On Pins & Needles

Last month we did a CD3 FSH just for the hell of it. I now wonder if it was a wise thing to do. The blood work was taken in May, not even a month after my whopper of an ovarian cyst was last seen on ultrasound.

So my E2 came in at 63 (ouch) and FSH at 9.8. Both high. Both making me quite nervous.

J said that maybe the cyst was still causing E2 to be elevated, but honestly I don't think that it would cause THAT MUCH of an elevation. In January my E2 was at 24, lowest it's ever been. I did my antibiotic treatments with Dr. Hungarian in December and January. Could that have caused a change in FSH/E2? Dr. Hungarian would likely argue that, yes, it does affect hormone levels. He argues antibiotics as the course of action for just about every malady under the sun. I was also 23 pounds heavier in January. Fat produces estrogen. I lost fat, and you'd think I'd lose a source of my excess estrogen, but instead E2 ROSE. I'm not quite getting it at any rate.

With AF's appearance on Saturday we did a new CD2 FSH and E2. We don't yet have the results in, but if E2 is still elevated, or if it's gone yet higher than 63, I am going to burst a neuron. Dr. B used to say that, "When the FSH is above 12 and E2 is above 50, the cycle won't work." So...what to do?

Tomorrow is my phone call with Dr. Generous to talk about this cycle and what we'll be doing. Or not doing. As always, I'm nervous. Wanting the green light, yet afraid to get it as it means needles and more needles. Ugh.

Holy Crap, I Just Canceled Myself!

We had our 8:45am appointment with Dr. Pompy today. An U/S appt to see how the follicles were doing. On the way to the appointment J protested that he didn't want to do another IVF cycle after this one. That he was tired of "throwing good money at bad". Yes, his words. I protested that I wasn't ready to throw in the towel just yet but he voiced that if I wanted to keep trying that it would be on my own. Fine. And shall I look for donor sperm, too, while I'm at it? "No, I didn't say that". Me, paraphrasing, "Okay. So you want the privilege of being a parent but you don't want to write your 50% of the check to help us be parents?" OMG. It was a terrible and hurtful argument. Infertility hurts couples in so many ways: emotionally, financially, and then there are the physical considerations. The shots, the hormones swings, possibility of overstimulating, etc. It's endless. But arguments like this are poison. Toxic.

So today is something like day 8 or 9 of stims. I tender in the ovary region and seriously bruised from the lovenox.

A bit of history: recall that we started off with 12 follicles...but they found a cyst...so they put me on stronger lupron in order to make the cyst go away. Dr. Russian said that antrals vary. They come and go. This was in response to his finding 7 on our last U/S about a week or so ago. I panicked but he seemed to imply that the others would likely be coming back.

But they didn't come back.

Today they only found 7 follicles. One at 7mm, a few at 11 and 12mm, and one at 14.4mm. I expressed concern over the 7mm follicle that it might not be able to "catch up" to the others. Dr. Pompy said "it might" catch up. So in reality we only had 6 follicles to work with.

I was devastated. This was my worst cycle ever. I always wind up with more follicles than they think I'll have. Heck, Dr. Moustache would always find extra follicles in the OR when he was poking around with the retrieval needle.

Withdrawing the wand, Dr. Pompy said that he wanted to test my estrogen to see if it was high enough to proceed. He didn't seem enthusiastic about it given how many follicles had disappeared.

I asked a multitude of questions as to how they might have disappeared:

"I worked out quite a bit the last two months. Might this have caused this?"

"No."

"I was on lupron since February 8t. Could it have put my follicles to sleep."

"No." (I have my doubts about this. Honestly, I think this was the culprit.)

"Okay. I've never done a cycle with menopur before. Do you think the LH did something to suppress my follicles to the point of disappearing?"

"No." (There are docs that would argue in my favor)

What he did say is that he felt that I'd done quite well for my age up til now and that it was possible that in the last year that it's caught up with me.

"But what about the 12 follicles? 12 is more like what I normally produce." I protested. There was really no answer for this.

Dr. Pompy said that they'd call with E2 results and would let me know what dosage to take for my evening shot. He said that if my E2 was lower than 250 that I'd be canceled and we'd try again next month. If this were the case I'd trigger with my hCG to induce ovulation so that I could get the "ball on the road" as soon as possible, rather than waiting up to six weeks for AF to arrive.

So we left and we argued all the way home as to what to do. It just doesn't sit right with me that 5 of my follicles disappeared. This has never happened to me before. With our first two IVF cycles I had 12 and 15 (or was it 16?) follicles. We had fantastic retrieval & fertilization rates.

About 4:30pm they called with my E2 results. 445. I asked what sort of number this represented in the spectrum of typical results. "Average". Okay. So I have less than normal follicles for me, and my E2 is average.

Evening came and I took my shots as planned save for the menopur and lovenox. It wouldn't matter if we proceeded or not: I'd still have to take them in order to trigger tomorrow. No reason to take the latter two shots as I'd made up my mind.

8:30pm came and I made the call. I telephoned our sweetie pie nurse and confided in her that J didn't want to do another IVF cycle after this one and that I didn't feel that we were truly giving it our best shot. I'd been thru the ringer with the cysts, the 2 months of lupron, and now I'd lost a huge percentage of my follicles. I explained that I didn't think that this was an optimal cycle for me and that I felt it was best that we cancel and start again with the next AF. I think I probably told her a bit too much about our reasons for canceling. Hopefully I didn't burden her with undue information.

