Wednesday, April 30, 2014

Birthday Blues?

My birthday is tough. Didn't used to be, but every year it's a little tougher. Sometimes I wonder if I would care so much if I already had that little family--do you care that you're inching towards forty when you have your little ones at your side? For me, turning 38 is a reminder that I was 33 when I started this mess, and that each year I tried to pull a Chelsea Clinton and have my Year of the Baby, but with no results. I shudder to even try to call a year THE YEAR, because I thought for sure 2013 would be Year of the Baby, and now it is impossible for 2014 to be Year of the Baby. Is the year I am 38 the Year of the Baby? Maybe. I am still in a timeline where I could feasibly give birth to a full term baby before my birthday next May. It is not impossible. I just am not sure how to keep holding on to the hope that THIS YEAR is THE YEAR.

But I do, don't I? Every year I see the promise of a new beginning despite having that promise beaten out of me at the end of each year.

So am I sad to be turning 38 on Monday?

Well, no.

As tacky as it might seem, I was touched by a meme on Facebook. It said, "Do not regret growing older. It is a privilege denied to many." Well, that sure made me feel small and whiny. It resonated. Even though I don't have that (literally) tiny little thing that we've been working so hard for, I sure do have a lot. I am reasonably healthy despite the infertility, the celiac, the asthma. My conditions are managed and while upsetting, they aren't life threatening. Lately. (Hey, remember when infertility became life threatening and my wayward baby lodged in my tube and distended it to the point of bleeding as they removed it? SO MUCH FUN.) I haven't had a life threatening tragedy in quite some time. I feel very sad and affected emotionally by my infertility, but it's not actively trying to kill me. The celiac sucks but I am not getting blood transfusions and iron IV treatments like my Dad, so I really don't feel like I can complain too much about not being able to eat cheese danish. As evidenced by my chub, there's a lot of crap I CAN eat. Like Cadbury mini-eggs. Mmmmmmm. And, as long as I faithfully take my twice a day inhaler, my asthma is no issue. So, I am healthy. I have a wonderful husband and a beautiful home and I do not want for any basic needs. I am fortunate. I have a job I love and that I think I'm pretty good at, and that's not something everyone can say. I have beautiful furry family members, and my gross cat (seriously gross, like his nose was flaking off and he was losing fur on his face and he just constantly shed pieces of himself all over the house) seems to be perfectly healthy and cozy thanks to a change in food. There's a lot I have going on that's good, really good. I get another year of this goodness. I am grateful. I actually feel like celebrating a bit. It's true, especially with so many tragedies lately, that I am being afforded a gift, the gift of another year, that others are denied all the time.


For all my gratitude at the things that are spectacular, for all my happiness at getting another beautiful year on this planet, I still hang on to a little bitterness.

I'm 38, and I'm still not pregnant. And while that's not everything, it's surely SOMETHING.

At this point, I will be 39 when I have my baby, if I am lucky. I will be in my mid-40s when I take my child to kindergarten for the first time. This is not a tragedy, for sure. But it is not how I envisioned things. Which doesn't mean that's bad, not at all. Someone at school today said, "babies will keep you young!" For one, I don't feel particularly old. I am goofy, I laugh my evil laugh in class ALL THE TIME, I do stupid things like accept a challenge to eat an Atomic Warhead Super Sour Hard Candy in class. I make my husband search the house for Easter treats I've hidden for him, while I clap and giggle like a 5 year old. Life is fun. I make it fun, to some extent. But, even with that, I am sad that my parenthood experience is hopefully coming so late. It will be perfectly fine, just a different experience than I thought. Each birthday reminds me of this. Reminds me that I'm older, our risks are higher, our odds a bit lower, my body a bit more tired and a bit less springy. So birthdays make me a bit sad, too. Maybe a lot sad at times. And I feel a little ungrateful, but at the same time, this is something that infertility has bequeathed to me. Thanks a lot. You've made birthdays a little less fun.


Bryce is doing a great job making my birthday interesting and exciting. This year we're not going away, because the 40th extravaganza was a lot going on, and I'm fine with being more low-key. BUT, there is some kind of secret surprise waiting for me on Saturday. Something from 10-1. That I must be dropped off at. And that my best friend has vetted as "something I would like." So I'm not SUPER anxious, but not going to lie, this surprise three-hour-event has me a bit nervous! What IS it? I doubt it's a spa day, my husband is way too practical to do that, especially since I get a massage 2x per month as a self care measure. Is it a class? Is it some kind of event? He's not going with me... what does THAT mean?

But do you see? Do you see what he's done? I'm so OBSESSED with this mystery that I am virtually FORGETTING TO BE SAD ABOUT MY BIRTHDAY. Genius. Absolute genius. And then, we are going out for a fancy schmancy dinner Saturday night, and then he is cooking for me on Monday and I get to open all my prizes that have been filtering in through the mail.  And...I am suspending Egg Boot Camp on Saturday and Monday. (And maybe today, I had two GF "beers" in the fridge that I really should drink up before they go "bad.") So good wine and good cocktails and good food are in my future. And whatever the hell that Saturday thing is.

