing. That's right, folks. April 26th and it is snowing. Big, fat, furious flakes. I tried to capture it on film, but you can't really tell and I didn't have the patience to play around with the camera settings. So those white things on the table that look like cotton, those are big ole flakes of spring snow.

Fluid Fiasco

When I met with the nurse yesterday morning, I was given strict instructions to call if I started to feel any worse (difficulty breathing, moving, pain, nausea). I readily agreed and went home to rest, drink and eat. About mid-day I started feeling not so great and laid down to take a nap. I felt a little better after that, but started to feel worse by the time evening rolled around. My stomach felt so tight from the fluid that it was a little difficult to stand up straight. I wasn't sure if it was my imagination, but it seemed like it was a little more difficult to breathe. The dilemma I was having was that if I called at night, the on call nurse would make me go to the emergency room. And it didn't feel like an emergency to me. So I went to bed.

I actually slept pretty good, aside from getting up every 2 hours to pee. And I felt better. No breathing problems, no problem standing up straight. This morning when I woke up, my stomach hurt. I think it probably has to do with my digestive system trying to move things through when there is very little room because of the excess fluid. Fluid pressing on different parts of my body = pain. Unfortunately I haven't been able to remedy that situation yet this morning, despite the stool softeners. I have resigned myself to calling the clinic today and likely going in for another ultrasound, but I don't want to make the call until this one issue is resolved. And I can't do anything to help it resolve faster.

Yesterday, in addition to much vitamin water and regular water, I ate the following salty foods: beef jerky, pickles, peanut butter, gardettos bread chips, frozen pizza, beef stew, processed cheese spread on wheat thins. Every single thing I ate had sodium and I must have drank my weight in vitamin water. If that isn't going to help the fluid situation resolve, I don't know what will. I am really hoping they don't call me for a day 3 transfer tomorrow, because I really think they will cancel me if that is the case. I need the extra two days to get rid of this fluid. I hope.

Friday, April 25, 2008

I'm No Santa

Instead of jiggling like a bowl full of jelly, I'm jiggling like a bowl full of water.



The ultrasound this morning showed some fluid in my abdominal area. Up high, down low. But none in the chest, which is good. They are concerned, so I am to keep up with the fluid and sodium intake and report in if I start to feel any worse. Overall, I feel pretty good so far. SO much better than last time. I think a lot of that can be attributed to my careful planning with starting the stool softeners two days before the retrieval. I learned a very difficult lesson about my body and anesthesia last time. So I'm happy to report that all bodily functions are now functioning properly! Yes, I know, TMI. I'm not even going to apologize anymore.

Last night was a bit rough as I was really sore. It was difficult to move around and even sit or lie comfortably. Today I am much less sore, but feeling pretty full. The plan is to proceed with a day 5 transfer. They will do another ultrasound the morning of the transfer to check fluid and hope that it has receded.

I just had to step away from the computer to answer the phone for our fert report! Out of the 16 eggs, 15 were mature, and 13 fertilized. So we have 13 to work with and we are very pleased with that number. Last time, with 27 eggs, we ended up with 18 to work with. This time, 11 less eggs, but only 5 less embryos to work with. Pretty good results, if I do say so myself.

The embryologist said they will check on our lucky 13 (my words, not hers) Sunday morning. If the majority of them are 6-10 cells, they will call to let me know we're on for a day 5 transfer. If not, they'll call to tell us to come in that day for transfer. I really hope they grow well and quickly so that we can stretch to day 5. I'm hoping that will give my body more time to adjust and get rid of the fluid.

On that note, I'm off to drown myself in vitamin water and salt for the rest of the day. Happy Friday!

Thursday, April 24, 2008

Does Bloat = Fluid?

Guess the Number

1. The age I was when I got my driver's license
2. The age Molly Ringwald's character turned in a John Hughes movie
3. The number of ounces in a pound
4. The number of waking hours in a day if you sleep 8 hours at night
5. The number of eggs retrieved from my ovaries today

If you haven't guessed by now, the number is 16! This is 11 eggs less than last time, but that is perfectly fine by us.

We are back from retrieval and I'm propped up in bed resting comfortably. No hint of nausea so far, so that is encouraging. I'm a bit achy, but not too bad. I'm trying to avoid taking any painkillers (even tylenol) as the anesthesiologist said this could contribute to nausea. They did not check for fluid today, didn't check estrogen level and didn't even mention the possibility of a freeze. Although it was a different doc who actually did the retrieval, we did see Dr. S briefly in recovery. He said he was not at all concerned about OHSS and that he was confident we would get to do a fresh transfer. Yay!!!

That being said, they do want me to go in tomorrow morning for an ultrasound to check for fluid.

I'm relieved and I feel pretty good. We should get a call from the embryologist tomorrow with the fertilization report. If all goes well, we're headed for a Day 5 transfer next Tuesday.

Thanks for all of your well wishes! I'm convinced it had a big part in why I feel so good and hopeful today. You guys are the best!

