Tagged!

I guess I'm it! I've been tagged not once but twice, so I will answer both sets of questions. Then I'll try to come up with some fun and creative questions to ask a few other fun bloggers.

The first tag came from Jenni at Hope Springs Eternal.

What would you say is the craziest thing you've ever done?

I'm not exactly the wild type, so this is kind of a tough one. The only thing that springs to mind is from when DH and I first started TTC. He had been traveling quite a bit for work but we were still trying to BD every other day around that fertile time of my cycles. Well, he had a 2-hour layover at the airport between trips and he dared me to meet him there. So, I put on a skirt and heels, packed a bag so as not to look suspicious, and met him. I'll never forget the look on his face! We joked that we were trying to start our family in the family restroom!

If you had to pick one thing to describe yourself as a child what would it be (the shy one, the quiet one, the crazy one, the pretty one, etc..)?

I would say I was the klutzy one. Grace is definitely not my middle name! I was never athletic and I grew to my adult height of 5'7" by the time I was 13. I had no coordination at all and it was quite common for me to trip over my own two feet.

If you could go an vacation anywhere in the world for as long as you wanted (No obstacles), where would you go

My dream trip would be Australia and New Zealand, with a South Pacific stop (say, Fiji or French Polynesia) both directions. The type of trip I have in mind would take at least a month to give me time to explore as much as I could.

What is your Favorite Color?

I've always been a big fan of purple. I don't care for lavender or lilac--I prefer a nice deep purple. Our wedding colors were platinum and purple and I loved it!

If you had three wishes, and you could only use them for other people, what would you wish for?

1. Better health (physical, emotional, financial, relationship) for my family. It's been a rough year physically and mentally for them and they deserve much happier times.

2. Happy endings to the IF issues for the many wonderful women I've met in this community. It is a fellowship that none of us asked to join, but the strength, kindness, and compassion I have witnessed as a part of it humbles me and makes me want nothing but peace and happiness for everyone I've "met".

3. A good man for my friend. She wants to be married probably as much as I want a baby, but there is no doctor she can see to create one in a petri dish for her. She has been a great support through this struggle and deserves to be happy.

Great questions Jenni!

Then I was tagged by Mummy in Waiting at Maybe Baby... .

(1) When you were a teenager, at what age did you envision yourself getting married? How old were you in reality when you got married?

I'm not sure I thought much about getting married as a teenager. I think I just assumed it would happen after college and med school (at the time, I still thought doctors did all the healing work--ha!). In a book project from elementary school, I had written that I would get married at age 24 and have kids by age 27. Yeah, sure--I didn't meet DH until I was 25 and we got married when I was 29.

(2) What is your all time favourite TV series and why?

When I was younger, I loved "Little House on the Prairie". I always thought that lifestyle looked like so much fun. And who wouldn't want a father like Michael Landon? I hated Nellie, though--she was pure evil!

(3) What is your earliest memory?

I can vaguely remember naming my younger sister when I was 3. My mom was pregnant with her and I was in the car waiting to pick up my older sister from school. I was reading "Casey at the Bat" (yep, I was a dork even then--taught myself to read at 3) and I told my mom that's what we should name the baby. I guess she liked it too since it stuck.

(4) Who is your biggest inspiration?

Definitely my mother. She raised us 3 girls all by herself and managed to keep her sanity at the same time. She is so much stronger than she gives herself credit for.

(5) Which country would you love to visit?

I guess I kind of answered this above. There are so many places I want to visit, but Australia would be at the top of the list.

(6) In a past life you think you were . . .?

My mom used to tell me I must have been a princess or something in a past life. I'm pretty sure that was her way of telling me I was self-centered as a teen. Heck, I want to be the queen now!

(7) How many kids do you want and has that changed through IF?

I've always wanted two kids. IF has definitely changed that because I'm not willing to go through all of the heartbreak and stress to get pregnant again. So whether we have one or two from this IVF, I will be done. I'm still hoping for twins, though!

Alright, so here goes with my questions:

What were you doing the last time you really had a good laugh?

What is your quirkiest habit and how long have you had it?

What is on your bedside table?

Describe the last good vacation you went on.

If you could have dinner with any three people in history, whom would you choose?

