Tuesday, June 29, 2010

Egg Retrieval Story

Hey there, folks. How are you? I'm much better than I was, happy to say. I have been all blown up like a water balloon from a touch of OHSS, which wasn't particularly painful but was kind of tiring, but on Sunday night I peed like I have never peed before -- I think someone told my kidneys there was a talent scout in the house -- and suddenly I can wear pants again. If I do end up pregnant, I know this will be only the eye of the storm, but I am enjoying it nonetheless.

As far as other ailments, I know Sugar told you I've been rather sick, but I want to make clear that pain and vomiting did at least happen on different days. The pain was very bad the day after retrieval -- probably because of all the endometriosis -- and then not. The nausea was bad around transfer (5 days post-ER), and I am convinced was a side effect of the progesterone. Now that my body's used to it, I'm fine. (The doctor tried to sell me on nausea as being because of the bloating, but I haven't felt sick when at my most bloated; when I felt nauseated was between the post-ER bloat and the real OHSS ballooning.)

I said before that your ER stories were all of so much help to me at my own retrieval, so I figured I'd better tell mine before it fades in the haze of the percocet-filled days that followed it. It's looooonnnggggg. I hope it will help someone later.


On the morning of retrieval, I was hungry and scared. My clinic says no food or drink at all after midnight the night before, and my procedure wasn't until midmorning. I have a touch of hypoglycemia, and that long without food leaves me a hot mess: shaky, frightened, easily confused, possessing the emotional self-control of a nap-less toddler. On the other hand, my ovaries felt so big and my back was so sore that if someone had handed me a grapefruit spoon, I might well have dug the eggs out myself. I was, shall we say, ready as I'd ever be.

We took a cab to the clinic, which was very empty because it was Saturday. After filling out payment contact forms for the anesthesiology department, we went up the the second floor of the clinic, where they have operating rooms. I really liked that I didn't have to go to a separate hospital. Not only was it less nerve-wracking to be in a familiar place -- a VERY familiar place, given how much monitoring I'd been having -- but it was also calm and uncrowded. Most of the nurses I saw that day I had met in the blood draw room at one point or other, which was comforting.

When we got to the second waiting room, there was one man by himself and one male/female couple. After a few minutes, the woman was called back. About ten minutes later, the nurse called her (presumed) husband back through a different door.

Wow, I thought, if he's already going to meet her in recovery, this really IS a quick procedure.

Very soon, a brusque nurse I hadn't met before called me back. "Okay, she'll come find you after she's done," she said to Sugar, prompting a freakout from me. The materials we'd been given all said that "depending on time and patient flow," she could meet me in recovery. Not anymore, the nurse said, new policy. I felt angry and even more scared. I would have been okay if I'd been expecting it, but I was in no state for surprises. I began to suspect that the nurse thought Sugar and I were just friends, that we weren't being treated like the het couple that had gone before us.

"What about that guy? How come he got to go, then?" I demanded. The nurse claimed no knowledge. I was rattled and pissed.

After that, I went to the locker room, where I exchanged my clothes for two nice, cloth gowns (one tied in back, one in front), little socks with rubber treads, and a shower cap that was extremely awkward for my long, heavy braid. The key was on a springy loop that I put on my left wrist. I then met the nurse in a tiny room with a table, where she took my pulse and BP (high for me -- "maybe you're a little nervous?" she said, rather kindly) and had me fill out more consent forms and so on. When we were done and the OR still wasn't ready, she totally redeemed herself in my eyes by fetching Sugar and letting us sit there together until it was time for me to go.

When they were ready, I walked with the nurse to the OR. The way there was through recovery, and I suddenly understood why Sugar couldn't meet me there -- there were just too many patients. The recovery area at the clinic is a series of curtained nooks (like you see in ERs sometimes) arranged around a nurses' station. Because some of the patients weren't conscious yet, all of the curtains were open. No partners were there, and I did understand that the nurse was right when she said that having partners come in had been a problem, since everyone was talking and people who were just coming to got confused. The atmosphere was very quiet and calm, even if it was still pretty weird to walk by the woman from the waiting room, out cold with her mouth wide open. She looked like a child or a rag doll.

The OR itself looked, well, like an OR. There was a table with white sheets and "stirrups" that were really just long things to put your calves in. I was standing in the big, open part of the room on the right hand side of the bed. To the left was lots of equipment. There were what seemed like a ton of people but was probably only 4 or so doctors and nurses bustling around. Everything was moving really fast. I got scared again.

"Hop up," they said, after having me take off one gown and "loosen" the other. (It turned out that by "loosen" they meant "completely untie." It would have saved some time and frustration on my part if they'd just said that. I felt like I was already supposed to know all this stuff, like in a weird dream.)

Hop up HOW? I thought. The bed was too high for me to get onto easily. They pressed something and it lowered down, I got on it, and everything started happening really fast. A man in green scrubs grabbed my left hand and pulled it out to the side, where there was a little table at a right angle to the bed. He started telling me to make a fist and so on, so he could start the IV. At the same time, a nurse I knew from the blood draw room was telling me to scoot down the table farther, so that my butt was at the edge of a hole in the bed that I could see because it was covered with a pad. Then she told me to put my legs up, then scoot more. Also at the same time, the anesthesiologist was asking me lots of questions about my history with IV anesthesia, my drug allergies, and so on. Only the anesthesiologist, on whom I have developed a bit of a crush, introduced himself.

