Monday, September 29, 2008

adding it up

OvCon50 uber-BCPs x 6 weeks = impatient woman

((75 Menopur + 225 Gonal F)x 3 days) + ((150 Menopur + 300 Gonal F) x 8 days) + (Ganirellex x 4 days) = sore abdomen and wild mood swings

5 ultrasounds + 5 blood draws = 13 mature follicles

10,000 units HCG + sub-cutaneous injection = relieved husband, happy ass

1 valium 10mg x back rubs in bed = best night's sleep ever

hospital gown + cap + booties + PIO targets drawn in Sharpie on ass cheeks = sex symbol

good anesthesiologist x not waking mid-surgery = grateful patient

(awesome nurses + fantastic doctor) x modern science = 12 eggs retrieved

(Progesterone + oil) x big f'ing needle = much much whining

2 pound kitten + post-anesthesia nap on the couch = happy, sleepy morning

and

All previous tallies + hope + optimism + luck = a lifetime of love with children of our own

Friday, September 26, 2008

must. eat. brains.

Because that's the only chance I have of having enough brain cells to put together a complete sentence while I'm in this state.

With IVF #1 I had virtually no side effects from stimming. Sure I had weeks of constant, pounding Lupron headaches (and hours of whimpering and whining to go with them) but once I was suppressed and the cycle got rolling I felt pretty darn ok. I'd hear girls complain about bloat, tenderness, mood swings and I thought they were wimps. I was bloated and moody too, but I wasn't begging for my eggs to be sucked out at any cost. But I have come to learn that that's because I never experienced the bloating and moodiness. Not really.

But today, with 15 follicles and 9 nearing maturity and an E2 of 2100(ish) I'm starting to get it. I'm a moody girl in the best of times (my husband is so lucky) but even I don't ordinarily spend an entire evening sobbing because I feel "wrong". And I'm a lazy lazy woman, but even I can usually manage to...I don't know, *do stuff*. And I like to think that I generally have half a brain, often capable of unique and complete thought, but as that last sentence illustrates all blood flow seems to have been re-routed from my brain stem to my ovaries. (No, seriously: in this morning's ultrasound the screen suddenly started pulsing as she focused on my left ovary. As we sat watching blood rush to my ovaries, a rhythmic thumping perfectly in line with my heartbeat, she pointed out a very large artery feeding my ovary: one that's not usually so obvious. I suggested that she try to refrain from nicking it during retrieval and she concurred. Although it would be nice, for once, to have an explanation for the random luteal phase bleeding I expect to experience.)

My next appointment is tomorrow morning, assuming that I can shove off my exhaustion enough to drag myself out of bed. I'll be in the stirrups at 7:30am for (hopefully) one last time, assuming I still have the intelligence to remember which pedal is gas and which is brake. And if things go as expected I will do my first of many intramuscular injections tomorrow evening, as we finally trigger for IVF #2. That is, assuming that I don't retain so much fluid overnight that it overflows from my gut and into my backside; the inch and a half needle unable to penetrate the muscle, never making it past the retained water in my fat, flabby ass.

The time has almost come. I'm ready to be done. I'm fat, sore, tired and stupid. But I'm happy - really very happy.

Wednesday, September 24, 2008

testing...testing

*tap tap*
Is this thing on?

Modern life is amazing - lights that turn on when switches are flipped, a TV free from improvised rabbit ears and no need to desperately search for rogue wi-fi signals in the backyard. Hurricane's over, folks. Nothing to see here.

We got our power back on Saturday after exactly one week of darkness. I feel so fortunate to have had it restored before the cool front left town, and feel such empathy for those who weren't so lucky. We were without cable and internet until, oh, about 25 minutes ago, and honestly the lack of TV was a nice way to ease back into the everyday. I was a lucky girl when it came to this hurricane. I've got nothing to complain about. I just wish the rest of the area could say the same.

