Fifteen!!!!!!

The six or seven exclamation points I just put in the title of this blog do not come anywhere near to describing how incredibly exciting it was (and is) that fifteen of my eggs were retrieved this morning.  I cannot put it into words but I am grateful, so grateful and humbled.

Of course I've said before that this whole experience has been (and still is) the sweetest yet most heart-wrenching gamble we have ever made.  We knew that my ovaries might not produce many follicles, and then that every follicle might not have an egg inside it, and now that not every egg may be of good enough quality to be fertilized with Michael's sperm.

And yet, just to reach this point and to know that my body came through for me (for us) in this amazing way is so hugely satisfying. 

I'll blog more about the actual retrieval experience tomorrow, but for now, I wanted you to know how many eggs we got, and how very happy and grateful and relieved Michael and I both are.

Thank you for your prayers.  <3

Four Hours Until Egg Retrieval . . .

 . . . and of course, I cannot sleep.  I think we set four alarms just in case, but I don't think they are going to be necessary.  If something big is on deck to happen in my life, usually I wake early and can't stop thinking about it.  But it's okay . . . hopefully it just means I will be super out of it during the retrieval.  Maybe I will sleep through it!  :)

Yesterday morning I saw Jelena for an acupuncture treatment geared toward helping me relax and let go of my worries.  It was wonderful.  We talked a bit about the transfer (which will be either Wednesday or Friday) and she assured me that she will be there--even if she has to move some of her other clients around on her schedule.  I am so, so grateful. 

After my appointment, I met Eileen at the Ling Garden for lunch on the patio.  It was lovely as always and she was so sweet to surprise me with some vibrantly colored flowers from her garden.  We had a good talk and reminisced on just how far we have both come in our individual "getting to baby" experiences.  I'm so glad we met that day at the support group and connected over our shared interest in natural methods of increasing and enhancing fertility.  I have a feeling we will be in each other's lives for a long time--and as of Friday, she is at 14 weeks.  :)

I headed home after lunch as Michael and I had plans to pick up a post-procedure pain prescription (to have on hand just in case), and also an enema for me to use before bed.  I know, fun, right?  I teased Michael that he seems to have gotten the better end of this deal as he gets to do quite a lot of "donating" while I get to have the injections, the enema and the procedures.  Just teasing, but still.

We had plans to see "Captain America" after running our errands, but I began feeling sick to my stomach and really just wanted to stretch out on the couch and rest at home.  Michael was very understanding (bless him), and we went home and watched "Secretariat," which is one I had been wanting to see for a long time.  What a great movie--I really loved it. 

It was really nice having a break from injections yesterday, but even so, I felt emotionally off-kilter again which was odd because Friday I seemed to do okay both mentally and physically.  I guess maybe the Ovidrel affected me since I didn't have the Menopur or Ganirelix injections on Friday evening.  I will definitely be glad when the drugs make their way out of my system and I feel more like myself more of the time. 

Well, I suppose I should try and get some more rest.  I'll try and make another blog post later today to let you know how many eggs were retrieved. 

Wish us luck!  <3

Ultrasound #6 . . . YES!!!

I got the great news today that I am finally ready for the retrieval!!!!  :)  You cannot imagine how happy I was to hear Dr. Lee say those words. 

He said that my uterine lining looked "perfect" in terms of the thickness it should be at this stage of my cycle, and I think I have between 15 and 17 follicles.  I can't tell you how proud I am of my body for working so well and producing so many follicles (with eggs!!!) 

I just got a call from the IVF Procedure Coordinator at OHSU.  She gave me all sorts of instructions to get ready for Sunday.  Tonight at precisely 7:30pm, we will do the Ovidrel injection and no others until after the retrieval.  Tomorrow I get an injection-free day (yahoo!), which you can be sure I will enjoy immensely.  I'm sleeping in!  :)

Michael and I (and Lindsey who is coming up from Albany) will check-in at 7am on Sunday and our retrieval will begin at 7:30am (36 hours after the Ovidrel injection).  I think the drug works to put the finishing maturation touches on the follicles and eggs so they are at the best possible stage on Sunday.

Michael will give his donation (we have frozen semen being stored there, but fresh is best) and then will be able to be with me during the retrieval procedure when I will be happily out of it on Valium.  I'm going to ask them to please give me as much as possible.  :)  Lindsey can't be in the room with us, but will be waiting out front and I know I will feel so much better just knowing she is out there. 

