Monday, November 28, 2011

I May Be Losing It

Well, it's been a while since I've posted anything on here...the OHSS sent me reeling for a while. I'm finally feeling normal, so I think all the hormones are out of my system. This whole blog has been about our struggle with infertility and going through our first round of IVF. Obviously, since we're at a stand still in the IVF process, I guess I haven't been sure about what I should write about. Although I am grateful for the success we had with IVF (14 embryos on ice) it's been difficult playing the waiting game once again. I've had many ups and downs over the past few weeks, but I feel like I have finally come to accept where we are at. I will enjoy the holidays. I will not sulk over not being pregnant *again* this holiday season. I will consume cocktails whenever and wherever I want. I will feel like myself again. I will be happy. 2012 will be the best year ever.
That being said, I have given in and began reading the Twilight series. I hate to admit this out loud. Through a library rental program, I rented the first book on my Kindle. I figured I'd just give it a try since it was free. If I hated it, I wouldn't read it and wouldn't feel bad about dropping $10 on it. Well, I am hopelessly and bashfully HOOKED! I'm not one for vampires or any science fiction for that matter, but the love story is what I can't resist. I'm such a romantic at heart....I live for romance and love. I've raced through the first two books in a week and watched the first two movies as well. The books are far superior to the movies. I just bought the 3rd book today and I'm hoping for a slow night at work so I can indulge in my new guilty pleasure. I am still in shock that I am reading these books...
Also, the husband and I have taken to getting in shape! We're doing a couch to 5K program with hopes of running a 5k in Jan. Week one is done! Week one consisted of walking 5 minutes then alternating between jogging 60 seconds and walking 90 seconds. We've both been huge couch potatoes recently, but it feels good to be up and moving again. It's helped to have a new goal to focus on.
Collin's surprise birthday weekend was last weekend. I'll write about it later; I'm running short on time at the moment.
That's the update on me. Twilight and getting in shape. Wow...the excitement. I'm surprised by the Twilight thing still....I have become one of them. Help!

Saturday, November 12, 2011

Cancelled Transfer

In case you haven't gathered from the posts my husband wrote on my behalf, I've been quite ill. I now know what it's like to have Ovarian Hyperstimulation Syndrome and let me just tell you, it's not fun. I experienced the worst OHSS has to offer. According to the U.S. National Library of Medicine, in terms of experiencing OHSS-

In rare cases, women can have more serious symptoms, including:

  • Significant weight gain (more than 10 pounds in 3 - 5 days)

