Sunday, October 30, 2011
We woke up at 6 am today *yawn* and made our way to Chattanooga. During the ultrasound, both of us knew something wasn't right. Dr. Murray was enthusiastic about all the follicles before the ultrasound, but during the ultrasound the enthusiasm faded. My follicles weren't measuring at the size he had anticipated. We were given 2 explanations- a. I had ovulated since Friday and this would mean canceling the whole cycle. b. People measure follicles differently and since I'm being monitored at two clinics, there could have been a slight discrepency between measurements. The MD added a progesterone level to my bloodwork to determine if I had ovulated.
The ride home was a bit stressful. I checked my phone every 4 minutes to make sure I didn't miss Dr. Murray's call. Thankfully, he called with the news we wanted! I had not ovulated. My follicles were not quite the right size; this was most likely a measuring discrepency. Easy fix. We're jacking up the Follistim to 225 units to get those follicles growing a little more. One more night of shots.
Unfortunately, we have to head back to Chattanooga again tomorrow morning for another ultrasound and labs. Not ideal, but what's a girl to do?
I've had plenty of transvaginal ultrasounds in my life by a variety of professionals. Everyone has had difficulty locating my left ovary, but I never thought anything of it. But, Dr. Murray enlightened us to the fact that they may have difficulty retrieving the eggs on my left ovary due to it's location. He explained they may need to use a very large needle and go in through my abdomen instead of the traditional method of aspirating the eggs vaginally. This would provide for a more complicated recovery. I'm not sure how I feel about this news. I'm quite nervous about the retrieval the way it is, but thinking about extra complications and recovery is freaking me out a bit. I'm just trying to push the retrieval piece out of my mind for now. First we have to get to that stage.
Back to Chatt tomorrow. Hopefully my infertility will play by the rules tomorrow!
Friday, October 28, 2011
I went in for my second monitoring ultrasound today and it went well!! I know, we have a long road ahead yet, but any positive news in the infertility battle is reason to celebrate. It was the longest wanding I've ever experienced, due to the number of eggs, but this girl isn't complaining!
I know you're just dying to hear about my egg follicles, so I won't draw it out any longer. My right ovary has 19 follicles measuring over 10. There were several at or below 10, but those will more then likely not catch up with the rest of them. My left ovary had 10 follicles measuring over 10. Most of the follicles were in the 12-14 size range. We want them to get to about 18-20 before we're ready to jab in the trigger shot. 29! 29 follicles!! This is great news! No wonder I feel so bloated.
The NP that did the ultrasound (she's a bit too 'cheerleadery' for me most days, but today I bought into the enthusiasm) was just as excited as I was. She was giddy with excitement. At one point she said, "they're going to have fun with you!" Not the kind of comment you typically would get excited about when you don't have pants on and a stranger is viewing your uterus, but again, I'll take what I can get. Go ahead and have fun with me!
Now what? I just got a call from Chatt and they want us to come to them on Sunday for an ultrasound at 8:30. Not an ideal situation. Since it's the weekend and we're at a crucial point in the monitoring game, the nurse said they prefer their 'out of town patients' come in to the office at this point. I get it. It would be difficult to ensure info is sent from one clinic to the other on a Sunday and we absolutely need to hear back from the MD on Sunday after reviewing labs with the ultrasound to know what our next move is. So, we're heading to Chatt Sunday and *h0pefully* will be doing the trigger shot on Sunday night. This means our egg retrieval (which I'm very nervous about) would be on Tuesday morning.
The NP told me to take it easy to let those follicles grow. I guess I'll be taking it easy the rest of the day. Doctor's orders!
I landed in the hospital back in May '07 for an ileus. I had an abdominal CT done that gave me the diagnosis. From the CT, the doc discovered I had a dermoid cyst (Side creepy note-you're born with dermoid cysts. They are referred to as 'your lost twin' because they contain mature tissue that may include skin complete with hair follicles, hair, sebum, blood, fat, nails, teeth, cartilage, eyes, and other tissues. Doody told me mine had hair the same color as the hair on my head. Gross.) and also a septate uterine. Once I was discharged from the hospital, I was told to seek out an OB bc surgery was necessary to correct both of these conditions. Keep in mind, at this time, we had moved to Knoxville only 6 months earlier and were absolutely not trying for kids at the time. We were still working on careers and wanted kids once our careers were well established.
