Wednesday, April 28, 2010

Symptoms?

6dp5dt -- 3 days to go until beta!

There's been a lot of "activity" in my body today. I've felt slightly crampy, with some lower back pain, and I had some feelings I don't think I've ever felt before. My breasts are also a bit tingly. All of this been happening off and on for several days but I wasn't so sure that some of it wasn't just effects of the estrogen patches and progesterone or wishful thinking for symptoms. There's no doubt that I'm not imagining this stuff now. But it still could be the meds.

I am not going to POAS (pee on a stick) because I just don't want to have to process the results. I won't believe it either way and if it's negative, that could really mess with my head. I am doing pretty well and just don't need to go there.

Amazingly, I've somehow convinced myself that the beta is just one more hoop to jump through, like the egg retrieval, the fertilization report, the wait for embryos to develop and grow to become blasts, the comprehensive genetic testing of embryos, the thaw of the two they transferred.... So many things have to happen "just so" that getting past this first beta is sort of just another hoop to jump through. If it is positive, I still have to jump through the second beta hoop, the ultrasound-looking-for-a-heartbeat hoop, and who knows how many more hoops before I end up with a live infant or two.

How have I ended up thinking like this? I think my experience a year ago was so traumatic, I just don't want to let myself go there again. I am the only person I've ever known to cry her eyes out before leaving the RE's office  (while standing in line to check out, in full view of everyone in the waiting room, waiting for their own good or bad news). But yes, that was me last May when the doc finally said there was no hope for a viable pregnancy to develop. I just couldn't hold it in until the parking lot. It had only been about 12 days since the first beta and six days since they started using the phrase "not genetically viable" but my hope was so fierce, I was determined to see those HCG levels rise. Tears streaming down my face, I apologized to the check-out girl saying, "Sorry. I know this is bad for business." Our train wreck cycle followed that -- 3 eggs, 0 fertilized. Then we were kicked out of the Attain financing program. After that, I crashed emotionally and did not begin to believe that perhaps I could conceive a child with my eggs until some time after our one day workup at CCRM.

Our experience with CCRM has been so enchanting. And it really isn't CCRM as much as it is their results. I mean, they retrieved 17 eggs and created 5 normal embryos in their lab. Hope was reborn. But there are limits to where I will let myself go. On Saturday, if I get a BFP, believe me, I will shout it to the mountaintops of this blog. But then I'll start thinking about Monday's beta. It sort of seems like the hoop-jumping could be never-ending, possibly sending me to crazytown pretty quickly. So instead, I'm trying to enjoy each day of this experience . After all, being PUPO (pregnant until proven otherwise) may be the only "pregnant" I ever am. I want to enjoy it as much as I can.

It will be interesting to see if I can keep this up. I feel healthy and at peace at the moment. Time will tell!

One last note: I am getting pretty good at telling people who know my infertility story -- and even know about Denver and in some cases, the transfer last week -- that we're just not telling. For example, here's what I said to a good friend who emailed me tonight with an "any news?" question: "We had a frozen embryo transfer (2) last week, so we hope to have some good news this summer! Once we get the initial result, we plan to hold back on sharing it until we’re feeling more confident that it’s really going to happen this time." People have been very respectful.

Tuesday, April 27, 2010

PIO Independence!

I'm so proud of myself, I have to brag to some people who can appreciate this . . . I gave myself my very own PIO shot in the bum this morning! DH is going out of town for two days this week, so I was faced with calling a friend who's a nurse, paying my home clinic $30 for each injection, or doing it myself. I didn't like the first two options, so I decided to try it under DH's supervision this morning. And it worked just fine! It actually hurt less than some of those smaller needles in my abdomen or thigh.

After I did it, DH said, "Am I out of a job?" as if he felt like he's no longer needed. I assured him that I'd prefer for him to do it because I didn't like twisting around like that -- the most uncomfortable part. He seemed relieved that his duties hadn't been taken away from him. He's so needy! I love him, though.

All is going well this week. It's hard to believe that my beta is in 4 days!!! I am doing a pretty good job keeping busy at work. I've been resting a lot in the evenings, just trying to not overdo it. So far, so good on the emotional front!

Sunday, April 25, 2010

Strategizing for Sanity

We're back home now and thankfully we somehow dodged all of those horrible storms that devastated parts of Mississippi. Ironically, we flew right over those areas but at 40,000 feet above the clouds, it was bright and sunny. I couldn't help but notice that our flight had an all female crew, from the pilot, co-pilot, and the flight attendants. As I exited the plane I felt like saying something about girl power and thanking them for a safe landing, but I did not.

