What the WHAT??

Ladies and a few gentlemen, the RE told me there’s a 99% chance my egg retrieval will happen next THURSDAY! Ha, not at all what I’d anticipated or told work. Oops! At least hubby’s work schedule is light that day so he should have no problem keeping me company. I have 15+ follicles (kind of lost track as he was calling out dimensions), evenly split between both sides. They range from 10 to 17mm, so he pushed the anticipated retrieval date back a day in hopes of letting the small ones catch up. All my medications will stay the same, and I’ll probably need to buy one bottle of Menopur through his office from another patient Tuesday at my next monitoring appointment to get a full dose that evening. My normally very stoic and quiet RE actually smiled and exclaimed “Great response!” just before he left the room – I think that’s the most emotion I’ll get out of him 😉 Please keep fingers crossed that the Lupron does its job and keeps me from ovulating early.

Other answers to the questions I had for him – he recommended 3 days no-ejaculation prior to retrieval for the hubby, and anticipates 5-day blastocyst transfer. He doesn’t recommend preimplantation genetic diagnosis for us, since studies show lower live pregnancy rate and we have no solid risk factors. Also said that assisted hatching is only done on 3-day embryos, since the blastocyst already has a thinning “shell”.

The waiting room was again interesting, though also informative for me. The 2 women I waited with happen to see OB/GYN’s at the clinic I work for, so it was great to hear them chat about their experiences there (all positive and making me think I may well see the male OB/GYN there, even if all the clinic nurses end up knowing my business). One was 8 weeks along with IVF twins, and her toddler looked familiar to me – who knows if I’ve run into them at work. The other had just gotten a positive pregnancy test after her 1st IVF cycle at age 39, but was waiting for her first HCG level to come back. It had been drawn yesterday, so the receptionist was on the phone with lab pestering them to give her the value. The two were bantering back and forth about how put off they were at first by the RE’s non-bedside manner, but how he’s just great at what he does, along with having the sweetest and technically briliant embryologist. All in all, I am happy I chose this office!

LATE ADD-ON: Oh yes, I hit up Victoria’s Secret to take advantage of their 7 panties/$26.50 sale. You know, since all my underwear is no longer fitting thanks to the addition of 15 pounds. Woohoo! Check out the deal this Labor Day weekend, everybody 🙂

ANOTHER LATE ADD-ON: Received the insurance check for my first medication shipment, just over 3 weeks after submitting. BANNER DAY!!

I waited 6 hours for THIS to get delivered?!

 The pharmacy sent me more Menopur and the progesterone suppositories today. The first time I had a shipment, it arrived by FedEx by 11am. As noon approached, I was getting antsy, especially since I planned to go to a yoga class at 2pm. So I called the pharmacy, and they told me they were using a courier since it was a weekday, and gave me the tracking info. I then called the courier, who promised it would be here by 2pm. At 1:55, I called them again, they said there was no indication it would be late, that it’d be here any minute. At 2, I gave up hope of going to yoga. Finally the courier arrived at 2:09. Quickly ripped into the box and pulled out an insulated pack containing these:

 Progesterone suppositories or candy? You be the judge.

I can’t believe that I’ll have to use these AND get IM injections. Anybody else luck out like this? And why is there only one applicator? Am I going to have to wash and reuse?? Ewwwww…

S*** people say in the RE’s waiting room

“There are TWO! He said our chances were LOW… but there are TWO in there! How is this possible??”

 – Stunned IVF patient whose 2 embryos stuck

“I’m leaving. It’s 10 minutes past my appointment time, and I can’t wait any longer. Please tell Dr. *** to call me afterwards to tell me if he recommends using a surrogate.”

– Frustrated patient (note the RE was running 15 minutes late – not bad in my book!)

“Hi. I’m returning your call about [blah blah blah…]”

– Man on the phone for at least 15 minutes (still on when I was called back)

I was lucky today and finished seeing my patients and closed all my charts with plenty of time to spare. So much time, that even after browsing a nearby dollar store, I was still 40 minutes early for my appointment. So I ended up in the waiting room for almost an hour. Bear in mind, this is a tiny triangle-shaped waiting room, with seating for 10 people tops. You hear everything, especially if you happen to be sitting near the reception desk. I had a hard time keeping a straight face hearing some of these things. And seriously, what is it with carrying on full conversations in public on the phone like that, without even a courtesy whisper? Or I dunno, stepping out in the hallway??

So of course, right after I finished my post yesterday, I went to the bathroom and saw EWCM, which has continued in full force today along with increasing belly fullness. I was very eager to see if the ultrasound would confirm what I was feeling, and it did! 5 follicles on each side, measuring 7-10mm each. The RE didn’t order blood today – whew… still bruised from last week and I have no doubts my estrogen has increased given all the EWCM. He told me I’m responding exactly as he expects. I’m to continue all my meds at their current dosages, and have a follow-up Saturday morning. Unfortunately he couldn’t pin down a retrieval date – still too early. Ugh, work scheduling will be a mess with the 3-day weekend, but not much I can do about it. For those interested, here’s how my Google calendar looks now that I’m further along in the process. Getting closer! Things should start to move more quickly in the next week.

