Stim Day/ Cycle Day 9 and My Bod

“You have a good body.” Ryan texts me. Where is this going, husband of 5 years…? “It does what it’s told.” Ah. Truth, brother.

My estradiol took a big leap today – what a sigh of relief. Back for bloodwork/ US tomorrow, and tomorrow night will most likely be the trigger.

I am knee deep in unchartered territory with my body.  Between injections, follicle counts, anesthesia, surgery, embryo transfers and (hopefully!!) pregnancy, this vessel of muscle and bones needs to give the performance of a lifetime, and it’s rising to the occasion. That estradiol scare was out of character, and I’m glad to see things back on track. Well done, bod.

While I have a healthy, body, I do not have a thin body, and for that reason I haven’t always had such warm sentiments towards my self image.  I am active and a relatively healthy eater, and hailed from a home where both nature and nurture produced two skinny, small-boned and long-limbed, sisters, but my body just likes being a little larger. In High School, fully grown at 5’7.5″ I was a size 12 and 175 lbs. Sure, there have been times when I dropped some major weight. Like Freshmen year of college when I was on a seizure medicine that caused me to lose all interest in food (as well as people, school, work, and staying awake in general). I switched medications and gained the weight back.  Later, this Rx was pulled from the shelves.

There were diets where I would practically starve myself to get down to – gasp – a size 8!! I even kept it off for a couple years, but my social life and sanity paid dearly since my entire existence revolved around weighing and measuring and calorie counting. It wasn’t worth it. Just recently I’ve finally understood what “the body is a temple” truly means.  Our bodies are astounding mechanisms, full of scientifically wondrous faculties and created in the likeness of Christ.  I want to go forth in life trusting it’s remarkable capabilities to signal fullness, hunger and cravings, and not screw up my metabolism with man-made numerical targets.

Today, at 33, I’m not sure what I weigh, but it’s probably right around where I was in high school.  This body, this meat suit I wear, simply runs big. But IVF does not care if I am skinny – only that I am in good health. And in 33 years this body has never needed surgery or had a major injury. It’s strong, it’s sturdy, it never gets sick.  Even my brain, born with faulty neurons and prone to seizures, has healed itself over time. Yes, I still wince at the sight of myself in a bathing suit. But there are times when I see beautiful definition and muscle tone.  Thanks to the likes of the Kardashians and Niki Minaj, my butt and thighs might even be considered a good thing these days.  At the gym, I may be one of the larger women in the mirror, but I can outperform them all, and that feels incredible.  Yes, I am privileged (dare I say even thankful?) to experience my days on Earth in this 175-lb instrument, because look what it can do!

IVF is not for the faint of heart.  Fortunately, I’m enduring this journey in my #1 vessel of choice.  I trust this one I have, I’ve taken care of it, and I know it intimately. This body may never have great sex appeal or look good naked, it may always struggle to be “normal” according to the damned BMI index, but it is nonetheless extraordinary.

We got this, bod.  I have faith in you.  Injections, medications, anesthesia, stress?  We can do this in our sleep.

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Cycle/ Stim Days 7&8 – and Slow Rising Estradiol

Saturday (CD 6) I woke up at 4:45 am to get to the  blood lab by 7:30 and make my ultrasound appointment. The Doctor was again pleased with my quick progress and told me to overnight my Lupron since I’d be most likely doing a trigger shot Monday, retrieval Wednesday. Whooo hooo!

But then I got a call in the afternoon- my blood work came back and the Doctor thought the lab made a mistake since it was so low, the asked me to have my blood drawn again the next morning just to be safe. So up again at the crack of dawn to drive to San Francisco (fortunately I didn’t have to go all the way to the clinic) for blood work. Results are back and it’s still low. Rising, but not as quickly as expected.

So all I can do is google what this means and freak myself out. The nurse called to tell me to come back in AGAIN tomorrow (Monday) and see where I am. Another early morning, 5 hours round trip, bridge toll, gas, you get it. I asked the nurse as much as I could. Why does this mean? Should I be concerned? She told me no, to keep taking my regular dosages and ask the Doctor when I see him tomorrow.

And I pray for the Lord to walk with me through this.

 

Stim Day 5/ Cycle Day 5

 

Today, Thursday, I went in for my 5 day blood work/ ultrasound appointment, and the Doctor says “you are progressing very quickly!” I think 12-13 follicles on one side, 9-10 on the other.  I am instructed to continue the Menopur and Follistim at the same dosages, and to also start Ganirelix tonight.  In two days (Saturday) I will back for another appointment, and Doctor says trigger shot likely for Tues/ Wed of next week.  That means a retrieval next Thurs/ Fri – this is happening fast, and I am very glad about that.

