I remembered today that a year or so ago I started a blog. A way to chronicle my path to starting our family. Possibly a place for others to come and get information. But definitely not a blog I would need to revisit more than a year later, with no great progress to speak of.
So, where are we? How are things going?
Here’s the short story:
Our first round of IVF “took,” yet vanished quickly.
Our second round of IVF didn’t work.
I went back to work after spending a full year of trying to conceive, exercising, eating perfectly, and slowly becoming a different person.
After two full rounds of IVF, and several procedures chronicled here, we have 6 frozen embryos. Monday, May 17, 2010 we will have a FET with 3 embies.
After a year of working hard core, long hours, I am not working again.
There is much to update, but that is the short story.
Monday is a big day. Think thick!
I will have two full days of bed rest, and more updates to come. I have received great feedback, comments, and loving stories from the world. Thank you. There is no way to adequately express my gratitude. I just hope, and know, that all that have been through this know how deeply I feel towards all those who have had kind words.
And, a very special thank you to everyone who sent well wishes without telling me “to just relax and it will happen.”
I have been overwhelmed by the response to my little blog here…and the number of people who have emailed and commented. I know I have been a bit silent for the past month, it has been a tough one. I am going to write a few posts in the coming days to catch up, we have had some interesting things going on that others may be able to learn from.
A quick little update…we are mid-cycle and are having our retrieval the week of May 11 (next week!) and the implantation a few days later, of course. Tomorrow we have an ultra sound and I’ll have much more information following that appointment.
Think 13mm follicles and thick uterine lining 🙂
It has taken me some time to sit down and write this entry. I certainly couldn’t do it the day of the procedure. It is now a few days later, and I am feeling much better, physically and emotionally, and am ok to recap.
Let me disclose by saying that my experience was less the norm, more the exception. There are women who have a hard time, some harder than I did. For the most part, I am told that the pre-op valium, vicodin and accompanying IV fentanyl does the trick. But you know me…I can never be the norm…so, let me take you through it, as the procedure and as the experience
A VIDEO I LIKE
I found this video on YouTube before my surgery. I think it is pretty thorough, and after going through the process, pretty accurate. A little cheesy? Ok, yes. But worth a watch.
GETTING THERE, CHECKING IN, ETC.
I was late leaving to pick my husband up, I couldn’t get off the toilet. I was anxious. (Oh, I have found that instead of reading in the bathroom I can type on my laptop.) Every time I thought I was okay, back I went. I was surprised to be so anxious and uptight. By the time I got to my husband, I felt pretty ok. He wanted to drive, but I said no. I prefer to drive. He drags the clutch in my car, makes me nuts. I didn’t want to break into some argument about his driving because I was edgy about the procedure.
TAKING MY MEDICAL HISTORY
We arrived at UCSF and checked in on our regular place on the 7th floor. The nurse came out and took my vitals, which I thought were pretty good:
BP: 107/53
HR: 66
Weight: 172
My eyebrows raised at my low blood pressure. It is usually 115/65 or so. I couldn’t understand how it was so low when I was antsy, but better than high. I was very happy about my weight, fully clothed. I was down 13 lbs! My initial weight in February was 185 lbs. I have been working hard to get to my wedding weight of 162 lbs, and I am close. (Actually, for those weight watchers out there, my weight on my scale at home was 170lbs that day, and I am really only 8lbs from my goal, yay!!!)
After my vitals were taken, my husband and I were taken to an exam room to wait for the doctor to come in to complete the pre-op history, procedure explanation and consent. We did not know this was going to take place. So, while a bit surprised, in the end, I think a good thing that we had some time to review the procedure with the doctor.
After about 5 minutes, the Fellow entered the room. I had a moment. One that I think a lot of people have around our age. The one where you realize that one of the doctors treating you looks like Doogie Howser. M.D.. I suppose I shouldn’t be so dramatic, he wasn’t THAT fresh-faced. He was, however, not any older than my husband or I. I don’t know why I need someone older to treat me. I actually, now that I give it more thought, think that someone younger may be more on top of it. Like in one of the last “ER” episodes of the season…Carter was getting a new kidney and Benton just happened to be on staff at Northwestern (of course, Carter was too good to get his kidney transplant at County General)…well, Benton makes the old time surgeon go through the surgery “checklist.” The guy gets all ticked off that he makes him do it, as if he is being questioned, and all the years of skill that this surgeon has are invalidated because Benton wants to review the “checklist.” Well, you know, something goes wrong, and damn if they didn’t need something off that checklist they wouldn’t have had if Benton, the young guy, hadn’t reminded the old guy to get. Rambling moral of the story, it’s ok for my doctor to be my same age. Or even younger. Maybe just have the experienced guy on standby? 🙂
OHHKKAAYY, back to the history…The Fellow pulled my profile up on the computer and did a comprehensive review of my personal and medical history. My history was complete and correct in the system already, I could see all of the fields he was looking at. He did, however, make a note in each field that we reviewed and all was current. I appreciated this as it not only shows the next user that I am current, but when it was most recently reviewed with the patient. I know some of you may say, isn’t that an oxymoron? If it is current, what does it matter what date(s) you are current on? I say no! The more discussion the better.