I'm not sure why I felt the need to apologize to her, and to Dr. Pompy, but I did. I feel that I kind of let them down in a way, but as La Coloratura said, I paid them for each visit, ultrasound, and blood draw. I had a right to do whatever I wanted with this cycle. I fought back tears of disappointment during our conversation. But it's done. We're canceled. I'm kind of shocked we canceled ourselves, but hopefully next month will be better.

It's a hell of a let down after all we just went through.

[Millie if you're reading...I'd love to hear what you think of all of this.]

Stims Day 8The Beginning of Panic

Tomorrow is our first U/S since commencing "stims" to see how the follicles are shaping up. The nurse who made my appointment today said for me to administer my shot of lupron, but not the FSH, as they might change the dosage during the appointment. I'm already doing 225iu of Gonal-F in the AM & PM, and 150 of Menopur (50:50 mixture of FSH and LH) so I'm getting a total of 525iu of FSH a day. This is more than I've ever taken. One would think that perhaps this would lead to overstimulation...at least I would, however, I'm feeling a bit tender in the ovary region but it's nothing outrageously terrible. I'm still working out without issue and going about my daily business without much thought to what's going on down there. Once in a while it feels crampy down there.

Clearly if they are planning on changing my meds, I would think they'd adjust them downwards as the risk of overstimulating me looms.

The hCG will change my tone of complacency. It always does.

After the shot of hCG that 36 hour clock starts ticking rather loudly, nerves set in, I start to panic, and who wouldn't? My ovaries will start to feel like they have lead weights attached to them and I'll fret that they'll explode before I can reach the clinic in time. I am already worrying if their custom blended lupron is adequate to suppress me. I'm 5'10" and weigh more than many of the waifs that I see in the clinic. Is 5iu twice a day enough for me? Such is the way in which I panic. This is the 3rd time. It's my routine and I do not anticipate wavering far from it.

Stims Day 5Black and Blue

Yesterday my stomach had a few bruises from the injections thus far. Post endermologie session, not only was I left with petechiae all over my upper back, leaving me to look like a victim of domestic abuse, but the purplish marks on my midsection are starting to coalesce into large purple bruises. Honestly, this is so icky that I've asked my BFF, JS, so swing by with her camera to capture the moment. If my child ever asks if s/he was "wanted" all I will have to do is whip out said photograph and it'll be clear that I walked through hell bring him or her forth.

Tomorrow morning I go in for my first IVIg infusion of the cycle and a routine blood draw to test my NK levels (Natural Killer cells). If elevated, I'll be doing yet another infusion of IVIg two days prior to the embryo transfer (knock on wood that we get some!). It's disconcerting to be doing an IVIg before we even know how many embryos we might be getting (one report said 12 follicles, one said 7, the latter report came from Dr. Russian who clarified that antral follicle counts can fluctuate within a cycle) but at least we'll know for sure by the time of the next treatment. I am worried about the idea of 7 follicles. We're used to much more. At my age (42) it's reported that 1 in 5 eggs is "normal" (which aneuploidies they're referring to is up for grabs) so I am quite uneasy about having so few. I'd like to put back 10, yes TEN, embryos as that would give me a chance at two normals, and hopefully one will implant. Both implanting would be ideal, actually, but given my score card, I think one will do nicely.

Stims Day 4Human Pincushion

Seven shots a day is excessive. There is little uncharted territory on my stomach for this to go on much longer. The Lovenox isn't creating huge bruises, as the heparin did, but I see telltale black marks where the needles entered.

What is most surprising in this cycle is how f*cking much the Menopur shots hurt. IF women will complain about the heparin. How it burns and the intensive bruising that it causes. They plead with their physicians for scripts for Lovenox, and that eases the pain a bit and lessens the bruising. But Menopur is something created in hell.

Tonight, for the first time in 4 cycles, the pain was so much I took the needle out and had to start over. Never before has that happened. Well, it might have happened with the Humira, but that memory is buried safely away.

I noticed this evening, while preparing my quartet of injections, that I have a veritable menagerie of infertility drugs in my refrigerator. Gonal F from Z, from JP, and even one box of Gonal F with a woman's name of it that I have never met, nor do I recall how it came into my possession. A few follistim pens without instructions, lot numbers, or expiration dates, a multidose Gonal F vial, a couple of 450iu multi dose vials, three boxes of 900iu pens, and so much more. Five boxes of menopur that were gathered from at least three sources, not one a pharmacy. There's even a box of vivelle patches in the lettuce drawer. I'll probably never use a few of these things and when this cycle is over, I'll pass them onto the next IF woman who is in need of such things.

One day she, or perhaps yet another woman, will find my name on a box in her lettuce drawer and wonder who I am, and what my story was.

Stims Day 2 Scale Success!

