16 weeks

The stand out thing about my 2009 was that I missed it. It passed in one, long, blurry moment. I barely noticed the seasons. Every waking moment was about IVF. I'm sure many know what I mean.

I realized today that I didn't really post the final results of our nuchal translucency scan which I received about 2 weeks ago. They are disturbing in restrospect not because of my results, which are "phenomenal" per Jill the geneticist (yay!), but because of what my basic odds were before the tests.

Apparently, a woman my age (33 years) has a standard 1:430 chance of having a child with Downs Syndrome (trisomy 21). Seems like a low risk right? After my test, our risk is 1:8,041. Holy cow, it was what before?! The basic trisomy 13 and trisomy 18 risk is 1: 727, sounds okay! After more thorough testing, our risk plummeted to 1: 14,521. This just seems amazing to me. I wish they could test for more genetic stuff, because while this is great, there are so many other syndromes.

We have 12 days to go before we learn the genders of the babies and I'm getting really antsy. I have not purchased the pee in a cup gender test but I did gaze upon it the other day, highly tempted. Then I put it down and bought some super cute gender-neutral froggy sleepers instead.

I got a couple of excellent books that I want to talk about next week. Right now the 30 rock marathon is on and I just have to focus on that. I love that show.

15 weeks

Luckily, we've had an uneventful week. Christmas was sort of a non-event for us because I'm on call for the day and Gregg is on call for the weekend. I've been doing a lot of laying around taking phone calls. At least one family that I saw yesterday spent the night in the emergency room with their two year old who had stuffed a french fry so far up her nose that I couldn't safely remove it. While I laughed, her parents did not. Quite an uncomfortable moment. They will laugh about it someday. Working with children all day, every day, I know how frustrating they can be, but I do a lot of laughing at things kids do and say (a classic conversation: "what is these dots on you face?" my response, "I bought them for decoration." child's very serious response, "hmph. so they washable?"). I hope my laughter is not because I'm not a parent yet. I hope I will still find children funny after caring for them for 24 hours a day rather than just 10-12.

We've started thinking about baby gear lately. Prior to imminent parenthood, you might over hear me saying things like, "I will never buy a $700 stroller, Never, never, never" while shaking my head in amazement at the folly of new parents. I felt emboldened by some article that said how much money you could make over the years by investing $700 in some other way.

Then, ummm, we started researching strollers...and, errr, ummm,...it turns out we're $700 stroller people. How does this happen? Okay, first of all, we live on a 13 acre homestead and need a stroller that can manage our long grass and dirt paths with ease (and I need to be able to rinse chicken poop off of it with a garden hose). This puts us in the $500 range right off the bat. Secondly, one of our cars is very small and no stroller will fit into the trunk other than the one we have our eyes on, especially not a twin stroller. Thirdly, well, strollers need to be versatile. As my cousin pointed out, you could end up with one for each situation. Our living space just couldn't accommodate more than one stroller. Also, they have to be easy on the eyes, light, and manageable. Also, we're having twins, if I didn't already mention it, which I did. One $700 stroller, coming right up.

While Gregg initially balked, (I mean, who in their right mind wouldn't initially barf at that price?), when he actually saw one belonging to a friend in person, his eyes went wide with desire and a thin rope of spittle leaked out from the corner of his mouth as he said, "wow, look at those welds!" and I knew he would be shelling out the big bucks. As he aptly pointed out, it's like buying a really nice mountain or road cycle. I cannot find a used one on ebay or Craigslist, so I know this particular stroller is not given up easily, a good sign in terms of longevity, ease of use, design, blah blah blah, and the company is environmentally conscious it seems, so that's nice.

Come to think of it, it's been at least a decade since the dawn of the $700 stroller and the associated stroller wars and media outrage, so I guess we're not too bad on the conspicuous consumption front. There is plenty of $700 stroller guilt amongst my peers, a pathologically guilt-ridden generation if you ask me. I could go on about this and whose fault that is, but I won't.

And so you will now overhear me saying, "I will never, never, never buy a $1200 stroller. Never, never, never". They're out there. They exist. I've seen them. Can you believe anyone would buy a $1200 stroller?

I am just reminded about how many times I said to myself that I would never do IVF. Will she ever learn?

14 weeks

Well, just when we thought, "oh wow, this pregnancy is going great!", we hit some bumps in the road.  Before I continue, I want to say that all is well with me and the babes and I didn't want to share our experience this week until I knew that everyone was okay.  Last weekend I woke up with the familiar feeling of fluid leaking from my nether regions.  I turned on the light to find a moderate amount of bright red blood and freaked the eff out.  Gregg's hair turned white.  No it didn't, but he freaked the eff out with me.  I am so happy that I bought the doppler because it reassured us instantly with 2 strong heartbeats.  I wasn't having any cramping which was also reassuring.  I looked at my OB new patient packet for guidance and found none so we went straight to the ER, a lovely recently remodeled facility, where we got a room with a flat screened TV within an hour.  In retrospect, both of us agree that we will try not to go the ER again in this situation.  It was sort of dumb.  While we got an ultrasound and saw our bouncing babies and good heartbeats, the doc knew nothing about ultrasonography for pregnant women.  He did the ultrasound, but didn't look at the placentas, probably because he didn't know how to interpret what he saw.  He checked my HCG level which, duh, was high, but means nothing as a single value.  He did call OB, but they weren't too impressed with the situation so we just went home.  It was a little disappointing given that we have this "high risk" label.  But we know that there is nothing that can be done for us if something goes wrong right now anyway.  The bleeding stopped and I went to see Dr. R on Tuesday who saw on ultrasound that I have a mild "marginal placenta previa" which means that a small edge of one placenta has edged over my cervix.  He also saw a small crop of tiny hemorrhages next to my cervix.  He was incredibly reassuring, saying that neither of these things is worrisome but that if we had intercourse, I would probably bleed.  Both issues are very common and should resolve by themselves in a few weeks.  

Great. Fine.  Wonderful even!

Until Thursday when I began bleeding heavily, once again without cramping or clotting.  I was sent home where, again, I heard two strong heartbeats.  Dr. R said it's a ruptured blood vessel related to the placental issue and I am now on a brief stint of bed rest.  Just 4 days.  The bleeding has slowed waaay down.  Dr. R was like, "no intercourse!!!".  I was like, "you couldn't order me to have intercourse right now or for the rest of this pregnancy", which got a genuine laugh.  I mean, Gregg and I have done a lot of clinging to each other like Hansel and Gretel in the woods, wide eyed and teary, but no, ahem, other stuff.  Do pregnant couples post IVF even have sex? 

This was enough for us, really.  Totally enough panic for one pregnancy.  But of course the universe blessed me this week with other stupid health issues on top of the above.  I have bronchitis or something and I am coughing my head off and my lungs out, which thankfully doesn't seem to lead to gushes of blood.  I also do not have a fever which I would hate but the cough is just hideous.  The babies kick me after I cough, so it's paradoxically reassuring.  

Just when I thought bleeding and coughing were just about all I could take...last night, at midnight, my body decided it was time for some vomiting.  Fabulous.  This does not seem to be related to my cough and I don't feel like a sick, infected person.  No watery poo.  No stomach pain.  No fever.  Not a viral infection.  Totally cheerful, painless vomiting.  We could not figure this out...I am 14 weeks pregnant and have not vomited once before this (which folks seem to find amazing, but is pretty common)...but our only explanation for the vomiting was...get this...that I am pregnant.  

Gregg said, "honey, you can have bleeding OR bronchitis OR vomiting, but not all three at once &%$#".  I'm hoping that the reason all three are at once is that I am super efficient.  Great! 3 problems in one week, that means I won't have any more!  I am hoping and yet dreading that the vomiting is simply pregnancy related.  If it's not, it means I'm ill.  If it is, it might continue, which would suck.  I'm already mourning my "no pregnancy vomiting" glory, and I would hate to have 2nd trimester morning sickness, when I need to gain the most weight.

I think we have coped pretty well this week, considering.  Gregg has been my hero, his love is palpable.  I'm sure many husbands just totally tune out.  Gregg is tuned waaay in, but after witnessing his stress, I can't say I could blame him if he decided to buy that ticket for a 6 month vacation.  I can't help but wonder if we would have been less terrified if our emotional resources weren't already sort of low from the IVF process.  We were really just feeling truly comfortable with the pregnancy.  I was planning to start my official prenatal strength training program (aka yoga) on the Saturday of the ER trip.  

I'm so glad I just have to sit in bed today.  That's my entire job.  Laptop, internet, knitting, sleeping and hopefully not bleeding or vomiting, but likely some nasty coughing.

My inner mantra this week has been, "I think I can, I think I can", like the little engine that could.  Our message to the babies is, "we believe in you".  We believe in you.  

We're all okay here. Promise.

13 weeks

While we're not exactly in the second trimester, we can see it from the doorstep, so to speak.  We're staring down it's barrel? It's right around the corner? It's coming around the mountain? Whatever! I'm almost there! 

