The number 4

A lot of people have a lucky number.  Some people go to Vegas and place bets on their lucky number.  Others may plan a special event on the same date as their lucky number.  I have always had a number that means something to me, but I've never been able to call it lucky.

It was 5th grade or so when I started playing sports.  As far back as I can remember, my jersey number was number four.  I don't know if I initially asked for that, or if it was randomly given to me.  Probably the latter.  At some point, as I was getting more interested in softball, I began following the Oakland Athletics.  My Papa loved baseball and I can remember him watching the games of all the local California teams.  He liked them, so I did too.  The Athletics quickly became my favorite team and because I played in the infield  I had a particular fondness for Carney Lansford.  Never heard of him?  I'm not surprised.  I might have been alone in my obsession   He played third base for the A's.  Bear in mind everyone, he is not some kind of pro athlete hunk (see below), I simply admired his skills and found some deeper meaning in the fact that we both wore number four.  Ever since, for every sport I played, I asked for jersey #4.


(My totally innocent sports crush circa the late 80s)

(sweet stance Carney!  see the #4?!)

While I might have had some good sports luck on the court or in the field, number four never really did anything else for me. I tried it on a lottery ticket once (I drive a 10 yr old car and have a 30 yr mortgage, so clearly I'm not wealthy from lottery winnings).  I've always wondered if something miraculous would happen to me on April 4th (so far, it's just been another ordinary, non memorable day).  But, finally- four has given me something I never would have imagined, and this four is far more important to me than all that other meaningless stuff.  As of this morning, H and I still have four maturing embryos.  They're in their 3-4 cell stage and so far have no fragmentation (I don't know what causes that, but am told it is good that we don't have any).  Today our little miracles probably look something like this:


(I think it looks like a stemless clover, which fits because our last name is Irish and because I'm writing about luck.)

Now we are more certain that we'll have a Day 5 transfer (meaning the embryos will grow in the lab for five days instead of three).  At five days, doctors believe that have a better sense of which embryo has the best chance at pregnancy.  They'll grade each one and transfer the prettiest or handsomest (no clue about gender yet).   Send all your positive thoughts to Sunday and wish our lucky little clover(s) the best.



One last (very important) message... thank you for following our story and for all of your supportive comments, calls, and emails- knowing you're there brings much comfort to an almost entirely uncomfortable situation.  xo

Water works.

Quick update - I'm turning into a cry baby; more tears of relief today.  Of our 6 retrieved eggs, 5 were mature, and 4 were fertilized.  FOUR!  More waiting and a couple more major hurdles ahead.  SGF will call tomorrow with a report about how our precious embryos are developing.  Not even meditation could help me sleep last night, not sure tonight will be any better.  The anticipation is hard to ignore.



If you're curious, here's the embryo progression we're hoping for:
http://www.ivf.net/ivf/embryo-development-o2591.html

Anesthesia Stole the Show.

My surgery was early in the morning, but the operation day instructions began hours before.  No food after 1am (no problem, I was well into in meditative sleep by then) and no beverages after 4am (also no problem, although I knew I'd be thirsty in the morning).  Our alarm went off and up we got.  I asked H if he thought I was allowed to brush my teeth.  Brushing would require toothpaste (is that a food) and water (definitely a liquid).  H didn't know; we scoured our instruction packet. - it didn't know either.  Nothing mentioned toothpaste.  I wasn't going to risk it.  I'd have to go to SGF with bad morning breath.

 The pre-op section of SGF is a busy place.  I arrived for surgery at the same time as two other women.  You can hear every conversation happening back there (those curtain dividers are not sound barriers).  The other women would have surgery before me so by the time the nurse got to me I'd heard her speech twice already.  She was in and out of my curtain room quickly.  Next the nurse anesthetist (NA) came.  Since it was on my mind, I asked him if I could have brushed my teeth that morning.  He said yes.  Oh sorry!  He told me it wouldn't bother him, but I should apologize to my husband.  I already had, but I did again anyway.  The NA hooked me up to an IV and told me to go use the restroom in 45 minutes.  I'll tell you, walking down the hallway, hooked up to an IV, in an ugly hospital gown, and blue surgical booties over my feet, kind of made me feel elderly.

A half an hour later, the doctor entered.  I remembered him from our talk about follicles and hot tubs.  Before he sat down, I felt obliged to apologize to him for my bad breath, explaining I wasn't sure if it toothpaste would count as food.  He smiled and told me not to worry, but maybe I wanted to give the NA a heads up.  Already did!  I'm all set.  With that off my chest, he explained the procedure.  In all, it takes about 15 minutes.  Two weeks to grow these things; 15 minutes to take them out.

(wanted to insert an image here, but googling trans-vaginal retrieval does not yield the most attractive results)

Finally my time for the OR came.  I sat down on a bed, complete with stirrups (I've seen enough of those in this past month!).  The nurse told me to put my feet up.  At the same time the NA was administering the anesthesia.  I felt a prick and the needle stung a bit.  He was behind me, I looked back and said, "I can feel that."  He told me I wouldn't for long.  It scared me though, thanks to a recent Atlantic Monthly I'd skimmed a story about patients under anesthesia who feel everything, despite being asleep.  I didn't want to be that dramatic so I asked, "Will I feel anything else?"  He told me I wouldn't.  Needing additional reassurance I asked, "Do you promise?"  He smiled and promised.  With that the drugs were kicking in.  The last thing I remember is looking around the room, noticing at least 7 people, then finding the nurse and saying, "It looks real serious in here."

