Not sure where that analogy came from, but in short, things are actually working in this IVF cycle. Hopefully the island in sight is populated by fertile people and healthy infants and not the land of the childfree. But like anything else, I won't know where I am until I get there.
After two weeks of taking both ovulation suppression drug Lupron and follicle stimulation drug Gonal-F, and four different blood and ultrasounds over the past week, my ovaries have actually grown four follicles on each side that are considered the right size. The left one has follicles ranging from 14 to 20.5 mm, while the right has four ranging from 13-17 mm. The target number is "more than 18."
This means that tonight (yikes! In an hour, actually), I'm officially taking my trigger shot, which will tell the follicles it's time to give up some eggs. The Lupron and Gonal-F are over for this cycle.
It's odd to know that my body has actually done what it is supposed to. Oh sure, it took some pricey drugs, several early-morning visits to be ultrasounded downstairs, and months of doctor's visits. But like the diabetes, with a little outside pharmaceutical help and needles, things appear to be working correctly inside.
This means that on Tuesday at 7 am (and yes, I think I'm first because of my diabetes), I'm headed to the fertility clinic for the egg retrieval. They tell me that the follicles can continue to grow between tonight's trigger shot and Tuesday's retrieval, so I'm hoping things look good once I'm knocked out (because let me be clear; IVF is surgery and I'm getting anesthesia) and someone's scoping around inside to see how many eggs there will be. And please, please, let's pray things go well on Tuesday and there's something to retrieve and I handle the procedure beautifully.
Mr. Lyrehca and I have been doing assorted rounds of "Woo, Woo, Go Lupron" or "Woo, Woo, Go Gonie" for good luck. At this point, we're trying to be as positive as possible.
I know it's still way too early to know how anything might transpire. But I'm actually trying to feel cautiously hopeful.
And for whatever reason, my blood sugars have been just dandy.
Oh, Tuesday actually corresponds with yet another eye doc's appointment, but I'll be rescheduling. Retinopathy, schmetinopathy. This week's R condition is all about egg Retrieval and possible Reproduction.
Sunday, July 30, 2006
Saturday, July 29, 2006
Two Shots A Day? Check
I envy the people who blog more than once a week. My slacker self can only get it together to post weekly.
Thanks, Nicole, for asking if I'm OK. I'm OK. The IVF shots have increased to two times a day, and now I'm going for blood and ultrasounds every few days to measure how well I'm responding to them.
After about a week of Lupron shots, I added Gonal F to the mix, which is the stimulation drug. Not sure if I mentioned this before, but the needles on the Gonal F shots are so much sharper than the Lupron needles. They just sink right into my skin without a push, while the Lupron shots, well, need a little more force: "Get in there, you surly Lupron shot. Don't make me get up and smack you. Why can't you be more like your sister Gonal F?"
Side effects have been minimal, although they included a day of abdominal cramps like a period. It was reassuring to think the drugs were actually working. I also noticed a weird numbness on the back of my left calf. This immediately made me think "neuropathy has finally reared its ugly head," and sent me straight to Google to determine why a diabetic complication would choose this week to show up. Dr. Google noted that numbness is a Gonal F side effect, so I called the fertility doc's office to report this. The nurse said to watch it and to call if things got worse. The next day, it was gone and thankfully it hasn't appeared since.
(Who are these women that are like, "I didn't know I was pregnant until the baby popped out of me nine months later"? I can document every bodily twitch and ache down to the hour.)
After five days of shooting Gonal F and Lupron, I went to my fertility doc's office (at 8:30 am, considered a late appointment) for ultrasounds and blood work. Mr. Lyrehca called me at work later that morning to ask how the ultrasound went, "and did it make those wwuah-wwuah sounds like it does when they ultrasound a pregnant woman on TV," he asked.
"Um, the ultrasound wasn't quite like that," I said. "It was internal."
Pause.
"Oh, eeyah!" he groaned.
Yep, checking the follicles of your ovaries requires a vaginal ultrasound. This is akin to having a giant tampon pushed up downstairs. For me, this is actually less of an issue than having a duck-bill speculum inside one's orifice, but the first time is pretty, hmmm, I'd say unpleasant, but there have been more traumatic experiences in that area than this. Suffice it to say the first ultrasound had me staring at the plaster in the ceiling. You'd think they'd put something colorful to look at up there. A mobile, maybe.
The first ultrasound tech was sort of close-lipped, but did say I was responding to the stimulation drugs and that I should wait for an afternoon call from my nurse to get the specific results.
IVF basically stimulates your ovary follicles to grow big so that eggs can be manually extracted. As of a few days ago, I had one follicle that was big enough to be seen (greater than 12 millimeters), and several that were just under 12 that were likely to get bigger. This was happening on day 5 of my cycle, which is early in the game.
