The Next Phase

When we last left our story, I was impatiently waiting for a doctor's appointment to see what would happen next and when it would occur. On Tuesday, we went to the center to have an ultrasound to make sure my system was properly suppressed, I had no cysts, and everything was ready to go. They went over some test results with us and we made a plan for the stims phase. The nurse told me I would start stims on Friday (today). I am still taking Lupron (the suppression drug), but at 1/4 of the dose. For today and tomorrow, I also am taking a drug called Menopur, which is a mixture of FSH (follicle-stimulating hormone) and LH (luteinizing hormone). Finally, for the next 10-12 days, depending on how things go, I am taking Gonal-F (FSH). So, that's 3 injections today and tomorrow and then two injections per day until trigger day.

This coming Monday, I am scheduled to go in for another ultrasound and blood work to see how my body is responding to the meds. The center will then call me in the afternoon and adjust my meds (or not) based on the results. I will also be scheduled for another ultrasound and blood test later in the week. At this point, retrieval and transfer should occur sometime the first week of March. In fact, this is why they delayed starting me on stims until today. I am technically on the center's IVF schedule for March. If I had started the stims before today, the procedures would likely have been in late February. So, to keep me in the right calendar month, they extended my Lupron protocol.

Now that I've started the stims, I cannot do anything that makes me bounce to avoid a condition called ovarian torsion. I have to take stairs slowly (or use elevators), and can do no aerobics, running, jogging, elliptical, etc. I can walk, stretch, swim, or bike in moderation. I have opted for walking and have borrowed a treadmill to allow me to do that easily (and without having to be out in the cold!).

I made it through the three injections with minimal problems today. I do seem to have a strange taste in my mouth and a slight headache but, all told, things have been going much better than I expected and I have my fingers crossed that they continue to do so.

A Strange Rejoicing

An odd thing happened to me yesterday. For the first time in over two years, instead of being crushed and disappointed, I was excited, indeed I was downright jubilant, because my cycle started. The difference, as with most things in life, was context. Not only was it not a surprise, it was something I was waiting for because it meant I could start the next phase of the IVF process. It was almost torture to wait until this morning to call the center to make my appointment. But, today arrived and I called and reported my news. Now, I have an appointment for blood work and an ultrasound for tomorrow afternoon to make sure the Lupron has properly suppressed my system. Depending on the results, I could start my stimulation injections as soon as tomorrow night! Although that will mean three injections instead of one, I'm like a kid waiting for Christmas morning. Have you ever seen someone so excited they looked like they were vibrating? Well, that's about what I look like. Here's to good news tomorrow!

Feel Better Bucket

As I was doing research on IVF, one of the books I read contained some advice that I thought was very valuable. The writer, who endured something like 7(!) rounds of IVF, came up with a neat way to get through the bad days. Before she began a new cycle of IVF, she put together a box of things she loved, like lotions and bath gel, that she could use to pamper herself on days when a shot was particularly painful, or her emotions were out of control. Bad day? Make it better by pulling something from the box of goodies. Part of the brilliance of this is that stress can reduce the chances of a successful IVF cycle, so keeping stress down is super important!

I adopted this idea and created my own box, which I named my "Feel Better Bucket." I put in foot lotion, a heated aromatherapy neck wrap, books, movies, clothes, candy and all kinds of things that would make me feel better. Phil joined in the plan and pre-ordered me some books from Amazon that will show up as soon as they are published, so I'll get some random surprises in the mail of books by authors I love.

Well, today I'm dipping into my bucket. This past week was brutal. It started with an ear infection. I stayed home for two days until the fever was gone and I looked better than death warmed over. I had, however, diligently worked from home. However, come Thursday, when I went to mail myself the document, it didn't exist. Oh, there was a shortcut in my "recent documents" as proof that it had, at one time, existed. But now, it was gone! So, I went to work and talked to the tech people, who confirmed for me that it really is gone. *sigh* Then, the emotional swings with the meds started. Although, I'm generally allowed to argue with my boss (We debate until we either reach an agreement, or we agree to disagree and I write things his way since he's the boss), our office assistant informed me yesterday that she thought I might have argued a little too much on Thursday. Oops! Fortunately, they both know what's going on and were very good about everything. I am working on building a stronger filter before I say the things in mind these days, however.