  • Severe pain or swelling in the abdomen

  • Decreased urination

  • Shortness of breath

I had ALL FOUR of these symptoms. It was horrible. I now know what it feels like to gain 17 pounds of fluid in 2 days in my abdomen (I looked 6 months pregnant no joke). I know what it feels like to not being to get out of bed by myself. I know what it feels like to be nauseous and puking for 3+ hours. I know what it's like to not eat for 4 days. I know what it's like to feel so ill you can't get out of bed for 6 days. I could go on and on with these, but I think you get the picture. I WAS F%@#$&@ MISERABLE (profanity necessary to clarify the level of miserableness I experienced).
To pick up where Collin left off, we went back to Chattanooga (we made a total of 5 trips in 8 days) on Monday and had another paracentecis done. The MD let C come back into the OR to watch this one-I'm very thankful I was asleep. They drained off another 2.5 Liters of fluid. I recovered and we went home. We started Lovenox injections (my labs showed I had an increased risk of a blood clot) and Cabergoline (to get rid of the OHSS) along with anti-nausea and pain meds. I woke up throughout the night Monday night to urinate 6 times. I lost 5 pounds overnight! I was actually able to get out of bed (other then to pee or puke) for the first time in 6 days.
I continued the urinating ritual throughout the day and night Tuesday and Wednesday nights and continued to shed pounds daily. Collin's birthday was on Thursday and we managed to go out to eat that night. It was a big outing for me! Finally, today, 10 days post retrieval I am feeling normal. It has been a very long journey for us. We're finally feeling back to normal...
Words cannot express how thankful I am to have Collin in my life. He diligently drove me back and forth to Chattanooga, ran to the pharmacy (they constantly were adding meds), made numerous phone calls to the MD, RN and family, tended to my every need and never complained once. The man is amazing. I love him so much!
Also, shout out to the staff at Tennessee Reproductive Medicine! One of the RN's gave us her personal cell phone number the day of the transfer and told us to call her with any issues. Once we were experiencing issues, the MD also gave her cell phone number to us. They were in regular contact with Collin and provided excellent advice and guidance in our time of need. I couldn't be happier with the support they offered.
So now what? We had amazing embryos that developed beautifully (10 were of the highest grade possible), but since I was incredibly sick we made the decision to freeze the embryos. There wasn't really much of a decision to be made, it's what the MD highly advised and we didn't see any reason to go ahead with the transfer. Transferring the embryos would make the symptoms of OHSS stay for even longer. We have 14 beautiful embryos frozen and waiting for us. We got to see the embryologist most days (since we were in the clinic anyway) so she gave us updates face-to-face and she was always beaming over how well the embryos were doing.
We decided to wait for a few months before we pursue a transfer. I want to feel 100% when we do the transfer and we don't want to be stressed about the holidays so we're probably going to wait until January.
This means another holiday season without any exciting news. I'm disheartened by this, but I know it's for the best. We were pregnant in Oct '09 and I was thrilled about the news and spending time with family over the holidays (our family all lives far away-in WI and IA-so we don't get to see them but a few times a year). Since I miscarried in early December, all my blissful thoughts and dreams of the holiday season we were supposed to have was ripped away. Instead I spent the holidays with family who didn't know what to say to either one of us and both of us felt empty and alone. All I have wanted since this is to be pregnant and to experience what was stolen from us. We'll have yet another holiday season spent without the news I so desperately want to share.
Infertility is a cruel game. It seems like there are so many set backs and let downs. Very rarely is there anything positive. I feel like we are ALWAYS waiting for something....it's never my freaking time! As much as I want to be negative, for my sanity and the sanity of my favorite guy, I can't dwell on all the negative things we have been through or I honestly probably won't get out of bed ever again. I know it sucks and it's not fair, but I need to put on my big girl panties and suck it up. We have 14 amazing embryos on ice-we have pictures and they are beautiful!!
That pretty much sums it up. 10 days of hell. Finally over the hump and feeling normal. Life goes on.
2011 has been a shitty year. I'm over it. Bring on 2012!!!

Sunday, November 6, 2011

Anybody in Knoxville up for a Sunday Paracentesis?

It is Collin again....and you know what that means. Amber was resting comfortably last night and was able to eat a little bit. We noticed that her abdomen was filling with fluid again, but were hoping we wouldn’t have to do another paracentesis until Monday or so. She woke up around 3:30AM feeling very ill, but took some meds and was able to fall back asleep. At about 7AM, she woke up vomiting yet again and we knew we were in trouble. I called Dr Scotchie and the IVF nurse this morning, but by the time we were able to get Dr Scotchie after she was finished doing her other procedures Amber was at a new level of discomfort. We decided that by about 9:30, there was no way we could get her to Chattanooga and through that drive. We went to the ER here in Knoxville with the hope that we could get this taken care of here. We walked into the ER and Amber headed to the bathroom as her vomiting was continuous at this point.

After only a few minutes (which seemed like hours to Amber), we were taken back to an ER room where they started an IV and gave her some nausea meds. They did an ultrasound and saw tons of fluid again, but the ovaries still had blood supply, so that was one worry resolved. Unfortunately, it was beyond the comfort zone of the hospital to perform the procedure as it needs to be done under these circumstances. Dr Scotchie called and said that it isn’t overly complicated to perform, but it is a bit rare clinically speaking. The ER doc called around town and was not able to find anyone in town who could perform the procedure...on a Sunday at least. By the time this was resolved, it was rather late in the afternoon, so we had two options: 1-Go to Chattanooga (either by me driving or via ambulance) and get admitted overnight and have the paracentesis first thing in the morning, or 2- get discharged and rest at home tonight and head to Chattanooga in the morning. We asked to be admitted here, but they said that because they knew they couldn’t resolve this tonight, that they would have a very difficult time finding a physician here would be willing to admit her. Understandable, I guess. We decided to get discharged and come home. Going to Chattanooga would involve me driving down and back tonight, and again in the morning, Amber having to get admitted, get another IV, blood work, etc., and then get discharged in the morning (all at a hospital that is out-of-network for us). That sounded like a lot to do and it may not be worth it. Let’s hope. They gave her a good dose of meds before we left and she is again in bed resting.

