Suppression Update

I am suppressed!  It was odd to see ultrasounds of my ovaries without follicles or circles or anything sticking out.  Weird to hear her say "You've got a nice, thin, lining -completely at rest".  I'm so used to hoping for X number of follicles at YY millimeters.  Instead, they measured my ovaries and took an antral follicle count.  No bloodwork needed.

One downside was the antral follicle count.  The last few times they have checked, they felt comfortable saying 7 on one side and 8 on the other.  Today, it was 5 on one side and 4 on the other - quite a difference.  I do know that what the antral follicle count is at suppression doesn't mean much since everything is so tiny and dormant, but I'm a teensy bit concerned.  My doctor has ordered me to go from 325 units of Follistim to 450 tomorrow. We'll check again on Monday afternoon to see how that affects things.

So, we march on!  And away from margaritas on the beach.

Am I Repressed? Oh - that's supposed to be Suppressed? whoops!

Oh, I've been reading too much on the lazyweb today.  I was trying to figure out what exactly would happen at my suppression check and what they would look for.  Apparently, this is all a much bigger deal than I realized and I should be freaking out.  I'm not.  I've been trying for a baby for three and a half years and this will just be another blip if there's an issue.  One thing infertility has taught me is the need for patience along a journey.  (Some of you who have known me a long time may be giggling over the idea that anything has taught me to be patient - giggle away!)

At 2pm, I will have an ultrasound.  They will look for cysts, follicles, maybe do a follicle check (I can't figure out if this is for dormant/antral follicles or if they want to make sure I haven't accidentally ovulated on birth control pills or the lupron).  I will also have bloodwork done to determine progesterone, estradiol, and some other alphabetical bloodwork names with which I am not familiar.

If any thing is off, I will not begin stimulation medication tomorrow.  I may have to continue on lupron for further suppression, wait an entire cycle, or ??  I am realizing that I'm in the dark on this.  I've been blissfully in the dark on this!  I don't know if I would have to pull off everything and wait for "that time of the month" (how quaint!) or just take some extra medication.

I'll find out later today.  If I am not at the right place in my cycle, could I at least be at the right place for my 40th birthday?  If I don't have to be here, could I go lie on a beach someplace?

Hey!  This isn't sounding too bad!  This whole IVF thing interrupted a beach vacation for me anyway.  I'll just see if I can go back to that.

And, it's statements like the above that make me realize how removed I am from this process.  I'm just following along, taking the shots, taking the needles, making the appointments, going here, there, giving blood, having a Wha? shoved up where??, and doing that every day or every couple of days for weeks.  I suppose that shows commitment to the process.  But, honestly, there are times when I wish I could have postponed this and taken that vacation with dear friends and seen my extended family (whom I've not seen since last summer).

So, I focus on that as a possibility instead of the issue of having to wait another few weeks.  I'll just repress any sadness and disappointment and anger with a good cocktail, a pedicure, salt water, and the love of friends. I've waited years and gone through many procedures.  At least now I'm on a path towards a baby in a more positive direction than I have been.

Now check with me this evening to see if I'm singing a different tune.

Holy Hot Flashes! and other fun stuff

Oh, man!  I've had probably a dozen hot flashes today.  It's like instantly being in the deep south without the benefit of the good food and charming accents.  I suppose this means the Lupron is working, though.  I get nervous that I'm not doing it right.  That I'm misreading the syringe, putting it in a vein, timing it too late or too early in the evening, accidentally spilling it back out - something.

My stomach has a few little red marks and one giant bruise which Bud calls my "owie" and kisses it.  I noticed tonight that after I pulled the needle back out, a little touch of blood came to the surface.  I think this means I hit something I wasn't supposed to and am dearly hoping that it's not a big deal.  I'd like to stay in ignorance.  On Friday, I'll have an ultrasound to see if I'm "suppressed".   I'm not sure what they are supposed to see, but I do know they also want to make sure I haven't developed any cysts with this.  If I have a cyst, we'll postpone for a week.

