I have a headache

So, I told myself that I'd only blog about ovary stuff. But I really want to blog about other stuff sometimes. Not that my life is very interesting, but sometimes you just want to vent about stuff but you're sworn to secrecy so can't share it with anyone. I guess this is where a husband would come in useful as I could make him listen to me ramble on. I've just been in a long meeting with my boss, all about who I can and can't delegate stuff to, and now I have a stinking headache. Urgh. Bosses.

OK, so, back to the ovaries. I am going to start the ovulation tests today. It's a little early I know, but they're cheap in comparison to an out-of-state IVF, so I'd rather waste a few and be certain that I didn't miss my LH surge than start stressing myself over the right day to start.

And I have GOT to get my taxes filed this weekend. I know I said I was going to do them in early February, and I did start them, but I can't find two IVF receipts. I've worked out what one of the fees was from old credit card statements, but you can only view 6 months online and I'm not sure which ones to order. So I've been putting off turning the house upside down looking for that receipt, but I HAVE to do it this weekend. I really need the refund to pay for the meds that I ordered last week.

Innocent lunch conversations

Oh the torture. We had a new team member start this week, after one of my coworkers left, and we all finally went out to lunch today, after the mandatory computer training the new person has been doing. Well, between the four of us, we have a 6-year old, a 4-year old and an 8-month old. Three of us have one child each. Of course you all know who the odd one out is. The old spinster lady who doesn't even have a boyfriend, let alone a husband, to want to try to conceive with. And who is probably past it anyway, as I'm the oldest of the group (maybe, don't know the age of the new coworker yet but I'm guessing she's younger).

And as that was the big thing that the others had in common, pretty much all they talked about at lunch was kids. Torture. Luckily, K., who knows about my infertility, was fairly sensitive and made a valiant effort at changing the subject a few times back to work, but the boss kept going right back to talking about kids.

Gack is all I'm going to say. It seems to be an appropriate word today. Even just an innocent occasion to welcome a new coworker can turn into a slap in the face.

Is ignorance really bliss?

Bills, bills, bills. Why do they never stop coming?

So, the coculture biopsy was supposed to be $500 ($250 to do the biopsy, and $250 for processing work). There's an additional charge of $750, but that's later on. When I got there, they charged me $800. I didn't say anything, as I knew they were doing the trial transfer at the same time, because of me being an out-of-townie and all, so I thought the extra cash must be for that. Although, if I may say, that's the quickest $550 I've seen someone earn in quite a while, as it took Dr. S. about 5 seconds to do the trial transfer, and then maybe 10 seconds to do the biopsy.

Anyhoo, yesterday a bill arrived for $301 for "hospital services". Que? So I called this morning, and was told that the initial $300 extra was for the trial transfer, and this really was a proper additional fee for pathology, as Dr. S. must have decided to run another test on the biopsy. Oh, so nice to be told. Just go ahead, spend my money without prior authorization why don't you?

Part of me wants to call and find out what the test was, seeing as how I'm paying for it, and part of me doesn't. I mean, they've published research about the likelihood of success being greater if the endometrial biopsy is "in phase" with your cycle day or not. What if I demand to know what they tested for, and find out that my endometrium is out of phase? Therefore implying that I will have a lower chance of success. Will that destroy the fragile hope that I've built up for this cycle? I kind of want to go in to this not knowing too much, on the basis that ignorance is bliss.

Taking this idea a step further, I know that Big New Clinic doesn't tell you your estrogen or progesterone levels unless you ask. They just tell you if they're good or not. If that. I understand with the progesterone levels they don't even tell you that much, unless you call to ask. There's a huge part of me that's wants to be so Zen and not ask what my estrogen level is every day of the IVF. Because wouldn't it mean less stress? Wouldn't ignorance be bliss here too? Wouldn't it mean I could relax a bit more and just let my body do its thang? Although it'd be hard not to know anything, it might be good to try it every now and then, maybe every other day I can resist asking about the actual level.

Bwahahaha.

Sorry, just nearly spat my tea out, snorting at myself. Me? Not ask about estrogen levels?