And I'm going to tag:

Christa
Beckie
Michelle
Missy

Progress check #3

So, follicle check and blood work #3 were scheduled for this morning. I had to fast for the blood tests because of my slightly elevated glucose from the non-fasting blood drawn a couple weeks ago. I am one of those people who wakes up hungry, so I really despise fasting blood work. But, they were insistent that I get it re-checked, so I tried to quiet my growling tummy with lots of water as I drove down for the tests.

Blood was drawn no problem, so it was time to head in for ultrasound. My favorite u/s tech was there, so we chatted all throughout the scan. She measured a nice triple-striped lining at 11mm and then moved on to follicle counting. She measured 9 on each side, but even I could see that there were smaller ones she didn't bother to measure. I tried to memorize all the numbers on the screen, but I failed. She gave me a big hug and wished me luck and then had me sit down with the NP.

I met with the NP and she said that I will most likely be triggering tonight for ER on Friday morning. Of course, this all depends on the blood work, but she doesn't think there is any way they are going to have me stim for another day and retrieve on Saturday. I guess the biggest follie was 21mm (a little overripe?) and that I had 11 follicles that measured over 14mm. She said there were even a couple more in the 12-14mm range that might mature by Friday.

It was a little bittersweet to meet with the NP today. It was her last day in this office, and she is leaving the practice as of Friday. She has been so nice to us and has treated me like an equal in this process. I really hope to stay in touch with her and wish her the best of luck in wherever she is going next. She is encouraging me to look into getting my NP and maybe even go into this field. It got me thinking about going back to school and possibly doing just that. I mean, who better to be an IF nurse than someone who has experienced it personally, bringing that experience and my nursing knowledge together to help future IF patients?

But first, I'm hoping to be too busy with a baby (or two!) to even think about school!

ETA: We are definitely a go for Friday morning ER. My E2 level was 1338 so I will be triggering tonight. DH is booked on a flight home for tomorrow night. I can't believe it's actually happening!

Progress check #2

First of all, I wanted to send some love to Michelle. She just had her IVF cycle cancelled for a lack of response and she is doing her best to cope. My heart just breaks for her, so head on over and give her some support as she tries to figure out where to go from here.

After a nice slow night at work, it was time to head into the RE office for progress check #2. I got to my usual office a little early and was greeted by the friendly staff and taken almost immediately to get my blood drawn. I had to wait just a couple minutes for the u/s tech to be ready for me. She found 14 follicles again, and then did some measurements of my uterine blood flow. She said they are seeing a big correlation between uterine artery blood flow and the ability to get pregnant and carry to term. She said both arteries showed good flow, so I was happy to hear that. She offered to have me meet with the office nurse or just head home and they would call me later. I opted for leaving and heading home to my bed as I was getting pretty tired.

I came home and napped for a few hours and then had my acupuncture appointment this afternoon. As I pulled into the parking space, the IVF nurse called with my results. My E2 was 529, up from 212 on Saturday. They measured 14 follies, finding 4 that were 14-17mm and 10 smaller ones. So, I'm to keep my Menopur and Gonal-F doses the same for tonight and tomorrow, plus add the Ganirelix to prevent premature ovulation and hopefully allow the small follies to catch up. She is thinking that we will likely trigger Wednesday or Thursday for ER on Friday or Saturday morning. She thinks we should be able to get at least 5 of the smaller follies matured by then, aiming for 9 or 10 at ER.

I let DH know that he might be cutting this week's trip short to be home for Friday morning's ER. He has been wonderful and has said he will come home whenever I need him to. He also bought me a "pre-bedrest" present over the weekend. He bought a bigger TV for the living room, allowing him to move the smaller one into the bedroom for when I'm stuck in bed post-transfer. I'm pretty sure it was just an excuse to buy a new bigger TV, but I love him for getting it all done so that I can be comfortable when I'm stuck in bed. Aren't I a lucky girl?

First progress check

So, after a crazy busy night at work, DH picked me up and we headed down to the main RE office where they do weekend appointments. I have noticed that this office tends to run later--every time we have gone there, we have waited until well after our appt time to be seen. Normally that would be no big deal, but I had just gotten off of work and could barely keep my eyes open in the waiting room. They finally called us back and we went straight to the u/s room. The nurse practitioner came in (I guess she was on u/s duty today) and started to scan. As usual, she commented on how full my bladder was, even though I just tried to empty it. She found 7 follies on each side but didn't measure any of them.