Yesterday, at the sunshine-happy time of 7:30 am (oy!), I had another blood and ultrasound experience. (The blood is measuring estradiol results, which are supposed to increase in tandem with the follicle growth). Yesterday I had three follicles on each side (left and right ovaries) that were measuring up well, and my Gonal F was actually reduced last night so that things don't grow too fast. And today, in an hour and a half, I am returning to the clinic on a Saturday to get another ultrasound. If things are growing accordingly, the nurse told me yesterday, the retrieval could happen early next week.
The retrival is outpatient surgery, so I definitely have to take the day off from work. I'm thinking that'll be more of a break in my routine than the multiple daily injections ("Heck, I'm diabetic. Taking shots is so old school.") or even the early morning fertility doc's appointments ("Multiple doctor's appointments? I'm diabetic. Been there, done that."
And yeah, in diabeticland, my blood sugars have been pretty good these days. I haven't noticed any specific changes based on the new drugs swimming through my body, but I have made a few food changes that seem to be making a difference.
One, I stopped buying peanut butter a few weeks ago. While I actually prefer eating natural peanut butter that has had most of the peanut oil poured out once I open the jar, the high fat content of peanut butter typically does a job on my overnight blood sugars, particularly when I spoon it straight from the jar at bedtime. My overnight blood sugars have evened out nicely.
Two, I've defected from my lunchtime sandwich of choice. Now, instead of a grilled chicken and Swiss with onions and cucumbers on seven grain bread with a dab of herb mayo, I'm now going to Whole Paycheck Whole Foods at lunch and creating my own veggie wrap. It's cucumbers, carrots, lettuce, onions and avocado with either Muenster or Monterey Jack cheese rolled into a whole wheat wrap. I'm still working out the carb count, as I've been going low in the afternoons, but it's fewer carbs than my chicken creation AND I feel good about eating a so many veggies at one meal.
And three, I made a slight adjustment to my 3am and 6am basal rate a week ago when a perfectly healthy grilled-chicken and salad dinner kept my blood sugars stable all night until 4am, when I woke up at 180, and things jumped to 228 three hours later. I upped both basal rates by a tenth. And since then, my waking blood sugars have all been within range. I'm pleased about that, since I have woken up with 200 blood sugars for years now. Overnights have always been my downfall.
Oh, this week a writer friend had lunch with her agent and told her about my diabetes and pregnancy book, which is still percolating along even when I don't blog about it. The agent told her that while a book like this is probably needed, she wouldn't represent it because the market is too small, and she thinks there are a glut of diabetes books on the market that aren't selling. There ARE a bunch of books on the market (and that's a future post I keep meaning to write), but I know I'm reading most of them. And honestly, there's a need for a patient-written type 1 pregnancy-only book. I just need to connect with the publisher or agent who agrees with me.
Thanks, Nicole, for asking if I'm OK. I'm OK. The IVF shots have increased to two times a day, and now I'm going for blood and ultrasounds every few days to measure how well I'm responding to them.
After about a week of Lupron shots, I added Gonal F to the mix, which is the stimulation drug. Not sure if I mentioned this before, but the needles on the Gonal F shots are so much sharper than the Lupron needles. They just sink right into my skin without a push, while the Lupron shots, well, need a little more force: "Get in there, you surly Lupron shot. Don't make me get up and smack you. Why can't you be more like your sister Gonal F?"
Side effects have been minimal, although they included a day of abdominal cramps like a period. It was reassuring to think the drugs were actually working. I also noticed a weird numbness on the back of my left calf. This immediately made me think "neuropathy has finally reared its ugly head," and sent me straight to Google to determine why a diabetic complication would choose this week to show up. Dr. Google noted that numbness is a Gonal F side effect, so I called the fertility doc's office to report this. The nurse said to watch it and to call if things got worse. The next day, it was gone and thankfully it hasn't appeared since.
(Who are these women that are like, "I didn't know I was pregnant until the baby popped out of me nine months later"? I can document every bodily twitch and ache down to the hour.)
After five days of shooting Gonal F and Lupron, I went to my fertility doc's office (at 8:30 am, considered a late appointment) for ultrasounds and blood work. Mr. Lyrehca called me at work later that morning to ask how the ultrasound went, "and did it make those wwuah-wwuah sounds like it does when they ultrasound a pregnant woman on TV," he asked.
"Um, the ultrasound wasn't quite like that," I said. "It was internal."
Pause.
"Oh, eeyah!" he groaned.
Yep, checking the follicles of your ovaries requires a vaginal ultrasound. This is akin to having a giant tampon pushed up downstairs. For me, this is actually less of an issue than having a duck-bill speculum inside one's orifice, but the first time is pretty, hmmm, I'd say unpleasant, but there have been more traumatic experiences in that area than this. Suffice it to say the first ultrasound had me staring at the plaster in the ceiling. You'd think they'd put something colorful to look at up there. A mobile, maybe.
The first ultrasound tech was sort of close-lipped, but did say I was responding to the stimulation drugs and that I should wait for an afternoon call from my nurse to get the specific results.