Next thing I knew I awoke back in my curtain room with H standing next to my bed.  Without missing a beat, I asked him, "Did we get any eggs?"  But, even though I was moving my mouth, no sound was coming out.  H looked confused and a little worried.  "Did we get any eggs," I repeated.  I was desperate to know the answer.  At about that time, the nurse walked in.  H told her I was having trouble talking.  I tried again, this time a whisper came out, "Were there any eggs?"  She told us there were six.  I looked at H, at first smiling, then the tears came.  "Are you okay," asked the nurse?  "I'm just so relieved," I blubbered, my full voice almost back by then.  She left H and I in the room, still holding hands.  I admitted to H that all along I had a terrible fear there wouldn't be any eggs to retrieve.  The moment I heard my AMH was beyond low, I couldn't shake the feeling that I might just be barren.  Barren is a horrible word, by the way.  Soon the doctor walked back in to tell us everything went well and that they'd call us the following day with fertilization results.  Since I was still crying he asked if I was all right.  I sniffled, "I'm having my meltdown now."  Until that point, I think I'd contained all my worst fears and sadness and every other emotion IVF can inflict.  H told the doc I was worried there wouldn't be any eggs.  He repeated we got six, I think just to be sure I believed them.  I thanked him and then I blamed the anesthesia for making me act weird.  I wouldn't exactly call these tears of joy (though I was happy they found some eggs), I felt more relief than anything and not so much for the six eggs, but that I wouldn't have to deal with whatever anguish being barren would have brought.  If round one IVF doesn't work (and it is statistically more likely that it won't), we can realistically try again.

(it took a while, but I finally turned into this)

Once home I rested feeling all the bloating and discomfort they'd warned me about.  I wouldn't say I was in pain, but I did want someone to poke a hole in my stomach to make all the air go away.  H and I are cautiously optimistic.  He's happy with six and felt badly I'd been holding in the fear of zero.  At the same time, we're incredibly anxious for the SGF call that will come later today.  If there guesstimates are correct, we shouldn't expect more than three eggs to fertilize.  Our numbers are small, but even in small numbers we can hope.

Random is the new normal.

Normally I'd have some theme for my blog post, but since IVF isn't exactly normal,  I'm not feeling obliged to be my normal blogging self.  Today you're just getting my random (mostly un-edited thoughts).  Life is too random be normal anyway.  Here's a glimpse of the last two days.

Sunday 8pm was the whopper shot.  By that time I'd already given myself over 20 shots, so I figured a nurse pro doing the injection would be a breeze.   I was wrong.  Nurse neighbor (calling him G from now on) and his Partner arrived right on time (we invited them to stay afterward for  dinner).  G, H, and I immediately went upstairs to my drug lair to do the deed.   H and I watched G mix the meds and ready the needle.  Yep, he looked like a pro.  At first I thought I'd stand and take the shot like a man.  But, my nerves got the better of me.  G suggested I lay on the floor, to make it easier on those nerves.  Within seconds I found myself laying in the exact same spot where I'd once petted the carpet (see "Well that was unexpected" blog post).  Dan walked to where my head was and G was near my feet.  I told G to go ahead.  Until... I quickly changed my mind.  I had questions.  Wait!  How much will it hurt?  (not much at all he said)  Wait!  How long will it take?  20 seconds?  (no he said)  Oh my gosh!  Longer?  30 seconds?  (no, maybe five he said)  Ok, now I'm ready.  Wait!  No I wasn't.  I had some things to say to Dan.  As he tells it, I'd eventually gotten myself into half of a fetal position.  One leg out, one leg curling up toward my chest.  Dan was still standing.  I demanded he kneel on the floor with me.  "You can do this," H said.  I took his support and unfortunately shoved it back in his face by snapping, "Just kneel!  And take that stupid hat off your head."  Ugh.  So mean.  He wasn't even wearing a stupid hat.  I bought him the hat he was wearing.  Thankfully, he took no offense, and held his laughter until later, when he admitted it was all pretty funny.  I made a little bit of a scene.  G was right, the shot hurt didn't hurt at all (in fact, I didn't know he'd done it).  And it must of taken less than 5 seconds (again, I didn't even know he'd done it).  Yay.  Hard part over.  For dinner, I allowed myself to pig out on pizza and a cupcake.  The rest of the supper gang had wine.  Lucky ducks (I've missed partaking in adult bevvies). 

(my drug pile - after I cleaned up all the used meds and boxes)

Yesterday was kind of a waste.  I felt nauseous and light headed and tried to lay low.  To boot, my mind was preoccupied with worrying about the surgery and with wondering about how many eggs would be retrieved (none?  please at least on one!  super pretty please 8?  I won't dare dream of 10).  My acupuncturist had previously encouraged me to try not to put stress on top of stress.   She recommended meditation.  I was so desperate I tried it (found something from the app store with good user ratings; reliable source, I'm sure).  If the measure of a successful meditation session is falling asleep, then I'm a pro.  Om conked me out within 10 minutes each time I tried.  Sleep was needed anyway, H and I had to get up at 430am to be at SGF by 6am.  Surgery was scheduled for this morning at 8 (by design, 36 hours to the dot after the whopper).

More on the retrieval procedure and egg (eggs plural ?) count later ...  after I've had some more meditation sleep.

And then the doctors came.

The end of this IVF cycle is nearing and a few days ago, I suppose because of the proximity of the whopper shot, the doctors began doing my ultrasounds.  I've grown used to having a tech wave the magic wand and take my follicle measurements, but there was something extra comforting about having the attention of a Reproductive Endocrinologist (RE).