At this point, I came a bit untethered. The man in scrubs -- who I recognized at some point as the surgeon, Dr. Saturday (and wouldn't it have been nice if he'd introduced himself?) -- put the IV in. It hurt like hell. In fact, it never stopped hurting for the rest of the day and I still have something of a bruise there, because it wasn't in right. I wish I had known that it wasn't supposed to be like that and that I should have asked him to do it again. (On the bright side, many people reported that the first stuff in the IV stings, and I barely felt that....) Everyone kept telling me to do things all at once. Someone put a BP cuff on my right arm, which inflated itself every minute or two. I started to cry, just a little.

"Oh, no! Don't cry!" said the sweet anesthesiologist, an Italian man of roughly my father's age. "Whenever I see a pretty lady cry, I start to cry too." I pulled myself together and explained that I was worried about the IV sedation, because when I had that for my wisdom teeth, I woke up in the middle and threw up for several days afterwards. He listened to that and to my saying I was going to need real pain medicine after, because tylenol doesn't do jack for me, and assured me that he would make sure everything was ok.

It was then that I really appreciated tbean's story, which scared the hell out of me when I first read it, such that I required much buoying from friends who'd done IVF themselves. As upset as I was at the time, my experience wasn't anything truly traumatic, but it helped during the worst part to remember what tbean had said about how this is surgery, no matter how much they act like it's just a "procedure." I looked up at the ceiling and told myself that everything that was happening was normal and how it was supposed to go, that these people were doing their jobs and that my job was to look at the ceiling, try not to think about how much my hand hurt, and trust that Dr. Italian would take care of me. The nurse tucked a white blanket around me so that my right hand was against my chest (nice touch), and the next thing I knew, I was in recovery.

My bed was facing the window, so I could see the green vacant lot next door and the bridge beyond. It was a sunny day, the view was pretty. I don't remember feeling anything but awake -- no groggy period or confusion. I knew where I was, why, and everything else. A nurse noticed I was awake and came over to check on me. She took care of me for the whole recovery period and was great in every way. She asked if I was in pain, and except for the &^$%ing IV, I mostly wasn't.

After a few minutes, I started to be. My belly was sore in the gas/endometriosis kind of way it had been that morning, my back was a little bit achey, as it had been for a week or more. My vaginal pain was very slight and never got bad, ever. Less pain than I have after a pap smear. I told the nurse and she said she would have the anesthesiologist see me as soon as he was out of the OR. That took 10-15 minutes, by which point my belly had started to be more of a problem.

Dr. Italian came out and gave the nurse something to put in my IV, and I started to feel better right away. He later gave her a syringe of the same something to give as an IM injection, which would last for the ride home.

I was my typically chatty self under the influence of drugs. I asked Dr. Italian to repeat his name a few more times. I ended up remembering it almost right. I told him, somewhat in awe, "I didn't wake up!"

"That's my job," he said.

The nurse brought me some apple juice and graham crackers, which were awesome. At some point, the nurse asked if anyone had told me how many eggs they got. She brought me a paper and pointed at the number 32. My eyes bugged out of my head.

I reminded her that I really needed a scrip for something that wasn't tylenol, and she had the fellow write for what turned out to be very necessary percocet. "Tylenol doesn't do anything," I said, "I might as well take water; it tastes better."

"That's my kind of lady!" said Dr. Italian, passing by.

A while later, she said it was time for me to try going to the bathroom, and helped me very slowly get up, carried my IV bag to the hook in the bathroom, and left me sitting there, with firm instructions not to try to stand if I felt weird.

So I sat there.
For a long time.
Nothing.

I had had two bags of IV fluid by that point, but nothing was happening. The nurse called to me that I should come out if it wasn't working. I was desperate not to stay longer than I had to, so I asked for an extra minute, turned on the sink, tried every mental trick I know, and peeds maybe 3 drops. When I wiped, I was shocked by how bloody the toilet paper was.

The nurse declared that even three drops counted, and I graduated to a recliner with the leg cushion out. Eventually I was allowed to sit up normally. Dr. Italian dropped by again and said "Good work, young lady," which I loved. (Seeing a theme? Why can't this man just be constantly passing through my life, praising me?) A while after that, she detached my IV from the cord (leaving it in my hand), and sent me to go put my real clothes back on. (I stopped to get a dreaded hospital pad from the bathroom, as I'd cleverly left the one I brought from home with Sugar.) Once in the locker room, I realized my fatal error: my key was attached to the wrist of my IV hand, which still hurt like hell. I had to gingerly stretch it over everything, which sucked. Nicole: put the dang thing on your right hand.

I returned to the chair, carrying my bra, because hell, no, it was not going back on. The nurse took out my IV, gave me my scrip, and sent me home with Sugar. As we left the 6th floor, I explained to Sugar my understanding why she couldn't be in recovery, but said I was still confused about where that first husband had gone.

"Dude. He went to give a sperm sample."

Oh. That's probably why the nurse didn't explain, huh? I hope the other waiting husband at least thought my outrage was funny.

We took a cab home, I retired to bed with my percocet, and everything was basically fine. I ate and drank normally. I peed. At some point, I stopped bleeding. The pain got bad the following day, probably as a combination of some OHSS and a lot of endo, but I don't think that's typical. In short (TOO LATE!), I was scared but nothing terrible happened. If I have to do this again, I don't think I'll be that upset.

Thursday, June 24, 2010

Lying Down All Over Town

Today we did the embryo transfer!

I took the day off work to be able to go with Baby to all her various appointments - acupuncture, transfer, acupuncture, home - and in order to do so I told my office that she was having 'surgery.' Now they are all worried about her, and probably think she has cancer, since I was so unspecific. On Saturday she actually had surgery (egg retrieval) and I was all worried about her, but didn't manage to talk to anyone about that, since it was Saturday. Between Sunday and this morning she has been quite sick - in pain, vomiting, the works. But now this evening she seems a lot better, thank goodness.