That Bryce, so thoughtful.

And so it goes--another birthday upon me without a baby or one on the way, but I have DATES for my redo of the hideous cancelled cycle, and a hysteroscopy to rid myself of my leetle friends (the polyps) on May 15th. Which, thanks to kismet, falls on the 8th grade DC trip, so I will be out and NOT MISSING ANYTHING! No sub plans necessary! No missed instruction! WHAT A FREAKING GIFT! (Those of you who teach will really get this--it is the best prize ever. Almost like an anesthetized vacation!) And then June, June is the month of the try. The month of the retrieval and the transfer, and my doctor will be on for both events. A re-do of all re-dos. No more cancellations, ovaries, I mean it!

My birthday can't be all bad. It's not all good, but this year I'm feeling a bit more hopeful and a tad less bitter. Older and wiser, I guess. Grateful for the life I have, while still pining for the life I don't have, but that really ought to be by now. Looking forward to a weekend with my husband, a weekend of celebration and surprises, a birthday that makes me forget my dusty ovaries and my empty womb. A birthday that maybe holds more promise than loss.

At least that's how I'm going to choose it, this year.

Sunday, April 20, 2014

Resolve to Know More About What Works For You

Happy National Infertility Awareness Week! This year's Blogger's Unite challenge is...

I could probably write a zillion posts on all the things that people could know more about when it comes to infertility. I am a little in love with this topic, because knowing more and helping other people to know more about infertility is kind of my thing. It is incredibly important to me to be as open as possible about my own infertility and to unflinchingly share the nitty gritty of what this process is like so that a) it takes any kind of shame or stigma right out of the conversation, b) I can fix misconceptions (ha ha) that are surprisingly prevalent about what it means to be infertile, and especially infertile FOR A REALLY LONG TIME, c) I can blanket people with information on how to better understand people who are struggling with infertility, because you just never know how this disease is going to touch you or the ones you love.

But, I am ridiculously open about all of this because it is what works for me. I do many of the things that I do when it comes to managing my infertility, battling my infertility, coping with my infertility because it is what I need to do to keep myself sane, to keep myself moving on, to be true to my own path on this godforsaken trip through hell. Even though I'm still deep in the flames, with a raw and not-yet-scabbed canceled IVF cycle oozing all over me, I still believe that it will be a trip THROUGH hell. I am doing a little too much sightseeing on the way to my destination, but I have faith that the destination is within reach.

It is important to me to stress that you need to Know What Works For You because there is a lot of information, misinformation, well-meaning advice, etc. that can make you feel like you must try this and that and that there is one good way to make your way through the infertile swamp. There's not. It's not one size fits all. It's not a sit-down dinner with no choices, it's a buffet. One where you can pick and choose what works for you and get seconds of some things and not go back for others and even change your mind about something you thought wasn't tasty the first time around. Everyone is different, and even on your own personalized journey you can change and morph and need different supports, different levels of knowledge, different tools to make your way through.

I'd like to share a few things that I feel are important to me to Know More about, because they help me. Not because I think they are magic fixes that will work for everyone. Not because I have the secret to success (obviously I don't given my timeline of failed treatments). But because they help me, and maybe they'll help you too, and I want to invite you to my buffet.

Resolve to Know More About Your Treatment. This is really important to me. I personally need to be an active participant in my medical care when it comes to my infertility treatment. I need to be well-researched, I need to have conversations with my doctor where I understand everything that is being done to me. I need to be able to bring ideas to the table and then have them discussed in relation to my unique case. I need to read books, and blogs, and (this is super important) credible websites that aren't trying to sell you something. I need to talk to others, but remember that I am not them and what works for someone else might not work for me. And vice versa. As cheesy as it sounds, knowledge really is power. What you don't know really can hurt you. Knowing too much and obsessing can hurt you too, though. The key for me is balance.

Resolve to Know When to Speak Up. This is a tough one. Once you know lots, you need to decide when to employ this knowledge. For me, I like to be able to ask a lot of questions and feel comfortable questioning decisions made around my care. I am not a pain in the ass patient (I hope), because I am not confrontational. But, when something seems a bit weird, it's important to go with your gut. You are one patient tracking one set of protocols/medications/pieces of advice. Your medical team is working with possibly hundreds of patients and, while it would be nice if they were, doctors are not superhuman. They make mistakes. They forget things. I need to be able to remind them, to pore over my history and my recommendations and feel comfortable with where we're going, medically speaking. I have actually caught mistakes in my protocols that would have compromised cycles. Does it make me mad? Yeah. But again, even though I am not a medical professional, I look out for me. No one else is going to keep close tabs on things as well as you can. I have had times where I wanted to not have to speak up and I didn't say anything when something seemed off, and it did not work out well for me. So, I feel like it's better to ask about something than to keep it to yourself. The worst that could happen is that your fears are unfounded. Speaking up isn't limited to doctors. Speak up if someone says something hurtful to you, even if it is unintentional. Speak up when there is an opportunity to educate someone who just doesn't know. Speak up to let your thoughts be known--sometimes you might feel like this is nobody's business but yours, and that's entirely possible, but it can be incredibly liberating to share information or your experience or gently tell someone that they are being insensitive to people who have difficulty conceiving. For me, it restores a bit of the feeling of power that I lose to the indignities of infertility.