I saw my midwife who was very pleasant.  She is the mother of twin girls, now aged 22.  She delivered them vaginally.  She said that I have a higher chance of vaginal delivery because our twins are fraternal.  That's nice to hear, but I'm not making any plans.  I'm open to whatever needs to happen, I think.  Our next appointment is with Dr. R in about 4 weeks when we will hopefully find out the genders of moo and foo.  They have new names every few days.  This is fun for me.

Something comedic happened to me while we were having breakfast with friends mid road trip.  These friends are very special to us especially because they are our trusted source for all  information pregnancy and parenting.  They have a 7 month old.  My favorite piece of advice so far: Forget the organic onsies.  Totally.  

Oh yeah, so what happened to me...we were having a totally normal and calm conversation in the restaurant about the ups and downs of cloth diapering when my friend uttered a statement like, "at first, you're changing so many diapers and laundry is impossible...".  With that, a switch flipped in my brain and a sense of sheer and unadulterated terror came over me.  Twins!!!??? Laundry???!!! I won't be able to do it!!!! It's too late!!!! Who the hell thought we should have babies??!! I began to tremble.  My heart was pounding.  My lip began to quiver.  My arms were not attached to my body.  My eyes welled up and I said, "I'm terrified!!!!", which I was at the moment.  The crew was very supportive. Emotional me had to make an instant decision: buck up or fall out on the restaurant floor.  I chose to buck up.  I realized later that I had a genuine, if very brief, panic attack, which I feel lucky to say I've never had before.  Pure fear.  I have not had the feeling since, but I would not be too surprised if it happened again once or twice before these two arrive.  I can see it happening at my work baby shower, or when we set up the nursery.  Way too real. 

After that, and after our trip, I went into full on planning mode.  Lists within lists.  I feel like we don't have much time.  Only about 5 or 6 months.  I've been in a stupor for the past 3 months and they passed in a blur, so will the next 5, I have to assume.  

In retrospect, the mini panic attack feels like a right of passage.  Ceremonial.  It sparked something in me.  

12 weeks

We had our super fun nuchal translucency scan on Tuesday.  They don't give us our final results (our actual risk for major defects) for a couple of weeks but the tech and our OB, Dr. R, said that everything looked "nice and average".  Thank you very much, I will take average.  Meeting Dr. R was actually a surprise.  We didn't know he would be there.  It turns out, he is like the head of some secret ultrasound medicine society and the head of perinatology and has a super, super kind manner.  We, parents-to-be, take thee, Dr. R, as our high risk OB, to have and to hold...do you think he would consider moving in with us? I love this guy already.

The ultrasound was really cool.  The babies are pretty well formed and "moving around like circus children", per the tech.  Gregg thought this was hilarious.  A quick aside: my fellow pregnant infertile over at Conceive This, a blog I obsessively follow which is found in my "lifelines" link list, recently posted an entry about quickening.  I have to say that I have felt baby A , who is closer to my groin, pretty regularly for about 2 weeks, and baby B, less frequently, for about 10 days.  It definitely does not feel like gas, and definitely does feel like goldfish flipping and tickling in there.  Bizarre.  I love it.

Anyway.  Both babies have nasal bones, 2 arms and 2 legs, stomachs, hearts, spines, brains.  All excellent things to have if you plan on living on planet earth as a human being.  We saw one rubbing his/her eye.  I never thought I'd say this but, it was totally, totally cute.  I know it's too early, but I could swear one had Gregg's big square head and one had my more roundish head.  It will be interesting to see. Okay, I'll admit it:  little tears squeezed out of my eyes when I saw them and I was grinning like a village idiot the entire time.  Apologies to any village idiots.  I'm talking about village idiots of yesteryear anyway, not current ones.  

 I got my first gender hunch, probably risky but who cares? I know that we will not know for sure for 6 more weeks, if then, but I really, really, really think at least one is a girl.  I Googled "very early genital development and detection" and I swear I saw a "genital tubercle parallel to the spine" on baby B, which could mean girl.  Baby A wouldn't show the goods, and Dr. R just said , "well, could be" and wouldn't commit, but it was sort of with a wink.  I guess with all of that research, my thinking Baby B is a girl qualifies as more than a hunch, but I can't buy girly stuff based on a guess.  We're not hoping for any particular gender, as long as each is fully one or the other anatomically.  These are things pediatric healthcare providers worry about.  There is this $35 pee in a cup to find out the gender thing at the drug store and it apparently works for fraternal  twins too, but if we did it, the results would have to be taken with a large grain of salt.  That's a lot of money for what could be as valid as a party game.

It is again past 1:30 am.  I cannot post my ultrasound pics right now because the scanner is too loud.  Also, they only gave us one super good profile of baby B, and just one of the top of baby A's head.  I know that the purpose of the the scan is to look for serious problems, not for photographs...but...well, darn.  I have a quick visit with the NP next Tuesday then another ultrasound (the official anatomy scan) in 6 very long weeks.  

Sleeping from 8 pm to 12:30 am and then 3:30 am to 6:30 am is working out for me, except for the tip-toeing thing.  Our washing machine is defunct, so I can't do laundry (a situation rapidly becoming dire down here on the farm but soon to be remedied) and I can never seem to knit in these early hours, although I think it would be ideal.  I think it's because I think I'll actually return to bed and fall asleep, so I don't want to get too involved.  Then again, here I am, tippity-tapping on the keyboard blah blah blah. 

11 weeks

Thanksgiving.  I am up at 1 am writing this because my stomach is still too full.  I am thankful for this in spite of the discomfort because I know many people are going hungry.  Having worked on farms, I know how hard it is to produce food for humanity and I am astounded at the abundance on our table today.  After saying my silent prayers for farm laborers, I completely stuffed my face. One piece of advice: Brine the bird.  Best. Turkey. Ever. 

What else are we thankful for this year? Hmmm....let me see...

1) The first dude who thought IVF might actually work. 

2) The first dude who listened to that guy.

3) My gynecologist who didn't mince words when I told him how long we had been trying to conceive on our own.

4) That I "only" had a fallopian tube problem.

5) That we could afford IVF.

6) That my clinic was awesome.

7) That the docs and nurses were so competent.  

8) That it worked the first time.

9) That I am plain-old pregnant.

10) That I am almost through the first trimester and am relatively symptom-free.

11) That my parents first comment upon seeing me today was, "you've got boobs, I know that makes you happy".  

The boobs showed up 2-3 days ago.  I bought 2 Medela "night nursing" bras that are perfect.  

I feel good. Yes, it's true.  I cannot believe that I never vomited. I have minor heart burn here and there and occasional insomnia and a very strange bowel pattern that you don't want to hear about, but that's it.  I've been afraid to say it, but for the past week or so, I feel sort of normal.  No more motion sickness even. 

Ah yes! I bought a small doppler.  I can usually find one heartbeat right away, but the other is elusive and makes me think his/her amniotic sack is placed mostly behind the other.  They swim around. Toward the doppler, then away.  The thought of this...is...hard to categorize.  I can definitely feel them on occasion.  I'm sure it will get more weird.  Our nuchal translucency scan is on Tuesday.  I'm so excited to see these two again. 

My parents are more excited than we are.  They want to know what kind of crib, stroller, car seat, clothing etc... that we want.  I pretended not to know yet, for politeness sake.  I don't want them breaking the bank, plus, I couldn't bear it if we began purchasing and something went wrong.  I'm not sure when we should set up though...probably at 28 weeks or so, just in case they come early...which won't happen because I say so. 

My father-in-law has issued a belly size challenge.  I think I will win.  I'm only 17 inches away.

Weeeee!

10 Weeks

I went for my first official OB visit today, which was with a nurse.  It involved a bunch of boring paperwork and a pee test and a blood draw.  I tried to whine my way into a quickie doppler evaluation, but it didn't work.  After posting this, I'm going to buy a doppler.  

There were a few really awkward moments during my appointment.  The IVF part of the clinic is highly coordinated and I felt that everyone always knew everything about me without me having to explain repeatedly.  I sort of expected something similar for the OB half of the office especially considering that they have my actual IVF file available, a rarity in this situation.  I will not judge my upcoming OB experience based solely on today's visit, but I was not impressed.  

First, the nurse put today's weight as my "pre-pregnancy weight".  I said, I actually know my pre-pregnancy weight (138 pounds), and it's also in my IVF chart.  She said that "because today's visit is the first documented OB visit, I have to write that this weight (148 pounds) is your pre-pregnancy weight, because we have no prior documentation". What? Does this make sense?  I'm 10 weeks pregnant through your IVF program, and you have my DOCUMENTED weight right in front of you in my IVF chart.  Okaaaay.

Then the nurse insisted that I had to have a repeat STD panel, which I had about 4 months ago as part of the IVF process.  She couldn't find those results in my IVF file, because she didn't look thoroughly enough and said that I had to have it done because she couldn't find the results right then.  She works in an OB/IVF clinic, and told me repeatedly that she has done so for years...so why doesn't she know that I had to have had these tests done pretty recently to even initiate IVF? Same with the PAP smear, which I just nodded about today, but plan to refuse when the time comes.  