IVF #2 is rolling right along, although more slowly than anticipated. On our first attempt I triggered on my 8th day of stims. Today is day 9 and we've got a good few days left in us. There are subtle signs, however, that the drugs are working. When I burst into tears at the sight of a convoy of electric trucks from Jersey I suspected that the hormones were kicking into gear. When I nearly punched out a family friend who suggested I had missed a couple of get-togethers last year - that was a sign. Taking my husband in a deep embrace as he sung a little song about how much he loves me...and then screaming at him for hugging too hard - thankfully I've got the drugs to blame it on. Toss in the sore belly, now being poked thrice daily, and the bloat which leaves semi-permanent impressions of my jeans on my gut. Yes, things are in full swing.

My follicles are less impressive than my bruises, though; we measured 9 today between 11mm and 17mm. Truly it's about what I expected, but my hopes? Well, they hoped for a bit more. But don't we always? I'm feeling relatively optimistic, though and have no doubt that my cycle is being managed with great expertise and care. I trust my doctor - a new experience for me - and didn't even *ask* for my E2 today. Progress. Definite progress.

My next (and fourth) stim check is Friday morning. I hope to report a sudden surge in glorious follicles, and I hope to do it in a far more interesting post than the one I've offered today. I swear, the fluid from my brain has gone straight to my uterus.

Friday, September 19, 2008

quiet

Growing up we never had much money. My parents were divorced – my dad a mailman and my mom a full-time student and bartender. We lived on quite a strict budget and saved wherever we could: I remember a school year when our household income qualified me for free cartons of milk at lunch – they were a nickel for the rest of my class.

For the lack of resources, however, we were never made to feel poor. Christmas was always a boisterous time with plentiful presents and birthdays were always greeted with large slumber parties. And each summer my mother would be sure that my brother and I had two vacations – she was always determined to provide experiences that would be the grounds for fond, lasting memories. We never went to Disneyland, never even left the state on our two trips. Rather we would spend a week each at Yogi Bear’s Jellystone Park and River Bend, a posh campground to which a friend held a membership.

My brother and I do have wonderful, everlasting memories of those annual camping trips. We’d shop for piles of junk food in the days prior, stocking up on Olde Tyme sodas (grape, cherry, cream soda) and Little Debbies. We would pack the family’s Dodge Colt so full of camping gear that we (and our one friend each) would be forced to squeeze into any space remaining for the hour-long trip to Yogi Bear’s. On our arrival, after scouring the grounds for the best site (each of us having different priorities: my mom to be close to the bathrooms, me to be near the pool and activity center, my brother hoping to find a spot secluded from the other campers) we would set up our tents and exhale. Over the next week we would do much (swimming, hula hoop contests, and near-miss first kisses) and nothing at all (read books, eat crap, go to bed early and get up with the sun).

This past week has been much like that – the anticipation of the hurricane, stocking up on junk food and non-perishables. The excitement of the storm and the calm in the aftermath. We had days in the same clothes (with no water to wash them) and spent time helping neighbors. We’ve eaten much food of little nutritional value and all cooked over an open flame. I’ve read 4 books, so far, by the thin light of a flashlight. In many ways this week without power (still without power) has been a lot like camping. But in some ways not so much.

I had been instructed on Friday to begin the meds for IVF #2 on Tuesday. We were expecting the storm, but didn’t really comprehend what would be left behind. I thought we’d be out of power until Monday, maybe Tuesday, but never did I imagine the estimates of 2-4 weeks. Once the full news of the outages reached us (over the radio) I just assumed that we’d be canceling the cycle, refilling my BCPs and hurrying up and waiting for another month. You can’t imagine my shock when the message came through: start stims as planned on Tuesday.

It’s a strange position to be in, hearing of so much devastation just 50 miles away (while being thankful for our own good fortune) and still being concerned about advanced reproductive therapy. To sit on the floor in my dark house, mixing vials and giving injections, prepping my ovaries for an elective procedure while others worry about finding gas, ice, food. This is not how I expected this cycle to go – how could I have predicted this? – but I think it’s working in my favor.
Having rare access to the internet means I’ve been unable to obsess about dosing instructions and my E2. I’ve been unable to compare my progress to friends and fellow bloggers. My poor husband has been subjected to my ponderings as to how the cycle is going, unable to provide insight, knowing he is just a sounding board to replace my usual network of overly informed IVFers. But it’s meant that I’ve had to trust my doctor, go with the flow and wait and see. A good thing, no doubt.