Resolve to Know Which Doctor/Clinic is Right For You. This can change. We loved, loved our first clinic. So much so that we stayed for four years despite limited breakthroughs and a niggling feeling that there was more that could be done. So we did second opinions after our donor egg cycle failed and looked suspiciously like our other cycles, leading to fears that we had a different issue going on. It was very eye-opening. We had gotten comfortable, which isn't necessarily a bad thing--you want to feel comfortable with your medical team. But we had limited ourselves by staying with the familiar. In getting second opinions, we discovered things that we did not know were possible, new technologies and methods that weren't available where we were. We also discovered that we needed a combination of the innovative and the friendly. One second opinion was a little too aggressive for us, a little too "I know exactly what will get you pregnant" with no conversation, just confidence to the point of arrogance. A stance that our previous history was so tainted with outdated methods that it couldn't be used (no one else said this), and that that doctor's way was going to be THE way. That could be, but I had never felt so UNlistened to in my life, and anyone who says I WILL GET YOU PREGNANT feels more like a hard sell to me at this point. No one can promise that. I did not used to think that, but after years of this and twenty embryos come and gone and trying lots of different things, it is possible to throw all you've got at something and still not get pregnant. For us, a good match was responsive, easy to get ahold of, a doctor who treats us as integral members of the team and researches as well to make sure what I find out there is appropriate for me, as an individual. And an amazing lab. Your doctor is important, but the lab is crucial. A good lab can make the difference between success and failure, and I wish I had known that sooner.

Resolve to Know What Type of Support Is Best For You. At the beginning, support groups were great. But, the way that I personally seek support has evolved and changed along with our experiences. I cannot go to support groups anymore. I cannot go to yoga for fertility anymore. Not because they are not helpful, but because I cannot continue to be a part of a group where people come and go and I remain a fixture. It may not be the most PC thing ever to say, but I have found this to be true--when you have been at this for a long time and you realize that a particular meditation cd or alternative treatment or positive outlook is not going to actually get you pregnant, going to support groups where people aren't quite as dusty from the road can actually be less helpful and more harmful. I do not need someone to tell me to "just think positive" or exhort how important it is to take a particular herb or set an intention for my day to invite the Universe to grant me my request. That goes through me like a nail at this point. You can, actually, put incredibly warm and motherly energy into the cosmos and dedicate 30 minutes every day to meditation or journaling or praying and do wheatgrass shots and acupuncture and hip opening yoga poses and invite your baby spirit to come to you, and have those invitations denied. It feels pretty shitty when you are left behind and it seems like the magic works for everyone but you. I found support groups incredibly helpful in the first year or two of things, when I was on the same page as many people. But then I realized that other people who were still going through infertility after years of disappointment and loss and failure stopped coming to support groups. And now I know why. This is not to say that it's not important to impart your wisdom to help newbies on the road. That's where one on one support and blogging come in for me. Again, maybe not PC, but I can try to make myself not feel so lonely by finding other people in the blogosphere who seem to be magnets of misfortune too. I comment and enjoy blogs from people who have become successful, people who suffer through IUIs instead of IVFs, but I really gain solace from finding people who are on a similar trajectory as me. I don't rejoice that they are also deep in the muck, but it is an amazing source of support to find people who are at a similar point as you. It's tough, because when you join support groups or reach out to online groups, there isn't really a handbook for what to do when your infertile friends find success and you don't. I don't begrudge anyone their success, and I keep hoping to join in and cross over to the "other side," but in the meantime it really helps me to pick and choose how I garner support. I enjoy one on one interactions with other people as well. That takes away the inadvertent but inevitable feeling of either "I've been at this longer" or "I don't deserve to complain because I haven't been at it enough." Neither of those are constructive, but in groups comparisons happen. In groups a mob mentality of "This is the magic fix!" tends to happen, too. Which is great unless the magic fix was apparently a placebo for you. I kind of wish that there was a support group for people who are long-term infertility patients, because I feel like there are concerns that are unique to being in that position of being left behind and wondering if this is ever going to happen for you. I realize that would be exclusionary, but it might also be really helpful. Because I feel like this population that I unfortunately find myself in can be lonely and underserved and it might be good to find each other to give support that's targeted, where you don't feel like the sad sap horror story of the group.

