Thursday 17 October 2013

venting

It occurred to me what a "debbie downer" this blog is right now.  I  never intended to really have a lot of followers. Not really.  Mostly, I think I just wanted a safe place to post my feelings.

I've already been the optimistic positive one, in my early 30's.  I've encouraged others.  I did my time, and felt not only content to do so, but happy I could help others in their difficult times. Actually made me feel better, like there was a meaningful purpose or something, to this crappy thing called infertility.

I always believed that if you just tried hard enough, fought long enough and had enough patience, it would happen. I supose if you are young enough, have enough money and are in it with someone who feels the same as you, then that's still true.  But it's not true for me, not now anyway.

So that's not the purpose of this blog.  I'm truly sorry if you've come here looking for answers.  I have none to give.  No, this blog is for me now.  It's for me to vent my frustration and sadness. I honestly have no where I feel safe to share this.  I can't begin to explain the deep sadness that penetrates my heart, and always will.  I know it doesn't make sense.  I. KNOW.  This.  But that's just the way it is. And it's something I will just have to live with. It's my hope one day I will have peace with it, but I don't think that's the case.  I think I will just learn to live with it. One has to, right?  Or they can just go crazy.

But I also want something positive going out into the universe right now too.  I want the 3 people or so in this world that might find this one blog page to know how desperately I love my children.  I would do anything for them. And they are the only ones, right now, that do pierce that sadness and make  life have meaning.  I look at them, and they simply take my breath away.  They just make me smile.

I may be 44.  It may be that no one would choose me as an adoptive mom, but let me tell you - and them -  despite what anyone may think, I *AM* a good mom. And I would be a great mom to anyone who did choose me with that privilege.

I recently started to homeschool my kids.  I felt like not only was the local school not getting the job done, some teachers were also actually emotionally abusive.  My brilliant son, who tests off the charts for intelligence was actually being led to believe he was not very bright, and was made to feel bad about himself...

over my dead body, people!

So I've been working with them at home with help from a cyber school for 6 weeks now and the change is nothing short of miraculous, in both my older two.  (youngest is still just a little too young for serious school) Confidence is way up, grades for  both kids are A+ in all subjects,  But best of all, I am getting to know my children on a whole new level.  They are not 4 and 5 anymore.  They are little people with thoughts, opinions and very complete personalities that I am learning more and more about each day.  I feel honored to be so involved in their little lives, leading them to become strong adults and I hope,  to fulfill their dreams one day.

I work like a slave to make this happen and I am grateful for the chance to do so. I am grateful that I can drive them an hour a way in the middle of a school day so they can take a hands on robotics class.  I am grateful I can have them learn to swim in the middle of the day, in a semi private lesson  and not be forced to have them settle for taking two 1 or 2 turns in the water with 8 others kids over a 30 minute period after a traditional school day.  I am grateful that I get to sit with my daughter at the dining room table and help her learn Mandarin Chinese and watcher her take pride in one part of her dual culture/citizenship. I am grateful that our school room is filling up with art work I get to teach them, not just see once a year at an art show (today's project?  An Africa Kota mask made with cardboard and tinfoil)  I am grateful that even though it's 9:16 at night, and I have three loads of laundry to fold and I'm tired, that my priority tonight is actually making a fossil with oven baked clay and a leaf for a science lab tomorrow.

I am simply grateful for these three wonderful blessings, and I love being their mom.  I know it's what I was meant to do with my life.

Wednesday 16 October 2013

limbo

There's nothing to report for now.  My body is a mess as usual.

I gained 10 pounds with this last IVF and had been unable to lose it all summer.  Turns out my tsh was in the toilet and my insulin level was crazy.  As the put it "your metabolism is at a standstill"

I was in pain most of the summer because of the tsh level.  Horrible joint pain in every joint in my body, even my fingers, toes and elbows.  Endo said it could be from the gluten free diet or it could just be a result of the IVF. She's seen it happen before.

I've been switched from.112 of synthroid to .60 of armour (natural form from a pig instead of fake synthroid) and as of last week, the pain is significantly better, and I'm starting to lose weight but my tow tsh levels are still a mess.  One level apparently likes the high doses, the other level likes the low doses. So the bottom line is  I spent about $23, 000 on an  IVF package I may never get to finish using.

To make matters worse, my kids desperately want another sibling now. How did that happen?  They mention it quite often, like I'm not in enough emotional pain already.  Now I've let them down too.

Seems like all  I do these days is let people down. Like I said, not much to report right now.

Thursday 6 June 2013

Egg transfer and results

Sorry it's taken so long to update, but well, it's been a long several weeks.  I had to get my mind strong enough to actually be able to write this.  Obviously it does not end well.

I'll start with the egg transfer.  When I got there, they had me change into the usual hair covering, hospital gown and footies and wait in the surgical area.  I had my bladder uncomfortably full and was frankly miserable.  The bloating had gotten so bad, my stomach was protruding and I had gained 5 lbs. IT pushed against my bladder making me regularly miserable.  It was so bad, I couldn't stand up directly without pain, I had to slowly straighten as my insides made room for everything to shift.

There was another girl waiting so I was really miserable. I actually had to get up and pee a couple of times just to relieve the pressure.  They gave me a cup so I would know when to stop. I couldn't imagine waiting for another 1/2 hour. For whatever reason, they took me first.  I was grateful.

I got in there and it was the same as the mock transfer and retrieval, except I was fully awake.  I had forgotten to take pain reliever before hand which was a big mistake.  It's not that the procedure really hurts, but with the bloating, it really did.  I was so miserable.  She had to push down on the bloating to with the ultrasound device.  I just did deep breathing and waited for it to be over.  It didn't help that he tried twice with the speculum only to discover he needed a longer one....boy was that fun.