The icing on the cake was that my mad scientist Turkish RE accidentally wrote down that my embryo transfer was on 9/22, not 9/27.  Who cares, right? There are other supporting documents...right?  But she wouldn't believe that he could have written the wrong day, and wouldn't believe me, and wouldn't look in the chart, saying she could only "look in the computer some other time".  So on every form, she put my due date and weeks a little off saying she'd "fix it later if it was wrong". If? GRRRRRR.  Insanely though,  she kept saying I was only 9 weeks, and at that point, instead of pointing out sternly that if my embryo transfer was almost a week before I said it was, then I would be a week more pregnant, not a week less, I just went within, avoiding eye contact for the rest of the visit.  She had my chart right in front of her, and I almost took it out of her hands.  My conclusion is that she is 1 card short, if you get my meaning.  

I know that this is not a huge deal in the grand scheme of things, and it will all be fixed, but I was underwhelmed by the 'I can't trust the patient' attitude after the can-do IVF crew.  I just decided to stop resisting the way the appointment was going and call the clinic in the morning to talk to my IVF nurse so that she can help me correct the dates and ensure I'm seeing who I'm supposed to see at the correct times.

All of that BS evaported though when I found out a phenomenal thing during my meeting with the biller's office today.  They told me that we only have to pay one 25 dollar co-pay to have these babies.  Including hospital costs, even if it's a c-section.  I asked them to repeat themselves about 3 times, and I still plan to call tomorrow to ask if this is really, really, really true.  They kept saying, "just make sure you pay the $25 when you see the OB or they won't schedule your follow up appointments" as if it was too much.  M-kay.  I practically wept.  I was like, "$25? Come on, how about 5G?". Such is the financial mindset of the self-pay IVFer.  I completely forgot that I actually do have health insurance.  

9 weeks, Back in Business

Our household has been incommunicado for 2 weeks.  I could ramble on and on about why, but I won't.  Okay, just a little... Last year we dropped our landline.  A successful, effective, money saving endeavor overall.  We were happy with our completely wireless existence until...Ver.izon took over All.tel and then got into a local fight with Spr.int about who got to use who's towers and we were very suddenly left out in the cold.  No phones.  No internet.  Panic ensued.  Feeling far too vulnerable, we have now returned to a land line.  We went with another company for our wireless needs.  We are back in business as of today.  The Spr.int guy actually said these words to me, "can't you just wait 2 or 3 more weeks while we fix this problem?"  BWAHAHAHAHA.  BYE-BYE! 

Here are my exciting updates:

1) We graduated from the IVF clinic to the high risk OB clinic, luckily it's in the same building.

2) I had my last progesterone shot last night.  My skin is lumpy and itchy.  Not attractive. 

3) I sleep and eat and that's it.  I love milkshakes.  Not smoothies. Milkshakes. 

4) I have indigestion but no nausea. 

5) I am now referring to the babies as "they" or "the visitors" or "the vees".  As in, "they want chocolate chip pancakes", or, "the visitors want a pickle". 

Our first OB appointment, which is actually a nurse visit, is coming up this week.  Then we meet the actual OB Thanksgiving week or so.  

YAY for everything!!! YAY!!

Vanilla Shakes with Breakfast.

Cymande is home (post-call) and I am at work. I've been given the task of writing a brief hello and to apologize for her lack of posting. We are without internet access at the moment due to an evil verizon plan to destroy alltel, but that is a story for a different time and place. Cymande and I would like to report that the twins are demanding spaghetti at all hours of the night and I was witness to Cymande consuming a vanilla shake at 7am after breakfast. The nausea seems better. The belly is noticeably larger. Things are good. More later.

7 weeks

We had our first ultrasound today at long last.  The verdict? Twins!  We're expecting twins.  They are well placed and have strong heartbeats.  We're really excited.  I keep singing "2 little monkeys jumping on the bed".  I also imagine them in there with little walkie-talkies having conversations like this:

Twin A: "Baby Bird, Baby Bird, come in Baby Bird, do you read me?"

Twin B: "I read you loud and clear Lil' Star." 

Twin A: "Let's arrive at 38 weeks, over."

Twin B: "Copy that, June 2nd, 2010 it is, over."

Twin A: "Let's both be head down for this, over."

Twin B: "Roger wilco. Over and out."

Nah, you're right. They probably don't need walkie-talkies. 

Anyway, I'm super nauseous.  Now the nausea I experience from walking across the room qualifies as motion sickness.  I feel lucky that it's not a 24 hour puke-fest around here especially with twins, but that doesn't ease the nausea.  My sense of smell is in overdrive.  No melted butter.  No peanut butter.  I was into onions, but now not so much.  I purchased some sea bands yesterday which seem to help.  Gregg has renamed them my "wonder bands" because they do remotely resemble Wonder Woman's wristy cuffs.  

I had to buy some maternity clothes today because the belly is bigger already.  I've gained 2 pounds.  The clothing situation was getting dire.  

Here is the ultrasound.  Dr. B couldn't get a good picture of both and I forgot who is who and which side is up.  They're measuring on time and at about .77 cm each.  They have such a long way to go, and a lot could go wrong but I'm still mostly ignoring the poo-poo info about twin gestation.  Que sera, sera.  

6 weeks

"What were you doing in the kitchen at 3:00 this morning?" you might inquire if you were visiting me.  "Why, I was making hard boiled eggs and eating them with caperberries, because we're totally out of pickles",  I would reply.  "Oh, of course!", you would return. 

The motion sickness has reached a new level this week.  I have to carefully consider which car I choose to ride in, whether I'm the driver or not.   The Mini is good because it doesn't have a nauseating new car smell, but the bumpy ride is almost not worth it.  Now the queasy lasts for about an hour after I exit the vehicle.  I rounded at the hospital today and while I received report from the floor nurses the only thing on my mind was, "don't barf on them, because that's not really nice".  It really made me wonder how many times I've been unknowingly in the presence of "one who may vomit on my shoes at any moment".  Probably a lot.  Probably you have as well.  I'm surprised there are not women spewing everywhere at all times a la Stand by Me.  

I've had a couple of brief episodes of moderate quantities of yucky brown sludgy discharge in the past two days, but no cramping and no bright red blood, so Sue said it's okay.  Probably old blood from implantation.  I get to stop my daily aspirin though.  Gregg informed me after this episode that he loved me, but that he needed to move to Puerto Rico for the next 8 months because the stress of worrying about me is starting to qualify him for insanity.  It's funny really because I'm not stressed at all.  I'm just queasy.  The ultrasound is in 8 days.  He says he'll feel better after the ultrasound.  I will too.  It's just that, again, I cannot worry today about something I cannot know until 8 days from now.  I know that the potential exists for us not to see what we think we're going to see and that we will feel really sad if things aren't good.  For now though, I'm just knocked up and so far so good and all of that.

And you know, my pants are getting too tight, which took me a few days to admit to myself.  I refuse to buy bigger clothes and scrubs and stuff at least until the ultrasound.  If it is good, I will invest more on every level, so the pants are just going to have to last another week.  This superstition hasn't stopped me from ogling stuff like knitting patterns and car seats and strollers and cloth diapers online though.  Ah, I just realized  another superstition...I have decided not to start any baby knitting projects until 2nd trimester at least.  Then, if all is well, it's on.  

Oh my god, I just realized that I actually have other superstitions, all blog related.  No widgets unless good ultrasound, no changing "profile" or "about me" info.  No changing the subtitle of GroupSex to "a pregnant after IVF blog".  Nonono.  I guess I'm more with Gregg on the "this is not real or worth planning for until the ultrasound" attitude than I thought.  Oh the damage infertility inflicts...sheesh.  8 more days.  

 

Dear Blog, (or, 5 weeks pregnant)

I'm not sure how to transition from "active IVF cycle blogger" to "pregnant after IVF blogger".  I know this is something that all infertile bloggers go through, so I know that I am normal.  I sort of feel paralyzed right now because I know that the numbers say that I'm pregnant, but I'm not feeling it that much and I often return to a state of disbelief.  I read that all pregnant women feel this way initially and that it's not unique to the formerly infertile.  

So I've been thinking about how to structure the blog if this pregnancy is real (don't laugh, what if it's not?), which I think I will really know on 10/29 when we have our first ultrasound.  

First of all, it might be a boring once a week post unless things are exciting.  Honestly, I hope they are not exciting because no one wants an exciting pregnancy, especially if twins are expected. Second of all , yeah, see "first of all".  See? It's already boring! (hahaha!)