I picked an OB (I didn't have one yet in Knox) and went in for an appt. She recommended a specialist for the surgery due to where the cyst was; there was a moderate risk of losing my left ovary. It turns out, she had infertility problems and went to a RE in Knoxville, Dr. Doody, and she highly recommended him. It takes months to get in to have an appointment with Dr. Doody, but she graciously called him and made a personal referral on my behalf. I had an appointment in a few weeks.
Once I started seeing Dr. Doody, the rest is history. (Yup. Real name. Doody. Go ahead an laugh.) We've been seeing him since the summer of '07 and he's operated on my 3 times. First to remove the cyst (I was able to keep my ovary). When he did that surgery, he discovered I had severe endometriosis and was told I needed another surgery to correct it as well as the septate uterus. Once all of this was fixed, he asked when/if we were thinking about having kids. Doody caught us off guard with that question, because it wasn't on our radar for another few years. Due to the endometriosis, he recommended we should start thinking about kids, sooner rather then later, if it was something we wanted to pursue. Obviously, we thought it over and decided it was time to jump on the kid wagon! We had no idea it would take years!!! So, sad to say, we've never 'tried' having kids the old fashion way; we'd been diligently avoiding pregnancy since we got married via the pill. Our first attempt at getting pregnant included a month with Clomid and ovulation predictor tests. I often wonder what it feels like to be married, decide to have kids, throw out the pill and get after it! We'll never know what that's like....
All 'Doody' jokes aside, we both highly respect him as a physician and a person. He's understanding, patient and considerate. He's the kind of MD that takes you into his cozy office to have discussions rather then having them in a sterile exam room. He always takes his time and listens to all of your questions and concerns. We've always felt comfortable with him.
Although we were pregnant after our first injection/IUI cycle in Oct '09, it ended in a miscarriage and D&C. We did 2 IUI's after we scraped ourselves off the floor from that experience, but neither were successful. We had lightly discussed IVF with Dr. Doody following our miscarriage, but he felt confident with the one pregnancy (and correctable genetic issue), that we were sure to have success with another IUI.
Obviously this didn't happen, so we had a 'WTF meeting' with Dr. Doody to discuss IVF once and for all. Unfortunately, he does not specialize in IVF. Turns out there are no clinics in Knoxville that do. Who knew?! He had two recommendations of clinics in Chattanooga and Nashville. Then the research started... Nashville is about 2.5 hours from us and Chatt is 1.5 hrs. Advantage Chatt. Chatt is a new clinic, but, according to both Dr. Doody and Dr. Google, they are well on their way to becoming one of the best IVF clinics in the country. Advantage Chatt. Doody's office said they would work with us no matter which clinic we chose. We ended up choosing Tennessee Reproductive Medicine, the clinic in Chattanooga.
We've only had to go to Chatt 3 times so far; 2 more for the upcoming retrieval and transfer. I've been able to do all the monitoring and labs out of Doody's office in Knoxville. Both offices have been wonderful about coordinating schedules and information back and forth. Up to this point, I've been pleased with both clinics.
So anyway, that's the story of why we're running back and forth from Knoxville to Chattanooga and seeing two RE's in two different cities.
Wednesday, October 26, 2011
This appt was at Doody's office and was fairly uneventful. I got to see my favorite NP, Andra. Results: (drum role please) there are about 35ish follicles growing-25 on my right ovary and 10 on my left ovary. WHOA! That's a lot of potential babies. No wonder I feel swollen!! She didn't bother on counting them all bc they are small and we'll be seeing how many progress in the next few days.
I got a call from Chatt this afternoon after receiving and reviewing my ultrasound from earlier. We will be decreasing the Follistim to 150, but continuing on with all the other meds and returning for ultrasound 2 on Friday. The RN that called me from Chatt said everything looked "great." I'm enjoying every single victory I can get, no matter how small.
We're right on track for a retrieval next week!!
In the meantime, I am working tonight *yawn* and doing my best to get those follicles growing!! I have to get shot up with 3 shots by the husband then rush to the hospital to work.
We got a new roof on our house over the past 2 days so work should be interesting since I wasn't able to sleep much today. BUT, I'm not complaining. I have 35 follicles! Grow grow grow!!!
Friday, October 21, 2011
Now that I got that out of the way, here we are. We're at the stimulation day. All the stimulating drugs are in the arsenal and ready to take over control of my ovaries. I have a few worries about this phase, but I am just hoping and praying it goes smoothly and brings us the results we've been trying to get to for 3.5 years. Sometimes I still can't believe we're actually doing this. I never anticipated we'd have to undergo such difficulty in trying to start a family. Like it or not this is our reality.