Wednesday, April 23, 2008

Twas the Night Before Retrieval

and all through the den, not a thing was going down, not even my estrogen. My E2 this morning was 7,757. We are still taking things day by day with the transfer versus freeze debate. It will depend on if my level continues to rise, if I'm retaining fluid, and how I feel. I will likely need to go in Friday for an ultrasound and blood draw. As of today, I feel okay. Not sure if there's fluid, but I'm definitely feeling more bloated today. I'm just glad there is still a little hope of a fresh transfer as I'm not sure I would want to go through with the retrieval without that carrot dangling out there.

I am stuffing my face with the saltiest foods and I can find and drowning in vitamin water. And other than my prenatal and starting a stool softener (in preparation for the lovely effects of anesthesia on my system), I am medication free for one day. Small victories, I suppose.

We are to arrive at the clinic at 10:45 am tomorrow morning for the 11:45am retrieval. I will try to post an update tomorrow evening if I feel up to it, but I'm not making any promises.

Tuesday, April 22, 2008

Fun With Trigger Shots

We are triggering tonight (well technically, very early tomorrow morning) at 12:45am. Retrieval is set for 11:45am on Thursday. It is still up in the air whether or not we'll get to transfer. My E2 was at 6,688 today. Although it did jump by 855, at least it wasn't a 2,000 jump like the day before. At this point last cycle, it was over 8,000. Instead of Lu.pron tonight, I'm taking an antagon shot (Gan.irelix), which should keep me from ovulating, won't interfere with the HCG (trigger shot), and will hopefully help to counter the effect of the HCG on my E2 level (HCG increases E2). I also take my last vi.agra tonight (thank god), my last dex.amethasone and no more es.trace.

Tomorrow I go back in for yet another blood draw (no ultrasound this time). My lining today was still at 7, so it appears that is where it will stay and they are fine with that. I think I get a break from meds tomorrow, although it is possible they'll have me do one more antagon shot. Thursday we are to show up at 10:45 for retrieval. It is likely they'll have me come in a day or two after retrieval to check for fluid and to check E2 level yet again. Based on how all that goes, they'll decide whether we can transfer, or if they have to freeze everything again.

Keep the positive thoughts coming. I think I need all the positivity I can get right now. I will be crushed if we end up having to freeze again.

Monday, April 21, 2008

SO FRUSTRATED

Ultrasound today showed 17-18 follies, with about 13 ready to go, so we were told trigger would likely be tonight. The ultrasound tech who measured my lining today could only get a 6 out of it, but it was a different tech with a different machine, so they are treating it as a 7. Great. Nothing like giving me more confidence here.

My E2 level is now at 5,833, even after a day of coasting it went up by over 2,000. We are not triggering tonight. The doc wants me to stop taking the es.trace and go back in tomorrow to see what my "true" estrogen level is without the es.trace. I really don't believe that taking one tiny little es.trace vaginally could be skewing my E2 level by THAT much. I also don't believe giving me another day off stims will cause my E2 to drop. Just speaking from past experience with my own body here, but what do I know?

I am so frustrated. I don't understand why my body is doing this and not reacting the way it should. Why didn't we start at the lowest possible dose of stims and build up if needed?

I had my mind set on triggering tonight with retrieval Wednesday and both B and I had told our bosses already (serves us right).

I think part of what is upsetting me right now is the thought of yet another day of the vi.agra. Have I mentioned how much I hate this stuff and how much of a freak I feel while on it (things just don't feel right in there)? I'm also worried about the fact that Nancy's doctor told her not to take the es.trace and vi.agra at the same time and mine didn't mention a word about that (I've been taking my es.trace at the same time as my 4th dose of vi.agra each night). I know each patient is different and each doctor has a different theory, but it's just one more thing for me to worry about.

Fuck. (sorry, Mom)

Sunday, April 20, 2008

No More Stims (Updated at Bottom)

Today's ultrasound showed about 17 or 18 good size follicles. More of them are a bit over 2.0 now, but there are still some stragglers around 1.4 or 1.5 that they are hoping might catch up a bit. Today is day 8 of stims and my estrogen is now at 3700. Yesterday it was at 2,500 on day 7 of stims, whereas day 7 of stims last cycle showed E2 of 3,300. I didn't get an exact number, but I glanced at my chart and my E2 on day 8 of stims last time was over 4,000 (I think around 4,100). So 3,700 is lower than last time, but still not low enough to make me all that comfortable.

I am officially being coasted now, with no more stims. This makes me happy because the Men.opur shots really sting and I hate taking those every morning. So I am to continue only the Lu.pron shots each evening, the es.trace and vi.agra (and the dex.amethasone and prenatal) and go back in tomorrow for another check. It is possible that tomorrow will be trigger, which would put retrieval on Wednesday. The nurse tried to reassure me that she didn't think we would need to freeze and that Dr. S hadn't mentioned anything about it. She said usually he would mention it if he was worried about it so that the patient would be prepared for the possibility. However, that doesn't give me much comfort either because I know he knows that we are already prepared for it (and worried about it). So I'm not really sure what to think right now.

