02.08.10

*Reward posted*

Posted in Life at 2:19 pm by lifebytheday

$10,000 to anyone who finds me a money tree AND my missing sex drive! ;-)  

Seriously, if we were able to find those two things I don’t think S and I would ever fight again.  LOL!

Oh, and P.S.?  I GOT THE JOB!!!

02.05.10

Pins and needles

Posted in Life tagged at 10:32 am by lifebytheday

So yesterday was the big day – my third and final interview (!) – where I not only had to meet with two additional managers, but also had to present a demo of one of our company’s software technologies.  I think it went really well, but I’ll find out soon!  Either today or Monday…although I hope it’s today.  Not sure how I’ll make it through the weekend not knowing!!

The best part of yesterday’s interview?  Staring into the face of one of the most beautiful men I’ve ever seen, lol!  Picture ice blue eyes, but warm…mmmm.  Seriously though, he was one of those thoughtful types, so while he paused to think of his next question, all I could do was maintain eye contact, and wait.  I mean, that’s what they tell you to do, right? ;-)

02.03.10

Guess what?!?

Posted in Blog, Infertility, Life at 7:30 am by lifebytheday

Yesterday was my one-year blogging anniversary, and I DIDN’T EVEN REMEMBER!!  Probably still wouldn’t have, if one of my favorites hadn’t mentioned that hers was coming up soon as well.  I was like “Wait, didn’t I start my blog before Jo??” ;-)   Oy.  I guess I just have a lot on my mind, huh?

It’s funny to go back and read my first few posts.  We were still on our break from treatments, so they were much more focused on “life”…S, Bailey, our house.  When I started the blog, I think I was sure I’d be pregnant by my one-year anniversary, but to be honest, this blog is probably the one reason why I’m okay that I’m not.  That doesn’t really make sense, I know, and it isn’t really 100% accurate…obviously, I’m not really “okay” that I’m not pregnant.  But this blog (and all of my wonderful readers) has been a way for me to express my feelings, and get support and opinions from some very smart people.  People that care enough to read about my crazy thoughts and not-very-funny stories, and keep coming back for more!  Seriously, are you guys gluttons for punishment, or what?? ;-)

But really, this blog has been like a diary, but so much better.  I can bare my soul as needed, but because I’m also writing for an audience, I find that I spend more time trying to explain my feelings, which also helps me to process and understand them.  And on top of that, knowing that people are taking time out of their day to come to my little piece of the world, I feel more pressure to keep up with the blog on a regular basis.  I still haven’t managed to get the post-every-day thing down pat, but I’m trying.

I also have to give S some serious credit for his support of this blog.  Clearly, I’m not a real private person…I like talking about what’s going on in my life, and a good number of my real-life friends know most, if not all, of what has been going on.  However, S does NOT.  S would rather no one knew about anything until we showed up with a child, and that involves anything to do with our sex life, our disagreements…fill-in-the-blank.  So I’ve tried to walk a fine line between fulfilling my need for release, and maintaining S’s request for privacy.  Some days that balance isn’t quite right, so you’ll find me editing posts after the fact…and other days, I find myself writing in code, desperately trying to express my feelings despite my self-censor.  I’m hoping that I’ll find an appropriate balance as my blog continues to develop, but for now, I just want to thank S for letting me talk about him at all!

Out of curiosity, I just went to take a look at my blog stats, and as of today, my blog has received7,777 hits.  Considering that my favorite number is 7, I’d say that’s a pretty good sign, wouldn’t you?  Definitely not as high as your 30,000 Jo, but in my defense, I think I’m in more of a niche market. ;-) LOL!

02.02.10

Laughter is the best medicine

Posted in Life at 4:46 pm by lifebytheday

Hi friends!  Sorry I haven’t posted for a few days…work has been absolutely crazy.  I’ll be back shortly with more IF information than you’ve ever wanted to know, but in the meantime, please go read this post from Big Mama, one of my absolute favorites.  She is wonderfully self-deprecating, hysterically funny, and always completely real about life with her husband and daughter.  Read through a few posts, she’s a riot! 

Anyways, I was on the train this morning, catching up on my blogs, and Big Mama’s post today struck me so funny that I literally laughed out loud…and then couldn’t stop! 

Reminds me of the time that my father told the following joke:

A man says to his friend – “I keep seeing spots in front of my eyes!  What should I do??”

His friend – “Have you seen a doctor”

The man – “No!  Just spots!!”

Seriously, I know that isn’t funny, but for some reason, the first time I heard it (although admittedly much younger at the time), it struck me SO funny that I laughed for like a half an hour.

