No Rest For the Weary

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So much for getting any rest on vacation, although that’s probably too much to ask from Las Vegas. We flew in last Friday (Oct. 24) and it was a whirlwind weekend spent seeing the sights, walking the strip, and eating. Our friends got married on Saturday (Oct. 25) and it was a lovely, low key but intimate wedding. We indulged too much and slept too little. I found I was very moody all weekend. I would be having fun one minute and irritable and grouchy about something the next. I had a little fit the morning we were leaving for Vegas because I couldn’t find my phone. I would get hungry and tired during the day and it made me crabby. I still had a good time but I was having a hard time controlling my mood swings.

I stopped my suprefact last Tuesday and the nurse told me my next period should start a week or two after stopping the meds. I hoped it would come sooner rather than later so we could make our next plan. I woke up Saturday morning in Vegas to find my period had started, the day after we had arrived. I had been feeling sort of off ever since I stopped the suprefact, and more than likely due to the fact that my hormones went on a bender after the suprefact stopped suppressing everything. I was surprised and a little bit annoyed at getting my period so early. So much for any fun hotel romps.

I also realised that I needed to call the clinic and advise them of CD1. Needless to say I wracked up some long distance while I was away. Once I called the clinic and left my info on the IVF message line I counted the days and noted that my CD3 was going to be Monday, and we weren’t due to arrive back until just before midnight on Monday night/Tuesday morning. I told the nurse my predicament when she called me back and she said she would talk to Dr. M and if it was going to be a problem she would let me know. They wanted to check my lining and my cyst to see that I a) did indeed shed all or at least a majority of my lining and b) to see if the cyst was gone. From there we could determine the new plan of action.

So after a long weekend in Vegas, and a late flight home I got about 4 hours of sleep Monday night before I had to get up to be at the clinic for 7am Tuesday morning. I was the 4th person to be monitored so I had to wait a little but not too long. When I went back the monitoring doctor looked at my chart to see what it was he was to be checking for. I don’t like this doctor, I may have mentioned him before, he’s retired but still just does the monitoring ultrasounds. He just irks me for some reason. Anyways, moving on; he checked my lining and it was looking good and thin beside a bit of blood that was still being shed. Then he moved to my left ovary, all quiet and over to the right. The cyst was still there, and not diminished in size. Fuck.

He made some measurements printed them out, and when he was done he told me I could return to my change room and the nurse would be with me shortly. The change rooms are open on the top and the bottom, and the nurses station is maybe 10 feet away so I could plainly hear them talking when I was getting redressed. The doctor was telling the nurse the cyst was still there, and she was discussing the fact that my doctor (Dr. M) had suggested a natural cycle, but that it may not be possible due to the cyst.

I was put in one of the other exam rooms so that the nurse could come and discuss the next steps with me. This was becoming a bad habit, being the special case who gets put away in a room for further instruction. I waited probably around 15 minutes, as the nurse was finishing with the other patients still waiting for ultrasounds. The wait was painful, I was exhausted and felt kind of ill because I had been chugging water on the way to the appointment in anticipation I would need to do bloodwork as well (I have slim veins that get smaller when I am dehydrated), only to not have any bloodwork after all. (I am now wondering if that was an oversight, you’d think they would have wanted my estrogen levels…). When the nurse finally came in, she sort of seemed at a loss for words, tsk-ing and shaking her head. She told me that Dr. M had left me two choices; either to do a natural cycle (if the cyst was gone) or try a medicated cycle, possibly with different meds. But, she said it would not make sense to do a natural cycle with the cyst interferring, and she wasn’t sure what Dr. M’s plan of action would be for a medicated cycle, again because of the cyst.

I need to redo my SHG, because my clinic needs an updated one every 6 months (and me being an eager beaver did mine back in May when we decided to pursue IVF, in August) so the nurse booked me for an SHG on Sunday (as in today, now) and she said her and Dr. M will discuss “what to do with me”. Great, that sounds really hopeful. So not only do I get to have my uterus accosted (again) I may very well be getting the bad news that they are going to delay me another cycle, and surgically remove my asshole cyst. To be honest I sort of hope I don’t have to do a natural cycle because I believe it would probably end up requiring more monitoring, and more stress due to the fact that we would be relying on my body to do it’s job, correctly and in a timely fashion (yeah, right). We’ll see how that all plays out.

Besides dealing with the unknown of our next transfer cycle, we’ve spent the rest of the week continuing renovation on our new place. After a long days at work, it was evenings spent working on paint, and flooring, trying to reassemble everything so we can move soon, as our new tenants take possession Nov. 15. I am utterly exhausted, both physically and mentally.