So the fun begins. Yesterday I asked DH for his opinon about three possible strategies for surviving this week:
A. Pretend like nothing has changed, focus on my busy week at work, and as a result, stay pretty even about the news we'll be getting on Saturday.
B. Walk around with a big smile in my heart (and maybe on my face, too), confident at the fact that I am PUPO (pregnant until proven otherwise). In other words, positive thinking all the way. Shut out those fears and doubts.
C. Try to keep a realistic mindset, don't forget that the odds are sort of against us here, prepare for a letdown and then if it's positive, be very pleasantly surprised.

I didn't get much advice from him on this (which is probably a good thing), nor did I firmly select A, B, or C. There are merits to all three strategies, but I am leaning toward a combination of A and B, with a bit of C well below the surface. I have a ton of stuff going on at work, we have the big backyard project, and I have a surprise birthday party to plan for DH.

One thing I'd like to avoid is getting into an intense study of possible symptoms day by day. Last night I actually googled "2dp5dt symptoms" (that's "2 days past 5 day transfer"). Reading what I found made me feel anxious and crazy. When I was doing bedrest, I felt some things -- mild crampy feelings -- but who knows if it was back pain from being in bed for so long, if it was something I ate, or if it was something happening with the embryos inside of me. Something like, oh, maybe, implantation?

Right now, I'm just happy that inside of me are two microscopic combinations of me and DH. Last October when my Atlanta doc said "adopt or find an egg donor" I never thought this day would be possible. So for THIS day, I am grateful. At moments yesterday, I thought, "Take your time, Saturday! I don't want to know." In some ways, ignorance is bliss.

Friday, April 23, 2010

Reporting Live from Bedrest in Denver...

First of all, I must comment on the crazy weather we're having here. Yesterday, it rained, it hailed, it was sunny for a while, and there were tornado warnings. Today, it has been raining but now it is changing over to snow. It is pouring snow right now! I think I heard that there could be 4" accumulation. Insane! We were here for 10 days in January/February and it was bright and sunny just about every day. We saw about 10 snowflakes in 10 days. Meanwhile, I hear it is sunny and supposed to be 86 in Atlanta today.

Enough about the weather. I think everything went great with the transfer yesterday. The day started with a call from the lab to confirm my "thaw plan." I learned that they were going to thaw numbers 1 and 17, which were both frozen on day 5. Their grades were 3AA and 5AA. I learned that after thawing, they would give them each a  % grade based on how much of each embryo was intact. Then, they would also grade the re-expansion, from slight to fully expanded. She said even if it was slight, there would be time for expansion between the thaw and the transfer. I think the thaw took place about 3 hours prior to transfer. I asked what would happen if something goes wrong -- would they call me back to talk about thawing a third one? She said yes, they would.

They didn't call, so that was my first sign that all was well.

Before going up to the CCRM surgery center, I had a blood draw to run the E2 and P4 (estrogen and progesterone). I was very curious about this because both had been low the last time they ran them. We also had our injection teach with our nurse. I suggested that DH actually do that shot under her supervision. It went fine. Thanks again to everyone for the tips and encouragement about that!

Everyone at CCRM's surgery center was so friendly and upbeat. I had acupuncture before and after the transfer. It is so nice that CCRM makes this really easy on patients who want to do this. They bring the acupuncturist in to CCRM so you have the same room the whole time you're there. (In Atlanta, I had to go to the acupuncturist's office before and after the transfer.) I was lucky because I got the same acupuncturist I had seen while I was here in January. And she's the one who spoke with my acupuncturist in Atlanta about electro-acupuncture treatments. She also gave me the strict "absolutely no caffeine and 64 ounces of water and 30 minutes of walking daily" regimen. It only seemed right for her to bring me across the finish line of this treatment cycle, acupuncturally speaking.

Snow update: "the lake is covered, the ground is covered, it's snowing more and more!!" This is an inside comment for one of my readers -- my dear friend S. who was my freshman roommate in college. I sat up one morning in bed, looked out the window and exclaimed the above. You probably had to be there, but that has become a catch phrase for 20 years now. In other words, there is snow everywhere. Sorry for the snow fixation, but I live in Atlanta, people!

Back to yesterday. You have to drink lots of water before an embryo transfer because it helps the sonographer find the uterus, the image of which the doctor uses to guide the placement of the embryos. A nice CCRM discovery is that they are very precise about how expanded your bladder should be. In Atlanta I had to drink more than 64 oz of water before the transfer. Here, I drank maybe 20-30 oz and they decided my bladder was too full, so they let me go to the restroom -- twice! They gave me a medium-sized cup and allowed me to fill it. What a relief!

