Coasting

I would not have predicted that I'd go three days before posting again since I'm in Denver now and I'm supposed to have all kinds of time on my hands. We actually have been pretty busy.

Thursday -- ultrasound and bloodwork, consult with genetic counselor, backup sperm sample, switched rooms in hotel (got the big one we wanted), dealt with work issues and internet problems in new hotel room

Friday -- IVF physical, electro acupunture, more internet problems in hotel room, trip into Denver to visit The Tattered Cover bookstore (thanks for the recommendation, Pie) and find a place to have birthday dinner, and oh -- intermittent gifts throughout the day from DH (he's so wonderful!)

Saturday -- ultrasound and bloodwork, spontaneous 300+ mile trip ino the mountains that took the rest of the day. It was so beautiful - lots of snow on the ground, bright and sunny

Today -- ultrasound and bloodwork, church, lunch, grocery store and Target, work projects due tomorrow, walk on treadmill, dinner at yummy Mexican restaurant out our back door

So that's what I've been doing, but here's the skinny:

Started stim meds 1/23 (Menopur, Follistim, Saizen (Saizen just for five days)

1/26 ultrasound/bloodwork
E2 593, P 0.3, LH 6.4
15 follicles

1/28 ultrasound/bloodwork
E2 1674, P 0.9, LH 6.5
11 follicles measured (L 13.5, 16.1, 11.9, 14 and R 14.6, 12.7, 13.5, 13.1, 15.2, 13.2, 11.5)
Need to watch P level -- if gets above 2.0, may have to freeze all embryos no matter how many we have

1/30 ultrasound/bloodwork and Doppler retest
E2 4076, P 1.7, LH 4.9 - stim meds discontinued p.m. to keep E2 from rising much more - "coasting"
11 follicles measured (L 12.4, 18.2, 13.1, 17.7,10.3 and R 17.2, 17.9, 13.9, 17.1, 14.0, 13.8)
Doppler results normal (PI down from 4.69 to 2.05 on R and 3.9 to 2.24 on L!)

1/31 ultrasound/bloodwork
E2 4815, P 1.9, LH 3.7
11 follicles measured (L 19.6, 18.3, 17.4, 15.3, 12.4 and R 18.2, 16.2, 15.1, 18.3, 16.5, 17.4)
Sonographer counted 17 but only measured the biggest ones.

I thought they might trigger me tonight, but I'm still coasting. I'm glad about this. My big problem in previous cycles has been getting enough mature eggs. Everyone here has been saying we should get double digits, which would be amazing. We got 7 last April and 3 in August.

When we met with the genetic counselor, we discussed plan A, plan B, plan C... Plan A is to get at least five eggs to fertilize so we can do the genetic testing. Plan B is either a fresh transfer or polar body testing. All of the possibilities are kind of mind boggling. I loved receiving the information that the genetic counselor shared, but it was a bit overwhelming when I started thinking about every little thing that could happen in our specific situation.

Tomorrow we have another ultrasound and bloodwork and a regroup with Dr. S. (we are now calling him Dr. Babycraft). In Atlanta, the docs often do the scans, so you get to have a pretty regular, ongoing dicussion with your doctor, which is nice. Here, they have a pretty different model for getting things done, which in many ways is also nice, but it doesn't give you the opportunity to regularly communicate with your doc directly, so I scheduled this appointment just to touch base. I'm so glad I did that. Can't wait to get his take on how I'm progressing.

I also asked today who is calling the shots over the weekend since Dr. Babycraft isn't on. I was pleased that he isn't totally out of the loop; he is apparently supervising the on-call doc's decisions. I asked about my chances for getting him for the retrieval and Nurse Julie explained that I can request him if that's what I want. I assured her that that's what I want because this is our last ditch effort at this and well, he's the man.

About the Doppler retest -- in November at our one-day workup, they discovered a problem with uterine bloodflow. I was told that a year's worth of acupuncture had been done incorrectly and that I needed to start doing electro acupuncture. My great acupuncturist in Atlanta talked to one in Denver who works with CCRM and she started treatments according to Denver's specifications. I was also told, "Absolutely no caffeine of any kind" so I eliminated Coke, tea, and chocolate (very painful, especially during the holidays). I started drinking at least 64 oz of water per day and walking 30 minutes each day. This new regimen was a pretty significant undertaking for me, but I decided to abide by these rules because I wanted to give this all I've got. And what do you know?! It worked!