Actually, I do have a few symptoms.  They are sort of boring though.  I have mild motion sickness, which I've never had in my life.  I feel really bad for those who deal with this frequently.  Driving myself doesn't help.  I've begun sleeping really, really well again.  I have slightly puffier, but sore breasts.  The most recent symptom though, which I didn't recognize for a few days, is an insane craving for pizza.  Actually spinach and feta pizza in particular.  I had it for lunch and dinner two days in a row.  When I couldn't get pregnant and fantasized about what I would be like as a pregnant person, I thought my cravings would be root beer and cucumbers.  I'm not sure why.  I really like root beer, and I really like cucumbers so I guess I just figured I would want more of those things.  I woke up this morning thinking anchovies are a really, really good thing to have on pizza and that I should have this for breakfast.  Alas, unavailable.  

Gregg has been hilarious this week.  He won't let me do anything too major.  Giving the stink eye to anyone who could potentially stress me out at work, even if I'm not stressed.  Hovering.  Gazing at me strangely as if I am some new creature who has moved in.  He's not sure what to do with this creature, but he just knows that he wants to protect it from everything.  Honey, it's me.  I'm just pregnant.  You're totally cute and I could cry.  He's more nauseated than I am. 

Christmas Day

Okay.  I get it.  I'm pregnant.  I actually got pretty excited today, for real.  My second beta this morning was 830.

The beta more than doubled and is well over a normal singleton value.  SuperSue said not to be concerned about twins yet because she has seen some ladies have values this high with singletons.  However, the Great Goog says twins.  Everyone with twins says twins.  I'm thinking maybe twins.

I'm just going to ignore twin pregnancy horror stories for now.  

I'm really not sure what everyone else on the planet is going to eat for the next 9 months, because my appetite is planet earth sized.  

The progesterone in oil, I think, or maybe it's pregnancy, has returned epic insomnia to my nights.  Folding laundry, eating, googling terrible twin names...

Now that it's 11 am, I need a nap.  Sleepytime.  Maybe the boobies will enlarge in the next couple of hours.  I've been waiting 3+ years for pregnancy, but about 15 years for knockers I can be proud of, knockers that might actually require a bra!  Now that would be a dream come true. My first real bra.  Awwww...

397

We recently paid some dudes at the University of Florida like 20g to make some embryos.  Then, we allowed one guy to put two of them into my uterus.  We did this with the expressed intention of becoming pregnant.  We did this on purpose.  I went to a bunch of acupuncture sessions and ate a bunch of supplements to actually increase the chances of becoming pregnant.  We are today, for some reason, totally stunned and amazed to find ourselves totally knocked up.  

The beta is 397 today.  The excitement of my family and all of our IF supporters is making my heart explode.  It's awesome.  We're still planning to remain very cautious with our joy because I just don't want to jinx this.  Saturday is our next beta.  Ultrasound on 10/29.  I hope this little star sticks around.  Little stars?  

Christmas Eve

A typical child of the 1980's, I spent some Christmases at my mom's house and some at my dad's. The tradition at my dad's house was that everyone got to open 1 present on Christmas eve. Christmas eve, by the way, was also the main extended family event and lots of people were present, but not many children. Upon one Christmas eve, I must have been 8 or 9 because my younger sister wasn't born yet [1985?], the adults were sitting around after dinner talking and my uncle Gerry began to tell a joke instantly deemed inappropriate for my ears. He was quickly hushed. My dad handed me my one present and when I opened it, it was pajamas. I pouted. My dad laughed and said, "yeah, now go put them on". I knew what was happening. I was being kicked out so that the dirty joke could be told. I already knew that I would be a gutter mouthed adult, so I thought this was unfair. I mean, I was okay with inappropriate jokes, why couldn't the adults get over it too? Sure enough, as I put on my stupid old pajamas, they were hooting and hollering down the hall. So I was annoyed. I was annoyed that my present not only sucked but also that it was used to trick me.

Well. Tomorrow is "official pregnancy test day". The serum beta hcg. It is not unlike Christmas eve.

I'll tell you what though.

This better not be another Christmas eve trick.

The chance that this is a false positive does not seem to exist, but, we're trying to remain calm and realistic. Neither of us are truly believing this unless tomorrow's numbers come back safely high, and then probably we won't even believe it then. More tomorrow. Please jump up and down for me, because I'm afraid to.

9dp3dt

It's official. Gregg is more obsessed than I am about symptoms. He called me twice at work (he was in the other office today) to ask me about them. He also has been holding forth google-style about stats and symptoms and facts in a way only infertile women can. He asked me about the boobies. I told him about the boobies. He asked me if I had any cramping. "Why yes dear, as a matter of fact I do", I said. I also reported the minor spotting I had at work today after which he became nervous. But, you know, spotting...and cramping...not necessarily a bad sign. I'm not getting my hopes up though. Also, I'm essentially 12 days post ovulation, and during my natural cycles, my period usually starts 13 days after ovulation...but this cycle is not my own so I don't really understand much about when the period would come. I mean, are "they" still in control? The progesterone helps stave off the period for a bit, but it's not a sure-fire staver-offer of periods. Hunger and hotflashes and night 2 of insomnia.

2 more days. Actually, sort of 4 more days because they do 2 pregnancy tests 2 days apart to see if the pregnancy hormone is increasing properly.

Deadwood in the dvd player...

8dp3dt

I returned to my virus infested, snot filled work today. It wasn't so bad. The week off has made me a distinctly nicer provider of healthcare. What is really nice about my job though is the lab coat I get to wear. I like it because I can check the boobs pretty inconspicuously. I have to say...they're a little different. I'm also still insanely hungry. I ate 2 lunches today. I invoked the evil goddess insomnia yesterday by pointing out that I have not been having any trouble sleeping...so of course I was up eating and googling from 3am to 5am. The progesterone shots are going well. I have some cute little bruises on my rear. We're hoping for 4 more weeks of this daily shot in the butt stuff. Sexy.

I have decided not to pee on a stick until the morning of the official pregnancy test. I am just not really sure how to deal with the result, so I'm just going with the flow, so to speak. Of course, I reserve the right to change my mind in the next 48 hours.

3 days to go. Then...if we are knocked up, we have to make it through a pregnancy. This is the sobering fact. Positive pregnancy tests don't equal babies sometimes. For now, I like not having to worry about that for a few more days at least.

3 days to go!

7dp3dt

Am I? Am I not? Am I? Am I not? I am. No I'm not. Maybe. Never. Am I? Am I not? What are we going to name them? They don't exist! What are they going to look like? They're not coming! Will it be 2? Will it be 1? What if it's 3 or 4? Am I? Am I not? PEE ON A STICK! DON"T PEE ON A STICK! GO FOR A WALK! DON'T MOVE! Do not laugh too hard. Don't eat so much garlic! Don't sniff that flower! Don't! Do! The grape juice you drank 4 days ago killed 'em for sure. Is that a cramp? Please be a cramp. Boob check. Boob check. Boob check. Whatever you do, don't sneeze, tra-la! They'll come flying out, tra-la!

Yeah. One flew over alright.

Wonderful day yesterday. Gregg took me to Marjorie K. Rawlings' homestead. She's the famous Florida author of "Cross Creek" and "The Yearling" and what not...which I promise to read after I finish my other 3 books. We have been there once before but this time we got a house tour. It was great. Very inspiring. She was from up north too, and became entranced with Florida after visiting one March during orange blossom season. Who wouldn't want to live in an orange grove during blossom season?
Then we went to the best pizza place in the state...Satchel's in Gainesville. I cannot believe we've never been there. It has a five and dime and a salvage yard in the back. If you visit us, you will go there.
Then we went to the movies! We saw the new Ricky Gervais movie which kept me at a low grade giggle for 2 hours. Then we ate ice cream.
It was the best day ever.

My only hopeful symptom really is that I've been sleeping like the dead for the past 3 nights. No insomnia. Epic dreams. I'm not sleepy enough during the day though...not taking my usual naps...so this is probably the explanation.

Boob check.

6dp3dt

Go go gadget defense mechanism. Pessimism. Sobbing. Planning for the next cycle. Mind overcome by insane, irrational heartache. Google says, no symptoms necessary for a positive, Blahblahblah.
Gregg smartly planned a day of fun for us today. I don't know what it includes, but he is so good, I might forget for a moment...
I have to do the sobbing thing this weekend because I go back to work on Monday. Pregnancy test on Thursday. Bracing myself.
urrgggh.

Okay, it's 10 minutes later.

I feel better. Yeah, I'm really, really not supposed to feel anything yet. But I really have to be very clear with myself this weekend...this really may not work. And that's okay. I've got my eye on a gaudy, expensive, totally not my style piece of jewelry that will be mine if this fails. And I sort of like the idea that I may not have to be pregnant in a pediatric office during the H1N1 thing. And I like the idea that my embryos will have forever come from a 32 year old...this means we can hold off on another try for a while...pay off this cycle...go to europe...yes, I will survive if this cycle is a bust.

A-Ok!

Mother nature is so raunchy.

