There's no crying (or winning) in IVF

Does anyone remember that song by Soul Asylum - "Frustrated, Incorporated"?  Yeah, that is kind of where I am at right now.  I had my follicle check yesterday morning and my follicles had barely grown.  Grrr.  This new protocol has me on a lower dose of stims since I've over stimulated previously...I had, like, the Jackie Joyner Kersee of ovaries...sprinting to the finish.  This time, they are poking along like...well, me, if I had to run against Jackie Joyner Kersee.  Adding to my stress, my estradiol levels dropped which the nurse and doctor told me can happen when I added in the ganirelix but it  is still a psychological blow.  

What does all of this mean?  My retrieval is being pushed back from either Tuesday/Wednesday to Thursday/Friday.  In addition, my RE is increasing the dosage of my stims.   I had to order more medications in order to make it that long.   So more days of being uncomfortable and anxious.  And re-arranging my work schedule.  That part actually stresses me out quite a bit...it's hard to call volunteers and say, 'uh, I need to reschedule our meeting because I have slow ovaries'.  Hooray!  

In 'let's focus on the positive' news, my RE did say that on this protocol the danger of over stimulating is almost non-existent which for me means that they can continue to stim me as long as needed to get where I need to be.  It's not a sprint, it's a marathon, blah blah blah.   I just need these damn follicles to grow. 

Nick has been very supportive and encouraging.  We are both scared and anxious but hoping for the best.  Luckily, we had a lot of distraction yesterday.  His parents and brother and sister-in-law are all visiting us for Easter.  Yesterday, we checked out the Titanic exhibit at Union Station (you'll be pleased to know that I refrained from forcing any of my in-laws to re-create Jack and Rose's 'I'm on top of the world' scene on the front of the ship) and then had an amazing lunch at Gram and Dun.  I have been eating really well lately in an attempt to reduce some of my bloating and discomfort.  That sort of went out the window yesterday but I figured I had earned it.   My sister-in-law Becky and I shared the beer can chicken sandwich  and chicken and waffles.  Yum.  Then we all sort of carb crashed and headed home for a nap.  We stayed in last night and made dinner.  Nick did a stuffed pork loin and salmon on the grill and I made some roasted potatoes and our favorite spinach salad.  My parents joined us and my mom brought an amazing tiramisu that I'm currently trying to pretend isn't in the refrigerator and wouldn't make a great breakfast.

Lots of fun stuff today planned so I'm off!  Please send some good thoughts our way! XO

Anxiety can be excellent motivation

I've had a lot of nervous energy the last few weeks...a lot.  Sure, I've been doing all of the things I'm supposed to - deep breathing, acupuncture, meditating, etc etc etc.  I even found my way to an infertility therapist and she's been helping with some additional relaxation techniques (sidenote: she told me I was surprisingly well-adjusted and self-aware for someone who has been trying to get pregnant for so long...even in therapy, I get a gold star!).

The upside of all this nervous energy is that I've been fairly productive at work and home.  Mostly the latter, though.  I've cleaned closets and drawers, re-arranged shelves, hung artwork, taken FIVE boxes of books to the Goodwill, hung curtains, and just generally puttered and fussed around the house.  In fairness, part of this is because of a couple of events I'm hosting at the house, but it has certainly helped keep my mind occupied.  

In fact, as I type this, I'm taking a break from cleaning the linen closet.  And...I just ironed pillowcases, which I almost never do.  But Nick's family is coming to visit this weekend and I was getting one of the spare beds ready, I noticed the pillowcase was pretty wrinkly, so I started to iron it.  Fast forward 45 minutes later and I had ironed ALL the pillowcases in the house.   Haberbergers - I hope you enjoy your pillowcases.  :)  We've got a lot of fun stuff planned this weekend, so I'm looking forward to it...and the distraction.