The nurse also seemed to think my lining was fine for moving forward now. The ultrasound tech (same one as yesterday) said that it had grown just a little bit since yesterday. She didn't give us a measurement and although she told us 7.5 yesterday, she only wrote down 7.0 in the chart yesterday and 7.2 today. The vi.agra and estr.ace must have given it an initial boost, but it doesn't seem to be doing much now. I hope that doesn't mean it isn't going to help anymore.

*TMI warning*
I also double checked with the nurse today (as she seemed more competent and open than the one yesterday) that it was normal for me to feel like everything was swollen inside from the vi.agra and she said yes, it is a normal side effect. I know it makes sense. It's just really disconcerting to feel like my hooha is closing shut. I really had a hard time getting the suppositories in far enough last night because I could barely get my finger up there. And my fingers are really not very big. I'm also worried that this crap will give me a yeast infection because it doesn't seem like everything would drain properly because it's all swollen. Then again, the vi.agra has no problem leaking out all over the place.

This stuff is really disgusting. I think it is worse than the prom.etrium because it is not as thick and when it leaks out, it just gets everywhere. I've resorted to wearing a full pad now, which I hate. It feels like I'm wearing a diaper. It's one thing to have to deal with this over the weekend while wearing happy pants for 2 days straight, but I'm really not looking forward to dealing with this at work tomorrow. I don't think it would be appropriate to wear happy pants to work. I really hope tomorrow is trigger because that would mean I can stop the vi.agra. I confirmed with the nurse that we stop the vi.agra once we trigger. I didn't ask why, but my assumption was something that improves blood flow shouldn't be in your system when you have surgery (ER) as you could bleed more. I'm no doctor (or nurse), but that was my guess.

I just wish that I could have one of those textbook cycles where everything goes perfectly and predictably, but that doesn't seem to be in the cards for me. I know plenty of people say that textbook cycles often result in BFN's and that the sketchy cycles can result in BFP's, but I just want some stability, you know?

That's all for now. I'll update again tomorrow afternoon/evening.


*********************

I forgot to answer Melanie's question. No, I'm not noticing any other "effects" from the vi.agra, which is probably a good thing. I'm not sure anything else would fit up there! Sorry, that was pretty crass. But seriously, I'm not feeling very amorous right now, just bloated, tender and uncomfortable. And with B's hernia(s), sex is the last thing on both of our minds. I know there is some debate as to whether vi.agra can increase a female's libido, but I would think it should be taken orally in pill form if that were the intent. With the suppository, it is mostly absorbed by the tissue and doesn't really make it into the blood stream.

Saturday, April 19, 2008

Pretty Good Day

Today's ultrasound showed about 6+ follies on lefty and 9-10 on righty, so we're back to about 15-16. They are ranging from about 1.5 to 2.0, so looking pretty good. And my lining (drum roll, please) is measuring at 7.5. Either my lining has just decided that it is a slow learner, or it is responding to the vi.agra and es.trace. Regardless, it is growing and is now within a range that they should be comfortable with a transfer. One problem on the mend.

After my appointment, I met up with the ColoBlogger girls again. It was good to see everyone and hear what's new in people's lives (cycling, waiting, preparing for surgery, blogging). I had fun surprising the girls with my "fun box" of vi.agra suppositories. Everyone oohed and aahhed and I felt oh so special with my very own box o'fun. They don't look anything like the little blue pill you would expect. They are about an inch (and a half?) long white, waxy, bullet shaped things. Much larger than the other pills and suppositories that I've had to shove up my hooha over the past year and a half, but then again, they are much smaller than other things (you know, tampons, dildo cam, etc.). Sorry, going off on a tangent here. When I first opened the box yesterday, I actually thought maybe I was looking at little styrofoam pieces that were holding the individual little blue pills. No such luck.

I had a yummy breakfast panini (complete with salty bacon) and drank a ton of water. Thank goodness it only took me 20 minutes to get home because I thought I was going to pee my pants. I am peeing constantly the last couple of days with all the fluid intake. And today I discovered that I don't mind the taste of vitamin water. It has electrolytes, like gat.orade, but without the horrid taste. It doesn't have any sodium, but I figure I'm getting enough of that in my diet. Snacking on some salty popcorn as we speak (I mean, as I write). So I'm gonna go stock up on the vitamin water later today.

The nurse called back just a few minutes ago with my instructions to keep all of my meds the same and come back in tomorrow morning. My E2 was around 2,500 today. It sounds a bit high to me, but at least it didn't double. I seem to remember it continuing to double last cycle and that's how it escalated so quickly resulting in our freeze all. I did ask the nurse if that level was normal or cause for concern at this point and she said it was fine. I don't fully believe her as she was the nurse I saw this morning who didn't bother even reviewing the ultrasound results with me and just asked "do you have any questions?" That mode of operation doesn't really do much to build my faith in her knowledge. But since I know Dr. S was the one reviewing charts today, and in keeping with my new motto of "let go and let Dr. S," I'm going to believe her that it is "fine."

It is amazing to me that some of these nurses don't tell you anything and just expect you to be fine with that. I had to ask her for my E2 level and then ask if that was normal. Do they just think we are willing to assume everything's great and not worry about it? I am way too much of a control freak for that.

Way Too Much Info...

