FRIDAY, MARCH 27, 2009

Holy phone calls, Batman! It has been a busy few days. I called our coordinator and nurse and let them know that I REALLY did not want to wait until April 15 to have the procedure. I mean, look, I am not in any real hurry to go through the pain, I KNOW it will hurt, but I want as few interruptions as possible.

So, at first they said one of the other docs, who originally found it, could do it Tuesday, March, 31. AWESOME! Over and done. Then he couldn’t. Don’t know why. Then the soonest he can see me is Tuesday, April 7. This is only a week later. I think, ok, no problem.

We’re on! They’ll call in bcp for me to take until the procedure (Reclipsen, never had that one) and later a few other pre-op meds. We’re on the way.

And, by the way, I am told I do get a nice IV cocktail for this procedure. Bless the anesthesiologist.

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TUESDAY, MARCH 24, 2009

Today we are on our way to have our baseline ultra sound…if all is well, we will start our IVF procedure this month. I am crossing fingers, toes, legs (I’ll have to uncross those later!), hoping we are ready to start.

I have an enormous mix of emotions about this. I am still unemployed. The economy is not helping our situation, and we don’t have the time to wait to do this. It is now or never. We keep believing that everything works itself out. No freelance work to be found. I even applied as a cashier at a candy story. NO GO. Overqualified. I just have to laugh. Okay, everyone laugh with me! I thought at least I could help my husband’s very expensive candy habit by working there. And I could merchandise cute windows. Ah, a pipe dream…

Okay, off for the ultrasound, more later…

We’re back…very sad and frustrated…I have to have the hysteroscopy. And I am a bit ticked because there seemed to be some discussion between a couple of the docs a month or so ago as to whether or not I needed it. Ultimately, they decided watch and wait. Well, we watched today and that little bugger is still there. Ummmmm….what the f?

To make matters worse, my doc is going on vacation in a few days and can’t fit me in until the week of April 12. No one seems to understand that is, oh, 3 weeks from now and not only will we miss this cycle, but probably the next if we wait that long.

Can you hear my heart crumbling to pieces?

My husband is trying to find the silver lining…this gives us more time to look for a job for you…we have more time to prepare…and on. He is sweet. He is trying. He can’t get it unless he is in it. It’s not his fault. I don’t blame him. I am not mad, angry, resentful.

Just silently sad.

MONDAY, MARCH 9, 2009

Brief conversation with Dr. Fujimoto…he said that he felt the bright spot on the saline sonogram was likely an air bubble and we should go ahead and review again at my baseline ultrasound when we get ready for our first round of IVF in a few weeks.

YAY! I thank him and am ready to hang up. He is not ready to hang up.

He wants to talk about my Day 3 blood work…my FSH remains about the same, 8.9. However, my Estradiol was 148 and shouldn’t be higher than 60-70. This will make it a challenge to balance my hormones without overstimulating my ovaries.

What does this mean? Can we keep on our schedule? What will we do?

He says: You need to be on the Microdose Flare Protocol. AND, with your husband’s latest test results, and his sperm count going down, I strongly recommend ICSI for you. Ok, ta ta!

That was pretty much it. He is busy. I always talk to him on speakerphone which makes me think he is multi-tasking on me, even though he is totally on top of it.

He did say that I needed to schedule my baseline ultrasound for Day Seven. I’m on it. I WANT TO DO THIS NOW.

TUESDAY, MARCH 3, 2009

So we were told yesterday there was a “foreign body” in the lining of my uterus. Something that was in the uterus that the lining “embraced” and grew around. Well, I am happy that my uterus embraces others, is very friendly, but not foreign things! And oh, the conversation I had with the doctor. Could it be…a tampon? condom? uhhhh, toy? MORTIFIED! NO, none of the above.

Last night was spent on the internet, site to site to site. What is a hysteroscopy? Is it painful? On and on and on. I did learn something important…it does need to be done the week after your period, this is the best time based on the thickness of the lining of your uterus.

So I wait to hear from Dr. F to see what he says, do we do it, or does he think it is an air bubble? I am kind of freaking out that there is some random foreign body in the uterus. I can’t stand it when there is something in there…a cyst we have to wait to grow or burst, a small fibroid. I just don’t like it.