For those of you who are not sure what this means, besides me becoming a hormonal nut case in the next week, it also means I'll be receiving gonadotropins-hormones that will stimulate my ovaries to produce multiple eggs. This phase will be about 8-12 days and will include ultrasounds to track the number and size of the ovarian follicles as well as Estrodiol levels.
I will be taking:
* 225 units of Follistim (injection)
* 75 units of HMG (injection)
* 5 units of Lupron (injection)
* 5mg of Letrozole (tablet)
* 1 mg Dexamethasone (tablet)
* Metanex tablets twice a dayCollin will be taking antibiotics for a week. Woohoo! He get's to join in the party and take some drugs with me! Is it just me or is that a lot of drugs to be taking?!
I'll be heading in on Wednesday for my first monitoring visit where I'll get to do my favorite stirrup-ed ultrasound to check out how these eggs are growing. We've had success with this portion of the process before, so I have high expectations for my ovaries this time around. Don't let me down!! Although this part before only included HMG; adding in all these other drugs makes it a whole new ball game! Let's hope I can keep it together for my wonderful husband. We've been married 5 years and it still makes me giddy to use the word 'husband.' I am completely enamored by this man! I hope, despite my impending hormornal surge, I can keep it together for him.
Let the fun begin!!!
Wednesday, October 19, 2011
I knew I couldn't remain optimistic forever...I received a call yesterday to inform me my Estrodiol was 27. This is an acceptable number to move forward with the injections on Friday. I know it's not exciting news, but in this infertility game, you have to celebrate any and every victory. Great news.
I did an inventory of our stockpile of meds. I read over our calendar for the 100th time to make sure we have the timeline down. I’ve been taking the shots in the stomach like clockwork. I looked through the checking/savings accounts and saw a considerable chunk of money missing. Everything seemed to hit home all of a sudden.
We are actually doing this. We are doing IVF. We are making test tube babies. We are embarking on a brand new adventure that has an unknown ending. When we started out on this journey, I thought a few meds would make this whole thing work. I never imagined life would bring us here. I never anticipated how many tears I’d shed over something I’ve never had. Collin and I have worked diligently over the past 9 years making many of our dreams come to fruition. We’ve always shared the idealism that you can make anything you want happen as long as you’re willing to put in hard work along the way. We’ve put in more then our fair share of hard work when it comes to infertility, but it seems this is the one thing we can’t accomplish.
I’ve been reading a lot of blogs; there are many out there that offer great support and have offered a much-needed glimpse into what the next few weeks entail. However, for as many inspirational stories I have read about women in the same situation as myself that end in pregnancy and a baby after 1 IVF, there are dozens of harrowing stories of women have gone through IVF 3-4 times and have nothing to show for it aside from bruises, tears and an empty bank account. I read a blog today of a lady who lost her twins at 20 weeks. It was a despairing read. Why do things like this happen??
So here I sit…questioning. What do we do if this doesn’t work? Where do we go from here? Do we continue to drain our bank accounts while chasing this dream? When do we throw our arms up and admit defeat? Can we admit defeat? Is this the one thing we can’t achieve no matter how hard we try? What if this results in pregnancy and another miscarriage? What if this actually works? What will we do with all our time, energy and resources if we’re not devoting it entirely to infertility?
The list goes on and on… I’m just starting to worry. I want this more than anything. I hope these questions go away. I worked a 12 hr night shift last night and I’m hoping between feeling ill (I’ve had a headache I haven’t been able to get rid of for 2 days) and tired, this will pass with some warm tea, time and yoga. This uneasiness that has taken over my day is really starting to be a drag.There’s no stopping now. We’re in this up to our eyeballs. I just hope it works….the alternative seems unbearable.
Monday, October 17, 2011
Fast forward past the weekend to Sunday night and after watching the Vikings lose (poor C), we went to sleep. What felt like 2 minutes after falling asleep, we were woke by a screaming alarm sound. We have an alarm on our house, but it wasn't the house alarm. It was the smoke detector in our bedroom. We have vaulted ceilings and the smoke alarm is quite high and does a fine job of echoing across the high ceiling. C, always the more level headed one, jumped out of bed and ran downstairs. He returned a few minutes later and I asked him what he was doing. He said he was checking to see if the house was on fire. Oh yeah....I was in such a stupor from just waking up, I didn't even think of that! Turns out it was a false alarm and I have no idea why it went off. C changes the batteries regularly, but about 2 times a year that thing goes off for a minute in the middle of the night and then turns off. Not a good way to wake up. Neither one of us slept well the rest of the night.