IVF basically stimulates your ovary follicles to grow big so that eggs can be manually extracted. As of a few days ago, I had one follicle that was big enough to be seen (greater than 12 millimeters), and several that were just under 12 that were likely to get bigger. This was happening on day 5 of my cycle, which is early in the game.
Yesterday, at the sunshine-happy time of 7:30 am (oy!), I had another blood and ultrasound experience. (The blood is measuring estradiol results, which are supposed to increase in tandem with the follicle growth). Yesterday I had three follicles on each side (left and right ovaries) that were measuring up well, and my Gonal F was actually reduced last night so that things don't grow too fast. And today, in an hour and a half, I am returning to the clinic on a Saturday to get another ultrasound. If things are growing accordingly, the nurse told me yesterday, the retrieval could happen early next week.
The retrival is outpatient surgery, so I definitely have to take the day off from work. I'm thinking that'll be more of a break in my routine than the multiple daily injections ("Heck, I'm diabetic. Taking shots is so old school.") or even the early morning fertility doc's appointments ("Multiple doctor's appointments? I'm diabetic. Been there, done that."
And yeah, in diabeticland, my blood sugars have been pretty good these days. I haven't noticed any specific changes based on the new drugs swimming through my body, but I have made a few food changes that seem to be making a difference.
One, I stopped buying peanut butter a few weeks ago. While I actually prefer eating natural peanut butter that has had most of the peanut oil poured out once I open the jar, the high fat content of peanut butter typically does a job on my overnight blood sugars, particularly when I spoon it straight from the jar at bedtime. My overnight blood sugars have evened out nicely.
Two, I've defected from my lunchtime sandwich of choice. Now, instead of a grilled chicken and Swiss with onions and cucumbers on seven grain bread with a dab of herb mayo, I'm now going to Whole Paycheck Whole Foods at lunch and creating my own veggie wrap. It's cucumbers, carrots, lettuce, onions and avocado with either Muenster or Monterey Jack cheese rolled into a whole wheat wrap. I'm still working out the carb count, as I've been going low in the afternoons, but it's fewer carbs than my chicken creation AND I feel good about eating a so many veggies at one meal.
And three, I made a slight adjustment to my 3am and 6am basal rate a week ago when a perfectly healthy grilled-chicken and salad dinner kept my blood sugars stable all night until 4am, when I woke up at 180, and things jumped to 228 three hours later. I upped both basal rates by a tenth. And since then, my waking blood sugars have all been within range. I'm pleased about that, since I have woken up with 200 blood sugars for years now. Overnights have always been my downfall.
Oh, this week a writer friend had lunch with her agent and told her about my diabetes and pregnancy book, which is still percolating along even when I don't blog about it. The agent told her that while a book like this is probably needed, she wouldn't represent it because the market is too small, and she thinks there are a glut of diabetes books on the market that aren't selling. There ARE a bunch of books on the market (and that's a future post I keep meaning to write), but I know I'm reading most of them. And honestly, there's a need for a patient-written type 1 pregnancy-only book. I just need to connect with the publisher or agent who agrees with me.
Saturday, July 22, 2006
IVF, Week One
It's been a busy week filled with freelance jobs, my regular job, Mr. Lyrehca's company picnic yesterday, a hair color change, and oh yeah, Lupron shots.
Lupron has been a minor ripple, to be honest. It's just like taking a shot of 10 units of insulin, except that when I flick an air bubble out of the vial and notice a bit of medication bubble out of the needle onto the floor, I think, "Oy, that was expensive!"
Mr. Lyrehca has been very involved in the Lupron administering. Not in giving the actual shot, of course. But telling me to "wipe the top of the bottle with alcohol. Then withdraw 15 units of Lupron and return five units to the vial so that no air bubbles are in the syringe channel."
"Honey, I've been taking insulin for three decades. I know what to do."
"But this is different. Did you use a second alcohol swab to wipe your skin like the nurse showed you?"
Um, no.
And for any fellow diabetics out there, shooting Lupron is just like shooting insulin. The shots have to be taken at the same time each day, or within an hour of each other, and I've been on top of that. I've had a bruise here or there appear, but nothing that worries me. And despite what pops up on Google when you type in "Lupron and side effects," I haven't noticed anything different since taking it.
(Actually, I'm lying. Last week, I had some weird rash on my ankles, of all places. A quick call to the IVF clinic confirmed that my red ankles were probably heat rash. A Lupron-related rash would be more all over the bod. And a week later, the ankles look fine.)
In fact, considering the high humidity and temps over the past week, I've been more concerned that maybe the Lupron isn't working right. Last weekend, we went to a ginormous antique show/flea market and walked around in the heat for hours each day.
I carried the Lupron vial in my purse on Sunday, because by then we'd already checked out of the motel room where we were staying. I've been refrigerating the Lupron while at home, and keeping it in the meat-locker air conditioned motel room, but had to stash it in my purse (instead of in my hot suitcase in the hot car) as we searched for fun stuff to buy. (I like heart-shaped items and scored an awesome rhinestone-studded flower-shaped belt buckle; the Mister collects vintage telephones and picked up a cool U.S. military compass.)
