A Big Sigh of Relief (or two or three)

The first sigh of relief is for my Atlanta RE, who hugged me 4 times and was soooo excited for us. She said she'd been thinking about me.  She could not have been nicer. (See yesterday's post for the back story on this.) I'm so glad I went out of my way to see her today for the ultrasound. She probably would have been disappointed if I had scheduled with one of her colleagues. And the outcome of the u/s was the perfect ending to this chapter of my story with the Atlanta clinic.

The second and third sighs of relief are for our TWINS!!!!

As soon as the image appeared on the screen, my doc sort of squealed and jumped and said, "We have two!"

I was just in awe looking at that monitor with those two gestational sacs and those tiny little fluttering heartbeats.

She took lots of pictures and printed them out. I'll have to see if I can scan them or photograph them another day.

Here are the details:

Embryo A
crown rump length (CRL) is .77 cm (7.7 mm) with a heartrate of 138 bpm
6w5d (based on size)
Projected due date based on size: 1/8/11 (my mom's 69th birthday!)

Embryo B
CRL is .71 cm (7.1 mm) with a heartrate of 137 bpm
6w4d
Projected due date: 1/9/11

I believe that full term for twins is 37 weeks, so those due dates are late. The u/s machine simply calculates things based on the individual size of each embryo.

I have mostly been in shock about this. I do feel like I now have an explanation for all the nausea. This evening I was going to take a short nap but my mind couldn't stop thinking about twins. DH was in the next room and every now and then, I'd say something like, "It just got a whole lot more expensive to fly home" or "Our childcare costs just doubled!" I started thinking about getting two babies in and out of car seats in my Volvo S60 and taking them ANYWHERE at all. Wow. If we do indeed end up with twins, I've got a lot to learn. I've got a lot to learn no matter what!

I am excited but kind of overwhelmed. I haven't cried at all. DH did get teary after the u/s. My mom cried on the phone. Actually the only time I got a bit misty was when I was walking toward the building from the parking lot thinking about all the times I've walked that path. I thought about coming and going before and after so many failures and wondered if I'd exit the building today with another failure under my belt. I thought about what good care my doc has given me, about the time she sent me to the ER across the street when I had unbearable pain a week after my first transfer. I thought about the times I'd been wheeled to the curb in a wheelchair post retrieval. It was odd knowing that any success I would claim today was not because of the work of this clinic. But I do give them a good bit of the credit. Without my Atlanta doc, her nurse, and the rest of the team, I would have never made it to this point. They weren't able to get me across the finish line but they've cheered me on along the way and my doc has coached me through this in many ways. It really has been a much more personal experience than CCRM. But that makes sense when I've only been to CCRM a few times in comparison. And I can't imagine Dr. Babycraft hugging me. Not in a million years.

You may think I'm crazy going on and on about the Atlanta clinic like this but I think it's something I have to do to put everything that's happened behind me.

More later!

Nauseous and Nervous

Tomorrow is our ultrasound! We will be 6w5d. I am nervous now that the day is upon us. I haven't had much time to emotionally prepare for it because I've been so nauseated and quite determined to find a way to manage it. I haven't even been anxiously counting the days until the ultrasound because just getting through one day is a major accomplishment right now. I read something yesterday about the importance of stellar nutrition during the first trimester and it launched me into action. Today I forced myself to eat a bagel, a small yogurt, some nuts, part of an apple, a few bites of a fruity granola dessert, about six cheezits, a bowl of chicken noodle soup made with egg noodles, and a small portion of ice cream. That's the most I've eaten in one day in quite a few days. And I wouldn't exactly call that stellar. But I think eating more helped keep the nausea at bay, to some degree. I hope my little embryos are still growing in there. I guess I'll know a lot more tomorrow afternoon.

The appointment is at 3:15 with our Atlanta RE. I haven't seen or spoken to her since last November after I got back from the one-day workup at CCRM and she was exhibiting a bit of professional jealousy. That particular day, we talked on the phone, and she actually told me it was a business decision that they don't do labs or monitoring for out of state patients. She said it was an inconvenience for the staff. By the end of the conversation, she had offered to "go to bat for me" with her colleagues at the practice. (She is one of the founding doctors of this practice... She can do whatever she wants. I knew this.) But I played along and following our phone conversation, I sent a very passive agressive email saying it is a lot more than business to me and for them to refer me to CCRM and then not continue to monitor me was contrary to the wonderful care they'd provided me during the previous 15 months. I also thanked her profusely for going to bat for me. About a week later, my nurse emailed and said they would do the monitoring. When I scheduled my first monitoring appointment, the scheduler acted like it was no big deal at all, so I casually asked, "So do you all do this pretty regularly for patients going to out of state clinics?" She said yes.