Now that it's Monday, I had a mini break down in the a.m., I haven't been feeling great and I got to thinking about growing old. I asked C what I would do if we had no kids and something happened to him. I'd be all alone with no one to take care of me. I'm sure I'd be a crazy cat lady.... C, with his calm demeanor, assured me this wouldn't happen and calmed me down. I had a monitoring appt back at Doody's office. The office can either be right on time or lagging behind by 45 minutes. Today they were on time! It was a suppression check; basically just a check to see if everything is calm and quiet in the uterus department so we can move forward piling on the drugs Friday. Everything looked great and calm in there; lots of tiny egg follicles (which is a good thing). I also had blood work drawn, an estrodiol, and as long as that looks fine, we're moving ahead on Friday. The appointment was uneventful. I did notice a hippo stamp on the outside of my chart. It looks like a sad hippo and it's blue. I 'm not sure if this means I'm seeking tx elsewhere so they know what's going on with my appointments or if it means I have overstayed my welcome at their clinic and they should try to get rid of me asap or if it means I had a sad experience in the office (being made aware of the miscarriage) and everyone should be extra nice? Kind of creepy. I did pass 2 little adorable girls in the parking lot walking hand in hand (with their mom of course) and both of them said hi to me. I'm taking it as a sign from God...I keep telling C we're having twin girls!
I'm tolerating the Lupron shots fine. One of them required some cussing. I'm not sure what went wrong, but it hurt and bled afterwards. C has been doing a fine job administering the drugs. I'm not brave enough to do give them myself. I can stick other people with needles just fine, in fact, I get paid to do it, but I just can't turn the needle on myself. The only side effects I've had are headaches, hot flashes and tiredness. Very tolerable compared to my last Lupron experience.
Let's hope this week goes smoother then the weekend...
Tuesday, October 11, 2011
Ah Lupron we meet again. I think Satan invented this drug. I honestly do. Hear me out: I was on a high dosage of it for 3 months prior to having surgery to remove Endometriosis tissue. Without getting too involved with how the meds work and what hormones it suppresses, it essentially puts your ovaries to sleep (aka menopause-like state). Since your ovaries are in "menopause", you get the symptoms that come with menopause including hot flashes, night sweats, headaches, dizziness and mood swings to boot. When I was on it for 3 months, there were times I completely lost it. I was ashamed of the way I treated people...I thought I may have developed Bipolar Disorder. It was terrible!!! In my last month of the med I called Doody's office in despair and told them they had to give me something to balance out how I was feeling. They gave me an estrogen patch, after much pleading, and it helped tremendously! Since Lupron is so effective in treating Endo, Dr. Doody suggested I go on it again while taking breaks between cycles. I flat out refused. I told Doody that if he wanted me to be able to have a husband to reproduce with, Lupron was not an option. I was sure another round of Lupron would send Collin packing (and rightfully so). So anyway, I'm on it again, but this is a smaller dose and much more manageable, so far. I'll let you know how I'm feeling after being on it for another 11 days. In preparation of the possible unwarranted crabbiness to come, Collin and I have developed a code word. When I'm getting crabby, he's supposed to say "puppies" and then I'll remember to take a deep breath and count to 10. We've had to use it already and it worked. I stopped mid-rant and just started laughing. Here's to hoping I can keep my moods in check over the next few weeks.
I am also taking Metanx currently. After the miscarriage, we did genetic testing to see if this was to blame. It turns out, I have a genetic defect called Methylenetetrahydrofolate reductase (MTHFR). Collin is also a carrier for this defect. This big long name means my body doesn't absorb folic acid, an essential nutrient for brain and spinal cord development in babies. Our baby didn't have proper brain or spinal development, therefore, it was thought I miscarried because of this genetic defect. If only I'd have known this information sooner, this could have been prevented...ugh!!!!!!! Metanx gives me folic acid in a different form so my body can absorb it. The MD told me I should be on it (or a similar med) for the rest of my life! That seems like a long time...
Other then the drugs, we also went to our trial transfer in Chatt yesterday. I had to have a full bladder for the procedure so I started chugging water on the road. By the time we got to the clinic, my bladder was indeed full, and sitting in the waiting area listening to their water feature was pure torture! We did the procedure, which to my surprise, was relatively simple. I had some cramping for a few hours afterward from the catheter, but that's it. We got great news (any positive praise I get on my whacky uterus is classified as great no matter how nominal the news) because it was easy to locate and see and Dr. Scotchie thought the embryo transfer should be a breeze.