Doing the flip flop

So, after all my freaking out, it took just a couple of people saying "hey, me too, I took that much!" both here and on those other sites we love to hang out on, and suddenly I'm all blasé about the meds dosages. So I decided not to bug the RE after all, and just shoot up with what they're telling me to.

Just call me Ms. Flip-Flop.

Hello, Sarah Melodramatic Flip-Flop here, nice to meet you.

My hobbies include knitting, doing 180 degree turns in my thinking, spazzing out for no good reason, and eating bon bons.

My period came early, so I'm now officially on my pre-IVF cycle. The cycle where I get to play with estrogen patches and ganirelix. Whoop! I shall refrain from commenting yet again at just how fucked up my cycle has become. Apart from merely noting that that old rule about how your luteal phase does not vary is just a big bunch of BS. Or at least, my body is not listening to the rule at the moment, as I've had 10 days, 16 days and 13 days, all in a row. Without meds to alter it.

I have also just dropped over $2500 on drugs, which are currently en route thanks to good old Fed Ex. Like a complete dolt, I forgot to tell the pharmacy that I have leftovers from my last cycle, so I have got enough to get me through six days of stims. Which probably means that I'll still have leftovers, damn it, if Big New Clinic steps down the dosage much. Why am I such an idiot? In my defense, I did call them early in the morning and hadn't quite woken up yet, but still.

Must. Not. Buy. More. Follistim.

Quietly freaking out

OK, I said I was Zen. I lied. Lied horribly. Well, I didn't lie exactly, but it didn't take much to ruin the mood. I could not sustain Zen, in other words.

I am freaking out over the meds dosage. 6 vials follistim + 2 vials menopur. A day. A day! That is a WHOLE shit load of drugs. That is $400 worth of drugs to shoot into my stomach a day.

I'm freaking out that I'll end up with a monster follicle on CD5 or something and ruin the whole thing. I mean, seriously. I know I'm a poor responder, but I'm not a slow responder. I'm an inappropriate responder. A fast responder. An over-eager dominant follicle responder. Isn't slow and steady the way we should be going?

It's just pushing the limits of my pharmaceutical tolerance too far. It's the maximum possible dosage, people. Do my poor ovaries really need the maximum? Do they really need the venti triple-caff when the grande might do just fine?

I really need to speak to the Doctor about this, but I am having no luck so far. I need to know if he really intends for me to be on this dosage, or if he misunderstood when I told him what my dosage was before. Although my dosage from previous cycles is right there in my medical records, so this shouldn't be an issue, but I remember him saying I'd be on the same dosage initially. So far, the nurse on call has confirmed that this is the correct dosage, because it says so in the computer. And computers are never wrong, right? My assigned IVF nurse has confirmed that this is the correct dosage, because it says so in the computer, and because I am likely to respond differently to a ganirelix/estrogen priming protocol than to a lupron protocol. OK, fine, that placated me for 5 minutes. But seriously, it just seems wrong. My gut is telling me that this is too strong a dosage for me, and I usually listen to my gut so I'd be a fool to ignore it this time.

I have a call in to the secretary for another issue. If she ever calls me back, I'm going to try to get her to ask the Doctor, or get him to call me. I mean, is it too much to ask just to want to know someone has posed the question to him, and to have him confirm his instructions? No, you don't need to answer that question. It is NOT too much to ask, and I guess I'm just going to have to become a difficult patient. Sigh. And I'd much rather be the nice, compliant patient. I mean, don't get me wrong, if he confirms that this is the dose he wants me on, so be it. I won't challenge him on that. I just want to know that this is what he chose based on all available facts, not just on a misunderstanding.

Spring in Florida

As a counterpoint to the usual ovary-gazing, behold:

Hopeful. Or not.

Well, I've recovered from the trip, I think. I've definitely eaten and drunk too much, out of tiredness, and have lost the impetus to diet, well, and then there was the whiskey in honor of St. Patrick which turned into 3 whiskies, but I'm trying to get back with the program today. I think things are shaping up for the cycle. I got my official IVF letter from the clinic yesterday, detailing my protocol. At least, I thought it'd detail my protocol, but what it said was:

Estrogen/Ganirelix/6 FSH/2 HMG/Ganirelix

Which is not all that detailed, to be honest, and to the uninitiated may be confusing. But essentially means I will be taking a shit load of drugs. I'm a bit freaked about the 6 FSH/2 HMG part, which means 6 Follistim and 2 Menopurs a day. For a total of 600 units, which is presumably enough to get a 90 year old's ovaries working again. I know it's my local clinic's maximum possible dose, but I don't know if Big New Clinic goes higher. My previous highest dose was 450 units a day. So I'm going to call just to double check before I order the meds, as I thought Dr. S. was putting me on the same dosage, not jacking it up to the maximum.