(those black blobs are follicles.  during ultrasound someone measures each one horizontally and vertically)

Last Wednesday, H and I had been waiting longer than usual and figured that SGF was even busier than normal.  When the door finally opened, my RE burst through apologizing for the wait and expressing how much she wanted to do the ultrasound that day.  I barely know her, but would say we've been through a lot together.   It is she who initially relayed our chances of conceiving naturally (just about zero) and walked us through all the tests, which all confirmed her initial diagnoses.  While I know that she has hundreds, maybe thousands, of patients and the chances of her remembering me are slim, her presence meant everything to me that morning.  The importance I placed on her could also be due to the two days prior when the nurses on staff shook my confidence in the abilities of SGF with a couple of inaccurate statements and instructions.  Needless to say, the arrival of my doctor put me at ease enormously.  She took my measurements and talked to me a bit about what would happen in the next few days.  Although, I'm sure it was very routine, I felt star struck.   I kept thanking her.  Profusely.  More than once I told her how great it was to see her.  It was as if my favorite celebrity had walked into the room and I lost the ability to create a rational question because I was so excited to see her.  (As an aside, as I'm typing this, I have no idea who my favorite celebrity really is, but the name Julia Roberts came to mind.)  H and I left the office feeling like we were back in good hands.



On Thursday, still to my surprise, another doctor entered the exam room.  I had met this particular RE before.  She's the one that did my mock embryo transfer.  Naturally, she isn't my favorite physician.  (Did I mention the last time I saw her she said if they had trouble keeping my cervix open during transfer day, they'd just use a stitch?  Meaning a needle and thread... down there!!  No thanks.  No thanks at all!  I hope, but doubt, she's been practicing.)  She scares me more than a little bit.  I tried to put that memory aside and to relax.  Turns out she's much better at ultrasounds.  Thank goodness.   H and I were in and out of there in no time and (bonus!) I didn't faint later that day.



By the time Friday rolled around I started expecting to see a doctor.  That day, however, there was still a semi-surprise for me.  A MAN walked into exam room #1.  I have no idea why, but it made me blurt out, "Wow!  I've never had a MAN do this before."  H laughed.  But, the doctor didn't.  He just said, "Well, I assure you I HAVE done this before."  "Ok," I said, "I do think you look like someone who knows what you're doing."  Finally, he laughed and replied, "Appreciate that.  I think it's the gray hair ... and I'm glad you brought your sense of humor today."  Thanks doc!  I am too.  It's not here everyday.



Yesterday we went to the Rockville office (we have to do that for every weekend/holiday appointment).  Rockville is 9 times the size of the DC office, so I really didn't expect to see a doctor that day.  But, I did.  Another dude.  He didn't have gray hair though.  He let the tech do the measurements and sort of just stood there watching.  Feeling as though he needed to engage more, I asked him the only question I could think of that I hadn't already asked someone.  "Hey [doc], why are they called follicles?"  Before he could answer, I followed up with a less intelligent sounding question, "Do they have hair?"  I caught him off guard.  He didn't even know why they're called follicles.  He explained something about follicles holding fluid in which the egg will eventually appear.  "Ohh," I said, "So, they're like little hot tubs."  He didn't laugh.  But, I thought it was funny.



Today, we're 99.9% sure, was my last ultrasound of the cycle.  My follicles have almost grown to the right measurements.  Unfortunately, to get the small ones caught up, they sacrificed one or two of the front runners which will be too big now to harbor an egg.  Losing them did make me a little sad.  I asked the nurse what to realistically expect.  She explained that of all the follicles present, not all will have an egg, and not all will fertilize.  I knew that. Then she added that they always tell people to expect half to make it to embryo stage.  In my case, that'll be three or four embryos.  That'd be great.  But, I'm cautious of being that optimistic.  Plus, there is absolutely no way to guess how many of those embryos will score the rating required to make it worthwhile to transfer them back to me.  Older eggs (as my AMH level suggests I have) statistically don't grade well.  Despite the odds, I'm still giving each and every follicle the benefit of the doubt.  My hope carries on.

Ok. That hurt.

Last week H and I went to his father's retirement party.  H's dad worked for this company for over 25 years.   I've only been in the family for some of those, but in that short time I've seen how much pride F-I-L (father-in-law) had in his work.  He put in a lot of hours, along the way earning the respect of his co-workers and the admiration of his son.  On vacations, with some frequency he'd have calls to take and give up free time to resolve work issues, but I never heard him complain about it.  He did his job with the vigor of a newly hired employee.  His work ethic is exemplary.  All this is to say, we were looking forward to the party his colleagues had put together for him.  I knew they'd miss him.  How could they not?  He seemed to me to be the glue (professionally and socially) of his workplace.

H and I arrived at the party and quickly noticed a slide show.  My brother and sister and law had combed through boxes of photos.   They found sweet and funny snapshots of time gone by and handed them off to someone at the company.  The result was a visual of a wonderful life full of family, friends, co-workers, and endless smiles.  Among other touching tributes, the slide show was one of the highlights of the party.

When things were settling down and as people started to leave I snuck off to find a place to do my nightly injections.  Even when I'm having fun, it's hard to forget about IVF.  When I returned, just a handful of people lingered to dig deeper into the slide show; reminiscing about work trips and embracing all the good times over the years.  The final slide was a family photo taken at the beach a few years ago.  H and I weren't married yet, but his brothers each had two kids at that time.  I admit, it is a nice picture.  In all, there were 12 of us in the shot.  The woman who put together the slide show, at the moment that picture appeared said, "You know, this is a person's real legacy.  It's not the work you leave behind, it's your children and grandchildren who are what really matter."  She's right (work isn't all there is to an accomplished life) and that's a beautiful sentiment.  F-I-L loves his family above all else and I know he's a proud husband, dad and grandpa.  To add insult to injury, she said it twice to two different groups of people.  I was obviously in ear shot for both.  What she didn't know is that his middle son and I are in the throws of IVF, constantly wondering if we'll be able to create a legacy through children of our own.  Her words filled my mind, heart, stomach, and soul with fear and pain.  I tired to smile, an impossible task after feeling like you've just been punched in the gut.  There was no escaping the sense of doom I felt.  I just had to hope my face didn't show my anguish.  An innocent, heartfelt statement can sometimes become the most hurtful words I hear.  H and I don't shout out our issue to everyone we meet and society doesn't know to be cognizant of these types of problems.   Heck, I didn't either before I landed in this category of people.  After having been through this, I'll forever be mindful of what I say or ask when it comes to the very personal journey of couples making families.  I don't expect others to innately know this, but that doesn't make a random statement hurt any less.