They did show me on the screen where the transferred embryo was, which was kind of cool, and gave me an ultrasound picture of it.  I was startled at how my heart tugged looking at it.  I so wished it would turn into my child.

I left with instructions to take it easy, no sex for two weeks and no physical activity for a couple of days.  No lifting more than 5 lbs.

As it turned out, the bloating just got worse.  Within days I was adding  more weight and by my check up Mon (transfer was Sat) I could barely move I was so bloated.  They ended up taking a "blood count" to see if my  blood was getting too thick, putting me at risk for clotting and renal failure.

You see, the bloating is really water from the blood stream collecting in your abdomen. The blood count would tell them if if I was any danger.  If that was the case, they would send me to hospital to have a catheter put in with a bag outside my body I could wear under my clothes.  Apparently, some RE's choose to drain with a needle.  However, my RE said this was just a quick fix as the fluid would just collect again.  The catheter would be a much better solution.

At this point I was on almost complete bed rest.  I just couldn't move very well.  Between Sat and Mon I had gained another 5 lbs and I just looked bad from what people told me.

I drank tons of gaterade and ate salty foods to help draw the fluid out.  This was bad advice for me.  AS it may have worked for some woman, it just made me retain the fluid.  I stopped the salty foods and added green tea to the mix and the fluid started draining on it's own.  By Wed's scan, I was much better and had lost 4 lbs.

The bloating slowly got better and better, but it took a good three weeks before I was closer to my normal body size.  Still seem to be holding onto a couple of those pounds though.  I think all that inactivity made me gain real weight - bummer.

Unfortunately, it just gets worse.  The embryo did not implant, and to add insult to injury ALL the embryos died.  Nothing made it freezing so the FET's are off the table too, unless we try to find a donor egg somewhere.  yeah good luck with that.  Like someone wants to give a 44 year old mother their egg.  Just like adoption, no one would choose me.

I have been heartsick and discouraged.  I feel like it's a sign I am too old that not even one made it to freezing.  My heart is so broken and I just don't understand why God has placed this burden on me.

I've decided to take at least one month off to let my body heal and recover.  I may even take two, but not more than that.  It's so scary going into this next cycle, the only other "fresh" try in our package because now I have the knowledge that I can go through all this, and not have an embryo even make it to transfer stage.  I've got to work up my courage for that kind of disapointment and heartbreak.

I keep telling myself it's just not fair and once again I am resenting all the women around me who can simply decide to have another child. Why do I have to wait for a miracle that won't even happen?

Thursday 16 May 2013

12 little embies...

No transfer today which I frankly suspected.  The indication all along was a 5 day transfer and I feel better about that.

We didn't lose any last night, although one has only divided into 3 cells, so it will probably arrest.  The remainder are:

4 four cell
1 five cell
2 six cell and
4 eight cell

This isn't mine, but this is what an 8 cell looks like:



Was so happy to see some 8 cell in the mix. If they all make it to Sat, that means we can have three ledt over for FET tries.

They are all a grade 2.   I asked her if there was anything to indicate the quality yet, and she didn't really have a good answer for me.  I know grade 1 is the best, and grade 4 the worst, but still don't really know much other than some, not all  are starting to show signs of fragmentation.

Fragmentation is when the cells divide unevenly leaving some leftover over "junk" cytoplasm.  The higher level of fragmentation, the lower chances of pregnancy.  Anything with a grade of 3 or 4 is highly fragmented and likely won't make it to blastocyst stage.

Here's a visual on the grading:


I wish I knew more about how each one graded, but they seemed kind of busy today.  I know now what they meant by waiting on pins and needles for the embryologist report.  It's going to be a long time til Sat morning!!!

Wednesday 15 May 2013

2 days post egg retrieval

Not a lot to report today, 2 days after the retrieval.  Embryology called early, around 7:45 to report that of the 15 eggs that fertilized 12 had survived and cells were dividing normally.  We again had the discussion about not wanting twins and she marked it in the file as there are three embryologists there.

She advised that they would tentatively schedule a transfer for tomorrow just in case.  But she did seem to echo that because we only want to transfer 1, it will most likely be Sat.  I find out tomorrow morning at 8am if we're a go.

I did wake up feeling significantly better.  I was glad I had showered the night before because while I was feeling better, I was still achey and I had to make some eggs for my share of the breakfast.

That was easy...spray non stick spray in a muffin tin, crack in eggs, add some leftover diced ham and a sprinkle of cheese, bake for 10 minutes in a preheated 350 oven.

After the meeting, I was really worn out and feeling pain again, so I came home and did nothing but drop off and pick up preschool, and order pizza online.

and so ends cd 28.

The "little" wait

So the day after retrieval, I was definitely sore.  I was able to get up and make a simple breakfast and pack lunches, but I was grateful for Rob's assistance with this.

Embryology called to let me know 15 of the 22 eggs fertilized.  They wanted to know if we were transferring 1 or 2 and I said, "that kind of depends on what you tell us about the embryo's."  I made it clear we really didn't want twins, so were leaning toward one.  But at the same time, wanted the best chance.  She said, based on that, they would probably lean towards a 5 day transfer but we would just have to wait and see.

They had said I could "go back to work" but I just don't see how anybody really could.  I mean, it wasn't pain like my c-section, but it was still tough to move around, bend over, walk very much.  I had so much going on that day....DAisy girls scouts (I am the leader), Set up for MOPS (I was supose to show the new coordinators for the next year what to do) and Josh's string concert.

