Friday, August 29, 2008

La la la....I can't hear you....la la la....

That's what I was saying to myself today. Yep, to myself. As I sat in the car driving to the clinic, as I sat in the waiting room while they processed Glenn's sperm, as I signed in for my IUI, as I sat in the exam room waiting for the doctor who, maybe, just maybe, after the 20+ other doctors I've encountered through this process, would try to impregnate me, all that went through my head, over and over again, like a mantra, while I struggled (somewhat unsuccessfully) to hold back the tears:

It wasn't supposed to happen this way. It wasn't supposed to happen this way. "Hi, I'm here to check in for my IVF....oops, I mean my IUI." It wasn't supposed to happen this way. It wasn't supposed to happen this way. Verify SS# and sign name for the 10th time today. It wasn't supposed to happen this way. It wasn't supposed to happen this way. "Yes, doctor, I've done this before. My cervix is hard to get to but I could draw you a map if you like. It's best if you use the long, narrow speculum on me." It wasn't supposed to happen this way. It wasn't supposed to happen this way. It wasn't supposed to happen this way. It wasn't supposed to happen this way.

Who knows? Maybe a miracle will happen (you can't continue to go through this if you don't believe in miracles, can you?) and I'll be able to say, "hmm, I guess it WAS supposed to happen this way"......

Before leaving, the doctor asked if I had progesterone at home. Of course, I told her, I have the progesterone in oil and all of the syringes - remember, I was prepared for an IVF cycle. But, nooooo, after an IUI, they want you to use the oh-so-disgusting progesterone vaginal suppositories, not the injections (is it strange that I would prefer that big needle in my butt every day over the nasty suppositories twice a day?). So, after we left the clinic, we had to schlep to the fertility pharmacy to fill yet another prescription.

Then we came home, I got into bed and cried, Glenn came in to comfort me, and we ended up napping for almost 4 hours. When I woke up, the funk had lifted a bit. I still hear the mantra, but, it's not as loud now and I can almost overpower it with my "la la la....I can't hear you....la la la".

So, now we wait. Day 1 of the seemingly interminable 2 week wait.....

Wednesday, August 27, 2008

Cancelled/Converted

Estrogen Priming Protocol. This is the protocol that was designed for people with low ovarian reserve. This was supposed to work. I honestly wasn't looking for a miracle and would have been happy to just get to 4 eggs, like my best cycle. I just wasn't, in any way, prepared for this to be my worst response out of the 7 injectable cycles I've done!

The doctor who did today's ultrasound, whom I never met before today (that's what happens when you change clinics) said "so, you have 1 nice follicle. Have you thought about moving forward with IVF with the 1 follicle?" Seriously, I had to restrain myself from standing up in the stirrups (in order to tower over him, because that's how I pictured it in my mind) and shouting "Are you effing kidding me?! Have you seen my history??". Instead, I said something way tamer than that, while sitting there, half naked, holding back the tears. His response, in a way-too chipper voice for someone delivering news to a woman about to add another failed cycle badge to her sash, "Oh, yeah, I see in the records that you have 5 failed IVF's. Talk to your doctor later today but I think we should move on and do the IUI. After all, it only takes one!". Really? REALLY? It only takes one???? Huh, I never heard that one before! (note my sarcasm....)

I have 1 follicle. I could have saved thousands of dollars and countless needle holes in my body and still produced 1 follicle. But, tonight, we stuck one more needle, in my butt, to trigger ovulation of my 1 lone follicle and we'll do an IUI on Friday. The odds of that working are so very low, but, maybe this long stim produced a good egg and, well, there's really no harm in doing an IUI.

I have no words to explain how I'm feeling right now and, at the same time, I have a million things I could say. Nothing in between. And, I don't think I have the strength to start the million, so, I'll stick with nothing...for now....

Monday, August 25, 2008

IVF #6 (or #7) Cycle Update

Thanks for all of your incredibly well thought out responses to my last post! I, too, believe that every cycle that requires you to stick needles in your body in the hopes of getting to ER and ET should count. In fact, I didn't realize until today that, by that definition, this is really IVF #7 (!!!!) because we stimmed in between IVF's #3 and #4 and called it an IUI while hoping we would get enough of a response to convert to an IVF, but, we didn't.