Warning, this post has a ton of TMI in it. In fact, that's all it is. If you are squeamish or don't want to know about the inner workings of my body, click away now. Just click away.

Last night at bedtime I went to insert the second vi.agra suppository of the day. I don't know if it is my imagination, but it felt like everything was all swollen "up there" and that the texture of the tissue had changed. I'm wondering if this is a normal side effect because it is meant to be absorbed by the vascular tissue, but Dr. Google had no answers for me. I will ask the nurse this morning. The second strange incident was that my bowel movement this morning was green. Really green. I haven't had anything diet-wise that would cause this, so I'm hoping this may also be a side effect of the suppositories and hopefully not a sign that my gallstones are acting up. The bowel movement was also a bit painful, even though it was soft. It felt like it was just pressing on tender parts as it was making its way out into the world.

Okay, done with the TMI. Sorry about that.

Friday, April 18, 2008

Let Go

This morning's ultrasound showed about 6+ follicles on each side. I have no idea how they measured 10 on one side two days ago and now there are only 6. But this was the least of my worries, so I didn't even ask. My lining measured at only 5. A measly 5. I was upset, of course, but was told that they would fit us in to see the doctor before we left. I got blood drawn and then we waited for about 30 minutes and were then told that he was too busy to see us. So we met with the nurse again, I cried, and she promised that she would talk to the doc personally to try to get some reassurance that we are still on track.

I went to work a miserable wreck. The nurse called while I was at lunch (and didn't hear my phone ringing in my purse) and left a voicemail saying that she had spoken with the doctor and he was happy with where we were at this point in the cycle. Happy? She didn't give any details, but said she would call back later after blood work results came back.

Around 3:30pm she called back with my instructions. I am to drop my Go.nal-F dose to 37.5 tonight, still take the 1 vial of Men.opur in the morning, and haul ass to the pharmacy to pick up some estr.ace and vi.agra. I am to start taking vi.agra supps 4 times a day and 1 estr.ace at night. The combination of these is meant to increase the thickness of my lining. I know it sounds a bit weird, but vi.agra is supposed to help increase blood flow to the uterus when administered vaginally. I guess it makes sense when you think about what it is normally used for.

Dr. S is apparently happy that we have fewer follicles this time (12+ compared to 22+ last time), so this must mean he thinks my estrogen will stay under control. And we are willing to give up all those extra follies if it means actually getting a chance at a fresh transfer. Today my estrogen was at 1,618. Although I think this is a bit high, it doesn't seem super high to me, but there is just no way to tell where we will end up right now.

I had a million questions for the nurse and she finally said (in the nicest possible way), that I need to let go and just trust that Dr. S knows what he is doing. I guess instead of "let go and let god" it is "let go and let Dr. S." So that's what I will try to do. I will take what I'm told to take and show up for as many ultrasounds and blood draws as they want. I go back in tomorrow morning for another wanding and a stick.

In the meantime, I'm going to sample as many beverages other than gat.orade as possible that have sodium and electrolytes (and no caffeine), and eat as much salty food as I can. I just can't drink gat.orade after my last fresh cycle. I felt like I nearly OD'd on the stuff and it makes me gag now.

After my appointment tomorrow, I'll be heading north to meet up with the ColoBloggers for a bit. I plan to spend the rest of the weekend on the couch as much as possible. I haven't been feeling great and started feeling pretty darn cruddy last night and into today. At least no more work for 2 days. The couch is calling.

Wednesday, April 16, 2008

Today's Results

E2=596 (or something like that). This is higher than it was at this point the last fresh cycle we did. I can't remember exact numbers right now, but it was somewhere around 530-550-ish. I think it's really weird that my follies are growing faster and my E2 is higher with a lower dose of stims. I don't go back until Friday and after they scan me, we will meet with the doc to get his view. He is keeping me on the same dosage until then, so I'm fully expecting my E2 level to skyrocket by Friday. We're going to be in OHSS land again and I am so, so, so worried they will cancel this cycle.

At least last time we had hope going into retrieval knowing they were going to freeze everything. We were comforted by the fact that we had so many embryos to freeze and work with later and that is what made the freeze all "okay" in my mind. Now that we're on the other side of three FET's (one cancelled before transfer and two BFN's), it makes everything different this time. I don't even see the point of going forward with a retrieval if my E2 is too high and we can't transfer. I don't see the point of freezing our embryos at all, it would just seem like a waste of time. 18 frickin embryos last time and, well, we know what that got us in the end. Jack shit.

The nurse didn't have much to say other than they are monitoring me really closely and I can speak with the doc on Friday to get his thoughts. She said I shouldn't be worried about my lining yet. There is still time. If it hasn't grown much by Friday, they might add some es.trace and see what that does. I don't have much faith in es.trace anymore. I think it's time to get a little more creative. I just don't know if there are any other options.

So 2 more sleeps until the next U/S and BW and a discussion with Dr. S. I'm actually quite proud of myself for how productive I've been at work this week. I feel like it has become a herculean task just to BE there every day, but I'm doing it and actually getting things done. At least I can do something right.