Tried to work out at the gym yesterday and I found myself exhausted much earlier than normal. I think eating a carbohydrate laden fruit/nut bar (a chocolate/coconut Larabar) before a workout was a total mistake. Rather than burning fat, my body was focused on digesting and after burning 300 calories I was winded and I quit. I can't blame my lack of performance on the single dose of Gonal F I shot up right before heading there as it is just too early for it to have had any effect on my ability to do cardio. I truly wish that someone would make a whey protein bar that is otherwise dairy free (no casein, caseinates, or the like) that didn't have a shitload of sugar in it, natural or otherwise. I just don't see them out there. It's so repulsive, to me, to eat a protein bar, in essence a meal replacement, only to have it coated with chocolate, or have 18g of sugar (or more!). I totally adore some of the nut bars that have come onto the market lately, but honestly, they really don't have much in the way of protein and they still have way too much sugar in them. J says I should go into business and make my own. Not sure where he thinks I'll find the time between IVF, classes, buying and rehabbing foreclosures, and everything else on my plate.

My digital scale says I've lost another 1.5 pounds today! Down 15.5 pounds total. Do I dare to trust it? Yeah, why not. I've finally figured out I have to place it in exactly the same position each morning, and then recalibrate it a few times before stepping on. I am totally wow'ed by my efforts. 15.5 pounds is a smidge over 3 of those 5 pound bags of flour you get at the market. That's a frigging lot of weight that I gained Put three of those in your hand basket at the market and walk around for a while. No wonder my lower back pain has been so bad in the last year. I got the "wake up call" to lose weight in late December when I hopped on the scale at the doc's office. My BMI was "right" at 25 and just about every IF knows what that signifies. Today my BMI is at 22.7. Just about right in the middle. I always wonder if when we're all looking at those BMI charts that the RE gives us if we're supposed to be in the middle? Or towards the lower end? I don't think I could ever have a BMI of 21, or 20. But if someone told me it would double my chances at conceiving I'd lose the weight in a heartbeat.

We do tend to eat really healthy food, mostly organic, here at home, so it wasn't the sorts of foods I was eating but, rather, the lack of movement. J is also a carb nut. He loves pasta, bread, tortilla chips. Dr. G was right on the money. The last month or so I've stopped making anything with starches or laden with carbs in the evening. If mom and J want rice, they'll have to make it themselves.

This tactic has worked wonders, so far. The entire pantheon of gods, if they're up there, will probably knock me up this cycle just because I lost weight and it would be oh so entertaining to watch me gain it all back with a big belly to boot.

I've tried to keep my weight loss to around 2 pounds or a bit less per week. Apparently this is a "safe" rate at which to lose. I wonder what they mean when they say "safe". Hopefully my pre-antral follicles have slept quietly through the cardio and the high protein diet and won't be affected by any of this. I've also been wondering if all of the hour long cardio sessions in the gym might help to get extra blood to my ovaries? I do femoral massage but it just doesn't seem like it can do much for long periods of time.

I'm also going in for an endermologie session on Sunday. Girls, if you have never done endermologie you have GOT to try it. It's a fancy machine assisted lymphatic massage that was developed by a doctor for breaking up scar tissue on burn victims (I think he created this for himself, I could be wrong) but it was found that it has all sorts of other great side effects: lymphatic circulation, toxin release, skin becomes moister, more elastic, increased collagen growth, reduction in cellulite, it helps with the pain from fibromyalgia & arthritis, and so much more. You slip into a sheer white stocking, for privacy and so that the machine stays clean, and they rub vacuum assisted rollers over your body in various directions. I've done massage here and there for years and let me tell you that this is by far more intense than any massage I have had.

I did acupuncture in the last 3 cycles and this time I'm just going to do endermologie instead. It's guaranteed to stimulate the hell out of any meridian point on your body and it is so much more relaxing that having someone jam needles into your body.

Stims at Last - Day 1

Well, after three postponements....we've finally been given the green light to start stims today. I had Dr. Russian again, instead of Dr. Pompy...not sure why we were given him twice in a row, especially as Dr. Pompy was there today. But there you have it.

Dr. Russian did an abdominal u/s rather than the usual wand (don't ask)...and so he wasn't able to "see" my ovaries as normal. He spent quite a bit of time pressing and looking and finally said, "I can't see your ovaries, and I can't see any cysts." He said they're run my estrogen to make sure it was still low, and if so, that I'd start stims this morning.

Bloodwork showed estrogen had dipped from 16 or 17 two weeks ago to 14 today...so nothing should be going on down there.

But actually things have been going on down there. Last Friday I started spotting and by Monday it was looking like AF had come. But how could that be? I'm on full strength lupron. Today the spotting had dwindled to a mere smear, at least I could be happy for that. But that was short lived as it just returned to Monday's levels. Dr. Russian said it should disappear altogether by day 3 of stims.

I'm quite pessimistic going into this cycle. What with two IVF losses and one FET loss all with a span of 14 months, who wouldn't be? What's more? J was totally freaked out over having to write a check for his share of the IVF w/ICSI fee. He argued, "I didn't know we had agreed to do ICSI!" even though the doctor said we should basically keep most things the same as we know they've worked for us in the past. When we get to the actual ICSI bridge I think we'll have to revisit. We each wrote our check for $5100 US. Ouch. That hurt. Oh yeah. I need to get to the bank today and deposit the moolah before they realize that there's nothing there.

And with check in hand I depart...

What's next?