Resolve to Know More About How You Can Become a Parent. For me, child-free living is not an option. Resolution for me cannot have a house with just me, my husband, and cats. So I know that the options available to us have to result in children. In the beginning, we had a flowchart that I created at the front of our "Family Planning Notebook" where I took notes on everything. I'm on my third notebook, and this flowchart is hilarious to me now. We would start with IUIs, then decide if we would attempt IVF or try IUI with donor sperm. We were willing to try IVF maybe twice. At that time we did not know that we'd need IVF for my set of issues as well, but already we were open to third party reproduction, not that we thought we'd ever need it. After the IUIs failed and we were told IVF was our path to parenthood, it was a no brainer. But then that didn't work, either, and we had our freak ectopic pregnancy that cost me my right tube and the early miscarriage that drove us to the egg donor decision. Not everyone would follow this new flowchart. I take it for granted that we do IVF, it seems like an extension of ourselves at this point, like regular tooth cleanings. But for some, that path ends at IUI. Third party reproduction is another fork that not everyone is comfortable with. To us it made sense. We want a baby, but we also want the experience of pregnancy if we can manage it. That is important to us, and it drives some of our decision making (ok fine, all of it). When egg donor failed, and we got all those second opinions, and we were told that it didn't look like my eggs were the issue but maybe sperm was, we decided to try donor sperm. And that is where the third party reproduction flowchart ends for us. We are planning a cycle with both of our materials with the new lab, but if that doesn't work out we will have embryos fertilized with donor sperm that's sitting in the cryofreezer as we speak. Would we try gestational carrier? No. That path is not an option for us. Will we try donor egg/donor sperm? I can't say never, but I doubt it if only for the fact that at this point cost is a huge consideration. There is a limit to the permutations we're willing to try because while we are fortunate financially, we are not of unlimited funds for this. We have come to the "End of the Road Conversation." It took us way longer than we thought to get here, but before signing on with a package at our new clinic, we decided that we would give it a year. Two fresh cycles and any frozens we'd have, and if we didn't get pregnant after that we would be officially done with the medical path. We would begin a journey toward domestic infant adoption, as when we were doing second opinions we also did orientation and information gathering with an excellent adoption agency. We have a plan that works for us. We have to be open to a lot of possibilities, and we put all those research skills to work, but knowing about all our options gave us power to make this decision. Because that's what's right for us.

Maybe some of this will be what works for you, too. But maybe not, and that's ok -- because one of the hardest things I've learned in this experience of prolonged infertility is that not everything that seems like great advice or a surefire way to increase success actually is, not for everyone. You have to go to that buffet and choose carefully, and revisit the buffet as your situation changes. What seemed like a great idea at the start may not be right anymore further down the road. Adjust and embrace flexibility, because bendy things take longer to break.

Resolve to know more. About the process, about options, but most importantly about YOU.

For more information about the disease of infertility and this glorious week of awareness and support, please visit these two links from RESOLVE:
Infertility 101
About NIAW

Wednesday, April 16, 2014

It All Comes Crashing Down

Literally. Crash, crash, crash.

Yesterday I was excited about my zillions of eggles, my possible retrieval Friday or Saturday, and still a bit nervous about OHSS. My estrogen was 4499 down from 5662, which was to be expected with the Ganarelix and the dialed-down FSH dosing. I was upped to 100 to try to coax my eggles to get ready for trigger, which was to be today or tomorrow.

Well, I'm triggering today but not how I wanted.

My cycle was canceled.

No obscenity is intense enough to cover how I feel. MOTHERFUCKINGSHITFUCKDAMNHOLYHELLFUCKERSUCKERASSSHITFUCKALL seems to be close though.

My follicles today were not quite ready for trigger, closer, but not quite there. But my blood, my blood told a different story. My estrogen crashed to 1600. WHICH IS COLOSSALLY BAD. Somehow I started to ovulate, despite the ganarelix, somehow my eggles mutinied against me and decided not to play nice. Going forward with a retrieval would be a relative waste because I only had maybe 9 follicles out of the thirty-odd that were close enough to be ready, and not all of those may have mature eggs in them. I fully realize that 9 eggs could be a freaking miracle for some and this course of action may seem like looking a gift horse in the mouth, but everyone on my team decided that for me 9 eggs is not enough to go forward with retrieval when I typically retrieve closer to 20. Plus, a crash in estrogen does not bode well for egg quality. It's bad business. A slight dip is ok due to the introduction of the Ganarelix, but a crash of several thousand is BAD NEWS BEARS.

Have I mentioned how tired I am of receiving bad news? Of choking back my tears while I try to have an intelligent conversation about how this happened and what I do now and where we go from here? And then fall spectacularly apart as soon as the phone call is over? I AM SO VERY TIRED OF THE BAD NEWS GAME.

Especially, ESPECIALLY because of how much effort I've put into this goddamn cycle. I have gone out of my way to get fresh squeezed frickin wheat grass EVERY DAY. I have not had ANY EASTER CANDY, and nothing with caffeine has passed my lips in a freaking month. Including chocolate. I have not had any alcohol. I HAVE YET AGAIN LIVED LIKE A PREGNANT PERSON, AN ESPECIALLY VIGILANT PREGNANT PERSON, FOR ABSOLUTELY NO FUCKING REASON.

You know, I usually try not to let the sailor mouth fly here, but it is incredibly freeing to let it go.

Since apparently I have to let it all go. And I have to trigger tonight and tomorrow morning with a hefty dose of lupron (which I did not know was possible but it is, * the more you know...), which means I will be OVULATING THOSE BIG FOLLICLES over the next couple days. Yeah, that's not going to hurt, the bursting of 4 then 5 giant follicles. ARRRGGGGHHHHHH.