Oh, I suppose you want an IVF update, too.  Not a lot new.  I'm still uncomfortable, although it seems to be much worse at night.  I actually got up around 3am and couldn't go back to sleep.  It's much better during the day.  Last night I added an additional injection called ganirelex.  It's the drug that prevents premature ovulation to ensure all my follicles can continue to grow.  It is my favorite injection to this point as it comes in a pre-filled syringe and involves almost no work on my part.  Tomorrow morning I go for another follicle check and blood draw to see where my hormones are at.  Fingers crossed all goes well!

Postscript

So, the nurse just called and said my Estradiol (estrogen) looked a little lower than they like.  Each follicle creates a certain amount of estrogen, so if that number is low than it can mean my follicles aren't developing like they should.  They are going to increase my stims slightly to see if that helps.  So, now basically I've gone from worrying about over-stimulating to under-stimulating.  I can't win!  (when I just typed 'win', I accidentally typed an 'e' at the end...to which I thought...yes, please.)  In other sad first world problem news, I think I'm too uncomfortable for the massage I had scheduled tonight.  I know, wah wah wah. 

Follicle Check #1

I had my first follicle check this morning.  I was a little nervous because yesterday I started feeling bloated and uncomfortable already...which seemed a lot earlier than I have in past cycles.  However, everything looks good - about a dozen follicles on each ovary, but the good news is that they are all about the same size.  Previously, I've had a couple of follicles get a little diva on me and grow far quicker than the others.  We want them to all grow steadily, so that's great news. 

The doctor didn't really have an answer for why I am already feeling uncomfortable other than to say he thinks I've just been lucky in the past that it took awhile for me to get to this point.  Great.   However, the best news is that the nurse got my vial of blood on the first try.  Hooray! 

Revenge of the Pincushion

I've been a little....grumpy this week.  A couple of factors are to blame - lack of sleep (allergies - argh!), lots going on at work, and vacation hangover.   It's important to note that I am not one prone to hysterics, public fits of crying, or snapping at medical professionals.   I consider myself a fairly well-adjusted person who, having worked in various fields of customer service, goes out of my way to be polite to anyone in that field.   All this by way of saying - I think I may have scared my nurses at the clinic this week.

I think I've explain my blood draw woes here before.  But for those of you who don't remember...I have the saddest little veins you ever did see.  Because I'm sadistic, I counted up how many times I've had my blood drawn in a year - 26.  Twenty-six!  I would say once out of every four times, they are able to get a vial on the first try and without blowing a vein.  Frankly, I'm surprised no one I work with thinks I have a drug problem based on the near constant bruising on my arms and hands.

I am 99% certain that the nurses at the clinic draw straws to see who gets to deal with me.  Below is a re-cap of my most recent experience.

