I was happy....for about 5 minutes

So u/s today.....I saw a sonographer that I had never met before and she was not very warm and fuzzy. When the image came up on the screen I immediately saw the sac, and the flicker. I was overwhelmed and thrilled. C and I held hands, so happy that our worries were for not - UNTIL the RE came in. He asked how I was doing, I said "I'm great now". Then he goes into a little sidebar with the sonographer. They talk about gestational sac size and crown to rump length, which are all just fine...this clinic doesn't really give out specifics very freely so I just typically take the no news is good news approach when it comes to statistics. Then we get to the heartbeat. It is 97. NOT good. It seems silly and maybe even trivial, but they wanted to see it over 100. So back for another u/s next week. Which is going to be tricky with my work schedule. They said I could be seen in 7-10 days...hello! How could I wait 10 days? So right now my appointment is for next Friday, but it might get bumped due to lots of retrievals that day. If Friday is a go, then I have to do some fancy rescheduling with work - I'll work on that tomorrow.

As I left the u/s room I ran into both of the IVF nurses that I have worked with, they were very supportive, but not saying terribly optimistic things. I got "at least you got pregnant" and "maybe things with turn around next week". I have no idea what to think right now. 3 beats per minute off doesn't seem like much to warrant such a dismal outlook, but that is the impression I was getting from the IF team.

Unfortunately we had to take my daughter to the appointment. I have never done it before and will do everything I can from doing it again, there was just no other choice. Luckily the clinic is not crawling with infertiles, I rarely see anyone else when I go. And the clinic shares the space with the regular OB clinic, so the place is lousy with pregnant women. Anyway, we have not talked about the pregnancy with her in weeks, but when she walked into the u/s room (I was already there seated with a sheet over my lap) she blurts out "are you having a baby?" Before the RE came in the room (and we were still happy) we pointed to the screen and showed her the baby. So all afternoon she has been pulling up my shirt and asking where the baby is. Boy do I regret saying ANYTHING to her earlier - and you can't just take something like that back.

So off to work tomorrow, I'm hoping that nobody comes up and congratulates me...I know that I won't be able to hold it together.

Back to worry and anticipation

So the last week has been somewhat of a blur. I have been trying to keep myself (read: my head) occupied and away from Dr. Google. We had a little family outing over the weekend to an amusement park that is just for little kids (Z will be 4 in a few short weeks). We had a blast and I saw a part of New England that I hadn't seen before. The White Mountains are truly spectacular and we are already planning our next trip up there before the end of the summer.

I've been struggling with my emotions and optimism this week. The "bump" and the lack of a definitive gestational or yolk sac is freaking me out. The radiology report also mentioned that the pocket appeared to have "collapsed" in the middle - that surely doesn't sound good. I did phone my IVF nurse and talked with her briefly. Although she didn't say anything along the lines of "don't worry about it, I'm sure it will be fine"....which was the answer I was fishing for. She did say at least one reassuring thing: embryonic development happens so fast this early in the game that an u/s done in the morning might not show anything, but an u/s that same afternoon might show something completely different.

I have been able to remain relatively calm. I am actually confident that I am pregnant. I don't think that my betas would have risen like they did if the pocket on the ultrasound was just fluid (which was a possibility also outlined in the radiology report). BUT, my fear right now is that there is some structural or chromosomal abnormalities that will prevent this pregnancy from resulting in a real live baby. Friday morning's ultrasound is huge. We will be out of limbo one way or another. I will be 7w1d at that time so they should see something. I've let my mind wander to the possibility of needing to make a decision about another round. I know it seems like a no brainer to do another, but truthfully I don't know if we would.

In other news, the cat is totally out of the bag all over town and work. Yesterday someone who I don't even really talk with all that much congratulated me. I was so taken a back, I had no idea what to say. I didn't want to deny it, but I also didn't want just say "thank you" and let it spread further. I ended up saying that nothing was certain yet and we were waiting for another u/s before we got too excited. She apologized and said that she was under the impression that "everyone knew". I have no idea where the leak happened. I can only imagine that someone overhead a conversation I had with my friend from work who also went through IVF. There are 4 people who I have told at work, and I know that none of them would say anything. I guess I'm not really angry....I'm trying to push anger out of my life right now anyway....but I'm disappointed that I was not able to tell people on my terms. Which wouldn't have been for a few more weeks. I suppose this is what I can except working in an environment of 95% women. I dread having people come up to me at work on Saturday and say "congratulations" if we get bad news on Friday. This is just bad timing.