First Stim Ultrasound

The good news is, my ovaries are working overtime. Lefty has about 5 follies right around 1.0, plus some smaller ones. Righty, apparently the overachiever, has 10 around the 1.0 mark, a couple that are at 1.2 already.

The bad news is, my lining, the underachiever, is only at 4.5. At this point in my cycle the first go round, my lining was at 7.0. I had a similar number of follicles, that were actually slightly smaller than where I'm at today. Go figure, lower the dose and the follies grow quicker. I'm all backwards.

I'm really anxious to see where my estrogen level is compared to last time. I'm really expecting it to be lower than last time since my lining is so much thinner. I guess it is a fine line for me between building my lining and keeping my estrogen under control. I'm really, really worried about this.

I'll update after I get a call back this afternoon with blood results and instructions for doses for the next two days.

Tuesday, April 15, 2008

The Storm

Today was better than yesterday, so I'm grateful for that. The crazy mostly subsided for the day, but the back aches are now plaguing me. It alternates between sharp, stabbing pain and dull ache on either side. My first ultrasound while stimming is tomorrow morning. Can't wait to take a peek in there and see what's going on. Please let there be lots of follicles, a growing lining, and a not too high E2 level.

Tonight while I was driving home, it was really windy and the gusts were blowing sheets of dust through the air. I was listening to today's tune on the radio at full volume and I felt like I was pushing forward through a storm-physically and metaphorically. This storm of infertility. It is a struggle, but as long as I feel like I'm pushing forward, I'm okay. I thought about this while driving through the dust storm, listening to lyrics about not sinking the boat. There just has to be an end to the storm at some point. A sunny, calm end to the storm. And in the meantime, "breathe...it's all you can."

Monday, April 14, 2008

There's Always Tomorrow

So I'm feeling a little better emotionally than I was earlier, which is good. The sunshine and coming home to B playing with the dogs in the backyard helped. I was proud just to have made it through the day-and without anyone at work really knowing how I was feeling-which is a pretty momentous task based on how I felt today. I still feel pretty cruddy physically, which is weird. I'm feeling all kinds of twinges from my ovaries, lower abdomen and my lower back is aching like crazy. It's weird. I don't remember feeling like this at all last time. I remember feeling bloated and uncomfortable, but not until I was about a week into stims. I guess it's true that each time can be different, but I just wasn't expecting to feel this way so quickly.

I'm wondering (and hoping) if part of it is not getting enough sleep. So I'm planning on going to bed early tonight and hoping I can sleep through the night. Here's hoping for a better tomorrow.

Thanks for all of your comments today. It really does help knowing I'm not crazy and other people feel the same way!

The Shots are the Easy Part

The shots themselves have been fine. Other than a little issue priming the first Gon.al F pen (which decided not to prime and then to shoot out precious liquid across the room on the second attempt), they haven't been a big deal. Wish my brain would cooperate.

2nd day of stims and I'm already feeling pretty out of wack. Yesterday was a bit rough emotionally and so far today has been, well, not much better. I really wish I had started blogging sooner (through my first fresh cycle) so I could go back to see if this is how I felt last time. I honestly thought I would handle this cycle a little better having been through it before and with half the Gon.al F dose, but not so much.

I'm only on 1 vial of Men.opur and 75u of Gon.al F. Shouldn't be too bad, right? But I find myself either in tears or close to it multiple times a day. I feel like I can't handle anything right now. Work, traffic, you know, life. Not for me right now. I just want to curl up in a ball in my bed and not come out for the next two weeks. Too bad I can't. Although even though not leaving the bed sounds nice, it would probably be torture since I'm also having trouble sleeping lately.

Saturday, April 12, 2008

I Should Get an Oscar

Have you ever had a bad massage? It is a waste of time and money. It is worse than no massage at all. I experienced my second bad massage today. By the same massage therapist as the first time. When I made the appointment yesterday, I made sure to ask who was available and it was a different therapist. One that my mom has been to before and liked. I showed up at the spa looking forward to a relaxing massage with the good therapist and was checked in and turned over to the bad therapist.

It all happened so quickly I found myself in the room undressing all the while willing myself to go back to the front desk and complain. But I'm a chicken. I couldn't face the therapist and tell her that she is THAT bad. I didn't want to hurt her feelings. So I suffered through another horrible 55 minutes of sausage fingers probing me like aliens. The whole time beating myself up for not saying something. After the massage, I quickly got dressed and escaped to the lobby where I promptly complained to the receptionist that I was supposed to have the OTHER therapist and that I do not like the one they gave me. At all. She said she didn't have the authority to waive the fee, but she would make sure the owner called me as soon as he was back.

I paid for my horrible massage and even included a $10 tip. I couldn't justify not tipping. It wasn't the bad therapist's fault that the front desk had screwed up and I didn't say anything. I then walked quickly back to the car and burst into tears. And called B, crying the whole time. It is times like this when I know the Lu.pron is affecting me (as if I didn't know before?). I mean, a situation like this would normally get me all riled up and I would be pissed off, but crying? I mean, come on. It wasn't the end of the world. I sound like such a spoiled privileged brat complaining about a horrible massage. Whoa is me, boo hoo.