Afterward, we will find out how many eggs they retrieved, but not their quality.  By Monday we will know more details and the embryos will be transferred into my womb either Wednesday or Friday, depending on how they grow.  If they seem to really like it in the culture, they'll stay there until Friday--if they don't seem to be doing as well as they could be doing, they'll be transferred into my body earlier, so they can find cozy spots in my womb and settle in.

I am amazed that we have made it this far (honestly), since there are so many variables that have to be lined up just right in order to reach this point--just as with a natural pregnancy.  I am excited and thinking of my future babies and talking to them.  Michael is excited too and so glad we are on to the next step of this adventure. 

Thank you all so much for your good thoughts and prayers--I know they have helped!

<3

Ultrasound #5 & Bloodwork Appointment

Dr. Lee did my ultrasound today.  He was warm and friendly and communicated what he was seeing pretty well.  Unfortunately, he didn't think I was ready for the trigger shot, so I will be going back in tomorrow morning for another ultrasound.  My estradiol level was over 2,000 today, which is good--still climbing, which is what they want to see.

One thing I thought was odd about this ultrasound compared with the others is that the sizes of the follicles seemed to be smaller today . . . maybe it's just in how each doctor chooses to measure them.  They use the mouse to draw lines across each follicle at the widest and longest points, but maybe some docs measure more to the outside of the follicles and some measure more to the inside.

Another thing that was odd is that yesterday I had 11 follicles that Dr. Patton measured (I copied their sizes down from the computer after I got dressed), and today Dr. Lee said he saw 10 (!) on the right and 7 on the left.  Dang!  Seventeen follicles is a number I didn't think I would reach!  I'm wondering if they were all there yesterday, but Dr. Patton just didn't count them if some were on the small side.  The smallest one I heard Dr. Lee measure today was 9mm, so maybe by the time of the retrieval (hopefully Sunday now), the egg inside will be mature.

We did more injections tonight and had no trouble with the Ganirelix (yay!), so I'm praying that tomorrow we get the green light to trigger.  :)

Quick Update (After Ultrasound #4 & Bloodwork)

Yesterday I had an afternoon acupuncture session with Jelena that left me feeling so calm and relaxed.  I got to enjoy it for a couple of hours before Michael and I had a problem with the Ganirelix injection and I got stressed out again.  The problem was that he said something (can't remember what now) while he was giving me the injection and I laughed.  My belly moved and the needle came out, leaving a rather large drop of medication on the outside of my belly instead of the inside.  I was worried since Ganirelix is the drug that keeps the body from ovulating until the retrieval and I didn't want to ovulate early as a result of not getting the full dose of medicine.  So I called the fertility clinic's after-hours number and had Dr. Patton on the line in a matter of moments.  He said that yes, I should probably take some extra Ganirelix if we had another pre-filled syringe--just in case.  So Michael injected about as much as he thought we lost but when he pulled the needle out, some blood (& drug) came out.  So to be safe we injected a bit more.  There wasn't a lot left by the time we were done but at least we were pretty sure I wouldn't ovulate early.

This morning I went in and at first Dr. Patton said "I think you're ready," meaning ready for the trigger shot.  But after the ultrasound was over and he was reviewing the various sizes of the follicles, he said that maybe we should go one more day.  Bummer.  One more day of meds and waiting to do the trigger shot.  But, if it means the follicles will all be a good size and the eggs inside will be mature, I'm willing to do it.  What's one more day at this point, right?

I was mostly bummed that we would have to buy more Menopur and Ganirelix for tonight and more Follistim for tomorrow morning's dose.  But again, at this point, what's a few hundred more dollars?  :)  It will all be worth it in the end!

So tomorrow I go in at 9 for another ultrasound--this time with Dr. Lee (Eileen's doctor)--and we'll hopefully get the go-ahead to do the trigger shot tomorrow night, which would make Saturday our retrieval day.  I am hoping with everything I have that I am ready by tomorrow. 

Today was tough again, emotionally.  I am convinced it's all the hormones pulsing through my body because I am a nervous, angry, crying mess, interspersed with periods of feeling "normal."  But mostly feeling not normal.  People at work started to notice today (both because I was wiping away tears as I worked and because I was a little more outspoken than I usually am).  I feel badly, but honestly, it is all I can do to hold it together right now.  I hope they understand, even though most of them don't know we are going through an IVF cycle.  I'm sure it will come out later when I am out for a few days after the transfer.

What I can tell you is that this is much, much, much tougher than I had imagined.  And I don't know how some women go through as many as 6 IVF cycles.  I know I couldn't do it.  Please keep praying for us that we get our baby(ies) with this one cycle. 