Me and my bump

Isn't a bump what everyone wants? I hear it so many times now with the celebrity "bump watch". My bump is not making me happy. As every hour goes by I am growing more worried. My ultrasound was yesterday at 5w5d. I was reassured before they even started the scan that all they were looking for was "how many and where". They didn't expect to see anything else. The APRN was in with the u/s tech to point out on the screen what I was looking at. Pretty early into the ultrasound the APRN says to the tech "are you seeing that bump?" Oh, no, please....let this be just a normal boring early ultrasound. I get the "it's probably nothing, we'll know more what we are looking at during the next ultrasound" speech. So I have to wait until next Friday the 20th.

So in the meantime, I check out my office notes for the ultrasound (because I have access to my own medical record), and get an official name for what they were seeing - a chorionic bump. In the notes it also says that there is not definite yoke sac or fetal pole, but from what I understand it can still be a little early to see that - am I wrong? The office note said that the gestational sac may just be fluid....

Just to add to my distress I decided to google "chorionic bump" and I came across an abstract from research that my clinic was involved in, including my specific RE. Here is the name of the article: A First-Trimester Pregnancy Sonographic Finding Associated With a Guarded Prognosis. Well THAT doesn't sound good. Here are some nuggets of information from the article:

Results. The difference in outcomes between the patients with bumps and the healthy control subjects was statistically significant (7 live births versus 13 live births; P < .03), but the difference in outcomes between the patients with bumps and infertility control subjects was not statistically significant (7 live births versus 11 live births; P = .1). Conclusions. The finding of a chorionic bump on the first-trimester sonogram is associated with a guarded prognosis for the early pregnancy (live birth rate <50%);>

So now I have THAT rattling around in my head. I'm going to have to keep myself extremely busy between now and next Friday, otherwise I will go out of my mind. I keep on trying to reassure myself that fluid would not cause the rise in hCG that I have. I've been told that with the rise in my betas it is a good indication of viable pregnancy....so that can't JUST be fluid, can it? C thinks that we got too excited too fast about the pregnancy. I know that this is all completely out of our hands now, there is nothing that I can do to change the outcome. I suppose it is back to just a waiting game. A game that I have been playing for a very long time, but I still suck.

Scared and happy

I've decided that it is possible to be scared to death and thrilled at the same time. My beta yesterday was 950 (I think....isn't that funny after obsessing for so long about numbers I can't remember this exact one). All I know is that it doubled in 48 hours and the clinic is pleased. Right now that is all that really matters....except that lurking fear that it is ONLY doubling. It seems that there are so many more women out there with much higher betas at this point (yesterday I was 20dpo). Anyway, I go back for what will hopefully will be the last beta tomorrow, then ultrasound at 8:00am on Tuesday.

I've allowed myself to pull out my two pregnancy books and start re-reading them. I went into the attic and took inventory of my maternity clothes - I'm definitely going to need some more pants. And I have begun the wonderings of what we are going to do with the spare bedroom. I haven't done anything crazy like actually BUY anything, but I have been looking. It will be quite a while before I am that confident to make a purchase. Now all that sounds very well and optimistic, right? Well, then there is the flip side. I can't say the words "I'm pregnant" without the sidebar of "at least for the moment". Most of our talks about the future start off with a big "IF". C knocks on wood (literally) whenever we speak about the idea of another pair of footsteps around the house. We had made plans to go to Disney this fall (I would be 24 weeks). The trip was going to be a big one - I would be off for 12 days. We would drive down and stop in Atlanta to see C's sister, then spend on full week in Orlando. My parents have a time share that has 2-3 bedrooms, a full kitchen and a pool that is 1.5 acres. There are so many unknown factors right now, physically and financially, that I'm not sure it is going to happen. Anyone have an opinion about Disney in October at 5 months pregnant?