I've more or less figured out where I am going to order the drugs from - a mail order place that just happens to have a location right by Big New Clinic. Handily convenient, no? Good planning on their part, methinks, to get the captive audience of people staying there for their cycles. So I'll order just enough to get me through the start of the cycle down here, and then will go every day in NY and fill up with whatever I need to get through the next day. That way, it won't be like every other cycle where I've been left with a ton of unused meds in the fridge. Which will hopefully be cheaper overall, even if the prices of each individual vial is a bit more expensive.

And I've made a decision on where to stay, although I expect to vacillate a bit more on this later. But for now I've stopped looking.

So really, all I have to do is order the sperm to be shipped, order the meds, and wait. Another month. Plenty of time to go crazy between now and then.

I'm feeling very Zen and hopeful at the moment, though I know this can turn on a dime. Particularly if I start stressing out about it being my last cycle, but I'm not going to close that door just yet so hopefully I can reign in too much stress. Haha, easier said than done, I know. I just hope that this new fancy clinic with all their great success will do the trick for me. I hope my intake of whey protein will have helped my egg quality, and I hope that the coculture will boost the embryo quality even further. I hope I have a nice, even response to stims. I hope it all goes perfectly, in other words, but I know enough to roll with the punches.

So why then can a sad song or sad thought bring tears to my eyes? Why do I think I feel really hopeful and then have this sadness bubbling to the surface so easily? I think maybe because the end of this dream of motherhood is approaching, one way or another. Either it will end well, or it won't. Either I will be embarking on a huge adventure, or I'll be mourning the loss of my dreams. I guess when we start out TTC we think, "well, there's always IVF if it doesn't work". And then we think "well, if IVF doesn't work locally, I can always go out-of-state to one of the top places". And then after that, there's nothing. Nowhere to go. Only on to donor eggs or donor embyros or adoption. None of which I think I want to do. So it is the end. And can I even do another cycle at Big New Clinic if this first one doesn't work? Can I gear up enough, have enough hope, have enough money and time, to go back again? Just not sure if that is possible. But then again, I don't know if I'm ready to face the end. How do you do that? How do you stop the rollercoaster and get off? Because, you see, I'm hopeful that this will work. If not this time, then maybe another time. I think of my future children, and imagine myself telling them that they would not be here if I had given up after IVF#4. So then, how do I give up after IVF#5 if I still have that hope? How do you balance hope with reality? I just don't know the answer to that one.

New York Diary

Hmmm

Well, I used to be able to post from the Blackberry without crap on the end of the posts. All deleted now, but I wonder how much trouble that will get me in.

Anyway, I'm home safe, but tired. Pics are coming soon! Just as soon as my slow-as-molasses dial up connection finishes with uploading them. Which will probably be next week.

All done!

Of course, wouldn't you know it, I got gassy. Right before the biopsy appointment. Must be a nerves thing. Or the fact that I have singlehandedly eaten enough over the last two days to feed a small village. Must be a greed thing.

I tried sneaking to the bathroom to do something about it, and wouldn't you know, they called my name as soon as I sat down. So I got into the exam room, which is now about an hour after my appointment time, and I start serreptitiously trying to relieve some of the gas. Most of which belched up nicely, but I'd just let out a big one from the other end and a nurse walked in. Typical. Luckily I'm not too much of a stinker and it turned out she had to move me to a different room.

There I was, sheet clasped around my naked lower half, streaking across the hall, quite grateful to leave the scene of the crime, to be honest

Dr. S. came in and was super nice. Except I didn't have a single question to ask him. He said that after you've done this a few times it must get a bit routine. Yup. That and I learn everything from internet message boards, but I didn't own up to the latter. Then it was time to stirrup up, and of course I needed to fart again. So I probably opened my knees the slowest he has ever seen a 4-cycle veteran ever spread their legs while I was lamely trying to prolong our discussion of the weather and me cycling in April.