What I'd really like is for a Vince Vaughn looking angel to come along and put ear muffs on my head in the instant before a stinging comment will be made.  I know that will never happen and I also know I can't hide from the unpredictability of social situations, as tempting as that may be.  I have to face the every day circumstances and continue to build a thicker skin.  I do that by reminding myself that I'm lucky to have H and our wonderful families and so many other of life's gifts.  When I'm done with this post, I'll put this memory to bed and go back to thinking about what I enjoyed from that night.  It was a pleasure to honor F-I-L and he deserved every second of it.

Because I now feel badly about having used some of these lines in the past, I share these helpful hints in a small effort to make the world a safer place for infertiles:  http://www.resolve.org/support-and-services/for-family--friends/infertility-etiquette.html

The ride.

A lot of people refer to the IVF process as a roller coaster.  A couple sits in a car, eager and anxious for the ride, going through ups and downs, laughing (if they're lucky), screaming, braving steep and scary twists until, finally, the car comes to a rest.  I've decided I don't like that analogy.  The IVF ride is more complicated than that.  On a roller coaster you can see the downhill approaching, you know to brace for it, and you know when it's going to end.  IVF isn't that predicable.  So, I've decided it's more like The Zipper.  Remember that one?  That crazy thing went up and down too, but it also spun you around without any warning.  Well, I don't think there was any warning ... my 10 year old brain certainly never wrapped itself around that mystery.  The rides are similar, but the Zipper adds the element of uncertainty... and it's the uncertainty that makes this process tough to take.  I haven't been on an actual Zipper in decades.  But, for the last couple of weeks, I feel like I'm right back at the amusement park, only this time - it isn't for fun and games.



The daily doctor appointments continue.  My internal alarm clock knows to wake me up at 530 - 6 am in order to get me ready and to SGF on time.  I'm tired.  Today my eyes feel heavy and I am trying to muster the energy to last another few days of drugs.  Since the injections started the Carny Zipper Gods haven't spun me around much and I've enjoyed a break from the unpredictable ups and downs.  It's as if the ride got stuck, at the top, where the view isn't all that comfortable, but after time it isn't so terrifying.  But, if I'm being honest, I'm worried about when the ride starts back up again.  Will I be able to hang on to my positive perspective and general (somewhat surprising) sense of calm?



The injections have been a breeze.  No mood swings, no tears, no eating binges.  The appointments show me everyday that my beloved follicles are growing.  I like to believe they're all (7-9 of them depending on the day and the technician)  working really hard to get themselves to the optimal size.  Some are better at it that others.  Today one follicle was 15.4mm.  Just above the goal of at least 14mm (the acceptable egg making range is 14-18mm).  Another follicle on my somewhat lazy right sided ovary was 12.1mm.  That little guy has fight, I'm sure of it.  And he has a couple more days to catch up (before the leaders get too big to continue with meds).


(the chicken follicle came first.  then the egg.)

Then what?  Then I get the trigger whopper shot.  This shot is the biggest needle of all the injections.  Unlike my daily doses, I can't give the whopper to myself.  I've asked my awesome nurse anesthetist neighbor to do it for me.  H, you recall, wasn't able to go to the injection class.  And, bless his heart, he just doesn't want to inflict any pain on me.  A nurse, we agreed, can get this done quickly and professionally.  My neighbor agreed to do the shot before really understanding what it would do to me.  I think I caught him off guard the other day when I said, "So- you're gonna make me some eggs!"  The whopper will help my body make an egg for each appropriately sized follicle (in a normal cycle, the body will only make one egg and shut down all the other follicles).  There will be some attrition.  I likely won't get as many eggs as there are follicles.  That's where my concern begins.


(btw, my neighbor looks nothing like this, but in my head, the shot does)

First, there's surgery to extract the eggs.  How many will there beeeee????  No way to predict.  We'll have to wait for the results.  Once those are in, we'll have to wait and see how many eggs were successfully fertilized   More attrition.  Once those results are in, we'll have to wait and see how many will be viable for implementation.  Even more attrition.  Assuming there's at least one viable embryo, there's another procedure to transfer it back to my uterus.  Remember the mock embryo transfer?  The one that made me faint? You can imagine, I'm a little apprehensive about the real deal.  Then what?  Another wait...  A two week long wait at the end of which the doctors will tell me I'm pregnant or I'm not.  That's not the end, by the way.  Then they measure something called beta (more blood tests; my arm already resembles what I imagine a heroine addict's to be).  The number should double every other day.  The rising beta will tell us if the pregnancy is sticking.  There's a big fat wait around every corner, the results of which may send me spinning (into sadness, or into uber-cautious happiness).  My peaceful Zipper ride is about to enter turbo mode.  I hope I handle it well.  That's the only thing I can do.  Worrying won't make a baby.  Neither will stress.  And the tears I feel welling up when I think about it too long won't help either.  A part of my body I have no control over will either take to a pregnancy or it won't.   That's why I consider it my only job to give my insides a peaceful environment in which to work.  My prayers are of course for a child, but also for serenity.  I can't let that Zipper scare me.  I want to land on my feet - no matter what.