So here was our day:

6 a.m.
vomiting (Baby)

8:30 We take the train to midtown and go to Baby's acupuncturist's office there. Baby goes to lie down. I wander around in search of breakfast, saltines, and a seasickness bracelet for Baby. It is ridiculously hot outside.

10:30 We take a cab to the Kips Bay Baby Factory, where everyone is surprised that we are early. The nurse clearly thinks Baby has already had some Valium at home because she is moving so slowly and acting spacey, but we convince her that no, it's just the puking and the lack of sleep. The nurse gives Baby some Valium.

10:45 We are seated in front of this sign. I had not previously realized that the doctors here think of themselves as ganstas.

gansta-doc
yo yo YO!


10:50 Dr. Thursday comes to talk to us. He is disorientingly jovial. Also he has tiny feet, which I find myself staring at. However, all the news he gives us is great. 26 of Baby's eggs fertilized, and 20 of those are still growing. There is a good looking blastocyst to transfer and there will be some to freeze, somewhere between 4 and 10. We won't find out how many they actually froze until tomorrow afternoon.

11:00 Baby and Dr. Thursday go into a Laurel and Hardy routine about left and right cervices. Dr. Thursday says Dr. Baby Factory told him to go in through the right cervix, but Baby says he must have meant Dr. Thursday's right, i.e. Baby's left, etc., etc. After a while Dr. Thursday agrees to poke around and not jab anything too hard until he figures it out.

11:35 Dr. Thursday breezes by me in the waiting room and says I can go back to the recovery room. He waves his arm around saying 'it's to the left.' I try the door he came out of, which is locked. I sneak through a different door and stick my head past the gansta sign into a completely empty hallway and shout. Eventually a nurse wanders by and directs me through two totally other doors to where Baby is lying down. She seems calm and happy and has this picture printed out and lying on her chest.

blastocyst001
our first blastocyst

12:30 IT IS SO HOT OUTSIDE, WHY IS IT SO HOT?

1:00 We sweatily arrive at another office near the Baby Factory where Baby's acupuncturist also works. Baby goes to lie down and have needles stuck in her again. I read a trashy vampire novel.

2:00 Back on the train to Brooklyn.

3:00 Baby lies down in our blessedly air-conditioned apartment. Because there is no food in the house, I prepare for the trek through the blazing heat to the Food Coop.

4:00 (presumably Baby is still lying down) I search for popsicle molds (no dice) and stuff to make miso soup, which Baby has requested.

6:00 I make miso soup.

7:00 Baby and I eat the soup. Nobody vomits. Score!

Wednesday, June 23, 2010

ET Phone Home

Okay, I know that post title makes no sense; I just felt like it.

The fact that I am aware that it's meaningless should indicate to you that I am off the percocet. After a fairly wretched Sunday and a somewhat rough Monday morning, my belly stopped aching and I didn't need it anymore. Acupuncture probably helped, too. I'm still somewhat bloated -- only up 2 lbs. from retrieval day but it's all in my suddenly barrel-shaped tummy -- and my back/hips/thighs hurt the way they have been ever since my ovaries got big, but nothing really excruciating. Walking sucks a bit because of the legs, but it's also 90+ degrees, humid, and smelly out, so staying in isn't such a problem. (Although I also think being sedentary is part of how my back got so bad....)

Saw Dr. BF today, who wanded and specul-ized both vaginae and declared me fit to fly without anesthesia. Yay! He thinks a tenaculum will be involved -- UNyay -- but it almost always is when my cervix needs crossing, so at least I'm pretty used to it. He didn't come right out and say it had been silly (lazy?) to suggest I needed to be knocked out, but he did say, again, that they really only use that for patients who can't stand a speculum at all. Here's an idea: maybe they could have left that decision to someone who's met me when conscious, not just gone by the word of Dr. Saturday. (And folks who can't stand a speculum and do IVF anyway? HATS OFF to you. You are at least eleventy-million times braver than I.)

It turns out Sugar can't be there anyway, because they just don't allow that. Poo. She'll come with me to the office, and I know the important part isn't whether she's physically with me for that particular 20 minutes but that she's with me in the ways that count throughout all this. I'm gonna stop before I make y'all yack on your keyboards, but the point is: my wife pretty much rocks.

So! We're on for a valium-inflected ET tomorrow. I asked how the ol' emby gang is doing, and while I didn't get numbers and letters (and frankly don't really want them at this stage in the game), Dr. BF says they're doing great, better than typical. Genuises, all, playing suzuki violin and writing plays, I'm sure. I really hope we'll have some to freeze, so that it doesn't feel like everything is hanging on this cycle.

Thanks for all your ET stories. I'll think of you in my valium haze, while trying to ignore the spikes in my cervix.

Sunday, June 20, 2010

Updates and Such

Hey there, internet. It's been a rather rollercoaster-y day around these parts, so I'm not sure how peppy I can make this.

Let's start with good things:

  • We now have two dozen fertilized eggs. Obviously 24 is too many to put back, but luckily vitrification and FET means we can have two, reasonable pregnancies of 12 each....
  • The red gatorade isn't so bad if it's really cold.
  • After no percocet overnight, I felt great this morning. Better than in a week, in fact.
...that's all I can come up with.