The embryologist came in with a clipboard to report on the embryos. Get this: both of them survived 100%!

When it was time to bring the little guys in, they rolled them in in a high-tech IVF chamber, that according to this web site (from which you can buy your very own IVF chamber if you like), will protect the embryos from harmful room air and boost your chances of success. I never saw this chamber in Atlanta. One more reason why I love CCRM. I'm telling you, they have got it going on. In Atlanta, there's a door between the transfer room and the lab, so I'd like to believe that it was just a few steps that the embryologist walked with my embryos in the pipette, exposing them to who knows what, but you never know.

The coolest thing is that we got to see them magnified on the video monitor above the chamber.

Here are a few pictures . . .


Embryologist at work


The dish under the microscope


Numbers 1 and 17, moments before transfer
(one is just above center, the other is in bottom right-hand corner of screen)

Dr. Babycraft got me ready for the embryos, the sonographer was pushing on my abdomen to keep a good view of the uterus, and when it was time, the embryologist actually inserted the embryos and accompanying fluid into the catheter placed by Dr. B. This was different in Atlanta, too; the embryologist didn't get to do the honors. She handed the  pipette to the doctor who actually did the deed. I don't know that these differences really matter, but I surely like the idea of everyone having their own task and specialty. I'm sure such attention to detail plays into success rates.

At the risk of giving TMI... Dr. Babycraft had some trouble getting "access." After it was all said and done, he said, "Did you feel anything?" and I immediately said yes. And he said, "What did you feel?" I told him it was uncomfortable when he was putting the catheter in.  (It actually hurt at moments.) He nodded and said he had some difficulty. He asked if I was cramping and I said yes, a little bit. I said that has happened before -- that my cervix has been kind of twisty. He agreed. Strange -- I felt like I was assessing his performance and that he was not happy with himself that I felt something. Like he prides himself on people not feeling anything. Which isn't necessarily a bad thing.

He said I had two beautiful embryos. Everyone was saying that, and they were all so excited for us.

After my second acupuncture treatment, when she said goodbye and left the room, the last thing she said was, "Send me a baby picture!" and I immediately said, "Okay!" like it's a done deal.

I could write all day, since I'm confined to the bed until tomorrow morning and it's not even noon! However, I realize you do not have all day to read my blog, so I'll sign off for now.

Oh, one more thing. Progesterone was still low, so PIO shots are now daily, plus the three-a-day endometrin suppositories. DH is already a pro! We did today's shot a while ago and I literlly felt nothing. Yay!

Thursday, April 22, 2010

Back in Denver

DH and I agree it's a bit surreal to be back in Denver. We arrived tonight. I was sooo excited to get off of I-25 and ride past CCRM on the way to the hotel. DH waved to the embryos when we went by.

I am ready! I feel like I have been prepping for a big game and tomorrow is game day. I'm sort of like, "Bring it on!!"

I have some slight fear about something going wrong with the embryos when they thaw them, but I'm not going to let myself go there. I can't control any of what happens in the lab.

We have to be there at 11:45 a.m. tomorrow. Transfer is scheduled for 1:30 or 1:45. I'm doing acupuncture before and after.

I'm pretty tired -- it is 1:00 a.m. in Atlanta and I worked a full day before catching the flight here.

Before I sign off for the evening, I want to say a sincere thank you to everyone who's been reading and following me. Thanks for your interest, your well wishes, your prayers, your advice, your encouragement, and your friendship. I am so grateful for this community.

Good night!

P.S. PIO shot done at doctor's office yesterday was a breeze. No pain at all. Maybe I have tough buns! : )  Tomorrow DH learns how to give the shot.

Monday, April 19, 2010

Progesterone shots -- eek!

PIO = Progesterone in Oil
PIO = intramuscular injection in your backside
PIO = P-I-Oh Crap!

I had my progesterone level checked this morning and it was only 4.1. CCRM wants it above 6. The nurse called with the news and I knew what was coming. I've heard about these shots.

I have a fear of intramuscular (IM) shots because the needle is huge and you can't give them to yourself. This means my DH has to give me the shot. Yikes! We paid a nurse $100 to come give me the HCG trigger shot at 2 a.m. in Denver in February to avoid this. But now, I have to have a 1 cc injection every other day at least through the pregnancy test and well into the pregnancy if successful. Getting someone else to do it just isn't feasible.