I am also very nervous about the actual delivery. Z's delivery turned into a bit of a nightmare. I was 9.5 cm at 11am and delivered (by c-section) at 7:20 pm. I pushed for at least 4 hours. So now I am faced with the decision on whether or not to TOLAC (trial of labor after cesarean) and where to deliver. I feel a strong bond with the small hospital that I just left and it is only 25 minutes away, but they do not have anesthesia in house 24 hours a day, so if we needed to go to a c-section it might be delayed, which is scary. The standard is "30 minutes from decision to incision", but 30 minutes can be a lifetime when the shit is hitting the fan. The hospital where I am now is over an hour away and I don't care for about 1/2 of the attending physicians, but I could be seen by a midwife and anesthesia is right there all the time. Someone told me the fastest c-section they ever saw was 9 minutes from decision to baby. That is extremely reassuring. But the hour drive in late January/early February makes me nervous. I have until the 20th of June to pick a provider.

So, I'm trying to stay in the moment and be happy, even added a baby ticker, although it is low on my sidebar. But I am also focusing on keeping my feet on the ground in the reality that all of these wonderings may be a moot point. I'll move that ticker up the sidebar as my confidence in the outcome increases.

My new favorite number...

...is 427. That is today's beta. In the words of my IVF nurse "it's marvelous". I will repeat my beta again on Wednesday. I am to call today to schedule an early OB ultrasound for either the 10th or the 11th. I am trying to remain calm and reserved on the outside but on the inside it is one constant "yippeeee".

Cautious....but VERY happy!

I've been avoiding blogging... not really sure why...because I have good news! I've been waiting so long to post this....I can officially add a BFP to my labels! My beta on the 27th was, well 27. 2nd beta yesterday was 97 - we've got tripling! I've been hearing "congratulations" each time the RN calls with my results, but when I press her a little for her impression she says that she is "cautiously optimistic"- a term that I think should be trade marked in this infertility industry.

I have to say, if I let my guard down, I have a good feeling about this. I have been feeling both ill and starving. I can't seem to get enough sleep and my bbs are huge! Except - yesterday I started spotting. Now I know this could just be implantation bleeding, especially since is seems to have stopped for the moment. But seeing any kind of blood is disconcerting. I have let myself look at my pregnancy book and I've even gone so far as to take a mental inventory of the maternity clothes that I have stashed in the attic. We told close family last night, but explained that we will continue to hold our breath for several more weeks...if not months. After the second beta, C let his guard down a little too and it was such a relief to see some raw emotion from him. He has not wanted to get his hopes up about any of this (he hasn't been pessimistic, just sort of middle of the road).

So, next beta is Monday, then possibly another one on Wednesday. The RN wanted to know what my work schedule was for the following week (week of the 9th) for an ultrasound. For now I am enjoying the change of pace - now I am googling pregnancy symptoms and beta results as opposed to side effects of menopur and 3dt vs 5dt. I am now looking at tickers and baby count downs and wondering - which one will I choose?

*addendum : I missed my blogiversary (sp?). I started blogging May 25th last year. Truthfully I never thought I would make it this long - for one reason or another. In honor of such an auspicious occasion, (both one year of blogging and the fact that at this very moment I am PREGNANT) I have decided to revamp my blog. The picture at the top is one that I took several years ago and is one of my favorites. I hope that seeing it frequently will remind me to get out there and do some of the things that have been missing in my life.

Vertical

I am finally feeling up to sitting and even walking around without the need to brace my belly. I made a phone call to the clinic this morning as I was starting to get a little worried about OHSS. My pain for the last couple of days was high in my belly, almost to my ribs. I have been taking the Tylenol #3 pretty regularly to get some much needed rest.

11-12 (the RN was exactly sure) of my 14 eggs fertilized - yea! We will be doing a 5dt tomorrow at 11:30. I've got to remember to go easy on the water as I tend to take "full bladder" a little bit too literally. Even the RE during the mock transfer said "whoa, not THAT full". My clinic is not very forthright with information on embryo development, I guess I thought I would get an update to see how many are still hanging on. When I asked my nurse this morning if she had heard anything about how they were doing, she dashed over to the lab and came back with a vague response of "they are doing well and growing fine". hmmmm....hopefully I will find out the stats on all of them tomorrow.

We are planning on transferring no more that 2. Even though I know that multiples are a risk, they scare me. We have had a child together already - no interventions needed - so I am operating under the hope that these embryos will be happy to be back home and snuggle in with wild abandon. Delusional, maybe - but most of all hopeful. Anyone out there that is nearing 40 with an opinion about how many to transfer?