But, I've gotten used to saying IVF #6 (I'd have to put a rush on a whole new badge if I called this IVF #7, lol) so I think I'll just stick with that.

I've received questions asking why I haven't given a status update on this cycle. I can't explain it, but, despite the needles, playing chemist every night, and the trips into NYC for bloodwork and ultrasound, for some reason, it doesn't really feel like I'm in cycle. Every night, I almost forget that I have to take my meds. Unlike in past cycles, it is not the number one constant thing on my mind. It's weird.

The only thing I can think of is that the lack of response has made me a bit complacent about the whole cycle. My response has been very, very slow. At my first ultrasound, after 8 days of stimming at max dosage, I had 1 measurable follicle, an 11. That's it. Today, after 10 days of stimming, the 11 had become a 12 and I still have nothing else worth measuring.

I happened to see my doctor (Dr. Expert) this morning and he is not discouraged yet. He said that the fact that this is a long, slow protocol, coupled with the reality that I stim long anyway, means that we are not out of the game yet. The 12 is not too large yet and there is time for some of his friends to catch up to him. Dr. Expert said that he has seen some people stim for 15-16 days on this protocol. Given that, I have time.

I'll leave you with a quote I'd heard some years ago from Margaret Thatcher that just popped into my head this morning.

"I am extraordinarily patient, provided I get my own way in the end."

We'll see what tomorrow's ultrasound shows. I'm waiting....patiently!

Friday, August 22, 2008

Badges

Nurse (with an "ugh, do I have to explain everything to you" attitude) to Lisa: "Is this your first IVF?"

Lisa (with a "don't worry about me, I'm an expert" smugness) to Nurse: "No, it's my 6th."

Nurse (with a "you don't know everything, you snot-nosed infertile" look) to Lisa: "Oh, but, it's your first one here with us, right?"

Lisa (with a "so the eff what, do you want to count the needle holes in my body from all of my previous cycles" defiancy) to Nurse: "Yeah, the 5 others were at another clinic, but, this is my 6th overall."

This exchange happened between me and a nurse at Clinic C last week, on the first day of this IVF cycle. As it was happening, there was a training nurse standing nearby, observing. I noticed an expression on her face, which I couldn't clearly define. Was it pity - a sadness for this poor infertile creature in front of her who has gone through this so many times and, a minute ago, told the nurse that she had suffered an ectopic pregnancy and a miscarriage for it to be put in yet another medical record in yet another doctor's offices computer systems? Or, was it an expression of respect - respect for this poor infertile creature in front of her who had been through so much and was still here, still trying?

I realized that the line between pity and respect is a really thin one. And, it made me wonder - do we wear our infertility, the things that have happened to us that define that, as badges? And, are these badges our way of garnering respect (or pity, remember it's a thin line) from those who have not earned as many badges as we have?

I say that I have had 5 IVF's, but, have I? I have started 5 IVF cycles, only to have 2 of them cancelled 7-9 days into stimming. Do I have the right to count those as IVF cycles? Is it really a cycle if you haven't gone through retrieval and transfer? Has someone who has had 1 fresh IVF cycle and 2 FET's (frozen transfers) really gone through 3 IVF's, or have they only gone through 1?

Do we use the larger number (in my case, 5 IVF's and not 3) because it sounds better? Are we looking for pity or are we looking for respect?

On the IF message boards, most women have their infertility history in their signature, so, every time they post a message, you know exactly what they've done treatment-wise, as well as what losses they have suffered. Many IVF bloggers (myself included) have this history somewhere easily viewable on our blogs. Is this purely informative, or, does each line sit there like a badge sewn to a girl scout sash? (Totally off subject, but, wouldn't it be ironic if you could earn a sewing badge for sewing on your badges?)

Badges tell a story. They show perseverance. They show experience. They show commitment. They are a way to honor the effort that has been put in, even if success has not yet been achieved. Yes, to answer my questions from above, I think that every cycle that we do counts. Every cycle is a badge earner. They are badges that each and every one of us wishes we didn't have. But, those badges tell the story of my struggle and, whether they earn me respect or pity, neither of which I want, I will wear my badges proudly and hope and pray that IVF #6 is the last badge I have to add to this already overflowing sash.