The capper is that I can't have sex for the next two weeks. No sexytimes. None. Because while there is no sense in moving forward with retrieval, maybe they are good eggs. Maybe 3-4 of them are spectacular, but because they are all coming out at once I run the risk, the laughable risk, of getting pregnant with triplets or quads if I actually have some fun between the sheets anytime soon. HOW IRONIC. In trying to have a baby, I HAVE ABSOLUTELY NO SEX. And, my eggs aren't good for IVF but they're scary enough to warrant a gag order on my vagina. What is this insane world I live in? How did I get here?

The silver lining, because I always have to have a fucking silver lining, is twofold. A) Canceled cycles don't count towards my package, so we still have two retrievals waiting in the wings. B) This does not actually impact our timing of things at all.

See, the original plan, which is now in the toilet, was to do the retrieval in April, the hysteroscopy in May, and the transfer in June. Now, we'll do the hysteroscopy in May and then the retrieval and the transfer in June. No more uncoupling for me. Sounded great, but unless I get close to OHSS again which I sincerely hope I do not, it's not going to happen. GET THIS SHOW ON THE ROAD, PEOPLE.

Have I mentioned my guilt? My feelings of horrible hindsight, where I think, "I thought the starting dose was too high, but I was going to let go and not say anything, AND LOOK WHERE THAT GOT ME!!!"? Yup. I kind of wish I had spoken up. I do not feel that there was a wrong done here. I honestly think that the dose was higher to start but not ridiculously higher (75 IUs) to account for my increased age, and maybe as a thought to push me a bit since the dilute HCG portion is different. It did not work so great, and I made sure in my very strained I-refuse-to-sob-on-the-phone-with-the-RE conversation, that there will be changes for the next cycle. And that adjustments will be made to ensure this doesn't happen again. But, cycles get canceled all the time. And I knew I was at risk once my estrogen soared past 5,000. They did everything they could to slow my runaway train, but in the end it just came to screeching halt.

So, I can't change that I didn't speak up, and honestly I might have spoken up and received a very logical answer for why the dose was higher and it still would have played out this way. I also can't change that I have worked my ass off doing Egg Boot Camp and it appears that it was for NOTHING. I am not going to lie, I can't keep this up through June. I need a little respite. I need some amnesty from Le Boot Camp D'Egg. Just a little though, because I don't want to fuck up the next cycle, but maybe (go figure) all of this is too much. It's all good for me, but maybe the stringency isn't totally necessary. I mean, it didn't exactly work a miracle for me this time. That's the problem with all these "miracle fixes." They're great when they work, but even if I HAD had the best cycle of my life and gotten pregnant, I really wouldn't know if it was the Boot Camp that had anything to do with it. I can look back with no regrets, but I can't know that this regimen is the key to my nonexistent success.

I wish that I could go on a vacation these last few days of break. I wish that I could hop a plane and be on a beach somewhere warm, with a tropical drink in my hand. And maybe some bodysnatching so I could lie out in a bikini rocking my tan celebrity body that I definitely DO NOT HAVE. I think I need to go watch a funny movie. I need to eat a Cad.bury Egg. There needs to be some good eggs had today by someone, because there aren't any in me, apparently.

Sorry I don't have better news. I am a mess, an absolute mess. I am grateful that I can keep trucking with this and I haven't lost any time, but man I was really hoping for retrieval this weekend. I wanted my birthday and Mother's Day to at least be met with some frozen progeny-to-be hiding out in the freezer, little symbols of hope that this will actually come to pass. Oh well. Empty womb, empty freezer, emptied ovaries. Until next time, eggles. Please play nicer in June.

Monday, April 14, 2014

An Abundance of Eggles

I guess all I can say is that maybe Egg Boot Camp worked a little TOO well. 

Maybe all that acupuncture and wheatgrass and Pregnitude and CoQ10 and prenatal fanciness and no caffeine/alcohol and limited sugar and fish oil and all that jazz conspired to give me a bumper crop of follicles. 

Because here I am, on Day 11 of stimming, and I have WELL OVER THIRTY follicles taking up space in my bloated belly. And, more concerning, my estrogen is 5652. Yup, you read that right. FIVE THOUSAND SIX HUNDRED AND FIFTY TWO. A new record for me, as when I had a lovely case of OHSS in 2011 that landed me a second go in the retrieval room for a pericentesis to tap me of all that fluid that had accumulated in my belly post-transfer, I was at 5500. Maybe 5600. But that was the last bloodwork before retrieval and I STILL HAVE A DAY OR TWO TO GO. 

Nervous? Me? YOU BETCHA. 

I am nervous about egg quality. Before when I had a zillion follicles, I didn't have a lot of good quality ones. So I am nervous about that. One good thing is that this clinic matures eggs in vivo, keeps 'em going in a dish, rather than discarding immature eggles. They get fertilized a day or two later. Which is insanely cool and weird, but it gives me hope that if they're not all mature those ones aren't lost. 