Less good things:

  • Stopping the percocet was stupid, stupid, stupid. Midmorning, I was suddenly in so much abdominal pain that I freaked out. Luckily, I did the responsible thing and called the Baby Factory. The doc on call there said she wasn't a bit surprised, given my age, battery-hen-style egg production, and extensive endometriosis. She told me to get back on the percocet and stay the heck in bed. Although it took several hours for the percocet to get back to its former level of effectiveness (because it always works better if you don't let the pain get away from you), I am basically okay now. I am also still in pajamas, which now have gatorade stains. Classy.
  • Way too sick to go to acupuncture, even if I hadn't been forbidden to leave the bed.
  • The nurse who called with the fert report announced that I would be having anesthesia for my ET, per the doctor who did the ER (Dr. Saturday, not Dr. Baby Factory), who never introduced himself in the OR and put my IV in badly so it hurt like hell the whole time.
Dr. Baby Factory and I had already talked about ET procedures, as he knows my ornery cervices better than anybody, and he did mention that anesthesia was a possibility. He mentioned it in a "in case you think *you'd* like this" kind of a way, just as information. We decided that valium was enough. Now some guy I don't even know has just announced that my care is changing, because he feels like it. I feel out of control and angry.

I also feel really, really sad about the idea of not being conscious for the ET. So much of the IVF experience is so distant from what I want the conception of our child to be like. I am grateful that I have the opportunity to use IVF, grateful that it may save us from infertility. But the experience is not without loss, you know? I've read so many IVF blogs, and ET day seems for so many couples like the day it becomes personal again, as they watch the embryo on the screen, hold hands as it goes in. I want that.

Doctor On-Call wants me to come in tomorrow anyway, to get checked for OHSS and so on. Since Dr. Baby Factory is also Dr. Monday, I hope to talk to him about it. I just hope I can keep from crying. Because crying hurts my belly so much right now.

Oh, I forgot one other good thing: a big shout out to my wonderful acupuncturist, who wrote to check in on me and is just generally a blessing.

Saturday, June 19, 2010

Eggy Update

Hey, y'all.

I'm back from retrieval, chillin' in the bed with my good buddies percocet and gatorade. I will write the whole story at some point, but the important parts are:

  • I made it. I was definitely scared, but even though I won't say it was all peaches and ice cream, it was nothing as bad as I'd feared.
  • THANK YOU THANK YOU THANK YOU for the messages of support and especially the stories. All the stories -- even tbean's scary one -- were helpful in one way or another. I'm gonna get all weepy if I say more than that now, but the bottom line is you are all amazing. And that's not just the drugs talking.
  • How many ounces are there in a quart*? That's how many eggs there were up in my ovaries. No wonder my back's been hurting.






*32. Thirty-fucking-two. Yes, I am on OHSS watch.

Thursday, June 17, 2010

It's time

I've been in stirrups so many times in the past week that I've started wearing skirts to the clinic, just to save the trouble of taking my pants on and off. I take my shoes off anyway, because not doing so seems somehow inappropriate, even though there's no real need.

I went into the Baby Factory for blood work and ultrasound this morning, as I have for the past seven consecutive days. First stop: blood draw room. There are lots of nurses, most wonderful, and I hadn't had this one before. She said something sympathetic about how much time I've been spending there -- both arms are pretty bruised at this point -- and I said I didn't mind, that I appreciated being watched so closely, that it helps me worry less. And anyway, I like having more data.

Oh, she asked, do you work in medicine?

This question comes up a lot. I don't work in medicine, but I was raised by two doctors in an area where hospitals and labs are major employers. Medicine is my mother tongue.

So I told her no, that my parents were doctors, though. And then she said what easily fifty percent of people do after that revelation:

"Aren't they disappointed that you're not a doctor?"

Now I ask you, what kind of small talk is that? To tell you the truth, I'm not entirely convinced they're not disappointed, though they never say so. Heck, sometimes I'm disappointed in myself for not being a doctor -- I'm pretty sure I'd be good at it -- and I never wanted to be one. But is this really a conversation I need to have with a stranger first thing in the morning? Public Service Announcement: If you find yourself about to ask someone who is not a very close friend whether her parents are disappointed in her, JUST DON'T.

Onward to ultrasound.

At the Baby Factory, all IVF patients on a given day are seen by the same doctor, no matter who your regular doctor is. Each day of the week has a doctor assigned to it; Dr. Baby Factory, for instance, is Dr. Monday. Ultrasounds are done by one of a trio of lovely fellows -- all women, just to complicate the nomenclature -- or by the doc of the day. Today I met Dr. Thursday, a jovial, paternalistic jackass.

First of all, I appreciate it when folks introduce themselves before sticking anything up my privates. Call it a quirk of my Southern upbringing. Second, when I tell you, since I'm not counting on your having read the details of my chart, that I have a vaginal septum and that you should aim to the right with that dildocam, the preferred response is, "thank you for telling me." Not:

"Why didn't somebody take that out?"

Luckily, my pre-cycle anxiety dreams had prepared me for this moment (only with more knives), so instead of blubbering I managed,

"Because it belongs to me."

The examine continued in that vein. Dr. Thursday is the only one of the docs I've seen who didn't adjust the u/s screen so I could see it, and I bet he wouldn't have told me the follicle measurements I'd asked for if he hadn't had to call them out to the resident in the corner. He ended the session with a pat on my knee and a "Good job" that made me feel like livestock.

So now I know why they want you barefoot in the stirrups: a kick to the face is bound to hurt less that way.



ONWARD.

I am triggering tonight. Ten minutes to midnight, which my sweet, strictly diurnal Sugar is bound to hate. I'm nervous as heck about the shot and mostly about the retrieval and continue to appreciate your reassurances and general support.