But now that I sit with access to the web for a moment, I will no doubt be frantically searching for others with low E2 (92 after 3 days of stims and an estrogen patch) and pathetic follie scan (8, all measuring under 6mm). I will look for stories of girls who reacted more slowly to a higher dose of meds than a previous cycle and will scour for the truth behind the rumor that “a slow stim is always better”. But before I have time to collect enough tales of similar cycles to calm my frayed nerves I will be back home, in our warm, dark house, far from the community of women who understand.

I will take my increased dose of meds (150iu of Menopur and 300 of Gonal F), pick up the flashlight and curl into bed with another mindless book, my thoughts slipping away from my ovaries once again. Until Monday when I am again pulled from the relative primitive life of our “camp” and thrust back into the modern world – another date with the butterfly needle and the vag cam and another missed opportunity to obsess as I ordinarily would. Unless, of course, we have power by then. In which case I’ll be right back here, desperate for you all comfort me and assure me that this cycle is going just fine.

Friday, September 12, 2008

yIKEs


Looks like after 12 years of life in Houston I am about to experience my first hurricane. We've got chips and donuts, canned peaches and gatorade. We squeezed both cars in the garage and dragged in all our patio furniture. We're staying put as advised and hoping for the best. It's odd - watching TV we know what is to come, but it's bright and sunny and hot outside. Everything we're seeing tells us to hunker down, but there's just no need. Yet. Like 6 weeks of birth control before IVF, it's all anti-climactic waiting for now.

I felt guilty when I called the nurse yesterday, asking what the plan was. An enormous hurricane is heading right for us, no doubt people have bigger things on their plate than my vagina. But she was a step ahead of me; already figuring out with to do with her IVFers. Next thing I knew I was on the table, vag-cam firmly in place. The ol' ovaries looked good and so, assuming power has returned, I will start stims on Tuesday. My uterus waits for no storm!

I expect that we'll be just fine (although if winds are as forceful as predicted our roof might not be - I don't have much faith in the two old, dying trees in our backyard). We live pretty far inland. If things go as planned we'll be in the neighborhood bar tomorrow evening, drinking a lukewarm beer by flashlight. I don't doubt that power will be out, probably for days, but the neighbor has a generator and we've already got the ok to store our meds in his fridge. (Priorities, right?) I'll update when I can, but until then I'll be on the hunt for Anderson Cooper. I mean, I might be infertile (and married) but I'm not dead!

Wednesday, September 10, 2008

mind over matter

When I was 9 years old I decided to stop being ticklish. My brother used to mock me for having so little self-control when I would collapse in fits of giggles at the slightest touch. My brother spent most of his waking hours making fun of me for one thing or another and I usually didn't take it to heart. But his suggestion that I was weak-willed hit home and I vowed to stop being ticklish. The next time hands reached for me, fingers wiggling under my neck or behind my knees, I breathed deeply and deliberately, forcing myself to remain calm. I didn't twitch or smile until the tickler reached for my feet, at which point I fell into a heap, laughing my little belly laugh. I wasn't deterred, though, and before long I was no longer ticklish. Even those who claimed their nimble fingers could bring laughter from a stone failed. I was not weak-willed. I was powerful. I was in control.

I was an avid cook from a very young age. Many of my culinary experiments were great failures ("fried meringue" anyone?) but I was determined. The only thing I enjoyed more than cooking was eating - my own creations and others'. When my mom would make a whole chicken she would pull that paper bag from the cavity and extract the livers from it. Two tiny pieces of creamy, fatty, deliciousness. As the chicken baked she would fry those livers in a small pan, salt and pepper them, and moments later she and I would each devour one. One little packet for each of us - the best part of the chicken. I was very much a carnivore and would eat any meat product offered to me. Lamb, smelt (little smoked fishes with their heads still attached), even sweetbreads. I loved them all. On New Years Eve when I was 15 years old I decided I needed a resolution. Not some vague utterance about being a better student or a nicer person. Something concrete. So without any premeditation I decided I would become a vegetarian. It wasn't an effort to save animals (although I was already an intense lover of all things furry) or even to be in vogue with my angst-ridden teenaged friends. Rather I decided to give up something I loved wholeheartedly, just to see if I could do it.