Nope, nope and NOPE!

I stayed home and rested.  I got up just enough to feed myself and Noah.  Pulled a pre-cooked sliced ham from the freezer and called that dinner and rested.  I just wasn't up to it.

I was starting to get frustrated by not feeling much better, so I called another MOPS mom who I knew had been through IVF a couple of times to get her thoughts and experiences.  I felt so much better after because everything she described was exactly what I was feeling.  The bloat is unbelievable.  For those of you who have been pregnant, it's like that really heavy pressure you feel below your tummy during the last month of your pregnancy....  And there is so much stimulation, it presses against your bladder, so you have to go to the bathroom every 10 minutes.  And since you are suppose to drink 80 oz of water it ends up you need to pee every 5 minutes.

I was hoping I would feel better the next day, so I could go to the last Mops meeting of the year before summer break.  and I was looking forward to seeing how many son to be embryos would survive the night.  They said the wait for that can be brutal, but that's OK.  It's just a little wait.  The big wait will be the "dreaded 2ww."And so ends cd 27.

The Big day: Egg Retrieval!

I had set two alarms to go off at 6:00 so we could leave by 6:45 for our 8:30 retrieval.  I didn't have much to do.  I had showered the night before, and I wasn't allowed to eat, drink,  wear makeup or jewelry.  So I got dressed, took the nail polish off (so anesthesiology could watch my color) and freshened up my hair, and sat to wait for hubby.

The drive was uneventful and because we left so early, we had a bit of a wait.  (the only way to get there is a very unpredictable freeway that has a habit of bottlenecking when you least need it to!).  Once they called my name, they were again, super sweet and gentle.  I again went to the changing room to strip down, gown up, get my little footies on and hair cover.  Then I went to my cubicle with my nice warmed hospital blanket.

can I just say again, I want one of those blanket warmers!

So they spent about a half hour taking some more medical history, taking vitals and then setting up the iv line for the anesthesia.  AS usual, they couldn't find a vein, my right arm which was always so easy is completely scared (the veins, not the outside skin) and the left is so hard.  She tried my left hand, it bled all over and then burned whenever they ran fluid so out that came.  Then they tried my right hand - nope!  Right arm again?  nope, just too scarred.  Finally on the fourth try, they got my left arm.  In their defense, I really am a hard stick.  So was my mom, so was my grandma (I'll have to ask my sister if she is as well!)

Then it was hurry up and wait.  While I was initially very nervous, I calmed quickly.  AFter all, they were putting me out for the hard part, right?  I mean, how bad could it be?

In the mean time....TMI report - the usual protocol is for the Dad to provide the sample for fertilization AT the surgical center.  But because we lived within an hour, DH was allowed to do this at home.  I pushed for this because for obvious reasons, that part of it makes Dh really uncomfortable.  Thank goodness I did, because they didn't realize he had brought it, and started to show him to the room.  It was awful!  Very clinical, a pad on the chair and a tv on the wall.  Um, ewe.  He said another Dad to be was walking "the walk of shame" either into or out of the room.  Wheh....so glad I was able to push for him to do at home!


When it was my time, they walked me into the OR and I took my seat on the deluxe stirrup table - yay me-  I described for the hysteroscopy.  The only difference this time was they strapped my legs to the stirrups, I'm guessing so I couldn't fall off the table since I would be out.

At the point, the anesthesiologist told me she was starting and I would start to feel woozy or dizzy.  Somewhere right in between was what I felt.  I remember wondering what I should do.  I was very sleep from not sleeping the night before, or was that the meds?  I didn't want to fall asleep on them if they had more questions.  Then the anesthesiologist said she was going to give me the next medicine and shortly thereafter I was out.  I don't even remember Dr. G coming in.

What I do remember is them calling my name and telling it was time to wake up.  I woke up pretty easily and was just a but unsteady on my feet.  They walked me to my chair and had me just slowly recover.  Thank goodness Rob was allowed to come back and sit with me.  I felt very emotional and was crying but that was more because I just needed my husband, and we were having a tough time at the moment (not for a public forum, sorry!)  I did feel sore and bloated, but not in a really bad way.  I felt like I could bear it pretty easily.

They told me almost immediately that they were able to retrieve 22 eggs!  Wow!  That is just fantastic, from what I understand, for a woman my age.  I was over the moon happy!

Rob had a lot of questions though, but my Dr. G is such a great man, so kind.  He said, he had to do the next patient, but to just give him a few minutes and he would talk with him.  It was a retrieval for someone else, so he had to go but when he came back in about 15 minutes, he pulled a chair over and gave Rob his undivided attention. He didn't leave til all Rob's questions were answered. I'm telling you, if you're in Phila area, go see Dr. Gocial, RMA of Philadelphia.

After that, Rob seemed more at peace with the responses and it was time to go home.  He helped me get dressed - I was tender for sure, but OK.  Then they had Rob pull the car around to  a side entrance that was easier for me to get to, and they walked me to the car. After that, it was 24 hours of strict bed rest - bathroom breaks only.

I was definitely achey, and really tired, so I spent most of the day sleeping. I started the antibiotic and anti-rejection medicines that day - the end of cd 26.



22....

So a lot has happened since Friday.  It's just been busy, and I'm uncomfortable and frankly, sometimes you just have to step away from all this stuff to maintian your sanity, kwim?

So Saturday, I went in for another blood draw and scan and I was greeted with "looks like we're ready to discharge you."

Huh?