The injections have been ok. Ryan did them at first but I mustered up enough guts to do it myself and it’s really not difficult – very tiny needles.  I have been feeling fine aside from a headache that won’t go away.  Typically, I’d treat it with Advil and caffeine, but not during IVF stim week.  So I muster through, and if this is as bad as the side effects get, it’s not bad at all. I am glad it’s my Friday, though, since thinking and productivity at work have been difficult with a pounding headache and so much else on my mind.

What will the outcome be…? I wonder.  I’m well aware our dreams could die in the petri dish in one week.  After all, we did have a doctor tell us she didn’t think Ryan’s sperm would fertilize.  There might be zero embryos – this is my worst fear. I feel a little like I’m going to be tried for a murder I didn’t commit.  The jury might let me off, and everything will be fine, or I will be convicted to life in prison.  In the blink of an eye, my whole life will be confined to a trajectory I never wanted or could have envisioned.

I realize that sounds a little dramatic, since I know there are worst things than not having children. But I am not at a point where I can say lightly “I give it all to God! Let His will be done!”  I wish I could, but I can’t.  I am still too invested in the hope of having a family, and certainly invested financially and physically in pulling off a good cycle.  To get zero embryos out of the deal would devastate anyone.  Ryan and I will not do a second IVF cycle; we have agreed on only one.

While I struggle with resigning my fate of motherhood to God’s will, I can at least say with confidence that I have complete faith God will deliver me. If this next week brings the worst and everything I have prayed would not happen, I will grieve and mourn and it will be maybe the hardest trial I’ll endure in my lifetime.  But God will still deliver me.  He will eventually bring healing.  I will eventually move on.  It won’t be easy and it won’t be overnight, but if that’s the path God has cut for me in life, I know He will walk it with me.

Enough of the fear. We did have a doctor tell us ICSI may not work, but we also had another doctor and a renowned urologist tell us it should work just fine.  We’ve got a lovely semen sample on ice, and every reason to believe my eggs are top notch.  I find in my gut I am expecting to get good embryos.  We will know one way or another very soon.

 

Stim Day 2/Cycle Day 2

stims.jpg

Obligatory IVF Medication shot. They even gave me a bio hazardous medical waste container, which is a first.

I’m on Day 2 of Stims, technically Cycle Day 2. I do 225 IU of Follistim in the morning and 75 IU of Menopur at night.  So far I feel a little drugged, headachy and cranky, but I am also on my period.  So I’m doing incredibly well considering that I’m on my period and getting 2 injections a day of hormones.

Ryan is a licensed paramedic, so the injections are a walk in the park for him. I joke that we are the best equipped couple ever to walk the IVF plank; Ryan with a medical background and myself with a finance background.  What else do you need to navigate this world, other than a gift for needle handling and serious budgeting skills? We got it in spades.

Baseline

Yesterday I woke up at 5:30 a.m., 45 minutes later than planned, and RUSHED out the door to get on the road to the clinic.  Fortunately, I didn’t get stuck in the worst of morning rush hour, so I did my lab work, ultrasound, and made it back home by 10:30 a.m.

Doctor said everything looked “as expected.”  I got the all-clear to call the pharmacy, order my meds and charge the $3,975.06 to my credit card.  Meds will be on my doorstep, requiring a signature, before 10:30 a.m. on Saturday morning.  The next 20 days or so I will be in the heart of an IVF schedule.

Today I stop birth control, Sunday (7/23) I start stims (follistim and menoupur).

My trigger shot will be anywhere from cycle day 9 – cycle day 14, although the doctor said most commonly it will fall on 10, 11 or 12. Egg Retrieval will be 2 days after that, Embryo Transfer will be 3 or 5 days after that.  I am booking myself for 2 days of recovery or bed rest after the transfer.  No one has told me this is necessary, but I am a Nervous Nelly and have heard this can help.  I want stress and strain to be as far from my mind and body as humanly possible as it recovers from an IVF cycle and hopes to make a suitable home for an embryo. 

In true accountant fashion, I made a spreadsheet to help assess what my next two weeks could look like.  This helped me decide I will take off work the 8/7 – 8/11.  The week prior, when I am driving down to the clinic for who know how often, I am just going to tell my boss I have to be on-call that week with my doctor and may have to come in late some days or not at all (in the case of the ET).  Since I know now I can make it back by 10:30 a.m. I’m not so concerned. If he asks why, I will tell him, but I knowing him I would very surprised if he showed any desire to know about my personal life.

The IVF Cycle is almost here! It’s been almost 5 years in the making and I am so excited to be doing SOMETHING.