Anyway, to continue, I ended up driving a friend's car on Thursday and almost ran out of gas as I was taking it back to her because the gas gauge jumps back up to full when it is empty?!?! Phil took me to the bookstore to try and make my day better and I couldn't find anything to buy! This never happens. Then, to cap off this fabulous week, I ordered my meds on Tuesday for delivery today (because you have to be home to sign for them from FedEd and Saturday is the only day I can do that). I get a call today--they're not going to be able to get them to me until Monday. I give myself full points. I did not yell and scream at the poor woman whose job it was to tell me. It was not her fault. But seriously. They offer Saturday delivery. And yet, BOTH TIMES I have had stuff sent, it has not arrived until the following Monday! Fortunately, I am anal-retentive and order things early, so I do not need the meds before then. I am, however, stressing out. So, today, I am dipping into my Feel Better Bucket and I am going to veg until late this afternoon by watching Harry Potter and the Half-Blood Prince. Here's hoping I don't need the bucket next week.

Sticking it to Myself

The day the first meds arrived was both exciting and frightening. It came with all the needles, gauze, swabs, etc necessary for use. I even have my very own sharps container. A good friend of mine came over that night with some extra needles and sterile saline for practice. We started with an orange. Very helpful to get some sense of what it's like to stick a needle through skin. Both my friend and Phil were willing to let me practice on them, but I was actually more afraid of hurting them than I was of hurting myself. So, stick two was sterile saline into my own stomach. It was surprisingly simple (after I stopped staring at my hand wondering when it was going to move). In fact, I was so surprised the needle went in that I almost pulled it back out again on the rebound. Phil then tried an IM shot with saline. Also surprisingly painless. I realize that it will be different when it's not saline, but it was a good lesson for both of us.

Next up, an actual shot. The first injections are once a day and have to be around the same time each day, sometime between 6-8 at night. The day of my first shot, Phil and I were out of state for a wedding, so I had to do it away from home. Ack! Worse, we had to leave the reception early so I could get back and still make the time frame. But, we made it back (though a snow storm), and I administered my first shot. It stung just a little and made me a little nauseated afterwords, but all told, it went really well. Gold star for me! When it came time for shot 2, I was back at home. For some reason, even having done this twice (if you count the practice shot), I still stood there with the needle only inches from my stomach and had to talk myself into moving it. My pep talk didn't go so well and I went a little slow. Turns out, you feel more when you do it slow (although it still wasn't that bad). Still had stinging and nausea, but I'd say it went well. Shot 3 occurred at a Super Bowl party. I did a lot better on the speed, but I still had to psych myself up. Again with the stinging and nausea, so now, I'll just expect that will happen each time.

As I prepare myself for tonight's shot, I am reminded of how far I've come. I will still probably stare at the needle for a little bit and psych myself up, but there was a time when I couldn't even consider doing any of this and now, I'm three shots in. I've been pushed outside of my comfort zone and discovered that I am capable of more than I thought possible. It's a great feeling and one I want to savor and remember, given everything I still have yet to get through. I feel stronger and more confident that I can get through this and, for me, that makes sticking it to myself much easier.

Taking a Shot at This

By now, the Mrs. has set it all out very nicely. And I share her excited anxiety, or anxious excitement, or whatever this admixture of feelings is. It is a very strange process for the male of the partnership, having some rather important roles to play, but not being nearly as involved in the initial processes of pregnancy as normal. (How is that for being euphemistic?!)

One role I get to play is giving shots. I hate needles. No, let me restate that. I HATE needles. I dislike shots so much that they let me sit down to give me my TB test, which is an itty-bitty needle. But now I will be learning how to administer them.

One positive aspect of doing fire chaplaincy is hanging out with EMTs and Paramedics. This means I see enough needles and such that I am getting used to them.

I will let you know how this goes.

Surprise!

So today I went to the center to have my nurse consultation--where they tell me all about the entire process, go over everything I need to know and answer all my questions--and also a mock transfer--where they go through the transfer process, but take measurements so that they know "the lay of the land," as it were, for the real thing. Everything went well, and I am only slightly freaked out. On the plus side, based on the meds they picked for me, the majority of my time I will only have one injection. There will be two days with three, and about 12 days with two, but all the rest of my almost two months will be one injection. Yay! I also discovered that most of them don't need to be refrigerated. Another plus! Finally, my med cost came in at the low end of things,(sometimes the meds can cost as much as the procedure, so that was a great thing), and my "monitoring" will be covered by insurance. So, the 6-7 blood tests and ultra sounds shouldn't be out of pocket. Woo Hoo! All in all, it was a visit filled with good news.