After I got dressed, she took us to an exam room where I was to meet with the nurse. Basically, she walked in the room (after a few minutes) to tell us that she would call later with the results and any change in dosage. I asked her to leave any instructions on my voicemail since I had every intention of being asleep by the time she called. I thought waiting for this little consult was a total waste of my very valuable sleeping time--couldn't the NP have written "leave voicemail" on the post-it note just like the other nurse did?

Then I headed down to get my blood drawn and nearly took the needle out of the phlebotomist's hand and did it myself. She's telling me how she's not feeling anything when she palpates, and I could have killed her. Um, I could stick a huge trauma fluid resuscitation IV in my right arm and you can't feel enough to hit it with the teeny butterfly! And she was talking about going back for her EMT license--um, if you can't find my huge vein in the comfort of the office, how on earth are you going to find anyone's in the back of a bouncing ambulance?!? OK--vent over, she got the blood and let me be on my way. We stopped for breakfast and then I only fell asleep a few times on the way home (don't worry, DH was driving). I made it inside, threw some breakfast at the dog and then stumbled to the bedroom for sleep.

The office called just after I fell asleep to tell me to increase my Gonal-F dose to 300IU for the next two nights and then go in for another progress check on Monday morning after work. DH just gave me my injection for tonight and now it's time to get ready for work again.

Stims Day 3

Day 3 injections are done and I'm still not having any major side effects (knock on wood). I'm anticipating the emotional crazies starting next week when DH is out of town. I don't normally deal all that well with his absence, but I'm sure the meds will just make it that much worse. I'm going to try to plan things to stay busy so that I'm not just sitting around the house.

I have my first progress check in the morning when I get off work. I'm kind of worried that nothing will be growing yet since it's only been 3 days of stims. I'm actually even more worried that I will have one dominant follicle again and that the cycle will be cancelled if we can't get the others to catch up. It's been a repeating pattern with my IUI's, so I'm just so afraid of it happening again. All I can do at this point is just try to relax and let my body do its job to grow some good follies. I used my meditations twice today just to try to calm down.

Oh yeah, and my request for FMLA got screwed up, of course. Apparently the RE office put down that I will be incapacitated from 10/2 until 10/11, so they are automatically counting those days against my leave. I was really wanting an intermittent leave so that I could take what days I need, but hoping not to need the full 2 weeks. So, now I have to go back and have the RE office fill out a new form and get that submitted before it's time for ER.

And you wonder why I'm anxious? Maybe they will prescribe some good drugs so I can sleep for the next week straight!

Stims Day 2

I had my hubby help with my Menopur shot this morning. He has offered to help me when he's home which I think is very sweet. But I mean, I'm a nurse, I should be able to do this for myself, right? It would have been a little bit of a challenge to do the shot left-handed (hey, I'm not a contortionist who can reach my left butt cheek accurately with my right hand) so I let him do it. It was his first one and I think he did great. The needle didn't hurt at all--just the sting from the meds.

I called the IVF nurse line today because it seems as though AF has arrived. I kind of suspected she would since I started spotting Monday (last BCP on 9/17) but I was worried that I was starting full flow after starting stims. She said not to worry about it and it will probably be short since my lining was nice and thin at my suppression check Tuesday. She also gave me the results of my blood tests from last week's physical. My blood sugar was a little high, but they never told me to fast so I had breakfast on the way down to the office. My vitamin D level was quite low, though, so they are calling in a prescription for a once-weekly mega-dose vitamin D pill. I guess my calcium + D supplement wasn't enough! I probably I need to get outside more, too.

Tonight I will have to do my first in-a-public-place injection. We are meeting one of DH's co-workers and his family for dinner. I have my little packet made with everything I need to do the shot. I've also planned my outfit so that I can quickly get to my upper arm in the bathroom of the restaurant. I'm not too worried, but it will be a bit awkward to have to get up from the table saying, "excuse me, but I have to go shoot up some hormones now." I know DH has told him about our IF but I don't know how much they know in terms of details. Wish me luck!

First day of stims

Well, I survived getting up early to give myself my first injection of this cycle. I didn't even go back to bed right after the shot, either. It means I didn't do my meditation this morning, but I'm thinking that I might be better off doing it before bed anyway. It might help me relax and sleep better too.