Monday, August 18, 2008

FSH is 3.5!

I'm sorry, I know, all of my posts lately have just been updates and I haven't written anything "substantial" in a while. I've got a couple of things germinating in my brain and, as soon as I have some time, I'll sit down and put words around them!

But, for now, I'm celebrating my FSH level.

For those who aren't embroiled in this world of infertility, let me explain.
For those who, sadly, are all too familiar with this crap, talk amongst yourselves for a minute and I'll tell you where to rejoin the post!

FSH stands for Follicle Stimulating Hormone and, basically, it is a hormone that stimulates follicles (which, ideally, contain eggs) to grow. The level is an indication of ovarian reserve and the potential onset of menopause. While it's not an absolute indicator of ovarian reserve, it is one of the markers that doctors use. The lower the better. Generally, an FSH over 10, while not death to your fertility, is an indication that your response may not be great.

***OK, IF friends, you can come back!***

So, my FSH has never been really high. For my first IVF cycle, the one where I had 2 eggs fertilize but only one embryo left to implant (that resulted in an ectopic pregnancy), my FSH was a 9.4. Getting precariously close to the 10 mark, but, not too bad.

For my 4th IVF, the one where I got 4 good eggs and had 4 embryos to transfer (my most successful cycle, if you don't count the resulting miscarriage.....), my FSH was down to 7.2. I thought this was wonderful!!

Here we are, in IVF #6 and I forgot to ask what my FSH was the other day so I did today. 3.5!!! 3.5. Yes, I said 3.5. I am in shock!

OK, I am not naive enough to think that this means that I am suddenly going to develop 10 eggs. Yeah, that's not going to happen. Honestly, I don't think this really means all that much, except that it gives me hope and encouragement that maybe, just maybe, this cycle will be a good one.

Friday, August 15, 2008

Mom was released, Dad was admitted

But, it's all OK. My mother was released today and is home and doing great!! I know I've said it before, but, really, the whole thing is miraculous.

My father went in for his angioplasty today, had a stent put in, and earned himself an overnight stay in the hospital. He's doing great and will be home tomorrow.

So, now, it's time to focus on me a little bit (I'm not forgetting about you, mom!). I went in for bloodwork and an ultrasound this morning and, woohoo, IVF #6 is officially underway!!

I'll write more later. For now, I'm off to start my shots!

Tuesday, August 12, 2008

Today's update (OK, not the catchiest title)

First of all, my mother is doing great! Less than 24 hours after receiving a new kidney, I swear, she sounded like she had spent the day at the spa, not in major surgery. She sounds great!!! The kidney is doing what it's supposed to be doing, but, not to full capacity just yet. This is not unexpected, but, all signs look good right now! As she wasn't allowed to have food yet, she had a liquid lunch today. That, in and of itself was a milestone! They gave her more liquid in one meal than, as a dialysis patient, she would have been allowed to have in a week!

My endometrial biopsy went fine this morning. Clinic C was very accommodating about offering to schedule me around Glenn's procedure, but, then didn't really follow through. However, when I showed up early this morning at, what turned out to be 3 hours before they had me scheduled and explained the situation, they were wonderful and got me out in about 40 minutes! And, I have to say, the biopsy wasn't nearly as bad as what I'd been led to believe. It wasn't a walk in the park, and I'm still having some after-effects, but, it was bearable and, more importantly, done quickly.

I was able to get back across town and get to the other hospital before Glenn was even taken in for his angioplasty. After a lengthy delay, they were ready for him. The best I can say is that it was moderately successful. The objective of today's procedure was to get more blood to the back part of the heart. The primary way of doing this was to clear a very old blockage. Well, they were not able to clear it. Stubborn sucker.... They did open another artery wider, allowing for more blood to flow, but, it's not enough. They feel they made enough headway on this nasty blockage that they want another go at it. So, looks like we'll be doing this again in a month or two. He feels fine and is in no distress, so, it's not an emergency, but, taking care of it now will stave off other problems in the future.