Occasionally I have a feeling of heavy, deep sadness for all the time lost, and burden carried. When we were shopping in Vegas I had a moment of pain as I had previously thought we would be pregnant by the time we were on that trip. Before we found out we weren’t doing a fresh transfer, I had hope that we would even know the gender of our baby by the time we went to Vegas (I am planning on doing early genetic and gender testing) and that I might be able to purchase a few baby items. I think it was lurking in my subconscience and sprung on me when I realised what I wouldn’t be buying that trip.

Having said all of that, I am feeling eerily calm (about the uncertainty of our cycle at least). I didn’t flip out when they cancelled my cycle, I didn’t have a breakdown with my untimely period, I didn’t cry at my bad news monitoring appointments. I don’t know why, because I am certainly frustrated that nothing is working according to plan, that it is further and further delaying our transfer. Our imaginary due date keeps getting bumped ever forward. I mostly feel ambivalent, which is weird.

Here’s hoping for some good news today, though I won’t hold my breath.

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Beaut of a Ute!

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Happy long weekend to my fellow Canadians (and next weekend for my neighbors to the South)! I, unfortunately, have to work today but generally speaking long weekends are very quiet at work and so far that has held true (case and point, I am able to write this post).

I had my saline sonohysterogram this past Thursday, and it was the last diagnostic needed before I am officially set for IVF. I was a bit nervous because I had read some pretty awful stories about other people’s experiences, and that it was similar to the HSG, which was not a nice experience for me. I took two Advil before I got to the clinic, and I made sure to get there early so I didn’t have to wait forever like with my antral follicle count. The clinic was practically a ghost town. For the 20 or so minutes that I waited, I was alone practically the entire time. A few people came and went (mostly men, dropping off samples I’d assume).

When the nurse called me back I recognized her immediately, nurse T! She was the one who did my last IUI, and she was very sweet. She’s one of the younger ones there, and is really nice (although the IUI she performed was the most painful of the 3). Nurse T walked me back to the same area I had just visited last week for the AFC, and explained to me to undress from the waist down, wrap myself in the sheet and scoot across the hall to the ultra sound room. By now, I knew what I was supposed to do, after figuring it out on my own last time. Where was she last week!? Although, when I visited last time the nurses were trying to get through all of the people waiting, and I guess didn’t have time for pleasantries, or to explain whats what. I got to use a different change room, so I got to see another inspirational whiteboard (and I added my own message).

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That's mine!

That’s mine!

I headed across the hall and got comfortable up on the table. The nurse came back, and told me the doctor would be with us shortly. Luckily it was my own Dr. M that was performing the ultrasounds that day. I seriously love him, he is the nicest guy. He is always joking with the nurses, and giving them a (good-natured) hard time. He has an accent, and I’ve always suspected him of being South African. {Google update} He graduated from the University of Cape town, so I figure I was right about his accent. Gotta say, love that accent. I dated a South African guy, and his accent was partly what made him so alluring.

But I digress, Dr. M isn’t sexy per se but his personality is appealing. He is a shorter man, sort of impish/hobbit like (a cute hobbit, not a nasty one). That makes me sounds superficial, but I would take him any day over some hunky doctor, because I trust him (and who wants a hot guy who isn’t your husband up in your business…). He is so kind, and friendly and really tries to put me at ease. He always tells me how brave I am, and I usually just shrug it off. I told him I do what I have to do, to make this work. But he said, this is a choice and I am brave for making it, and he’s right (about it being a choice at least, I don’t know how brave I really feel about it all). Sometimes I feel like he is just coddling me, and trying to build me up (somewhat unrealistically) but I appreciate his efforts in reassuring me. I am extremely comfortable with him, and know he will do his very best for me, and I’m sure all of his other patients. I’m sure other doctors are just as proficient at the medical part of their jobs but he has bedside manners in spades.

Back to the SHG, it was slightly uncomfortable, about the same as an IUI. There were a few points where I had to take a couple of deep breaths. When the saline goes in it causing cramping, and Dr. M apologized profusely for hurting me. Once the catheter and saline were in, then it was time for the dildo cam. He took several different angles of my uterus, told me everything looked “beautiful”, showed me where he “is going to put the triplets”. I just scoffed at that one, let’s not get ahead of ourselves (and as if I would let him transfer three embryos! I don’t even want to do two!). He took a couple of pictures that he said were “for instagram”. Always the jokester. All in all, it was fairly quick. Just before he finished everything, he turned to wand to look at my follicles and remarked, “Look at those follicles! I hope you’re not letting those go to waste”. To which I replied, “Actually I am”. The nurse asked me where my husband was and I told her he is here, but I’m on birth control because I was tired of the “what if” every month.