5dp3dt

Oh the obsession. It's in full swing. It's on. It's raging. I woke up at 5:30 am, thristy and hungry for yogurt and dried plums. Why? I am a mere mortal and cannot answer such deep questions. Since I've got nothing better to do at 5:30 am...well...there's the internet. I'm a bit frustrated because I cannot seem to respond to your comments. I apologize for that. I would like the "what is the embryo doing now" thingy that Simple mentioned, can you post the website please? Thank you in advance. I haven't any symptoms. Nary a symptom. Sans symptoms. Nada symptoms. Zilch. Nine. Kine. Nope. However, I read somewhere, probably on another blog, that the average pee on a stick positive in this situation is 10dp3dt. So, I'm not overly concerned. Just. Well. Impatient. And I'm not POASing until at least Sunday...7dp3dt...I think.

4dp3dt

I woke up this morning knowing that the trigger shot has left my body entirely.  I only had to take half of the amount that is usually given because my estrogen was so high, but it still took 9 days to leave my system.  I know it's gone because I slept all night without getting up to pee and my boobies, what little I have, are back to normal.  They don't hurt at all.  I figure that at least I might know if I'm producing real hcg if they start hurting again.  I'm glad to see that people don't have symptoms at this stage.  I so wish that I did.  A cramp.  A poke.  A wave of nausea.  Passing out.  

I am left with one progesterone symptom.  Hunger.  Food is on my mind.  Cupcakes. Ziti with meatballs. Tapioca pudding for some reason.  Steak.  Kale with garlic. Cream of Wheat. Hot chocolate with whipped cream.  I figured I should take my higher iron prenatal.  In spite of this ravenous hunger, I have lost like 10 pound since egg retrieval.  They put 2 liters of fluid in me that day.  Before retrieval I weighed 140 and after 146.  They told me to tell them if I gained 3-5 pounds "over the next few days"...I decided to pretend that they wouldn't care about the 6 pounds I gained that very same day.  Anyway, it's gone now.  I peed gallon upon gallon this week and now I weigh less than when we started this whole thing.  I did not develop ovarian hyperstimulation syndrome. 

Some bloggers do not post embryo pics because if the cycle fails, then the photo won't be there to remind them.  I seriously contemplated this.  I totally get it.  Actually, some clinics don't even give you the photo unless it works.  Right now, having a photo of embryos hanging around the house is kind of cool, even if they don't make it.  It is kind of strange gazing at the photo thinking, "stay, stay!" while also thinking "forget you then!".  I don't know though, I may have an embryo photo burial ceremony to officially let them go if needed...the image will remain on the computer...so complex.  

The embryologist says that these are grade A textbook 8 celled 3 day blastomeres.  She said not to worry about the thick oval shaped zona on the one, it has nothing to do with the 8 cells inside.  It might be that that one is closer to the camera too.  

35th 2ww

I am living proof that one can survive, and even thrive, without internet access for 3 days.  Holy moly... I have not been able to Google queries such as:

1dp3dt symptoms

2dp3dt symptoms

3dp3dt symptoms

when to pee on a stick

how often is it considered sane to pee on a stick

progesterone in oil side effects

when should i feel symptoms

what is a "good" number of blasts to have left to freeze?

early pregnancy symptoms

very early pregnancy symptoms

things to do during the longest 2 weeks of one's life

It's great that I have had 3 unencumbered days of naps, and walks and knitting and reading...

But now, the Goog is back.  I am proud to say that I have not consulted the Google yet on the above questions because I really wanted to communicate our updates.

First of all, 4 of our 14 remaining embryos survived to cryopreservation (freezing).  When I first heard this, I felt a dark, cold panic deep inside my heart.  Then I realized that many couples do not have any embryos make it to this stage.  So we're the lucky ones.  It means we have 2 more chances if the 2 currently residing in my womb opt out.  I have attended the requisite acupuncture and have listened to my hypnotherapy cd diligently daily to encourage both of them to opt in.  Also, I am super glad they did a 3 day transfer instead of a 5 day.  We could have had even  fewer to freeze.  The frozen embryos are known as "frosties".  I like it.

Secondly, I actually don't mind the nightly muscular progesterone in olive oil shots.  Really. The subcutaneous shots were worse I think.  I sit on a heating pad for 5 minutes prior, then I get a shot in the rear and it's no biggie.  I was a bit nervous about this, for no reason turns out.  Clinical me knows that this is because there are not as many nerves in the haunch as the belly... but whatever.  If I'm pregnant, I will have to do this for 6 weeks.  One can dream.

Also, I remember when I didn't know we were having trouble getting pregnant and I saw lingo like "3dp3dt" and had no idea what this could possibly mean.  I a big girl now.  It means "3 days post 3 day transfer".  That's where I'm at.  

How many 2 week waits have I endured on this quest? Around 34.  I should know how to deal with it by now.  I think this is just about my 35th 2 week wait...  That is a bit excessive.  The wait thus far has been rather mellow.  I know that I won't have symptoms until early next week if any at all. 

I peed on a stick to see if the pregnancy hormone used to trigger ovulation was out of my system... it wasn't.  I think that I'll pee on a stick on Sunday (7dp3dt) but I'll see what the Goog says.  The real test isn't until October 8th, next thursday... hey! Only 1 week left to wait...that seems nice.  

I'll post embryo pics tomorrow, in the meantime, here are flowers that sort of look like our embryo picture.  Thank you to all for your support.  

Shooting Stars

Hello, this is Gregg posting because Cymande is home without internet access due to technical difficulties. This post will be mostly free of IVF jargon because I don't really understand it, but let me start with some. We are PUPO (pregnant until proven otherwise.)

Sunday, we arrived at 9 AM for the 3 day transfer. The Russian embryologist presented us with a photo of two grade A embryos that she described as 'textbook.' Our RE explained the procedure and we watched via ultrasound on the big screen. Catheter through the cervial os? Check. Embryos in the catheter? Check. Ready. Set. Go. There was a tiny flash of white microbubbles on the ultrasound and the embryologist exclaimed, "Shooting stars!" She examined the catheter for an embryo that didn't want to leave, but it was clear. So, two embryos in a nice warm uterus. This is the closest we have been to pregnant. Now we wait. We will post the photo as soon as our technical difficulties resolve. PUPO.

Hexadectupletmom

Our 16 are still developing. We're still going for a 3 day transfer of 2 embies tomorrow morning if everything continues well. This is the Valium part I've been so looking forward to! Cool! I have to take it 1 hour prior to the procedure. I'm also on an antibiotic and prednisone which have been harder on my system than the suppression/stimulation meds. My belly is a wreck and I'm back to irritable yet totally psyched. An odd state of mind. We, well I, actually had the energy to go out on the town last night and incidentally got to drive by the embies. We said hello as we drove by and told them we are ready for a couple of them to come now.
Then, Gregg disclosed his, um, his experience in THE BATHROOM on egg retrieval day. The University of Florida's IVF clinic is actually split into 2 centers. The appointments and minor procedures are in a clinic, and the major procedures like egg retrieval and embryo transfer as well as the embryology lab are in the hospital down the road. So on egg retrieval day, Gregg had to do the deed in a new, unknown, secret ejaculation room. He was given a canvas satchel the contents of which were not explained. So, thinking this new room was like the room at the other clinic, he began looking for the, um, porn. He looked in cabinet after cabinet, drawer after drawer until he came upon some movies and he thought, "Eureka!". However, the only movies in the drawer were Cinderella and Dora Goes Undercover. He was pretty sure that the Dora movie was not pornography, but with that title, he just couldn't be 100% sure. So, he put the dvd in the player just to check. Luckily, Dora's integrity is intact. He didn't check the Cinderella dvd, so who knows about her. Then, he realized what was in the canvas valise.

16

We are the proud parents of 16 embryos. I love them dearly already. The fate of the other 8 eggs is really interesting...4 eggs were immature, 3 eggs allowed the sperm in, but didn't really want to get together (they only had 1 polar body) , and 1 egg allowed 2 sperm in (it had 3 polar bodies).
I am in total awe. I'm so excited. I really hope they make it. SuperSueIVFNurseSupreme told me to prepare for a 3 day transfer, which would be Sunday. I am a little disappointed with this because I've read that 5 day blastocyst transfers work a lot better. The risk of the 5 day transfer is that they don't make it to 5 days living in the lab. The risk of the 3 day is that they replace embryos that are destined to expire. I kind of like the Darwin-esque survival of the fittest thing of the 5 day transfer. I guess we've already bucked that whole system though. The clinic is having a team meeting this afternoon and they will sort of decide then. I've read on other blogs that clinics often say to get ready for a 3 day and then change their minds...I hope this is what happens. The clinic feels that the best place for the embryos is my body. I'm going to have to continue to trust this amazing group of people who have come to mean so much to us.
Gregg caught a glimpse of the baby lab yesterday when he was dropping off his goods. He said it was very dark. 16 lil' embryos down there in the dark. 2 anxious parents, fingers crossed. Copious tears.