I started spotting three days ago. Lightly, but bright red, but it persists and even got a little bit heavier this morning. The 21st will be six weeks that I've been on lupron, the latter two weeks on full strength lupron. I shouldn't have ANY lining TO shed at this point. What gives?

Nearly two weeks ago I had some rather intense ovary pain on the right side, fertile CM (nice and clear). One would think I was ovulating. On. Lupron. Nearly two weeks later I'm spotting. I honestly think that this is when I'd normally have AF. So why isn't the lupron shutting me down? I don't understand. Millie? Help?

I anticipate being canceled this Thursday when we go to see Dr. Pompy & Dr. Russian. Everything has been so abnormal this cycle.

Maybe it's for the best at this point.

Rambunctious Ovaries

So I'm five days into my new bottle of lupron, the stronger stuff, and someone forgot to tell my ovaries that they are supposed to be behavin'. I've been been having loads of twinges in the ovary region that feel like mittleschmerzes as well as copious amounts of fertile CM.

And my libido should be absent. Right? I'm supposed to be in chemical menopause, aren't I?

At this point, I believe we'll be canceled when we got back to see Drs. Pompy and Russian. Something's just not right.

What gives?

Good News, Bad News

Good News:

I have lost 13 pounds since the end of January. Nearly 1 stone for you UK folks (thanks for the correction Pamplemousse!). It took daily torture sessions on the elliptical trainer and a diet that was as lacking in carbs as I could stand, but at long last I have made it back to the weight I was at last summer.

Bad News:

At our last ultrasound (Thursday) Dr. Russian found a cyst on my RIGHT ovary that measured 17mm. Okay. We knew we had a cyst on my LEFT ovary the previous week: it had gone from 17mm two weeks ago to 11mm a week ago. Progesterone was down to 0.6 and so we anticipated getting the green light to start stims on Friday.

He gave us two options: (1) Test for estrogen and if it was low enough, start stims, watch me like a hawk, and if the cyst started to take over we would cancel the cycle. (2) Put me on full strength lupron (after having been on a microdose Rx for an entire month) for two weeks to see if we could get it to suppress. If not, the cycle would be cancelled.

Being that the first option would waste up the bulk of my GonalF, which will not be replaced by insurance (we are all maxed out) I opted for the second option. I also figured that my uterus, formerly chock full of endo, might actually benefit from the lupron, and I did not want to give that cyst a chance to grow. Either we suppress it or screw it.

So we are in a holding pattern of sorts, and I am descending further into the hell that is lupron. I am certain, at this point, that J is close to killing me and burying me in the backyard. Lupron is evil stuff and let me tell you: doctors do not warn patients enough of how bad it will mess with your psyche.

Blessed Cursed with a Good Memory

I'm one of those strange cookies that remembers the details of my life with a bit too much detail. Sometimes I even dream and awake with perfect clarity of the details, remembering smells, textures, colors, etcetera. Dreams are sometimes a little too vivid for me and, on occasion, I awake and am not sure where the dream leaves off and reality begins.

But it has been pointed out to me a few times in my life by friends, coworkers, and family, that I have a knack for remembering details, events. One of my supervisors, many many years ago, was rather frustrated when I challenged him with the details of a raise that he had long ago promised my trust coworker, JS, and myself. My recollection was so precise, quoting him nearly verbatim, that he whined, "...you and that damned memory of yours!!" We wound up with a raise, but nothing like that which was promised.

Having a great memory also proved useful in college for remembering human bones, noble & diatomic gases, the cranial nerves of the head, organic & biochemical reactions, handy phrases in Egyptian, Japanese, and Vietnamese that I'll never need to know, yet they are stuck in my head. Permanently. Why on earth do I need to know how to ask for a "key" in Japanese? I have no idea but it's burned into memory. I aced my pre-med courses thanks to a good memory. How else is it done, really?

I remember with uncanny clarity people that have come into my life. Places we visited, things we did. Most of all I remember situations or events. Where each person sat or was standing, what they wore, the exact sound of their voices in particular situations, the words they used, the expressions on their faces be it happy or sad. The smell of their cologne or of a room. I am not so good with sequencing events (or remembering people's names), but if left for a while to sit and brew, I can piece everything together into a chain of events, and sometimes even the names come back to me.

It's wonderful to remember good times with people who are still a part of my life. Happy memories that I can linger over and relive. But there's a dark side to having a good memory.

I remember all too clearly those that have disappeared from my life, and where memories are conflicted with good and not so good, the conversations and situations that preceded our parting are memories that I wish I could bury at times. They're just too vivid, too painful. They singe and burn. I guess I can't have a good memory only for the purpose of recounting the positive events in my life though. But sometimes the memory is just too intense and I wonder if I would be better off without such "total recall".

I've wondered if part of the reason for this memory curse is that I have always kept in touch with people I've met throughout my life. My DH, like many, does not keep connections with anyone from the past, whether schoolmates, old coworkers, old flames, etc. I have never been that way. I've always felt a need to stay connected with people that made marks or impressions in my life. If the person was valuable enough to me, say, 15 years ago that at that point I spent years of quality time with them, time out of my very short life, well then why on earth would I suddenly behave as though they didn't exist? I shared many years of my life with them. To shun them is to ignore that part of my very finite life. Many people grow apart, and that's fine to do so, but we're all together in this common experience called life and it just seems so strange, to me, that people try to erase everything. As if it didn't happen.