But the need passed (or he got a faceful of SBD that I didn't notice escaping and was polite enough not to gag). He did the trial transfer then the biopsy. Which resulted in me exclaiming "Is that it? I expected pain.". He offered to cause pain if I really wanted, which he said he was very good at doing, but I declined. It was very quick, and only mildly uncomfortable.  So that was a nice surprise.

And that's me all done for New York. For this trip, at least.
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Sent from my BlackBerry Wireless Handheld

Post coculture blood draw instructions

Go straight back to your hotel room after your blood draw.

Do not decide on a whim that straight after your blood draw would be a fine time to take that walk to Central Park you've been promising yourself.

When you feel faint on said ill-advised walk to Central Park, don't assume that a small chai latte and a 5 minute sitdown is going to miraculously fix the problem.

Don't meander all over town looking for a suitable coffee shop to use the bathroom in. The extra mileage is likely to cause you to require fried eggs on toast as a restorative, thereby ruining any chance you had of salvaging your diet.

When you get to Central Park still feeling lightheaded, don't park yourself on a bench at the "Pinetum" if you're allergic to pine trees.

When you push on regardless because you're tough and it was only a little blood, damn it, expect to be overtaken in your wanderings by old ladies, Italian tour groups, chic mamas pushing pampered tots in fancy strollers and a weird guy with a stiff leg.

That is all.
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I got shat on by a New York pigeon

Who knew that standing waiting for a traffic signal was dangerous in NY due to guided missiles from above? I always thought it was the traffic I had to look out for. 

Anyway, having a lovely time so far. Apart from pigeon shit in my hair. And on my face. And my coat, gloves, sweater and glasses. Apart from all that. I have met up with my lovely Big New Clinic buddies Alacrity and Luz, both of whom are winding down their cycles and transferring in the next two days. They are both fabulous, gorgeous women, as I knew they would be. Why is it that those of us that are struggling are the most deelightful people?  Myself included, of course. ;) I'm praying for good things for both of you gals. We had yummy food, that I would just kill to have in my own town, mediocrely supplied with good restaurants as it is.

So, I'm sitting in the waiting room and there's probably 100 people here. I kid you not. This place really is the big leagues. It's all very lovely and new - well it should be, it's a brand new building after all. There are lots of nice red chairs for us to sit on. I wonder if they chose the color so that any nasty spots or gushes don't show?

I'm just waiting to have the bloodwork taken for the coculture. I was warned several times to have a good breakfast and lots of liquid, as I'm about to lose a fair amount of blood volume. But of course I have no fear of that. I mean, come on, veterans don't fear the needles any more. Much.
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I'm off to New York!

I'm in! I'm in!

I got the phone call this morning. The blood work was positive for the LH surge (well, duh, I already said the OPK was positive), so I can keep the Tuesday appointment for the biopsy. Phew! Phe-eee-eeew!

So, flight to NY is at 6.45am on Sunday, which will really be 5.45am because of the time change (ugh). Yay me for the $99 cheapy flight, but boo for the cheapy flights being at crazy times. Then I will take the subway into the city as I'll have plenty of time to kill, drop the bags off at the hotel and do some sightseeing. Bloodwork on Monday morning between 7am and 9am, then more sightseeing. Then a facial at Bl!ss spa. Then the biopsy is at 10.45am on Tuesday, with the flight home at 8pm. Busy busy. Oh, and I'm going to check out a hotel that I'm thinking of staying in for the IVF at some point during all that.

I'm totally swinging around on the choice of accommodation. Previously I wanted the cheapest of the cheap so I didn't end up spending $2500 just on hotel fees. But with my now irregular cycle, booking an apartment is looking increasingly iffy, and what if I got cancelled? I'd be stuck with the rent regardless of whether I stayed there or not. Cheap hotels may just create stress in their own way - I want to be able to rest during an IVF cycle, not have to leave the building just because it is nasty and loud. So there's a suite hotel I have my eye on. Which will probably work out at $3500 for the IVF trip, so it ain't cheap. But then again, if this is my last shot, shouldn't I do everything possible to have a stress-free, successful trip?

