Monday, August 1, 2011

Focusing On Today

Usually, when I am in a cycle, I am a basketcase. I freak out about everything, and I get ahead of myself. That leads to the most freakouts--getting ahead of myself and worrying about what's next. Worrying about what could go wrong instead of celebrating the (even infinitesimal) good things of each day. So, this cycle I decided to approach my attitude a little differently.

It definitely hasn't been easy, because I like to interpret data and extrapolate what it might mean in every, even ridiculous, scenario. And I like to plan. And planning means taking into account what might be happening, what might be in store. But, I was determined to try this new and novel approach of only thinking about today, of celebrating today, of accepting what is happening now as opposed to all of the could-happens. Even though it is in total opposition to my personality. 

It takes a level of trust that is difficult for me. I have to trust that tomorrow will be ok, because today was good (or at least some part of today was good). I have to trust that the people taking care of our reproductive mission know what they're doing. It's not like I think I'm some sort of expert or anything, but thanks to my data-minded self I have a lot of information on all of my cycles, all the way back to the clomid IUIs. I know what my estrogen levels and follicle sizes were for every time they were altered. I even made a chart once of my starting estrogen levels because I noticed they were dropping over time and wanted to see it across all the cycles at the same point. It didn't actually mean anything medically, but again, it gave me a sense of control. I can write all this stuff down (usually pantsless, rushing to get the numbers off the ultrasound screen before it goes to screensaver mode) but really, I can't compare them with any effectiveness. It's helpful because my little notebook can serve as a reference point for some things (how many follicles have I produced on average? What size are they at trigger? What side effects have I had in the past?) but at the same time I don't have the medical knowledge to really make any decisions or understand the decisions being made without having a doctor or practitioner explain it to me. So, I still wrote everything down in my journals, but I had to let go of comparison. I had to let go of the idea that I have some semblance of control over my cycle.

This cycle was so dramatically different that I really didn't have anything meaningful to compare it to--it drove me absolutely crazy. The dosages were different. I started Menopur on the same day as Follistim, which was different. I didn't take Lupron, which was totally different (and lovely). I took Ganarelix instead, and only for a few days. Because of all these changes, my estrogen levels were pretty low throughout my cycle. My follicles were wicked slow coming to maturation, which was very scary for me. It was hard not to think that maybe now I had some other issue butting in on my diagnosis party, some poor responder action showing up for Act Three of IVF. However, because of the change in protocol, I had to trust that everything was going in the right direction. Every day I focused on the fact that my follicles were growing. On my baseline day I celebrated that I had no cysts and my hormone levels were all within normal ranges. On the first day of shots, I celebrated that we were on our first day of shots. We were on our way! Each day after that, I celebrated that my follicles were getting bigger. Even if they only got bigger by a millimeter or so (which sometimes was all the growth I got), it was movement. I hadn't stalled out, I was still in the game. I tried to focus on the fact that there were rises in estrogen and the growth in the follicles instead of how slow everything was moving and how low the estrogen was. And then we got close to trigger, and they told me to trigger and take my last dose of Follistim. But... according to my notebook, the last two IVF cycles only had mature eggs retrieved from my biggest follicles--those measuring 18-22 mm at time of trigger! My estrogen last time was way higher (around 5500) and my follicles measured much bigger. Now, the high estrogen was BAD and not something to hope for. I hyperstimulated last time, required an additional surgical procedure to remove .5 liters of fluid from my abdominal cavity and was on bedrest and out of work for about a week longer than anticipated, all because of that crazy high estrogen. And my eggs weren't even all that stellar in that cycle. So, even though I felt panicky, I had to let go of my comparisons and trust that with follicles topping out at 18mm and estrogen around 1800, that triggering would result in beautiful eggs because the timing and dosages were planned differently. I had to celebrate that I was ready to go for retrieval, even if I felt like maybe it was a disaster in the making. I had to trust in my medical team and this new protocol that I had no comparison for. I had to trust in the quality not quantity approach we were following. I had to be happy about today and not freak the F out about tomorrow. It was really, really hard. I went for my daily stimming wheatgrass shot after my appointment and scheduled an impulse massage--I figured if I was struggling with letting go of tomorrow and I was stressing out about it, I could do something about it. It was the best thing I could have done! I felt so much better afterwards. The next day I celebrated my one day of NO SHOTS in the whole cycle--it's a beautiful day. I didn't freak out about how retrieval was the next day, at least not more than in passing. I always get nervous that I will ovulate early and all those eggs will go flying into the septic system instead of into the dish for fertilization, but I think I did a pretty good job this time of having that fear, acknowledging that fear, and then letting it go. 

All of this attitude adjustment really did wonders for my stress levels during this cycle--I felt really good and balanced throughout the stimming period. It definitely helped that I'm not working this summer--not having the stresses of working in a hot building and the responsibilities that go with teaching summer school has absolutely been helpful. But I really credit this new TODAY philosophy for my saner state of mind. Tomorrow will come and it will either be good, bad, or somewhere in between. But I don't want to taint today's successes with worries about tomorrow's possibilities. And we had a lot of Today Successes. So far, this is the absolute best cycle we've ever had. We had good quality. We had our best fertilization rate. We had beautiful embryos. And we had excellent embryos that made it to blastocyst and were frozen--a tremendous accomplishment! That's something we've never done. This cycle has been so totally different from the others--instead of disappointment after disappointment and bad news after bad news, it's been a good news train the whole way. So now, my mission is to keep focusing on my today and all the success that we've had. And not worry about whether our train will continue on its path towards our ultimate exciting destination or suffer a devastating derailment. Because today was a really good day.

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