Biggest follicle is about 19.5 mm. Dr. Thursday said about 10 on each side. So now I'm nervous about OHSS, too. E2 is 3364. Talked to Dr. Baby Factory, and he sounds a little nervous, too, but not nervous enough to have me trigger with Lupron. So I guess we just hope for the best and stock up on gatorade.

Retrieval is Saturday.

Which means a 5-day transfer would fall on...Dr. Thursday's shift. Awesome Sauce.


Wednesday, June 16, 2010

More To Say

...but not tonight. Holy Moses, this stimming business has me worn out, internet. I seriously do not know how some of you have done this and had real jobs, other kids, etc., at the same time.

Things continue apace around here. Back still hurts, but other side effects have tapered off. Mostly between a 4 ("My pain is not fucking around") and a 6 (Ow. My pain is super legit now) on Hyberbole and a Half's* brilliant pain scale. Definitely nowhere near 10 ("I am actively being mauled by a bear").









E2 rising. Follies growing in fits and starts. I've been in for monitoring every day since Friday, as my quicker than expected response made them think OHSS thoughts. It's sort of annoying to schlep in every day, but mostly it's comforting to feel so cared for.

They said today I'll probably trigger tomorrow or Friday ('course, they said that yesterday, too), which means ER this weekend. I'm still a little scared, though mostly I'm too tired to remember to be anxious.

That said, your "it was no big deal"-type ER stories are very appreciated, in comments or links.

xo
Bionic

*Do you need more funny in your life? 'course ya do. (Try this one, for instance.) Exercise extreme caution when reading Hyperbole and a Half at work, as Sugar points out that sudden, repeated laughter in your cubicle is not very professional.

Monday, June 14, 2010

Sleepy Updates

Hey, y'all. I keep thinking I'll find energy to write a coherent post, but apparently not yet. In the interest of keeping you abreast of the situation chez Bionique, here is a disjointed post, instead.

Things are basically okay. Stim dose keeps going up and down. Things happened faster at 225 than they expected, so it went down to 187.5 and then 112.5 -- thanks for helping me brush up my 37.5 times tables, Gonal-F. Just got told to put it back up to 150, as E2 isn't all that different from yesterday. (Now at 1347.) Hoping this doesn't spell doooooommmmm.

At today's ultrasound, looked like a bunch of little follicles on both sides, the biggest about 11mm. Lining is 12mm -- the doc on Saturday called it "beautiful," which helps make up for her rather fierce dildocam technique.

In side effect land, I'm pleased to report that the bad headache (plus attendant vomiting -- Go Team Migraine!) only lasted a day. I've been having little headaches on and off since then, but nothing to write home about. Besides, I'm too distracted by my aching back (ovaries) to notice. Thank you, whoever invented heating pads. Acupuncture also helped for a few hours. I remain crazy tired, but that might be partly because I'm not sleeping well, thanks to the backache. A little mood-swing-y, but is that so different from usual? (Don't answer that, Sugar. It's the drugs.)

The shots themselves have been less bothersome than expected, especially since Sugar's doing the scary part. (And, full disclosure, since I've been using the spray numbing stuff we have on hand for waxing -- yes, we are cheap enough to do it at home, thank you very much.) Gonal-F is just a little pinch. Ganirelix/Antagon stings, not gonna lie. I get a nice red patch there for the next hour or so, and it feels like a bee got trapped in my pants.

I finally got the HCG situation dealt with today, by getting a new scrip and walking it to a regular pharmacy, since the mail-order place STILL says they haven't received (read: can't find) the paper scrip sent to them two weeks ago. (My insurance company requires me to use the mail-order place, but I'm allowed one-time amnesty.) The mail-order place is considering waiving the co-pay on the second shipment of Ganirelix due to arrive tomorrow, since it's their fault they read a 5 as a 3 and sent too little in the first place. Everyone on the phone there is super-nice, but sheesh.

I wish I had a funny picture or a clever thing to put here, but as I said, I'm wiped out. In the interest of keeping this blog vagina-oriented and overshare-y, I will offer you the following New Math:


IF

High Levels of Estrogen = Increased Cervical Mucus

AND

High Levels of B Vitamins = Highlighter-Yellow Pee

THEN

Sky-Rocketing Estrogen Levels + Prenatal Vitamins =
Buckets Of Highlighter-Yellow Cervical Mucus

Friday, June 11, 2010

Some Good Advice

Internets! Hello from day 4 of stims.

Things are going pretty well. I went in for blood work today, and they say I'm showing a good response. My estrogen is at 545. So tonight, Gonal-F went down to 187.5, and tomorrow we're going in for more b/w and the first u/s look at what's up in the ol' egg cartons. I'm to bring the Ganirelix with me, in case it's already time to start antagonizing the follies.

In side-effects land, I've had a bit of a backache, especially on Cysty Lefty's side. Yesterday I had a tiny headache, which reached "blinding" this afternoon. Yuck, but Dr. Baby Factory said I can take the codeine I have for migraines if I need to, so it's down to "splitting" now. I sure hope my head doesn't just feel like this from here on out, but I feel I can't complain much, since I'm not teaching right now and I can, in fact, lie down and groan if needed.

I can also lie down and nap, which is a darn good thing. I can't believe how tired this stuff is making me. Sugar points out that I am, after all, growing a bunch of stuff, so maybe that's why. Or maybe it's just my native sloth. Lordy, though. I took a nap as soon as I got home from the Baby Factory and other Manhattan errands this morning. When I woke up, I felt like I could really go for a nap.