Curse of the Nurse

Get comfy, this could potentially be a very long post...one that I will probably have to do in shifts as I am remarkably sore.

Let's start with a couple of days ago. I had a massage a while ago, this woman as it turns out is primarily a therapist but does various types of bodywork to compliment her therapy. My massage session turned into a cranio-sacral session plus some energy work. I went for a follow up on Tuesday, expecting to continue with the work that we did last time. All it took was a simple "so how are you doing?" that prompted me to burst into tears. Next thing I know I am talking about my friends death from almost 4 years ago. She gently suggests that maybe the focus of our sessions should be emotional health with bodywork as an adjunct. Sounded perfect to me. During the session, a recurrent theme of fear surfaced. By the end, I felt like I had let go of some of those fears. Then, the most amazing thing happened. With some of the fear out of the way, I was actually able to let in hope and joy. For the first time during this cycle, I was able to say (out loud even) that I was looking forward to the outcome, that I had hope, REAL hope, that we might have another baby.

Fast forward to today - retrieval day. We left the house at 6:10 to be seated in the waiting room by 7:30. Anesthesia shows up 8 to start my IV and give me the good stuff. Three IV attempts later and I have some fluids running in and the meds were quickly to follow. Next thing I know I am waking up and the process of recovery begins. After about an hour I'm feeling woozy, but pretty good. C wants me to go into "assist" him with his specimen so we don't have another "incident". Finally around 10:00, we are ready to leave. C goes to get the car and bring it around front. I politely decline being taken out in a wheelchair. I go downstairs and almost immediately start to feel pretty awful. I feel like I am going to pass out and/or throw up. I dash over to the security guard and ask him to tell me husband that I had to go back upstairs. Now I'm back in the procedure room and my blood pressure is 89/43 - crap. Then the pain kicks in. The crazy thing is that the pain is in my right back - like kidney area - and it is sharp! They do a very thorough transvaginal u/s, (which is a special treat after retrieval) and in the middle of the scan the sonographer says to the nurse "can you go get the doctor" - well that is never a good thing to hear, is it? Turns out I had some internal bleeding. I got another IV (only 2 attempts this time), more fluids, blood work in preparation for the possibility of going to the OR. The doctor prepares me that I may need to be admitted for observation and pain control. So then I sit, or lay there rather for hours. I was able to doze a little, but with the blood pressure cuff going off in regular intervals, I can't say that I got much sleep. C left for a while to get something to eat, I didn't want to here about it as I had not eaten since 6pm and they were keeping me NPO just in case we had to go to the OR. When C returned he flipped out a little because my diastolic pressure was 54 and the machine was alarming. The nurse in me told him not to worry, my pulse was not rising so I was pretty sure I wasn't bleeding out, so I showed him which button to push to silence the alarm.

Finally around 1:00 I turned a corner and felt completely pain free. I had to stay until some lab work comes back, but I was finally discharged around 3:30. The nurse said the good news about planning on doing a 5dt is that my innards should be recovered by then. I just hope we can make it until then. On the way home I am so hungry that I could eat the seat of the car. I restrained myself and we stopped for some good ol' comfort food.

So the good news in all of this is: 14 eggs retrieved.! Not sure how many are mature, will find that out tomorrow with the fert report. I'm planning on 2 full days of laying low and regular Tylenol #3.

Lessons

I've been obsessed with message boards lately, and find myself a little negligent on posting on my blog. Let's see, where am I in the stim process? Today I reduced my dose to 2 Men.opur and 150 Folli.stim in the evening only and 5 units Lu.pron in the am. My u/s on the first was good enough for me to bypass blood work that day. My lining was thin, and there were follicles waiting in the wings. My next appointment is Friday u/s and b/w. At my previous ultrasound the tech asked if it was ok if one of the residents came in and scanned me after she did....hmmm....did I mention that I work pretty closely with the residents? Unfortunately it was the only male resident in the program and I don't really know him all that well. So I am trying to formulate an answer that really should not be that difficult - yes or no. But here is my predicament: I plan on refusing having residents do any procedural work that may directly affect the outcome of retrieval or transfer. So after a tremendously long pause, I say "yes", because just doing a scan is not going to affect the outcome.