So when I returned to work this week, I called the pharmacy where I ordered the fertility stuff and asked if the heat would bother them. Besides the Lupron, they sent the stimulation drugs (which have lived in my fridge for the past week and a half, per instructions), and two other meds that didn't have to be cooled (so they've been in the cardboard box they arrived in, in my unairconditioned-during-the-day kitchen).
The pharmacy assured me that everything should be fine, so I'm going to release my Type A tendency to think otherwise ("But it's been 90 degrees for part of this week. Are you sure the Lupron was OK inside my heavy blue leather pocketbook (now adorned on the strap with said rhinestone flower)?" and just see what happens.
The latest fertility event to happen is that my period arrived yesterday and today, right on schedule. While this has caused some negative energy in the past (see the "meltdown when the second IUI didn't work" post, or the "resignation, there it is again" past posts), the month-of-first-IVF-cycle period says to me "OK, we're moving on to the stimulation drugs. Here are the big guns."
So now I reduce my Lupron dose in half and also start Gonal-F, which hypes up my follicles to hopefully make some decent numbers of (and just plain decent) eggs. So while I'm annoyed about the extra trip to CVS to buy some tampons to replenish my stock (oy, I really thought I'd be done with those for awhile by now, months ago, when I bought what I thought was my last box of multiple-sized tampons), I'm pleased that things are moving along, IVF-drug-wise.
Once the egg stimulation begins, I'm not supposed to do things like train for a marathon or color my hair. While the training is something I wish I could say I'd miss (I haven't worked out seriously in ages, besides walking), coloring my hair will be a major life change. I've been enhancing my natural color, with various degrees of bleach, for a solid 20 years. As of Thursday, I was a typical over-processed, over-highlighted, roots-come-in-like-clockwork-every-three-months light blonde. And while I could see the hair colorists' concern that it was too light, too trashy-looking, too one-dimensional, and too drying for my hair, I just loved the look.
But on Thursday, I went back to my natural eyebrow hair color, which in the stylist's vernacular, is a "dark blonde." To me, it's just dark. Happily, no one's asked why, or even seemed to notice much of a change (which says that my natural hair color isn't all that dark, I guess) and Mr. Lyrehca said he liked it. The whole idea, though, is that should I actually get pregnant, I can avoid the whole should-I-or-shouldn't-I debate about hair color during pregnancy. Some docs forbid it, some say it's OK. Personally, I'd like to know how healthy Gwen Stefani's kid is, because I certainly didn't see her showing any dark roots over the last year.
Otherwise, this week was a nice blend of light work at my day job, and heavy freelance work from my side jobs. Oh, and my husband's company picnic yesterday, which I took a day off from work to attend. It was fine, and everyone was super friendly. One guy, though, who claims the Mister is like a grandson to him, came by to chat and wanted to know when we'd have "some crying around the office." I played dumb, and the Mister was similarly vague.
"You know, some little feet crawling around here," the guy pressed.
"Um, like cockroaches or mice?" I asked. "Hopefully not anytime soon."
He went on to talk about someone he knew who had adopted three kids. Which I appreciated. But at the same time, I certainly didn't need to get into a discussion about why we don't have children yet.
In the midst of all this, I was very clearly feeling some annoying cramps coming on, so I knew that the period was on its way. But because of all the IVF hoops, I knew that Advil wasn't recommended. So the Mister and I found a nurse at his company picnic who had access to Tylenol.
"I'm getting my period," I confided. "Do you have any Tylenol?"
"What about Advil?"
"I can't take it."
"Why not?"
"I'm diabetic and Advil's really hard on the kidneys," I purred. Who knew where that came from, or how I managed to say it without tripping over the real reason I was avoiding Advil, but I managed to get the nurse to give me the Tylenol. Blessedly, those cramps were history.
And now it's the weekend, where I actually have a free morning to blog without worrying someone's monitoring my computer at work. So enough about me; how are all of you?
Oh! I forgot about this because it's been up for a few days already, but Jenni at ChronicBabe featured my recent IVF post on Grand Rounds earlier this week, along with a few other diabetes blogging babes. Go check it out.
Lupron has been a minor ripple, to be honest. It's just like taking a shot of 10 units of insulin, except that when I flick an air bubble out of the vial and notice a bit of medication bubble out of the needle onto the floor, I think, "Oy, that was expensive!"
Mr. Lyrehca has been very involved in the Lupron administering. Not in giving the actual shot, of course. But telling me to "wipe the top of the bottle with alcohol. Then withdraw 15 units of Lupron and return five units to the vial so that no air bubbles are in the syringe channel."
"Honey, I've been taking insulin for three decades. I know what to do."
"But this is different. Did you use a second alcohol swab to wipe your skin like the nurse showed you?"
Um, no.