...which brings me to the advice portion. I was whining a bit to the splendiferous Fat Chick about all of this -- do you all read her blog? Do you already know how brilliant and marvelous she is? I certainly hope so. (If not, I am dead jealous, since you get the pleasure of finding her blog for the first time.)

Here she is on side effects. I think I should print this out and stick it to the bathroom mirror:

Oh Bionic, you are a sweet, sweet noob. Here's the thing: No matter what you are feeling, whether it be emotional or physical, if it is in the slightest way disconcerting, annoying, painful or otherwise negative - in your opinion or the opinions of those near and dear to you - it is always, always because of the drugs. If, on the other hand, you are feeling something positive, it is because you are such an emotionally and physically strong woman that you are able to do the impossible. Namely, you are able to function at a high level despite the added hormones.

Some examples, for clarification purposes:

Road Rage: Drugs
Laughing: You
Small Kitten Cuteness: You
Loud Neighbor Annoyances: Drugs
Inappropriately Unpleasant FB Update: Drugs

All clear?


I <3 Fat Chick. As does my Native Sloth:

Thursday, June 10, 2010

Your Questions...ANSWERED

Hey, internet. How's it?

Things are chugging along, chez Bionique. I'm astonished (and a little frightened) to report that I am already feeling occasional soreness in my ovaries. This is getting worse before it's getting better, I know. Oh, well. This is the perfect time in my year to be incapacitated. I'm in between teaching gigs -- I'll start summer school in July -- so I am more or less able to just lie down and whine. Which I plan to.

I've been devouring blogs about IVF lately (surprise), and I keep finding myself reading really old entries and then being annoyed that the author hasn't talked about something or other I'd like to hear. But I'm just as bad, I'm sure -- I'm lousy at keeping track of what I've said here and what I've only obsessed about quietly to myself (read: "yapped Sugar's ear off in re:").

So. Anything you'd like to know? I'll start off with a couple questions that have come up in comments lately and update this post to address questions in the comments.

Kristen asked at some point what we were up to in early August, i.e., are we going to BlogHer. Happily/sadly no, we are not...because we're getting hitched again! Or at any rate, we're having a big party. We are extremely behind in planning same, but the room has been rented, so we're doing it. When we got married in November, we only had our parents and two friends with us, because we thought we'd have a party 1) in decent weather and 2) when we had more time to plan it properly. (We almost didn't even have our parents there, but our two friends -- who have each known one of us our whole lives or close to it -- pointed out that our parents would kill us.) So no BlogHer. I am a bit jealous of all y'all who will be there getting to meet each other and all that, but, well, my wife is pretty damn awesome.


Pomegranate asked what manner of IVF cycle this is -- lupron, antagonist, etc. It's a basic, stripped-down, no fancy-stuff antagonist cycle. We'll do Gonal-F for a bit, then Gonal-F plus Ganirelix, which will keep my eggs from busting out before their time. Then HCG trigger, egg retrieval, progesterone, and transfer, hopefully on day 5.

I don't know all that much about what determines the cycle type they try first, except that I'm thinking it's partly to do with my endometriosis. I gather we endo gals can be not-so-great responders, so maybe that's why no lupron? In case it quiets things down too much?

So far, I'm glad it's this kind of cycle, because I have limited stores of patience, and this one is quick.


So. What else you wanna know?

Wednesday, June 9, 2010

Helping

So last night Baby had to do her first injection for IVF using a little needle attached to a pen that goes into the flesh around the navel. After a couple of hours of waiting for the on-call doc to call back and explain what to do when the pen dosages don't match up with the dosage instructions (wtf Gonal-F?) it was time to do the deed. Baby swabbed her stomach with antiseptic and then stood there poised. And stood there.

"I can do that, if you want." I said after a few moments.

"Maybe that would be a good idea."

She handed me the pen, told me the procedure, and looked away. So I squeezed a pinch of her stomach and stuck in the needle and depressed the pen. This felt a little creepy. But it was also kind of awesome. This was the first time I felt like I was actually doing something to help this pregnancy thing along. Yay! I helped!

During previous cycles I mainly stood around like a third wheel while the doctor stuck his hand up Baby's hoo-ha and shot in yet some other guy's stuff. It's disorienting to feel like an unnecessary body guard during the possible moment of conception of your own kid. So I'm surprised but pleased to find that moving on to what is a more difficult, physically taxing, and 'medical' attempt to knock Baby up has at least one positive result - involving me in the process. Hopefully it will also work. Fingers crossed . . . .

Tuesday, June 8, 2010

Off To The Races

CD2 bloodwork and scan this morning. New cyst on right ovary caused panic that cycle would be canceled already, but voicemail says start shooting up tonight (!)

Off to go watch so injection videos, screw courage to the sticking place, etc.


For the cycle nerds:
200 U Gonal-F for three days; another scan + bloodwork on Friday.

ETA: REAL cycle-nerds may already know that Gonal-F pens don't do 200 units, only 187.5 and 225. Several calls to the on-call doc later, I'm at 225.

Saturday, June 5, 2010

Quickie

Okay, I really do have half (read: three throat-clearing sentences) of a Come and Eat post written, only now it's time to leave the house for a day trip to the beach! (Read: Sugar is going to photograph someone's house, like she do, and I am going to drive to the nearby beach in our borrowed car and lie there.)

...which in turn means, via the Law of White Pants and its corollary related to bathing suits, that today looks very much like it's going to develop into CD1.

Thank you to my darling Clitty for the heart-warming, vag-affirming shout-out.

Friday, June 4, 2010

Roselle's Tree

Thank you all for you kind and thoughtful comments on the Memorial Day post. It means a great deal to me that you took time to read it and to think of Roselle. A college friend read it today and concurs: she really was that great.