I'll let you know what we find out tomorrow.

3rd IVF Ultrasound & Bloodwork (!)

Today is Day 10 on the injectables and I did try my very best to go in to the appointment with the sense that whatever the news, I would be okay.  I had a feeling that it would be good news, however, and it was!!

Dr. Patton said something like, "Oh, now things are starting to happen," like he was pleased.  The follicles that had been dragging their feet about growing caught up a lot since Friday's appointment and whereas many of them had been measuring at 2 or 4 or 6mm, now almost all of them were at least 11mm and two were 15mm!  So, naturally I was overjoyed and giving all the credit to my two acupuncture sessions last week--especially Saturday's treatment where I got the electric stim acupuncture. 

I asked the doctor if he could give me an idea of how many more days I'll need to take the injectables, so we know how much to order . . . we do not want to have any left over since they are so pricey.  He said two or three days, but he would know more after my bloodwork came back.  He seemed cautiously optimistic, but not encouraging really (I suppose they try to be very careful of that so as not to devastate someone if things suddenly look different on the next visit), and said that he would probably want me to come back on Wednesday.

When the nurse called me this afternoon, I could tell from her voice that the news was good and that we are still on track.  My estradiol level was 1,666 and she said it's been a "nice, steady climb" in terms of how it's been increasing from appointment to appointment, which is what they want to see.  I was glad.  And then she gave me the best news: tonight we begin the third injection which is Ganirelix.  It's a prefilled syringe (yay, no mixing!), and gets injected subcutaneously like the others.  Then I'll go back on Wednesday for another ultrasound and if things are still progressing nicely, they'll have me do the "trigger shot" in preparation for retrieval 36 hours later. 

So, Friday could be a BIG day for us!  But we'll still try to take it a day at a time and try not to get too excited too fast.  I can tell you that it was really hard concentrating on work after I got the nurse's phone call.  Granted, our IVF cycle was all I had been thinking about before I got the call, but after the call I got a surge of adrenaline, so then it became almost impossible to concentrate.  I did finally pull it together and get some work done, but I think I had a small smile on my face (like I do now) the rest of the day.

Ah, patience.

<3

Surrender

Thursday I had acupuncture with Lee again, but my session didn't go quite as well as the first one.  We talked for awhile before the treatment and I updated her on everything to do with our IVF cycle.  She put in the needles and left me to relax on the table for awhile.  Right before she came back in I started getting a headache on the left side of my head.  It was getting quite strong by the time she came in and I told her about it.  She said it meant it was time for the needles to come out.  After she took them out, I touched my head where one of the needles had been and there was a pretty good-sized area of swelling.  She felt it and said it was a hematoma and was probably from nicking a blood vessel with the needle by accident.  I think she said that the drugs are probably making my blood thinner, hence the bleeding.  She pushed on the hematoma to force the blood out of the area and make the swelling go down.  Lee assured me that it was fine and nothing to worry about, but I left with a fairly decent headache that managed to hang on into the next morning--it kind of put a damper on the relaxation I normally get from my acupuncture sessions, but I went home and slept well so at least there was that.

The next morning I woke up with the headache still there and a slight queasy feeling that I noticed most when I was sitting in the waiting room at OHSU for my appointment.  I didn't get as good of news as with Tuesday's appointment--not bad news, but not great news.  Dr. Patton did my ultrasound and wasn't really clear in communicating to me what he was seeing.  I'd say Dr. Amato is better at that.  Dr. Patton talked to the medical assistant during the whole procedure, pointing out the cysts and then reading off numbers.  This led me to believe that I had new cysts that had formed from the drugs.  It made me nervous but I held my questions until he was done.  It turns out there are no new cysts--what he was measuring were my follicles.  There is one good-sized follicle (11mm), but the others hadn't grown much since Tuesday's appointment.  I was disappointed because he wasn't able to tell me much; he said that I just need to keep on with the meds and that he would be able to tell more after my blood work came back.  When they called yesterday afternoon, the news was the same: stay on the same meds dosage and come back on Monday for another ultrasound and blood test.

I had acupuncture this morning with Jelena and she did some "stim" points where she runs an electric current through the needles.  It's a buzzing, vibrating sensation that is oddly relaxing.  Jelena's goal was to bring blood to my ovaries and help feed the follicles so they grow.  And I did feel some stirring sensations around my left ovary while I was having the treatment, so I'm taking that as a good sign that the follicles were getting the boost they needed.