And for any fellow diabetics out there, shooting Lupron is just like shooting insulin. The shots have to be taken at the same time each day, or within an hour of each other, and I've been on top of that. I've had a bruise here or there appear, but nothing that worries me. And despite what pops up on Google when you type in "Lupron and side effects," I haven't noticed anything different since taking it.
(Actually, I'm lying. Last week, I had some weird rash on my ankles, of all places. A quick call to the IVF clinic confirmed that my red ankles were probably heat rash. A Lupron-related rash would be more all over the bod. And a week later, the ankles look fine.)
In fact, considering the high humidity and temps over the past week, I've been more concerned that maybe the Lupron isn't working right. Last weekend, we went to a ginormous antique show/flea market and walked around in the heat for hours each day.
I carried the Lupron vial in my purse on Sunday, because by then we'd already checked out of the motel room where we were staying. I've been refrigerating the Lupron while at home, and keeping it in the meat-locker air conditioned motel room, but had to stash it in my purse (instead of in my hot suitcase in the hot car) as we searched for fun stuff to buy. (I like heart-shaped items and scored an awesome rhinestone-studded flower-shaped belt buckle; the Mister collects vintage telephones and picked up a cool U.S. military compass.)
So when I returned to work this week, I called the pharmacy where I ordered the fertility stuff and asked if the heat would bother them. Besides the Lupron, they sent the stimulation drugs (which have lived in my fridge for the past week and a half, per instructions), and two other meds that didn't have to be cooled (so they've been in the cardboard box they arrived in, in my unairconditioned-during-the-day kitchen).
The pharmacy assured me that everything should be fine, so I'm going to release my Type A tendency to think otherwise ("But it's been 90 degrees for part of this week. Are you sure the Lupron was OK inside my heavy blue leather pocketbook (now adorned on the strap with said rhinestone flower)?" and just see what happens.
The latest fertility event to happen is that my period arrived yesterday and today, right on schedule. While this has caused some negative energy in the past (see the "meltdown when the second IUI didn't work" post, or the "resignation, there it is again" past posts), the month-of-first-IVF-cycle period says to me "OK, we're moving on to the stimulation drugs. Here are the big guns."
So now I reduce my Lupron dose in half and also start Gonal-F, which hypes up my follicles to hopefully make some decent numbers of (and just plain decent) eggs. So while I'm annoyed about the extra trip to CVS to buy some tampons to replenish my stock (oy, I really thought I'd be done with those for awhile by now, months ago, when I bought what I thought was my last box of multiple-sized tampons), I'm pleased that things are moving along, IVF-drug-wise.
Once the egg stimulation begins, I'm not supposed to do things like train for a marathon or color my hair. While the training is something I wish I could say I'd miss (I haven't worked out seriously in ages, besides walking), coloring my hair will be a major life change. I've been enhancing my natural color, with various degrees of bleach, for a solid 20 years. As of Thursday, I was a typical over-processed, over-highlighted, roots-come-in-like-clockwork-every-three-months light blonde. And while I could see the hair colorists' concern that it was too light, too trashy-looking, too one-dimensional, and too drying for my hair, I just loved the look.
But on Thursday, I went back to my natural eyebrow hair color, which in the stylist's vernacular, is a "dark blonde." To me, it's just dark. Happily, no one's asked why, or even seemed to notice much of a change (which says that my natural hair color isn't all that dark, I guess) and Mr. Lyrehca said he liked it. The whole idea, though, is that should I actually get pregnant, I can avoid the whole should-I-or-shouldn't-I debate about hair color during pregnancy. Some docs forbid it, some say it's OK. Personally, I'd like to know how healthy Gwen Stefani's kid is, because I certainly didn't see her showing any dark roots over the last year.
Otherwise, this week was a nice blend of light work at my day job, and heavy freelance work from my side jobs. Oh, and my husband's company picnic yesterday, which I took a day off from work to attend. It was fine, and everyone was super friendly. One guy, though, who claims the Mister is like a grandson to him, came by to chat and wanted to know when we'd have "some crying around the office." I played dumb, and the Mister was similarly vague.
"You know, some little feet crawling around here," the guy pressed.
"Um, like cockroaches or mice?" I asked. "Hopefully not anytime soon."
He went on to talk about someone he knew who had adopted three kids. Which I appreciated. But at the same time, I certainly didn't need to get into a discussion about why we don't have children yet.
In the midst of all this, I was very clearly feeling some annoying cramps coming on, so I knew that the period was on its way. But because of all the IVF hoops, I knew that Advil wasn't recommended. So the Mister and I found a nurse at his company picnic who had access to Tylenol.
"I'm getting my period," I confided. "Do you have any Tylenol?"
"What about Advil?"
"I can't take it."
"Why not?"
"I'm diabetic and Advil's really hard on the kidneys," I purred. Who knew where that came from, or how I managed to say it without tripping over the real reason I was avoiding Advil, but I managed to get the nurse to give me the Tylenol. Blessedly, those cramps were history.