I probably would have done a similar thing with Big Mama’s post today if I hadn’t started to get “crazy lady on the train” looks.  LOL!

I think I might be just a little punchy. :-P

01.31.10

The light at the end of the tunnel

Posted in IVF tagged , at 11:35 am by lifebytheday

First of all, thank you all SO much for the warm thoughts and kind words…I feel so very lucky in my group of friends.  You all seemed to know exactly what I wanted to hear…even when I didn’t know that myself.  Although I’m still sad and disappointed, things are starting to look up.

On Friday evening, while S and I were sitting around watching tv, I got a call from my RE…you know, the one I hadn’t heard from my entire cycle?  I had called earlier in the afternoon to make a follow up appointment and was told that his earliest available appointment was on March 4th.  Sorry, not acceptable.  So then I asked to be transferred so that I could leave a message for him (I knew that he was away last week) and was told that patients weren’t allowed to leave messages for the doctors, but that I could leave a message with his nurse.  I was flabbergasted.  “So you’re telling me that I’m not allowed to leave a message for MY OWN doctor?”  Apparently not.  So once I got past that, I was transferred to the nurse’s line and left a very stern message asking for a return call from Dr. T.  45 mins later, I got a call from the nurse telling me that he’d be calling and to leave my cell on.   

Four hours later, around 8pm, I got a call.  Dr. T had wanted to wait until he knew neither of us would be interrupted so that we could talk as much as we needed, for which I was surprised and extremely grateful.  I put him on speaker so that S could hear, and we talked for almost 20 minutes.  Some of the key takeaways:

  • I am an extremely severe case, and will require careful monitoring and likely constant tweaks to the meds (and will always be at risk for cancelation, due to my extreme response)
  • He was very concerned to hear how early in the cycle I had been feeling pain and bloating, and implied that a cancelation would have been likely even without the false ovulation
  • He doesn’t think that we need to take a break, and actually told me to keep taking the Lupron to get my ovaries suppressed more quickly, so that we can jump right back into the BC pills (and hopefully not have to be on them as long)
  • I’m to track how I feel (bloating-wise) and call next week with a report, and also to call if and when I get my period.  If it hasn’t arrived within the next 7-10 days, he’ll likely induce it.
  • He’s going to closely review my past three stim cycles with his team, and will consider starting me on a lower dose of Gonal-F, and perhaps only Gonal-F and no Repronex.  Not using Repronex might cause the same quality issues that we dealt with my first two cycles, so that’s also a consideration.

I also expressed my concerns with how my care had been managed – i.e. as a team, but without any one person who seemed to know the whole picture.  I told him that I obviously didn’t begrudge him time out of the office, but that each morning, I felt like I had to remind the RE(s) on call about the severity of my situation, and answer questions they should have known.  This was really hard for me to do – I don’t like to rock the boat (and don’t want to be known as “that girl” amongst the staff) – but I spoke up for the sake of our future children, and for other women who might not have the confidence to do so.  Dr. T made it clear that his team works very closely together and claimed that everybody had been aware of my situation, but apologized and said that they’d do better next time…that if I wasn’t happy, then they hadn’t done their job.  I know there was more than a little feather-smoothing going on there, but I appreciated the sentiment.

The other really interesting thing that came out of our conversation was a Plan C, that Dr T wanted to make sure we knew he was keeping in his pocket.  Apparently there is a program at McGill University (in Canada) – the only one of its kind in the world – for people (like me) with severe PCOS.  They actually harvest the eggs before maturity – using NO stim meds – and then mature the eggs OUTSIDE of the body.  Then the rest of the IVF procedure continues as normal.  Apparently they have had some great success rates, and Dr. T wanted us to know that might be an option down the road.  Strangely, S felt really encouraged by knowing that this option was available, but all I could hear when he was telling us was…$ $ $ $ $ $ $…I mean, only program in the world, outside of U.S…? 

In any case, Dr. T told us that we absolutely shouldn’t give up, that as a 27 year old woman, we have plenty of time and options available to us.  Usually that pisses me off more than anything else, but this time I really took it to heart.  After realizing that we were officially entering the “over 3 IVF cycles club” I forced myself to think about whether we should change our plans going forward, maybe consider adoption or something else.  After much thought and prayer, I realized that I’m just not there yet…more than anything, I want to have that little girl who wraps S around her little finger and reminds him of the woman he fell in love with, or that little boy that I see in S when he’s being silly or grouchy.  I want to have that feeling that my mother has told me about since I was a child, the feeling of love unlike any other, for a person that is a combination of you and your partner in life and love.  I absolutely don’t judge anyone who does adopt, in fact, I think they’re probably stronger than me, but at this point in my life, I’m still craving my biological child. 