Oddly quiet in there…

I figured by day 5 of stims I would be feeling something in my belly, but it’s really been very quiet in there until tonight. I was definitely enjoying the break from the Lupron headaches too. Work has been crazy with kids headed back to school, then I enjoyed a beautiful weekend filled with brunches with girlfriends, a concert with the hubby, and SUP yoga – just twice a day I’d work some time in to shoot myself up with meds. No biggie.

I was enjoying an odd lull at work today around 3pm – seemed like some patients weren’t showing, then all of a sudden 7 patients check in within 30 minutes of each other, and by the time I’ve had a chance to finish seeing all of them, I look at the clock and it’s 5:15. CRAP. I need to get some Menopur into me, and drive 15 minutes away to a 5:30 yoga class. Managed to get there 10 minutes late, but the teacher was totally cool. She explained that we were focusing a lot on back strengthening. This sounded like a good idea to me since it’s one of my weak spots, but after class I realized my lower abdomen was feeling a little full. Planning on mostly gentle/restorative yoga from this point on.

Let’s hope this translates to some good action on the ultrasound tomorrow! And hopefully a somewhat firm date for egg retrieval since hubby and I have some crazy work schedule juggling to accomplish next week.

Money talk, and why I’m not in a procedure-oriented specialty

For those interested, I started a page tabulating the costs of IVF so far. I wanted to keep track somewhere, so figured why not here. I’ve found it very interesting to hear the wide range in costs. The lowest I’ve heard is $9K (from the NP who did my last IUI’s – she also used my RE), and the highest I’ve heard is $25K – for one round! My acupuncturist says it can be a total racket with some doctors, who may not be upfront about a certain woman’s chances and will just tack on every possible test and procedure to rake in the money. Scary… I feel confident that my RE won’t rip me off, and though he is a man of few words, he hasn’t made me feel dumb for asking all the crazy questions rolling around in my head. Even so, I’m pretty certain I would not be doing this if I didn’t have insurance covering most of it!

Wheeeee!! Now the real fun begins!

I’m actually pretty competent at the few procedures I have to perform in my specialty, but there is a reason I could never be a surgeon – I can be a real klutz sometimes, and I stress myself out way more than I like with procedures. I decided to make up the Gonal-f solution last night, so it would be one less thing/needle to worry about this morning – see the contents of one full package in the top left photo. The 2 morning injections of Lupron and Gonal-f went very smoothly as a result (top right photo).

The evening Menopur injection was a hot mess – see bottom left photo. 3 bottles of powder, 1 bottle of diluent… thank goodness for the Q-Cap (bottom right photo), without which I would’ve unintentionally stabbed myself a few times. Of course, I still managed to screw it on the wrong end the first time. Yikes… It also took me a few tries to determine how much force I needed to insert then remove from each bottle. After almost 10 minutes of messing around, I finally had a syringe filled with 225 IU of Menopur in 1 mL of diluent. Popped on the injection needle, carefully pushed out the air bubble, jabbed it in, and HOLY-MOTHER-OF-ALL-THAT-IS-EVIL-THAT-SHIT-STINGS!! I mean, I’d read that it stings, but I still wasn’t expecting THAT much of a burn. I had to bite my lip to keep from screaming/crying out since I was at work. There is no way I’d be able to give myself Menopur at a concert tomorrow, so I’m glad I chose to give it in the early evening to avoid that trauma outside of home and work.

My belly now has quite a collection of tiny red blood spots and small bruises. Only 10 more days of injections to go!

Green light!

My RE’s office called and left a message that my estradiol was good and gave me the green light to start with the stims as planned tomorrow. This was of course not nearly enough information for me, so I emailed him asking for the level, and he replied back “11”. YAY! Nice and suppressed, I should be primed for ovarian stimulation. I was hoping today would be without a headache but as I sit here typing, I can feel the ache starting to creep up the back of my head. Let’s hope some inverting helps that – I’m taking my last aerial class tonight (snuck it in since the stims start tomorrow).

Oh, and this may make me a huge nerd, but who cares because I know I am one – check out how I’m transporting my Menopur and supplies to work:

My supply box of Menopur vials, Q-caps, syringes, and needles

Holy Lupron headache!

What the… I thought I was in the clear with avoiding the Lupron headache, but nope, after the 9th dose yesterday morning, I got a horrible right-sided occipital headache while having a crappy afternoon at work. Went to sleep hoping it was due to stress, and woke up feeling better, but by noon today, I had a dull ache at both temples that worsened despite taking acetaminophen. Boo… Going to try a cooling patch on my forehead tonight when I go to bed, but unfortunately that would probably not go over well at work.