Mile High Anxiety

Well, it's not that bad (mile high), but I am having some anxiety, which is pretty unusual for me.

• I think it's partly lack of sleep. Too many long days at work trying to prep for being out for two weeks.
• It's also an inability to pack well -- DH and I checked 4 bags -- yep, FOUR -- and had three carryons. Of course I had a backpack jammed full of meds on ice, boxes of Menopur and Prometrium, and swabs and syringes.... And I had to bring my normal jeans AND my fat pants because I imagine at some point, I'm going to feel a litte bit, well, full. I just wanted to be prepared to be comfortable and now is not the time to insist on not checking bags. So in the name of taking good care of myself, I found myself with DH dragging seven bags -- oh and a tiny purse that I hoped would fit in one of the carryons if they got picky about such things. I miss my big purse.
• It's the fear that someone from work will see me at train station with my husband and seven bags when I'm supposed to be out for a "medical procedure" for the next two weeks. Ha. Thank goodness that didn't happen.
• It's the awkwardness of injecting meds on my the plane because I ran out of time before the flight and didn't want to be three to four hours late.
• It's the feeling of despair when you desperately want to sleep but can't -- that was me on the plane. (However the silver lining to that cloud was that we had free TV on the flight, so I watched the State of the Union address. Not that that reduced my anxiety level -- so many issues, so little bipartisan cooperation in D.C. But I won't go there.) 
• It's the frustration of arriving at the hotel where we'd stayed in November (in a huge room) to find our room much, much smaller. We inquired and may be able to move to a larger one today.
• It's the fact that yesterday I ate Dunkin' Donuts for breakfast, half a turkey sandwich and potato chips from a corporate boxed lunch, a Whopper Jr. from the airport, and a bowl of microwave pasta from the store at the hotel (at midnight Atl time). Ick. That is awful!
• Add all of the above together and that leads to the fear that this stuff has impacted my cycle -- that's the Mile High Concern.

But now that I'm here, things are going to get better.

• I'm going to have a proper breakfast at the hotel restaurant.
• I'm going to walk on the hotel treadmill later today.
• I'm going to get our room changed if at all possible and then unpack and settle in. Making our stay comfortable is really crucial to my sanity for the next 2 weeks.
• I'm going to catch up on my sleep one way or another (I love a good nap).
• I'm going to my first monitoring appointment here in Denver this morning and hopefully get some reaassurance that things are progressing well.
• I'm going to write a LOT in this blog because it is part of my sanity plan -- and with all this time on my hands, the potential for lack of sanity has never been greater.

It's all going to be fine. One way or another. In fact, here is the first evidence of that:  I just read a preview of what I've written here and considered changing all of the "It's" to "It was" in the list of concerns. That is a very good sign. Thank you, Blog!

More later.

Thought-provoking quote

I saw this quote in someone's Facebook status several days ago and it stayed with me. I'm pasting it here in case I need to make a graceful exit after our trip to Denver.

There’s a trick to the "graceful exit." It begins with the vision to recognize when a job, a life stage, or a relationship is over — and let it go. It means leaving what’s over without denying its validity or its past importance to our lives. It involves a sense of future, a belief that every exit line is an entry, that we are moving up, rather than out.

                                                                 ~Ellen Goodman

My husband just asked, "Are you working or blogging?" so I read him this quote and told him why I'm saving it. To the possibility of needing it to help make a graceful exit, he said, "You won't. We're going to have four or five fertilize."

We do both feel fairly optimistic, which is nice. I feel very balanced at the moment. I hope it lasts!

Grateful, Enchanted, and Hopeful

Thanks so much to everyone who commented on my last post -- and a huge thanks to Mel for mentioning me in her 172nd Friday Roundup. I feel like I'm really part of the blogosphere now. Thank you all for your kind, encouraging words.