So for now, I’m trying to stay upbeat and focus on the positives in the situation.  If this cycle wasn’t meant to be, at least we found out a month earlier than if we went all the way through to transfer and 2WW, and got a negative anyways.  I have to admit though, my prayers have gotten a bit desperate.  “Please God, don’t tell me that biological children aren’t part of your plan for us…”

01.29.10

And just like that, it’s over.

Posted in IVF tagged , at 8:04 am by lifebytheday

Long story short…our cycle has been canceled.  The third time wasn’t the charm.  Since I found out yesterday afternoon, I’ve been alternating between hysterical crying and locking it up tight inside a corner of my mind so that I can function, which just makes me feel dead inside.  I don’t know how to process the information without stooping to one of those two lows…

On Tuesday night, after finding out that my estradiol levels were elevated (650 at that point), I was reduced from 75 mls each of Gonal-F and Repronex, to just 75 of the Repronex.  Wednesday I woke up already very uncomfortable – every step I took meant a sharp ache in my ovaries.  I went back in Wednesday morning for more monitoring, at which point there were a few measurable follicles – 8-9 on each side, ranging from 8-11 mms.  I got a call Wednesday afternoon to reduce the Repronex even further, to 37.5 mls, which meant throwing out half of the dose of meds.  Turns out that my estradiol was already up over 1,100 and the dr’s were starting to freak out. 

 Thursday morning, more monitoring, at which point, the dr told me we were in a “tenuous” situation, that we were walking a fine line between making sure the follicles developed enough to trigger, without my estradiol rising to dangerous levels.  I asked her what the likelihood was of having to cancel, and she said to stay optimistic, that we’d know more after getting the results of my blood work. 

So then I went off to do my campus project for my sales interview…five hours of walking back and forth across campus to try and catch certain people during their office hours, which my ovaries did NOT appreciate.  I got back to the office around 2 o’clock, absolutely exhausted (which kind of makes me wonder how I’d handle this job pregnant…not that I have to worry about that now). 

By 3 o’clock, I still hadn’t heard from the RE’s office, so I called and left a message.  I finally heard back at 3:45, that my cycle was cancelled and that the RE on call would call with more information.  Great, thanks.  Then, my day ended by being walked in on during my hysterical sobbing fit (was hiding in a nearby unused office), by a much more senior colleague who works in our California office.  Perfect. 

I headed out early, and got a call from the RE on my cell phone.  My estradiol had dropped down to 745, which I would have thought was good news.  Wrong.  Apparently when estradiol levels drop that “precipitously” it means that the estrogen has caused your body to ovulate on its own, but without any eggs that have reached maturity.  So with that, it was over. 

By the time I got home, I had cried myself into a migraine, so I took Tylenol and a warm bath and then settled down in my pj’s in front of the tv.  (S had plans, and I didn’t want him to cancel, so I was on my own…which was really what I wanted.)  Oh, and another part of this whole farce?  (Warning, TMI – look away Brian ;-) )  While going to the bathroom last night, I noticed the CM that confirmed that yes, I am ovulating…which would have been a miracle on any other day, but last night, was just another piece of the nightmare.

So I woke up today thinking “well, maybe my ovaries will feel better after no meds last night…”  Nope, still as swollen and painful as ever, which is just a mean joke.  Oh, and even better, I have my second interview today at 11, which is why I had to pull myself together and stop crying last night, so that I wouldn’t have a swollen face for today.  I literally have to not think about it any more until after my interview, but I’m fully planning to cancel all of my plans for the weekend and stay in bed and cry.  I’m going to sleep until I wake up tomorrow, which is a HUGE treat…now that I don’t have to wake up at 6am for my Lupron.

So what now?  I’m going to call my RE today and hope that we can make a plan for immediately moving forward into our next cycle.  If I have to take another 2-3 months off between cycles (like my old RE made me do), I just may lose my mind.  I can’t believe that two months of meds and hormones, feeling sore and sick and sad…was for nothing.  When is this going to happen for ME???

01.26.10

Monitoring and IVF boot camp

Posted in IVF tagged , , , at 11:40 am by lifebytheday

Today was my first monitoring appointment, and so far, not a ton of progress – no follicles over 10 mm.  I know that I shouldn’t have expected anything different, but I was really hoping for some growing follies, to be able to see the light at the end of the tunnel a bit.  These damn stim shots HURT!  Not going in, but for 2-3 days afterwards, the injection site feels like someone punched me with a brass knuckle…not that I know what that would feel like, but still! ;-)  And the annoying part is that you can’t see a bruise or any mark AT ALL, so before I shoot up each night, I have to poke around and make sure that I’m not hitting the same spot.  My first injection site (from Saturday night) finally stopped hurting today!  I’ve actually moved my Lupron shots to my upper thighs (which on me are more sensitive) – to preserve belly fat real estate for the stims ;-)  - so I should have some good bruising going on there by the end of the week.  Really though, I’m grateful that the injections have gone relatively smoothly, and hope that my estrogen level will reflect slow and steady growth.  (I’ll update the post when I hear from the RE’s office.)