Up until yesterday, I had been feeling pretty okay emotionally while on the injectables.  One of my fears in going on them was that I would feel like I did on the Clomid--cranky, irritable, angry and definitely not myself.  I think that some of that has started while on these drugs.  Yesterday everything and everyone was irritating me and I had an enormous sense of anger flooding my veins.  Today started off better, but as the day has progressed, it's gotten worse.  I hope when I go in on Monday they'll tell me the retrieval will be this week because I don't want to keep feeling like this.

For now, I meditate and do qigong when I feel up to it, do reiki on my ovaries, visualize the follicles growing and the cysts continuing to rest, do the restorative yoga postures that bring blood to my ovaries, listen to my IVF meditation and listen to music that helps ease my heart.  Lately it's been Elton John and Natalie Merchant.

Jelena gave me some good advice today--she said all I can do now is surrender to the process.  Despite all my best efforts (see above), ultimately I cannot control the outcome of this cycle.  My head understands and knows this to be true; my heart does not.  Still, I must surrender and let my body do its work, as best as it can.  I repeat these words in my head, "Surrender, release, let go.  Surrender, release, let go."  Jelena said to try, as much as I can, to not have any expectations when I go in on Monday.

But how can you not, when it matters so much?

IVF Medications 101

I've been meaning to do a post about the meds we've been using during our IVF cycle.  We just completed Day 6 of our injectables and believe me, we have come quite a long way in such a short time.  I really have to give Michael all the credit because he has been so wonderful as my twice daily injection-giver. 

The first day of drugs (last Saturday), we managed the Follistim injection just fine--that's the one that takes a cartridge and only has a tiny needle.  There's a dial that you use to dial up the correct dosage and then it's just a matter of pushing the plunger.  It got a little trickier when it came to the Menopur in the evening as it is 2 vials of powder and 1 vial of saline that must get mixed and then injected as one shot. 



The Follistim pen and way more tiny needles (the pink containers) than we will ever need.  Note the handy carrying case!



By the time we started the injections, it had been nearly a week since we'd  had our training with the nurse at OHSU and I couldn't remember the procedure for mixing the powder with the saline.  Michael wasn't sure at first, but once we got the supplies out he remembered pretty quickly.  He injects 1 ml of saline into the first vial and the powder almost instantly dissolves.  Then he draws the solution out of the vial and injects it into the second vial.  There's a little connector piece called a "Q-Cap" that attaches to the vial so the saline can get in and the powder can dissolve.  It's "needle-free reconstitution" as it says on the cap.  The Q-Cap gets taken off when it's time for the shot.  My job (besides being brave :) ) is to pick an area of my upper abdomen in the half-moon section above my belly button where I want to get poked and clean it with an alcohol pad.  Then I grab a section of belly fat and pull it up so Michael can get the needle all the way in.  He tries really hard to make it as pain-free as possible and there have been a couple of times when I really haven't felt much at all.  Usually I do feel the needle go in and then a little pain as the medicine is injected, but it's over before I know it and then I'm good for another 12 hours. 

The morning injection is the funniest one to me.  We debated about what time to choose to do the injections and decided to go for a later time since we are often at work past 6:00PM.  Our time is 8:15 or as close to it as possible.  This means that I go to work earlier than I usually do (I used to roll in around 9:30 or 9:45AM), and I text Michael when I am a few minutes away.  He walks out to the parking lot and meets me and we do the Follistim injection in the car.  A couple of times someone has pulled up and parked in the spot next to us while I've had my shirt hiked up and am holding my belly while Michael injects it.  The first time it happened, Michael joked that they would probably call Security thinking we were shooting up in the parking lot--which we were--but only one of us was actually getting any drugs and I promise they were entirely legal.  :)  After my shot is over, I get my stuff, including a brown New Season's grocery bag which holds my sharps container and the Follistim pen, and we walk into the building together.  It's actually kind of sweet and I think that it's a good way for Michael to be involved in what is otherwise a process that revolves almost entirely around me.  Plus he puts up with me being wimpy and whining about my shot.  :)  I really couldn't ask for a better nurse.

Tomorrow we are going to a wedding after work, and will take our Menopur injection with us.  Sometime during the reception we will slip off to our car and go through our nightly routine, although it may prove slightly more challenging as Michael will have to do his mixing in an improvised setting.  But I have every faith in him.

More on meds later as soon we will be adding a third shot--Ganirelix and then later, Progesterone.



I had to smile on Saturday when I came back from my appointments downtown and saw what Michael put on our white board.  Guess he wanted to make sure we remembered our time!