24

I'll be brief because I'm in a post Demerol "amIasleeporamIawake?" state of being. I gave 24 good looking eggs. I think the embryologists may have by now but sperm and egg together. The future children may exist. We won't know until tomorrow how many embryos we'll have. I'm watching the Darjeeling Ltd., my favorite half conscious on the couch movie. I'm not uncomfortable. I was sort of nervous about what might come out of my mouth under conscious sedation but nothing too strange was said...apparently I asked three times if they gave me the Versed already. By the third time, they were giggling. I actually do remember most of the procedure. As one of the three embryologists cleaned my eggs under the microscope the image was projected on a television above my head. There were 12 people total in the room. We gave the embryologists a bag of chocolate covered espresso beans.
I bravely tried to eat marscapone and amaretto crepes at a nice little restaurant after discharge, but barfed in the bathroom after 3 bites. My glasses fell into the toilet right before I tossed my cookies, so I had to quickly do it in the little rubbish bin. Gregg said he couldn't hear it from where he was sitting and we were the only patrons anyway.
Night night.
24 eggs. Holy cow!

Gatorade is Kinda Yucky

Tomorrow is egg retrieval day! I am super calm. My facebook status even says so. I listened to my IVF hypnosis cd this morning. I'm puttering around with my gigantic ovaries. I'm going to take a nap. I'm going to watch Oprah. I never see daytime television because I'm always at work, so this is exciting. I don't have to give myself any injections today. I just get to chill...that and continue begging the universe with all my heart that this works out while simultaneously thanking it in advance because apparently gratitude is better than begging when it comes to this stuff. I'm hoping for 15 mature eggs and that they all fertilize and that at least 8 embryos make it to day 5. This may be asking a lot, but I'm asking anyway. We are planning to replace 2 embryos if we should be so lucky. I'm became not okay with the elective single embyo transfer [eSet] thing somewhere along the way, just like many others. We have to get up at 4:30 am to get ready and to the hospital for a 7:00 am retrieval. Maybe we'll take pictures.
I decided to make my own version of Gatorade because for the past 3 years of trying to conceive, I have been scrupulously avoiding dyes and flavorings and I really just couldn't stomach the thought of adding them in now, and no one had the clear version (I went to 4 stores!). I did have 1 bottle of lemon-lime in all of the excitement. The recipe for oral rehydration solution (Pedialyte) is easy and cheap to make at home and I recommend it to parents of dehydrated infants nearly daily, but I bought some Target brand solution and some organic apple/grape juice and I made my own super nice Gucci Gatorade. Plus, maybe the apple juice will help me remain regular...as in not constipated. Strangely, this is my primary fear...constipation. I don't want any struggling in the pelvic region. Of course the Pedialyte was in the baby section at Target. I tried not to look at carseats and baby stuff, because it is a dangerous emotional move of the sort I have avoided much like artificial dyes, but, like some kind of addict or indulgent parent, I allowed myself one long look...I gazed upon all of the gear...and thought...maybe this time...oh what joy...(the baby, not the stuff!)

Gatorade

Tonight, I take my final doses of Folistim, Lupron, Ovidrel and dexamethasone. I went in for my appointment this morning and Dr. B gave me a 99.99% chance of triggering ovulation tomorrow! YAY!!! This means egg retrieval on Thursday morning. I calculate that my ovaries are about the size of fists right now. I have lots of follicles and my estrogen is in the high 3000 range. I have to walk funny to accommodate them. That, and the belly pooch and the bruises all together make for a lovely sight.
Actually, I was greeted today in the ultrasound room with, "congratulations on your beautiful, beautiful stimulation". I really tried not to feet like a pageant winner, because I know this may not work, but I grinned widely.
I was also instructed today to begin sipping Gatorade to prevent ovarian hyper-stimulation syndrome [OHSS], a bad outcome involving supergigantic ovaries and sometimes hospitals. The Gatorade apparently keeps my "peripheral fluid" in balance so that my ovaries don't take it all. The coincidence that my IVF clinic is the University of Florida (go Gators) and that UF invented Gatorade is not lost on me. My clinician mind instantly thought, "oh, they are gently suggesting this because you already have an early case." I'm going to let them tell me if they are worried and not try to guess. I'm not even going to look on the Google.
Over the weekend, I got to see the other couples who are cycling with us. There are about 5. One can't help wondering what their stories are. One odd thing really stood out today when we all arrived at the clinic for our labs and ultrasounds...4 out of 5 of us are nurses. Everyone was in scrubs, on the way to work. I thought it was curious and then I realized that (1) it's a recession, and healthcare providers might be the only ones with money to spend on IVF and (2) healthcare providers are probably more likely to seek care for infertility. Interesting.
Another appointment in the morning and then...trigger. Blammo!

I can't seem to get my flower pictures off of my camera right now. I'm bummed, but I get to enjoy Florida's autumn live, which is like a second spring...flowers and butterflies everywhere. The smell coming from the field is heavenly. Sun-warmed grass. mmmm.

Day 7 Follicle Report (and stuff)

Today the news is good on all fronts...the mood has stabilized, for one, and for this we can all be glad.  We went for the estrogen and follicle check this morning, but saw a different doc than usual because it's the weekend and she was the one on call.  My estrogen is now 1912 blahblahs per blahblah on day 7 of Follistim and is therefore nearly doubling daily.  Dr. R  found 32 follicles but before anyone freaks out, the way that I nearly did but didn't because there was an ultrasound "wand", er, where the sun doesn't shine, she said that the small ones don't really count, so I really have 18 meaningful follicles and they're gettin' big.  I now have to go to the clinic every morning.  This means we're getting close.  They may do the egg retrieval on Wednesday.  I can really feel my big ovaries today.  They don't hurt...they're just...present.  I'm sure I'll be bloated before too long.  Yeah, okay, I'm already bloated. 

Follicle Report

Yesterday, I read the article suggested by cousin Kari that is in the comments section and laughed until I cried.  I especially laughed when the author mentions crying while listening to James Taylor, which I just experienced not 1 week ago.  So this morning, on the way to my ultrasound/blood work appointment,  I did not choose James Taylor on the iPod.  Nope. I chose something that would, on a normal day, not make me weepy: Gnarls Barkley.  But, well...these are not normal days.  Yes, that's right, I got weepy when listening to Gnarls Barkley by myself in the car.  Abnormal, I mean, has anyone ever experienced this with Gnarls Barkley?  Anyway, this being Florida, it was raining...the sun was rising too.  I decided to pull off of the highway to go to the bathroom, get gasoline and get myself together at a really charming "Florida Welcome Center" where they sell baby citrus trees which will be confiscated if you try to leave the state with one in your trunk or suitcase and 200 t-shirts for $10 made right here in China.  And then, a rainbow.  At 7 am. A rainbow.  Of course, what happened next? More crying.  Oh the hormonal beauty of it all. 

The Estrogen Report:  542, SuperSueIVFNurseSupreme says, "great!". 

The Follicle Report:  11 on the right, 10 on the left, all still smallish, but also "great!" per Sue.

Next update on Saturday evening.  Yay! 

GRRRRR....

I'm grouchy.  I can totally intellectualize this crankiness though. It's because my estrogen is rising and it's bringing out the feisty female voodoo energy. I decided to have half days at work this week because I didn't think I could keep my cool for 10 hours straight. I'm very happy that I made this decision. My estrogen level is now 126, which is good. I cruised the web to see other people's numbers, and mine seem low, but Dr. B says that as long as it is twice as high as my starting estrogen level, then we're doing really well...and it's 4 times higher...so...I trust it's okay. I thought I was having an ultrasound yesterday, but it's actually tomorrow. I can feel my ovaries taking up more space in my belly...so I'm expecting good numbers.
One of the injections I'm taking, Ovidrel, was made by Dick Cheney and the devil in their shared undisclosed location. Yes, I'm pretty sure about this. The other injections do not hurt. But Ovidrel makes me cry. I made Gregg administer this one because, once again, my arm would not allow me to inject liquid fire into my abdomen. Go figure. I've decided that it's okay to be pissed off that I'm going through IVF even though I chose it. I see the acupuncturist (Dr. D) on Friday. I'm going to have a cup of tea now and chill out.  grrrrr...stay calm...grrrr...

My ovaries better look like this, or else...

Ladies, Start Your Engines

Alright! I made it through suppression without any cysts or surprises.  Dr. B and SuperSue IVF nurse supreme say, "GO!".  So this evening, instead of 1 shot and 2 pills, I will be giving myself 3 shots and 2 pills.  The Lupron will continue at a lower dose so that my ovaries don't get too excited about the microdose Ovidrel and Follistim, which will mimic the LH surge and FSH and stuff...making my ovaries make more eggs.  

I had an appointment a couple of days ago during which they also did a mock transfer.  I was excited because Dr. B said that my uterus is 70mm on the inside, which is a good size if one would like to carry twins to term.  He also said that I have over 20 pre-eggs.  That's cool.  We could be the proud parents of 20 embryos in about 10 days if everything goes well, although I'm not sure I can deal with being the parent of 20 embryos.  Anyway, all of the eggs are not really likely to be perfectly mature...and some will probably not fertilize...and some that do will not make it.  So, honestly, we will probably not be the parents of 20 embryos.  However, if we do start with that many...it means that we probably won't have to repeat this process even if it doesn't work this time.  (Instead, we could do a FET, a frozen embryo transfer. no shots, blahblahblah).