Nurse: Okay, Sarah - did you drink a lot of water before you came in?  Remember, that helps!
Me: Yep!  (Gold star for me!  Also, I am going to float away in my attempt to get an A in water-drinking)
Nurse:  Let me take a look at your veins.
Me: The right elbow is useless; there's one you can get on the left side but it's sort of hidden. 
Nurse: :::Pokes my left arm repeatedly::: Hmmm....it's really hiding, isn't it?
Me: :::Nervous laughter:::
Nurse: Okay, I think I found it.  I think.
Me:  :::Panic rising:::  You know what?  Why don't we just take it from my hand?  Really, it's okay. 
Nurse: No, I think I've got it.
Me:  (thinking to self - don't be a hero, nurse!  Take it out of my hand!) Okay! (trying to be cheerful and optimistic) You can do this! (I've taken to giving my nurses pep talks)
Nurse:  Alright, here we go... (dig, dig, dig)...I think I see it...(dig, dig, dig)
Me: :::Trying not to faint:::
Nurse: Oh, dear.  That didn't work.
Me: ::::tries not to scream I told you so!:::  Well, guess we should go with the hand.  Here's the vein on the hand that works the best.
Nurse: Nope, I don't like the looks of that one.  I am going to try and get this one to work.  :::Points to sad looking vein:::
Me: Um, are you sure?  
Nurse:  Of course!  I've been doing this for years.  Trust me.
Me: Um, okay.
Nurse: Here we go again!  Okay, I'm in.  See -  I told you!
Me:  Yay?
Nurse: Oh, dear.
Me: What?
Nurse: Your veins aren't cooperating; the vial isn't getting filled all the way.
Me: :::screaming in head:::
Nurse:  I'm going to call in Other Nurse and see what she thinks.  Maybe this is enough for the test.  (Ed.note - almost all of my blood draws involve calling in Other Nurse for back-up and consultation.  It typically ends with both of them clucking in dismay over the sad state of my veins, which I KNOW.)
Me: Why don't we go ahead and try the other hand?  I've got a really great vein on that one.  :::Points to awesome vein and wiggle my hand in an attempt to attract their attention:::
Other Nurse: This is not enough blood.
Nurse: Well, let's check.  ::::clearly has given up and wants to be done with me:::: (to me) You can wait, right?
Me: Um, okay.
Other Nurse:  Hey, are you the person that Other Other Nurse did a blood draw on and she blew your vein really bad?
Me: That would be me. (infamy!)
Other Nurse:  Wow - she was so scared after that, she couldn't draw blood for a week!
Me:  I am not sure what I am supposed to say to that.
15 minutes later
Nurse: This is not enough blood.
Me: :::on verge of breakdown, but trying not to lose it::: Okay, let's do this!
Nurse:  Other Nurse, why don't you try this time? (Nurse has clearly lost her blood draw mojo)
Other Nurse: Okay, I choose this sad looking vein on your other hand.
Me:  Not this really good vein that works every time?
Other Nurse:  No, I like this one.
Me:  ::::screams in head::::
Other Nurse: Okay, here we go.   Oops, I blew that vein.

I'll end the dialogue here because at that point, I had been there for 45 minutes, was late for work, and just started crying.  Which I never do in public, which is fairly indicative of just how frustrated I was.   And while I am poking (ha!) fun at the nurses here, I really do love all of them and they've been very good to me...I think they're all scared of my veins and I'm scared of the draw and none of that makes anything go any smoother.

On this particular day, the draw culminated in my tearful claim to the nurses that "I...(sniff, sniff) told you (sniff, sniff) so....."  I think they took pity on me and decided that there was enough drawn to get the tests done.  Which there must have been because later they called and said my levels (estradiol aka estrogen and FSH) were fine.

In other news,

• (Okay, I promise this is the last needle reference!)  Stims started yesterday.  It's interesting to see how laissez-faire I've become to the injections.  When I first started doing them, we had calendars and reminders and alarms and this time, it was like 'oh, hey - I've got to go stick myself.  Be right back'.  Except I'm on a new follicle stimulating drug called Bravelle.  It's far more complicated to prepare (lots of vials and powders and such).  I ended up calling Uncle and had Nick come help me.  He's good at this type of stuff.  At any rate, follicles are officially being stimulated!  Huzzah!
• Last night, we went and saw Hunger Games. (Finally!  I was so sad to miss out on going to the midnight release with a group of girlfriends last week)  It's so rare that I like a movie as much as the books but in this case, I do.  Nick made me dig up the second and third books in the series when I got home so he could find out what happens next. :)

Alright, my friends.  I'm off.  My momma will be here soon.  We are co-hosting a brunch bridal shower tomorrow and we have a date with some quiche. :)

Proof I Haven't Lost My Sense of Humor

Not really sure that I have enough going on in my world to warrant a full post, so instead - you're getting a post full of random thoughts.  It's like a peek inside my brain.  Be scared.