Good for Something

"What does not destroy me makes me stronger," (Friedrich Nietzsche) is the original quote perhaps from which Kelly Clarkson derived her tune Stronger (What doesn't kill you makes you Stronger, Stand a little taller, la la la).  I like Kelly's song and blast it when it comes across the radio.  Normally. I'd belt out the lyrics if I was sure no one would hear, but now I want to shout to anyone who might listen- she (rather, Friedrich) is right!  I'm trying to see the sunshine and rainbows even though sometimes it feels like it is raining.  Here are some perks of IVF (am I allowed to say perk and IVF in the same sentence??!!):



Me and H; H and me.  Our young marriage got a big test in the very first year.  At first we clumsily stumbled through the IVF news - with love, sadness, and some fights.  I remember one not so elegant conversation that ended with me leaving the condo in tears and wandering the neighborhood in search of comfort, which I found after sitting on the front steps of my church.  I guess I figured if my husband couldn't help me (and he normally could), God was a pretty good second stop.  After a few minutes, I just wanted to go home and hug it out.  The quick change of heart was either the power of the Lord, or I just felt ridiculous sitting there with tears on my face.  Plus- the mosquitoes were out.  When I got home, there wasn't any further discussion about that particular topic for a few months; we just left it unsettled and moved on with our day.  Back then we knew we wanted a baby, but we weren't on the same page about how to get there and we definitely didn't know how to talk about it.  Now we understand how to share our thoughts with one another and more importantly how to listen while trusting that the other person wants what's best for us both.  Listening sometimes takes more patience and understanding than I initially knew I had.  Passing through this test is giving us communication skills to help us now and forever.  We do slip up from time to time (I definitely snapped at H yesterday about flip flops in front of the door) but then I remembered that we're dealing with much bigger things and I regretted sweating the small stuff.  Our perspectives are forever changed.  When we got married I was more than confident we'd be able to get through life's bumps, but until you're truly tested you don't completely know if you will get through it with grace and/or dignity. Now I know.  Absolutely.  Without the a doubt.  We're pretty much rock solid now.



Food.  Eating and body image has been an adult long issue for me.  I love sweets, but when I eat them, I don't love myself.  The joy of a cupcake is later ruined by feeling too fat for my pants (as if gaining weight happens in an instant, right after I'm done licking the icing off of my fingers).  Sugar, sadly, is a bit like an addiction.  The more I eat, the fatter and sadder I feel, yet I keep going back for more.  When infertility reared its head some friends, some books, and some blogs shared a myriad of ideas on what I shouldn't be eating.  No alcohol.  No caffeine.  No sugar.  No gluten.  No dairy.  I was desperate, so I tried really hard to change my habits.  Weekend wine, morning coffee, constant sugar, anytime bread, and yogurt snacks became enemy #1.  I was more successful at some restrictions than others.  When I wasn't successful I got mad at myself for not having more will power ... why didn't I have the will to give up a few food groups to gain a  BABY!?  After sufficiently beating myself up,  I had to amend from none to LESS and recognize that food probably wasn't the problem nor the solution to infertility.  Miraculously though, as I ate less and less of these things, I started to notice that I just plain felt better.  I have more energy, I'm sick less, my clothes aren't tight, etc.  Good healthy habits, IVF has inadvertently taught me (I never seemed to quite get that message on my own), is a great thing.


"I never shall have that Park Avenue air, but I'm in such health, why should I care?" -Bette Midler / Beaches

Just Me, my thoughts, and I.  I'm full of quotes today.  One of the best lines from Shawshank Redemption goes like this, "The world went and got itself in a big damn hurry."  Isn't that so true?  In fact, one of my nick names from H is "Run Around Ris."  I'm in a big damn hurry.  I constantly over schedule myself in an effort to stay busy and to what end?  Usually a stressed out one.  But, stress is not productive for anyone going through IVF.  During acupuncture, when I'm alone with my thoughts (no distractions) for 30 minutes each visit, I'm forced to focus on myself.  It's the calmest part of my day.  Since starting, I've learned that I have to have quiet time even on the days I don't see the acupuncturist   I suppose what I'm doing is a cross between meditation and therapy; I lay on a couch and stare at the ceiling.  A little bit of couch time has shown me that slowing down and finding moments to work through my spinning mind is surprisingly helpful. I'm not ready to commune with Buddah (may not ever be), but I'm beginning to understand why Buddhism teaches that peace comes from within.  I control my thoughts, no one else.  Just me.


Dont' get me wrong - IVF shots, appointments, poking and prodding all score a big fat zero on the fun scale - but it's upsetting and overwhelming to spend too much time thinking about that.  Instead, I'm choosing to see that this process has it's privileges and (along with luck) has the power to lead the greatest something of all, a child of our own.

Mid-Cycle Musings

According to protocol I'm about mid-way through the cycle.  Here's a bit about the week gone by and the week ahead.

Thursday - H came home on Thursday night.  He arrived just as I was doing my injections.  I could tell he'd been feeling badly about not being home for the first few days of drugs.  I was fine, but he still wished he'd of been around.  When he walked upstairs he handed me a little package - he'd gift wrapped a surprise.  By gift wrapped, I mean he took a paper towel, taped it around the surprise, and wrote "To Risa Love Dan" on the front.  I opened it with delight.  Inside was a necklace with a little trinket -  a small elephant charm.  I smiled at how cute it was.  "Do you know why I got you an elephant?" he asked.  "Um... because the trunk is up and that's good luck," I responded.  "No," he said.  He didn't know about trunk luck.  I guessed again ... "Ohhh mmmmmyyy goooooodness... because you're taking me on an African safari??!!"  H laughed.  Loudly.  I took that as a no.  He admired my continual ability to wishfully think in a totally ridiculous yet earnest way.  I laughed too - even though I had a pang of disappointment that we weren't going on Safari.  Finally he told me - "It's because you're a Republican."  I was still completely touched that he'd brought me a gift, but I reminded him it is a little embarrassing to be a Republican right now.  So, we agreed to tell people the elephant is for good luck.  I gave the little guy a name - he's Mr. Giggle.  He made us laugh (during a not so funny injection moment) and I smile now when I look at him.  Mr. Giggle has become my good luck charm.  I wear him almost everyday.