My ovaries and lining looked nice and quiet, and ready for action this afternoon. Had my blood drawn for an estradiol level, but won’t get it back until tomorrow. Hopefully it’s nice and low, so we can proceed as planned. On Friday, in addition to the morning Lupron, I’m to start Gonal-f 187 IU in the morning and Menopur 225 IU (3 bottles) in the evening. I’ll also start an oral steroid (Medrol 8 mg a day). Sadly, this means 3 daily injections, and I understand that Menopur stings like a #%&*. In order to try and keep my injection time the same every day, I plan to bring the Menopur to work in case I’m stuck late or running errands before heading home. This way I don’t have to worry about what to do at our concert on Saturday – I can just take it before we go.

My next appointment is in a week, and it’ll be the first time we see how exactly I’m responding. Right now, the RE is planning for September 3 for my egg retrieval. Too bad my work scheduler just took me out of clinic on September 2 Emailed her to see what she wants to do. I don’t want to have her drop me in, then risk having to come back out if I respond more quickly than expected.

Thank goodness for the beef broth I made a few weeks ago! For once I actually cooked myself a tasty, nutritious dinner. I used Trader Joe’s mirepoix, white beans, and kale to make a quick minestrone soup. Added a little salt to taste, and it was done in less then 15 minutes! Just forgot to add tomatoes, but will be sure to do so the next time. May also try adding quinoa if I’m feeling up to it. I love quinoa, but haven’t yet mastered how to cook it.

I survived

I survived the socially busy weekend, but am now dreading the next one – why is August so crazy? I made it 2 hours through the baby shower, though I did have to run to the bathroom about 20 minutes in to wash my face after a small cry. There were just. so. many. pregnant. women!! Seeing my friend – not a problem, I expected that. I just wasn’t expecting 1/4 of the guests to also be pregnant, and when my other friend remarked on it, I couldn’t help but tear up. I focused on eating the rest of my time there, then took off as they started playing games. Ugh, no thank you.

I’m now mentally preparing myself for the week ahead – it’s the last push for physical season at work, I have to get blood drawn tomorrow to check on my thyroid, which has been recovering from Clomid wackiness a few months ago. I’m waiting on my period to show up, since it’s been over 48 hours since my last birth control pill. Then I have the baseline ultrasound and blood draw Wednesday, and hopefully starting the stim injections right after that. I am so ready to get this show on the road!

And good riddance!

I took my last dose of birth control this evening, and am so happy that’s done with! It zapped me of my libido and my appetite, even while giving me 3 extra pounds. Just hoping it hasn’t been the reason for avoiding Lupron headaches so far.

I also took my last aerial class for a while, and sold my home apparatus to a classmate who will put it to much better use than I’ve been able to the past year. I’ll still be taking SUP classes but taking it easy with more yoga, along with regular yoga classes too.

It’s a crazy busy weekend ahead, between lunch plans with a friend, a big birthday party, and a baby shower. Yes, I’m planning on attending a baby shower, even after bailing on one just 4 months ago. This friend knows all about our struggles, and told me she completely understood if I didn’t go.  But her baby will be my patient, and I’m so excited to meet the little one! I know that I can leave early if things are getting to me, but I really want to be there for her.

Auto-pilot

It’s strange to say that I feel like I’m in auto-pilot mode, given that I’m sticking myself with a needle in the stomach every morning, and swallowing several supplements 3 times a day. But honestly, that’s how it goes – reminder alarm goes off, take medication, proceed on with work and life. I don’t start stims for another week, and the spotting has finally dropped off. I feel blessed to not experience Lupron headaches yet, though I just took my 4th dose this morning, and supposedly this is when they tend to start.

I’m still enjoying aerial and SUP every moment I can, as challenging as they’ve become lugging my heavier body through the air and water. Last night out in the ocean was glorious – a fiery sunset, dolphins playing nearby, sitting on the board getting rocked around by the waves. I tried to soak it all in at that moment, because I don’t know when I’ll be able to experience it again. I don’t see myself taking too many chances with a non-flat ocean when I’m on stims or pregnant. Even while kneeling, I half-fell in the water a couple times last night, angling myself trying to get the perfect sunset picture. And I really didn’t mind – the water was so warm and inviting.

Can you spot a couple of my classmates in this photo?

I know that once the stims start, things will move more quickly, but it still feels so far away. I asked my RE when he anticipates retrieval, and he said about 13 days after I start stims, which would mean the day after Labor Day. I wasn’t expecting it to get pushed back that far – I’d anticipated my retrieval to happen just before the long weekend so that I could take advantage of the rest time. But I had to let my work schedulers know, and they’re changing my schedule up so that I don’t end up working 12 hours the day after my retrieval. And it may be for nothing – I could respond more quickly than my RE predicts, or more slowly. Who knows…