*******

I started my meds this week. Bought most of them at a local specialty pharmacy in the ATL, except for the Lupron -- which CCRM insisted I get from a pharmacy in Denver because they mix it differently -- and the Saizen, which the local people didn't carry. I'm pretty excited about taking Saizen because I hope it will make me taller! (Kidding. Sort of. I do want to be taller but I realize that's probably not going to happen in six .33 cc doses. Unfortunately.)

The time difference between Atlanta and Denver is on my side  -- CCRM has nurses on call from 4 pm to 10 pm, which for me is 6 pm to 12 am. Good thing since I had a work event Thursday night and although I thought I had figured out how to dilute the Saizen the night before, at 11:30 pm on Thursday, I knew I didn't have it right. I called CCRM and talked to a very friendly nurse who straightened me out. Then last night when I was prepping to do the Menopur this morning, I had another question, so I called again. And again, so friendly. So helpful. They are great.

I must admit, I'm pretty enchanted with CCRM right now. I grudgingly went out there for my one day work-up, pretty annoyed that they wanted to repeat tests I'd already had done in Atlanta. But as I observed how they do things and as I have dealt with them over the phone and through email for the past two months, I am very impressed. I feel like I'm giving this my best shot by going to CCRM. If this cycle doesn't work, I don't know what I'll want to do. Mentally, this is the end of the ART road for me. But emotionally, I don't know if I'll be ready to stop and choose adoption or not. I was at that point before when my Atlanta doc sent me to Denver. I think that's part of the enchantment. I was hopeless before we decided to talk to Dr. S. I was grieving the loss of the possibility of having a genetic connection to my child. Even as we went to Denver for the one-day, I really didn't think Dr. S. was going to be able to help us. But now I am spellbound by the magic of the wizard and his lab.

Doing injections again is kind of bittersweet. I feel hopeful but want to balance that feeling with reality: this might not work. The key for me is getting enough eggs. First IVF, we got 7 eggs and only 2 fertilized. Second IVF, we got 3 eggs and 0 fertilized. Dr. S. has said we should have gotten more eggs because I had 17 resting follicles the day of our one-day workup in November. He said with 17 resting, we should get into the double digits upon retrieval. I am crossing my fingers.

We are heading out to Denver after work on Wednesday. DH is currently second-guessing our hotel selection, obsessing over all the options. I really liked the hotel where we stayed for the one-day workup, so that's where we have a reservation. I think we'll stick with it. DH is coming with me the whole 2 weeks because his work allows him to work from anywhere. I'm grateful for that because my birthday is Friday and I really would hate to spend it alone.

I wish so much that I could take a day and go skiing while we're there but I'm just not willing to take the chance on something going wrong and needing to be airlifted to Denver or something crazy like that. After my first IVF attempt, about five days after transfer, I landed in the hospital for two days because I had severe pain. (See my post "Rather Belated and Dramatic Update" from May 2009).

If anyone has suggestions of day trips, museums, bookstores, restaurants or anything cool and entertaining in Colorado, please share!

I need this

It's been a rainy three-day weekend so I've allowed myself some time to check out other blogs about infertility. I had no idea there were so many! Everyone seems so interconnected. What a great community. I think I need this. Here's why:

I have a handful of close friends who know what I'm going through and are wonderfully supportive, but I don't talk to them every day or even every week.

I have some friends at work who know about our nearly three-year quest to become parents, but I have regretted confiding in at least one of them. I have cut that person out of the loop of information about all of this because she kept asking me repeatedly for the latest news. It became a problem for me because I am her supervisor. I know she means well, but I just don't want infertility to interfere with work. I have a demanding job and it's actually a great distraction from the stress of infertility (when I get to decide what and when I want to share). I really appreciate those colleagues who know what's going on but they NEVER bring it up first.

Another community that's important to me is my church, but it is honestly the most difficult part of my world when it comes to infertility. Most people there do not know what we're going through. It often doesn't make sense to me to be part of a caring community of people and to deliberately choose to not express the depth of the stress, the jealousy, the hopefulness, the hopelessness, the determination, the confusion, the doubt, the excitement and anticipation, the fear of another disappointment.... I know it's best to not share all of that -- or any of that -- because the church is probably full of quite a few well-meaning but nosy people like my coworker above. But I feel like such a fake.