I am REALLY NERVOUS about OHSS. Had it before, and it is really not fun. I honestly don't see how that is going to be avoided when my estrogen is this astronomically high. The good thing, again with the silver linings, is that I am not doing a transfer with this cycle. So apparently there are drugs they can give me to keep me from hyperstimulating too terribly and then if need be I guess I can get tapped again? Because now is not really the time to be so worried. All that fluid is in those giant follicles all over my ovaries. It's after retrieval that I get nervous, because after they aspirate the eggs and the fluid out of each follicle, guess what happens? The follicles fill back up with fluid, often more than before, and you are WICKED UNCOMFORTABLE. Thank heavens for narcotics. Count up 30+ (in fact, they said "well over thirty" at my ultrasound yesterday morning) of those babies and that's a lot of fluid. That then can start accumulating all around your abdomen, around your organs, making it hard to, you know, BREATHE. I am a super watchdog for shortness of breath. So far, so good. 

I'm feeling a little conflicted, because I wanted them to do what they do and give me the best shot ever with this, my hopefully LAST retrieval. (I have one more in the chamber with this package, but MAN would I love to not have to use it.) But I was also nervous with the starting dose of 375 and I did not say anything. I did not challenge the directions because I wanted to be more hands-off, more trusting of the team, less of a control freak. And I'm feeling a little like maybe I should have said something. Because I become one hell of a runaway train. 

My first bloodwork was last Monday and it was 379. Then it was 1000 on Wednesday. Then it was 2349 on Friday. Then, yesterday, it was 3600. And then today's whopper -- 5652. The funny thing is, I was only on 375 Follistim for the first three days. I got dropped to 350, then 300, then all the way down to 100, then 75, then 50 and now I'm at a piddling 25. Plus the dilute HCG stuff. So, either the high dose at the beginning gave me a jet propelled boost to the stratosphere for follicular development and estrogen levels, or maybe my body got a swift kick in the ass and figured out what to do just in time to blow up my estrogen. Who knows? 

No one seems to be overly concerned--I have not been put on bed rest, I have not been told to do anything differently other than my changing doses and the addition of Ganarelix. Which stung a lot yesterday--I don't remember Ganarelix stinging. Today, the first real day of break, it was 80 degrees out (believe it or not this time tomorrow we will be in the midst of 2 inches of snow. SNOW. Rochester weather has a sick sense of humor), and I cleaned up in the garden. I am trying not to "overdo it" but I AM HORRIBLE AT LAYING LOW. I feel ok though. It was my only nice day where I could get out and do stuff until I felt too sore/tired to do anything. I worked for two and a half hours, maybe three, but some of that was sitting while I pulled weeds. Why the weeds have to come first I will never understand, but I got 'em early. But now I am worried. I am going to try to lay lower. No more gardening (it's all done anyway for now minus laying compost and mulch), no running around the house doing laundry (much), just quality couch time. I have all my books lined up, and my fun super intricate coloring book (don't laugh, it's really soothing and pretty, especially if you have ZERO artistic talent other than assembling and choosing colors), and I stockpiled some magazines. 

I suspect post-retrieval recovery is going to suck. 

But, what else is break for? I am just nervous that it's coming towards the end of break and if I do end up with OHSS, I may need more time off. Oh well. Que sera sera, right? 

In the mean time, I will try to be more of a couch potato. I will try to relax and trust that Egg Boot Camp did its job and not only do I have quantity, I have quality. I will keep an eye out for shortness of breath. I will relax. I will relax. I will relax. I will hope that this truly is my last retrieval. Because I'm not sure how much more of this nonsense I can put my body through in good conscience. I have a tough, resilient little body, and I really admire what beatings it can take. But man, it's crying out for a bit of amnesty. 

PS- The party for Bryce went smashingly well! A separate post on that one, because it was really a lovely time and I could almost forget that I was like a roe-filled salmon the whole time. He had a blast and he felt very loved and celebrated, and I couldn't ask for more. So more on that later, when I've gotten some pictures off picasa and I'm maybe not so full of estrogen and eggles.  

Tuesday, April 8, 2014

Why Wheatgrass

One of my late-stage Egg Boot Camp elements is Wheatgrass shots. Foamy, bright green, tastes-like-fresh-spring-at-first-and-then-coats-your-mouth-with-earthy-bitterness liquid. That on average costs about $2.70-$3.00 an ounce depending on where you get it. It starts out fresh, green spears of grass that get fed into an old-fashion-dy looking metal juicer/grinder that is hand-cranked (probably hence the cost in addition to the organicness of the grass), leaving behind a green poop-like husk of plant fiber while all that precious green juice goes into a little plastic cup (at not my favorite place) and an espresso cup at my favorite place. Favorite place also provides orange wedges for you to chase the shot with, which gets rid of the horrid aftertaste and makes it actually really refreshing. Sort of. I like to joke around and lick my hand before knocking back the shot and then stuffing an orange wedge in my mouth, like I'm doing tequila shots. Which would be a lot more fun, but not so beneficial for the eggles.

Why wheatgrass?