Am I through?  Was the whole thing a bust after all?  No, no, thank goodness.  All that meant was,  is they thought I was ready and that I would probably have the retrieval Monday instead of Tues.  So I would get the call later to determine would I take cetrotide (don't ovulate) or Pregnyl (hcg trigger). I was hoping it was the later because frankly, I didn't want to take that big old nasty cetrotide injection again.....

As it turns out, it was the later, so while I took menopur that Sat morning, I did not take the Gonal F or Cetrotide, but rather the HCG trigger that night at 8:30 so that 36 hours later, at precisely 8:30 Monday morning, I would ovulate and they could retriece the eggs....

That trigger has always made me nervous....I mean, it is so exact...How did they know exactly at 8:30 I'd be ready?  What if I was ready at 7:30 and they missed it?  While I didn't want to take it, it was so hard not to take the cetrotide... or to call the dr and say, how about a half dose?  I had to sit back and just trust my dr.

Sunday morning I went in just for blood work.  At this point, I must share that my arms are black and blue and i look a bit like a junkie. But they wanted to make sure everything was still on track, and that there was HCG in my system.  Actually, the way she said it was, "we want to make sure you took the shot correctly?"

Huh?   (scratching my head....) I've taken how many up until now, and you want to check this one?  Hey, whatever, they're the experts!  And it was Mother's Day, and we had to stuff to do, so short appointments are always good.  Quick in and out.

So, after the Mother's Day festivities (thank you to my sweet SIL, Christine who organized a lovely barbecue with awesome food....) I packed the kids up and dropped them off at my dad's to spend the night.  We were going to have to leave at 6:45 the next morning, and they all had school.....I have a great dad who got them all where they needed to be.

And then home to NOT sleep the night before the transfer.... (does anyone I wonder?)


Friday 10 May 2013

Big needle = Big fear

So I had my blood work this morning, and another ultrasound.  All went well, My E2 was around 1600, continually on the rise, and p4 had risen to 2.63, LH stayed the same, around7.5.  What does all that mean?  Hell if I know, but apparently it tells Dr. G to start the cetrotide.

Cetrotide does the same thing as ganirelex or Lupron.  Since some of the follicles are really starting to mature, the worse thing would be that I ovulate now, with like 10 eggs or something crazy like that.  So the cetrotide shuts down my pituitary gland from sending the  "green light" hormone to ovulate.

The needle scared me to death.  It wasn't a half inch like the others I've been using, but more like a full inch.  But it has to to be done, and Rob is away on a business trip, so I gritted my teeth and got the job done myself.  At these times, I cheer-lead myself saying, it's all for a greater cause, and will be so worth it if we succeed.  It helps anyway.   I remember my IVF nurse telling me not to do it on the same side as the Gonal F or they could  interact in some way.  So to be safe, I opted to do it in my thigh.

Again, that big needle scared me (I am so glad they have worked these injections into sub-cu rather than intramuscular.  I simply cannot imagine getting stuck with those huge 27 gauge needles every day!) I knew right away I was going to try the icing trick.  It did work, while I did jam the needle down with a little more force, I did not feel it go in at all, nor the medicine like I do the menopur.  But now, after 10 minutes, and the my leg is warming up - it feels very sore and tender.

Speaking of sore and tender, that's me.  My ovaries are completed enlarged and stimmed and I really hurt.  No walking in the gym today, although I tried.  Bending over is too much, walking fast is too much, so I just kind of hobble about.  There was a little fluid on the scan, but not anything to worry about, or so I was told.  But my ovaries are now "kissing" ovaries.  They are so heavy, they are kind of flopping over each other and touching.  Nice, I hope they are encouraging each other on!

One quick funny bit...I saw another dr this morning, not one I often see.  She just doesn't come up on the rotation for me that often.  The minute she walked in, the first thing she says before anything else is, "how old are you?"  I very sheepishly admitted I was 44.  I thought she was going to give me grief because of the whole advanced maternal age thing.... but that wasn't it at all.  She said I am responding so well (or rather my ovaries are) that she thought my chart was wrong.  In her words "You're not responding like a 44 year old usually does." I said that's good, right?  And she affirmed that it was a good thing. Even the IVF nurse agreed and said "You're not even on a really big dose either!"   She (the dr.)  said she can't make any guarantee about eggs, but my ovaries were really good.  I found it really encouraging anyway.  Hopefully that means they can get tons of good eggs to work with.

On the way home, thinking about that morning's appointment, I couldn't help but think that the gluten free diet had to have contributed to this good outcome.  I can't prove it, have no scientific fact behind it, I just feel it in my gut.

So today's shots include 3 vials menopur in the morning, back to 225 Gonal-F in the evening, and add  .25 mg o f cetrotide.  And they want to see me again tomorrow, so I am guessing this starts the daily monitoring they mentioned would come just before retrieval.

I am trying to think positive.  I could be pregnant in slightly over 2 weeks.  Oh my gosh, I really hope so!

And so ends cycle day 23.

Thursday 9 May 2013

Just keep swimming, swimming swimming swimming....

Any Nemo fans out there?  Remember Dory singing "just keep swimming?"  That's a little how I feel right now.  Just plodding along, taking my injections and going in every other day for blood work and ultra sounds.

This week has been uneventful, really, if you don't count the anxiety and anxiousness I keep stuffing down throughout this process.  Monday I was a bit anxious because there didn't seem to be any activity.  Those old fears came out in full force - What if it didn't work?  What if I am one of those people who don't respond?  I mean the clomid doesn't really work for me anymore, maybe these won't either?