The thing is, I tend to look at things very drastically and fatalistically when I'm all emotional on hormones (or lack thereof). I kept thinking this was my last chance for a massage because I start stims tomorrow and my ovaries will start swelling and it will be too dangerous or uncomfortable to get a massage. This morning I really wanted to sleep in because I knew that it was my last chance for the next couple of weeks while stimming as I'll need to do my Men.opur shot at 7am sharp every morning. And because I kept thinking about that, I couldn't sleep. Then the massage fiasco just made it feel like nothing was going right. The universe was imploding. Dramatic much? Yep, that's me.

The owner did call me back this afternoon and after a half assed apology and an attempt to get me to settle for a free massage at another time or even today (as if I want to go back to the scene of the crime in the same day), he agreed to refund my money and pay the therapist himself. Am I satisfied? Sort of. I mean, I feel like he fixed the immediate issue, but problem is, now I don't know if I can ever show my face there again. *Sigh*

Friday, April 11, 2008

Our Exciting Friday Night

Months and months ago we noticed a very large structure going up just down the street from our house. Our initial assumption was that it was yet another ginormous church in the land of ginormous churches. We soon discovered that we were wrong, but sort of right. We were about to welcome to the neighborhood the soon to be largest liquor store in the state-a different kind of church, if you will. It seemed that the construction would go on forever. There was no indication of an opening date-no signs posted, nothing on the internet. And today was the big opening day.

Tonight after eating dinner at a nearby restaurant, we wandered around this place wide-eyed and drooling, taking in the sights which include a deli (complete with pastry and cheese counter), fireplace, lounge with piano, wine bar/restaurant, and huge flat screen tv's everywhere you look. What a shame we can't partake due to our IVF cycle. 7,000 varieties of wine, for the love of God! I'm sure I will have dreams of gulping down bottle after bottle of wine in this place in the coming weeks. And if this cycle doesn't work for us, I'm proposing the next ColoBlogger meeting take place there.

Let me just caveat here that I would obviously rather be pregnant than able to drink wine, but still, can't a girl complain just a little bit here.

I forgot to mention in my update earlier this evening that I asked the nurse why I'm staying on 10 units of Lu.pron until retrieval, whereas my first IVF cycle, it dropped to 5 units once I started stims. She said that they started having more people break through (ovulate) while on Lu.pron, which requires a cancelled cycle because the eggs are no longer in the ovaries to retrieve. Apparently they had 3 people in one month break through, which is unheard of. Dr. S decided that he wasn't all that confident that the Lu.pron batches were working as well as they used to and so he decided to change the protocol to 10 units for the duration. The nurse said that a lot of clinics are doing this and that some actually start with 20 units and drop to 10. This is all fine by me as long as it doesn't mean double the appearances of EB.

The nurse also reiterated that Dr. S will not be raising my dose of stims at all unless I'm just not responding at all, which isn't likely. Slow and steady wins the race.

To enjoy my last day before starting stims, I made an appointment for a much needed massage tomorrow. Ahhhhhh.

Preppin for Stims

Just a quick update from this morning's appointment. The ultrasound showed no cysts, a thin lining, and tons of small antral follicles. All good things for a suppression check. The blood work also came back great. Estrogen at 44 (should be less than 50), and progesterone 0.2 (should be less than 1). So we've been given the green light to start stims on Sunday!

Do I sound excited? I am. Except that I'm dreading the daily Men.opur shots. Those suckers sting.

Thursday, April 10, 2008

Comfort Books

When I was in high school (or was it middle school?), I discovered the book "Clan of the Cave Bear." The book and the sequels that followed chronicle a young girl growing up in "caveman" days who is separated from her family by an earthquake and is taken in by a different, older species of human. She grows up in a world that should have been completely foreign to her and doesn't understand why she is so different. There is so much detail in these books on how early man made tools, kept fire, hunted game, used herbal medicine, and how he may have evolved into different species. It sounds utterly boring reading about it here, but the book is fiction and is written well enough that you forget how much history/archeology may actually be embedded in the story.

There is a fantasy element to the books, but I think what most appealed to me was the heroine, Ayla. She defies all odds over and over again and becomes this extraordinarily strong, amazing, independent woman who discovers flint can make fire, tames a wild horse (and then a lion cub and a wolf), and teaches so many lessons to those around her. But she is also very human, making mistakes, falling in love and suffering such devastating losses. For my 18th birthday, my parents gave me hardbacks of the series and they are still one of my most prized possessions. So much so that even though I read the books over and over again, I read the paperbacks so that I don't damage the hardbacks.

The other series that speaks to me in the same way is the Outlander series. There's definitely a lot of fantasy in these books in addition to steamy sex scenes (come to think of it, the Clan series has that too), but at it's core, it is a love and destiny story. The love and destiny of a wife, lover, and then a mother. And the underlying theme throughout of family. There is another strong heroine in this series, Claire, who is just written so real she seems to jump off the page at you. You feel like you know her, or that you are her in a way.