So in the last few weeks I contacted a few people that I hadn't talked to or seen in a few years. I just had to. Call it a lupron-induced mania if you will, but I had to do it. I always wonder if these people are truly happy to hear from me, or if they wonder why the heck this person is writing, calling, emailing me out of the blue? Are they possessed by their memory as am I?

Is my memory is the result of my unwillingness to let the past disappear into the ether? Am I purposefully staying in touch with people in an effort to not forget? Or am I helpless, a slave to this memory thing, and as a result of it I have no other option but to stay in touch with people from long ago?

I wish I knew.

----------------

On the infertility front, our U/S is scheduled for Thursday morning. Two days away. Hopefully that nasty cyst has disappeared and we can move forward with stims. All I know is I do NOT want to be told, "Oh just come back in another week. That'll be $500."

200 Posts Came and Went

I just realized today as I was starting my post that this makes my 203rd post. 200 posts came and went. Wasn't I just saying in my last post how time flies by? It continues to do so at an astounding speed.

I guess it is an anniversary of sorts.

I remember back in December 2005 I was sitting around a table of infertile (IF) bloggers yet I was not yet a blogger myself. I barely even realized that I was infertile, my first telltale surgery had just happened in October and I was still recoiling from the shock that my tubes were blocked.

I'd stumbled onto this group of ladies' blogs and was intrigued at their stories. Somehow I wound up with an invitation of sorts to this infertiliblogapalooza event and I showed up. Everyone had met online and this was the first time they were laying eyes on each other. They knew each other intimately from blog world, and what was interesting is that everyone had already shared their stories and it was more of a re-meeting because, as I mentioned, most of these people had never met before. I remember listening intently to everyone's stories, trying to glean some bit of useful information, and of being taken aback by one lady's experience dealing with reproductive immunological issues. She told me eye popping stories of how she and her husband had to travel to Mexico to get this procedure called LIT (leukocyte immune therapy). I nodded my head, listened, and thanked the gods that I'd never have to go through any of this.

I only had blocked tubes, you see. Immunology wasn't something that I needed to really think about.

R.I.G.H.T.

Little did I know at that brunch that my infertility was more far reaching than I could ever imagine. Not only would I, too, become an immunology patient like the lovely red haired lady on my right, I would myself make two trips to Nogales Mexico for LIT, I'd travel to NYC to see Dr. Hungarian, and I'd even go so far as to buy three centrifuges and a lab full of supplies so that I could do my own LIT and never have to fly to Mexico again.

Talk about a reality check.

I was so ignorant. I look back on that silly woman sitting at the brunch table and wonder, "How could I have been so incredibly naive?"

Despite having my head buried firmly in the sand, I left, promising a number of the women that I would make an attempt at blogging.

Well I came through on my threat and here I am 203 posts later.

I hope that I've written something useful. I look at my stats on occasion and it's interesting to see the queries that bring people to my blog. I saw one query today that said "Q Tip in Penis". Okay. That's an odd way to get to me but I understand why they found me. (I recounted J's experience with Dr. Hungarian and the Q-Tip. Better leave it like that).

I haven't been too careful about the quality of my writing in general. I apologize for that if you are reading. I don't mean to be careless about my writing, it's just that it's just so hard to even get the words out at times that I can barely think of style and flow. There are plenty of bloggers who I think must spend hours writing their posts, editing and re-editing. I just can't do that. If I did that I fathom that I wouldn't blog at all.

Thanks for bearing with me this long.

Where Did The Time Go?

Two nights ago I telephoned, CR, a very dear old friend. She is someone who I was very close to up until 7 years ago when I moved to the SillyCon Valley. The distance has made it hard to stay in touch as they are just not "online" people. I had met her husband, KR in 1993. I remember the year because it was the year I got my real estate license. KR was a sheriff's deputy and so was my BF at that time. I remember the day we met. My deputy went to the R's house and the deputy's sat in the garage with their guns and beer. (You're thinking: "Guns and alcohol don't mix!" Honestly, I haven't met a single cop that believes that one). It was a blazingly hot summer day and I was working as a real estate agent. I showed up in my own car. Over beers we all became close friends.

A year or two after befriending this couple, the husband found that his wife had cheated on him and he had pressured her to leave. (Ironic because, after knowing him for a few years I discovered that it was HE who was the one carrying on the clandestine affairs and his whole charade of punishing her, for the same thing he was doing, was pathetic at best). Being a close family friend, and recently parted from my deputy BF, who I had caught cheating on me with the Sheriff department's "blood nurse", I moved into the R household and became an instant Au Pair.

Their three children were young. The oldest a boy, was in 3rd grade or so. The middle girl, just starting kindergarden. And the youngest, little M, my sweet pea, she was barely a toddler when I took over the household. I think it had to be 1994 or 1995 when I moved in with them. I was a post grad student at the local community college right down the street and I was taking courses to get my fanny into medical school. It was a perfect arrangement as my physics & bio courses were in the AM after the two older kids went to school, and my chemistry courses were in the evenings.