I am learning so much from being the one on the bed versus the one at bedside. My first lesson is that IM injections REALLY SUCK, and when at all possible give one in the hip (as opposed to the arm or leg). The next lesson I think that I am already good at, but I definitely need to keep in mind what it is like when two caregivers are standing at bedside and talking about the patient as if she was not there. This happened when the resident took over the wand. At one point they pointed out how my retroverted uterus was pushing my ovaries out of the way, but they were going exactly where they should. I spoke up and said "that is the nicest thing anyone has said to me all day". They both stopped, I believe they were shocked that this object on the table with wand up her chickie was talking! But then everyone laughed.

There is another lesson out there. One that does not have an outcome yet. C and I got into a huge fight the other day, and I believe there is still tension in the air - I will know more in a few minutes when he comes home. I will make a very long story as short as I can: C still needs to go in for freezing of his man juice. The timing is sensitive because he has to be "activity" free for 2-5 days before the freeze and before ER. ER is possibly mid next week. When I asked when his appointment was for the freezing he told me "next week some time". He went on to explain that he had a lot of things on his plate right now.....I hit the roof. I freaked a little and told him that no matter what else was going on, this needs to be our priority for the next 2 weeks. I don't get why he doesn't understand the timing of all of the procedures for the next week or so. I also wish that he had just taken care of this a few weeks ago so this wouldn't be an issue. I was at work when we had this conversation and was starting to stew...so I called back to find out what needs to be different in our communication for him to be more aware of appointments etc. The conversation ended very unresolved. C said that he had to "think about it" and he would get back to me.

*update* So when he came home tonight, he had brought me a peanut butter chocolate chip cookie. We have not talked specifically about the above conversation - frankly I'm not really in the mood to get into it. I've gained 4 pounds since Saturday, although it could very well be from the cookies I've been indulging in "because I deserve it". I'm a little worried that I'm not feeling bloated enough and that my ovaries are not plumping like they should.

Freakin' clomid

AF finally showed on Monday. I was starting to get a little worried. RE said that AF would probably be light - yeah, not so much. (TMI ahead) And what is worse is that is that same clomid brown particulate type of flow. I have been reassured that my lining will be closely monitored and adjusted with meds, but the more I think about it, the more I wonder if this is the source of our problems for the last year (plus) - too much freakin' clomid!

I have an u/s an b/w tomorrow morning, then I will sit in class for 8 hours. I'm looking forward to not being on the unit tomorrow. It has been nuts and I need a little break.

Now, tell me how twisted this is: the other day I took care of a patient who had major substance abuse issues, including during pregnancy. Her baby was delivered prematurely, but even for being premature was small for gestational age (less than 2 lbs). Now, here comes the sick part - did I get emotional about this? - no. Did I start to cry when I overhear a coworker that I barely know tell someone that they just found out she is having a boy? - yes. What is that all about?

I decreased Lupron to 10 units today - thank goodness!

Struggle

I opened up a fortune cookie today that said "Struggle as hard as you can for whatever you believe in". It was just the right phrase at the right moment. I never thought that I would have such doubts about an IVF cycle once I was in the middle of it. Usually once I make a decision, I am committed and I don't look back. Not the case this time around. I've actually even questioned whether or not we would do another cyle after this one. Now, doesn't that seem a little silly after changing jobs strictly for the IVF benefits?

Lupron sucks. The headaches, the moodiness - I could do without it! C has really stepped up to the plate and been so helpful with my morning injections. We did not go to an injection class because I do this all the time. So I have had to talk him through drawing up the medication. The first day he almost wiped the needle with the alcohol swab instead of the top of the vial! I've done all the injections so far....but will definitely need his help for the IM shots that start next weekend.

I went to a funeral yesterday. My dear friend and co-worker lost her long battle with breast cancer. The last time I talked with her she was doing pretty well. She had stopped chemo and the tumors were shrinking. She suddenly stopped communication. I didn't push it because she has always been such a private person. I have so many regrets of not pushing harder to be there for her at the end. The funeral was heartbreaking. Her daughter-in-law is pregnant and due in August - she really wanted to be around to see her second grandchild. During the graveside service the minister read a letter that my friend had written to her first grandchild on the day she was born. The whole situation was no place for an infertile on lupron.....I was a mess. I didn't even go back to the house after the service, every time I opened my mouth I was bawling and I didn't figure her family needed that around.