I loved to fly when I was young - after my 1st flight (to California with my aunt in 3rd grade) I announced that I was going to become a flight attendant. (I've never been particularly ambitious in my career aspirations and knew even then that pilot was beyond my lazy reach.) I often claimed that the flight was the best part of a vacation - 3 hours of sitting under a blanket while eating miniature food was an excellent way to pass the time. And then, on Wednesday, July 17th, 1996 I sat in my room and watched on TV as the pieces of TWA flight 800 burned on the surface of the ocean. I had a flight booked for a few days later and suddenly I was dreading it. From that moment on I was terrified of flying, needing a sedative just to approach the tarmac. And yet, 6 years ago I drove myself and my (now)husband 40 miles to an open field with a long runway. We watched a video about falling through the air and mimed jumping out of the plane. Within a few hours I was sitting on a tiny, terrifying propeller plane next to the open door as the world got smaller beneath us. I had no desire to sit on that airplane and even less to jump out of it. But I needed to know that I could - that I was bigger than my fears. And I was. Twice.

I don't think of myself as a controlling person. I don't feel as though I manipulate those around me to fit into my own plans. And yet as the stories above illustrate it is clear that I yearn for the knowledge that my future is in my own hands. I know that I am strong and I know that I am capable. I know that I can trust *me* to do whatever it is that needs to be done. And if I fail or make mistakes I am comforted in knowing that the mistakes, too, are my own responsibility. So to hand over that power to someone whose own strength I have not tested is enormously challenging.

As you probably know, because I can't shut up about it, I am scheduled to start stims on Monday. (That is, if my ute can keep it together for 2 more days and quit with the bleeding already. I'm popping 2 BCPs a night - get the message!) I am so excited for this cycle to get underway and will practically be bouncing on the table as the vag-cam checks my sleepy ovaries. But until that moment when I'm told we're good to go, I will continue to stress about my protocol...or lack thereof.

You see, I have never cycled with this RE before. She has my history from our failed IVF (and all the records from the myriad of doctors I've visited on this journey) but her first-hand knowledge of my reproductive organs is minimal. We decided at our initial consult, based on my poor showing for IVF #1 and the drugs I had available to me, that I would do an antagonist protocol. So I did my research, learned why this was an appropriate choice for me and got an idea of what I might expect. I was armed with the knowledge I'd gained and was ready to move forward. Until last week, while signing the consents, when the IVF coordinator dropped the "C" word. No, she didn't call me or my c*nt a c*nt. Rather she pointed at the calendar and said "this is when you'll start taking the Clomid".

What? Clomid? On IVF? When I have a giant box of Gonal-F and Menopur - probably 2 cycles' worth - sitting in my kitchen? Why, why in god's name would I take Clomid? The nurse was sweet and did her best to explain that a Clomid "boost" before the injectibles works well for some poor-responders. Improving quality as well as quantity. But she couldn't tell me why, couldn't tell me how they'd come to this conclusion. Had she suggested any other protocol I probably would've been fine - I've *heard* of all those! But putting me on a med combo that I was not only unfamiliar with, but thus far unsuccessful in attempts to research has sent me into a tailspin. And the later decision that we wouldn't actually determine whether or not to use the Clomid until *after* my baseline on Monday morning has me in a total tizzy.

I don't like my inability to control my fertility, but a lack of control over my body is something I've gotten pretty used to. But this inability to prepare, either with knowledge or advanced planning, is giving me heart palpitations. I want to know what we'll be doing and I want to know why. And I don't want to wait until hours before I pop the pill (or not) to find out! But for the time being I have to keep quiet and keep sane. I need to learn to let go and trust in the professionals I have paid to take care of me. I have to look at her success rates and remember that those 65% of IVF cyclers who became parents last year did not decide their own protocols.