2nd IVF Ultrasound & Bloodwork Appointment

I try my best to be grateful every day, but today, I am especially grateful and am reminded of what Anne Lamott said in her book Traveling Mercies: that the two greatest prayers she knows are "Help me, help me, help me" and "Thank you, thank you, thank you."

What a relief today's appointment was!  My first ultrasound since beginning the injectables showed that I have four follicles maturing in my left ovary and four or five maturing in my right ovary (!) (!) (!)

Dr. Amato did my ultrasound again and I think she was a little surprised (as was I) by just how well I am responding to the drugs.  I did have a feeling that something good was happening though, as I have been feeling a lot of "activity" where my ovaries are--kind of a stirring sensation along with some achey pain.  I've had one really sharp pain on the left side that didn't last long, but Dr. Amato didn't seem concerned about it, so I'm not going to be either.  :)  Probably just my little ovary getting a wake-up call from the drugs. 

I'm so proud of my ovaries for doing such a good job getting follicles (with eggs inside!) ready for our upcoming retrieval.  And I'm so proud of my cysts for doing such a good job resting quietly while the activity occurs around them.

My estradiol level was 171 which the nurse said was just fine.  She said that Dr. Patton wants me to continue on the same dose of drugs and go in again on Friday for another ultrasound.  Hopefully by then we'll have a better idea of when the retrieval might be as it all depends on how long it takes for the follicles to reach the proper size of 12-14mm.

Thank you, thank you, thank you.  <3

Thursday's Acupuncture Treatment

After Wednesday's emotional appointment at OHSU, I was very, very glad I had an evening acupuncture appointment scheduled for Thursday.  Jelena thought it would be a good idea to up my acupuncture visits to twice a week since we are ready to start the injectables.  Since she didn't have any available appointments later than 4pm, I scheduled with her colleague, Lee Hullender Rubin, who is also a doctor of Chinese medicine and acupuncturist.  Eileen told me she'd had a few appointments with her when Jelena was on vacation and she had really liked her personality and therapeutic style.

I reserved the latest possible appointment (6:30PM), hoping I would be able to leave work no later than 5:45PM.  After a slow morning at work, I got busy around 4PM but was able to make it out the door by 5:30.  Thank goodness, because as it was, I barely made it to the clinic on time; I'd forgotten about rush hour traffic.

I liked my consult and treatment with Lee very much.  She listened to everything I had to tell her about what's been happening lately and to my fears about taking the stim drugs.  One thing she said that was very helpful to hear was that from her experience with OBGYNs (Lee used to work in a fertility clinic in Seattle), they are so worried about malpractice claims that they feel it is their duty to point out everything they see to patients--so there can be no question later in case something comes up.  I understand that and I need to keep that in perspective when I have my OHSU appointments--and I need to try and be less sensitive about the cysts.  They are there, but my hormone tests have also all been normal.  And that means that I still have some good eggs. 
Lee did several points on my head, just under my collarbone and on my belly.  She left the room a couple of times to verify she was getting just the point she wanted and I was grateful to her for that.  She also kept checking my pulses, during and after the treatment to see how they compared to when we began.  And she  encouraged me to keep my eyes open while I was on the table with the needles in, which she said would help me stay in the moment.  I agreed, but didn't really think I'd get very relaxed that way.  Usually I drift around in that blissful soft state between sleeping and waking when I have an acupuncture treatment.  This time I kept my eyes open and concentrated on my breath and on the room with green walls I was in and on the ceiling with its lovely old painted woodwork.  And when Lee came back again to take out the needles, my entire body felt deliciously heavy and relaxed and peaceful.  It was heaven.

I left the clinic at 7:45PM and decided to head over to the Ling Garden to get some dinner before going home.  Michael was playing golf with a friend and wasn't expecting me at any certain time.  I sat at a booth and had some of their lovely egg flower soup.  While I ate I imagined my body soaking up the nourishing protein and using it to get my follicles ready for maturation.  I was happy that the heavy feeling lasted all the way home where I did a castor oil pack and went to bed.  And I felt like I was taking good care of myself.

I have another appointment with Lee next Thursday, and one with Jelena on Saturday.  I am so thankful for my acupuncture appointments.  They are good for my body and so very healing for my soul.

1st IVF Ultrasound & Bloodwork

Yesterday was my "suppression check" at OHSU for our IVF cycle.  It consists of a bloodtest to measure estradiol level and also an ultrasound to make sure the ovaries are "quiet," or not yet developing follicles for the month.  The idea is to control the rate of maturation of the follicles, so that they are retrieved at just the right time, before the body would normally ovulate on its own.