At this point in my life, I didn't think that I would ever have children. I'd had no less than three relationships, all long term, that had led no where. The first one isn't worth mentioning. The second, CD, I was engaged to. I actually wanted to have children with him like nobody's business. I even used to secretly plot to poke holes in our condoms so that he'd let me have a child. The third was the Deputy. The only one I'd thought of having children with was CD and CD and I parted in 1989 or 1990, so by the time I stumbled into the R household, the idea of raising children had long left my psyche.

I don't really recall how long it was that I took care of the children. One day CR had come back to visit. She and KR were on the verge of reconciling. Some chaos ensued over the dinner table that evening and little M cried out,

"I WANT NINAAAAAAAAAAAAA!"*

CR realized at that point that her youngest had bonded a bit too closely to me and she moved back home rather quickly after that. I stayed on for a short while but when a young couple across the street mentioned to me that they had a room that they were looking to rent out I moved out. I wasn't really needed anymore by that point except for the occasional night or morning.

But I stayed close to the R family for years to come.

So I've been meaning to telephone CR. I think of her and the kids often and somehow I just never pick up the phone. But I finally did it. I called her two nights ago. She seemed so happy to have heard from me. Said my last card to them was still on the refrigerator. The child have been asking where I'm at, how they can write to me, etc, etc.

And here is where my jaw dropped.

The oldest boy is now at one of the Cal State colleges. I think he's been there for a couple years as the middle girl, BR, is a freshman at a college in Idaho. They were a couple years apart so the oldest, the boy, must be a junior or senior by now. And my little M? My sweet pea? She's a freshman in high school. Her mother says that she has "long blonde hair just like you".

How did my little sweet pea go from saying "Nina*...more powder!!" when I was changing her diapers, to a freshman in high school?

I missed her first crush. Her first date. Her first dance. I miss her so much. She may be the closest thing to a daughter that I'll ever have. I think I just realized that...in the 11th hour.

Where did the time go?

I do know that when this cycle is done, I will be making a trip down there to see my sweet pea and her family the first chance that I get.

---

*M couldn't say my name, Linda, so I became "Nina" to her and the rest of the family.

Holding Pattern

Today we did our baseline U/S with Dr. Pompy.

Lining 5mm. 5mm is "borderline". A bit too thick and he'd like to see it thinner. I'm on day 2 of AF and I should have started on the 18th. Instead AF came on the 21st, taking her own sweet time.

Left ovary: 5 follicles & a small cyst (corpus luteum). There might be more follicles behind the cyst but impossible to tell. It appears to be blood filled so he said it's likely a remnant of ovulation and thinks another week will help it to disappear.

Right ovary: He had a really hard time finding my ovary with was a bit strange. I wonder if it's moved due to adhesions or scar tissue. 7 follicles.

Bloodwork:
Progesterone 2.3
E2 35

Nurse K said that the progesterone should be at ZERO and that because it's not they feel the cyst is a corpus luteum that is just taking a while to disappear. U/S #2 next week. If I'm still bleedin' I'm going to postpone a day or two as those $290 U/S rack up fast.

So 12 follicles in all. Maybe more. I pray that a few more come out of the woodwork and surprise us.

So we continue on with the lupron for another week.

Yippee.

Weighty Issues

I dared to stand on the scale today.

Since late January I've lost about 10 to 11 pounds or so, depending on whose scale you believe. But today I discovered that I am within 1.5 pounds to get back to where I was when I started my last FET last September.

Gone is a large portion of the fat on my ass from my trip to NYC to visit Dr. Hungarian where we enjoyed way too many lovely meals....then Bologna, Italy, where I inhaled everything in sight: pizza, tortelloni in porcini mushroom cream sauce, near-pint-sized servings of gelato, and let's not forget the chocolate....the divine chocolate..... then came Thanksgiving dinner, my birthday dinners (yes plural), and of course all of those boxes of candy from Christmas, pre Christmas dinners, the actual Christmas Eve dinner, etcetera, etcetera, ad nauseaum. It's no wonder why I gained the weight.

I've been doing a 45 minutes to an hour a day on the elliptical trainer, followed by about 15 to 20 minutes of weights. I'm a wimp though. When I am done with cardio I can barely move. I slither off of the elliptical trainer all sweaty and with "bad hair" and am barely able to get my sweatshirt back on. I make my way back downstairs to the weight room, legs trembling, and try to do 15 minutes of weights. That is about all I can do. As for diet/food, I've been laying off of all things white (sugar, flour, rice, potatoes) and eating lots of protein (especially at night). I am thankful that it worked. I pray my eggs have not suffered from the change in my diet and hope that the increased cardio means that more blood has gotten to my ovaries.

Dr. Moustache puts these pages in with his IVF documents that discuss BMI and probability of conceiving. If you're too thin, you don't get preggers. If you're too fat, you don't get preggers. I understand the skinny part of it. Fat produces estrogen and you need estrogen. But if you're heavier, how does that function in infertility? Why is it that BMI screws with an IVF cycle anyways? Anyone? Please pipe in. So my BMI is about 23.4 once again. I am thrilled. No quite in the middle of that safe zone of 20 to 25, or is that 19 to 25? But close enough.