Since we’re getting into more of the technical aspects of IVF, I thought I’d give a quick tutorial on some of the terms I reference regularly, for my real life friends who try their darndest to understand what the heck I’m talking about (J and B, this is for you)!

  • Follies, or follicles, are located in the ovaries and are where eggs are housed as they grow.  PCOS causes multiple follicles to develop, which in turn forces the ovary to grow to accomodate them.  Here is a picture of an ovary with PCOS (mine looks very similar) – see those black dots?  Each one is a follicle.  The goal is for some of these follicles to start growing…retrieval is scheduled once there are several follicles over the 18 mm mark.Polycystic ovary ultrasound picture
  • Lupron is a suppression medication that is often prescribed (especially for people with PCOS), to supress the growth of those millions (well 60 in my case) of follicles, and focus the stim meds on growing a few good quality, mature eggs. 
  • Stims, or stimulation drugs (in my case, Gonal-F plus Repronex) are what are used to grow the follicles and create mature eggs.
  • OHSS, or ovarian hyperstimulation, is typically only found in women who do fertility treatments, and it’s essentially just the formal term for big, swollen ovaries.  It’s usually relatively harmless, just uncomfortable, but in some cases can lead to twisting or rupturing of the ovary.  So for people with PCOS, this is a major concern (since the abundance of follicles makes this occurence more likely) and is tracked pretty closely. 
  • ER, or egg retrieval, is when the follicles are aspirated (poked with a big needle with a vacuum on the end of it…vaginally – sounds fun right? :-P ) and removed from the body, then mixed with the sperm and set aside to fertilize.  Don’t worry, they put you out for the ER. ;-)
  • Occasionally, sperm is injected directly into the egg (called ISCI) in cases of poor fertilization rates or embryo quality.  We’ll likely be doing ISCI this time around.
  • Finally, the ET, or embryo transfer, is when the fertilized (and hopefully developing) embryos are transfered back into the uterus, via a catheter essentially.  Besides the gallons of water you have to drink before the procedure (essentially using the bladder to re-position the uterus), the ET is easy and you can actually watch the procedure on ultrasound.

Okay, so that was definitely TMI, but I hope that things make a bit more sense now.  Shout out if you have a question about something I’ve mentioned previously and I’ll try to explain!  And thanks for caring enough to try and understand. :-)

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Update – just heard from the RE’s office…my estradiol level is 650, too high really for this early in the cycle.  So tonight I’m to take my Repronex only, and tomorrow morning have to go back in for bloodwork and ultrasound.  While I appreciate that they’re being cautious, I really hope this doesn’t turn into a daily monitoring.  My veins and my beauty sleep are going to suffer! ;-)

01.25.10

Stim night #2

Posted in IVF tagged , , at 10:40 am by lifebytheday

Thanks for all of the comments and concern friends – I’m really okay, promise!  I know that I probably should have called the RE on Saturday night, but I just didn’t want to seem alarmist, or hypochondriac-y.  Also, secretly (well, not so secretly after I tell you ;-) ) I think I just didn’t want them to tell me to stop taking the meds.  Twisted, I know.  But for some reason, I really believe that these are the right meds for me, and I want to give them a chance to work.  After my shot last night, I felt a twinge of itchiness around my mouth, but I think it was primarily psychosomatic…I kept rubbing my mouth and swallowing to make sure that it wasn’t happening again, which I’m sure is why I felt any itchiness at all.  I’m definitely keeping track of symptoms though (with Benadryl at the readiness) and plan to talk to the doc about it at tomorrow’s ultrasound appt.