So, for tonight, we are camped out in a beautiful private hospital room overlooking the Hudson River and George Washington Bridge. I'm absolutely exhausted and pretty sure I won't make it until midnight when the Olympics coverage ends for the evening (although, don't be surprised if I fight to stay awake!). And, I'm looking forward to going to see my mother tomorrow, after we're discharged from here!

And, finally, thank you to everyone for your kind words, prayers, and well wishes!! I'm a tad behind in my blog reading, commenting, and responding, as you might imagine, but I will definitely catch up when things calm down (do they ever?)!!

Monday, August 11, 2008

A miracle happened today....

...and not the kind you're thinking!!

About a month and a half ago, I posted about Medicare's End Stage Renal Disease program and told you that my mother has been on dialysis for almost two years and had just gone on the kidney transplant list within the last month.

We don't know yet how or where it came from, but, my mother got the call last night that they had a kidney for her! After a very long night of travel (they were in VA when they got the call and had to get back to NJ!!) and many tests on the kidney, it was confirmed at 8:00 this morning that it was a perfect match and, as of 5:30 this evening, my mother has a working kidney in her!!!

I am so emotionally drained and have my endometrial biopsy and Glenn's angioplasty tomorrow. But, this is a kind of exhaustion I'll take! In fact, it's wonderful!!!

Sunday, August 10, 2008

And, we're off!

I just put my first estrogen patch on my abdomen.

Irrational Fear #1 - the picture on the pamphlet that comes with the patches shows a woman with a cute little shape and flat stomach. Will the estrogen be able to successfully work its way through the roll of fat on my stomach??

Right on the package, it warns that the patch may cause dizziness.

Irrational Fear #2 - I'm out, running errands, and suddenly everything starts to spin. Funny, considering irrational fear #1 is that the patch won't even seep through the fat.

Regardless, I'm going to stay around the house today.

Next step - endometrial biopsy on Tuesday.

Irrational Fear #3 - I'm having MAJOR PMS. As Glenn will attest to, I've been a tad bitchy the last couple of days. My body has been really off this cycle. What if I get my period before the biopsy on Tuesday? If that happens, they won't be able to do it and we'll have to push everything back.....which leads to:

Irrational Fear #4 - what if I don't get my period on time. Again, my body was off this cycle. What if my period comes later than expected? Than, we'll be off timing from the estrogen patches and ganirelix shots I have to take tomorrow, Tuesday, and Wednesday, again, causing us to have to delay.

I will freely admit that, given my level of bitchiness, irrational fear #4 is highly unlikely! She's-a-comin', just, hopefully, not too early.

Glenn just asked me if we are still looking at retrieval around Labor Day weekend. While, yes, in theory, that's when it would most likely be:

Rational Fear #1 - we've been here before. I've had 2 cancelled cycles because of low production, so, I don't take anything for granted. For me, it's one step at a time. Let's get past all of my irrational fears, begin stimming, and hope and pray that my response is decent enough to keep going.

One step at a time....

Tuesday, August 5, 2008

Getting closer to starting!

Well, the sticks, or, more accurately, my body didn't behave and decided this would be a month where I would ovulate late. But, thankfully, I finally detected my surge on Sunday, CD19. Of course, that knocked me out of the window to have my endometrial biopsy today or Thursday, so, I'm scheduled for it next Tuesday.

Know the expression "the best laid plans of mice and men...."? When asked if we could schedule Glenn's angioplasty for today, I said, "oh no, that day is my biopsy", so, yep, you guessed it, we scheduled it for next Tuesday, now the day of my aforementioned biopsy!

We're going to do both. Mine has to happen that day and, well, we just don't want to change Glenn's. I'll probably drop Glenn on the west side of Manhattan, cab over to the east side, have my procedure, cab back and hopefully get there while he's in recovery. Not ideal, but, really, what good am I doing sitting in the waiting room worrying?

But, this was the least of my worries. I will be doing the estrogen priming protocol this cycle. You count 10 days after your surge and that's when you start the estrogen patches. Well, 10 days after CD19 seemed awful late to me and I was very worried they would cancel this IVF cycle until I ovulated at a more reasonable time. Thankfully, nope, they are just starting me on the meds earlier. So, I guess you can say that, as of this coming up Sunday, I will officially begin the meds (IVF patches and 3 days of ganirelix) for IVF #6!