....it must be the Lupron

...or am I just in a REALLY bad mood? This morning was my first Lupron (20 units), done covertly in brother's house at 6:30 am. I awoke at 4am, thinking that I had over slept and could not for the life of me get back to sleep. The rest of the morning was mayhem. My parents left early, and my brother's family spent the morning getting ready for one of my niece's cheerleading competitions. I snuck out thinking that getting back home early would be a great idea - that I could spend all of this quality time with C.

Instead I walk in the house and immediately feel a black cloud hovering over me. I am completely over critical of EVERYthing that C has done (or not done, rather) in my absence. The day I left I had asked him if he had read through the folder the RE's office gave us. "Not yet", was his reply. Not yet? Not YET? When would be a good time then? Maybe next month when all of this is over?!!! A few weeks ago he told the psychologist (mandated session for our clinic) that he was going to do more research and ask more questions about this process. I was so happy to hear him take on some responsibility and make an effort to learn about this journey without me spoon feeding him information. Has he done any of that? - not yet. Did he ask me about my first injection? Not yet. I've lost nearly 20 pounds since the beginning of the year because the RE said it would improve my fertility. Has C started his exercise program to do the same? Not yet.

It is completely impossible for me to express how I'm feeling to him right now without verbally ripping off his head. Is this Lupron rage (already?), or am I just over tired and over stressed?

Thank you all for the comments. I haven't gotten around to individual blogs just yet as it has been a very busy week. But I just wanted to acknowledge how much your support means to me!

Right of passage

Meds came today so I felt I had to do the picture.....

I thought that I would be giddy. Instead I look at all of those boxes and the only thing that goes through my mind is: "surely I didn't get enough needles". No matter, I can always get more from work. I don't start Lupron until next Sunday, so right now all the meds are in the basement. They'll stay there until I can figure out how I am going to organize them upstairs away from curious little hands.

I also received in the mail today a baby shower thank you note from my cousin's wife who is pregnant with IVF twins. She included her email and an extra note letting me know that she is there for me if I need support - amazing considering that I've only seen her twice.

Not too much else to say. Thank you for the input about 3 vs 5 day transfers. I guess we will just see how it goes - how many eggs, how many fertilize and if it looks like there will be 2 that will make it to 5 days. I keep on reminding myself that I just need to take this one day at a time - not an easy task for someone who likes to have a plan. My RE told me that I needed to find some way to have some peace in my life. I took that as a prescription for a massage and made an appointment today.

Naps

So apparently today's meeting with the RE and IVF nurse was a bit more emotionally taxing than I had expected - as evidenced by my 1 hour nap on the way home and my husband's nap once we got home!

Nothing terribly exciting discussed today other than protocol and dates of upcoming appointments. I will by on 20u of Lupron, then 10u then 5u. I start menopur and 150 of Follistim am and pm on May3. Ultrasounds on May 1st and 9th. We discussed 3 day vs 5 day transfer and number of embryos. From everything that I have read 5 day blast transfer is preferred primarily because you don't have to transfer as many embryos, thus decreasing the risk for multiples. My RE said that they usually do 3 day transfers and that there is no difference in pregnancy rates with 3 vs 5 day transfer. Of course we will see how things go and possibly convert to 3 day. Does anyone have any input? My RE said she would do whatever I wanted. I am walking that line between trying to be my own health advocate and trusting that the doctors do this all the time and know what they are doing.

We didn't get any formal injection training as I do them all the time. My husband is a little too excited about giving me the IM injections. I will be out of town for my first Lupron shot, so it will be all me.

The RE isn't worried about my FSH =10 during the clomid challenge. Although she did say several times that my age was more of a concern than anything else. Both the RE and RN were ver bubbly and attentive today - which has been a bit of a change from the last couple of visits. We left feeling very reassured, but apparently tired.