I realized at some point that being ticklish isn't a bad thing. Losing yourself in laughter as your loved ones grin over you is something to be relished. But it's too late for me - I'm no longer ticklish. I also learned that I *could* say no to the meat I craved, and I did for 8 long years. But one day I learned it was ok to say yes, too. And that was the best damn burger I'd ever eaten - up until the one I had the next day, and the next. I have to keep reminding myself that sometimes it's ok to let go, to accept that I'm not always in charge, even of myself.

And I need to learn that maybe I shouldn't jump out of a plane prove to myself that I am in control. I should jump because free-falling is an amazing ride.

Friday, September 5, 2008

a little patience

I cannot wait until next Thursday when I pop my last birth control pill (hopefully for a very long time). 6 straight weeks of BCPs and I'm ready to get rid of the acne and the bloat.

I cannot wait until the following Monday when I start stims - even if those "stims" will inititally be (the confusing and anti-climactic) Clomid. Clomid that will no doubt bring about acne and bloat.

I cannot wait until 4 days later when I start real stims - hamster ovaries and nun pee, straight to my abdomen.

I cannot wait until I hear that our big, plump and numerous follicles are ready to trigger - not because one runaway is threatening to ruin it for everyone, but because they are all mature and ready to make babies.

I cannot wait until I'm bent over the kitchen counter, my husband standing behind me with that inch and a half needle aimed right for my ass.

I cannot wait until I wake up from anesthesia to hear how many beautiful, textbook quality eggs were retreived. And I can't wait for the long day of napping and gatorade that will follow.

I cannot wait until the phonecall that tells me how many fertilized, how they're growing and that we're definitely doing a 5 day transfer.

I cannot wait until the moment when my husband stands at my side, grasping my hand as we watch on the ultrasound screen as our babies are sent home.

I cannot wait until I am waited on hand and foot. We wouldn't want to upset any precious embryos with chores or cooking. And just to be sure they're feeling safe and sound, their daddy will caress my bruised abdomen and tell them through layers of fat (and bloat) how much he loves them.

I cannot wait until I experience an entire 14 day luteal phase without a single smear of blood, for the first time ever.

I cannot wait until the phone call that changes our life - for the good - and tells us that maybe this time we will finally become parents. Even if it does mean another 2 months of shots in the butt.

I cannot wait until we see our baby(s), bright and healthy, on the ultrasound screen for the first time.

I cannot wait until I use the doppler on my own belly, in my own home with my husband at my side and hear the woosh-woosh-woosh of life growing inside.

I cannot wait to watch the trimesters fall behind me as my belly grows big and healthy before me.

I cannot wait until we learn if we're having boy(s) or girl(s) and to watch my future change before my very eyes to adjust to this new reality of our growing family.

I cannot wait until I feel flutters, pinches, kicks and rolls from inside, knowing their personalities before anyone else can even imagine who they are. Until my husband, too, can feel them; know them.

I cannot wait until I'm struggling in my own labor, learning that things don't always go as planned (but sometimes do). My man will be at my side, comforting, coaching in a way that only he can.

I cannot wait to hear that first scream as a wet, bloody and very confused new person is brought into this big world.

I cannot wait to meet my child(ren), placed squirming and pink on my chest after my husband cuts the cord connecting them to me.

I cannot wait to get home and wonder what in god's name we've done and how we're possibly going to do this. And then we'll do it, day in and day out, better and better as it gets easier (and sometimes harder).

I cannot wait until milestones are reached: they'll smile and roll over and sit and stand.

I cannot wait until reaching hands and tiny fingers torture the cats. I can't wait...but the cats can.

I cannot wait until I hear my name - the only name I've ever known in my heart - spoken by my baby. Mommy.

I cannot wait for first days of daycare, first days of school, first loose teeth, first friends, first fights.

I cannot wait to watch them grow bigger, grow up, grow away from me as they become their own individual selves. Selves who sometimes just need their mom.

I cannot wait to to live all the moments I've been imaginging my whole life. And to experience all the experiences that I never could've known were to come.

I cannot wait for any of it. But I will. I'll wait as long as it takes.