Friday - SGF began doing daily blood work and ultrasounds.  I go every morning at 7am.  The drugs haven't caused any major mood swings or crying fits, but the early mornings and the stress of it all does make me tired.  Despite that, I'm not sleeping as well as I normally do.  My mind races at night - I'm nervous for the trigger shot and all that follows.  But, mostly I think about the nurse reports.  Every afternoon they give me my estrogen level (it's going up, as it should), the measurements for my endometrial lining (it's getting thicker, as it should), but my follicle count (to me, the most important number) remains unclear.   I need to be better about asking exactly what I want to know.   Instead, I lay awake at night, with little information, and try to go over all the possible scenarios my follicles may have.  If I have 7 (as I did on Friday), then maybe they'll retrieve 5-6 eggs, and maybe 3-4 of those will fertilize, and maybe 1-2 of those will be viable.  But, today I thought they told me I had 8 follicles on one side (big ones and small ones).  I have no idea how to hypothesize about those.  Will only the big ones produce eggs?  How many??  Only time will tell.  In the meantime, I'm trying to find a way to fall asleep more easily.

 

(Follicle Goal:  As many as possible at 18mm measurement)

Tomorrow is Monday - Monday, Funday.  I'm taking my follicles frolicking.  I read somewhere that I need to think positively about my insides.  So, H, me, and my follicles are going to a party.  The office where I work is having an Inauguration Open House.  I've never been, but from what I hear it's a nice affair with open bar, passed hors d'oeuvres and the works.  Also, since CBS sometimes films from the roof of the office building, I'm hoping that some of the reporters will be there.  I LOVE CBS - love 60 minutes, love Scott Pelley, love the morning show.  Love Love Love.  Not so secretly, I'm plotting to meet Charlie Rose and the gang.  I think even the follicles will jump for joy if I get to see some newscaster celebs.  Forget the Prez, I'll be looking out for someone else!

I expect on Thursday or so we'll receive instructions to do the trigger shot.  Until then, it's a little like groundhog day around here.  Get up, get blood drawn, get an ultrasound, get a phone call, get a stat report, get injection instructions.  Repeat.

Research, Reading, and Realizations

For me, one of the hardest IVF emotions to deal with (other than not yet having a child) is that I want someone to relate to and through her see that no matter what it is, my ending will be a happy one.  In order to find that someone or that story, I've taken to the world wide web.  Along the way, I've uncovered realizations about  myself and learned a whole lot about others people's infertility.  When I read a blog, or google, or a book the words seep into my brain and then I replay them - way. too. much.  Diving into the web, if I'm not careful, might make me crazy.


Blogs.  There is an entire website devoted to blogs about infertility.  It's called Stirrup Queens.  She boasts 1800+ blogs dedicated to this sensitive topic.  I've probably looked at 100 of them.  I was on the hunt for someone like me.  I wanted to find a story of another woman, with all the same diagnoses, who had a baby.  After 20 or so reads, it dawned on me that finding another "me" was going to be difficult.  Infertility comes in many different packages.  One blogger had endometriosis (I don't).  One blogger had too much Follicle Stimulating Hormone (Not me.)  Another blogger had an AMH of 5 (remember mine?  I do.  It's .017).  But, I kept searching anyway.  These stories aren't easy to digest and after another 80ish blog reads I discovered something many of them have do in common - profound pain.  It's written all over their pages.  They sound depressingly desperate.  I just don't feel that way (more on that later) and I don't want to feel that way.  Reading the blogs, unexpectedly, just made me feel more alone.  Stirrup Queens exists so people can find a community.  But, I just don't fit in.  Ironically, this realization is part of what made me start blogging.  I have my own, unique story and sharing it with you all creates a more personal community.  I don't need to seek one on the internet, I already have one.  Thank goodness for that and thank you for reading.


(image from Sirrup Queens' site)

Google.  You've heard me call it evil.  It really can be a waste of time.  Other than blogs, what I find when I type in search terms (e.g., blocked fallopian tube) are discussion forums (oh- and usually a wikipedia page).  On the forums a woman will post her symptoms and then ask for advice.  For example, this one:   "Im 29yrs old and just found out yesterday from the radioloigist doing my HSG that both my tubes are blocked and its going to be impossible for me to have babies :< My partner whom Im with today, my first and only partner gave me chlmedia about 10yrs ago which was taken care of back then but my radiologist is banking that my tubes are blocked due to the infection?? Any body been through that if so what actions did u take??? and how has it helped u????"  She followed up later with " ... Its hard to deal with this as I have no one else to talk to other then my partner whom i strugle to connect with as in my eyes he is to blame for this..."  Is reading that beneficial to me?  My answer is NO.  No, that is not helpful and I don't have time to think about the multitude of issues her post presents.  (I am compelled to note - I never had chlamydia.) While I'm pretty close to never googling another symptom,  I won't totally give up on the internet.  Today it lead me to this: Dr. Malpani's Blog.  A blog ... by a common sense doctor.  Eureka!  In another post I'll write about how Dr. M's blog has already been a life saver.  It relates to all the pressure I've been putting on myself to take vitamins, eat right, avoid caffeine, etc.  A lot of those ideas came from random sources, but Dr. Malpani set me straight.


(Does Taking Supplements Help IVF Patients?)