I'm on my way

So yesterday was cd 1. And with that comes a whirlwind of emotions. First there is the ever looming sadness as of course I thought that this would be the month that we would get our BFP and not need all of this silly IVF business. But I could only greive this briefly as now it is time to make a plan for the next few weeks, check schedules and get all hormoned up. So here is the tentative schedule:

BCPs (started yesterday) until April 22
Start Lupron on April 20
Baseline u/s on May 1
Gonadotropins May3
u/s May 9
ER/ET week of May 12

I talked to the person in charge of my orientation as soon as I got these dates and I will be working from home the week of the 12th doing a self study education thingy. How awesome is that?

This morning I awoke with a MONSTER headache. I don't know if it is the lack of sleep, the stress (I've developed what I think is a stress related eye tick!), my lack of morning coffee, or the dramatic change in the weather.

I'm off to rest and will my headache away. This will be followed by a massive house cleaning effort if the headache goes away.

Comments, protocols and a birthday party

So I've turned on the "moderate comments" button. Never in a million years would I think that my little blog would turn into the internet's version of telemarketing. Okay, so I've only had two comments like that, but it is still a little disturbing.



Last weekend I went to the birthday party of one of my best friend's little girl. This of course is the little girl that was conceived 6 months after we first started trying. In some ways time is passing so quickly. Of course when it comes to getting going with this first IVF, it is taking forever! I have been off clomid for several months and my cycle had just started to get regular again - 28 days on the nose. Then we throw in a clomid challenge this month and just because I had them laying around the house I did OPKs this month as well. Unfortunately I didn't have enough OPKs to make a pin point determination about when I surged, but I think I am on a 32 day cycle this month.



I don't have my protocol yet, all I know is my IVF nurse told me it would be about 7 weeks from AF to ET. The only thing I know for sure is BCPs starting cd 1-3 and lasting for about 3 weeks. I am expecting a lot during the meeting next Wed with the RE. We don't know meds or cost (even though everything will be covered, we have to pay for the meds out of pocket then get reimbursed). Frankly, I'm a little disappointed with the IVF nurse so far. For example: I was originally anticipating AF this past weekend, and the only instructions I got after my mock transfer was to call on cd 1 so I could start BCPs. I had to call her last week and ask if I should get a prescription called in just in case AF came over the weekend. It seems that she should be thinking proactively about these things. Maybe I'm expecting too much, but I have never done injectables and from everything that I read, timing of meds is critical. Am I expecting too much?

Relief

Yesterday was a big day. I told my boss. I had been dreading this moment. Would she immediately see right through me and say "you only took this job for the IVF benefits, didn't you?" I wouldn't say she was ecstatic, but she definitely understood and appreciated my situation. The first thing she said was that she was glad that I came to her first and told her early (partly so that she could anticipate a hopefully relatively soon maternity leave). Of course I will schedule as much as I can on days off and if I need time off during a shift, they will happily accommodate my needs. The day got even better when I talked to the woman in charge of my orientation schedule. She was very warm and fuzzy and full of hugs and excitement. My latest concern about my schedule had been that I anticipate the week of ER and transfer will be around my last week of orientation. "No problem", she says. There is one week that I will need to spend doing some "classwork". It is a self study module.....so I will do that the week of ER and transfer. I almost cried of relief.

Earlier in the week I had my ultrasound and mock transfer - ouch. Everything was fine and looks clear with no problems anticipated for transfer. The results of my clomid challenge are another story. Since I had my day 10 FSH done at the hospital where I work, I looked up my results: 10. Piss. I don't know what my day 3 FSH or E2 is yet. My FSH 6 months ago was 5. I've heard that the results are only as good as your worst FSH, so I'm becoming less optimistic. In the online research that I've done, 10 is the bottom of the range for not responding well to the IVF hormones. If there is anyone out there still reading this and has any input, please let me know what your experience has been. I don't officially meet with my RE until April 9, but I will probably be getting my calendar dates in the next couple of weeks, and AF is due to arrive end of March -first of April. I'm trying desperately not to get too pessimistic without more information.

Hard core

We had our first appointment with the actual RE today. Silly me thought that by seeing a woman doctor, I may get some of the warm fuzzies that I have been absent from my providers during this very long process. I will now refer to her as Dr. Professor. Both C and I felt like we were back in a college lecture and that we should be taking notes for a pop quiz somewhere down the road. Everything was very technical - as it needs to be I guess - lots of statistics and a step by clinical step explanation of IVF from suppression to stims to transfer. I have been doing lots of research and of course keeping up with blogs the best I can. C on the other hand left with his head in a bit of a spin. A lot of the information was review for me, but I did learn some very interesting things about ICSI. The only thing that I wasn't crazy about was that she always gave me statistics for the 40 year old age group.....I've got another year before I'm in that category. Ok, so maybe I'm a little sensitive.