Another strong side effect are tender breasts.  Ouch!  It's gotten to the point where I think I may just wear a soft bra for the next several weeks. I wonder if I could shower in one? Not really, but it may get to the point where I just stand under a cold shower for my burning breasts.  (Sounds like I'm writing a trashy romance novel!)  I'm not sure my breasts have been so tender since I was pregnant.  It's a small price to pay and in the grand scheme of all the side effects I could have, I'm relatively unscathed.

I've also noticed that my appetite is up and I feel like I have low blood sugar if I don't eat. I may have to manage this with a more insulin resistant related diet.  If I gain much weight, they'll have to move my procedures out of our regular center and to a hospital, or so I've been warned.  The anesthesiologist for my hysteroscopy was sure to mention that, since I'd be on all these medications and weight gain and appetite might be side effects.  I don't suppose it's too late to eat lean cuisines and slim fasts?  I will be undergoing anesthesia/sedation for the egg retrieval as well as the egg transfer.  (Usually one would not be under sedation for the transfer, but I'm a special snowflake in that uterine catheters make me scream out in pain and grab the table as if I'm undergoing some kind of alien medical experiment.  Pain management is my friend, and the only way I agreed to go through this.)

I've also got a lovely bullseye bruise on my right hand, between my thumb joint near the wrist and my first finger.  It's one of the key fertility points for acupuncture.  I think of it as evidence that the acupuncture will work.  I did have a strange experience with it the first time I did it in years on this past Friday.  I've had acupuncture dozens of times, but never had an experience like this.  I sat in a chair with needles in my hands, legs, feet face and scalp, having an issue relaxing.  About ten minutes into my session, I suddenly felt this weird rush come over me, almost like getting goosebumps without the bumps.  After that, I found myself completely relaxing into it.  I had my right hand jerk, then my left, then my right leg.  Each involuntary jerk seemed to drive the points home again.  Once the treatment was complete, I gathered my things and put on my shoes.  As I put them on - I kid you not - my uterus had a contraction.  I'm now seeing her twice a week.  What I did not know (and they really should give you some kind of sticker to highlight this) is that a study showed that ladies who did acupuncture as they went through IVF increased their success rate by an additional 50% from the control group.  50%!!  So, looks like I will be loving the needles for the foreseeable future.

Maybe I'll name the kid Pinny if this all works out.

Choices at Sixteen - to keep my organs or not?

I had to choose whether or not to have a hysterectomy at 16.  That's right, folks, 16.

In honor of Fertility Awareness Week, I'd like to share my history.

It began when I was 15.  The nausea was so bad I would be huddled in a ball, crying.  The shooting pain was so intense that I would double over and scream.  We didn't know what was wrong.  Everyone around me thought I was exaggerating.  But, one day, my mom was passing by my room with a laundry basket and she saw me cry out and grab my stomach.  "You really are in pain, aren't you?".  Well, yes.  And off to the doctor's we went.  We were referred to having an ultrasound.

Have you ever had an ultrasound?  It's really cool.  They squirt cold goo on your belly and then place a wand over it, just rubbing your stomach.  Shades of white, black and gray appear on the monitor.  I remember the technician marking off places around circles.  And again. And again, again, again.  When I came out and saw my mother, I was so excited to tell her they found something!! Lots of somethings!!  She tried to play it down as a mistake on my part.  I know that she was terrified that the "something" could be horrendous.  Me, in my naivete, assumed that whatever it was could be fixed.  The next day we received a phone call.  Multiple ovarian cysts - the smallest, the size of a dime and the largest, the size of a golf ball.  I was put on birth control pills as a remedy to shrink the cysts.

And they shrank. I had some awkward gynecological appointments with a very kind, gentle OBGYN to monitor them.  But what didn't change was the pain and nausea.  And it was getting worse.  I ached all over and was exhausted.  I was put on anti nausea medication 24/7 as well as naproxen.  And when "that time of the month" came - watch out!! Pain.  Excruciating, as if a knife was ripping me through, Pain.  There were other details that would make some of my gentlemen readers blush and squirm, but suffice to say that there was physical evidence that all was not well, either.