My dear friend Kate who has actually adminstered her own PIO shots and taught her DH how to do it has agreed to help me out tomorrow. Then on Thursday, the nurse will teach my DH how to do it.

They ordered 20 doses -- enough for 40 days! Someone's being optimistic... I'm sure that's the standard initial order, but I'll just pretend it's Dr. Babycraft! : )

Sunday, April 18, 2010

On being hopeful

Hope is such a mysterious and sometimes elusive thing. Friday night I googled something about FET and one of the top FET links that came up was something from the blog of another CCRM patient. I clicked over there and was absolutely drawn in by her storytelling abilities. And she was so positive! Her FET was last October and it worked. It was her last chance and she transferred her very last embryo. And it worked! The great thing is, she was so, so hopeful and positive beforehand. She wasn't disappointed when she learned the outcome. Was her joy at the good news even more full because she'd already been in a positive place?

I thought about her positive energy several times yesterday, wishing I could be so positive. I don't know if I just don't have it in me at all or if I can't let myself go there because I've had too many disappointments to grieve over already (dad's brain injury and death 9 years later being the chief disappointment -- that absolutely changed my outlook on so many things, including my faith and my beliefs about how God works in our lives, answers prayers, etc.). I worked really, really hard after dad died to reclaim a positive and hopeful outlook on life. When I met my wonderful, sweet, funny husband and became part of his very cool family, hope was restored in a big way. Although my dad and four grandparents died within the span of 11 years and my own family was reduced to just a few special people, I was given a new family and learned that there's always an opportunity for renewal, one way or another.

But I still find it difficult to be super-positive and upbeat about the FET results that will be known on May 1.  My hope is laced with caution.

Perhaps I could decide now that it will be more fun to be hopeful and positive. I'll just throw my caution to the wind. The journey of the next few weeks would be much more fun and light-hearted, but if it doesn't work, will the disappointment be greater?

Friday, April 16, 2010

Six More Days 'til FET

I'm excited and relieved that after all this time of waiting and preparation, the FET date is almost here. I'm "locked in" now on the date. This week, on Monday, my E2 was 126 (they like it to be 50 or more). Today, it was 312 (they like it to be 300 or more). My nurse asked if I'm moving the estrogen patches around, because apparently if you put them in the same vicinity, the absorption is limited. I have not been putting them in the exact same place, but I have been using the same section of my lower abdomen. Guess I'll be moving them tomorrow. I had my lining check today, too, and the PA said, "It looks beautiful. I can't imagine a more perfect place for an embryo to implant." That made me feel really good. The measurement was 11 and it has a great triple stripe, as desired.

I had my 7th electro acupuncture treatment this evening. One more to go on Monday and then I should be set. The acupuncturist said tonight that I sound so positive and sure that this is going to work. I wouldn't say that. I am just ready. I'm excited that two weeks from tomorrow, we'll know something.

When I talked to the nurse today I asked how that will work -- the beta. It will be May 1. My clinic in Atlanta will get results and send them to Denver and someone in Denver will call me. They want the HCG to be at least 50. If it is, on May 3, they'll retest and hope it has doubled. If it has, that's it. They'll do weekly estrogen and progesterone checks, but no more HCGs. Two and a half weeks past the beta, they'll do an ultrasound and hope to see a heartbeat. The thought of that makes my own heart race!

If the beta is negative, I don't even want to think about that. At least May 1 is a Saturday, so I could cry and mope all day long if I wanted to.

Part of my preparation for the transfer is preparation for how to communicate with people who want to know NOW. With some of the "fringe" people who know what's going on but don't get the play by play, I've started being very vague about the transfer date and then I've said, "So hopefully this summer, we'll have some good news to announce." With my mother-in-law, I tested this out: "Well, after what happened last year, I just don't know when we'll really feel comfortable making any kind of announcement . . ." With my mom, I haven't brought it up. She knows we're going to Denver next Wednesday but I'm not giving her the play-by-play on E2 levels, my lining, etc. I don't know how it will all pan out with our moms. We'll see. They both live out of state, so it's not like we're going to see them soon. Keeping information private will be easier when we don't have to see them.

One year ago today was my first IVF retrieval. We got 7 eggs.

Thursday, April 8, 2010

Reality Check

Here's an update, real quick, because it is midnight on a "school night" (I have to go to work in the morning).

We talked to Dr. Babycraft yesterday for our pre-FET follow-up. We decided to transfer 2 embryos although he would be willing to do three, given my age and my past failures. I declined, saying I'm afraid of triplets. I suppose if this attempt is another failure, we can do a Hail Mary Transfer with 3 next time. That's assuming that all 5 of them "thaw" nicely.