PROCEDURE REVIEW & RISKS
At this point, the Fellow reviewed the risks of the procedure with me. He did this rather routinely, and quickly, stating that all risks had “well less than a 1% chance” of occurring.
Puncture of the uterine wall
Severe pain causing inability to complete
Discovery of item causing need for extended surgery
Infection
The Fellow explained that the hysteroscopy is one of the safest, minimal risk procedures they can perform to determine if there are any issues preventing a successful pregnancy. It is rare for the pain of this procedure to be such that general anesthesia is required. Although a risk, it is also rare that the hysteroscope, once inserted into the uterus, can completely perforate the uterine wall. The uterus, which acts like a muscle, he said, quickly heals around where the probe punctured…much like a sea anemone. Interesting analogy. However, that could cause immediate termination of the procedure.
At this time, Dr. S, who would be performing the actual procedure, entered the room and did a quick review of the procedure again for my husband and I. I was happy that Dr. S was going to be executing the procedure since he had done the Saline Sonogram and was the one who saw the “foreign body” in the first place. Also, my uterus is retroverted and, apparently, my cervix is a bit difficult to navigate. Dr. S was quite mindful of that and remembered my case specifically. As he discussed inserting the camera to view my uterus more clearly, we talked about the possibility of increased difficulty navigating, maybe needing to dilate my cervix. We also reviewed the different options / potential need for additional surgery based on findings. Dr. S was hopeful that whatever was showing on the ultra sound would be scar tissue or something equally benign that he could easily and painlessly remove during the exploration.
Honestly? No real questions by now. They did an excellent job describing, prepping, reviewing everything as far as I could tell. It’s funny, in that way things are funny but not funny, that you feel prepared, all questions asked, but you don’t really know what to ask. Not that anything really catastrophic happened. I am not leading up to the worst news ever. It was simply excruciatingly painful. You just don’t know the little parts of the procedure that are going to take place that if you did, you may have had questions. Example, the cervical block…they don’t really tell you they are going to stick a very long needle into your cervix, multiple times. They just say, then we perform the cervical block. You are led to believe that the IV drugs will eliminate all the wrongs in the world. Not the cervical block. I think I would have asked more questions about how that was done. Also, the video…there must be one from the camera, right? Where is that? I would have asked to watch live streaming video.
Moving on.
The Fellow turned to me and asked if I had the pre-op meds, I said I did. He gave me a dixie cup of water. I took a valium and two vicodin. Herein lies the genesis of the problem. The pre-op meds should have included one toradol. For whatever reason we found out, much later in the day, Walgreen’s never filled that part of the prescription that was called in. Somehow, I missed it…that this was a 4th drug in the instructions for pre-op. I don’t know how that happened. I am ususally SO organized and buttoned up. That I missed it…for some reason, looking back on it, I thought that toradol was the generic for valium. At the same time, the Fellow should have reviewed the pre-op medications specifically, as opposed to asking if I had the pre-op medications with me. All in all, in my mind, we all kind of screwed that one up. And, as a result, this was the most painful thing I have ever felt. The pain manifested itself in several ways—pinching, cramping, burning, stabbing—which honestly leads me to think that this would have been a painful experience for me no matter what. The toradol is a NAISD used to control cramping of the uterus. Ultimately, the cramping was the residual pain I had, but the pain I had during the procedure was beyond cramping pain and discomfort.
PRE-OP PREP
On to the procedure…after taking the pre-op meds, we were told to go upstairs to the procedure floor and wait for the nurse to get us. As we sat in the waiting area, I could feel the valium and vicodin take effect. It was good, though. Not good in a, dude, this is gooood way. More, good in a “I was paying less attention to my anxiety” good way. My husband and I started chatting about silly stuff instead of IVF stuff. I can’t remember what, but I remember distinctly thinking that it was so unimportant. And that it was totally ok. Have I said recently how much I love my husband? I couldn’t ask for a better partner in life or IVF.