There is something about both of these series of books that speaks to me and I can read them over and over again without getting sick of the stories. They have become something of a security blanket for me-comfort books. When I feel lost or disconnected from myself, I go back to these books and lose myself in Ayla and Claire's stories again. It is like an old friend who reminds me of who I am.

Since we moved into our new house almost a year and a half ago, we haven't bought bookshelves and my old friends, the books, have remained packed away in boxes in the basement, untouched. I think it might be time for me to dig them out and pay them a visit.

What books are your "comfort books?"

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AF arrived today. She was quite the congenial visitor for a change, with very little flow and very minor cramping. I go in tomorrow morning for my suppression check (U/S and BW).

Wednesday, April 9, 2008

Some Ramblings

I think AF is just around the corner. As in tonight or tomorrow (hopefully). If so, things will start moving along. It just can't happen soon enough. I hate being on Lu.pron and this part of the process is just painfully slow.

Now that it appears B should be able to provide a fresh sample on retrieval day, we have to decide how long we want to store the frozen boys for. The nurse suggested possibly waiting until after his surgery to make sure everything "works" properly before we decide we don't need them. I'm inclined to agree.

Sage actually called me this afternoon. We didn't talk long since I was at work, and I almost felt bad trying to explain why we hadn't called since our last cycle failed. But given that I've been feeling bad about missing work for treatments, I told her that it is just too hard to find time in the middle of the day to drive all the way to the other end of town for a session. I need to save my time away from work for retrieval and transfer for this next cycle. She was very understanding and said that if we want, we can try to work out coming in for an evening session. It was reassuring, but I honestly feel like we're in a pretty good place right now. Even with EB surfacing here and there. B has been very understanding and we are just focused on getting through this cycle and his hernia surgery.

What really made my day though is that my Ugg's finally arrived. I ordered them from Nordy's over a month ago and something got screwed up and they lost my order. I called last weekend and they immediately ordered them from another store and paid to ship them to my house. I spent 30 minutes walking around in them when I got home and they are SOOOOO comfy. Good thing they showed up today just in time for the 8 inches of snow we're supposed to get tonight and tomorrow. Gotta love spring time in Denver. Snow on Thursday and 60's by Saturday.

Monday, April 7, 2008

What Did You Do This Afternoon?

I spent this afternoon watching my husband get felt up by a doctor. Don't worry, I won't give you any more detail on the actual exam, other than there was a LOT of coughing and turning of the head involved. It's the most action poor B has seen in awhile.

All kidding aside, B's surgery consult went fine today. He has actually developed some pain on the other side from where the pain originally was and the doc thinks he might actually have 2 hernias. Two for the price of one. The good news is that the recovery time is the same with two done at the same time as one. The doc wants B to get a second ultrasound because the first only looked at one side and to also confirm the findings of the first ultrasound. He wants him to go to a specific person who specializes in ultrasounds to diagnose hernias because he said that ultrasound is subjective. Sound familiar? We've heard that one before.

The bad news is he couldn't get an appointment for an ultrasound until May 12th. So the surgery is scheduled for May 14th. It will be outpatient and recovery should be no more than a week or so, so not too bad. We did learn more than we ever wanted to know about hernia repair and the advances made in recent years. The technique they will use is a mesh device that goes on both sides of the abdominal wall at the site of the tear. Pretty fancy stuff, actually.

As of now, my retrieval is scheduled for April 24. If we stay on track, transfer will be either April 27th or 29th. Even if we end up a week later than estimated, that would put retrieval on May 1st, with transfer on the 4th or 6th. That gives us some cushion time-wise between the IF stuff and B's hernia surgery. And B should be able to provide a fresh sample on retrieval day. The only downside to the timing is that B is uncomfortable. Hopefully it won't get any worse in the next month.

On the IF front, nothing much to report. Tonight is my last BCP and then I call with CD1 to go in for baseline ultrasound a day or two after.

Sunday, April 6, 2008

Ah, Weekends

Why can't weekends be longer? Or more frequent?

Yesterday I spent a leisurely day at the outlets with Nancy talking, shopping, eating. And the pocket of fluid really wasn't noticeable until she pointed it out (don't worry, Nancy, it doesn't look like a goiter at all). It just made me wonder, yet again, why all of this has to be so hard. Nancy's retrieval experience sounds like it was just as horrible (with the same end result of a freeze all) as mine. Why can't it just go smoothly for anyone I know? Seriously.

I spent an hour in the sunshine this morning picking up dog poop remnants from the parts of the yard that don't see the sun much in the winter. Piles of snow sat over the poop for long, frozen months, turning it into some kind of petrified thing that no one would want to encounter. I know this sounds pretty gross, but it was actually a nice morning. I was in the sunshine, by myself, just me, the dogs and the birds. And for once, the neighborhood dogs weren't barking. Which meant Scout wasn't barking. I know this doesn't sound like a big deal, but those of you who know Scout know what a miracle this truly is. A whole hour of peace and poop.

This afternoon was family time. We went with my parents and my grandma to see this exhibit and then went to an early dinner at this restaurant. A good time was had by all and I was home in time to take my 7pm Lu.pron shot. Speaking of Lu.pron...