(T = Trigger, BW/US = Blood Work, Ultrasound, R = Retrieval, ET = Embryo Transfer)

Scenario 1 Scenario 2 Scenario 3 Scenario 4 Scenario 5 Scenario 6
Monday July 31 CD 9 T BW/US
Tuesday Aug 1 CD 10 T BW/US
Wednesday Aug 2 CD 11 R T BW/US
Thursday Aug 3 CD 12 R T BW/US
Fri Aug 4 CD 13 R T BW/US
Sat Aug 5 CD 14 ET R T
Sun Aug 6 CD 15 Recover ET R
Mon Aug 7 CD 16 ET/ Recover Recover ET R
Tues Aug 8 CD 17 Recover ET/ Recover Recover ET
Wed Aug 9 CD 18 Recover Recover ET/ Recover Recover ET
Thurs Aug 10 Recover Recover ET/ Recover Recover ET
Fri Aug 11 Recover Recover ET/ Recover Recover
Sat Aug 12 Recover Recover ET/ Recover
Sun Aug 13 Recover Recover
Mon Aug 14 Recover

T- 4 days

Baseline Ultrasound is tomorrow, and injections begin Sunday. I can hardly believe it.  I feel like I’ve been utterly consumed by a move and remodel, policy deadlines at work and oh yeah throw in an IVF cycle, too.

I mean, I am prepared, I’ve called the clinic several times “just to talk” aka answer my lists of questions. The drug order is standing by at the pharmacy at a whopping $4k waiting for me to make the call after tomorrow’s baseline appointment to have them overnight it. Consents all signed, time off work kind of confirmed (going to wait until the Baseline scan is a sure thing….) But still, how did we get here already?!

There are still so many uncertainties. Last time we moved into an IVF cycle, I tried to talk out all the details with Ryan beforehand.  I wanted to know we were on the same page for EVERYTHING, that we were fully educated, discussed all scenarios, and had a game plan.  This time around, I’ve accepted that’s just not realistic.  Ryan is emotional and a worrier (he would totally disagree, but I am married to the man after all, so I have a right to assess his personality).  Trying to present “worst case scenarios” and too much detail just gets him all revved up and the conversation gets nowhere.  So instead, I am playing it by ear.  If and when we have to confront embryo counts, miscarriage, FETs or embryo quality, we will.  Until then, it’s just not worth diving into the messy particulars.

I’ve been worried something is going to go devastatingly wrong. Maybe because that’s what happened last time?  Or maybe because my body never does well on birth control.  I skipped a day last week accidentally, so took 2 the next day, and ever since I’ve been spotting and bleeding daily.  Last night my left ovary was hurting – badly enough to wake me up several times.  I am nervous that I’ll go in for the scan tomorrow and something will be off.  As a male-factor couple, my body performing perfectly is something we are banking on.  I tell myself the doctors know what they are doing, I am nothing new or unusual, and I need to trust the process.  Still, I will feel better after tomorrow when we have a look at my system and I’m told we are a go.

And then, let IVF begin.

How to talk to your 40-something upwardly mobile divorced-with-no-children Director about infertility

In short, I don’t. I honestly don’t think he wants to know about my personal life and I don’t want to discuss my infertility with anyone, let alone my boss.  But my Director approves all my time off, and the erratic requests for blood draws, ultrasounds, egg retrieval surgery and embryo transfer will no doubt raise his curiosity.  My options, as I see it, are 3:

  1. Say nothing at all. Request the time off that I know in advance. When the unpredictable couple weeks come around and I’m driving 4 hours round trip multiple times a week to get my blood drawn and undergoing minor surgery and an embryo transfer, just call in sick as needed. It’s legitimate sick time, used at the doctors, and I can’t arrange it in advance. So call in sick when I need to, which will be a lot, and just let everyone deal with it.
  2. Be cryptic. Sit down with the boss and say “I’m having a minor surgery and will need some time off, but my doctor is waiting to see how my body reacts to certain medications before he schedules it. So I will be taking a lot of time off in the next few weeks for consultations and surgery, and just have to be kind of on call. Sorry.” I don’t think he’ll ask questions or pry, but I do realize this sounds fishy. Or like I’m getting cosmetic surgery or something embarrassing.
  3. Be honest. Tell him everything. It’s the workplace, so he can’t discriminate, and I’m sure in all his uber-professionalism he is tight lipped and does not gossip. But still – what if it doesn’t work? Will he feel obligated to be polite and ask how everything went? So, so awkward.

Another concern is the secretary I share with my boss. She’s really sweet and motherly, and no doubt if I call in sick or take sick time off she will be badgering me with questions about my well being, with the best of intentions of course.  If I tell her I’m having surgery and deny details is that weird?  Again, telling my work people I am doing IVF is a territory I’d rather not traverse.  If it’s unsuccessful it’s just another bad conversation I must have.  Not sure how to approach this.