So again, we watch and wait.

MONDAY, MARCH 2, 2009

I am set today for my Saline Sonogram. From what I have read, it should be a really easy, painless procedure. In fact, so much so, that I told hubbo not to cancel his important meetings and that I could take myself. And, to be honest, the HSG was SO painful, I can’t see how this will be painful. Instead of dye, this is simply saline injected for contrast. The saline sonogram is used to evaluate the inner cavity of the uterus (endometrial cavity). It can also be used to discover whether either of the fallopian tubes is open. This test does not reveal any abnormalities on the outside of the uterus or on the ovaries, such as adhesions or endometriosis. From what was explained to me, I was told they would be looking for polyps, fibroids, or any “foreign matter.”

This is what we hope the sonogram looks like…dark with no light streaks or spots!

Normal Saline Sonogram

Normal Saline Sonogram

Okay, off to the procedure! More later…

Hey gang, it’s the next day, last night was ROUGH, to say the least. I am coming to learn that I am incredibly sensitive—and that my retroverted uterus makes it tough to get up in there.

The procedure was performed by Dr. Sohn, who couldn’t have been more kind, knowledgeable and gentle. In the practice they rotate docs, so this was my time to meet Dr. Sohn. Unlike many, he talked me through the entire procedure, which I appreciated. The procedure is performed as follows:

  • The procedure is performed in the office
  • A speculum is inserted into the vagina.
  • The cervix is swabbed with an antiseptic to help avoid infection that can be caused by insertion of a small, balloon-tipped catheter through the cervix.
  • The speculum is removed and a transvaginal ultrasound probe is inserted into the uterus, providing a picture on a monitor.
  • A warm saline solution is injected through the catheter, expanding the fallopian tubes to allow for better visualization.

The doctor and nurse will tell you to expect mild cramping, and to take 800mg ibuprofen an hour before the procedure. If there is any pain, it should go away after the probe is removed.

THAT IS THE EXPECTATION. I, of course, could not be the norm, and had to be in dire pain. It wasn’t as bad as the HSG, but we ran into a few issues that created more pain than anticipated. Due to my retroverted uterus, Dr. Sohn had to manipulate the cervix in several ways to insert the catheter. My opinion is that the balloon on the end of that sucker is what hurts. Following that, there was some resistance flushing in the saline. When it did flush through, it felt like the most incredible menstrual cramp where you would expect an enormous flow to exit. I felt the cramp swirl from the bottom of the right of my uterus and flow up around the top around to the bottom of the left. I visualized a large marble in there. Then I started thinking about roulette. Then I started thinking about the movie Casino Royale…then I wondered if I would ever design anything as amazing as the opening credits for that movie. ANYTHING to distract, I suppose. I laid back on that table crying silent tears down the sides of my face.

Very Cool. I pulled it together. I got to watch the whole thing on the video monitor. I didn’t actually know what I was looking at. Kind of like Rachel on Friends when she can’t see the baby on the ultra sound. At that moment, Dr. Sohn showed me a bright white spot on the monitor. It kind of looked like a AA battery. Maybe an air bubble? He asked, Have you ever had an IUD? Uh, no. Are you sure? I laughed. He said, yes, you would likely know better than I would. So he, in his words, rooted around in there for a while to see if he could change the size, shape, position…an air bubble shouldn’t remain that long.

After about 45 minutes he removed the probe, sat me up and said, I think you have a “foreign body” lodged in the lining of your uterus. Uh, EXCUSE ME? He suggested I have a hysteroscopy to determine what it was. This is where they insert a camera into the vagina to get a better look. Want to know something funny? THE FIRST THING I ASKED? Do I get any pain medication for that procedure? I was not doing one more thing that was going to hurt that much. He said he would discuss with Dr. F and they would call me later.

I WILL TRY TO GET THE IMAGES OF MY SONOGRAM SO YOU CAN SEE WHAT IT LOOKED LIKE.

MY TIPS FOR THE SALINE SONOGRAM

Procedure Time. 20-45 minutes depending on size, shape and position of uterus. Additionally, any findings can increase time to take additional images. It seemed to pass quickly for me.