I must say that I had to psych myself up a bit for the IM injection in a way I never had to with the SQ shots. It's such a tiny needle (and such a big target!) that I hardly felt it at all, but it was disconcerting nonetheless. I remembered that the Menopur did sting a bit the last time I used it, so I wasn't sure what to expect with doing it IM. It really wasn't bad at all--in fact I think the stinging was less than what I remember from doing them in my belly last time. I'm just hopeful that the protocol change to doing everything IM will pay off!

I had to do my first semi-public injection tonight, too. I say semi-public because I was teaching a class for other ER nurses on our new computer upgrade. It just so happened that the three nurses in my class are all familiar with stims--1 did an egg donation when she was younger, another is in the midst of an egg donation cycle, and the other has done IVF (though nobody else at work knows about that). I had one of my co-workers give me the Gonal-F shot tonight in my right arm, a place that will be a bit tougher to do by myself. I'm trying to rotate which sites I use so any one particular site doesn't get overused and sore.

So far, I haven't had any side effects from the stims. I think the dexamethasone was interfering with my sleep since I had been taking it at night. I was having trouble sleeping and was having hot flashes during the night. Both of these are common side effects of steroids, so I changed today to taking it after lunch. Hopefully that (and the meditation) will help with the sleep issue.

Suppression check and ICLW

Today is day 2 of my IVF cycle and I had my suppression check today. At my u/s this morning, the tech counted 13 resting follies (9 on right, 4 on left). It's down from the 20 I had in April, but she said that they are happy with at least 4 on each side. No cysts on either side--yeah! Then I had my blood drawn and waited all morning for the phone call as to whether I am clear to start stims tomorrow.

Around noon the IVF nurse called to let me know that my E2 level was fine (she didn't tell me what it was, though, and I forgot to ask). I am clear to start meds tomorrow at the evil hour of 7am (have I ever mentioned that I am definitely not a morning person?) My plan is to wake up just in time to do the shot and then do my daily meditation as I relax in bed. With any luck, I'll be able to fall back asleep until a more reasonable hour. On my work nights this weekend, I will have to do my shots at the beginning and end of my shift.

At this point, my protocol calls for 3 vials of Menopur at 7am and 225IU of Gonal-f at 7pm. I started my dexamethasone and prescription PNV's yesterday. I will go in for a follie check after work on Saturday morning and then make whatever adjustments we need to.

Maybe this will all sink in once I stick a needle in my butt tomorrow morning, but for now it's still very surreal. I can't decide if I'm more afraid that it won't work or that it will. I still have some days where I worry about how much our lives will change, whether we will be good parents, whether we can handle all that parenting entails, etc. Most days I still want this so badly, but I admit there are times when it scares me so much that I want to run the other way. Does this make me a bad mom even before I get a chance to be one?

On a more positive note, this month is my first ICLW. I decided to finally sign up for it because I have received such nice comments and support here. It was time to share the love, ya know? So, for anyone stopping by from ICLW, thanks for visiting my little corner of the web! Kick your shoes off, get comfy, and stick around a while!

Ready or not...

Here we go! I have to get up in a few short hours to head in for my suppression check. No wonder I can't sleep! I have no reason for it, but I'm just so afraid they are going to find something wrong that would force us to delay the cycle. I guess now that we've finally decided to go through with this, I just want to get started. Of course, it's much more important that everything be right in order to have our best chance of success. So, if we have to wait a few more weeks, then we will.

I will come back later with the results. Keep your fingers crossed for us!

Meltdown

The IVF nurse called this morning to let me know they are changing me from the microdose Lupron protocol to a protocol with Menopur, Gonal-F, and Ganirelix. The only reason that she would give me is that they want to do all IM meds for me and the Lupron can't be given IM. I understand that because I'm fat that the SQ meds will have inconsistent absorption and the IM meds will be more consistent. They didn't spell that out specifically, but I understand that the circulation to my belly fat can't be as consistent as that to my thigh and hip muscles. I get that, logically, but it was enough to cause a minor meltdown this morning. I'm already on edge here, one change this close to the start date was enough to toss me right on over.