And now it's the weekend, where I actually have a free morning to blog without worrying someone's monitoring my computer at work. So enough about me; how are all of you?
Oh! I forgot about this because it's been up for a few days already, but Jenni at ChronicBabe featured my recent IVF post on Grand Rounds earlier this week, along with a few other diabetes blogging babes. Go check it out.
Thursday, July 13, 2006
Erev IVF
I start my first round of IVF tonight.
Just like a Jewish holiday, this cycle begins the night of the first day. So right now it's Erev IVF, or the day before IVF.
There are four different drugs to take: Lupron, Gonal-F, HCG and Crinone. Three are sub-cutaneous injections, and one's a vaginal suppository. In a nutshell, they all prepare the bod to stop ovulating naturally, to stimulate follicles in the ovary to grow big, trigger the follicles to release said eggs, and then keep the vaginal lining cozy enough to support an embryo that's been placed back inside. This is all concurrent with having two outpatient procedures: a surgery where a needle is threaded up into the vagina laparascopically to retrieve as many good eggs as possible, and then another where a sperm-fertilized egg is shot back in to try to implant and start the road to fetus-hood.
That's a mouthful, huh?
This weekend, the Mister and I went over all our notes and paperwork to figure out exactly what would happen when I take these drugs, exactly how much we are paying for them out of pocket, and exactly when I'm supposed to take them.
We had a lot of paperwork.
We met with a nurse educator Tuesday who went through the details of each drug and how to take each one. In this case, I'm happy I've taken shots most of my life. Some of the drugs use the same orange-tipped syringes I know so well, and filling them is similar to preparing an insulin shot.
The Gonal-F comes in larger pens, pre-filled, and while I haven't taken insulin this way, I know many still on shots do and it seems easy enough to figure out.
After reading everything on Sunday, I looked at the Mister and said, "You know, I think this is sort of exciting."
The Mister, however, immediately pointed out how much this was costing us out of pocket.
I told him kids are expensive anyway and that at least for this first round, where we are going through a relatively "discount" pharmacy to get the drugs, that we're paying as little as we can.
(The Mister's comment was a bit different than usual. Typically, he's the one telling me to have a positive attitude throughout this whole infertility trip. Many times, my cynical and thinking-ahead-several-steps nature has surfaced. "Should we just sign up with an adoption agency right now?" I glowered at the infertility doc after the first IUI didn't work. "Do I need to sell stocks I have as long-term investments to have more money at our disposal?" So far, the answers have been "not yet" and "no." So feeling excitement at the upcoming cycle is frankly, a great departure for me.)
Of course, while it's impossible to predict specific days right now, it looks like the procedure for egg retrieval or embryo insertion may happen during one of my busy weeks at work. I'll definitely be out the whole day for the first procedure (which is akin to having surgery under light anesthesia) and likely out the day things are put back in. (This is also presuming, kinehora, that all goes well this round and there are no problems or reasons to stop the IVF cycle altogether.)
So there is someone at work who can do my job, at what point do I tell him, or my boss, that I'm having an outpatient medical procedure and that I need to be out? A week before? Earlier?
Also, my current boss is a woman who is filling in for my former boss, who left to give birth. The current woman is also pregnant, and her last days are sometime in August. Her replacement (another woman, not pregnant as far I can tell), is someone I'm friendly with, but ultimately, I don't necessarily want to tell anyone that I'm going through IVF cycles. Or do I?
I mean, heck, I'm telling all of you, cyber-readers. And that feels fine. But I don't want to be seen as someone not up to the job while I'm trying to get pregnant, a task that will certainly take me out of the office for some time should I actually have a child. And when I'm at work, I'm actually really into the job, and don't want to have conversations about fertility with people who may not necessarily understand what I'm going through. (This office appears to be pretty fertile, at least for others, since I've been working there. In fact, except for a handful, all the women who have left the job have been those who left to have kids and didn't return. It's not a particularly family-friendly office, if you didn't already guess from my worked-past-midnight post.)
If it doesn't work, frankly, I don't want sympathy from people at work as the Mister and I figure out if/when we'll do more round(s) of IVF. And if it does work, I've thought about keeping silent about it until I was actually pregnant for a while, like four or five months, until it was impossible not to tell. I just don't want to get prematurely public about a pregnancy that honestly, could go wrong in so many ways, having read blogs about miscarriages and terminations and other issues.
(Although, no, it's not like I'd have a reason to think this could happen to me, but then again, why am I dealing with infertility in the first place when the majority of the people I know are popping out kids or announcing pregnancies left and right?)
Tomorrow I have another endo appointment, and I want to double-check with her about whether any of these drugs will affect my blood sugars. I've heard they might and they might not. Looks like I'm back to keeping intense paper records of my every blood sugar. We're also going to go over the results of my week-long effort wearing a continuous glucose monitor a few weeks back. We'll see how that goes.
Just like a Jewish holiday, this cycle begins the night of the first day. So right now it's Erev IVF, or the day before IVF.