Ask for meds. If you had a hard time with anything else, get a valium or vicodin or something more than advil.

Wear granny panties. I don’t know about you, but I am a thong wearer! I have found that for these appointments I need to wear full undies to wear a sanitary napkin.

Wear loose clothing. They shoot you up with TONS of saline/water. You will be bloated for about 24 hours. Since it is not in your bladder, it will need to be absorbed or leak out, so fun.

Sanitary napkin! They gave me one, but it was short. When I took a few steps, I GUSHED saline and blood. I had to stop in the lobby and change out. Be prepared.

Recovery Time. Take it easy. AS ALWAYS…I say take it easy that day, and don’t over-exert the next. The doctor will tell you that you can resume normal activities within 3 hours. Having had it done, IF you can, relax. Let someone take care of you. My hubbo made me really fresh swordfish, cous-cous and my all-time favorite SO bad for you dessert of vanilla ice cream with magic shell chocolate. He is the best.

IMPORTANT NOTE: I was completely ok to drive myself home. I had terrible cramps, but nothing worse than a very bad period by the time I left.

THURSDAY, FEBRUARY 26, 2009

I was up early today, LOTS of blood work to get done with a couple of them fasting since 8p last night. I also wanted to be the first there to just get it over with. I arrived at 7:30a, found a space right in front and realized they were not open until 8a. Okay, time to listen to the radio. Little by little I watch a few people come and go from the front door of the lab. I wonder, do they just think they’ll come back later since it is closed? DUH. Holy Dum Dum, Batman. The lab is CLOSED, closed. And has moved to the Cal Pacific Medical Center. So I book it down the street, and still make it as the second person on the list.

Let me say up front, my dad is a Hematologist. I am SCARED of needles. How funny is that? Over the years I have learned which are the least painful, espeically when there are many vials to fill. I recommend the green butterfly needle. This has a bit of  a larger bore needle (to vacuum the blood out faster) and a long plastic tubing that the tech can attach the vial to collect the blood. The new needles have a VERY cool new retractable feature so when the tech is done, the needle is pulled into the hard plastic core to protect the tech. I LOVE this invention.

Butterfly Needles

Butterfly Needles

In this photo you will see the blue butterfly needle as well. This is a smaller bore needle. This hurts SO LITTLE, but does take longer to draw the blood.

The lab techs couldn’t have been nicer. They saw the number of vials they needed to draw—14!!!—and felt immediately my anxiety. The whole process went really quickly…Here is a YouTube video of a guy getting his blood taken to show you what to expect.

MY TIPS

Follow instructions. If they tell you to fast, follow that carefully. This could throw off your results, and ultimately delay your cycle.

Eat. Make sure you have something with you to eat after you give your blood. This is not like  giving a vial or two for a regular office visit. They collected 14 vials of blood.

Get up slowly. You may be lightheaded. If they have some juice, drink it. Don’t try to be tough, drink your juice!

Give yourself some time to rest. If you can, try to just take an hour at home on the couch to recoup. I went and got my favorite latte and muffin and enjoyed the previous night’s TiVo of Law & Order.

WEDNESDAY, FEBRUARY 25, 2009

One of my friends said, in short:

“Oh, IVF, they do that all the time. Everyone is doing it! Apparently it doesn’t hurt any more than a root canal!”

would you like a root canal?

would you like a root canal?

ARE WE ON THE SAME PLANET? I swear, I thought I was speaking a different language to a complete alien.

So I am talking this week to a few of my close friend about this. Now you must know, all of my friends have children. ALSO, within the last two weeks, 4 of my good friends have told me they are pregnant. I couldn’t be happier for them. They are all wonderful mothers, and are extremely excited to be pregnant. In fact, one of my dearest friends has been trying for 4-5 years. After many miscarriages, she is in the clear. I love her so much, and am OVER THE MOON for her.

At the same time, as I talk to my mom, sister-in-law and girlfriends about this, they do all seem a bit blasé. Are they trying to downplay it to make me feel better? Do they just not understand how dire our situation has become? Maybe people only want to hear good news? In the end, it comes across as they are blowing me off. My own brother, who I think I am quite close to, didn’t even call me to discuss until I phoned him first. At times, I think I am being dramatic, over thinking it all, and having sky-high expectations for those around me. Finding a way to balance that has been near impossible for me this week. I am not working right now, and am on my own most days. This leaves much time to think and research. Time has been just creeping by.