The nurse came to get me, and brought both of us to the prep area, where my husband helped me change into a gown, surgical cap and booties. I was CUTE! At this point, I was a little woozy, and certainly needed the help. I was also a little disappointed I had to wear booties since I went for a cute pedicure that morning 🙂 Oddly enough, they told me to undress only from the waist down, even with the gown. I was happy I had a comfortable bra on and a soft, long sleeve thermal tee shirt on. Indeed, it was cold in there, so it was nice to have the shirt on.
From here we moved into the prep area where I sat in a very comfortable lazy boy-like recliner, very comfy. The nurse, Kathy, inserted my IV and started giving my fluids. They brought the wheel chair, I kissed my husband good-bye, and off we went down the hall to the procedure room.
THE HYSTERSCOPY
Once in the room I moved onto the table, slid down and placed my thighs in the stirrups. I felt a split in the table right where my tooshie was. Dr. S dropped that part of the table out from under my toosh, and I was essentially suspended by my thighs and the tension of my back on the rest of the table. I was unsuspecting of this, so it took a moment to relax and get comfortable. If there is anything I have learned, it is that the less tense and anxious I am, the more accessible I am physically for the doctor. While it can be trying on me, the doctors and nurses, and my great husband, all work to get keep me breathing and as loose as possible.
Lying on the table as they set up, I looked around, thinking I really wanted to take in the equipment and instruments in the room. It was quite dim in there, and I was feeling a bit dim myself, but do remember a few things distinctly.
The nurse was on my left side next to my IV.
Next to the nurse was a sterile tray with vials of medication. I later learned this was fentanyl.
There was a set of monitors also on the left capturing my heart rate, blood pressure and oxygen levels.
Above me was a large, round light on a swing arm. Very stereo typical of what you would see on ER or Grey’s Anatomy.
At my feet was a large machine that had a color monitor and a printer. This was a new piece of equipment that the doctor and nurse were very excited to use. In fact, the technician for the machine was there, and in and out of the room when I was covered up to make sure it was functioning properly.
Also at my feet was a sterile tray with a speculum, the hysteroscope and betadine to clean my cervix.
The one thing I did not see, thankfully, was the syringe and needle that were to be used for the cervical block.
As he began the procedure, Dr. S told me that he would be talking me through every step, likely OVER talking. He said that some people didn’t like all the talking, but he wanted to make sure he was communicating as much as possible throughout so I knew what was going on. As I have said before, I am down with this approach.
He began by placing the speculum in my vagina, and really cranking that puppy open! He wanted to be able to have wide and full access. He then took the betadine and swabbed my entire cervix to sterilize the area. (Prior to swabbing, he asked if I was allergic to betadine. I really like the centers’ thoroughness when it comes to checking and double-checking for allergic reactions.) The swabbing felt like a wet, prolonged pap smear. I am not sensitive to pap smears, so this didn’t bother me…I know it gets to some people.
Following the betadine, it was time for the cervical block. Here, the doctor injects a local anesthetic around the cervix. Once the anesthetic has taken full effect, the cervix will dilate to allow the lighted scope to be inserted. Dr. S told me to expect a “little pinch” as he numbed my cervix. He also said that some people reported a metallic taste in their mouth from the medicine. HOLY COW! I didn’t just have a metallic taste in my mouth…I felt a buzz all the way up to my jaw. Yikes. But, it is done, SO I THINK…Dr. S then says, Ok, another “little pinch” on the other side. That was it. There were two injections, one into each side of my Phew, by this point I am in a cold sweat. I hear the nurse ask him if she should give me 25 of fentanyl. He says yes. I feel the drug wash over me like sun breaking through parting clouds on the beach. Yet, I still feel the pain. I am trying to think of things that relax me. Being at the beach. My husband kissing me on my shoulder. Laughing with my nephews. Going to s great spin class. Singing in choir. I still feel the pain.
I felt Dr. S place his hand on my thigh, apparently I am shaking pretty hard at this point. He tells the nurse to give me 25 more fentanyl. And, we’ll wait a few minutes to let the cervical block take effect.
Once the cervical block had taken effect, Dr. S threaded the hysteroscope through the cervix up to my uterus. At this point, I was seeing stars. I don’t recall if I was saying much, but I think there must have been a look of intense pain on my face. The nurse kept asking if I was ok, I was shaking my head and saying no. I was feeling an all-consuming, exquisite cramping I had never before felt. At the same time, I had sharp pain in the cervical area that the block did not eliminate. My sister-in-law reminded me she had a similar issue with her epidural not taking, and she felt her contractions down one side of her body.