There are four different drugs to take: Lupron, Gonal-F, HCG and Crinone. Three are sub-cutaneous injections, and one's a vaginal suppository. In a nutshell, they all prepare the bod to stop ovulating naturally, to stimulate follicles in the ovary to grow big, trigger the follicles to release said eggs, and then keep the vaginal lining cozy enough to support an embryo that's been placed back inside. This is all concurrent with having two outpatient procedures: a surgery where a needle is threaded up into the vagina laparascopically to retrieve as many good eggs as possible, and then another where a sperm-fertilized egg is shot back in to try to implant and start the road to fetus-hood.
That's a mouthful, huh?
This weekend, the Mister and I went over all our notes and paperwork to figure out exactly what would happen when I take these drugs, exactly how much we are paying for them out of pocket, and exactly when I'm supposed to take them.
We had a lot of paperwork.
We met with a nurse educator Tuesday who went through the details of each drug and how to take each one. In this case, I'm happy I've taken shots most of my life. Some of the drugs use the same orange-tipped syringes I know so well, and filling them is similar to preparing an insulin shot.
The Gonal-F comes in larger pens, pre-filled, and while I haven't taken insulin this way, I know many still on shots do and it seems easy enough to figure out.
After reading everything on Sunday, I looked at the Mister and said, "You know, I think this is sort of exciting."
The Mister, however, immediately pointed out how much this was costing us out of pocket.
I told him kids are expensive anyway and that at least for this first round, where we are going through a relatively "discount" pharmacy to get the drugs, that we're paying as little as we can.
(The Mister's comment was a bit different than usual. Typically, he's the one telling me to have a positive attitude throughout this whole infertility trip. Many times, my cynical and thinking-ahead-several-steps nature has surfaced. "Should we just sign up with an adoption agency right now?" I glowered at the infertility doc after the first IUI didn't work. "Do I need to sell stocks I have as long-term investments to have more money at our disposal?" So far, the answers have been "not yet" and "no." So feeling excitement at the upcoming cycle is frankly, a great departure for me.)
Of course, while it's impossible to predict specific days right now, it looks like the procedure for egg retrieval or embryo insertion may happen during one of my busy weeks at work. I'll definitely be out the whole day for the first procedure (which is akin to having surgery under light anesthesia) and likely out the day things are put back in. (This is also presuming, kinehora, that all goes well this round and there are no problems or reasons to stop the IVF cycle altogether.)
So there is someone at work who can do my job, at what point do I tell him, or my boss, that I'm having an outpatient medical procedure and that I need to be out? A week before? Earlier?
Also, my current boss is a woman who is filling in for my former boss, who left to give birth. The current woman is also pregnant, and her last days are sometime in August. Her replacement (another woman, not pregnant as far I can tell), is someone I'm friendly with, but ultimately, I don't necessarily want to tell anyone that I'm going through IVF cycles. Or do I?
I mean, heck, I'm telling all of you, cyber-readers. And that feels fine. But I don't want to be seen as someone not up to the job while I'm trying to get pregnant, a task that will certainly take me out of the office for some time should I actually have a child. And when I'm at work, I'm actually really into the job, and don't want to have conversations about fertility with people who may not necessarily understand what I'm going through. (This office appears to be pretty fertile, at least for others, since I've been working there. In fact, except for a handful, all the women who have left the job have been those who left to have kids and didn't return. It's not a particularly family-friendly office, if you didn't already guess from my worked-past-midnight post.)
If it doesn't work, frankly, I don't want sympathy from people at work as the Mister and I figure out if/when we'll do more round(s) of IVF. And if it does work, I've thought about keeping silent about it until I was actually pregnant for a while, like four or five months, until it was impossible not to tell. I just don't want to get prematurely public about a pregnancy that honestly, could go wrong in so many ways, having read blogs about miscarriages and terminations and other issues.
(Although, no, it's not like I'd have a reason to think this could happen to me, but then again, why am I dealing with infertility in the first place when the majority of the people I know are popping out kids or announcing pregnancies left and right?)
Tomorrow I have another endo appointment, and I want to double-check with her about whether any of these drugs will affect my blood sugars. I've heard they might and they might not. Looks like I'm back to keeping intense paper records of my every blood sugar. We're also going to go over the results of my week-long effort wearing a continuous glucose monitor a few weeks back. We'll see how that goes.
Sunday, July 09, 2006
Midnight Thinking
Coming out of a several-week stretch of heavy workloads and deadlines, I'm just about out of the woods this weekend. This is the busiest time of the year for the publication I work at, and finishing everything up is like emerging from a long tunnel.
As a result, I haven't blogged and I've noticed my meter averages creeping up. I'm seeing the endo again this Friday and am scheduled to start the IVF drugs this week. While I'm not worried, I'm also not waiting another six weeks if my A1cs are above 7. They've been between 5.6 and the low sixes for more than a year so I can get back on track when I need to.