I arrived at the clinic feeling optimistic and practiced taking deep breaths in the waiting area while listening to soothing music on my iPod.  I don't think I was really expecting anything negative to happen; maybe I was excited more than anything else. 

I ended up having to wait for awhile since there was a retrieval scheduled before my appointment.  OHSU had called me on Monday in fact, to change my original appointment time in order to allow for the retrieval appointment.  No big deal.  I figure that when it's our turn for retrieval, someone else will probably have to rearrange their schedule for us.  It's just the nature of IVF. 

I'd been waiting for about 15 minutes before a medical assistant took me back and did my bloodwork and then I waited for about another 10-15 minutes before the doctor was ready to see me.  They asked if it was okay for the medical student shadowing the doctor to observe the procedure, which is something that has been my experience every time I've been there.  I said that was fine.

Dr. Amato (the lone lady doctor in the practice) performed my ultrasound.  She looked at my womb first and didn't have anything to say (good sign), and then it was on to measuring the cysts on my ovaries.  She pointed out the endometriosis to the medical student, which didn't really upset me in itself.  What got me was that the doctor made it sound like I only have a small part of each ovary that is "normal" tissue--since the cysts are so large.  She asked me if my drug therapy was going to be aggressive.  I told her that I didn't know; we were told to start 175 IUs of Follistim in the morning on Saturday, followed by two vials of Menopur in the evening.  She commented that no, that was not very aggressive, but that we would see how I responded. 

Now I was upset--not from any specific thing that the doctor did or said, but from all of it.  I left the office crying and tried to pull it together in the car, but the fear was (and still is) pretty overwhelming.  It's not only fear that there won't be enough eggs to complete the cycle, but also that we are investing a great deal of money in this venture, and if it doesn't work it will be some time before we're able to explore a different option.  I can't convey in simple words how it feels except to say that it is a place of dark worry and sadness, frustration that all I am doing doesn't seem to be having an effect on those cysts, and fear that we are going down a fruitless path.

I had to go back to work and try to get through the day after the appointment.  First I tried finding Strohecker's, the specialty fertility pharmacy we are using for my meds, but the Garmin had me driving around in circles for about 20 minutes before I finally gave up and just headed to work.

Luckily, Michael was able to leave work earlier than he normally does and picked up the drugs and assorted paraphernalia (needles, sharps container, etc.)  He texted me that he ended up putting the cost of the drugs on our credit card since it was way more than we had been expecting (about $3600), although in retrospect, I remember being told that in our inital consult back in April . . . cost of drugs for one fresh IVF cycle is generally between $3-5,000. 

Right before I got Michael's message about the cost, I got a call from OHSU with the results of my suppression check.  The nurse or medical assistant was curt and not really friendly.  She said that I was fine to proceed to the next step of the cycle (Estradiol level was less than 20 which is what they want, but she couldn't give me a specific number since they don't do that specific of a test during the suppression check), but that based on what they found during the ultrasound (cysts, big surprise), Dr. Patton is bumping me up to taking 300 IUs of the Follistim instead of 175.  The amount of Menopur stays the same. 

I was both relieved and saddened.  Relieved because all day my mind had been racing from Dr. Amato's reaction to my not-so-aggressive scheduled drug plan.  I was all set to ask to have Dr. Patton call me so I could ask him if I should be on a higher dosage.  I do know that the team of clinic doctors (there are three of them), meets every day between 1 and 2p.m. to discuss each patient currently going through an active IVF cycle.  Maybe Dr. Amato told Dr. Patton she thought I should be on a higher dose of drugs.  I like the fact that they all discuss my case, because it's kind of like having three doctors for the price of one--three insights into our specific situation.

I made it home close to 8p.m. and Michael showed me all of the stuff he picked up at the pharmacy.  He had already gone through and put certain of the drugs in the refrigerator, but there was still a big bag of supplies on the table--mostly packets of needles of different sizes, the sharps container which is larger than I thought it would be, and some of the drugs that don't need refrigeration.  I felt much better when he told me that he was able to get all of the drugs we will need for $3600 because at first I thought he paid that much for 8 days' worth of Follistim and Menopur which was what we were going to start with.  Apparently, you can't order less than 10 days' worth even if you don't need that much.  Since I'm now on a higher dosage of Follistim, we'll need to buy more of that because 10 days has now become about 6 days worth of drug, but I'm hoping we won't need a whole lot more of it.  The nurse did tell us it keeps for 3 years, so I guess that's good in case we need it for another cycle. 