Other than discussion of the number to transfer, the only other news flash from the Babycraft call was that I somehow distorted the success rate for embryos that have tested normal. I was thinking it was 70% per embryo, but it is actually 70% per transfer. Dr. Babycraft seems to think that my chances are actually lower than 70% because, again, of my past failures, my age, etc.

Oh -- and he said that having 5 out of 6 normal embryos was good news and bad news. The bad news is that if that many were normal now, that many were probably normal before and it still didn't work. I pointed out that I've only made two embryos before. Also, and I didn't think to say this during the call, those two embryos from a year ago were poor quality (and cultured in an inferior lab). They were below average three-day embryos with quite a bit of fragmentation. The grades our 5 current embryo indicate they are in a different league than their "sibs" from 2009.

Despite all of that *encouragement* the call ended on a good note. He said that it is amazing that I've responded as I have, considering the poor responses from before. I reminded him we went from 7 eggs making 2 embryos to 3 eggs making 0 embryos to 17 eggs making what we have now. He said, "It's like you're a different patient." I agreed and told him I'm feeling optimistic. DH told him how glad we are that we are cycling with them.

So, nothing like a good reality check with Dr. Babycraft. His brilliance just gets in the way of his ability to be encouraging. I'd be lying if I didn't admit I fell asleep last night with a few tears on my pillow. Today, I've been okay, though. Up and down. Scared. Impatient. The usual.

Sunday, April 4, 2010

Accepting (and embracing?) infertility

As much as I want to think that I’ve got all of this infertility stuff under control and that the outcome isn’t going to break me if it’s not what I want, that’s just not the case.

As much as I want to live just one day without thinking about my childless state, that’s not possible.

Although I try to live my life as fully as I can, filling my days with work, projects at home, volunteer commitments, travel, time with friends and family . . . infertility is always there.

I work at having a positive and energetic attitude as if my life is good and as full as it can be. As if all is well. As if infertility is not ever-present.

I pretend that my life is about other things, but right now, it is about one thing – the ever narrowing window of opportunity to become a parent.

* * * * *

Days 'til FET: 19 . . . .
 
I had a breakdown today after church. My dear friend, the pregnant one who almost never comes to church, came today because it was Easter. She looked lovely and had the most adorable little baby bump, making it obvious to everyone that she is expecting. I wanted to talk with her after the service but she was quickly surrounded by people congratulating her. Hearing the excitement in their voices and seeing the hugs and smiles made me feel like someone had sucked all of the oxygen out of the room. It was a visceral reaction. I tried to stick around and smile and participate, but I found myself unable to speak. In slow motion, I walked away.

Our church has a sweet tradition of having a simple Easter egg hunt immediately following the service. It’s a nice opportunity for families and friends to linger in a beautiful area that looks like a garden –  full of azaleas, green grass, daffodils and tulips on the edge of a wooded forest – while the children hunt plastic eggs filled with candy. There were cute babies and children everywhere! And did I mention the cameras? It was like a photo shoot – all these families recording their memories. My dear friend worked the crowd, catching up with people and sharing her good news, and I’m sure, just drinking in the anticipation of this event next year when her baby will be about seven months old.

After an appropriate amount of time, I was able to get to my car and head home. I’m not sure I was out of the parking lot before the tears started to flow. And then the sobs came.

For me, the most difficult part of all of that was watching people react to my friend’s news. I know they would be just as excited for me, should the day ever come. I think this was so challenging for me because the congratulatory reactions of people are the only thing I can truly imagine at this point. In my “Six Months At A Time” mindset, I don’t let myself think very much about actually having a baby. It still seems like a long shot.

I know how much love the people in our church have to give. I know how deeply they love my DH (he’s been a member of the church since the 1980s). I know how joyful they were when I came into his life and he got a second chance for a truly happy life. I yearn to be able to answer the question, “How are you doing?” with something authentic rather than a load of bullshit about how work is oh-so crazy busy. I’m so tired of having my guard up at church. If we ever get pregnant, maybe I can actually have some real relationships.

Sorry to be so negative. . . . But it feels good to be honest.

* * * * *

A strange new thought occurred to me tonight -- the idea that I need to embrace infertility. Accept that it is part of my life. And think about ways to acknowledge it, to show it some respect. Not that I want it to be so welcome that it wants to stay longer (because infertility has already worn out her welcome in my house). But the idea of making peace with infertility's presence is appealing. I'll be thinking about this in the coming days.