The most redeeming part of my day is there is a new episode of LOST on tonight.

FEBRUARY, 20, 2009

I am not working right now. I am looking for a job. I am stressed that we are going through with IVF without a second income. As my husband likes to joke with me, Honey, put the cuckoo back in the clock. My mind jumps ahead months and thinks, okay, so I am pregnant, and who hires a pregnant woman? Even a woman with 15 years of incredible experience and a great portfolio. Will I be able to get a job before I get pregnant? How many tries will it take to get pregnant? Can we afford more than one or two? Can my body take it? I have these worries, but no answers. I try to not think about them too much, but I know I need to process them.

Conversely, like most people who are working right now, my husband is SLAMMED at work. It seems like everyday he has a new project or grant due. He gets home at 8 or 9p and immediately turns on the computer. I want to give him time to decompress, but some nights I am bursting at the seams to talk to him about what I have learned about our situation. It is on my mind a lot. I don’t know anyone else who has been through this. {All my friends thought, let’s have a baby, and bling! A baby.}

MONDAY, FEBRUARY 16, 2009

So we notified UCSF we were ready to get started with the IVF process. We had questions, but wanted to go to the Orientation, see how many were answered there, then follow up with Dr. F. A few days later we received a large manila envelope in the mail with our startup goods:

  • Orientation confirmation
  • IVF prep checklist
  • Set of prescriptions for both hubbo and I
  • Blood work order for both hubbo and I

Holy Cow! It was really a lot to take in. And honestly, coming as a checklist, not enough explanation for me. There was some explanation as to when some of the tests needed to be complete, but not others. I didn’t hesitate to call our coordinator Janet for questions. We are developing a very good relationship over the phone!

I’ll scan the checklist so you can see what there is, but a quick recap:

Bloodwork—Female

  • Rubella
  • Varicella (chicken pox)
  • Infectious disease screening (HIV-1, RPR, VDRL for Syphillis, Hep B surface antigen, Hep C antibody and HTLV I/II Ab) NOTE: This test is absolutely mandatory before you can proceed by federal to protect the lab employees handling sperm, eggs and embryos.
  • Cystic Fibrosis
  • CBC with platelets
  • Fasting Glucose
  • TSH or Prolactin Levels
  • Cycle Day 3 FSH and Estradial
  • Blood type and RH Screen
  • Fasting Lipid Panel

Bloodwork—Male

Infectious disease screening (HIV-1, RPR, VDRL for Syphillis, Hep B surface antigen, Hep C antibody and HTLV I/II Ab) NOTE: This test is absolutely mandatory before you can proceed by federal to protect the lab employees handling sperm, eggs and embryos.

Testing—Female

  • Pap Smear
  • Baseline Ultra Sound
  • Saline Sonogram

Testing—Male

  • Semen Analysis with Strict Morphology

Medications—Female and Male

  • Multi Vitamin with Omega 3 and Folic Acid for female
  • Doxycycline Pre-treatment (this is a one time 10 day anti-biotic treatment, as long as you remain monogamous, to be taken twice daily at the start of menses.

PHEW!!! All of this, plus the orientation and a financial consultation need to be completed prior to even starting hormone therapy.

TUESDAY, FEBRUARY 24, 200

I have never been SO excited to get my period. My husband, not so much. Before we started TTC, I was on continuous bcp, so we never had a break. THEN, when we were really trying naturally, we were on it all the time. POOR GUY. Do any of you really feel for him? No, I don’t either. 🙂 I do love him more than anything, though. Like I said before, even more than the Valentino handbag I want 🙂

As instructed, I called our coordinator, Janet {we LOOOOVE her} and got our instructions:

  1. Day One: Begin taking the Doxycycline
  2. Day Three: I needed to have all bloodwork done (dude, that is a lot of blood)
  3. Day Seven: We scheduled the saline sonogram

Okay, I feel like I am on my way. Happiness.

happy happy

happy happy