Then Wednesday, I had a bit of an issue.  Ever have one of those mornings where you just can't do anything right?  That was me...with my Menopur - yikes!  At $70 per vial, it was not easily overlooked.  I goofed up the steps and tried to take the vial off the Q-cap before filling the syringe with the medicine, so I lost half of it.  Ended up using another vial.  Then, to make matters worse, I must not have screwed on the injection tip properly because although the needle was firmly in my belly, the medicine seemed to be slowly, actually quite liberally running down my stomach.

Double yikes!

I had blood work and another scan that morning, so I told Dr. G what had happened and thank goodness, it was no big deal.  He said it stays in your body about 36 hours, so one missed dose was OK.  After the scan, he actually said it might have ben fortuitous as those follicles had finally started to grow!  He said after seeing the blood work, he may just reduce my dosage.

That's exactly what happened.  I am down to 150 IU of Gonal-F but still the 3 vials of Menopur daily.

Side effects seem to change daily.  The dizziness and bruising is much better.  (Icing the injection point prior has helped tremendously with the pain and bruising).  But I am still fatigued is not listed as a side effect. I get headaches, my joints hurt a bit, I have a sore throat and runny  nose, my breasts and ovaries hurt and I am starting in with nausea. But none are severe enough to make me miserable.  But I am anxious to be done with this part of the process and on to retrieval.

The one concern I have (TMI alert!!!!) is that things are starting to flow down south in the girly bits.  I am clearly getting what's considered fertile Cervical mucous and of course, Rob is in Atlanta for the day and won't be back til tomorrow night.  I am hoping beyond hope that I don't ovulate between now and tomorrow, and I will ask about it.  I know in my hoard of medicines they prescribed, I have three boxes of cetrotide.  Maybe I will start this tomorrow? (yay, more shots....)

Tomorrow is another blood draw and scan.  I am hoping they will have a better idea of the retrieval which has been "guestimated" at this point, for Tuesday, 5 days from now.

And so ends cd 22.

Monday 6 May 2013

Just another step down the IVF trail....

There's not much to report at this stage of the game.  For the past two days, I've just given myself the injections of Gonal-F at night (225IU) and Menopur in the morning (3 vials).  This morning (cd 19 if you are keeping track) I had another bloodwork draw and scan.  Dr. G commented that my lining was thin but that kind of makes sense.... I've been spotting since stopping the bcp's.  Only just stopped spotting yesterday.  He said we will just have to wait and see what the bloodwork reveals.

It revealed that my estrogen was 400 something and that I would continue on the current levels of injections until Wed morning at which time I will have more bloodwork and another scan.

I can tell you that while the needles are the same size as those used for insulin, the medication inside is not.  All I can say is OUCH.

This is the assortment I use to mix the menopur.



 I don't actually use the long needle at all, just the syringe part of it.  I screw off the needle end, and screw on the clear plastic "Q-cap" to mix everything. Then I screw off the Q-cap and screw on the half inch needle for the actual injection.


Honestly, sticking the needle in does not hurt at all, at least not me.  What hurts is the medicine (menopur the most) going in.  It burns and I can feel it spreading.  I have found that icing the area before hand helps tremendously.  The tonal-F is not nearly as bad.  But my IVF nurse had given me the advice to let the filled syringe sit for 10 minutes to come to room temp.  I have done this and the pain is minimal.

But my tummy really hurts.  I really do feel like a pin cushion. It feels slightly swollen, but hugely bruised.  I am wearing looser clothing so as not to rub up against the area.  Side effects are not too bad....some headaches and dizziness but only when I bend over, like to tie my shoe.  And emotional.  I feel like I want to cry over the silliest little things.  Trying to keep that in check so as not to make my husband crazy.

Is it difficult?  yes.  Unbearable?  No.  I don't like it, but so far, it's nothing I can't handle.  Still not trying to worry about if I will have enough eggs retrieved to do this, still not thinking about getting through all the cycles in my package and not getting pregnant.  I have been searching my heart...Is this really worth it?  Do I really want another baby.  I can honestly and sincerely say yes.  I want it as badly as ever.

And so ends cd 19.

Friday 3 May 2013

Day one as a human pin cushion - drugs for IVF

Not much to report today.  Absolutely nothing happened on cd 15 as I was waiting for my appt today.  One minor note, I started spotting last night which had me slightly worried.  But I thought it made sense seeing as I stopped the bcp's 2 days ago.  The IVF nurse confirmed this was completely normal and nothing to worry about. Only other item of interest was this great big expensive box arrived on my doorstep.  $4300 worth of fertility meds.  I have to admit, even with all that money spent, it certainly did not feel like Christmas.




Had an early morning bloodwork and ultrasound.  The bcp's did their job and everything looked good. They said my ovaries looked "fantastic"which made me laugh.  I made the comment "at least something in my body is doing it's job!"

I do want to interject here.  While not eating straight paleo, I have been strictly gluten free, and I do tend to try and lay off the grains.  I think that has had a seriously positive impact on my ovaries.  I've noticed on the ultrasounds, those "string of pearls" have been conspicuously absent.  I think my inability to get pregnant really falls under either my age or that "unexplained" category.

Anyway, my "fantastic" ovaries were showing about 20-25 follicles on each side.  I am hopeful that that means we will have a very successful retrieval.

Anyway, around 2:30 I got the call that everything looked good and my instructions for the weekend.  I'll take 225 IU of the Gonal-F tonight, tomorrow and Sunday.  In the mornings, I will take 3 vials of the menopur.  Time to whip out these babies....


Don't they just look scary?  The good news is, these are just used for mixing the menopur, NOT for injecting into me, thank goodness!  The actual needle is much smaller, no bigger than an insulin needle. I'll try and remember to take a picture of it tomorrow so you can see.