EB has returned. The beginning of this post makes it sound like it was such a nice weekend. Parts of it were, but Saturday evening, I was a raging bitch. Everything made me FUMING mad. For no apparent reason. I can hear myself, see myself becoming this horrible person I don't like, but I CAN'T HELP IT. It is like my body and mind has been taken over by this alien who's sole purpose in life is to HATE and be ANGRY. It makes me feel so pathetic and hopeless. I loathe this drug. The next couple of weeks are going to be rough.

In case you were wondering, I am still spotting. I spoke with the nurse this morning and she is not concerned. It's a big relief to me. You see, I take my last BCP tomorrow and then I'm supposed to have a period a couple of days later. That is what jump starts the cycle. It prompts the first ultrasound and bloodwork and assuming all goes well, stims. I was worried that after 6 days of spotting, there would be nothing left for a period and we'd be cancelled-starting over. The nurse assured me that I will still likely have a period. It might just be lighter than normal which is fine by me-as long as it comes.

I remember during my first fresh cycle how overwhelming the process seemed. At the time I almost wished I had been through one cycle already so that I would know what to expect. So the shots, appointments, procedures wouldn't be such a big deal to me. In recent weeks I've actually been longing for my early days of IVF where I had no idea how many things could go wrong. Ignorance is bliss, and all that jazz.

The "what ifs" are now what has become overwhelming. What if I spot too much and don't get a period. What if I'm not properly suppressed. What if we don't find the proper dose of stims for my body. What if we don't get enough follicles. What if we get too many follicles. What if I hyperstimulate. What if B's hernia surgery coincides with my retrieval or transfer. What if he is in too much pain to "perform." What if the eggs aren't mature or don't fertilize. What if the embryos don't grow. The what ifs go on and on.

So it seems that no matter which side of this I find myself on, it is not any easier. The beginning was terrifying and the middle is terrifying. I just hope the end makes it all worthwhile.

Friday, April 4, 2008

Sunny Friday

Not much to report today. First Lu.pron shot last night went fine. I'm really an old pro by now (this is my 4th cycle on it). I also started the dexamethasone (a steroid) last night (according to my patient handout, this is to prevent the secretion of excess male hormone, but I've also read that it helps if there are immunological problems).

I received a voicemail from my OB's office today saying that my thyroid tests came back "within normal limits." She didn't give me any numbers and she also didn't say anything about the results of my pap.

Today was sunny and pretty warm and it was the home opener of the rockies. Going out for lunch downtown is never a good idea when there is a day game. You see all the people in their rockies gear walking to the field and it really makes you want to skip out on work and head to the ball park.

Thursday, April 3, 2008

Warm and Fuzzy Internet

I feel so warm and fuzzy! The fantastic Melanie has bestowed this honor on me and my blog:



I've never met Melanie in person, but through her posts, comments, and emails, I feel like I know her so well and I'm so grateful for her constant support. And I heart her blog too!

And now I must pass on the honoring to a couple of others. I will first say that I heart Jen's blog. Hers was the first IF related blog I ever read and she inspired me to keep going with mine. And she is just as fabulous IRL.

I also heart Amanda's blog. Amanda is not an IF blogger (thank goodness-and hopefully she never will be), but she always has entertaining stories that help me to not think about IF for a minute or two. And mostly, I get my Amanda "fix" through words instead of in person. Not the most ideal way for an Amanda fix, but better than nothing.

Wednesday, April 2, 2008

Just Another Day in Stirrups

So things are looking up just a bit. Something must have opened up at the original surgeon that was recommended to us and B was able to set up an appointment for next Monday afternoon. I can't wait to get all of my questions answered and have some clarity around my expectations. I also spoke with our nurse and she assured me that using frozen sperm would not be a problem if that is what we need to do. She said the only difference with frozen is that they do ICSI, but they were already planning on doing ICSI for us because of our "unexplained" diagnosis. She did suggest we bank some extra samples just to be safe, so B will be making a couple of stops at the clinic in the next week or so.

I also had my pap and annual exam today. Hopefully the pap comes back normal. Everything else looked fine. I absolutely love my OB. She is so warm and kind and we talked at length about what we've been through in the past year. She was so understanding and encouraging. If anyone needs a recommendation for an OB in Englewood/Littleton, just let me know!

They also drew blood to check thyroid function (TSH and T4) per Dr. S's recommendation.

For some random reason I started spotting a little yesterday and the pap made it a bit worse today and I actually had some cramping. The nurse said it is nothing to be concerned about as long as it doesn't persist. Hopefully it will go away. I suspect that I'm also a bit more sensitive right now because I've had some digestive problems the last couple of days. Having someone poke around in that general vicinity probably wasn't the best timing. Oh well.

In other good news, I finally got the insurance company to process 2 of the 3 bills from my D&C last December! It only took about 10 phone calls, faxes, letters, etc. I hate insurance companies. One more bill to go-this one they told me I need to submit an appeal letter. I wrote it, pulled together all the documentation, and put that in the mail today. It felt so productive.

The dreaded lu.pron shots start tomorrow. Oh joy. Can't you tell I'm excited?