Today at church I had to plaster a big smile on my face as I heard the latest new mother tell someone, "I counted and I think there have been 7 babies born in our church during the past few years" as people oohed and cooed over her beautiful new baby, which I had never laid eyes on until that moment. The most difficult part is that last May, we were pregnant together. She knows what my husband and I are going through. Our babies were going to be friends. But now, she has this beautiful baby and my little embryos didn't make it. (I don't believe she had any idea how her words stabbed into my heart. She is either sleep-deprived and oblivious or perhaps just slightly insensitive. I must choose to believe this if I'm going to function as a relatively healthy member of our church community.)

There are days when I wonder why I'm putting myself through this again. Today is one of them. I could've easily moved on and chosen adoption. IVF is so much work.

This is why I need this blog. If anyone is reading, please comment so I'll know. If no one comments, I'm going to have to work on figuring out how to make this an interactive experience for me. I want to engage with others in this community.

Six Months (At A Time)

I selected the wrong name for this blog last spring. We had been accepted into the Attain program, which gave us up to three fresh and three frozen IVF cycles for the price of about two cycles. I actually thought that I could do three fresh cycles in six months. (I didn't anticipate the opportunity to do a frozen cycle because my doc said it was unlikely.) After two unsuccessful cycles in five or six months -- the second of which was a complete train wreck -- Attain kicked us out of the program and refunded us 70 percent of the money. Financially, we came out ahead of where we would have been if we paid for both cycles outright. Emotionally, I was feeling pretty defeated. I had been counting on that third and final attempt.

After the failure in August, my doctor in Atlanta suggested we consider egg donation, adoption, or a second opinion. I was ready for adoption. My husband was ready for egg donation. So we went for a second opinion.

In Colorado. She sent us to the best in the country -- the Colorado Center for Reproductive Medicine and Dr. William Schoolcraft.

I approached the second opinion with Dr. S. matter of factly, in order to protect myself from further disappointment. I really wasn't open-minded about the possibility of treatment at CCRM because I couldn't imagine that they could offer anything I hadn't gotten in Atlanta. I just wanted him to tell us that our Atlanta doc was right so we could move forward and try to sort out the adoption vs. egg donation dilemma. Well I was wrong. Schoolcraft seems to have a quiet "bring it on" kind of attitude about our case. He thinks he can help us. After a phone consult, a whirlwind trip to Denver for a one-day workup (we were literally in Denver for about 16 hours!), and a follow up phone consult, we decided to try one more IVF cycle.

I'd like to summarize how I came to that decision in another post -- I'll do an Atlanta vs. Denver Infertility Smackdown -- because if anyone from Atlanta ever reads this blog, what I have to say might be interesting reading.

So here we go again. I should start stims in five days if all goes well at my appointment on Monday.

Back to the blog name change. Six Months (At A Time) feels right to me. I thought of other names like "Babytrain to Crazytown" or something like "Womb Available" or "Race to the Womb"... But this name will remind me to live in the present and not get too far ahead of things. There are many ways that my thoughts don't take things Six Months At A Time. Sometimes I dwell all too much on how old we'll both be when our unconceived child graduates from high school or how old the child may be when we die, because no child should lose a parent too soon. I lost my dad when I was 33 and that was way too soon for me.

I like the idea of imposing a six-month limit on my musings about the future. If this were truly possible, I would not dream about next Christmas and whether I'll be enormously pregnant and unable to travel to see our families. I would not think about my colleague who has confided that she is also TTC and I would not worry about which of us is going to succeed first and how we would work out our possibly overlapping maternity leaves (my boss would absolutely freak out about that one).  At this point, I would not worry about the possibility of a late-term miscarriage or multiples that weigh just a couple of pounds apiece.

All of these things are part of the grand reality check of trying to conceive a baby through IVF at age 39 with a soon-to-be 50 husband, but they aren't things I should ponder frequently or seriously.

Here's to Six Months (At A Time)!