I did it the best cycle I've ever had, two years ago. DEAR LORD IT HAS BEEN TWO YEARS SINCE I LAST STIMMED. Regardless of how long ago that was and how dusty I fear my ovaries may be, when I did a wheatgrass shot every day once stimming started until the day before retrieval I had 26 eggs retrieved. 26!!! And, we ended up with 6 embryos to transfer, and, in my opinion, the most perfect blast we've ever had. I got pregnant with that frozen blast (but then miscarried), but it was our most successful cycle EVER.

A girl I went to fertility yoga with had recommended the wheatgrass shots, said they made a difference for her. I didn't really know much about the science behind it, but I thought it was worth a try. At the fertility yoga place, where I love to get the wheatgrass because of the beautiful presentation and tasty orange slices, they have a little informational poster up about the benefits in general of wheatgrass. One ounce is like eating a bushel or something of vegetables. It's chock full of antioxidants. It's super healthy for your body, whether you're trying to conceive or not. I was sold.

And, even more sold after I seemed to have better egg retrieval and better egg quality and better embryos result from daily grassy goodness.

So, wheatgrass it is! In case you were wondering how it purportedly can help infertility, I looked it up on a bunch of websites. I didn't want to post them here because so many were selling juice or otherwise advertising-ish, but the upshot was the same all over the place. Apparently, according to what I read, wheatgrass juice is alkaline and can balance your Ph, which leads to better receptivity for eggs and sperm and better conditions for implantation...which may have me doing wheatgrass shots around my transfer, too. Can't hurt. Apparently there is a lot of anecdotal evidence that wheatgrass juice lowers FSH and increases egg output and quality. Which I totally buy into because of my one personal experience but have absolutely no scientific facts to back up. Such is life in the world of infertility. Going with the gut here, and the fact that more green stuff in my body can't be bad.

The logistics of getting the wheatgrass juice each day can be daunting. Luckily, Favorite Place is right around the corner from my house. So I can get it on my way home during the week, Monday-Thursday, or after acupuncture appointments. It's the weekend that's tricky. They close at 4 on Fridays, and it is so hard for me to get out of school on time for that. I am still trying to figure out how I am going to get everything ready for Friday when I have to get sub plans on my desk for the first Monday and Tuesday after (ELA Scoring). I really don't want to come in over break, but if I have to to keep my sanity this week, I will. Then, Saturdays they close in the afternoon sometime, and Sundays at 2. And I freak out if I think I'll miss the shot. I can always go to Wegm.ans and get Green Glory juice, which has wheatgrass in it. BUT IT'S NOT SQUOZE RIGHT IN FRONT OF ME. It's not as fresh. It's not as anti-oxidant-y. So says my crazy mind. But, it's better than nothing. The other place, the plastic cup/no oranges/aloof-juice-bar-attendant place is open until 5 on the weekends, so it's a good emergency go, too. But now I find myself planning my afternoon commute based on the tiny amount of fresh green juice I feel I must ingest to give myself the best shot at success.

Isn't it crazy the things we do in the name of seeking success, an end to this merry-go-round of pain? It's all a means to an end and that end after all this craziness really should be a chubby little baby or two. The crazy is temporary, although it feels neverending. It will all be worth it when I have our (hopefully not green-tinged) little one in our arms.

Sunday, April 6, 2014

Everything All At Once

It's here, it's finally here. Egg Boot Camp has kicked into high gear because I am MAKING EGGLES AS WE SPEAK. I take my third round of shots tonight, and I head into one of the craziest weeks I think I could have planned ever.

I actually didn't plan it this way, it's just everything sort of piled up at once. This is kind of what happens to us, every single cycle. There is always something else going on at the time, usually some kind of family crisis (knock on wood that doesn't add itself in). During cycles I have had my grandmother end up in the hospital, I've had to put my beloved cat to sleep, I've had family in from out of town, the list goes on.

This time it's just an insane week. I try really hard to frontload myself so that the week of my stimming and whatnot I am all planned and everything is pretty easy. I mean, everything is all planned anyway, in my head, but I try to make sure that everything is ON PAPER planned and all my stuff is done ahead of time and I don't have any major grading to do and I can sit and there's not much that will keep me after school. I plan to be a slacker, which I most certainly am NOT most of the time. I was both bummed and excited that my retrieval window falls during April Break. Excited because I wouldn't have to worry about sub plans or missing school and I could truly relax. Bummed because THIS IS THE GOOD BREAK, the one where all my IEPs are written and there's not much work I have to do for school. A true respite. And now it is going to be spent driving back and forth to Buffalo and feeling pretty crappy and being all woozy from anesthesia. But, it means the only frontloading I had to do was for this coming week, the Stimming Week.

Except, I am actually out two days this week for annual reviews. Tuesday I sit in on the 7th grade Special Class annual reviews because these will be my 8th graders for Reading and English next year. So not the most stressful of days, since I sit there smiling at students and parents, take notes on things to help me plan for next year, and then give my spiel about my program and what to expect. The stressful part comes from the sub plans for the day and being away from my students. If you are not a teacher, you don't get that it is SO MUCH MORE WORK to be out of school and write sub plans than it is to just be there. I worked in the corporate world for 10 years, and if I was out I didn't have to give a play-by-play of what needed to happen in my absence, every moment of the day, to keep everything going. This week, I have TWO days of sub plans--Tuesday, when I sit in, and then Thursday, when I run the show for my Resource Room annual reviews. And miss my classes all day again. And hope to goodness that I don't have to go in for monitoring.