Around this time, I remember lots of discussion between the nurse, Dr. S and myself, but not necessarily in sequence. Gas was released through the hysteroscope (to expand my uterus to give Dr. S a better view of my insides)…Dr. S was viewing my uterus through the scope, which was also visible on the video screen. I didn’t know where to look for it, and was distracted by my pain level. In retrospect, I would have liked to watch the video, it may have distracted me FROM my pain.
Once all the “prep” work is done, and the scope is in, the procedure is finished fairly quickly. I would say the entire process took about 30 minutes. For me, it was likely on the shorter side as there was not much to do once they were in there, and my pain level was so high. I was pleasantly surprised at how quickly they were done.
I must say, that through it all, Dr. S and Nurse Kathy were amazing, compassionate human beings. They did not treat me like a number, just another patient. They did not work the procedure like it was routine and commonplace. They were acutely aware of my comfort and pain the entire time. And, as objectively as I can say, I feel as though I was as tough as I could be. I was not complaining, whining or bitching at them. I remember clearly one moment when I felt hot tears streaming down my temples. I was unaware I was even crying. I was biting my lip, not speaking or making a sound, working to focus on anything but the cramping. The nurse quietly stroked my hair and gave me additional fentanyl.
POST-OP
I lay on the table for about 15 minutes waiting for the cramping to subside. The movement of the instruments in, out and around caused the most intense feelings. When I was able to get up, Kathy took me in the wheel chair back to the comfy lazy boy. Another nurse named Kathy was waiting with a heating pad, so nice. I was still in tremendous pain, doubled over, warranting, apparently, more IV fentanyl.
At this point, I asked for my husband. They wouldn’t let him in yet. Not until they had my pain under control. It would seem that many husbands become a but unruly seeing their wives in such pain. And, in turn, the wives become even more amped up. What the nurses didn’t know, is that my husband is so Zen. He would have brought such a great presence to us all, and it would have really helped me. BUT, I was in no condition to push it. They finally brought him in about 20-30 minutes later.
To end this very long story, it took a few hours for us to be released. My cramping was uncontrollable, and my pain level consistently at a 7-8. We maxed out the fentanyl I could take as my blood pressure was pretty low (somewhere around 80/45). After a couple of hours, we realized that I had not taken the toradol, the muscle relaxant. Fortunately, they were able to give me an IV dose, and after about an hour or so, I was on my way to feeling better. The other option was to stay the night in the hospital for pain management. I really felt that the fentanyl wasn’t doing the trick anyway, so I would rather be home. It is SO HARD to get rest in a hospital room. We were discharged around 5:30pm.
THE NEXT FEW DAYS
Dr. S prescribed me vicodin for the pain. This was helpful. However, I continued to have pretty bad cramps for 3 days following the procedure. Definitely worse than a regular period. I was just really nice to myself, laid on the couch, and waited until I felt better.
RESULTS
There was a bright silver lining to this experience…what had illuminated on my saline sonogram was a calcification that Dr. S was able to break up. It was nothing serious that required additional surgery, I was able to just grin and bear it. This meant there would be no healing time needed and we were clear to start our IVF cycle immediately.
Today is the day, we have been somewhat anxiously waiting for…whatever this “foreign body” is showing up on my ultrasound is disturbing to me. As I said before, it renders as a BRIGHT WHITE object among a field of black and grey sound waves. I am going to ask for the films today when we go in. I like to have everything in my own file, and then maybe I can post for you all to see. It isn’t subtle.
I am challenged by the angles we look at the uterus during the ultrasound, so I am unclear exactly where it is. Suddenly I feel uneducated, I am usually pretty on top of it.
I have a few small pre-op instructions, and as I have reviewed them this morning, I am getting really anxious. Not so much that it will go wrong. From what I understand, there are very few risks…infection, puncture of the endometrium…all less than 1%. I think I am scared of the pain. The HSG and Saline Sonogram were more painful for me than the average bear. I am working hard at just breathing this morning, and not getting worked up. However, I have not been able to keep myself out of the bathroom for long, yikes! Nerves.
The procedure is at 1p, with a check-in of noon. I’ll pick hubby up at 11:40a.
Here are the pre-op instructions:
Take 1 Doxycycline at bedtime night before procedure
Take 1 Doxycycline morning of procedure
No food or water after 10a
Bring pre-op meds with you to noon check-in (They called in 1 valium, 2 vicodin)
OKAY! I’ll be interested to see how it goes. I expect I’ll be drugged up after the procedure as they’ll give IV fentanyl or verced during as well. Luck to me 🙂
It would seem that the bcp was the culprit. I am feeling better all the time. Thank god the crying is over. Although, I am now very anxious about what is to come with the injections. Right now I can’t think too much about it, I just need to go day by day.
We decided to head out of town for the weekend. Hubbo has been working too hard, and a change of scenery will do me good.