On Thursday, I left work after midnight and walked to the garage where I'd parked my car. I was talking to the Mister on my cell when I noticed the locked doors.
Look at that--the garage closed at midnight, and my nice silver car was locked inside. I was stranded.
Oy.
The Mister offered to drive into the city to pick me up, but he'd already been fast asleep when I called him to tell him I was coming home. I told him I'd call him back.
Public transit stops running around 12:30 am, so that wasn't going to help me get anywhere closer to the suburb where we live.
I called my parents, who live 15 minutes away from my office, and brokered a deal: I'd cab to their house, borrow my father's car and drive home, then return it early Friday morning and take the subway back to work. My mother was OK with this, but worried.
"You're going to take a cab this late at night? That's so stressful!"
"I've taken many cabs at night when I lived in New York and you never knew. I'm not stressed at all. I'll be fine."
And I was.
That night, I crawled into bed next to the Mister around 1:15. He barely remembered I was there.
The next morning, since I left the house much earlier than I ususally do, I got to my parents' place around 8:15. I walked to the subway, saw that I'd just missed it, and ended up walking to work. It reminded me of being back in New York again, and I adjusted my insulin dose accordingly. Weirdly, my sugar was super high that morning, for no other reason that getting less sleep than usual.
I got into work around 9:15, a solid fifteen minutes earlier than usual. I was pleased about getting a good hour of exercise, too.
And when I picked up my car at the end of Friday night, they didn't even charge me for an extra night.
Stuff like this, I feel, happens all the time. If it's not the garage closing at midnight, it's the traffic slowing you down and delaying you, or the subway is late, or someone doesn't do what they said they were going to do and it affects your entire day.
But rather than get frustrated over these simple issues, I was able to figure out a plan on how to get home, felt level-headed about it, and things went accordingly.
Telling my story at work the next day, a few people were like "Wow, that's a story." The Mister told all his buddies at work about my night, too.
But for whatever reason, maybe from years of living with health issues, it didn't faze me much and I was able to move on to Plan B and make it happen.
Has living with diabetes, or infertility, or cancer, or *whatever*, helped give you a clearer head when faced with life's smaller challenges?
I mean, really, if I can manage the mental gymnastics of life with diabetes, or the disappointments of infertility, or living through a cancer diagnosis, who can get worried about how to get home after midnight?
As a result, I haven't blogged and I've noticed my meter averages creeping up. I'm seeing the endo again this Friday and am scheduled to start the IVF drugs this week. While I'm not worried, I'm also not waiting another six weeks if my A1cs are above 7. They've been between 5.6 and the low sixes for more than a year so I can get back on track when I need to.
On Thursday, I left work after midnight and walked to the garage where I'd parked my car. I was talking to the Mister on my cell when I noticed the locked doors.
Look at that--the garage closed at midnight, and my nice silver car was locked inside. I was stranded.
Oy.
The Mister offered to drive into the city to pick me up, but he'd already been fast asleep when I called him to tell him I was coming home. I told him I'd call him back.
Public transit stops running around 12:30 am, so that wasn't going to help me get anywhere closer to the suburb where we live.
I called my parents, who live 15 minutes away from my office, and brokered a deal: I'd cab to their house, borrow my father's car and drive home, then return it early Friday morning and take the subway back to work. My mother was OK with this, but worried.
"You're going to take a cab this late at night? That's so stressful!"
"I've taken many cabs at night when I lived in New York and you never knew. I'm not stressed at all. I'll be fine."
And I was.
That night, I crawled into bed next to the Mister around 1:15. He barely remembered I was there.
The next morning, since I left the house much earlier than I ususally do, I got to my parents' place around 8:15. I walked to the subway, saw that I'd just missed it, and ended up walking to work. It reminded me of being back in New York again, and I adjusted my insulin dose accordingly. Weirdly, my sugar was super high that morning, for no other reason that getting less sleep than usual.
I got into work around 9:15, a solid fifteen minutes earlier than usual. I was pleased about getting a good hour of exercise, too.
And when I picked up my car at the end of Friday night, they didn't even charge me for an extra night.
Stuff like this, I feel, happens all the time. If it's not the garage closing at midnight, it's the traffic slowing you down and delaying you, or the subway is late, or someone doesn't do what they said they were going to do and it affects your entire day.
But rather than get frustrated over these simple issues, I was able to figure out a plan on how to get home, felt level-headed about it, and things went accordingly.
Telling my story at work the next day, a few people were like "Wow, that's a story." The Mister told all his buddies at work about my night, too.
But for whatever reason, maybe from years of living with health issues, it didn't faze me much and I was able to move on to Plan B and make it happen.
Has living with diabetes, or infertility, or cancer, or *whatever*, helped give you a clearer head when faced with life's smaller challenges?
I mean, really, if I can manage the mental gymnastics of life with diabetes, or the disappointments of infertility, or living through a cancer diagnosis, who can get worried about how to get home after midnight?
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