I am terrified that I am going to have to go in for monitoring on Thursday, and I have such a tiny window for it. I can't go to Buffalo that day, because these meetings were set up months ago and involve 7 sets of parents. My first meeting is at 8:30, so I can't do ultrasound monitoring before school because my OB/GYN doesn't open until 8 for ultrasound and I won't make it. I do have a window from 9:00-10:30, and so if I absolutely have to I can scoot out then and pray I make it back in time for my next meeting. NO STRESS OR ANYTHING.

The monitoring has me a little weirded out, because I am used to having both bloodwork and ultrasound about every three days, then every other day, then every day until retrieval. I started stims on Friday, and I go in just for bloodwork on Monday. No ultrasound. Then I might have an ultrasound midweek or it might be just bloodwork again, and then by the end of the week I will go in for an ultrasound. At my trial transfer they mentioned that they'd want me to go in for monitoring in Buffalo by the weekend, possibly sooner. What? YIKES! I had to send a panicked text to my doctor begging that if I have to do monitoring before Friday, that it be in Rochester and that it please, please not be Thursday April 10th. I will make it work if it has to be, but if there's any way to make it Wednesday or Friday instead I am really hoping it can be, for my state of mind, for my stress level...and because those meetings are kind of the culminating event of the school year for special education teachers. A lot of work goes into crafting a quality IEP and making everything come together for a meaningful discussion about this year and goals for next year. I can't get a sub for that, as I am the ringmaster. I'd have to reschedule everyone, and that would be HORRIBLE, especially last minute. Luckily my awesome doctor said he'd do all he could and put it in my chart to avoid 4/10. On top of all that stress, our district decided to have 8th grade state ELA test scoring on the FIRST TWO DAYS BACK FROM BREAK. Which is horrible planning, because we all have to have sub plans on our desks on Friday. And it stinks not to be able to start back up after the break full swing and go into the fourth quarter guns blazing. Pfffft.

So, odd monitoring schedules aside, there's one last thing I've put on our plates this week...Bryce's 40th birthday party is Saturday. I PROBABLY COULD HAVE TIMED THAT BETTER, but I really didn't plan it to coincide with the weekend before retrieval. That happened later. Again, I'm trying to have as much done as possible before the day so all I have to do is pick up all the various goodies we'll have at the party and set things up and... whoosh. Then it will be party time and we'll have Bryce's parents in from out of town. They aren't staying with us, they're staying in a hotel. I am immensely grateful for that, because I am going to be BEAT after the party. I am so excited for it, and I will write all about it after and post pictures because I am so excited for how fun it will be, but I can't write about it now because a certain someone tends to read my blog from time to time. :)

So, off like a shot. A ginormous 375 unit Follistim shot, plus a 10 unit insulin needle shot of HCG (Solution X). I am used to being on less meds and I am used to being on a split between Menopur and Follistim, so it doesn't seem like so much all at once. Definitely never started at higher than 300 though. So that worries me a bit with the lax monitoring schedule, but I have decided to Put My Trust In My Team. I am going to keep track of stuff and report if something's not right, but I am NOT going to over-manage my care this time. I am going to do what I'm told and try to interfere less. DROP THE CONTROL-FREAKINESS, MISSY. We'll see how that pans out.

In the meantime, I am proud of how I've done with Egg Boot Camp, and I've put it into high gear for the actual stimming. Wheatgrass shots started Friday and so my commute has to take the need for a gross green shot into account. Another reason to leave school as close to contract time as possible so that I can fit all this crap in. I am not having any caffeine (no coffee, no caffeinated tea, no chocolate, which is just about killing me since it's Easter Candy Time...). I am trying to limit my sugar intake. Not NO sugar, which is virtually impossible, but LOW sugar. It was warm and sunny today and I wanted ice cream in the worst way... no ice cream for me. I think I might run out to Trader Joe's though and get some of their Honey full fat greek yogurt, because that is LIKE ice cream but with less sugar. No candy. No desserts, minus the cupcake on Bryce's party day. I FEEL LIKE A NUN! A FOOD NUN! But, this is a 12 day period. I can do this for 12 days. And if I screw up, it's minimal. The point is to limit, not deny completely. I really, really want to feel like I did everything. I'm true to my acupuncture schedule, and I love it this time around. Very relaxing, and I feel like I'm doing everything possible for my eggle harvest. I am going to stack my deck as much as possible. Go, eggles, go!

There it is... the start of stimming, the beginning of another beginning. A stressful week that ends in a party that once it's started will be a great kickoff to Spring Break. A lack of monitoring that will actually be good for my obsessive self. An attempt to control less and Be present in this cycle, don't compare it, don't obsess about it, just try to do the best for my plump little ovaries. Good luck to me on all accounts... this is going to be challenging in its own right, but I feel ready. Let's hope this is one heck of a week!