Tuesday, April 7 is the hysteroscopy. I am sure there will be plenty to report next week.
Would you believe that the bcp they put me on last week caused this total melt down? I suppose I should have thought of it, but I wasn’t thinking of anything except how to stop the crying. I have stopped that particular bcp (Reclipsen) and gone back to what I was taking before I got married (Levora). Levora never caused any problems, so we should know pretty shortly if this is the issue.
I can say, I am incredibly tired, and for once, grateful I am not working right now.
My parents have been unbelievably supportive. My mother took me to my psychiatrist appointment and waited outside in the car. When I got back in the car she didn’t ask questions, probe for answers, I was shocked. She just wanted to take me to eat, she said I looked a little gaunt. After lunch she came over, cleaned the kitchen and did some laundry. I took a little nap, she read some mags and just sat with me. I felt a little like a child, but I really needed my mom to just be my mom, and she was. I could never put into words how that helped me, and how much it means to me that she did that.
I am exhausted, so that’s all I can journal for today. Interested to see how I progress throughout the week.
Still waiting on my mom, listening to one of my favorite songs by Lyle Lovett, If I Needed You. My husband had said, If you need me, call me, have them get me if I am in a meeting, I can be home in five minutes. He means it, he does. But he is busy, and we need him to have a job now! So I listen to this song instead and have great solace.
If I needed you
Would you come to me
Would you come to me
And ease my pain
If you needed me
I would come to you
I’d swim the seas
For to ease your pain
In the night forlorn
Ah, the morning’s born
And the morning shines
With the lights of love
You will miss sunrise
If you close your eyes
That would break
My heart in two
Lady’s with me now
Since I showed her how
To lay her lilly hand in mine
Loop and Lil agree
She’s a sight to see
And a treasure for
The poor to find
Here is a video of EmmyLou Harris doing a cover. LOVE THIS SONG.
It just won’t stop. I am in a fog. And it has nothing to do with our San Francisco weather. The day is beautiful. The kind that is so clear you want to run outside and do anything.
I made sure to get out of bed as soon as my husband did. I took a klonopin right away to preempt the breakdown. My mom is coming over. Sometimes this is good. Sometimes she says things like, You just have to buck up, kiddo. Or, We all have rough patches and need to pull ourselves up by our bootstraps.
A few years ago I had a similar fall from grace. Being so “out of control” isn’t really the thing to do in my family. You should really have a better handle on who you are and how to maintain your composure. I had been taking some medication for the cluster headaches I get, and felt it was interfering with my cognitive abilities in a new job. I stopped taking the meds, and didn’t tell anyone, including my neurologist. Poor judgment on my part, yes! I was out of work for a month, and ultimately left that job. There was no way to recover in my role.
At the time, I felt that my husband (boyfriend then) and sister-in-law were the ones who really pulled me through. She had suffered incredible post-partum depression, for which I took time off of work to help her out. She understands the gripping, crushing, TRUE breathtaking pain you feel that you cannot explain. And then you try to put a reason on it. Then you sit with a therapist and feel more screwed up than ever before. Circling the drain.
This time it doesn’t feel as bad. But it feels bad. And I am scared, because there have been a lot of stresses, and am I ready for all of this, having a baby? But this is it, our shot, now or never. And I am crumbling under the pressure.
Someone please help stop the pain. I just know it will go away, but when?
I have been crying for two days straight. I don’t know why. I am trying to attach all of these reasons why I could be so upset. You would think by now I would have run out of tears. I cry about not having a baby. About not being able to find a job. About being so incredibly lonely being on my own all day. I cry listening to the new Miley Cyrus song. I know for sure there is something wrong. I don’t know what. I would think that all my tears would be gone.
Two days. I woke up Saturday morning with that feeling…the moment where your life feels beautiful, and before you can realize you are fully awake, you have crashed. My husband was off already on a long bike ride. I lay in bed wailing, sobbing, gasping for air…hoping it would be gone before he returned. I had no explanation.
By the time he came home I was exhausted by tears, dehydrated, nauseated. Still, no good explanation. I started grasping for things. I thought I needed REAL help, like to go to the hospital.
We made it through Saturday with a lot of crying, gatorade and hubby by my side.
Today is worse. I called my mom. I didn’t know what to do. She put my dad on the other line. I cried to them. I don’t know what I said. I have a therapist. We called her, made an appointment for tomorrow, Monday. I am hanging on to get to her.
I don’t know if the hysteroscopy threw me over the edge. Maybe this whole year has been too hard. All I know is that I want to have a great sleep and wake up to a sunny day and a happy feeling.
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