While at the clinic, we also signed all the consents. Amidst these straightforward consents, we had to sign consents for our embryos, should there be any to freeze, to determine what should be done with them if I die, Collin dies, we both die, we divorce or when I turn 49 (too old to have a child). Thinking of these scenarios was kind of odd. In case you're wondering, we're giving them to each other if either one of us dies, if we both die we're donating them to another infertile couple, if we divorce C has graciously agreed to hand them over to me, and if we're 49 and age out, we're donating them. I told Dr. Scotchie she'd be awful sick of me if I kept coming to see her for another 20 years trying to get pregnant! She pointed out, our embryos would be 20 years old! Imagine...living in a test tube peering out at the world thru glass for 20 years...
We also had to pay up for all this fine care we are about to receive. That one hurt a little. Nothing like handing over hard earned cash for a "chance" at getting pregnant. Side note: I am convinced this is the time it will work!!! On the way to the car, C said we should feel good about it because it's our little way of helping to stimulate the economy. I guess that's one way to look at it...
Thursday, October 6, 2011
As I am sitting here, typing on our beloved iMac, I must first say rest in peace to the innovative Steve Jobs.
Here's the run down on what we've been up to: we joined in the neighborhood rummage sale (our first rummage sale experience ever) over the weekend. We both were surprised how easy it was to sell junk to strangers and we were entertained by some of East Tennessee's finest. We didn't have a lot to sell; but we got rid of a bunch of stuff that was sitting around the house and we managed to make $88. One guy paid with a $100 bill toward the end and I'm paranoid that it's a counterfeit. Now to find an inconspicuous location to spend the bill so I don't get arrested when trying to pass counterfeit bills at Target... We also had some friends over for dinner Saturday night. Since our fridge is stocked with various fertility meds, we had to be creative to hide them. These people don't know what we've been going thru and I didn't want them to think we're running some kind of meth business out of our house. Collin can give Bobby Flay a run for his money on the grill. Yum! It was a farewell party of sorts (although our friends weren't made aware of this either). We had margaritas with our dinner and this was my last cocktail for a while (the longer I have a reason to extend this absence the better....like 9 months would be perfect!) Adios alcohol. Next up, caffeine.
I feel like I've been in fast forward mode the past few weeks. I've been picking up extra shifts at work in preparation to work less when we start the IVF appointments (Monday brought a 16 hour work day. Ugh.) Collin has been on a few trips for work; he just returned from Philly last night. We've had a few projects around the house as well. Starting today, the hectic work schedule is on pause for the time being.
I am well aware stress can have a negative impact on the entire fertility process (just relax, right?), so I have been/will be making an effort to slow down and relax. It's about that time to make the positive life changes like we have at the beginning of every cycle (i.e. give up alcohol and caffeine, eat organic, exercise regularly etc.). Every cycle starts out with a renewed hope. This could actually be the one that is successful and brings us the baby we have been yearning for! This could be it!! This could be the end of our 3+ year struggle!! Why not give it everything we can?
If you're experiencing infertility, I know you'd do anything to make it go away. I'd stand on my head, skip instead of walk, or shave my head if someone told me it would make our chances of success better. If anyone has suggestions for what they do prepping for/during a cycle feel free to send them my way. I've read up on a few books, Navigating the Land of IF and Fully Fertile. I also started a yoga and relaxation DVD (thanks for the idea Julie!) Today was my first time trying the DVD and I felt so relaxed afterward, I didn't want to get up off the floor. I know acupuncture can be an advantage, however, this is an option I'm not pursuing at this time. Collin did get me a gift card to my favorite salon and spa, so I do plan on getting a few massages over the next few weeks. I don't know what else I could possibly do?! I know all of this could be completely absurd and have zero influence on the outcome of the IVF. However, it makes me feel like I have some kind of control over this uncontrollable situation and it keeps me feeling sane, so I'm going with it!
We're scheduled to head to Chatt on Monday for the trial transfer, to sign the 31 pages of consents (yes, I counted them) and hand over the payment for all of these fine services. Not all clinics do a trial transfer, but I have been told it is simply to determine the angle and depth of the uterus so the RE can map it out ahead of time in order to have a smooth embryo transfer. Although I'm not looking forward to logging more stirrup time, it will be useful info for the RE, Dr. Scotchie, since I have a messed up uterus with odd angles and that thing is just down right uncooperative when it comes to things like this. Anything to make the embryo transfer a smooth process.
*3 days until the shots begin!*