I would love to lose the other 11.5 pounds I've gained in the last six years, but I think I will try to be pleased with the progress I've made. If I could lose the rest of this weight I'd suddenly have access to a huge wardrobe of clothes I've put aside. Stims start Thursday night or Friday morning so I guess I just try to maintain from here on out.

The protocol from the RE is looking like the following:
5 iu Lupron AM & PM
225iu GonalF AM & PM
75iu Menopur AM &/or PM (TBD on Thursday)
10 days of doxycycline before retrieval

The protocol from Dr. S is as follows:
50mcg Synthroid (1X/day)
30mg/.3ml Lovenox AM & PM
30g IVIg on day 2 of Stims and 2 days before transfer
Dexamethazone (1X day) *This is something we're likely to skip out on
Baby Aspirin
Folgard
4g Fish Oil

The protocol from Dr. Hungarian is as follows:
500mg Zithromax 1X/day.

It's hard to keep this all straight in my head.

Dr. Hungarian said "No immune meds!" so he doesn't want me to do Dexamethazone or Humira. Both of which I will be a bit afraid to cycle without. (What is the reason for the steroids anyways? Thalia? Anyone?)

I guess we'll be making a few quick decisions if we have the green light on Thursday.

Lupron Crisis

I am literally freaking out.

I'm pissed for no particular reason, and for every reason in particular. I have warned all parties in the house that I'm jacked up on lupron and things will only get worse. I'm not using this as an excuse to "go off". Really, I'm not. I actually thought that I was impervious, impenetrable, immune to the evil lupron, and I didn't cave in easiliy, but this time all bets are off.

It remains to be seen if my dosaging was increased this time. Dr. Pompy's nurse mentioned to me, "You'll either be doing 2.5iu or 5iu twice a day." Turns out they gave me 5iu twice a day. I'll have to check my old protocol sheets to see if this is an increase or not.

Increase or not. This stuff is hell.

We set out late to see houses today. J had the idea that we should go to the new Panera in Campbell and use our "free coffee and bagel" coupons today. I'm not thrilled about the idea of a carb filled bagel so I get mine to go. Mom can eat it. I get my cup and pour some decaf into it. Absentmindedly, I poured soy into my coffee. Then suddenly realized that I can't have soy right now. I poured out the coffee. I refill. Then I come to the oh so late realization that the coffee was in a styrofoam cup. STYROFOAM! Grrr.... I was on autopilot from my usual trip to the Bux where they have the sense to use paper cups. Don't people know that this stuff leaches out chemicals. I poured out a second cup of coffee and went and sat by J and mom while they ate their carb laden bagels. This was the beginning of a very ugly day.

Off we went in search of a few houses in Redwood City that fit a number of our criteria. There were two in all. The original list was something like 12, 14 or 16 homes, but after I got ahold of the list and culled out the "undesirables" a mere two remained. Driving 20+ miles in either direction to see two homes? Even J wondered about this. "Yes, that's all that is worth seeing on the market right about now." So we continued on.

I misinformed mother and J that our appointment to see "house A" was at 2pm. Our appointment was at 1pm. Luckily we arrived on time. $1.05M and it needed kitchen and bathroom remodels. Jesus christ. It's bad enough that housing is expensive in the Bay Area, but to spend that much moolah and still have to remodel? Screw that.

We left.

J and I got into numerous mini fights over just about everything while we drove looking for the second house. He went to turn right. I said go left. Then he wanted to go left when we needed to go straight. Everything was grating on my nerves.

Second house was just under $1.0M. Old windows, old doors, shitty kitchen and bathroom. I screamed, "ARE THESE PEOPLE ON CRACK OR WHAT??? I sold the house five doors up the road for $880,000 a year and a half ago and it was UPDATED! And had a view!" I can only hope that the next agent coming in after us didn't hear me freaking out.

We left. J thought we should just drive up and down streets looking at homes. Okay. Fine. But let's go somewhere NEW? How about Belmont? San Bruno? San Carlos? There's nothing worth seeing in Redwood City in our price range.

No. We were going to see "the streets of Redwood City." We came across a really sweet house in RWC. I tried to pull it up on the WIFI phone to no avail. J got impatient with me. I crashed my browser. Had to reboot my phone. I started to snap at him for being impatient and it got pretty bad, so bad that he parked the car, got out, and went for a walk while I tried to coax beat the listing price information out of my WIFI phone. After we leave the house and drive down about 10 more streets I find the "really sweet house" on the MLS. $2,395,000. Jesus f*cking hell. Why is it that one needs to spend a fortune to have a nice house in this area? I just don't get it. The housing here all sucks. It's old, dirty, rundown, and it's likely next to an apartment building with cars parked everywhere. I want to scream, yell, move back to SoCal where $800,000 buys you a villa in my old area.

By now my stomach was really pissed off that I didn't eat that stinkin' bagel. I said, "I need food. I don't care if you two aren't hungry, let's just get to Bear Sushi so I can get food. You can eat, watch me eat, or share a bowl of soybeans but I need food." J meandered through a few more streets. We get to Bear Sushi. The sign says "open". We try to park but that, too, leads to a fight over where to park. We get to the door and the lady says, "Oh, we closed!" Yeah, "But your sign...it says 'we open!'" So we left and headed downtown. We finally were able to get food into me at long last. Good thing as a girl hyped up on lupron with hypoglycemia is an ugly ugly situation.