I feel like I've run the gamut of emotions in about 24 hours and am now in a kind of neutral place.  We've begun and all we can do is see where the road leads us.  I'm so thankful that Michael is helping me as much as he is.  He doesn't seem worried, even about all the money we are spending, which is quite the opposite of how it usually is--usually I am the calm one and he stresses financially.  Maybe he can tell I couldn't handle it if he were stressed about it and is putting on a brave front.  Whatever it is, I'm thankful for it and hope we can get through this in one piece. 

Please think good thoughts, pray for us, send us good energy--whatever works best for you.  I go back to OHSU on Tuesday for another ultrasound and blood test.  I will have been on the drugs for four days by then.

Injections, Here We Come!

We met with a super nice nurse at OHSU today and she spent about 90 minutes with us going over our IVF schedule and showing us how to do the different injections.  When I found out last Friday which medications I would be taking, I thought I would be taking them all at once, but I was happy to learn today that I will begin with two meds: 175 IUs of Follistim in the morning and then 12 hours later I'll take two powder vials of Menopur mixed with saline.  The Follistim is injected in a pen--it looks similar to what I imagine an Epipen looks like.  This kind of pen has a dial that you turn to the desired dosage of medicine and it measures it for you.  Very cool.  The Menopur has to be measured in a regular syringe from the vials after the powder and saline is mixed and you have to be careful to get the air bubbles out.  The good news is that I'm pretty sure Michael will be able to help me with most of the injections--even if I have to do some of them at work, he can probably prepare them for me and I can do them in the bathroom.

Tomorrow is my last day on the Pill (it will be 17 days taking it).  I'll go in for my first IVF ultrasound and blood draw on Wednesday and then I'll start the medications on Saturday. (!)  If all goes well, we'll have our egg retrieval sometime between July 24th and July 30th, and then the transfer anywhere from 3, 5 or 6 days after that.  So here we go, friends.  The roller coaster has definitely picked up the pace and I am hoping for a steady climb with no descent.  In just a few short weeks, I could be pregnant.  :)

11 Weeks for Eileen

I met Eileen for lunch today after my acupuncture appointment (which was wonderful, as I knew it would be), and we spent a couple of hours catching up at the Ling Garden in northwest Portland.  She is eleven weeks along as of yesterday (!) and was kind enough to share her experience with IVF with me in more detail, giving me the pep talk I needed as we begin the injectables next week.  I am grateful to have her as a resource, because even though I'm sure our experiences won't be entirely the same, we share a similar medical history and as those of you who read this blog regularly know, both of us have been supplementing our fertility with acupuncture, herbs, etc.  She told me about some yoga positions that were recommended to her while she was doing her IVF cycle and you can be sure I will be doing them too during mine.  :) 

I'm feeling more confident today and I know I owe much of that feeling to Eileen.  Just knowing that she was able to do the injections, juggle the appointments with work and home life and be successful helps enormously.  Once again, I am grateful.  <3

Still On Track

It's been just over a week since my last post and it feels like so much has happened since then. 

When last I wrote, I was worried that we wouldn't get our financing paperwork in to Attain in time for this month's IVF cycle . . . we did get it done and emailed late last Wednesday before we left for San Francisco.  I had put a note in the email requesting that we be notified when our paperwork was received, but I heard nothing during the 6 days we were in California.  I still hadn't heard anything by yesterday (Thursday) and was going to call them today just to make sure all was well, when they called me first and left me a message bright and early this morning. 

The woman who called said she wanted to touch base with us and see if we had any more questions and if we were planning to begin an IVF cycle soon.  This made me a bit nervous as I figured if they had received our paperwork, they would know we didn't have any more questions and were gearing  up for a cycle.  When I called, I explained that I had emailed our paperwork and copies of our driver's licenses a week ago.  The lady I spoke with said they had received all of that, but had I signed the loan document from Springstone? Springstone is the financing company giving us a loan for the multi-cycle plan we chose.  I told her we hadn't received any paperwork from them--we had applied and been approved for the loan using an online application.  Again, I was nervous that this would throw a wrench in our plans since we are so close to beginning the "injectables" as the stimulation drugs are called, so you can imagine my relief when the lady said she would email me the Springstone documents today and I should just sign them and send them on to Springstone.  I still think it's odd that one company would give me the other company's documents, but I guess that is the nature of their relationship.  The Attain lady assured me that all would be well, even if we started the injectables next week--which we will be, but more on that in a bit.