Silent Sorority.  One of the blogs I came across is called Coming2Terms.  It chronicles the story of a woman who tried to conceive for 11 years.  The post I read focused on a New York Times article, in which this woman was featured, entitled, "Facing Life Without Children When It Isn't by Choice."  I was immediately fascinated.  How DO people deal with that?  I had to know.  Remember... I like to think of all the worst case scenarios, find solutions to them, and/or make myself feel better about them.  If I explore it now, it won't be a shock if I have to face it later.  When I noticed she wrote a book on the topic, I wasted no time and bought it (thank you kindle!).  Once I started reading, I couldn't stop.  At first I was captivated by her story.  We had some very important things in common (for example, we're both tall and hate our feet!).  But, as she delved deeper into her anguish, I couldn't relate.  She wrote about feeling like her body was failing her.  That never occurred to me.  I didn't cry when I had to start wearing glasses in the 8th grade.  My eyes just wore out early.  So, maybe my eggs are too.  I don't consider that a personal failure; it's part of the unpredictability of life.  She spent paragraph upon paragraph detailing all the experiences she'd miss out on.  I'd never imagined that I'd miss the opportunity to go to a parent-teacher conference, to be the tooth fairy, or to send my kid off to college... until I read it.  H and I don't spend much (if any) time fantasizing; it's not our nature.  This book was starting to scare me.  She also spent a lot of energy avoiding friends with kids and conversations about kids.  It never dawned on me to do that (it'd be impossible and it'd steal the joy I get from being around nephews and godbabies and little cuties).  Now terrified I'd one day think this way, I kept reading ... waiting for her to tell me the formula to her getting over those "losses."  Her answer was time ... years of time.  That scared me too.  I wouldn't want to spend years being depressed and hiding.  By the end of the book I was wondering if something is wrong with me.  Do I not want this badly enough?  That can't possibly be true, but I did begin to doubt myself.  I continued to think about why I am not an emotional wreck.  Am I in denial?  Am I delusional?  No, the conclusion I came to is that it's because I already had my melt down.  When we found out our diagnosis back in July I was a sad, mad mess.  I was devastated and heartbroken (in my own way).  I've had six months to wrestle with my feelings about being infertile.  I started IVF in between roller coasters, not already riding one.  I didn't know it then, but those six months were a gift.


(A side note - This memoir wasn't what the step by step guide to happiness I was searching for, but it did help me in an unexpected way.  I am grateful for and do admire her honesty.)

There is a chance IVF might work, and I'll consider H and I the luckiest people in the world if it does.  But, there's also a chance it may not work.  If not, we'll try adoption.  And if adoption doesn't pan out, then we may face a life with no kids.  It does break my heart if I think about never knowing what it is like to have a loving son or daughter stare into my eyes, but it isn't going to kill me and I'm learning to push those thoughts aside.  H and I will move on and keep living this wonderful life.  He's a gift too and either way I'll be thankful for him everyday (maybe not alllll day everyday, but definitely everyday).

I did it!

Twelve hours past injections and so far I have not turned into this:

or this:



or this:

Although... I'd be okay with that last one.

I'm a pin cushion.

My life is becoming a series of run ins with needles.  Last week I took an injection class.  Well, SGF calls it a class, but in reality it was just me, another woman, her husband, and a nurse.  It's hard for me to explain why, but it was awkward.  The nurse did all the talking, revealing along the way some of our individual issues.  I suppose she had to in order to walk us through our respective meds.  To the nurse though, our facts were just talking points.  To me (and I'm sure to the woman across from me), they're much more than that.  They're part of a long story of struggling and coping and unfortunately what has lead us into this next battle with drug vials and needles.  I wanted to say, to that other lady - Hey, I'm sorry you are going through this.  I know how hard it is.  Good luck.  I wish you the best.  But, she didn't really look at me and I didn't really look at her.  No words were exchanged between us.  We both just stared at the nurse.



I'm always antsy before a flu shot, so I shouldn't have been surprised that sitting at a table full of needles would be unsettling.  Being in a small room staring down something I'm mildly afraid of made me think of Fear Factor.  Note:  I think those Fear Factor people are crazy.  But, if I wanted a chance at the prize (in my case a baby), I'd have to play and get through this freaky, anxiety heightening class.  During the session the nurse showed us what all the vials and needles look like.  To my surprise, the needles don't already come pre-mixed with meds.  First we stuck the needle into a vial of saline.  (No problem.)  Then we drew out 1mL of liquid.  (Shoot.  I took too much.)  Then we were supposed to get rid of air bubbles.  (Darn it.  The air bubbles in my needle were infinite.  I was struggling.  I moved on anyway.)  Next, we stuck the same needle into another vial and drew out the medicine.  (The couple across got to sit there while I did that again; I'm apparently taking two times as many meds as her.)  Again, we were told to get rid of the air bubbles.  (I try, but end up with more bubbles.)  Last, we stuck our needle into a bean bag like prop.  (Sure, that's easy when it isn't into your own stomach skin.) We did a similar exercise for the next drug.  Same struggles.  Class wasn't going well.  I deserved a C, at best.  Then it ended.  Not exactly feeling confident about doing this for real.  Thankfully, the SGF site provides videos.  Watching is my self-assigned homework.