My next appointment is on Tuesday morning.  Blood work and ultrasound every day or every other day.  40 minutes each way translates into lots of singing in the car alone time. 

I'm all about hope and action right now.  I physically cannot worry right now.  I've tried.  It's not there. I've tried thinking about failure, and I can't.  I will when I have to.  Now is go time. Go, go, go!

Lupron Day 5

I'm giving my own shots now, YAY ME! It's not so bad. It still kind of stings and I still get a little itchy after, but it's not so bad. I figured out that if I actually push the needle in slowly (EEEEEEK! Sorry!) it doesn't hurt as much. I don't think Gregg minds not giving the shot. He just watches in mock-horror. I think I had a side effect today...but I'm not sure if it really qualifies...I got grouchy and irrational for like 15 minutes...Gregg wouldn't take the bait, so the mood passed. YAY Gregg! I just can't tell if it was a side effect or is just the stress of the whole IVF situation. I've been listening to this British IVF hypnosis cd every couple of days. Her accent was very funny to me at first, but is now very mellowing. I don't think I can accurately portray the accent in writing...okay, I'll try..."noo eemagine yoorr loosh yootereyne loining..." hysterical...[pun intended].
My suppression check (when Dr. B makes sure he has adequately removed any chance of me ovulating on my own) is on Thursday. He's also going to do a "mock transfer" which is when they sort of map my uterus so that they can see in advance where the correct spot to put the as-yet-non-existent embryos is. Sue the IVF nurse said that Dr. B gets really into it, draws diagrams and everything. Good!
I also am enrolled in a study! It is dependent in the end on if I get pregnant. I hope I'm not breaking any laws by disclosing the study...it doesn't seem like top secret stuff...okay...it's a study of how the cardiovascular system changes in women who get pregnant using IVF versus women who get pregnant naturally. (and if they are studying this, they must already know that there is a difference, and I hope it's not too bad). It involves lots of urinating and blood pressure checks and an echocardiogram (which I get to keep to share with my primary care doctor, who is my boss, a pediatrician, another story). So I get 2G if I get pregnant and can really finish the study. YAY! I still get $250 for the initial part, pregnant or not, so it's a win/win really. It only involves 8 office visits over the course of the pregnancy, no biggie really. When the head researcher (a NP, thank you) took my blood pressure the other day she said that I would probably be at risk for passing out and falling down a lot if I get pregnant because my pre-pregnancy blood pressure is only 100/60 and blood pressures tend to drop (unless you have pre-eclampsia) during pregnancy because the pregnant body has to accommodate so much more blood and blood vessels and stuff. I guess I'll try to find a pro-bono spotter. He or she would be required to stand next to pregnant me and yell "TIMBER!" as I go down whilst also ensuring my safety. Anyway, the study is a benefit of being at a university IVF clinic. Maybe the hypnosis is affecting my blood pressure? Probably.

Undress me, Suppress me: Day 1

I'll take a cocktail of aspirin and dexamethasone followed by a sub-cutaneous injection of Lupron... and the gentleman will have one doxycycline... thank you. Artificial menopause coming right up! Very good.  

I decided that I definitely can not give myself the injection.  I though I could...but no.  The hand will not allow it, the elbow does not move, I trembled.  Besides, Gregg shooting me up is more like "we" are making a baby.  I whined, I'm ashamed to say.  It kind of stung.  There's a little hive. It's sort of itchy.

We had popcorn for dinner. 

I've decided to take some melatonin in case my insomnia kicks into higher gear.  
Is that erythema? No one said erythema.

Big Box O' Meds

Well, il est arrive.  I'm happy to report that the big box o' meds arrived without incident and no one screwed anything up too much, not even me.  My name is misspelled on the Rx...and not even my oft-missspelled first name.  {Is anyone's last name "Baxtra"?}  Anyway, I'm also happy report that the meds cost 1/2 of what I was originally quoted by the clinic.  This is kind of twisted because no one should be happy about 'only' having to pay 1800 bucks for medication. I think the clinic just wanted us to be ready to pay whatever the cost, and highballs the estimate to soften the blow...or something...or maybe some people do have to pay 3500 bucks because they've got more diagnoses then I do and thus, more meds.

Today is our final appointment prior to next Wednesday's start date.  Gregg actually has to have another sperm count (but not a semen analysis....there is a difference) today because of his recent fever.  That's right, it's back to THE BATHROOM for him.  I also have to have a blood pregnancy test  in spite of the fact that I've been on birth control without taking the blank pills for like 2 months and I've been bleeding for like 2 weeks.  Birth control pills are wonderful. Severe nausea and then non-stop bleeding! Lovely!  I have achieved a new level of compassion for the patients to whom I prescribe oral contraceptives. Barf-o-rama! 

Anyway, I feel that I have a duty to post my medication invoice because I know there is someone out there right now trying to squeeze every drop of information about real IVF medication costs from The Google and they aren't having much luck.  I've been there.  I have AvMed health insurance.  They covered some medications.  Guess which ones?  Yeah, the ones that cost under 20 bucks.  So I ended up having to pay 1-4 bucks for meds that originally only cost about 20 bucks.  Thanks AvMed! 

(an aside:  This whole process has periodically brought out the bitter middle classer in me.  Too rich and too poor all at once.  I could write entry after entry about my personal experiences with health insurance companies, but I don't want to become violent. Besides, I've already taken political action by writing to my senators and representatives in support of health insurance reform because those companies are making life miserable for people every single day, including me and many of my patients. So there! Oh darn, I got angry. Phooey! @#%&$#!) (apologies all around)

So...here's the list.  May the Great Goog serve that obsessed infertile well.  I know she's out there. 

Initial Out of Pocket IVF medication cost list for a first time IVF patient with AvMed

Schraft's  Specialty Pharmacy  {a division of Walgreen's} 8/09

Follistim AQ cartridge 300IU $249.00

Follistim AQ cartridge 600IU $498.00

Follistim AQ cartridge 900IU $747.00

Human Chorionic Gonadotropin 10,000 U $44.95

Leuprolide 1mg/0.2 ml (KIT) $99.00

Progesterone in olive oil 50mg/ml (2) $90.00

Ovidrel Micro 2.5 mcg (1) $75.29

Dexamethasone  0.5 mg (22) $4.15

Doxycycline Hyclate 100 mg (20) $4.73

Methylprednisone  4 mg (16) $8.64

Tetracycline 250 mg (16) $2.37

Diazepam  woot woot 10 mg (1) $1.81

syringes (60) $0.00

needles (23) $0.00

GRAND TOTAL $1824.94

Schraft's said they gave me a discount because I'm self pay, but I don't see where it is and when I called to ask, they wouldn't tell me.  I don't understand this, but okay.  They did give me free needles and syringes though.  I did not get a biohazard box, but I guess I could bring my used needles to work and dispose of them in the office's biohazard box, which would not be very nice.  It would be kind of like stealing office supplies because we pay the hazardous waste company by weight.  I'll think on it.  Maybe my IVF clinic will give me one.  I'm sure someone will explain to me why I got 60 syringes and only 23 needles.  

I have been chuckling (or is it cackling?) to myself about one aspect of this medication getting experience....the medications I have to take cost $1822.57, and Gregg? Gregg's medication? $ 2.37.   

BWAAAAHAHAHAHAHAHAHA

Anyway....

I'm breaking my photo protocol. No flower photo, and more than 1 to boot.  Besides showing the impressive pile o' meds, I had to show Schrafts' logo and the cute picture on the bag o' needles which reminds me of my mom for some reason.  Something about pilgrims and bonnets...and also, the image is the nearly absolute antithesis of modernity, of which IVF is the near epitome.  What does Holly Hobby have to do with making humans in a petri dish?  That'll keep me busy for a while.  

           Yup, just waiting for the dumb 'ol stork to bring us a dumb 'ol baby hyukhyukhyuk. 

  Sure, he's cute, but he's a real pill pusher.

So is she.

I wrote this at 4:30 am.  The birth control pills give me nocturnal hot flashes....I can't imagine how I'll be sleeping when the Lupron induced menopause begins....oh crap, I just got nervous.  

T-11 Days

Here we are. Just sitting around waiting for IVF.  I said in my last post that I am feeling a little like this isn't really happening.   Yet today, after counting the actual days until we begin suppression (Lupron shots every day to shut down  my ovaries entirely so that Dr. B can have total control blahblahblah) I have a little flutter of...anticipation. Finally, this seems to be happening. In like 11 days. 11 days.  Can I stand the wait? Will there be disappointment? Further delays?  

We're expecting our "big box o' medications" (as it has come to be known in the IVF community) on Tuesday.  I am having the big box o' meds delivered to my workplace so that I can have total control over them from the minute they arrive within 200 yards of me.  It will take supreme self control not to hover over them every minute until I get them home to my safe...er...I mean fridge...

If I could have a fridge installed onto my person, I would.  And in that fridge? My big box o' meds.  That's right.  