Honestly, I was more nervous about mixing everything up.  The vials actually come with the meds in a dry powder form, and you have to add a special water to it. But my IVF nurse had walked me through it, then suggested watching videos on youtube.  So that's what I did, I laid everything out on my computer desk, watch the video and did my thing.  It was just like an insulin shot (I had gestational diabetes with both boys) and it did not hurt one bit.  I chose to do it myself into my stomach.

DH tried giving me insulin shots back when I was pregnant with both boys, and frankly he's horrible at it.  He either jams it in (the man has strong Scottish genes) or loses his nerve at the last second and goes too slow.  In any case, it hurts and I really am OK doing it myself.

So shots over the weekend, then I go in Monday to see what's happening. And that wraps cd 16.


Thursday 2 May 2013

Name that price! How much are the drugs?


So cycle day 14 brings the quest to actually acquire the drugs in my possession.  I have to admit, I put it off as long as I could because I am still waiting for them to say "You are too old, go away.  Your body is most certainly NOT a temple let alone an incubator for a little life.  Go home!"

But they haven't. They continue to insist I have a chance at this.  On Monday, if you recall, I had a very stressful day pricing everything.  While it was upsetting and frustrating, I HIGHLY recommend this.  Here's why.  For the past how many years, they've always recommended Rosemont Pharmacy so of course I wasn't surprised to see it on my list of places to try.  Their price for Gonal-F?  $810 per vial.  I need 5 vials for a total of  $4050.  Cornerstone in Willow Grove, the company I chose to go with?  $384 a vial after they applied some sort of rebate (they applied for me and gave me the after rebate price).  That totals $1920 for a savings of $2130!  That's huge!



The other thing Cornerstone did was, they mentioned that cetrotide could be taken in place of Ganilrelex for a savings of $106.50 overall.  So I called the nurses and asked if that was OK and it was - hooray!

The other good news is that I did indeed qualify for one of the Compassionate Care programs and they gave me 50% off the price paid for gonal-f and cetrotide.  So take that off the prices listed above and I ended up with a total bill of $4300 instead of the $6000 ($7300 if I had gone with Rosemont) I was looking at before I started pricing.  So do that if you can.  These are all the cash out of pocket no insurance coverage prices by the way.  I can't tell you what it looks like when insurance covers some or part.

My next challenge was paying for them.  I had maxed out my credit card to pay for the IVF services last week and it was a race to see how quickly they would post the transaction my account,  I could pay that electronically and set my balance back to 0.  By 11:30am, my balance was back to 0 and I could call the pharmacy!  It seems like everything is starting to fall into place now, and I am catching some of those breaks...like Compassionate Care taking pity on me and processing my application in 3 hours instead of 3-5 days.

I did have a back up plan. The worse case scenario is I would take the money out of my account in cash and drive the 2 hours to Cornerstone.  But a) who wants to drive around with $4300 cash in their purse, and b) I wanted the credit card points.  If I have to go through all this, I'm at least going to get an airline ticket to someplace warm and sunny out of it! ha ha ha



So after running to the UPS store to fax in the script, my Compassionate Care card, and my insurance card (there were three things that they thought they could get covered in my insurance - the antibiotic, the immunity rejection drug medol and the esterase -estrogen- that all have uses outside of fertility) and several back and forth calls, I am now patiently waiting for my big expensive box of drugs to arrive. 

I am supose to start Friday.  Again, I am compartmentalizing the ideas of all those shots, of what if this doesn't work, how many embryos to transfer, will I even get enough eggs to make embryos..  If I think too long on any of those, I start to get a little crazy.  I noticed yesterday during my walk, that I made a conscious decision NOT to think about anything IVF related.  I  needed a break, and frankly, I think breaks away are good for me.  I will take each day, and it's decisions, as they come.

And so ends cd 14.

Wednesday 1 May 2013

BW, scan, Hysteroscopy, IVF Mock transfer and SA....Lions and tigers and bears, Oh My!

As you can see by the title, yesterday was a busy and let's be honest, scary day.  Bloodwork and ultrasound were no big deal.  I bet after 10 years of trying to have babies I've had at least 100 of each.  Those turned out fine and yielded us good news.  My estrogen was great, as was my progesterone... my system was "dimmed" as they put it, so I could stop the bcps (i had been on them 10 days total) and get ready to start the injectible drugs soon.

It was the after that, that had me so nervous.  All the reports I had found online were scary.  "Excruciating"  "painful"  "lasted forever" were just some of the keys phrases skyrocketing my blood pressure from it's healthy normal of 120/60 to a crazy high of  160/90  (um...the last time it was that high, they admitted me into the hospital and performed a c-section 20 minutes later!)

I have to stop and give kudos to my Dr.  If you are in the philadelphia area, and are looking for a great RE - check out Dr.  B. Gocial.  He's amazing.  He's never made me feel dumb for asking silly questions or being scared or anxious, and when you have bad news like a loss (or two) he is gentle and sympathetic.

So while I was shaking and on the verge of tears, he literally stops and touches my arm and says, "What exactly is scaring you?" in the most concerned tone.  I flat out said, I was scared it would hurt, and I was scared he would find bad news and say "Sorry, game over, your uterus is a mess!"

He was very honest with me, described to process and indicated the discomfort wouldn't be bad, just talked about the cramping.  Then he said, he's seen my uterus on ultrasound enough to know there probably really wasn't a problem.  That he wouldn't even order it except we were doing an IVF and they just want to be sure.

I can hardly fault that logic. Yes, before I spend $25,000, I'd like to be sure too, that there's at least a chance!