After everything we’ve been through, I think my tolerance level has been raised to Herculean levels.  That’s not to say that I don’t occasionally complain about bloating or injection site reactions (bottom line – they’re not fun!), but only that I’ve accepted that this is part of our journey.  Even after ending up in the hospital after our last ER, I never for a moment considered giving up this battle.  Unless these side effects will in some way impact our future em-babies (or me to the point of danger, obviously), I say bring it on!  I’m just going to save up all of these things in a list to share with my children, when they’re driving me crazy in a few years…who better at guilt than a Catholic mother (with Jewish tendencies)? ;-)

01.23.10

Stim drama

Posted in IVF tagged , , at 10:24 pm by lifebytheday

Tonight marked the first night of stims, which I wasn’t too worried about (at least not since Nurse Jeannie showed me how to mix the meds ;-) )…but surprisingly it turned into a FIASCO.  I made S keep me company, and good thing I did!  Once I had all the meds mixed, we couldn’t figure out how to get the second needle screwed on for the actual injection.  Then once I finally had the needle in my skin, I couldn’t depress the plunger!  So S had to do it…good thing neither of us have a needle phobia, huh??  That sucker was hanging out in my belly for a good 30 seconds!  On the plus side, the actual injection didn’t hurt at all (even less than Lupron), although it did leave a little circle of a rash.

You’d think that’s where the drama would end, right?  Wrong.  Over the next 10-15 minutes, my mouth gradually started getting itchy, then the roof of my mouth, then the back of my throat.  Seriously?  Could I actually be allergic to one of these stim meds??  I called the nurse on call at Village Pharmacy, who told me to take Benadryl immediately and call my RE’s office.  I did take the Benadryl, but decided to wait and see whether it happens again tomorrow night before calling my RE.  As I write this post, I still feel about the same – not much better, but at least not worse.  The drowsiness is starting to set in, so I’m headed off to bed…hopefully tomorrow’s injection will go a bit more smoothly.

In other news, my girlfriends and I decided today that I need to start a list – of things that I’m not allowed to watch while I’m this hormonal!  Haiti coverage is at the top of the list…I actually woke up with a hangover this morning from all of the crying I did last night while watching the “Hope for Haiti” special.  Oy vey…you’d think I was pregnant already!

01.22.10

Another green light!!

Posted in IVF tagged , , at 9:21 am by lifebytheday

Just got to work after my baseline ultrasound, and long story short – all looks good and we’re cleared to start stims tomorrow night! 

Funny story though…the doctor that did the procedure this morning (another doc I hadn’t met yet, more on that later) was amazed when she got her first shot of my ovaries.  She had just finished reading off my uterus and lining  measurements to the attending nurse (2.2 – I thought that sounded low, but she said it was very good) and was like “…and THAT’S an ovary!”  LOL!!  I was like, “yup, that’s what mine look like” (i.e. if you were my RE you would know)…  But then she said that my ovaries are actually the size of some people’s UTERUS!  I have always known that I was an extreme case (of PCOS), but had never had anyone put it in those terms. 

Then she went on to say that she wasn’t going to bother counting follicles (that she “can’t count that high”, lol), and that she wished she had a med student or resident to show (yes, I know I’m an anomaly, thanks ;-P).  I started to say that I wished I didn’t have so many (I mean, we’re talking 30+ follies in each ovary, which is why I’m at such risk for OHSS), and she was like, “no, don’t wish that, it’s much better to have this than the alternative” and said “…don’t tell any of the ladies out in the lobby what your ovaries look like, you’ll incite a riot!”  Okay, kind of funny, and kind of sad…both for people like me at risk for OHSS and cancelled cycles, but also for those women who are poor responders and would KILL for 6 follicles, let alone 60.  Yet another example of wanting what we can’t have in this ridiculous IF battle…

Oh well, I’m going to try to stay positive and hope that the meds my RE chose for this cycle (Gonal-F and Repronex) do what they are supposed to do and create mature, good quality eggs, and that the Lupron does what IT’S supposed to do and suppresses the heck out of the rest of those suckers!  Speaking of meds, before I left, the nurse (another new person) sat down with me to make sure I didn’t have any other questions before starting my stims.  Good thing she did…because I have been freaking out about how to mix my meds (and wouldn’t have done it correctly if I hadn’t talked to her).  She broke it down for me, even drawing a diagram on a piece of paper, so now I should be good to go.  I start 75 units of Gonal-F and 75 units of Repronex tomorrow night at 7pm!

I also asked her about something that has been concerning me – whether my RE would be reviewing my bloodwork and ultrasound scans every time.  Over the past few weeks, I’ve come to discover that this practice operates as a true “practice” and that all of the dr’s and nurses rotate through each of the patients (taking week-long turns to cover the IVF procedures).  One of the huge benefits is that ultrasounds are always done by an RE, not a technician, but I’ve been feeling a bit concerned that no one person would be “managing” my care.  The nurse today – Jeannie – assured me that they were all fantastic and that they would take good care of me.  I guess I just have to hope that they keep good records…and be glad that I’m perfectly capable of managing my own care.  Jeannie said something about how everyone should just do their job and no one will get hurt and I was like “at least not until I’m on the meds for a little while!”  LOL ;-)

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