I think a good part of the meltdown came from the fact that I really only have one chance at this, realistically. Our insurance is wonderful, but I will hit (or come very close to hitting) my lifetime max for IF treatment with this IVF cycle. I don't happen to have an extra $15k laying around, nor am I willing to take out a second mortgage on the house to pay for a chance at having a child. Plus, I barely got DH to agree to try this once. There is no way I can convince him to do it again.

The other part of the meltdown is from the fact that we used Ganirelix in a previous cycle (IUI #5) and still only came up with 1 follicle. I only used it once and the purpose was supposed to be to slow down the growth of that dominant follicle in order to allow the smaller ones to catch up. It didn't work. So here I am, getting ready to use it again and deathly afraid of a poor response and a cancelled cycle.

Logically I know that my poor response in the past may have also been due to inconsistent absorption of all of the meds that I injected into my fat tummy. I get it. My brain understands, but I just can't seem to convince my heart to believe that using meds that failed me before will somehow magically work this time because I'm putting them in a different spot. If you look purely at the numbers (FSH of 8; AMH of 1.3; resting follicle count of 20), there's no reason to think I will respond poorly to the meds. But then why have we only once gotten more than one follicle during 5 cycles of IUI?

I have to trust that, since the office has done this more often than I have, they know what they're doing. I have to trust that they are trying at least as hard as I am to make this cycle successful. I have to relax and try to think positively, but so far it isn't working.

Can someone please help pull me back up onto the emotional ledge I was precariously clinging to before this morning?

New look

So, what do you think of my new blog look?

I absolutely love it! Alison designed it for me and I think it is just awesome! She totally took the very few hints I gave her and made it so perfectly "me". I've known Alison for a while on IF message boards and her blog is one of the first blogs I followed. She is a very talented graphic artist and has designed quite a few other blogs, mostly in the IF community.

So, if you want a fresh new look for your blog, head on over and check her out! She is the best!!!

Overwhelmed

As in totally, completely, sinking in over my head, what did I get myself into?!?

So, DH and I rose before the butt-crack of dawn yesterday to meet with the RE office for our IVF consult. It started off quite stressfully as construction/accident/general Monday morning traffic made us a few minutes late for the start of our 2-hour appointment. I really hate being late, but considering it's 80 miles one-way to the office on the other side of the city, a few minutes wasn't bad. The first meeting was with the business office people, essentially agreeing to the fact that insurance is covering everything except this "coordination of care" visit. It started the theme for the day--we have awesome insurance coverage for IF treatment.

The embryology chick came in next. We discussed how many embryos to implant, how to deal with any leftover embryos, and looked at some pictures of various stages of embryos. We talked about what to expect as far as how often they would call us and what they are looking to see happen with each day of incubation of the embies. I was very happy to hear that they never put in more than 3 embies, and it's very rare for them to even put in 3. She said they are working on perfecting their process to have more success with only putting in 1, but for now they are usually doing 2 with a success rate of 80% if it's a good 5-day blast. Of course, all my DH could hear was the 50% twin rate when they put in 2 blasts!

So, then the nurse came in to go over all of the consents and to give me my protocol. We reviewed all of the consents--yes, we still want to do this, yes we understand the risks, yes we want to freeze any extra embies for now, yes please knock me out for the retrieval, etc. Then she gets out my protocol and starts to review all the meds/doses/appointments/etc. My own personal pharmacy had arrived over the weekend, so I knew that it was going to be a lot of shots and pills. Here's a pic of all my meds (sorry for the blurriness, I took it with my phone)



(so happy to have insurance cover this--I paid a measly $0.75 for all of this, and that was for the baby aspirin which my insurance won't pay for since it's available OTC)

But seeing the protocol in writing made it so real and so "right now". I'm not at all intimidated by the idea of shots, but it just seemed so theoretical up until that point--now it was happening for real and so quickly! I can't believe that I only have 3 BCP's left to take! I go in next Tuesday morning for my suppression check and then it's off to the races! Yikes!

I'm meeting with my boss today to discuss what days I might need to miss work because of procedures. It's looking like it might be the worst possible timing, with ER being on the day of a big computer upgrade at work. I am one of the teachers and super-users for the new upgrade, so it would be really bad if I couldn't work that night. But, the IVF has to be my main priority and work will just have to deal with it. I called yesterday to set up an intermittent FMLA leave so that they can't get rid of me or revoke my weekend contract if I have to miss work. I'm hoping to not need it, but it's nice to know I have that protection if I do need it. Maybe I will get lucky and the IVF will fit around my work schedule.