The ER doctor wished us luck and told us that he understands everything we are doing. He said he and his wife went through 5 rounds of IVF before they got their twins. He then said that he could not believe how nice Dr Scotchie was and that we were very lucky that she cared so much. He said he is not used to working with someone like her. She called this morning and gave me her personal cell number and we have been in contact all day. As I said yesterday, she and the rest of the crew in Chattanooga have been exceptional.

We will be heading to Chattanooga in the morning for the paracentesis and hopefully we are able to make it through the night without any surprises. As long as we can keep the nausea away, she thinks she can handle the fluid build-up. Here’s to hoping that is the case!

As for some good news, the embryologist again called with a glowing report this morning. Of the 21 embryos from yesterday, 19 are dividing and compacting like we want. The other two will probably drop off and not be viable. The grading scale changes a bit today, but long story shorter, 15 of the 19 are what would be considered a Grade 1. Again, that should give us plenty to get through this other situation and do a frozen cycle (and more, if necessary). At least we are getting some good news amongst the other terrible things going on these past few days.

Time to get some rest for the night and get ready for another big day tomorrow. Again, all of your thoughts and prayers are appreciated through this latest ordeal!

Saturday, November 5, 2011

Our First (and Last) Egg Retrieval

This post is being brought to you by Amber’s husband. For non-immediate family members who are unaware of the past 24-36 hours, you’ll understand why I’m writing this by the end of the post. I’ll start from where she left off...

Wednesday: Retrieval Day!

Amber came out of this feeling ok. The 90 minute ride home from Chattanooga went fine for the first hour, but she got very antsy to get out of the car the final half-our. She couldn’t get comfortable in the car, but we got her home and in bed and it started to look a bit better.

The egg retrieval procedure went well and everybody at the clinic was really excited! They were able to retrieve 27 eggs, which is a ton! 15 is considered to be about average, 20 would be great, so they were able to get way more than expected. Because of the high number of eggs she was likely having some ovarian hyperstimulation syndrome (OHSS) symptoms. That makes her really uncomfortable and feeling pretty terrible. We were hopeful that it would subside and that she would be feeling better in the next couple days
The embryologist at the clinic (I had no idea this was a career...) called us that night and again the next morning to give us an update on how the eggs looked and the fertilization process. Here is what we knew as of Thursday morning: They got 27 eggs total during the retrieval. Prior to retrieval, we chose to do an ICSI procedure on 50% of the eggs (Here is the Mayo Clinic definition on ICSI: Intracytoplasmic sperm injection (ICSI). This procedure consists of a microscopic technique (micromanipulation) in which a single sperm is injected directly into an egg to achieve fertilization in conjunction with the standard IVF procedure). So, they took 14 of the eggs for ICSI and after preparing them, found that only one of those was not mature enough to be used, which is a great percentage, and that takes our number down to 26 eggs. They did the ICSI on Wednesday and then the "regular" method on the other 13, where they just put everything in a dish and hope they fertilize on their own. The embryologist called Thursday morning with the best news we have gotten in a very long time. Of the 13 ICSI eggs, 12 fertilized (92%; the clinic said typical is 80%), and of the 13 from the "regular" method, 10 fertilized (77%; typical is 60%). That left us with 22 embryos growing in Chattanooga on Thursday morning! She said everything looked great and if it stayed that way, we should be on track for a transfer of 2 embryos on Monday (and we would be freezing however many are left).

It isn't often we have gotten great news throughout this process, so this had our spirits pretty high. Rightfully so!

Thursday:

As I said, the embryologist called in the morning and gave us the news listed above. Amber was feeling better, but still pretty sore. All was as expected and we were feeling pretty good about how everything was going. A pretty uneventful day looking back on it.

Friday:

Uneventful Thursday took us into a more eventful, and unwelcome Friday.

Before we get to that...We did get another call from the embryologist and she at least had more good news. Of the 22 that made it through the fertilization process, 21 divided. All of them were between 2 and 6 cells, which is where we want to be for that first day. Each one is then graded on a scale of 1 to 5, with 1 being the best. 10 of the 21 were considered to be Grade 1 and the other 11 were either Grade 2 or 3. That is great news and we are still on schedule for a Monday transfer.

Back to the unwelcome part: Amber woke up feeling really pretty decent, all things considered, but after eating a full breakfast and taking the substantial amounts of medications she is on, things took a turn for the worse. She was still having some abdominal pain, but the worst part was the onset of nausea. She began vomiting a bit and got extremely uncomfortable. After I had several calls back and forth with the clinic in Chattanooga over the course of the morning they were concerned but we were all hopeful it would subside. She was able to rest a little more comfortably throughout the afternoon, so I kept an eye on her when I got home from work and thought we might be ok.