Tuesday, September 2, 2008

children's children

1/3 of American girls become pregnant before the age of 20. Should I repeat that? One-third, one out of three, thirty-three percent, of American girls become pregnant before the age of 20.

Or so says Barbara Walters in response to the announcement of 17 year old Bristol Palin's pregnancy. (Yes, in addition to watching Regis and Kelly, I believe I may have just outed myself as a viewer of The View.) I know that many an infertile's reaction to the announcement of yet another oops! pregnancy is bitterness. Jealousy. We might find ourselves pleading with the universe, begging for an answer as to why they get pregnant and we don't. I have been there. I still do that. But this time that is not my reaction.

As an exceptionally liberal liberal, one who has developed a serious aversion to the pick of Palin for V.P., my immediate reaction might've been glee. Upon sharing the news I could tell my mother expected me to lick my lips at the scandal. My husband, who has been surprised by my violent reaction to Palin's candidacy, assumed I would rant about the hypocrisy of a champion for abstinence-only education finding herself a 44 year old grandmother. But I didn't experience this revelation as a liberal, but rather as a woman. My gut reaction was simple sadness at the official statement that the parents-to-be will be married.

An unintended teenage pregnancy can be, I imagine, a devastating, scary event for the family. And I understand the desire when faced with a personal tragedy to do everything you can to Make Things Better. In some situations that might mean an abortion and in other, more right-wing families they Make Things Better with the sound of shotguns ringing in the air...er, I mean, wedding bells.

I can understand a girl, a child, who thinks that Johnny No-Condom will make a wonderful husband - I mean, he *always* texts when he gets home! - and I can relate to her dreams of an (off-)white wedding and blissful family days to come. But what I cannot understand is the parent who condones these childish delusions. More likely than not, the parents have had their doubts about this boy from the start. They don't like that he beeps from the driveway instead of ringing the doorbell. They aren't sure about all those text-messages - isn't it too soon to be *so* swept up in each other? They probably haven't trusted this boy to bring their daughter home by curfew, but now they trust him to hold her beating heart in his palm? Now they ask him to help raise their grandchild, when days prior they wouldn't have allowed him to pet sit their dog? I understand the need to fix things, but I wonder just how many things, how many hearts, how many people will be broken as a result of this "fix". And I worry that Bristol, like so many other young mothers, will feel herself and her life speeding past her, without her control, on a crash-course with a future she never intended.

Upon blowing out the candles on my 20th birthday cake I exclaimed that I officially would never be a teenage mother. It was a joke, of course. Mostly. I didn't even lose my virginity until I was in college and officially legal and I went on birth control immediately thereafter. At 20 I'd still only slept with one boy and he was so concerned about knocking me up that we often tripled up on protection - pill, condoms and spermicide. But I'd known of so many unwelcome surprises (I *was* an unwelcome surprise!) that I assumed the same fate would befall me.

When my brother, at 21, found himself an unexpected father to a very unexpected pregnancy I couldn't help but try to picture myself in his place. He loved his son, as did his girlfriend, but it was clear that this was not a path they would have chosen for themselves. They fought through those early days together and now work separately to give him a stable(ish) home. They've done their best and it's been enough, but it wasn't what any of them wanted. I look at my nephew today, at almost 11 years old and am proud of the smart, feisty boy he's become, but I cannot for a moment imagine him to be mine.

I might not have chosen the path I currently walk, had I been given the chance. I wouldn't have asked for the waiting, the heartache, the loss. But if I'm honest, I wouldn't have traded it for the alternative. I am glad that I didn't drop my 10 year old off at school this morning. I am thankful that I haven't spent the last decade wondering how I would provide for myself and my child. I would've loved my baby and I would've done my best, but I don't know that my best would've been enough.

Infertility might hold my heart in a vice-like grip, forcing me to grow in ways that I never expected and wasn't prepared for. It's battered and bruised me. Teenage motherhood would have beaten me just as thoroughly, however it's pushes and punches would've fallen not just in my gut, but in my child's. And I'm so thankful that I'm the only one taking the beating.