On one appointment, my doctor and my mother had a long conversation.  She had the grace to have him include me in the conversation.  It was thought that I might have endometriosis.  Endometriosis is where the lining of the uterus, for whatever reason, also grows on the outside of the uterus, unchecked.  He couldn't feel anything, but he could take a look through surgery.  And as long as we were doing exploratory surgery, he would also take care of the problem.  There were three solutions.  One, have a complete hysterectomy.   The second, an oophorectomy - the removal of my ovaries so I would no longer cycle.   Each would leave me permanently infertile and unable to bear children.  He did mention that there was a third option, but I would likely need surgery again and be in pain on and off the rest of my life as I continued to battle this, and that was something that at the time was relatively new.  Laparoscopy.   It's standard procedure nowadays, but it was a new treatment for endometriosis almost 25 years ago.

I thought about the kids I had babysat.  How much joy I found in them.  I knew I wanted kids.  I had to make a decision.  At 16, some kids are planning how to avoid being a parent.  I was planning on being a parent.  My daughter was conceived in my heart that day.  She came twenty years later after attempting for almost two years to conceive physically, but my wanting and waiting to be a mother started that day in the doctor's office as we chose a course of action as we watched my symptoms progress.

I had a difficult time a few months later with my cycle. My mom called the doctor and I was put into surgery within a few days.  Endometriosis is listed in stages, like cancer.  I had advanced Stage IV endometriosis. I had tissue growing on the outside of my uterus, my Fallopian tubes and ovaries, over my pelvic bones, climbing up my rib cage, circling in back and covering my kidneys.  My doctor did the best he could to laser all of it off.  As further treatment, I continued on birth control pills and had a shot each month of a medication that was (at the time) used off label to inhibit the regrowth of tissue.

That medication?  Lupron.  The same medication I am now injecting each evening in order to have another child.  I feel a certain symmetry with that.  In some ways, it began my path to treating my uterine and fertility issues. It is interesting to me that the Lupron is here again, at the end of this long road, almost twenty five years later.  Full circle.

A Shot fired cross the bow er, belly.

So the first shot was weird.  The Hubs stood by and watched as I did it.  (He has a thing about needles to the point that I have to go with him for blood draws in case he gets too ill to drive and/or passes out.)  I took off the white cap from the plunger end.  I swabbed the top of the now unsealed canister of Lupron with an alcohol rub.  I then rubbed a different swab all over one half of my belly - I didn't know where that needle would go, so I figured a broad area would cover it.

I took off the orange needle cap and pushed the needle through the rubber stopper.  I turned the vial upside down and carefully measured out 10 units.  I pulled it out and looked.  THIS was going in my belly?!?  By my own hand?  I took a deep breath, hovered for a second, then took the nurse's advice of doing it straight on and quickly.

I plunged it into my belly.

And stared.  ohmygod, there is a needle in my belly!  And I didn't feel it! now what? oh, make sure it sticks in all the way.  Wait!  now I have a needle all the way in my belly!  And i did it!  and it doesn't hurt!  Oh, yeah, remember to actually push the medicine through the needle. Leave it there for a few seconds, now pull it out.

Wow, the first one was done.  Hubby hovered, repeating, "Are you alright, I think I'm going to be sick".  Once he saw I was fine, he hung his head and repeated several times about being ill.  We'll take it in stride.  He was a real trooper for trying to support my first shot.

About to Begin

So nervous!  I've rumbled through the box o'meds and pulled out the correct syringe, taken the seal off the lupron, and have the alcohol swabs ready.  And dinner ready. Of course, the Hubs opted to eat dinner and watch Jeopardy before we embark on this last leg of our journey.

Let's look at the highlights, shall we?  Multiple IUI's, the use of Femara and Clomid, month after month of disappointment, then despair, then numbness.

I'm kinda there now. It's like I will go through these shots and we'll see.  I have worry and hope and nerves, but at this point, today, I just want to get through all the procedures.  I've had procedure after procedure, drug after drug, not result in a pregnancy.  This is it.  We have a multicycle plan - two IVF cycles, two FET cycles. Then we're done.  For good.  I figure that by the end of 2012, I will no longer have to plan my life around a "what if?" and that, in itself, is worth going through all of this.