So while I was still terrified, it helped to know my Dr. was sympathetic to my concerns.  So I left the office and went to the adjoining surgical suite to wait my turn.  Turned out, there were a lot of women "ready" so I had to wait while they performed FIVE retrievals!  yikes, that's a lot of eggs!

My friend, "A" had said really the worst part about it was the "uncomfortably full" bladder you need to go with.  OMG she was so right! That really was the worst part.  I mean, how much do you actually have to drink to be "uncomfortably full?"  I didn't want to not drink enough, and then they couldn't do it, but I've always been a bit of a camel, not needing to go to the bathroom too often.  So I drank a glass of water when I awoke, a glass with breakfast, and grabbed a 24 ounce cup of decaf to drink on the way.

My eyes were yellow I was so "uncomfortably full."

And did I mention they were running behind schedule?  Yikes!  But finally it was my turn.  The nurse was thankfully, very kind.  I was led to a changing room with lockers.  They had me change into a surgical gown, hair cover and footy socks (I love those socks with the little grippy things on the bottom... I had to contain myself from searching the cabinets to take home a stash of them). I locked my  clothes, purse and phone in a locker and went out into the hallway.

The nurse greeted me almost immediately and led me back to a large room divided into three sections made into private rooms by  hospital curtains.  Instead of a bed was a large recliner chair covered in surgical pads.  I took a seat, and they immediately gave me a warmed blanket to cover my legs.  They went over my post-op instructions which was basically "go home, you're done" and then the, Dr. G checked on me once more.

In a few minutes they walked me into the OR.  I took a seat on the table which is just a glammed up version of what's in the exam rooms.  But the stirrups were much more robust and padded.  And then it was time.

They did the mock transfer first.  He inserted a speculum joking about how they haven't redesigned those things in 150 years.  No kidding!  I, like I'm sure most, really hate those things.... Do they have to be so heavy?  Every time they put one in, I feel like it's pulling me down.  I'm waiting for the day it does eventually fall out, pulling all my girly bits out with it....

Anyway, next was the insertion of the catheter.  The only hard part about that was the nurse pushing down on my belly (read "uncomfortably full" bladder here) with the ultrasound device while he did the mock.  It was over in about a minute, seriously.  Felt much better when they were done pushing on the pee bag.

Next was the hysteroscopy.  Huge deep breaths.  I have a history of panic attacks, and I felt one coming on.  My husband taught me to breath big deep breaths when this happens, and so that's what I did, and focused on relaxing. But really, it honestly was nothing.  I felt some minor cramping, but honestly the HSG I had done 5 years ago pre-Noah, was much much worse.  It was a little gross after, as the saline dripped out but it was done.  And again, it took like maybe a minute or two at the most?

They did say I could spot so it was a little embarrassing when they asked me to scrunch the big paper covers between my legs and walk down the hallway to the bathroom.  I prayed the husbands of other patients were all ensconced quietly behind the little curtains and they were.

And I was done.  I went across the hall back to the changing room, got dressed and left.  All that worrying for nothing.  I wonder if the difference between those that had so much pain was that they hadn't had children before?  I had been reading a blog where the woman said for her first child, it was excruciating, but the second one was nothing.  I don't know, but it sounds like a good theory, anyway.

I was incredibly exhausted getting home, but I'm sure that's more about the emotional energy output and the lack of sleep from the night before.  I did experience some cramping but it was closer to late afternoon.  Nothing I couldn't stand, but let's just say I curled up on the couch and let DH make dinner for a change.

So that's it for cycle day 13. Tomorrow is the quest for drugs.

One final note, in all the blogs I found describing this experience, it was from the point of view of donor/adopted embryos.  Just want to clarify that this will be a different process because we will be using my own eggs.  So the drugs will be different as I prepare for the ER - egg retrieval.

Monday 29 April 2013

....and I haven't even started the drugs yet

This process is not easy.  There is no way through it, but through it.  I have found myself wondering if indeed I am strong enough to do this.  I remind myself that thousands of woman go through this process all the time.

Today's struggle has revolved around medications.  I honestly did not expect to move forward so quickly.  In my mind, this was a multi-month process.  So I was shocked that just one week to the day after testing negative for last month's IUI cycle, I was starting BCP (birth control pills) for an IVF cycle.


(brief pause for back story....At my initial consultation in Feb to see if I would even be a candidate, Dr. G told me that both my AMH levels and both FSH levels on a clomid challenge test had to be normal or my chances of successful IVF using my own eggs would be less than 2%.  No one in their right mind spends $25,000 dollars on something with those odds, so we went ahead and did those tests.  On the clomid challenge, since I was indeed responding, we decided to go ahead and do an IUI on Easter Sunday of all days,  for one last attempt.  How I hoped that would be successful, so I didn't have to do the IVF but as usual, bfn.... (big fat negative).

OK, back to our normally scheduled programming.  So I test negative on Sunday night which was 14 days post IUI, and they call me Monday to see if I want to come in for a blood test beta.  They agreed a negative home test was sufficient and told me to call when my cycle started to schedule my 3 day baseline blood work and ultrasound.

I posed the question, if I was going to start an IVF cycle, why do they do that?  She gave an iffy answer that didn't make sense at the time.  Now I know, it really was because this process moves quickly and they really do need the baseline.  I couldn't come in on cd 3, but they said cd 4 was just fine.  Again, it was a Sunday morning just 3 weeks post my failed IUI and I started bcps.