After Dr. M finished, I mentioned that we would probably try for an August retrieval, as I was giving my hubby 3 months to clean up his system. I told him that J had recently quit smoking, and was using an e-cigarette. Even though it has a low dose of nicotine, Dr. M agree it is better than smoking real cigarettes, and a good start to get him completely off nicotine all together. I asked him approximately how long the stimming process would take, and he said generally 12 – 14 days from CD1 (wow that seems fast!). From what I understand, my clinic doesn’t do any sort of down regulation, you just call on CD1, come in for your baseline ultra sound and start stimming for retrieval.

I also asked him about the egg retrieval, and how the sedation worked; if it was light sedation or fully under? He told me they would put me out completely, which makes me happy and nervous at the same time. I have always been a very healthy person, and up until this past year I rarely saw a doctor for anything other than a regular check up. I’ve never had stitches, a broken bone, an IV or been sedated. I do not like needles. I don’t mind the slight pain but the sight of the needle in my skin and blood coming out, or something going in grosses me out. I have this phobia for IVs, they just gross me out and I really, really don’t want one but I am fairly certain that being put under, I will have to have one. It also freaks me out to be put all the way under. I don’t know what to expect from that, and I’ve seen people coming out of sedation and it does not seem nice . But at the same time, I don’t think I want to be conscious, even a little bit, when they are retrieving the eggs. I know I am being a sissy, when this is rather minor. I also realise I will have to stick myself for my injectables, something else I am not looking forward to. Might have to deligate that job to J, but I don’t know how I feel about him doing it either.

When we had our first consult with Dr. M about moving forward with IVF, he told me that more than likely I will have OHSS and that he would almost cause it intentionally (he’s ok with mild OHSS, not full-blown, really bad requiring hospitalization). He just wants to maximize the number of eggs retrieved, which I can understand and appreciate. At least that way, if our first IVF fails we may have more hope of having fro-yos than doing another retrieval. Now that I have seen how many follicles I had on each side in the AFC, I seem to agree that I may overstimulate. I just hope it’s not awful. Dr. M told me that I don’t need to take the next day off work after the retrieval but I guess that will depend on how I feel if I am mildly over stimulated.

He also told me that if I am over stimulated then they would just do a freeze all, rather than a fresh transfer, and that eventually he would like to see all of his cycles go to FET. He said it gives the body time to recover from the stimulating drugs, and the retrieval. Which again, makes sense, but the clinic’s fresh vs. frozen live birth rates are nearly identical, so if I can do fresh, I think I would try for that. Just to get it done all in one shot. Plus, it would work better with my schedule, as I have to go on a work trip in September, and would prefer not to have to worry about transferring that same month. But life does not go according to my plans, so I will roll with whatever comes.

So, basically I am all set (physically) to start IVF. I am going to try to get into a good routine of going to the gym, and obviously eating healthy as well. I am taking my prenatal, omega 3, vitamin B and, baby aspirin. J is on his multi vitamin with selenium, omega 3, vitamin E, and vitamin C. We are in preparation mode. He has still been applying for job transfers to the states but has had no luck yet, and frankly, I don’t think it’s going to happen. And I’m ok with it (now). If we can’t get out of here, I am happy to go forward with IVF. I think he still has hopes for a move, but we do talk as though IVF is happening so either way, I know he’ll be ok.

I would like to do the egg retrieval and transfer in the beginning of August, so I am going to use my birth control pills to modify my cycle slightly so that I can start stimming in mid July. As Dr. M said, the benefit to being on birth control is that we can plan for my start date. I can’t control most things in this process, so the things I can, you can believe I will take advantage. For now, that repetitive sentiment applies, we wait.

*Anyone who has any words of wisdom, advice, pre IVF prep tips, I welcome it all!

Update: my clinic just called me today because they were going over my file in preparation for our IVF cycle. They need J to update his blood work and SA. I am happy he has to redo his SA because I am curious what his numbers will be at, even though it hasn’t been long that he’s quit smoking and taking vitamins. His numbers got progressively worse since his first SA and through our IUIs. I also was planning on calling the clinic next week because I literally have no instructions on how to start my IVF cycle. The nurse told me to call in next week to pay the $200 deposit and they would send me a package. Things are coming together. It’s getting real, and scary!