While we're eating I have the sudden realization that my menopur is due to arrive today. I can't pull up the FedEx page of the phone and start thinking about how my menopur might be baking in the sun on the front porch. (It's unseasonably warm this week and I am just loving it). We eat and dash home.

No package.

I login to the FedEx website and see my package isn't due to arrive at all today. It's due to arrive tomorrow.

Fuckity fuck fuck fuck. All that freaking out for nothing.

Okay. I don't need it today, but hopefully it's sitting someplace "cool".

Still sitting with my laptop on my thighs I open my email and an old boyfriend had replied to an email I sent him a week or so ago. He writes that life is great and his wife is having their FOURTH CHILD the first week of May.

FOURTH. As in 4. Four. IV.

Somebody shoot me. Please.

Sunday Breakfast

J and I drove out and visited a fellow IF and her DH today for a leisurely breakfast. We walked down the street to a cozy neighborly restaurant. They warned us that it was a "greasy spoon" but it wasn't very greasy to me. Just one of those very comfortably places where people can eat and linger. Speaking on lingering, I think we hovered over our table for three whole hours. And you know what? The topic of infertility wasn't raised once. We talked about SEP IRAs, real estate investing, taxes, Flash programming, Windows registries and why the hell do we need them anyways, the myriad ways that Macs are so awesome, whether France is going to hell in a flaming handbasket (or not), where one might wish to bank "anonymously" (ahem), and so much more. As usual, time flew by and before we knew it the afternoon was quickly slipping away.

We sometimes meet someone because of our joint paths of IF, something no one wants to have in their lives, but it's a pleasant surprise to find so much more to discuss and enjoy, for a brief moment, we all forget our common plight.

Thanks For Your Replies!

Thank you's are due to all of you who responded with emails about my plea for menopur. One good pal offered up three vials of the elixer for me and I was able to find three boxes (15 vials) on FGS for a really really great price. The gal selling them got preggers on her 4th IVF with menopur and so I am hoping that her meds are "good luck" for me and that we'll get some good news, too. My insurance company paid for 3 GonalF 900iu pens, but after that I only had $256 worth of fertility drug benefits left. Ever. I have never had fertility drug coverage before so I am ever so grateful that a bit of this burden was taken off of my shoulders.

I'm not sure what it is about adding menopur (or repronex) that really does the trick. I may have this wrong, but isn't menopur just FSH with some LH in it? Follistim is also FSH with a hair of LH in it because it's not recombinantly produced, but is it that it just doesn't have as "much" LH as menopur? Maybe Modern Millie will pipe in with her words of wisdom and show me the light on this mysterious (and tres expensive!) substance.

I have also read that one reason that menopur works for some women is that the LH helps to improve egg quality. We haven't had problems with our numbers to this point (knock on wood, spit, toss salt) so hopefully we can still get some good numbers and improve our quality.

Last night was my last BCP and so I'm lingering on lupron til our baseline U/S on the 22nd. ON that day they'll tell me how much menopur I'll be doing each day and we'll hopefully get an antral count done.

I am praying for a good antral count at this point.

Sadness

A girlfriend of mine, MG (who isn't a blogger so I can only use initials to safeguard her privacy), just found out today, that she just lost her baby girl at 13 weeks. Her ultrasound was today and there was no movement and no heartbeat. It sounds like the amniotic fluid was on the low side and the doctor estimated that the baby had likely passed about a week ago.

MG had done CVS in the last few weeks and it had determined that her baby girl was chromosomally perfect. MG is an immune patient of Dr. B's and Dr. S's so she did the usual humira, lovenox, IVIg cocktail when she found out that she was pregnant.

Everything was fine. Fine until she did her CVS. Immediately prior to CVS her NKs were at about 22. Ultrasounds looked great. She had a SCH (subchorionic hemmorage) but it was handled effectively by cutting of her lovenox until it had subsided. Which it did. What is telling, however, is that after her CVS her NKs mysteriously skyrocketed to over 30. My take is on this that her CVS like introduced a uterine infection into the placental area that her body responded to with a full blown immune attack. We won't know for sure what happened until they are able to obtain a tissue sample for biopsy.

That CVS and amniocentesis can cause an infection that, in turn, can lead to miscarriage, scares the hell out of me. It's a strong arguement for doing PGD so that you can avoid having to do CVS or amnio at all. I think the risks for miscarriage due to CVS are something like 1 in 100. Maybe less. I remember when my friend Mary was pregnant last year, her NS showed her odds of a Down's baby were something like 1 in 300. The risk of miscarriage due to CVS was higher. 1 in 100 or thereabouts. They opted to not do an amnio or CVS due to the risk.

I thought they were being reckless. But you know, after hearing, tonight, about MG's loss, I really have to wonder if I will do CVS or amnio now. I'm not sure if we can afford to do PGD with each IVF. I doubt we can. But this really has opened my eyes to something I hadn't given much though to. Til now.

This was MG's second loss. The first came at 5 months and it was because her amnio showed DS. She terminated and she still lives with the torment of that decision. Today's loss was just another needle into her heart. And ours.

MG. I am so sorry for your loss. It's just utterly unfair.

Menopur anyone?

Looking for 20 vials of the elixer.