Back in December when H and I met with our doctor, he asked her for her thoughts on acupuncture.  Most doctors turn their nose up to the homeopathic side of medicine.  To my surprise, she recommended it.  She wouldn't exactly attest to acupuncture leading to pregnancy, but she did say at the very least it could reduce stress.  I'd been thinking about whether or not to try it anyway.  So, when it became semi doctor approved, I figured I'd kick myself later if I didn't do it and we didn't get the results we're hoping for.  I researched some clinics in my neighborhood and found one that seemed legit and would also be convenient.  I met with the acupuncturist last Friday.  She's nice (very calm and soothing voice).  She smiles a lot.  She does things I don't understand like "listening to" my pulse.  She closes her eyes when she does that.  It's weird.  For the first session she did a "cleansing."  I don't ask for further explanations (those might be weird too).  I just laid on my stomach while she put a bunch of tiny, thin needles into my back.  They're flimsy (not like a sewing needle, which is what I'd always envisioned).  Before hand, I did ask her what it would feel like when she put the needles in - she said it'd feel a little like a mosquito biting.  That's pretty accurate; even better- sometimes it feels like nothing.  When she was done, by my count, there were 18 needles sticking out of my back.  She left the room and turned on some ocean waves music.  I was alone with my needles and my thoughts for about 30 minutes.   I didn't sleep, but afterwards I did feel like I'd napped.  She removed the needles, listened to my pulse again, and told me I was responding well to the treatment.  Is it all hog wash?  I'm still not sure.  But, all in all, it's a simple thing to do and if it helps - great!   If it doesn't, at least I'll get some pseudo napping in over the next couple of weeks.

Today is Cycle Day 4.  I'll be starting the injections tonight.  For the first few nights I'll poke myself twice, subcutaneously.  One drug will assist with egg production and ovulation.  The other, if I understand correctly, is a synthetic form of the follicle stimulating hormone.  I know it won't hurt THAT much.  I know diabetics (and all the other IVF-ers) do it all the time.  I know once I get the hang of it will be less scary.  I know, I know, I know!  All that logic will be easier to believe once I'm over the - this is my first time hurdle.  Were you (or would you be) scared the first time you had to jump off a high dive?  Even though you watched other people do it?  That's how I feel.  I'm nervous and I'm going to be alone on that diving board (H had to go out of town for work).  I'll do it, there just won't be anyone around to push me or to hold my hand.  I have to jump though.  And when I come up for air I'll think it's silly I worked myself up so much.  I'm trying to focus on that moment... the afterwards.  Everything always seems easier in retrospect.

Marisa Hope.

Cycle Day One for us IVF-ers means that you've just finished your prescribed duration of birth control pills and you should be beginning a very doctor controlled few weeks.  You move to Day Two and beyond only if Day One tests go well.  For H and I, Day One was on Saturday. 

We arrived at SGF at 7am to a waiting room full of women, couples, and not too many smiles.  It is a little strange to sit in a room full of strangers, but at the same time know something very personal about all of them - they are having trouble getting pregnant.  I pondered just how many of us in the world are quietly affected by infertility as H and I waited.  About 20 minutes later I was called back for blood work.  They draw blood so they can check my hormone levels.  They also always check my weight, which always irritates me, especially in the winter.  Isn't everyone 5 lbs heavier in January (post Christmas and wearing multiple layers)?!  They measure my height too.  Still 5'8".  Not shrinking, so that's a relief.

Next up was the ultrasound.  H hadn't seen one of these yet, so he came into the room with me.  The tech entered and began poking around in search of my ovaries.   I knew ahead of time that the one thing we didn't want to see in this episode of Poltergeist was a cyst.  Cysts are like pregnancy obstacles; they get in the way and can wreak havoc in a place where I need things very controlled.  After getting the all clear on the right ovary, the tech spent a few seconds looking around for the left one.  When she found it, she also found a cyst.  Unlike all the other times I looked at that little screen, this time I saw an image loud and clear.  The cyst comes across like a big, fuzzy, black smudge.  As soon as she pointed it out, I looked at H.  "That's not good," I said.  The tech, hearing my premature conclusion, began trying to ease my worst fears (a delayed protocol and/or yet another procedure to drain the cyst).  She measured it to convince me that it was small (that didn't help).  She explained something about estrogen vs non estrogen cysts (estrogen spewing ones are bad).  She patted my leg and told me not to cry.  But, it was too late.  The tears were already there.  They began to form the second I saw the smudge.  I was upset because I keep wishing that for once, my body would cooperate and do what it is supposed to- the FIRST time.  The longer this process lasts, the more I realize that I have really no control over what my insides do.  I can take my pills at the same time every day, eat well, drink lots of water, be a health nut, you name it - and it might not make a difference to my ovaries.  I have to let time take care of things.   The lessons on patience are endless.  On her way out the door, the tech reminded us that we'd get a call from the nurse later that day.  The nurse would give us our instructions:  Continue to Cycle Day 2 or wait out the cyst.

Once we were alone, I got dressed, walked over to H, gave him a hug and said, "Well, I guess we're not pregnant."  He laughed at the ridiculousness of the statement, but also knew I was probably, just a little, secretly wishing the ultrasound would reveal that kind of miracle.  "You're a hopeful young lady," he said.  "It's my middle name!" I exclaimed.  We laughed again.  I do work very hard to manage my expectations, because as Saturday further evidenced, anything can pop up and possibly throw things askew.  But even a midst all the twists and turns, part of me does hang on to hope.  Something has to keep me in this crazy game, so hoping for us to be parents is never far from my mind.  I'll take a miracle whenever and however it comes; big ones or small ones.  I left the office knowing I had a cyst, but hoping it wouldn't be the protocol disrupting kind.

We stayed fairly busy on Saturday.  Based on history, I expected a call around 4pm.  No such luck.  At 5:30pm I was beginning to panic... not knowing what kind of cyst I had, or if I should keep taking the birth control pill, or if I should proceed with the protocol.  So many questions.  H convinced me to call the after hours number.  I didn't want to because it is supposed to be for emergencies (was this an emergency?).  But, as he correctly pointed out - SGF had a job to do (call me with results) and they hadn't, so I didn't need to feel guilty for paging a doctor.  As I started dialing the number, the SGF digits popped onto my screen.  Phew!  The nurse told us that my doctor had reviewed all the lab work and determined it was safe to start my meds on Tuesday, as planned. My cyst was the non-estrogen kind.  Crisis averted.  A little joy filled my heart.   Hope won; I'm going to keep it around for a while.