What I wasn't expecting was the news that I will not be starting my suppression injections the first week of March as I expected. Why? Because I am starting them a week from tomorrow! They moved me up a month. Ack! Don't get me wrong. This is a great thing. Not only is it less time to worry and fret and freak myself out about everything, but it completely removes the difficulties of trying to miss Holy Week with the procedures (and the possibility of being due around Christmas). But my mind has not quite wrapped around the fact that this is really happening in a week. I thought I was going to have more time to prepare. I have decided, however, that this is just the first of many opportunities to learn to go with the flow. After all, once I have children, plans will have to be a lot more flexible. So, I might as well take this opportunity to learn that lesson early.

In other news, Phil has agreed to learn how to give me the IM injections, so I am going to pull up my big girl pants and learn to give myself the SQ ones. In the added degree of difficulty category, I will start my injections on a day that I am out of town. Even so, I am going to do my best to keep my stress levels down and live the experience. After all, I really only plan to do this once.

So, here's to good news and good surprises. May there be more of these down the road.

Change of Mind

Having paid my nonrefundable deposit to the clinic this past week, I am officially committed to at least one cycle of IVF. I am excited, but most often, when I think about it, I am terrified! The sheer number of injections (approx 2-4/day for over a month and then one a day for another month) has me wigging out. Did I mention Phil doesn't do needles? Fortunately, we have several nurse friends who have agreed to stick me. Without that, I'm not sure this would even be possible.

To be honest, after I read multiple first-hand accounts of the misery involved, and after I determined that our insurance didn't cover any of it, Phil and I had pretty much written IVF off. When we first started going in for testing, we agreed that we would try Clomid, but we weren't going to take any "extraordinary measures" to have children. If we were supposed to have children, it would happen. That's an easy enough decision to make when the doctors keep telling you that they don't have any idea what the problem is, everything seems fine, just keep trying. As it turned out, my squeal point was more variable than I thought. Once we found out IVF was our only option if we wanted to have biological children, it suddenly wasn't something I would "never" do. I was at least willing to consider it (and, obviously, decided to move forward with it).

But I was bothered by my decision. I felt as though I had gone back on my agreement not to use extraordinary measures. I know that we are allowed to change our minds and that, often, that can be a good thing. But I also know that sometimes we are given choices where the better choice is to stick with our original decision. Doubt plagued me. Was this one of those times? Was I making a mistake by moving forward with IVF?

I initially decided that I had not actually changed my mind. I was merely making sure that I completely explored all of my options before ruling any of them out. Yes, it was a rationalization (something I am extremely good at). But as I thought more about it, I decided it was like math--once the givens had changed, it was time to reevaluate the assumptions that had been based on those givens to make sure they were still valid. And as I researched IVF, I discovered that many people struggle with this decision. Whether the difficulty with the decision is monetary, religious, or something else, there are many couples who swore they would never do IVF who find themselves considering it. Reading their stories, I also discovered that there was no single right answer. Some couples decided to stick with their original decision. Others opted to try IVF. What became clear was not whether they changed their mind, or even why, but that they took the time to figure out what they thought was best for them. As with many things, there was no one right answer.

I finally decided that if IVF was the right track, it would work. If it wasn't the right thing to do, it wouldn't work. Suddenly, everything fell into place. The center was wonderful and we would only have to travel there three times; the rest could be done locally. My surgery was scheduled in the short time period necessary to allow me plenty of time to recover and still try a cycle in March. We were able to get a low-interest loan to fund the cycle. We would be able to extend or shorten the protocol as needed to make sure that the major events didn't fall during Holy Week. When we called to reserve our spot, March was still available. Whether simply good timing, or a divine answer to my question, everything has continued to work out precisely as we needed in order to follow through with IVF. It has made me hopeful again. And that, in and of itself, has been a gift. And so, at least for now, I am glad I changed my mind. But feel free to ask me again after the injections start.