We had dinner last night and she was doing ok, relatively speaking. We went to bed and then it began....

Saturday (Today) - Rock Bottom? (lets hope...)

She started vomiting pretty regularly throughout the night. About every hour or two, she would wake me up to let me know that she had to go to the bathroom for another round. At about 6 AM, I noticed that her abdomen was getting very swollen and she was saying this was as bad as she has ever felt in her life, and I couldn’t disagree by looking at her gray coloring and obvious pain. We both new that the Ovarian Hyperstimulation Syndrome (OHSS) had fully set in, and was progressing rapidly. It wasn’t going to go away on its own, and we had to get her help. Now.

One of the nurses from Chattanooga had given us her personal cell phone number at the retrieval in case anything came up over the weekend (the staff there has been nothing short of exceptional through this whole thing!) and I took advantage of it. I texted the nurse at about 7AM this morning and she called back immediately. She said that Dr. Scotchie would be in about 7:30 and she would call back after talking to her. She called back and said that she probably had to have the fluid removed from her abdomen, but they were worried about us driving 90 minutes with Amber being so nauseated. They gave us the option of picking a hospital in Knoxville and then she would call to make sure they could accommodate us. We talked it over and decided that we just needed to go to Chattanooga, as awful as the drive would be, rather than try our luck here. I was worried about getting in, sitting in a waiting room, getting results sent to Chattanooga, having some resident or other doctor do the procedure if they hadn’t done it before, etc. As they were calling back, about 30 min later, to find out where we wanted to go, we were walking out the door to go to Chattanooga. Easily the best decision we could have made!

The car ride was just as terrible as you would expect.....it involved Amber’s head being in a garbage can for half the ride. Talk about some interesting looks from people we passed. I don’t think there is anything further that needs to be said about that trip.

At 10AM this morning, we walked into the clinic and Dr Scotchie was walking past the front desk. She took one look at Amber and dropped everything and walked her right to the back and set up an IV. They had two transfers scheduled that they were just getting started, so we had to wait a bit, but they got her hydrated and on some pain and anti-nausea meds. She was resting as comfortably as could be expected within a few minutes of arrival. Again, a great decision not to go sit in an ER here in Knoxville, and huge thanks to the Chattanooga staff! By the time we got there her abdomen was even more swollen and there was a ton of fluid that had to be drained.

As soon as the two transfers were done, we were the only people in the clinic and they gave Amber their full attention and took here into the IVF clinic’s version of an Operating Room and started doing a paracentesis to remove the fluid.

While we were waiting, the embryologist came out and talked to us and gave our daily update. Of the 21 embryos we had from the previous day, ALL 21 are still dividing as well as they/we could hope. 11 are a Grade 1 (again, the best on a scale of 1-5), 6 are a Grade 2, and 4 are a Grade 3. No Grade 4 or 5. The embryologist is almost giddy when talking to us and has had nothing but great things to say, so we’ve enjoyed hearing from her these past few days. Again, this is really great news and lifted our spirits quite nicely amongst the obviously difficult day.

After the good news, it was back to the immediate worry. Amber was off to do the paracentesis and then I had 3 different people come out and tell me it was going well and that they were getting a great deal of fluid. When it was done, Dr. Scotchie came out and told me that they had drained 2.5 Liters of fluid! Yes, you read that right...LITERS! No wonder she was sick! After bringing her out of anesthesia, they brought her back out to recovery and she already had her color back, was feeling much better. They then said that if she was able to eat and keep down some crackers, we could go home today. If not, she would have to be admitted to a hospital in Chattanooga. Luckily, she was able to eat and they gave us the ok to go home.

We had already discussed with Dr. Scotchie that we did not feel comfortable with a Monday embryo transfer with how Amber was feeling and she said she was going to recommend the same thing. Because our embryos are doing well, we have decided that we will proceed with freezing all of the embryos on either Monday or Tuesday (depending on when the embryologist determines each individual one is ready to undergo the freezing process). She explained that typically about 80% of the embryos will survive the freezing/unfreezing process. We are very comfortable with this decision and this will give Amber the opportunity to get off all of the IVF-related meds, take some pain meds, and most importantly, get healthy. Once she gets back to feeling normal, or as normal as it gets these days, we will decide when to proceed with the embryo transfer. Dr. Scotchie said this would be a very sensible approach and that whenever we decide to do the transfer, it will seem like nothing compared to what we have been through the past six weeks! We are very thankful that our embryos are growing so well and that we even have this option to consider.