I was pretty hurt by this whole thing. I felt like my doc had kicked me in the stomach the day she said they wouldn't do the monitoring. She actually made me cry. She is the warmest, most friendly doctor I've ever had. She has amazing bedside manner. But she's human and I guess she got jealous.

I could have scheduled this appointment tomorrow with another doctor in the practice but I asked for her because I'd like to "feel the love" for her again. I don't want that kick-me-in-the-stomach phone call to be my lasting impression of her. She did pretty much talk me in to going to CCRM and giving them a chance, after all. So I'm turning the other cheek.

Obviously, my nervousness tomorrow isn't just about the ultrasound. I hope she acts like a grown up! I'll let you know. More importantly, I'll let you know the status of numbers 1 and 17. This seems surreal!

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!

Before the good news came

So the news that we actually have five genetically normal embryos is beginning to sink in - sort of. I feel like I've won the lottery or something, but it's not like I'm actually pregnant yet. However, our chances are significantly better than they've ever been. And yes, Pie, that feels great! (And a little bit surreal, to tell you the truth.)

Each time we've gotten good news since going to CCRM, as it begins to sink in, DH and I will share a moment where he usually says, "And I can't believe we were ready to give up." And we ponder together for a few moments about our doc in Atlanta and we wonder out loud what she was thinking telling us to adopt or consider egg donation. Thank goodness she could tell we weren't ready to go there and she suggested we talk to Dr. Babycraft.

I have mixed feelings about the clinic in Atlanta. I love the people there; they're all very personable and professional (much, much more so than the people at the first Atlanta clinic I tried -- readers in Georgia, email me if you want the skinny with clinic names and all). But they just couldn't get the job done. And the thing is, with CCRM, things have been nothing but a string of successes. Makes us wonder how much time and money we wasted in Atlanta. If only we had known!

When we first considered the idea of going to Denver -- when our doc here recommended the possibility -- she actually said only people who have money growing on trees go out of town for treatment. Really? Truth be told, if you're already paying for all of this, the cost of airfare, hotel and food just isn't much more. And if we had gone to Denver FIRST, before paying out of pocket for 5 IUIs and participating in the Attain program to pay for IVF and buying all of those medications, we would have saved tons of money, enough to start a really good college fund. So, if you're trying to figure out what to do, Dear Readers, my advice would be to consider another clinic out of town sooner rather than later if things aren't working at home. I would venture to say that the biggest consideration for many people might be the time away from work. If I hadn't been in my job for more than 7 years and saved up more than 400 hours of sick leave, being out for a week and a half would have been a difficult thing.

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Over dinner last night I confessed to my husband how down I've been (deep down on the inside) the past few weeks. He was kind of surprised when I shared about some moments where I felt so heavy inside, like everything in the world is completely screwed up. "Everything" ranges:

• from the U.S. Congress, unable to create passable healthcare legislation
• to the economy that's causing universities and so many vital government-funded programs to slash budgets and eliminate critical services that make a huge difference in so many lives
• to my husband's totally insane client who hasn't paid him and is oblivious to the fact that she has made him question his career choice and has jeopardized his reputation because he's chosen to represent her
• to women who commit to do 50 hours of volunteer service before May at a local children's hospital but to date have 0 hours, seem unconcerned about it, and probably think I'm going to lie about it for them (not)
• to so, so many couples who want to have children and would be great parents but just can't seem to get there, or in getting there, go through so much heartache

Wow, what a depressing post this is! That is not my intent. I am just getting some recent thoughts out so I can hopefully find a more positive attitude. I can't attribute the dark thoughts and feelings to simply waiting for test results. It's just waiting in general. At the risk of sounding like a broken record, I'm tired of waiting to find out what my life will be like going forward. I have lots of mixed feelings about my job but there's nothing I can do until I sort out the parenthood question. This makes me feel stuck in a big way. And I guess when I feel stuck, I have a tendency to get really pessimistic on the inside.

DH said -- after I gave some examples for why everything in the world is so screwed up and why this depresses me -- "Is this why you've been so crabby lately?" He said this with a chuckle. I thought he was joking but I said, "I have?" and he laughed out loud and assured me that I had not.

I am relieved that thanks to the news we got yesterday, we're now beginning a new chapter in this story. I'm closer to a resolution. And right here and now, in the presence of all the blogosphere, I'm recommitting to my regimen: walking, water, no caffeine, and electro-acupuncture. And in the process, I'll hopefully shake the stuck feeling (and the pessimistic thoughts) as I move forward. I'm off to the treadmill!