Still in limbo

Well, the good news is that I got a positive OPK at 11am. Woo-hoo! Cycle day 18, so it's now got later and later every month since the last IVF. But we'll ignore that for the moment. The bad news is that the coculture scheduler and I have been trading voicemails, and she wants to wait and see what the bloodwork says before making a decision. Except if it had been yesterday, she would have just trusted the damn OPK! Grrr.

And she said she was leaving the office today at 2pm, so if the results weren't faxed to her by then she'd have to give me instructions tomorrow morning. It's now 2pm and I haven't heard from her, so now I am stuck waiting until tomorrow before I know whether I'll make that Tuesday coculture slot.

I should do, right? I mean, if the biopsy has to be done between 5 and 12 days after the LH surge, and that'll be 6 or 7 days, depending on how you count it, it should be good. Unless she already gave the slot to someone else, which I wouldn't be unduly surprised at.

I don't know why this has to be so complicated.

I never knew.

Huh, so. You never know what is going on beneath the surface of someone's life, do you?

A little backstory.

My local RE has 3 clinics, the main one and two satellite clinics. One of the satellite clinics is more local to me than the main office, so I try to go there whenever possible. Unfortunately, up until about 6 months ago, they shared office space with a perinatologist, so there were always pregnant bellies walking past - and being that it was a peri, not an OB, there weren't the happiest faces on top of the bellies. Anyhoo. The ultrasound tech there, Franny, was the loveliest loveliest person. A genius with the u/s wand - could find follicles hidden where noone else could, without hurting me. I loved having her do my u/s's. Until she too got visibly pregnant. And then it was just damn hard, seeing the pregnant bellies in the waiting room and then hers. I mean, she never ever said anything about it, and would sometimes smile ruefully at me, so she wasn't in your face about the belly, but it was hard to ignore. I was all "god damn, I can't even go to the infertility clinic without the damn fertiles rubbing their damn big bellies in my face." Eventually she went on maternity leave, I saw her bring in the baby once, and then didn't really see her again. I guess she left.

Cut to today.

I went to have the blood work done to ship to Big New Clinic to make the decision on the whole surge situation. The chatty nurse, Karen, was saying "oh, so you did decide to keep cycling, then?" I told her about being booted out by Dr. M, and not being ready to give up on my eggs. She asked what the blood tests today were for, and if I was cycling right now, and how the traveling was. So I started to explain about the coculture thing, assuming she wouldn't know what it was as it's kind of rare. "Oh, yes, coculture," she says. "That's what Franny did - you remember Franny, right?" "Huh?" I said, "Franny did IVF? I didn't know that". So then I get the full explanation. Franny did 7, count 'em, 7 IVFs for unexplained infertility, and adopted a daughter, before doing one final last ditch cycle at Big New Clinic. Yup, Dr. M. recommended his own staff member go to Big New Clinic. She did coculture. She too didn't want to give up on her own eggs without one last ditch attempt at the best place possible. Her 8th IVF worked, and resulted in the birth of her son.

Wow. I never knew. I assumed she was a fertile. It just goes to show that you never really know what's going on.

Anyway, update on the surge later. Yesterday's tests were negative, although a tad darker than previous days. We'll see. I'm expecting to be bumped but perhaps that's just the pessimism talking.

Delinquent

My LH surge is now officially a delinquent. A truant. A bad kid, not turning up to school on time.

I got a phone call from the coculture scheduler at Big New Clinic because I was supposed to have surged by now. And I haven't. I have to go and get bloodwork done in the morning and faxed to them STAT so that they can see if my surge has come and gone or if it is on its way. And if it doesn't make it here tomorrow, well I'm not quite sure what will happen. If I'm lucky, I'll get bumped to Thursday for the coculture biopsy. If I'm unlucky, I'll have to wait a whole 'nother freaking month because of their lab closure.

I want to cry.

I mean, as setbacks go, it's not that huge, and I've had worse. Far worse. But, you know, this is Big New Clinic. New place, new hope, and all that. I didn't want things going wrong before I even get there.