We loaded Amber back up in the car and she had plenty of pain meds to get her back home comfortably, which again was a welcome change. She has been up in bed since we got home and feeling much better (again, this is all relative). We can only hope this continues. There is a chance that we will have to go back one more time either Monday or Tuesday to do another paracentesis if there is further fluid build up. Hopefully we do not have to do this, but we will be proactive in making sure today’s events are not repeated.

Well, there you have it, folks. You are now up-to-date. Thank you to everyone who has written, called, texted, etc, to let Amber and I know you are thinking about us. Your continued support and prayers are very much appreciated. We thought we were prepared for the difficult road that this IVF process would be, but these past couple days have been more than we ever anticipated. With that said, we are very thankful that things did not turn out any worse than they have.

Hopefully Amber will be back on her feet soon and writing to provide her witty take on everything that has taken place this week. I’m not sure when that will be, but we know many people are following our journey and we will do our best to keep you updated with any new developments. Thanks again to everyone for your support!

Tuesday, November 1, 2011

49 Shots + 5 Ultrasounds = Egg Retrieval Eve


Ladies and gentleman we have made it!! I feel bruised, bloated, emotionally unstable and have a serious case of general malaise. I have come to one conclusion, IVF is not for wusses!!! We've become champs at the HMG injections/ultrasound/IUI routine, but IVF is an entirely different beast all together! You can see by the pic (please excuse the bloating, I have a lot of follicles growing) a glimpse of how intense it has been.
This being said, however, we went back to Chatt on Monday for another ultrasound. Although the follicles grew, we were still at an "iffy" phase for follicle size. Some were large enough, but a few were lagging behind. So we left Chatt Monday feeling befuddled. We were again waiting for the phone call regarding my labs before we knew if we'd have to undergo another round of stim injections or move on to the trigger shot. Who knew so much could be riding on an Estrodiol level??
I have been quite tired lately (is this a normal side effect of all the drugs/growing all these eggs??) so I dozed on and off on the couch after I dropped C off at work. I don't know his boss, but I'd like to hug him for being so understanding with all of these appts. It's a blessing to have him by my side and not forced to face the barrage of appointments alone. Finally, the phone rang and it turns out my Estrodiol was over 4000 so we were indeed ready to trigger. We shot up with the HCG injection (our 49th and final injection of this cycle) at precisely 10 pm.
I've been cleaning, doing laundry and gave the dog a bath just to occupy my mind because I can't believe I'm going to have an egg retrieval tomorrow! Ah! I went in for a deep tissue massage today to prep for tomorrow. If this lady wasn't utterly amazing with her hands I may have puked on her (I was feeling nauseous all morning). Here's a small interaction at the beginning of the massage:
Masseuse: Any areas you want me to avoid?
Me: Yes, my abdomen. I've been going through IVF so it's quite sore from injections.
Masseuse: Does that have anything to do with fertility?
Me: It sure does. Told her what it stood for.
Masseuse: You're back is full of knots! No wonder why you're having problems getting pregnant. It's so important for people to relax while trying to have kids. It happened to my sister; after 6 years of trying they gave up and then she got pregant!
Me: Rolling my eyes through the little face pillow and thinking you're lucky this feels so damn good, Peaches.
Normally this kind of interaction would bother me, but I felt so relaxed and calm I let it roll right off my back with the rest of my stress. She was a young thing, probably only 20 years old and she had no idea what she was saying. She did inform me my back was so knotted that I should really consider getting massages at least once a month. If she had any clue what I have been through, she may know just why my back was so knotted. Amazing massage minus Peaches ignorant comment.
So for the first time in 3 weeks we're not doing any shots today! What a rush! Nothing to eat or drink tonight after midnight for me. Tomorrow morning we're rushing off to Chattanooga at 8:15 for the retrieval. I'm apprehensive about the retrieval. I'm worried about Ovarian Hyperstimulation Syndrome, a needle possibly going through my abdomen (talked this over with the RE yesterday and feeling slightly better about it) and the general risk of dying (after all Michael Jackson died from Propofol so it could happen to me).
Wish us luck, say a prayer or keep us in your thoughts tomorrow please! It's going to be an intense day for both of us.
Until you hear from me again, Happy Egg Retrieval Eve!!