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.

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.

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)

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.

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.

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.

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.