The warm fuzzies finally came from the IVF nurse....let's see, let's call her Nurse Bubbly. She was awesome. We laughed and joked. She was a nurse for 21 years in the department where I will be starting in January, so I think there was a little sense of kindred spirits happening. The plan is for me to call Nurse Bubbly in February and we will schedule b/w and ultrasound (complete with a mock transfer) in March. Then we will start suppression with my April cycle and hopefully be looking at May for retrieval and transfer. At least that will give me a little time at the job to feel out if I will be able to take an hour out of my day to go for ultrasounds, etc. I don't like starting a new job and already anticipating taking time off.

I risked asking the question "Is there anything that I can do to improve my fertility?" Dr. Professor looked at me ever so briefly, then before she could answer I said "I need to lose weight don't I?" The response was a definite yes. Even though this blog is pretty anonymous, I still cannot bring myself to reveal my weight...let's just say that 15 pounds would be good start, more would be better. Both C and I have struggled with our weight for so many years. The good news is that even before this appointment, we have been taking steps to modify our diet and exercise. When we got to the car we agreed to go "hard core" in the diet department. If you raided my lunch box tonight, you would see carrots, celery, turkey sandwich, an apple, an orange and a yogurt....and yes I am already hungry.

Reality

Well, it's official. My last day at my current job will be January 9th. Orientation starts on January 21st. What am I going to do with all this time off? I think that I may go to a yoga retreat (Kripalu) and go to a knitting weekend of all things (and yes, those are one and the same). Kriapula has amazing workshops - my first thought was to attend one on letting go of "fear", but then I saw this knitting workshop: 3 days for experienced knitters and lecturer is (drum roll please) Karen Allen......of "Raiders of the Lost Ark" fame....c'mon you know who I'm talking about. Apparently the actress thing got boring and now she has a knitting book and goes around the country doing knitting seminars/workshops. So fear be damned.....I'm gonna learn inartisa knitting! I would love to go with a friend, but my friends who knit don't do yoga and vice versa.

I'm trying not to think too hard about how far away IVF #1 seems (5 1/2 months). We have an appointment with the RE on November 28th. They have scheduled it to be one hour long, so hopefully we will come away with a bit of plan and an idea of how much the meds are going to cost. I believe that they have done all the testing for me that they are going to do, so I'm hoping that I will even have a protocol so I can start doing some research. In the meantime we are "trying" this month on our own. I have only a vague idea of what cd it is. This weekend C asked me what kind of "schedule" we were on....of course the most fertile days are going to be the day the whole family arrives through when they leave....of course. But my response to the schedule question was that I am not going to get wound up about it this month....or maybe even next. The family is coming here for Thanksgiving, so that is the last thing on my mind right now. My brain is full of thoughts of vacuuming and cleaning toilets.

The reality of leaving this job is hitting me in little jabs. The other day I was at a committee meeting and the group leader was asking for someone to volunteer for a project. It was something that I normally would jump at doing, but I know I wouldn't be there to see it through, so I sat there silent- which is not like me at all. My OB is part of this committee, I had not told him my decision yet. He has actually been left out of the loop because I didn't really trust him not to spill the beans at work. So I said "I need to tell you something". He says "Let me guess you are leaving and going to work at ****Hospital so you can have IVF".

What the *#%$?

Apparently my primary care doctor and my OB were at a seminar about infertility and my primary care doc spoke up and said that she had a patient that was changing jobs specifically so she could have insurance coverage for IVF....didn't mention any names....that was all she said. But my OB knew that she was talking about me.....have I mentioned that I currently work for a VERY small hospital.

Anyway, so after I hit the "publish post" button. I will be working on my resignation letter, which I need to turn in today. Then comes that task of starting to tell people that I am leaving. I have never given this much notice...almost 2 months. I know that I should tell co-workers sooner than later. I had said right from the beginning that I would definitely tell people the reason I am leaving, but now I am not so sure.