Why bcps?  It slows down your system in preparation for all you are going to do to it.  My IVF nurse explained, Lupron or Ganirelex is taken after the stim drugs to prevent you from ovulating before the retrieval.  They act like an "off" switch.  The bcp's, she explained act in the same way, but as more of a "dimmer".  So I will take those for about 10-12 days or so, and they will check my levels via blood work.  When they think I'm ready, then they will start the injectible drugs.  Hence today's great big stress ball.



They are incredibly expensive.  I have a list of 10 pharmacies they gave me to try.  Your local Walgreen's or CVS generally doesn't carry these.  The first one I called refused to give me prices over the phone, only in person.  They are a full hour away.  In fact the closest one was still 45 minutes away, some were in other states.  *gulp*

In conjunction with getting prices, I was trying to ferret out information on the Gonal-F cares discount and rebate programs for the uninsured  (I sound like I'm homeless, don't I?  a real charity case....depressing).  This information seems to be a closely guarded secret.  The income part is "proprietary" so you can't tell at all if you qualify until they've processed your application.  Normally this is no big deal, but I didn't have that kind of time.  According to my IVF nurse, I will probably start these drugs at the end of the week!  And they pharmacies need the discount card in hand before they will honor it.  I can't go next week after the fact and say "Can I please have my thousand dollars back?"

Are we seeing my stress here? We are talking about $5000 - $6000 worth of medications here.  So even a 10 or 20% discount is significant.

I will share the name of one pharmacy only  because they were so very kind to me.  Freedom Pharmacy in MA.  And they ship overnight for free.  Most likely thought, I will go with Cornerstone in Willow Grove, PA.  They will ship overnight for free too, and they had better prices, and had some rebates already in house that they would file for me and give me upfront.  That one little act saves me almost $300.  And they said, if I do end up qualifying for the compassionate care program they will honor that in addition to the first rebate.

I don't feel like we will be approved though.  I think they will look at Rob's income and say no.  They don't ask important questions...  They don't ask "Are you paying $17,000 out of pocket cash up front for the medical procedures?"  They don't ask " Have you been paying off a $26,000 adoption for the last 5 years?"  Nope, just a tax form for proof of income.  But hey, if you don't ask, you don't get, right?  So I'm asking.

The last few days, I've found myself incredibly emotional.  I'm not sure why since I haven't even started any of the hormones or ovary stimming drugs yet, you know, the ones that supposedly make you a raving lunatic?  I just find this whole thing very scary.  I am intensely scared of tomorrow's hysterscopy and mock transfer.  No drugs but tylenol or motrin.  I've heard it hurts.  :(

Hopefully, there will be a silver lining and after bw and scan, they will tell me I don't need to start the other meds until after I can actually get them in my possession.

ttfn  (ta ta for now...) I'll post more hopefully tomorrow about all the procedures.


Thursday 25 April 2013

The Beginning of the End - my IVF story

Yes, it truly has been a year since I've written.  A long tough year.  I always thought I would be prepared to lose my mom, given her healthy history.  But I was thoroughly wrong.  When I lost her, it felt like I lost the strength to go on, like she was the rock behind me, quietly holding me up.  I've had to learn to find my own inner strength.

I'm not sure I did, but I have learned to compartmentalize.  Life has thrown me some nasty curves... enough now that at times it can be too much to bear.  But I don't want to live my life sad and afraid of the next bad thing.  So I tuck those fears into those little boxes and just deal with each day as it comes.

Healthy?  I don't know, but it seems to be working for me, helps me get through each day and I finally seem to be healing some.

I've wondered if I should delete this blog, continue it or what... I'd be lying if I didn't say I didn't desperately want to still get pregnant.  Again, I find it truly amazing that I have not been able to get through this, to just let it go.  I have three amazing children and a mostly wonderful life.... yet it is  always there haunting me, in the morning when I wake, the evening when I try to sleep and several times through the day.

Clearly I have been dealing with depression as I've had the physical pain, sleep issues and complete lost of interest in all my usual favorite hobbies. But the hardest part is the complete lack of hope.  I had none, no faith in people, in God or that life could be good.  I was fearful for my children growing up in a world of such sadness and disappointment.  I have been to church maybe twice in the last year.  Can't go - I no longer believe in the power of prayer. When I do go, I come away completely sad to be so abandoned by God. What did I do?

Then something happened around Oct/Nov of last year.   I started forming some friendships, with true genuine women who have been quietly supporting me, lifting me up.  That has helped so much, being able to talk about my sadness and receiving such compassionate sympathy.  But then an amazing thing happened.  One of those women led me to an IVF program I didn't know about.  And suddenly, there was a new spark of hope in me, something I hadn't felt in a long time. And it felt good.

I knew this was something I had to do.  In my mind, it would bring me peace. It felt like the beginning of the end.   If it worked, then I would be overjoyed and beyond happy.  But if it didn't?In a strange sense, that was OK too.  Then I would know I tried everything.  And that meant that it would be time to move on, but with peace about it this time. Even accepting I would never have that child would be a huge improvement over the limbo I had been living in.  No more  "what if's" or "if only's" hanging in the air....  I am learning to never underestimate the power of closure.

The question remained however, what would my husband say? Well, there were lots of discussions over this, some good, some bad.  I'm not comfortable sharing these very private discussions on a public forum such as this.  In the end, the decision was made, yes, we could do this.  I started taking pills 4 days ago.

Which brings me back to the question of this blog. I have been searching for people's personal experiences with IVF and finding very little.  So I thought I would document mine.  The one single comfort I have found in infertility was the ability to help other women like me.  So  Over the next 30 days, at least, I will share what I am going through, what it's like both emotionally and physical, and of course, the results.

The beginning of the End.  May it bring peace, in whatever form that may take.