Said friend also thought to take pictures of Roselle's tree at reunion, and she's said I can post them here.





Thursday, June 3, 2010

Bullets

RIMG1017
  • I have to admit they look more bullet-like than I'd imagined.
Meds are here!
RIMG1015
  • ...almost. Can you spot what's missing?
  • How about if I name them? Pictured:
  1. Progesterone bullets
  2. Sharps container
  3. Alcohol swabs
  4. Syringes I hope I won't need (for PIO)
  5. Gonal-F
  6. Ganirelex
  7. Prednisone
  • Not pictured?*
I had figured I would write one of those peppy, everything's-moving-forward!, I-am-gonna-get-a-baby! posts when the meds arrived. Like ya do. Instead I spent the next several hours trying to decide whether to hide under the covers and cry, or drop everything and join the Russian circus. (I opted for just plain crying -- too hot to get under the covers today.)

So! Peppier bullets!




  • The mind reels at her fashion choice, though. Satin tie-blouse? C'mon Jane. Go butch or go home -- this shirt falls into the uncanny valley between butch and femme formal wear.
  • But then the heart warms at the thought of a big famous star wearing awkward wedding clothes. Clearly no stylist was involved. They're just folks after all. Group hug!
  • (But seriously, Jane, at least ask a friend next time, 'kay?)

*If you said HCG trigger shot and antibiotics, you win! Apparently HCG is a controlled substance in NY, so more hoops to jump through. At least if my cycle gets canceled I can sell it on the street.

OMG UPDATE: Kym says in the comments that HCG is used for body-building. So does this mean that if I do get pregnant, I can sell my pee? 'Cause I could really use the money. And I have plenty of practice peeing in cups.

An Ad for FedEx, In The Form of A Short Play

[Scene: Brooklyn apartment, summer morning. BIONIC is stuck inside, waiting for packages of refrigerated medicines to arrive via UPS and FedEx.]

[sfx: door buzzer]

BIONIC: Hello?

Voice Over: UPS!

BIONIC: Please come up!

[BIONIC presses door buzzer for a good minute, just in case.]

[Two minutes pass.]

[sfx: door buzzer]

BIONIC: Hello?

VO: FedEx!

BIONIC: Please come up!

[BIONIC presses door buzzer for a good two minutes, just in case. BIONIC opens apartment door, finds FEDEX.]

BIONIC: Oh, huh. Did you see the UPS guy by any chance?

FEDEX: Yeah, he just drove away.


So, yeah. I now have 40 coochie-bullets of progesterone and no stims, antagon, or trigger shot. I do have a UPS InfoNotice saying delivery was attempted.

Even the customer service lady at UPS agreed this was a good advertisement for FedEx.


UPDATE: Okay, several panicky/annoyed phone calls later, the UPS driver returned. And was totally nice and said he was sorry and so on -- apparently the super was working on the elevator so he went to deliver a package next door. Which is reasonable (and thank goodness about the elevator, because I was bargaining with God in there just this morning), but how's a girl to know?

Tuesday, June 1, 2010

Memorial Day

Hello, internets. Welcome back -- physically, mentally, whatever -- from the holiday weekend.

Sugar and I took a last-minute trip to New Hampshire with Womb Buddy, stayed in the 200-year-old house she moved to after leaving our hometown when we were both little. I visited in the summers for a few years, sliding in the swimming hole under the covered bridge, getting locked in a horse stall full of kittens, and generally living the country life, oblivious to the fact that W.B.'s parents' marriage was collapsing. (The packet of old photos I found at my parents' house this Christmas suggests I was oblivious to everything except kittens. One picture of a person in the whole batch: a fuzzy me, holding a kitten.) Until last summer, I'd never been back, though I picture the house and its yard whenever I read Madeline L'Engle's Wrinkle In Time books, remembering lying on the glacier-scraped granite outcropping to watch the sky as Meg lies on the stargazing rock.

The house is different in some ways, despite its familiar creaking floorboards and narrow stairs. Parts have been remodeled, and its denizens now include W.B.'s step-mother and step-siblings. But the town is old and small and slow to change. There is still no mail delivery to houses, no stop light, no noise or light at night. Its valley of green fields and shuttered houses is still watched over by blue mountains, the postcard-perfect New England town.

On Monday, we walked down the road to visit a woman we met last year, who with her son raises alpacas and shetland sheep for wool. Last year, her fluffy tom cat herded geese away from us as we walked the road towards the swimming hole, and she insisted on taking us out back to meet the animals. We loved it, of course. She's a single mom, and she explained that this is an inexpensive way for her to keep her son close -- the animals themselves were gifts from 4-H. We wondered, a year later, if they'd still be at it, if her son ever was as invested as she, if he might have grown older and started racing dirt bikes or chasing girls.

Thumper and the Bug
W.B. and Thumper, July 2009


We found the shepherdess at work in her front garden, spending her birthday putting in new perennials. She was happy to see us and happier still to usher us back to the barn and pastures, where her son showed off two-day-old lambs with evident pride. The alpacas were overdue for a visit from the shearer, who is behind in his work. Our favorite ram, Thumper, died of bloat over the winter, but nevertheless, the little farm carries on.


Mostly, he looked happier than this, but I chose this picture because OMG I AM HOLDING A LAMB!

We continued down the road, over the covered bridge, and into the old part of the cemetery, where flags marked graves of those who served in wars all the way back to the Revolutionary.