Fuck it.

Come on LH surge. Get with the program, already.

Waitin' for the surge to come..

I'm just waitin'
Waitin' for the surge to come

No LH surge yet. I'm pee sticking away, but nothing. And it's cycle day 15. I've got until Wednesday (possibly Thursday) before we have to cancel the coculture biopsy for the 13th, so a few days yet, but I'd really like to see that positive ovulation test soon. Please, universe?

It's weird, after I got off the pill and started TTC'ing, I was mostly a cycle day 13 ovulator, and worried that it was too early, that my eggs wouldn't be mature, and all that jazz. I stressed out over it, wishing it was a bit later, wondering if this was the start of the slide into perimenopause. I always used to have 29 day cycles before the pill, so figured that my norm must have previously been a cycle day 15 ovulation. So I wanted to go back to that. And even last year, during the IVFs, I'd have a late ovulation the first cycle off drugs, but if I went to a second cycle, it clicked back to normal. Day 13. Except now. Now I've had a day 17 ovulation, a day 19 and a day ??. Hmmmm. Weirdness. I don't like weirdness. I mean, if day 19 was normal for me, it'd all be fine. I just don't like weirdness.

So, come on luteinizing hormone. Do your thang, please.

Buh-bye blood

5 vials of blood. Gone. Off to the lab for testing for all manner of dread diseases. And some not so dread diseases.

But it got me thinking - how much blood volume have I lost to testing since starting to TTC? I mean, sure, it's probably not as much as if the ridiculous Americans would let me donate blood. Which I would gladly do, and used to do in England. Except here they think I have mad cow disease because of my residence in the aforementioned England during the period between 1980 and 1996. Even though I've been a vegetarian since 1988. And you'd think if I was going to get sick I would have started showing some symptoms by now. But I digress. I've had the HIV and other dread disease tests done 3 times now. The first time, it was more than 10 vials, now it's down to 5 as I don't have to repeat things like varicella and Tay Sachs testing. I seem to have done 13 cycle day 2 blood draws (didn't have them done on unmedicated cycles) and 14 progesterone checks. Don't know how many betas. Don't know how many mid-cycle estrogen checks (well, I could count them up, but I don't want to scare myself). Then bloodwork for the laparoscopy. Oh, and there was the immune and clotting testing - that was several vials too.

Let's just say, it's probably a whole leg full of blood. If not a leg and a half

I expect a good arm full will go to Big New Clinic, as I know they draw a shitload of blood for the coculture work. As well as all the estrogen tests. Sigh.

In other news, my trusty BBT thermometer finally died the other day. Yet another reminder of how long I have been doing this. It was actually my second thermometer, as the first one went screwy after only a month or two. But this one had lasted over 2 years, so it was my trusty friend. I decided to buy a regular digital thermometer yesterday, as I have no plans to be doing the old temperature charting for much longer, but I went to Walgreen's as it was close to where I went out for dinner. I hate Walgreen's, by the way. Always have, always will I imagine. Anyway, I paid $7.99 for a crappy useless digital thermometer - when I got home and tested it, my temp was apparently 95.3. Yeah right. And this morning it was 96.7. I never have a 96 temp in the morning. Never. So clearly Walgreen's brand of thermometers are a bunch of crap and now I think I'm going to have to go back to CVS and buy a real BBT thermometer again and stop messing about. And it's all because Big New Clinic doesn't use BCPs and wants you to monitor for your LH surge before doing the coculture and before starting lupron or estrogen. While I could rely just on the ovulation pee sticks, I'd much rather have the backup of knowing I got the right date because it was followed a day or two later by a nice temp rise.

Holy crap I had a lot of gray hair!

Behold: the grand hairdye experiment of 2007. Doesn't look much different in person, or in these photos I think, but I guess it depends on the lighting. This "before" shot showed the grays up when it was big, but now that I resized it to fit on the page, I'm not sure you can see them. I got one friend to admit that she saw less gray after the dye, although she had to qualify with "not that you could see that much gray before". Indeed. Not that there's anything wrong with that.

Before:



After:



Oh, and can I just say gratuitously: hot damn! I have cute hair. Thanks Stephanie! ;)