• a friend recently dubbed my 'support group' the YaYa Sisterhood of TTC (trying to conceive) Friends...she needed a fertility drug question answered and came to the infertility mecca - me and my infertile friends.   I have laughed (out loud, no less) about this repeatedly.  Mostly because when the book and subsequent (horrible) movie came out, Nick would just yell out "Yaaaa-Yaaaa!" at random intervals.  Sort of like he had a tick or something. 
• she also dubbed me the Obi Wan of IVF.  I'm not much of a Star Wars buff - do I get a light saber?
• It's only in the last couple of months that I have found a lot of infertility humor on the Internet.  I know - infertility doesn't seem that funny, right?  Wrong!  Turns out it is EXCELLENT comedic fodder.  This will probably not be funny to you fertiles out there, but trust me...it, as well as this totally kills with the infertile crowd.
• I make it a practice not to discuss work on here (because you know, I value my job), but without getting into all the details, work has just been unbearably bad the last couple of weeks.  HR issues that I never imagined myself having to deal with fell into my lap and I've been navigating murky waters ever since.  The issues have stressed me out, caused me to lose sleep and just generally give me a headache.  Fortunately, there is an end in sight.  One of my favorite bloggers use to be in HR.  She recently posted an excerpt from her soon to be released memoirs and this post made me laugh so hard I snorted my lunch out of my nose.  Gross, I know, but true. 
• I'm guessing you probably want to know what's going on with our IVF cycle, too.  Geez, you people are so nosy.   All of our paperwork is complete and my medicines were delivered to the office this week.  I start the stims on March 30th and the retrieval is schedule for either April 10th or 11th with the transfer to occur five days after that.
• I was commenting to someone the other day (probably a Ya-Ya) that my excitement for each cycle has proceeded sort of along these lines.
• Cycle 1: YAY! I am so excited to be doing IVF! Look - needles! I'm going to have me a babbbbbyyyyyy!
• Cycle 2: I am still very excited to be doing this.  It is going to work I just know it!
• Cycle 3: I am cautiously optimistic.  With no exclamation points.
• Cycle 4: Again?  Really?!
• In more exciting news, Nick and I are off to Boston this weekend to visit friends.  We both really, really need a break.

IVF: Part 4 - first update!

Today, we (well, I...Nick had a meeting he couldn't get out of) had an appointment with our doctor to go over the cycle in more detail and talk about next steps.  He still believes IVF with our own eggs/sperm is the best option for us so we are in the process of scheduling a cycle for April.  I asked a lot of questions, mainly about how our protocol will be changed to lessen the risk of hyperstimulation.

For our next cycle, I will be on a different drug to stimulate the ovaries and instead of using a mega dose of HCG as the trigger to send the message to the eggs right before retrieval, I will instead get a big dose of Lupron (which is the drug we've used to suppress the ovaries in previous cycles - I don't exactly understand how something that in one use can suppress ovulation and then in antother use, stimulate - but whatever.  I trust the doc.). 

This protocol is designed for patients with a history of hyperstimulation.  As you might remember, despite being on a lower dose of the stims in our October cycle, I actually hyperstimulated more and produced more eggs than is typical.  This protocol will hopefully 1) produce a more manageable quantity and higher quality of eggs and 2) keep me from being in such pain/discomfort subsequent to the retrieval. 

I went over that last point in great detail with our doctor because even though no doctor will say it, I cannot believe that being that miserable and in pain helps our chances of success.  If I was a little embryo, I doubt I would want to implant into such an angry uterus. :)  It's like there was a big red warning on my lady parts scaring off the embryos.   Geez, maybe I've gotten a little too comfortable talking about this stuff with you all; that can't be an attractive visual image.  Oh, well. 

He assured me that I should be much more comfortable in this cycle.  He said that when he's done the protocol in the past, the ovaries 'get quiet' (that's the term they use for when the ovaries aren't producing a ton of eggs) much more quickly after the retrieval and virtually go back to normal within weeks.  (It was two months after the last cycle before my ovaries 'quieted'.

Overall, I left the appointment feeling very positive about our chances and while maybe not EXCITED exactly...anxious to get started again.  I'm still pretty bummed about our recent failed cycle but I'm okay with that.  I think I just realized it is okay to feel sad when something like that happens.  But you all probably all knew that already.  :)

XO