Mill Cemetery, Meriden, NH

The cemetery is beautiful, shaded by ancient maples, in sight of lupin-covered hillsides. It is not so hard to think of spending eternity on the high banks of the fast river there, visited by hikers on their way down from the mountain behind it. We hiked there this weekend, as most of those buried here must have at one point or other. The forest shifts from dark hemlock to brighter groves of beech and maple. Where sun creeps through, forget-me-nots cluster around the path. From the bald on top, you can survey the valley.

View from French's Ledges

Hiking in the eastern mountains this time of year always makes me think of a college housemate of mine, who hiked the Appalachian Trail the summer after she graduated. I remember how excited she was for the trip, and also the quiet confidence that ran under her talking about it, the knowledge that she had the skills for the trip but also the right mindset, that she knew well how to break big projects into steady, determined days.

That attitude was typical of Roselle. She was so steady in every way, like a sturdy tree you know will always be there to be counted on. She was pre-med, and it was clear that she excelled in school not by lucky flashes of brilliance punctuating long weeks of sloth but by day after day of orderly studying. She got her work done without panic, and yet never shook her head over those of us who were grasshoppers to her ant when it came to laying up stores against the coming winters of exams and final projects. Her professors noticed, too:
"Roselle was smarter and more capable than the rest of us, and she held an almost tender benevolence toward others. She did not ask anyone else to work to the high standards she herself was working to achieve. "
Tender is the word exactly. She paid attention to you in such a quiet way that you could easily miss it, until you sat with her at dinner and discovered she remembered everything about that play you were in, that joke you told once. When I watered her plants while she flew to Texas for a med school interview, she brought me back a packet of bluebell seeds, having remembered a small picture of a blue-blooming field I'd had up on my wall.

If Roselle was a more diligent student than most of us, she seemed thrilled with the clownish ways we were different from her. If I close my eyes, I can hear her sudden, full-throated laugh, surprised at whatever we living room layabouts had invented to amuse ourselves while she studied in the dining room, somehow untroubled by the cacophony we regularly raised. And we all loved her. Of all the women I lived with those four years, Roselle is the only one I can think of no one's complaints about (unless you count her old roommate's assertion that she closed her dresser drawers too loudly in the early mornings). There simply wasn't anything to complain about.

Roselle died in Iraq in 2007. She was an Army doctor, and had volunteered for overseas duty because others in her group had small children. She was by all accounts tender and devoted as ever.

The news of her death was a shock. When another housemate forwarded me the email she'd received, I thought the dead Smithie in the subject line must be Madeline L'Engle, who died close to the same time. I didn't expect it to be someone I really knew -- but why not? Exactly how naive am I, that I expected to go without losing a friend with our country at war for so long? Did I think that the pins I'd worn (paltry activism), the letters I'd written (never enough) would somehow protect me? Did I think this was all just an intellectual debate? (Answer: of course not. Knowing how our volunteer army works, I instead counted on my race and class to insulate me.)

Soon, nausea set in. The Army would not release the details of Roselle's death, only that she'd died in Kirkuk not long after arriving there with her unit, that her death was not combat-related. Another soldier in her unit, a man, died the same day. I hate what I know of what women are too often subject to in our military. I hate that they are often raped, hurt, killed by their fellow soldiers, that the military doesn't seem to care enough rid itself of its old habits of misogyny (that seems too weak a word). Rape is twice as common in the military as in civilian life, a statistic all the more disgusting because the Army purports to teach unit cohesion, to protect one another. I hate that the only big name who ever seems to talk about this publicly, to admit that it exists, that it's not just isolated incident after isolated incident, is Garry Trudeau. Shouldn't we be reading about this outside of the comics section?

I didn't know that's what happened to Roselle, of course. I knew it could have been anything. A munitions accident in a warehouse somewhere. A car crash. A fall down a flight of stairs. But knowing that it was far from outlandish to imagine her attacked by a comrade is unacceptable.

The Army has since released its report. They say that she was overwhelmed, unprepared. That a senior officer berated her, that she told a fellow officer that she couldn't do it anymore. That she returned to her barracks and shot herself.

I can't tell you how difficult I find it to square this story with the Roselle I knew, who seems just like the one described by medical school classmates and hospital colleagues who wrote messages of condolence after she died. Yes, I know that suicide is often an impulsive act, that there is no "type" of person who attempts it, that it can happen out of the blue. Maybe she was sent overseas without proper training, a less awful negligence on the Army's behalf. Maybe she was that thrown by whatever was said to her, though that's hard to imagine. I keep trying to build a version of Roselle in my head that allows me to believe this story, but it hasn't worked yet.

Instead, I am left with doubt and with anger at an Army that promises to take care of its own. At an Army I can't trust to tell the truth, when it has tried so hard to cover up or ignore other problems. At a war we had no business starting, made possible by jingoism and racism and calculated lies. It's not politic, I realize, to say such things on Memorial Day. We are to wave the flag and believe sacrifice makes every cause noble. We are to "Support the Troops," which means ignoring the kinds of support the troops may actually need, if the real circumstances of their service don't lend themselves to blockbuster movies. But Roselle didn't heroically give her life to keep us free and I refuse to forget her that way.


We college housemates, classmates, teammates, and friends of Roselle pooled money to have a tree planted on campus in her honor, a Cladrastis lutea "Rosea" -- pink-flowered Yellowwood. Sugar and I saw the young tree this month, growing on the street where we all lived together. It takes several years to begin blooming, but when it does, it sends out surprising, wisteria-like clusters of pink. I hope it will stand watch on our street for many years, steady and lovely and sometimes laughing with flowers.


Thanks to Tom Gill for the picture of a blooming Yellowwood.


Pictures of Roselle's tree are up here.