Back on schedule

Well, the bleeding has slowed down to just spotting again. When I talked to the IVF nurse yesterday, she said that if it became full flow AF again, we would consider it CD1 and just move forward with the cycle. I would need to come in on CD2 for u/s and blood work, start Lupron on CD2, stims on CD3. Um, hello? I haven't even had my consultation yet! I don't know what my med schedule is yet! This isn't supposed to happen out of order like this! Can you tell my control freak side isn't handling this well?

The nurse went ahead and called in all my meds to the pharmacy so that I could have them this weekend in case I needed to start. They called me yesterday with the list of like 13 meds that were ordered. Thank goodness for great insurance that will cover all of this without a co-pay!

And have I mentioned how much I love my DH lately? When I thought that I was going to have to start all this over the weekend (and I still might), I arranged for Saturday delivery of my meds. Someone has to be available to sign for the truckload of stuff and, while I will technically be home, I will be sleeping all day in between work shifts. I totally forgot that he had plans with a friend for Saturday morning. He immediately offered to cancel his plans with his friend, or at least delay them until the meds show up. (his friend will totally understand--they know about all of this and they had to deal with IF prior to having their son) I told him that I could sleep on the couch to wait for the meds so that he could go do his guy thing. "No way", he said, "if you have to give yourself a thousand shots over the next few weeks, the least I can do is stay home to get the meds." Isn't he wonderful? (hi honey! *mwah*)

WTF?!?

Argh! So frustrated right now!

I've been spotting intermittently since Sunday--probably leftovers from the trial embryo transfer on Friday, so no worries, right? When it continued into Monday and Tuesday, I thought it might be a little much to be coming from the procedure, but they warned me about spotting while on the pill. Today, it seems to be turning into AF--cramps, diarrhea, actual red blood flow, etc (sorry if it's TMI). WTF?!?!?

I let them know about my BCP issues before they put me on this. The last year or two that I was on the pill, I would bleed at random times during a pack of pills, sometimes for just a day or two, sometimes like a full AF. When I was training for a marathon in 2006, I was calling my GYN office regularly because I couldn't seem to control or predict when I was going to bleed. I did not want to be running 26.2 miles with my stupid period and all the paraphernalia that entailed. (Luckily, it worked out) At one point last year, I decided to take a pack of pills so I could time AF to stay away from our anniversary trip--nope, bled/spotted for like two and a half weeks instead, nearly ruining the trip.

So, here I am again--on day 12 of my 21-day pill pack and bleeding. I've called the IVF nurse line and I'm waiting for a call back to see what, if anything, I should do. Why can't my body just do things right for once?!?

ETA: Just spoke with the IVF nurse. She is going to meet with the RE at lunch, but she said he might just want to count this as day 1 and get started with stims. Eeeeeeekkk! Now it's really happening too fast! DH is out of town and in important meetings all day so I can't even talk to him about it.

Boring

Not too much going on around here to write about lately.

I'm taking my BC pills without any major ill effects. I had my trial embryo transfer last Friday and it went well. The RE laughed when I told him I wasn't sure if my bladder was full. Heck, I'm an ER nurse--I can go a full 12-hour shift without a potty break if I have to! I'm not sure I know what a full bladder feels like anymore. Of course, when the u/s tech was pushing on it, I could tell just how full it really was. The trial transfer went fine--I didn't feel a thing internally and it was really cool to watch on the screen. I can't wait until there's a couple embies going in, not just an empty catheter.

I've got a pretty busy week ahead and DH will be out of town for most of it. Then Monday, a week from today, is the next big IVF related thing. We have our consult that morning with the business office, the embryologist, and the nurses. I'm hoping to have a much better handle on the potential schedule after that appointment. I've really been stressed lately about how this is going to effect my work contract in terms of missing too many days of work. My nursing supervisor suggested I look into doing an intermittent FMLA for the duration of the IVF (and hopefully, the subsequent pregnancy) so that they can't screw me over when I have to miss work. I'm going to go into HR tomorrow to look into that. If I could qualify for that, it would take a huge stressor off my shoulders.