After I figured out where we stand with Attain, my next order of business before heading off to work was to call OHSU back.  Tracy, the IVF coordinator working with us had called me yesterday and left a message that I need to choose a pharmacy where we will get the injectables.  I ended up leaving a voicemail message for her to call me and headed off to work.

A couple of hours later my phone rang and it looked like OHSU's number so I answered right away.  It was Jeannette, the financial counselor calling to "check in" and see if we had applied with Attain.  She had seen our upcoming Monday appointment on the calendar and wondered if our financing was in order.  I'm sorry to say that I wasn't very nice to her--not rude, but not friendly.  Part of it was that I have been fighting an on-again, off-again headache for the past three days (side effect of the Pill perhaps?) and part of it was that I was annoyed she was calling to check up on me when I felt like she didn't help us much at all with the financing part of this venture.  I kept it short and told her what I'd found out from Attain this morning.  She seemed quite happy but could probably tell that I was not really pleased about talking with her. 

I still hadn't heard back from Tracy by 4pm, so I called again and was transferred right to her.  Tracy explained that we basically have 3 options for getting our injectables: we can buy them from OHSU's specialty pharmacy; we can go through another local specialty pharmacy called Strohecker's or we can choose to go through a mail-order pharmacy.  She explained that OHSU doesn't really recommend using a "regular" pharmacy since most don't have what I will need in stock and it will take longer to get them and also that the cost will probably be higher since they don't order fertility drugs in bulk like specialty pharmacies do.  I told her I thought someone from OHSU had said that OHSU's pharmacy will match prices if you find a drug cheaper somewhere else, but Tracy said she didn't know anything about that.  I guess I will need to do some legwork this weekend and see what I can find out online. 

I asked Tracy if she knows when I will start the injectables and she said she did--she has our schedule ready and we will get all the news at our Monday appointment.  She did tell me that I am scheduled to begin taking injections next Saturday, July 16th.  This was actually a little later than I thought it would be . . . I'm on Day 15 now, so I was thinking I might start as soon as Tuesday.  I'm still not quite sure how it works going from the Pill straight to the follicular stimulation drugs, but Eileen said she had a small period between the two.  I know that most women doing IVF don't take the full cycle of the Pill and I have almost taken it for 14 days, so maybe they will have me go off of it for a few days next week, then start the injections.  We'll find out for sure on Monday. 

Here are the four drugs I will be starting out with:

• Follistim
• Menopur
• Ganirelix
• Ovidrel

OHSU has already scheduled me for my first 2 ultrasound appointments during which they will check on my ovaries to see how the follicular development is coming along.  It was kind of funny because I got an email message from them yesterday, I think it was, telling me I had a new message from them on my OHSU MyChart account.  When I checked it, I saw they had already put me down for an ultrasound next Wednesday at 9:15am and another one on July 19th at 9:45am.  I guess you don't really get a say in what time you come in . . . maybe I can ask about that on Monday too.

Michael and I have decided that it will probably be best to sit down with our boss and fill him in on what is going on after Monday's appointment, once we have our schedule and can give him an idea of the time I will need off.  We've already missed some time at work because of fertility appointments and I have wondered if he thinks it odd that we go together to the doctor, but he hasn't ever made a big deal out of us being gone.  I honestly don't forsee it being a problem, mostly because I am the one who will be late coming to work or out a few days in a row--Michael is the more vital to the company of the two of us, and he will probably really only miss work time on the day of the retrieval and the transfer.  I'm not too nervous about talking to our boss, but all the same, I'll be glad when it's over and he knows what's going on.

I have a feeling that things are going to start moving very quickly after Monday.  Today I really got the sense that this is going to happen, and to be honest, I got scared.  It's a big unknown and while I still have a quiet sense of confidence deep within me that we are going to get pregnant and have our baby (ies), what it comes down to is that I still have to do quite a lot to get there: daily injections, near-daily ultrasounds and bloodtests, and at any time something could happen (or not happen) that would mean cancelling the cycle and trying again later.  Maybe that is the scariest part: knowing that after all of the things I have done over the past year and longer (diet, herbs, supplements, etc.), now I have to let go of being in control.  I have to accept that I cannot control the outcome of this IVF cycle and I have to trust that what is most right will happen. 

I know I will feel better after I see Jelena tomorrow for acupuncture.  And knowing that I have the support of so many family and friends going into this almost guarantees I'll feel more confident in a day or two.  Thank you to all of you who read this blog and who send me your good thoughts, your love and encouragement.  I can't tell you how much they mean to me.

<3