Did you know that there are entities known as "specialty pharmacies"?  I wish I didn't know.  My big box o' meds will come from such a pharmacy.  

I'll post a picture of my big box o' meds this week after injection teaching.  We, 2 seasoned nurse practitioners [winkwink], must be instructed on the administration of these injections.  I'm the patient.  Gregg is the husband of the patient. Sue, IVF nurse supreme and my current number 1 lady, says that nurse patients are the biggest wimps about these injections.  I'll let you know, but i think she's correct. 

We've started watching Battlestar Galactica season 4.5 this week, which has reacquainted me with my obvious cylon origin.  Something about IVF is very...modern. I guess post-modern would be the term.  Maybe post-post modern.  I apologize for obscure references.  

Big box o' meds, coming right up.

Back to Life

Well. I thought this might happen and it did. Gratitude. I am actually very grateful that our cycle got delayed. I had way too much going on this month to also go through IVF. Let me see...lactation exam, cash for clunkers, family reunion, new glasses, new doctor at work, gardening. All big deals for me. And I am tired. Between call and stuff, this is my first free weekend in like 2 months. And did I mention that there are 3 potential hurricanes heading for Florida right this minute? If we were doing egg retrieval this very week as we were originally supposed to, I would be a basket case worrying about power outages and embryologists getting crushed by falling trees and stuff.
Note that I had to write the word "egg" in one sentence and "basket" in the other. This constitutes comedy to me, for some lame reason.  

Also, I almost forgot, Gregg was ill with a virus not unlike H1N1. About a week before he became ill, I said, "honey, maybe we should bank your sperm in case you get a fever which could kill all of your sperm after which we'd have to wait 3 months more to do IVF". He said, "okay", then proceeded to get sick enough to have to stay home for 2 days. My trusty IVF nurse Sue, my IVF guardian really, said that because his fever did not last over 24 hours and he didn't have a fever high enough to induce chills, we're still good to go. I only panicked and google obsessed for about 12 hours about sperm counts decimated by fever. Luckily the flu vaccine arrives at our office in 2 days.
So here I am ready to get ready for IVF, unburdened by all of that other stuff, including fear of influenza.  But, we work in primary care pediatrics, so illness is a constant threat. 
We actually have an official schedule. Come to think of it, the cycle really only got delayed by about 5 weeks. That's better than 8 weeks I guess...if I had to qualify the whole situation. The official cycle start date is September 1. That's when the shut down of my pituitary gland begins. Sounds nice, doesn't it? Egg retrieval (ER) is predicted to be on 9/23 or so which means embryo replacement will be around 9/28.
In the meantime, it's massage and acupuncture and knitting for me.
I'm pretty detached from the whole thing at the moment. It does not seem real. Our medications are getting ordered in one week and our teaching appointment is in 10 days. I'm sure it will all become much more real at that appointment, where they will teach me how to shoot up our life savings.

Game Delay

I have not posted anything lately because I was a bit despondent about a setback in our carefully laid plan to go ahead with our IVF cycle.
I have written a few entries, but just couldn't get it together to put them up.
The suppression phase of our cycle was due to start next Monday, incidentally the same day I'm sitting for the apparently difficult to pass Lactation Consultant exam.
Unfortunately, shortly after I began the "birth control lead-in" I developed a medium-sized ovarian cyst. I've never had one before to my knowledge. It is not something to be concerned about for the average lady, but it can interfere with ovarian hyper-stimulation. So...our cycle has been moved 4-8 weeks into the future. The date is sort of wishy-washy because we cannot really control when the cyst resolves or ruptures. The birth control should actually fix the cyst.
This sucks, but we're nearly over it now...I mean, we've waited this long, what's 2 MORE months? And of course...."EVERYTHING HAPPENS FOR A REASON...." ARRGGGHHH. Well the reason for this better be damn good. Here are a couple of reasons acceptable to us:

(1) I'm not one for wishing for natural disasters, but we're mid-hurricane season here. Maybe if we were to remain on our original schedule, a hurricane was planning to come and knock out power for a week the result of which would have been the loss of $3,500 worth of medications.
(2) Maybe the universe wants me to get a flu vaccine first; They arrive in late August.
(3) The universe wanted to give us several more chances to both play and win powerball.

Soon I'll post my angsty entries about teen pregnancy and our recent insurance change, and our exciting purchase this weekend of a station wagon. (Which may be overly hopeful but hey, we have 2 dogs and 2 kayaks...station wagons aren't only for parents).
I'm just taking this one day at a time for now...one foot in front of the other.

The Elusive 'Male Perspective'

I've been told the male perspective on infertility is under-documented and elusive. I will likely only muddy the already murky waters, but I can assure you that I am both a male and that I have a perspective on infertility. That perspecitive can be summarized as follows:

1. It sucks. It sucks entirely and with every resonating cell of your body. It pervades work, family, leisure, sleep, eating and of course one's salary. That being stated, my experience is a fraction of my wife's exerience. I need only masturbate in a cup. She gets her fallopian tubes pumped with radioactive dye; she gets exploratory surgery of her abdomen; she gets to enjoy daily injections of medications that send her body into a endocrine roller coaster culminating in a needle aspiration through her vaginal wall of mature eggs, then several days after the needle aspiration she hopefully gets the blastocyst deposited in her uterus via a tube, and procedure is just through the cervical os, but hey, that's the fun part. Sometimes I need to remind myself that most people have sex and get pregnant. Again, I'm not complaining about my role which mostly involves a bathroom, a cup and pornography.

2. Assvice: "Relax. You just need to relax. I will just happen." Well, stupidly we DID relax for 22 months at which time our Reproductive Endocrinologist said we basically had no chance in hell of getting pregnant. But even smart people say stupid things when they don't know what to say. Stupid is not better than nothing. Thank you to all the people that said nothing or just asked simple questions and didn't feel the need to give assvice.

3. To the idiot quasi-mystic nursing assisant ('Oh, she is really good at this') that would try to diagnose my wife's impending pregnancy with her proclaimed psychic powers every time she rounded at the hospital: Your powers don't exist! She didn't get pregnant! No matter what kind of mystic body language you expressed everytime you saw her! You have no special powers! You should stop doing this because it might actually hurt someone. And by the way guessing that someone is pregnant when they are obviously trying is a bit like shooting fish in a bucket...unless that fish is impervious to bullets which is our case.

4. To the state of Florida and the general attitude of insurance companies towards IVF: News bulletin...infertility is a disease. It's really NOT amusing how most states and insurance companies will allow me to prescribe hundreds of thousands of dollars on medications for diabetes or hypertension for people that don't care for themselves. I guess me paying into the system for 10 years was to reward people that eat and smoke themselves into a pile of vile toxic fat. Which leads me to my next point.

5. My wife and I work as pediatric NP's in rural North Florida and get to see the best and worst of humanity. After 5 years I've become a bit intollerant of pregnant women who have absolutely no plan for the future. They have no idea they are pregnant. They smoke. They drink. They do drugs. Civilized cultures plan for babies whether in San Francisco or Uganda. The only plan here is ensuring that grandma will parent their child so they can continue their perpetual adolescence. I'm not even going to discuss fathers because discussing them would mean that they can be accounted for. The only evidence of men is that a human was concieved. We planned. We have a safe thoughtful home with a long term plan. They are getting pregnant like farm animals. We are not.

6. I think my wife's fallopian tubes should be bigger. I also think someone should design a cheap at home version of IVF or an over-the-counter balloon fallopian tuboplasty.

7. I'm amazed that the RE's office is so well run. From the front staff to the lab to nursing and to Dr.B everyone has been in top form at every office visit. Considering the level of stress they deal with and trying to accomodate the crowd of educated upper-middleclass infertiles with unlimited internet access...well they do a damn good job. They are patient and chipper and don't seem to suffer from empathy fatigue. If the clinic wasn't so well run I think we would probably be much unhappier with this experience.

8. If this big ol' IVF experiment ends without a pregnancy then we will pay off the debt and set out to complete the list of 'Fulfillment Through Material Goods' that Cymande wrote about. We have a plan, we don't intend to do this for the next decade if it isn't working. Lake Como is no substitution for parenthood, but ravioli caprino with a generous glass of 2001 Luce could totally distract me for the afternoon.

9. Here is my assvice to responsible future parents: If you are waiting 5 or 10 years to have kids because (insert reason)...don't wait. Start now. Plans be damned.

10. Lastly, I don't believe in ghosts, voodoo, magic, gods of any sort, and I don't believe that "IVF is not natural." I don't believe this because I don't entertain the supernatural. There is nothing supernatural about not being able to concieve. There are no immaculate conceptions or immaculate non-conceptions. Nature will not be corrupted anymore than nature has corrupted us. There was no punishment from god; there was no hex or curse; nature didn't decide to reduce the population. Appendicitis can be cured and I suppose we could decide that surviving appendicitis is a choice and treating it unnatural, but I'm not willing to join that cult. Yet.

Love, Gregg